Tag Archives: Northern Inyo Hospital

City of Bishop Declares May as Healthcare District Month

As the world continues to celebrate healthcare workers, the City of Bishop chose to salute its local healthcare and first responders Monday night with a proclamation naming May as Healthcare District Month.

This is not the first time the City recognized healthcare workers in May. For the past several years, the City set aside May as Healthcare District Month, and May traditionally housed National Hospital Week and National Nurses Week. The arrival of the Coronavirus indeed lent itself to expanding this recognition to include the first responders and county-based public healthcare staff who work alongside Northern Inyo Healthcare District.

Kelli Davis, Interim Chief Executive Officer, told the council that this recognition focuses on all the community heroes, who are working tirelessly through the crisis at hand. “These first four months of 2020 have been very trying, frightening, and devastating throughout the United States and in our small communities through the Eastern Sierra due to the pandemic,” Davis said.

While many of the frontline workers are obviously our physicians and nurses, Davis noted that other often-unsung heroes contribute to the health and well-being of the community during trying times such as this. These include, but are not limited to, firefighters, air ambulance teams, police officers, paramedics, EMTs, hospital and county teams at every level, and many other community workers required to respond to health-related needs and medical emergencies.

“We are very appreciative of the action our City Council is taking in honoring all of these community members,” Davis said. “These workers continue to risk their personal safety to execute their respective duties, day in and day during this crisis. Honoring our healthcare workers and first responders by proclaiming May as Healthcare District Month demonstrates the appreciation and heartfelt thanks for these folks and the work they are doing on the front lines against the pandemic we have been facing for the past few months and will continue to face for some time.”

Before the City Council read the proclamation into the official record, Mayor Laura Smith paused to recognize some of those who contributed to the team effort. Those workers included: Northern Inyo Healthcare District’s Andrea Daniels, Denice Hynd, Dr. Stacey Brown, Jannalyn Lawrence, Krissy Alcala, Amy Stange, Janice Jackson, Genifer Owens, Emily Smith, Tanya DeLeo, and Scott Hooker; along with Symons Ambulance’s Judd Symons; Sierra Life Flight’s Mike Patterson; Bishop Volunteer Fire Chief Joe Dell; Big Pine Fire Chief Damon Carrington; Chalfant Valley Fire Chief Steve Lindeman; and, Inyo County Public Health’s Anna Scott.

“Our community deeply appreciates the work that’s been done and continues to be done within the healthcare district and beyond,” Mayor Smith said.

Northern Inyo Healthcare District Oust Former CEO Kevin Flanigan

At last evening’s special meeting of the Northern Inyo Healthcare District Board of Directors, the Board voted 5-0 to terminate the employment of Dr. Kevin S. Flanigan, MD MBA as Chief Executive Officer pursuant to his Employment Agreement, without cause, effective May 4, 2020.

Board Chair Jean Turner said the District wants to clarify that any reports that alleged Dr. Flanigan was accused of embezzlement are false and untrue. The Investigation focused on financial and operational issues and was never about embezzlement. The District is moving in a new direction and wishes Dr. Flanigan the best in his future endeavors.

Kelli Davis will continue to serve the District in the role of Interim CEO alongside Interim Chief Medical Officer William Timbers, MD; Chief Nursing Officer Tracy Aspel; and Chief of Staff Stacey Brown, MD.

In a message released to the staff earlier today, Turner noted the challenges staff faced since the Board placed Dr. Flanigan on paid administrative leave February 13.

“While the last few months have been incredibly challenging for our entire workforce, I note the steady and unrelenting teamwork that has become a trademark of this NIHD staff,” Turner wrote.  “On behalf of the Board, I thank each of you for your many emails, phone calls and visits to provide input, while simultaneously taking care of yourselves and our community through this COVID-19 pandemic. You have equipped the Board with your information and insights about challenges and opportunities ahead. I am confident that we will get through all such challenges and find even greater opportunities for problem solving.”

Northern Inyo Hospital Opening Services for Non-Coronavirus Patients

Interim Chief Medical Officer of Northern Inyo Healthcare District, Dr. Will Timbers, provided the latest update on how the hospital is faring in its fight against the coronavirus.

