SVH releases report on struggling skilled nursing facility

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The Sonoma Valley Hospital has released the results of a report on its money-losing Skilled Nursing Facility, which has a projected $880,000 operational loss in the fiscal year 2019. Hospital officials are considering whether to close the facility.

Regulatory, Risk, Compliance Specialists, Inc., a Pleasanton consulting firm focusing on healthcare, wrote the report. To read the report, visit the hospital’s website at

The consultants conducted onsite meetings and telephone interviews with Chief Executive Kelly Mather; Jane Hirsch, board member and chair of the task force; Melissa Evans, the facility’s nursing director; doctors, nurses and staffers at the facility; community members; and a number of other people who will be affected by the outcome.

The report includes a very brief section regarding recommendations for improved occupancy and profitability. “Occupancy could be improved with new services at the hospital that require long stays and/or rehabilitation,” the report notes.

Another option would be to contract with other area hospitals that don’t have their own skilled nursing facilities. The report doesn’t elaborate on either option.

The report also includes cost-saving options.

According to the report, the skilled nursing facility presently provides 8.9 nursing hours per patient day. If that were lowered to 4.5 nursing hours per patient day, which is the state-required standard, this could mean savings of $1.2 million per year, depending on a number of factors. These savings don’t include benefits.

Another possibility might be using a contract group of physical, occupational and speech therapists instead of the in-house group that currently works at the facility, as a cost-saving measure.

“We are exploring this option in order to determine feasibility and potential cost savings,” Hirsch said.

The report also discusses the possibility of closing the facility, noting that there would be available beds at skilled nursing facilities within the community.

There are three such facilities in Sonoma, and they have enough beds to absorb the additional patients from Sonoma Valley Hospital’s skilled nursing facility, according to the report. About 60 percent of the patients at the hospital’s facility are Medicare patients, “and would effectively double the Medicare patients at other local SNFs,” the report says.

“This would likely represent a positive impact for those SNFs as Medicare often reimburses higher than every other payer,” according to the report.

One difference between the facility at the hospital and other skilled nursing facilities in Sonoma is that, “though quality of care appears acceptable, physician visits would be limited to once weekly,” the report says.

The report described keeping the hospital’s emergency department open as a key strategy for providing a vital service to the community, while continuing the skilled nursing facility “would be a strategic public relations benefit.”

Hirsch said, “We are using the report as a guideline for our task force’s work, and even if they didn’t estimate cost savings for a given recommendation, we will be doing research to determine if there is a financial benefit.”

No decisions will be made for several months about the possible closure, because the task force will be testing possible changes to the facility to see if they are effective in saving money.

Hirsch said the task force will soon hold another public meeting to update the community.

Reach Janis Mara at

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