It was announced to staff of Sierra Nevada Home Health Care (SNHHC) on September 30 that the facility would be ceasing its home care operations, affecting 24 employees and scores of people who have received or are receiving the specialized care.
The closure will officially take place December 31, 2025 and is due to financial losses, according to SNHHC nurses Amy Clute, RN and Christi Huff, RN.
The announcement was delivered in person during a staff meeting—of which attended by both Clute and Huff—at SNHHC held by Julie Ostrom, Executive Nurse Leader for the hospital. Ostrom was not available Thursday for comment, nor was anyone in the Dignity Health Sierra Nevada administration offices.
“Medicare requires a 30-day written notice when an agency is closing,” said Clute. “However, it’s best practice to do 90 days. Unfortunately, the hospital is electing the 30 days, which is resulting in us clinicians having to break the news to the patient population, which has been really difficult for us.”
SNHHC was founded in 1986 with humble beginnings in the parking lot of Sierra Nevada Memorial Hospital. It has grown significantly and provided in-home care to the region for post-operative, newly diagnosed, and those facing chronic illness.
Clute is a Registered Nurse with Sierra Nevada Home Health Care and has been for 23 years. She said some of her colleagues are experiencing double worry—not only are they potentially out of a job, but as nurses are compelled to ensure the welfare of their patients.
“We are the eyes and the ears of the doctors,” said Clute, who added that it was determined a home health care nurse logs about 10,000 miles of driving per year. At one point the system included areas like the San Juan Ridge, Alta, Foresthill, Collins Lake, and places closer to adjacent towns.
The nurses are represented by California Nurses Association, their union.
“The management of the hospital is telling people that we will have jobs here in the hospital,” said Clute, a proud Nevada County native who would like to stay in her hometown and keep doing the job she said she loves so much. She said that during the initial announcement of the closure, the people in the room were assured they would retain a spot in the Dignity Health Sierra Nevada system.
As of Thursday there are about seven nursing positions open in the hospital, Clute said, and even with her experience she is not qualified for all of them. For example, she is not a candidate for a 12-hour shift in Labor & Delivery. Two of the seven available are per diem. She is worried that there aren’t enough available positions to accommodate the staff that will be laid off from SNHHC.
Both Clute and Huff said they have yet to hear from someone who has successfully landed a new position within the hospital. They also both claimed that though they have applied, neither has been contacted for an interview.
Patients of SNHHC will eventually be notified by mail of the closure, though Clute and Huff both said they have been having conversations with existing patients, sometimes lasting 30-45 minutes, to deliver the news in person.
“We were told that patients would be sent a letter 30 days prior to closure, which is technically around about December 1,” said Huff. “That doesn’t line up because we’re not accepting any new patients after November 1, or re-certifying people. Home care does 60-day episodes. At every 60 days, we do a recertification if that patient needs continued care.”
Huff spoke with a patient who said she had no clue about the closure.
In these conversations, Clute and Huff said they have tried their best to direct their cases to alternative solutions, though they said not all of them are, in their opinion, optimal. The two suggested that “the employer” will only be offering alternative plans that are managed by for-profit organizations.
Huff said for one patient of her many she printed out the information regarding Medicare and presented a list of agencies.
The two nurses said they have had clients asking how they are doing themselves, which they think is a semi-reversal of the caregiving role. The extension of kindness, they each said, has been endearing.
Additionally, some patients are concerned about insurance matters. According to the two nurses, Dignity Health at this point has chosen not to partner with any nonprofits that could potentially extend in-home care.
For its part, Dignity Health Sierra Nevada sent out an announcement on September 30 announcing the impending closure with Dr. Scott Neeley, President and CEO of the hospital, writing: “Over the past two years, a multi-functional team engaged in a thorough program improvement process, meticulous operational model reviews, and extensive strategic planning to explore every possible avenue for a sustainable path forward for our Home Health services.”
He added in the statement that the decision to cease operations within Sierra Nevada Home Health Care was not an easy one for him and the Sierra Nevada Memorial Hospital Board of Directors, and followed a “multi-year strategic review.”
Michelle Tagg is a social worker at Sierra Nevada Home Health Care and said she has helped her patients and families overcome barriers to independence, such as transportation. Her role, she said, is flexible, though she does deal heavily with the mental mindset of any given patient. This could mean anything from helping the patient access food to getting to medical appointments.
Tagg said the news of SNHHC closing was abrupt in her opinion.
“It was a shock,” Tagg said. “I was angry and emotional. The people that we serve are our neighbors and they are our co-workers’ family members. So Nevada County is very unique in that sense.”
Huff said that it’s very simple—a potential majority of her colleagues are about to be unemployed, though she and Clute are more concerned about the patients they have cared for and with whom they’ve developed friendships. Those patients want “high quality, fair health care in their homes” and that is their biggest concern.