New designation, familiar challenges at PMH

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CNO Kerry Ridgeway proudly displayed Pocahontas Memorial Hospital’s just-received Certificate of Designation as a Level IV Trauma Center to the board of directors at Thursday night’s meeting.

 The certificate states “that this designation is reflective of the extraordinary dedication and commitment of this facility and its entire staff to the improvement in the care of trauma patients in West Virginia.”

 CEO Barbara Lay shared some of the comments from the Level IV Trauma Survey which included the involvement of outside EMS agencies in the Performance Improvement process, and the survey team reported that “wherever they walked in the facility they saw people dedicated to making this work.”

 The survey team gave “Kudos for nursing education,” Lay said.

 Doctors at PMH are 100 percent ATLS (Advance Trauma Life Support) certified, nurses are 100 percent ACLS (Advanced Cardiac Life Support) and 100 percent PALS (Pediatric Advanced Life Support ) and 75 percent TNCC (Trauma Nurse Core Course) certified, and that is reported to be “way above the curve of the facilities they are surveying.”

 The staff is trained, but there is work to be done when it comes to collecting fees for services rendered as CFO Chad Carpenter again asked the board to write off exonerations and bad debts in the amount of $111,178.89.

Of that amount, $47,466.76 was for Charity Care and could have been collected with the community’s help.

 Forty-seven patients recently filed the appropriate paperwork for Charity Care, and the hospital was reimbursed for its services.

 “It’s good for the community – good for the hospital,” board president Dr. Bob Must said. “People should not hesitate to seek care when there is a program in place to help them.”

But they need to file an application and there are folks available at the hospital to help them.

The financial statement for the month showed a loss of $177,281, for a year-to-date loss of $162,360.  

The facility recorded the second highest revenue of this year, Lay told the board. But expenses or deductions were for services billed for last month, or longer. And there were a lot of denials in the billing process.

“There is a lag in payments which makes deductions effective in the month the payment is received,” she said.  “Medicare and Medicaid are the biggest payers. If you look at expenses, we are below budget.”

PMH has a new EMS director, Travis Copenhaver, who has implemented changes which will be beneficial, Lay said.

The PMH Ambulance showed a profit for the month of $2,677.72 bringing its year-to-date profit to $20,159.01.

As for the hospital’s census and inpatient days – “those have improved,” Must said. “That’s good.”

Total in-patient days were reported at 163, the highest in that category since March, and the average census was the highest since March, as well. The length of stay came in at a high not seen since August 2011.

PMH continues to focus on improving the turnaround time in the billing department.

“We’re working on days in AR [Accounts Receivable]” Carpenter said. “We will be hiring for two positions in the billing department.”

Days in AR have remained steady for the past three months at around 99, down considerably from a high of 149 days in July 2011. 

Lay told the board that staff will work with Revenue Cycle Solutions, LLC, a company that will assess the processes in place at PMH.

A group of three people will spend two weeks at the facility, beginning as patients, and following through to the end of the billing process.

The company has done this type of work for ten years,” Lay said. “The results are never less than a ten percent return for the organization.”

COO Terry Wagner told the board about changes to improve patient flow, as well as adjustments to eliminate the need for those patients “to travel up and down the hallway when they are not feeling well.”

We are constantly looking at how we can get better at what we are doing, she said.

CMO Dr. Frank Puckett told the board that, as of Saturday, the acute care side of PMH would go paperless and begin the use of electronic health records, and that the surveyors [Level IV Trauma] were very impressed with the credentials that the staff “brought to the table.”

The changes, the improvements in patient care and the designation as a Level IV Trauma Center have put PMH in a good place as the winter ski season begins and emergency room visits increase. 

Staff education will continue as they meet for a two-day Studor event, looking at topics such as “Key words at Key Times,” to be presented by Chuck Kinder. This program will focus on creating and maintaining a positive environment. 

An additional training on “Managing Me and My Money” will be open to staff, board members and their families.

“There’s a lot of exciting things happening,” Must said, “in a lot of different areas.”

The board meets again December 20 at 6 p.m. in the hospital conference room.

Jaynell Graham may be contacted at jsgraham@pocahontastimes.com