facebook tracking pixel Nevada County health care providers pivot on financial tight rope | TheUnion.com

Nevada County health care providers pivot on financial tight rope

John Orona
Staff Writer
Nurses, doctors, and simulated patients came together to run a high impact covid drill last week at Sierra Nevada Memorial Hospital.
Elias Funez/efunez@theunion.com

In order to prepare for and mitigate the potential local outbreak of the COVID-19 pandemic, health care facilities in Nevada County have had to rework their practices and prioritize services, hoping to balance the immediate need to slow the virus and the long-term financial health of their institutions.

According to the National Rural Health Association, rural health care providers face funding, work force, and reimbursement challenges that has led to nearly 100 hospitals shutting down in the last decade.

A Centers for Disease Control and Prevention study found the disparity in health care access has led to worse mental, behavioral and developmental outcomes for rural patients, who are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke than urban counterparts.

At Sierra Nevada Memorial Hospital, which serves 75,000 residents in western Nevada County, the facility has limited its essential services to include cancer care, lab work, ultrasounds, and infusion care in addition to inpatient health care.

“The COVID-19 situation has both challenged us and also inspired us to rethink health care.”Dr. Christina Lasich, Western Sierra Medial Clinic chief medical office

According to Sierra Nevada Memorial Hospital CEO Dr. Brian Evans, the changes have been effective, with the hospital seeing just a few acute COVID-19 patients, but they’ve had a definite financial impact.

“We have good financial reserves but in the last few months we’ve really been upside down due to the lower revenue because of having to cancel elective surgeries and having a relatively low census in the hospital,” Evans said. “We’ll catch up and recover and get back to where we were but I don’t think the fundamental financial pressure that all rural hospital are facing are going to go away any time soon.”

Evans said the situation is difficult but preferable to the alternative which could have been catastrophic with the potential to overrun the hospital if services weren’t limited.

“If we did nothing, we could have seen some very difficult times at the hospital,” Evans said.

According to Evans, the hospital is now in position to evaluate what a recovery and return of services could look like going forward. Officials will consider their labor force, amount of patient influx, local coronavirus trends, supply chains and evaluate what is defined as an elective procedure as they map out their next steps, Evans said.


Prior to the pandemic, the hospital implemented services targeted at alleviating the region’s rural barriers to health care access, including increasing access to telehealth practices. Other providers in the area say this will be one of the keys to how health care providers pivot into the future.

“The ability to do telemedicine in a rural setting is extremely valuable,” said Dr. Christina Lasich, Western Sierra Medial Clinic chief medical officer. “We’re planning in the future for this to be an important part of our business model and bottom line.”

According to Lasich, the clinic has seen a spike in behavioral health telemedicine demand, which she attributes to both the increased accessibility of services and stresses people are experiencing during the pandemic.

“Patients are very grateful to, in this situation, have the option to come in or not,” Lasich said. “Although this has been a very daunting, challenging time for people, its also an exciting time for medicine and health care in general. The COVID-19 situation has both challenged us and also inspired us to rethink health care.”

Lasich said the heath emergency has led state and federal officials to relax billing regulations, allowing health care facilities to get paid for services they wouldn’t normally charge for, like phone calls without a visual component.

dealing with downturn

Lisa Davies, CEO of Chapa-De Indian health clinic, said despite an overall decline in patients, the clinic has seen a similar surge in behavioral health appointments.

The clinic has suspended non-urgent and non-emergency dental and optometry care. Their daily visit count is down nearly 60%, leading the clinic to furlough just under half of its 250-person workforce.

“You drive down the visits because you want people staying home but by not coming in we’re driving down business which, in turn, drives down revenue,” Davies said of the furloughs.

The clinic, she said, will look to bring back those furloughed as the practice picks up and is confident that time will come.

Davies and many of the clinic leadership came on board in 2010 following the 2008 recession and have over the years prioritized ensuring the clinic can withstand a significant revenue decrease.

“Looking at our cash flow projections, in the worst-case scenarios, we can operate like this for about the next 10 to 12 months,” Davies said.

According to Davies and Lasich, as their health care facilities tread water while evolving to meet the needs of the pandemic they will look to continue some of the innovations created by the necessity of the situation but whether the regulations, broadband access and funding allows that innovation will be crucial.

“It’s an opportunity that kind of hit the pause button in some respects,” Lasich said. “We’re hoping going forward people are recognizing the value of having increased access through technology but right now everything we’re doing is a result of emergency declaration.”


