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Dr. Cory Offutt Returns to the Ozarks to Practice Medicine

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Cory Offutt, MD

Cory Offutt, MD

Cory Offutt always imagined that he would go into the medical field.

Raised in Lebanon, MO, Offutt’s strong suits in school were math and science.

“I had some personal healthcare issues that gave me the opportunity to experience the medical field,” Offutt said about his interest in a career in medicine.  Offutt’s older brother also pursued a career in healthcare, providing additional insight to the field.

Offutt graduated with honors from Missouri State University.  His undergraduate degree was in cell and molecular biology with minors in chemistry and healthcare management.

While a student at MSU, Offutt met the requirements to be in the Bryant Scholars Pre-Admissions program.  As a Bryant scholar, Offutt met certain academic achievement requirements, and he was a Missouri resident and an undergraduate at a Missouri university that participated in the Bryant Scholars program.

Offutt knew early on that he was pre-admitted to the University of Missouri School of Medicine in Columbia.  Before heading to MU, Offutt married his college sweetheart, Samantha.

The Offutts settled for four years in Columbia, and Cory Offutt did rotations through rural hospitals and clinics in the Ozarks as part of his training.

“My first family medicine rotation in medical school was not a good one,” Offutt said, “But I was really interested in pediatrics and obstetrics.”

Offutt liked the idea of providing care to a woman before pregnancy, during pregnancy, after pregnancy, and also caring for the newborn and other family members.

“There’s great continuity of care in taking care of pregnant women,” Offutt said.

Offutt originally thought he would pursue an obstetrics/gynecology residency after medical school, but he didn’t find an OB/GYN residency with “a good fit”.   The family medicine residency at the University of Missouri in Kansas City was a good fit, and Offutt had the opportunity to do a lot of obstetrical care, including surgical obstetrics to do Cesarean sections.

The UMKC program offers a fellowship in surgical obstetrics with an additional year of residency. Offutt pushed himself to gain extra, additional experience during his three-year residency stint, so a fellowship in OB wasn’t necessary at the end of three years.

“I didn’t want to wait another year to do the surgical OB fellowship,” Offutt said.  After all, undergraduate school, medical school and a traditional family medicine residency requires 10 years of training.

In his three years of residency, Offutt delivered 330 babies, and 150 of those deliveries were done by C-section.

“There was a lot of OB opportunity available to me,” Offutt said, “And I took advantage of it.”  Offutt delivered about 20 percent of the babies his class of 14 residents delivered total in their three years at UMKC.

Offutt’s training includes an additional American Academy of Family Physicians’ certification in women’s health.

When it came time to find a place to live and work after residency, Offutt knew it would be difficult to practice OB and do C-sections in a large hospital or town.  “Samantha and I were definitely open to a smaller town,” Offutt said.

Samantha Offutt grew up in Northwest Arkansas, so she enjoyed “small town feel” as well.

The Offutts first visited TCMH in January 2015 during Cory Offutt’s second year of residency.

“I definitely wanted to figure out where I was headed after residency as early as possible,” Offutt said.  He explained that he wanted to take advantage of any stipends that might be available for residents signing early and student loan repayment opportunities for healthcare providers.

“Houston was the first opportunity we looked at, and it had a feel that was different from the other places we looked at,” Offutt said.

Offutt described TCMH staff as “extremely welcoming”, and Cory and Samantha appreciated that during their TCMH interview both of them were included in all talks about the job position and the way of life in Texas County.

“I looked at other jobs, and I found that working here is the closest I can come to actually having a private practice without the headaches of managing my own private practice,” Offutt said.  He also liked “the security” available to a hospital-employed physician.

The Offutts thought Texas County was a nice location between Cory’s family in the Lebanon-area and Samantha’s family in Northwest Arkansas.

In February 2015, Cory Offutt signed an agreement to practice family medicine and obstetrics with Texas County Memorial Hospital.

The extra time between signing a contract with TCMH and finishing residency gave the Offutts plenty of time to hunt for and purchase a house in Texas County.

While Cory finished up his residency program, Samantha obtained an associate’s degree in graphic design to go along with her bachelor’s degree in marketing.  They also did minor repairs and fixed up their home in Lee’s Summit to sell it prior to moving to Texas County.

The TCMH Medical Complex in Houston is the primary base for Cory Offutt’s practice.  He is working there four days a week.  He also sees patients—primarily kids and obstetrics patients—at the TCMH Mountain Grove Clinic on Mondays.  While he’s building his practice in Houston, Offutt is taking some patients that come into the TCMH Walk In Clinic, too.

