St. Joseph’s grapples with long-term care unit shutting down

(COLIN HAFFNER/Chewelah Independent)

The long-term care unit at St. Joseph’s Hospital in Chewelah will be closing down. (Brandon Hansen photo)

HEALTHCARE SHAKE UP: Unit will remain open at Chewelah hospital until all residents find new place to live…

In a statement released Tuesday, Providence St. Joseph’s Hospital in Chewelah announced that a decision to close the Long- Term Care unit at the hospital was made after a difficult discernment process.

There is no set date for the closing, according to Ron Rehn, Chief Administrative Officer for Mt. Carmel, Dominicare and St. Joseph’s hospitals, who says it will take as long as it needs to see all of the current residents of the unit find new care homes before shutting things down.

The Long-Term Care unit currently cares for 25 residents with varying needs, according to Rehn. Those in long-term care tend to need help with even basic daily needs such as getting dressed or taking their meds, or have need for skilled nursing staff to help with physical therapy type needs. Rehn says that those utilizing skilled nursing typically can be discharged after some time, but those residents with daily needs are not as likely to be discharged.

Altogether, the unit has enough licensed beds for 40 people, but Rehn said they struggled to have enough caregivers to fill all of those beds with the unit currently employing 31 caregivers.
Providence has employed the help of a social worker along with state assistance to work with each resident and their family in order to find a new faciltity, Rehn said, adding that there are two facilities in Colville that could be eventual landing spots with the next closest being in Spokane and Newport. However, Rehn said, each resident must be accepted by a facility based on numerous factors such as the resident’s needs and the facility’s ability to meet those. A resident can’t just be directly transferred to a new facility.

Cited as factors for the decision, Providence noted in their release that the cost of care continues to rise and they lack qualified, full-time staff leading to higher labor costs for contracted and temporary staff.

Rehn explained that the cost of healthcare is ever-increasing, and that the insurance reimbursements from Medicare and Medicaid for long-term care have actually gone down even while inflation continues to drive the costs up. The growing gap in coverage puts a strain on the budget and the ability to maintain high-level care.

On top of the rising costs of care, Rehn also noted that properly staffing the unit has been difficult. Certified Nursing Assistants (CNAs) make up the bulk of caregivers for the Long-Term Care unit, with nurses being the second largest. St. Joseph’s has run its own training program for CNAs to help facilitate staffing, but even that program can’t maintain needed staff levels.

CNAs are an entry-level position and require a lot of hard work, Rehn said, meaning that those hired will generally come from the community. Most people are not likely to relocate for an entry-level salary. In order to compensate, they must contract for staff, bringing the higher salary expense than a person hired on to a full-time position.

Rehn says he hasn’t had any direct questions from the community about the closing just yet, though it’s still early in the process after the announcement. He does expect to talk with people as he is out and about in the area over the next days and weeks and will do his best to fill in the blanks that are likely to pop up as people try to understand the decision.

It was extremely hard to make the decision to close the unit, Rehn said, explaining that in all his talks with residents, caregivers and volunteers, it became very clear that they all have developed deep feelings and built strong relationships for each other, things that tell him that the team did a great job with their dedicated care.

St. Joseph’s operates as a Critical Access Hospital in Chewelah, which means the prognosis for its long-term viability has a better outlook. In contrast to the increasing cost of care for long term health, Critical Access Hospitals receive reimbursements for all other services at-cost plus a small percentage above that cost through Medicare and Medicaid.

Rehn says the plan is to utilize the unit to expand the care for a larger portion of the population with other healthcare needs, possibly to include expanded in and out-patient care.