May 04, 2001 11:00 pm

By Gary Fletcher

Observer Staff Writer

ENTERPRISE Revenues have been declining at Wallowa Memorial Hospital. But it may pick up another $400,000 annually by changing its Medicare designation.

Citizens can participate in the decision at a special meeting Monday. The meeting starts at 6 p.m. downstairs in the hospitals human resources room.

Being considered is whether to change from the current designation of a Sole Community Provider to that of a Critical Access Hospital.

At stake is how the hospital will be reimbursed by the federal government for its Medicare patients. They now comprise 80 percent of those in the hospital, administrator Kim Dahlman said.

Currently, the federal government does not necessarily reimburse the actual cost of procedures. Instead, it pays for them according to an arbitrary fixed payment schedule.

Under the critical access designation, the government would reimburse the hospital for its costs. Last year, if the hospital had the critical access designation, it would have received

an additional $464,000 in Medicare reimbursement.

A trade-off in the designation change would be that a maximum of four days would be imposed on how long Medicare patients, on the average over a year, could be treated as acute-care patients. Dahlman sees no practical problem there. In checking the last two years records, acute care stay has average 3.01 days per year. That is typical of hospitals throughout Oregon.

With a new critical access designation, Wallowa Memorial Hospital would still keep its Level IV trauma status and other services.

The hospital district has been considering this change in designation since about three years ago. Thats when the federal government deemed it as critically necessary to provide service to the area, Dahlman said.

At Mondays meeting, the board will review the 17 questions it is required to address to apply for the critical access designation. Public input is welcome.

The designation issue was previously considered at the districts April 30 meeting.

That meeting was preceded by the budget meeting. A portion of the conclusion of the budget message stated, Wallowa County Health Care District has shown decreasing volume for the past two years and has been able to offset that by controlling expenses

and increasing non-operating


The proposed budget projected that the hospital would take in $1.6 million less in fees than its $7.6 million in expenses in providing services. Tax revenues of $827,000 and other non-operating revenues would make up that loss in order to break even.

The next budget committee meeting will be 11:30 a.m., May 14 at the hospital.