We wouldn’t have this wonderful new ambulance without the generosity of our donors. We’re extremely grateful, and proud to serve our community with this new state-of-the-art emergency vehicle.

According to Morgan Daniel, our paramedic coordinator, the vehicle, a Leader Mercedes diesel Sprinter Van, has a well-lit, clean modern interior design with lots of cabinet space.

“Our equipment is laid out nicely, and easy to get to,” Daniel notes. “And the new four-point safety belts (lap and shoulder) are an important new safety feature for crew members working in the back of the van. What really makes this a great ambulance for us is its smoother, quieter ride, and its more functional design. We can stand up in the back, which is a huge plus. In the older ambulances we’re hunched over. Overall it provides us with a much better work environment.”

Support Our 911 Raffle

“Approximately eighty percent of the Hospital Foundation’s Ambulance Funds are generated through the Foundation’s annual 911 Raffle,” says Jeri Erickson, MCH Foundation Executive Director, who notes the 2012 raffle drawing will take place June 22. “Because of our remote location in Mendocino County, it is extremely important that we continue to develop the most efficient and effective ambulance service possible.”

The 911 Raffle assists our community in assuring that a modern mechanically sound ambulance is always available. By participating in the 911 Raffle you help to provide complete ambulance coverage and vital emergency services for you and your neighbors.

Get Raffle Tickets Now

For details and online ticket purchase, visit http://mchfoundation.org/, or call 707-961-4671.

Dear Raymond Hino,

We have received a survey letter twice and my mother, who was the patient, has a bit of dementia and doesn’t remember things very well. I would like to say that from my perspective as a daughter and her caretaker, the care I witnessed my mother receive was excellent.

There was one nurse in particular named Ashley McGuire [Medical/Surgical], who was great. She put us at ease with her manner of caring and relating to my mother. The other thing I would like to mention is the Home Health Care people who came, made it possible for me to understand how I could care for my mother in this new level.

I was so frightened at one point I was sure I couldn’t do it. There were a number of people who helped me.

The discharge person Phil Sullivan, a wonderful man, was very good at communicating information to me without having any judgmental attitude. Helen Jacobs from Multi Senior Service Program was fantastic. The physical therapists taught me about proper body mechanics and showed me how it was possible to care for my mother in ways I never would have known. Brenda Ross and Nancy Stair were their names. Also Ann Kelsey, Home Health, who helped ease my fears and helped get a better walker for safer use. My praises go out to all of them.

We are lucky to have this excellent hospital and caring staff in this community.

So even though my mother can’t navigate the survey, I wanted to let you know what I observed, experienced and felt.

Very Sincerely,

Nicoline Vander Heyden

Mr. Hino, Board Members and Staff:

… I recently was hospitalized for surgery by Dr Bellah as I have prostate cancer. I had a cancer spot in the femur and have been doctoring with Dr Rochat for four years. When it was found, Dr. Rochat immediately contacted Dr Bellah and surgery was scheduled. From Dr Rochat, the X-ray dept, Dr. Bellah, Dr. Kirkman and the hospital staff, I had the best of care!!

I liked the idea that all of my doctors are in the same group. When I saw each one of them they knew my history; if I have had to go out of the area, the doctors would not have had it. We are so lucky to have all the above named doctors.

I have to see Dr. Rochat once a month now for treatment and I have nothing but praise for him. Also the reception desk, clerk Mrs. Cudney always has a smile on her face. Being a business owner myself, I know that greeting your customers with a smile is so important. Also, when I was released from the hospital I had to give myself a shot. Amy Richardson called me at home that evening to make sure I was able to administer the shot myself!!  Now is that not service and caring? …

Anthony Canclini
Marilyn Canclini

An evening of entertainment

Conceived as an evening’s entertainment, the event starts with music and an open bar at 5 pm. Appetizers will accompany entertainment before, during, and after the main course in a bistro setting. Local wines, as well as beers from the North Coast Brewing Company, have been donated for the event.

Family style dinner, musical entertainment and more

Dinner will feature homemade pasta sauces with options for vegetarian and gluten-free. “Mouthwatering, hand-made meatballs will be abundant, as well as family-style service of bread, salad, and small desserts,” notes FoH volunteer Cynthia Wall. A silent auction and raffle will add to the excitement, with businesses and individuals contributing generous gifts and certificates. At 5 pm local song-man, Harry Rosensteel, will sing songs we all remember. Then to end with a sizzle, “Torch Jazz” featuring Ira Rosenberg on piano with Zida Borcich vocalizing, picks up the pace at 6:30 and closes the place down at 9PM.

Yesterday I wrote about all of the construction activity that has taken place at MCDH over the past 6 years.  All of the construction projects have been necessary for the continued operation of MCDH.  There have been other factors that have affected our hospital during the past 2 + years that have also had a dramatic effect on financial performance.

