Iowa legislature establishes licensure for Rural Emergency Hospitals

DES MOINES — The legislature is sending Governor Kim Reynolds a bill setting up a state process so small Iowa hospitals may be licensed as a Rural Emergency Hospital.

Under federal rules, Rural Emergency Hospitals may discontinue in-patient care, while keeping out-patient services and an emergency room open. Rural Emergency Hospitals get five percent extra in federal reimbursement for treating Medicare patients. Senator Jeff Reichman is a Republican from Montrose, which is a 15 minute drive from the Keokuk hospital that closed last fall.

“Access to health care services is a critical issue in our state,” Reichman said. “…Rural Emergency Hospitals will help rural communities that need health care services, stabilize hospitals that may be struggling in rural areas and help ensure that essential needs for Iowans and specifically for us in Lee County are met.”

Bill backers say it’s likely a Rural Emergency Hospital will reopen in Keokuk. “Both of my grandparents’ lives were saved at Keokuk Area Hospital in the last five, six years, so having access at least to emergency care is very, very important,” Representative Amy Nielsen, a Democrat from North Liberty, said.

Republican Representative Martin Graber of Fort Madison said a constituent in Keokuk recently had to decide whether a relative who’d suffered a stroke should be taken to a hospital in Fort Madison or Carthage, Illinois because Keokuk’s hospital is closed. “There very aren’t many times that you and I get to vote on a bill that means life and death to people,” Graber said. “This one does that. When it’s fully implemented, it’ll make a difference.”

Republican Representative Tom Moore of Griswold said only hospitals in rural areas that can keep an emergency room open 24 hours a day, seven days a week will be able to get this new designation. “This bill will only affect a few rural hospitals, but it is critical in giving them the option to stay a viable, financially stable hospital or, in the case of the Keokuk hospital, the ability to reopen as an REH,” Moore said.

The Rural Emergency Hospital designation will also be available to rural surgical centers that provide outpatient services if the bill becomes law. Senator Janet Petersen, a Democrat from Des Moines, voted for the bill, but warned without higher reimbursement rates for the care provided to Medicaid patients, more Iowa hospitals will have to downgrade to Rural Emergency Hospital status. “I think the bigger question Iowans are asking is what can we do to prevent Iowa hospitals from failing in the first place,” Petersen said.

Representative Dave Jacoby, a Democrat from Coralville, was the only legislator to vote against the bill. Jacoby said the bill did nothing to help urban hospitals, which are also struggling with low reimbursement rates while providing care to rural as well as urban residents.