TMH to focus on physician recruitment

In other action

In other business, the board:

• Approved, 5-0, the Medicare Cost Report from 2007 after Don Hoerl, an independent consultant, reported on the report via conference call.

• Approved, 5-0, to allow for the replacement of a Siemens Arterial Blood Gas machine that is more than 10 years old. The replacement was deemed "medically necessary" by the Joint Conference Committee.

• Approved, 5-0, to contract the services of general surgery and OB/GYN (not including family physicians with obstetrician focus) exclusively by the hospital. They also voted in favor 5-0 of reaffirming that the services of anesthesiology, pathology, radiology and emergency medicine will continue to be exclusively contracted by the hospital.

• Approved, 5-0, to start outsourcing laundry services to Omni Laundry Services of Grand Junction. The new hospital is not designed to have laundry facilities, which according to chief executive officer George Rohrich was done because "the steam required for laundry services would cause another section of infrastructure, which would have been very expensive." Omni also will purchase the equipment currently used by the hospital for laundry and resell them. The outsourcing will not result in personnel reduction for TMH.

• Approved, 5-0, a mid-year budget adjustment to allow for a new OB/GYN.

• Approved, 5-0, to authorize the change in policy allowing for the opening of bids if there are less than three turned in for the pre-construction stages of the new facility. Previously the policy stated that bids wouldn't be accepted unless there were at least three. This allows for the hospital to proceed with the work without having to rebid a job that doesn't receive three bids.

• Approved, 5-0, to allow for the American Health Facilities Development to accept the lowest qualified bid for new facility needs, as specified by the Department of Housing and Urban Development.

• Approved, 5-0, to adopt a consent agenda format for future meetings.

— Dr. J. Scott Ellis is settling into his new office at The Memorial Hospital as its newest staff member. The obstetrician and gynecologist said he wouldn't mind being the "rookie" for a short period of time.

"I'm supportive of the efforts of this hospital's administration to actively bring in doctors with OB experience," he said. "Right now, as far as the way I see it, it's crucial for the community to have more primary care physicians who are OBs."

At Thursday night's TMH board meeting, the board voted, 5-0, to recruit four to five family or internal medicine physicians to the community. That recruitment will be bolstered by $130,000 in incentives for doctors to move to the community.

"Our immediate need is for more family physicians and internal medicine physicians," said George Rohrich, TMH's chief executive officer. "It is my primary focus to bring our numbers up to improve the quality of life for everybody involved."

According to industry standards, the population of Moffat County has a need for 11 family physicians, Rohrich said. He said there currently are seven, with three of those transitioning away in the coming year.

"There are currently more patient needs than physicians," he said. "I expect that the doctors we bring in will become busy almost right away."

Included in that recruitment is the goal to recruit three family practice physicians with the intention that they will be housed in the Craig Medical Clinic Building and employees of the hospital.

All of the new doctors could have an OB background, which Rohrich said is another pressing need.

"Up until this month, we had two (family physicians who are) OBs, which meant they were on call every other day," Rohrich said. "That is a schedule that is very demanding and few are willing to work that schedule."

The recruitment attempts come on the cusp of two months in which the hospital's in-patient visits for surgeries have been lower than established goals. According to the finance committee report, "surgeries continue to be a tremendous concern, with only 94 in April versus the budgeted number of 109."

More surgeons could be next.

"Another way to improve efficiency will be to increase the availability of surgeons," Rohrich said. "That could happen through recruiting."

Other financial numbers were better than planned with overall ER visits and admissions at 1,955, which is 21 ahead of budgeted. But overall TMH's profit is now $145,000 behind where it was last year.

Two reasons for the lower profits were higher-than-budgeted medical claims from employees and contracted salaries, according to the financial meeting minutes. Chief financial officer Barry Bergman said that the employee claims would decline as the year progresses and the stop loss coverage from insurance takes effect, but the expenses to hire traveling staff could continue to exceed predictions.

Rohrich said the additional expenses for traveling staff are an issue for most hospitals.

