A financially struggling Delta hospital received another bit of bad news: its application for a federal designation that would bring in more money has been initially denied. 

The regional Centers for Medicare and Medicaid Services office in Atlanta has declined to designate the Greenwood hospital as a critical access hospital, according to a letter the agency sent to interim CEO Gary Marchand on Aug. 24.

Leaders of the hospital, which is co-owned by the city and county, have long been counting on the hospital’s conversion to increase its financial viability — critical access hospitals are reimbursed by Medicare at a higher rate. The hospital is currently classified as an acute care facility.

Marchand has repeatedly called the application their “plan A.”

But all hope is not lost — despite the regional office’s denial, Marchand is still counting on the national CMS office in Washington D.C. approving the hospital’s application.

He shared in an internal email to staff sent Aug. 30 that even with recommendations from the state Health Department and a regional Medicare administrative contractor to convert the hospital into a critical access hospital, a review by the CMS regional office did not yield the same results.

Marchand stressed the decision wasn’t a surprise.

“We expected the Regional Office of CMS to review the application without considering the full scope of the arguments for its approval,” he said. 

Critical access hospitals must be located 35 miles from the nearest hospital. South Sunflower County Hospital in Indianola is just 28 miles away from Greenwood Leflore Hospital. The regional CMS office cited the hospital’s proximity to nearby hospitals as cause for the application’s rejection.

Marchand’s argument for waiving that requirement was that transportation issues plague the Delta — many of the hospital’s patients struggle to make their appointments because they don’t have a way to get there. 

This doesn’t mean the conversion is out of the question, though. The hospital’s application is still being considered by the national CMS office, Marchand said.

“We have always expected the final decision would be made in the national office, and Congressman (Bennie) Thompson and Senators (Roger) Wicker and (Cindy) Hyde-Smith and fully engaged and supportive of the GLH application,” he says in the internal email, before noting that he doesn’t not expect a final answer from the federal agency before the end of the year.

The pandemic has left the hospital in financial straits this past year, and stakeholders are exhausting all options to keep the facility open. Aside from the critical access hospital application, hospital leadership has also closed several departments and services, including neurosurgery and labor and delivery. 

After a potential lease agreement fell through last year, the hospital went up for lease again recently.  

Greenwood hospital leaders have also applied for grants from the Legislature, but as of August, no hospitals in the state have received that money. 

They desperately need it — one report puts nearly half of the state’s rural hospitals at risk of closure.

The longer the state goes without Medicaid expansion, the more dire the situation becomes, Greenwood Mayor Carol McAdams previously told Mississippi Today. 

In the meantime, leaders are still accepting bidders to buy or lease the hospital and save it from closure. 

Marchand says the hospital can stay open until 2024. After that, its future is unclear. 

“Critical access status remains key to the hospital’s ability to provide services over the long term,” Marchand said. “We remain hopeful of the application’s final approval by CMS’s National Office.”