One-tenth of a mile has kept Elbert Memorial Hospital (EMH) from getting 100 percent of Medicare reimbursements for services rendered, but EMH CEO Kerry Trapnell said that may change in the future.
According to Medicare rules, because Elbert County is 14.9 miles from the Abbeville (South Carolina) Area Medical Center, EMH has been denied Critical Access Designation.
With such designation, EMH could recover the full cost of its services through Medicare. Currently, the Medicare system considers EMH a PPS (Prospective Payment System) hospital, and as such the Elbert County hospital can get reimbursed for only 70 percent of the cost of services.
When EMH had a partnership with AnMed Health Systems, AnMed applied for the critical access designation, but in the end Medicare turned down the application because the Abbeville hospital was 14.9 miles from the Elbert County border, when 15 miles in the legal requirement.
“They turned it down because they said 14.9 miles is not 15 miles,” Trapnell told the EMH Authority Board at its monthly meeting Tuesday night.
However, Trapnell said the Georgia Department of Transportation will be submitting information with EMH’s upcoming application for Critical Access Designation that shows Abbeville’s health facility is 15 miles or more from the Elbert County Border.
“They (Georgia DOT) are doing an ‘official review’ and we will be submitting that information when we make the Critical Access application,” said Trapnell. “When we try to get the designation, we will include their analysis with the application.”
As the hospital enters the final quarter of its fiscal year 2018-2019, the hospital’s financial statement shown at the authority meeting reflects good news, but Authority Chairman Daniel Graves warned that the figures in the statement are somewhat misleading.
The statement is showing EMH with a $978,733 profit in FY 2018-2019.
“We are doing well and we are pleased, but there are some things that need to be noted about our financial situation,” said Graves.
Graves said the hospital was gifted with a non-cash contribution of a building, which the hospital will be using to house medical offices and possibly a telemedicine facility. Although there were no funds attached to EMH acquiring the building, the gift is being reflected in the statement.
Also, the hospital received one-time state rural health funding and funds from the Georgia HEART program, which is a direct contribution to state hospitals through the state tax system.
Those three items on the EMH financial statement reflect a good portion of the revenues over expenses, said Graves.
Graves said funding from the Georgia HEART program can be used only for capital outlay projects, while funding from county millage levies can be used for operations at the hospital.
Graves said after the meeting that the county’s return on investment with tax funding is about 20 percent when the EMH’s $25 million annual economic impact on the local economy takes effect.