Rohrich said there is a shortage for radiology technicians, lab technicians and respiratory technicians. "We are currently advertising nationwide for more techs, and, until then, we are paying extra for traveling techs to fill in the gaps."

Comments

Cole White 5 years, 11 months ago

What a shocking article! This has been a problem for years. Why is the hospital just now doing something about it? I guess though I should be glad to see that the hospital is focused on recruiting new physicians, but they have a complete disregard for the ones they already have. My doctor is leaving at the end of the summer because of how they are mistreated. She delivered all three of my children. If the new doctors are going to be employed by the hospital how do the current doctors feel about having to compete with the hospital for patients?

Also, $145,000 behind last year? The hospital showed that they ended the year with a ($250,000) loss. Does this mean they are on pace to have a ($685,000) loss? What is going on over there? Stan can you shed some more light for us? Why haven't you ran for the hospital board?

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50cal 5 years, 11 months ago

I've got a good recruitment plan for them.

1) go to big city 2) get big stick 3) go to good hospital 4) smack needed doctor on head with big stick 5) drive back to craig 6) chain needed doctor in examination room 7) send in patiants 8) take money on way out 9) give doctor Big Mac Pretty sure thats the only way this hospital has any chance of getting a good doctor. Although I here CSU has one hell of a vet plan.

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grannyrett 5 years, 11 months ago

I don't understand the practice of hospital privileges. If a doctor is licensed to practice medicine in Colorado, what is it that he can't practice medicine at the hospital? This has happened on more than one occasion. Craig will never keep good doctors if the hospital will not give them hospital privileges. Can someone out there explain it to me?

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50cal 5 years, 11 months ago

1) get big stick 2) go to hospital 3) smack existing doctors with big stick 4) break up strangle hold monpoly existing doctors have

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grannyrett 5 years, 10 months ago

okay 50cal-I'm bringing a big stick when I get to Craig and guess who I am going to whack with it? Lol!

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CindyLou 5 years, 10 months ago

Oh my god you should here what I just heard about what is going on at the hospital.

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50cal 5 years, 10 months ago

I heard it to CindyLou, It was amazing granny. The hospital actually saved someones life AND diagnosed someone else right for the first time in one day. These two feats have never been done on the same day before at THE memorial hospital.

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Kyote 5 years, 10 months ago

(I feel compeled to post it here too).

I have often read these articles but I have never been very motivated to add anything to the conversation. It seems there are already enough people writing comments that anything I could add wouldn't account for much. But today I feel different. Having seen now three CEOs and three CFOs come through our doors I feel I am a relatively good judge of administrative character and I feel compeled to start asking the question "what is our hospital administrators doing?" We have a CFO that has had every person who works under him either fired, demoted, or quite because he fosters a very bad working environment. These aren't slacker employees. These are employees who have been singled out as being some of our best, but because the CFO is incapable of managing his departments, they are treated as scape goats and run off when his policies fail. It isn't just those that work for him, but almost every manager in the hospital has found you can't work with him. Seek out almost any hospital employee and they will tell you how bad of a job he is doing. Many of our department managers don't even want him around their departments because whatever he touches he ruins.

Sadly, our CEO isn't any better. While he is a nice guy to your face we receive almost no support to do our jobs. Yes, Randy wasn't the best CEO, but atleast he supported his staff and gave them the tools they needed to do their jobs. Our nursing staff receives very little education to keep skills current because all of our money is being funneled into the new hospital. They cut corners on maintenance and when we don't pass inspection he blames the department manager and forces him to quit. Neither the CEO or the CFO is being held accountable for their actions and it seems like they don't have to answer to anyone. It seems as if one of them tells a lie and the other will back him up. All through this I would like to know where our hospital board is? They have to see what is going on. They have to know that our administration received the lowest marks ever for employee satisfaction. It is widely known that they just laughed at the results of the employee survey and said they mean nothing.

