As Idaho hospitals fill, patients end up in other states, at great expense

In late August, 2-year-old Charlotte McCabe started vomiting in the middle of the night. 

Her parents, Megan and Cliff McCabe, initially thought she had a stomach bug. When she began acting listless, they brought her to an urgent care center, where a provider recommended driving her to the emergency room right away. Charlotte was soon moved from Saint Alphonsus in Nampa to St. Luke’s in Boise, which has a pediatric intensive care unit. 

After running some labs late that night, doctors at St. Luke’s set up a transfer to Primary Children’s Hospital in Salt Lake City. The toddler was COVID-19 positive, and her liver was failing. Within a couple of hours, Megan and Charlotte were on an Air St. Luke’s plane to Utah.

Charlotte was one of an unknown number of Idaho patients transferred to hospitals outside of the state. The Idaho Capital Sun and Idaho Reports reached out to Idaho hospitals and public agencies for information on the number of COVID-19 patients who have been transferred out of state. On Thursday, the Idaho Capital Sun reported that Idaho is one of two states that do not collect large amounts of data from hospitalizations, including information on transfers.

What we do know: As Idaho hospitals continue to be overrun with unvaccinated COVID patients, providers continue to reach out to health care facilities over state lines, and those patients face additional expenses for the out-of-state transfers. Meanwhile, Idaho has received some blowback for the stress its unvaccinated residents are putting on neighboring states.

In September, Dr. Stacey Good of Bonner General Health told Idaho Reports the critical access hospital was having trouble finding beds for everyone who needed care, COVID-positive and otherwise. In normal times, Bonner can transfer patients to Kootenai Health in Coeur d’Alene or Sacred Heart in Spokane — both short drives from the Sandpoint facility. 

Now, as Kootenai Health continues to admit record-breaking numbers of COVID patients, those transfers are getting harder and harder to complete. 

“It is a long process. We’ve called up to six states, and 30 to 40 hospitals to try to find a bed for patients,” Good said.

That means more patients are ending up further from home. Patients from North Idaho have been transferred as far away as Twin Falls and Wyoming.

And those rides are often one way. When Charlotte was discharged from Primary Children’s Hospital after more than a week in the pediatric intensive care unit, doctors gave the McCabes follow-up instructions for when they got home, but it was up to them to get back to Nampa.

That was fine for Megan McCabe — Nampa is just five and a half hours away, and though Charlotte wasn’t happy in her car seat after her difficult stay in the PICU, they made it home without any problems.

For medically fragile patients, driving home in a car isn’t always an option. In September, Rep. Caroline Nilsson Troy told Idaho Reports it cost more than $9,000 to bring her mother home to Lewiston in a private ambulance after she was transferred to Seattle for non-COVID-related reasons. Half of that had to be paid up front, she said. 

Transportation isn’t the only expense. The McCabes also had to pay about $200 a night for a hotel. Megan also bought most of her necessities when she arrived in Salt Lake City. 

“Thank God we weren’t there for much longer,” she said. “Those expenses, they do add up really quickly.”

Though insurance usually covers at least part of medical transport, the McCabes are still waiting to see how much they owe.

“We have yet to receive any sort of bill or statement from Saint Al’s or St. Luke’s,” Megan said. “We just received the statement from Primary Children’s this past week, but it didn’t have flight or ambulance costs on it. We’ve never been through anything like this before, so we have just been waiting for the bills to show up.”

Data void leaves a blind spot in Idaho hospitalizations

It still isn’t clear how many Idaho patients and families are facing these costs.

The Washington State Department of Health provided the Idaho Capital Sun a spreadsheet of monthly admissions for COVID-19, and all other causes of hospitalization, since January. The data came from a Washington system that tracks hospital data from nearly every facility in the state.

Idaho residents made up an average of about 110 hospital admissions per week in Washington, since January. 

Idaho does not collect such data. Idaho is one of just two states in the U.S. without a centralized database of health care use and/or cost information.

Hospital executives in Washington said last month that Idaho’s unvaccinated COVID-19 patients are a burden they cannot keep carrying. The Associated Press reported that hospitals on the North Idaho border had dozens of Idaho patients taking up a large share of their beds — causing a ripple effect on hospitalizations in the rest of the state, as Washingtonians sought hospital care of their own.

Washington Gov. Jay Inslee last week called out Idaho during a visit to a Spokane hospital.

“It is frustrating that politicians in Idaho are not helping,” Inslee said, according to The Spokesman-Review.

Inslee also said on MSNBC, “When the Idaho politicians refuse to act with common sense measures, it not only endangers Idaho citizens it endangers Washington citizens.”

Idaho Gov. Brad Little fired back.

“Governor Inslee blames Idaho, yet Spokane County and the surrounding area on his side of the border continue to be hot spots for virus activity with the lowest vaccination rates in Washington, despite Governor Inslee issuing vaccine and mask mandates,” Little said on Twitter.

Idaho Reports has reached out to departments of health in Utah, Montana, and Oregon for information on Idaho residents in those states’ hospitals, as well as information from individual hospitals throughout Idaho.

Kootenai Health and St. Luke’s were unable to provide the data. Charla Haley, public information officer for the Utah Department of Health, told Idaho Reports that the state doesn’t track the number of Idaho patients in Utah hospitals, as many Idaho hospitals are in the catchment area for Utah’s facilities. 

“Utah hospitals do field requests from Idaho hospitals, have before this response, and will do so after,” Haley said. 

It also isn’t clear how many residents of other states are being transferred to Idaho for medical care. Mike Weimer, regional vice president for Life Flight in southern Idaho and Oregon, said Life Flight also doesn’t automatically track data on out-of-state transfers. 

Weimer told Idaho Reports that he has seen a recent increase in transfers from Oregon, Washington and from north to southern Idaho. In one day this week, Life Flight transported three patients from the Spokane and Coeur d’Alene area to Boise.

“That’s just not a normal referral for those hospitals up there,” Weimer said. 

This story originated at the Idaho Capital Sun, a nonprofit news organization delivering accountability reporting on state government, politics and policy in Idaho. Audrey Dutton, senior investigative reporter, joined the Idaho Capital Sun after 10 years at the Idaho Statesman. Melissa Davlin is the host of Idaho Reports, the West's longest running legislative TV program.