New Mexico
Fewer beds and smaller earnings will hurt New Mexico hospitals as new state law goes into effect • Source New Mexico
Smaller New Mexico hospitals will soon start missing out on government funding due to their fewer number of beds and smaller financial performance.
Senate Bill 17 signed into law earlier this year is set to go into effect this summer, redefining how the state calculates its portion of the Medicaid match for hospitals. The Healthcare Quality Delivery and Access Act establishes that 60% of the state’s match is based on “Medicaid service volume” or beds while 40% is based on performance, which is determined by the Health Care Authority based on reports from the hospitals.
“Ultimately, the bill aims to improve and increase access to healthcare services within the state. However, hospitals that do not have significant Medicaid service volume will not see much benefit,” reads a Legislative Finance Committee report.
According to the report, smaller hospitals with fewer beds care for fewer Medicaid patients, compared to bigger hospitals with a larger capacity to treat Medicaid patients.
“Given the structure of the act, hospitals most at risk of down-sizing may not see much benefit. Generally speaking, hospitals that are not fiscally-challenged will receive the bulk of the financial aid based on bed count,” the report reads. “Ultimately, the act does not target hospitals that are financially struggling, and instead helps larger hospitals which are generally already profitable.”
The LFC report uses Rehoboth McKinley Christian Hospital in Gallup as an example. The smaller hospital lost around $20 million in 2022 and will receive about $6.5 million from the new law.
Rehoboth has made headlines recently by being ordered to pay over $100 million in medical malpractice damages. The civil case was filed in 2019 following a patient’s botched hernia surgery left them with life-long complications.
Gallup hospital says it is ‘indigent’ ahead of court order to find more than $100M
“This will not cover the full extent of the losses that Rehoboth faces and they will still have a negative net margin of more than $13 million,” the LFC report reads.
On the other hand, the larger Eastern New Mexico Medical Center reported a profit of about $80 million in 2022 and will receive over $37 million from the law. The report said if the Roswell hospital’s earnings remain on track, it could see over $117 million in combined profits and matched funding from the state.
Twelve New Mexico hospitals which qualify for funding under the new law reported net losses in 2022. Four of them will not receive enough state match funding to turn a profit. These include Rehoboth, Presbyterian Hospital in Albuquerque, Santa Fe Medical Center, and Encompass Health Rehabilitation Hospital of Albuquerque.
In Southern New Mexico, Artesia General Hospital reported a nearly $3 million loss in 2022 and is only projected to receive $5.6 million in match funding. The hospital will be profitable at $2.7 million, which is low compared to other larger hospitals in the region.
The report also noted that public funds made up about 70% of total hospital revenue in 2022 and this number is projected to reach 74% by 2025. These include funding from Medicaid, Medicare, Medicare Advantage and state subsidies.
“As the state continues to increase hospital subsidies, New Mexico is in a unique position to ensure hospitals use their revenue to improve patients’ outcomes and access to healthcare,” the report reads.
During a Legislative Health & Human Services Committee meeting this week, Rep. Tara Lujan (D-Santa Fe) said the report raised several “red flags” for the lawmakers.
“We don’t always have all the answers when we come up with legislation. But I knew that we worked together with institutions, with legislators, with the executive office particularly on this bill,” Lujan said. “It looks like we need to make some adjustments.”
When asked by Rep. Pamelya Herndon (D-Albuquerque) about solutions the legislature should consider, LFC Analyst Allegra Hernandez said lawmakers need to make sure there are measures in place to hold hospitals accountable, and to improve care.
She added that the goal should be to make sure New Mexico hospitals are in a financially “healthier place” in five years, and that she does not believe Senate Bill 17, as it is currently written, will do that.
Hernandez offered one solution – the rural emergency hospital designation through Medicare. This designation was established through the Consolidated Appropriations Act of 2021 by Congress. The idea is that smaller, often rural hospitals would transition to become a rural emergency hospital and only offer emergency care to patients. This would limit access to broader services for patients seeking care.
“The rural emergency designation possible by (Medicare) is one potential answer, although it’s not necessarily the most popular answer as it would close hospital beds and only allow for emergency services,” Hernandez said.
Hospitals that choose to transition to this designation would receive another 5% in Medicare funds and a monthly facility payment of about $272,000. According to the LFC report, Guadalupe County Hospital is the only hospital in the state that has chosen to make this transition.
“The state and hospitals will likely need to continue to make difficult decisions about when it is necessary to close hospitals or sections of hospitals,” Hernandez said. “(The rural emergency designation) is an option, although, as I said, it is controversial,” Hernandez said.
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New Mexico
Group asks lawmakers for additional funding to help rural New Mexico libraries
NEW MEXICO (KRQE) — They are community pillars in some of New Mexico’s towns. However, for dozens of the state’s rural libraries to survive, advocates are now hoping state lawmakers can pitch in with a crucial life-line.
“It’s critical for our success to have this space available to us,” said Placitas Community Library Patron, Geeta.
Geeta and her book club meet every month inside the Placitas Community Library. For them, it’s convenient and comfortable.
“Being in an environment with all of these books just feels right,” said Jody, who is also involved in the book club.
However, the rural library east of Bernalillo, said they offer much more than just books.
“Everyone comes here when they need anything. When they need internet, when they need books, when they need faxing, we really are the heart of the community,” said Board Chair at the Placitas Community Library Lynnette Fields.
While serving the community, the Placitas Community Library is among dozens across New Mexico that see no municipal funding.
