Three Rivers tackles budget

Brewster hospital ponders staff cuts, major changes

— Three Rivers Hospital commissioners will consider two new options to cut costs in 2014 during a meeting Monday that may assuage fears of closing down the labor and delivery department.

The meeting will begin at noon at the Hillcrest Administration Building, 415 Hospital Way.

“We hope the board will take action that will allow us to move forward in the process of streamlining our operations,” Chief Executive Officer Bud Hufnagel said.

Hospital spokeswoman Rebecca Meadows said Hufnagel and his administrative team “have been working on two plans to present to the board on Monday. They are different from any of the others, because the board directed Bud to begin negotiations to sell Advantage (Durable Medical Equipment) and Healthbeat (Fitness Center), and because we have two more months, with October and November’s numbers, to use than we did before.”

Board Chairman Dan Webster said at least one of the new options might be a revised version of what he considered the most likely of the six presented at the Nov. 25 meeting. Option B was the only one to keep the labor and delivery department, but it also estimated the greatest loss for next year at $309,316.

Although some protested the possibility of ending such programs as cardiopulmonary rehabilitation, none drew more ire than the proposal to cut labor and delivery.

“The community told us loud and clear they did not want that,” Webster said.

Some physicians and other health care providers submitted a letter to the board protesting the proposals and requesting a larger role in the decision-making process. The letter stated there could be “irreversible consequences” if any of the plans were put into action.

“We, the medical staff of Three Rivers Hospital, are stating that we have no confidence in the present CEO’s proposals for our hospital,” the letter read.

Dr. Gordon Tagge said it was the opinion of those who signed the letter, not necessarily that of everyone who works for the hospital.

“I specifically know there were one or two that were a little bit uncomfortable signing it,” he said, referring to other doctors.

The Top 3 scenarios put forth Nov. 25 all involved laying off around 20 percent of the 104 full-time staff, reducing surgery department hours to regular business hours Monday through Friday, and keeping the emergency room but reducing the trauma level from 4 to 5 so an on-call surgeon wouldn’t be required.

The board acknowledged the community and medical staff’s desire to keep labor and delivery, then directed the delivery, then directed the administration to gather more information for the December meeting.

“Rules are made and rules are changed, and there are exceptions to rules. I just want to explore them before a decision is made,” Commissioner Jerry Tretwold said at the last meeting.

Hufnagel said the hospital has essentially been bankrupt since 1998, operating with warrants from Okanogan County. As of last month, the balance owed was around $2.1 million.

Physicians retiring or leaving the area, a lack of patients and an ongoing struggle to get adequate reimbursement from Medicare and Medicaid, all combined with offering services that are not traditionally profitable such as Healthbeat and labor and delivery, has kept the critical access hospital dependent on the county, Hufnagel said.

Advantage manager Bennie Polvos has made offers to buy Healthbeat and Advantage to keep them in the community.

In a state accountability audit released May 23, the agency stated the hospital had “insufficient funds” for operation and recommended further spending cuts. A financial audit released in July showed the hospital lost $115,000 in 2012, which Hufnagel counted as an improvement over the $1.1 million shortfall in 2011.

Also on the agenda at Monday’s meeting, Tretwold and fellow commissioner Mike Pruett will take their oaths of office for their next terms; the board will select new officers and committee assignments for the new year; and officers will be appointed to the revived and renamed Three Rivers Hospital Foundation.

It will be the last meeting for Webster, who is leaving the board at the end of the month to focus on the hospital foundation.

Cherryl Thomas of Winthrop ran unopposed for his seat in last month’s election.

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