Dr. Flaim


Texas County Memorial Hospital board members approved an upgrade to the hospital’s cardiac monitors at its meeting last week as the hospital took another step in planning for the arrival of three new physicians.

TCMH currently utilizes cardiac monitoring — medically referred to as cardiac telemetry — on some patients in the intensive care and medical surgical units at the hospital. The upgrade cost is $24,242.

Cardiac telemetry is continuous monitoring of a patient’s heart rate and rhythm at a nurse’s station. This medical service is offered to patients recovering from heart events — patients who may be at risk of heart events and patients experiencing ongoing heart problems.

The board of trustees unanimously approved the capital expense to have the 12 telemetry monitors at TCMH refurbished and new software updates completed to maximize the cardiac monitoring capabilities in the ICU and medical surgical departments.

“We are back on track where we need to be with the physicians we have coming in, and we want to be prepared for their arrival at the hospital,” said Wes Murray, chief executive officer at TCMH.

Arriving in the following months at the TCMH Medical Complex in Houston are:

–Shaun Flaim, D.O., an internal medicine physician, on April 19.

–John Paulson, D.O., a family practice physician, in July.

–Gretchen Price, D.O., an internal medicine physician, in September.

TCMH expects the acuity of hospital inpatients to increase with the addition of Flaim, Paulson and Price. Cardiac telemetry and ICU have been upgraded for the new physicians’ arrival.

In early March, the ICU was closed for a week to complete an in-house refurbishing project that included new cabinetry, floor covering and a nurse’s station that is computer compatible.

“The refurbishing of the ICU is complete, and everything in all four rooms is in working order,” Murray said. He explained that the new ICU nurse’s station allows a much better work flow for the physicians and staff and is much more efficient.

“Dr. Flaim and Dr. Price dropped in to take a look at the improvements in ICU,” said Murray. He that they are pleased with the efforts the hospital has made in anticipation of their arrival.

TCMH anticipates an increase in hospital inpatients and in hospital outpatient services with the addition of the three new physicians.

“We expect that our outpatient services will greatly increase by bringing internal medicine physicians back to the hospital,” Murray said.

Board members also discussed the hospital expansion plans that were placed on hold in 2008, noting that the physical needs of the hospital and the healthcare needs of the community have not gone away.

“There is still the possibility that funding for the hospital’s expansion project may still be available through the U. S. Department of Agriculture (USDA),” Murray said.

The funding, released in 2009 as part of the Economic Recovery Act, is available until Sept. 30.

“The USDA has over half a billion dollars in funds left to award, and they believe an interest rate of 4.5 percent might be possible for us,” Murray said.

A financial feasibility study of TCMH is required by the USDA to determine if the hospital would qualify for any funding, and the study takes about 60 days to complete.

“Our last two year’s financials are not the best but if we have the opportunity to optimize our potential, I believe we should look at it,” Murray said.

Murray explained that even if the hospital qualifies for the USDA funding, TCMH is not obligated to accept any funds.

“I think it’s wise to take a look at this opportunity,” said Omanez Fockler, chairperson of the TCMH board of trustees. “If it’s something that will work for us, we can jump on it.”

Jane Kirkwood, board member, echoed Fockler.

“We don’t want to look back and say, ‘That’s where we missed it,’ ” she said.

Murray reiterated that TCMH “would not be obligated in any way to the USDA” following the financial feasibility study.

“This would just allow us to get our name out there to potentially have an opportunity at some funding for a much needed project,” he said.

In other hospital news, the Mountain Grove clinic and ambulance base construction continues. Windows have been placed in the building and concrete for the ambulance garage driveway has been poured. Inside the clinic, cabinetry and tile have been put in place.

“The clinic is coming along nicely,” Murray said.

Murray explained that the “impressive building” in Mountain Grove has garnered a lot of attention, and many community members are interested in taking a look inside the new building. Murray said an open house is planned in early May.

The TCMH ambulance base in Mountain Grove continues to be the busiest of the hospital’s four bases.

“Our purpose for being in Mountain Grove is successful,” Murray said. “There have been no issues from having an ambulance in Mountain Grove. We have received only positive comments from the community.”

Dr. Michael Moore, a family practice physician, and Sheri Stofer, a physician assistant, will begin seeing patients in the Mountain Grove clinic when it opens. Dr. Charlie Rasmussen and Dr. William Wright, family practice and obstetric physicians at the TCMH Medical Complex in Houston, will hold weekly clinics for obstetrics patients in Mountain Grove.

Murray reported that cuts to rural ambulance service were restored in March with the passage of the healthcare reform bill and were retroactive to January 1, 2010, when the additional payment for ambulance runs for Medicare patients in rural areas expired. The payment, which equals $135.00 per ambulance run, had already cost the hospital more than $20,000 in two months with a potential annualized cost of more than $200,000.

“The healthcare reform bill that was signed into law earlier is still quite an unknown for us,” Murray stated.

TCMH will work closely with other hospitals and the Missouri Hospital Association to begin to understand how the healthcare reform bill will affect TCMH.

“This bill is much more complicated and convoluted than it seems on paper,” Murray said. “There is a mountain of things in the healthcare reform bill to wade through.”

Although inpatient volumes were up at the hospital in February, outpatient revenues were down again in February by $442,081, reported Linda Pamperien, chief financial officer at TCMH.

For February TCMH had a negative bottom line of more than $126,000 and a negative year-to-date balance of $122,377.

Pamperien attributed some of the decrease in revenue to lagging emergency room volume and a 28-day month.

“We also had several physicians that were out during the month of February,” she said.

Expenses for the month were down over $227,000, which Murray credited to the hospital’s managers.

“They are doing everything they can to control costs in areas they manage,” he said.

Murray emphasized that the addition of physicians will improve the hospital’s numbers in 2010.

“They can’t get here fast enough,” he said.

Present at the meeting were: Murray; Pamperien; DorettaTodd-Willis, chief nursing officer; Joleen Senter Durham, director of public relations; Dr. Charles Mueller; Dr. Charlie Rasmussen; and board members Fockler, Kirkwood, Janet Wiseman, Mark Hampton and Mark Forbes.

The next meeting of the TCMH board of trustees is noon Tuesday, April 27, in the downstairs meeting room of the hospital.



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