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Buena Basin Hospital CFO briefs commissioners on Upper Payment Limit partnership with county
Summary
Buena Basin Medical Center CFO Brent Hills explained the county's role in a federal Upper Payment Limit (UPL) arrangement that helps the local care center draw additional federal Medicaid funds; commissioners asked questions and expressed support.
Brent Hills, chief financial officer at Buena Basin Medical Center, briefed the Duchesne County Commission Feb. 10 on the county's partnership with the hospital and the Upper Payment Limit (UPL) program that helps subsidize long‑term care operations.
Hills described the care center's history, including a 2003 purchase and a subsequent expansion to a 90‑bed licensed facility. He said occupancy historically ranged from about 65 to 75 residents and that the facility lost about $1 million per year during a period from roughly 2008 through 2016.
Hills explained that UPL permits eligible non‑state governmental entities to participate in a federal funding match that narrows the gap between Medicare and Medicaid rates for long‑term care. Under the existing arrangement, the county acts as the governmental partner and on paper holds the bed licenses; the hospital operates the facility and manages day‑to‑day care. The county contributes quarterly “seed” funds that are used to draw federal dollars; the state then distributes the federal match and a portion is returned to the county and hospital under the parties' agreement.
Hills said the county and hospital have used UPL proceeds along with patient revenues to substantially reduce operating losses and to maintain staff and building upkeep. He noted the state has not yet published the new UPL gap rate and that the partnership relies on annual calculations and accounting to manage the seed funds and returned revenues. As part of the arrangement the hospital pays the county 5% of each UPL distribution as the county's share for administrative involvement.
Commissioners thanked Hills and several said the care center is an important local asset. One commissioner related a personal experience of a family member's positive stay at the center. Hills said the county‑hospital arrangement can revert to previous arrangements if either party decides to end participation in the UPL program.
No formal action was requested at the meeting; commissioners asked staff to continue monitoring the state UPL rate and to report back when the state posts new figures.
