Dec 29, 2006 - 04:12:39 CST
A Wilton medical facility that treats patients with mental illnesses faces an uncertain future.
"We're hoping we don't have to close," Redwood Village administrator Dana Polk-Simmers said. She doesn't know when a decision will be made.
Redwood Village has 34 patients.
The uncertainty comes from a North Dakota Department of Human Services finding that it's out of compliance with federal regulations that guide Medicaid reimbursements. It gave the facility until Dec. 31 to reduce the number of patients to 16, or it would no longer receive Medicaid payments.
Human services has known about it for a year, and has worked with Pride Wilton, the owners of Redwood Village, to sort it out, said Maggie Anderson, director of the medical services division of the Department of Human Services. Her department would not be involved in making the decision whether or not the facility closes.
Polk-Simmers said the facility will be able to remain open after Dec. 31, but the facility's long-term future is uncertain.
Any facility with more than 16 mentally ill patients is classified as an institution for mental disease. Those institutions don't qualify for Medicaid.
The facility is out of compliance with the definition of an institution of mental diseases because it has more than 16 beds and it primarily engages in diagnosing, treating and caring for mentally ill patients, Anderson said. Redwood Village relies on Medicaid payments to stay open.
Once the population drops to 16, it will not be an institution of mental disease, and it will become eligible for financial participation, Anderson said.
If Redwood Village is considered out of compliance by the state, other health care providers cannot receive reimbursement from Medicaid when residents seek outside health care, Anderson said.
Officials at Redwood Village are attempting to meet the request of human services by relocating patients and working out a way to still be financially viable with fewer patients.
"The majority (of patients) are on Medicaid," Polk-Simmers said. "It makes it impossible to run with only half the beds filled, and we would not be able to stay open."
Polk-Simmers was told Medicaid will only reimburse a facility that treats mental illness patients if it serves 16 or fewer patients. Redwood Village is operating at capacity now with its 34 residents.
West Central Case Management, a long-term care case manager and the North Dakota Long Term Care Association are working with the facility to redesignate the facility for basic care and to relocate patients to other facilities so that it meets the human services department's request to no longer meet the definition of an institution for mental disease. Changing the facility's designation would help with Medicaid reimbursement for room and board and basic care services, Anderson said. West Central Case Management is helping relocate patients so that the facility can pare down to 16 beds.
In determining new facilities for the displaced patients, Redwood and West Central Case Management are considering patient preference, location of family, hometown or where they grew up, Polk-Simmers said.
Redwood Village employs about 25 people. It has been open for 35 years, treating illnesses like bipolar disorder and schizophrenia.
(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@;bismarcktribune.com.)
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