August 8th House Rep Scott Tipton Visit to SHS

It was our pleasure to host Representative Scott Tipton at Southwest Memorial Hospital on Thursday, August 8th.  Rep. Tipton toured the facility including the new 20-bed inpatient wing, ICU, and Family Birthing Center, as well as our OR, ER, Rehab Department, 4-suite Medical Office building with primary and specialty care clinics.  Tipton and his staff were impressed with the extensive services offered at our facility.


Following the tour, representation from support and clinical departments, MCHD and SHS Board members reviewed recent successes, challenges and opportunities with Rep Tipton.  Discussions included challenges in recruiting rural primary care providers and surgical call coverage, opportunities and challenges with telemedicine to provide additional support to patients and clinical staff to improve mental and behavioral health, need for additional resources for suicide and substance abuse, access challenges for our service members, reimbursement, high-cost insurance premiums in rural communities, and infrastructure upgrades needed in the older part of the facility. It was a great opportunity to collaborate and share. Rep Tipton provided great feedback on current bills working through legislation that could potentially address some of our concerns.

We’d like to extend a special thanks to Cody Burke, CRNA for coordinating the visit!

7-19 CEO UPDATE

Stage 1: SURVIVAL

Our recent successful turnaround at Southwest Health System continues to receive recognition. Community Hospital Corporation (CHC) recently selected SHS to be the subject of a case study demonstrating the impact of the changes that were necessary to ensure the long-term survival of SHS.

As you know the primary (Stage 1) focus was to find major issues and solve them quickly enough to assure the organization would survive.  The case study CHC just published focuses on that remarkable turn-around.  The link to that case study is: https://communityhospitalcorp.com/lessons-for-leaders-of-distressed-hospitals/.

So, year one is over and I could not be prouder of the work all of you have done to turn this organization around – it is because of your hard work, willingness to adapt and your amazing resilience that have made this possible. This was only the start as now we move on from survival to the second stage to ensure our continued success.

Stage 2: STABILIZATION

We have worked through the survival stage and year two’s focus is to stabilize our position to assure we continue moving in a positive direction. We are continuing to find and address opportunities, building cash and continuing to build and strengthen relationships with our community, our staff, our lenders and our boards.

Here are a few examples of what we are working towards and have accomplished this year.

  • PAY INCREASES: Last year we froze raises as part of the “Survival Plan”, annual performance increases will be reimplemented in August with a potential 4% increase, based on your individual evaluation.
  • EMPLOYEE ENGAGEMENT: By the end of July I will have visited every department to review the employee engagement results with you and your respective leaders with the goal of assuring we are looking at and addressing areas where we can improve our employee experience and thereby improving our patient experience. Communication and leadership are a huge part of ensuring our teams success and our senior leadership team is fully engaged in addressing those items that can facilitate our staff’s professional success. In addition, over the next few weeks we will be sharing the results of the PROVIDER ENGAGEMENT survey with our SHS providers so we can continue to improve their experience as well.
  • HOSPITAL COMPARE RATING: I have mentioned before how impressive it is that during our time of turmoil you have continued to step-up and continue to provide excellent patient care to the extent, we have experienced impressive increases in our patient satisfaction scores. Well now that improvement in not only patient satisfaction but also our quality scores has resulted in our SHS rating on the Medicare Hospital Compare Web-site to increase from a 3-star to a 4-star.  Again, only due to your hard work and continued focus of making our patients your priority.  I expect we will continue to see this improve and fully believe a 5-star rating is in our future.
  • COMMUNICATION: We continue to build on our focus of improved communication with all our stakeholders including the MCHD Board, the SHS Board, our Lenders, the Community and our Staff assure we are maintaining complete transparency on our financial, operational and strategic position and vision for the future. We are committed to continuing our monthly employee forums, and our quarterly community open forums in addition to publishing relevant financial information on our web-site.  We also just added internal support in the form of a Community Relations Manager, Linsey Yeager, to ensure our community and staff are engaged and receiving information through community events and involvement, social media, and internal communications through multiple platforms.
  • CAPITAL PLANNING: We are working with the SHS Board and the MCHD Board to address significant capital needs to address the infrastructure items that have been ignored for years while being cognizant of our cash flow needs and restrictions resulting from our debt covenants. This year we will be developing a 5-year capital plan to address these needs as well as the internal capital equipment that also must be addressed.
  • SOLIDIFYING LEADERSHIP: The hiring of a permanent leader for the clinics was a critical step in our on-going success. The clinic staff have experienced significant upheaval through this entire process. With the hiring of Kerri White and her assuming Clinic Leadership as SMG-Chief Operating Officer, we will put another piece in place to assure the continued growth and success of our clinic practices.

STAGE 3: STRETCH: Once we address the forbearance requirements and continue to demonstrate our long-term viability, we can look to the future and further serve our community. As we continue with the trend of positive cash flow, we look to address the following priorities:

  • Correct infrastructure issues mentioned above in the older portions of our buildings
  • Update/Expand our ER
  • Fully integrated EMR for the Hospital and Clinics
  • Continue to market and expand to regain market share
  • Focus on improving the image of Southwest Health to assure that SHS is the preferred provider for all patients in our service area
  • Continued focus on employee engagement to also assure SHS is the preferred healthcare employer in our area

Ultimately our goal will continue to be ensuring the SHS mission is fulfilled: TO PROVIDE THE HIGHEST QUALITY OF HEALTHCARE TO OUR COMMUNITY BY BRINGING EXCELLENCE AND SERVICE TOGETHER TO PROMOTE, IMPROVE AND RESTORE HEALTH.