Offutt will deliver babies at TCMH, and he will admit and see inpatients at the hospital, too.

As a family medicine physician, Offutt will see patients of all ages from newborn to elderly.  He hopes to eventually have a large practice of families with lots of babies and kids.

“I like being able to watch families and kids grow, providing for all of the family’s healthcare needs,” Offutt said.

Offutt plans to squeeze kids into his practice schedule whenever they are sick, and established adult patients that are sick will have priority in his daily schedule, too.  Offutt’s office practice will include dermatological procedures, joint injections, and other minor procedures.

“I enjoy doing anything with my hands, so I really like doing procedures,” Offutt said.

Offutt plans to add stress testing to his medical repertoire once he is settled in to his new practice.  He also does some physician moonlighting in the hospital emergency department.

When Offutt is not working he enjoys spending time with Samantha.  Currently, the Offutts are busy unpacking and settling into their new home and the acreage they purchased in Texas County.  Their only child is Parker, a Yorkshire terrier, but they hope to add some human kids to their family soon.

“Samantha and I enjoy concerts and plays,” Offutt said.  “We like going to St. Louis Cardinals games when we can.”

Offutt thanked the hospital staff for being “extremely helpful” in helping him get started at TCMH, and he noted that community members he has encountered are very welcoming, too.

“We couldn’t have asked to be part of a better community,” Offutt said.  “We love living and working here.”

Wes Murray, chief executive officer at TCMH, is grateful that the Offutts chose TCMH.

“Our hospital and the community are fortunate to have Dr. Offutt and Samantha here,” Murray said.

Murray explained that Cory Offutt’s training will be an asset to the hospital.

“Dr. Offutt already knows a lot about the Ozarks because he grew up here,” Murray said.  “We are dedicated to helping him grow a practice here that can last for years to come.”

Appointments are available for Offutt at the TCMH Medical Complex in Houston at (417) 967-5435 or at the TCMH Mountain Grove Clinic at (417) 926-1770.


Stephanie Kinker is Employee of the Month

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Stephanie Kinker (right), Texas County Memorial Hospital June employee of the month, with her supervisor, Amy Wilson.

Stephanie Kinker (right), Texas County Memorial Hospital June employee of the month, with her supervisor, Amy Wilson.

Texas County Memorial Hospital has named Stephanie Kinker of Houston the June employee of the month.

Kinker is a housekeeping aide, and she has worked at the hospital since February 2015.  Kinker was nominated for the award by her supervisor, Amy Wilson.

“Stephanie is always willing to pitch in and do whatever needs to be done,” Wilson said, describing Kinker as “a team player”.

Kinker is known for offering to work on her days off.  During times when the housekeeping department is short staffed, Kinker will stay late or come back in to work when needed.

“Stephanie always asks, ‘Do you need me to do anything else?’ before she leaves each day,” Wilson said.

As employee of the month, Kinker received a certificate honoring her achievement; a pin; 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; Blissful Nirvana Massage, Wher Motors, and TQ’s BBQ.  A reception will be held at the hospital in honor of Kinker.

Kinker is eligible for the 2016 TCMH employee of the year award.


New Device for Infant Resuscitation Available at Hospital

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The Neopuff infant resuscitation device.

The Neopuff infant resuscitation device.

The latest technology in infant resuscitation is now available at Texas County Memorial Hospital thanks to a $2500 grant from the Kerr Foundation to purchase a F & P Neopuff Infant T-Piece Resuscitator.

Commonly referred to as a Neopuff, the T-piece device has a self-inflating bag that uses compressed air to ventilate newborns via a face mask or endotracheal tube.  The Neopuff is used by doctors, nurses and respiratory therapists at TCMH to help newborns that are in respiratory distress by providing exact air requirements needed for inhaling and exhaling.

Angela Watkins, obstetrics department director at TCMH, describes the Neopuff as “the best” way to resuscitate newborn babies that are not breathing when they are born or newborns that are having issues with breathing.

“We get great outcomes and great results with the Neopuff,” Watkins said.

In the past, infants with breathing issues at birth would receive air from a manually squeezed bag.  The manual resuscitation method was less consistent and subject to human error.

Neopuff provides continuous positive airway pressure for as long as needed.  The Neopuff at TCMH is on a cart, so it’s available to the emergency department to assist with an infant brought in by ambulance, to the surgery department during Caesarean section deliveries, and to be used throughout the obstetrics department.

“The mobility of the Neopuff is a big advantage for us,” Watkins said.

Watkins explained that with the addition of the new machine, hospital staff received training on the Neopuff functions.  “Now that our staff knows how important and how useful the Neopuff is, they want it at the bedside at every delivery,” Watkins said.

