Transparency called for Hospital District's second Town Hall meeting

POMEROY-The Garfield County Hospital District (GCHD) hosted its second Town Hall Meeting October 9. Rep. Joe Schmick, R-9th, and Rep. Mary Dye, R-9th ,spoke on the value of the GCHD to the community.

Rep. Schmick has been working to keep the six Critical Access Hospitals (CAH) in our district in business. CAHs nationwide are struggling, but Washington has not lost any yet. He strongly recommended that if the people in Garfield County want to keep the GCHD in operation, they must support the levy. Without support, he said, there is not enough interest in having the services available locally, and reduces the likelihood of continued support in the state legislature.

Rep. Dye said there were similar problems in the 1990s, but voters decided to approve special levies. Dye said changes in changes in private-pay insurance has hurt the hospital. She encouraged voter support so “we have services here when we need it.”

Co-CEO Mat Slaybaugh announced the recently hired provider had backed out and the search will continue.

Slaybaugh’s and co-CEO Jayd Keener’s priority is to reduce the turnover rate. One incentive is to offer student-loan forgiveness as a benefit to signing a longer-term contract. Not only does the district need to provide some consistency with the provider staff, he said, but it is expensive to recruit, hire and train new providers.

Another goal is to enhance services that receive a higher percentage of reimbursement from insurance providers and Medicare and Medicaid, such as the swing bed or acute care services. Cutting costs in the same departments, however, has an adverse effect on the cost reimbursements that would otherwise be available.

A major obstacle to enhancing those services is that capital improvements need to be made to the building, such as a new electrical system that would allow the use of new equipment, or air-conditioning. A possible grant could fund a some of the cost.

Earlier in 2019, Slaybaugh said there were cash-flow problems with switching to a new billing system. Patients were turned away, and some employees were laid off to reduce costs. He believes those problems have been resolved and has faith in the billing staff.

Cindy Wolf said the strategic plan’s development is not advancing as quickly as she would like, but the focus will be to continue the search for partner entities which could manage all or parts of the district, bringing their own “brand” to attract more business to the hospital or clinic. Updating the electrical system is a priority so the hospital building will be more attractive to potential partners.

At smaller rural hospitals, services cost more because the community served is smaller and the patient-use level is so low. This puts GCHD at a disadvantage and requires more community support.

Asked if this special levy is truly a “one-time levy,” Commissioner Gary Houser responded that “there will need to be a yearly levy” to survive. CFO Jim Heilsburg said the hospital’s dependance on Medicare and Medicaid reimbursements, which never cover the costs of the services rendered, force capital improvements through the special levy.

To receive Medicare reimbursements, GCHD must retain its CAH designation, which means keeping the Emergency Department and the swing bed, acute care, services. If the CAH designation is lost, it can never be regained.

One member of the public reminded the board that many special levies have been supported in the past, until one year that a levy did not pass. She stated that the reason was that “people were tired of being lied to, and were tired of losing providers because of a poor work environment.” She also stated it was a lack of transparency that caused the lack of support, and asked “What assurances do we have that you won’t go down that road again?”

Wolf replied that people need to come to the board meetings, ask questions, tell the board about problems, but take responsibility for letting them know when there are problems. Chris Herres added that the transparency problem was because of “financials,” but they now have up-to-date financials. Houser stated the current co-CEOs have done a better job than their predecessors, and the CFO, so he feels that there is a good management team now.

Another member of the public asked what percentage of the current 19 long-term care patients are on Medicare, Medicaid or private pay? Keener replied that two (10.5%) are on Medicare, 13 (68%) are on Medicaid, and four (21%) are on private insurance. The member asked “Have you considered putting a cap on that?” meaning to limit the number of Medicare or Medicaid patients admitted. Keener replied that they had considered doing that, but it is hard to justify empty beds and turning away patients because of the type of insurance.

A final suggestion made by Louise Munday was to keep the public informed by continued Town Hall Meetings after the levy is passed, possibly in six months, rather than wait until the situation becomes desperate. She stated that communication is crucial to getting the support they are seeking.

Wolf responded that they “do have board meetings” to which the public is free to attend, but Munday countered with the fact that the public does not have access to items in the “consent agenda” which is just approved by the board members and never discussed.

The consent agenda includes minutes of board and committee meetings, as well as expense and payroll vouchers and financial reports. Cannon commented that he liked the idea of the continued Town Hall Meetings, and Wolf said it was something they could consider.

All GCHD Commissioners were present.