Facility weighs budget options

Three Rivers Hospital could cut staff, make major program changes

— Three Rivers Hospital commissioners may decide the fate of some of the hospital’s staff and services Monday.

A few possible actions put forth to save money in 2014 include laying off about 20 percent of the employees, ending non-emergency surgeries while keeping the 24-hour emergency room, and restructuring or eliminating some departments that don’t make money, such as labor and delivery.

Hospital spokeswoman Rebecca Meadows said Chief Executive Officer Bud Hufnagel and other administrators have been in meetings all month, preparing several scenarios to present to commis-sioners during their regular meeting at noon Monday at the Hillcrest administration building, 415 Hospital Way.

“They’re still working at them, refining them,” Meadows said Thursday, adding that the board could decide to postpone a decision until either a special meeting or their next regular meeting Dec. 16.

“We are absolutely not” closing the emergency room, Meadows said, but “I know that some of the plans/scenarios do say there will be no more emergent surgeries here.”

The surgery department and emergency room are separate, and the hospital plans to follow the community’s wishes in continuing to provide a 24-hour emergency room, Hufnagel said at the Nov. 5 meeting.

As a critical access hospital, Three Rivers must provide an emergency room to stabilize patients before sending them to other facilities for more intensive treatment. Starting in January, the hospital will also be required to add acute care beds.

The emergency room operates at a loss of about $1.2 million per year, Hufnagel said.

To help cut costs there, the emergency room’s trauma level could be changed from 4 to 5, meaning the hospital would no longer be required to have an on-call surgeon within 30 minutes of the facility at all times.

Other possible plans include:

• Reducing the surgery department’s services to regular business hours Monday through Friday.

• Outsourcing laundry services.

• Restructuring departments and services

identified as unprofitable: Respiratory therapy, cardio rehabilitation, Healthbeat Fitness Center, Advantage Durable Medical Equipment and labor and delivery.

Departments that will be maintained are the laboratory, pharmacy, radiology, physical therapy and the swing bed program.

However, Hufnagel said changes to some departments will impact others, and administrators would need to be mindful of that when drafting new plan proposals.

The proposition that received the most negative feedback at the Nov. 5 meeting was cutting labor and delivery.

“I think that’s the most important service we provide,” Dr. James Wallace said.

Hufnagel agreed, but said the hospital loses at least $2,000 for every infant delivered, partly because Medicaid doesn’t reimburse at cost, but at about 60 percent of the total cost of delivery.

“I think a lot of women want to come here to deliver their babies,” Dr. Keith Hanson said. “If obstetrics goes away – for some providers, that’s the favorite part of their practice. What are they going to do? Are they going to want to stay?”

Three Rivers had released a preliminary 2014 budget of $11.3 million that plans for a $30,000 profit. However, with the approximately $2.6 million in warrants still owed to Okanogan County, several physicians leaving the area and a continued shortage of patients in the wake of the recession, the hospital is being spurred to take further action.

The hospital has taken several mitigating actions to save about $80,000 per month since Hufnagel was hired in September 2011, including canceling its contract with managing firm Quorum Health Resources, outsourcing billing collections to cut down on bad debt, and closing Mansfield Clinic. But those decisions haven’t kept the facility from operating at a loss most months out of the year.

Earlier this year, a routine state audit recommended that the hospital cut non-essential services to become financially solvent.

Three Rivers is also discussing an affiliation with Wenatchee-based Confluence Health that would allow the facilities to share resources, but that could take up to two years to complete, Hufnagel said.

Log in to comment