I am beginning to think that the only reason that the CFO and CEO are being kept around is because our board is so focused on getting the new hospital built that they are willing to overlook negligence and very bad practices because they feel they have invested too much to change leaders at this junction. Many of the managers who see our cash and income reports believe that if they brought in a new CFO they would uncover that we are all being deceived. I read Stan Hawthorns posts and thought he was full of poo until I started talking with our department managers.

Continued>>>>

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Kyote 5 years, 10 months ago

<<<<<ontinued

Hospital board, I challenge you to look pass the smiles and bull crap our administrators are giving you and come seek out employees and ask them what is going on. The CEO and CFO are telling you one thing and the truth is going untold. Community members, - talk to you neighbor who works here and ask them how moral is. Yes the service is great in spite of lack of leadership. That can be credited to the hardworking people who dedicate themselves to being the best we can. We are doing it without support or leadership.

We all want to see a new hospital built and I am confident that it can be accomplished, but how many individuals' careers and lives will have to be ruined so our CFO and CEO can put it on their resume. They will both be turning the keys of their cars to move away as the new building door key is turned. Their actions show they have little or no regard for their staff or this community. They are looking at outsourcing many of the vital services we perform locally and provide good jobs for dozens of people. The CFO already tried to disastrously outsource payroll to Denver and is now outsourcing laundry services. After that they are looking at outsourcing patient records and billing services. When will it stop? I am also mad now because all of the money I have donated to the hospital foundation is being used to pay our current bills because we are doing so poorly financially. Are our CFO and CEO not accountable to the people who gave a million dollars to the foundation? Are they not accountable to the foundation board for using this money inappropriately?

Again, I ask you all to talk to your neighbor. Ask them to give you their opinion on our CEO and CFO. I think you will be surprised at what you here.

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Globe 5 years, 10 months ago

Kyote,

You don't need to tell me about the CFO. I met him at Mather's when he was half drunk. Full of crap is what he is. When you know banking and finance the way I know it you know when the other guy doesn't know a thing he is talking about.

Come to think of it, I think the only time I have ever seen him has been at the bar. I use to see Randy and Roger doing all sorts of community service, but I have yet to see this CFO or CEO.

I also have it from a good source we are losing Dr. Riley who is our best doctor in town because of the way the hospital's CEO treats the doctors.

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STANHATHHORN 5 years, 10 months ago

Hwy1340

   TMH admitted to being $146,000 behind last year. Why don't they tell us how much farther behind they are compared to the prior month? (about  $205,000).  It's true 4/30/08 net income is $146,354 below compared to 2007. What they don't tell us is the 3-mill tax provided $514,390 in 2008. Without which, TMH would have posted an operating loss of about ($305,000). So, they are on track for operating losses of nearly ($1million) for 2008, compared to ($287,000) for 2007. Also their Medicare Cost Reports were not a part of their 2007 audit, which may make the picture worse yet. This thing is falling apart.

As for why don't I run for the Hospital Board, they are appointed positions by local officials. There's an old adage "people hire in their own image". I don't fit that image.

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CindyLou 5 years, 10 months ago

Stan,

Are you telling us that the hospital is using tax dollars that are ear marked for the new hospital to fund operations? Didn't you say this would happen last year before the elections?

Kyote,

Thanks for giving everyone the heads up. I started hearing rummors last week before I went on vacation and since returning I have talked with a half a dozen people who confirmed exactly what you are saying.

I also donated money to the foundation Kyote, do you know if we can ask for that money back if it isn't being used to build a new hospital. Remember they said if you give money to the foundation we won't ask for a tax. They should have refunded all that money after they welched on the deal.

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taxslave 5 years, 10 months ago

Hey editor of the Press,

Why aren't you addressing this issue on the front page?

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STANHATHHORN 5 years, 10 months ago

CindyLou Yes, our three mills appears to be keeping this thing afloat. At the end of April there was only $104k in operating cash, and bills to pay of $641k. There are monies due TMH but a monthly payroll of about $600k will someday soon collide with the aforementioned cash position. Watch the building fund take the hit! $104k cash on a business that generates $19million in sales is a retention of only 1/2%, dangerous!!