Regional housing trust fund in the works for Nevada County

Nevada County looks to emphasize smaller units

No fears of housing density among planning officials

COVID-19 protocols strain Nevada County homeless shelter’s budget

Tenants, landlords arrange payment options during COVID-19 eviction ban

Patchwork of tenant protections intact for now

The high cost of homelessness in Nevada County

Nevada City collaborates with county and nonprofits to move campers off Sugarloaf Mountain

Nevada County housing market sees increased demand, limited inventory

‘I may have now but I might not tomorrow’: No uptick in Nevada County homelessness amid COVID-19, but future concerns linger

Nevada County graduates consider options in wake of COVID-19

Nevada County students receive more than $800,000 in scholarships

Graduating seniors in Nevada county weigh financial, academic concerns for college

Career education program adapts to meet needs of students

‘I just want to play’: Players, coaches, ADs and officials eye safe, speedy return of high school sports

‘Should I jump into a career?’ Many questions remain for students, teachers and administrators as the future draws nearer

Nevada County middle schoolers, high school underclassmen unsure what to expect next year

Support systems for Nevada County teens go virtual during pandemic

Sierra College summer enrollment not slowing

‘The best they could’: Nevada County Superintendent of Schools reflects on the school year, ponders what’s to come this fall

‘I can’t see the bottom now’: Administrators consider where and whether to make layoffs amid revenue shortage

‘These kids want to ball’: Youth sports organizations grapple with tough decisions regarding COVID-19 safety

Hamstrung: Nevada County summer sports scene hit hard by COVID-19 pandemic

Nevada County theaters go dark for the year

Movie theaters struggle to cover rent, utilities in an industry that typically operates with narrow profit margin

‘Planning for all of it’: Nevada City Film Festival moves online for this year’s event

Nevada County’s music festivals look to virtual events to build community, recoup finances

For Nevada County musicians, the show goes online

Nevada County artists adapt, host online galleries, concerts and workshops

Street fair cancellations in Nevada City, Grass Valley a huge economic hit

‘We are the recovery; we are essential’: Nevada County Arts Council survey reveals artists, art organizations are struggling

Who’s zooming whom? Creativity among Nevada County artists in the pandemic era

Nevada County Arts Council receives $112K Tahoe Truckee Excellence in Education grant for new project

Nevada County nonprofit funding in jeopardy

Nonprofits struggle to serve clients during pandemic shutdown

Nevada County animal rescue groups see surge in fosters, adoptions

Nevada County’s thrift stores move ahead with reopening

Possible postponement, cancellation of Nevada County Fair would negatively impact several Nevada County nonprofits

Local nonprofits feeling the effect of canceled, postponed fundraising events due to COVID-19

Feeding Nevada County: Effort to help those hungry bolstered by partnerships between nonprofits (VIDEO)

Nevada County youth organizations adjust to public health requirements

Volunteer work faces changes at Nevada County nonprofits amid restrictions

‘Do you have reserves?’ Still much uncertainty over how nonprofits will fare in coming months, years

Government business continues in isolation during COVID-19 pandemic

Nevada County, cities collaborate to reopen safely

Wildfire prep in Nevada County continues virtually during pandemic

‘This is why we signed up’: Librarian, homeless shelter manager continue working during pandemic

Financial aid offers much-needed relief in western Nevada County for those who can get it

Grass Valley trims staff in response to COVID-19 shutdown

Nevada County: Staffing, service reductions not yet needed

Nevada County property tax on par despite pandemic

Nevada County health workers say they currently have sufficient supply of personal protective equipment

Hospice of the Foothills continues providing end-of-life care during COVID-19 crisis

Senior care facilities on lockdown during COVID-19 pandemic

Residents of Nevada County senior living communities staying connected

‘Continue to plan and prepare’: Hospital analyzes finances, anticipates federal funding to ensure financial stability

Nurses in Nevada County and the region talk about why they love their jobs

Nevada County not planning to release more detailed COVID-19 case data

Officials: Testing is key in calls to reopen in Nevada County, across California

Nevada County doctors change approach to providing care due to COVID-19

The trifecta: Public health experts recommend testing, contact tracing and supported isolation to phase into a reopened world

Investigating the impact: Lack of revenue, uncertain return date causes concern for arts and entertainment venues

Impacts of Idaho-Maryland mine to be revealed soon

Nevada County artists discuss how COVID-19 shutdown has affected them

‘The arts are essential’: Center for the Arts launches emergency relief fund

Real estate sales strong in Nevada County despite challenges

No slowdown seen in Nevada County construction industry despite COVID-19 lockdown

Nevada County government, home improvement and real estate representatives talk business during COVID-19

‘I’d like to place an order’: In light of COVID-19, the demand for home delivery services in Nevada County is at an all-time high

Grass Valley, Nevada City first to feel COVID-19 economic hit

See you soon? Small business owners struggle, but are hopeful for a brighter tomorrow in Nevada County

Nevada County businesses struggle navigating economic relief

Nevada County health care providers pivot on financial tight rope

‘A sudden and dramatic downturn’: Nevada County economy will be hurt for longtime following coronavirus slowdown, expert says

‘A recession, let alone a depression’: Western Nevada County businesses apply for federal loans, but most have yet to receive money

Nevada County businesses, governments, nonprofits navigate uncertain times, worry what’s ahead




Coronavirus Guidance for Businesses/Employers

Nevada County Relief Fund for Covid-19

To contact Staff Writer John Orona, email jorona@theunion.com or call 530-477-4229.

More Like This, Tap A Topic

See more

Support Local Journalism

Support Local Journalism

Readers around Grass Valley and Nevada County make The Union’s work possible. Your financial contribution supports our efforts to deliver quality, locally relevant journalism.

Now more than ever, your support is critical to help us keep our community informed about the evolving coronavirus pandemic and the impact it is having locally. Every contribution, however large or small, will make a difference.

Your donation will help us continue to cover COVID-19 and our other vital local news.