Barbara Lay, at her last meeting as Interim CEO, presented an employee improvement plan from the Studer Group to the Pocahontas Memorial Hospital Board of Directors at Thursday night's meeting.

The plan is based on nine principles including "commitment to excellence and building a culture around service and individual accountability."

Lay quoted founder Quint Studor with regard to PMH's future.
"To survive, we must get better faster."

Lay's tenure at the hospital has heretofore focused on improving its financial condition.ﾠ In addition to improving the employment base at the hospital, Lay wants to improve life for the residents of the community, as well.

She recently attended the Town Meeting on Prescription Drug Abuse.

"I noticed that the hospital is not a part of the [Drug Prevention] coalition and we will change that," Lay said.

The hospital will also be involved in the upcoming Oral Health Summit to be held at Mountain Quest on October 21.ﾠ
There is a movement afoot to provide access to good oral health care for the children of this county.

"We are beginning to understand the importance of oral health for overall health," said Lay.

Board members discussed the correlation of good dental careﾠand prevention ofﾠfuture health problems, such as heart disease and diabetes. The implementation of the Oral Health Initiative will have a positive effect on the community.

But the loss of physicians and lack of readily available replacements is presenting a struggle for the hospital and is having a negative effect on the facility's bottom line.

Some of that struggle has been relieved with PMH's announcement this week that Dr. Bonnie Gifford, MD, Internal Medicine, has agreed to see patients at PMH Medical Practice on Wednesdays, beginning October 5. Gifford, of Hillsboro, has been credentialed to practice at PMH since July and did sports physicals at the PMH Pediatric Health Fair this past summer.

CFO Chad Carpenter presented the August numbers to the board, numbers that reflect low in-patient census, a decrease in the number of clinic visits and the continuation of write-offs for bad debt.

The hospital showed a monthly loss in the amount of $91,000, bringing the two month year-to-date loss to $131,000, Carpenter said.

Like July, a low patient census for the month played a significant role in the hospital's loss, as in-patient revenue contributed only $175,643 to the hospital's coffers. And that daily census is down from a high of 11.37 in September 2009 to 3.50 in August 2011.

With patient revenue, which includes in-patient, out-patient, clinic and Our Ambulance service at $1,070,655 and operating costs at $847,891, the hospital is staying in line with expenses, Carpenter told the board. Workers are being utilized between the hospital and clinic when employees call in sick and other employees are being sent home.

Daily charges for in-patients dropped to $1,611 per day, down from a high in March and April of more than $2,000.

"Lack of physicians is the more weighty of the issues," said board president Dr. Robert Must. "We need to fix that."

The August allowance for bad debt in the amount of $244,000 took its toll on the bottom line, as well.

"We are working claims as hard as we can," Carpenter said.
"Ed [Lawaty] and Chad reviewed cash collections," Interim CEO Steve Whited said.ﾠ "Cash collections are increasing.ﾠ Aging is getting cleaned up.ﾠ They are doing a great job."

Of the $700,000 that has been turned over to the collection agency, only $500 has been recovered.

The Minnie Hamilton group recommended using two or three collection agencies.

"We usually get 10 percent back," said Whited. ﾑGranted, ours [accounts] is cleaner. But 10 percent has been our history."

"It was some pretty trashy stuff," said Whited of the PMH accounts.ﾠ "It should have been written off years ago."

Another $148,399.41 will be sent to collections and written off as bad debt this month.

"We will always have write-offs," said Lay.

"We have made numerous attempts to contact these people," said Carpenter, "but they are not responding."

"As for the Balance Sheet for June 2011," said Whited. "It is before audit.ﾠ We have found adjustments. We will get some money back, but it will not be the half-million we got back last year."

Days in Accounts Receivable are down to 120, Carpenter told the board.ﾠ That number continues to drop from a high of 149 in July, but needs to be much lower.

The current ratio of assets/liabilities stands at 0.86, not the 1.0 that the facility was working toward.

Our Ambulance runs remained fairly steady in August. With adjustments from the previous month, that serviceﾠ showed a loss of only $146.97.

But considerable losses still plague the clinic, which showed a monthly loss of $21,784 and a two month year-to date loss of $45,715.

Just as the lack of physicians is costing the hospital, that lack is costing the clinic, as well.

Lay said she is continuing to work on recruitment of physicians, but there is a shortage statewide.

Thursday night's meeting was the end of the interim relationship between Minnie Hamilton Healthcare Systems, and the beginning of a new chapter for PMH.

Lay, who has served as Interim CEO, will become the permanent CEO of the hospital on October 1.

"As we end our official association, it has been very positive," said Must.ﾠ "We thank the Minnie Hamilton team.ﾠ You have made a tremendous difference in our financial picture."

The end of the PMH-Minnie Hamilton relationship is not the only change for the board.

Long-time board member Neal Kellison tendered his resignation.

Kellison has served on the board, off and on, for decades.ﾠ He, at first,ﾠasked to be appointed to the board in response to a family issue.

Through the years he has been through hell and literally "high water" with the hospital.

The flood of 1985 began talks about relocating the facility, and in October 1995 the hospital moved to its high and dry location, narrowly missing another major flood in downtown Marlinton in January 1996.

In an interview at his home on Sunday, Kellison said the hospital had often, in the past, been in danger of closing.

"A number of times," he said. "But somehow it was always pulled out.

"Something that was probably wrong but used for good - but wrong in the long run, was that there were times that they were going to shut us down," he said. "That was in the days of politics and political intervention. A few calls were made, and the problem was resolved.

"But those days are over," said Kellison.

"I have been from politicians - to grants - and everything in between, and I have been kicked off the board three or four times," he laughed.

But despite that, Kellison continued to do what he thought was best for the hospital.

The County Commission will advertise for a replacement for his seat, but the "up close and personal" nature of Kellison's tenure may be hard to replace.

ﾠ