Troubling Indicators of Cascade Medical’s Future

In the late 1980s, mismanagement cast Cascade Medical Center (CMC) into financial ruin. Doctors and staff left in droves. Morale and trust were decimated. A CEO was finally hired to close CMC due to insolvency and imminent bankruptcy. Instead, healthcare leaders came together to face the ugly mess and ended up saving the CMC and growing it forward.

Many of those healthcare workers and leaders who worked to redeem CMC from the brink still live in our community.  In the last few years, they have become alarmingly concerned by seeing the same patterns and problems that nearly shut the doors of CMC 30 years ago. In 2020, several community members began meeting and discussing these concerns. Sadly, rather than engaging with the community, CMC’s administration and the board ignored the data provided to them, deeming the concerns “unsubstantiated.” Yet staff attrition, operational mismanagement, financial gaps and patient dissatisfaction continued to proliferate.

In 2021 an Ad Hoc Cascade Medical Citizens Committee was formed to bring together current and past CMC staff as well as leadership and operational professionals. In early July, we identified four main “buckets” of concern and provided those to the Commissioners in a letter:

1.   Degradation of Quality Patient Care. Negative patients’ experiences have seen a significant migration of CMC patients to seek care at Confluence or in Seattle.  While the doctors and other medical professionals here are highly respected, their support system failed terribly. Patients who cannot get phone calls answered or returned, or get timely medical appointments, lose trust in a facility.

2.   Physician and Medical Care Accessibility. In just the last few months, CMC has lost multiple long-time physicians and a large number of nurses, x-ray techs, and other employees, creating a significant void in meeting patient needs. Patients trust healthcare providers they know, not a revolving door of temps. New and long-time patients are turned away because of the lack of staff. Physicians struggle with CM operational problems and organizational complexities, preventing them from doing what they love and excel at: Treating patients.

3.   Staff Retention. Employees express that CMC is a toxic work environment. There has been a growing gap of mistrust between hospital staff and administration that predated Covid.  So much so that at the September Commissioners meeting, sixty employees and community members attended...none of them happy.  Reports have been filed with substantiated claims that both state and federal policies and procedures are being ignored, yet employee whistleblowers are very fearful of retaliation.  Key staff (with decades of experience) have left to be filled by people with little experience.  Of those healthcare workers who are left, many are actively seeking other employment.

4.   Financial Viability. Organizational accountability has been anemic, especially at CMC’s upper levels. Over six months went by before a financial report was provided to the Commissioners.  When the first report finally came out for 2022 at the end of July, it was discovered that CMC was $2million in the red for the first quarter.  And those losses may be even higher since the administration admits that the data is most likely inaccurate. The issue intensifies when administration’s initial income forecasts for 2023 increase up to 8%, even with less physicians. Although CMC still has funds in cash reserves, those finances should be used for capital expenditures, not operational expenses.

In our letter to the commissioners, we asked 18 questions relating to the Four Points, and invited a couple commissioners to meet with our committee. Three months later they met with us, yet with the caveat that they wanted to listen to us, not engage in discussions or answer questions. They were attentive and cordial.

Since that meeting, the Citizens Committee has continued to engage in conversations with employees across CMC, including physicians, nurses, EMS staff and other groups. Representatives from the nurse’s union showed up at the September Commissioner meeting.  Yet so far, CM leadership has not indicated to staff or community members that they have an action plan to address the issues raised, nor have they engaged with the community or broader staff in discussion.

With that communication gap, our committee has decided to sponsor a community discussion to bring together current and former employees, community members and administration for a conversation, with the purpose of outlining the concerns and looking together at ideas and solutions to redirect CMC back onto the pathway of great patient care in the Upper Valley.

If you are interested in the successful future of our treasured public health facility or have observations, ideas, or perspectives that you can share with other interested community members to help revitalize the healthcare in Leavenworth, please join us at the Leavenworth Fire Hall at 6:30 p.m., October 28, 2022.

Cascade Medical Citizens Steering Committee Alex Saliby (former CMC Commissioner), Anne Hessburg (City Councilwoman), Camille Stemm (former CMC Commissioner and Chief Nursing Officer), Doug Williams (former CMC CEO), Duane Goehner (former Friends of Leavenworth Chairman) Louise Bolser (former career nurse at CMC), Teri McIntyre (former CMC Clinical Nurse Manager), Multiple current CMC employees (who wish to remain anonymous for fear of retaliation)