Tulsa World: 2 rural hospitals struggling

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2 rural hospitals struggling
The Bristow and Fairfax hospitals lose their management firm.

Jim Clough, Cleveland Area Hospital CEO, said when the hospital cut ties with its management company, the hospital's financial situation turned around. SHERRY BROWN / Tulsa World

By KIM ARCHER World Staff Writer
Published: 8/24/2009 2:29 AM
Last Modified: 8/24/2009 3:33 AM

Two small rural hospitals are struggling to stay afloat since the company that operates them appears to be in financial distress.

A private, Tulsa-based hospital management firm, Community Partners LLC, had operating lease agreements with facilities in Fairfax and Bristow. The company can no longer afford to operate the hospitals, said Val Schott, director of Oklahoma State University's Center for Rural Health.

The potential closing of those hospitals could have implications not only for the health of the towns' residents but their economies.

Bristow Medical Center and Fairfax Memorial Hospital are now looking for new hospital management companies to oversee their operations, Schott said.

"One of the things we have to do is keep these institutions open and viable," Schott said.

In Bristow, civic leaders are feverishly working to find some working capital to keep their hospital open.

"We're doing everything we can to survive," said Peter Kelly, a member of the Bristow Medical Center Foundation. "Unfortunately, there are no other entities in town to provide working capital."

Community Partners recently notified the hospital it could no longer afford to operate the facility. Kelly said he doesn't know when the company will pull out.

"I start by thinking of the faces of the people out there," he said of the hospital's 63 full-time employees. "If it closed, Bristow's economic efforts would grind to a halt."

And it would put people's lives

in jeopardy because they're unable to get to an emergency room in a timely way, he said.

"I look at the peace of mind a 24-hour emergency room provides," Kelly said. "There is no way to overstate the impact of what the closing of that hospital would do."

In Fairfax, hospital board member Bob Stephens declined to provide specifics, but acknowledged difficulties. "I'm not at liberty to say much. There is a problem. But we're not going to let the doors close," he said.

Rural hospitals provide essential health care services to nearly 54 million people in America, including 9 million Medicare beneficiaries.

Throughout the country, these facilities are facing increasing pressure amid declining Medicare payments, modest assets and financial reserves, and a higher percentage of Medicare patients, according to the American Hospital Association.

These facilities are critical for people who live far from urban hospitals. Many rural hospitals provide primary care in their communities, officials said.

Rural hospitals also are often the largest employer in their communities.

"You've got to keep open and working and doing high-quality work," Schott said. "But you can't stay open without local support."

Community Partners took over Pawnee Municipal Hospital in 2006. But as city leaders were about to submit a proposal to extend its relationship, the company backed out, said Pawnee Mayor Tom Briggs.

"I don't know why. They just said, 'That's OK. We're not interested,'" he said.

After exploring options to keep the hospital open, city leaders had no choice but to close in August 2007.

"We had to upgrade our ambulance service, provide extended training with our EMTs and work with LifeFlight," Briggs said.

Although Cleveland is just 21 miles away, he said it can take too much time to get there during a life-threatening emergency.

"If you're going down Highway 64 and get stuck behind a hay truck, you're doomed," Briggs said.

Meanwhile, Cleveland Area Hospital has become a success since taking back operations of its facility from Community Partners, said Jim Clough, the hospital's chief executive officer.

"It was a very bitter divorce," he said. "The partnership was not a good fit."

Now owned by a city trust, the facility was looking at $700,000 in operating losses a year ago. This year, the hospital turned a $340,000 profit, Clough said.

"A lot of that is attributable to getting out from under them," he said.

The city already had reserves from a penny sales tax it could use to support the hospital, and local banks helped establish a line of credit for the facility, Clough said.

Cleveland Area Hospital is the only such facility in Pawnee County, serving a population of some 25,000, he said.

