A rural Nebraska hospital administrator testifies at a Congressional hearing in Washington that federal regulations threaten the financial stability of rural hospitals and restrict their ability to care for patients.
Brown County Hospital CEO Shannon Sorensen has testified before the United States House Ways and Means Committee.
Sorensen tells committee members the federal rule that limits Medicare and Medicaid patients to a 96-hour stay in the hospital interferes with patient care.
“It impedes rural providers in their ability to care for their patients,” according to Sorensen. “Having to focus on regulatory burden interferes with the best judgment of physicians and other health care providers, placing them in a position where our providers are constantly making regulatory decisions to dictate the medical decisions they need to make.”
Sorensen says the Centers for Medicare and Medicaid have changed how they will interpret two regulations; both changes detrimental to rural hospitals.
The first, the 96-hour rule, had some flexibility in the past, according to Sorensen. The rule requires assurances that patients on Medicaid and Medicare will spend no more than 96 hours at a hospital in order for the hospital to be reimbursed. Once treated as an average, the rule now is to be strictly enforced, according to Sorensen.
The second mandates a physician directly supervise certain medical procedures.
“Rural facilities and providers face many challenges without the heavy hand of government,” Sorensen says. “We must be given the flexibility to provide affordable and efficient health care.”
Sorensen says the 96-hour rule doesn’t just interfere with treatment, it threatens a vital source of funding for rural hospitals. The physician mandate creates a real burden for rural hospitals with few resources.
“Our community has one, full-time primary care physician who is supported by two mid-level providers,” Sorensen explains. “With some of the regulatory burdens we face, such as requiring only a physician to oversee cardiac rehab or only a physician being able to order durable medical equipment, home-health, or hospice services, any time our lone physician is not on our campus, takes a vacation, or attends continuing education, significant patient needs have to wait.”
Sorensen backs legislation by Congressman Adrian Smith called the Critical Access Hospital Relief Act. It would remove the 96-hour requirement for patients at critical access hospitals and relax the physician mandate for rural hospitals.