The Neopuff prevents over-inflation of the infant lungs.  In addition to helping newborns breath that may have stopped breathing or that have not taken their own breath at birth, the Neopuff can help clear up infant lungs that have mucous or fluid in them from the delivery.

“The TCMH OB department takes a lot of pride in the one-on-one and personalized care we provide with every delivering experience, and we are very proud to have state of the art equipment to go alongside our care,” Watkins said.

TCMH delivers approximately 300 babies annually.  Delivering healthcare providers at the hospital include Patricia Benoist, MD; Matthew Brown, MD; Cory Offutt, MD, and Joshua Wolfe, MD, all family medicine physicians; Christopher Baldwin, MD, obstetrician/gynecologist, and Tracey Arwood, certified nurse midwife.

The Kerr Foundation, Inc. located in Oklahoma City is a nonprofit charitable and educational corporation.  Kerr Foundation grants are only available for project in Oklahoma and the states that surround it.  The Foundation seeks to identify and support programs, organizations and institutions that provide new or enhanced opportunities for young people in their granting area.


Expansion of Sleep Study Laboratory in the Works at TCMH

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Texas County Memorial Hospital is planning an expansion of the Sleep Study Lab later this summer board members heard at their monthly meeting on Tuesday.

Juan F. Mella, MD, a board certified pulmonologist, joined TCMH part-time as a clinic-based pulmonologist in mid-June.  The two-room Sleep Studies Lab located in the TCMH Office Annex operates two rooms three days a week.  Currently the Sleep Studies Lab is booked for the next three weeks.

“We are already looking at increasing the number of days that we do sleep studies,” Wes Murray, chief executive officer at TCMH, said.

New equipment is also on order.  TCMH had $34,798 in the 2016 capital budget for an upgrade in equipment and software for the Sleep Studies Lab.  When the new equipment is installed, TCMH plans to increase staffing and operating hours for the lab.

“Dr. Mella sees patients Monday through Wednesday in the clinic, and he’s very passionate about sleep and pulmonary issues,” Murray said.

In addition to overseeing the Sleep Studies Lab, Mella is working with the TCMH cardiopulmonary department to provide free testing for chronic obstructive pulmonary disease (COPD).  COPD is a top admission diagnosis for patients at TCMH.

“If COPD is caught earlier, there are treatments available,” Dr. Jonathan Beers, chief of the TCMH medical staff, said.

TCMH is also pursuing a grant through the Missouri Foundation Health (MFH) to start a cardiopulmonary rehabilitation program for patients with moderate to severe lung disease.

The TCMH grant application to MFH was one 20 applications selected for further review among 135 received this grant cycle.  For additional review MFH sent a representative to the hospital for a site visit.

The grant would fund a multi-disciplinary program that patients would qualify for following testing for lung disease.  The 12-week program would help patients improve lung function and activities of daily living.

Currently approximately 10 patients complete pulmonary function tests at TCMH each month.  Over half the patients receiving pulmonary function tests at TCMH in the past year would qualify for a pulmonary rehabilitation program because they have moderate to severe lung disease.

Doretta Todd-Willis, TCMH chief nursing officer, met with MFH during the site visit.

“We provided information explaining how the program would benefit our patients and our community,” Todd-Willis said.  “We were encouraged to seek appropriate funding to meet all of the program participants’ needs including transportation and nicotine replacement therapy costs.”

TCMH will receive word in September if the cardiopulmonary rehabilitation program is approved for funding with an MFH grant.

Cory Offutt, MD, a board certified family medicine and obstetrics physician, joined the June board of trustees meeting.  Offutt has completed residency at the University of Missouri in Kansas City, and he and his wife, Samantha, have moved to Texas County.

“Dr. Offutt begins seeing patients full-time on July 18th,” Murray said.  “We’re very pleased to have him here, and we look forward to helping him grow his new practice.

Offutt is based in the TCMH Medical Complex in Houston.  He is doing an outreach clinic at the TCMH Mountain Grove Clinic, too.  Board certified in family medicine and obstetrics, Offutt sees patients of all ages.  He will deliver babies at TCMH as part of his practice.

Murray asked Amanda Turpin, quality management director at TCMH, to update board members on the grievance process at the hospital.

“The majority of most hospital complaints around the nation generate in the ER due to the fast turnover of patients,” Turpin said.

Turpin noted that the hospital complaint may be generated by the family member of a patient, too.

“Many times a patient will bring their complaint to hospital’s administrative office where the information is taken and quickly passed along to me,” Turpin said.

