Sutter Coast Hospital Update from Gregory Duncan, M.D.
January 25, 2013
Sutter Health Calls Special Meeting to Discuss Cutting Hospital Bed Capacity by 50%

THE FUTURE OF OUR HOSPITAL HANGS IN THE BALANCE
Dear Fellow Citizens of Del Norte and Curry Counties:

Sutter Health is stepping up their legal battle to take down the Injunction granted to our County Healthcare District.

Last month, Sutter Health filed a motion asking the Court of Appeals to lower the Injunction granted in Del Norte Superior Court by the Hon. Leonard La Casse.  Sutter Health claims the Injunction "ties the Board's hands and creates barriers to being able to consider and move forward with all available options to secure Sutter Coast Hospital's future."  

Actually, the Injunction blocks just two actions:  Regionalization (transfer of hospital ownership to Sutter Health) and Critical Access.  Remember, in order for us to convert to a Critical Access hospital, we would need to cut our bed capacity by 50% and maintain an average length of stay of less than four days.  Also, the current requirements of having a physician on duty in the Emergency Room, and a General Surgeon and Intensive Care Specialist available on call, all disappear under Critical Access designation.

Last Tuesday, Sutter Health arranged a special meeting of our local hospital Board to discuss Critical Access designation for our hospital, bringing executives from Sutter Lakeside Hospital in Lakeport, CA to our Board room to make a presentation.


As with past Sutter presentations, no alternate viewpoints were heard.  In addition, before the meeting, hospital Vice Chief of Staff  Dr. Mark Davis and I were denied access to the two prior Critical Access studies which Sutter Health had commissioned for Sutter Coast Hospital, rendering it impossible for us and the rest of the Board to properly prepare for the presentation.

Here's a quick Fact Check from the meeting:

Sutter Claim:  Sutter Lakeside executives told us that Critical Access had stabilized the hospital's financial condition and allowed the hospital to maintain services in Lake County. 

Fact:   In 2008, Sutter Lakeside Hospital (SLH) had "over 600 high quality jobs" (source: Sutter Lakeside press release, early 2008).  Today, SLH has less than 300 jobs.  In 2012, four years after Critical Access was implemented, Sutter Lakeside announced a 10% across the board reduction in staffing (source: Santa Rosa Press Democrat, 3/30/12). Services were also reduced.  On 4/18/12, SLH Chief Administrator Siri Nelson (who attended Tuesday's meeting) announced the closure of a pain management clinic, and an outreach primary care clinic. (source: Sutter Lakeside press release 4/18/12)

Sutter Claim:  Critical Access has resulted in only 120 patient transfers out of Sutter Lakeside per year.

Fact:  Prior to Critical Access designation, Sutter Lakeside transferred 250 patients per year to outside hospitals.  In 2012, Sutter Lakeside transferred over 600 patients to outside hospitals, an increase of over 350 transfers per year, which Sutter executives claim was largely unrelated to Critical Access designation.  Senior physicians I spoke with at Sutter Lakeside told me the opposite--the increase in patient transfers was due to lack of beds, because the hospital is usually full under the 25 bed cap imposed by Critical Access.  A senior nurse at Lakeside told me the hospital keeps three beds open for elective surgery patents, which are prioritized higher than Emergency Room patients, forcing the ER to ship even more patients to outside hospitals. So it comes down to whether you believe the doctors and nurses, or the administrators.

Sutter Coast Hospital Board Member Claim:  Emergency patient transfers out of Sutter Coast are no more problematic than transfers out of Lakeside.

Fact:  Sutter Lakeside patient transfers occur by helicopter or ground ambulance, which means the patient is transported from the Sutter Lakeside helipad or ambulance bay directly to the receiving hospital.  Due to our remote geography, Sutter Coast patient transfers nearly always occur by airplane.  This requires three separate ambulance rides--ground ambulance to our local airport, aircraft transport to the airport in the destination city, and another ground ambulance to the receiving hospital. This leads to a second difference in transfers between Lakeside and Sutter Coast--longer transfer times and very high costs. The average cost of the ground transport segments for our patients is $1,500 for each trip.  The cost of the aircraft portion is much higher--$41,000 for my friend who was flown to Medford last summer.  A third obvious difference between SLH and Sutter Coast is the distance to the next hospital. Lakeside executives told us their next closest hospital was 40 miles from Lakeport. Our hospital is at least 85 miles to the next acute care hospital in any direction.   A fourth difference is weather.  In general, weather conditions for transporting patients are more favorable in Lake County than here in Del Norte.

Unfortunately, I was unable to convince even one local Board member that patient transfers are more problematic here as compared to Lakeside.
What would Critical Access mean for Sutter Coast Hospital?

Based on hospital patient census figures since 10/1/12, if Sutter Coast had been a Critical Access facility, at least 86 patients would have been transferred to outside hospitals. The hospital would have been closed to new admissions 50% of the days. Yesterday, there were 34 patients in the hospital.  Under Critical Access, yesterday alone, between 9 and 12 of those patients would have been flown to an outside hospital. 

How Can We Stop Sutter?
Most of all, we speak up!  Together, we can stop Sutter and create a better hospital for our two counties.

Call or email our representatives often!  They want to hear from us.  Tell them what you think of Sutter Heallth's attempt to end 28 years of local ownership and governance of Sutter Coast Hospital, even though every elected official in Del Norte County opposes Sutter's plans.  Ask them to support our Healthcare District's legal action against Sutter--the Healthcare District alone cannot match Sutter Health's legal might.  Tell them we need a hospital management firm that is honest, listens to the community, and will not cut our hospital in half.

Write a brief letter to the Triplicate, with a cc to the Board of Supervisors.  The Triplicate provides our community a great forum to express concerns and exchange ideas. If you have a question or comment to share, send me an email at drgjduncan@yahoo.com 

Write the County Board of Supervisors, who this week heard concerns from Dr. Kevin Caldwell and me, available here: http://www.ustream.tv/recorded/28725986  The presentation begins 45 minutes into the meeting. The Supervisors were unanimously supportive of our efforts.

Thank City Council members Kelly Schellong and Kathryn Murray, and Supervisor Martha McClure, all of whom serve on the Healthcare District subcommittee opposing Sutter, for their efforts.

Contact our state and federal representatives at the numbers below: 

Congressman Jared Huffman:  (707) 407-3585
State Senator Jim Nielsen: (916) 651-4004
State Assemblymember Wesley Chesbro:  (707) 445-7014

PLEASE FORWARD THIS EMAIL TO ANYONE WHO MAY BE INTERESTED.
Meanwhile, Asante Health System, owners of both Three Rivers Hospital in Grants Pass and Rogue Regional Medical Medical Center in Medford, are standing by to assist us in the event Sutter leaves.

Many thanks to those of you who have written letters, stopped by my office to sign the petition, and given Anne Marie and me encouragement.  Your support is more important than you know.

Finally, flu season just arrived in Del Norte, with two patients testing positive for influenza as of yesterday.  Please be extra careful with hand washing, and consider staying home if you are coughing or sneezing.
Sincerely,