ADIEU TO TCU

Kathy Barber, the discharge planner for the transitional care unit, and patient Harold Harris of La Grande chat in the lounge at the TCU. (The Observer/Laura Mackie-Hancock).

By Alice Perry Linker

Observer Staff Writer

Celeste Homan was dying from cancer, but she wanted to spend her final days at home in La Grande.

Her family turned to the one place they knew could provide the specialized care she needed.

"If the TCU hadn't been there, she could not have come home," said Celeste's sister, Belinda Butcher. "It was the only facility skilled enough to take care of her; to provide the medical attention she had to have."

Belinda spoke about Grande Ronde Hospital's Transitional Care Unit, scheduled to close the end of June in a cost-reduction measure.

A Grande Ronde Hospital nurse, Celeste was familiar with the TCU, and her sister, Belinda, was a certified nursing assistant there.

"She wanted to come home," Belinda said about her sister. "If it hadn't been for the quality of care at the TCU, she would not have lived that long."

Celeste's husband, Doug Homan, shares Belinda's sentiments.

"Without that I would not have been able to bring her home," he said. "I was very pleased with the care. I'm very disappointed it's closing."

Medicare funding for the TCU has been reduced, and with a patient load that varies from about three to no more than 13, the hospital board of directors decided to close the unit and care for long-term recovery patients on the medical-surgical floor. About 20 jobs will be lost in the closure.

"It boils down to the fact that the Medicare and other reimbursement is so low that the hospital loses money for every patient who goes in there," said Dr. Patrick McCarthy, chairman of the hospital board. "The function of the TCU long-term post-rehabilitation will be continued in the hospital, but it won't be an independent unit."

McCarthy said the hospital will "be able to maintain service, yet get away from the money-losing aspects of a separate TCU."

Hospital officials have said that some of the amenities of the TCU, such as a television lounge and dining room, will be lost.

Bill and Lane Demastus of La Grande said they were more than happy with the care his mother received during two stays in the TCU.

"I was just sick to find out it was closing," Lane Demastus said. "I realize they didn't have a lot of patients, but, boy, those patients received the one-on-one care they needed when they were there. The aides were just as good as the nurses."

Demastus's mother is doing well at home in Baker City, Lane Demastus said, after recovering from a broken femur, below her hip.

Bill Demastus said he thought hospital cuts could be made in other places, including top administration salaries.

"If they're going to be cutting jobs, my question is why is it that the top executive receives nearly $200,000 in compensation each year?" he said. "In my opinion part of that could be used to keep people working in transitional care."

McCarthy said salaries were not reduced, but "we made significant cuts in administration. The executive director of the (hospital) foundation — we made a 40 percent cut there — and some secretarial positions ended."

"The administration did take significant cutbacks; it didn't get away unscathed."

Hospital President Jim Mattes said the board decided to make specific "incisive cuts instead of across the board salary cuts."

"All of our salaries are compared against our peers, and we are bound to a fair market value under IRS law," he said. "We cannot excessively compensate under IRS without being in jeopardy."

Mattes praised the work of the TCU staff.

"They are really caring employees doing an outstanding job," he said. "Great people doing great work.

"The TCU is a model for the industry, and we wish that the federal government would recognize the benefits to patients and would pay for it."

Mattes said federal reimbursement for patient care in the TCU "has gotten worse each year, and it would require a substantial subsidy every year from here on out."

Jean Fromwiller, manager of the TCU, agreed with Mattes about the quality of the staff.

"I would like to honor my staff because they're such a dedicated group," she said. "It's been an honor to work with a group that cares so much about the patients, and it's made my job so easy to manage a group that are so dedicated to their profession. We're going to miss working together."

A staff working together made a difference for La Grande resident George Brookshier, who spent seven weeks in the TCU last winter while recovering from a stroke. Brookshier said the home-like atmosphere made recovery more pleasant than it might have been.

"No one wants to spend that much time in the hospital, but that's not like a hospital," he said.

Brookshier recalled having his wife join him for Christmas dinner and spending the night in his room near the end of his recovery.

"When I left, I felt like I had family there," he said.

Dorothy Brookshire of Union also remembered the family atmosphere. Her mother, the late Avol Silvey, recuperated in the TCU on three different occasions.

"It was so much like home for them," she said. "We had Christmas dinner with her; we had a party there and brought her presents, and everybody came.

"I hate to see it go."

Another who will miss the TCU is Libby Goben, manager of the La Grande office of the state's services to seniors and people with disabilities.

"Absolutely (we'll miss it)," she said. "The TCU is a valuable part of the community."

Goben said her office will meet other nursing homes "to see if they can meet the rehabilitation needs of the people."

The TCU staff feels a sense of loss, although some have found jobs elsewhere.

"We're losing a resource that can't be replaced," said RN Kathy Kirby, who began working in the TCU the day it opened in 1989. "It makes me sad to think that society dictates these losses by not wanting to pay for the care people demand."

Kathy Barber, the discharge planner for TCU, said about her work in the TCU, "I love this job. I feel like I'd work here forever. We're a good team."

Barber said people of all ages with all types of illnesses have used the TCU. Many patients are stroke victims, she said, but others have had joint replacements, broken bones, and some arrive for nutritional treatment.

"We build people up who are getting ready for surgery or other medical procedures," she said. "We do a lot of pain management."

Barber's job requires her to prepare people for a return home after treatment in the TCU.

"I make sure they feel OK about their plan," she said. "I try to make leaving as successful as I can."

On a day in mid-April, Harold Harris of La Grande was looking forward to going home. He was admitted after a stroke, but had to transfer to the medical floor for a brief stay during his recovery.

"When I got back here, I said, ‘It's so good to be home,'" he said. "They have everything; they make you do things like exercise, balance. They're the best."