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

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1 year ago

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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.

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Meet the 2 Candidates for Mississippi Supreme Court’s Nov. 26 Runoff Election

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2 hours ago

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November 25, 2024

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mississippitoday.org – The Marshall Project – 2024-11-25 09:30:00

On Tuesday, Nov. 26, voters will determine who will hold one of central Mississippi’s three seats on the nine-member state Supreme Court. This 22-county area includes Hinds County and Jackson.

Justice Jim Kitchens is seeking a third, eight-year term on the high court. State Sen. Jenifer B. Branning is the challenger.

The state Supreme Court often has the final say in cases involving criminal, civil and death penalty appeals, questions on the state’s laws and constitution, and legal issues of public interest. It hears appeals from lower courts, such as the chancery and circuit courts. The court decided 260 cases in 2023 and issued rulings in 2,656 motions and petitions.

The Marshall Project – Jackson and Mississippi Today compiled information about each candidate to help you make an informed decision at the polls.

Admitted to Mississippi Bar: 1967

Residence: Crystal Springs, Copiah County

Relevant experience: Completing second term as Supreme Court justice; 41 years as practicing attorney, including nine as district attorney of Copiah, Walthall, Pike and Lincoln counties.

Campaign finance: As of Oct. 10, his campaign committee has raised $288,502, mostly from trial lawyers, and spent $189,675, leaving the campaign with $98,827. Read the latest report here.

Statement of economic interest: Kitchens and his wife are partners in a real estate company, Kitchens Properties, LLC, in Copiah County. Read the latest report here.

Kitchens was first elected to this seat in 2008, after more than 40 years practicing law, which includes nine years as a district attorney across four counties. He is one of two presiding justices, who have the most years on the bench, following the chief justice. Presiding justice is a role on the court’s executive committee that includes administrative duties, such as enforcing the court’s deadlines, and presiding over panels during oral arguments.

Campaigning at the 2024 Neshoba County Fair, Kitchens stressed his experience in the courtroom, especially on criminal cases, and promised impartiality.

Kitchens said he is “the guy that carries his oath of office around in his pocket as a daily reminder of what he swore to do. That oath teaches me that I’m not supposed to care whether people before the court are rich, poor, Black, White, Republican, Democrat, Libertarian or Independent. And I don’t care.”

Mississippi College of Law Professor Matthew Steffey described Kitchens as a “middle-of-the-road centrist.” On the bench, Kitchens’ dissents have keyed in on what the justice called oversteps in judicial power and scrutinized prosecutorial decisions.

Kitchens wrote a partial dissent on the decision about House Bill 1020, calling the creation of the court in Hinds County a “fiction of convenience that overreaches our judicial function, and of ultimate importance, our constitutional duty.” He also joined a dissenting opinion in the case that killed Mississippi’s ballot initiative.

Ensuring defendants who can’t afford representation have court-appointed lawyers is a theme throughout Kitchens’ career. He was the chair of the Public Defender Task Force, which was created in 2000 to study and make recommendations on the public defender systems in the state. In a 2018 interview with Mississippi Today, Kitchens expressed support for a more well-organized and adequately funded state public defender system for Mississippi.

The bulk of Kitchens’ campaign donations through Oct. 10 have come from trial lawyers. In addition to Mississippi attorneys, the campaign also received contributions from lawyers as far away as Oregon and Pennsylvania. In the three months since the July finance report, Kitchens’ campaign raised over $200,000, more than it had previously raised in the entire race. He has also received an endorsement from the Southern Poverty Law Center, an advocacy group specializing in civil rights litigation.

? Read Kitchens’ response to the candidate questionnaire from The Marshall Project – Jackson and Mississippi Today.

Admitted to Mississippi Bar: 2004

Residence: Philadelphia, Neshoba County

Relevant experience: State senator since 2016.

Campaign finance: As of Oct. 10, Branning’s campaign committee has raised $665,624, including a $250,000 loan from the candidate, and spent $343,728. The campaign reported a balance of $319,876, which left a discrepancy of about $2,000. Read the latest report here.