Thanks to our staff, the SHS Board, the MCHD Board, our Lenders, CHC and everyone in the community that we are here to serve – Thanks for being a part of this amazing success story.

 

PATIENT COMPLIMENT: I received a very nice letter this week from one of our former patients thanking the staff for taking excellent care of her this past year during multiple stays. In the letter (Copy attached to this email) she closed with the following:

“Please know that I will continue to tell everyone I know about your excellent hospital and you, the wonderful and dedicated people that work there. I deeply feel you need to be recognized more for the excellent healthcare service you provide for the people of Montezuma County and the surrounding area. And also, what a valuable gift Southwest Memorial is to this community.”

I could not agree more with what she says and what a great ambassador she will be for this organization.  I hear these comments all the time and I am never surprised.  It is this type of recognition that will move us toward our goals.  Thank you for your impressive work.

 

NEXT WEEK – PUBLIC FORUM:  On Wednesday next week will be our quarterly community forum with the SHS and MCHD Boards in the EMS Ambulance Garage.  We wanted to switch it up a little and hopefully have a more relaxed environment (and some snacks/refreshments) to facilitate further public comments.  Your participation would be greatly appreciated.

As always, thanks for all you do to support our mission and make SHS a truly remarkable success story.

Tony

May 24, 2019 CEO Update

CEO UPDATE TO SHS STAFF:

On Wednesday, we had the opportunity to again present our Board another month of excellent financial results.  We were very busy during April.  All in all, it was one of the busiest months this organization has ever experienced resulting in record gross charges.  We held our costs down and a combination of higher revenue and lower costs is usually a very good combination as it was for SHS this month.

Overall, we continue to experience excellent cash collections which is reflective of our increasing revenue and also improvements that are being realized in our revenue cycle.  The Revenue Cycle group has addressed and continues to address a number of issues that affect not only the amount of dollars we collected but also the timeliness of those collections.  As we all have heard by now a major issue a year ago was the amount of cash we had on hand and the fact that our cash balance had fallen to a dangerous level.  The revenue cycle improvements above have assisted in providing a steady increase in our cash on hand.  We finished April with 46.51 days cash on had up from 15 days in April, 2018.  We continue to add about 2 days a month which puts us on target to exceed the established expectations of our lenders.  The chart below shows our days cash on hand progression.

As you can see, we are already exceeding our June 30, 2019 goal and are well on our way to exceeding our December 31, 2019 goal.

It is also important to note that concurrent with increasing cash we have also reduced our amount due to our suppliers, accounts payable, by over a 1.0 million during this same time.

On a year-to-date basis, we are now about $3.0 million ahead of prior year for Gross Patient Revenue and about $2.4 million ahead for Net Patient Revenue (the amount we expect to collect from our services).  In addition, our total expenses are down about $1.5 million including the additional expense related to the new construction.  When you exclude Interest and Depreciation related to the construction, total operating expenses are down nearly $2.8 million.

The combination of the increased revenue and reduced expenses has resulted in a substantial increase in our bottom line.  Our EBIDA, (Earning before Interest, Depreciation and Amortization) has increased from a negative ($2,044,582) to a positive $3,080,817 for an improvement of over $5.1 million year-to-date in 2019.  This represents an EBIDA margin of nearly 16% which is outstanding for a healthcare organization.  As I have said before, this has only been accomplished due to your hard work and effort to turn this organization around.  Thank you for all your hard work.

 

MARKET STREET:

The closing date for the sale of the Market Street property has been pushed back to June 24, 2019.  However, we will continue on track with the movement of the traveling physicians that will be relocating from Market Street to the SHS hospital building, 2nd floor location. (The previous Medical/Surgical Wing).  This will affect Dr. Silva, Dr. McLaughlin, Dr. Mannas and Dr. Chaney-Roberts.  

 

 

 

 

 

 

 

 

 

 

MEDICAL STAFF ADDITIONS:

As previously communicated, we have a few new medical providers that will be joining us in the near future:

  • Melissa Sims, NP has already joined us and is working in the SMG Clinic.
  • Susan Lanningham will be starting July 1 and will be located in the SMG Clinic.
  • Charlotte Barry will be starting this summer, we are hoping in July and will most likely be located in the Mancos Clinic.
  • We have a signed contract with Dr. Flemmings who will be joining our ER staff this summer.

Other upcoming SMG Practice changes:

  • Maria Cornelius will be stepping away from her clinic practice in Mancos this summer and will be working as a Hospitalist.
  • Dr. Daney will be moving from the SMG Clinic to the Mancos Clinic this summer.
  • Crysta Jones, NP will be transitioning from Mancos Clinic to the walk-in clinic this summer.

As we head into the Memorial Day holiday weekend, I want to wish everyone a safe and relaxing time.  Please take this time to remember the ones that are no longer with us, and those that have sacrificed all.

 

Tony