TCMH has a formal grievance process.  Turpin, physicians, nursing and ancillary staff members are involved in reviews of every complaint as needed.

“Any complaint involving treatment must be reviewed by a physician,” Turpin said.  “They review the processes of treatment to determine what, why, and how things were done.”

Turpin noted that when the review process is lengthy, she tries to stay in touch with the patient throughout the process.

The TCMH medical staff meets monthly and reviews complaints with Turpin. Turpin also meets monthly with Murray, per state regulations, to go over any grievances with the hospital.

After everything has been reviewed by appropriate parties, Turpin sends a letter out to the patient explaining the resolution to the situation.

Turpin includes some data regarding the grievance process in the quality information she provides monthly to the board of trustees.

“We want you to know that there is a formal grievance process, and we take every complaint seriously,” Turpin said.

Murray presented a recent study from the Georgetown University Health Policy Institute and the Georgetown University Center for Children and Families. The study was an in-depth look at the effect of Medicaid expansion on hospitals, healthcare facilities and the states that have allowed expanded Medicaid coverage.

Highlights from the study which looked at all states included:

  • Medicaid expansion has led to major reductions in uncompensated care delivered by safety net institutions, significant drops in the number of uninsured residents, and budget savings for hospitals and community health clinics.
  • States with Medicaid expansion report opening new clinics, buying new equipment, and hiring new staff to fill gaps in the healthcare system.
  • States with Medicaid expansion report active integration and improvement of healthcare while states without expansion are maintaining “status quo”.

 

“All states that have expanded Medicaid have experienced a positive financial impact to their overall state budget,” Murray said, noting that Medicaid expansion has benefited the healthcare providers, the communities, the jobs, and the states where it has taken place.

The study found that in some situations, children are benefiting from insurance coverage for the first time.  The numbers of uninsured are dropping to single digits, and the cost to the state is actually less that the cost of Medicaid prior to the expansion.

“More than two years since states started expanding Medicaid coverage, there is an overall positive financial impact,” Murray said.

Murray plans to share the study with the hospital’s state legislators.  The study is available to the public online here.

Linda Pamperien, TCMH chief financial officer, presented the financial report for the month of May.

A five-week month and increased emergency department utilization by patients without an ability to pay led to $640,856.98 in bad debt for the month.  According to Pamperien some of those funds will be collected later, but the initial monthly numbers reflect a high contractual adjustment.

“Inpatient and outpatient volumes were down slightly during the month of May, and there were some budgeted but big ticket expenses for the month,” Pamperien reported.

TCMH ended the month of May with a negative bottom line of $196,273.41 and a negative year-to-date bottom line of $173,926.69.

Present at the meeting were Murray; Pamperien; Todd-Willis; Turpin; Beers; Offutt, Joleen Senter Durham, public relations director, and board members, Dr. Jim Perry, OD; Mark Hampton; Omanez Fockler, and Janet Wiseman.

Russell Gaither, TCMH board member, was not present at the meeting.

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


Brenda Barton is Employee of the Month

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Brenda Barton (right) is the May employee of the month at Texas County Memorial Hospital. She’s with her supervisor, Amanda Blaylock.

Brenda Barton (right) is the May employee of the month at Texas County Memorial Hospital. She’s with her supervisor, Amanda Blaylock.

Texas County Memorial Hospital has named Brenda Barton of Houston the May employee of the month.

Barton is the insurance verification coordinator in the registration department at TCMH. Barton has worked at the hospital since 1996. She was nominated for the award by her supervisor, Amanda Blaylock.

“Brenda knows all the ins and outs of our department, and she’s not afraid to tackle anything,” Blaylock said, describing Barton as “an outstanding employee”.

In addition to making sure that patients at TCMH have approval from their insurance company for the services they need, Barton also trains new employees in the registration department and registers patients for inpatient and outpatient services.

“Brenda comes to work with one thing in mind,” Blaylock said, “And that is to help others.”

As employee of the month, Barton received a certificate honoring her achievement; a pin; 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; Blissful Nirvana Massage, Wher Motors, and TQ’s BBQ. A reception will be held at the hospital in honor of Barton.

This is Barton’s second time to receive the TCMH award; she was the January 2014 employee of the month. Barton is eligible for the 2016 TCMH employee of the year award.


TCMH Readies for Pulmonologist, Obstetrician and Nurse Practitioner to Start Practice

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Texas County Memorial Hospital is remodeling office space and putting everything in place for three new healthcare providers planning to join TCMH in June and July board members heard at their May monthly meeting.

