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Town hall meeting to explain why achieving Critical Access is important for St. Joe's

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DICKINSON - Regional residents have an opportunity tonight to better understanding why achieving Critical Access status for Dickinson's St. Joseph's Hospital and Health Care Center is important for the facility's long-term financial viability during a town hall meeting in the hospital's auditorium at 6:30 p.m. MDT.

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St. Joseph's CEO Claudia Eisenmann also is to explain how a health care facility operates under a Critical Access designation, along with the financial benefits it provides. St. Joe's, which is owned by Catholic Health Initiatives of Denver, continues to seek ways to recover from $13.2 million in operational losses from fiscal 2002 to the end of the most recent fiscal year this past June 30.

Obtaining the Critical Access designation provides for increased reimbursement of services from the Centers for Medicaid & Medicare Services (CMS). The problem facing St. Joe's is federal regulations state that Critical Access facilities may not be located within 35 miles of each other. The Richardton Memorial Hospital & Health Center Inc. already has Critical Access status and is just 25 miles east of Dickinson.

In leading to tonight's discussion, Eisenmann had a conference call with Sen. Byron Dorgan, D-N.D., Sen. Kent Conrad, D-N.D., and Rep. Earl Pomeroyp, D-N.D., Wednesday afternoon about what's taken place recently and the continued effort to obtain Critical Access status for St. Joe's.

"They are in agreement that obtaining Critical Access status is essential. We do all really agree on that point," Eisenmann said of the delegation. "The real issue is how that is achieved. From their point of view, we need to come up with a regional approach that will achieve that end by continuing our dialogue with Richardton."

Unfortunately, Eisenmann said talks with Richardton officials broke off earlier this spring. St. Joe's and Richardton officials met in March, where St. Joe's made a proposal to Richardton, she said.

"We made a final proposal to them on a way that we could work together," Eisenmann said. "They contemplated that proposal. They spent a lot of time deliberating it with their own board and they decided they need to continue on an independent course."

Eisenmann said the St. Joe's proposal to Richardton included remuneration that she is not at liberty to talk about.

"They did not feel because of their situation, that they were in a position to accept our offer. And we respect their right to make that decision," she said.

Dickinson hospital officials were hoping Congress would pass legislation to allow an exemption to the 35-mile guideline for Critical Access status to be given to St. Joe's. In a letter forwarded by the congressional delegation to The Dickinson Press in response to a St. Joe's advertisement that appeared in the paper Tuesday, they state a legislative remedy to the Critical Access situation is highly unlikely.

"The simple fact is despite our efforts to pass a bill, it is highly unlikely that Congress will be persuaded to pass legislation that would allow both St. Joseph's and the Richardton hospital to be designated as Critical Access hospitals. Legislation to allow that arrangement would generate significant opposition from other members of Congress because it would set a national precedent with far-reaching consequences," the letter states.

The letter continues, "There is no question that maintaining a viable hospital in Dickinson is critically important - not just for the health of people in southwest North Dakota, but as an employer and anchor for economic development. That is why we all need to work together for a result that allows St. Joseph's to get back on its feet."

Eisenmann said St. Joe's "would welcome the opportunity for Richardton to work with us and our congressional delegation to find a mutually beneficial solution. We don't know what that is right now, but we would be very anxious to participate in those discussions."

She told the congressional delegation if the legislative avenue is not the best approach to achieving Critical Access status, St. Joe's is open to what the best option is.

The congressional delegation had earlier achieved the re-opening of a rural hospital demonstration program to increase revenues to St. Joe's over two years. Eisenmann said St. Joe's has turned in its application, but in a couple of conversations with the CMS regional office in Denver, she has not been provided a final answer on the matter.

Eisenmann had also earlier achieved increased reimbursements from Blue Cross/Blue Shield of North Dakota to help improve revenues, while at the same time shutting down the hospital's oncology department to reduce expenses.

She said these recent adjustments have improved the bottom line performance by 16 percent, but that "doesn't make a material enough difference." The biggest step is to obtain the Critical Access status, even though that doesn't allow the facility to completely get out of the red.

"It is an absolutely vital milestone for this hospital to accomplish if this hospital is to be viable in the future," Eisenmann said of the Critical Access designation. "There is still a gap, but the gap is so much reduced compared to where it is now, that it really gives us the opportunity to go with the rest of our strategy."

That strategy includes working closely with the local physicians, recruiting and enhancing ambulatory services, she said.

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