Hospital board discusses roof funding

During their Tuesday night meeting, the Hot Springs County Memorial Hospital Board of Trustees discussed the re-roofing of the hospital. Earlier this year, a proposal was presented to the State Loan and Investment Board (SLIB), for $1.5 million for about 27,000 square feet of the current hospital roof to be replaced.

The new roof cost is about $685,000, not including asbestos abatement of $164,000, and the request to the SLIB was to ensure all costs were covered, with initial plans to use the remainder to move the kitchen from the basement to the ground level.

However, it was learned later that the SLIB would only grant about half of the money for the roof, $342,650. With that money, however, documentation was also requested from SLIB as to how the hospital will pay the remaining balance.

It was suggested, and approved, to inform the SLIB that the money would come from operations. The board will make a decision later as to whether that means it will come from the cash reserve or the line of credit.

Also during the meeting, Dan Odasz, the architect with Plan 1, and Jake Schrickling, the project director with Sletten Construction, provided an update on the progress of the hospital addition.

Schrickling expects the concrete work to be done within a week, and another two to three weeks for steel support construction to finish. Also in a couple weeks, he noted, door frames should be going in.

Pipe and duct work is also getting laid out, he said, and there have been meetings with the medical equipment firm at the site, in order to coordinate installation of the equipment and construction continues. Overall, Schrickling said, the project is tracking way ahead of the baseline schedule and people will really see it start to take shape in the coming weeks.

Odasz added there will be a mock up wall made available, so the board will be able to see how the metal and rock exterior will look before it actually goes on the building. The current project phase is the biggest, Odasz said, and is expected to finish in the first couple weeks in January.

Though all the pieces are fitting together nicely, Odasz pointed out there have been some changes as to where the MRI would be placed. Originally, he explained, it was to be moved into a shell space. However, the cost of moving the equipment and adapting the space for it could cost up to $200,000. There is also the consideration that this is sensitive equipment that could be damaged in the move, leading to further expense.

Leaving the MRI where it currently is would also require a redesign of the kitchen area, though Odasz noted this had already been drawn up and seemed amiable to the kitchen staff. Later in the meeting, the board approved keeping the MRI where it currently is.

Odasz further noted the new addition would be available to tour in the next month.

Dr. Vern Miller, in his report, said several things have been discussed. Among them is looking for staff for areas such as obstetrics and surgery. He further clarified that the hospital does have travellers who come and do a wonderful job, but those travellers eventually leave and new travellers have to be trained. He indicated it would be better to have people who sign on for more permanent staff positions.

Also discussed were the “bundles.” Miller explained these bundles are specific groups of orders in incidents, such as a person having sepsis. Another topic was where would people go who need treatment, if they are coming from one of the clinics or from outside the hospital. The default, he said, would be to run them through the emergency department, as it would be the quickest way for them to get quality care.

Work is also being done, Miller said, to finalize the criteria when it comes to activations in trauma events. These activations are in place to make sure everyone who is needed — from surgeons, to lab workers, to radiology and other departments — are notified and ready when a trauma event is called in.

Miller further noted that Hot Springs County Emergency Management Coordinator has offered to do an active shooter training with the hospital.

Another topic being discussed, Miller said, is efficiency in the nursing area. As the transition to the hospital expansion comes, he said it would be possible to have one person who knows what is going on with all the patients, in addition to the regular nurses who each focus on two or three. It would help in relaying information to doctors, he said, as there would be no need to try and track down a specific nurse for a specific patient.

Nina Landis said the hospital has met the national standards for the sepsis bundles, but that’s unfortunate as it means they are only at 50 percent. She added they will continue to improve and she’s looking to “crush” that national average.

Landis also reported the lab had its Clinical Laboratory Improvement Amendments (CLIA) inspection, and a few minor deficiencies, such as maintenance documentation, were found and are being resolved.

Chief Financial Officer Shelly Larson reported the days in accounts receivable are at 64.16, down a couple days from last month, and work is being done to help clear up some of the backlog. She further noted the clinics are doing well, with an average 42 days in accounts receivable, and there is an upcoming audit of the self pay accounts.

Days cash on hand are at about 38, and Larson said that will decrease, as August has three payrolls.

Hospital CEO Margie Molitor reported that a jail agreement has been signed to provide medical management. She explained this will allow staff to go to the jail at set times for routine medical issues and to ensure inmates are receiving their medication. More complex issues will still require a trip to the hospital.