Juan Mella, MD (right), a board certified pulmonologist, has signed a contract to work part-time for Texas County Memorial Hospital at the TCMH Medical Complex in Houston beginning in mid-June.  Mella is shown here with Wes Murray, TCMH chief executive officer.

Juan Mella, MD (right), a board certified pulmonologist, has signed a contract to work part-time for Texas County Memorial Hospital at the TCMH Medical Complex in Houston beginning in mid-June. Mella is shown here with Wes Murray, TCMH chief executive officer.

Juan F. Mella, MD, a board certified pulmonologist, is joining TCMH to work part-time as a clinic-based pulmonologist and to oversee the hospital Sleep Studies Lab.

“Dr. Mella approached us about working part-time at TCMH, and we were able to work out an arrangement that is mutually beneficial,” Wes Murray, TCMH chief executive officer, said.

Mella has over 30 years experience as a pulmonologist. He attended medical school and residency at Wayne State University in Detroit, MI. He completed a pulmonology fellowship at Mount Sinai Medical Center in Miami Beach, FL. He’s board certified in internal medicine, pulmonology and sleep medicine, and he’s a fellow of the American College of Chest Physicians.

Mella has practiced in Florida, Michigan, Ohio, and most recently, at Ozarks Medical Center in West Plains, MO.

“We have a large number of patients with pulmonary conditions,” Murray said. “Access to a pulmonologist has been a major problem for many of our patients.”

Chronic obstructive pulmonary disease, commonly referred to as COPD, is one of the top admission diagnoses at TCMH. The hospital has a cardiopulmonary department that is staffed 24/7, providing breathing treatments, managing ventilators, and performing outpatient pulmonary testing for a variety of issues.

The cardiopulmonary department did 105,156 procedures in 2015, an increase of almost 2,000 procedures from 2014. A two-bed sleep studies laboratory is also part of the department.

“Dr. Mella is very passionate about a sleep issues, and he looks forward to working with our medical staff and their patients in identifying and treating sleep issues,” Murray said.

The TCMH Sleep Studies Lab operates three nights each week. With Mella’s help, TCMH hopes to grow sleep study availability.

Additionally, TCMH is pursuing a grant from the Missouri Foundation for Health to start a pulmonary rehabilitation program for patients with moderate to severe lung disease.

According to Murray approximately 10 patients have a pulmonary function test done at TCMH each month. Over half the patients receiving pulmonary function tests at TCMH in the past year would qualify for a pulmonary rehabilitation program because they have moderate to severe lung disease.

The grant would help start the pulmonary rehabilitation program, and qualifying patients would participate in the 12-week program that would help patients improve lung function and activities of daily living.

“If we are able to start a pulmonary rehab program, Dr. Mella will also be an asset to the program and the patients involved with it,” Murray explained.

Mella will see patients in the TCMH Medical Complex, located next to the hospital in Houston. Mella will not be part of the hospital call group, but he is willing to do consultation work with patients in the hospital as needed.

“This is a great opportunity for us to work with a specialist physician that wants to continue to work in the area without call responsibilities or full-time employment,” Murray said.

Mella will begin seeing patients in mid-June.

Cory Offutt, MD, family medicine and obstetrics physician is joining TCMH after he completes residency at the University of Missouri in Kansas City in June. Offutt just completed a surgical residency rotation at TCMH working with Dr. Linda Milholen, TCMH general surgeon. Offutt began moonlighting shifts in the TCMH emergency department in May, too.

Offutt’s final residency rotation is also at TCMH—a clinical rotation with Dr. Jonathan Beers, TCMH internal medicine physician at the TCMH Medical Complex, the same clinic where Offutt will be based.

In late June, Offutt and his wife, Samantha, are relocating to a home they have purchased in Texas County. Offutt begins working full-time at TCMH in mid-July. He will be based in the TCMH Medical Complex, too. Offutt will see patients of all ages, and he will deliver babies at TCMH as part of his practice.

“Dr. Offutt received word this week that he passed his board certification exam,” Murray told board members. “He is very eager to start his new practice with TCMH.”

Sheena Painter, a TCMH nurse and an instructor for the Cox College of Nursing program in Cabool, has completed her family nurse practitioner program at Frontier Nursing University in Hyden, KY. After completing her board examination, Painter will continue to work part-time for TCMH as a family nurse practitioner.

“Sheena will be primarily based in the TCMH Walk In Clinic, but we may also utilize her in other clinics, too, when needed,” Murray said.

Recruiting efforts are also underway for an additional full-time general surgeon and an additional full-time family medicine or internal medicine physician.

With the addition of Mella and Offutt and the growing popularity of the TCMH Walk In Clinic, remodeling work is being done to the TCMH Medical Complex.

