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New hope for a struggling hospital in southwest Kansas

Bryan Thompson
/
KHI news service

From the Kansas Health Institute:

A southwest Kansas hospital on the verge of having to close its doors appears to have a new lease on life, thanks to a recent management contract with an Oklahoma company.

The Hamilton County Hospital in Syracuse has been struggling financially for years. This March, Hamilton County Commissioners refused to put any more burden on the county’s taxpayers to support the hospital.

Instead, they formed a steering committee to look for other options to preserve access to health care.

Local Ford dealer Mark Davis, who served on the committee, said closure seemed imminent because of the hospital’s financial situation.

Davis said his oldest son would like to move back to Syracuse with his wife and new baby. But he’s an airline pilot and is often away from home.

“I told him no, you can’t come home if there’s not 24-hour emergency care,” Davis said. “She can’t get up in the middle of the night and have a baby with a 104 temperature that needs to go to an emergency room, and know that maybe there’s a blizzard going on here, or whatever, and that she’s got to get to wherever, Garden City, to see a doctor.”

The committee requested proposals from other hospitals in the area. Ron Munyan, chairman of the hospital board, didn’t like the responses they received. In fact, none of the area hospitals proposed a way to keep the hospital in Syracuse open.

“One hospital wanted just to do the clinic and close the hospital. So what happens when somebody needs to go into a bed? Well, you go to Lakin, Johnson or Tribune or Garden City, all right? So that was not too good of an idea,” Munyan said.

Munyan said the hospital’s troubles have been building for years.

“It didn’t just happen overnight. Years ago, you know, we’ve had some bad CEOs that have came in, and we’ve had some problems keeping good doctors, and a lot people are taking their business to Lakin or Johnson or Tribune,” he said.

Interim hospital CEO Rob Rawlings told the board at a meeting last month the hospital had barely enough money in the bank to keep paying employees.

“We should end the week with about $128,000 in cash,” Rawlings said. “It looks like we can get through, now, it looks like the second week of May, assuming everything stays the same.”

However, everything is not staying the same — due to blind luck or what Davis called “divine intervention.”

Either way, Dr. Richard Carter, from Edmond, Okla., happened to be at a hospital in the Oklahoma panhandle a few weeks ago. Someone there mentioned the problems at the Hamilton County Hospital, so Carter boarded his private helicopter and headed for Syracuse.

Carter, a family practice doctor, operates Carter Professional Care, which specializes in rescuing ailing rural hospitals.

Davis said he and the other steering committee members were as thorough as they could be in checking on Carter’s track record. He came away impressed.

“Carter’s group moved into five critical access hospitals, as we are, in Oklahoma. One of them was actually four days away from closing when they first heard about it,” Davis said. “And all of those hospitals that they have taken over management of are still open. Not much better endorsement than that.”

Carter said the Hamilton County Hospital has been losing between $80,000 and $110,000 a month — but even at that, it’s still in better shape than some rural hospitals he’s seen.

“The average hospital we come into contact with, usually we try to find emergency financing in the tune of about $1.5 million for operating capital just to sustain the operation, the losses they’ve been having, for the next year to year and a half. That’s fairly common,” he said.

But Carter is optimistic that his team can put the Hamilton County Hospital back in the black — so much so that he’s signed a 10-year agreement to manage the facility.

While he expects to lose money on the operation for the first two or three years, he thinks it will turn around. The key to saving rural hospitals is not to keep cutting services to hold costs down, he said, but to provide quality care close to home.

“I believe that 80 to 90 percent of health care can be achieved locally, at a relatively low cost. We’re just not seeing that,” Carter said. “Like I said, we’re seeing sometimes 10 to 20 percent utilization of the facilities.”

Rural residents tend to have higher rates of obesity, high blood pressure and diabetes but less access to quality medical care, he said.

“All of the physicians I know really care about patient care and patient health,” he said. “And as a family practice doctor, you look at, where is that needed the most? And it’s definitely the rural community.”

“I believe that 80 to 90 percent of health care can be achieved locally, at a relatively low cost. We’re just not seeing that.” - Dr. Richard Carter of Carter Professional Care

That is a common theme at rural hospitals in Oklahoma, Kansas and across the country, Carter said.

“What we’ve seen is that there’s been an evolution towards transferring most patients out, even patients that could be managed at a rural health facility,” he said. “We go in and we recognize what a facility is capable of, what its potential is in patient management, and then we try to help that facility try to achieve its potential in a very quality fashion, and as a result we see utilization of the hospital increase.”

Patients should be transferred to a larger facility when specialty care not available at the local hospital is needed, he said, but once those patients are stabilized they should return to the local hospital.

“Beyond a certain number of days after those procedures, they (larger hospitals) will actually be losing money, so they try to find placement where you don’t need acute care, a high level of care, but you need therapists and nurses engaged with you to transition you back to home as quickly as possible,” Carter said. “Why would somebody in our community not want to come back to our hospital in Syracuse if we can provide that service for them, and we can do it at a very high level?”

Carter said that’s good financially for the larger hospitals and the rural hospitals, and being closer to family and friends generally is better for the patient, too. With an estimated one-third of all critical access hospitals at risk of closing, it’s likely many people will be watching to see how well this model works.

The nonprofit KHI News Service is an editorially independent initiative of the Kansas Health Institute and a partner in the Heartland Health Monitor reporting collaboration. All stories and photos may be republished at no cost with proper attribution and a link back to KHI.org when a story is reposted online.