The Greenwood Leflore Hospital Board of Trustees held its regular monthly meeting.

According to the financial report given by Mrs. Dawne Holmes, the Hospital had an overall loss of $2.16 million in November. Operating expenses were $6.78 million, while operating revenue was $4.39 million.

The overall loss would have been greater, but Greenwood Utilities and the city forgave $231,000 in utilities for the months of October and November.

At the end of November, the cash and equivalents were $5.56 million. Of the cash left, $2.70 million cannot be touched legally because it is in trust to cover the malpractice insurance. That would mean that in reality, at the end of November, there was only $2.86 million in cash left to spend.

In November, the hospital made approximately $103,000 in payments to Medicare for the repayment of the short term loan. The hospital still owes Medicare $5.40 million.

Dr. Dan Edney, Mississippi State Health Officer, discussed the hospital's financial situation. He pointed out that the federal government determines how health care is funded, and that the federal government really does not see a need for this hospital. It makes these determinations based upon population and the number of hospitals in the area. It doesn't pick which hospitals should close down, but the reimbursement model it has implemented means that not all 20 Delta hospitals will survive. Dr. Edney stated that this conversation isn't being held often enough in our state, so people are not aware of the basic facts of medical care finance.

Dr. Edney described how it is costing hospitals in Mississippi not to expand Medicaid. Fifty-four percent of rural hospitals are in jeopardy of closing. GLH hasn't closed, but it has downgraded its services.

Dr. Edney praised GLH for what it did during the COVID pandemic, with the nurses and doctors and other staff members working to save lives.

He described how operating costs have skyrocketed, but payments have not gone up. Medical providers cannot raise their prices, since the government dictates the amount actually paid.

Dr. Edney stated that there is no single answer for solving this crisis. He does not expect a "silver bullet" to come out of the state legislature in 2023. He stated that there is a long line of hospitals with their hands out for help.

Dr. Edney urged the board members to learn these facts and understand them if they are going to make decisions on how to run the hospital.

He described the new Rural Emergency Hospital designation that CMS is introducing in 2023. He stated that it is an opportunity for rural hospitals to "get out of the hospital business," while still providing emergency and outpatient care to their communities. This new designation will incentivise hospitals to downgrade services in order to stay afloat.

Dr. Edney stated that this will mean that "there will be less competition" six months from now, but that he has no ability to direct how that process plays out, or who will survive.

Edney stated that GLH is worthy of saving, because it provides critical services to the Delta.

Edney stated that in his position, he is trying to strengthen the "safety net" at the Health Department to help fill in when services are cut back at the hospitals across the state.

Edney stated that the "winds of change" are in GLH's favor, and that the economic stressors will be better then, so long as GLH can survive to that point.

Edney stated that the state has 110 hospitals, and Mississippi doesn't need that many. With 20 hospitals in the Delta, there is not enough patient volume to sustain them all.

Edney stated that even critical access hospitals aren't making it economically any more, and are looking to downgrade to rural emergency hospitals, which will have only emergency and outpatient services.

He discussed Medicare Advantage plans, and described them as federal HMOs with less payment levels than regular Medicare. He stated that Medicare will continue to push down on payments, because Medicare is itself unsustainable.

He stated that GLH does not presently quality for either critical access or the new rural emergency hospital designation, due to federal regulations now in place.

Edney expressed concern that GLH would not be able to overcome the 35 mile rule that would bar the hospital from being designated for critical access.

Some ideas for how to raise awareness and lobby state and federal government leaders were discussed by audience members and Dr. Edney.

The board then went into executive session, with the public and the press excluded for 69 minutes.