“We are going to rearrange the flow of some parts of the clinic to make the clinic space more user friendly for our staff and for our patients,” Murray said.

The hospital’s maintenance department is doing the remodeling work in-house. The project will centralize some administrative offices and add more patient exam rooms.

Doretta Todd-Willis, TCMH chief nursing officer, reported that TCMH does not have any full-time or part-time registered nurse vacancies at the hospital with the recent hiring of eight graduate registered nurses that recently completed their RN training.

“All of these nurses are graduates of area nursing programs, and prior to full-time employment, they worked part-time or did nursing rotations at the hospital,” Todd-Willis said.

Nursing students from Missouri State University in West Plains, Cox College/Drury University in Cabool and Texas County Technical College in Houston do clinical rotations at TCMH during their training programs.

“Having these area nursing programs nearby gives us an opportunity to show off our hospital to area students,” Murray said. “Many of them look forward to working full-time in their community after completing their education.”

Amanda Turpin, quality management director at TCMH, presented updated quality measurement information to board members.

According to Turpin, the Center for Medicare Services (CMS) will soon make public hospital data for readmission and mortality rates for stroke, pneumonia, heart failure, COPD and heart attack. All of the TCMH scores are risk adjusted for specific patient demographics by CMS before they are reported

“Overall, our scores were good, and even with the risk adjustment by CMS, TCMH ranks better than the state and national averages for these quality measures,” Turpin said.

Cost per patient episode is also part of the information to be released by CMS, and Turpin noted that TCMH averages about $2,000 less per patient episode than state and national averages.

“We make a lot of efforts to control costs at TCMH, and I think we should be very proud that our costs are significantly lower than state and national averages,” Murray said.

Linda Pamperien, TCMH chief financial officer, presented the financial report for the month of April.

“Inpatient and outpatient volumes were above budgeted expectations,” Pamperien reported. She noted that contractual adjustments were at normal levels for the month, and overall expenses were down for April.

TCMH ended the month of April with a positive bottom line of $58,343.46, and a year-to-date bottom line of $22,346.72.

Present at the meeting were Murray; Pamperien; Todd-Willis; Turpin; April Steele, administrative secretary; Dr. Jonathan Beers, TCMH chief of staff; and board members, Dr. Jim Perry, OD; Mark Hampton; Omanez Fockler, and Janet Wiseman.

Russell Gaither, TCMH board member, was not present at the meeting.

The next meeting of the TCMH board of trustees is Tue., June 28 at 12 p.m. in the hospital board room.


Marlene Collins is Employee of the Month

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Marlene Collins (center), Texas County Memorial Hospital April employee of the month, with Jeff Ijames (right), her supervisor, and April Steele.

Marlene Collins (center), Texas County Memorial Hospital April employee of the month, with Jeff Ijames (right), her supervisor, and April Steele.

Texas County Memorial Hospital has named Marlene Collins of Houston the April employee of the month.

Collins is the assistant dietary department supervisor at TCMH. Collins has worked at the hospital since 1985. She was nominated for the award by April Steele, administrative assistant in the hospital’s administrative office.

“I go to Marlene daily with dietary needs for hospital events,” Steele said, describing Collins as “dedicated” and a “huge asset” to TCMH.

In the TCMH dietary department, Collins works with patients, hospital staff and visitors to the Mayuga Café. Collins also makes arrangements for special events at the hospital as well as regular events like medical staff and board meetings, nurses’ week and national hospital week.

“Marlene anticipates our dietary needs before we even know we need it,” Steele said, adding, “She keeps us on schedule with our events, too.”

As employee of the month, Collins received a certificate honoring her achievement; a pin; 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; Blissful Nirvana Massage, Wher Motors, and TQ’s BBQ. A reception will be held at the hospital in honor of Collins.

Collins is eligible for the 2016 TCMH employee of the year award.


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 on May 6.

Shanda Melton (center) Texas County Memorial Hospital nurse of the year, with Doretta Todd-Willis (left), TCMH chief nursing officer, and John Sawyer, medical surgical department manager.

Shanda Melton (center) Texas County Memorial Hospital nurse of the year, with Doretta Todd-Willis (left), TCMH chief nursing officer, and John Sawyer, medical surgical department manager.

Texas County Memorial Hospital named Shanda Melton of Mountain Grove as the 2016 TCMH Nurse of the Year and Modena Jones of Mountain Grove as the 2016 TCMH CNA of the Year.

Melton, a registered nurse in the TCMH medical surgical department, has been employed by the hospital for six years.

