Aspen hospital should cautiously re-examine Medicare designation
A local doctor correctly raised concerns over Aspen Valley Hospital’s ability to adequately care for its patients while qualifying for special consideration under federal Medicare guidelines.Dr. Mallory T. Harling, an obstetrician and gynecologist in Aspen, questioned whether the hospital should keep its Medicare designation as a “critical access hospital” after one of his patients had to wait three hours longer than she expected before admission to the hospital for a Caesarean section. If AVH had more beds, Mallory’s patient might have received faster care. Hospitals can have no more than 25 beds to qualify for critical access designation. The Medicare system compensates them at a higher rate than other hospitals, a fact that resulted in an extra $1 million for Aspen Valley Hospital last year.Aspen Valley Hospital is one of 25 hospitals in Colorado with the designation. Only hospitals in rural areas qualify; AVH is the only one in a wealthy resort town.When Aspen Valley Hospital first sought critical access designation in 2004, it made sound financial sense. The organization was reeling from years of fiscal mismanagement under the former administration. Massive layoffs and other cuts were only part of the solution necessary to bring the hospital back into the black. Every little bit, including an extra million from Medicare, helped.Harling is correct, however, to call on board members and administrators to re-examine the hospital’s critical access designation now that it is on better financial footing than it has been in years. In a letter to administrators and the board of directors, Harling encouraged them to rescind the critical access designation and look for alternative cost-saving measures so there aren’t bed shortages that hinder admissions.We agree. It’s not acceptable for patients to wait around until someone else checks out before they are allowed to check in, even if it has only happened two or three times in the past few years.But the hospital needs also move cautiously. The financial crisis that forced it to seek critical access designation was significant and had profound effects on the institution and its staff. Rushing to eliminate the designation might mean difficult and unacceptable cuts that would leave the hospital in worse shape than it is even when all 25 beds are full.Aspen Valley Hospital needs to remove the critical access designation and expand its bed base as soon as possible, but not before it’s in sound financial shape.
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