Connect with us

Mississippi Today

At least three Mississippi hospitals aim to end inpatient services, convert to rural emergency status

Published

on

As the state’s health care crisis persists, four more Mississippi hospitals have applied to become rural emergency hospitals, a federal designation meant to increase their financial viability.

The “rural emergency hospital” designation – a move State Health Officer Dr. Daniel Edney likened to a hospital closure – was rolled out at the beginning of this year. To qualify, hospitals have to end inpatient services and transfer emergency room patients to larger hospitals within 24 hours. In exchange, they get monthly stipends from the federal government and higher insurance reimbursement rates.

If approved, the hospitals – Quitman Community Hospital in Marks, Panola Medical Center in Batesville, Jefferson County Hospital in Fayette and Magee General Hospital – would be some of the first rural emergency hospitals in the country. Just a handful have been approved so far, including Alliance Healthcare System in Holly Springs, according to a database last updated on Aug. 15.

For rural hospitals with an already-small daily census, it can be a lifeline — instead of losing money on what few patients they have, the adjusted reimbursements help them break even or even profit.

However, for the communities with only one hospital, it means the end of inpatient health care and a hospital with little more than an emergency room.

In an interview with Mississippi Today in February, Edney said converting to a rural emergency hospital was basically a closure.

“It’s mainly critical access hospitals that are shifting, and when that happens, you’ve lost the hospital,” he said. “It’s a critical access hospital without the hospital.”

Critical access hospitals — another designation designed to improve hospital finances — are reimbursed by Medicare at a 101% rate, theoretically allowing a 1% profit. However, they must have 25 or fewer inpatient beds, be located 35 miles from another hospital, operate emergency services and transfer or discharge their patients within 96 hours.

In Mississippi, where nearly a half of rural hospitals are at risk of closure, others think the conversion is worth keeping the hospital functionally open.

Quentin Whitwell Credit: Submitted/Quentin Whitwell

Quentin Whitwell, an attorney from Oxford, is one of those. He was behind the effort in Holly Springs as co-owner of the hospital, as well as in Georgia where two of the country’s first rural emergency hospitals were approved. He’s also spearheading the change at three of the four hospitals that have applied in recent weeks: Quitman Community Hospital, Panola Medical Center and Jefferson County Hospital.

Whitwell co-owns the Quitman and Panola hospitals and is working as a consultant for Jefferson County Hospital, he said.

The fourth hospital pursuing the designation is Magee General Hospital, led by CEO Gregg Gibbes.

The Centers for Medicare and Medicaid Services, the federal agency primarily responsible for approving these conversions along with the state Health Department, would not comment on pending applications.

While some see the new designation as a last resort for struggling hospitals at the brink of closure, Whitwell views it as a way to streamline services and create a financially successful hospital that serves the specific needs of the community.

“It’s a game changer for a lot of hospitals,” he said. “What we’re trying to do is create a model that makes these hospitals vibrant again.”

Gibbes stressed that hospital leadership at Magee are pursuing the designation as an option – a decision has not yet been made.

“The plan is to exhaust all efforts to make sure that the organization and ultimately health care is delivered in Magee and the surrounding areas,” he said. “Applying for the rural emergency hospital status is so that we can have an option, should we get approved.”

The hospital, which was in bankruptcy when Gibbes took over in 2019, survived the pandemic — but just barely, with the help of COVID-19 relief funds. He said the hospital is essentially breaking even, and hospital leadership wants to make sure, now that those one-time funds that kept them afloat have dried up, that the hospital remains viable for years to come.

The hospital, licensed for 44 beds, has an average daily census of 13 people, Gibbes said. He said that’s why it makes sense to explore the rural emergency hospital designation.

“This is just under consideration,” he said.

Whitwell, who acknowledged he’s become somewhat of the “REH guy” across the country — he recently spoke at a CMS event about the benefits of the designation — is exploring turning more of his hospitals into rural emergency hospitals for a different reason.

“I believe in this model, and I want to help, but I also think that a lot of people are going to miss the mark on it,” he said. “And I want to be the guy that CMS holds up … and says, ‘This is how you do it.’”

In Panola, for example, the hospital is losing money on its psychiatric unit, and he sees the new designation as a way to focus its resources on what the hospital already does well: outpatient services.

“I believe that Panola is going to be probably the most robust REH in the country,” he said. “But we’re definitely losing money right now in psychiatric inpatient services.”

Panola Medical Center, aside from a long-term care facility, is the only hospital in Batesville, a town in north Mississippi with a population of around 7,000, according to the most recent census data.

Over the years, the hospital has shut down different portions of its psych unit – the geriatric psych section is the only part left. If they qualify as an REH, those remaining beds will have to be closed. But hospital leaders stressed that’s a last resort and would only be considered when their application is finalized. 

