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Your Hometown News Source
POMEROY-Garfield County Hospital District's (GCHD) Board of Commissioners announced the interim co-CEOs Jayd Keener and Mat Slaybaugh were officially appointed Superintendent/Co-CEOs on Monday, September 30, 2019. Serving in the capacity as interim co-CEOs since April of 2019, they were offered permanent positions last Friday, September 27. The two will continue to work together as they have been for the past five months.
the GCHD held a town hall meeting to allow the public to ask questions relevant to the upcoming one-year special levy this last Thursday evening, September 26. As stated in the Public Hospital District No. 1 Garfield County, Washington Proposition No. 1, the purpose of the levy is to "finance and maintain the availability of health care services" by providing "funds to pay operating, maintenance and capital expenses of the District." The property tax revenue would be collected in 2020 in the amount of $860,000, "resulting in an estimated levy rate, in excess of the district's regular property tax levy, of $1.41 per $1,000 of assessed value."
The meeting began with a slide presentation by Slaybaugh outlining pertinent information regarding the operations of the hospital, how the GCHD compares to other rural hospitals in Washington, and a brief discussion of the problems and challenges facing the hospital district. Because the GCHD has the designation of a Critical Access Hospital (CAH), they are limited to 25 swing beds, and must maintain and operate a 24-hour Emergency Department (ED). This designation allows them to receive enhanced reimbursement payments from Medicare and Medicaid, upon which the district is highly dependent. Operating the ED requires staffing of one provider, as well as a lab and x-ray technician at all times. When the hospital averages 1.5 patients per day in the ED, it is easy to see that the ED will probably never be profitable.
With the recent hire of a full-time Nurse Practitioner, Victoria Hughes, the clinic will soon have two full-time providers, with Rhonda Freeman, Nurse Practitioner as the second, and two part-time providers, Dr. Park, M.D. from Dayton, and Dennis (Sonny) Talbot, Physician's Assistant. The GCHD is currently recruiting for one more provider.
As presented by Slaybaugh, the GCHD could make more money by expanding service lines, and attempting to improve the insurance reimbursement mix to include more private insurance patients. But in reality, the GCHD has limited service lines and is hindered by an aging facility without adequate wiring to allow many types of service uses. Also, the insurance mix currently is less than ideal. All public Critical Access Hospitals in the state relay on regular tax support, and Slaybaugh has stated that the district will most likely have to run more special levies in the future before the current financial difficulties can be turned around. The GCHD is the smallest rural hospital district in the state, and has received the least amount of funds over the last three years due largely to the fact that no special levies have been run in the past three years. The cash on hand is currently 88 days, including some grant funds that are not available for spending, with 120 days being the standard number of days.
Considered previously, it has been determined that it is not feasible to move the clinic to the hospital building due to the moratorium on adding any new services there. Slaybaugh also reported that they have had to turn some patients away for a short time because of cash flow problems. When asked if they have turned away patients in order to keep two to three swings beds open, Slaybaugh responded that it has not happened yet, but the swing beds can't be tied up long term. He was also asked if they sometimes decide to admit or not admit a patient based on the type of insurance coverage he or she may have. He responded that it has not happened yet either, but it could happen depending on the situation. Keener added if a patient is denied, it would only happen with the swing beds, and only based on the patient's medical needs or what services the hospital would have to provide.
In an effort to move forward, the GCHD continues to search for grant opportunities and cost-saving opportunities. They have been working with a strategic planner, but this effort has produced no plans as yet, and according to Board Chairman, Cindy Wolf, they don't expect to have a plan before the levy vote in November. Wolf admitted that they can not stay with the status quo because they are not breaking even financially. One solution being considered is establishing a partnership with another entity, though no specifics could be given. Wolf warned that if they would choose to partner, the process would most likely take about a year to complete. Members of the board of commissioners have been in contact with other CEOs, such as with the Dayton hospital for advice, or even partnering with another hospital for purchasing supplies and use of equipment. She also promised to keep the community up to date on any progress made, but gave no specifics on how this would be accomplished.
Chris Munoz, Pomeroy citizen, asked the commissioners how reaching out to other rural hospitals is going to be effective since each hospital district is profoundly different. He also asked "if everything is really on the table," you "need to accept that it may not be possible to keep everything you now have, such as all of the staff, or the use of the pharmacy." Wolf responded that "there are some tough changes to consider, and it might affect some employees." Munoz then stated that he "would like to hear about the proportion of employees who live in Pomeroy." Slaybaugh said that he had that number for the years of 2017 and 2018, but didn't remember what those numbers were.
Jonathan Harker, owner of Pomeroy Physical Fitness, stated that the community needs to have a full-time, in-house medical doctor to supervise the nurse practitioners. Keener replied that the hospital district has not interviewed any potential doctors in the past three months, but that they have started advertising. Harker followed up by asking if all of the GCHD staff use the Pomeroy Medical Clinic for their own medical care. There was no answer.
Dave Boyer, Pomeroy High School coach, commended the GCHD for staffing providers at local sporting events. He also asked about the outcome of a meeting involving Dr. Glenn Hauser, M.D., and CEOs Slaybaugh and Keener. Dr. Hauser had offered to come back to work for the GCHD for three days per week. Slaybaugh answered that they had met with Dr. Hauser, but that ultimately, he turned down the opportunity to return.
When asked if they were continuing to search for a permanent CEO, Commissioner Steve Cannon replied that they had been advertising and had narrowed the candidates down to two, with whom they would be interviewing the next day, Friday, September 27. The press release on Monday, September 30, 2019, stated that it was the two interim co-CEOs to which Cannon was referring, which resulted in hiring them as permanent CEOs. Cannon also stated that it was difficult to find CEO candidates willing to move to Pomeroy and accept the salary they would have to offer.
Keener shared some background information about herself with the audience, stating that she and her family live in Clarkston, where she was born and has always lived. She stated that she is frequently asked if she will move to Pomeroy, however, she has four boys, which would make moving difficult. She added that she is invested here in the community, and that she loves the patients and staff at the GCHD.
