MMH preps for urban patients

Melissa Memorial Hospital in Holyoke has been making plans to accept noncritical patients — who do not have COVID-19 — from medical facilities in the Front Range.

Cathy Harshbarger, interim CEO at MMH, briefed the East Phillips County Hospital District Board of Directors about the situation at a regular monthly meeting Tuesday, March 24.

She said hospitals in urban areas are preparing for a surge of COVID-19 patients and are even considering revamping old hotels and other buildings to make room for more people.

For Harshbarger, it makes sense that a critical access hospital in a rural area, like MMH, could take some of the load. She reassured the board that these will be patients who don’t have COVID-19, and right now the plan is to accept noncritical patients, although she said she doesn’t know if there could be a need to accept ICU patients in the future.

Harshbarger also emphasized that not all of MMH’s beds will be used by Front Range patients. MMH will also be holding back beds to be used by locals.

“This is our community, and I would hate to turn someone away,” said board member Angela Powell.

Another board member, Gary Rahe, agreed that MMH needs to serve the local community. He also said he wanted to remind the community that urban hospitals have made room for rural patients when they have life-threatening emergencies, so now it’s MMH’s turn to give back.

Harshbarger said staff members and other local agencies have been brainstorming ways to support the families that could potentially come to Holyoke with the Front Range patients.

Planning, planning and more planning

At the time of the meeting, no positive COVID-19 cases had been identified in Phillips County, but that doesn’t mean MMH hadn’t been busy planning.

“I’m really proud of the work everyone’s done,” said Harshbarger.

Provider meetings have taken place, backup plans have been put together, and temporary and voluntary staff have been identified. New protocols have been written, schedules have changed, home visits have been made, and facilities have been rearranged.

On top of all that, virtual meetings have taken place with people across the county and state, paperwork has been filed, data has been tracked, and radio and social media announcements have been made.

“We are ready for this influx of patients,” said nurse practitioner Lane Looka with confidence.

Harshbarger was also happy to report that Seabord Foods donated masks and gowns to MMH, and locals have been sewing masks that can be used when all other options for standard masks are gone.

Board amends budget

At the March 24 meeting, the board of directors approved an amended 2020 operating budget and an amended 2020 capital budget.

MMH CFO Wes White said in his financial report that the original budget approved Dec. 10, 2019, was amended because the utilization during the fourth quarter of 2019 was significantly lower than originally projected using historical utilization levels.

The amended budget for departmental utilization was adjusted to new levels based on total 2019 utilization, department revenues and department expenses.

White said the amended operating budget has a total margin of $500,000, an increase from $360,000 in the original budget. The amended capital budget is $500,000, a decrease from $1 million in the original budget.

White also gave the board an update for the month of February. Utilization levels were lower compared to January in most of the major locations of care.

February’s total days cash on hand for all sources was 115, down 15 from 130 days in January. Operating days cash on hand was 41 days, down 14 from 55 days the prior month.

White anticipates an increase in days cash on hand due to higher collections in March. MMH is also working with the Medicare cost report preparer to file the cost report earlier than the normal timeline. The amount is equivalent to 11.5 days cash on hand.

White reported a year-to-date net loss of $313,433.

In regard to the COVID-19 pandemic, MMH will be tracking the financial impact from cancellations of nonessential services. Harshbarger said that the Front Range patients who will be accepted in Holyoke could help MMH make up some of that lost money.

Other business

In other business at the March 24 meeting, the board:

— Reviewed Policy 1.5 regarding knowledge necessary for a healthy lifestyle and Policy 2.2 regarding treatment of patients.

— Noted the May 5 board of director election has been canceled because there were not more candidates than positions to be filled. The two four-year terms will be filled by incumbents Gary Rahe and Sheila Gift.

— Heard an update from board member Steve Young on his attendance at the Colorado Hospital Association’s rural health conference. Two key takeaways for Young were the important responsibility of credentialing and how board members should be actively involved in hiring providers. He also said he was asked to be on the workers compensation trust board.

— Listened to the 2019 provider report by Lane Looka. He said there was some improvement in same-day chart completion, physician order entry and provider volume in regard to the number of patients they see per day.

— Heard a quality report from Jenn Cano. Among other positive aspects were the annual wellness visits, which showed an increase in January and February.

— Held a 50-minute executive session for personnel.