Leaders Continue The Dialogue About LG Hospital’s Future

Fayette County Commissioners Court listened to more concerns from the public about the future of St. Mark’s Medical Center at their meeting last Thursday, March 23.

St. Mark’s laid off dozens of staff and slashed many services as part of its transition to a Rural Emergency Hospital (REH). The REH designation will bring St. Mark’s an injection of funding including a $272,000 monthly “facility fee” from the Centers for Medicare and Medicaid (CMS) along with increased reimbursement rates for Medicare. However, rules for the REH program stipulate that the hospital may not perform inpatient services such as surgeries or other procedures requiring overnight stays. Despite the extra dose of funding and cost savings from the layoffs, the leadership at St. Marks says the hospital still won’t generate enough revenue to cover its mortgage – which stands at around $13 million.

Eugene Niemeyer of the Fayette County Farm Bureau spoke about the topic during the public comment period at Thursday’s County government meeting.

“I’m here representing the Fayette County Farm Bureau, and I’ve talked to a lot of people, and they want to keep a full hospital here in La Grange,” Eugene Niemeyer said.

Niemeyer said he always thought the hospital belonged to the County and only learned recently that it was a private institution.

“I believe it should be a community hospital,” he said.

Niemeyer asked the Commissioners how they could help reverse the changes at the hospital. County Judge Dan Mueller informed Niemeyer that state law prohibits the Court from deliberating about topics that are not on the agenda during the public comment section.

Niemeyer said the Farm Bureau represents 4,000 members and their families in Fayette County.

“If we push it, we can get a lot done,” Niemeyer said.

Mueller invited Niemeyer to request the topic to be placed on a future meeting agenda.

“If it’s an agenda item, we can address it at that time,” Mueller said.

Fayette County Republican Party Chairwoman Deborah Frank also spoke about the hospital at Thursday’s meeting. Frank asked the Court to invite the leadership of St. Mark’s and its management company, Community Hospital Corporation, to a future meeting to answer several questions she posed.

Frank wants the hospital to release financial documents relating to Medicare and Medicaid reimbursements, income tax returns, and the dates from when it last negotiated rates with private insurance companies. She wanted to know St. Mark’s payer mix – the ratio of patients with private insurance, Medicare, Medicaid, etc.

“Has there been any substantial changes in the payer mix in the last five years?” Frank asked. “Has St. Mark’s tried to market its services to increase its commercial payer base?”

At the meeting two weeks ago when St. Mark’s officials spoke to the Commissioners about the transition at the hospital, CHC CEO Jim Kendrick said the St. Mark’s board tried selling the hospital to an Austin- based healthcare system in 2019. That effort was unsuccessful. He said St. Mark’s also hired a consultant to try selling the hospital.

Frank asked for details about those negotiations.

“The residents of Fayette County were unaware of the dire financial situation at St. Mark’s until the newspaper article announced St. Mark’s conversion to a rural emergency hospital after the fact,” she said. “Who on the St. Mark’s and CHC boards was not in favor of publicly disclosing information about the pending transaction and why?”

Frank wanted to know if there have been any discussions to sell all or part of the land, buildings or assets of St. Mark’s. Frank noted that St. Mark’s board chairman Dudley Piland is also a paid board member of CHC, the hospital’s management company.

“This appears to be a conflict of interest,” Frank said.

Frank called for the leadership at St. Mark’s to explain why Piland’s position on both boards is not a conflict of interest.

“Once we have information and answers from St. Mark’s and CHC, citizens can have meaningful discussions about what needs to happen in order for Fayette County to have trusted quality medical services we need,” Frank said. “Taxpayers were so relieved after the 2019 defeat of the hospital tax district that we got complacent. We thought the St. Mark’s board took our concerns about CHC, poor hospital management, billing issues, and lack of transparency to heart and would correct those problems. We went on with our lives and no changes were made at St. Mark’s. We thought all was well until St. Mark’s conversion to a rural emergency hospital was announced with no advance notice to the community.”

Frank said most citizens want a local hospital with quality healthcare.

“We need to figure out how to make that happen,” she said. “Not by throwing money down the current dark hole, but figuring out to reimagine, reorganize and reestablish the medical services this county actually needs. There are a lot of intelligent people here. Some ideas have been proposed. Some ideas have already been shared publicly. We appreciate those who are willing to step up and start the conversation. So far, we all agree on one thing – no new taxes.”

Frank closed with the following remark: “Like it or not, perception is reality. The hospital will not rebuild the community’s trust or regain their support without removing the root causes of the distrust.”