Carson Tahoe closures reflect ‘changing landscape’ of health care

Officials at Carson Tahoe Health and Carson City Health and Human Services believe a handful of forthcoming closures from Carson Tahoe Health reflect new realties in a post-pandemic world but will not negatively impact patient access and care.

Closing May 31 are the clinics at Walmart in north Carson and south Gardnerville. According to CTH, some providers serving those locations will be relocating to Carson Tahoe Medical Group primary care facilities in Minden and Carson City and will be able to offer same-day appointments.

At the old hospital site off Fleischmann Way, two CTH facilities will be affected. Outpatient lab services at the Specialty Medical Center will be closed. Starting June 9, lab services will be available at Carson Tahoe Regional Medical Center, Carson Tahoe Sierra Surgery, Minden Medical Center and Dayton Medical Center. Information can be at https://www.carsontahoe.com/lab-services.

The Carson Tahoe Continuing Care Hospital at the old hospital site will also close by July 14.

“While the volume of patients visiting the Walmart clinics over the last few years has dwindled to less than five per day, the need for access to primary care has increased throughout our community,” Kitty McKay, CTH administrator of community and patient experience, said in an email to the Appeal. “By closing the Walmart clinics, we are able to reposition the providers who had been serving there to our Carson Tahoe Medical Clinics in the Minden Medical Center and the Eagle Medical Center in Carson City.”

Although CTH is still adjusting workflow details, McKay said the move to the other medical facilities will allow for “walk-in primary care.”

“This allows us to begin offering ‘walk-in primary care’ Monday through Friday 8 a.m. to 5 p.m., which promises to be a far more readily accessed option,” she said.

McKay said the closures do not involve layoffs.

“While there are a few staff who are voluntarily transitioning into other things, no layoffs,” she said.

The news of the restructuring follows a Community Health Needs Assessment performed by CCHHS in partnership with CTH. From more than 1,500 community surveys, stakeholder interviews and focus groups conducted during the assessment last year, four priority needs surfaced in Carson and surrounding rural counties: access to basic needs like primary healthcare and housing; mental and emotional health; access to healthcare for specific populations; and substance use prevention, treatment and recovery.

Access to primary healthcare for low-income and underinsured individuals is a specific challenge as wait times can be one to four months, according to the assessment. CCHHS Director Nicki Acker told the Appeal the CTH changes will not cause longer wait periods.

“The most recent Community Health Needs Assessment identified long wait periods to get into primary care for vulnerable individuals,” she said. “Since the community is not losing health providers and same day appointments are being offered, this consolidation should not cause longer wait periods for these individuals.”

In the next several months, CCHHS is creating a Community Health Improvement Plan that addresses needs. The goal is to bring diverse partners together, including the public, and assess service gaps and barriers while developing new strategies and programs.

“We are committed to continuing to serve as a vital community hospital,” McKay said. “To do so requires us to be nimble as the entire health care landscape shifts. The impetus for these closures was in response to the changing ways people are accessing care, regulatory shifts on the part of federal entities and a shifting financial reality which no longer provides any cushion for subsidizing services that are no longer sustainable.”

McKay pointed to a recent report by the American Hospital Association showing hospital expenses nationwide increased by 17.5 percent between 2019 and 2022.

“After three years of unprecedented challenges and caring for millions of patients, including over 6 million COVID-19 patients, America’s hospitals and health systems are facing a new existential challenge — sustained and significant increases in the costs required to care for patients and communities, putting their financial stability at risk,” reads the AHA’s April report. “A confluence of several factors from historic inflation driving up the cost of medical supplies and equipment, to critical workforce shortages forcing hospitals to rely heavily on more expensive contract labor, led to 2022 being the most financially challenging year for hospitals since the pandemic began.”

In a press release, CTH President and CEO Michelle Joy reflected on the balance between successfully serving the community and “navigating the changing landscape of health care in this post-pandemic world.”

“Our ‘new normal’ requires that we continuously watch, listen and respond to the changing needs of the people we serve,” Joy said of the CTH closures. “Over the last several years, we’ve seen the utilization of these locations and services decrease significantly, while other focus areas have grown. We are committed to being where our community needs us most, in the way that best supports their health and wellbeing.”

One location affected by the changing landscape is the Carson Tahoe Continuing Care Hospital at the old hospital site.

“Carson Tahoe Continuing Care Hospital opened in 2008, in response to community need and based on criteria regulated by the federal entity, Centers for Medicare and Medicaid Services (CMS),” said McKay. “The care model of these hospitals is termed ‘long term acute care,’ providing continuing treatment to patients with clinically complex medical conditions who need hospital-level care for an extended period of time (usually 20 to 30 days), at a higher level of care than skilled nursing facilities can offer.”

McKay said five years ago, CMS “dramatically altered” the criteria for patient admission, resulting in the average of more than 25 patients daily dropping to 8.

“Over this same period, the (CTH) system has subsidized over $20 million to maintain these services,” she said. “Given today’s financial climate, however, such subsidies are unsustainable, and this closure is achievable without any risk of diminished care to patients.”

McKay said patients from the facility will remain with CTH or be placed in another appropriate facility.

Carson Tahoe Health is a not-for-profit healthcare system and an affiliate of University of Utah Health. For information, visit www.CarsonTahoe.com.