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Packed house for hospital meeting
BY JAY WORKMAN
Employees of Memorial Medical Center filled the room for the meeting of the Board of Trustees on Tuesday to voice concern about the possibility of reduced benefits.
Last year the board increased the health insurance premiums and co-payments of employees. The agenda Tuesday included an item on the insurance committee but it was not taken up at the meeting.
“My intention is to see employees get the best benefits we can afford,” Trustee Ben Comisky told the staff members, before saying revenues are down and costs are up.
Chief Financial Officer Rhett Fricke, however, reported that revenues from patients for the first 10 months of 2008 are 14.8 percent greater than in 2007 and the hospital’s year-to-date increase of net assets is $998,838.
“Retaining nurses saves money,” Dr. Paul Bunnell told the trustees. “Before you make a decision to cut nurses’ health insurance benefits, you need to know how much it will cost.”
“The reason we have such a good hospital is that you provide benefits,” said Dr. Reza Malek. “The system is working. The patients are happy; the doctors are happy.”
Speaking directly to County Judge Mike Pfeifer, Malek said, “It is easy to cut. If you do that you’ll destroy this hospital.”
County commissioners, who appoint the hospital trustees, have recently expressed displeasure with an increase in the cost of care for indigent patients that the county funds.
An employee of the county, Peggy Hall, hand delivered copies of a letter from County Treasurer Rhonda Kokena to each trustee that was critical of communications about accounting procedures at the hospital and the indigent care situation.
One paragraph in the letter:
“I can tell you that the 1.5 million dollars given for Indigent Healthcare is not handled as sufficiently as it could be. In the past 2 years only 1 time was the CD interest deposited into the indigent checking account and that was done by my office. I don’t make the “big bucks” and really shouldn’t have to inform ones that make triple what I do, BUT when the certificate of deposit is purchased, the interest off that CD should either be compounded, which would allow it to gain a hefty amount, or deposited directly into the Indigent Healthcare checking account NOT into the MMC operating account. This scenario is basically “robbing Peter to pay Paul.” This would help the lack in funds that is it facing at this time.”
The portion of the financial report given trustees on indigent care showed expenses of $113,495 for October with a 10-month total of more than $1.8 million. There have been 300 patients treated in the idigent program in the first 10 months of 2008.
Executive Administrator Buzz Currier, who is leaving the job in June, reported to the trustees on several matters.
He said he has some applications for his replacement, but noted one e-mail from the chief executive of a county hospital in Oklahoma who was briefly interested in the job who said after reading reports in the local newspaper she offered “condolences.” The administrator said, “Sounds as though you have a lot of ‘outside advice’ in running your hospital. Good luck in finding a replacement.”
Currier reported that attorney Anne Marie Odefey was negotiating with Hitachi, which has requested a $222,000 payment after the purchase of a Hitachi open MRI machine was canceled.
He said he was pleased with the hospital’s finances, and told the trustees that when they talk about employee benefits they should be compared with other hospitals, not other public entities.
Director of Nursing Crystal Mozley reported on plans for an electronic documentation system for the emergency room that will decrease wait time, track how long a patient was in the ER and prompt the staff of procedures and billing. Implementing the system will cost $75,000 plus $23,000 for software and monthly licensing fee of $3,563.
Human Resources Director Pat Trigg reported the annual employee competency evaluations found no unsatisfactory staff member.
Last year the board increased the health insurance premiums and co-payments of employees. The agenda Tuesday included an item on the insurance committee but it was not taken up at the meeting.
“My intention is to see employees get the best benefits we can afford,” Trustee Ben Comisky told the staff members, before saying revenues are down and costs are up.
Chief Financial Officer Rhett Fricke, however, reported that revenues from patients for the first 10 months of 2008 are 14.8 percent greater than in 2007 and the hospital’s year-to-date increase of net assets is $998,838.
“Retaining nurses saves money,” Dr. Paul Bunnell told the trustees. “Before you make a decision to cut nurses’ health insurance benefits, you need to know how much it will cost.”
“The reason we have such a good hospital is that you provide benefits,” said Dr. Reza Malek. “The system is working. The patients are happy; the doctors are happy.”
Speaking directly to County Judge Mike Pfeifer, Malek said, “It is easy to cut. If you do that you’ll destroy this hospital.”
County commissioners, who appoint the hospital trustees, have recently expressed displeasure with an increase in the cost of care for indigent patients that the county funds.
An employee of the county, Peggy Hall, hand delivered copies of a letter from County Treasurer Rhonda Kokena to each trustee that was critical of communications about accounting procedures at the hospital and the indigent care situation.
One paragraph in the letter:
“I can tell you that the 1.5 million dollars given for Indigent Healthcare is not handled as sufficiently as it could be. In the past 2 years only 1 time was the CD interest deposited into the indigent checking account and that was done by my office. I don’t make the “big bucks” and really shouldn’t have to inform ones that make triple what I do, BUT when the certificate of deposit is purchased, the interest off that CD should either be compounded, which would allow it to gain a hefty amount, or deposited directly into the Indigent Healthcare checking account NOT into the MMC operating account. This scenario is basically “robbing Peter to pay Paul.” This would help the lack in funds that is it facing at this time.”
The portion of the financial report given trustees on indigent care showed expenses of $113,495 for October with a 10-month total of more than $1.8 million. There have been 300 patients treated in the idigent program in the first 10 months of 2008.
Executive Administrator Buzz Currier, who is leaving the job in June, reported to the trustees on several matters.
