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Under a new program, rural hospitals could get more money — but they have to end inpatient care

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Under a new program, rural hospitals could get more money — but they have to end inpatient care

by Devna Bose, Mississippi Today
February 22, 2023

Thanks to a new federal program, a few rural Mississippi hospitals at risk of closure might have been given a lifeline.

The Mississippi Department of Health finalized its rules for “rural emergency hospitals” last week, so Mississippi rural hospitals with less than 50 beds and critical access hospitals can now apply for the designation.

Critical access hospitals — another designation designed to reduce hospital financial strain — must have 25 or fewer inpatient beds, be located 35 miles from another hospital, maintain an annual hospital stay of less than 96 hours for patients and provide full-time emergency services.

The federal government created the rural emergency hospital program, which was finalized in November, to ease the financial strain of rural hospitals across the country at risk of closure.

To qualify, the hospitals must agree to have emergency care available all day, every day, and provide observation care and outpatient services.

But there’s one more catch: In exchange for monthly payments and higher Medicare reimbursements, rural emergency hospitals must end all inpatient care and discharge or transfer its patients to bigger hospitals within 24 hours of their arrival.

Ryan Kelly, executive director of the Mississippi Rural Health Association, said the program is ideal for hospitals that have low patient counts and are in deep financial distress.

“It’s a good opportunity,” Kelly said. “This is no silver bullet, but the more tools we can put in the tool belt to solve this issue, the better.”

The premise of the program is that so many rural hospitals already struggle with low census counts and inpatient care costs far higher than what they’re paid. In states that have not expanded Medicaid, the program could be a solution for small hospitals that only operate some of the health services in their communities and have shuttered other units in order to maintain operations.

Harold Miller, president and CEO of the Center for Healthcare Quality and Payment Reform, takes issue with several of the program’s requirements.

Seniors whose health conditions most often need more intensive care might have to be transferred to a larger facility if their local hospital is a rural emergency hospital, and transferring patients is no longer as easy as it used to be, he said. Bigger hospitals, already under strain, must be willing to accept them.

The University of Mississippi Medical Center, for example, was on diversion (or at capacity) for both critical care and medical-surgical beds consistently from Jan. 30 to Feb. 11 of this year, according to a website that tracks hospitals on diversion. The website is updated at least twice a day.

Richard Roberson, the vice president of state policy for the Mississippi Hospital Association, said UMMC is not alone.

“You always had hospitals go on diversion, even prior to COVID, so that’s not a new thing … but what we’re seeing now is more and more diversions becoming the norm in some places,” he said.

Hospitals – even larger ones – are making decisions based on limited budgets, inadequate nurse staffing and increased wages for employees.

“Unfortunately, what’s happening is it’s impacting patient care,” said Roberson.

Additionally, when a facility is converted into a rural emergency hospital, it can no longer provide swing bed services. In that case, when there’s no separate skilled nursing facility, the community loses its nursing home, too.

Rural emergency hospitals also can’t utilize the federal 340B drug pricing program, which allows hospitals that treat low-income populations to buy prescription drugs at a discount.

“For some very small hospitals, all of the changes in payments might mean that the hospital is more profitable than it was before,” Miller said. “But it also has to eliminate services for the community in order to do that. Why should a small rural hospital that is losing money be forced to eliminate important services in order to get higher payment?”

And still, there is no guarantee that the hospital will be paid enough to remain open, Miller said.

However, for some Mississippi communities in danger of losing their only hospital, the payoff might be worth the risk.

According to a report from the CHQPR, 19 out of the state’s 74 rural hospitals are at risk of closing within the next two to three years, putting Mississippi fourth in the country for percentage of rural hospitals at immediate risk of closure.

The University of North Carolina’s Sheps Center estimates that more than 1,700 hospitals might be eligible. Kelly said he estimates around five Mississippi hospitals will qualify for the program.

Though the federal program took effect Jan. 1, the state had to finalize its qualifications before hospitals could begin applying for the designation.

Mississippi will be one of the first states to roll out the program, Kelly said.

“We’ve been waiting on the Department of Health to finalize their rules,” he said. “Now, they have the guidelines that they need to follow through and begin work.”

To become rural emergency hospitals, officials must first notify the MDSH Office of Licensure of their intent to convert, provide required documents and complete the Centers for Medicare and Medicaid Services’ application. Then, they must complete an initial survey, and apply for an MSDH rural emergency hospital license.

