The Arkansas Department of Health and Human Services is sending out letters to 20 hospitals that haven’t yet attained the trauma designation they’ve sought, saying time is running out.
And another letter already had been sent to Northwest Medical Center-Springdale, which failed its first site survey, said Bill Temple, the department’s branch chief for injury prevention and control.
Of the 82 hospitals inor near Arkansas that are eligible to apply to be in a trauma system that the state is establishing, 76 applied to participate and 55 have been designated as having passed the surveys, said Margaret Holaway, a trauma nurse coordinator who oversees the department’s northwest, north-central, southwest and southeast trauma regions.
The remaining hospitals are about to receive written notification of the consequences of not being admitted to the trauma network,said Temple, whose branch is under the department’s Center for Health Protection.
The trauma system will include four designation levels regarding emergency room capabilities, with Level I being the highest, and a statewide call center that will help route ambulances to the nearest and best available care.
“The hospitals will be getting a letter saying that in the next three months, they need to request a site survey,” Temple said.
Once they request this site review, they have six months to be evaluated.
If the hospitals choose to discontinue their pursuit of joining the trauma network, things won’t be the same as they were before because the state would no longer give those hospitals referrals of trauma patients.
“They will be taken off the trauma dashboard at the call center,” Temple said. “They will be ineligible for trauma system funding.”
The letter, dated July 1, reads in part:
“The Trauma System Act, passed by the Arkansas Legislature in 2009, states that in order to be eligible for start-up funding, hospitals seeking Level II, III, or IV trauma center status must demonstrate the capability of fully achieving this status within 12 months of receiving the funding.
“With respect to your hospital, this time frame has now passed. Your facility is in the small group of hospitals that have not yet requested a designation site survey.”
Temple said the tardy hospitals risk a time delay in having to start over, as they would have to submit a new intent letter.
Of the 20 hospitals notified, 18 are seeking Level IV designation, said department spokesman Ed Barham. They include Physicians’ Specialty Hospital in Fayetteville as well as hospitals in Harrison and Siloam Springs.
The other two are Sparks Regional Medical Center in Fort Smith and St. Bernards Medical Center in Jonesboro, though the latest on the levels they seek wasn’t immediately available, he said.
Arkansas is among the last states in the country to develop a fully operational network to coordinate injury-related medical treatment, state health officials have said. Its trauma-related death rate is about 50 percent higher than the national average.
The Springdale hospital is the only hospital so far that has flunked the site survey, Temple said. It was seeking a Level III designation.
“‘The designation site visit with Northwest Medical Center in Springdale resulted in a finding which is preventing them from being designated at this time,’” Temple said, reading from a April 20 letter noting the failure.
“‘They remain in pursuit of designation and continue to receive trauma patients,’” he continued. “‘The facility is in the process of strengthening quality improvement efforts.’”
Temple said he expects the Springdale hospital will request a follow-up site visit within the next six months.
Asked for more specifics on the deficiencies noted, Barham said, “There is a lot we can’t talk about, about hospital operations, by law.”
Barham cited Arkansas Code Annotated 20-13-806, titled: “Trauma data collection and evaluation system - Confidentiality of records.”
Subsection (c), which falls under a heading intent on keeping patient records confidential, reads: “Records and reports made pursuant to this subchapter shall be held confidential within the hospital and department and shall not be available to the public.”
Contacted for comment, Northwest Health System spokesman Pat Driscoll said, “We’ve not yet successfully obtained trauma designation, but we remain in pursuit of it.”
Barham said the Health Department notified the Northwest system’s chief executive officer, Dan McKay, by letter April 20 that the site review of the Springdale hospital uncovered “several deficiencies” and that the hospital had six weeks to respond.
“The hospital has responded with a plan to correct those,” Barham said, adding it did so within the six-week period. “The earliest they can reapply for designation is six months after the letter we submitted on April 20.”
Fayetteville’s Washington Regional Medical Center received its designation as a Level II trauma center on March 27, after notifying the state last November it would change its pursuit from Level III to Level II.
Before that, Washington Regional had been among other major hospitals in the Northwest Arkansas and Fort Smith River Valley areas seeking Level III.
That left health advocates concerned that the nearest Level I or Level II care for residents in the state’s northwest corner might be as far away as Springfield, Mo., which has a participating hospital and another applicant.
The Springdale medical center’s sister hospital, Northwest Medical Center-Bentonville, received its Level III designation Feb. 24.
Others among the 17 that have achieved Level III status include Mercy Hospital Fort Smith and Mercy Hospital Berryville, according to the state’s list.
A full list of the designated trauma hospitals serving Arkansas can be found at: healthy.arkansas.gov/programsServices/injuryPreventionControl/TraumaticSystems/Pages/DesignatedTraumaCenters.aspx.
So far, of the 55 designated hospitals, five have achieved Level I and five Level II, with 28 attaining Level IV designation.
The two levels offer similar emergency room capabilities, including having general and specialized surgeons available 24 hours a day and capabilities to treat patients with the most complex injuries, though Level I’s must also have the research, education and community outreach programs that typically go hand in hand withbeing a teaching hospital.
Level III centers are required to have fewer specialists, and Level IV centers are required to have only a trauma-trained nurse and a physician on call.
Northwest Arkansas, Pages 9 on 06/30/2012