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AltitudeAdjustment 5 years, 10 months ago

Hmmmmm ... while I think Kyote has touched on some points that definately need to be talked about, I don't think they paint the whole picture. Anyone who is concerned should definately talk with someone who is a reliable source at the hospital before just jumping in and assuming things are as bad as that. Kyote's best point would be to talk to your neighbor if they work at the hospital and ask them directly.

Stan always bring many interesting points about the hospital's financial situation to the table. While the hospital doesn't appear to be doing great, they arene't doing that bad really either. The biggest item that impacts this is the difference between the net and gross patient revenues, which could/would likely change at mid year when they take a closer analysis of this. It is quite possible that mid year adjustments will see the net income rebound.

Also, I believe their cash on hand, while low, isn't a huge factor since they are holding a pretty sizeable amount under their limited use assets, which are likely not restriced completely from being used for payroll and other operating purposes.

While the financial picture isn't outstanding it isn't ask bleak as it first appears. Also, since the hospital has to deal with insurance companies it isn't unusual for one to withold payment for 60 days and realease it all at once. This would likely result in 400,000 or 500,000 coming through in just a couple days for one of their big payers.

Also, they may have recognized the revenue from the Tax dollars but haven't yet received it so it hasn't hit their cash. If they spent cash from thier opperating account on the new hospital planning and stuff then the tax dollars would come back into that account and then be used for operations since it would just be reimbursing the hospital for money that they spent out of operations.

You bring up some great points but more information is helpful.

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50cal 5 years, 10 months ago

tax slave, if you want an answer write on this forum that they misspelled a word and they will answer you

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STANHATHHORN 5 years, 10 months ago

Altitude,

Sorry for the delay in responding. I believe TMH board recently approved the Medicare Cost Report for 2007, buried in that report was a Profit & Loss statement that indicated an operational loss of ($587,922) for the year 2007. Remember, we were told in the fall of 2007 that TMH was on track for a $1million profit. That was later recanted to a $28,000 profit, which was then trumped by the audit figure of a ($287,000) loss.

TMH April 2008 financials indicate a loss from operations of about ($300,000) on track for a $1million loss. It appears the 3-mill tax for a new hospital is critical to keep TMH afloat as is. Remember $514,390 of that 3-mill tax was recognized through April.

Also noteworthy is $1,422,086 was booked in the 2007 Medicare Cost Report balance sheet. The same amount that is apparently due from the 2008 3-mill tax collection. Wrong year? Besides, the balance sheet doesn't appear to balance?

It appears that the TMH board is, and has been, driven by hospital administration which is backward from any normal business. Perhaps we need a wholesale replacement or, at a minimum, new management. THINK OUTSIDE QUORUM!!

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CindyLou 5 years, 10 months ago

COUNTY COMMISSIONERS,

I thought they were going to start building the hospital this spring. Why are they spending tax dollars to pay for things other than the new building? Hey county commissioners, that money should be going into a trust fund until they have to start paying off the loans, they shouldn't be spending it on whatever they want.

Tax Slave,

The paper does report on how the hospital is dong. Everyday they usually have a quarter page article on the second or third page. It costs the hospital about $300 and it covers things like "Do you think we should change our name?" or "What should we do with a building that isn't fit to house chickens?" I particularly liked the annual report they put out that had pictures of doctors and nurses that didn't even work at the hospital. Too many advertisement $$$$$ surely are clouding the judgement of the Gods of the Copybook Heading.

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taxslave 5 years, 10 months ago

Where are the funds? Weren't they supposed to be approved by now?

Hey, e-mail the county commissioners on their web-site and pass this info on to all of them. Perhaps a follow-up phone call to the office letting them know there are e-mails to be read.

You bet we need to ask the questions...like, "Who are these people?".

HEY DAILY PRESS.....You will be held accountable as well if this project goes amiss. I will personally bring up your irresponsible coverage at both the city and commissioners meeting.

