General

Hospital Honors Nurses and CNAs for Service to Patients

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In a special recognition event for all the nurses and certified nurse assistants (CNAs) that work at Texas County Memorial Hospital, a nurse and a CNA were chosen for special honors this week.

Melanie Evans (center) was named Texas County Memorial Hospital’s Nurse of Year.  She is shown here with Wes Murray, TCMH CEO, and Doretta Todd Willis, TCMH CNO.

Melanie Evans (center) was named Texas County Memorial Hospital’s Nurse of Year. She is shown here with Wes Murray, TCMH CEO, and Doretta Todd Willis, TCMH CNO.

Texas County Memorial Hospital has named Melanie Evans of Houston as the 2015 TCMH Nurses of the Year and Modena Jones of Mountain Grove as the 2015 TCMH CNA of the Year.

Evans, a registered nurse at TCMH Hospice of Care, has been employed by the hospital for eight years.

“Melanie is a very well-rounded nurse, and she works in almost every department at TCMH,” Courtney Owens, TCMH Hospice of Care director, said.

Owens explained that Evans works about four days a week for Hospice of Care and is scheduled weekly to work as a nurse in another TCMH department.

Evans is also one of few nurses at TCMH that has peripherally inserted catheter (PIC) line certification. Certain patients receive a PIC line because they require long-time intravenous (IV) usage or they cannot receive a regular IV.

“Melanie is always willing to work, and she doesn’t complain about any work she’s asked to do,” Owens said.

Owens noted that a lot of nurses “look up to” Evens due to her education and broad nurse training.

“Other nurses seek Melanie out to bounce ideas off her when they have questions,” Owens said.

Jones is a certified nurse assistant in the TCMH medical surgical department, and she has worked at TCMH for 10 years.

Modena Jones (center) was names Texas County Memorial Hospital Nurse Assistant of the Year.  She is shown here with Wes Murray, TCMH CEO, and Doretta Todd Willis, TCMH CNO.

Modena Jones (center) was names Texas County Memorial Hospital Nurse Assistant of the Year. She is shown here with Wes Murray, TCMH CEO, and Doretta Todd Willis, TCMH CNO.

“Modena’s work ethic is the best you can have,” John Sawyer, TCMH medical surgical department nurse manager, said.

Sawyer described Jones as a well-rounded CNA that provides “great customer service and gets done every job that needs to be done”.

“Modena is a great patient advocate, and she is not afraid to speak up to others about what she believes her patients need,” Sawyer said. “She helps everyone.”

The nurse and CNA of the year received $250 cash, a plaque, an engraved crystal trophy and fresh flowers.

Eighteen nurses and 5 CNAs from nursing departments throughout TCMH were nominees for the annual nursing awards. TCMH nurses and CNAs were nominated by hospital managers, physicians and fellow staff members for the annual TCMH Nurse of the Year and TCMH CNA of the Year awards. The TCMH nurse managers chose Evans and Jones as the 2015 nursing honorees.

TCMH also recognized each nominee with a framed certificate.

Also during the week, a mandatory nursing skills lab was provided for the nursing staff. Eleven stations provided education—some of which was hands on—on topics such as foley catheter care, patient safety, customer service, wound care and pharmacology.

Scrubs and Beyond of St. Louis came to TCMH to allow nurses and other employees the opportunity to shop for uniforms during the day.

On Friday breakfast or lunch was served to all members of the TCMH nursing staff.

TCMH currently employs 110 nurses and 28 CNAs. The nurses and their assistants work in many departments of the hospital—medical surgical, obstetrics, emergency room, surgery, intensive care, home health, hospice and clinics.


Merritt Named as March Employee of the Month

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Texas County Memorial Hospital has named Lisa Merritt of Houston the April employee of the month.

Merritt is a licensed practical nurse at the TCMH Family Clinic in Licking, and she has worked at TCMH for 14 years. Merritt was nominated for the award by Anita Kuhn, controller at TCMH.

