Alva Review-Courier -

Dr. Lawrence moving to ER, hospital launches recruitment effort


March 31, 2019

A physician recruiting effort is underway at Share Medical Center (SMC) in Alva. CEO Kandice Allen told the Alva Hospital Authority Tuesday evening that she and CFO Kevin O’Brien have been talking to some soon-to-graduate possibilities.

Allen has an interview scheduled in April with someone expecting to graduate in a year. O’Brien is looking at one who will be finishing his residency in June. Allen said they will probably have a couple of other interviews in May. She also talked with a third-year medical student last week, offering a stipend for a commitment to come to Alva.

The recruitment effort resulted from changes in doctors at SMC. “Dr. (Michael) Lawrence has decided to wind down his family practice and to stay working ER,” said Allen. Lawrence has agreed to work at least eight shifts a month in the emergency room. “When he’s working those eight shifts, he’s still going to see some patients,” she added.

While Dr. Lawrence can’t see a full schedule of patients, Allen said he’s willing to see a few patients and to write narcotics prescriptions. “That’s one of the big things we needed him to do because the PAs and nurse practitioners cannot write narcotics. It has to be a physician,” she said.

Patients needing these prescriptions must see a physician every 90 days, but they have to get their refills every 30 days. Allen said Jennifer Nichols has agreed to see these patients at 30 and 60 days with Dr. Lawrence seeing them every 90 days.

In January, the hospital’s contract with Dr. Benjamin Hicks expired. Dr. Lawrence and Dr. Phil Self, who has a private practice, are the only physicians currently practicing in Alva.

Allen said the hospital initially considered hiring a locum, a physician who works on a contract basis. She said that costs around $175 an hour. With Dr. Lawrence agreeing to see patients with narcotics prescriptions, they decided not to do that right now.

Until the hospital can recruit another physician, Allen said they believe the mid-levels (PAs and nurse practitioners) can handle patient volume. “If not, we’ll go ahead and hire a locum to pick up that extra slack,” she said. “We don’t want people having to go outside of town for care.”

Bo Hannaford, board member, asked how long until SMC might have a new physician. Allen said it could be August of this year if the one contact is successful or it could be next year in July or August.

“As hard as it has been on our patients, it’s kind of got us out of our box to be more flexible,” said Allen. Instead of telling a physician the hospital needs them to work five days a week with an afternoon off, SMC is willing to try other schedules. She said most physicians being recruited say they only want to work four days a week.

Share Medical is also dealing with a shortage of nurses. During the finance committee meeting held earlier, Allen said that was the main topic of conversation. She said they discussed how to decrease labor costs. Agency staffing with aides at the nursing home and RNs at the hospital is costly.

Allen noted that up front collections almost doubled and that was “very helpful.”

She said the hospital is looking at upgrading the CT machine.

CFO Report

O’Brien said overall February was a really good month financially. SMC filed an interim cost report with seven months of data and he’s hopeful this will improve the Medicare and Medicaid reimbursement rate even more. He said they will continue to file cost reports to make sure SMC is not paid too much or too little.

The operating cash balance for February was $124,206. This represents 4.8 days of operating expenses, excluding depreciation. Hospital accounts receivable had a balance of $3,796,547, a decrease of $188,509. Accounts payable balance for February was $1,047,562. This represents 100 days of operating expenses excluding the costs related to salaries, benefits and depreciation.

Hospital gross patient revenue for the month was $1,956,299, which was a $139,933 decrease compared to January. Total patient days for February were 164 compared to 189 in January. Total clinic office visits for February were 1,714 compared to 1,440 in January.

Hospital operating expenses excluding salaries, benefits and depreciation for February totaled $296,370 a decrease of $36,219 compared to the prior month. Hospital salaries and wages for February totaled $383,230 which was a decrease of $24,898 compared to January. The net loss was $38,275 for the month compared to a loss of $37,762 in January.

Medical Staff

Dr. Self, medical chief of staff, asked the board to approve updated by-laws for ER back-up calls. He said the policy had not changed in 32 years. Those rules required that the on-call physician must be within 20 minutes of the hospital. Self said with the changes in technology, ERs only require being able to reach the physician by phone. The board voted approval of the update.

Reappointed to courtesy staff were Gregory McKinnis, MD; Zahid Cheema, MD; Salman Zubair, MD; Gregory Blair, MD; Robert Rader, MD; and Benjamin Love, MD. New appointments to courtesy staff are Julie Mahaney, MD and Gregory Schuchard, MD. All but Love and Schuchard are associated with the telemedicine program.

New Telemetry Equipment

The hospital authority trustees approved an operating lease with Hospital Equipment Rental Company for a new telemetry unit. The $132,420 will be paid at $2,750 per month for 60 months and will include maintenance. This equipment will interface with EPIC software. SMC is looking at changing their electronic health records system to the EPIC program. The new unit will replace one that was 25 years old.

Share Convalescent Home

Convalescent Home Director Rita Goodrich reported in-service meetings were held on subjects including pain recognition or screening and on resident abuse and neglect.

Valentine’s Day was celebrated with cards made and delivered to all residents. The Candlelight Dinner originally scheduled for January was moved due to flu. It was held on Feb. 26.

Skilled census days in February increased to 279 from 201 in January. Average daily census for February was 56 compared to 60 in January. Goodrich said staffing has been a struggle, mainly for the 7 to 3 and 3 to 11 shifts. Several applicants are being interviewed and a few have been hired. The nursing home continues to have a high usage of agency staffing.

The bi-annual kitchen fire extinguisher inspection was completed with no problems found.

The convalescent home had a net loss for February of $7,420.

The Homestead

Director Kelly Parker reported The Homestead had a decrease of 11.9 percent compared to February 2018. The average paid nights decreased by 5.7 residents or guests per night compared to a year ago.

During February there were 45 residents occupying 42 apartments including one SMC provider and four SMC contract staff.

March is the ninth month for The Homestead to offer expanded services and use of those services continues to grow. Due to the threat of flu and other illnesses, free deliveries of meals, etc., were offered to resident who didn’t feel well or didn’t wish to be around others, totaling 52.

Work has begun for the installation of a new walk-in cooler and two freezers. It will take six to eight weeks to complete.

The super two apartment conversion with a lift has gone on far longer than expected due to scheduling of out-of-town contractors. The Homestead already has someone waiting to move in when it is completed.

The Homestead had a profit of $14,104 for February compared to $15,881 for January.

Donor and Volunteer Appreciation Dinner

During the SMC Foundation report Parker reminded everyone that invitations had been sent out for the volunteer and donor appreciation dinner to be held Tuesday, April 9, at 6 p.m. at The Runnymede Hotel.

The Foundation had probably the best six months of giving in 2018 since the big EHR campaign in 2012-2013.

Chairman’s Report

The meeting scheduled for May 21 will be moved to May 28 because CEO Allen will be at a meeting and CFO O’Brien will be on vacation on the 21st.

Board Chairman Jason Gaisford said with the passing of Lynn Martin, the board wanted to thank the Martin family for all the years of coverage of the medical center, which he described as fair and balanced. “Many times Lynn would call and say, ‘hey, what can you tell me on this?’” he said.


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