A physician-owned hospital in Dayton — which has been locked in an anti-trust lawsuit for years against Premier Health hospitals — might now have to close not because of competition but because of a change in the way the federal government defines what’s a “hospital.”
Federal regulators no longer consider Medical Center Elizabeth Place to be a hospital as of Jan. 18 so it can no longer bill Medicare and Medicaid.
“It had nothing to do with clinical quality. It had nothing to do with the care that we render or the community need for that matter,” Elizabeth Place CEO Beth Johnson said at a Monday afternoon press conference. “It was strictly based off of CMS’s (U.S. Centers for Medicare and Medicaid) interpretation of what constitutes a hospital.”
The center lost its hospital status because the 12-bed facility sometimes had too low of a volume of patients admitted to count as a hospital under federal standards.
The hospital remains open for business for now and hospital officials are still trying to change U.S. Centers for Medicare & Medicaid’s decision. Johnson said if given more time, the hospital could have enough patients admitted per day to meet federal standards.
U.S. Representative Mike Turner, R-Dayton, U.S. Sen. Sherrod Brown, D-Ohio, and U.S. Sen. Rob Portman, D-Ohio, on Jan. 17 wrote a joint letter to the federal department requesting the hospital be given more time to meet the requirement.
With about 60 to 65 percent of its patients covered by Medicare or Medicaid, hospital leaders said this threatens the hospital’s ability to stay in business.
While Medicaid and Medicare typically pay less than commercial insurance, the majority of hospital patients are covered by the two public health insurance programs. On average, about 74 percent of Dayton-area hospital patients are covered by either Medicare or Medicaid.
While a relatively small hospital in Dayton — with about $55 million to $60 million in annual gross revenue — Medical Center at Elizabeth Place made headlines when it filed a suit claiming the four Premier Health hospitals were conspiring against competition in a way that violated anti-trust law.
The suit accuses the hospitals — Miami Valley, Good Samaritan (which has since closed), Atrium Medical Center and Upper Valley Medical Center — of working together to block its access to insurance contracts and illegally drive down competition. Premier has denied the allegations.
Premier declined to comment for this story.
The status of the case was unclear Monday.
Elizabeth Place officials previously said Premier’s actions forced the center in 2009 to sell a partial ownership stake to Kettering Health Network, the only other hospital system in the Dayton area.
Hospital officials at the press conference touted its quality of care and above average patient satisfaction surveys.
“People would like to see us go away. The competition would. And we’re not going to do it because we’re doing everything we can not to. We feel very, very strongly that we’re doing the right thing,” Johnson said.
Johnson said this threatens the jobs of the 90 people who work at the 12-bed, four operating room hospital, which opened in 2006 in the former St. Elizabeth Hospital campus.
She said the hospital is being punished for having short hospital stays when that is what Medicare and Medicaid have been pushing for.
“It will be a terrible shame if they have to look for additional employment,” Johnson said.
She said the hospital is an asset for west Dayton as well as for the whole city and for the region. She said city officials are proud of how much activity there is today at the former St. E’s campus and the hospital is a key driver of that.
“This is a hospital that is working very efficiently. It’s a valuable asset for all the city of Dayton,” said Mayor Nan Whaley, who had also sent a letter to Medicare and Medicaid requesting Medical Center at Elizabeth Place be given more time to meet standards.