UVM Health Network – Alice Hyde Medical Center is applying to the Centers for Medicare & Medicaid Services (CMS) to become a Critical Access Hospital (CAH), hospital leaders announced today, saying the move will reduce the community hospital’s financial vulnerability amid financial and operational challenges for rural health care organizations across the country.

“Critical Access Hospital status will directly support Alice Hyde’s mission of caring for our community,” said Michelle LeBeau, President, UVM Health Network – Alice Hyde Medical Center. “Our ability to invest in our people, our facilities and our campus is critical as we continue to change to meet the needs of our community. CAH status will support those needs through improved reimbursement from government payers, and advance the already high-quality care we provide.”

Critical Access Hospital (CAH) status is a designation given by the Centers for Medicare & Medicaid Services (CMS) to hospitals that meet certain eligibility requirements. Those requirements include:

·         Being located in a rural area.

·         Being located more than 35 miles from the next-nearest hospital.

·         Having a maximum of 25 inpatient beds.

·         Maintaining an average length of stay of 96 hours or less for acute inpatient care patients.

·         Providing 24-hour emergency care services seven days per week.

Currently Alice Hyde is considered a Sole Community Hospital by CMS, meaning it receives lower reimbursement for services for patients on federally-funded health insurance plans such as Medicare, which make up a significant portion of the population served by the hospital. CAH hospitals are reimbursed 101 percent of “reasonable costs” for services, while the federal reimbursement rate for non-CAH hospitals is much lower. The hospital estimates that it would receive between $3 million and $4.5 million more per year in service reimbursements as a CAH.

“The Critical Access Hospital model provides an opportunity for facilities to continue to meet the emergency needs, inpatient care and outpatient service needs of their communities by bolstering their financial stability,” said Dr. James McDonald, Acting New York State Health Commissioner. “This model has been successfully integrated at 18 hospitals across the State, ensuring critical access to care for the communities they serve. We look forward to working with Alice Hyde Medical Center as they continue to plan for the future.”

To meet the 25-bed maximum allowed under CAH status, hospital officials said 45 beds that remain on Alice Hyde’s Hospital Operating Certificate – a legal document filed with federal and state officials – will be decertified as part of the transition to CAH status. Those 45 beds have not been used in many years, hospital officials said. Over the past year, the hospital cared for an average of 17 inpatients per day. Alice Hyde’s highest inpatient census over that time was 22 patients

To optimize patient care, Alice Hyde will designate all of the 25 acute inpatient care beds as so-called “swing beds.” Swing beds are specifically-designated inpatient beds that allow patients to switch from receiving acute inpatient care to skilled nursing care, without leaving the hospital. The hospital’s Intermediate Care Unit and Medical-Surgical inpatient care unit will also be combined, removing the IMCU designation from Alice Hyde’s operating certificate but retaining all the acute inpatient care services the hospital currently provides. The changes will give Alice Hyde’s nursing and hospitalist teams more flexibility and support as they respond to patients’ emerging clinical needs throughout the day.

“Our inpatient care teams will continue to provide the same care and services they do today,” said Dr. Paul El Azoury, Associate Chief Medical Officer and Director of Alice Hyde’s Hospitalist program. “Combining our inpatient units and utilizing swing beds will give our providers the ability to care for more sick patients without being confined to the limited number of beds in the current IMCU,”

There are no restrictions on the services a Critical Access Hospital can provide, and Alice Hyde does not expect any service reductions as a result of pursuing CAH status.

“Our hospital already operates like a critical access hospital in many ways — we just don’t get the benefits that critical access hospitals enjoy,” said Becca Shutts, Alice Hyde’s Chief Nursing Officer and Vice President of Practice Operations. “Our patients and our community should rest assured that this process won’t reduce services or change the ways in which they receive care. This is about doing everything we can as an organization to ensure we are set up for future success and here always to provide the care our community needs.”  

Hospital officials say the state and federal review of Alice Hyde’s CON is expected to take months, and they hope to make the transition to CAH status by October 1, 2023, which is the start of the organization’s fiscal year.

The hospital will host a public community forum from 5:30 – 7 p.m. on May 17, at Malone Golf Club, to ensure members of the community have a chance to ask questions regarding the hospital’s CAH project.