Catholic Health Initiatives has offered to hand over to the City of Larned the St. Joseph Memorial Hospital building and some of its contents, including all the land it occupies, when it closes Sept. 30.
But the offer, according to Larned city officials, means little without the Critical Access Hospital (CAH) license that Catholic Health Initiatives (CHI), which owns Central Kansas Medical Center and St. Joseph Hospital, refuses to transfer. “A vacant, deteriorating building is of no value to [Larned],” said Kansas State Treasurer Dennis McKinney. “What is of value is the critical care designation.” The Critical Access Hospital designation was established in 1997 to aid small, rural hospitals in operating critical care services. The designation would allow the hospital to receive reimbursements on Medicare and Medicaid. Short of a legislative miracle, Larned can only get the designation if it is transferred from Catholic Health Initiatives – and it must be transferred before Sept. 30. Once the hospital closes and service is interrupted, it will no longer qualify for the emergency services designation. Sharon Lind, chief executive officer of CKMC, explained that “Because of the unknown liabilities and the complexity around transferring it, CHI and our local board of directors are not willing to transfer any licensure for any provider agreement.” Lind said that the decision to offer Larned the building and land came after it was disclosed to them that the city was considering establishing emergency room services in temporary, modular buildings. “Those concessions came by way of new information,” Lind said, “that the city was exploring bringing in portable medical modular trailers to house ER service. The board said that if we have an otherwise vacant building, why wouldn’t we let them use the building? I thought that was a very good-will gesture on the part of the board and CHI.” Mary Beth Herrmann, a member of the Pawnee County Community Health Organization and Administrator of the Pawnee County Health Department, said that Larned would accept the hospital building, but not without the CAH designation. Otherwise, the building is a “financial liability” due to needed reconstruction, she said. Herrmann confirmed that the city was working with an organization that would help them establish emergency health care in temporary, modular building until another more permanent facility could be constructed. “We are going to make it so that we have emergency room services,” Herrmann said, adding that without the emergency access CAH designation, “it’s going to take a lot of tax dollars. We’re trying to get a sales tax implemented; we’re increasing the mill levy. We’re doing everything we can to at least ensure that we have an emergency room. They close their doors Sept. 30. We’re going to have our emergency room up and running Oct. 1. That is our goal; that is what I pray for -- that all of these things will fall into place.” Lind said she suggested to Larned officials that they utilize the St. Joseph Family Practice Clinic building adjacent to the hospital. Central Kansas Medical Center currently leases the building from the City of Larned. “I talked to the city about the options they could use to build out that clinic on the west end,” she said. “They could expand about 30 feet and ad emergency room bays.” In return, CKMC has asked that the City of Larned forgive them the remaining 10 years on the lease contract, which amounts to approximately $750,000. The move would also require Pawnee County to obtain a waver from state and federal agencies to run a freestanding ER as an “urgent type care clinic.” If allowed to become a “federally qualified clinic,” the clinic “could receive additional reimbursement for every Medicare/Medicaid patient they see in the clinic,” Lind said. Charles Moore, Director of Medical Facilities for the Kansas Department of Health and Environment], was unavailable for comment and therefore could not confirm whether a waver would be possible. Herrmann alleged that the cost involved in utilizing the clinic would result in a “double whammy … to the tune of over $600,000 in bonds and $7,000 monthly lease payment.” At press time, Larned officials had refused the offer. In a letter to Larned City Manager Don Gaeddert dated July 23, Kevin Lofton, Catholic Health Initiatives president and CEO, offered in addition to the St. Joseph Hospital building and land, to provide Larned with funding for a new ambulance, salary and benefits for one additional emergency medical technician (EMT) for a pre-determined period, and training for two additional EMTs. According to Larned farmer Tom Giessel, the lack of an emergency room in Larned creates a critical problem that could cost lives, especially when considering he’s often farming far from paved roads. It’s a problem, he said, that an extra ambulance just won’t fix. “If I’m farming up here in northwest Pawnee County and have an accident, it’s going to take half an hour for the ambulance to get out there at the minimum, and you turn around and it’s going to take a half hour to get back to Larned, and then drive another half hour to get to Great Bend,” he said. “I’m dead.” After speaking extensively with both sides, one thing is clear: both hope and pray that the situation -- which has resulted in so much hurt and frustration -- can somehow, some way, be resolved justly and swiftly. As Moore told the SKR in a previous interview, “If CKMC is left with an empty building that’s just going to deteriorate, and the City of Larned is left with no facilities when one is sitting right there, that would be terrible. Then nobody wins.”