‘How much trouble is the hospital in?’: With staff reduction, concern voiced on future of Sierra Nevada Memorial | TheUnion.com

‘How much trouble is the hospital in?’: With staff reduction, concern voiced on future of Sierra Nevada Memorial

Sierra Nevada Memorial Hospital recently terminated nearly a dozen positions, according to sources connected to the institution. Such a reduction in staff is, an official says, sometimes necessary for rural hospitals to balance the bottom line while also investing in infrastructure and responding to new regulations.

“Community hospitals in rural areas are under significant financial pressure from increasing costs, reduced reimbursement, and regulatory requirements. Sierra Nevada is feeling these pressures, and we are adjusting accordingly,” hospital CEO and President Dr. Brian Evans wrote in an email to The Union.

“We have made reductions in our workforce in order to reduce our costs in the last couple months,” Evans continued. “We are still the largest employer in western Nevada County with over 800 individuals employed, and we spend almost $100 (million) on salaries and benefits annually. Our primary responsibility is to continue to serve this great community for generations to come. That requires exceptional stewardship.”

Evans did not confirm the number of employees laid off, but one of those let go included the chaplain of the hospital’s spiritual care department, according to Ronnie Paul, who volunteered for six years with the interfaith program.

“Through careful management of our costs, we will be here for the long term.”— Brian Evans. Sierra Nevada Memorial Hospital CEO and president

Paul said she is unhappy by the change as she believes the hospital isn’t living up to its marketing mantra. Rather than investing in its infrastructure, Paul believes the hospital should invest in its personnel.

Dr. Jeff Kane, Paul’s husband and an individual who ran the hospital’s cancer support program for decades, agreed. (Paul and Kane are food and health columnists, respectively, for The Union.)

“I feel bad about who they’ve cut because those very people exemplify Dignity Health’s motto, ‘(Hello) Humankindness.’”

Paul said some “wonderful, caring” people who best represented the hospital had their contracts terminated. She recently resigned as a volunteer after six years with the spiritual care department.

“(The group) is for us, it’s for the staff, it’s for the patients, it’s for the family,” she said, adding “I’ve become a better human by the training and the hospital.”

Evans said the hospital does its best to balance the needs of patients, and that all employees — including front line nurses, doctors, social workers, food service workers, environmental service workers — contribute to the care provided to patients.

“Hospitalized patients need care for their physical, emotional, social and spiritual needs. With limited resources, we need to continuously assess how to best provide that care,” Evans wrote. “We recognize that reducing even a single position affects many people inside and outside our organization, and this is not a decision we take lightly. I’m grateful that we have incredible support from our spiritual care volunteers, auxiliary volunteers and many throughout the community who partner with us.

“Investing in our infrastructure isn’t optional. We must replace aging equipment and structural components, and keep up with new regulatory requirements.”

The California Nurses Association has been engaging in labor discussions with the hospital, according to representative Kari Jones who declined comment for this story.

No registered nurses were laid off from the hospital, and the California Nurses Association is not currently in discussions with the healthcare entity, wrote association spokesperson Martha Wallner in an email to The Union.

“The nurses will be going public with their concerns after the holiday,” she wrote.


Over 80 rural hospitals have closed from 2010 to 2018, according to health care publication AthenaInsight, and about 670 more are in jeopardy of closing due to “declining reimbursements, patient debt and competition.”

The publication and a separate National Public Radio report found a handful of rural hospitals were able to stay open by requesting comment from its community via town halls, and diversifying its services that extend more deeply into the community, including addressing problems related to hunger, housing and fitness.

Rural hospitals that thrive rethink their strategies, said Kane, like reducing inpatient services and expanding outpatient ones. Social services, he said, like counseling, chaplaincy program and social work are crucial.

Although Kane said he has faith in Evans, he does think the community should have more say in the hospital’s direction. In fact, he said, this is how rural hospitals have been able to sustain themselves.

“The places that are succeeding at this made it a community project,” he said.“They really opened it up to everybody.”

Kane remembers that when the hospital was renovating a parking lot years ago, his annual compensation was equal to one-third of one parking space.

Evans noted the hospital has served Nevada County since 1958 and intends to be here for generations to come.

“We need to maintain a positive operating margin so that we can remain financially healthy,” he wrote. “Many rural hospitals across the country have not been able to do that, and have subsequently closed. Through careful management of our costs, we will be here for the long term.”

He also said he’s open to holding a town hall “or something similar” to receive feedback on how the hospital should proceed.

“I am asking for everyone’s partnership and support as we adapt to the ever-changing healthcare landscape,” wrote Evans.

For Kane, transparency and communal involvement is most important.

“How much trouble is the hospital in?” asked Kane. “And what can the community do to keep the hospital afloat?”

To contact Staff Writer Sam Corey email scorey@theunion.com or call 530-477-4219.

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