As the economy has worsened in recent years, the effect has been felt not only at the local level but also in our Nation in Washington, D.C. and our State.  In 2009 a new program was created at the Federal level called the Recovery Audit Contractor (RAC) program.  The RAC program is designed to allow Federally designated (RAC) contractors to have open access to Medicare hospital admissions from prior years.  The RACs are looking for overpayments made by Medicare to hospitals and, in the early years, they were permitted to keep a percentage of every dollar that they recovered for the government.   The program sounds reasonable. 

However the problem soon became that RAC auditors began to second guess decisions made by doctors 5 to 6 years ago.  We had several instances where we had admitted Medicare patients to our hospital because of the patient’s severe acutely ill condition, only to have a RAC contractor made a determination that the patient never should have been admitted in the first place!  In June of 2009 we received a bill from Medicare for $415,000 to be repaid in 30 days or less.  We successfully negotiated that bill down to $118,000.  But every year we are hit with more and more audits and requirements for repayments of dollars paid to MCDH in years past.  Last year in 2011, MCDH was hit with over $1 million in repayments back to the government for money that had been received in prior years.   This environment of audits and takebacks of funds has become increasingly difficult on hospitals both large and small.

Another trend that has become a reality in our community in recent years is a dramatic shift in the availability of medical doctors in our community.  When I arrived in Fort Bragg 6 years ago we had 11 private doctors offices.  Today there are 2 large clinics and only 5 private doctors offices.   The biggest reason has been doctors closing their offices due to the pressures of keeping a private practice open.  7 doctors have closed their offices and joined either Mendocino Coast Clinic or North Coast Family Health Center.  For our hospital, the biggest change has been that now most of the doctors that support our hospital have become independent contractors at our hospital.   This is the model of the future.   Doctors and hospitals working together.  However it has put pressure on our hospital, as now hospitals need to become smarter and skilled at running doctors office practices and billing and collecting for the doctors services.  These are skills that most hospitals have, historically, not done well in.

So many changes have taken place in the past 6 years.  The ones that I have mentioned so far (construction projects, Medicare and Medi-Cal audits and repayments and aging of the medical staff) are the biggest ones.  But, there has been one more factor that has been major for the Mendocino Coast and our Nation.  That is the economy.  Unemployment and homelessness have hit high levels that most of us have never seen in our lifetime.   Every City, County, State and even our Country, have been hit hard.  Our hospital is no different.  The bottom line is that our business is shrinking.  We cannot afford to continue adding expense to our operations when our patient activity is shrinking.

Tomorrow I will continue my series on “what has happened at MCDH” with a look at the planned change for our Home Health Department.

I took over as the CEO of Mendocino Coast District Hospital in November of 2006.  At that time MCDH was in very good shape in some respects and poor shape in other areas.  After suffering a loss exceeding $5 million in fiscal year 2006 (ending June 30, 2006), MCDH was on a very strong path towards recovery.  Due to the phenomenal efforts of Jon Baker, Interim CEO and the entire MCDH family, Critical Access Hospital designation had been approved and became effective on October 5, 2006.  This ensured that the hospital would have a more stable source of Medicare payments effective immediately at that time.  Jon Baker and the staff had also done a great job of identifying some programs that were losing money for MCDH and eliminated them, putting the hospital on a stable course.  On the negative side, the hospital was down to only $500,000 in it’s Funded Depreciation account.  And just as significant, I soon learned that our (then) 35 year old hospital had some major physical plant deficiencies. 

Gus Killion and Linda Dutcher made an appointment to see me shortly after I arrived for the purpose of bringing me up to speed on the hospital’s physical plant issues.  I learned from them that (1) MCDH did not meet seismic requirements and that the estimated $5.0 million cost for retrofit was unfunded; (2) The Patient Services Building, although in use, was operating under a Temporary Certificate of Occupancy and that necessary improvements to complete it, were also unfunded; (3) the hospital’s CT scanner needed to be replaced and there was a source of funds for a new one through the Hospital Foundation; (4) However the hospital’s X-Ray Flouroscopy Room and X-Ray room also needed to be replaced and they were unfunded; (5) a replacement of the hospital’s boiler and chiller was also necessary because they were so old.  The replacement boiler and chiller had been included in the original project for the Patient Services Building but had been dropped out due to cost.  There was no source of funds to replace either of them.  I have learned over the years that the hospital’s nurse call system, telephone system, sterilizers and other key equipment are also nearing end of life.   The good news for today is that all of these projects have either been completed or have a source of funds available to complete them.

