Dear Editor,

To the North Okanogan Community: As I looked around at the faces of the community members present at the Hospital Board meeting on Thursday night, Feb., 14, I saw many folks I know. I could see in my memories many of their relatives that I have taken care of at Extended Care, still fondly called the “Nursing Home.” I feel so connected here in this community.

All of us in this community are so upset by the pending closing of the Assisted Living facility. I remember its construction and how proud everyone was. In this town there is such a wonderful arrangement for health care, from birth to the care of our elders with everything inbetween, all in a two block area. A continuum like ours is difficult to find in most small towns and something that many community members, including myself, have worked very hard to build and to protect.

It is undeniably sad and painful for this community to have to watch the packing up and relocation of the residents of the Assisted Living facility. It feels and seems like a betrayal of our elders and we all want to do better by and for them. There will be a huge hole in this fine care network we have built.

With this in mind we as a community need to consider what is at stake. We live in an economy that is fragile and has been squeezing us for a long time. It will most likely not improve fast enough, if it does at all, for us to have what we want most. Priorities must be set or we risk even more than what we are giving up now.

I have been here as a working member of this community since 1974. To some that is a long time and to others it is not. I have seen health care here evolve from a user friendly, simple and not very regulated system where you could pay as you could afford it, to the present system which is so over regulated that the cost of health care is suffocating our nation. At this time Long Term care is the most over regulated system in the U. S. except for our nuclear energy system. The system for reimbursement is extremely cumbersome and difficult to understand, even by those who work with it. It also changes and multiplies frequently. I was one of those who worked with it and watched it evolve with consternation and even with rage when the nursing assessments that I did were changed to include reimbursement as part of their function. I always thought that nursing meant taking care of people. Now it is much more and we need at least three nurses to do what one used to do. Just that change has cost our hospital a huge amount of money.

I graduated as an RN in 1970 and have seen many changes over the years. When I started here one chart for a longterm resident of the nursing home was one half to one inch thick. Now a chart can be three inches thick containing only the last six months worth of hard copy record. Now we have computers and send assessments out to the state and federal windows which use these assessments to run our surveys for risk and reimbursement, to make sure that we are not only taking care of our folks, but also that we are not overcharging them and committing fraud. These are the assessments that run reimbursement. All of this is very complex and costs us lots of money. We are paying more now because of HIPPA (the Privacy Act), building and safety codes and materials. With the rise of disposables we have had to change more and pay more. I could go on and on, but this letter would never end and eyes would roll in boredom and with utter weariness. Mine have been. I was so glad to retire and did so just in time for the system to become even more cumbersome and expensive. My poor successors.

It has become so apparent to me that if we as a community are not careful, we could lose our hospital. Warrants have been held for the hospital by the county for far longer than they were intended to be and now we, meaning this community and our hospital, are being asked to get them under control now. There is not much time. This hospital is part of ”us.” It is a hospital district and we vote for it. It is “us” no matter how imperfect it is and the team that manages it is. I do not know anything or anyone that is perfect. Mistakes have been made in the past and will continue to be made, no matter how hard we work to avoid them. That is part of the human condition and who we are.

We, the community that our hospital is part of, need to imagine this town and the northern part of this huge county without this important part of ”us.” I have. You may think that things are bad now, but imagine what it would be like without the hospital, which includes the “nursing home” and clinics. It is a large employer here. It brings people into the community that would not come without it’s presence. This brings money into our community and allows businesses to exist and even thrive. Doctors would have to leave. Our citizens need good health care and right now enjoy and benefit from having the hospital district. If we are careful, and this includes those who manage the hospital, we will continue to benefit in spite of the closing of the assisted living facility. Over the years we have had to adjust how we do things and now we must do so again. We need to work on this together for “us,” the community. Yes, for some of us it means relocating our elders to other places, a very sad and life-changing ordeal for older folks who cannot adjust as easily to change. With difficulty and work these family members will be taken care of with or without the assisted living facility because that is what we do as a community.

We must work together now.

Sincerely and with great love for this community,

Karen Schimpf, retired RN and Resident Care Manager

North Valley Extended Care

Tonasket