“Lisa provides excellent customer service to our patients,” Kuhn said, adding, “And she works with the other members of the clinic team to accomplish a lot at TCMH every day.”

Kuhn noted that Merritt is known for “going above and beyond” to help Dr. Joshua Wolfe with anything needed. “Lisa has an amazing relationship with the doctor she works for,” Kuhn said.

“Lisa is known to help out whenever she’s needed, and she will volunteer to help in places when she hears of a need,” Kuhn said.

As employee of the month, Merritt received a certificate honoring her achievement; a pin; $100 cash; a special parking place in the TCMH lot; one day of paid vacation; a $50 gift card, and gift certificates to Paws N Claws, D&L Florist, Janstiques and Blissful Nirvana Massage. A reception will be held at the hospital in honor of Merritt.

Merritt is eligible for the 2015 TCMH employee of the year award.

Lisa Merritt (left), Texas County Memorial Hospital April employee of the month, with her supervisor, Anita Kuhn.

Lisa Merritt (left), Texas County Memorial Hospital April employee of the month, with her supervisor, Anita Kuhn.


Special Surgical Instrument Purchased for Hospital with Grant Funding

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Texas County Memorial Hospital is the beneficiary of a new hysteroscope thanks to a grant from the Bess Spiva Timmons Foundation and funding support from the TCMH Healthcare Foundation.

An Olympus brand hysteroscope was purchased with a $4,500.00 grant from the Timmons Foundation, and the hospital’s own Healthcare Foundation kicked in the remaining $2,500 in funds needed to make the complete purchase of the surgical instrument.

Christopher Baldwin, MD, a board certified obstetrician and gynecologist, needed a hysteroscope to perform additional surgical services at TCMH.

Dr. Christopher Baldwin, obstetrician/gynecologist at TCMH, performing surgery using the hysteroscope at TCMH.

Dr. Christopher Baldwin, obstetrician/gynecologist at TCMH, performing surgery using the hysteroscope at TCMH.

Hysteroscopy uses a hysteroscope—a thin, lighted tube—to examine the cervix and inside of the uterus. Hysteroscopy can be diagnostic or operative.

Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.

Hysteroscopy may be used to correct polyps and fibroids, adhesions, septums and abnormal bleeding. Patients undergoing hysteroscopic procedures may experience a shorter hospital stay and shorter recovery time, require less pain medication and avoid hysterectomy or open abdominal surgery in the future.

The new hysteroscope at TCMH is small—5.5 millimeter diameter. The lens on the instrument is scratch resistant which provides exceptionally clear images. The instrument is also fully autoclavable after each use.

Wes Murray, chief executive officer at TCMH, is pleased to have the hysteroscope available at TCMH.

“Dr. Baldwin is the first OB/Gyn we’ve employed at TCMH, and he brought with him skills that we could use to offer new women’s health services in our area,” Murray said.

Murray explained that TCMH always seeks to provide physicians with the tools they need to augment their practice, and he expressed appreciation to the Timmons Foundation and to the Healthcare Foundation.

“The Healthcare Foundation’s partnership with the Timmons Foundation to provide grant funding to purchase this surgical instrument helps us improve the healthcare services available to women in the area,” Murray said.

The Timmons Foundation is a private family foundation of the descendants of Bess Spiva Timmons. The late Dr. Joe L. Spears, a long-time family practice physician from the Cabool area, is a past president of the Timmons Foundation Board.

Tim Spears, son of Dr. Joe L. Spears, assisted in obtaining the funding for TCMH through his family’s foundation. “We are impressed by the vision of TCMH to reach out beyond its facility to address the long-term health issues of Texas County and the region,” Spears said.

“The Timmons Foundation is proud to assist TCMH in obtaining the hysteroscope,” Spears said.

The TCMH Healthcare Foundation is the non-profit organizational arm of the hospital with a mission to ensure the quality of healthcare services for children, women and men at TCMH.