Management company’s status unclear

It is unclear whether Community Partners LLC has gone out of business, but rumors are circulating that it has. More than a dozen calls to various extensions at the company’s Tulsa offices over two days went unanswered. Once, a woman answered but declined to answer questions. She supplied the office number of her supervisor. a call to that number went directly to voice mail and a message wasn’t returned.

according to a 2006 Tulsa World story, the company was considering taking over operating leases for facilities in Cleveland, Bristow, Pawnee and Wagoner because Hillcrest HealthCare System decided to terminate its operating agreements with those hospitals. Community Partners had already taken on Fairfax at that time.

Kevin Gunn was mentioned in that story as chief operating officer and his name was among employees listed in the company’s telephone directory this week. a call to what was believed to be his home number in Claremore was not returned.

Kim Archer 581-8315
kim.archer@tulsaworld.com By KIM ARCHER World Staff Writer

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Some reader comments for this story were copied from "Rural hospitals in Fairfax, Bristow struggle," which was published on 8/23/2009.

	Report Comment Santa Fe Train, Riding The Rails (8/23/2009 8:16:52 PM) Are the problems non pay, or what. If it's non pay is it the emergency room being misused? How much has been written off for uncollectible patient accounts? In order to find a solution you have to know what the problem is.
	Report Comment Four Sixteen Rigby, Tulsa (8/23/2009 9:20:28 PM) Nothing new here. I remember when there were lots of small hospitals around in various small towns. Afton had one. Miami had one. Holdenville had one. There were many others.
	Report Comment Bullhead, Nicut (8/23/2009 10:47:34 PM) Santa Fe, all ER's are misused. That's why the Indian hospital had to start a fast track clinic at night. People can't afford to miss work so they show up after 5 pm to see a doctor to keep them going. I think the night clinic at Hastings is the best thing that could have happened to the NAs. They hand out the antibiotics and other non emergency meds and send the patient on their way. A lot of what is wrong with these small town hospitals are the product companies who sell a 2 dollar pill or box of kleenex to the hospital for 19 dollars who turns around and has to bill the patient 39 dollars for the 2 dollar product. No one can afford it. This is where the President needs to focus on. IMHO anyway.
	Report Comment KarenD, (8/24/2009 12:04:23 AM) Last I heard Miami still has their hospital.
	Report Comment Thunder196, Tulsa (8/24/2009 12:09:12 AM) Yes Miami still does, I just took my mom to the hospital about a month ago. She doesn't live in Miami but she lives close to Miami.
	Report Comment Thunder196, Tulsa (8/24/2009 12:23:17 AM) Bullhead Your right about the emergency rooms not used as intended. I waited for 9 hrs at St. Francis emergency room to see a doctor. From about 6pm left at 4:30am. EMSA kept bringing people. Found out St. John had put into affect their divert program. That's when any patients that are stable St. John diverts them elsewhere. EMSA patients come before all the others. Which I have no argument with that. That's why they are trying to cut out diverting EMSA patients. In my situation I was sent to emergency room by a med center. They wanted to make sure I didn't have a blood clot. There were so many people in the emergency waiting room there were patients standing everywhere and was still like that when I went home at 4am.
	Report Comment Thunder196, Tulsa (8/24/2009 12:26:42 AM) 4am=4:30am
	Report Comment Four Sixteen Rigby, Tulsa (8/24/2009 5:31:12 AM) Thunder: Miami had two. Miami Baptist, which is still there and is now owned by Integris, IIRC. And Miami Bradshaw, which was smaller and closed.
	Report Comment Oldfatdude, Whoville (8/24/2009 10:18:10 AM) Question to TW - do any law enforcment or other agencys have plans to investigate Community Partners LLC? TW - "Now owned by a city trust, the facility was looking at $700,000 in operating losses a year ago. This year, the hospital turned a $340,000 profit, Clough said. " Seems like if a hospital was losing money under Community Partners LLC control and went to a profit under city control, something might have been wrong. Especially since all republicans know that the gov can't run any kind of health care program.
