New Year Brings Recruiting Opportunities and Challenges at TCMH

Texas County Memorial Hospital has hosted site visits for five healthcare providers and has executed two signed contracts with nurse practitioners, members of the hospital board of trustees heard at their monthly meeting on Tuesday.

“Last fall, we began working to add to our medical staff, and those efforts have continued to be very strong in the new year,” Joleen Senter Durham, TCMH director of physician recruiting, told board members.

Durham explained that since January 1st, TCMH has hosted site visits for five healthcare providers and visited the CoxHealth Family Medicine Residency in Springfield for recruiting efforts.

Holly Atterberry of Evening Shade and Sheena Painter of Houston, family nurse practitioner students, have signed contracts with TCMH, and will work for the hospital when their training is complete.

Atterberry will complete her training program in May, and she will work in the TCMH Medical Complex collaborating with Dr. Jonathan Beers, TCMH internal medicine physician.

“Holly is very sharp, efficient, and she knows our system well,” Beers said.

Atterberry has completed clinical training with Beers and other TCMH providers while in school. She is also a registered nurse in the hospital’s medical surgical department.

Beers explained that his office is already putting patients on a schedule for Atterberry, and he described the office staff as “excited” for her to join them.

Atterberry will see patients by appointment and also through the TCMH Walk In Clinic in Houston.

Painter has a year and half of nurse practitioner school to complete, and she wants to work at least part-time for TCMH when she completes her training.

TCMH is also actively seeking additional full-time physicians for the clinics in Houston and in Mountain Grove and for the hospital emergency department.

“Primary care physicians continue to be the hardest positions to fill, and less than two percent of physicians are willing and interested in practicing in a community with less than 50,000 people,” Durham said.

On January 9, Dr. Schaun Flaim and Dr. Gretchen Price, married internal medicine physicians, resigned from their positions at the TCMH Medical Complex, indicating that they are going to Cape Girardeau, MO to practice as hospitalists.

“Our positions at TCMH give physicians the opportunity to see hospital inpatients and to do hospital procedures as well as seeing patients and having a clinic practice,” Durham said, adding that hospitalist positions across the nation are hiring internal medicine and family medicine physicians that want to practice only in the hospital.

TCMH is currently in contract negotiations with a physician that would do a traditional inpatient and outpatient practice.

“We are hopeful that we will be able to make an official announcement very soon,” Durham said.

Three providers have met with TCMH regarding full-time practice opportunities at the TCMH Mountain Grove Clinic.

“Again, it seems very positive that we may have a full-time provider in the clinic very soon,” Durham said.

Currently Dr. William Wright, a family medicine physician, Tracey Arwood, CNM and Terry Bruno, FNP are seeing patients at the clinic one to two days week to provide full-time coverage at the clinic.

TCMH has a physician that has worked at TCMH in the past that is interested in a full-time emergency department position. There is a need for additional coverage in the ER due to currently employed full-time physicians cutting back their number of monthly shifts.

“We have recruited two excellent nurse practitioners, and it looks very positive that some of these other site visits will result in contracts, too,” Durham said.

Durham explained that student loan repayment opportunities through the National Health Service Corps continue to draw healthcare providers to look at employment with TCMH. Due to Texas and Wright County’s status as “medically underserved”, healthcare providers are able to receive loan repayment or forgiveness for hundreds of thousands in student loans by working full-time or part-time in a TCMH clinic.

“Almost all of our area healthcare providers have received student loan repayment or forgiveness, which is a great recruiting tool for us,” Durham said. “Unfortunately many providers leave TCMH after their loans are forgiven or repaid because they seek a different lifestyle or practice opportunity.”

Wes Murray, chief executive officer at TCMH, noted that the hospital recently completed a review by legal counsel of the standard physician contract.

“Our legal counsel had a couple of minor changes, but told us that the contract was ‘very strong’,” Murray said.

In the medical staff report, Beers noted that with the current physician changes, he has taken over the role of chief of the TCMH Medical Staff. Dr. Steve Hawkins serves as vice chief of staff, and Dr. Matthew Brown serves as secretary/treasurer of the medical staff.

“We have some committee leadership changes that will take place, but overall it’s a seamless transition,” Beers said.

Murray, Doretta Todd-Willis, chief nursing officer at TCMH, and Amanda Turpin, quality management director at TCMH, presented data showing 2015 hospital reimbursement adjustments based on data gathered from hospitals across the nation by Center for Medicare Services (CMS).

“CMS can penalize hospitals up to five and half percent for Medicare reimbursement, and hospitals have the opportunity to gain up to an additional two percent in reimbursement,” Turpin explained.

Data gathered by CMS has given TCMH a positive reimbursement of an additional 0.82 percent for Medicare patients.

According to Turpin, 3,559 hospitals in the US are affected and over half the hospitals in the nation and in the state will experience a negative financial impact from CMS in 2015 in Medicare reimbursement.

Twenty-one of the 79 Missouri hospitals and 794 hospitals in the nation will have a positive financial impact from CMS in 2015 in Medicare reimbursement.

“TCMH ranked second in the state and 132nd in the nation in the data points CMS looked at,” Turpin said.

Turpin explained that the CMS data is public information and the data has been part of recent local and national media stories.

“There is a consistent theme to our numbers,” Turpin said. “We rank at our above the state and national averages as shown on the website www.hospitalcompare.gov.”

TCMH will continue to manage patient expenses, patient experience and patient care so penalties from CMS will not be incurred at the hospital in future years.

“It’s nice to see a positive result for the hospital,” Murray said.

Because TCMH is a recipient of Federal Transportation Administration funds through the Missouri Department of Transportation, board members were asked to approve and sign a resolution of non-discrimination for providing non-emergency transportation through the TCMH Medivan service.

The board unanimously agreed to pass the resolution which formally identifies the Medivan’s operation for area patients regardless of race, color or national origin.

Janet Wiseman, member of the TCMH board of trustees, will not face an opponent in the April election for the TCMH board of trustees. TCMH board members agreed that a “public election” was not necessary since Wiseman was unopposed.

The board member position will not be listed on the April ballot which will save funds for the Texas County government.

Linda Pamperien, TCMH chief financial officer, presented the financial report for the month of December which showed a negative bottom line of $376,234.18.

“Our inpatient and outpatient volumes were right in line with our budgeted expectations,” Pamperien said. “Unfortunately we had six patients that made our contractual adjustments rise over 75 percent for the month.”

Pamperien explained that the patients were extremely ill and unable to be discharged, and TCMH continued to provide care for the patients although the reimbursement for care was much less than the cost of care.

“We are not able to ship patients on to other hospitals if we can care for them,” Pamperien said. “We did what was best for the patients, but it hurt us financially last month.”

TCMH will end the year with a negative bottom line of $1,141,477.28.

“My numbers are always a conservative projection,” Pamperien said. “I’m hopeful that our annual audit will create a positive number with the settlement of Medicare and Medicaid payments.”

Present at the meeting were Murray; Pamperien; Todd-Willis; Durham; Turpin; Beers, and board members Wiseman, Omanez Fockler, and Dr. Jim Perry, OD.

Board members, Mark Hampton and Russell Gaither, were not present at the meeting.

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