“The Healthcare Foundation was pleased to partner with the Timmons Foundation to bring this important surgical tool into our surgery department,” Jay Gentry, TCMH Healthcare Foundation director, said.

For additional information about donor programs at TCMH, contact Gentry at (417) 967-1377.


Annual Audit Shows Financial Improvements at Hospital Even with Losses

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Texas County Memorial Hospital ended 2014 with a net position of -$698,123 in excess revenues over expenses hospital board members and administration heard at their monthly meeting on Tuesday.

Stephanie Weis, partner at BKD, LLP of Springfield, MO and David Taylor, senior manager at BKD, presented the annual audit report at the monthly meeting.

“The audit shows that there are positive underlying operations at TCMH,” Taylor said, “In fact, 2014 was a better year operationally than 2013.”

Taylor pointed out that in 2014 TCMH had depreciation and interest payments of $2,882,675 related to the new hospital construction, up over half a million from the previous year. In 2014, TCMH also received only $435,000 in government electronic medical records incentive funds, down from over $1 million in incentive funds in 2013.

“The bottom line for 2014 is lower, but the long term depreciation and interest numbers present a truer picture of hospital operations,” Taylor said.

Net patient revenue was up 3.63 percent for 2014 over the previous year and operating expenses were up only 2.56 percent for 2014 over 2013.

“Last year you found ways to get extra revenue out of your expenses,” Taylor said.

Grants and donations to the TCMH Healthcare Foundation totaling $1,180,978 were utilized for capital projects at TCMH in 2014.

Taylor pointed out that over the past two years, TCMH has utilized over $2 million in capital grants and donations. In 2014, the net property and equipment assets at TCMH rose by 3.15 percent or $826,361.

“Generally, hospitals are not investing funds in capital projects right now,” Taylor said, “But TCMH is on the offense, investing in the future of your hospital.”

Taylor noted that TCMH is not different than many other big and small hospitals across the nation with a negative operating margin in 2014. However, the hospital has $9.3 million in total current assets which includes cash, accounts receivable and third-party settlements.

According to Taylor, TCMH continues to operate with “clean revenue cycles”. At the end of 2014, 92 percent of accounts receivable from 2013 had been collected, and currently the hospital’s accounts receivable is at 52 days, which is less than the average of hospitals in rural Missouri.

“You have a strong financial position with 94 days of cash on hand,” Taylor said. Cash on hand indicates how many days the hospital could operate without bringing in any funds.

Taylor noted that the average rural Missouri hospital has 41 days of cash on hand.

Construction projects at TCMH have the average age of the hospital facility down to about 10 years which is at or below Missouri hospital averages.

The debt to capitalization ratio at TCMH is a 46.9 percent, which Taylor called “not too high”. TCMH is in line with other hospitals in the state.

Taylor cautioned TCMH about cost shifting that hospitals are dealing with related to healthcare reform.

“Regardless of the patients you serve, the costs remain the same,” Taylor said. “However, the only patient population currently showing a positive margin for hospitals is those with private insurance.”

In 2014 at TCMH, 46 percent of patients were Medicare patients, 21 percent were Medicaid patients, 24 percent were commercial insurance patients, and nine percent were self-pay patients.

Taylor noted that many employers are changing their private employee insurance plans by scaling back the coverage offered. Expansion of Medicaid in Missouri has not occurred, creating additional holes for healthcare coverage of patients.

“We can no longer believe in the traditional foundation of hospital economics,” Taylor said. He explained that employer-sponsored healthcare coverage, steady public-payer pricing growth, and predictable volume channels have all changed and continue to change creating numerous uncertainties for hospitals.

“At TCMH you continue to find ways to increase revenues without increasing expenses, and the right buttons are being pushed to help improve your facility,” Taylor said.

Taylor commended TCMH for efforts made in difficult times. “You have to continue to look at services to see what you can offer,” he said.