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Taxpayer 5 years, 10 months ago

It's too bad as a group we didn't start asking more questions regarding what the hospital was really going to cost all of us. And why hasn't the Hospital opened up the bidding process. It would appear the money is moving from one pocket to another, and the companies in Craig/Moffat County should be getting some of the work. The financials of the hospital should be giving the board members nightmares. I don't know how they sleep at night. Maybe they are afraid to ask questions, as in Craig/Moffat County, asking a questions to give clarity or to receive more information means you are negative . It's either "you are with us, or you are against us" whenever you want clarity. If you question any financial data provided, you also are painted with a negativity. It is so sad. Maybe we need to have the Rocky Mountain News or the Denver Post start looking at this, or maybe O'Reilly might want to have his staff look into the financials. Time for transparency with all the numbers thrown around for the hospital. I think the citizens would be shocked to know just how poorly the Profit and Loss is for the Hospital. There is just too many incidents of conflict of interest.

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CindyLou 5 years, 10 months ago

Stan,

So what is the final loss for the hospital last year? Which numbers do the people loaning the hospital money get to see when they are making decisions? Does it amount to the hospital keeping two sets of books? Do they have to give a "final" report on what the final numbers are? If their loss changed since they were audited do they have to have the auditors come back and look at the books again? Why doesn't the hospital give the public all the facts so we can be better informed?

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STANHATHHORN 5 years, 10 months ago

Taxpayer, It's called the design-build process, same as the middle school. First, officials determine how much money the county will provide. Then, much later they decide what we will get for that money. No bids, all the players are already in place. That's why the school had a $2million cost overrun before ground was broken. Lot's of room for hankey pankey. I don't think TMH board is losing any sleep, if they had any idea what is happening they would have set a different course.

CindyLou Who knows what final number will be recognized. I think it is similar to appraisals, which most of us are familiar with, you can always find someone to give you the answer you want. In this case none of the answers are good, so how bad is it? The 2007 audit probably should never have been released without the Medicare Cost Report as an integral part. Both the 2007 auditor and the MCR analyst are new players. See what I mean! On 4/15/08 & 4/16/08 I requested copies of the TMH financials that would be used in the HUD application process. The response to the 4/15/08 request was, "TMH financials will not be included in the application only those supplied by outside audit firm". The 4/16/08 request was answered as follows,"We do not have any financials that will be used in the HUD applicaton process. An ouside firm performs the feasibility study that will be included in the application". So, is HUD flying blind, do they know we probably can't make the payments? Ask the questions!

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Globe 5 years, 10 months ago

Are you telling us Stan that an independent outside organization is going to do a feasibility study and they don't care about the past or the present they only care about what might happen in the future? How do they even come up with a number if they aren't at least looking at what the current environment is? The is messed up! Is this "independent" outfit owned by the same company that manages the hospital?

I would be willing to bet that if the county or the city was showing budget shortfalls like the hospital is that the Daily Press would be reporting on it. Human interest stories and advertisements that is all the Press is these days. Can you image if the county or city was tracking a million dollars in the red? That would be front page news!

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50cal 5 years, 10 months ago

who's there for them to answer to taxslave the daily press has NO compettition they answer to no one.

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Taxpayer 5 years, 10 months ago

The hospital will be full of overruns. Stan tried to tell everyone what was going on, how to read the misinformation from the hosptial staff and why the voters should vote NO. Now that all the truth is coming out, there isn't much coming from the hospital is there? I would hope that HUD does due dilligence on this application. And having an open bid would be a good way to make sure we aren't paying for a purse made out of a sow's ear! I would hope the Board of the hospital has seen the application so they know what a mess is being created behind their backs. The County Commissioners need to review the application too before they end up with another Justice Center. Patricia McCaffrey, Moffat County Taxpayer

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50cal 5 years, 10 months ago

I urge everyone to go out and drive the road through the new location this is a terrible site to see. I will not blame Elam const. because they just made it black but the company that did the sub base of the road should be ran out of town (wait they are from out of town) I hope the rest of the project isn't this bad or the cost overruns will be the least of our worries.

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