From Crisis to Comeback: Helena’s Hospital Nears Profitability After Rural Emergency Designation

Justin Pope, CEO of Progressive Health of Helena, on Monday Oct. 21, 2024, in Helena (Steve Lewis)

Ten months after Helena’s hospital became a rural emergency hospital, owner Quentin Whitwell says the designation rescued it from life support.

“Well, absolutely,” said Whitwell, CEO and owner of Progressive Health Group of Oxford, Mississippi. PHG bought Helena Regional Medical Center in January for $2.5 million and renamed it Progressive Health  of Helena.

“That hospital was losing $8 million a year” when he bought it, Whitwell told Arkansas Business. “And you know, we’re right about to the break-even point right now.”

Profitability is now around the corner, said Whitwell, a lawyer by training whose group owns or manages eight hospitals in Arkansas, Mississippi and Georgia.

PHG turned six of those hospitals into rural emergency hospitals, which get cash infusions of more than $260,000 a month and better reimbursement rates for outpatient care.

In return, the hospitals halt inpatient care and pledge to keep a staffed emergency department 24 hours a day. The federal REH program began in January 2023, but only 19 hospitals nationwide made the transition that year.

As of Aug. 22, 32 U.S. hospitals had the designation, including Helena and three others in Arkansas: Eureka Springs Hospital, South Mississippi County Regional Medical Center in Osceola and St. Bernards Five Rivers Medical Center in Pocahontas.

Despite repeated phone messages and emails seeking comment for this article, administrators at those hospitals did not respond.

Getting It Right

By the time Progressive Health of Helena received the REH designation Feb. 1, the program was already a pillar of PHG’s business plan, Whitwell said.

Congress created the designation to stem a tide of rural hospital closures. REH provides an additional 5% payment for Medicare patients receiving covered outpatient services, along with monthly payments adding up to $3.3 million for this calendar year. The money comes from the Centers for Medicare & Medicaid Services.

“For the first time in a long time, I think the government got something right, at least on the front end,” Whitwell said. “The laws have been devised in such a way that a rural hospital can’t really keep patients in the house any longer, because of the criteria required to keep a patient as an inpatient. These hospitals are dying, so why not just go ahead and rip the Band-Aid off?

“You just acknowledge that you’re no longer going to do inpatient care and they’ll subsidize you for maintaining your emergency room, and they’ll pay you more for your outpatient services,” he added.

Whitwell said Helena’s wasn’t the first hospital losing $8 million a year that he’s turned around. In 2012, after years of practicing health care law, he was asked to rescue a struggling hospital in Holly Springs, Mississippi, which led to his acquiring and managing hospitals on his own.

After the REH law took effect at the start of 2023, Whitwell moved quickly, converting the status of Irwin County Hospital in Ocilla, Georgia, on Feb. 1. It was the second REH-designated hospital in the country.

“We kind of famously converted the hospital in Holly Springs right after that, but that was taken back because it was allegedly in the metropolitan statistical area of Memphis,” Whitwell said. “That’s not what the law says, and it is still an ongoing debate to this day. We converted the hospital in Batesville, Mississippi, in November of  ̕23 … and then we converted Helena in 2024 and Houston, Mississippi, in August.”

PHG, which has more than 1,000 employees, also owns a critical access hospital in Marks, Mississippi. The company is also managing Southwest Arkansas Regional Center in Hope.

Pafford Medical Services of Hope bought the Hope hospital out of bankruptcy for $200,000 in September. 

Beyond Saving Hospitals

The premise of the REH program was to simply save rural hospitals, but Whitwell sees far more potential.

“I’ve gotten some national attention about this, and I personally believe that this rural emergency hospital [program] is a way to actually improve services that otherwise wouldn’t be there. It’s not just saving hospitals from dying. … Now we have the opportunity to grow our outpatient services because we get reimbursed at a higher rate.

“My surgeries are up in my rural emergency hospitals, my clinic visits are up, and my ER visits are up. My imaging business is up, and we’ve added specialties like pain management and wound care and podiatry. We’re even bringing in clinical business by specialists such as cardiologists and rheumatologists. This has actually improved our rural hospitals and services.”

Rural emergency hospitals must provide 24-hour ER care, lab services “consistent with the needs of the patient population,” diagnostic radiology and discharge planning supervised by a “registered nurse, social worker or other qualified personnel.”

Designated hospitals are allowed to provide additional outpatient care like behavioral health, surgery and outpatient rehabilitation. They can also set up a separate licensed skilled nursing facility to provide post-hospital services. They can also be originating sites for telehealth services.

A New Leader

Justin Pope, who took over as Progressive Health Helena’s chief executive officer just this month, drew praise from Whitwell as a talented, high-energy leader “who is setting the right tone” for a brighter future at the 100-employee hospital.

“Today marks my second week here, and we’re already trying to make some strides with the community,” Pope said when reached by phone earlier this month. “I’m a hands-on person, so I’m here every day, meeting new people and trying to help us grow.”

Many Helena-West Helena residents had misconceptions about the rural emergency hospital designation, Pope said.

“When they heard we were going REH, they didn’t understand we were just ending inpatient care,” he said.

“They thought the hospital was shutting down. Rural hospitals are one of the main things going for a struggling community.”

Plans call for continued expansion, Pope said. “That’s what we’re going to try to do over here in Helena. Bring back more outpatient services, bring in more outpatient surgery.”