The Eastern Plumas Health Care long-term skilled nursing facility in Loyalton experienced some boiler troubles in December 2016, leading to a 19-day adventure with a large price tag.
“It started with a call from our head of maintenance, Stan Peiler,” Loyalton Director of Nursing Tracy Caudle said. “On the evening of Saturday, Dec. 10, Peiler and a nurse on site informed me that the boilers were about to go completely.” This was a major issue, as the main boiler system and the secondary system failed within weeks of each other, and the failure would cut off the heat supply for residents at the facility.
“Fortunately, we knew leading up to the issue that this was a possibility, and so we had a disaster plan in place to move all residents to the Portola SNF facility, located at the EPHC hospital campus,” Caudle explained.
“Stan Peiler, Rick Lowdermilk and Dave Mann, our maintenance staff, went above and beyond to stay at the Loyalton location the night of the 10th and nurse the boilers through the night to keep things warm.”
After a long, hard night, Peiler and crew jumped at the call for “all hands on deck” the morning of Dec. 11, along with nearly every other staff member at the Loyalton SNF.
“I put out the call for extra help to all of my staff, and there was an amazing turnout. Staff members that lived in Reno or had the day off still came in to help, with great attitudes and wonderful teamwork,” Caudle noted.
It was a frigid day on Dec. 11, when members of staff, ambulance crews and even EPHC’s CEO Tom Hayes showed up in Loyalton at 8 a.m. to start the transportation process for the SNF residents.
“There were 21 residents total, with four that went home to stay with family for the duration of the boiler outage, and 17 that were moved to the Portola SNF location,” Caudle said.
“We had three ambulances out that day; two for transportation of residents, beds and medical equipment, and one on call to keep available for emergencies. We were able to transport a couple at a time in the ambulances, aside from the bedridden, with our first trip from Loyalton to Portola at 10 in the morning, and the last at about four in the afternoon.”
All during that last day on site, Caudle says that the facility stayed warm, right up until the last resident had been safely moved.
“I can’t reiterate enough how much everyone jumped in, no questions asked, to help out with this matter,” Caudle said. “Even after the residents were on their way over to Portola’s SNF, the Loyalton staff followed them over to Portola to be there for the residents and greet them. It really shows how much the staff care about the residents here — just such a huge show of love.”
The move to Portola lasted for 19 days, and Social Services Designee Mandy Rivas and Caudle made it a priority to phone the residents’ families daily with updates. Caudle and Rivas also took it a step further, and made home visits twice a week to the four SNF residents that had chosen to stay with family instead of moving temporarily to Portola, even the residents that were staying in Nevada.
“Rivas went even further, providing respite care of her own accord, up to 12-hour shifts,” Caudle added. “We both feel that these are our residents, and remain our responsibility whether we’re in Loyalton or Portola.”
She added, “The Loyalton staff felt much the same, and really helped with continuity by keeping their regular shifts at the Portola SNF. It seemed to really help the residents with the change during upheaval.”
Once in Portola, the residents quickly filled the space. “We had such great cooperation and teamwork with Portola SNF and Portola Director Lorraine Noble, as well as the Acute Care staff. Residents were staying in the acute wing at EPHC, as well as filling the SNF library and ‘Annie’s Room.’” Acute care staff had to rapidly pick up a completely different computer system to use for SNF patients, and also shifted gears mentally to care for a different “type” of patient.
“Despite these new challenges, the acute care and ER staff were great, and very supportive of the residents and Loyalton staff,” Caudle said. “Lorraine Noble was essential in everything we did, from documentation to paperwork — she really helped to keep everything running smoothly and was an amazing help.”
Meanwhile, during this time, CEO Hayes was dealing with the business side of things, including the costs.
“The system we got for Loyalton SNF is a temporary six-month system, which is a temporary boiler and backup forced-air heating. This cost upwards of $200,000 and took quite a bit of footwork to get in place,” Hayes said. “We had to take the proper steps to go through the Office of Statewide Health Planning and Development for approval on what was a serious issue.”
Hayes ultimately had to reach out to California State Assemblyman Ted Gaines for assistance.
“It was looking like the state was going to require an architectural team to sign off on the temporary system in person before the state itself would sign off on it, and there was a real time crunch,” EPHC’s Linda Satchwell commented.
“After all of the additional requirements had been included with architectural regulations, a temporary fix went from $50,000 to over $200,000. It was starting to look like permission to bring residents back to Loyalton SNF wasn’t going to happen any time soon.”
Hayes started by connecting with Sierra County Supervisor, Jim Beard. Beard then contacted Senator Gaines office, where Gaines’ assistant, Dave Meurer, immediately got involved and wrote a letter to OSHPD emphasizing the seriousness and urgency of the situation in Loyalton, and asking for assistance in expediting the process.
“That letter was very effective,” Satchwell said. “It seemed like overnight, all of the red tape had been dropped and we could move forward.”
The temporary boiler system was installed in quick order, and residents could be moved back home via the Sierra County senior van on Dec. 31 in two trips.
“It took no time at all,” Caudle remarked. “The first bunch that came home literally cheered aloud when we got to Loyalton — it was a similar feeling to when you get home from a long vacation.”
Hayes is now focused on funding permanent boilers for the Loyalton SNF, which is estimated to cost around $400,000.
“I am reaching out to the Sierra Healthcare District for financial assistance, as well as researching grants and loans,” Hayes said. “The replacements, primary and secondary, will require an architect design engineer review, and could take up to a year, so I’m really focused on expediting and funding this future inevitable project.”
Despite the moments of stress and confusion, Hayes would like to commend his staff for doing such a fantastic job. “It was a real team effort to get everything accomplished, and all staff were very conscientious. It really shows to me that EPHC prepares for potential disasters and that this preparation is essential. Thank you to all that rallied during this time.”
Loyalton SNF 4a
From left, Director of Nursing Tracy Caudle greets with open arms Loyalton skilled nursing facility resident Larry McEneaney with Assistant Director of Nursing Lena Verdicchio as residents finally get to come home Dec. 31. Photo submitted