{"database": "press", "table": "releases", "rows": [["https://www.hydesmith.senate.gov/hospital-fighting-status-change", "Hospital Fighting Status Change", "2025-10-28", "2025", "2025-10", "Republican", "Senate", "MS", "Cindy Hyde-Smith", "H001079", "www.hydesmith.senate.gov", "hydesmith", "https://www.hydesmith.senate.gov/newsroom", "scraper", "By Paul Keane\n\nMEADVILLE \u2013 Major changes could be coming to the Franklin County hospital if congressional or state changes aren\u2019t made before Jan. 15, 2026.\n\nFranklin County Memorial Hospital leaders have been working with state and federal officials to try and get a decision from the Centers of Medicare & Medicaid Services (CMS) to overturn a ruling from Jan. 15 of this year moving the facility from a Critical Access Hospital (CAH) to a Rural Emergency Hospital (REH). The designation would make a huge difference in the amount and kind of services the local hospital could offer to residents.\n\nThe letter from CMS was part of the normal recertification for the hospital. The change in status seems to result from requirements that a CAH facility be located a certain number of miles away from similar services.\n\nIn the Jan. 15, 2025 letter, Melissa Foreman, RN, CCM, CPHQ \u2014 the Acute and Continuing Care Branch Manager for the Center for Clinical Standards and Quality \u2014 stated the following: \u201cDuring the recertification review, Franklin County Memorial Hospital is located less than 35 miles from King\u2019s Daughters Medical Center in Brookhaven, of which there is not 15 miles of secondary roads available between the hospitals and therefore found to be noncompliant with the distance requirement to remain a CAH.\u201d\n\nThe letter also asks for documentation that would change the mileage requirements be submitted by Feb. 14. \u201cIf no documentation exists, your facility will need to convert to another provider type in the Medicare program by Jan. 15, 2026 to avoid termination of the Medicare provider agreement between Franklin County Memorial Hospital and the Secretary of the Department of Health and Human Services.\u201d\n\nIn order to obtain or maintain a CAH designation, the facility must be located more than a 35-mile drive on primary roads (or, in the case of mountainous terrain or in areas with only secondary roads available a 15-mile drive) from a hospital or another CAH. To determine the driving distance, federal highways \u2014 including interstates, intrastate, expressways of any other numbered federal highway with two or more lanes each way or a number state highway with two more lanes each way.\n\nIt was believed for many years that one reason FCMH had the CAH designation was due to the fact that it was more than 15 miles along rural roadways to Jefferson County Hospital. Roughly three years ago, that facility changed its status to an REH.\n\nThe local facility is roughly 32 miles away from King\u2019s Daughters, meaning the 35-mile rule could not be used for CAH designation.\n\nThe local facility has enjoyed the CAH designation since 2009, but now it is in jeopardy if something isn\u2019t worked out before Jan. 15, 2026.\n\nSince receiving that letter, FCMH Administrator Michael Boleware, Hospital Board Attorney Lane Reed and countless other local people have been working to hold onto the CAH status, which has been in place since 2009.\n\nA change from a CAH to an REH will mean the hospital won\u2019t provide acute care and there will be no in-patient services available.\n\nBoleware said that if an elderly patient with something as simple as pneumonia could stay in the facility for 24 hours but then would have to be moved to another facility for extended care. The change in status could also affect employment in a negative way.\n\n\u201cPrior to becoming a Critical Access Hospital in 2009, there were 64 employees at the hospital,\u201d Boleware said. \u201cNow, we have 229 employees. We\u2019ve been able to grow because of the CAH status. \u201cIt gives you the ability to grow and grow slowly as you increase services and also increase your patient volume. That\u2019s what we\u2019ve been doing for the last 15 years \u2014 enjoying slow growth.\u201d\n\nBeing designated as an REH would cut into patient volume, meaning the local facility would have to find ways to be more efficient.\n\n\u201cAn REH facility is volume driven,\u201d Boleware said. \u201cIn an area like Franklin County, where is that volume going to come from? \u201cWe\u2019re trying to be innovative. We have been meeting with department heads for months trying to find out what more we can do in regards to labs being done in-house, more radiology services and more respiratory services. We\u2019re trying to think outside the box and find ways that we can be innovative while being as efficient as possible.\u201d\n\nLocal officials have also been speaking with congressional leaders \u2014 including U.S. Sens. Cindy Hyde-Smith and Roger Wicker \u2014 and have even met with White House officials in an attempt to either have the decision overturned or at least an extension given until the issue can be resolved. So far, according to those officials, every attempt has \u201crun into a brick wall.