“We don’t have any tax dollars. We get our funding from the New Mexico state library, from county bonds, and mostly from donations from our patrons,” said Fields.
The library is part of the New Mexico Rural Library Initiative which helps 60 remote libraries statewide in towns from Clayton to Abiquiu.
“We support rural libraries with hands-on help. Things like grant writing, helping them with programming, and questions about bylaws,” said Executive Director of the New Mexico Rural Library Initiative Shel Neymark.
Normally in towns without any other public services, rural libraries often host education programs and other resource connections. The initiative is asking lawmakers for nearly $30 million next legislative session to double the size of their endowment.
“The disbursements from the endowment would give each library approximately $45 thousand dollars a year,” said Neymark.
The organization said each of the 60 libraries received more than $20,000 this year. The Placitas Community Library said the critical funding keeps the doors open, helps grow their collection and a lot more.
“We are also going to get a sound booth which will allow our patrons to come in and have meetings in a private space,” said Library Director of the Placitas Community Library Lynne Hynes. “When that funding comes in, it allows us to provide the furniture, the spaces, the things that we need.”
The initiative is also a key player in opening new libraries. They are working now to see possible new openings in Pecos and La Cienega.
New Mexico
NMDOT and Santa Ana Pueblo break ground on $2.4M intersection project
The project is aimed at making it easier for drivers to turn in and out of the pueblo.
SANTA ANA PUEBLO — Construction is set to start next month on a road project designed to help drivers turn in and out of the Santa Ana Pueblo.
The Santa Ana Pueblo and the New Mexico Department of Transportation broke ground yesterday at New Mexico State Road 313 and Dove Road.
The Santa Ana Pueblo governor said they’ve been working on plans for that intersection for a decade now. The whole project is expected to cost $2.4 million.
New Mexico
Water managers push for funding to remove invasive plants from the bosque
NEW MEXICO (KRQE) — It’s a major problem, sucking up lots of water from the Rio Grande. Now, some water managers are asking lawmakers to get serious about ripping invasive plants from the bosque by spending millions. An “out of control bosque” is how the head of the Middle Rio Grande Conservancy District (MRGCD) describes the areas around the river in central New Mexico, and he said it’s time for a generational project to take on the problem.
Not everything green in the middle valley’s bosque is helping New Mexico’s water supply, with a newer study highlighting how the Rio Grande’s riparian species are taking just as much water as surrounding farms. In fact, they’re actually consuming a percentage point more than agriculture.
Jason Casuga, the MRGCD’s CEO and Chief Engineer, said conversations are not being had across the board regarding water conservation. “We’re not having a fair conversation about riparian depletions,” said Casuga.
He said he thinks both the bosque and farming are worth protecting. “If we’re going to have standards for depletions on urban areas, standards for depletions on reducing those across farming, then the only way to have a realistic discussion about reducing depletions, as a whole, is to include the riparian area.”
Casuga said that invasive Salt Cedar and Russian Olive plants drive the problem of the extreme riparian water depletion, and that it’s unfair to farmers and cities to ignore what he calls a “takeover.” And that is especially when irrigators are often the first to cut back on water use. “Are we really going to ask farmers and have cultural farms on the Rio Grande go away? And leave hundreds and hundreds of acres of invasive species of Salt Cedar and Russian Olive? Is that what we’re protecting?
He stressed that he thinks if there are standards for agriculturalists and municipal entities, then there ought to be standards for invasive species as well. That feeling has Casuga pushing for a massive, coordinated invasive plant removal effort. He’s calling on lawmakers to fund a multi-million dollar investment in the project next session.
He said not everyone is quick to get on board with proposals like this. “Right now, everyone says, ‘Hey, it’s expensive, and it’s hard, and the easy thing to do is to target ag.’ But, I pose the question back, ‘If we love the Rio Grande in the Middle Valley, and we love the heritage of ag, is it a conversation worth having?’”
He said the millions would also ideally pay for bosque upkeep and native plant restoration. But one hurdle is finding qualified contractors to take on that difficult job
A Mississippi crew is now working to clear invasives near Belen. The MRGCD said while saving water, the job also cuts wildfire risk, and makes a big difference if firefighters do need to move in.
The MRGCD’s Bosque Management Coordinator said the next step in the Belen bosque restoration project is to plant more native grasses and bushes, which is expected to help wildlife. The methods used to eradicate the invasives protected the native plants that were already there.
“The more diverse food sources you have available for the wildlife, the different types of wildlife you have, and you’ve got a healthy food system that’s supporting multiple species throughout the year,” she said. “The species that come here in the summer to breed, and the species that come here in the winter will still have access to be able to find bugs under the ground, find any of the seeds from the species that have been seeding out, and still have access to water and then access to places where they can hide and they can have burrows and sustain themselves through multiple conditions.”
The MRGCD is celebrating its 100th anniversary this year. It was founded to create the infrastructure capable of transforming the Middle Rio Grande Valley—by building and connecting more than 1,200 miles of canals and hundreds of miles of levees—to support agriculture and enable the growth of Albuquerque and surrounding communities.
Casuga said that it was a difficult endeavor then. “Tremendous amount of effort and resources were put in for that day—to set the river for essentially a hundred years that we’ve enjoyed with some problems here or there,” said Casuga.
He took a moment to think. “This might be generational work that needs to be done that sets the stage for the next hundred years.”
The MRGCD said Valencia and Sandoval counties need the most attention in removing invasive plants. While the District is still considering its exact proposal for a large removal effort, and doesn’t have a specific dollar figure on potential cost, it’s thinking of a project worth at least several million dollars.
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