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Tyler County Booster - Local News

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Hospital details challenges at budget hearing

Tyler County Booster

By Valerie Reddell
news@tylercountybooster.com
Tyler County taxpayers will have their final opportunity to share their views on the proposed county budget for the upcoming fiscal year as well as the tax rate for the county's general fund, the road and bridge tax rate and the hospital district tax rate at 8:15 a.m. Friday. At 8:30 a.m. Commissioners will take a record vote on the adoption of the budget and tax rates. A public hearing on the budget was held Monday. Dr. Sandra Wright, Administrator of the Tyler County Hospital (TCH), addressed the court regarding the hospital's proposed tax rate of 20.846 cents per $100, which represents a 2 cent increase — after holding the rate steady for the last two years. A property owner with property at the average value of $58,938 will see their bill increase $12.98 a year. Wright said the hospital has weathered many financial challenges in the last few years. "There have been many regulatory changes and those have greatly reduced reimbursement," Wright said. "While we are getting paid less for our services, our bad debt is increasing." The hospital has seen a decreasing number of in-patient admissions as doctors closed their Woodville practices. Some of them retired while others wanted the advantages of living in a larger city. In an interview following Monday's meeting, Wright said the challenges TCH has faced are the same as those that forced the closure of many rural hospitals in Texas, including Trinity and Crockett. "The remaining rural hospitals across Texas operate on a shoestring and struggle every day to stay open and serve their patients," said Dave Pearson, president of Texas Organization of Rural & Community Hospitals (TORCH). Medicare cuts by Congress in recent years amounted to $50 million in lost revenue to Texas rural hospitals. Expenses related to underpayments by Medicaid are approaching $60 million a year for Texas' rural hospitals, according to Pearson. The area served by these hospitals amounts to 85 percent of the state's geography and 15 percent of the population. The gaping holes left by hospital closures in the state's trauma care network and other vital medical services are having a devastating impact on Texas' economy. "[These rural hospitals] help healthy the workforce that supplies the state's and much of the nation's food, fuel and fiber," Byrom said. "Each Texas rural hospital on average employes 173 people and has an annual payroll of $23 million. Statewide that is more than 22,000 good paying jobs and expenditures of $3.7 billion a year. The combined economic impact of the 163 Texas rural hospitals is more than $18 billion a year. Hospital closures can be a death blow to a rural community, Pearson adds. "Most of the employees and their families will move elsewhere in pursuit of a hospital job.Local businesses suffer and the rural schools suffer, losing money from the state because of declining students. The chances of future economic development are lessened without a hospital. " Here is Woodville, Dr. Wright says Tyler County Hospital and its 120 employees are in the community to stay. "We are not in jeopardy of closing, thanks to the additional revenue from the TCH Foundation," she adds. The foundation has covered many of the capital expenditures required to keep the hospital current with ever changing federal regulations. A recent upgrade in the radiology department cost $70,000 to upgrade the hospital to digital imagery. Continuing to use film x-rays for medical imaging would result in a 20 percent reduction in Medicare reimbursements. Other expenses relate to HIPPA privacy regulations, security audits and software changes — all unfunded mandates. Medicare and Medicaid provide most of the insurance reimbursements for charges incurred by TCH patients. But 30 percent of the patients that visit the Emergency Department have no insurance, Wright said. Many uninsured families use the emergency department as their primary care provider — and it's the most expense way to deliver care. It's better for the hospital and the patient to seek treatment in TCH's clinic. The hospital not only provides 24 hour physicians in the ER, hospitalists care for inpatients who do not have a primary care doctor. Ultimately those accounts are turned over to a collection agency. The bad debt is in addition to the charity care the hospital provides. Patients who meet the hospital's financial criteria become eligible for 40 to 90 percent reduction in their expenses.

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