Editorial: Sonoma Valley Hospital forges ahead

The Sonoma Valley Hospital Foundation’s capital campaign to fund a new outpatient diagnostic center got a shot in the arm this week when Sonoma residents Sandy and Joan Weill on Tuesday promised to donate $1 million to the cause if and when the campaign reached its goal of $20 million.

If a CT scanner had been imaging the SVH officials in the room at the time, it would have revealed several hearts bursting with joy.

The Weills announced their philanthropic offer Feb. 26 at a private celebration of the first anniversary of the hospital’s affiliation with UCSF Health, a move toward some sharing of resources and branding between the two hospitals in an effort to expand patient access to a wider variety of services than single entity health care providers these days can offer. It’s perhaps a necessary alliance in an era when such medical networks as Sutter and Kaiser are carving out bigger and bigger slices of the healthcare pie.

The hospital foundation, meanwhile, announced its $20 million campaign for the diagnostics center last November and, according to foundation executive director David Pier, it’s currently just shy of $16 million raised.

While they’re still working toward the full monty and more – they’ll likely need between $21 million and $23 million, foundation officials concede – it’s enough for the hospital to set expectations that central components of the diagnostic center will be operating within the year. Hospital CEO Kelly Mather told the Index-Tribune in January that she expects to have the first phase of the project, a 128-slice CT scanner – key for outpatients as well as emergency patients – in use by the end of 2019.

The full diagnostic center is expected to be a serious revenue generator for the hospital, as it seeks ways to mitigate its $3 million a year budget deficit.

The shift in services to outpatient care is swiftly growing in hospitals throughout the country. Estimates from industry website modernhealthcare.com show that outpatient care in the 1990s accounted for between 10 to 15 percent of a hospital’s revenue – today they report it at closer to 60 percent.

Sonoma Valley Hospital envisions this as giving healthcare district residents what they want in terms of care, as well as revenue generation for those paying the $250 per year parcel tax that was renewed by voters in 2017 – barely.

The parcel tax narrowly passed in June of that year, by about 2 percentage points – but it was even closer than that. An initial vote in March failed, and the district had to swiftly call for a do-over vote, and campaign vigorously to persuade district voters that the fate of the hospital was in the balance – which, potentially sans the annual $3.85 million from the parcel tax, it probably was. It worked – the Measure E tax passed, but a message was sent: District taxpayers are willing to meet the hospital halfway – they’ll pony up the parcel tax, but a never-ending, and occasionally increasing, tax can’t be the hospital’s business model; it must improve its bottom line.

And, based on the past year, no one can argue that hospital officials aren’t giving them what they asked for.

If the proposed diagnostic center and the UCSF affiliation are intended to breathe life into Sonoma Valley Hospital, they’ve been coupled with cost-cutting measures to help stop the bleeding.

Last July, the hospital announced the closure of its obstetrics ward, which had seen a 35 percent drop in births since 2015 and was losing about $500,000 per year. In August, SVH transferred its home-care services to Hospice By the Bay. And, in a meeting last week, hospital officials said they are looking at outsourcing the skilled nursing facility to outside management.

Make no mistake, there are district residents sorely unhappy with the hospital’s abandoning, or seeking outside operations, of some of its most helpful and comforting programs. It’s a credit to those programs and the staff who worked them that so many people hold them in high esteem; some have told the Index-Tribune they’ve saved lives.

But a louder message was also sent to healthcare district officials in the last parcel tax election – a third of the district residents demand a more cost-effective operating model. This is what that looks like.

The bad news is that Sonoma Valley Hospital isn’t in the clear just yet. Its cost-cutting moves haven’t erased the budget deficit; its UCSF affiliation, in its infancy, hasn’t realized any stated revenue; and the outpatient diagnostic center hasn’t scanned a single patient. Meanwhile, overhead continue to rise and federal reimbursements will continue to fall.

More than 100 California hospitals have closed in the last 20 years, many similar in size or demographic to SVH – think Novato Community Hospital, or Sonoma West Medical Center in Sebastopol. The Sonoma Valley Healthcare District, with its fewer than 40,000 taxpayers, isn’t immune to joining their ranks.

The good news: Sonoma Valley Hospital isn’t one of them, and doesn’t plan to be in the future.

That’s largely due to district residents who’ve supported the hospital through the parcel tax. But going forward, the long-term future of Sonoma Valley Hospital will be linked to both the parcel tax and creative steps like the UCSF partnership and the funding and building of the diagnostics center – as well as other healthcare district decisions the community will be debating in the years ahead.

Hippocrates, the ancient Greek physician sometime referred to as “the father of medicine,” once observed that “healing is a matter of time, but it is sometimes a matter of opportunity.”

And it is from that perspective that the Sonoma Valley Healthcare District must forge ahead.

For information on the Hospital Foundation’s capital campaign, reach David Pier at dpier@svh.com. Jason Walsh is at jason.walsh@sonomanews.com.