Many of the Mendocino Coast's key medical care decision-makers, along with state and local elected officials and a large community audience, met by Zoom on Feb. 3 to talk over questions facing the region's hospital, its struggling nursing home and broader healthcare future.
The forum, sponsored by the Mendocino Coast Democratic Club and still watchable on the club's Facebook page, brought together executives from Adventist Health — operator since July 2020 of the coast's hospital — the medical directors of the hospital and Sherwood Oaks Health Center, all five directors of the Mendocino Coast Healthcare District, Mendocino County's Fourth and Fifth District supervisors — Fifth District Supervisor Ted Williams moderated —State Assemblyman and Chair of the Assembly's Health Committee Jim Wood, a representative from State Senator Mike McGuire office, Fort Bragg Mayor Bernie Norvell, and members of a number of local community groups.
Regarding the coast's 26-bed hospital, built in 1971, it is subject, like all other hospitals in California, to new and costly seismic standards by 2030. Adventist Health executives and Wood presented a united front on a couple of points: that the coast's hospital is safe as it is — “this is one of the safest buildings on the coast,” Wood said — and that the state's seismic requirements — the current statewide estimate stands at $145 billion — be scaled back. In any case, according to comments by Wood and Adventist Health Vice President for Strategic Planning Jason Wells, the coast's hospital is neither in danger of falling down in an earthquake, being closed, nor of Adventist abandoning it in the foreseeable future.
Wells emphasized the large investments Adventist Health has put into the coast hospital and the advantages to running all three of Mendocino County's hospitals, saying “We're not doing that to walk away in seven or eight years… We're going to be at the table to solve these problems.”
Costs for a coast hospital retrofit or rebuild range from $2 million, if only the emergency room is retrofitted, to $30 million and more for a complete retrofit of the existing buildings, to $120 million for a completely new facility.
To pay for that, by 2030, the Mendocino Coast Healthcare District expects to have about $18 million — payments from Adventist Health under the terms of its lease of the hospital — to fund a seismic retrofit or rebuild, or whatever other capital project the district decides is necessary, which could include a new nursing home.
How many beds a new or refitted hospital should have came up. A consultant hired by the healthcare district last year sketched out a facility with as few as 6-10 beds. No one in the discussion last week pushed for a number that low. Currently at 26 beds, Adventist Health Mendocino Coast qualifies for slightly higher healthcare plan reimbursement as a “Critical Access Hospital.”
Wells, noting that Mendocino County has 100 hospital beds total, said he would not like to see the hospital lose Critical Access status, nor go below 15 beds.
Dr. William Miller, the hospital's Chief of Medical Staff, was emphatic that cutting the number of hospital beds is not the way to go.
“I will say definitively: 25 (beds) is the right number. We should not go lower,” Miller stated.
While acknowledging trends toward moving more and more hospital-based care to the home, Miller said that approach only goes so far, especially with an aging population.
“We are going to see more people needing hospitalization in eight years, not less,” Miller said. “We're going to need more nursing home beds, not less.”
“The models using telemedicine to keep people at home are great,” Miller continued “for young people who are technically savvy. For the 86-year-old lady living along, it's not so great.”
“The fundamental benefit of a hospital is nursing,” Miller said, and the most pressing challenge for the future of healthcare on the Mendocino coast is providing enough nurses and CNA's, as well as doctors.
As for slimming down the coast hospital to a “treat and transfer” facility with just a handful of beds, “That is a pipe dream”, Miller said, because it is already extremely difficult to find available out-of-area hospital beds.
“The city hospitals are full,” he said, “They were full even before COVID and that is not going to change.”
Miller has been closely involved in efforts to keep Sherwood Oaks Health Center, the Mendocino Coast's only nursing home, running. The facility — like many across the nation — has been in a COVID- generated staffing crisis for months and was reported last December to be near closure without immediate help from the state. Miller said last week that a group of local people is working on a near-term solution for Sherwood Oaks that is showing signs of hope, but he was reluctant to give details.
Some participants said they would like to see another healthcare forum in the near future devoted to Sherwood Oaks and the long-term outlook for nursing care — possibly via a non-profit care facility — in the region. Healthcare district directors also encouraged people to attend their meetings where further discussion and action on these subjects is expected.
(Correction: There was no representative from Senator McGuire's office at this meeting.)
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