Timbers says the hospital is opening up limited operations this week in order to assist people who need other health concerns addressed which are unrelated to COVID-19. “Starting today, we are shifting the hospital toward limited operations. We will be providing many of the services we provided before the pandemic hit, just with some alterations such as implementing things like social distancing and providing telehealth visits when possible,” Timbers said.

Some of these services include surgeries, doctor checkups, and other hospital examinations.

Over the past month and a half, the hospital has modified nearly all of its operations to combat COVID-19. Because of these alterations, the hospital has had a large decrease in hospital admissions, which has taken its toll on the district’s income. Dr. Timbers spoke more about the lack of revenue saying, “I can tell you it has had big impact on the district’s finances. We have cash on hand currently and we are looking at how long we can sustain operations with that.”

Timbers also said the hospital is seeking assistance from the government. “The federal government appears to be working on a bill that will help critical access hospitals. If we don’t get help from the new bill, our grant department has also been busy trying to acquire funding,” the Interim Chief Medical Officer added.

Herd immunity from coronavirus could play a factor in curtailing the amount of new infections in the coming months. However, Dr. Timbers appears to be cautious when it comes to the notion that once people have coronavirus, they cannot get it again. Timbers said, “Making blanket statements about herd immunity this early is a bit immature. There are still some unanswered questions. We don’t know about whether or not COVID mutates and changes every year like the seasonal flu. If that is the case, herd immunity is not going to be very effective. My hope is for a vaccination from COVID-19 to happen sooner rather than later. That is going to be our best chance of stamping this out.”

Though a vaccination is not going to happen in the immediate future, social distancing and other preventative measures have made a difference in limiting the amount of new cases of COVID-19. Timbers emphasized that the community is doing an excellent job when it comes to “flattening the curve.”

“I wanted to say thanks to entire community for their participation in this effort. If they weren’t covering up and social distancing, we would be in a different place right now,” Timbers expressed.

Northern Inyo Hospital Not Panicking After Five New COVID-19 Cases

Northern Inyo Hospital held a press conference on Thursday, April 16, 2020, in response to the five new confirmed cases of COVID-19 in the county. All cases were confirmed at the hospital, bringing the total amount of victims to seventeen.

Dr. Stacey Brown could not comment on whether or not the cases were all connected, but did say that each patient’s tests were confirmed to be in the same batch of testing kits that were sent to LabCorp in Phoenix, Arizona. “Those five positive cases were in a batch of twelve people that we tested last weekend,” Brown said.

The Rural Health Clinic Director added that he is not overly alarmed by the five cases. It is more likely that the test results were confirmed at the same time and less likely that every person tested came down with the virus at the same time. Brown said, “The new confirmed cases is not diagnostic of a surge, but more of a testing glut. Usually five to eight tests per day is what we send out for lab analysis. With just one data point to look at and five tests confirmed, I can’t say we are in a surge.”

Turnaround time for testing results will be faster than the usual two days it takes to receive coronavirus testing outcomes. The in-house testing has been approved for the hospital to use, which will allow for patients to find out whether or not  they have the virus in approximately an hour. “As of today, we have in-house testing via nasal swab available,” Brown remarked.

Interim Chief Medical Officer, Dr. Will Timbers, added that the healthcare district has also implemented antibody testing, which will let patients know whether or not they have built up immunity to COVID-19. “Antibody testing in-house is available as well. However, we are not entirely sure how accurate it is right now,” Timbers said.

California Governor, Gavin Newsom recently said in a press conference that in order to lessen up on societal restrictions and go back to some semblance of normal life, he would need to see a decrease in hospitalizations and ICU admissions. The governor outlined “the six critical indicatiors” the state would need to see in order to consider modifying the Stay-at-Home guidelines.

When asked whether or not there has been an increase or decrease in hospitalizations locally, Dr. Timbers said there has been a moderate increase of admissions to the hospital, but not enough to warrant alarm. “Volumes have been up marginally, but nothing that is coming at all close to taxing our resources,” Timbers expressed.

It has been well documented that the majority of cases of COVID-19 are considered by the medical community to be mild, with eighty-one percent of patients reporting mild symptoms. However, just because it is deemed to be a mild case, does not mean that many of the individuals who come down with the sickness do not experience tremendous pain and discomfort.

