TCMH Receives State Designation as Stroke Center

Houston, MO—Texas County Memorial Hospital has received designation from the Missouri Department of Health and Senior Services (DHSS) as a Level III Stroke Center, hospital board members heard at their monthly meeting on Tuesday.

“A lot of work has been done by our staff to achieve this designation. We are proud to have received it and to offer this level of care for our community,” Wes Murray, chief executive officer at TCMH, said.

According to Murray, hospital staff began working on the designation application over a year ago. Last spring Dr. Jeff Kerr, emergency department medical director, and other key members of the TCMH “stroke team” provided on site information and a presentation to a panel from DHSS to apply for the stroke designation.

TCMH received word from DHSS shortly after their presentation that the protocols and processes were in place for TCMH to receive stroke designation.

DHSS officially recognized and designated certain hospitals in the state on Monday. TCMH was among the first hospitals in the state to receive the stroke designation.

“With the stroke designation, our hospital emergency department is recognized statewide as a place for stroke victims to receive emergency care,” Murray said, adding, “There should be a level of comfort that area patients take in knowing that TCMH is a state-designated stroke center.”

With the stroke designation, emergency medical services personnel in the field are required to advise patients and their family members where the nearest “stroke designated” hospital is to the proximity of the patient and to take the patient there if the patient does not object.

“With the TCMH stroke team, patients with stroke symptoms will receive faster, more streamlined care from the moment we begin caring for them,” Murray said.

Currently TCMH is working on designation as a Level IV STEMI (ST segment elevated myocardial infarction) facility. The STEMI designation will allow emergency medical services personnel to bring any patient with symptoms of a heart attack to TCMH where the hospital team will proceed with protocols to begin medical treatment to prevent cardiac muscle damage.

After the initial medical treatment, the patient would be transferred to a healthcare facility where interventional cardiology was available.

At the meeting, Kerr addressed board members, explaining that the need to make some personal lifestyle changes has him leaving the medical director position at TCMH to take an administrative position in the emergency department at Phelps County Regional Medical Center in Rolla.

Kerr will be assisting the hospital in Rolla with administrative issues, and he hopes to continue to provide some emergency department physician coverage at TCMH as well as continuing to help TCMH with the special emergency department designation applications.

“I have been working here for over 20 years, and I am very passionate about TCMH,” Kerr told those present. “This is an awesome place, and I want to thank you for all that you’ve done for me.”

“On behalf of the board and everyone at TCMH, thank you for your commitment to TCMH and to our community,” Omanez Fockler, chairperson of the TCMH board of trustees, said.

Kerr and Murray presented information regarding emergency department staffing sources that will be used beginning in May in addition to the continued services of hospital employed emergency department physicians–Dr. Randal Qualls, Dr. Lynn Hauenstein, and Dr. Louise Wilkinson.

Murray noted that TCMH has entered a contract with Emergency Medical Care, LLC (EMC) of St. Louis to provide emergency department physician staffing. Kerr participated in the interviewing process and recommended EMC among those interviewed.

“This company already provides image reading services through radiologist staffing for our radiology department,” Murray said, “And they work with other hospitals in the area providing emergency room physicians.”

Joleen Senter Durham, director of physician recruiting, explained that with the healthcare trend for hospitals to utilize physician staffing firms in the ER it has become “nearly impossible” to find physicians that want to work in the TCMH emergency department.

Murray and Kerr believe that EMC will be able to retain the physicians needed to provide stability and continuity of care in the TCMH ER in addition to utilizing the physicians that are already employed by TCMH.

“EMC has a local pool of physicians that understand our local needs,” Kerr said.

TCMH continues to recruit physicians and mid-level providers to employed hospital positions. Durham gave a physician recruiting update to those present explaining that TCMH has hosted three recruiting visits since the February hospital board meeting.

“All of the site visits have been very positive,” Durham said. She noted that two visits were with mid-level providers.

Sara Openshaw, a family nurse practitioner student from Mountain Grove, was one of the candidates interviewed, and she has signed a contract with TCMH to practice at the TCMH Mountain Grove Clinic.

“Sara’s training program ends in August, so she won’t begin working for us until the fall,” Durham said, adding, “We are thrilled to have a Mountain Grove resident providing patient care in the clinic.”

Durham explained that Openshaw will also do a clinical rotation with William Wright, MD, a TCMH family medicine physician, at the TCMH clinics in Mountain Grove and Houston in May and June.

“Sara will have the opportunity to meet future clinic patients while working with Dr. Wright, and she will get hands on experience with our electronic medical records program and the hospital and clinic services before she even starts working for us,” Durham said.

Durham also reported that a family medicine physician that interviewed at TCMH in March is considering a contract with the hospital.

The TCMH board of trustees will have a new chairperson beginning in April. Dr. Jim Perry, OD, of Cabool was elected unanimously to the position by his fellow officers. Janet Wiseman of Houston remains in the vice chairperson/secretary position for another year, also by unanimous decision of the board.

Linda Pamperien, TCMH chief financial officer, presented the February financials which showed an overall drop in revenues.

Although inpatient volumes were up slightly for the month, Pamperien explained that weather played a role in a drop in the numbers for the emergency department, the ambulance service, the clinics and outpatient services.

“Unfortunately, we had a lot of patients in February, but we were only paid for a small percentage of the patients we cared for,” Pamperien said.

TCMH ended the month of February with negative bottom line of $582,731.39 and a year to date loss of $585,260.60.

“We are not going to turn away any patients that need to be seen,” Pamperien said, “And in February we had many seriously ill patients that either didn’t have a way to pay for the care they received or the care they received wasn’t reimbursable.”

Murray presented updated information regarding Medicaid reform efforts in the state of Missouri.

“Data is out showing that the states surrounding Missouri that have expanded their Medicaid coverage are seeing the numbers of uninsured patients and uncompensated care drop dramatically,” Murray said.

Iowa, Illinois, Kentucky and Arkansas have expanded Medicaid coverage to their state residents. The governor of Tennessee has also moved to expand Medicaid coverage in Tennessee.

“TCMH is the poster child for why Medicaid expansion exists,” Murray said.

Murray and other healthcare leaders in the region plan to participate in a public round table discussion regarding Medicaid in West Plains on March 31.

Present at the meeting were Murray; Kerr; Pamperien; Durham; Doretta Todd-Willis, chief nursing officer; Dr. Jonathan Beers, chief of staff; Dr. John Duff; and board members, Fockler; Perry; Wiseman, and Mark Hampton.

Board member, Russell Gaither, was not present.

The next meeting of the TCMH board of trustees is Thur., April 28 at 12 p.m. in the TCMH board room.