Many of these physical plant needs were so critical that they could have closed our hospital if they were not addressed.  And in the case of the X-Ray and Surgery departments, they included equipment that is necessary to preserve crucial revenue for our facility.   Some people have speculated that the Diagnostic Imaging Center is the cause of MCDH’s financial problems.  That is absolutely not accurate.  First of all, due to modular building construction, we were able to replace all of the equipment that was nearing end of life with new equipment in a new building by using construction technology that was faster and less expensive then retrofitting our existing department in the old building.  And second, had we done nothing, we would be in worse shape because we would no longer have the ability to provide diagnostic imaging services at this hospital.  Or, in other words, the millions of dollars that MCDH derives from diagnostic imaging procedures would be gone AND we would not be able to provide the excellent level of care that our patients need and deserve.

Tomorrow I will continue with Part 2 of changes that have occurred during the past 6 years that have affected our hospital and have contributed to our current financial situation.  I will talk about changes in Medicare and Medi-Cal reimbursement, the change in our relationships with our doctors and, of course, the state of the National, State, County and local economy.

 Our management team had sought 2 outcomes from these meetings.  First, we wanted to reach an agreement on some specific action steps that we can accomplish within the next 3 months.  At the very least we expected to receive a compromise offer from the UFCW leadership that would still allow us to move forward.  Second, we expected that ultimately the choice of a partnership solution between both sides would be put to a vote by our employees.  Neither of these steps was taken by UFCW. 

We regret that this inability to reach an agreement will have an effect on the services that we provide.  The MCDH Management team proposed the following 4-step plan to financial recovery. 

• An immediate 5% reduction in hourly compensation for all staff.  This would match the 5% reduction that has already been in effect for hospital managers and supervisors for the past 4 weeks. 
• A repeal of the 3% wage increase that is due to go into effect in July of this year. 
• A repeal of the 6% employer contribution to the employee’s retirement plan beginning in July of this year.  Employer matches for fiscal years 2011 and 2012 would not be affected.  MCDH would continue to make required contributions into those 2 plan years in June of 2012 and June of 2013. 
• The implementation of an employee contribution for dependent coverage under the current health plan.  Under this fourth step, MCDH would continue to cover all employees for 100% of the cost of the employee’s health insurance plan.  However, we asked that employees and MCDH share in the cost of dependent coverage.

MCDH Administration does not take lightly the gravity of asking our employees to help at this critical time.  Our plan includes having our medical staff contractors share in a 5% reduction as well.  Employees may think that the troubles that MCDH is experiencing are only happening in Fort Bragg and on our Coast.  They are not.  Each of us does not have to look far to see that other hospitals in our region, as well as cities, counties and businesses are also struggling.  We are not alone in this.  MCDH management has implemented several cost savings measures, including a management restructuring, a profitability improvement plan for home health, a labor productivity program and the 5% reduction in management salaries.  All of these steps will save over $1 million for MCDH this year.  However, at the rate that the hospital has been sustaining losses during the most recent winter months, this will not be enough to put MCDH back on solid financial footing.  Our inability to reach an agreement on a financial improvement plan means that management will continue to seek other ways to trim costs from our budget.  I will keep our employees and the community informed, as we continue to pursue ways to return MCDH to profitability.

With that in mind, it is always a pleasure to get feedback about the care we have provided.

I am especially pleased to share a personal, hand-written note I received from Jeannie Alderson of Gualala:

“I recently had a condition making it necessary to spend an extended period of time in your hospital. I would like to commend every member of the staff that I encountered. You all made a very unpleasant illness into a much more pleasant experience. You all seemed to truly care about your patients as human beings, not just a job.

I will always remember this and be grateful.” She even included a red, heart-colored “Love” postage stamp.

On behalf of our entire team — our doctors, nurses, technicians, therapists and patient access coordinators — we thank you, Jeannie Alderson.

We had over 25 of our medical staff come to the breakfast. They were treated to a sit-down (full service like a restaurant- they really appreciated that!) breakfast: Eggs Benedict or Eggs Florentine or bacon and eggs; home-style seasoned potatoes;  fresh fruit; homemade granola with yogurt; homemade apricot or blueberry muffins; fresh squeezed orange juice & Thanksgiving coffee.

MCDH also thanked them with embroidered Medical Staff Polo shirts; Winesong! coffee mugs filled with chocolates and a nice thank you note from the Foundation.

Peaceful music performed by Janie Rezner- she sang and played her hand-made Ocarina.

It was a very nice way to express our appreciation for all the dedication and hard work of our medical staff.

These dedicated men and women are highly qualified physicians who have chosen to live in our wonderful rural community and practice medicine. They’re working every day to keep us healthy, and for this we are extremely grateful.

Of course we shouldn’t wait for National Doctors Day to say “Thank You.” It’s a sentiment I think about every day, and try to express often. Consider sending your doctor a note once in awhile, letting her or him know how much you appreciate their care. Or tell them in person at the end of your next visit. Like all of us, they appreciate an occasional “warm fuzzy.”