Hospital board selects construction firms to interview

During their June 27 meeting, the Hot Springs County Memorial Hospital Board of Trustees chose to interview construction firms Groathouse, Sletten and Layton, with regard to the forthcoming renovation and expansion to the hospital. Another two firms - Sampson and Erdman - were not selected for interview.

The three construction firms were chosen after review of all five in areas such as cost and fee proposals, work on comparable projects, availability, pre-construction design and planning.

Interviews are scheduled for July 13 at the Hot Springs County School District administration building, with Layton at 8 a.m., Sletten at 9:30 a.m. and Groathouse at 11 a.m.

Dr. Jason Weyer, providing the medical staff report, noted there was discussion regarding update of policies so they fall within the new guidelines. He further added they are updating standards with regard to how patients are cared for before they arrive at the hospital.

Weyer also pointed out the hospital has a lower rate of Caesarian sections than the national standard, about 30 percent compared to the national standard of 35 percent.

CEO Margie Molitor reported with regard to patient satisfaction, noting the scores for May and June are looking great so far, which she attributed to more consistent rounding on nurses and patients. She's hopeful to continue on an upward trajectory.

CFO Shelly Larson reported for May, the number of accounts receivbale days did increase by about three days to 45. She attributed that to an increase in gross revenue for May, and projected they will finish at the 45-day mark for the fiscal year. Cash in hand days did increase to 60, Larson reported, attributable to the fact that the hospital did receive a lump sum payment from Medicare in May. Larson noted this is an interim settlement for the current year, and is very well timed.

Molitor noted May was the first month the hospital saw over $2 million in gross revenue since August.

Larson also provided a quick look at the preliminary budget. She explained the budget, as a district, typically goes through a couple stages. The final stage is a budget hearing, which has to happen within a few days of the last Thursday in July. The hearing was scheduled for just before the board's next meeting, at 6 p.m. July 25.

Larson noted the construction project at the hospital next year will not impact any of the gross revenue or operating expenses to the point where any space in the hospital is impacted. She further explained they will have to recognize they receive funds through the special purpose tax. Those funds will be restricted funds, and listed as non-operating income.

Larson said, with regard to the budget, they are expecting a 17.84 percent increase in net revenue. This is primarily attributable, she said, to additional services provided through orthopedic line of services, as well as projected increase in obstetrics revenues. There is also a projected 12 percent increase in expenses, primarily related to supplies.

Molitor noted there was a trauma survey on June 28, and encouraged any of the board members to attend.

Following the survey, and outside the regular meeting, Molitor reported the hospital did very well. "We had an awesome trauma survey," she said. The hospital has received a full three-year accreditation as a Level 3 hospital, meaning there is a general surgeon available at all times. Molitor noted in the last trauma survey they also received a full accreditation, showing the hospital has an ongoing high quality trauma program.

Molitor spoke highly of Dr. Vernon Miller, the trauma director, as well as trauma coordinators Joann Moore and Bri Christiansen for the work they've done in making sure policies, protocols and the trauma registry are up to date.

Molitor noted trauma doesn't just happen at the hospital, as it includes emergency medical services, so they are looking at the full patient experience and continuity of care from injury until they leave the hospital.

Those conducting the survey, Molitor said, could tell the hospital had a well-established program, and they were pleased the hospital was doing a renovation and expansion, as it would have advantages from a trauma perspective. The surveyors also noted the hospital's education and outreach were superb, Molitor said, and there was excellent survey preparation.

"We did some things they said were best practices," she said, "which they wanted to share with other hospitals in the state." Among those practices were in regard to the trauma flow sheet, as well as policy regarding rapid transfusions.

Chrisitiansen and Moore have also done some activities to get all staff involved, Molitor said. Being a small hospital, trauma impacts every department when it happens and everyone has a role. These activities helped staff understand what those roles are.

Molitor also pointed out the hospital is always looking to make sure everyone is up to date with their skills, so Friday there was a hands-on skills lab for physicians, nurses and emergency medical staff. "It was things you don't see that often, but you want to be proficient at." Among the activities were interosseous IV insertion – which goes straight into the bone rather than a vein – emergency tracheostomies and putting in chest tubes.