Community Health Editor Kate Royals contributed reporting to this story.

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

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Mississippi Today

1964: Mississippi Freedom Democratic Party was formed

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April 26, 2025

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mississippitoday.org – @MSTODAYnews – 2025-04-26 07:00:00

by Jerry Mitchell, Mississippi Today
April 26, 2025

April 26, 1964

Aaron Henry testifies before the Credentials Committee at the 1964 Democratic National Convention.

Civil rights activists started the Mississippi Freedom Democratic Party to challenge the state’s all-white regular delegation to the Democratic National Convention. 

The regulars had already adopted this resolution: “We oppose, condemn and deplore the Civil Rights Act of 1964 … We believe in separation of the races in all phases of our society. It is our belief that the separation of the races is necessary for the peace and tranquility of all the people of Mississippi, and the continuing good relationship which has existed over the years.” 

In reality, Black Mississippians had been victims of intimidation, harassment and violence for daring to try and vote as well as laws passed to disenfranchise them. As a result, by 1964, only 6% of Black Mississippians were permitted to vote. A year earlier, activists had run a mock election in which thousands of Black Mississippians showed they would vote if given an opportunity. 

In August 1964, the Freedom Party decided to challenge the all-white delegation, saying they had been illegally elected in a segregated process and had no intention of supporting President Lyndon B. Johnson in the November election. 

The prediction proved true, with white Mississippi Democrats overwhelmingly supporting Republican candidate Barry Goldwater, who opposed the Civil Rights Act. While the activists fell short of replacing the regulars, their courageous stand led to changes in both parties.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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Mississippi River flooding Vicksburg, expected to crest on Monday

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April 25, 2025

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mississippitoday.org – @alxrzr – 2025-04-25 16:04:00

by Alex Rozier, Mississippi Today
April 25, 2025

Warren County Emergency Management Director John Elfer said Friday floodwaters from the Mississippi River, which have reached homes in and around Vicksburg, will likely persist until early May. Elfer estimated there areabout 15 to 20 roads underwater in the area.

A truck sits in high water after the owner parked, then boated to his residence on Chickasaw Road in Vicksburg as a rising Mississippi River causes backwater flooding, Friday, April 25, 2025.

“We’re about half a foot (on the river gauge) from a major flood,” he said. “But we don’t think it’s going to be like in 2011, so we can kind of manage this.”

The National Weather projects the river to crest at 49.5 feet on Monday, making it the highest peak at the Vicksburg gauge since 2020. Elfer said some residents in north Vicksburg — including at the Ford Subdivision as well as near Chickasaw Road and Hutson Street — are having to take boats to get home, adding that those who live on the unprotected side of the levee are generally prepared for flooding.

A rising Mississippi River causing backwater flooding near Chickasaw Road in Vicksburg, Friday, April 25, 2025.
Old tires aligned a backyard as a deterrent to rising water north of Vicksburg along U.S. 61, Friday, April 25, 2025.
As the Mississippi River rises, backwater flooding creeps towards a home located on Falk Steel Road in Vicksburg, Friday, April 25, 2025.

“There are a few (inundated homes), but we’ve mitigated a lot of them,” he said. “Some of the structures have been torn down or raised. There are a few people that still live on the wet side of the levee, but they kind of know what to expect. So we’re not too concerned with that.”

The river first reached flood stage in the city — 43 feet — on April 14. State officials closed Highway 465, which connects the Eagle Lake community just north of Vicksburg to Highway 61, last Friday.

Flood waters along Kings Point Road in Vicksburg, Friday, April 25, 2025.

Elfer said the areas impacted are mostly residential and he didn’t believe any businesses have been affected, emphasizing that downtown Vicksburg is still safe for visitors. He said Warren County has worked with the U.S. Army Corps of Engineers and the Mississippi Emergency Management Agency to secure pumps and barriers.

“Everybody thus far has been very cooperative,” he said. “We continue to tell people stay out of the flood areas, don’t drive around barricades and don’t drive around road close signs. Not only is it illegal, it’s dangerous.”

NWS projects the river to stay at flood stage in Vicksburg until May 6. The river reached its record crest of 57.1 feet in 2011.