BKD sends an audit team to TCMH each March, spending about a week pouring over hospital financial information from the previous year. The firm takes about a month to complete the audit information including expense statements, balance sheets, statement of cash flows and other information that comprises the financial report documents presented at the April board meeting.

BKD uses historical TCMH data and data from other healthcare facilities for comparison purposes during the audit. BKD also has access to the latest information regarding hospital payers which helps the firm reach concrete numbers in the final audit report.

“The annual audit is a huge amount of work for a very small staff,” Weis said. “Everyone did a great job and quickly responded when we had a need.”

In the hospital administrative report, Wes Murray, chief executive officer, explained that physician staffing for the TCMH emergency department is progressing well.

“Dr. Randal Qualls has taken the emergency department medical staff director position,” Murray said, adding, “He’s doing a great job.”

Qualls is employed by the hospital, and he continues to work for TCMH as an employed physician in the emergency department.

Murray reported that at the end of 2014 309 past and present hospital employees were participating in the hospital’s 403b retirement plan.

“The overall plan is at $8.5 million, up from about $3 million over 13 years ago,” Murray said.

Murray explained that all employees receive information about the plan during orientation at TCMH.

“We are really trying to stress the importance of retirement savings to our younger employees,” Murray said.

Linda Pamperien, chief financial officer at TCMH, presented the financial report for the month of March. “Revenues and expenses were down, and inpatient and some outpatient volumes were up,” Pamperien said.

Admissions are up by 32 patients for the first quarter of the year, with TCMH showing 426 inpatient admissions through the end of March.

TCMH ended the month of March with positive bottom line of $11,396.02, decreasing the negative year-to-date bottom line to $584,645.62.

Present at the meeting were Weis; Taylor; Murray; Pamperien; Doretta Todd-Willis, chief nursing officer; Joleen Senter Durham, director of public relations; Anita Kuhn, controller; Dr. Jonathan Beers, TCMH chief of staff; Dr. John Duff; and board members Jim Perry; Mark Hampton; Omanez Fockler and Janet Wiseman.

The next meeting of the TCMH board of trustees is Tue., May 26 at 12 p.m. in the hospital board room.


Excellent Rating for Mammography at Texas County Memorial Hospital

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The Texas County Memorial Hospital mammography department has again received a “zero deficiency” rating from the Mammogram Quality Standard Act (MQSA) for digital mammography done by the department.

Lori Dailing (left) and Terri Bailey, two of the radiologic technologists at TCMH, that use the digital mammography for mammograms.

Lori Dailing (left) and Terri Bailey, two of the radiologic technologists at TCMH, that use the digital mammography for mammograms.

For the sixteenth consecutive year the department has received a flawless rating in the state and federal survey. Ann Hamilton, TCMH radiology department director, noted that it is “virtually unheard of” to be deficiency free for so many years.

Over half the survey time was spent inspecting paperwork collected in the mammography department. Hamilton complimented Terri Bailey, technologist in the mammography department, for her role in compiling paperwork.

“Terri’s precise record keeping is one of the main reasons we continue to receive excellent ratings,” Hamilton said.

The mammography technologists, interpreting radiologist and physicist are required to have mammography specific continuing education annually. Quality assurance testing is performed on the equipment daily, weekly and monthly, and the medical physicist performs an annual review of the mammography unit.

The TCMH radiology department offers the complete range of radiologic services—CT, digital mammography, MRI, nuclear medicine, ultrasound, bone density scan and x-ray. The radiology department upgraded almost all of the departmental equipment in 2013 when the new department opened as part of the hospital expansion.

The radiology department at TCMH is open 24-hours a day.


Whitney Young Receives National Medical Examiner Certification

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Whitney Young, PA

Whitney Young, PA

Whitney Young, physician assistant at the Texas County Memorial Hospital Family Clinic in Licking, has received certification as a medical examiner for the Federal Motor Carrier Safety Administration (FMCSA).

