December numbers and plans to improve the PMH Clinic set a positive tone for the Pocahontas Memorial Hospital board of directors meeting on Thursday night.

The results of tweaking, planning and having Dr. Frank Puckett on staff are beginning to show up in print in the hospital's financial and statistical reports.

Total admissions for the month of December were reported at 61, the highest number of admits reported on the statistics chart which covers the period from 2009 through December 2011.
ER visits stood at a record number, as well, coming in at 399, with 44 of those patients being admitted to PMH for further care.

Puckett reported to the board that during the same period last year, 30% of ER patients were transported to other facilities. That number was down to 4% this year.

With the ski season in full swing, 74 patients were transported from Snowshoe to PMH.

Puckett shared a letter he'd received from the family of one of those patients.

The letter read, in part, "We can't thank you enough for the outstanding care we received for our daughter.ﾠ She suffered from a concussion and memory loss while skiing at Snowshoe.ﾠ Being in such a remote area we had initial reservations about the quality of care we would find for her.ﾠ Needless to say, our preconceived notions were debunked the moment we came through the ER doors."

The staff'sﾠ focus on quality care and capturing charges for services rendered put PMH in the black for the month of December to the tune of $96,468.

In addition to December's gain, CFO Chad Carpenter reported that the results of the audit by Arnett and Foster improved the June 30, 2011 fiscal year-end numbers, as well.

The loss, originally reported to be $280,862, was reduced to a loss of $83,683.

What appeared to be a detraction from the positive news for December was the $21,834 loss at PMH Clinic for the month.
"Does the clinic always have such losses?" asked new board member Freda Jackson.

"We will discuss that later," Puckett responded.

In that later discussion, COO Terry Wagner addressed plans to improve the clinic's operation.

Rural Health Clinic Status and cost-based reimbursement will reduce those losses, Wagner told the board.

The clinic housed within the hospital has been approved for RHCﾠ status, but the clinic "over the hill has had issue after issue," Wagner said.ﾠ "We do not have a letter of approval for the main clinic."

Approval for the main clinic requires a site-survey by the Office of Health Facility Licensure and Certification (OFLAC) which may not be done for another year.

To overcome that delay and to make the clinic more profitable, Wagner presented a plan for all clinic operations to be moved to the already RHC approved clinic at the hospital.

To facilitate this change, the billing office will move to the current clinic site in the medical plaza on Duncan Road.ﾠPersonnel and office functions for Case Management, Utilization Review, Risk Management and Director of Nursing, now located in the back hall of PMH, will move to the present billing office just off the hospital lobby.

PMH is scheduled for a Critical Access survey by the end of March.ﾠ Once that status is received, the clinic will move, with minimal costﾠfor renovations, Wagner said.

CEO Barbara Lay advised the board of other plans to "reinvest in our facility."

During the recent planned power outage, it was discovered that some areas of the hospital were not on generated power.ﾠ A new, larger generator is needed to provide sufficient power to run the facility. To be in compliance with licensing requirements, PMH must always be prepared for a three day (72 hour) outage.

Expenditures will also include implementation of Electronic Health Records, a new ambulance and an upgrade to the facility to bring the CT scan in-house. These proposed investments total nearly $500,000, with the CT company helping to pay for renovations to properly house the CT.

Lay will present a more concrete plan and numbers at the next meeting.

"We will make sure that our financing matches depreciation," she said.

In addition Lay informed the board about the implementation of a Worksite Wellness program for hospital employees which meets on Thursday mornings. The staff has planned activities to coincide with Heart Month in February; will attend the WV Hospital Day at the Legislature on February 9; and PMH will host a Health Care Summit regarding Affordable Healthcare February 22 at the Opera House in Marlinton.

Collection of old accounts remains at a stalemate, as there have been few-to-no responses to billing notices.

The board approved another write-off in the amount of $107,087, and those bills will be sent to the collection agency.
But despite collection efforts, "only about $1,000 has been recovered," Carpenter said.

Measures are now in place to ensure that billing info is being correctly collected, for correct and timely billing.

Administration and staff reports are filled with plans for improvements to the quality of care, as well asﾠ cash flow.

ERx has supplied ER doctors for PMH for the past five years.ﾠ That contract is up for renewal.

At the present time Puckett and Dr. Chase Ranson are providing ER coverage for 86 hours per week.

Efforts to recruit another physician continue.

"We are exploring the option of having our own physicians," Puckett said.ﾠ "The goal is to build our own staff."

With an eye to quality of care, efficiency and time management, the board approved the purchase of InterQual software at a cost of $14,375.

That program will provide staff with criteria for admits for acute care and observation, which will correspond with insurance company requirements.

"It will pay for itself in a month," Lay said.

Within the last month, 11 insurance claims required adjustment from acute to observation, and one claim was denied.ﾠ The lag caused by erroneous paperwork leads to a delay in payment to the facility.

"InterQual will alert physicians to the criteria for diagnosis, reducing the need for phone calls, excess time and paperwork and the risk of denial," Puckett told the board. "If we do it right the first time, every time, we will continue to improve."

The board meets again on Thursday, February 23, at 6 p.m. in the hospital conference room.

Jaynell Graham may be reached at jsgraham@pocahontastimes.com

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