Patients driven out of Callaway County

The future of the Fulton Medical Center is unknown after officials at University of Missouri Health Care announced plans to withdraw the organization's 35 percent ownership.
The future of the Fulton Medical Center is unknown after officials at University of Missouri Health Care announced plans to withdraw the organization's 35 percent ownership.

While plenty of ambulance calls in Callaway County end by transporting people to Fulton Medical Center, far more patients end up at University Hospital in Columbia, according to records kept by Callaway County Ambulance District officials.

In 2012, 20 percent of patients were transported to FMC, then known as Callaway Community Hospital. Now, that number is 11 percent.

"Patients have the right to be transported to a facility of their choice," Charles Anderson, director of the ambulance district, said. "A clear majority of patients choose to be transported to facilities in Columbia or Jefferson City."

The ambulance district handles all calls in the county, Anderson said.

From Jan. 1-June 30 this year, 1,567 patients were transported to hospitals. A report shows 168 patients (11 percent) were transported to the Fulton Medical Center, compared to 627 patients (39 percent) transported to University Hospital. Another 262 (16 percent) of patients went to Boone Hospital, also in Columbia.

Anderson said a lack of specialty services at Fulton Medical Center has driven patients to other destinations.

"Serious trauma patients are transported directly to the University of Missouri trauma center," Anderson said. "STEMI (a type of heart attack) and stroke patients are transported to Boone Hospital, University Hospital, SMH-Audrain and SMH-JCMO (St. Mary's Hospital), and Capital Region Medical Center."

Sometimes patients are incapacitated and not able to voice their preferences.

"Absent a patient choice, which always prevails, our goal is to take patients to the right facility to treat their condition," Anderson said.

Until December 2014, Fulton Medical Center was doing business as Callaway Community Hospital. At that time, it was purchased in an agreement between NueHealth LLC (previously Nueterra), a private, for-profit company, and University of Missouri Heath Care. The purchase price for the 37-bed hospital was $6 million, with NueHealth as the majority owner (65 percent).

In recent months, at least two meetings have been conducted to discuss the hospital's ailing finances. Present at those meetings were Callaway County and Fulton city officials, plus those from the Callaway Chamber of Commerce, the hospital and NueHealth. Lack of payments made by indigent patients were making the hospital unprofitable, hospital officials said.

Those in the meetings said they discussed the possibility of creating a "hospital district," capable of levying taxes to offset costs of indigent patient care. The idea of a tax on Callaway County residents, however, may be too late to rescue the hospital.

"Assuming there is support for a tax to support a local hospital, the process would take some time to complete, and I don't see how it could be done with the urgency in which it needs to be done, based on the current circumstances of the existing facility," Anderson said.

A request for the Fulton hospital's financial records has not yet been answered.

The competition the Fulton Medical Center faces is also notable, Anderson added. Besides regional hospitals, a walk-in clinic was opened last summer by SSM Health Medical Group at 350 Country Meadows Drive, across U.S. 54 from the Fulton hospital.

"Fulton is unique because we are situated within 30 minutes of four full-service hospitals between Jefferson City and Columbia," Anderson said. "I believe this makes it difficult for any operator of a hospital in Fulton to generate a profit. Many people are simply accustomed to receiving their health care outside of Fulton, and that obstacle is hard to overcome."

There are also patients who use the hospital's emergency room for non-emergency situations, rather than going to a medical clinic. By federal law, hospital ERs are required to treat people, whether they can pay or not, while clinics are not, Dave Dillon of the Missouri Hospital Association said.

"Some individuals depend on Fulton Medical Center for their health care, which is primarily accomplished by using the ER," Anderson said. "From what I have read, much of this care accounts for the write-offs at Fulton Medical Center."

It's hard to say what the loss of the Fulton hospital would mean to the ambulance district, Anderson added.

"Losing our local hospital would create an increased workload for the ambulance district; however, the exact increase is difficult to determine," he said. "We do know that we would likely have to increase our staffing levels by changing our 12-hour truck to a 24-hour truck. Beyond that, we just don't know.

"No matter what, closure of our local hospital will increase our costs and create hardships for many in our community."