“Shanda is awesome,” John Sawyer, medical surgical department director, said.

Sawyer explained that Melton takes a leadership role on the medical surgical floor by taking responsibility for all patients and processes when she’s working.

“Shanda is a ‘go to’ person for the other members of the nursing staff,” Sawyer said. “She works with the students from all the schools that send our students to us, and I regularly use her as a preceptor for new nursing hires.”

Melton also sees certain patients in their homes following their discharge from TCMH as part of the TCMH house call program for patients that are likely to be re-admitted.

“Shanda’s compassion for our patients is above and beyond,” Sawyer said.

Jones is a certified nurse assistant in the TCMH medical surgical department, and she has worked at TCMH for 11 years. This is the second time Jones has received the TCMH CNA of the Year award.

Modena Jones (center) Texas County Memorial Hospital CNA of the year, with Doretta Todd-Willis (left), TCMH chief nursing officer, and John Sawyer, medical surgical department manager.

Modena Jones (center) Texas County Memorial Hospital CNA of the year, with Doretta Todd-Willis (left), TCMH chief nursing officer, and John Sawyer, medical surgical department manager.

“Modena’s work ethic is the best you can have,” Sawyer 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.

All Nurses and CNAs from nursing departments throughout TCMH were nominees for the annual nursing awards if they had worked at least two years at the hospital and if they had worked at least 1,040 hours over the past year. All TCMH employees were asked to vote for one nominee in each category, and awards were given based on the popular vote.

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 wound care, patient restraints, fetal heart tones, infection control 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.

Nurses are Superheroes cake

Nurses are Superheroes cake

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

TCMH currently employs 126 nurses and 23 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.


TCMH Managers Graduate from MHA Leadership Series

joleen General Comments Off on TCMH Managers Graduate from MHA Leadership Series
John Sawyer (left) and Bill Bridges

John Sawyer (left) and Bill Bridges

The Missouri Hospital Association Center for Education’s Health Care Leadership Series recently concluded, with 63 hospital staff members from throughout the state graduating from the program. The series provides leadership training to a diverse cross section of hospital and health care supervisors and managers.

Texas County Memorial Hospital managers, Bill Bridges of Raymondville and John Sawyer of Houston, were graduates of the 2015-2016 training program. Bridges is the director of the TCMH emergency medical services department. Sawyer is the director of the medical surgical department and intensive care unit at TCMH.

“The MHA Leadership Series provides excellent training to better equip our managers to do their respective jobs at the hospital,” Wes Murray, TCMH chief executive officer, said.

The series consists of comprehensive leadership training courses designed to enhance participant’s managerial skills. The seven-month program includes training sessions featuring topics on building and retaining customer relationships, producing a high-performance workforce, designing and revising processes to ensure quality performance, and understanding hospitals’ budgets and finances.

“Health care is an increasingly complex field,” said Herb B. Kuhn, MHA president and CEO. “The leadership series offers tools for health care leaders to strengthen their organizations and improve the quality of services offered in their facilities.”

The MHA Leadership Series is offer free-of-charge to MHA member hospitals, and TCMH has had several employees graduate from the program since the course was offered.

The Missouri Hospital Association is a not-for-profit association in Jefferson City that represents 149 Missouri hospitals. In addition to representation and advocacy on behalf of its membership, the association offers continuing education programs on current health care topics and seeks to educate the public about health care issues.


Annual Hospital Audit Shows Strong Financial Position Despite Year End Loss

joleen General Comments Off on Annual Hospital Audit Shows Strong Financial Position Despite Year End Loss

Texas County Memorial Hospital ended 2015 with a net position of -$2,071,369 in excess revenues over expenses hospital board members and administration heard at their monthly meeting on Tuesday.

Texas County Memorial Hospital board of trustees chairperson, Dr. Jim Perry, OD (left), administered the oath of office to Omanez Fockler, returning board member at the meeting on Tuesday.

Texas County Memorial Hospital board of trustees chairperson, Dr. Jim Perry, OD (left), administered the oath of office to Omanez Fockler, returning board member at the 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.

“2015 was an atypical year for operating results,” Weis said, citing the loss of two doctors in the first quarter of 2015, which led to lower operating revenues of $1,848,391.

Audit results also showed that expenses at the hospital dropped by $475,145 in 2015, which Taylor described as “not common”.

“A substantial portion of expenses are fixed in a hospital of your size,” Taylor said. “It’s very hard to be responsive to volume changes, but you were able to control expenses that were controllable.”

