Tilden Community Hospital To 'No Longer Be A Hospital'

The Tilden Community Hospital plans to cease inpatient services as of July 1, transition to an outpatient-only care center and no longer be a hospital.

According to hospital administrator Lon Knievel, he recommended 
to the board of directors to enter into negotiations with Faith Regional Health Services (FRHS) to lease the clinic and 1970s wing and to assume the operation of the clinic, lab, X-ray, therapy, and any other specialty clinics and utilizing current staff. 

"I know this is not what anyone wants to hear, and it is not the course of action that anyone wants to take; unfortunately, we are being guided by circumstances that are out of our control," Knievel said. "The hospital board of directors, administration and staff are doing their very best to make a smooth and uncomplicated transition from what we currently are, to what we will become. Please know that we have the best interest of the community and the hospital staff in mind."

For the past year, inpatient volumes have been low enough that, even with cost-based reimbursement, the hospital has run an operational shortfall of $30,000 to 60,000 per month, according to Knievel.

"Being a city-owned facility, I do not feel that running into debt is an option, especially with the current level of patient volumes and the healthcare environment becoming more stringent," Knievel said. "Before our cash becomes totally depleted, I want to see us make rational decisions for the future of healthcare within the community, and also be able to provide some semblance of support and adequate notification to the employees that will be affected by this decision."

No recommendation is being made at this time for emergency care, Knievel said.

"One of the many unfortunate results of this action is that we will no longer be able to provide emergency room care. In effect, we will no longer be a hospital," Knievel said. "I have briefly met with the Northeast Region EMS Coordinator for the Nebraska Department of Health and Human Services and explained our forthcoming situation. The dilemma of Emergency Medical Services is one issue that we will be looking to find a solution for in the coming months."

The nearest hospital to Tilden is Antelope Memorial Hospital in Neligh, which offers emergency treatment. The hospitals are 14 miles apart. 

When asked about utilizing AMH emergency services, Knievel said, "This is one of the things we need to discuss. We'll have discussion on what decision will be best for the community."

The Tilden Community Hospital is a city-owned facility, so the city council must take action on the board's recommendation. The next council meeting is Tuesday.

Knievel said Tilden Community Hospital has had affiliation with FRHS since December 2010.

"I have looked at the option of the city maintaining these services, but I do not see this as a viable, long-term solution. The overhead and administrative costs that would be required to maintain an outpatient center would eventually result in the same scenario we are facing in the hospital currently, with expenses exceeding revenues," Knievel said. "Since FRHS is the regional referral center, and since we have a longstanding relationship with them and already receive many services from them, I feel they are in the best position to maintain outpatient healthcare services into the future."

Knievel said his recommendation to the board was not made lightly, and it is something he has wrestled with for several months.  

"For the past 13 years, TCH has been on a path of progress. Our goal has always been to improve the quality of care that we provide to the community. We have made many changes and fought hard to reach that goal. Over the past six years, we have seen a steady decline in our inpatient volumes. There are many factors that have contributed to those declines: everything from inpatient admission criteria to changing community demographics and high quality care from our clinic providers," Knievel said. 

Knievel said in order to make a smooth transition to an outpatient healthcare facility, the board will recommend to the city council to allow the current board of directors and administration to plan and implement this transition. Also, in order to continue to enhance the delivery of healthcare services, any funds remaining will be put in a trust and used solely for the purpose of delivering healthcare services to the community.

Knievel said the hospital currently is not in debt, and he is unsure at this time if there will be any funds remaining.

If the Tilden City Countil approves the above recommendations, the hospital will cease inpatient services as of 12 a.m. July 1 but continue to meet the healthcare needs of the community through the clinic and other outpatient services. 

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