Hospital leaders forecast cloudy with clear horizon

In six months, a hospital recruiting team has managed to attract at least two doctors, a third is on the way, and another health care provider who had cut her time in Grand Coulee to emergency room work only will restart her practice in the clinic.

That record contrasts sharply with the prior three years of little luck as a former administration stuck to a more traditional talent search method through recruiting firms.

The future now appears bright, with physicians committing to come to the coulee, even as a pall hangs over current hospital finances, mostly due to state decisions on years-old Medicaid payments, and to lower revenue because of fewer health care providers.

Monday night, Coulee Medical Center Interim Chief Executive Officer Debbie Bigelow said Advanced Registered Nurse Practitioner Wendy Hughes will return to her Grand Coulee Clinic practice after having left for months following conflicts with former administration.

Her return will likely be an important revenue booster for the hospital, which showed a steep decline in monthly income about the time she and ARNP and Certified Nurse Midwife Dawn Lovelace cut their hours to part time in Grand Coulee.

Two physicians have also committed to joining Coulee Medical Center's team on a more regular basis, each filling half of a critical slot, which, left unfilled, would have led to the departure of the hospital's stalwart Dr. Andrew Castrodale. Dr. Jacob Chaffee decided last June that he would take a sabbatical for a year, beginning in January.

Castrodale had told hospital leadership that even he would have to give his notice if another doctor were not on board by October.

"And that would break my heart," Castrodale told hospital commissioners Monday, insisting that the equivalent of one and half doctors for a facility that calls for four could not continue. "It wouldn't be physically, emotionally, spiritually healthy at all."

That situation is now turned around. Dr. Shannon Servin-Obert was the latest to join the staff, following a committent by Dr. Andre Nye. Both are family practitioners with advanced training in obstetrics. They will fill alternate weeks at CMC, starting in January. And both have or are currently working some weekends in the CMC emergency room.

In addition, a doctor who is nearly finished with her residency has also said she would like to come on board, Castrodale said.

And an orthopedic surgeon, Dr. Joshua Drumm, new to a Brewster-based practice, will start performing some surgeries here.

"The interest we have is through the roof," Castrodale said, crediting the recruitment team with an effort that far exceeded his expectations last summer. The chief of staff said morale at the hospital is now high, compared to the opposite a year ago.

The promising future view made less jarring another horrible monthly financial report.

Since April, CMC has been paying back some $1.4 million that the Washington State Health Care Authority decided in February it had overpaid CMC for Medicaid services in 2012. Two more similar assessments arrived at the start of October. The current total for all back overpaid Medicaid billings now stands at over $2.4 million.

Bigelow said she told the state she wants any more bad news to arrive soon, so she can try to avoid carrying it over into 2015.

The payback on the Medicaid "cost reports" weighs on profit and loss statements. August's shows a $437,000 operating loss on revenue of $1.5 million and a loss of $2.2 million for the year. $1.85 million of that can be attributed to "contractual adjustments" for Medicaid.

None of that has discouraged hospital district commissioners, who Monday authorized negotiating with Bigelow to take away the "interim" part of her title.