Hospital CEOs see ‘collaboration’ differently
Could the three hospitals in Plumas County consolidate? Not likely.
Could the three hospitals in Plumas County collaborate? Yes, but it could take some time.
“We’ve met for nine months and gummed this to death,” Plumas District Hospital CEO Doug Lafferty said during a recent interview. “Let’s finish the community needs assessment and figure out how to work together. I don’t want to talk collaboration until we know what we need to collaborate on.”
A $20,000 study, commissioned by the Sierra Institute for Community and Environment, lists more than 30 areas of potential collaboration.
“No one small rural hospital can do it all,” read a portion of the report provided by Mike Bell of WIPFLi CPAs and Consultants. “Together, the three providers have an improved ability to compete in the new healthcare environment if they work together.”
Bell is a member of the National Rural Health Advisory Board and has spent 30 years working in the healthcare industry.
Bell suggests that while the hospitals could pool resources in a number of areas, it would be important for them to remain separate.
“It is imperative that all providers remain autonomous with local control — legally separate entities — separately governed,” the report read.
Jonathan Kusel, director of the Sierra Institute and the driving force behind the collaboration effort, agreed.
“It is not about combining facilities; it is not about merging all of the facilities,” he said. “But it is about finding ways to better serve the patients.”
Past attempts at collaboration went nowhere. “Dick Hathaway and Charles Guenther didn’t have a collaborative bone in their bodies,” Kusel said of the former heads of the hospitals in Quincy and Portola respectively.
Their successors, Doug Lafferty and Tom Hayes, want to collaborate, but even they look at the situation differently.
“We are not on the same page,” Lafferty said of Hayes. Lafferty said that he could envision six or seven areas of mutual assistance, but “Tom is on the other side; he would like to have one organization for the whole county.”
Lafferty said that the concept is a good one, and that over multiple years he helped consolidate hospitals in the Hanford/Visalia areas, but there were more than 2,500 employees and 500 doctors in a small geographic area.
“It makes sense in that environment,” he said.
Hayes likewise presided over consolidations in the Yuba City/Marysville area, but still sees potential here. Hayes is also working on collaborating with Tahoe Forest in Truckee.
“Tom wants one medical staff office; one medical staff. But what’s the goal?” Lafferty asked.
Theoretically, one staff could help cover for each other, but Lafferty said that in reality it just doesn’t work.
“I have too few physicians today; I have nobody to send him,” Lafferty said, “and my docs don’t want to go there anyway.” He then explained that the doctors have their lives and practices established in Quincy.
What Lafferty does offer as an example of realistic collaboration is how he provides his ambulances as backup for the other hospitals.
“I have two ambulances and Portola and Greenville have one — every time they have one leave the area, we send one of ours halfway in that direction as backup,” Lafferty said. “That kind of collaboration makes sense.”
He doesn’t think it makes sense to consolidate such things as human resources or billing.
But Hayes thinks consolidating such areas is important. “This is the way that other hospitals are successful, for example Sutter Health,” he said.
Another potential area of conflict is the financial health of the institutions.
“Our financial pressures are entirely different,” Lafferty said.
“I can’t undermine my own organization,” he added, noting that Eastern Plumas Health Care carries a lot of debt.
Hayes said that he is aware that the administration and board of the Quincy hospital worry about taking on Portola’s debt, but that isn’t what he is seeking.
“Sometimes people misperceive this,” he said. “It’s just working on joint things,” and then added, “though sometimes consolidation becomes obvious.”
During the health care district’s June 28 meeting, Hayes addressed the need for more collaboration as he does during every meeting. This time he presented the directors with a copy of the study.
“These things I have been talking about for quite awhile,” Hayes said and then enlisted the help of his directors.
“The board has to say this is important,” Hayes said.
Gail McGrath, the president of the Eastern Plumas Healthcare board, said that she would contact her counterparts at Plumas District and Seneca and invite them to a meeting.
To date, the boards have not participated in monthly meetings coordinated by the Plumas County Public Health Agency.
While Doug Self, the CEO of Seneca Healthcare District, had been attending the monthly meetings, he has recently resigned his position. Linda Wagner is the interim chief, but was unavailable to comment about the collaboration effort for this article.
The Greenville Rancheria, as a local healthcare provider, also attends the meetings, but declined to be part of the study.
The next meeting is slated for July 19 at the Health and Human Services Building in Quincy.
Kusel is hopeful that some progress toward collaboration can be made but acknowledged, “It’s been slow in coming.”
Janie McBride, a member of the Portola hospital’s board, said, “We just need to make small steps.”