Sugar Bowl clinic spotlights Summit Fire Department issues
August 25, 2005
This season injured skiers and snowboarders at Sugar Bowl Ski Resort will have a choice for their final run down the mountain ” a 15-mile, $1,000 ambulance trip to Tahoe Forest Hospital or a visit to an Urgent Care center right at the resort.
But if the bruised and broken choose the latter, it could spell financial disaster to the Donner Summit Fire Department.
On busy ski days, the new medical clinic is expected to reduce the number of guests having to travel to Truckee’s Tahoe Forest Hospital by ambulance to only the most seriously injured.
“Often in a family or group, one member is injured. The options are everyone packs up and goes home, or down to Tahoe Forest Hospital,” said Rob Kautz, general manager of Sugar Bowl. “Or now with the clinic you can see a physician and be x-rayed on site.”
The Urgent Care center is expected to improve what is generally a very negative experience for the individual, family and friends, Kautz said.
While less than one percent of Sugar Bowl visitors are expected to be seen in the clinic, for those that are a doctor exam is only a step across a room.
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“Ski Patrol will continue to provide initial first aid. We envision doing business as in the past with the first aid room doing an initial exam, followed with a recommendation,” Kautz said.
The Urgent Care Clinic will provide the option of the guest seeing a physician immediately, as well as being open to summit residents, or anyone skiing or staying in the area on a walk-in basis.
Sugar Bowl’s new clinic, however, comes at a challenging time for the Donner Summit Fire Department, which receives 55 percent of its revenue from ambulance services, said Doug Rinella, Donner Summit fire chief.
The department provides fire and ambulance service to the Donner Summit ski resorts as well as area residents. It also responds to medical calls for areas as far west as Blue Canyon.
If estimates based on other ski resorts with similar clinics are correct, demands for ambulances at Sugar Bowl could drop by as much as 50 percent.
“From my point of view the fire department is fiscally challenged, and any reduction [in ambulance revenue] could be significant,” Rinella said. “We are speculating we will lose 30 runs, or $30,000 minimum [per season] if Sugar Bowl runs are reduced by just 25 percent.
“This is not going to help,” Rinella added.
To address the department’s financial situation, annexation talks between Donner Summit Public Utility District, which manages the Summit department, and the Truckee Fire Protection District were started late in 2003. According to Tom Skjelstad, the Donner Summit PUD general manager, Sugar Bowl’s Urgent Care clinic is not driving the annexation discussions.
“In the last two years the fire department has run with deficit budgets even with the current ambulance calls to Sugar Bowl,” he said. “If we lose even 5 to 10 percent of ambulance revenue it puts us in an even more precarious position. It points out one of the reasons we approached the Truckee Fire District to see if annexation was a viable solution.”
Skejelstad said a number of items are motivating the annexation proposal in addition to the general economies of scale, including fiscal viability, chief officer coverage, and retention of fire staff.
“An independent consultant, funded by both districts, showed that it was fiscally viable to annex the department to the Truckee Fire District,” Skejelstad said. “If annexation were to occur, this community would continue to enjoy the level of service they have today.”
For the size of the Donner Summit community the level of service provided by the fire department is very good, he said.
“North Star doesn’t have this level of service, nor Squaw Valley, or Alpine,” Skejelstad said.
Sugar Bowl’s Kautz agreed, saying that response time and service from Donner Summit Fire “has been very, very good.”
“When considering the clinic, in all likelihood there will be a reduction [in ambulance runs and revenue]. We are just not sure how much,” Kautz said. “We took it very seriously, but felt the benefits outweighed the revenue issues given the best interests of Sugar Bowl, its customers, and the community.”
The new Urgent Care medical clinic at Sugar Bowl’s expanded Mt. Judah Lodge will be the product of a partnership between the resort and Tahoe Forest Hospital. That partnership is expected to save customers ambulance fees and emergency room charges.
In building the new clinic, the old first aid room was almost doubled in size to 2,000 square feet and a number of additional
improvements made, said Chris Parker, Sugar Bowl director of resort planning and development. “We have made improvements for better gurney maneuvering; built a covered and heated ambulance pad, and deiced covered ramps.”
Managed, and staffed, by Tahoe Forest Hospital, the clinic will be similar to an urgent care doctor’s office with basic x-ray, and lab facilities. The facility will have a nurse on site seven days a week providing first aid, said Dr. Michael MacQuarrie, medical director of emergency services at Tahoe Forest Hospital. On weekends and holidays it will have additional staff including a doctor who will be able to assess patients, order x-rays, and apply splints or casts, as needed.
“We will staff the clinic with sports doctors, emergency room physicians, as well as urgent care physicians that are familiar with ski injuries through being members of the Doctor’s Volunteer Ski Patrol at Sugar Bowl,” MacQuarrie said.
Sugar Bowl general manager said he expects the clinic could see as many as 2,500 visitors during the coming season.
“The vast majority will be treated and released for injuries such as sprained fingers,” Kautz said. “We fully realize we won’t process serious injuries. This will be urgent care. More serious injuries will still go by ambulance to Tahoe Forest Hospital or for life threatening injuries by helicopter to Tahoe Forest or Washoe Medical.”
Tahoe Forest Hospital really suggested the Urgent Care Clinic approach when the U.S. Forest Service required changes to Sugar Bowl’s expansion plans. While Tahoe Forest Hospital has had a relationship in the past with Sugar Bowl, this represents a “different commitment with more structure to it” said Sandra Carter, director of community development at Tahoe Forest Hospital.
The clinic at Sugar Bowl complements the hospital’s new Center for Health and Sports Performance planned to open in October.
“The goal of the new center will be to provide on-site, on-hill experiences for skiers, young and old; providing access to professionals in physical therapy, training, and injury prevention.” Carter said.
Sugar Bowl looked at a number of medical providers for running the clinic but selected Tahoe Forest Hospital, which in past years provided a nurse at the resort on busy days without charge.
“While we had other medical groups look at running the clinic, we have had a long, satisfactory relationship with Tahoe Forest, and know they are here for the long term.” Kautz said.