“We’re getting ready for surveys so that’s why everybody’s hair is standing on end,” said Share Medical Center CEO Kandice Allen. She told the Alva Hospital Authority (AHA) trustees Tuesday that the virtual accreditation survey by DNV Healthcare will be on April 4. Staff has been busy gathering documents to send to DNV so they can be previewed prior to April 4.

Allen announced a couple of new staff members at Share Medical. Veronica Durkee is the new environmental services supervisor. Jane Bowles, RN is not only a floor nurse but will also take on discharge planning while another employee is on leave with health issues.

Karsten Group, who is covering HR (human resources) needs as well as payroll, has been working with Kiki Bowden to get employee files in order and organized. Karsten did their first payroll for the hospital, and it went well.

With possible Russian tech threats in the news, Allen reported the hospital as had no significant threats. The hospital has a rule in their Fortinet firewall to block the entire country.

KnowBe4 has about 60 new accounts bringing Share Convalescent Home into the system. These staff members have not been exposed to this type of testing and training so they are still prone to clicking on the wrong emails or attachments. In addition, the hospital runs Crowdstrike all the time to mitigate any issues that get through other protection.

In surgery, Allen said the hospital is talking with a company from Steamboat. All providers and hospital board members are encouraged to attend one of three presentations on April 20 to learn about this program and what it could do to benefit hospital revenue. There will be an opportunity to ask questions. AHA Chairman Jason Gaisford reminded the trustees that no more than three may attend any meeting together in order not to have a quorum.

Staff surveys are being done to determine the interest in opening a daycare for employees’ children. This would include the hospital, nursing home and Homestead staff. The daycare could be located in the hospital-owned house on the corner of Share Drive and Murray. It is currently occupied by Steve Madrid, PA but he plans to move out in the next couple of months.

The hospital is engaging BKD, the company that does the hospital’s audit, to do a revenue cycle audit to identify issues with TruBridge, the billing company. Allen said TruBridge seems to work the big accounts while letting the little ones “time out.” That’s why people are not getting bills.

Gaisford said the hospital has done such revenue cycle audits before. The last one was done in 2018 by BKD. He said they will “put boots on the ground” to look at the hospital’s revenue processes and TruBridge’s cycles.

“I think it’s very much needed because our revenues have gone up over the last four years, but that doesn’t necessarily mean our bottom line has gone up over that time,” he said.

Allen said the hospital was considering switching to a different billing company, HRG, recommended by BKD. Just as she was ready to contact HRG, she learned the company was bought by the same group that owns TruBridge. The hospital contacted the company, and a leadership team from HRG will be assigned to the Share Medical account. “We hope that this gets us where we need to be,” said Allen.

Dr. Rader, the hospitalist who has worked with Share Medical for the past six to seven years, has accepted a new position with SSM. His successor, Dr. Jared, has been working with Share staff. Allen said, “We are very appreciative of the hard work and dedication Dr. Rader has put into this program to make it successful. We are also grateful for the knowledge our staff have gained from him through the years to better prepare us to take care of much sicker patients than ever before.”

At the end of her report, Allen introduced Clark Housen, CEO of the Okeene Hospital. He also works for SSM. Share Medical Center is an SSM affiliate.

Financial Reports

CFO Chris Lauderdale presented written financial reports for December through February. He highlighted items from the February report, explaining the meaning of unbilled days and billed days. In February, unbilled days were 17.3 which he said should around six. If a billing day is revenue of $50,000 then ten unbilled days would total $500,000 that should have been collected.

He said the billed days for February were 100.3 and should have been half that. These are indicators of the issues the hospital has been having with the billing company.

Although receivables decreased by $29,387 from January, the $6,632,821 for February is still high said Lauderdale. The hospital had a net profit for February of $236,928, but he said that shows the impact of reimbursements from Covid funding.

Share Convalescent Home showed a net loss of $34,982 for February. However, the accounts receivable decreased by $132,870 during the month due to collections. Patient revenue totaled $211,183 which was a $78,577 decrease from the prior month. Total patient days for February were 1,044 compared to 1,115 in January.

The Homestead had a profit of $14,076 for February compared to a $20,125 profit in January. The retirement center had a loss of $16,875 in December.

Credentialing

Chief of Staff Dr. Scott Burk presented two appointments and one reappointment for approval. The trustees approved Karen Sagner, ARNP for appointment to allied staff and Roger Mason, MD for appointment to courtesy staff. Steve Madrid, PA was reappointed to allied staff.

Share Convalescent Home

Share Convalescent Administrator Kelly Parker spoke about the addition of KnowBe4 to monitor email at the nursing home which was a requirement for SQSS (Strategic Quality Support System). He said some staff members aren’t proficient in technology so it has been a learning experience.

“I can’t believe we didn’t do that (SQSS) years ago,” he said. “Already I think it’s proven to be well worth the investment.” He said the growing pains with email and technology are well worth it.

Allen said the SQSS program helps them track nursing staff performance. Parker said they are using high performance in the program as an incentive for the opportunity to work extra shifts.

Parker said within a 65 mile radius of Alva in comparable size nursing homes, there are 18 homes, our market. “Within our market, we have the third best RN staffing, we have the highest LPN staffing, we have 13th in nurse aide staffing. But overall we put all our staffing together, we have the fourth best total staffing in our nursing department,” he said.

However, this staffing level has not translated into quality measures, Parker said. It doesn’t help to be fourth overall in nursing but 13th in nurse aides. They are going to work toward having fewer nurses on staff and more nurse aides. “Those nurse aides are the ones answering the call lights and feeding the meals, and all of those things. And have our nurses focus more on nursing,” he said.

Parker highlighted the activities program which repeatedly gets 100 percent satisfaction grades from residents. It’s the highest marked part of our program, he said.

The nursing home does not yet have a Covid policy put together for approval by the trustees. Parker said the terminology keeps changing. Instead of “unvaccinated” the preferred terminology now is “not fully vaccinated.” He said he didn’t want to put a policy in place “that we’re going to change every time we turn around.”

The Homestead

Written reports were provided on the Homestead. Parker said he’d spent more time there the last six weeks. He said residents seemed to be experiencing “cabin fever” and needed a little more attention, but the change in mask-wearing policy has helped.

He talked about a split of food service oversight between the nursing home and the Homestead with one person over each. This should give more consistency in leadership with staff knowing which person they report to.

A video of the meeting may be viewed at http://www.AlvaReviewCourier.com.