It seems to be a fact of life that bad news filters through to everyone and sinks in deeper than good news does. So, Eastern Plumas Health Care’s battle with the state of California to save its skilled nursing facilities—which, by implication put our entire hospital and community under threat—spread like wild fire. Our ongoing battle has been watched closely, and the community has come together to fight these cuts in a way that should make us all proud.
But, in the aftermath when we say, “Our hospital will not close. Our skilled nursing facilities will take fewer patients, but both facilities are still strong—and they will continue to thrive,” many people don’t seem to hear us. I wouldn’t make a statement like the one above if I didn’t believe it completely. I’ll say it again—“We will not close! The hospital won’t close, our skilled nursing won’t close, our community will not fall.”
That is, of course, unless our residents so thoroughly convince themselves that we are going to close that they stop using our services. This mindset could become a self-fulfilling prophecy, because you can’t have a hospital, 4 medical clinics, 1 dental clinic, nursing facilities, a lab, imaging services, a 24 hour physician staffed ER, and a round the clock ambulance service unless patients use our services.
I’d suggest that our community members began saying, “Our hospital is here to stay. All of the big organizations, like the California Hospital Association, that vowed to stop the cuts through legislation, were unsuccessful. But, this little hospital has figured out a way to survive, just like it has every time it’s been threatened in the past.” Because, we’ve done just that—we’ve figured out a budget we can live with.
Some staff positions have been consolidated, and department heads have been asked to trim their budgets even more—making sure they cut all non-essential supplies as much as possible. The skilled nursing facilities have gone from a high of 67 residents between the Loyalton and Portola facilities, to a current target of 24 residents per facility. And, to tell the truth, the fact that patients, families, and community supporters fought so hard in both communities to keep their facilities made an impact on our decision to fight on our end to keep both sites open. As our Chief Financial Officer, Jeri Nelson, said, “We all agree that these cuts are tough, but we are tougher.”
In addition, we are still waiting to hear from the CA Department of Health Care Services (DHCS) whether we will receive an exemption from these cuts based on the research we provided them proving our frontier and sole community provider status. While DHCS hasn’t been able to give us details, we know our request has been moved up the ladder, and we’ve received some positive signals from them.
Aside from that, however, I believe we’re responding with flexibility and an understanding, both of the direction the state is going, and of the needs of our community. We are working to ensure that our clinics and emergency services are the best they can be. And, we are increasing our focus on services that acknowledge the specific needs of our communities. We have and will continue to increase our specialty services, especially those such as Cardiology, Dermatology, Neurology, Othropedics, and Podiatry.
In addition, we have expanded our services for low income and Medi-Cal patients, because we know that particularly in times like these, our community members need our help as much as we need theirs. We offer a comprehensive Medicare Wellness Program with many free to the patient lab tests and screenings, including colon, breast, and prostate cancer screenings, diabetes screenings, and more. We provide year-round low-cost lab testing and, currently, a lab ($40) and a digital mammography ($80) cash special that we hope makes essential testing available to everyone who needs it.
Finally, I’m very excited that we have embraced telemedicine services for this community. We now offer many specialists via our encrypted, high-speed telemedicine video connection. This allows our patients to stay at their home clinic rather than be forced to drive long distances and wait for long periods for appointments. Also, our Telemedicine Coordinator facilitates the visit for each clinic patient, and for many specialties, there is also a Family Nurse Practitioner or doctor working with the patient on our end.
Specialties include: Cardiology, Dermatology, Diabetes Education, Diabetic Retinopathy Screening, Endocrinology (Diabetes, Thyroid Conditions), Internal Medicine , Nephrology, Neurology, Oncology (Cancer), Pediatric Emergency/Critical Care, Psychology Counseling, Psychiatry, Pulmonology, and Rheumatology. While patients are initially skeptical about “seeing” a doctor over video, once they try it, we’ve found patients to be overwhelmingly positive about the experience.
In many cases, our Telemedicine Specialists ensure that patients who might otherwise not seek the care they need, or for whom travel would be far more than an inconvenience, get the best quality care available. We are the only medical facility in Plumas or Sierra Counties that offers essential retinopathy screenings to diabetes patients on Medi-Cal, for example. We’re very proud of the fact that all of our diabetic patients’ retinal images are read by top Opthalmologists at University of California, Berkeley.
Our Oncology patients receive their follow up care via telemedicine and are seen by top nationally rated Oncologists at Tahoe Forest Cancer Center and UC Davis. Now these patients, some of whom are receiving chemo and/or radiation therapies, don’t have to travel winding mountain roads for their care, and add to that, dangerous, icy roads in winter. Now, patients who might not be able to afford to travel, can come to our clinics and receive the best possible care.
We are strong, hearty people—those who have lived for generations in our community, especially. If we chose to believe our hospital and community will survive then, quite simply, that will be the truth. It’s also true that if our residents use our clinics and other services, they’ll ensure that our emergency room and ambulance service will be here when they need us the most.
We’re doing everything we can on our end. I would ask that you do yours. Pass the word to friends, family, and neighbors that we will be open, that we will survive, and that we’ll thrive. If you’ve had good experiences in our hospital, ER, or clinic, pass that on too. If you’ve had a less than positive experience—let me or my staff know so that we can make things better. More than anything use our services when you need health care.
Because, in the end, whether we survive or not depends on you.

Tom Hayes, CEO, Eastern Plumas Health Care