The boat launch area is closed and shored up on Levee Street in Vicksburg as the Mississippi River rises, Friday, April 25, 2025.
The boat launch area (right) is closed and under water on Levee Street in Vicksburg as the Mississippi River rises, Friday, April 25, 2025.
City of Vicksburg workers shore up the bank along Levee Street as the Mississippi River rises, Friday, April 25, 2025.
The old pedestrian bridge spanning the Mississippi River in Vicksburg, Friday, April 25, 2025.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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Mississippi Today

With domestic violence law, victims ‘will be a number with a purpose,’ mother says

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April 25, 2025

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mississippitoday.org – @MSTODAYnews – 2025-04-25 15:07:00

by Mina Corpuz, Mississippi Today
April 25, 2025

Joslin Napier. Carlos Collins. Bailey Mae Reed. 

They are among Mississippi domestic violence homicide victims whose family members carried their photos as the governor signed a bill that will establish a board to study such deaths and how to prevent them. 

Tara Gandy, who lost her daughter Napier in Waynesboro in 2022, said it’s a moment she plans to tell her 5-year-old grandson about when he is old enough. Napier’s presence, in spirit, at the bill signing can be another way for her grandson to feel proud of his mother. 

“(The board) will allow for my daughter and those who have already lost their lives to domestic violence … to no longer be just a number,” Gandy said. “They will be a number with a purpose.” 

Family members at the April 15 private bill signing included Ashla Hudson, whose son Collins, died last year in Jackson. Grandparents Mary and Charles Reed and brother Colby Kernell attended the event in honor of Bailey Mae Reed, who died in Oxford in 2023. 

Joining them were staff and board members from the Mississippi Coalition Against Domestic Violence, the statewide group that supports shelters and advocated for the passage of Senate Bill 2886 to form a Domestic Violence Facility Review Board. 

The law will go into effect July 1, and the coalition hopes to partner with elected officials who will make recommendations for members to serve on the board. The coalition wants to see appointees who have frontline experience with domestic violence survivors, said Luis Montgomery, public policy specialist for the coalition. 

A spokesperson from Gov. Tate Reeves’ office did not respond to a request for comment Friday.

Establishment of the board would make Mississippi the 45th state to review domestic violence fatalities. 

Montgomery has worked on passing a review board bill since December 2023. After an unsuccessful effort in 2024, the coalition worked to build support and educate people about the need for such a board. 

In the recent legislative session, there were House and Senate versions of the bill that unanimously passed their respective chambers. Authors of the bills are from both political parties. 

The review board is tasked with reviewing a variety of documents to learn about the lead up and circumstances in which people died in domestic violence-related fatalities, near fatalities and suicides – records that can include police records, court documents, medical records and more. 

From each review, trends will emerge and that information can be used for the board to make recommendations to lawmakers about how to prevent domestic violence deaths. 

“This is coming at a really great time because we can really get proactive,” Montgomery said. 

Without a board and data collection, advocates say it is difficult to know how many people have died or been injured in domestic-violence related incidents.

A Mississippi Today analysis found at least 300 people, including victims, abusers and collateral victims, died from domestic violence between 2020 and 2024. That analysis came from reviewing local news stories, the Gun Violence Archive, the National Gun Violence Memorial, law enforcement reports and court documents. 

Some recent cases the board could review are the deaths of Collins, Napier and Reed. 

In court records, prosecutors wrote that Napier, 24, faced increased violence after ending a relationship with Chance Fabian Jones. She took action, including purchasing a firearm and filing for a protective order against Jones.

Jones’s trial is set for May 12 in Wayne County. His indictment for capital murder came on the first anniversary of her death, according to court records. 

Collins, 25, worked as a nurse and was from Yazoo City. His ex-boyfriend Marcus Johnson has been indicted for capital murder and shooting into Collins’ apartment. Family members say Collins had filed several restraining orders against Johnson. 

Johnson was denied bond and remains in jail. His trial is scheduled for July 28 in Hinds County.  

He was a Jackson police officer for eight months in 2013. Johnson was separated from the department pending disciplinary action leading up to immediate termination, but he resigned before he was fired, Jackson police confirmed to local media. 

Reed, 21, was born and raised in Michigan and moved to Water Valley to live with her grandparents and help care for her cousin, according to her obituary. 

Kylan Jacques Phillips was charged with first degree murder for beating Reed, according to court records. In February, the court ordered him to undergo a mental evaluation to determine if he is competent to stand trial, according to court documents. 

At the bill signing, Gandy said it was bittersweet and an honor to meet the families of other domestic violence homicide victims.

“We were there knowing we are not alone, we can travel this road together and hopefully find ways to prevent and bring more awareness about domestic violence,” she said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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