Texas Health Presbyterian Hospital Rockwall is petitioning the U.S. Department of Health and Human Services for permission to double the number of beds they have.
Although Texas Health Resources is the management partner and holds majority ownership, the hospital is partially physician owned. The Affordable Care Act mandates that physician owned hospitals must lobby HHS before any expansion. Only three hospitals have been granted permission to expand, including The Baylor Scott & White-owned Lake Pointe Medical Center, which just added another 36 beds.
Texas Health Rockwall is currently licensed for just 60 beds. They need a total of 120 beds to meet the needs of the county’s recent growth. Rockwall County has grown 14.5% in the last 5 years. The state average is just 8.7%.
“When we built the hospital in 2006, we had growth in mind because we knew that Rockwall was continuing to grow at an unprecedented rate,” says Cindy Paris, the hospital’s president. “We built the hospital with the idea to expand into two floors on our patient care tower and grow our ancillary services with construction surrounding the hospital on our 33 acre campus.”
The provisions of the Affordable Care Act have delayed the expansion. Rather than licensing another dozen beds on the second floor of the patient care tower, Texas Health Rockwall added a unit for observation. Paris called it a “Band-Aid,” but it was a creative way to keep patients out of the licensed beds that may not need them—think a patient who arrived to the emergency room thinking they were having a heart attack when it’s really a bad case of indigestion.
“We can do lab work and diagnostic tests and so-forth that let us know within a few hours what’s really going on with the patient,” she said. “They get observation status because we don’t want them to go home.”
If a patient does require treatment, they will have to be moved to one of the hospital’s operating room beds or procedure beds before being admitted inpatient.
To be approved for expansion, the hospital must prove that the county’s population has grown at a 150% of the state average, that their total Medicaid admissions exceed the average, that the occupancy rate is greater than the state average, and that the hospital accepts public programs like Medicare and Medicaid.
“If you can’t take care of the patients that are coming in the door, you have to figure out how to deal with the delays,” Paris said. “As healthcare providers, when you can’t meet the need of your growing community—and we all actually live here in this community—we want to do the absolute best that we can.”
Last December, Rockwall was struck by a series of devastating tornadoes. In all, the storms killed 13 and injured hundreds. Paris said patients were being treated in hallways of the emergency room, that many members of the community fled their homes and took shelter at the hospital. Interstate 30 was closed at Dalrock, blocking the most direct route over Lake Ray Hubbard. The hospital, located on the east side of the lake, had to reroute to Highway 80 south of the lake to transport patients to other hospitals.
“It was very, very clear how isolated you can become so quickly,” Paris said.