Powell hospital cuts oncology, Cody clinic to improve finances

POWELL — Powell Valley Healthcare is shutting down its oncology services and its internal medicine clinic in Cody within the next 60-90 days. Interim CEO Sean McCallister said the PVHC board made the final decision as a way to remain sustainable in tough financial circumstances. 

He said it’s the latest and biggest decision the hospital has made in the last few months to reduce expenses. 

“Operationally, it’s a bit of a balancing act,” McCallister said. “So one, we have to have the cash to operate. And this is a large organization for a small hospital, and we have a significant labor force, and so we have to make sure we have the cash so that we can pay everyone, so we can provide the high quality services to the community that we do. And there’s a balance of, you have to have enough profitable services to offset the ones that lose money.” 

McCallister has made financial viability a major focus of his time as the interim CEO. 

He took on the role following the spring resignations of CFO Coby La Blue — who left to take the same position at Cody Regional Health — and then-CEO Joy Coulston, who went on to become the CFO of Memorial Hospital of Carbon County in Rawlins. 

The hospital has struggled for years to have an appropriate reserve. 

Currently, McCallister said, PVHC only has 21 days cash on hand. 

“The industry minimum threshold days [cash on hand] for operational stability is 45, and truly viable hospitals have 90 plus. Our challenge is that our cash reserves have been static at around 20 days for a prolonged period,” McCallister said. “This is a growing concern and puts us in an untenable financial situation.” 

PVHC is also facing the prospect of lower Medicaid payments in the future as part of changes made under the One Big Beautiful Bill.

The closure of the oncology services at the Cody clinic affects seven PVHC employees, and McCallister said they’re working to find other roles for as many of those workers as possible. 

Administration is also working to ensure patients have a “continuity of care” and are able to connect with other providers, Chief Nursing Officer Arlene Campeau said. 

Cody, for instance, has the Big Horn Basin Cancer Center with multiple oncologists. 

“The bottom line is that we have too many negative margin services,” McCallister said. “Many rural hospitals across the country are grappling with the same challenge — historically high operating costs, low reimbursement, and other limiting factors. We have an aggressive plan to increase efficiency, reduce expenses and capture more revenue, but sustained income statement and balance sheet improvements will take time.” 

PVHC board chair R.J. Kost said it was a tough decision, but needed to ensure the hospital remains stable and can continue to provide its other services going forward. 

Kost said it was discussed for months and the board “has been very thoughtful” in making the decision. 

“Our administrative team and board toiled over this decision,” McCallister said. “Terminating these services is in no way related to our providers — an oncologist, physician assistant and nurse practitioner — and their support staff. They all have provided stellar care to patients, and we’re truly grateful for their service and commitment.” 

Campeau noted that infusion services, which help far more people than just those needing chemotherapy, will continue at the hospital. 

“We’re trying to look at decisions that are best going to serve financially for stability for our hospital, and at the same time, be the best we can provide for our community,” Kost said. “We’re doing what we can do to provide infusion, which is a good example. Lots of people that need infusion, we can sustain that here.” 

The issues facing PVHC are not uncommon in rural areas. Many smaller hospitals in the state have had to reduce services, from obstetrics to ambulance service, due to similar financial issues. 

“As difficult as this was, we’re optimistic these changes and other operational strategies underway will make a material difference over time and enable us to continue to sustain the many other quality services we provide,” McCallister said.