Amid a sea change in medical reimbursement, TCMH is closing its Summersville clinic and halting plans to add urge care in its emergency room.

The Texas County Memorial Hospital board of trustees received a detailed list showing utilization of healthcare services at last week’s monthly meeting.  The list specifically highlighted services in the new construction such as the medical surgical census and emergency room visits as well as number of diagnostic services such as ultrasound and mammography.

“We are in the very early stages of using our new construction,” Wes Murray, chief executive officer at TCMH, told board members. “But we hope to see a good positive move.”

Emergency room visits were up for June in comparison to May. TCMH moved in to the new emergency department in mid-May. Diagnostic procedures for June were slightly higher than the previous month, too.

Linda Pamperien, chief financial officer at TCMH, reported that the first monthly depreciation expense of $70,645 for the new construction and equipment was included in the June financials.

Inpatient and outpatient revenues were down for June, and TCMH ended the month with a negative bottom line of $192,052. The year-to-date bottom line is also negative at $572,065.

Murray explained that TCMH addressed the continual monthly losses associated with the TCMH Summersville Community Clinic by announcing its closure, effective Aug. 29.

“Dr. Diana Koenig has agreed to see patients two days a week at the TCMH Medical Complex in Houston,” Murray said, explaining that personnel at the clinic have found other employment inside and outside the hospital system as well.

“We will be out from under the clinic’s significant monthly loss at the end of next month,” Murray said.

Murray also spent one day this month connecting with employees at “Employee Round Table” events — forums open to all employees where hospital finances were discussed.

“We had strong participation and good discussion at each Employee Round Table meeting,” Murray said. “The employees were in agreement to do whatever it takes to move the hospital through this time.”

Murray explained that while ancillary services like the Medivan non-emergency transportation are scrutinized, it continues to operate while outside funding sources are sought.

Additionally, both Missouri state representatives –– Rep. Robert Ross, R-Yukon, and Sen. Mike Cunningham, R-Rogersville –– have been by TCMH talking with Murray about Medicaid expansion. Jason Smith, the newly elected U.S. congressman for Missouri’s 8th district, has also visited TCMH.

“Our state representatives have been talking with all of the area hospitals,” Murray said. 

Murray pointed out that hospitals across the nation are facing financial woes.

“It’s not just the rural hospitals that are affected,” Murray said. He noted that hospitals like TCMH with higher numbers of uninsured and Medicare and Medicaid patients have been “hit harder.”

Dr. John Duff, Cox Health representative, explained that Cox is facing flat revenue forecasts with increased expenses in the upcoming budget year.

“This is the most dismal financial picture we’ve seen,” Duff said.

Bottom line consciousness has led Murray and Dr. Jeff Kerr, TCMH emergency department medical director, to put on hold plans of adding a fast track or urgent care tract to the emergency department during weekend peak times.

“Since moving into the new ER, we’ve had several peak times in the middle of the week,” Murray said, explaining that the fast track/urgent care plan they were working toward was only going to be in place during certain times.

“Dr. Kerr and I agree that while a fast track or urgent care is our goal, it’s too early to take on that expense,” Murray said. “We don’t want to set that new service up to fail.”

For now, the emergency department will continue to track peak times and patient numbers and put a plan in place to better utilize staff on hand and available space in the new department during any peak times when the department is very busy. 

Murray also reported to board members that the TCMH Healthcare Foundation should eclipse its $3.2 million “Care for Your Future” capital campaign goal with the addition of $250,000 in tax credits with dollar for dollar matching from the Missouri Development Finance Board.

The foundation will have two years to raise $250,000 in state tax credits that will be matched by the state, totaling $500,000 when all the tax credit funds are raised.

“We are very happy to be able to take advantage of this state program to vault us over and past our goal for the project,” Murray said.

According to Murray, the tax credits are available now and will be used on a firstcome, first-serve basis.

Currently, the TCMH Healthcare Foundation has raised $2.9 million toward the goal for building a tornado safe room and new surgery department.

Work on the area that will be the tornado safe room has begun with the removal of asbestos from old areas of construction.

“The company removing the asbestos is finding less than we thought was there,” Murray said, “and they are doing a great and professional job for us.”

The final plan and design is in place for the tornado safe room and surgery department, which must be complete by October 2014.

Renovation of vacated areas in the hospital is also ongoing. 

“Demolition inside the areas set for renovation is nearly complete,” Murray said, adding that there have been “no major hiccups.”

“The contractors have found a few support issues to address, and they will begin building back new walls next week,” Murray said.

The renovation portion of the construction project is slated to be complete later this fall. 

 Present at the meeting were Murray; Pamperien; Duff; Doretta Todd-Willis, chief nursing officer; Dr. Schaun Flaim, chief of staff; Dr. Matthew Brown, vice chief of staff; Joleen Senter Durham, director of public relations; Dr. Charles Mueller; Ellen Willis, physical therapy department director; Regina Bodine, student; and board members Omanez Fockler, Janet Wiseman and Dr. Jim Perry, OD. Board members Mark Hampton and Russell Gaither were absent. 

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

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