N.J. congressman helps Deborah, other rural hospitals make case for added U.S. funds

New Jersey lawmakers in Congress say they’ve come up with a bipartisan legislative fix that could mean an extra $5 million a year in federal payments for a hospital in Burlington County.

Years ago, Congress decided that rural hospitals are important, so to keep them open for business, the federal government pays rural medical centers a little bit extra if the hospital cares for a large population of older adults in the Medicare program.

To qualify for the Medicare Dependent Hospital Program, a medical center must be in a rural area, have 100 patient beds or fewer and 60 percent of its patients must be enrolled in Medicare.

Joseph Chirichella, CEO of Deborah Heart and Lung Center in Browns Mills, said his South Jersey hospital should qualify for the added funding, but federal health officials have designated the entire state as “urban.”

“We’re a small rural hospital, that’s how we meet the regulations; we’re not a Jefferson, or University of Pennsylvania or a Robert Wood Johnson Hospital,” Chirichella said.

Medicare’s reimbursement barely covers the cost of the health care services Deborah provides, he said, and that doesn’t leave much money to invest in needed new equipment.

Right now, a hospital foundation provides the funding needed to keep the hospital going, Chirichella said.

Deborah’s chief financial officer Grant Leidy said the reimbursement increase would help the hospital increase workers’ wages.

“Whether it be an OR tech, whether it be a cath lab nurse, whether it be a radiologist, we’re a little behind in terms of what we pay versus the average,” Leidy said.

Hospitals counting on legislative fix

Hospital executives have already asked the Centers for Medicare & Medicaid Services to close what they say is a loophole. Now, they’re hoping a new proposal from U.S. Sen. Bob Menendez, D-N.J., and U.S. Rep. Tom MacArthur, R-N.J., will give them the rural recognition — and payment boost — they seek.

“This really shouldn’t require legislation in my view,” MacArthur said.

But after looking for administrative solutions, the legislators crafted a bill that would give Medicare Dependent Hospital status to rural hospitals in mostly urban states.

“I drove from Ocean County, I drove through the Pine Barrens, I went 20 minutes without seeing a house. This is not urban New Jersey, this is a rural area that deserves to be included,” MacArthur said.

If federal administrators would visit Browns Mills, they’d see that too, he added.

Maggie Elehwany, vice president of government affairs and policy for the National Rural Health Association, said 76 rural hospitals have shut down since 2010.

“That has to do with a lot of things — other cuts, too,” she said.

After the Affordable Care Act passed, she said, health care policy planners assumed that — as many more Americans gained health insurance — rural hospitals would not have to provide as much charity care.

“It hasn’t really worked out like that,” she said.

Her lobbying group has offices in Washington, D.C.