To achieve certification with the FMCSA, Young completed required training and testing. She is listed in the National Registry of Certified Medical Examiners. Young is certified and qualified to provide physical examinations for class E commercial drivers.

Beginning in 2014, commercial drivers were required to be examined by a medical professional listed in the National Registry of Certified Medical Examiners to obtain a medical certificate. An up to date medical certificate is part of the commercial driving license and required by the Department of Transportation.

Young sees patients Monday through Friday at the TCMH Family Clinic in Licking. For additional information or to make an appointment, contact the clinic at (573) 674-3011.


Ribbon Cutting Planned for TCMH Community Safe Room

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safe roomTexas County Memorial Hospital is hosting a ribbon cutting at the new TCMH Community Safe Room on Tue., May 5 at 1 p.m.

The safe room has 4,000 square feet of climate-controlled space that can be utilized as a meeting space during non-threatening weather times. During threatening weather, the room was designed to withstand 250 mile per hour winds for three seconds and to provide shelter for up to 462 patients, staff members and community residents. The safe room at the hospital also enhances the hospital’s capabilities for triage during times of mass casualty with a backup power supply.

Federal and state grant programs provided most of the funding for the TCMH Community Safe Room. The Federal Emergency Management Agency awarded $873,689 in grant funds, and $298,400 was awarded to the project through a Community Development Block Grant. The Missouri Development Finance Board allocated $250,000 in state credits to assist with raising the additional funds needed to for construction of the tornado safe room. The Healthcare Foundation has these tax credits available for donations received on the project through December 2015.

In between the tornado safe room walls and the current hospital building construction for a new surgery department is underway. The 7,000 square foot surgery department will include two operating rooms, an outpatient procedure room, and larger pre and post-operative patient care space.

Before the ribbon cutting on Tuesday, the Houston Chamber of Commerce will hold their monthly luncheon at noon in the safe room. The luncheon will feature “Give Ozarks Day” with presentations by the TCMH Healthcare Foundation and the Houston Education Foundation.

The luncheon will dismiss shortly before 1 p.m. to allow time for chamber members to participate in the ribbon cutting ceremony.

The TCMH Community Safe Room is located on the South side of the hospital (closest to Walmart). Ample visitor parking is available on the South side of the building, near the safe room.

For more information about the event, contact Joleen Senter Durham, director of public relations at TCMH, (417) 967-1258 or 1-866-967-3311.


Matching Funds Help TCMH Healthcare Foundation Create Endowed Scholarship

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Houston, MO—The Texas County Memorial Hospital Healthcare Foundation is planning to create an endowed scholarship fund for the TCMH Youth Ambassadors. The Foundation has launched a campaign to raise $10,000 through a matching challenge grant from Community Foundation of the Ozarks (CFO) to benefit affiliate endowments.

The Healthcare Foundation was one of 24 CFO affiliates selected to participate in the program that will match every dollar given up to $5,000. Progressive Ozark Bank in Houston and Mountain Grove and the Intercounty Charitable and Educational Foundation have already donated funds to the Healthcare Foundation that will be matched by CFO.

Progressive Ozark Banks in Houston and Mountain Grove partnered together to make a $1250 donation to the TCMH Healthcare Foundation Youth Ambassador Scholarship Fund.  Shown here during the donation presentation are (left to right) April Steele, TCMH Youth Ambassador program coordinator; Youth Ambassadors Claireesa Ridenhour of Licking, Melody Tate of Houston, Jessica Wensel of Plato; Earleen Holder, Progressive Ozark Bank Houston market manager; Danetta Rodgers, Progressive Ozark Bank Mountain Grove lending officer, and Jay Gentry, Healthcare Foundation director.