Timbers also spoke about the misconception that many people have when it comes to what the word “mild” means relating to coronavirus. “Mild, severe,  and critical are used to classify illness in the medical community. Eighty-one percent of people who have COVID-19 are determined to be a mild case based on if they have mild viral pneumonia or no pneumonia. Mild cases in the medical community is not what the majority of the public would perceive as a mild,” Timbers remarked.

The Tide May Be Turning In Northern Inyo Hospital’s Favor in Fight Against Coronavirus.

There is finally some good news when it comes to Northern Inyo Hospital’s fight against the coronavirus pandemic.

During Monday’s press conference with Rural Health Clinic Director, Dr. Stacey Brown, the hospital announced that the long-awaited  speedy coronavirus test will be ready for NIHD to use by the end of the week.

Brown said, “We finally got our rapid turnaround testing kits validated. The new testing protocol for coronavirus will take around an hour to complete. We will have this testing up and rolling by the end of the week.”

The rapid testing will mostly be used for critically ill patients and essential healthcare workers.

Dr. Brown also expressed that the hospital is aiming to expand testing capabilities to the general population in the future. The district would essentially move from a “containment” public health strategy, back to a “surveillance” strategy. With a “surveillance” strategy in place, NIHD would resume contact tracing, meaning the hospital would test those who have been in contact with a confirmed COVID-19 victim.

However, the hospital does not plan to test random individuals from the general public. The idea of doing so is simply unrealistic, since Dr. Brown said the hospital has roughly 200 testing kits available.

Brown added, “It would be an epidemiologist’s dream to test everyone in the town, but we don’t have the capacity to do that right now.”

Even better news than the rapid testing, is the notion that there is finally an end in sight when it comes to lessening social distancing measures and reintegrating various parts of society back in to the picture. As Interim Chief Medical Officer, Dr. Will Timbers remarked, “The rational here [when it comes to opening services] is that even if we do see a surge of COVID-19 patients, it is unrealistic that this disease is going to go away after we have one big surge. It will likely be a slow burn for cases, but we have to get some people back to some semblance of normal life. To that end, over the next several weeks, the hospital will provide a wider scope of services. This is going to be more like a marathon opposed to a sprint.”

When it comes to an actual timeline of when some societal functions will return to normal, Inyo County Public Health Officer, Dr. James Richardson, recently said he expects social distancing measures to lessen around May. “I suspect around mid to late May, things will start to lighten up. However, there may be a undercurrent of this virus in our community for a while,” Richardson said at last week’s “Inyo County Virtual Town Hall Meeting.”

Dr. Brown shares similar sentiments when it comes to an expiration date on the intense measures currently being taken. “I would hope that we could start some sort of phased return to normalcy by sometime in May. I will put a caveat on that though. We will be following guidelines from state and the feds before we start to open up.  All kinds of functions of society must be carefully considered, and it has to be a staged and phased rollout to ensure that we don’t have to lock down everyone for another fourteen days.”

 

Coronavirus Testing Results Coming Back Faster for Northern Inyo Hospital

Northern Inyo Hospital gave their weekly COVID-19 update to members of the media on Monday, April 6, 2020.

Dr. Stacey Brown told the media that the hospital is currently functioning at full capacity. “NIH is fully functional for all services at this time. If you break your leg, we are here to treat that,” Brown expressed.

Interim Chief Medical Officer, Will Timbers, shifted the discussion to COVID testing protocols at the hospital. He highlighted false negative tests, which are tests where a patient appears to not have coronavirus, but ends up actually having it. “No test that we do is going to be 100% perfect. We need to make sure to get a really good nasal swab to ensure that we can find out if they have it or not. There are false negatives, where the tests aren’t completely reliable due to limitations in the testing,” Timbers remarked.

Brown added that testing kits will continue to be reserved for essential workers and those with pre-existing conditions. The Rural Health Director said, “The priorities for testing will be for critical staff and critically ill patients. We know the spread of COVID-19 is communicable, so there is no need to test the general public.”

