Alliance Hospital seeks county support
Dr. Kenneth Williams and consultant Debra Griffin joined a group of over 20 current and past employees at Alliance Hospital Monday Dec. 16, to ask for community support for the hospital and for the backing of the board of supervisors so service can be resumed.
Williams said all rural hospitals are struggling and some are closing because of changes in the funding, particularly how CMS Medicare married with insurance companies to put reimbursement for services under the Medicare Advantage pricing structure.
“We cannot exist without the county and us working together,” Williams said.
This year is the 25th Anniversary of Alliance Hospital.
He presented some of the history of the old hospital that was operated by other hospital systems including Methodist, until they all pulled out in the 1990s.
He said Methodist left a year after he arrived in Holly Springs. The last owner of the hospital was named Netcare and they borrowed money from Venture Capitalist and bought a group of small rural hospitals, Williams said. They sold them a year and a half later for a net gain of about $75 million, he said.
“Out of the ones sold, this was one hospital that nobody wanted,” he said. “The employees came to me to try to keep the hospital from closing. We took it over 25 years ago and within five years we had it out of the red and in the black.”
In year 2005, the hospital was “smoking hot, doing good,” Williams said.
In 2006, Medicare Advantage was put in place and the hospital lost $1.7 million in one year. He said the insurance companies got into the Medicare business and ruined it.
“Back then, nobody understood or believed it happened,” Williams said.
Alliance made an adjustment and changed its designation to a rural emergency hospital for financial reasons, just as many other rural hospitals in the state and others have done in order to try to keep services. That allowed local rural hospitals to keep emergency room services open but had to curtail inpatient care.
He said Alliance was supplemented under that program designation by $2.75 million a year and the hospital could still keep patients for observation for several days.
But that fix did not last long for Alliance, as Medicare ruled that Alliance was in the greater Memphis Hospital service boundaries, changing its rural designation to urban.
“The government came back and said, `we made a mistake,’ so Memphis had Marshall and Benton counties in their federal statistics area,” Williams said. “They came back and asked us to re-certify as an acute, full-service hospital. They did not give us our previous Medicare number back so we haven’t been able to bill Medicare for eight months. We’ve operated very lean. We need words of support.”
District 1 supervisor Charles Terry said the hospital had a bad reputation even before Williams purchased the certificate of necessity from Netcare.
“What can we do to keep the hospital in this county?” Terry asked. “You have the CON for a new hospital. No one else can come in here because you hold the CON. If Alliance closes, we’re without a hospital.”
Williams said in 1999, there was no one wanting to take it over.
“CMS is trying now to save some small rural hospitals, but we have to work with you all to make it possible,” Williams said.
Terry said not just Alliance, but small rural hospitals all over the state are trying to keep their rural hospitals open.
“I think it’s a positive. Move,” he said. “We need to give support and the citizens of Marshall County need to use your services. You can’t do your job if people go outside (the county for services).”
“You are only as strong as those who support you,” said Williams. “This is not a one man show.” He said 60 to 65 percent of his business covers Medicare clients.” He said cost for medical care skyrocketed after the COVID-19 pandemic. And costs for staffing, nurses and physicians went up with it.
“We put everything in pause,” Williams said. “We couldn’t staff it without patients. Our license is good. We have to update the CON every six months. We came back and we put in place vascular procedures and other things at the clinic. It’s harder to work on those things without the support of the county. We have patients.”
Terry said there has been a stigma regarding the old hospital and the age.
“Do you think building a new hospital would help in any way, fashion or form?” Terry asked
“The reputation was here when I got here,” Williams said. “We (Williams Clinic) moved out of the hospital on J.M. Ash Drive in 1998 and my business doubled over night.”
District 4 supervisor George Zinn III said it would take a lot of money to keep the old facility open. The ER department is there, he said.
“Do you want a hospital or an ER?” Williams asked. “Does the county still want it? The building is y’all’s.”
He said every now and then a renter will ask the landlord for something.
“We haven’t ask you for anything in 25 years,” he said.
Zinn said he has no idea what it would take to open back up.
Williams said he saw what the county is paying for ambulance service.
“We could build a new hospital and run the ambulance service on the amount of money you are paying for the ambulance,” he said.
Griffin said the hospital is open on a limited basis but has to be staffed up. Williams can call people in the community to staff his hospital business when needed, she said.