In recent months, St. Dominic closed its behavioral health services unit, which provides inpatient mental health and geriatric psychiatric treatment and was one of the only single point-of-entry hospitals for Hinds Behavioral Health Services for people with mental health issues in the metro area. The following weeks saw consistently full beds at Jackson-area psychiatric units.

While Whitwell recognizes closing those beds will be a loss to the community, he said that it might be the only way to turn the hospital’s finances around.

In the meantime, he’s been pitching legislators on changing certificate of need laws to create a hospital within a hospital in order to keep those beds open.

The Quitman hospital got its letter of approval from CMS on Aug. 31. Once the state Health Department finalizes paperwork on its end, Whitwell said the hospital will begin operating as an REH, retroactively effective Aug. 1.

Aside from a 5-year period in which it was closed, Quitman Community Hospital has been a critical access hospital since January 2004, Whitwell said.

He said Jefferson County Hospital leadership anticipates final approval in the near future and expects to receive its first federal check by October at the latest.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

On this day in 1972

Published

on

mississippitoday.org – Jerry Mitchell – 2024-11-16 07:00:00

Nov. 16, 1972

Credit: Courtesy: LSU Manship School News Service

A law enforcement officer shot and killed two students at Southern University in Baton Rouge after weeks of protests over inadequate services. 

When the students marched on University President Leon Netterville’s office, Louisiana Gov. Edwin Edwards sent scores of police officers in to break up the demonstrations. A still-unidentified officer shot and killed two 20-year-old students, Leonard Brown and Denver Smith, who weren’t among the protesters. No one was ever prosecuted in their slayings. 

They have since been awarded posthumous degrees, and the university’s Smith-Brown Memorial Union bears their names. Stanley Nelson’s documentary, “Tell Them We Are Rising: The Story of Black Colleges and Universities,” featured a 10-minute segment on the killings. 

“They were exercising their constitutional rights. And they get killed for it,” former student Michael Cato said. “Nobody sent their child to school to die.” 

In 2022, Louisiana State University Cold Case Project reporters, utilizing nearly 2,700 pages of previously undisclosed documents, recreated the day of the shootings and showed how the FBI narrowed its search to several sheriff’s deputies but could not prove which one fired the fatal shot. The four-part series prompted Louisiana Gov. John Bel Edwards to apologize to the families of the victims on behalf of the state.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Mississippi Today

Gloster residents protest Drax’s new permit request

Published

on

mississippitoday.org – Alex Rozier – 2024-11-15 13:33:00

GLOSTER — Drax, the United Kingdom-based wood pellet producer that’s violated air pollution limits in Mississippi multiple times, is asking the state to raise the amount of emissions it’s allowed to release from its facility in Gloster.

In September, the state fined Drax $225,000 for releasing 50% over the permitted limit of HAPs, or Hazardous Air Pollutants, from its facility Amite BioEnergy. In a pending permit application that it submitted to the Mississippi Department of Environmental Quality in 2022, the company is seeking to transition from a “minor source” of HAPs to a “major source.”

A “major source” permit would remove the limit over the facility’s total HAP emissions, but it would apply a new limit over the rate at which Drax could release the pollutants.

This year’s fine was its second penalty for violating Mississippi law around air pollution limits. In 2020, the state fined the company $2.5 million for releasing over three times the legal threshold of Volatile Organic Compounds, or VOCs, one of the largest such fines in state history. Drax underestimated its VOC releases since the facility opened in 2016, but didn’t realize it until 2018. The facility didn’t come into compliance until 2021.

The Environmental Protection Agency lists a variety of potential health impacts from exposure to HAPs, including damage to the immune system and respiratory issues. VOCs can also cause breathing problems, as well as eye, nose and throat irritation, according to the American Lung Association.

About sixty people packed into a Gloster public library for MDEQ’s public hearing over Drax’s permit application on Nov. 14, 2024.

For years since Drax’s violations became public, nearby residents have attributed health issues to living near the facility. During a public hearing on Drax’s permit request Thursday in Gloster, attendees reiterated those concerns.

“We all experience headaches every day,” resident Christie Harvey said about her and her grandchildren. Harvey said she has asthma too, and her doctor was “baffled” by her symptoms. “Each week I have to take (my grandchildren) to the clinic for upper respiratory issues … It’s not fair that we have to go through this. Drax needs to lower the pollution as much as possible.”

Part of the public outcry is the proximity of people’s homes to the plant, which is within a mile of Gloster’s downtown.

A screenshot of Google Maps showing the location of Drax’s Amite BioEnergy facility relative to the rest of Gloster. The facility is within a mile of the downtown area.

