Opinion

It’s been six months since Eastern Plumas Health Care heard that a 9th Circuit Court of Appeals ruling meant the huge rate cuts to our skilled nursing facilities (SNFs) would go into effect after all. The state of California would, indeed, balance its budget on the backs of its most vulnerable and needy citizens — the elderly and disabled. 

Much has been written about the unfairness of this decision. Words spelling out the tragedy set in motion by these cuts and resultant closure of our skilled nursing residents’ homes, their transfer to distant cities and loss of the lifeline that family and friends provides have not been able to dent the opinion of legislators focused on numbers and dollar signs. In short, appeals to the heart, humanity or what is simply right don’t translate in this arena.

Since the time we first learned we would be fighting once again for our lives (as a skilled nursing facility, a hospital and, therefore, as a community), Plumas and Sierra county residents have rallied to help — writing letters and making phone calls to legislators, lobbying in Sacramento and educating their fellow community members and those in power about the devastation these cuts will cause.

Behind the scenes, however, the impending cuts have set in motion other actions and reactions. The fear of SNF residents and their wives, husbands and family members for their future is not a statistic — it is the very fabric of their daily lives as long as this crisis continues. 

Further, the long-term uncertainty takes its toll on those of us whose daily work involves protecting the well-being of our SNF residents. The SNF staff, whose job it is to care for these residents and who view them as extended family, also fear they may lose their jobs. They wonder how they’ll provide for their own families and futures. 

Others of us at EPHC have been working day in and day out to stop what often feels like a rising tsunami. We attempt to influence legislators by telling them our compelling story, we demonstrate to the Department of Health Care Services that we deserve an exemption based on our frontier and sole community provider status, we author our own bill that would exempt rural SNFs from the cuts. We wait and we wonder if any of this will make a difference. We work some more. And, we wait some more. 

Currently, we’re trying to make sense of a failed court case, a new court case, failed bills, bills still alive but changed through amendment, the mystifying and ubiquitous budget process, sleight of hand legislative support and the governor’s veto power. Also, we’re waiting to hear whether the Department of Health Care Services will grant us the requested exemption from the cuts, while at the same time we are budgeting for and planning space and staffing for the SNF reductions. All of us feel the pressure to work harder and longer, and to spend less in order to support our organization as it struggles to survive the tidal wave.

Meantime, we try to tell the public that our efforts and theirs are not in vain. We will survive — and that’s the truth. Our SNF may be changed, but it will survive. The high quality of care we offer also will survive. I’ll be honest. We’re pretty exhausted from this battle. But, when I feel like giving up, I make myself look at what we have and what we are. Those of us who live here are survivors by nature. It’s trite but true to say the things that do not kill us make us stronger.

We will still be here. We’ll still be offering the best care we can give in our clinics, our hospital, our SNFs and our ER. Our community has been with us in this fight, and more than ever we need our community to support us by, very simply, using our facilities and our services.

Yes, we will be here! And, we hope you will be too. For all of you who have joined with us in this fight, in ways large and small, thank you for caring. We wouldn’t be here without you!