Eastern Plumas Health Care’s (EPHC’s) July 23 Board of Directors meeting focused on financials as the fiscal year winds down. (A detailed financial review will be presented by the independent auditor at the September board meeting.)

Skilled Nursing Successes
Board member Paul Swanson, MD reported that the hospital’s skilled nursing facilities in Portola and Loyalton contribute significantly to the hospital’s bottom line. This is because the state reimburses rural hospitals like EPHC for some overhead costs.

What this means practically, explained Chief Financial Officer Jeri Nelson, is that while essential services such as ambulance and emergency room don’t make money, the skilled nursing facilities (SNFs), with the state’s reimbursement for certain costs, help keep the hospital as a whole viable.

Winning the battle with the state a few years back and blocking those large rate reductions, meant the SNFs stayed open. This, in turn, helps keep the community’s elderly residents near home and family and also helps EPHC offer other necessary services.

“We are a great example of sticking through the tough times, knowing what to do and getting it done,” said Nelson.

After having to scale way back during that SNF rate cut fight, the Portola SNF is now up to full capacity, and the Loyalton SNF currently is accepting several more residents in order to reach capacity.

“The excellent care, and the ability for residents to remain local, allows us to increase our patient numbers fairly easily when we are able,” said Chief Executive Officer Tom Hayes.

Managed Medi-Cal Expansion

Managed Medi-Cal (MMC), an Affordable Care Act creation, has increased the number of insured patients in Plumas County. Managed Medi-Cal programs, however, are going through growing pains, which require small hospitals like EPHC to get even more tenacious about getting paid for services.

Managed Medi-Cal (in Plumas County the two MMC programs are run by Anthem Blue Cross and CA Health and Wellness) pays on average

twelve cents on the dollar. In years past, under traditional Medi-Cal programs, the state has issued hospitals a check several months later to make up for some of the lost revenue. It’s a tricky business, and Nelson spends much of her time chasing these elusive “pots of money” in an attempt to “make us whole.”

Under the new MMC system, however, the supplemental monies are coming in eighteen months to two years later, which makes it difficult for small, rural hospitals like EPHC that don’t have a huge amount of cash in the bank.

According to Tom Hayes, “Some hospitals that don’t have Jeri Nelson’s sophistication might leave money on the table.”

That said, Nelson reported that “we’ve got money in the bank.” This is attributable, in part, to a mysterious check from Anthem Blue Cross for over $209,000. Nelson said she doesn’t know just what the check is for, but it is somehow related to the high volume of MMC Anthem Blue Cross patients served by this hospital.

“This has been a neat year,” said Hayes, “because we grew instead of just maintaining. I’m hoping this will continue next year, too. That allows us to buy needed equipment and offer more services that this community needs.”