Smith Named Employee of the Month
September 6, 2013Hospital Plans Groundbreaking
October 7, 2013With $1.7 million in grant and donation funds on the line, the Texas County Memorial Hospital board of trustees voted unanimously to proceed with building the planned tornado safe room and surgery department shell at their monthly meeting on Tuesday.
Wes Murray, chief executive officer at TCMH, presented construction options to the hospital board members, noting that several tornado safe room projects around the state have been bid about 30 percent higher than initial estimates.
“The safe room portion of this project came back about $300,000 higher than estimated,” Murray said. Bales Construction in Waynesville, MO had the lowest bid for the project.
Murray explained that TCMH will approach FEMA to help cover some of the higher than projected cost for the FEMA-eligible portions. According to Murray $225,000 in the bids for the tornado safe room are FEMA-eligible.
“South Central Council of Government is going to help us go back to FEMA to request additional funding,” Murray said.
In June 2011 FEMA awarded TCMH $562,500 for the project, thought to be 75 percent of the total cost of the FEMA-eligible portions of the tornado safe room. TCMH was covering the other 25 percent of the FEMA-eligible cost of the building.
TCMH also received a $298,400 in a Community Development Block Grant toward construction of the tornado safe room and surgery department. The TCMH Healthcare Foundation has also raised and received funds for $909,555 in donations toward the project through a capital campaign effort, and additional pledges toward the project have also been made.
“If we don’t proceed, we risk losing $800,000 in grant funds for the project,” Murray said.
FEMA stipulated that the tornado safe room must be complete by November 2014. The South wing of the hospital has already been removed in anticipation of building the tornado safe room.
HMN Architects in Springfield designed the tornado safe room and new surgery department to connect to the existing building where the South wing was removed. The design also allows for a shell for the new surgery department. Infill of the surgery department is not required immediately.
“If we scale down our current construction plans, we can continue to seek funding for completing the infill of the new surgery department and the fixtures for that department,” Murray said.
According to Murray, it may be possible for TCMH to have some of the infill work done in-house by the TCMH plant operations department.
The TCMH Healthcare Foundation will continue to collect pledges through 2017 for the “Care for Your Future” capital campaign portion of the project. The Healthcare Foundation is also working toward raising $480,000 in tax credits for the project.
Murray explained that the surgery shell will connect the tornado safe room with the current hospital via corridors. The new corridors will access the current hospital, the tornado safe room, and the hospital wing the currently houses the surgery, obstetrics and intensive care departments.
“This scaled down plan will allow us to proceed without losing the funding we have been awarded, and at the end of next year if we are able to do the infill, we can proceed at that time,” Murray said.
The surgery shell will have the needed electrical and plumbing components, but the walls, flooring, lighting, and details of the interior of the department will not be complete. The necessary surgical components—lighting, tables, fixtures—are a separate component to the department that will require additional expenditures.
TCMH is planning a public ground breaking for the construction project on Thursday, October 17 at 1 p.m.
Murray also reported that 75 to 90 percent of the renovation work is complete and TCMH departments should be utilizing their new space by the end of October.
“Everything has gone very smoothly,” Murray said regarding the renovation of vacated areas.
Hospital departments that will gain additional patient care areas, office and storage space are cardiopulmonary, cardiac rehabilitation, laboratory, education and dietary. Several departments will also be moved into a centralized suite of offices with administration.
Murray explained that JE Dunn, the general contractor for the new construction and renovation, would move their construction trailer off site within the week.
“While JE Dunn’s construction manager will still be on site overseeing the project, the book work for the project is nearly complete,” Murray said.
The hospital’s in-house pharmacy has moved into a new space between the obstetrics department and the East wing of the hospital. A connecting hallway to the mixing room and a service window must be added, but the work in the department has been done by the hospital’s plant operations department.
“Our guys have done a great job with the new space for pharmacy, and they have saved us quite a bit of money by doing the project, too,” Murray said.
TCMH is working with certified counselors from CoxHealth that will come to Texas County in October to provide education and enrollment opportunities for the uninsured.
“We want to utilize every resource available to help area residents get healthcare coverage,” Murray said, explaining that TCMH does not have the resources available to provide a counselor.
CoxHealth was one of several healthcare entities in the state that received funding to hire insurance counselors—formally known as Healthcare Navigators–that will go out into the public to provide education and help enroll patients in the health insurance exchange.
Dr. John Duff, CoxHealth representative, explained that at Cox facilities the counselors would be able to talk to uninsured patients that arrive in the emergency department or patients that are admitted and do not have insurance.
“Although we cannot counsel patients, we hope to be able to provide our uninsured patients with information about counselors that they can contact that will help them with their questions and possible enrollment,” Murray said.
Murray anticipates that the education and enrolling process will be ongoing. Additional information about the services will be posted on the TCMH web site and in the TCMH clinics as well as publicized through area media outlets.
Linda Pamperien, chief financial officer at TCMH, reported continued decreasing revenues at the hospital during the month of August.
“Admissions are down 100 patients for the year in comparison to 2012,” Pamperien said.
Pamperien attributed some of the decrease in admissions to changes in patient admission requirements. “We’ve had more ‘observation’ stays versus admissions, and our physicians are very conscientious about moving patients to swing bed status when the time is right,” Pamperien said.
It was noted that patient admission and observation requirements are expected to change again on October 1. With the new rule, physicians that expect patients to be in the hospital for “two midnights” will be considered “admission” rather than “observation” patients.
Pamperien has also been collecting and compiling hospital employee wage data for BKD, the hospital’s accounting firm, which is doing a statewide wage index review of hospitals. TCMH and other hospitals are currently facing a $15 decrease in payment for each patient admission from the Center for Medicare Services, and BKD is working to show the true cost for labor in patient care areas.
“With the data BKD is collecting, we may be able to get a $53 increase in payment per admission rather than a cut,” Pamperien explained.
TCMH ended the month of August with a negative bottom line of $71,677.86 and a year to date negative balance of $702,879.99.
Present at the meeting were Murray; Pamperien; Duff; Dr. Schaun Flaim, chief of staff; Joleen Senter Durham, director of public relations; Amanda Turpin, quality management director; Dr. Matthew Brown; Dr. Charles Mueller; John Hammons; and board members, Omanez Fockler; Janet Wiseman and Russell Gaither.
Board members, Mark Hampton and Dr. Jim Perry, OD, were absent.
The next meeting of the TCMH board of trustees is Tuesday, October 22 at 12 p.m. in the downstairs meeting room of the hospital.