The Times Journal & Russell County News
Saturday, Apr. 19, 2014 — RUSSELL SPRINGS & JAMESTOWN, KENTUCKY — russellcounty.net
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Hospital loses funding source for expansion, searches for others
In May 26 Issue
By John Thompson
TJ Reporter

Russell County Hospital CEO David Rasmussen reports that hopeful funding through the USDA was not likely, as the $7 million allocated for Kentucky for the year has already been "promised" for fiscal year 2011. "They put our application in inactive status for 25 months," said Russell County Hospital CEO David Rasmussen. "But it doesn't mean it's forgotten, it's just that it's inactive until there's some budget movement for us, and so we're not going to let it die."

The lack of funding through this source led to a discussion to alternative funding sources, with one funding source being that another grant possibility through the state if the 2012 state fiscal budget proposal keeps in it a proposed one billion dollars in research and development. The budget proposal still faces many hurdles before becoming a possibility, but the proposed budget item would be geared largely toward the development of rural hospitals.

Another idea presented was to go with a bonding option, with possibly talking with a representative of the investment banking firms of Ross Sinclair and Associates or Morgan Keegan about bonding possibilities; or municipal loans through the Kentucky Association of Counties (KACO) or Kentucky League of Cities; and also grant or funding opportunities through the Appalachian Regional Commission (ARC).

Rasmussen said that the design phase of the new hospital expansion for which they are currently searching funding was 97 percent completed, "now it's just waiting on the financing," said Rasmussen.

Efforts to develop a policy of Strategic Planning is going ahead on schedule with a finish date set for July 8 or 9. Recent interviewing efforts are a part of fact gathering, reports Rasmussen and over the next two weeks employees will be filling out an Employee Satisfaction Survey. The online survey is kept confidential and will be used to evaluate employee/manager relations.

Hospital Chief Financial Officer Ken Kimsal reported on efforts at getting a large fuel storage tank removed from hospital grounds that has not been used for approximately 15 years.

Kimsal said that they had received two proposals to have the tank removed, one at a small cost and one that might result in a net profit for the hospital due to the tanks still holding 15,800 gallons of diesel fuel in it.

Board Attorney Jeff Hoover cautioned that government regulations governing removal of fuel storage units are very stringent. "I just want to make sure that before we start anything we get some releases signed and indemnification agreements to protect us if something goes wrong," and as such requested he review any agreement before beginning the process of the actual removal.

The board agreed to accept the best bid presented by Marion Environmental Inc. for the project subject to the hospital attorney approving the release and indemnification agreements.

Chief of Staff, Doctor M. Kent Gibson, presented the board with the monthly medical staff report. Gibson said they've been investigating changes in staffing that is increasingly becoming the norm at other hospitals in how doctors would cover inpatient duties.

The proposed change will be in hiring specialist doctors called a "Hospitalist." A hospitalist is becoming the norm trend that calls for inpatients to be seen by a staff doctor on residence rather than the patients primary care physician.

Rasmussen said that in a survey he had done with local doctors 71 percent said they would like to put a hospitalist utilization plan within three months. A proposal for this significant change in hospital inpatient care would be prepared for approval next month, according to Rasmussen.

CFO Ken Kimsal presented the board with the monthly financial report for the month of April, with the monthly revenue being four percent over budget, with the yearly budget still falling about two percent behind, mostly in the in-patient side, with out-patient being six percent over.

Further numbers indicate that in acute care admissions are 13 percent below what is budgeted, or two patients less this year over last year for a 10 month period. Swing bed admissions are about on budget, and the E.R. is showing about three percent above what was budgeted, with 10,500 plus visits compared to the 10,200 plus visits budgeted. Lab is also three percent over budget, and O.R. is about 10 percent below budget on the number of patients expected. In Radiology, including all radiology modalities, the numbers show only 10 procedures over the budgeted number of 15,875 procedures budgeted. Physical Therapy is showing 13 percent over budgeted visits, or 14,000 compared to the 12,500 budgeted for.

Dr. Gibson noted, "I think if you listen to those numbers, everything that's above budget is outpatient, everything that is below budget is inpatient. If we don't think about that as we go we're going to spend money in the wrong direction. You're not going to make any money in inpatient any more it's all outpatient." To which it was remarked that the hospital expansion was heavily focused on outpatient services.

Dr. Gibson also offered praise to hospital radiologist, Dr. Jerry Westerfield on the operations in radiology, including recent efforts at procuring grants "a lot of radiology would not be here without him. As a fellow physician I want to pat him on the back. I don't think anyone else would have pushed to get all the equipment he did, and it's paying for itself."

"A lot of Alliance hospitals have contacted us to find out how we got that grant," offered Rasmussen.

Dr. Westerfield offered that he works with a great group of people in the Radiology Department and that they deserve credit for the success of the department.

Salaries show three percent under for the month, and one percent under year-to-date.

Professional fees were over by nine percent, attributed to E.R. costs.

Overall, on a year to date basis, the hospital is showing a net income of $1.1 million.

Kimsal said that at the end of May they will be turning in numbers to Alliant to do an interim cost report.

Rasmussen then presented the CEO Report, stating that of five patient satisfaction surveys that had been so far received by the emergency room the result was 100 percent on all five for the first three weeks of May. Ambulatory surgery satisfaction is at 92 percent. Outpatient services was 92.2 percent patient satisfaction. Inpatient services satisfaction is at 87.8 percent.

Rasmussen also reported on the Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS. 77.8 percent rated the hospital over in the "top box" or top end of the 1 to 10 scale, with an 8, 9 or 10 being "top box." For the question "Would you recommend the hospital?" the hospital received 72 percent in the top box rating. Communications with doctors with their patients was 81.5 percent. Hospital environment and cleanliness was at 72.3 percent. Hospital quietness rating was at 66.7 percent but Rasmussen expressed that recent changes to some hospital equipment would assuredly result in better rating in this area.

Hardware conversion has been completed in the project to convert to an electronic health record system within the hospital. Currently work continues on software conversion. "We need to be at the higher level so we can move to a true electronic medical record, and that process is under way," said Rasmussen. Corey Stearns has been named as Project Manager for the project.

"The goal is to be fully up to meaningful use by July 2013," said Rasmussen of the two million dollar project, "by hitting that deadline we also become eligible for 90 percent reimbursement for the cost of implementation."

The final item on the CEO Report was to announce the intention to start looking for additional family practice doctors.

The hospital has now been three weeks "smoke-free" reports Rasmussen, and the transition has been going better than expected.

Due to scheduling problem the June session of the Russell County Hospital Board has been moved to June 23 at 7 p.m.

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