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Hospital Board discusses patient decline

Friday, October 5, 2012

The need for more patients was the prime topic of discussion as the Fulton County Hospital Board of Governors met on Monday, Sept. 24.

In presenting the August financial report, Ozarks Medical Center Chief Financial Officer Kim Thompson said a drop in Emergency Room visitors and inpatient admissions hurt income, and was the reason for a disappointing report.

"We dropped to 37 (inpatient) admissions for the month (August), compared to our budget of 55, and the prior year, 49," Thompson said. "Swing bed admissions were five for the month (compared to 15 patients in August of 2011)."

Thompson explained that 432 Emergency Room visits for the month were fewer than the 533 patients projected under the hospital's budget, and a big drop from the 544 patients seen in August of 2011. "Your E-R is the front door of your hospital, basically, and as those visits drop, your inpatient admissions usually drop right along with them."

According to Thompson, the decrease in admissions caused a nose dive in net patient revenue, creating an operating loss of $114,541, compared to a projected loss of $37,187.

"The whole story of the month of August is, we've got to get patients in the door," Thompson said. She called on the board and staff to "talk up the hospital. We provide good care. Get out there and talk about it. Let people know."

Thompson said, in the months she served as interim FCH administrator, there were good financial months, but it was frustrating to have good months only to see patient levels drop off.

"I don't know why that is. The people I have spoken with in Cherokee Village, that have come over here, they have been very complimentary of the care."

There were positive signs in the financial report. Managers are closely watching expenses, and expenses for August were lower than budgeted. One way to reduce expenses has been to reduce the number of employees on duty, when admissions fall below expected numbers. Salary and wages were $288,600 in August, compared to $374,000 in August of last year. "That's a huge improvement," Thompson told the board. "That's an almost $100,000 improvement over the prior year. The staff is to be commended for good management."

Another encouraging sign is a big increase in the number of colonoscopy and upper g-i procedures performed in August by Dr. Chris Cochran, an OMC physician who sees patients at FCH once a week.

The 24 patients he saw was twice the number budgeted (12), and three times the number of procedures done in August 2011 (8).

"So he (Cochran) is ramping up, which is a good thing. We need to get more people coming in for individual services," Thompson said. "I know OMC is working on that, to get more specialists down from Ozarks Medical Center, because we see fruit from what Dr. Cochran is doing."

Thompson mentioned that Dr. Joseph Forney, a heart care specialist, may be the next physician to schedule regular visits here.

The board discussed ways to reverse the decline in the number of patients who receive light rehab services in the swing bed unit, which was one of the hospital's bright spots, but is struggling with competition.

"It seems like every body that is providing health care (in the area) has a swing bed unit, the nursing home in Ash Flat, and I think I heard ads on the radio about the one here in Salem," board member Bill Pace said.

Administrator Tony Thompson said the swing bed staff realizes it has to compete for patients and is actively marketing the hospital's service, even making personal calls to potental patients.

Thompson agreed with Dr. Griffin Arnold that the hospital needed to meet with area nursing homes to discuss how the hospital can help them, by providing lab, x-ray and other services the nursing homes do not offer.

Arnold, the hospital Chief of Staff, reported that work is continuing to try to establish a wound clinic, that would regularly meet to help people with wound healing problems, and teach them what they can do at home to speed the healing process. Arnold indicated FCH may partner with OMC, working with Dr. Jon Mattson, OMC's Wound Care Services Director.

"I actually saw, tonight, some of the patients he (Dr. Mattson) is taking care of, and he is doing excellent in wound care. We want him on our team," Arnold said.

Dr. Arnold mentioned that his wife, Renee Arnold, a nurse practitioner, plans to open a clinic in Baker's Pharmacy in Salem, in December, in a partnership with Baxter Regional Medical Center. Arnold told the board that, if any of her patients are in need of hospitalization, she will admit them to the FCH, and not automatically send them out of t own.

In old business, Tony Thompson said all three companies interested in helping the hospital install an electronic medial record system have made presentations to hospital staff members. Of the three, a company named Healthland has been chosen as the preferred company, if a suitable contract can be negotiated.

Healthland will install and maintain the system, accepting reimbursement funds provided by Medicaid and Medicare, as the three phases of the system are installed and up and working. The three payments may amount to $1.4 million.

The federal funds may total more than the actual cost of the system, but Thompson said the hospital will not have to borrow money and pay interest to get the system, required beginning in 2013, up and running. The only complication may be the company's maintenence fee, which it wants to double over what the hospital is currently paying.

At the conclusion of the meeting, State Representative Lori Benedict distributed information regarding grants that may be available for the hospital through USDA and other sources.

Tony Thompson recognized Kim Thompson and her husband, Steve, for making a donation that allowed the hospital to purchase a custom made cabinet to serve as the drink dispenser in the cafeteria.

The next regularly scheduled meeting of the hospital board will be on Monday, Oct. 22 at 6:00 p.m. in the hospital conference room. The public is invited to attend.

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