In addition to approving trash and recycling changes, the Sedalia City Council heard an annual report regarding Bothwell Regional Health Center during Monday’s meeting.
BRHC CEO Jimmy Robertson gave a presentation during the pre-council meeting for the first time since taking over as CEO at the end of 2015.
In regards to the hospital’s budget, he reminded council of the “big loss” in 2014, the “big gain” in 2015 due to a government settlement, and told them that it has normalized in 2016.
He gave statistics regarding patient discharges, showing council that they have been steadily decreasing since Fiscal Year 2013, but explained that when combined with the number of observation patients, it’s not as large of a decline.
“What happened is a lot of our patients converted from an inpatient stay to an observation stay. That’s because the government changed some of the rules and regulations back a couple years ago that drives that,” Robertson explained. “Why do we care about that? The difference in reimbursement for that is about $2,000 a patient, so that’s part of the Affordable Care Act is to drive more patients into the outpatient ward, cut reimbursement. … We’re still providing the same amount of care, it’s just a reimbursement thing.”
Robertson noted some challenges the hospital has experienced over the last year, including loss of physicians and having to use contract labor.
“We have to have the nurses to do the work so we had to bring in contract labor. Contract labor is about two to two-and-a-half times the price of regular employees,” he said. “We couldn’t hire employees fast enough, we had some problems hiring, so had to bring in the contract labor right then. We did bring them in, it was very expensive and it does hurt your bottom line. Right now we have a few contract employees still in the house, we are in the process though of hiring our own nursing staff (in those areas).”
He also talked about Bothwell’s achievements last year, including being ranked No. 1 in the state for value-based purchasing. He said the hospital dropped a few points but he expects to remain in the top five hospitals.
Leapfrog is an organization created by large Fortune 500 companies “intended to be able to give A through F scores to a hospital so these large purchasers of health care can understand who they’re doing business with,” Robertson explained. “A lot of these companies now will only do business with A- and B-rated hospitals, so when you get in the contracting phase of it, you want to have those scores so you get the contract.”
Bothwell was ranked at a D three years ago and at a C last year, but this year has a B rating. Robertson said several large hospitals have a B ranking, including Boone Hospital Center in Columbia, SSM hospitals in St. Louis and Centerpoint Medical Center in Independence.
Robertson said Bothwell has been working on recruiting physicians in urology, nurse practitioners, family health, rheumatology, anesthesiology and immunology. A new oncologist will begin in September 2017. The hospital is hoping to now recruit physicians in orthopaedics, family medicine, surgery and internal medicine.
Something Robertson has talked about with the Democrat previously, he told the council about Bothwell’s efforts to “get back to basics.”
“To refocus on the three things that make a hospital: our physicians, our patients and our employees,” he said. “We’re doing a lot to make sure all of our employees understand the value they have to our organization and how we value them. … We’re going back to the basics of requiring everyone to treat each other with courtesy, dignity and respect. That goes from the bottom up, top down, however you want to say it. That’s the kind of organization we’re going to be. … If you can’t do that, you can’t work here. It’s non-negotiable.”
He said that philosophy should carry over into patient loyalty, something he said Bothwell struggles with.
“By the time we get through, we get the right physicians, the right atmosphere in the hospital, we take care of our patients, we treat them the way they need to be treated, we’re going to build that loyalty because that loyalty is what’s going to keep us in business down the road,” he said. “It’ll take some time, but that’s the goal.”
Bothwell has a large capital budget this year to replace its reporting software to be more user-friendly for doctors and nurses, as well as expanding the cardiac unit, purchasing new ultrasound and surgery video machines, and facility updates in the women’s health wing and the lobby.
Multiple council members commented on the positive comments they’ve heard from constituents about improvements at Bothwell over the past year.
“Mr. Robertson we appreciate everything you’ve done for Bothwell,” Mayor Stephen Galliher said. “It’s made big changes since you’ve been there, we’ve noticed. You hear that throughout the community on a daily basis how much better it is and the way it’s moving forward.”
Nicole Cooke can be reached at 660-530-0138 or @NicoleRCooke.