	Report Comment bristow1, Bristow (8/24/2009 11:57:12 AM) I don’t know about Cleveland but I do Bristow. I know for a fact Community Partners did not pay for the employee’s health and retirement insurance after the employees paid and it was a mad scramble to take care of it. Our hospital has been threatened with cut of lab supplies and many other hospital supplies because of lack of payment by Community Partners. Many on our town question Community Partners abilities to run a hospital. If that is integrity I will eat your hat. BEWARE VINITA!!
	Report Comment CattyAmy, (8/24/2009 4:14:33 PM) It is a fact that Community Partners did collect money to pay for health insurance that was not paid to the insurance company. Immagine how you would feel going to the pharmacy and finding out you no longer had insurance as the bristow hospital employees did on approx. July 15th. To make matters worse the insurance company wants the money back that they paid out to pharmacies, doctors, etc. during the first part of July when they hadn't yet gotten tired of Community Partners excuses. The employees are getting calls from the insurance company wanting money back. The previous poster is refering to the hospital in Vinita that is run by a relative of the president of Community Partners. It's all a sortid story that will go on a little longer before Bristow is hung out to dry.
	Report Comment BristowMom, (8/24/2009 6:40:34 PM) I am mad myself about the whole situation in Bristow. Does anyone know why this company is not being investigated? Have any crimes occurred? I have relatives up around Afton, Oklahoma and I will make sure to warn them about that hospital up there and this company. It does not sound good. I think a whole lot of innocent people are paying the price.
	Report Comment I Voted For Marvin, Don't Blame Me (8/24/2009 7:29:04 PM) Hospitals are definitely not run like they used to be. I had a doctor tell me one time, hospitals are not the same as they were years ago. He wasn't implying for the better either.
	Report Comment Harold Brookens 1, Tulsa (8/24/2009 7:44:58 PM) And who says our health care system isn't broken. It isn't broken. It's corrupted like a hard drive. Corrupted by mismanagement, inflated charges, incompetence, fraud, greed, and most of all by millions of users who cannot afford to pay. All which cycles around forcing those who can pay to pay more to cover the cost of those who don't. And now with the possible closing of these two facilities, how soon will it be before their patients are diverted to Tulsa hospitals and we have to pay for them too? Be prepared, nation wide if this swine flu breaks out as predicted this fall. ER's in Tulsa, everywhere will be overwhelmed 24/7. Patient care will be compromised for everyone. Car accident victims, heart patients, everyone. And the hospitals will be left holding the bills as uncollectible. Some hospitals might become desperate and file lawsuits placing liens on patients assets, however meager those assets may be. Just a complete mess. No health care in America is not broken. It's a corrupt hard drive and needs to be erased and replaced.
	Report Comment Polar Bear, (8/24/2009 8:43:29 PM) Why are the Tea Part people so in love with Corporate run health care.The search for big profits closes small much needed Hospital.Focus on Health not corporate ,non competitive prifit please...As The World Burns.....
	Report Comment not your friend 2,,,, missy, no thanks (8/24/2009 11:37:09 PM) yeah yeah yeah,I heard that one of these hospitals let some man lay outside(passed out)in the parking lot and that they(hosp.staff)stood inside and watched because it was against their policies to go out and get him from the parking lot because he did not call the hosp.for someone to come and get him and all he had to do was make it to the door,that may be why one of these hosp.is in trouble,oh the horror stories I could tell,really hair raisin.
	Report Comment CattyAmy, (8/26/2009 2:03:22 PM) Oh please tell us more missy. Make my hair raise. Try and be a bit more specific though, sweetee.
	Report Comment FuglyDude, (8/26/2009 5:41:11 PM) hospitals are so corrupt they make me sick. have ya'll read theangrypatient dot com patient diary? seriously, it's going to be the next horror movie.

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