Expansion of Sleep Study Laboratory in the Works at TCMH

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.