"There are ways to have an ER, but there are serious consequences if we don't do it right," Joe Walls of White River Medical Center (WRMC) stressed to the crowd at the meeting held Aug. 26 at the Sharp County Health Department, to discuss the progress on a 24-hour emergency care facility in Sharp County.
Walls presented figures, facts and data he has found in his research in the past year concerning an ER in Sharp County. He also gave an update on information he has submitted to Centers for Medicare and Medicaid Services (CMS). While Walls said he feels like 24-hour emergency care is something that could happen in Sharp County, he also expressed that there are no promises being made at this time.
Walls said he has to conform to the policies of CMS which, for our region, is located in Dallas, Texas. CMS sets requirements for provider-based off-campus emergency departments and hospitals that specialize in provisions of emergency service. The emergency facility being discussed for Sharp County is considered an off-campus department for WRMC.
Walls began the meeting by saying, "I am not trying to be harsh, I am simply trying to be absolutely factual, with no innuendos."
Walls proceeded to tell those in attendance about the financials of opening and maintaining a 24-hour ER starting with the cost of the current Urgent Care Center for last year. Walls stated that while the Urgent Care Center is doing better than the year before, it is still losing money.
The Urgent Care's labor cost are currently $349,000 per year and that is just labor, no bills included, Walls said. Urgent Care lost $337,000 last year, but out of the 62 hours per week it is opened it is averaging 70 patience per week. Walls says that while this is an improvement it is still losing money.
Walls then went on to inform the group about what it would take to keep a 24-hour ER open. Walls told them that for WRMC to open this facility, the ER would have to be run exactly like all of the White River Emergency Rooms. This means having a doctor, LPN, RN and receptionist on duty around the clock, 8,760 hours per year. This also means the facility would have considerable cost in equipment that would need to be purchased.
The discussion continued with Walls explaining all of the requirements of CMS. CMS requires the facility to be within 35 miles of WRMC. The Urgent Care location is exactly 34.7 miles. The next requirement is one they are still working on, which is the 75 percent rule. This rule states that 75 percent of the population of Sharp County and its surrounding areas use WRMC. Walls said that in research done by WRMC, 55 percent of patients admitted to a hospital from Sharp County used WRMC.
With all of the figures Walls has determined for an ER, he said WRMC cannot lose $1 million per year. It has to show an increase yearly to succeed. "This is do-able with circumstances but I am not making any promises. I am working on this and have not stopped but I cannot make any guarantees," Walls said.
Judge Brown asked Walls when the county can start coming up with a plan for funds. Walls told Brown if he wanted to, he could come up with a figure for WRMC and he (Walls) would be happy to present it. "Instead of us offering what we're going to pay I would like to see White River come up with what they want," Brown replied.
"This concerns a serious issue we are trying to solve for them (the people), on the other hand, they (the people) need to know we are not making any promises," Judge Brown said.
Brown also stated that it will come down to the people and if the people are willing to take on extra taxes for what they want.
Martin Carpenter of FNBC asked questions about state funding but Walls said he didn't think there was any money there due to the trauma center Arkansas is working on.
Walls told the group that CMS for our region is in Dallas, and they have no health care like this (off-campus) in their region so he thinks they are excited about it and will help all they can and the same goes for the Health Department. Walls stated that those are some positive things on our side.