Another rural hospital at risk, this one in northern California

Ana Ibarra reports for Cal Matters from Willows, in Glenn County. home of a small hospital, the Glenn Medical Center, which is under threat of closure.   The reason for the new threat:  a new interpretation of a provision on distance in relation to a regulation that requires facilities with the "critical access" designation to be at least 35 miles from the nearest medical center.  Here's an excerpt: 

Glenn Medical Center, a 25-bed hospital in the rural agricultural town of Willows, north of Sacramento, is about to lose its “critical access” title. Without it, administrators say the hospital couldn’t afford to stay open because it would lose its increased Medicare reimbursements and regulatory flexibilities.

Glenn Medical Center received a letter in April from the U.S. Centers for Medicare and Medicaid Services notifying the hospital that it was no longer in compliance with the distance requirement to qualify as “critical access.” That requirement states that hospitals must be more than a 35-mile drive on primary roads — or a 15-mile drive on mountainous or secondary roads — from the next nearest hospital.

The next closest hospital is Colusa Medical Center, which the federal Medicare and Medicaid agency places at 32 miles south of Glenn Medical Center. That makes Glenn County’s hospital three miles short of the qualifying distance for the critical access title. But local health officials and the Willows Fire Department say ambulances and most patients take the “more reliable” route of I-5 and Highway 20, which makes the distance between the hospitals 35.7 miles — far enough to qualify.

About 40% of Glenn County’s 30,000 residents rely on public health insurance programs — Medicaid and Medicare — and 12% live under the poverty line.

“We treat and see and care for a lot of people who are unseen in the community. A lot of behavioral health crises, a lot of justice-involved folks, a lot of elderly, a lot of people without transportation. And we are truly a lifeline for those folks,” said Lauren Still, chief administrative officer at Glenn Medical Center.

About 40% of Glenn County’s 30,000 residents rely on public health insurance programs — Medicaid and Medicare — and 12% live under the poverty line.

“We treat and see and care for a lot of people who are unseen in the community. A lot of behavioral health crises, a lot of justice-involved folks, a lot of elderly, a lot of people without transportation. And we are truly a lifeline for those folks,” said Lauren Still, chief administrative officer at Glenn Medical Center.

Closing the only hospital in this Sacramento Valley county would mean residents would have to travel farther for emergency care and ambulances would take longer responding to 911 calls.

Dr. Jared Garrison, Glenn County’s health officer, said losing the hospital would be a devastating blow to the community. Garrison worries about the elderly who may be afraid to drive at night and people who don’t have transportation to make it out of the county. Heart attacks, strokes, traumatic injuries and overdoses can become more deadly when hospital treatment is delayed.

“If Glenn Medical Center closes, it’s not just a health crisis — it’s an economic and social crisis,” Garrison said. “We’ll see longer emergency response times, job losses, declining local businesses, and worsening health outcomes for our most vulnerable neighbors.”
‘This is not the road people would take’

Both hospitals, Colusa and Glenn, have been at the same location since their construction decades ago. In 2001, Glenn Medical Center was first approved to participate in the federal Critical Access Hospital Program under the same distance rule. Hospital and county health officials say geographically nothing has changed.

“We tried to send some emails back and forth and say, ‘Hey, this is not the road people would take. This is not the road the ambulance takes. This is just not accurate,’” Garrison said. The “shorter” route, he explained, actually takes longer because it includes a county road that often floods and is primarily used by farm equipment.

The hospital’s appeals to the federal agency have been unsuccessful. Still said she is clinging to one last hope that U.S. Rep. Doug LaMalfa, a Richvale Republican, can make the hospital’s case.

Mark Spannagel, chief of staff at LaMalfa’s office, told CalMatters that no resolution has been reached yet, but that conversations with the federal agency continue and that the hospital’s situation is under “heightened review.”

The federal Medicare and Medicaid agency is supposed to review critical access hospitals’ eligibility periodically. This review started last year and the issue seems to be a reclassification of roads, Spannagel said.