Despite difficult conditions for rural hospitals statewide and nationally, Marion General Hospital remains profitable and has a positive future outlook, its chief executive says.
“Marion had positive cash flow last year. We have positive cash flow year-to-date this year,” Hospital Administrator Alania Cedillo said in an interview this week.
Cedillo credited the Marion County Board of Supervisors for its foresight in partnering with Forrest General Hospital seven years ago to manage the hospital. When the operating agreement took effect in 2012, the hospital had $6 million in debt that the county and Forrest General agreed to split. Since then the financial condition of Marion General has improved.
“That was what I would call a turning point. It was done at the right time,” Cedillo said. “If you were trying to do the same thing right now, it would be a lot harder.”
Board of Supervisors President Terry Broome said the county is pleased with how things are going with Forrest General running the hospital, saying it’s come a long way and is one of the better things that’s happened in the county.
“They changed up a whole lot of things at the hospital. I think it’s all for the better,” he said. “We’re just tickled to death with them.”
The improvements at the Columbia hospital come as rural hospitals overall in Mississippi are struggling. A report published last week by the online news site Mississippi Today said that 31 of the state’s 64 rural hospitals are at “high financial risk,” according to an analysis by consulting firm Navigant. It looked at 2,045 rural hospitals across the nation and found that the national rate of high financial risk hospitals is 21 percent versus 48 percent in Mississippi.
The study used three factors: profit margins over the past three years, amount of cash on hand and debt-to-capitalization ratio.
The report listed Marion General among those at high financial risk.
But Cedillo said the methodology doesn’t give the full picture because it doesn’t show the hospital’s financial position as part of the full Forrest General system.
Forrest General provides infrastructure support for things like billing, creating redundancies in the system that a smaller, standalone hospital might not have if someone in the billing department was out sick for a week, for example.
Economies of scale also help a hospital’s buying and negotiating power, she said.
“The volume you have drives pricing. There’s a big difference in buying 10 of something and 100 of something,” Cedillo said.
She said the hospital’s goal is to cover expenses and make enough in profit to reinvest in capital.
Its benefits to the community include being a major employer, having 130 full-time employees and 30 to 40 part-time and as-needed workers.
It also helps when time is of the essence for things like heart attacks and strokes by treating people sooner than if they had to be taken to Hattiesburg or McComb, Cedillo said.
The hospital keeps people locally for things like the swing bed unit, which helps keep Forrest General’s beds open for more acute medical problems, she said.
The health care environment does force hospitals to make business decisions, such as cutting surgery at Marion General in 2017, she said. The hospital also doesn’t have an MRI machine, which Cedillo said just doesn’t work financially, but instead it brings in an MRI truck on a regular basis.
She said the hospital won’t be going back to the time when it was founded of having an operating room but will be the best it can be at what it does in ER, swing-bed and ICU.
Telemedicine will grow as a larger part of what Marion General offers, Cedillo predicted, eventually becoming the norm.
She said it’s been well-received by patients and their families so far through a tele-stroke initiative. Physicians from Oschner’s hospital in New Orleans are able to examine stroke victims via video link, helping them get the proper care as quickly as possible. Cedillo said they used the service five times last month, and she’s not heard any negative feedback since it was rolled out in 2018.
“There’s been even more positive response than I anticipated,” she said.
Another factor in the statewide struggles of rural hospitals is that Mississippi is one of 15 states that has declined to expand its Medicaid program as part of Obamacare. That would have added an additional $1 billion in federal money with a small state match and would cover people who are currently self-pay. Self-pay charges often go uncollected by hospitals. State Republican leaders have said they do not want to expand the program and then have the federal government back out, leaving the state on the hook for the full cost rather than just its small match.
Four rural hospitals in Mississippi have closed in recent years, in Kilmichael, Belzoni, Newton and Marks.
Pictured Above: Marion General Hospital has seen its financial status improve since entering into an operating agreement with Forrest General Hospital in 2012. | Photo by Charlie Smith
