Janesville74.2°

Status preserves Medicare funding

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Stacy Vogel
December 26, 2007
— Edgerton Hospital and Health Services qualifies to receive 60 percent of its funding through Medicare because it’s a federally designated “critical access hospital,” said Nancy Hoffman, director of foundation and marketing.

The program aims to improve rural health care by reducing hospital closures, said Peggy Sivesind with the Wisconsin Office of Rural Health.


To qualify as a critical access hospital, the facility must be either more than 35 miles from any other hospital or certified by the state as a “necessary provider” of health care services to local residents.


Edgerton meets the second criterion by fulfilling at least five of 10 requirements, Sivesind said. The requirements the hospital meets are:


-- The hospital is located in a county where the percentage of the population age 65 and older exceeds the state average.


-- The hospital is located in a county where the percentage of people with incomes below the federal poverty line exceeds the state average.


-- The hospital is located in a county where the unemployment rate exceeds the state average.


-- The hospital is located in a service area where the population increases at least 30 percent during certain times of the year.


-- If the hospital were to close, residents’ access to health care services would be severely affected.


As of Jan. 1, 2006, states can’t waive the 35-mile requirement, but Edgerton Hospital still qualifies because it was named a critical access hospital before that date.


The hospital’s relocation won’t affect its status as long as it offers at least 75 percent of the same services it offered before, serves 75 percent of the same service area and employs at least 75 percent of the same staff, according to the Rural Assistance Center, a service of the U.S. Department of Health and Human Services.


As a critical access hospital, Edgerton Hospital must provide 24-hour emergency services, with medical staff on site or on call at all times. It can’t have more than 25 beds.



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