The amount of time it takes for Northern Inyo Hospital to obtain COVID-19 results is becoming more efficient as each week passes. Brown told the media that the hospital is now getting results back in about a day and a half. “Turnaround testing via LabCorp takes about 1.5 days now. LabCorp in Phoenix is doing a really nice job of getting the results to us,” he remarked. When NIHD started testing last month, the turnaround time for lab results was taking anywhere between 7-10 days.

Patients can expect even faster coronavirus testing in the future. The hospital is about one to two weeks away from rolling out their in-house testing, which will take about an hour. “In-house testing is about a week or two off at this point. We are hoping to do in-house testing by the end of the month,” said Brown.

Whether to wear facial covering or not to reduce the spread of coronavirus has been a hot topic of discussion throughout the world, with the CDC now recommending that the general public wear masks after previously discouraging the public from using them. Dr. Brown is encouraging the general public to cover-up. “The CDC came down with recommendations for decreasing transmission in the community by wearing masks. The push on that is to have you protect the rest of the community from spewing out the virus from your mouth. It looks like many people are transmitting coronavirus without showing symptoms, so it is smart to wear masks. My anticipation is that you are going to see the adoption of the masks in our community,” Brown expressed.

The Rural Health Director stated that the community has been stepping up as far as helping out with medical supplies. One such program that Brown says has been quite successful is “project cover-up,” a grassroots effort in which local seamstresses and quilters have created masks for healthcare workers to use. “’Project Cover-Up’ has been a great example of the community stepping up during the pandemic,” Brown said. “So far, we have had over 200 masks donated.”

Dr. Brown is encouraging people to continue to donate medical supplies. “If people are interested in dropping off Personal Protective Equipment donations, you can drop them off at the front of the hospital.”

The Interim Chief Medical Officer, Will Timbers spoke about the possibility of people building up immunity to coronavirus, and if the data he has been examining is accurate, it is a promising sign. “It does seem like with the majority of patients who have COVID, that there is some herd immunity at this point. The data suggests that there are some antibodies that are being built up in patients,” Timbers said.

Antibody testing to see if patients with COVID-19 are building immunity to the virus will be implemented in medical facilities across the world soon. As for testing locally, the public can expect it to be ready some time around May. Dr. Brown said, “Larry Weber, our Director of Diagnostic Services, says there is a rush for antibody testing to be implemented by many companies. Larry and his team have vetted a company that has a good reputation, and that looks very promising. I still don’t see testing happening for a few weeks though. Right now, we are looking at early May.”

Teamwork and Preparation Most Important in NIHD’s Response to COVID-19

It is an overused analogy, the war against novel coronavirus, but as any employee at Northern Inyo Healthcare District will tell you, the battle is real. Ironically, it is a battle most have prepared for throughout their respective careers.

“Every team member brings something to the fight,” says Dr. Stacey Brown, Medical Director of NIHD’s Rural Health Clinic and current Vice Chief of Staff. “Every department plays a role.”

For NIHD Board President Jean Turner, the show of teamwork fits right into the District’s operational design. “When I came onto the Board, I was told our basic structure is that of an inverted pyramid,”
Turner says. “Leadership at the bottom, the workforce at the top. The top is where the real work goes on; it’s where things really matter. If I wanted our community to remember one thing at this point in time, it’s this: Our staff is disciplined, well-trained, and ready for this challenge.”

The District’s fight against coronavirus began in mid-January. For weeks, Infection Preventionist Robin Christensen, RN BSN HIC, kept an eye on what was transpiring in China. On January 28, she called the first team meeting to talk about coronavirus and its potential impact on NIHD and the community. Everyone in the room knew the odds, had watched the numbers coming in from China.

“It is safe to say we wished for the best, but as healthcare workers, we always prepare for the worst,” Christensen says. “It’s who we are; it’s what we do; it is what the community expects from us at a time like this.”’

As the NIHD team developed needed plans, they carried on with providing day-to-day care. Hallway conversations and internal emails began to refer to coronavirus more frequently. The District conducted a pandemic disaster drill on February 13. The tipping point came March 6 when a two-hour coronavirus meeting gave way to a day-long review of staffing levels, supplies, policies, plans, and shared concerns.

