Bill would ease rules on critical access facilities

When patients are admitted to Big Sandy Medical Center or any of the 40-some critical access hospitals in Montana, providers have to assure they will be discharged within 96 hours or four days.

If the patient has to stay longer, it can mean the hospital will lose some of its reimbursement.

Most of the time, that’s no problem, said Big Sandy Administrator Harry Bold. The hospital is designed for short-term stays.

But it is impossible for the provider to know for sure how long the patient will need to stay, he said.

So he and similar administrators are supporting a bill by Sen. Jon Tester, D-Mont., and a bipartisan coalition of rural state lawmakers that would repeal the federal regulations.

Bold said the way things stand now, at the end of the four days, doctors must decide whether to discharge the patient or move the patient to Northern Montana Hospital in Havre or Benefis Medical Center in Great Falls.

Sometimes, he said, they would have to move them to the larger facilities for as little as one day.

“It’s a clumsy, cumbersome rule,” he said.

It hasn't affected the Big Sandy facility thus far, he said.

Although the rule has been on the books for some time, federal officials decided to enforce it effective Jan. 1.

But he said he is sure problems will arise unless the regulation is repealed.

Putting limits on how long patient can stay in the critical access hospital “is dangerous and violates the trust patients put in their doctors and nurses,” Tester said in a press release.

Tester said critical access hospitals provide quality care to people in rural and frontier communities “and we shouldn’t shortchange the care someone received because of their zip code.”