In 2015, grants and donations to the TCMH Healthcare Foundation totaled $619,196. In 2014, grants and donations totaled $1,180,978. Although the Healthcare Foundation funds are designated for specific purposes, the numbers are included in overall year end fiscal results.

“The funds you have received for grants and donations are very strong,” Taylor said. “Numbers like these are not typically seen in a hospital of your size.”

Although revenues at the hospital were down in 2015, TCMH continued to invest in the hospital with capital purchases totaling $500,940.

TCMH made principal payments of $747,356 on the major construction project completed in 2014, and depreciation expenses made up a good portion the hospital’s losses in 2015.

“A lot of this year’s loss is related to depreciation,” Taylor said. “If you take out the depreciation, 2015 showed a ‘true decrease’ of about $450,000.”

The audit report showed a decrease in accounts receivable of over 12 percent for 2015, most of which is third-party insurance collections for clinic-based billing. Auditor called the decline “favorable”.

“Our report shows that you are doing what you can to watch any funds that are going out the door,” Taylor said.

TCMH had 83 days of cash on hand—the days the hospital could operate without bringing in any funds. The rural Missouri hospital average is approximately 50 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 at 50 percent, which Taylor called “not too high”. TCMH is in line with other hospitals in the nation.

“Your balance sheet is good, and your financial position is strong,” Taylor told board members.

Taylor pointed out that revenue from the 340b pharmaceutical program helped offset losses in 2015, and he noted that TCMH plans to grow those revenues in 2016. Additionally, TCMH has hired Dr. Cory Offutt, a family medicine and obstetrics physician that will begin working full-time in the hospital and clinic in July.

In 2015, TCMH brought $14,127,908 in Medicare and Medicaid funds into the hospital. Due to the patient population in the area TCMH relies heavily on federal funds.

Taylor spoke to board members about the shift that hospitals are experiencing as Medicare makes payments for healthcare related to value rather than volume.

“TCMH experienced some value-based payments in 2015, and there are more of those to come in the future,” Taylor said.

Taylor explained that understanding the financial path for risk-based reimbursement versus the traditional fee for service payment method is not entirely known.

Beginning this April, a pilot program for hip and knee replacement was put into place in major-metro areas of the state. Hospitals are given a bundled bulk payment for the joint replacement, and with the joint replacement, the hospital assumes a 90-day responsibility for the patient post-discharge.

“The bottom line for each joint replacement is dependent upon improving the outcome of the patient,” Taylor said. “This is forcing conversations on the coordination of care for patients.”

Taylor and staff at BKD anticipate that more healthcare procedures and services will be placed into “bundled” payments, placing the hospitals at risk financially.

As a result of the anticipated changes to the payment delivery methods for the hospitals they serve, BKD has hired non-CPA staff to help the accounting firm better understand the clinical side of the business.

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.

“As our numbers show, there was not a significant change from the numbers you reported internally to those we are reporting,” Weis said. “You did a good job making decisions throughout 2015 based on your internal results.”

In the hospital administrative report, Wes Murray, chief executive officer, explained that he and Joleen Senter Durham, physician recruiting director at TCMH, visited the Cox Family Medicine Residency Program in Springfield where they talked with residents about TCMH.

“We had a very productive meeting and provided lunch for about 15 people,” Murray said, adding, “We spoke with them about moonlighting in the ER, rural residency rotations in the clinic or surgery department, weekend hospitalist work, and full-time opportunities after residency.”

Durham noted that several of the current residents have roots in the Ozarks.

“Most residents will take a job within 100 miles of where they complete residency,” Durham said. “We are very fortunate that Cox allows us the opportunity to meet with their residents regularly.”

Ron Prenger, CoxHealth representative, pointed out that the Cox residency program was recently allowed to add an additional resident, and the program hopes to add more slots for residents in the future.

Linda Pamperien, chief financial officer at TCMH, presented the financial report for the month of March.

“Inpatient volumes were below budgeted expectations, but outpatient volumes were above budgeted expectations for an overall revenue of $23,261,” Pamperien said.

Due to Medicaid payment remittance for three weeks instead of two in the month of March, contractual adjustments were higher, coming in at almost 68 percent.

With the higher contractual adjustment, TCMH ended the month of March with negative bottom line of $132,017.53, creating a neative year-to-date bottom line of $35,996.74.

Present at the meeting were Weis; Taylor; Murray; Pamperien; Durham; Prenger; Anita Kuhn, controller; Dr. Jonathan Beers, TCMH chief of staff; and board members Jim Perry; Mark Hampton; Omanez Fockler, and Janet Wiseman.

The next meeting of the TCMH board of trustees is Tue., May 24 at 12 p.m. in the hospital board room.


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