Progressive Ozark Banks in Houston and Mountain Grove partnered together to make a $1250 donation to the TCMH Healthcare Foundation Youth Ambassador Scholarship Fund. Shown here during the donation presentation are (left to right) April Steele, TCMH Youth Ambassador program coordinator; Youth Ambassadors Claireesa Ridenhour of Licking, Melody Tate of Houston, Jessica Wensel of Plato; Earleen Holder, Progressive Ozark Bank Houston market manager; Danetta Rodgers, Progressive Ozark Bank Mountain Grove lending officer, and Jay Gentry, Healthcare Foundation director.

“To make an annual $500 scholarship to a Youth Ambassador, we need to establish an endowment of $13,000, so we hope to raise enough funds to receive the $5,000 match and more,” Jay Gentry, TCMH Healthcare Foundation director, said.

Gentry is currently working to secure the $5,000 match by the end of April, but the Healthcare Foundation also plans to participate in “Give Ozarks”, the 24-hour day of giving organized by CFO for Tuesday, May 5 to add to the endowment funds.

“In addition to our two major donors to the project, other donor partners are also stepping up to meet the challenge and partner in the endowed scholarship project,” Gentry said, adding, “This is a great opportunity to make a long-lasting impact in the lives of area students.”

The Healthcare Foundation and the Houston Education Foundation are two area entities that are participating in Give Ozarks with organized activities in Texas County including hosting the Houston Chamber of Commerce luncheon and a Give Ozarks event at Lone Star Plaza.

Give Ozarks is a one-day surge across the state of Missouri that is part of the national “Give Local America Day”. With the assistance of CFO, donors will be able to make online donations at www.giveozarks.org to the Healthcare Foundation and to the Houston Education Foundation.

The Intercounty Charitable and Educational Foundation made a $1000 donation to the TCMH Healthcare Foundation Youth Ambassador Scholarship Fund.  Shown here during the during the donation presentation are (left to right) April Steele, TCMH Youth Ambassador program coordinator; Allison Griffin, Youth Ambassador from Mountain Grove; Paul Smeltzer, chairman of the Intercounty Foundation, and Jay Gentry, Healthcare Foundation director.

The Intercounty Charitable and Educational Foundation made a $1000 donation to the TCMH Healthcare Foundation Youth Ambassador Scholarship Fund. Shown here during the during the donation presentation are (left to right) April Steele, TCMH Youth Ambassador program coordinator; Allison Griffin, Youth Ambassador from Mountain Grove; Paul Smeltzer, chairman of the Intercounty Foundation, and Jay Gentry, Healthcare Foundation director.

CFO will match donations made that day up to $5,000, and they have additional matching funds and prizes available to organizations that rally donors to participate in the 24-hour day of giving.

“We are excited about creating an endowed scholarship for the TCMH Youth Ambassadors,” Gentry said. “The Youth Ambassadors have volunteered over 1,950 hours at TCMH since September of this year, and they are an important resource at TCMH.”

The Youth Ambassador program at TCMH allows selected area high school juniors and seniors and college students to volunteer in hospital departments for medical experience. Volunteer duties include passing out fresh linens and filling ice water cups for patients on the medical surgical floors, rocking newborns and greeting visitors in the obstetrics department, and reading to and talking with patients in the hospital’s swing bed program.

With the endowed scholarship, eligible Youth Ambassadors would have an opportunity annually to receive a scholarship toward higher education.

Funds donated to the TCMH Healthcare Foundation are tax-deductible. For funds to be matched by CFO for the Healthcare Foundation’s endowed scholarship program, donations must be made online on May 5th or in the Healthcare Foundation’s hands by April 24, 2015.

For additional information, contact Gentry at (417) 967-1377 or jay.gentry@tcmh.org


Cope Named as March Employee of the Month

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Houston, MO–Texas County Memorial Hospital has named Yvonne Cope of Houston the March employee of the month.

Cope is a registered nurse in the obstetrics department, and she has worked at TCMH for almost 19 years. Cope was nominated for the award by Angela Watkins, obstetrics department nurse manager.

