Just weeks before Baton Rouge General Medical Center decided mounting losses of some $2 million a month would force it to shut down its Mid City emergency room, hospital officials thought they were close to reaching a deal with the state that would enable the ER to remain open.
“We had escalated our discussions with the state to come up with an answer, and I think we were coming close,” CEO Mark Slyter says. “But in the last month with everything that was happening with the state budget (which is facing a $1.6 billion shortfall), it just became more and more challenging, but we accept the difficulties they are facing.”
The hospital announced Tuesday it would close down its Mid City emergency room within 60 days, the second time in six months it has made such an announcement. Unlike the threatened closure last summer, however—which was staved off when the state came through with $18 million to help cover the hospital’s cost of providing uncompensated care in the ER—this time state and hospital officials say the shutdown will be for real.
Slyter declines to says specifically what possible options hospital officials had presented to Louisiana’s Department of Health and Hospitals or how much they were asking for. He also won’t say whether Baton Rouge General was pressing for changes to the state’s reimbursement structure, which gives Our Lady of the Lake the lion’s share of reimbursements for providing care for the poor while giving very little to Baton Rouge General and other providers.
Slyter would only say, “We had presented them with some options, but we exhausted all of those.”
Still, the CEO has nothing but words of gratitude for DHH and Gov. Bobby Jindal’s administration, which he says is committed to helping hospital officials try to find new uses for the Florida Boulevard facility.
“They’ve been great to work with,” Slyter says. “We’re looking for other partners to come up with creative ideas to better utilize the capacity.”
One potential option is to expand the hospital’s post-acute care facility. The hospital’s Mid City campus already serves a large elderly population, so using part of the hospital for long-term care or rehab services is one viable option.
“We feel we can do that in a bigger way, but that might take out-of-the-box partnerships with other providers,” he says. “So we’re fortunate to have a very supportive governor and mayor to help us come up with solutions.”
While those decisions will come in the long run, Slyter says for now hospital leadership is “committed to Mid City” and to helping the uninsured and underinsured patients who have relied on the emergency room for medical care transition to what the state is calling a new model of health care. That model will include developing a new urgent care clinic in the immediate vicinity of The General that will see patients who are ill but not suffering from medical emergencies.
Last year, only about 17% of the some 45,000 patients who sought care at the Mid City emergency room—fewer than 8,000—had actual emergencies, Slyter says. What the hospital’s financial picture will look like once the ER is closed, some time in April or May, is still unknown. Most of the facility’s inpatient admissions came through the ER, so Slyter says it’s too soon to say what the impact of the closure will be, except that it will stop the mounting losses.
In the meantime, Baton Rouge General’s Bluebonnet campus has recently expanded its acute care facility with two new floors of inpatient beds, which will free up some capacity in its emergency room. Slyter says he hopes some employees from Mid City can be moved to the Bluebonnet facility, but it is too early to say how many.
“We’re working on that right now,” he says. “We’re optimistic that we will minimize the impact on jobs.”
—Stephanie Riegel
