Debt falls to below $1 million

TONASKET – The North Valley Hospital District hit a long-awaited milestone on Thursday, Aug. 26, as its warrant debt to Okanogan County dropped to below $1 million for the first time in recent memory.

Hours before that evening’s meeting of the NVH Board of Commissioners, the hospital received its 2012 cost report settlement of $278,000, dropping the warrant level to $953,000. Warrants have dropped precipitously in the last couple of months as stalled Medicare and Medicaid payments have begun coming in and the sale of the Oroville clinic building was completed.

The warrants spiked at nearly $3 million almost exactly a year ago, precipitating layoffs, the closure of the Tonasket and Oroville clinics and, most contentiously, the closure of the North Valley Assisted Living facility.

“That’s a real positive thing to celebrate,” said board chair Helen Casey. “And we still have that ‘meaningful use’ money (for conversion to the federally mandated electronic records system) out there.”

HHS rule proposal

CEO Linda Michel reported on a rule change proposed by the U.S. Department of Health and Human Services that would have a dire effect on rural hospitals – including North Valley Hospital – if put into effect.

The rule would eliminate Critical Access Hospital designation for about 70 percent of the nation’s hospitals. That would include NVH, Mid-Valley Hospital of Omak, Brewster and Chelan.

“Critical Access Hospitals were established in 1977 because rural hospitals were closing everywhere because they could not make it in the ‘prospective payment system,'” Michel said. “So they came up with the CAHs, that let us get reimbursed in a cost-based system so rural communities could be served.”

Because NVH has another medical facility within 35 miles of it, it (as well as the other hospitals) would be stripped of its CAH designation. Of the 39 CAH hospitals in the state, only 13 would retain their status.

“They have no consideration for how far you have to travel,” Michel said. “They won’t close us – but if they decertify us we can’t survive.”

Commissioner Lael Duncan said that the issue would require phone and email campaigns to legislators to prevent such a rule from taking effect.

“I think part of this is political maneuvering as well,” she said. “Their first offer (may be) to take away everything and then get back to a middle ground. But it’s still frightening.”

“It would be huge,” said board chair Helen Casey. It’s really a travesty. Just devastating.”

Boiler update

Kelly Cariker, who has been overseeing the replacement of the hospitals’ aged boiler system, said that McKinstry representatives had visited that day, this time with engineers on hand.

“They were looking at more of the nuts and bolts of what actually has to take place during deconstruction of the boiler and construction of Phase I,” Cariker said. “We looked at moving water lines and how things would work without losing services at the hospital.”

He said that IRS Environmental (a toxic substance remediation outfit, not the federal tax agency) provided a plan should any asbestos be encountered while removing the old boiler, which dates to the 1950s.

“They wanted to get an idea, if as we decommission the boiler, if we run into any asbestos inside the boiler, they would be able to take care it,” Cariker said. “They’ve abated the room in the past, so there is nothing on the exterior. The only thing we need to worry about inside; without knowing what’s in there, they’re being cautious about that. They were really down and detail-oriented.”

Obamacare

Patient Financial Services director Jana Symonds reported that a speaker from the Washington State Insurance Exchange Commission had been invited to speak to both hospital staff and the public about the new Affordable Care Act (Obamacare) insurance exchanges.

“It’s outlining how the program works and who qualifies,” Symonds said, saying a tentative date was Sept. 12. “When it’s confirmed that they’ll be here then, we’ll get the information out as best we can.

Business Development Coordinator Terri Orford added that she has begun putting together a presentation to take to community groups to help educate the public as to how the exchanges will function as well.

“Jana and I will be meeting to talk about the role her department will play and I will play in connecting to the community,” Orford said.

The NVH Board of Commissioners next meets for a special meeting on Monday, Sept. 9, at 7 p.m., in lieu of its regular board meeting on Sept. 12.