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Mo. hospital sues state after officials revoke trauma center designation

Officials cited insufficient “trauma surgeon coverage” and more as cause to remove Northeast Regional Medical Center’s Level III trauma center designation

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By Jack Suntrup
St. Louis Post-Dispatch

JEFFERSON CITY, Mo. — The owner of a Kirksville hospital is suing the Missouri Department of Health and Senior Services in a dispute over the healthcare provider’s ability to treat trauma patients.

The Kirksville Missouri Hospital Company LLC, doing business as the Northeast Regional Medical Center, sued the health department Monday in an effort to stop the state from stripping the hospital’s Level III trauma center designation.

The health department denied the hospital’s renewal application in a Dec. 19 letter to the medical center, citing five deficiencies including insufficient “trauma surgeon coverage” resulting in multiple documented cases “where the trauma surgeon, on call at the time, did not respond to trauma patients’ bedsides within the promptly available time requirements.”

But, the hospital’s lawsuit said none of the five “perceived deficiencies” mentioned by the state involve “adverse patient outcomes.”

It said the 54-bed hospital is the only trauma provider of any kind in northeast Missouri and that losing its designation would cause irreparable damage to the hospital and northeast Missouri residents.

The designations — Level III is the lowest tier — determine whether ambulances bypass certain hospitals that aren’t equipped to provide necessary levels of care to trauma patients.

Removing the Kirksville hospital’s designation would mean ambulances carrying trauma patients would have to make a 95-mile trip to the next-nearest trauma hospital in Columbia, the lawsuit said.

“Trauma patients in northeast Missouri will have no option but to travel that additional distance before being evaluated and treated by trauma surgeons,” the lawsuit said.

It called this an “unnecessary risk” to northeast Missouri residents, “many of whom are already long distances from NRMC and are transported by rural roads.”

In the state’s December denial letter, Nicole Gamm, system administrator for the Time Critical Diagnosis Unit of the DHSS, said that while the health department finds having Level III trauma centers beneficial, patients who experience delayed treatment “have a greater potential to die or become even more critical while waiting for a trauma surgeon to respond to the trauma patients’ bedsides.”

The state found “multiple documented instances where the trauma surgeon arrival time after trauma patient notification was greater than thirty (30) minutes,” the letter said, in violation of state regulations.

The December denial letter cites four other deficiencies that had not been resolved after a May 2022 review: insufficient resources for the trauma program, incomplete and non-current records submissions to the state on trauma patients, an inadequate performance improvement program, and no evidence that the hospital provided training and clinical resources to local and regional emergency medical services systems as required.

The lawsuit challenging the denial said the hospital appealed the state’s decision on Jan. 13 to the Administrative Hearing Commission.

While the state allowed the hospital to continue its trauma program while the case was pending, “the Department now takes the position that it cannot continue to do so without a court order.”

In addition to longer distances for trauma patients, the hospital said its trauma surgeons were also highly likely to leave if the hospital can’t accept trauma patients, the lawsuit said.

“It is exceedingly difficult to recruit qualified physicians to rural hospitals like NRMC,” the lawsuit said.

The state in December said Northeast had two trauma surgeons to handle all trauma patients.

The lawsuit filed this week said that to provide trauma services, the hospital employs or contracts with “several specially trained providers, including three trauma surgeons, trauma trained nurses, a trauma program director, and others.”

If the hospital loses its trauma surgeons and patients, other employees’ jobs would be threatened, the lawsuit said.

“Those losses are borne heavily by the community, which loses access to a valuable resource when lives are at stake — timely trauma care,” the lawsuit said.

The hospital filed the lawsuit in Cole County Circuit Court and the case has been assigned to Circuit Judge Cotton Walker. A hearing had not been scheduled as of Wednesday.

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