Diversion miscue put county on alert

SANDPOINT — Bonner County officials were briefly thrown for a loop Thursday when Bonner General Hospital inadvertently advised dispatch and EMS to bypass the hospital because it had reached its patient capacity.

Although the facility had indeed met its 25-bed capacity, hospital officials quickly called off the advisory and urged Bonner County EMS to bring patients to BGH to be evaluated to determine if they should be admitted or transferred to another facility.

“There was a little bit of a misunderstanding,” said Sheryl Rickard, the nonprofit hospital’s CEO.

Rickard said a new employee misunderstood the diversion protocol, which only applies to patients with minor injuries. Critical-care patients are admitted regardless of the facility’s licensed capacity.

Bonner General took on the designation as a critical access hospital about a year and a half ago, said Rickard. The designation qualifies BGH to receive cost-based reimbursement from Medicare as opposed to partial reimbursement from federally funded programs.

More than 50 percent of BGH’s patients are covered by Medicare and Medicaid. Hospitals nationwide are embracing the critical access hospital designation to safeguard their financial futures, according to Lynda Metz, BGH’s director of community development.

Bonner County officials were caught off guard by the initial advisory and the hospital’s designation as a critical access hospital. They understood BGH’s capacity to be nearly 50 beds.

Before the advisory was updated, Bonner EMS Chief Rob Wakeley met with county commissioners to discuss the practical and financial impacts of the diversion protocol. Wakeley was concerned EMS resources would be consumed by runs to Kootenai Medical Center for relatively minor injuries.

“Every run is going to take a 911 resource out for two to three hours,” said Wakeley.

Wakeley obtained assurances from Kootenai County EMS that it would help fill the gaps should they develop. Wakeley also prepared to scramble off-duty EMS personnel if need be.

“I’ve never heard of this happening,” Commissioner Cornel Rasor said.

Commissioners Lewie Rich and Mike Nielsen were likewise surprised.

Rickard said it’s uncommon — but not unheard of — for BGH to reach its 25-bed limit. It’s happened twice before since BGH was designated a critical access hospital, she said.

“Our average daily census is 17, so we’re well within the 25-bed limit,” she said.