BY ARLYSSA BECENTI
NAVAJO TIMES
WINDOW ROCK – All the negative news coverage and controversy surrounding Sage Hospital has impacted the facility’s ability to recruit staff, the hospital’s CEO, Christie El-Meligi, told the Health, Education and Human Services Committee at its regular meeting.
For a few years Sage Hospital has been in an ongoing court battle with “whistleblowers” or former employees accusing the hospital’s former Chief Executive Officer Ahmad Razaghi of taking millions of dollars from the hospital, firing those who questioned him and gouging for services.
The Indian Health Service had withheld funds from the 501©(3) hospital, but in a recent court decision that action was ruled unlawful and Sage is entitled to the full amount.
Though very serious, the legal fights overshadow the fact that the hospital is still the only health service provider to hundreds of Navajo patients from seven service areas. “It’s had a huge impact on recruiting and retaining physicians and staff,” said El-Meligi in a brief interview with the Times.
“It’s had a tremendous impact on the community worrying about whether or not to believe what they read in the articles, if it’s true or if their hospital is going to be closing. It’s unfortunate.”
She said recruiting for the dental office, physical therapy and behavioral therapy providers was difficult because “if you’re getting ready to come to a facility and commit your time and you pull up Sage on the Internet … it makes it hard to recruit.” But, now dental visits are increasing under the direction of Dental Director Gordon Wilson.
“Our dental director advocates for dental restoration,” said El-Meligi. “He’s really good with anyone who comes in as a walk-in. They get seen that day.”
Committee member Amber Crotty (Toadlena/Two Grey Hills/Red Valley Tse’alnaozt’i’i’/ Sheepsprings/ Beclabito/Gadiiahi/To’Koi) asked El-Meligi if health providers are brought in by agencies then why are they having a hard time recruiting?
“Agencies can give these (offers) to physicians, but it’s up to the doctor’s choice of whether they want to go to Phoenix or Ganado,” said El-Meligi. “We get those who want to come out and get involved and give back, but there aren’t enough of them. Physicians are in the positions to make money.”
But Sage has also been fortunate enough to have two hospitalists’ agencies working consecutively at Sage for two years and El-Meligi said this has led to a drop in acute patient days. The care that is provided has been continuous, and this has helped physicians become familiar with the patients, giving them better treatment to the point where hospital stays aren’t prolonged longer than they have to be.
Crotty asked for data to support this, so that it could be confirmed that patients aren’t just rushed out. “
What it would correlate to is readmission rates,” said El-Meligi who added they would present those findings at another meeting. “If we just push them out they would be coming back because they would still be sick. What we are seeing is they’re getting better and quicker because their care is better.”
Another service that has been growing is optometry, El-Meligi said. Currently they have two part-time and one full-time optometrist. With a full patient schedule the small room for optometry isn’t cutting it for them anymore, so they will soon cut a room in half in order to get more patients seen.
As a not-for-profit organization Sage Hospital is required to conduct a community health needs assessment with input from community members every three years for the Internal Revenue Service, which was done. The hospital’s diabetes program reported receiving $613,028 to continue with the program, which focuses on case management.
“We have case patient care coordinators and assign them with a portion of our diabetes registry,” said El-Meligi. “They navigate their care for them. We just help them and guide to keep their diabetes under control.”
The hospital even has a community garden where they gave away 400 pounds of vegetables in 2015 and another 400 pounds this year. The director of nursing also works along with Ganado High School’s certified nursing program to help students get an idea of what it takes to be a nurse and work in the health field, by giving them the chance to shadow nurses at the hospital.
Swing bed stays at the hospital bring patients back home if they’re still ill or healing at other hospitals, El-Meligi said, adding that Sage may be the only hospital on the Navajo Nation that provides indefinite swing bed services.
Committee Chair Jonathan Hale (Oak Springs/St. MIchales) was interested in whether or not Sage Hospital is ready for the change in or discontinuation of the Affordable Care Act during the new Presidential administration.
“We have to react to it,” said Franklin Hoover, the hospital’s general counsel. “We honestly don’t know what this incoming administration plans to do with health care or Indian country. He doesn’t have a record we can go by; all we can do is look at the people he surrounds himself with.”
Whatever the outcome for the hospital legal fights, El-Melgi explained that business is still operating inside the historic hospital walls and they’re continuing with trying to provide the best in health care that they can with what they have.