Statement of economic interest: Branning is listed as member, owner, stockholder or partner in several companies located in Philadelphia, including her law firm, Branning Properties, LLC, and Triple E Investments. Read her latest report here.

Republican state Sen. Jenifer B. Branning is running on a platform to represent Mississippians’ conservative values on the Supreme Court, she said at the 2024 Neshoba County Fair candidate forum.

Branning has no judicial experience. Since she joined the Mississippi Bar in 2004, she has practiced as an attorney, primarily representing businesses through her private practice in areas including real estate development, banking and agribusiness. She has also served as a special prosecutor in Neshoba County, a guardian ad litem in Neshoba and Winston counties, and as a staff attorney in the Mississippi Secretary of State’s Division of Business Services & Regulation.

Branning described herself as a “Christian conservative.” She has been endorsed by the state’s Republican Party and the National Federation of Independent Business Mississippi PAC, a special interest group for small businesses. She has been outspoken about overturning Roe v. Wade and supporting the state’s abortion ban, and about reducing taxes on businesses. Branning is also a member of the National Rifle Association. On criminal justice issues, Branning has voted in favor of mandatory and increased minimum sentences for crimes including shoplifting, motor vehicle theft and fleeing law enforcement.

In the state Senate, Branning chairs the Highways and Transportation Committee. She has touted her record on lowering taxes and reducing regulations on farmers and small business owners.

Branning comes from multiple generations of business owners in Neshoba County. Her grandfather, Olen Burrage Jr., owned and operated a truck farm, hauling timber and corn, according to previous news reports.

Her election committee has received contributions from political action groups including Truck PAC, Mississippi Petroleum Marketers & Convenience Stores Association PAC and the Mississippi REALTOR PAC.

Much of Branning’s campaign funding, however, comes from the candidate herself. She kicked off her campaign with a $250,000 candidate loan. She has also bankrolled her previous senate campaigns, with candidate loans as high as $50,000 in 2018. This year, her campaign committee also received funding from other Republican politicians and their campaign funds, including Lt. Gov. Delbert Hosemann, the Committee to Elect Jeremy England (state senator), Harkins for MS (state Senator Josh Harkins), and Friends of Jason White (Mississippi House speaker).

Branning did not acknowledge or return the candidate questionnaire from The Marshall Project – Jackson and Mississippi Today.

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

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On this day in 1915

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3 hours ago

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November 25, 2024

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mississippitoday.org – Jerry Mitchell – 2024-11-25 07:00:00

Nov. 25, 1915

Credit: Wikipedia

A week before the silent film, “Birth of a Nation,” premiered at an Atlanta theater, William Simmons, along with 15 other men (including some who lynched Leo Frank) burned a cross on Stone Mountain, Georgia, signaling the rebirth of the Ku Klux Klan. 

The movie’s racist portrayals of Black Americans prompted outrage by the NAACP and others, leading to huge protests in towns such as Boston and the film’s closing in Chicago. 

Despite these protests, the movie became Hollywood’s first blockbuster, making as much as $100 million at the box office (the equivalent of $2.4 billion today). In the wake of the movie, the KKK became a national organization, swelling beyond 4 million members.

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

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Podcast: Mississippi Hospital Association’s Roberson discusses Medicaid expansion outlook under Trump, other 2025 legislative health care issues

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5 hours ago

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November 25, 2024

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mississippitoday.org – Bobby Harrison and Geoff Pender – 2024-11-25 06:30:00

Richard Roberson, president and CEO of the Mississippi Hospital Association, tells Mississippi Today’s Bobby Harrison and Geoff Pender a new Trump administration would likely approve Mississippi Medicaid expansion work requirements. He says revamping the state’s certificate of need laws is likely to be a major issue before lawmakers, and he discusses a new alliance of hospitals that left the MHA and formed a new organization.

READ MORE: As lawmakers look to cut taxes, Mississippi mayors and county leaders outline infrastructure needs

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

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