Commission gives $1 million loan to Lakeland

HALEYVILLE - A $1 million transition loan has been provided by the Winston County Commission to Lakeland Community Hospital in Haleyville to financially sustain the hospital during its ongoing transition from Acute Care to Critical Access designation.
The commission’s loan to Lakeland was part of the Winston County Unification Resolution the commission approved by unanimous vote at its regular meeting Monday, Feb. 9.
At some point, when Lakeland officially received the Critical Access hospital designation last November, no new claims for patient Medicare and Medicare Advantage  reimbursements could  be filed through the Centers for Medicare and Medicaid Services, also known as CMS, under the Acute Care designation, county officials explained.
During Lakeland’s transition from Acute Care to Critical Access, it could take up to at least six months for the payment systems to get caught up from one designation to the next, officials explained.
“The resolution renews the Commission’s commitment to the healthcare and economic growth of our county,” the press release from the commission noted.
The transition from an Acute Care to a Critical Access hospital is a difficult one, meaning during the transition the hospital does not receive any payments for services provided until months later, when the billing system is completed by CMS and their billing contractor, the commission stated.
“The transition was made even more difficult by the government shutdown in October and November of this past year,” the commission’s press release also stated.
“The money we had in reserve, we had to take that because we didn’t have any money because we had already filed for the critical access,” explained District 2 Commissioner Roger Hayes, who is also chairman of the Health Care Authority for Haleyville and Winston County Alabama, which owns Lakeland Community Hospital.
Hayes was speaking on behalf of the Health Care Authority when making that statement.
“In order for the government to get started back up, by the time you get people back to work, you are talking about another two or three weeks, so actually you’re talking close to three or four months that it hurt every hospital, not just us,” Hayes pointed out. 
An Acute Care hospital’s services are similar to that of a Critical Access.  The major difference is Acute Care means the hospital is paid by contracts, versus being paid by cost under Critical Access, according to Lakeland Chief Executive Officer Cherie Sibley.
“In rural America, it costs more to do business,” Sibley stated. “We’re paid based on costs it takes to deliver care here.  That’s the big difference.
“We have to have a doctor in this hospital 24/7.  Whether we see one patient or 50 patients, we are paid the same,” Sibley further explained. 
The transition loan from the commission to the Health Care Authority of Haleyville and Winston County Alabama, will be paid back with interest over the next four years, county officials explained.
The $1 million transition loan is not expected to place the county in a financial bind, seeing that the funds for the loan came from their reserves set aside for use in emergency situations, county officials said.
Sibley explained that anytime a hospital changes status, there are delays in payment.
“The old hospital (status), all the old insurance numbers, anything that is related to that closed.  You have to start new,” Sibley explained.
“You have to set up new contracts with all the payers,” Sibley added. “You have to work with all the insurance companies, all the Medicare companies, to get new contracts to get our new rates.
“What happens is your money stops,” Sibley pointed out. “You need funds to help with the transition. That is common with every Critical Access hospital.  This is nothing new to us. This is just the process.
“No business can run without revenue coming in, so we are very appreciative  to the county and the commissioners for having the foresight to help with this,” Sibley stated.
“Our goal is to pay them back as quickly as possible, with interest,” she added.
Hayes stressed the transaction is a guaranteed pay back from the Health Care Authority to the county.
“It’s not costing the county anything,” Hayes stressed.
When asked the importance of the county’s transition loan to the hospital, Hayes added, “We’re talking about life and death situations here.
“The hospital has to do with economic development,” Hayes added. “The hospital has to do with life and death.
“If you have a stroke, you have a heart attack, you can go to Russellville. You can go to Winfield, but in the time it takes to stop a heart attack or a stroke, to get stabilized, you are 15 or 20 minutes away,” Hayes explained.
Sibley noted the transition loan from the commission stabilizes the hospital for years to come.
“This is the answer to healthcare here in Haleyville,” Sibley said. “This is a way for rural hospitals to succeed in the long term and the county commissioners have the ability to see that.
“What they are putting in place today will benefit years to come.  This money will all come back to the county, not from the citizens’ money, but from the hospital’s money, as we start getting our reimbursements back,” Sibley stressed.
Sibley expressed her appreciation to both State Senate Pro-Tem Garlan Gudger and to U.S. Congressman and Haleyville native Robert Aderholt for their assistance in helping make sure the hospital obtains its reimbursements under Critical Access status.
Sibley thanked Gudger, who worked with Lakeland Chief Financial Officer Wes Sigler on the Rural Investment Program, ensuring that funding would flow back to the hospital appropriately, Sibley explained.
Aderholt was also thanked for receiving the hospital’s Letter of Approval and pushing it through to CMS, according to Sibley.
“He pushed through the red tape to get what we needed done much faster so we could get the designation,” Sibley then pointed out.

