Will Merit Health Central's plans to downsize violate its lease with Hinds County?

by Kate Royals, Mississippi Today
October 12, 2022

Merit Health Central, facing a litany of recent struggles, will become a primarily psychiatric facility if the Mississippi Department of Health approves its request to move 50 beds from its Vicksburg hospital to Jackson.

The hospital, which serves majority-Black neighborhoods in south and west Jackson that have high concentrations of people living in poverty, is discontinuing most of its operative services as of this month, including orthopedics, neurology, urology and general surgery, according to hospital officials. It has already closed its burn center —the state's only accredited program — and moved its cardiovascular services, neonatal intensive care unit and endoscopy to its facilities in the suburbs.

READ MORE: Merit Health Central is moving many services from Jackson to the suburbs. Employees wonder what's next.

Those in the medical community and county officials have a question: How will the hospital fulfill the terms of its lease agreement with the county without these services?

Health Management Associates leased the former Hinds General Hospital from the county in the early 2000s. Community Health Partners, the Nashville-based company that owns Merit Health Central and eight other private hospitals in the state, acquired Health Management Associates in 2013, thus inheriting the hospital and its lease requirements. 

The agreement states the hospital must operate as a “full service general acute care hospital.” It also is obligated to provide medical services for Hinds County Detention Center inmates.

A source familiar with the situation said the hospital has been transferring inmates elsewhere and is not fulfilling the duties of a full service hospital.

Hinds County Administrator Kenneth Wayne Jones said the county is “still investigating” the impact of the discontinuation of services at the hospital on the county. He declined a phone interview but provided Mississippi Today with an emailed statement. 

“Our legal team has been in touch with Merit Health and they are reviewing the matter,” Jones said. “Once they have completed their review, we will have more information regarding Merit Health's presence in Hinds County.”

Officials with Merit Health Central said it is in compliance with lease obligations and will continue to be. 

“We have been in contact with county leadership about the lease as well as the challenges Merit Health has with labor costs and staffing challenges facing all healthcare organizations following the COVID pandemic, inflationary pressures and other dynamics, including the state's decision not to expand Medicaid,” said Jana Fuss, director of marketing at Merit Health. “We will address concerns as they share them with us.”

Merit Health Central incurred just shy of $16 million in net uninsured costs, or the cost of services for which the patient had no insurance coverage, in fiscal year 2022. That is the largest amount of uncompensated care of any Merit Health hospital in the state that year.

When asked about inmates being transferred, Fuss said: “Patients, including inmates, may be transferred to another facility if their medical needs require a higher-level of care or services than Merit Health Central can provide. We are not aware of a situation in which inmates have been transferred to another facility for reasons other than their medical needs requiring it.” 

Merit Health Central filed a certificate of need application Sept. 16 with the state health department to move 20 adult psychiatric beds, 10 adult chemical dependency beds and 20 adolescent psychiatric beds from Merit Health River Region in Vicksburg to Merit Health Central in Jackson. 

If approved, the hospital will increase from 71 psychiatric beds to 121.

“Access to comprehensive Mental Health Services at the hospital will benefit the health and well-being of Mississippians, particularly those in the central/metro area of the State. With additional capacity in the area, the patients (and their families) in need of these services will be able to more easily access these services thereby improving their health and the well-being of those around them,” the application stated. 

Hinds County Sheriff Tyree Jones, Jackson Mayor Chokwe Lumumba and a host of health care professionals wrote letters to the Mississippi Department of Health advocating for the approval of the movement of the beds. 

“This is something we recognize great need for, especially while we still face the social implications of the COVID-19 pandemic,” Lumumba wrote. 

Community Health Systems determined that moving the services to Jackson and spending money to expand psychiatric services at Central would be a “better use of capital” than upgrading the old River Region building, which will eventually be demolished, according to the application. 

The estimated cost of renovating Central to accommodate the new beds is around $6.5 million. The hospital will have to hire two physicians, 36 nurses and a host of other health care professionals, totaling around $2.7 million. 

“As we plan for the future, our network is looking at how we can best provide behavioral health services … This proposed consolidation will allow adolescent and adult behavioral health patients to receive treatment in a newer and more central location,” a Sept. 23 letter from Chief Executive Officer David Henry to staff said. 

The letter made no mention of the services the hospital has moved or closed.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.