Increased Inpatient and Outpatient Volumes at Hospitals = Positive August Bottom Line

Increased inpatient and outpatient volumes at Texas County Memorial Hospital combined to give the hospital its second positive bottom line for the year, board members heard at their monthly meeting on Tuesday.

The TCMH August financial report showed a positive bottom line of $232,039.15, dropping the year to date deficit to $643,612.21.

In the financial report, Linda Pamperien, chief financial officer at TCMH, explained that inpatient revenues were down $21,459.00 from budgeted expectations and outpatient volumes were up $332,656.00 from budgeted expectations.

“Every outpatient department but two had increased numbers for the month of August,” Pamperien said, adding, “We also had 20 swing bed admissions in August compared to our usual nine to 12 swing bed admissions.”

Pamperien noted that TCMH is still down 168 inpatient admissions compared to 2013.

“We have had an amazing turn around on outpatient revenue in the last two months,” Pamperien said.

Wes Murray, chief executive officer at TCMH, expressed hope that the uptick in volume was the “new norm”.

“We have made staffing changes, cut expenses, and changed our services to save money for over a year now,” Murray said. “This is where the bar needs to be right now.”

Murray told board members that he was going to continue to challenge the department managers to add to their monthly department numbers.

“We continue to face serious financial challenges without state Medicaid expansion,” Murray said, explaining that merit raises for hospital employees have been put on hold for a second year.

According to Murray, hospital volumes are down across the nation, but TCMH has made efforts to grow volumes. In the past year, hospital departments have spent time educating area healthcare providers about the ancillary services offered in each department. Efforts have been made to encourage area residents to support their local hospital and healthcare providers by using local healthcare services.

“We all have to work together on many different levels to try to help ourselves in these tough times,” Murray said, adding. “All of our departments can be busier.”

Murray and Pamperien also attributed the change in numbers to the addition of new healthcare providers.

Pamperien provided surgery case numbers showing 66 cases in May; 55 cases in June; 124 cases in July and 105 cases in August.

“We are back up to where we were a year ago in the number of cases we are doing in our surgery department,” Murray said, adding, “And the bottom line is indicative of us getting that department back where it was.”

Murray explained that with the addition of general surgeons Linda Milholen, MD and Leroy Wombold, DO and obstetrician and gynecologist, Christopher Baldwin, MD, there was “room for growth” with the surgical case numbers.

“More services are being offered in surgery than ever before,” Dr. Jonathan Beers, vice chief of staff, agreed. “There are things that we used to send to Springfield that we can now keep here.”

Murray noted that members of the medical staff have expressed their pleasure and support of Milholen and Baldwin.

“Our surgery department depends on strong referrals from the primary care physicians,” Murray said.

Amanda Turpin, quality management director at TCMH, reported that as a member of the Hospital Engagement Network (HEN), TCMH received funds from the Center for Medicare Services (CMS) that allowed her to attend the National Association for Healthcare Quality conference this month.

Funding was also provided for Turpin to attend additional classes at the conference that will allow her to take the exam to become a Certified Professional on Healthcare Quality.

Turpin and two additional hospital departments provide monthly data to HEN. TCMH has been reporting to HEN for two years, and the data is compiled and shared at national, regional and state levels.

In addition to the educational funding, TCMH received a $3,000.00 stipend from CMS to help offset the cost of man hours for the data collection and reporting by three departments.

“Our participation in the Hospital Engagement Network is voluntary but highly encouraged by CMS,” Turpin said. “It’s nice to receive a little something for the effort that we put into collecting and compiling data for the network.”

Murray reported that the hospital’s emergency department has seen a rise in the number of transfers by ambulance to the department and a higher acuity level among patients in the department.

“As we thought might happen when we doubled the size of the ER, we need to change the strategy of handling patients in our department,” Murray said.

The new strategy includes using mid-level providers in the ER during peak times. The mid-level provider—a physician assistant or nurse practitioner—will provide care for the primary care cases that end up in the emergency department but could be seen in an office-based clinic setting.

“We hope that utilizing a mid-level provider in the ER will help us establish those patients with a primary care provider in one of our clinics,” Murray said.

Murray explained that TCMH still has low emergency room waiting times compared to national averages, but when acuity levels rise in the patients in the ER, wait times increase.

“The peak times in the ER are becoming more consistent, and we want the service we provide in the ER to go as smooth as possible,” Murray said.

Chip Lange, physician assistant at the TCMH Medical Complex, is already helping out during peak times in the TCMH emergency department. Ray Bruno, a family nurse practitioner, and Jeff Blue, physician assistant, are also expected to begin to provide additional coverage in the emergency department very soon.

Two new hospital department directors stopped in at the monthly meeting—Angela Raymond and Connie Brooks. Raymond, a registered nurse with family ties in Licking, has taken the helm in the TCMH obstetrics department. Brooks, a long time TCMH nurse from Mountain View, is heading up the education department at the hospital.

Present at the meeting were Murray; Pamperien; Beers; Turpin; Joleen Senter Durham, director of public relations; Dr. John Duff; Ellen Willis; Jenna Saraga, and board members Omanez Fockler; Janet Wiseman; Mark Hampton; Dr. Jim Perry, OD, and Russell Gaither.

The next meeting of the TCMH board of trustees is Tues., Oct. 28th at 12 p.m. in the hospital board room.