Protecting the Future of Healthcare in Martin County

We continue to work with CMS and others to get the information we need to be able to begin the RFP/public bid process. During this period, Ascendient and the County commit to providing updates as progress is made, and at least monthly.

Below are updates from Ascendient and Martin County regarding the lease of Martin General Hospital and the provision of healthcare in the county.

Updates as of May 31, 2024

Updates

Ascendient and the County are still working diligently to find a solution to sustainable healthcare in Martin County. This process has taken much longer than anyone had hoped, but please know that we care deeply about this community and are doing everything possible to find a long-term solution for care in the County.
Earlier this year, Ascendient and the County identified three essential questions that must be answered before beginning the search for a new operator for Martin General Hospital and issuing an RFP:

1. How—within both state and federal regulations—can we reopen a closed hospital as a rural emergency hospital (REH)?
2. What, if anything, needs to be done to the existing hospital building before it can reopen?
3. What, if any, kind of capital does the hospital need to reopen and what potential funding options are there for Martin General Hospital?

Today, we can share answers to some of these questions, but further work is still needed before we can find an operator and move toward reopening the hospital.
Regarding questions about the REH designation and needs of the existing hospital building:
- The Centers for Medicare & Medicaid Services has indicated that we are able to reopen the now closed facility as a rural emergency hospital. This is a positive step forward, but still requires that the building meet the facility requirements mandated by CMS, which are different requirements than those for a general hospital.
  - Martin General could be the first hospital in the country to reopen as an REH. Therefore, CMS had to determine how the regulations would apply under those circumstances, which is why this process has taken longer than expected.
- Before Martin General can be reopened, the North Carolina Department of Health and Human Services (NCDHHS) must determine whether the building meets those REH facility requirements and we need to identify any other updates the building would need before reopening.
- On Tuesday, May 28, NCDHHS and the County’s advisors conducted a walkthrough of the hospital to begin the process of determining if it meets the REH requirements and if needed, identify necessary updates. The purpose of this visit was to:
  - Begin the process of determining if the building meets the requirements for an REH,
  - Familiarize DHHS with how the building could be used as an REH, and
  - Identify any necessary updates the building needs.
- The visit on Tuesday was a great start. Since DHHS must approve the licensing of the REH it is important they understand and see firsthand our vision for the building.
- NC DHHS recognizes the importance of rural healthcare in the state and wants to help.
We are cautiously optimistic and recognize there is still a lot of work that needs to be done.
In addition to identifying the needs of our current facility, we must also determine the potential funding options to reopen the facility.
The good news is that we are now working to answer both the funding and existing needs questions at the same time.
As soon as we have answers to these remaining questions, we will be able to move forward with the process including issuing an RFP to all interested parties and anyone else who wants to submit a proposal to provide healthcare in Martin County.

Previous Updates

Ascendient and the County have met with the NC Department of Health and Human Services Division of Health Service Regulation (DHSR), Centers for Medicare and Medicaid Services (CMS) and others to discuss options for providing sustainable healthcare in the county.
Over the past few months, there has been interest from more than a dozen potential partners in operating healthcare services in Martin County.
Down the line, Ascendient and the County plan to facilitate an RFP and state-required public bid process, where interested parties will submit their proposals for providing sustainable healthcare in Martin County.
Each party is currently under a non-disclosure/confidentiality agreement (NDA), as is the County, to protect the County’s interests ahead of releasing requests for proposals.
The following questions need to be answered before the RFP/public bid process can begin:

1. How—within both state and federal regulations—can we reopen a closed hospital as a rural emergency hospital(REH)?
2. What, if anything, needs to be done to the existing hospital building before it can reopen?
3. What, if any, kind of capital does the hospital need to reopen and what potential funding options are there for Martin General Hospital?

As previously noted, Ascendient and the County believe an REH is one viable model that could ensure access to healthcare services in Martin County. Many of the interested parties are open to operating Martin General as an REH.
The rural emergency hospital model is brand new, and no other hospital in North Carolina has converted to an REH yet—certainly not one that has previously closed. Therefore, the state and federal governments are still figuring out how this can and should be done.

About Rural Emergency Hospitals

A Rural Emergency Hospital (REH) is a new designation designed to support rural communities by providing emergency and outpatient services without maintaining inpatient facilities. Existing rural hospitals can convert to REH status to receive enhanced Medicare reimbursements, ensuring financial viability.
As you may recall, REH legislation was passed as part of the state budget in early fall last year. Without the work of the Martin County Board of Commissioners, this model would not be possible in NC today.
Many of the interested parties we’ve talked to are interested in operating Martin General as an REH.
We believe an REH is a viable, sustainable model that will ensure access to healthcare services in Martin County. Making this come to life requires intense collaboration with the NC state government and federal government and interface with the Williamston Hospital Corporation bankruptcy process.
However, this is a brand-new model and NO OTHER hospital in NC has converted to an REH yet.
In addition to the fact that there are no other REHs in the state of NC, no one else has been in the situation that we are in – trying to reopen a closed hospital as an REH.
- That means that all the questions about how it can and needs to be done, what regulations apply and what regulations don’t in our unique situation, are being explored and answered for the very first time with the help of state and federal government officials.
As we continue to work with state and federal officials to resolve these questions, we also need to be mindful of the interface that will be necessary with the bankruptcy trustee during the process.

Frequently Asked Questions

Where can I go for care now that the hospital is closed?

The nearest emergency room is ECU Health Beaufort Hospital in Washington, NC is 22 miles south.
The following clinics remain open to care for patients: Martin Family Medicine, Agape Health Services.

Where can I go to remain up to date?

Watch the most recent Martin County Update here:

Submit your email to receive updates on the future of healthcare in Martin County.

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