SVH Finalizing Plan To Keep Skilled Nursing Facility In The Hospital

May 9, 2019 | SVHCD Board Chair Report

The board received an update at the May meeting on the plan to maintain the Skilled Nursing Facility in the hospital and serving our community. 

We had a presentation from Adam Willits, representing the Ensign Group, a national operator of skilled nursing and rehabilitative care services. Ensign is working with the administration on a proposal to assume operational management of the Skilled Nursing Facility, keeping it in its current space, while expanding services to include subacute care. Under the proposal, the SNF will remain under the hospital’s license with administration and board oversight. 

I firmly believe that this is a positive and necessary step that will strengthen services offered to the community while putting the operation on a more stable financial footing; one which will generate incremental revenue for the hospital instead of the current situation where we are losing money. SVH will receive revenue from Ensign both as part of a revenue-sharing agreement, and by providing certain medical and operations services to Ensign. Under the draft agreement, SVH would not be liable for any losses if they were to occur. 

As I noted in February, the hospital received proposals from two skilled nursing facility operators and chose to recommend Ensign because of its strong track record. Ensign successfully operates 254 healthcare facilities, including 197 skilled nursing facilities, in 16 states and has the expertise and resources to make our SNF financially viable in ways that our own staff, despite their strong efforts, could not.

Specifically, Ensign brings capabilities in post-acute care that we do not possess, including broad expertise operating facilities under ever-changing regulations and significant efficiencies of scale. Additionally, Ensign’s ability to add a subacute unit will bring in new patients. Ensign reports that currently there are only two subacute units in the North Bay and both operate near capacity. 

Ensign also has an impressive commitment to quality, with many of its SNFs receiving 5 stars, the top ranking from Medicare. It operates several facilities in our area, including Broadway Villa Post Acute, which is CMS 5 Star rated.  Willits reported the company has made job offers to all but one of the existing SNF staff. The hope is that many of our staff will continue to work in the SNF. Our goal is to finalize agreement on the contract terms before June 1, then have the board review and hopefully approve the terms, and have the new structure operational by July 1.  

Stroke Ready Certification

We were very excited to learn, as CEO Kelly Mather reported during our meeting, that the hospital has received Acute Stroke Ready certification from the Center for Improvement in Healthcare Quality (CIHQ), which strengthens the hospital’s emergency services to the community. Certification is given to hospitals that meet high standards of care for the initial treatment of stroke patients when quick action and proper medication can save lives and limit the long-term disabling effects of a stroke.

Acute Stroke Ready hospitals are certified to provide immediate care for stroke patients on a 24/7 basis, including life-saving medications, and then transport the patient to a primary or comprehensive stroke center if needed. Our hope is that this will bring additional patients to our hospital. It would not have been possible without the help of UCSF whose stroke specialists helped to prepare our team for the certification process.

Strategic Plan

The board approved a new three-year rollng strategic plan that supports the vision of making the hospital an Outstanding Regional Center for Healthcare. It identifies four strategic initiatives:

  • Exceed community expectations in emergency services
  • Create UCSF Health outpatient center
  • Become a 5 Star Hospital
  • Provide access to excellent physicians

Several board members commented that this is a strong plan that identifies timely and well thought out initiatives to support making our hospital financially sustainable. The plan is available here on the hospital website and I encourage you to take a look.

Sonoma County Health Services

We also heard a report from Barbie Robinson, Director of the Sonoma County Department of Health Services. Ms. Robinson described several of the Department’s responses to the county’s public health challenges. 

In particular, she emphasized the challenges to maintain behavioral health services in the face of growing financial pressures. These services are critical for many in our county, especially the homeless, and the Department is looking for ways to get much needed additional funding for this population. She reported the county has expanded its mobile behavioral health support team to Sonoma Valley and the Russian River area.

We applaud the Department’s efforts to provide the critical services needed by Sonoma communities, and encourage all to support these initiatives.

Next Board Meeting

Our next regular District Board meeting will be held on Thursday, June 6, at 6 pm in the Community Meeting Room, 177 1st St. West in Sonoma. The public is welcome to attend and public comment is always encouraged. 



Joshua Rymer
Chair of the SVHCD Board of Directors