The group met the next afternoon again for several hours. They got a late start, beginning at noon. It gave those who volunteered to help at the Eastern Sierra Cancer Alliance’s Blue Ribbon Walk & Run a chance to meet their commitment. For many at NIHD, it was the last “normal” day of the month.

NIHD initiated an internal Incident Command on March 10 and continues working under it today. Incident Commands use a standardized approach to direct, control, and coordinate emergency response. More importantly, it brings people together to reach a common goal.

Like her co-workers, this was not the first time Allison Partridge, RN MSN, worked under an Incident Command. Partridge, the Director of Nursing for the Emergency and Medical-Surgical departments, knows the system well and aids Chief Nursing Officer Tracy Aspel in keeping the daily meetings on task.

Partridge now spends much of her days working with others to put together workflows for the departments that will be most affected. With guidance from Infection Preventionist Christensen, Partridge
and others closely watch the Centers for Disease Control and Prevention and the California Public Health Department for direction. No area or service escaped review.

“We track daily our current availability of Personal Protective Equipment (PPE), and the recommendations for use,” Partridge says. “Additionally, we have made modifications in how we provide services and how visitors access the campus. All of these measures are in place to protect our teams and community. We encourage all employees to adhere both while at work and at home to the recommendations issued by national, state, and local government.”

Carefully crafted plans address the care of Patients Under Investigation (PUIs). Partridge says the standardized workflows are based on the patient’s level of care, whether that be critical care at the hospital or self-isolation at home. Care of multiple positive COVID-19 patients within the hospital remains an area of concern for the small 25-bed hospital.

“A great amount of planning and preparation has gone into every action, and it’s still ongoing,” Partridge says. She notes that just this week, the team was searching every square inch of the facility for places to place more beds. No space is overlooked. An unused and unfinished room located in the two-story hospital was turned into a four-bed safe patient care area within hours.

As for staffing, the level is adequate at this time. The District is working closely with the American Federation of State, County, and Municipal Employees Union on staffing plans should the virus take hold of the community.

As non-essential services are scaled back, staff in those areas become available for use in others. Nurses and caregivers were surveyed to see if they would be OK to serve in other departments they were cross-trained to work in. Recently retired nurses may be considered for voluntary return to bolster staffing numbers. The dedicated care given by generations of NIHD nurses is legendary in the community.

They were also asked who would be willing to work with critical coronavirus cases. No one will be asked to step into a situation they are uncomfortable with — and to date, no one has opted out.

As for the physicians, Dr. Brown and Dr. William Timbers, NIHD’s Chief of Staff, are relying on the aid and advice of many of the District’s Medical Chiefs – Dr. Richard Meredick (Orthopedics), Dr. Charlotte Helvie (Pediatrics), Dr. Sierra Bourne (Emergency), and others. The Medical Support Staff office issued emergency credentials for other physicians in the area should their aid be required at bedsides.

The Rural Health Clinic team launched drive-in coronavirus testing well before some larger, urban hospitals did. The move was based on when the RHC offered drive-in flu shots more than a decade ago.
“Hometown health care can work anywhere, even in the big city,” Dr. Brown smiles.

Dr. Brown’s reliance on RHC Directors Paul Connolly and Jannalyn Lawrence, RN, is evident. Both work closely with the District’s outpatient clinics and played critical roles in clearing barriers for drive-in testing. When offered kudos for the work, Lawrence scoffed. “One Team, One Goal,” she says, incurring the closing line of the District’s mission statement.

Later, as Director of Nursing Partridge studies the endless worklists that paper the walls of Incident Command, she agreed with Lawrence. “Teamwork has played a huge role in managing every aspect of this situation,” she says. “This collaboration has taken place across all disciplines and has included a multiagency approach across Inyo and Mono counties. This great work truly exemplifies our mission of ‘One Team, One Goal, Your Health.’”

Meanwhile, as another day ends for the District team, Infection Preventionist Christensen is in her office. It is quiet in the usually bustling hallway; the result of the District’s temporary telework plan. Almost 80 employees are working from home, practicing social distancing.

Laying across Christensen’s desk are signs of a community lending its support to its healthcare workers: Packages of the valued N95 masks recovered from businesses and home garages, plus several handcrafted face masks. The handcrafted masks, with bright patterns of cacti, cats, and paisley, are especially touching
to Christensen.

