LEXINGTON — Lexington Regional Health Center hopes to purchase a new software system that can be used for all aspects of their operations.
The LRHC board of directors gave authorization for CEO Leslie Marsh and Chief Financial Officer Wade Eschenbrenner to discuss this significant IT capital request with bond holders so that they can enter into negotiations with a software provider, during Tuesday night’s monthly board meeting. Previously the board had okayed gathering information from vendors to narrow the field.
Although it will be a significant capital expense, Eschenbrenner said an integrated system is needed so records can be shared between the hospital and clinic to maximize efficiency.
“To be successful over the next 10 years we need to have an integrated system,” he said. “Having two systems has been difficult on both sides.”
He said when Family Medicine Specialists Clinic was added, the current hospital software company said they would eventually be able to bridge the two systems.
“We are five years down the road and they are no closer than they were,” said Eschenbrenner. Nationwide, a lot of organizations experience similar frustrations with having two separate software systems — clinic and hospital.
Dr. Fran Acosta-Carlson said it is frustrating when a patient who is seen at the clinic is referred to the hospital for lab work, because it can be time consuming to access those results.
“It’s frustrating when we are right here and we can’t easily and quickly access those labs,” she said.
Chief Nursing Officer Nicole Thorell said the emergency room doctors have that same experience. A patient who comes in may report they are taking a prescription, but can’t remember what it is called, and the ER doctors and staff have to access two systems. She said it’s inefficient and impacts the patient and doctor experience.
Thorell said there needs to be “one patient record, one patient chart.”
Marsh said the electronic health record software solutions can be a recruitment issue.
Board president Rob Anderson, said there would be an expense upfront, but over time it would save the hospital money.
Additionally, an integrated system would help the hospital when looking at data said Marsh.
In a medical staff report, Acosta-Carlson said Family Medicine Specialists has been busy. It is currently hosting a third-year resident, who has completed one month of a two month rotation. A physician assistant student is also at the clinic. LRHC is scheduled to have a continuous stream of additional residents and students over the next years as LRHC is now one of the designated resident sites and a main precept site for PA students, both through University of Nebraska Medical Center (UNMC).
Being involved with residents and students gives LRHC recognition, builds its reputation and prompts medical providers to stay up to date, said Acosta-Carlson.
“To me, it just feels great because this is looking more and more like a busy educational place,” she said. “We are important in the community and the state. We are a good educational site.”
In a nursing service report, Thorell said nurse Hannah Hild recently completed advance certification as an emergency room nurse and LRHC now has four nurses with advanced certifications in this field.
She said recent nursing school graduates hired to work at LRHC have all passed their state boards and are currently in training. LRHC has hired three new graduate nurses since the first of the year.
In a service excellence report, Chief Operating Officer Jim Hain told of positive feedback from someone who was seen by Dr. Wray, a podiatrist.
Dana Steiner, who oversees quality and compliance, said LRHC has received a $5,000 grant from the Susan G. Komen organization to promote breast cancer awareness in the community over the next year.
“There is a high rate of late diagnosis in our county,” said Steiner.
In a report on marketing, Human Resources Director and Physician Liaison Jill Denker said the sports physicals offered in July were well utilized.
A Ladies Night at Mac’s Creek Winery to introduce nurse practitioner Julie Thies was well attended. “That was one of the most successful events we’ve ever had,” Denker said.
LRHC is finalizing details on their new website and will have a template for departments to look over by end of August with a launch to go live in late September.
Board members were given a photo tour of the Bertrand Clinic which is being prepared for opening, but no date has been set yet.
The building has two exam rooms and the exterior door was painted LRHC red.
“It’s nice and cozy, but there is still quite a bit of room,” said Thorell.
Plans are for the clinic to be open from 8 a.m. to noon on Mondays and Wednesdays.
Eschenbrenner gave board members an overview on Medicare Advantage, which is operated by insurance companies as an option for seniors who qualify for Medicare.
He said that pre-certification is being added for some procedures, but such pre-certifications aren’t required with traditional Medicare. He said Medicare Advantage is more of an HMO (health maintenance organization).
He warned the public to look closely at a plan’s details because upfront costs might be misleading if other things must be paid out of pocket. He said if a medical provider recommends a procedure that an insurance company denies, the patient may be liable for the expense. An alternate option would be to not have the procedure or test.
“Just be aware,” said Eschenbrenner. “There are things you might not be aware of that are creeping into those plans. Cheaper is not always better.”
Dr. Acosta-Carlson said she has seen patients taking a prescription medication be told that particular medicine won’t be covered anymore.
The open enrollment period — a time when people can make changes to various aspects of their coverage, including switching from Medicare Advantage to original Medicare or vice versa — is Oct. 15 through Dec. 7 for 2019 coverage.
Pat Samway said the hospital hopes to host a Community Wellness Connection in August on the topic of Medicare.
During a financial report, Eschenbrenner said although the fiscal year ended June 30, accounts payable is kept open longer and a full financial report for the year wouldn’t be ready until later.
Eschenbrenner said there continues to be revenue growth year after year, with 10.9 percent growth in 2018 which is up from the 10.2 percent growth in 2017.
In looking at gross revenue over a three year period, inpatient revenue fluctuates while the outpatient revenue shows more stability and trends upward, said Eschenbrenner. He said specialists’ schedules impacts overall revenue.
For inpatient services, the average daily census in June was 8.1, compared 10.4 a year ago and to 9.3 in May. Detailed figures showed 102 acute patient days, 80 swing bed and 14 newborn.
In the outpatient category there were 13,700 ancillary services (down from 16,000 last month), 275 emergency room visits (up from 250 last month), 1,600 rehabilitation services (up from 1,500 last month), 500 specialty visits (down from 600 last month) and 1,900 clinic visits (the same as a month ago).
In other business the board wrote off $5,005.28 as charity care.
The LRHC board approved recommended changes to the organization’s retirement plan, including adding some options, such as a 403B plan, a Roth contribution option for after-tax money, and LRHC will match 1 percent of employee contributions to a 401A plan. A potential change in the 457 plan administrator was also discussed.
“From a recruitment perspective this is a huge issue,” said Marsh.
“It’s their money, not ours. These are big things we can do at very little cost,” said board member Tara Naprstek.
The board went into executive session to discuss personnel.
The board’s next meeting will be Aug. 28.