Gudger comments on need for hospital

“The hospital is crucial for this area, and we need to do everything we can to keep it,”  Gudger stated.
Critical access designation, Gudger explained, only helps to produce more revenue, which is what is needed to keep the hospital doors open.
“It’s an economic engine for this community,” Gudger continued. “We need to be able to keep people employed there instead of people with health issues having to be transported to another hospital.”
Gudger explained the state is doing a Rural Transformation Program through the federal government funding $203 million, with rural hospitals compiling a plan through the Alabama Department of Economic and Community Affairs.
“They have an advisory board.  They placed me on that advisory board, so that helps us here in this community,” said Gudger, “because if I have a strong voice, then this community has a strong voice.”

Haleyville mayor, Aderholt comment on the need for local healthcare

The City of Haleyville voted in a previous administration to give Lakeland Hospital $1.2 million a year, according to Haleyville Mayor Dr. Ray Boshell. 
“It is very rough to stay sustainable, so we need to find a model that works,” Boshell said.
Boshell said he had been in discussions recently with Aderholt about the local hospital’s changeover to Critical Access.
Aderholt said his office had been working  to help free up needed funding for Lakeland after the changeover to Critical Access caused a delay in Medicare reimbursements.
Aderholt has been actively engaged in protecting access to local health care in Haleyville during this process, according to a press release issued by his office.
“His office worked with Lakeland Community Hospital to support its transition to Critical Access hospital status, providing a long-term solution to strengthen the hospital’s financial security and ensure continued care for area families,” Aderholt’s press release stated.
During the hospital’s transition to Critical Access, the hospital is experiencing a reimbursement issue that threatened its financial stability due to an error by CMS, Aderholt emphasized.
Aderholt worked with both CMS and the hospital to resolve the error and help ensure Lakeland received its appropriate reimbursements, Aderholt’s press release continued.
“I’ll always fight to make sure Alabama’s Fourth District has the resources and support it needs to thrive,” Aderholt stated.
“I’m also proud we helped Lakeland Community Hospital through its Critical Access Hospital transition to provide long-term financial stability,” Aderholt said, “and when a CMS error during that transition threatened the hospital’s reimbursements, we worked fast to resolve it.
“Access to quality health care close to home should never be in jeopardy,” Aderholt emphasized.
Chris Lawson, chief of staff to Aderholt, stressed their focus has been on many rural hospitals.
“We have been able to do mandates through the years to keep them open,” Lawson pointed out, 
“But we’re trying really hard to find sustainable ways.   That’s the key thing with this Critical Access designation, sustainable ways to keep rural hospitals open and profitable so the public is not worried about its closing,” Lawson pointed out.
“We’re working for ways to create sustainable viability for these hospitals, not just keeping them open,” Lawson further emphasized.
Boshell commended Aderholt’s work in supporting Lakeland Community Hospital during this transitional process.
“His involvement helps support its continued viability and the essential care it provides to our community,” Boshell pointed out.
“We are very blessed to have a hospital here,” Boshell added. “Haleyville is very  blessed with all the medical services we have here.  A lot of towns aren’t as lucky as we are to have a hospital here.
“I think the work that has been done by the Congressman will help continue its legacy,” Boshell added.