NIHD is looking into options that could allow the homemade masks to be used as covers for approved personal protective equipment. That would occur if, and only if, NIHD’s supply of approved masks is
depleted. The covers would help keep the N95 masks free of transferred hand oils, possibly extending the life of the N95s.

“One team,” Christensen says, circling her index finger, gesturing from east to west, north to south. “It’s all of us in the community. Together, we will get through this.”

NIHD BIlling Office Temporarily Closed to the Public

Per Governor Newsom’s Declaration, Northern Inyo Healthcare District announces that due to the COVID-19 virus, the NIHD Billing Office, which accepts payments from the public, will temporarily close to patients. The office will remain open to receive telephone calls for billing questions and payments. Hours are Monday through Friday, 8:30 a.m. to 4 p.m. The direct telephone number is (760) 873-2190.

Payments may also be made by:

  • Mail: NIHD, Credit and Billing Office, 150 Pioneer Lane, Bishop, CA 93514,
  • Telephone: (760) 873-2190, or,
  • NIHD’s website: www.nih.org

Correspondence and Documents may be sent one of two ways:

  • Mail:NIHD, Credit and Billing Office, 150 Pioneer Lane, Bishop, CA 93514, or
  • Email:credit.billing@nih.org

These measures are to keep you, our customers, as well as our employees, at minimal exposure to the virus by social distancing. Stay home, be safe.

Coronavirus in Eastern Sierra Likely More of a ‘When’ Rather Than ‘If’

Director of Northern Inyo Healthcare District’s Rural Health Clinic, Dr. Stacy Brown provided KIBS/KBOV with the latest relating to novel coronavirus in the Eastern Sierra Friday afternoon.

Brown says there have been no local cases of coronavirus identified yet. “At this time, no local cases have been recorded.” Brown said. “We are stepping up our efforts as conditions change to try and contain the virus, and patients may see increased procedures before they even enter the buildings.”

Such procedures include staff asking questions relating to travel history, asking patients to describe symptoms, and checking temperature before they even enter the building.

Though increased precautions are being taken, the Rural Health Clinic Director expressed that hospital operations are currently running at 100%. “We are fully functioning and fully operational, with no limitations of services at this time. There may be a little bit of a delay at times, but right now it is business as usual for NIHD.”

Even with all of the preemptive provisions at the hospital, NIHD is treating a local outbreak of coronavirus as a very real possibility. Coronavirus arriving locally is, “probably not a matter of if, but rather when, so we want to be ahead of the game.”

If for any reason an individual has to go to the hospital for any medical problem, Brown asks patients to not be alarmed when they see staff workers wearing protective masks, clothes, and other equipment.

KIBS/KBOV News will continue to provide updates on novel coronavirus.

 

 

Chair of NIHD Board of Directors Issues Statement on CEO Suspension

Chair of the Northern Inyo Healthcare District’s Board of Directors, Jean Turner issued a statement on CEO, Kevin Flanigan being put on paid leave for alleged financial and operational issues.

“Northern Inyo Healthcare District placed its Chief Executive Officer on paid leave, pending an investigation of financial and operational issues. Dr. Kevin Flanigan was notified of this change in status on Thursday evening following a special Board of Directors meeting.

Effective immediately, Chief Operations Officer Kelli Davis will serve as Interim Chief Executive Officer.

NIHD will be contracting with a consultant to conduct a review of the issues of concern. The expectation is this may take several weeks or more.

Decisions like this are never easy, and the Board did not take this action lightly. We are aware of the impacts these actions have on the lives of those involved, and we encourage you to be supportive of your colleagues during this time of transition. We appreciate any questions and concerns you may have. We ask you to be patient with the process and understand that we may not be able to answer specific questions due to the status of the investigation.

I have a high level of confidence in this staff and have faith in our ability to weather this challenge as well. I look forward to continuing to work with everyone.

On behalf of the Board of Directors, I thank you for your ongoing commitment to the District’s mission to improving our communities, one life at a time. Together, we have achieved so much, and it is my deepest hope that we will continue to do so.”