Broadwater Health Center’s nine-bed hospital in Townsend has corrected problems that temporarily closed it in July, setting the stage for the re-entry of some of the patients displaced from the center’s nursing home and giving a new boost to the long-term viability of the embattled facility.
A letter Monday from the Montana Department of Public Health and Human Services to the center’s CEO, Jan Kalgaard, said all deficiencies found during an investigation July 11 were found to be corrected in a follow-up survey Sept. 28.
Kalgaard, the center’s CEO since July 13, said the center is now working to “bring home” the first five residents from those who were forced to move out of the center’s nursing home when the state ordered it closed July 6.
“The healing can happen now, because we get to reunite families,” she said.
Of the 30 nursing home residents forced to move in July, eight have died, she said.
The successful state survey and return of patients also means much-needed cash flow for the facility and represents a huge turnaround from just a few weeks ago, when a member of the board of Townsend Health Systems, which oversees the facility, suggesting it may be “time to throw in the towel” amid mounting debt, tapped credit and an absence of cash flow.
The facility now has a dual license for nine beds, allowing each to function for either acute patients or for long-term care.
The facility is working with the state toward expanding the license to 18 beds and ultimately to 25, once certain issues are tackled on the last seven beds.
The health center’s problems followed a June 12 audit by DPHHS that found deficiencies the department said constituted “immediate jeopardy” to patient health and safety.
Many of the problems involved the failure of staff to properly report certain circumstances to physicians. The nursing home failed to correct the problems and was ordered closed July 6; the hospital, except for its emergency room and a few other services, was closed the day after the July 11 follow-up investigation.
The state allowed the hospital to start admitting patients in early September, but continued to investigate whether it followed through with its plan to correct the problems.
But with the lack of nursing home patients, the hospital had trouble paying its bills and payroll, over-drawing its account with the State Bank of Townsend by about $70,000 and exhausting a $150,000 line of credit with another bank.
That began to turn around Sept. 24, just days before another payroll was due, when Bill Kearns, the chairman of the board of the Townsend bank, announced a $100,000 donation to the health center, along with a $400,000 loan.
Meanwhile, the Broadwater County Commission also approved a $120,000 loan to the Broadwater County Hospital District, which owns the hospital and whose board is publicly elected.
Tuesday, the Broadwater County Commission will consider approval of the $400,000 loan, which it would then in turn lend to the hospital district. County Commissioner Laura Obert said Thursday the loan would be paid back at 3 percent interest over five years, starting five years from when it's issued.
The idea is to help the hospital get on its feet and then start repaying the loan, she said.
She said commissioners have been talking with numerous citizens and civic groups about the importance of the hospital and how they feel about the county taking on the loan.
“And the absolutely huge majority has said we need the hospital, but we want to see some changes,” she said.
That includes bringing certain policies and procedures up to date to ensure this year’s problems don’t return.
The earlier $120,000 loan includes provisions that the health center and its board follow open meeting laws and “review and update its bylaws in keeping with best practices for healthcare facilities,” among other requirements.
Commissioners met for more than eight hours Wednesday, she said.
She credited Kalgaard with accomplishing some “phenomenal” things, including educating the hospital board and others on what needs to be done.
“I see some real positive changes in the future, if they heard her,” she said.
Also Tuesday, the Commission will consider conducting an election for a mill levy suggested by the hospital district board. That election, if approved, would take place by mail Dec. 13.
“My hope is that in five years, we’ll be able to say that everything happened for the best,” Obert said.
Sept. 27, Townsend Health Systems members elected two new board members, Bill Hubber and Brad Campbell, according to Kalgaard. The next day, board chair Joni Carlton’s previously announced resignation took effect, and the board appointed Marcia Bieber to replace her.
Jaque Swenson was re-elected and will serve as chair until the board appoints officers, possibly at its next meeting Kalgaard said.
She said 117 people voted in the election, compared with only 12 last year.
To help with its long term viability, Kalgaard and the board are talking with Billings Clinic about helping the board and management, possibly a future management agreement and interim CEO services.
An interim CEO may be needed because Kalgaard herself is facing serious health issues, she said, and could resign by the end of next week.
“It’s tough for me,” she said. “It’s hard to not finish something that you’ve started.”
She credited hard work by medical providers, the hospital board and the entire community for getting the hospital as far along as it has on the path to recovery.
“They took on every challenge that we put in front of them, and they did it with a smile on their face and they got it done,” she said.
Reporter Sanjay Talwani: 447-4086 or firstname.lastname@example.org or Twitter.com/IR_SanjayT