On life support?
Southern Inyo Hospital is struggling.
As a measure of the community’s concern, well over 200 local residents attended Tuesday evening’s workshop on the future of Southern Inyo Hospital in Lone Pine. Rumors have been floating for weeks, if not months, that the hospital is failing. Fueled by stories that employees were weeks behind in being paid, and that the hospital had serious cash flow problems, many feared the hospital would be forced to close.
Hospital CEO Lee Barron told the crowd that much of the problem is with state and federal reimbursements falling behind new health care mandates imposed by the Affordable Care Act (ACA) and that almost all rural hospitals across the country are in a similar financial bind. She admitted that the hospital had made some mistakes early on under the ACA, anticipating income from preventative care services that simply never materialized.
According to Barron, the emergency room costs almost $5 million to operate but brings in a little over $1 million in revenue. There has also been a drastic change from inpatient to outpatient care. She said that in 2014, SIH had 179 days of inpatient care, compared to only six in 2015.
“It is very complicated to run a hospital in today’s environment of changing rules, regulations and mandates,” she said. “It changes almost day-to-day. And it’s very expensive.”
The meeting was facilitated by David Sandberg with Focus and Execute, but the meeting at times appeared to be out of control. Midway through the 3-hour meeting, half of the audience left either out of anger, weariness or despair. Those who remained started to get angry. At one point, Barron’s presentation was interrupted by local resident Russ Monroe to cheers and jeers, when he accused the hospital of denying services to his daughter. CEO Barron’s response was to walk out of the room.
As the meeting came back on track, Administrative Assistant Mary Gonzalez explained the hospital’s dilemma. “We just paid $69,000 for emergency room physicians and have to pay $13,000 for the licensing fee, which we don’t have. We also need $25,000 to pay for employee insurance.” To emphasize the problem, she noted that their deposit for that day was only $1,500.
Gonzalez said that “everybody’s taking a hit” in response to rumors that “some people are still being paid.” She said that simply was not true, and that everyone working at the hospital, including the administration, has not been paid.
Fifth District Supervisor Matt Kingsley offered some ideas and brought together other county department heads, as well as the CEOs of Northern Inyo Hospital and Ridgecrest Regional Hospital, to the meeting. Noting that “We’re all worried,” Kingsley suggested savings could be made through an association with the other hospitals, or possibily consolidating shared administrative costs such as payroll and billing. County Planning Director Josh Hart, County Counsel Margaret Kemp-Williams, and Auditor-Controller Amy Shepard offered their assistance to the hospital district, as did Health and Human Services Director Jean Turner.
Of immediate concern was the $13,000 needed to pay for the hospital’s license fee, without which it cannot operate. Other concerns were how to pay employees and make payments on the employees’ health insurance. Local resident Francis Pedneau observed that without the license, the discussion on other matters was moot, and offered a $1,000 donation toward the licensing fee. Others in the audience quickly responded, and by the end of the evening, enough money was collected to pay the fee.
In a phone interview with The Sheet on Thursday morning, SIH Board member Carol Roster said that at the Board meeting Wednesday the hospital had raised $60,000 in donations as a result of Tuesday’s meeting. One donation was for $50,000. They are also looking into a loan to bring the employees’ payroll out of arrears, although it looks like employees will be without health coverage until December or January. The Board is also pursuing a combined services arrangement with NIH or Ridgecrest. Another public meeting is being held at the hospital next Tuesday at 8 a.m.
CEO Jim Suver of Ridgecrest Regional and NIH’s Interim CEO Dr. Kevin Flanigan said that they are willing to work with SIH. They advised stabilizing the cash flow, making sure the major insurers are being accepted, and forming partnerships for specialized medical services.
Other suggestions from the community included forming a foundation to support the hospital and being proactive through contacts with political representatives to take legislative action protecting rural hospitals.
Toward the end of the meeting on Tuesday, local resident and businessman Doug Thompson said, “We should have done this two, three, five years ago.” He also said the major employers in the area such as Inyo County, the Bureau of Land Management, Forest Service and Los Angeles Department of Water and Power should step up to the plate, as they all send their injured employees to the local hospitals in Bishop and Lone Pine.
Whether or not Southern Inyo Hospital survives will depend on just how much support it can garner in moving forward. For now, things look to be stabilizing, but it is clear that the hospital will need to change its business practices, down-size its services, and partner or form associations with other hospitals in the area to provide needed specialized services that simply cannot be supported by the local hospital. There is much work needed and from the results seen so far, there does appear to be some cause for hope
