Hospital board readies labor, delivery changes

Mendocino Coast Healthcare District directors took a step toward closing Labor and Delivery services on the Mendocino Coast by voting Jan. 26 4-0, with Board member John Redding abstaining, to ask the hospital’s medical staff to come up with a “stabilize and transfer” model for mothersto-be who arrive at the hospital’s emergency room.

Training for ER doctors and nurses, and other aspects of handling births without a labor and delivery department or necessarily an obstetrician on hand, will be the focus of the plan requested by the board, according to hospital Chief of Medical Staff William Miller.

The vote came after a wideranging discussion that has shifted more toward options for the future than keeping the existing department.

But board members were chastised by Araceli Rivas, who accused them of abandoning Fort Bragg’s youth and young families. Rivas and others asked the board not to move toward closing the department until more research has been done on ways that might save or replace the service.

Others implored board members to close the department to save hospital finances. John Allison warned of an imminent financial crisis if Labor and Delivery

is not closed and thanked the board afterward for their vote.

Board member John Redding abstained, saying he wants a more detailed plan for the future before voting to close the department.

Board chair Jessica Grinberg said she doesn’t think there is one particular solution to the issue, but a variety of approaches.

“I don’t know that there’s only one path forward,” she said.

Mendocino Coast Clinics Executive Director Lucresha Renteria said she has been talking with Partnership Health Plan and that they may be interested in negotiating higher reimbursement for labor and delivery services, which would relieve pressures on the service in many ways.

Finances

Mendocino Coast District Hospital saw a $2 million month-to-month positive swing in its finances in December, healthcare district directors were told by Interim Chief Financial Officer Dorand Hammer.

The positive financial news came after consecutive months of growing losses since Adventist Health, interested in taking over operations at the hospital, signed a tentative agreement, pending voter approval, with healthcare district directors in November. The losses prompted anxious talk that Adventist might rethink its commitment to the deal.

The month showed a $1.3 million surplus, after November’s approximately $400,000 loss, on gradually rising patient volumes, along with an adjustment in the estimate for Medicare reimbursements that resulted in nearly the entire amount of the increase.

The hospital has been notified by Medicare recently that the public insurer underpaid MCDH in 2017. Hammer said he expects a $1.5 million check soon to settle the underpayment and another of unknown but probably large amount a little later.

Based on the past underpayments, Hammer said, he adjusted the estimated, or “contractual allowance” to reflect a higher level of expected payments, and significantly affecting the hospital’s financial picture.

Operating room shutdown

The hospital’s operating room and Labor and Delivery department were temporarily closed after state inspectors found that the rooms conformed to 2011 infection control standards instead of updated 2017 standards. Hospital administration reopened the operating and labor and delivery rooms Jan. 31.