Northern Montana Hospital converting to critical access hospital

Havre's hospital is in the process of converting into a critical access facility.

Northern Montana Vice President of Regulatory and Community Services Christen Obresley said the change, which the hospital hopes to have in place by July 1, should be essentially invisible to its patients and members of the community.

"The patients won't notice anything," she said Thursday.

Obresley said the change is more in accounting, how information is reported to Medicare and Medicaid and how the hospital is reimbursed by Medicare and Medicaid.

"The only thing that changes is the information that's included in our cost report and how we're reimbursed," she said.

As rural hospitals were closing across the country, Congress passed the Balanced Budget Act in 1996 which included creating critical access hospitals. Hospitals that met certain criteria could become critical access facilities, which received higher reimbursement from Medicare and Medicaid.

The requirements for qualifying as critical access hospitals were loosened in subsequent acts of Congress, and a change that took effect just last year is what led Northern Montana Hospital to decide to make the change.

Obresley said one requirement was that the hospital had to be at least 35 miles away from the nearest other critical access hospital, and Big Sandy's critical access hospital is 34.6 miles away, less than a mile too close.

But that rule was amended last year to say the requirement is 35 miles by a road with two lanes of traffic in each direction - if the road has only one lane in each direction, a "secondary" road, the distance dropped to at least 15 miles away.

She said the hospital had met the other requirements, such as not having more than 25 acute care beds in operation and the average annual length of stay of patients being 96 hours or less, for several years.

Obresley said that, since Northern Montana Hospital now met the last requirement, it decided to make the change.

"So we took the opportunity to change our status from a (prospective payment systems) hospital to a critical access hospital," she said.

She said designations like prospective payment system hospitals and critical access hospitals are set by Centers for Medicare and Medicaid Services to determine the amount paid for services.

Critical access hospitals is the designation given to certain qualifying rural hospitals.

"The reason that they do that is because rural hospitals are a very important part of the health care system," Obresley added. "They provide care along the continuum of care, you know, cradle-to-grave services, and also critical access hospitals contribute to the overall wellbeing of the community like, in Havre, we're the largest employer."

She said as the change is essentially a bookkeeping and recording issue, it should have no impact on the services the hospital, and other parts of Northern Montana Health Care's services, at all.

It should have no impact on Northern Montana Care Center, on the Family Medical Center, on the system's clinic or vision center or pharmacy, Obresley said.

"The patients aren't going to see changes in their care," she said. "They're not going to see changes in their providers. We're still going to have the same providers, the same staff, the same services, the same emergency room. It's like nothing's going to change from the perspective of our community."