Health Care

Without Medicare funds, this hospital could cancel surgeries, even close. It's suing

A small hospital in Overland Park is suing the federal government in an attempt to prevent the loss of its Medicare funding.
A small hospital in Overland Park is suing the federal government in an attempt to prevent the loss of its Medicare funding. Photo provided

A small hospital in Overland Park is suing the federal government in an attempt to prevent the loss of its Medicare funding.

In a court filing last week, Blue Valley Hospital officials said that if the government pulls its Medicare certification, it would mean layoffs and canceled surgeries in the short term and the closure of the hospital in the long term.

"Any loss of certification would likely result in closure of BVH, which would have an enormous negative impact on patients’ access to much-needed services and on BVH’s employees and on the local community,” the lawsuit complaint states.

The hospital has asked a federal judge to keep its Centers for Medicare and Medicaid Services, or CMS, certification in place while it appeals the decision to terminate it.

CMS declined to comment because of pending litigation.

According to the American Hospital Directory, the facility at 12850 Metcalf Ave. has just four beds, but discharges more than 1,500 patients and makes about $165 million in revenue per year by performing a variety of imaging services, nerve injections and surgeries.

It was one of three hospitals in the Kansas City metro, along with Truman Medical Center and the University of Kansas Hospital, to be hit with a controversial 1 percent Medicare deduction last year because of high rates of preventable complications.

But the Blue Valley Hospital suit says the impending loss of Medicare certification stems not from poor care, but from falling short of new federal requirements that the hospital believes are "arbitrary."

“This action taken by CMS was not related to any patient safety or quality of care issue, but results from CMS’s change in the definition of hospital, under the Code of Federal Regulations," D. Chris Dixon, the CEO of Blue Valley Hospital said in a statement released by the hospital. "Although this came at very short notice, we are doing everything possible to limit the impact to our operations. We are confident that this proposed action by CMS will be reversed.”

The new rules, enacted last September, require facilities to average at least two inpatients per day and at least two nights average length of stay to be considered an inpatient hospital for purposes of Medicare reimbursements.

Facilities that fall short of that might instead be considered same-day surgical centers, which have different reimbursements.

Blue Valley Hospital's lawsuit says it fell short of the two night average stay, but it's not fair to count that against it.

“Many of BVH’s patients do have an expected length of stay of two midnights, but given the high quality care received and above-standard results, they are able to go home earlier than expected," the suit says. "The CMS’s new criteria suggests that hospitals should keep patients longer than necessary just to meet arbitrary CMS requirements, which is against public policy.”

The suit notes that the loss of CMS certification would also likely result in a major loss of business from Medicaid plans and commercial insurers, which often don't cover care at facilities that aren't certified. It said that would also result in a major loss for the community, because Blue Valley Hospital currently performs 35 percent of Missouri Medicaid's bariatric surgery procedures.

“The public interest is not served by the unwarranted and accelerated shut down of a thriving facility that provides unique and specialized (service) to residents of Kansas and Missouri,” the suit says.