Garfield County hospital levy seen as key to operations

Officials say that without additional funding, the district may have to suspend operations.

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POMEROY -- Garfield County Public Hospital district directors and administrators are hoping the one-year, $750,000 levy on the Feb. 14 ballot will help turn the tide eroding the district's financial stability.

Without the levy, the district could be forced to suspend operations, according to a levy fact sheet prepared by the district.

As one of the smallest public hospitals in the state, the district is between the proverbial rock and a hard place, exacerbated in part by a Medicare/Medicaid catch-22, according to district CEO Andrew Craigie.

The district maintains three main units, a clinic, long-term care and hospital. It employs approximately 92 full- and part-time staff, with an annual budget of nearly $8 million.

For a number of years, some departments within the health system have generated enough revenue to sustain other lines of service, particularly the long-term care.

With a high number of nursing home residents on Medicare, and Medicare reimbursement not adequate to pay for routine nursing home care, the district reached a point where subsidizing the nursing home from other areas of the health system was no longer sustainable.

Adding to the problem was diminished demand for long-term services over the past four years, resulting in about half the long-term beds being unoccupied.

To meet the challenge of decreasing revenue due to a smaller reimbursement from Medicare, the board decided late in 2011 to reduce the available number of beds in the hospital and long-term care facility from 45 to 25.

If voters approve the levy request, which will cost property owners an estimated $2.32 per $1,000 assessed value, the funds won't be collected until 2013.

Already, the district has reduced about 30 employees' hours to 32-hour weeks and closed the business office on Fridays. That reduction went into effect Jan. 16. There have been no layoffs so far.

Another stop-gap implemented was to release about $250,000 in reserves to help with cash flow. Those funds were previously earmarked for replacement of equipment and other unexpected expenses, and are now allowing the district to operate until Medicare reimbursement rates catch up to the new cost structure.

While the district waits for Medicare rates to stabilize, revenue from the levy would allow the hospital to stay open. It will take time for Medicare to recalculate rates and pay the hospital correctly, according to the published information from the district.

If the levy passes, hospital officials will reevaluate the financial situation and look at which resources and employees to bring back on and in what order, Craigie said.

"The levy will make a huge difference in stabilizing our position, but it will not be fully stabilized for a year," he said.

Officials knew the change to fewer beds would cut cash flow, but "we simply did not expect the impact of these changes to affect cash flow so quickly," Craigie said.

As CEO of the health care district, Craigie is no stranger to operating with a tight budget. "We've always kind of bumped along on a zero margin. It's always been right around break-even for us," he said.

"The irony is we're on budget for revenue and for expenses, but because of the deductions from charges, the contractual adjustments have affected cash flow," Craigie said.

The community seems to understand the situation, Craigie said.

"We've had very good questions from people that are very well thought-out, ,nd that has been helpful because it means people are engaged and they understand the issues," he said.

"I think people understand the future of the hospital hinges on the next few months," he said.

District employees have also been supportive, Craigie said.

"That is what is really amazing because our staff has held together. This has been very hard on them, but the unity among the team, and the level of commitment has been incredible. Every day it is amazing to see, just the level of passion that every member of our team brings to the work they do," he said.

Craigie, who has been district CEO for 11 years, was reluctant to admit to having had sleepless nights over the last few months.

"I really believe that this is what I've been called to do, and I'm doing what I've been called to do, so that gives me greater confidence. I know where we're headed, and it's in a healthy direction, and that gives me peace," he said.

Craigie, district Chief Financial Officer Shannon Jones and chief of nursing Susan Morrow are not immune from the furloughs, but at least one is available at all times. The executive team has taken a 40 percent salary reduction "until we see our way through this period," Craigie said.

Despite the cutbacks in staffing, patients will continue to receive the same care they've always received at the hospital, long-term care facility and the clinic, Craigie said.

Ballots were mailed last week and must returned to the Garfield County Auditor's office in the courthouse on or before 8 p.m. on Feb. 14.

Carrie Chicken can be reached at cec@innw.net or 522-5289.

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