\u201d\n\nThe office of Hyde-Smith provided the following response: \u201cI am very concerned about the Franklin County hospital losing its Critical Access Hospital designation, which has allowed the hospital to remain financially stable as it provides a multitude of health care services to Meadville and the surrounding communities,\u201d Hyde-Smith, said. \u201cI do not want to see the community to suffer from a lack of access to that care. I continue to work with my colleagues in the Senate, the Trump Administration, CMS and the Governor\u2019s Office to find a path forward that would allow the hospital to retain its CAH designation. We\u2019re not there yet, but this remains a top priority for me.\u201d\n\nHyde-Smith serves on the Senate Labor, HHS and Education Appropriations Subcommittees and has worked to use the appropriations process to address the CAH designation issues, the statement point out. It also says the Senator has aggressively reached out to CMS, including CMS Administrator Dr. Oz, regarding the local facility and other rural facilities in Mississippi.\n\nThe statement further says the senator is continuing to encourage the Senate Finance Committee to consider a legislative fix for the CAH issue, which also affects other rural health care providers across the country.\n\nWicker said he is willing to continuing working on behalf of the local hospital. \u201cSenator Hyde-Smith and I are working with elected officials and the hospital to retain Franklin County Memorials\u2019 current designation,\u201d Wicker said. \u201cIt is imperative rural communities in Mississippi have access to quality health care. Hospitals in Mississippi must have the resources they need to serve our constituents well.\"\n\n\u201cWe\u2019ve been working on this issue for nine months now,\u201d Boleware said. \u201cWe\u2019ve met with CMS, White House and congressional leaders and staff. There are many avenues for a waiver and we\u2019ve explored nearly all of them.\n\n\"One thing that we constantly hear is that a waiver for us would open the floodgates for other hospitals. We say that it would be only a leak in the faucet.\u201d\n\nBoleware said the process of fighting for the designation has been challenge at best. \u201cWe\u2019ve beat our heads for nine months with this issue,\u201d he said. \u201cWe\u2019ve had multiple meetings with our senators, our congressmen and everyone we could meet with. It seems like everywhere we go, there is a roadblock.\u201d\n\nThe REH designation, established by CMS in 2023, is intended to help rural hospitals remain open and financially sustainable by focusing on emergency and outpatient care. Under the REH designation, though, the local hospital would not be able to provide general inpatient services. Under this model, FCMH would continue to provide:\n\n24-Hour Emergency Services\n\nOutpatient diagnostic, imaging, laboratory and rehabilitation services\n\nA comprehensive Ventilator/Tracheostomy Weaning Program\n\nInpatient Swing Bed services for patients requiring short-term rehabilitation or skilled nursing care following hospitalization\n\nWhile the hospital would no longer provide general inpatient admissions if it receives the REH designation, the programs that will be continued will allow the facility to care for patients locally during recovery, rehabilitation and long-term respiratory hospitalization. This includes Inpatient Swing Bed Services, which provides short-term rehabilitation and skilled nursing care for patients recovering after hospitalization \u2014 for example, following surgery, stroke, or injury. These services are focused on helping patients regain strength and independence so they can safely return home, and are not intended for active treatment of conditions such as pneumonia or urinary tract infection.\n\nBoleware said plans are to continue the Ventilator/Tracheostomy Weaning Program but that things might have to be scaled back somewhat. \u201cOne thing that would change is there may not be one respiratory therapist for each patient,\u201d he said. \u201cThat is not a definite, but it is something we would have to look at doing.\n\n\u201cLet me say, though, that our staff can handle more than one patient at a time. I have the utmost confidence in our staff and our therapists to work with multiple patients and still provide the same quality care.\u201d\n\nThere is hope that money from the \u201cBig Beautiful Bill\u201d could assist in the issue. A total of $50 billion was allocated to the state for rural healthcare transformation, with $25 billing being awarded to facilities through a competitive grant program and other other $25 billion being administered by Gov. Tate Reeves.\n\nBoleware and Reed both said the competitive grant program is not an option at this time due to the fact that guidelines for applying for a grant have yet to be established. With the current shutdown of the federal government, there is no timetable for when those guidelines and applications will be available, but it is not expected to happen before Jan. 15, 2026.\n\nThe administrator said while he has helped move facilities into CAH status, this is the first time he\u2019s dealt with a facility being given an REH designation. \u201cI\u2019ve been working with hospitals for 30 years now, and I have more questions than answers,\u201d he said. \u201cIf not every day then every two or three days things are changing. \u201cWe are going to keep working to find a solution to this issue because we want to continue providing quality care in as many areas as we can for local everyone in this area.\u201d", 1, "2026-03-30T01:40:41Z", "2026-04-06T19:32:54Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://www.hydesmith.senate.gov/hospital-fighting-status-change"], "units": {}, "query_ms": 1.2550679966807365, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}