Paris, Tenn.–At Thursday night’s meeting of the Henry County Medical Center, CEO Lisa Casteel discussed current COVID-19 trends. West Tennessee is still considered a state hot spot, though cases in the state overall are trending downward.
She said the hospital continues to see four to eight positive cases daily at HCMC. As schools are now in session and the Labor Day holiday approaches, she said they will continue trending the rates of cases in the communities we serve as well as West Tennessee.
HCMC remains on a day-to-day bed management program due to staffing. Neely Ashby, Chief Nursing Officer, updated the board on the critical staffing shortages for RNs, LPNs, and CNAs. This shortage is a national issue and HCMC is not able to compete with the increased pay that many organizations are offering for these positions.
Pre-COVID, HCMC had a bed capacity of 85. Today, HCMC has anywhere from 52 to 60 beds available due to staffing. In February, HCMC had only four nursing openings. Today, HCMC has 31 RN positions open. Nursing staff are currently in mandatory overtime and managers are working nights and weekends to cover needs in their units.
“In 26 years of nursing, this is the most challenging time I have ever seen,” said Ashby. “During a two week period in August, of the 77 patients who were transferred, 33 could have been treated at HCMC but were transferred due to staffing, beds available, and surgery call coverage. It has been a struggle. Every day is a juggling act.”
In her administrative comments, Casteel addressed the federal and state funds granted to HCMC for COVID-19. The hospital has received approximately $14.3 million to assist with the loss of revenues, productivity, inefficiencies, and supplies. Casteel noted that two of the grants have forgiveness periods which will require us to adjust our June 2020 financial statements and not recognize these grants until the grants are forgiven later this year.
CMS recently released two proposed payment models for rural communities known as the Community Health Access and Rural Transformation (CHART) Model. HCMC will evaluate these models to see which one will be most beneficial to the organization. Locally, HCMC received a Rural Residency Grant from the US Department of Health and Human Services to develop a rural residency program.
US Senator Marsha Blackburn’s office called to congratulate us and would like a tour of our facility, which is currently being planned.
The board began the meeting with a presentation by Bethany Adams, a representative with the Delta grant program. Adams discussed what HCMC has accomplished over the first year of the grant including a financial and quality review as well as a telehealth evaluation. Upcoming projects include a physician practice review.
The Delta grant program involves community care coordination planning with the help of our Community Champion. In year two, a communication plan will be developed for both internal and external communications along with development of assessment plans from the reviews that were done in year one. The ultimate goal is to ensure that HCMC is ready for the transition to population health. Adams was extremely complimentary of HCMC and the staff involved and is looking forward to seeing what we will accomplish in the next two years.
“We are very excited about all the things we have on our roadmap to help us continue to grow forward,” Casteel said.
HCMC has two excellent candidates for general surgery. One will be working with the hospital during September and October as a locum to cover ER call. We are also working to recruit a gastroenterologist. With the retirement of Dr. Compton, HCMC hopes to recruit quickly.
Paula Bell, Director of Pharmacy, was selected this month as Department Director of the Quarter.
Financially, Casteel highlighted several items on the report. Currently, days cash on hand is good as well as a positive operating margin and EBIDA. Physician practices have seen an increase along with outpatient services. Surgeries are above last year, though under budget. With a surgeon retiring, we may see a downward trend. HCMC had a positive bottom line of $490,000, even with the grants received. Most expenses were down for the month. With less visitors, some of our revenues like the cafeteria and retail pharmacy are down.
Physician practices have reduced their losses significantly with increased volumes and we look to see more improvement with the rural health clinic designations for Eagle Creek Clinic and Transitions Health along with the development of a FQHC look alike. We still have some staff furloughs in the physician clinics until volumes come back completely.
Bad debts continue to be high with this month at $746,409.36. Additionally, several capital items were approved for a total of $63,016 which includes the pipe repair at the Healthcare Center and needed equipment throughout the organization.
Rob Smith, Director of Plant Operations, presented a facility project update to the board. Smith discussed the completed projects in the facility including the stereotactic room, pharmacy clean room, an OR Bronchoscopy room, as well as the 2 East Med Gas update. This unit is currently serving as our COVID-19 unit and will become our step down unit as planned once COVID-19 trends downward.
Smith also provided an overview of the new Cath Lab construction which will occur in four phases. Phase one involves moving around various areas to build out the next areas needed. Each phase allows for the next phase of the construction to occur because of utilizing space that is currently occupied by other departments or areas.
“It is really a much better use of space for our surgical services,” said Ashby.
Scott Whitby, MD, Board of Trustees Chairman, adjourned the HCMC board meeting and called to order the EMS board meeting. Twila Rose, EMS Director, introduced Mark Pierce with American Medical Response, the new partner for EMS. Rose discussed the transition over the last two months with them and Pierce discussed the development of the new partnership including equipment and recruitment. Rose reported four new people hired full time along with three part time people.
Casteel proposed a change to EMS board meetings quarterly, developing a separate committee for EMS meetings to include a board member, a member from AMR, and staff. It was approved by the board and James Travis will serve on this committee. Reports from EMS will still be presented to the board, but an official meeting will not occur during regular HCMC board meetings.
Dr. Whitby discussed a letter received from a concerned community member about issues or concerns related to HCMC. Casteel read the letter to the board discussing employee turnover and the need to focus on the most profitable areas of the organization, compensating staff more in those areas. At this time, the letter does not have a name or address to provide information back to the person who sent it. Casteel discussed how it takes all our services to ensure the health of our community and that we do not receive reimbursement to cover many of our services, but the services are greatly needed.
“If community members want to support our hospital and ensure it continues to be here providing needed care, we need them to support all our services,” said Casteel.
To learn more about the growth at Henry County Medical Center, go to our website at www.hcmc-tn.org and read about all the services we offer to care for our community.
The next Board of Trustees meeting will be September 24 at 5:30 p.m. at Henry County Medical Center.
Photo: Rob Smith, Director of Plant Operations, presents the Cath Lab construction to the HCMC Board of Trustees at Thursday night’s meeting. (HCMC photo).