Renovation and the current construction project were discussed during a meeting of the TCMH board of trustees last week. 

A proposed plan for a Texas County Memorial Hospital renovation project was presented to the TCMH board of trustees at its monthly meeting last week.

The renovation will begin inside the current hospital when certain departments within the hospital are relocated to the new construction. The relocation and the renovation will be done in phases.

“(Chief nursing director) Doretta (Todd-Willis) has assembled a relocation team that includes all affected departments and others that are needed to make the move happen such as maintenance and information technology,” said Wes Murray, chief executive officer at TCMH.

Todd-Willis is also working with outside companies that install and service new equipment going into the construction and equipment that will be moved to the new construction. These companies are also scheduled to provide advance training to TCMH employees before installing new equipment.

“We will have the X-ray and CT units up and running first,” Murray said, describing the phases of moving into the new construction.

“The emergency department will move in the wee hours of the morning when the department is least busy,” Murray explained. “The ER will care for patients in the old and the new department until everything and everyone is moved.”

The plan will begin implementation the first week of March.

After the emergency, radiology and registration departments move to the new construction, renovation in the vacated areas will begin. Departments such as laboratory, cardiopulmonary and dietary will have increased space for patient care and for storage.

The hospital’s administrative offices will be displaced temporarily during the renovation portion, but all other hospital departments will be able to remain in their current location during renovation.

The second floor of the new construction will be completed with an estimated date to move in to the new floor in May.

“We are just a few months away from moving into our new construction,” Murray said. “We want to be as prepared as possible.”

Murray also noted that the additional parking areas and new driving routes are “working well.”

A generator for the new construction has been put into place. Drywall installation is under way throughout the first and second floors. Headwalls for the patient rooms have also been delivered and are being installed.

“The project continues to progress well, and we are on target with our construction plan,” Murray said.

Murray also reported that in 2013 TCMH will be able to offer health insurance to employees at a lower rate in 2013 through Anthem Blue Cross Blue Shield “Blue Preferred Select” plan.

“The plan is a 7.5 percent decrease in premium, which will save TCMH about $84,000 annually,” Murray said, noting that a cost savings would be passed along to employees, too.

The plan will make TCMH an “in-network” provider, encouraging employees to utilize TCMH providers and services. Due to CoxHealth’s affiliation with TCMH, CoxHealth providers will also be “in-network” for referral of services not covered at TCMH.

“We have also included Dr. Benoist and Dr. Brown from the Mercy Clinic in Houston because they utilize our hospital for their inpatients,” Murray said.

Dr. John Duff, senior vice president and chief hospital officer at Cox Health explained that CoxHealth would send representatives to the upcoming TCMH benefit fair for employees.

“We believe this is good for both of our organizations, and we want to help connect your employees with our physicians,” Duff said.

Dr. Charlie Rasmussen, chief of the TCMH medical staff, expressed eagerness to work closely with CoxHealth.

“I think our employees will like this as well,” Rasmussen said.

Rasmussen is familiar with CoxHealth, having completed the family medicine residency program at Cox before coming to work at TCMH.

“Currently, TCMH covers 75 percent of individual employee health insurance, which is slightly higher than the national average,” Murray explained. “We hope that making TCMH the preferred healthcare provider will encourage employees to get their healthcare through TCMH.”

Linda Pamperien, chief financial officer at TCMH, presented the October financial report, which showed a negative bottom line of $333,491, dropping the bottom line for the year to a negative balance of $160,310.

“Overall revenues for the month were up by $550,132,” Pamperien said, explaining that both outpatient and inpatient revenues exceeded budgeted expectations.

Contractual adjustments for October were at 68 percent, approximately 10 percent higher than usual, amounting to $841,000 more than was budgeted for a contractual adjustment October.

A contractual adjustment is the actual amount of payment for services received by TCMH from payer groups like Medicare, Medicaid and other insurers versus the amount TCMH billed to the payer group for services rendered.

“We whittled down our contractual adjustments for the month and found that we had 72 Medicare patients during the month of October, but only nine of those patients fit within Medicare’s ‘global length of stay’ guidelines,” Pamperien said.

Eleven of the Medicare patients had charges totaling $313,000 that TCMH was not reimbursed for because the patients were hospitalized longer than Medicare allowed. In October there were 80.9 patient days that TCMH was not reimbursed for.

“In the past, a high month for us would be 50 patient days, and we average 16 days over the global length of stay monthly,” Pamperien explained. “Even though revenues were up, we were working harder and making less for it.”

Pamperien explained that she’s meeting one-on-one with TCMH physicians to discuss utilization at the hospital, and nursing is also studying utilization review more closely.

“We have looked at patient days through Nov. 26, and we are back at 16 days over the global length of stay,” Todd-Willis said, calling the number “something we can live with.”

“How one month became so skewed is hopefully not an indicator of what we are facing moving forward, but we are trying to stay on top of this,” Murray said.

Omanez Fockler, chairperson of the TCMH board of trustees, explained that she was familiar with contractual swings from her time as an employee and director of nursing at TCMH.

“We have been through this before,” Fockler said, “We will provide education where it’s needed, and everyone will work together to move forward.”

Pamperien also noted that the number of Medicaid and self-pay patients continues to rise at the hospital.

“We are monitoring it, and we may need to make some adjustments to our collection procedures to be sure we are being paid for services rendered,” Pamperien said.

Present at the meeting were Murray; Pamperien; Todd-Willis; Rasmussen; Duff; Joleen Senter Durham, public relations director; and board members Fockler, Dr. Jim Perry, OD, Janet Wiseman, and Mark Hampton. Board member Mark Forbes was absent.

Due to the Christmas holiday, the December TCMH board of trustees meeting will be noon Tuesday, Dec. 18, in the downstairs meeting room of the hospital.

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