The California Hospital Association (CHA) filed a temporary injunction in their case to stop the state of CA from implementing proposed Medi-Cal rate cuts to hospital skilled nursing facilities (SNFs). U.S. District Judge Christina Snyder granted the injunction, citing EPHC and Plumas County as examples in her decision.

On Jan. 10, the state filed an appeal of the decision to the 9th Circuit Court. According to the attorneys for CHA, it’s likely we’ll learn the outcome of the appeal within one to three months. If the injunction holds, the rate cuts will not occur for the duration of the case. We’ve heard that the case itself might take between one to five years to complete.

We’re breathing a collective sigh of relief over the decision. But, we’re looking at this as a reprieve rather than a complete victory. Even if these cuts aren’t successful, it’s likely others will be. So, it’s not business as usual. This SNF case has been a wake up call, causing us to realize we need to change, to some degree, the way we do business in order to survive into the future.

We will be discussing ways to downsize our skilled nursing facilities to the number of beds we can sustain even if there are cuts. We’ve already started changing our payer-mix. Clearly, SNFs with 93% Medi-Cal payers are not sustainable.

This, perhaps, is the greatest lesson we’ve learned from this crisis. We have to be flexible; we have to be willing to change. We have to be willing to fight, because our part in this case has made a difference, and we’re proud of that. We need to ask, and have our community ask, just what services we really need to provide here in order to stay viable.