Hospital District experiencing growing pains

DAYTON-The Columbia County Health System (CCHS) monthly board meeting was held on March 3 to report on the month of January during which a net loss of $131,000 was reported. Updates were provided for the Rivers Walk Assisted Living Project and the progress towards opening a community child care center. Also, because of its success, CCHS has been asked to be a contributor for a regional advisory council for Community Health Access and Rural Transformation (CHART). Chief of Staff, Dr. Lewis Neace also spoke of the success of the health district.

CFO Matt Minor gave the financial report which reflected a loss of $131k for January. With an uptick of COVID cases in the community at that time, staff was out, resulting in one of the two clinics closing on two occasions and having to send patients elsewhere. This affected the patient revenues. Offsetting the low volumes for clinic and acute care was higher volumes for emergency care. Minor said that January is already a tough month because there is no Medicare payment.

The Rivers Walk Assisted Living Project has required advanced ordering of software and hardware for the facilities because of the supply chain disruptions so supplies expenses were up.

Additionally, there has been persistent delays in medical coding for processing insurance claims. To resolve delays in coding services, CCHS will be hiring a coding manager to work with contracted coders and eventually hire in-house coders. This will expedite collections for services.

McGuire presented updates on projects in his report. Progress towards opening a child care center in the community was discussed. He told the Board that childcare is facing some opposition with concerns about the YWCA running it, the location and the Port of Columbia using resources to aid the project. To answer questions and concerns, McGuire said a community forum is likely to be held in April.

For the Rivers Walk Assisted Living Project, three units are well under way. The trusses and roofing are up on one unit with another ready to have trusses go up. The other has windows and doors installed.

Dr. Lewis Neace spoke of the success of the local health system as other critical access hospitals have been closing. “If you look around this campus, you have a clinic that is running full, you have a brand-new dental clinic that to my understanding is extremely busy for the little time that they’ve been opened. You have a critical access hospital...that is open, taking patients nowadays, really sick patients, and we’re admitting more really sick patients. You have a clinic in Waitsburg that is running full all the time. You have people applying for jobs here. But to me the biggest point of success is, these doors are open.

Around the country the last few years the number of critical access hospitals that have closed I think it’s now approaching 200 and it’s increasing...I get reports from all of these agencies that are talking about hospital closures. Some of them are much bigger than we are and they have gone bust and have gone under. They are all critical access hospitals. On the other hand, this one is doing extremely well–I might dare to say thriving. Then you look across the parking lot with the assisted living that is going up, my understanding it is basically full and they haven’t even built the buildings yet. To me, as a physician coming from an entirely different health care background for most of my career, this is a major success–it really is. The culture, all of that is positive.”

McGuire acknowledged the success is in part due to Board of Directors and the tax support from the community. He also shared about his involvement with the CHART Advisory Council based on the success of CCHS. “CHART focuses on hospital and health systems located in the North Central part of the State. Because of our work with the State Stakeholders on health system transformation, we were asked to participate on the advisory council.” CHART aims to provide innovative ways to overcome the limitations to health care in rural communities.

McGuire told the Board about legislation that may affect rural hospitals. “House Bill 1868 and Senate Bill 5751 regards nurse staffing with mandatory patient to staff ratios appears to not have made it out of committee. There are some opportunities for the bill to get revived as there is a budget line item in support of it included in the houses passed version of the budget. The budget item concerns L&I funding for enforcement. This can be used as a strategic lever to revive the bill which can happen very fast and at inopportune times for defense, like late at night at the end of a long session. There is enough concern about how this bill will affect access to care with the staffing requirements increasing open nurse positions to more than 10,000 above the current 6,000 positions already open in the State. This bill does not create new nurses but will levy fines on hospitals if nurse staff ratios are not maintained.”