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a2 TVS FACT SHEET eS eed Definition of a Critical Access Hospital Bon Secot 5s Richmond Health System began a commitment to quality, com nate care for the Northern Neck and Middle Peninsula with the acquisition of Rappahannock General Hospital (RGH) in December of 2014 On May 1, 2016, RGH became a Critical Access Hospital (CAH), which is a Medicare designati ‘al hospitals that meet rigorous administrative and quality measures. This new desig stability of RGH while allowing for for n nation has assisted in the financial rowth in patient services in areas of need. The combination of financial stability and growth in services will help secure the future of RGH as this rural area’s only hospital, a major employer, and contributor to the local economy. PUNT Neen Key Facts (lS) S57.Vee aire - By operating as a CAH, RGH receives cost-based reimbursements from Medicare. Prior to attaining CAH status, RGH was only reimbursed for 65 percent of the cost of care. + Some of the requirements for the transition to a CAH include: having no more than 25 inpatient beds; maintaining an annual average length of stay of no more than 96 hours for acute inpatient care; offering 24-hour, seven-days-per-week emergency care; and being located in a rural area at least 35 miles from any other hospital. + There is a “swing bed” provision within the 25-bed limit which allows physicians to transition a patient from one level of care to another while staying in the same facility. For the aging population RGH serves, this is particularly helpful since some patients may need additional time to recover from a surgery, illness, or injury. Once the physician swings the Oy lad bed, the patient can stay longer at RGH where there is easy access to General Hospital nursing care and therapies, versus being transferred to a nursing home. DT The objective of swing bed programs is to assist the patient in becoming (Clear as independent as possible before discharge. PS Pr eR) (Ete RAPPAHANNOCK cts5 37 Neel Lae nr SO ee Cas Coo reer Pee RUE Lard Pe Ee Pear eeu! bee Q: Are you considering closing Rappahannock General Hospital (RGH)? Ne : Will the proposed transitions result in layofts, of reduced hours for employees? AN :Is the hospital profitable? ‘A: No. In fiscal yeat ending March 31, 20) acquisition of RGH, the hospital lost more than $ million, and in the eight months following that, the losses exceeded $12 million. Bon Secour hose combined losses were unsustainable and depleted the available reserves the hospital held. That prevented RGH from investing further in the community's health care needs. since then, Bon Secours has brought new resources to the community while continuing to operate at a loss. Q:Isit possible for new services to be added to the hospital in the future, and how is that decision made? A: Yes. Care models that most effectively deliver health services to rural areas are based on the demonstrated needs of the community. @: Whatis a Critical Access Hospital? A: Please see Critical ‘Access Hospital designation fact sheet. FREQUENTLY ASKED QUESTIONS G: Is there a four-day limit on lenath of stay in the hospital? Hospital designatior determining the lenath by each patient's condition and their @: Why are you suspending the Intensive Care Unit (ICU)? A: Over the past few year: Bon Secours has seen a shift to larger centers with available specialty care fo many intensive care level patients. : What types of care would | receive if! were awaiting transfer toa nearby ICU? A: Patients awaiting transport to a nearby ICU may receive inpatient care ineither a Progressive Care Unit or in the Emergency Department. Q: What is a Progressive Care Unit? A: A Progressive Care Unit refers toa unit within a hospital; itis not a type of hospital. The care is @: Why did you transition to only day shift surgeries in the Perioperative Unit? J ne shift. We wall realign our resources toward ambulatory surgical services hour surgeries proms {Q: What if! come in through the Emergency Department after hours and in need of surgery? ‘A:in that case, a transfer to the appropriate higher level of care facility would be facilitated @: Are you planning to transition RGH to a Short Term Hospital? A:No. @: What services have you added recently? ‘A: Same-day mammography, a state-of-the-art nuclear medicine camera for enhanced imaging provided by specially trained diagnosis capabilities medical professionals and is designed to stabilize a patient awaiting transfer t a higher level of care. @: What is the cost of being physi transferred to another hospital that has an ICU? ‘A; Transport costs vary ‘st. Mary's | Memorial Regional | Richmond Community Westchester Emergency Center | Rappahannock General | Bon Secours Medical Group sleep lab, and electronic ‘medical records. Additional 0 infrastructure updates include a hospital emergency generator, al plant chiller, Rad Fluor Unit, and medical ‘vacuum pum y | St. Francis |

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