Iowa Statehouse

Iowa State Capitol 

(Des Moines) -- State lawmakers have sent a bill to Governor Kim Reynold's desk allowing small, rural hospitals to apply for new licensure.

The Iowa Senate Tuesday unanimously approved Senate File 75 to implement a state process for hospitals to be licensed as rural emergency hospitals. Under federal rules, the designation allows hospitals to discontinue in-patient care while still offering out-patient services and an emergency room. The Senate initially approved the bill in February, but Iowa House members approved an amended version 97-1 last week. Senator Mark Costello served as the floor manager for the bill. The Imogene Republican says the amendment added clarifying language for who is eligible for the designation.

"It ensures that the applicability section is not limited to a singular county, but applies to all existing hospitals in operation or have since closed," said Costello. "It does add new language expanding the ambulatory surgery center licensure to include cosmetic, reconstructive, or plastic surgery centers. It further clarifies that licensure requirements set by the (Iowa Department of Inspections and Appeals), will not exceed application requirements under the (Center for Medicare and Medicaid Services)."

Rural emergency hospitals would also get an additional 5% in federal reimbursements for treating Medicare patients. In addition, supporters of the bill say it's likely to allow a rural emergency hospital to re-open in Keokuk, whose hospital closed last year.

Representative Tom Moore served as the floor manager for the bill on the House side. The Griswold Republican says hospitals that can remain open 24 hours a day, seven days a week, will be the only ones able to receive the designation.

"This bill will only effect a few rural hospitals, but it is critical in giving them the option to stay a viable and financially stable hospital," said Moore. "Or in the case of Keokuk Hospital, the ability to re-open as an REH."

Once a critical patient is stabilized, they would be transferred to in-patient care elsewhere, while patients with less acute emergencies could be quickly treated and discharged. Moore adds that the rural emergency hospital designation will be available to ambulatory surgical centers that provide out-patient services.

"An ASC is defined as a distinct facility that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization and in which the expected duration of service does not exceed 24 hours following an admission," said Moore.

In a previous interview with KMA News, Moore says the Grape Community Hospital in Hamburg was identified as another hospital that could fit into the program. The designation was created through the federal Consolidated Appropriations Act of 2021, which several federal lawmakers, including Senator Chuck Grassley, pushed.

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