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It's official: Nursing home to close

Arizona Range News of Willcox, Arizona

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The local hospital's district board voted 4 to 1 last Wednesday to close the Northern Cochise Nursing Home (NCNH).

Hospital CEO Roland Knox said, "Our staff care deeply about the residents and will continue to provide quality care while they are in our facility."

In a statement released after the Oct. 28 vote, Knox vowed to keep the nursing home open "until the last resident is placed."

Northern Cochise Community Hospital (NCCH) released its nursing home closure plan Monday afternoon.

"We called the state licensing office, who approved the plan," said Jared Wilhelm, the hospital's director of community relations.

"The nursing home administrator (Jim Dodd), along with staff, is committed to the residents residing at NCNH," Wilhelm said.

"He has made contact, and is working with, local and state agencies to ensure all procedures are followed to protect the rights and dignity of all residents, and ensure continuity of care occurs."

Wilhelm said that "in this spirit, the following timeline is in process:"

Over the next 60 days, NCNH staff will coordinate "with the residents, their families, the State Ombudsman's Office and Bridge way Health Solutions to assist all residents in finding comfortable and appropriate living arrangements in terms of quality, services, and location that would take into account their needs, choice and best interest."

"NCNH will provide transportation for the residents to tour other facilities within a 50 mile radius of Willcox, so they can make an appropriate choice about their next place of residence," Wilhelm said.

"Once they choose where they would like to live, NCNH will assist them in moving to their new home."

The nursing home closure plan includes notifications, as prescribed in the Center for Medicare and Medicaid Services (CMS) rules, which outline notifying the state survey agency, the ombudsman's office, the residents, and family (where applicable).

"The nursing home will follow all regulations regarding notification of residents, their families, and the appropriate state and/or federal agencies," said Wilhelm.

In addition, "all medical records will be handled according to requirements in the Healthcare Insurance Portability and Accountability Act (HIPAA), and in accordance with CMS guidelines."

Each of the resident's medical records will be housed at NCCH, and "any required records will go with each resident to their new home."

Asked about rumors that NCCH may be fined for closing the nursing home without following Medicare protocol, Wilhelm replied that they have reviewed Medicare protocol, and has been in contact with the Arizona Department of Health Services (ADHS) "regarding requirements associated with the closure of a nursing home."

"We are currently in process of notifying all state agencies, and will then officiaEy notify families and residents," he told the Range News.

Wilhelm went on to say that Dodd "has committed to ensuring each resident has adequate time and assistance in finding appropriate and desired homes. Additionally, we are going to assist them in moving to their new homes."

Knox and Dodd "have both indicated that we will follow all requirements so that no one involved will be rushed or denied ample time to make appropriate arrangements."

Prior to the Oct. 28 vote, Knox gave a presentation on hospital finances to the NCCH District Board.

It was the same presentation given during the Oct. 22 community meeting at Valley Telecom.

An article on Knox's presentation was published in the Oct. 28 edition of the Range News, which is available at

After the presentation, board member Carol Dunagan asked Knox, "What other source could we go to make certain not one thing left unchallenged and not one thing left and not one thing not looked at?'

"Are there other companies we can go to have an overall review to make certain there is no options left available to us from other places, including the federal or state government?' she said.

Knox replied, "Over the last six months, I have talked to six different consulting firms and they told us they won't work with our model."

"We could pause and we could do that. But if we pause, with our cash position, we wouldn't go past March," he said.

Knox then introduced CEO Jim Dixon, with the Copper Queen Hospital in Bisbee, who said that his board "wanted me to come talk to you because we care."

"We have faced the same decision you are facing today," he explained. "We made this very hard decision over eight years ago."

"Don't think you can't lose your hospital-Tubac and Douglas did," said Dixon, adding, "You have to make the really hard decisions."

The hospital "must shed services in order to protect those core services necessary to preserve and meet the greater needs of the community," he said.

He listed skilled nursing; low acuity inpatient stays, emergency room, and "a modern battery of diagnostic services to diagnose and treat diseases," such as cancer, heart disease, and basic primary care.

"These are the trends in healthcare. If you ignore them and all the professional advice, your hospital will close," Dixon said.

"We had to realize the very hard reality that residence care of the elderly is not a core service of the hospital," Dixon said.

"Don't ask the hospital to subsidize the nursing home," he said.

"At the nursing home you spend $750,000 to care for 25 people. That's about $40,000 per person," Dixon said.

"Your hospital will close." said Dixon, adding, "Don't ask the hospital to subsidize a big service that'll make it go under."

"The reality is that you must move your hospital and its limited resources to outpatient care providing those services of high demand and improving population health."

"You don't have the right to deny care to everybody. It will work itself out," Dixon said.

"Don't do Douglas. That was a 100 year old hospital and that was sad."

Dixon said Douglas "imploded," because they "failed to preserve their core services to outpatient care. They continued to lose revenue and could not provide the quality care and new services."

Having served as a CEO for more than 17 years, Dixon said he knew "your last three CEOs," each of whom identified "this major flaw" in NCCH's delivery system.

"A good economic model for a nursing home is 50 to 100 people, not 20. Bisbee is looking into an assisted living facility," he said.

"I can give you names of consultants to do a feasibility study to see what else you can do."

Referring to Knox.