“Yvonne is such an asset to our department with her many years of experience,” Watkins, said. “She has served as a mentor to many new nurses.”

Describing Cope as “irreplaceable”, Watkins noted that Cope’s soft spoken demeanor and gentleness “automatically make her patients feel at ease”.

“Yvonne helps with any task, and she always helps with a smile,” Watkins said.

As employee of the month, Cope received a certificate honoring her achievement; a pin; $100 cash; a special parking place in the TCMH lot; one day of paid vacation; a $50 gift card, and gift certificates to Paws N Claws, D&L Florist, Janstiques and Blissful Nirvana Massage. A reception will be held at the hospital in honor of Cope.

Cope was also TCMH employee of the month in December 2008. She is eligible for the 2015 TCMH employee of the year award.

Yvonne Cope (left), Texas County Memorial Hospital March employee of the month, with Angela Watkins, obstetrics department director.

Yvonne Cope (left), Texas County Memorial Hospital March employee of the month, with Angela Watkins, obstetrics department director.


TCMH Receives State Designation as Stroke Center

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Houston, MO—Texas County Memorial Hospital has received designation from the Missouri Department of Health and Senior Services (DHSS) as a Level III Stroke Center, hospital board members heard at their monthly meeting on Tuesday.

“A lot of work has been done by our staff to achieve this designation. We are proud to have received it and to offer this level of care for our community,” Wes Murray, chief executive officer at TCMH, said.

According to Murray, hospital staff began working on the designation application over a year ago. Last spring Dr. Jeff Kerr, emergency department medical director, and other key members of the TCMH “stroke team” provided on site information and a presentation to a panel from DHSS to apply for the stroke designation.

TCMH received word from DHSS shortly after their presentation that the protocols and processes were in place for TCMH to receive stroke designation.

The certificate for Level III Stroke Designation received by TCMH this week.

The certificate for Level III Stroke Designation received by TCMH this week.

DHSS officially recognized and designated certain hospitals in the state on Monday. TCMH was among the first hospitals in the state to receive the stroke designation.

“With the stroke designation, our hospital emergency department is recognized statewide as a place for stroke victims to receive emergency care,” Murray said, adding, “There should be a level of comfort that area patients take in knowing that TCMH is a state-designated stroke center.”

With the stroke designation, emergency medical services personnel in the field are required to advise patients and their family members where the nearest “stroke designated” hospital is to the proximity of the patient and to take the patient there if the patient does not object.

“With the TCMH stroke team, patients with stroke symptoms will receive faster, more streamlined care from the moment we begin caring for them,” Murray said.

Currently TCMH is working on designation as a Level IV STEMI (ST segment elevated myocardial infarction) facility. The STEMI designation will allow emergency medical services personnel to bring any patient with symptoms of a heart attack to TCMH where the hospital team will proceed with protocols to begin medical treatment to prevent cardiac muscle damage.

After the initial medical treatment, the patient would be transferred to a healthcare facility where interventional cardiology was available.

At the meeting, Kerr addressed board members, explaining that the need to make some personal lifestyle changes has him leaving the medical director position at TCMH to take an administrative position in the emergency department at Phelps County Regional Medical Center in Rolla.

Kerr will be assisting the hospital in Rolla with administrative issues, and he hopes to continue to provide some emergency department physician coverage at TCMH as well as continuing to help TCMH with the special emergency department designation applications.

“I have been working here for over 20 years, and I am very passionate about TCMH,” Kerr told those present. “This is an awesome place, and I want to thank you for all that you’ve done for me.”

“On behalf of the board and everyone at TCMH, thank you for your commitment to TCMH and to our community,” Omanez Fockler, chairperson of the TCMH board of trustees, said.

Kerr and Murray presented information regarding emergency department staffing sources that will be used beginning in May in addition to the continued services of hospital employed emergency department physicians–Dr. Randal Qualls, Dr. Lynn Hauenstein, and Dr. Louise Wilkinson.

