NRMC searches for new CEO, moves forward on hospitalist program

Nevada Daily Mail

A strong leader, honest, able to engender good will and a good grasp of finances are the qualities the Nevada Regional Medical Center Board of Directors stressed as important for the hospital's next CEO at its meeting Tuesday.

"They have to tell us the truth," board member Bill Turner said. "They cannot lie to us."

"We need somebody with really strong leadership skills and a good palm presser, someone who will go into the community," board member Bill Denman said. "It's going to take somebody with a unique skill set."

Angela Cobb, executive recruitment director for Quorum, told the board the search for a new CEO generally takes 120 days.

"Right now, we are in the phone interview stages," Cobb said. "We will present a slate of three to four finalists to the board. At that point, you will take over the interview process. We recommend you do one round with all of the finalists, then narrow it down to your top two for your second round."

Turner joked that Cobb might mention to the candidates the most frequently asked day off for vacation is the first day of deer season.

On a more serious note, Cobb asked what qualities of the community she could share with potential candidates.

Board member Catherine Hissink stressed family as important.

"I think that family is important to the staff, the hospital and the board," she said. "If it's someone who has a family, I think that they can relate to the community better."

Denman mentioned the good park system, sports and schools in the community.

While the search is underway for a new CEO, Turner complimented Interim CEO David Hample and attributed the morale improvement in the hospital to his presence.

In his report, Hample said 265 employees attended his hospital-wide employee meetings.

"I think the challenge going forward is trying to react to what we learned and continuing to convey to them transparency of what we're trying to do," he said.

Hample stressed the importance of implementing a hospitalist program, a program with medical physicians who only specialize in the care of hospitalized patients, and reducing unassigned calls in the emergency room (patients unassigned to a doctor while in the ER).

"I think these two have to be taken together," he said. "I see an opportunity where we might take both of these ideas and work them together into one solution where we can accomplish the physician needs and the hospital needs. I don't know what that's going to look like in an agreement. There will be dollars involved. Rarely, rarely does such an endeavor wind up in paying for itself and increasing the direct contribution on the bottom line. In the long run it is a positive for the hospital, medical staff and community. I would like to have this in place by May 31."

He said two larger hospitals will present program proposals in April and local physicians have shown interest in offering services for inpatient care and unassigned patients.

"We're trying to increase the volume," he said. "We really believe our focus needs to be building our patient volume. Our answers lie (in the hospitalist program). We want patients wanting to come here. We want physicians wanting to put patients here. It's important to point out we're not losing any of our autonomy. We're not giving up who we are to anybody north or south."

He also said the hospital needs to work with the ambulance service to ensure patients come to the hospital's ER.

Turner said he had talked to the ambulance barn about this issue.

"They want to work with us," Turner said. "They've invited us to their meetings."

Other goals Hample included in his report were compensating physicians for providing coverage of unassigned calls in the ER, following ER patients as an inpatients, providing post-discharge and post-ER visit care to unassigned patients, making the hospital operational in ICD-10 (a new coding system for billing) by Oct. 1, completing assimilation of the Cerner system, keeping bond covenant compliant, ensuring operational profitability and meeting Meaningful Use requirements- a complex initiative governed by Centers for Medicare and Medicaid Services to utilize technology to improve patient care in hospitals.

"CMS have five goals," IT director Chris Crist explained, "improve quality, safety, efficiency and reduce health care disparities, engage patients and families, improve care coordination, improve population and public health, and ensure adequate privacy and security protections for public health information."

He said these goals translate into reducing medical errors and engaging patients through patient portals where people can have access to medications and health information and set up appointments.

"The goal behind the health information exchange is to have critical patient information accessible to any care provider, at any location, at any time," he said. "The goal is for all the hospitals in each state to be connected in one way or another in order to exchange patient information. Eventually, the entire country will connect together."

He said Meaningful Use compliance is required for the hospital to receive incentive payments up to $2 million and not face penalties from Medicare and Medicaid.

"In July, we are going to attest Meaningful Use for a 90-day time frame (monitor the hospital to give evidence of compliance)," he said. "If we are successful, we will get an incentive from CMS, $825,000. October 1 is where the culture change comes into play. We are to attest for 365 days straight. Meaningful Use will have to be a reality for all of us. This is not one person leading Meaningful Use, it's not one department, it's going to be multiple departments working together to attain Meaningful Use. Ultimately, it's the nurses and physicians that are going to impact Meaningful Use."

He said he doesn't believe the hospital will struggle to attest, at this point.

In his report, Hample added radiologist Marcus Wade announced his resignation, effective in April, and Julie Postai accepted the position of Med/Surg and ICU nurse manager this month.

"We are moving forward with manual entry of home health and hospice claims in order to bill and collect over $600,000 for services rendered and in surgical outreach possibilities with Bates and Cedar counties as well as Freeman," he said.

In other business, the board approved a $66,213 three year service agreement for a mammography unit which includes parts, labor, system upgrades and technical support at a flat rate of $5,518 per month.

"They will be looking at another arrangement this summer," CFO Greg Shaw said. "Siemens would swap out the machine with a cheaper new piece of equipment. This agreement would go away, and the new equipment would be under warranty."

The board also approved a Cerner proposal to extend the hospital's agreement from eight years to 10 years to spread $658,000 in outstanding invoices over the length of the contract and reduce the cost by half for six months to be spread over the contract's term.

The Community Health Fair is scheduled for April 12, at the YMCA. Planning is underway for the Annual Golf Classic, scheduled for May 9.