Last week during Inland Journal, we talked with Todd Nida, the chief executive of East Adams Rural Healthcare, the hospital in Ritzville, about its tenuous financial position. You can hear that here.
This week, we meet with two people from the group Prosperity Eastern Washington who are paying close attention to what’s going on at that hospital and others in eastern Washington.
Dr. Pam Kohlmeier is a physician and attorney. Mike Bell is a retired CPA who worked with small rural hospitals for more than three decades.
This interview is lightly edited for length and clarity.
Pam Kohlmeier: We've raised $91,000. We put up 13 billboards throughout eastern Washington, all the way down to Clarkston, up to Colville, not endorsing one candidate. Not saying how you should vote. Stay up to date and use your critical thinking to respond.
DN: One of the billboards was in Ritzville. Mike Bell believes that hospital and a handful of others in eastern Washington may be in financial trouble.
Mike Bell: I went to the state website and got their year-end reports and and then did some analysis on what effect the Big Beautiful Bill is going to have on these hospitals. I identified several that were having financial difficulties. Two of them had not filed their mandatory year-end reports in three years and that tells me there's a big problem. If you've gone three years without filing mandatory reports, there's an issue.
The first one was Ritzville. I read minutes and I said these these guys are in deep trouble. Then a couple months later, the new administrator came out and I said I was wrong. They're not in deep trouble. They're in really deep trouble.
The other one was a couple hours north of here and they had not filed in three years and I went up to have a community meeting. I said I can't tell you what effect the Big Beautiful Bill is going to have on your hospital because you haven't filed these mandatory reports in three years. So I would ask the board members, where are those mandatory reports? And what are you hiding? Because you don't just stop filing these reports unless there's something going on.
Six weeks later, they filed the reports and six weeks later, we got an answer. They were burning through about $2 million in cash each year for the previous three years. They've got a new administrator now. So that hospital was pretty much the same thing as Ritzville except they're still around. I mean they identified the problem before it got critical.
After I reviewed the rural hospitals, I took a look at the urban hospitals in the Fifth Congressional District and I was shocked to find out that the four big hospitals in Spokane lost $2 million each year between ’22, ’23 and ’24. I don't know about ’25 because those reports haven't been filed with the state yet. But how do you sustain that kind of loss, knowing that the Big Beautiful Bill is going to cost these hospitals another hundred million dollars a year.
PK: My mom actually died when we lived in a small town, not in Washington, but in Manson, Iowa. One night she collapsed. The volunteer ambulance crew from the closest hospital was 19 miles away because our town didn't have a hospital and she died. So, I do understand the impact of not having a hospital when you need one.
DN: Tell me about your organization.
PK: Prosperity Eastern Washington was actually started by two 80-year-old-plus women, Shirley Grossman and Roz Luther. They're dynamos and they were just scared for what's happening to rural health. They pulled together people that they knew and they have hundreds, if not thousands and thousands of friends. Pulled in Mike as a retired CPA, me as an ER doctor. We have educators and, you name it, there's a group of about 12 of us that meets at least every week.
Our goal was to get accurate information to these small towns because what we found is most of the people in the towns don't realize whether or not their hospital is healthy, like financially viable. A lot of them weren’t, so this was a way to get people to raise their own awareness, so they could use their own critical thinking, and then make decisions about reaching out to hospital administrators, reaching out to elected officials, like what the hell's going on.
DN: The billboard in Ritzville. What has happened because of it?
PK: That billboard went up in the fall, September, October. It says how far to care when your hospital closes.
The phone was ringing off the hook with the CEO's office at Ritzville saying please. Then they reached out to us and said please take the billboard down because people are calling, asking what's going on with the hospital. People had no idea that the hospital was at risk and so we decided as a group, okay, we'll soften it with one word. How far to care IF the hospital closes?
Shortly after that, the article came out in the Spokesman-Review about Ritzville's hospital being really in a bad spot, about how they gave pink slips basically to almost their entire staff because it looked like they were going to have to close the hospital the beginning of this year. They ended up getting some emergency funds from the state. They're in the process of trying to become a rural emergency hospital.
That billboard raised awareness and then people started showing up in the community, trying to get more information and try to act.
MB: These hospitals are critical to these small communities, not only for health care, but from an economic standpoint. You lay off somebody at the hospital, you’re gonna lay off somebody else in town.
Ritzville was talking at one time about laying off a hundred people. Imagine if a hundred people at the hospital are laid off and another hundred in town, from restaurants from banks from all businesses. So it would be devastating for that community. The same is true with all the other hospitals. So it's a critical part. It’s usually the biggest employer in a rural community.
DN: Do you think people are asking the right questions now that you have raised a lot of awareness?
MB: I was interviewed when the Big Beautiful Bill came out by a Spokesman reporter. After we talked, I said you need to go talk to the chief financial officers in these rural communities and let them tell you what effect it's going to have. The answer we got was, we did and every one of the CFOs, without exception, said, we're not sure. We don't know. It's too early to tell. We haven't really talked to the community about it.
I told the reporter, I worked with a lot of those guys. They're not stupid. They had an estimate the day that bill was signed. They do not want to tell the community. They don't want to tell the board in some cases.
The Big Beautiful Bill, nationwide, basically allowed the federal government to save $917 billion and force local communities to pick up the tab. So there's no overall cost savings. It's a shift from the federal government to the local communities. And when you're in a small rural hospital and your community is going to have to provide $500,000 to $1 million more free health care, where's that money coming from? You're either going to have to raise taxes or cut back on services. A lot of them can't cut back any further than they already have. Or become a rural emergency hospital, which is basically nothing but a rural emergency room.
DN: That is the route East Adams in Ritzville has taken. Speaking of East Adams, we asked Chief Executive Todd Nida about Prosperity Eastern Washington. He praised the messaging, saying the community has become more engaged. He says that has allowed his team to share the hospital’s story and to build more community support.
