FARMINGTON — At the July 25 Select Board meeting, a presentation on the proposal for Franklin Memorial Hospital to become a Critical Access Hospital highlighted the financial benefit for the hospital, that patient care would remain the same.
If approved, the change in status would take effect Oct. 1.
“There will be no difference in your stay or your care,” Barb Sergio, president of Franklin Community Health Network at FMH said. A patient on Sept. 30 or Oct. 1 will see no changes, she noted.
“When we become designated as a Critical Access Hospital we are entitled by Medicare/Medicaid to be reimbursed 101% of reasonable costs to provide care in rural America, which is traditionally more than in your urban settings,” Sergio stated. “Right now we get about 30 or 40 cents per dollar.”
A government payer such as Medicare/Medicaid is responsible for almost 74% of patient care/services at the hospital so the change would be a tremendous boost for the hospital financially, she noted.
There are criteria that must be met to be a CAH, Sergio said. “One that a hospital has to meet is that you can’t have more than 25 in-patients on any given day,” she noted. “We definitely have more than 25 patients in our hospital at any given time, but they are not all classified as in-patients.”
Another criteria is that over the course of a year the average patient stay can’t last more than four days/96 hours, Sergio stated.
“One of the biggest and important numbers is you can’t be within 35 miles of another hospital over a highway,” she said. “That rule is what recently changed in the fall of 2022 because of lobbying across the nation with rural hospitals struggling to stay afloat.”
With the change in definition, highways now must be four-lanes when considering distance – there aren’t many of those in Maine other than the interstate, Sergio noted.
Historically, FMH has had 25 in-patients or less for the last 10 years, if not longer, she stated. Many years ago the board tried to change to a CAH, found they couldn’t, she said.
Average length of stay at FMH is about three and a half days now, peaked above that during COVID-19 but there were waivers put in place then, Sergio noted.
“We have been running the numbers, talking with state and federal entities since last October or November to pull all this together,” she said. “The same beds that are there on Sept. 30 will still be there on Oct. 1. We are not shuttering any beds, not limiting any services or cutting any jobs.”
FMH is increasing services with a new surgeon, pain doctor and ear-nose-throat person coming on board, Sergio said. There will be no downgrade in services, patients won’t be shipped out if their stay lasts longer than four days, she stated.
If there are more than 25 patients in the hospital, not all meet in-patient status as some may be there for observation, Sergio noted. Obstetrics will stay the same, won’t be closing as the Rumford hospital recently announced, she added.
Sergio said she will be giving a similar presentation on FMH becoming a CAH at other area Select Board meetings, to share “what that means to our public, our communities and to alleviate any concerns or fears, answer any questions as they arise.”
Chair Matthew Smith said the hospital’s emergency department is expanding.
Expanding the hospital was considered, would have cost $50 million so changes are being made within the current facility to better use space, Sergio said. Oncology, day of service, emergency department will see changes, she noted. “There is a lot of under utilized space,” she added.
“I am pleased to see the inclusion clinic expanding,” Selectman Stephan Bunker said. “It saves a lot of mileage for people I know.”
When asked, Sergio said there would be no impact for NorthStar with the change in status to CAH.
Selectman Dennis O’Neil asked if patients there for observation would remain in the emergency room.
There are about 38 beds upstairs, they would get one, Sergio answered.
When Bunker asked about new ways for caring for behavioral patients, Sergio said there aren’t enough beds for them, a lot of lobbying is taking place, but nothing will be coming any time soon. Two new psychiatrists will be joining the FMH staff the beginning of September, will be a great thing for the community, she noted.
Hospital staffing is also improving, Sergio stated. There were 40 openings last year, it’s down to 10 now. “It’s getting better, not as quick as we would like,” she added.
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