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Eastern Plumas makes changes in wake of coronavirus

Addresses first positive patient protocols

The Eastern Plumas Health Care Board of Directors held a special virtual meeting on the morning of Wednesday, April 1, with the focus around Covid-19 and the way that EPHC is meeting the moment.

After brief introductory comments, Chairwoman Gail McGrath noted that the Nifty Thrifty is closed in keeping with the current orders for all non-essential businesses to remain closed to prevent the spread of Covid-19.

Chief Nursing Officer Penny Holland noted that she and staff had been hard at work formulating a surge plan, which will be altered as necessary.

Director Theresa Whitfield then asked Holland whether risk assessment was being done for any employees that had come into contact with a patient that had been transferred from EPHC to St. Mary’s Medical Center in Reno, Nevada, and then tested positive for Covid-19, the first confirmed case from Plumas County.

Holland said an assessment is underway to determine if employee exposure was high-, medium- or low-risk, as well as closely monitoring employees. She explained that the county is testing exposed family members and contact tracing.

Clinic Director Rhonda Grandi reported that as of March 24, the hospital had been at an average of 2.76 new patients per day since January, but noted that it was expected to decrease over the next 30 to 60 days due to the coronavirus response.

“A lot has changed. We only have staff on site deemed essential to work,” Grandi said. “Clinic volume is currently down by about 50 percent.”

Grandi reiterated the strong actions being taken at EPHC to ensure the safety of the community and staff, including protocols that require each person to call ahead and go through a screening prior to any appointment.

Starting Wednesday, April 1, clinics are closed to walk-ins, and all patients are required to wait in their vehicles rather than in a lobby to further reduce potential exposure. “We’re trying to keep people out of the lobby and screen them,” Grandi said.

This is in addition to phone screenings, and applies to all patients, including those still utilizing the outpatient lab draws and radiological services offered at EPHC.

The dental clinic in Portola has limited all visits to emergencies only, available on Mondays and Tuesdays. Grandi also reported on the work to implement Telehealth visits, with limited local internet connectivity for many rural patients causing challenges.

“We are working on ways to get around these issues, and are conducting phone visits in the interim,” Grandi explained. “Our response is constantly changing as needed. Really, it’s been changing daily.”

Finance

Chief Financial Officer Katherine Pairish reviewed financial statements for February, noting that EPHC had posted $27,845,863 in gross revenue. Year-to-date patient revenue after contractual adjustments and allowances was $16,930,921 with year-to-date net loss of $1,190,248 as of Feb. 29.

Pairish also remarked on looking into sources for potential federal aid to respond to Covid-19.

“There are a lot of potential options, such as CMS potentially allowing us to take six months worth of payments and get a 125 percent advance on funds which could be kept for four months before being paid back over a 12-month period,” Pairish explained. “I am looking into all of the options to see what makes sense and will be attending several webinars to further educate myself on what will work for us.”

Pairish also noted that office staff is moving toward remote, from-home work for as many employees as possible.

The employees

Human Resources Director Lori Tange opened her report by expressing how HR had been undergoing challenges with a lot of questions, confusion, and fear from employees.

“We’re working to sort through the legalities of benefits that are coming out such as the new extended family leave, and the new extended sick leave, as well as what benefits are available for unemployment,” Tange explained.

“Some of the newer questions coming out are about people feeling like they want to stay home and self-isolate, for various reasons- maybe an at-risk family member, and concerns about potential exposure has really increased.”

In order to support all staff through this time, Tange sent instructions for managers to direct all such concerns back to HR, adding, “We don’t want any manager to feel like they are navigating themselves through something with which they are not familiar.”

Tange then noted that two dental clinic staff members will be laid off in the near future, with no other layoffs planned at this time. “We’re not there yet,” Tange said.

Facilities

Interim Chief Executive Officer Jayne O’Flanagan then reported on Facilities Director Stan Peiler’s behalf, noting the many changes that had occurred over the past week.

“There has been a focus on changing hospital access this week,” O’Flanagan said. “There is also a focus on refurbishing an additional two rooms on the Portola campus with the intent that Covid-19 patients be treated there.”

O’Flanagan noted that there had been some roof leaks to address on the Loyalton campus, but the primary focus of the facilities department had been locking down each campus and preventing unmonitored public access.

Jim Burson, Director of Rehabilitation, reported that he and his team had rapidly worked to close outpatient care inside the hospital and move all treatments to the building previously known as the Education Center at the Portola campus.

“We have made more restrictions on access in order to further isolate the patients coming in to be treated, as well as my staff,” Burson said. “We are still at 75 percent of our previous capacity at outpatient therapy with patients being actively treated. My staff of nine is down 2.75 full time equivalents.”

Chief executive’s report

O’Flanagan reported that it had indeed been a busy week, and noted that changes had been made, including access-related changes. “There will be no movement of staff from acute to the skilled nursing facility,” she said. “We do not want anybody in the long-term care area that doesn’t need to be there.”

O’Flanagan also noted that two representatives had made a short-notice visit on Monday to assess and evaluate Covid-19 plans at both long-term care facilities.

“It’s not something that we were expecting,” O’Flanagan said. “They really only identified two areas of concern related to communal eating, so staff is being very inventive to care for the residents. We’re trying to keep them from feeling isolated while keeping residents safe.”

It was noted that EPHC is moving forward on an HVAC system for the Education Center, and she also congratulated physical therapy on getting moved from the acute space at EPHC to the Education Center in less than 36 hours.

“As you are all aware, we did have a positive covid patient in the county,” O’Flanagan noted. “Our focus is really on communication and how we are communicating important information internally and externally.”

She closed by stating that the staff at Eastern Plumas Health Care “is remarkable,” adding, “We are really fortunate.”

The next regularly scheduled meeting of the Board of Directors of Eastern Plumas Health Care is April 23 at 9:30 a.m. For more information on this or any other meeting, contact Ashlie Preston at [email protected], visit ephc.org or call 832-6500.

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