Petersburg Medical Center reports high inpatient census, aging infrastructure and Medicaid uncertainty to assembly

Phil Hofstetter, chief executive officer of Petersburg Medical Center (PMC), updated the Petersburg Borough Assembly on June 2 that PMC is experiencing some of the highest inpatient and rehabilitation census levels the hospital has seen in recent years and that its long-term-care facility is at or near full capacity.

Hofstetter said PMC completed an emergency water-valve replacement that required a planned shutdown from about 8 p.m. to 2 a.m.; facilities staff froze pipe sections at each end to avoid collateral damage when water service was restored. He said staff obtained internal images of pipe interiors showing heavy scaling and that the hospital will share those images with the assembly on request. "It was a pretty major project and it went successfully," Hofstetter said.

On capacity, Hofstetter said the inpatient swing bed and rehabilitation program are at historic peaks and the long-term-care unit is fully staffed and fully occupied much of the time. When asked by assembly members, Hofstetter said the facility has 15 long-term-care beds; some rooms are double-occupancy and cannot always be fully counted as individual beds in practice. He said the majority of long-term-care residents are covered by Medicaid.

Hofstetter said PMC had brought patient billing (accounts receivable) work in-house after problems with outside vendors. That change is producing measurable results: despite increased volumes, accounts-receivable totals are declining, and patient billing inquiries are handled locally.

Hofstetter also reported on his recent trip to Washington, D.C., representing PMC and the Alaska Hospital and Healthcare Association; he said the association is tracking proposed federal changes and state-level proposals that could tighten Medicaid eligibility and redetermination requirements. He said the principal concern is potential changes to work-eligibility requirements and recurring eligibility redeterminations, which could reduce Medicaid coverage for expansion populations and increase pressure on rural providers. Hofstetter said he was told proposed changes would likely not affect elderly long-term-care populations in the same way but that the assembly should monitor developments.

Assembly members asked questions about the composition of the long-term-care census and whether residents are primarily local; Hofstetter replied they are local to Petersburg. Members also asked about bed capacity in the planned new facility and whether the design should be revisited to provide more long-term-care capacity; Hofstetter said the phased new-facility approach gives the borough time to revisit design and funding before incurring local debt.

No formal action was taken; the update was received as information.