The Chewelah long-term care unit, operated by Providence St. Joseph’s Hospital, finished relocating all of the residents in August after leaders announced in May that it would close.
The 40-bed long-term care unit was classified as a nursing home and served elderly residents with both rehabilitative and long-term care needs. Not all residents stayed there long-term, and some came to rehabilitate and then be discharged back to their families or communities.
The decision to close the unit, which was open for three decades, took almost a year to finalize, said Ron Rehn, chief administrative officer of Providence’s Stevens County locations, and ultimately came down to several factors.
Beyond finances, staffing the facility was a challenge, he said.
“Being a nursing assistant or a person working in long-term care, it’s really hard. It’s physically and emotionally hard,” Rehn said.
At one point about 75% of the staff were travelers (medical temps supplied by an agency), Rehn said. Leaders were in the midst of trying to hire a medical director when the process to consider closing the unit began.
Hiring staff in rural health care is a constant struggle, one not unique to the long-term care setting.
“We have rural health care shortages, from physicians to nursing assistants, all the time,” Rehn said.
Providence has programs that promote employment, like nursing assistant classes in Chewelah as well as the family practice residency in Colville, at Mount Carmel Hospital.
The average nursing assistant wage is higher than minimum wage in Washington, but not by much. The average nursing assistant salary in the state is $15.61 an hour.
When staff members and community leaders, including Rehn, began discussing closing the unit last December, there were only 30 residents in the facility, and at the time of the closure announcement, that had dropped to 26. Rehn said they did not accept new patients during that time. Providence committed to staying open and helping all residents transition to new homes before they closed.
Residents primarily went to Spokane, with some to Newport and Colville. The other assisted living facilities in Chewelah did not have room to take new residents at the time; some still have wait lists.
All residents were out by mid-August, and Rehn said Providence is completing the last stages to officially close, although there is still no official closing date. The facility will be used by the hospital, which has 25 acute care beds, for other services, but officials are still determining what to do with the space.
Operating a nursing home inside a hospital comes with regulations and high costs, both factors that contributed to the unit’s closure.
“It’s a really vulnerable population, so the regulations need to be there to protect that vulnerable population, but they were getting harder and harder and harder to meet, and reimbursement wasn’t going up at the same rate as regulations,” Rehn said.
Staff members who worked at the long-term care unit mostly found different roles in the Providence system, which also operates Mount Carmel as well as some clinics in Stevens County. A few took their severance pay, Rehn said, but the majority of people who wanted positions found them.
The most recent Centers for Medicare & Medicaid Services health inspection report of the St. Joseph’s long-term care unit was completed on May 17, days before the announcement that the unit would close. The report shows that one resident was never formally evaluated by a mental health professional for needed services when she first came to the unit. This led to the resident losing a lot of weight (the report says she weighed 70 pounds), and she was placed on end-of-life care.
“The resident had ongoing mental health concerns throughout her stay in the facility, and had experienced a gradual decline in her physical health,” the report says.
The unit was not closed due to this incident or the inspection report, however, and it had an above average rating on the CMS Nursing Home Compare site.
Citing health privacy laws, a Providence spokesperson said they were not allowed to address patient care specifics.
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