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Richardton hospital to relinquish status

Richardton residents will soon have to go elsewhere for their acute care. Within six months, Richardton Memorial Hospital will be converted into a skilled nursing facility, relinquishing their Critical Access Hospital (CAH) status, allowing St. J...

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Richardton residents will soon have to go elsewhere for their acute care.

Within six months, Richardton Memorial Hospital will be converted into a skilled nursing facility, relinquishing their Critical Access Hospital (CAH) status, allowing St. Joseph's Hospital in Dickinson to be eligible for critical access designation.

Under federal rules, a provider applying for critical access designation must be located more than 35 miles from another critical access hospital.

Changes occurring at both hospitals are due in part to last month's announcement by Senator Kent Conrad, who secured a grant for more than $940,000 to help with Richardton's conversion to a long-term care facility.

An additional grant of $500,000 will also be given to Richardton Hospital by Catholic Health Initiatives, which will remain in escrow until St. Joseph's receives CAH designation.

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Once the CAH status is achieved, the financial situation at St. Joseph's is expected to improve, said St. Joseph's CEO Claudia Eisenmann.

"We're very excited because what achieving the Critical Access designation will mean for St. Joseph's, is an increased level of financial stability," Eisenmann said. "It really changes the whole frame work on how we can go forward with our ministry."

Facilities within the hospital are expecting to change, going from 49 beds to 25 beds. Although the beds are downsizing, Eisenmann said the patient numbers may not change.

"Twenty-five beds does not mean 25 patients," Eisenmann said. "We can still have patients in observation status and we can still have them in the emergency room. So there may be any number of occasions that there are more than 25 patients being served in the hospital, but there will just be 25 in-patient beds for the purposes of when those patients are actually admitted."

Part of the CAH status also mandates that the average length of stay within the facility may not exceed four days, which Eisenmann said is what the average hospital stay is currently.

"We currently keep our average length of stay under four days," Eisenmann said. "On an average daily census basis, we have not exceeded 25 in-patients for several years."

No changes to equipment, services or staffing are expected, Eisenmann said.

"Really nothing changes much," Eisenmann said. "It sounds more like a change just because people are not used to thinking about the hospital in this kind of terminology, but relative to the way we're operating and have been operating for the past few years, people aren't even going to see a big difference in the community."

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Eisenmann stated that an estimated $1.3 million in revenue per year is expected to be taken in by St. Joseph's once CAH status is achieved.

The hospital went through $13.2 million in operational losses from fiscal years 2002 to June 2007, according to a May 2008 Press story.

Though a rather large amount of losses, Eisenmann said they are seeing better results financially.

"We have gone through a lot of change at St. Joseph's to try to make sure that our organization fits the needs of the community," Eisenmann added. "All these changes over the past 18 to 20 months have put us in a position where we are having the best financial quarter that we have had in probably the past seven years of St. Joseph's history. We have already strengthened the organization, and the critical access designation strengthens us even more and gives us room to look towards growth."

Richardton Memorial has approximately six months from the time they receive their federal grant to make the conversion.

Richardton Hospital Administrator Jim Opdahl said the hospitals tried to find a "win-win" situation.

"In order for this organization to convert, it would require some significant dollars," Opdahl said. "Therefore the Hospital task force got involved and came up with a number of different initiatives."

The money within the grant will be used to purchase up to 20 skilled nursing beds, which Opdahl says costs anywhere from $18,000 to $21,000 per bed, making the grant helpful.

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"We need to get 20 beds in place before we make the conversion," Opdahl said. "There will be money available also for us to address a number of physical plant ADA and safety code issues that will need to be brought into compliance before we can become a skilled nursing facility."

Monies from the grant will also be used to help transition the staff, payment systems and making the clinic into a separate entity and not-for-profit; as a skilled nursing facility is not allowed to own a clinic.

"There is also money available to update patient care equipment that has been outdated here for a number of years," Opdahl said. "We've basically been a nursing home operating as a hospital for about 25 years. No one here will see much of a change, there will just be some different rules and payment systems in place."

Opdahl said he has been working on a plan to convert for some time, but now has the funding available.

"Now that the money is available, we can start drawing on the funds and move this process forward," Opdahl said.

On or before the end of March or beginning of April 2009, Richardton would have to have completed their conversion, Opdahl said.

"The biggest issue is once we convert to a skilled nursing facility we probably would not have emergency services," Opdahl said. "That's the biggest loss, but we don't do OB, we don't do surgery; we have a very limited acute care capability, so I don't see that as having an impact."

Eisenmann expects that it may be another six to eight months before the conversion is complete at St. Joseph's.

The agreement between the two facilities emerged from a task force Governor John Hoeven and the state's congressional delegation organized last May.

North Dakota Senator Kent Conrad, a part of the task force, said he is "delighted" with the agreement between the two hospitals.

"I'm glad we were able to get the money and I think it's an important step forward," Conrad said. "It's been something we've been hoping for for many years."

Conrad said he hopes the grant will help both hospitals.

"We hope for brighter days ahead for everybody," Conrad said.

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