Dixon said, "Please don't beat him up. He's the bearer of bad news, but this bad news is all over the country. It's not him"

"You are better off than Douglas was, but not by much," he said. You have to take this seriously. You can't wait for consultants-1 know it's hard, but you won't have a hospital if you do."

"Don't let the emotions of this very sad and hard issue cloud your decision to preserve your hospital or it will surely close," said Dixon, adding, "You must change."

When it came time for the board to vote, Dr. Dale Scott asked for a motion, to which Dr. James Malone replied, "With a heavy heart, I vote to support the recommendation of the corporate board to close the nursing home."

It was seconded by Winfield Thomas.

Scott then asked for a roll call vote, and Malone began by saying yes.

Prior to her vote, Carol Dunagan said, "There are many ways of looking at this. My heart is never going to vote to close the nursing home. But when me or my husband or one of you needs the nursing home, what are we going to do?'

"With a heavy heart-with a broken heart-1 vote yes," Dunagan said.

With her husband recently in the hospital, Shirley Shotton said, "God, we need this hospital."

"Some time ago, my husband and I were farming and we went to a banker. He told us that we should get out of the business. We found another banker. We were farming for many years after that until we retired."

"Do we need another banker?' said Shotton, before casting the board's lone nay vote.

When it came his turn to vote, Thomas said, "I'd be devastated if we lost the hospital and people in the community could die. I vote to close the nursing home."

"I also vote yes," said Scott, then announcing that the vote was 4-1 to approve the motion.

"We will close the nursing home."

The board then voted 5-0 to modify the lease agreement to allow the nursing home's closing.

After Dixon's presentation and prior to the vote, members of the public were invited to make comments to the district board.

Bob Coder, whose mother is a nursing home resident, said, "My wife and I have seen the plans that have been paid for and drawn up (nearly 10 years ago) for a continuing care assisted living facility."

"They would have to be re-done, but there are solutions," Coder said. "It may take a year, but if this community is sincere, it can be done. "Coder said they are working with A Place for Mom" and were going to visit a Green Valley facility the next day.

"I'm not going through this ever again," said Coder, adding, "Hopefully she'll get placed."

"I have been an aide at NCNH for 22 years," said Monica Matched:.

"I've never run into a facility where you walk in and feel the love and compassion the aides have for the residents. You are not going to get a better place than this Crystal Scheu, whose husband died from cancer in 1999 through the hospice, said, "They helped ease my husband into death."

"If it was not for hospice, I would have gone crazy," said Scheu, adding, "I had three teenage children at home at that time."

She reminded the board that closing the nursing home "also affects hospice patients."

"We need this (the nursing home) to stay here," Scheu said. "We need to find a way to do it."

Scheu, who worked in geriatrics in Southern California said, "I've been retired since 2006, and I'd gladly volunteer my time to find solutions."

Dan Douglas, president of the Charles Wm. Leighton Jr. Hospice, said that if the nursing home closes, "It could be the closing of the hospice, as well."

He asked the district board to "postpone the closing until all the avenues have been exhausted."

"I don't think 13 days is long enough to make this important decision," Douglas said.

Malone responded, "This process is not 13-days old. We have been losing money since 2007, but nobody paid attention."

"The nursing home is costing us $50,000 a month and it has taken three years to get this data together and get it audited and accurate," he said.

"There is only one choice here. Close the nursing home or keep the nursing home open and lose the hospital," Malone said.

"Two weeks ago we were within one hour of not making payroll. I'm 62, and if I have a heart attack, I will be dead before I make it to Benson."

"Everything that has been said about looking for options can still be done," said Malone, adding, "But it doesn't have a a place in this decision to keep the hospital open."

Thomas said, "This is not something that's only been talked about in the last 13 days."

"The hospital is in very large danger of closing. Willcox is half a ghost town as it is already. Without the hospital, people won't come here and people will leave, as there will be no jobs."

"With no hospital and no helicopter, people are going to die," said Thomas.

"I hate to see it (the nursing home) go, but without the hospital, Willcox is going to be in very bad shape."

After the district board meeting adjourned at 10:09 a.m., last Wednesday, community members spoke with the Range News.

"We'll have the legal aspect," said Ken Decker, whose sister is a nursing home resident.

"If we need to, we'll get an injunction

Lori Fortner, a registered nurse from J-Six, told the Range News that she has been the MDS coordinator at NCNH for more than a year.

"We finally have a great Director of Nursing and administrator in place and it is closing," Fortner said.

"I wish they could have waited to see if they could make a difference."

"I love this community," she told the Range News.

"I'm ashamed of my. own community (Benson). There is no comparison between this nursing home and the one in Benson," Fortner said.

"The hospital will also be hurt by not having the diagnostics and admissions coming from the nursing home," she added.

NCNH Activities Director Jane Cox said, "I could not have done my job without this community."

Dunagan spoke to the Range News, as well, saying, "My decision was still no until Jim Dixon spoke. That made my decision. My challenge to Roland and the board is you better make it work."

"I was opposed to the way it was presented to the community-not giving the community their due respect," Dunagan said.

"We'll look at assisted living-there were two Circle B nursing homes here. We'd have to open an assisted living facility as an independent corporation."

Copyright 2015 Arizona Range News, Willcox, Arizona. All Rights Reserved. This content, including derivations, may not be stored or distributed in any manner, disseminated, published, broadcast, rewritten or reproduced without express, written consent from SmallTownPapers, Inc.

Original Publication Date: November 4, 2015

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