Murray noted that TCMH has entered a contract with Emergency Medical Care, LLC (EMC) of St. Louis to provide emergency department physician staffing. Kerr participated in the interviewing process and recommended EMC among those interviewed.

“This company already provides image reading services through radiologist staffing for our radiology department,” Murray said, “And they work with other hospitals in the area providing emergency room physicians.”

Joleen Senter Durham, director of physician recruiting, explained that with the healthcare trend for hospitals to utilize physician staffing firms in the ER it has become “nearly impossible” to find physicians that want to work in the TCMH emergency department.

Murray and Kerr believe that EMC will be able to retain the physicians needed to provide stability and continuity of care in the TCMH ER in addition to utilizing the physicians that are already employed by TCMH.

“EMC has a local pool of physicians that understand our local needs,” Kerr said.

TCMH continues to recruit physicians and mid-level providers to employed hospital positions. Durham gave a physician recruiting update to those present explaining that TCMH has hosted three recruiting visits since the February hospital board meeting.

“All of the site visits have been very positive,” Durham said. She noted that two visits were with mid-level providers.

Sara Openshaw, a family nurse practitioner student from Mountain Grove, was one of the candidates interviewed, and she has signed a contract with TCMH to practice at the TCMH Mountain Grove Clinic.

“Sara’s training program ends in August, so she won’t begin working for us until the fall,” Durham said, adding, “We are thrilled to have a Mountain Grove resident providing patient care in the clinic.”

Durham explained that Openshaw will also do a clinical rotation with William Wright, MD, a TCMH family medicine physician, at the TCMH clinics in Mountain Grove and Houston in May and June.

“Sara will have the opportunity to meet future clinic patients while working with Dr. Wright, and she will get hands on experience with our electronic medical records program and the hospital and clinic services before she even starts working for us,” Durham said.

Durham also reported that a family medicine physician that interviewed at TCMH in March is considering a contract with the hospital.

The TCMH board of trustees will have a new chairperson beginning in April. Dr. Jim Perry, OD, of Cabool was elected unanimously to the position by his fellow officers. Janet Wiseman of Houston remains in the vice chairperson/secretary position for another year, also by unanimous decision of the board.

Linda Pamperien, TCMH chief financial officer, presented the February financials which showed an overall drop in revenues.

Although inpatient volumes were up slightly for the month, Pamperien explained that weather played a role in a drop in the numbers for the emergency department, the ambulance service, the clinics and outpatient services.

“Unfortunately, we had a lot of patients in February, but we were only paid for a small percentage of the patients we cared for,” Pamperien said.

TCMH ended the month of February with negative bottom line of $582,731.39 and a year to date loss of $585,260.60.

“We are not going to turn away any patients that need to be seen,” Pamperien said, “And in February we had many seriously ill patients that either didn’t have a way to pay for the care they received or the care they received wasn’t reimbursable.”

Murray presented updated information regarding Medicaid reform efforts in the state of Missouri.

“Data is out showing that the states surrounding Missouri that have expanded their Medicaid coverage are seeing the numbers of uninsured patients and uncompensated care drop dramatically,” Murray said.

Iowa, Illinois, Kentucky and Arkansas have expanded Medicaid coverage to their state residents. The governor of Tennessee has also moved to expand Medicaid coverage in Tennessee.

“TCMH is the poster child for why Medicaid expansion exists,” Murray said.

Murray and other healthcare leaders in the region plan to participate in a public round table discussion regarding Medicaid in West Plains on March 31.

Present at the meeting were Murray; Kerr; Pamperien; Durham; Doretta Todd-Willis, chief nursing officer; Dr. Jonathan Beers, chief of staff; Dr. John Duff; and board members, Fockler; Perry; Wiseman, and Mark Hampton.

Board member, Russell Gaither, was not present.

The next meeting of the TCMH board of trustees is Thur., April 28 at 12 p.m. in the TCMH board room.


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