State reacts to BR General MidCity emergency room closure plans

As Baton Rouge General moved to close its MidCity hospital’s emergency room, the Jindal administration indicated Wednesday it might come up with funding to stop the shut down of the only facility between Zachary and south Baton Rouge to treat life-threatening medical crisis.

The General’s board of directors decided to shut the emergency room Nov. 1, a casualty of growing red ink associated with uninsured patients entering its doors.

“It’s gotten to be unsustainable,” said the General’s medical director Dr. Floyd “Flip” Roberts.

Democratic state Sen. Yvonne Dorsey-Colomb said Kathy Kliebert, Jindal’s health agency chief, told her Wednesday morning that some financial relief would be forthcoming.

“They said they have found the money,” said Dorsey-Colomb, who lives five blocks from the MidCity hospital. “From my appreciation it is to help them for this year and they are going to work on something to sustain them for the long term.”

Dorsey-Colomb said she understands the General’s board will have a meeting to consider rescinding the emergency room closure decision.

The closure announcement apparently put pressure on the administration, which had declined past overtures to come up with a solution to the growing problem of reimbursement for uninsured care. The General reported losses of $1 million a month. Officials projected the losses would reach $20 million next year.

“It’s been horrible,” said Dorsey-Colomb, who has been involved in discussions between the Jindal administration and the General, a non-profit, acute care community hospital that opened as Baton Rouge’s first hospital in 1900.

State Department of Health and Hospitals Secretary Kliebert said in a email Wednesday afternoon that the administration is working with the General, whose top officials did not return calls Wednesday morning. “Our discussions with the Baton Rouge General leadership this morning confirmed that, as a result of this additional funding, they will continue to operate the ER. We’ll be working with all of our regional health care partners to develop a plan that ensures the sustainability of emergency services in Mid-City Baton Rouge,” Kliebert wrote in an email.

Medical Director Roberts said the General’s MidCity campus was impacted by the April 2013 closure of LSU’s Earl K. Long Medical Center, and the charity hospital’s mental health emergency room extension, as well as the relocation of Woman’s Hospital.

“It’s killing access to care in my area,” said state Rep. Ted James, who had just learned of the planned closure.

Our Lady of the Lake Regional Medical Center, which the Jindal administration contracted to handle the services that had been provided by Earl K. Long, and Lane Regional Medical Center, in Zachary, can’t afford to take any more indigent patients, said James, the Baton Rouge Democrat in whose district the General MidCity hospital sits.

The MidCity emergency room has received nearly 400 additional uninsured patients every month, a 30 percent increase, Roberts said. In addition, there’s been a 60 percent increased in uninsured psychiatric consults; and a 70 percent increase in surgeries provided to uninsured patients, he said.

One of every three patients cared for at MidCity is uninsured, care for which the hospital receives little, if any financial reimbursement. Physicians also are not reimbursed for the services they provide, Roberts said.

“This loss which we attribute to a significant increase in ER visits and (resulting) hospitalizations and surgeries ... are simply not sustainable to preserve our hospital system and the services we provide,” said Dr. Evelyn Hayes, chairman of the General’s board of directors. “It was a difficult decision. It was with sadness and heavy heart that we decided this should be done.”

Hayes said General Health will continue to operate its MidCity hospital and remain an active part of the community just as it has for the last hundred years. Its internationally reknowned burn unit will not be impacted, she said.

“We will focus on some quality programs” such as the nationally-certified senior services offered within the hospital, out-patient cancer treatment care, behavioral health and continued emphasis on graduate medical education programs for physician training, Hayes said.

“We will maintain acute care services through a direct admitting process,” said the General’s president and CEO Mark Slyter. “This is a realignment of services....Mid City will be here for many years to come.”

“It’s very difficult for us,” Slyter added. “We have been put in this situation ... The board struggled with the heart-wrenching decision we had to make.”

Officials of MidCity, located on Florida Boulevard at Acadian Thruway, and Lane Regional have complained about increased use of emergency rooms by the uninsured and lack of reimbursement since LSU closed Earl K. Long Medical Center in north Baton Rouge in April 2013. The two hospitals are the closest to the shuttered Airline Highway facility known as the Earl.

The LSU hospital closed as part of the Jindal administration’s plan to privatize operation of the state’s charity hospital system, previously run by LSU. LSU partnered with Our Lady of the Lake Regional Medical Center located off Essen Lane in south Baton Rouge for patient care and medical education programs. It constructed an urgent care center a few blocks from the Earl.

Follow Marsha Shuler on Twitter @MarshaShulerCNB. For more coverage of the state capitol, follow Louisiana Politics at http://blogs.theadvocate.com/politicsblog/.