Alva Review-Courier -

After over two months of discussion and consideration, the Kiowa District Hospital Board voted to enter a contract with Cohesive Healthcare, a leader in providing management and consulting services to rural and community hospitals.

Board President Brenna May read a statement at the board of directors' regular March meeting Thursday explaining their decision. One comment she made from the letter was, “Rural healthcare is a difficult place to be these days, and it has become glaringly obvious to the board that we have to be proactive and progressive in our strategy to be able to continue to provide excellent health care services in our community.”

May called the meeting to order with all members present, including Jeff Miller, Pat Myers, Jim Parker and Chantae Simpson. CEO Margaret Grismer also sat at the board table. Other hospital personnel attending were: CFO Janell Goodno, Director of Nursing (DON) Heidi Courson, RN Robyn Whitaker, PA Melissa Stroh and KDH Foundation President Judy Schrock.

Two board of director seats are open for vote at the KDH Annual Board Meeting to be Thursday, May 25. May announced she will not accept another term on the board. Simpson's seat is also open, but said she will accept a nomination for another term.

Pertinent Info about Cohesive Contract

KDH entered a three-year contract with Cohesive that include a provision at the end of Year One for evaluation for continuation. The contract started April 1.

Grismer said the contract will cost KDH approximately $300,000 per year. This cost includes Cohesive taking over paying salaries and benefits for three administrative positions, including the CEO (Grismer); the manor administrator (Kim Balding); and HR/IT (Philip Anton).

Cohesive's management will extend into administration, inpatient, outpatient, risk management, quality initiatives and compliance, adult and pediatrics and manor, Grismer explained.

She said Cohesive's focus is on maximizing KDH's swing-bed operation. Cohesive has liaisons who work with long-term placement of patients. These are patients who, by regulations of the Affordable Care Act, have exceeded their days at PPS and LTAC hospitals and can finish their treatments in a swing bed.

PPS stands for Prospective Payment System, which is Medicare reimbursement based on a predetermined, fixed amount. LTAC stands for long term acute care for patients with serious medical problems that require intense treatment for usually 20-30 days.

To accommodate increased patient load at KDH, Grismer said Cohesive has clinical nurse specialists who can educate the existing staff and work with them should a patient require skills staff has not needed in a while.

DON Courson said she and the nursing staff are excited about the possibilities of working with Cohesive. She said the KDH Board members met with the entire staff prior to the board meeting Thursday evening to apprise them of the impending change. When she and Grismer later unveiled details of the plan to have more patients in the hospital for nurses to care for, Courson said the idea was well-received by staff.

Grismer said Cohesive has a variety of staff from nursing to administration. Additionally, Cohesive has two physicians who work within their facilities. The docs will not be permanently placed in Kiowa, but will help as KDH continues to build their services and recruit.

The major source of revenue to KDH by the patients provided by Cohesive is Medicare reimbursement for services provided to each patient. That's the norm with every Medicare patient in the hospital.

The board sees their role with Cohesive as also generating new lines of revenue, both on the inpatient as well as the outpatient side. Grismer said Cohesive will assist with marketing and placements through their contacts and vision of placing more residents at the manor.

Grismer said while her salary is now paid by Cohesive, she continues to manage KDH employees as CEO. “I will manage the way their company envisions change,” she said.

When asked about the KDH Board's role in this agreement with Cohesive, Grismer said, “Cohesive answers to the board through me as the continued CEO.”

“We understand that these are times of uncertainty concerning health care regulations and believe that the Cohesive team will allow us to be on the forefront of these changes,” May read in her opening remarks. “We feel that our KDH teams at the hospital, rural health clinic and manor perform very well. With the addition of the resources and expertise that the Cohesive team can provide, we will continue to be able to provide outstanding services to our community.”

The remainder of the KDH March board meeting will run in a separate story.