ELKO – University of Nevada, Reno School of Medicine is planning to end its family medicine rural residency program in Elko on July 1 after Northeastern Nevada Regional Hospital decided not to renew its contract to pay salaries for UNR resident physicians.
Talks are under way to look at options, Elko County Commissioner Delmo Andreozzi and UNR’s assistant dean in Elko Gerald Ackerman told commissioners this week, but Medicare patient advocate Larry Hyslop said “it doesn’t matter what happened in the past or will happen in the future, what matters is what happens July 1.”
Northeastern Nevada Regional Hospital issued a statement Feb. 2 that said the decision not to renew the contract “was a difficult decision but a necessary one given the rising costs and increased requirements of the residency program itself.”
Hyslop brought up his concerns during public comment, stating that he is “hoping the county will talk with the hospital and ask them to come here to ask them what they will do. They are the ones who created the problem.” He said the hospital was “striving for profit.”
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Hyslop said commissioners also should talk to Nevada Health Centers. The statewide nonprofit organization provides medical care on a sliding fee scale and takes Medicare and Medicaid patients. Its facilities in Elko were recently expanded.
Andreozzi said the hospital currently pays roughly $700,000 in salaries for doctors in the residency program as part of a partnership between the hospital, UNR and Nevada Health Centers, and he said the program “is not working for all the partners,” so the ultimate decision was to end the partnership.
He said the hospital’s decision not to renew the contract is an “unfortunate turn of events and no doubt will have an impact,” and he was hopeful there would be better news in the future.
Andeozzi, who is the county’s representative to the hospital board, said he has had conversations with the hospital, UNR officials and Nevada Health Centers, which provides services not only in Elko but also to Carlin, Jackpot and West Wendover.
Commissioner Jon Karr said he has talked with the hospital and UNR President Brian Sandoval, and he thought it was unfair to say the hospital is “being a penny pincher or tight with the purse strings.” He said there is more going on behind the scenes and the hospital’s action was “a piece of the puzzle.”
Ackerman told commissioners that UNR’s rural efforts are not going away, and “we will roll up our sleeves” to find solutions, but “it breaks our hearts” that the hospital won’t be paying resident salaries beginning July 1.
He said UNR’s relationship with NNRH is still good, and the hospital is still training medical school residents.
Ackerman, who is on the board of Nevada Health Centers, said later that residents work at the Nevada Health Centers “but also with community physicians and the hospital for training. We appreciate the hospital and physicians for training our residents.”
The hospital reported in its statement that NNRH has helped sponsor the residency programs of the UNR School of Medicine, and “as part of this sponsorship, medical residents have served rotations at our hospital, as well as practicing at Nevada Health Centers and other local clinics.”
The hospital also said “we remain committed to maintaining a positive relationship with our colleagues at UNR, and we have been in frequent contact with the Dean of the School of Medicine. Both parties are optimistic about continued collaboration in the future.”
The statement concludes that “all of us at NNRH remain dedicated to our mission of making communities healthier. It is our honor to provide high-quality healthcare to our neighbors throughout northeastern Nevada.”
Andreozzi also said he has a “crazy idea” that doctors in residency could take over the medical needs at the Elko County Jail and be paid to do so, in order to keep them in Elko. “Their team is looking into it.”
A letter to the Board of Regents from Sandoval and Paul Hauptman, dean of the UNR School of Medicine, states that UNR started a rural residency track in Elko in 2017 as part of the family medicine residency program, but the hospital’s decision not to renew its contract means UNR School of Medicine will withdraw from the National Resident Matching Program, “admitting no future residents for that track.”
Patient care provided through the residency program will continue at the clinics and hospital through the end of June, the letter states.
“UNR Med cares deeply for the patients of Elko and for health care in rural settings. We will actively plan for a new, more sustainable, rural residency track in northern Nevada,” Sandoval and Hauptman state in the letter informing regents of the Elko hospital’s decision.
Hyslop said the rural residency program provides the equivalent of four full-time providers.
“We can’t afford to lose more providers,” he told commissioners. “Here in Elko, we don’t have enough family and primary care physicians.”
Andreozzi said the hospital was spending money on recruitment, and the program transferred some of the dollars to the residency program in hopes that there would be residents interested in practicing in Elko, and “by and large it has been a successful program.”
Commissioners also received a letter from David White, president and founder of Aspen Quick Care in Elko and Spring Creek, who said he had heard about the loss of the residency program and “wanted to reach out personally and tell you we are working towards a solution. We are one of the few providers in the area who accepts Medicare and Medicaid, and the only independent practice who access the insurance carried by most veterans.”
He said Aspen Quick Care has increased staffing, and he wanted commissioners to know about the Aspen Quick Care option when looking for solutions to the community’s healthcare needs.
