Eastern Plumas Health Care recently received news that Governor Brown signed a bill on managed care that includes an elimination the skilled nursing clawback – that is, that retroactive recoupment of money the state had arbitrarily decided to take back from hospital skilled nursing facilities going back to 2011.
Four years ago, EPHC successfully fought the state on a similarly arbitrary reduction in SNF fees, amounting to a loss of over $1 million per year. The hospital was able to receive a state exemption from the cuts based on its “frontier status” and the fact that it was the only health care facility and hospital skilled nursing provider in the area.
At that time, however, the state refused to remove the “clawback.” This meant that EPHC would be required to pay the state $2.5 million over the next ten years. While survivable, the clawback would cause EPHC a substantial financial burden for years to come.
Assemblyman Brian Dahle spearheaded the effort that eliminated the clawback, and EPHC was an active participant in the successful lobbying effort. According to EPHC’s CEO, Tom Hayes, “As a safety net hospital in a severely economically depressed rural area, it is our mission to be here when our community members need us. Yet, we are constantly struggling to remain afloat, and the amount of the clawback became a survival issue for this hospital. If we were forced to pay the required amount each month, it would mean we wouldn’t be able to pay for essential infrastructure repairs and upgrades, among other things.”
The elimination of the clawback capped the four year battle by the hospital that saved the hospital millions of dollars and, ultimately, saved it from being forced to close its skilled nursing facilities—a lifeline for the elderly citizens of Plumas and Sierra counties.