Estes hospital to transfer some services to bolster care, save money

ESTES PARK – In its latest move to balance Estes Park Health’s budget and provide the best possible care for the greatest number of people, the Park Hospital District Board voted 5-0 on Monday to transfer some services to other companies while adding and optimizing other services.

Among the major changes will be contracting out home health, home care and outpatient hospice services as well as housekeeping duties.

Estes Park Health CEO Vern Carda cited decreasing reimbursements for care as one of the factors creating a deficit in the hospital’s home health, home care and outpatient hospice operations. The Centers for Medicare and Medicaid Services is ushering in a 3.8% cut this year, with more cuts in reimbursements expected in 2024. Added to that are reductions in commercial payers’ reimbursements, as well as in Medicare Advantage, Medicare’s managed-care program.

“EPH does not see these reimbursement challenges letting up in the near future,” Carda said. “The rate adjustments in 2023 and 2024 will take a toll on EPH’s bottom line. It will be difficult for EPH’s small agency to sustain business in this reimbursement environment.”

EPH home-health and hospice visits have declined dramatically in recent years. The department serves about 10 to 15 patients a month.

An optimistic five-year forecast for Estes Park Health shows those services will have incurred total losses of $4.9 million, but what officials call a more realistic five-year forecast projects a $5.5 million loss for all three programs during that time.

“Estes Park Health will do its best to help patients find alternative means of care with other agencies,” Carda said. “We will add a social worker to help people navigate the system. We will help with transportation to needed services such as wound care and physical therapy.”

According to an EPH news release, those services will be transferred to other companies by Dec. 31. When end-of-life comfort care is needed in the hospital, EPH will admit the patient to an acute care bed. Eight employees will be provided with a severance package of up to three months’ compensation and insurance based on their years of service. Another full-time employee will be offered a different position within EPH, and open positions within EPH exist if employees are qualified and want to apply.

Those operational units will be closed no later than Dec. 31, and no new patients are being added to the rolls as of today. Patients using these services will have their care completed.

The housekeeping department – what EPH calls “environmental services” – is being transferred to Austin, Texas-based Hospital Housekeeping Services. EPH employees will be offered employment by HHS, although one supervisor has been offered a severance package.

Home Health Services will take care of all staffing, supplies, protocols and management, a move designed to save EPH at least $100,000 a year.

“This larger scale company has a clinically proven system to enhance cleanliness,” Carda said. “It manages the capital equipment required and employs robust infection-control measures. We believe this move will provide the best environment for our patients, staff and visitors. This move will improve quality at a lower organizational cost.”

HHS will employ a manager who has completed extensive managerial programs. That manager is employed at HealthOne’s Swedish Medical Center in Englewood.

Also among the 16 moves approved by the board Monday were implementing urology services, mobile positron emission tomography imaging, phase one pulmonary rehabilitation, phase one cardiac rehabilitation and associated dietary services, and a critical hospital ambulance service.

The approved plan also includes optimizing orthopedic services, telecommunications and telehealth services, fluoroscopy, the sleep lab, the 340 B drug program, workforce organization and revenue cycles as well as “chargemaster” assessment and market alignment.

The hospital hiring team is close to finalizing a contract with a new orthopedic surgeon who will be in place by January. That person will replace Dr. Aaron Florence, who said in June that he would be leaving EPH this fall.

Estes Park Health was founded in 1975 as the Elizabeth Knutsson Memorial Hospital, funded by a tax subsidy approved by Estes Park voters. 

The hospital has been in discussions with other health care organizations about affiliation, driven by the increasing demands of economic and market forces on smaller hospitals, but no move toward such an association was taken at Monday’s meeting. Voters in the hospital district on May 2 approved a ballot measure that authorized the board to enter into a multi-year financial agreement if it decides to affiliate with a larger nonprofit health care services organization.

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