Hospital and assisted living facility remain stable

DAYTON-The Columbia County Health System board reviewed budget matters, and was updated on Assisted Living facility certification.

Washington hospitals continue to face operational cost losses for the first half of this year, according to the CEO for Columbia County Health System Shane McGuire. These losses have been reflected most months of 2023 in the financial reports for the hospital district.

For September a net loss of $312,000 was reported during the October 26 meeting. For the first three-quarters of the year, the district has an operation margin of -11%. Chief of Staff Dr. Lewis Neace specified one reason for this is the staffing shortage resulting in lack of staffed beds.

McGuire said other reasons given by the Washington State Hospital Association (WSHA) include low Medicaid reimbursement and lack of available nursing homes or rehab facilities upon hospital discharge. The Department of Health came and surveyed the campus with exceptional results.

McGuire gave brief updates on the Rivers Walk Assisted Living and progress on the Childcare Project, as well as changes to Room 110 for adding a headwall for medical gas, oxygen, suction, and emergency power and changes to Hall 1. The Board passed a resolution to change the monthly board meeting location to the Fire District meeting room beginning in January.

Another monthly loss was reported for the district in September of $312,000. According to CFO Matt Minor, inpatient revenue was down significantly at $443,000 lower than budgeted with about a quarter of that a result of the delay in moving patients from the nursing home care to assisted living. Helping to offset the loss was strong collections from accounts receivable and Medicare payments.

McGuire and Dr. Neace provided some context that this is a macro problem that all hospitals are facing losses as a direct result of a staffing shortage and the lack of staffed beds. McGuire expanded on this in his report, "WSHA released updated information regarding Washington State Hospitals financial indicators for the first six months of 2022...

Hospital and Health System losses grew to $1.75 billion through the first six months of 2022 with $1.2 billion of the loss from operations." Some of the contributing factors McGuire shared that WSHA identified were as follows. "Low Medicaid reimbursement as urban hospitals have not received a rate increase in more than 20 years. Reimbursement is growing at a much slower rate than inflation. Labor shortages leading to higher costs of staffing, including increased labor contracts, and travelling staff. Hospitals are unable to increase their prices to cover increasing costs of labor and supplies. Between 2021 and 2022, hospitals reported 931% decrease in net income [and] a decrease of 221% in net operating revenues...

This is being driven by a 266% increase in agency and traveler costs, a 7% increase in wages and benefits, and a 5% increase in other operating expenses. Washington State hospitals has posted a net income margin of -11% for the second quarter of 2022 and -12% for the first six months of the year...

A large and increasing number of patients ready for discharge who are not able to secure placement in nursing home or other post-acute care facilities...24 of 32 independent and rural hospitals had negative operation margins through the second quarter of the year. Our health system currently has a -11% operation margin. Including non-operating revenue (tax, grants etc.) that drops it to a -8.9% margin for 2022 as of the September financials." McGuire then said the effects of ongoing large financial losses means reduced health care access for patients, possible closure of hospital units, potential bankruptcy, and closure. "What we are seeing is rationing of health care."

The Department of Health came and surveyed the CCHS campus and shared the preliminary findings were only minor. The full report is still expected.

McGuire said that all but unit D has the certification for occupancy. Unit D is not certified because of a delay with the nurse call system, but they can begin to move patients in phases. He also updated on the childcare facility project that they held an on-site visit, the technical inquiries were due, and the requests for qualifications were advertised for operators early in the month which was set to close October 31. They will be scored by a committee of volunteers with various kinds of experience in the field. The contract would be offered to the operator with the highest score. McGuire said he anticipates remodeling Hall 2 in the first quarter of 2023 and opening for care by the second quarter. Other projects are to complete the addition of a headwall for room 110 that would bring in medical air, medical gas, suction, and emergency power. The quoted cost is $27,000. Also, with patients moving from Hall 1 to the assisted living units, outpatient wound care and respiratory therapy will be move to Hall 1. Room 110 and Hall 1 will provide 15 rooms for acute care. Some rooms will be double occupancy to maintain the 25-bed requirement.

The Board approved a change to the board meeting location. Beginning in January, most monthly board meetings will be held in the board room at the Fire Station on Patit Road. Two times per year the meetings are held at Town Hall in Waitsburg.