AHN Westfield Memorial to pursue new “rural emergency hospital” designation, protecting health care access for Chautauqua County

WESTFIELD — AHN Westfield Memorial Hospital announced Tuesday that it intends to pursue a “rural emergency hospital” designation, meaning it will seek to transition from a small inpatient hospital to 24/7 emergency, observation and outpatient care hospital that meets specific criteria established by U.S. Centers for Medicare and Medicaid Services and the New York state Department of Health.

The conversion would provide greater reimbursement certainty to the Westfield hospital, ensuring its long-term financial and operational stability going forward, and protecting care access for its patients in Westfield and the surrounding Chautauqua County region. Designated rural emergency hospitals (REH) are eligible for additional federal funding and higher Medicare reimbursement rates.

“The rural emergency hospital designation was built for a hospital like Westfield,” said Rodney Buchanan, DNP, administrator of WMH. “We are a vital health care access point for our community, but the vast majority of the services we provide are outpatient in nature.”

In an average year, Westfield Hospital sees thousands of patients on an outpatient or observational basis and receives nearly 10,000 emergency department visits. The hospital, however, sees just 110-150 inpatient admissions annually — or about 10-12 inpatient admissions a month. Westfield is licensed for just four inpatient beds.

“Maintaining a 24/7 inpatient unit is costly, and the expenses aren’t warranted by the volume we see at Westfield,” Buchanan said. “By converting to a rural emergency hospital, we can redirect those resources toward new programs that are a better fit for our community and retain and grow the specialties and services that are most important to our patients.”

Following the conversion, which must be approved by the New York Department of Health and will likely take effect in 2026, most patients who require overnight inpatient stay will be transferred to AHN Saint Vincent Hospital in Erie, Pa., about 35 miles away. WMH has been a satellite facility to Saint Vincent since 1999; Saint Vincent is a 348-bed hospital that provides comprehensive access to obstetrical care, cardiovascular surgery, cancer care, emergency care, neurosurgery, orthopaedic surgery, and many other advanced specialties.

“The synergy between Westfield and Saint Vincent was an important consideration as we discussed this conversion process,” said Chris Clark, DO, MHA, president of SVH and Westfield. “We wanted to ensure that the residents of Westfield and northern Chautauqua County would still have access to all of the health care services that they need, including overnight observation care.”

The federal government and the U.S. Centers for Medicare & Medicaid Services, which classify hospitals by category — such as short-term, long-term, rehabilitation, children’s hospitals, and so on — finalized the new “rural emergency hospital” option in January 2023. Later that year, New York formally changed its public health code to recognize the rural emergency hospital (REH) designation and allow for the conversions.

By rule, the hospitals applying for the conversion must have no more than 50 beds and be located in a rural area, or must already be designated as a Critical Access Hospital.

To date, only 35 U.S. hospitals have completed the conversion process, most of them in the South and Midwest. The REH program was created by Medicare to address the growing concern over rural hospital closures, and to help alleviate the financial pressures experienced by those hospitals, many of which are annually operating in the red.

As part of the conversation process, WMH must develop a Health Equity Impact Assessment and solicit stakeholder feedback, by way of public meetings and a community survey. That survey is now open to the public, and can be viewed at https://www.surveymonkey.com/r/WMHredesign

“Our goal is to ensure that, throughout this conversion process, we are collaborative and transparent with all of our stakeholders, and that the community’s needs are clearly articulated and addressed,” Buchanan said. “We remain committed to providing outstanding clinical care and remarkable experiences to the people of Chautauqua County.”

Chautauqua County’s patient base is diverse — the county has a number of port towns and lakeside recreational communities, adjoining both Lake Erie and Chautauqua Lake, but geographically it is mostly rural. It has about 127,000 residents, with an Amish population of about 2,000 and a growing Latino population. It also includes a small portion of the Cattaraugus Reservation of the Seneca Nation of Indians.

As of February 2024, the poverty rate in Chautauqua County, New York is 17.6%, about 20% higher than the poverty rate in New York state and 1.4 times the U.S. poverty rate.

Founded in 1942, WMH is the only Allegheny Health Network hospital outside of the state of Pennsylvania. In 2018, WMH unveiled its new five-bed emergency department; in 2024, it opened a new radiology and diagnostics suite.