Randolph County medical center to become Arkansas’ first rural emergency hospital

A Northeast Arkansas hospital will be the first in the state to opt into a program that could bolster federal funding for rural hospitals as an incentive to specialize in emergency and outpatient care.

St. Bernards Five Rivers Medical Center in Pocahontas, part of the St. Bernards Healthcare system based in Jonesboro, will become a “rural emergency hospital” Sept. 1, the system announced Wednesday in a press release.

The federal Consolidated Appropriations Act of 2021 established rural emergency status as a new way for hospitals to be reimbursed for treating Medicare patients. The designation is meant to attract more federal funds to rural hospitals if they reduce or eliminate inpatient services and focus on emergency and outpatient treatment.

Act 59 of 2023 enshrined rural emergency hospital status into Arkansas law and went into effect as soon as Gov. Sarah Huckabee Sanders signed it in February.

Becoming a rural emergency hospital will help St. Bernards Five Rivers keep up with increasing demand for both outpatient and emergency services in Randolph County, hospital administrator Randy Barymon said in the press release.

He also said financial and staffing constraints make it difficult for rural hospitals to provide the care their communities need.

“Recent reports cite that nearly three in ten rural hospitals across the United States may close without making changes,” Barymon said. “As a smaller, rural hospital aligned within a healthcare system, however, we can make proactive changes that better position us for the future.”

St. Bernards Five Rivers will receive Medicare reimbursement rates at 105% for outpatient services, in addition to a “standard monthly facility payment,” the press release states.

The federal Centers for Medicare and Medicaid Services subsidizes critical access hospitals — located no less than 35 miles from other hospitals and maintaining no more than 25 beds — for inpatient treatment of Medicare recipients. Arkansas has 28 critical access hospitals, and they do not receive CMS reimbursements for outpatient care.

St. Bernards Five Rivers is not a critical access hospital because it has 40 beds. Act 59 allows hospitals with a maximum of 50 beds to receive rural emergency designation and the resulting funds.

Hospitals with 25 beds or fewer will retain their critical access hospital designation if they apply for rural emergency status, according to Act 59.

The law requires rural emergency hospitals to keep their emergency departments staffed 24 hours per day and seven days per week with a physician, nurse practitioner, clinical nurse specialist, or physician assistant.

The law also requires hospitals to provide services that do not require patients to stay at the facility for more than 24 hours.

St. Bernards Five Rivers implemented an “enhanced transfer process” in order to comply with this requirement and get patients to larger hospitals, including the primary St. Bernards facility in Jonesboro, the press release states.

The hospital will retain its entire staff after the transition, according to the press release.

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