A long-term acute care hospital in Salem, Mass., will end inpatient operations later this year because its leaders concluded it won't be able to survive under new CMS admitting criteria.
Spaulding Hospital for Continuing Medical Care North Shore is expected to close inpatient services by Sept. 30, affecting 320 full- and part-time employees. The hospital, a part of Boston-based Partners HealthCare, includes 120 long-term acute-care, or LTAC, beds and a 40-bed skilled nursing facility.
Starting in October, LTACs will be reimbursed at the full prospective payment system rate if patients have spent at least three days in an intensive-care unit or at least 96 hours on a ventilator. All other stays would yield a per diem “site-neutral” payment rate.
The hospital, which was already struggling, wouldn't survive under the regulations, said David Storto, president of Partners' continuing-care division and the Spaulding Rehabilitation Network. Spaulding North Shore's average occupancy has been less than 50% over the past four to five years, and would likely decline to around 25% under the new admitting criteria, Storto said.
“We evaluated different possibilities but concluded that there was really nothing we could do that would be viable given how we're organized,” Storto said.
Medicare's new so-called 25% rule, which will penalize LTACs who receive more than 25% of their patients from a single referring hospital, would also have a negative effect on the facility, Storto said. The rule is expected to go into effect on Sept. 30, 2017, when an ongoing moratorium on new LTAC facilities is scheduled to end.
Spaulding's other LTAC, in Cambridge, Mass., can survive under the new regulations because it has more referral partners and is not as dependent on Medicare patients, Storto said.
Partners is currently working to find jobs for the facility's employees in the health system's other facilities. It's not clear how many will be without a job once the hospital closes.
“Right now our major priority is winding down things as smoothly as possible,” Storto said.
