On behalf of my fellow Board members and our Medical Executive Committee of the medical staff of Sutter Coast Hospital, I would like to share what differences you can expect to see as a patient or consumer of health services if Sutter Coast Hospital is granted approval to become a Critical Access Hospital (CAH).

The simple answer is none. Critical Access does not require us to reduce the variety of services we provide.

We currently offer inpatient and outpatient surgery. Under Critical Access, we will offer the same surgeries - both inpatient and outpatient. And last fall, the Board of Directors made a recommitment to the obstetrics department with the decision to hire two new OB/GYNs when our previous doctors left the community. These services will also remain intact.

Sandy Saunders, M.D., (medical staff secretary/treasurer) leads a team of highly skilled physicians and health care professionals in our local emergency department. They will continue to be available all day, every day. A misperception is that as a CAH, we will not maintain a doctor on site. That is not the case. With 22,000 emergency department visits per year, we will continue to have a provider on site all day, every day.

Nikki Schwartz, D.O., (Sutter Coast Hospital chief of staff) co-leads a team of board-certified hospitalists who staff our inpatient populations. They too are on site - all day, every day.

Our lab services and diagnostic imaging service will continue to offer the same services. Our rehabilitation services and respiratory therapy will continue to offer the same services. We will continue to have an in-house pharmacy for our inpatients.

As an inpatient or family of an inpatient, you can continue to count on Case Management to intercede with planning discharge and the next steps in health care for your loved one.

From an outside perspective, you will see no difference from what you see today. Those who oppose Critical Access designation state that the difference is the number of beds available. This is true. Critical Access puts a cap on inpatient capacity, but it does not require any reduction in services. Inpatient beds will be 25.

What these opponents also fail to share, however, is that the average number of inpatients at Sutter Coast each day is currently 18. From January 1 through the end of April (typically our "busy" season), we had two days over 25; one with 26 and one with 27. In those rare circumstances where our patient load is 26 or higher there are a number of options available to us to possibly keep these patients on site.

However, if a transfer is required, that is not an unusual process for Sutter Coast. We currently transfer out over 650 patients per year because they need a higher level of care than we can provide. Our team has been doing this for years; they are very capable of stabilizing patients and getting them to the proper level of care.

If virtually everything stays the same, you may wonder why the change in designation to Critical Access is necessary here at Sutter Coast. That is because health care is changing nationwide. The options to ensure enough revenue to meet expenses are declining. And here at Sutter Coast over half of our patients are covered by federally funded Medicare, which does not cover the full cost of care. Approximately 87 percent of our patients pay below the cost of care or nothing.

Under Critical Access designation, our service offerings and quality of care stay the same but the reimbursement we will receive from the federal government for services provided to Medicare patients more accurately reflects the actual cost of care. That is why nearly 70 percent of small rural hospitals nationwide have already applied for and received Critical Access designation.

Sutter Coast Hospital has been a significant partner to this community for more than 22 years. As a Board of Directors, our commitment is to keep that intact for generations to come.

Finally, as the chair of the Sutter Coast Hospital Board of Directors, I would like to recognize and thank our dedicated physicians, staff, volunteers and fellow Board members who work tirelessly to keep the patient at the center of attention at all times. You can rest assured if you are to visit the hospital, you will continue to receive all the expertise and compassionate care that you have come to expect.

Ken Hall is chairman of the Board of Directors for Sutter Coast Hospital.