With funding cut, OMC officials put Sequim projects on hold

The comment was tongue-in-cheek, Fire District 3 chief Ben Andrews said, but the sentiment had more to it than any quick fix: build a hospital in Sequim, and that nagging funding issue goes away.

Andrews and a host of community leaders from a spectrum of community and government groups — including representatives from local clinics and health care centers, the Jamestown S’Klallam Tribe, Peninsula College and the like — joined leaders from Olympic Medical Center for a round table discussion on May 29 in Sequim, in hopes of helping OMC further refine the medical center’s strategic planning.

In Sequim, those plans include three major capital construction projects centered around OMC’s Fifth Avenue campus. A proverbial wrench thrown by the Centers for Medicare and Medicaid Services (CMS) in late 2018, however, have put two of those three projects on hold, after CMS announced it would move forward with 60 percent cuts to Medicare reimbursements at off-site clinics, Olympic Medical Center CEO Eric Lewis said.

The result was significant, with OMC officials cutting $1.7 million from the center’s operating 2019 budget — and another $1.7 million from the 2020 budget — and refocusing any significant spending on emergency services in Port Angeles until federal funding issues are resolved, Lewis said.

“We don’t know how we’re going to get paid (on) Jan. 1, 2020,” he said.

CMS’s cuts spawned a lawsuit against the U.S. Department of Health and Human Services in U.S. District Court late last year that’s yet to be resolved, and also saw concerned citizens write about 3,000 letters to CMS about the off-site cuts — 1,700 of those from Clallam County residents.

The final rule phases in the 60-percent cut to OMC in practice expense reimbursement for patient visits more than 250 yards from the Port Angeles hospital. Of OMC’s patients, 83 percent rely on government-paid insurance with almost 59 percent of all patients relying on Medicare, the lawsuit said.

“We appreciate the outpouring,” Jennifer Burkhardt, Chief Human Resource Officer and General Counsel, said last week. “We’re continuing to fight that ruling.”

Burkhardt said OMC wouldn’t be a partner in the lawsuit without the community support.

OMC is already committed to completion of a $4.4 million expansion of the Olympic Medical Cancer Center in Sequim, a 3,700-square-foot project that officially broke ground in April and should be complete by December.

“In my 20 years here, this campus has grown exponentially,” Lewis said. “When we first got here, this was nothing but dirt.”

But both of the the Sequim Primary Care expansion and Sequim Outpatient Surgery project — $5 million projects each — have been deferred.

Those projects are “definitely still on the radar,” Lewis said, but on hold until OMC sees how federal Medicare and Medicaid reimbursement settles.

Andrews asked Lewis and OMC to consider further into the future for a capital projects plan that would include emergency services in Sequim.

“The population is shifting (and) growing east of Port Angeles,” he said. “The reality is your customer base is shifting east.”

Andrews said the changing attitude toward what requires medical unit responses has changed over the years, putting pressure on a department that has four medic units to cover 145 square miles.

A Fire District 3 unit making a run to the OMC emergency room in Port Angeles has a 93-minute turnaround time, Andrews said.

“It’s not a sustainable model for us,” whe said.

And while an emergency services facility in Sequim isn’t in OMC’s immediate plans, both Andrews and City of Sequim Manager Charlie Bush urged Lewis and other OMC officials to give it serious consideration for the near future.

Lewis said OMC is looking at five major areas of immediate change and adjustments in the strategic plan: emergency/immediate care services; inpatient services; surgical services; primary care, and scheduling issues at Olympic Medical Physicians.

Emergency services receives a boost

OMC officials plan to reduce wait times in the hospital’s Emergency Department, expand hours at the walk-in clinic and add more than a dozen inpatient beds.

Lewis described OMC’s plan to community leaders during a round table discussion involving city, county, school and health care officials on May 28 in Port Angeles.

“There’s a lot of exciting things we’re going to do in the Emergency Department and you will see a difference,” Lewis said.

Lewis said that currently the median wait time at the Emergency Department is 202 minutes, which he hopes to reduce to 160 minutes by expanding hours at the walk-in clinic and improving efficiency throughout the hospital.

The walk-in clinic is open from 9 a.m.-6 p.m. and those limited hours have led to people who need same-day care to seek it at the Emergency Department.

“If you need care today and it’s 7 p.m., the Emergency Department is your only option, or leaving the county,” Lewis said. “What we’re trying to do is create more options for people to be at the right setting and get their care on a more timely basis.”

He said that sometime next year the walk-in clinic will be re-branded “Immediate Care.” It’s hours are expected to be from 7 a.m. to about 10 p.m. or 11 p.m., he said.

By expanding those hours, the hope is that fewer people will need to go to the Emergency Department.

“It will help the lowest acuity people have access and that frees up resources in the Emergency Department to deal with the sicker patients,” he said.

He said there are opportunities for “process improvement” throughout the hospital that also will free up resources, including streamlining processes to get people into inpatient units faster.

That will allow the Emergency Department to focus on outpatient needs, he said.

In addition, over the next couple of years hospital officials want to expand from 67 beds to about 80 beds, moving some administrative positions out of the building to make room for the extra beds.

Lewis said that it is rare that the hospital fills all 67 beds, but it is not unusual for all beds of a specific type to be filled. The hospital has beds for obstetrics, medical-surgical, intensive care and intermediate care.

For more about Olympic Medical Center and the OMC Strategic Plan, see www.olympicmedical.org or call 360-417-7000.

Peninsula Daily News reporter Jesse Major contributed to this report.