LA CROSSE ? The administrator of the federal Centers for Medicare and Medicaid, toured Rush County Memorial Hospital on Tuesday and discussed problems facing rural health care providers.

Thomas Scully was joined on his tour by U.S. Rep. Jerry Moran, R-Kan., who sought to give Scully a firsthand view of conditions facing small Kansas hospitals.

Moran and Scully were also joined by U.S. Rep. Earl Pomeroy, D-N.D., and officials from the Kansas University Medical Center. Moran and Pomeroy are co-chairmen of the rural Health Care Coalition in Congress.

Scully, who leads the agency that is considered the largest health-care insurer in the nation, never had visited a critical access hospital — those with fewer than 25 beds.

Getting that designation, said Tom Dechant, a La Crosse hospital board member, was key to survival. He said the hospital was ready to close four years ago.

Instead, the hospital borrowed $400,000 from the county, trimmed unprofitable services and reduced the number of employees. Today, the hospital is profitable and has repaid nearly half of the $400,000 with interest.

The critical access designation helped, Dechant said, since it ensured reimbursement at cost.

Dechant and Deuel also said the Health Insurance Privacy and Portability Act — HIPPA, as it is frequently called — had caused considerable burden for the hospital.

Unable to hire a privacy employee, the hospital reassigned one person to attend meetings to learn about the privacy program.

“So now we’re behind on billing,” he said.

Generally, the Rush County Hospital has anywhere from five to six patients at a time, ranging up to 13 when influenza strikes.