CCHS Board OKs Initial Look at Assisted Living Facility

State hopes to save money with assisted living pilot programs

DAYTON—At the regular hospital district board meeting on Oct. 27, the board of commissioners honored CEO Shane McGuire’s request for seed money to develop a plan for an assisted living facility in Dayton.

For the past few months, CCHD administrators and the Board of Commissioners have been talking about the lack of assisted living options for older people in the community, or what McGuire refers to as “a donut hole”, in health care for our region.

The hospital district officials convened a special meeting on Oct. 18 to begin serious discussions about aging in the community, and to develop goals and strategies for meeting some of their objectives.

McGuire told the commissioners that he and nursing home representatives, and representatives from other rural hospitals, met at a recent meeting of the Washington Rural Health Access Preservation project. There they learned that the state is focusing on redesigning health care for older adults, which includes moving patients away from costly long-term health care models.

McGuire said that the cost of assisted living is one-third the cost of long term care, and the state is willing to invest in pilot programs in order to save state dollars.

“I’ve never seen the state so willing to look at pilot programs,” he said.

McGuire said he would need around $10,000 to get an architect and civil engineer on board to do the site work, and site planning, and to get the hospital accounting firm on board with developing a business plan for having the assisted living facility.

McGuire told the commissioners that he favors a facility, modular in design, and that in order to be financially feasible, the residential mix would be both private pay and Medicaid.

A business plan won’t work unless we hit sixty beds, he said.

If that were to happen, memory care patients would receive their care at the Booker Rest Home, McGuire said.

Director of Nursing Stephanie Carpenter has been appointed to head the Aging in the Community program. She has recently visited several assisted living facilities, including Guardian Homes and Sullivan Assisted in Spokane, and Wheatland Village in Walla Walla, to gather information.

“The state is on board, but needs something tangible. I’ve never seen the state participate the way they are now,” McGuire emphasized.

Hospital Renovation and Enhancement Project Update

In his report to the commissioners regarding the renovation, McGuire said that the parking lot is being brought down to grade, and preparations are underway for curb and gutter concrete. Asphalt has been scheduled for Nov. 1, he said.

The therapy pool structure is being completed, and physical therapy supplies have been ordered for the pool and the expanded gym space, he said.

A Board of Pharmacy review is scheduled, after which the new pharmacy area will be ready for construction, and the project manager expects it to be completed during the week of Nov. 7, said McGuire.

Senior Project Manager Carl Moses has given a timeline of December for the completion of Phase I of the hospital renovation/enhancement project.

Outreach and Business Enhancement Initiatives

McGuire said that there will be an open house in the new Physical Therapy Department, coinciding with the Dayton Chamber of Commerce-sponsored Christmas Kickoff on Nov. 25.

Elk Drug owner Sean Thurston has requested help with the work load his staff is experiencing due to an increase in pharmacy hours at the hospital. DGH has contracted with Medication Review of Spokane to help with that, he said.

A team including Dr. Neace, Dr. Terry, Tom Anderson RT, and Michael Schwarz PT has met with staff at Walla Walla General Hospital to discuss opportunities for cardiac rehab, cardiology services, and ultrasound services at DGH. The team also presented the DGH swing bed program to the Trios Health discharge team, McGuire said.

McGuire said a facility design for possible hyperbaric wound-care services is in the works. The hospital renovation and enhancement project team is looking at Phase V for a wound-care/hyperbaric space, and to see if there are enough funds from the hospital renovation for that as well, he said.

CashFlow and Financial Statements

The month of September continued August trends for patient volume, one time payments, and charge master increases, providing a positive operational bottom line of $73,940, as well as a net of $202,633, after non-operational income, according to McGuire

“Year to date net income is $608,487, and we hope to finish the year strong,” he said.

CFO Tom Meyers is making conservative accounting treatments to the gross revenue, as a hedge on what is believed can be collected, McGuire said.

Accounts payable had ballooned up while cash was being aggressively managed during cash-tight summer months. Headway has been made on that, with accounts payable decreasing by $279,138, from a 2016 high of $1,587,928, said McGuire.

The number of days’ cash on hand increased 13 1/2 days, to 35 1/2 days, driven by the 2015 cost report settlement and a one-time $53,000 payment from the Public Hospital District Unemployment Trust Fund, he said.

Net Accounts receivable dropped by $144,588, as collections improved. AR is still sitting at $3,371,516, McGuire said.

Year-to-date gross patient revenue is $12,569,220, and is $1,097,587 over projected budget as of September, McGuire said.