Even as Rennova Health's CEO vows to reopen the rural Tennessee hospital he was forced to close last month, local government officials are working up an extreme contingency plan: opening their own facility.
"Doctor's health is in danger because of stubbornness," Fentress County Executive Jimmy Johnson said. "That's all it is."
Leadership closed Jamestown (Tenn.) Regional Medical Center the day after the CMS revoked its Medicare billing privileges in June for accumulating more than $4 million in unpaid bills, lacking key supplies and keeping money from employees' paychecks.
Now, the fate of medical care in Fentress County is wrapped up in a tussle between local government officials and the West Palm Beach, Fla.-based lab testing company that bought the hospital a year ago.
Rennova CEO Seamus Lagan wrote in an email that his company has filed to reactivate its provider agreement with the CMS in lieu of appealing the federal agency's decision to revoke its original agreement. A provider agreement with the CMS determines whether providers can bill Medicare and Medicaid. A CMS spokesman did not return a request for comment.
But Johnson, the county official, called it a "hostage situation." He said Lagan has received at least one offer to buy the hospital. If he doesn't accept, Johnson said he and others may seek a certificate of need from the state to repurpose an existing building in Fentress County for use as an emergency department that can treat trauma patients. He said he is aware of buildings that could potentially be purchased and reconstructed into medical facilities.
Lagan wrote that he has not received any offers to buy or lease the facility, but that he would consider them if he did.
As it stands, if any of Jamestown's roughly 2,000 residents needs hospital care, they will have to travel 45 minutes to an hour to the nearest facilities in Cookeville, Crossville or Livingston.
"It's sad that one person could have this much power over someone's health if they got sick, if they got hurt, if they were in desperate need," Johnson said.
Johnson, Jamestown Mayor Lyndon Baines and three state representatives whose district includes Fentress County met recently with Tennessee Gov. Bill Lee to discuss the hospital's fate. A spokeswoman for Lee did not return a request for comment.
Lagan blamed the CMS for keeping the hospital closed.
"It is our opinion that the CMS decision to terminate Medicare participation has caused more risk to health and cost to the community than an effort and collaboration to rectify their identified deficiencies would have cost," he said.
Johnson said he no longer believes what Lagan says. He said Lagan does not accept responsibility for the hospital's closure, and instead blames it on a new billing system and on the CMS.
Michael Alexander, an executive with a long history of work in rural hospitals, took over as CEO of Jamestown Regional just days before it closed. He said he was aware of the problems going into it, and has experience turning around struggling hospitals. During his nearly decadelong tenure with Carrollton, Ga.-based Tanner Health System, to replace the aging Alabama hospital he led.
"That was just one of the things that kind of drove me was seeing it go from almost nothing to a successful facility," he said. "I wonder, 'Can we do that again?' I'll take on the challenge."
Alexander, who most recently worked for a Knoxville, Tenn.-based emergency department staffing company called ERx, said he wants to reopen the Jamestown hospital as soon as possible. He said he checks on its CMS application every day.
"As soon as it starts to move, we can set our plan better," he said.