“The wood pellet plant in Lucedale is situated in an industrial park outside of town,” Andrew Whitehurst of Healthy Gulf, an environmental group dedicated to protecting the Gulf of Mexico’s natural resources, said at the meeting. “The wood pellet plant that (Enviva is) trying to put in Bond will be situated north and west of the downtown area. Not like this when it’s right smack in the middle (of the city). It’s totally inappropriate. People can’t take it, they don’t deserve it.”

In a statement to Mississippi Today, Drax said it prioritizes the public health and environment in Gloster, adding that the permit modification is a part of standard business practice.

“When we first began operations, some of our original permits were not fit for purpose,” spokesperson Michelli Martin said via e-mail. “We are now working to acquire the appropriate permits for our operating output and to improve our compliance. Within these permits the requirements may change based on engineering data and industry standards. This permit modification is part of our ongoing plan to provide MDEQ with the most accurate data. Drax fully supports the resolution of our permitting request and looks forward to working with MDEQ to finalize the details.”

While researchers, including from Brown University, are studying the health symptoms of residents near the wood pellet plant, there is no proven connection between the facility’s emissions and those symptoms.

Erica Walker, a Jackson native who teaches epidemiology at Brown and who’s leading the study, spoke to Mississippi Today earlier this year. Regardless of the cause and effect, she said, the decision to put the plant near disadvantaged communities with poor health outcomes is concerning.

“We want to make sure we aren’t additionally burdening already burdened communities,” Walker said.

Operations resume at Drax in Gloster, Miss., on Friday, Feb. 16, 2024. Some Gloster residents are concerned with the industrial pollution caused by the company that produces wood pellets in the town. Credit: Eric J. Shelton/Mississippi Today

About 1,300 people live in the city, according to Census data, and 39% live below the poverty line.

Moreover, Gloster residents often have to travel hours, to cities such as McComb and Baton Rouge, to find the nearest medical specialist. Amite County, where Gloster is, has a higher rate of uninsured residents than the rest of the state, according to County Health Rankings, and the ratio of residents to primary care physicians is over three times greater in the county than Mississippi as a whole.

As part of its application, Drax is seeking a Title V permit under the Clean Air Act, which the EPA requires for major sources of air pollutants. This gives the EPA the opportunity to review Drax’s application and public comments submitted with it. The public can submit comments on the application until Nov. 26, and can do so through MDEQ’s website.

The Mississippi Environmental Quality Permit Board, which is made up of officials from several state agencies, will then decide whether or not to grant the new permits. A full overview of the process and Drax’s application is available online.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Mississippi Today

Mississippi receives ‘F’ rating on preterm birth rate

Published

on

mississippitoday.org – Sophia Paffenroth – 2024-11-15 10:11:00

Mississippi received an F grade for its rate of preterm births in 2023 – those occurring before 37 weeks gestation – from the 2024 March of Dimes report card

Mississippi’s preterm birth rate was 15%, the worst in the country. Any state with a rate greater than 11.5% also received an F. The U.S. average was 10.4%. 

Preterm births in Mississippi have risen steadily over the last decade, increasingly nearly 2% since 2013. In Jackson, the state capital, nearly one in five babies are born preterm, according to the report. 

“As a clinician, I know the profound impact that comprehensive prenatal care has on pregnancy outcomes for both mom and baby,” Dr. Amanda P. Williams, interim chief medical officer at March of Dimes, said in a press release. “Yet, too many families, especially those from our most vulnerable communities, are not receiving the support they need to ensure healthy pregnancies and births. The health of mom and baby are intricately intertwined. If we can address chronic health conditions and help ensure all moms have access to quality prenatal care, we can help every family get the best possible start.” 

In addition to inadequate prenatal care, factors such as smoking, hypertension, diabetes and unhealthy weight can cause people to be more likely to have a preterm birth.

The report highlighted several other metrics, including infant mortality – in which Mississippi continues to lead the nation. 

In 2022, 316 babies in the state died before their first birthday. Among babies born to Black mothers, the infant mortality rate is 1.3 times higher. 

The state’s maternal mortality rate of 39.1 per 100,000 live births is nearly double the national average of 23.2.

Mississippi has yet to expand Medicaid – one of only 10 states not to do so – and tens of thousands of working Mississippians remain without health insurance. It also has not implemented paid family leave, doula reimbursement by Medicaid, or supportive midwifery policies – all of which March of Dimes says are critical to improving and sustaining infant and maternal health care.

The Legislature passed a law last session that would make timely prenatal care easier for expectant mothers, but more than four months after the law was supposed to go into effect, pregnant women still can’t access the temporary coverage.

“March of Dimes is committed to advocating for policies that make healthcare more accessible like Medicaid expansion, addressing the root causes of disparities, and increasing awareness of impactful solutions like our Low Dose, Big Benefits campaign, which supports families and communities to take proactive steps toward healthy pregnancies,” Cindy Rahman, March of Dimes interim president and CEO, said in a press release.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Trending