CHCC: Clinics may close

The Commonwealth Healthcare Corp. is starting to feel the pressure as the CW-1 issue creeps up on it. The corporation, which runs the CNMI’s lone public hospital, expects to lose more than half of its nurses come December 2017.

If worse comes to worst, the Commonwealth Health Center may have to close down some clinics to make up for the lack of manpower, according to CHCC chief executive officer Esther Muña.

“If we don’t have any solutions [to the lack of manpower], then it is a possibility that we would have to close a few of the clinics,” Muña told Saipan Tribune.

If that happens, only the emergency and non-acute area of the hospital will remain operational, Muña said. That includes the emergency room, the dialysis center, the operating room, the hospital wards, and the ER office, to name a few.

Clinics that would likely close temporarily include the women’s clinic, children’s clinic, adult clinic, and quite possibly the program clinics such as the immunization clinics, Muña said.

Expensive solution

A possible solution that CHCC is looking at to avert closing down the clinics is to avail of nurse staffing agencies.

Nurse staffing agencies are like manpower agencies but they focus solely on providing nursing manpower, or “travelling nurses.”

“Travelling nurses” are nurses that belong to larger organizations that provide manpower to hospitals at a cost.

“Those are just some of the options but they are more expensive,” said Muña.

As a temporary solution to the CW crisis, CHCC would be paying the nurse-staffing agency to provide nurses that are ready to work. Muña stressed that that solution is temporary.

“[The nurses] are not here to move and take over the jobs [of those that had to exit the CNMI],” said Muña. “We are already making communication with someone to try and provide these services. There is actually some interest to come to Saipan.”

‘Worsens the situation’

Future dependence on nursing staff agencies are costly. Muña said that availing of these services “actually worsens” the financial situation of CHCC.

Muña pointed out that CHCC relies on a reimbursement method of payment, meaning that CHCC first pays for the services it offers to patients.

“If [CHCC] uses an expensive resource pool, we cannot just increase our rate for the sake of covering that expense,” said Muña. “When you determine your rate for fees, it is based on your costs.”

Without additional appropriations from the central government, Muña does not see the nurse staff agencies as a permanent solution to the manpower problems of CHCC.

“If we don’t have the funding, then the likelihood is that we have to increase our rates to pay for these services. That’s the option, basically,” she said.

A common problem with manpower agencies of any type is the availability of people.

“If you are contacting somebody for their services, [it ultimately depends] on the availability [of the nurse]. Again, [CHCC] is not the only one tapping into this kind of business,” said Muña.

In official CHCC documents obtained by Saipan Tribune, 182 employees are scheduled to exit the CNMI, five of which are H-1B employees.

Of the 171 set to exit, 125 are nurses, with three from the Rota Health Center and five from the Tinian Health Center. The total population of nurses is 137, including those at the Rota and Tinian health centers.

According to Muña, top priority goes to taking care of CHCC staff because “it is directly in line with patient care.”