Hospital Financial Situation Still a Concern for Board

Hospital officials continue to work on expense reduction and increasing revenue according to administrator Tim Brown, who reported a loss around $100,000 for the month of January at the February meeting of the Claiborne County Hospital and Nursing Home Board of Directors.

"Most of what we're seeing is better," he said. "As time goes on we'll see more."

The staff is working toward getting reimbursed more and reducing the number insurance denials, all part of a plan set in place when reimbursement specialist and consultant Frank Shiffer was brought on board.

Shiffer reported that he and some of the local staff have looked at another hospital's process of registration in the Emergency Room.

"We came back and changed our processes and there's a big difference," he said.

Now the registration clerk checks for high-risk complaints when a patient comes in the door and those patients go through an abbreviated registration process to shorten their time in the waiting area.  There are also no more clipboards at the registration area and the area will be slightly remodeled to help ensure the patient's privacy.

The changes come at a time when volumes have been increasing because of seasonal flu, Brown said.

"We've seen a dramatic change in wait time," Shiffer said. "It's really working very well."

Shiffer is also addressing complaints from physicians about direct admissions, which are patients who are admitted directly into the hospital and don't go through the emergency room.  There have been delays reported in the registration process and even transporting those patients to their room.

Now, he said, "we give them the highest priority when registering and we finish their registration at the bedside."

Shiffer also reported on new and improved processes throughout the hospital regarding insurance and billing.

Board member Terry England requested management provide answers for what Shiffer is doing.

"We want some quantitative results," England said. "What in the world's been going on that Frank's come in here to say it's been wrong all this time?"

The contract for the Emergency Department is up for renewal after a three-year agreement. The contract is current held by Team Health, which is the parent company of Emergency Coverage Corporation - the group that provides physicians for the Emergency Department.

"They're trying to establish a core group of physicians and also trying to get them to become more a part of the community." said Brown, adding his recommendation to continue with the current group.

"To change at this point would be a big challenge," he said.

Team Health collects what they bill and the organization doesn't pay them anything, according to Brown.

The board voted to keep ECC for one year, which is the new contract term.

Attorney Steve McSween, who is helping to handle the sale of the Claiborne Home Health to SunCrest Health Care, reported that almost all of the due diligence is complete, and that the target closing date is March 15. The board members decided to recess the meeting to look over the entire sale document and contract before approving it. The board will meet on March 14 5o go over the contract. No other items will be discussed.

At the request of County Mayor Jack Daniels at a previous meeting, Steve Clap, president of Restoration Healthcare, presented to the board several options there are available to them regarding the future of the hospital.

The three biggest options are a management contract such as the one the organization currently has with Restoration, leasing the hospital out or selling it. Currently the financial risk to the county is 100 percent because the county owns the hospital.

When the control is traded off the board loses autonomy, Clapp explained, adding that right now all strategic decisions are made by the board.

If the hospital is leased out, the county would still retain ownership of the assets but would be renting the assets to another organization. The lease term can be structured, but most want to do an extended period because of the capital investment they must make.

"The good thing about a lease is there's not a restriction on the use of the proceeds," Clapp said, adding that the State Attorney General gets involved in a sale and there are restrictions as to how the proceeds can be used.

"The community doesn't get a windfall" if there is a sale, reported McSween.

There are a lot of financial implications to think about if the board were to consider a lease or as sale, McSween said. Some of those include the impact on the current debt, the implication on the bonds, governance structure and any potential buyer or lessor's access to financial resources. The overall organizational stability would need to be examined, he said.

After several prompts from Daniels regarding a leasing or selling the organization, the board declined to discuss any specifics as to a potential lease or sale and instead voted to recess until March 14 at 6 pm.