The Grand County Council approved providing $195,000 in seed money at their Tuesday, Nov. 7 meeting in order for the Moab Regional Hospital to participate in the Medicaid Disproportionate Share (DSH) payment program.
The hospital needs $247,744 from a government entity to show community support for the regional hospital in order to receive $856,000 in compensation for care provided to low-income patients. The money must be received by the State of Utah by Nov. 30 in order for the hospital to receive the 2012 DSH payment.
The $195,000 will come from the county’s general fund. It will be distributed through the Canyonlands Health Care Special Services District.
Moab Regional Hospital staff and board chair approached both the county and the City of Moab for seed money. The City of Moab have a discussion item on their Nov. 13 agenda to provide a one-time allocation of $80,000 to assist the county in providing seed money for the DSH payments.
If the city approves the $80,000 allocation, the combination of money from both the county and city will total $275,000. This leaves a remainder of $27,256 over the $247,744 necessary for the 2012 payment.
The Moab Regional Hospital now owes $26,825 to the DSH program because it did not submit the full amount of seed money for monies they had received previously. The $27,256 remainder will allow the hospital to pay for the previous debt.
“Our request is simple and straight forward,” said Roy Barraclough, Moab Regional Hospital Chief Executive Officer at the Oct. 2 county council meeting. “We need seed money of $277,000 in order to receive $876,000. Secondly, we need assistance in identifying potential resources to acquire seed money on an annual basis.”
The county council has repeatedly discussed that future allocations may have to come from a sales tax. In order to enact the sales tax, the council would have to agree to put it on the June 2013 ballot. The measure would have to pass by a two-thirds vote by county residents.
“DSH will most likely be procured through sales tax. In order to secure that, you need to make the community comfortable that operations are being repaired and everything is efficiently run at the hospital,” Baird said in the Oct. 2 council meeting.
Moab Regional Hospital is now working with Quorum Intensive Resources (QIR), a healthcare consulting firm, to help the hospital improve its systems and services. Due to insufficient cashflow, the hospital was unable to make payroll and the mortgage payment. The May mortgage payment was made five days after the grace-period ended.
“Housing and Urban Development (HUD) chose to recognize it as a technical default and they began monitoring us very closely,” Barraclough said. HUD provides insurance on the hospital’s $30 million mortgage.
Even if a sales tax is approved by both the council and voters, it will not be able to provide seed money for the 2013 DSH allocation.
The council re-allocated mineral lease distribution at their Oct. 9 council meeting which may double the Canyonlands Health Care Service District’s revenue if mineral lease money distribution remains the same in 2013 as it was in 2012.
Grand County received $1,328,000 from mineral lease, mineral bonus and Payment-in-Lieu of Taxes money in 2012. These monies come from oil, gas and mineral leases and development on federally owned land within Grand County. It varies year-to-year based on the number of active leases and royalties from oil, gas and mineral development.
If mineral lease, bonus and PILT monies remain near the same in 2013 as was distributed in 2012, Canyonlands Health Care District may receive $515,000 in 2013, as compared to $270,000 it received in 2012.
Baird expressed that he hopes the public will approve the sales tax, in order to allow the mineral lease, bonus and PILT money to go to other special service districts in the county.
“If that rural health care tax passes, that money comes back into the pot,” Baird said at the Oct. 9 county council meeting.
Moab Regional Hospital provided $1,164,167 in charity care and had $1,724, 270 in bad debt, which is 11 percent of the overall revenue.
Barraclough feels strongly that the county should step up and provide the seed money, due to the financial losses the hospital has due to charity and bad debt.
“That indigent care would otherwise be the responsibility of the county,” Barraclough said.