He said he has some applications for his replacement, but noted one e-mail from the chief executive of a county hospital in Oklahoma who was briefly interested in the job who said after reading reports in the local newspaper she offered “condolences.” The administrator said, “Sounds as though you have a lot of ‘outside advice’ in running your hospital. Good luck in finding a replacement.”
Currier reported that attorney Anne Marie Odefey was negotiating with Hitachi, which has requested a $222,000 payment after the purchase of a Hitachi open MRI machine was canceled.
He said he was pleased with the hospital’s finances, and told the trustees that when they talk about employee benefits they should be compared with other hospitals, not other public entities.
Director of Nursing Crystal Mozley reported on plans for an electronic documentation system for the emergency room that will decrease wait time, track how long a patient was in the ER and prompt the staff of procedures and billing. Implementing the system will cost $75,000 plus $23,000 for software and monthly licensing fee of $3,563.
Human Resources Director Pat Trigg reported the annual employee competency evaluations found no unsatisfactory staff member.
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The following are comments from the readers. In no way do they represent the view of portlavacawave.com.
Sam wrote on Dec 5, 2008 3:41 PM:
" Interesting letter. Is Buzz implying that he is irreplaceable because the people paying his salary and car allowance are interfering with his job by asking for accountability? Are you now vested, Buzz, and able to benefit from this retroactive retirement increase? Regarding ER documentation--$100,000 to track patient wait time? Use the clock!Billing help--hire "experienced" staff! Ms Mozley, this is not your county's money you are spending, last I heard, you reside in Palacios. Have a care with spending when the hospital is having such financial difficulties. In my experiences, it is not the amount of time waiting, but the quality of care given that is more important. Does a 25 bed hospital require a CEO, CFO, Director of Clinical Services, Director of Nursing, Education Director, Nurse Auditor, Infection Control Nurse, Quality Control Director and Human Resource Director? How many other titles are there? Indigent care--100% reimbursement to MMC operating fund--wow, seems to me that qualifying for indigent care is a great benefit to MMC. "
Peggy wrote on Dec 7, 2008 5:40 PM:
" The email that was read aloud at the board meeting from one of Mr. Currier's colleagues has me worried. The colleague was offering her "condolences" because it "sounds as though you have a lot of "outside advice" in running your hospital."
Do all CEOs feel that it is "their hospital" to run "their way"?
Do we really want to consider someone for the CEO position that feels this way?
Wouldn't we be in the same situation we are in now?
I can only speak for myself, but I hope that the Hospital Board looks long and hard at each applicant and chooses one that is not only qualified but also is willing to work with the Hospital Board and Commissioners' Court. A good working relationship between the CEO, Hospital Board and Commissioners' Court will build a stronger hospital.
Which brings me to my last questions? Who chooses the new CEO? Who receives the resumes from interested applicants? Who interviews the applicants? From listening at hospital board meetings, to me, it sounds like the current CEO.
And in reference to Dr. Malek speaking directly to the County Judge regarding cuts.....Calhoun County is still paying 100% (less 5% as stated in the State Handbook ) actual cost for indigent inpatient care and 51% actual cost for indigent outpatient care. Indigent Healthcare payments to MMC DID NOT GET CUT. Calhoun County is still paying their own County hospital more than Medicare or insurance companies pay. Our County Jail is also paying 100% of all medcal bills (no deductions) for county inmates...yes, the county jail also pays more than medicare and insurance companies pay.
Commissioners' Court does not cut MMC benefits...that is a decision by your hospital board and with the economy the way it is, wouldn't one rather have an increase in co-pays and other benefit cuts and be able to keep their job rather than risk the chance of pink slips having to be handed out? It was stated at the hospital board meeting that MMC provides more for their employees' benefits than the average in the area. MMC employees copay for doctor visits is $15. This seems low when most other companies have copays of $20, $25 or $30. No one likes to increase the cost of benefits to employees, but sometimes it is necessary in order to keep up with the rising costs and to keep employees instead of laying them off.
Why is it that I keep hearing about area plants and businesses cutting back, laying off and shutting down units and if you turn on the tv and listen to the news, you will hear that cuts and layoffs are being made all over the world, but it appears that the MMC administration and employees do not feel like this should happen to them? Are they living in a fantasy world? Why are they the only ones that seem to feel that they should not be affected by what is happening in our economy? I am not saying there should be layoffs, what I am saying is that spending needs to be watched more closely and items that are not necessary for running the hospital should be stopped. If one continues to spend as rapidly as MMC is, then pretty soon the bottom is going to fall out.
When things start going bad, as they are in our economy, it seems that the first things a good administraton would start doing would be to cut or stop things that are not necessary in the day to day operations of the business.
The administration keeps spending without any regards to their budget and the hospital board keeps approving everything. Why can't the hospital board say no to the administration? Mr. Currier says he can "justify" the expense....Well, anyone can justify an expense....the point is, will the money be there or is the money there for the expenses that keep piling up? And most importantly, Why should Commissoners' Court bail out the hospital when all the hospital keeps doing is spend, spend, spend! Why does the MMC administration, hospital board and employees feel that Commissioners' Court should give them whatever they want. Commissioners' Court has had to cut their own employees benefits to the point to where a man or woman cannot even afford family health coverage for their family because the cost is their whole paycheck! Do we like it? No, but unfortunately, it is just the way things are because of the economy and we are happy to have our jobs when there are so many others that don't have one. "
Do all CEOs feel that it is "their hospital" to run "their way"?
Do we really want to consider someone for the CEO position that feels this way?
Wouldn't we be in the same situation we are in now?
I can only speak for myself, but I hope that the Hospital Board looks long and hard at each applicant and chooses one that is not only qualified but also is willing to work with the Hospital Board and Commissioners' Court. A good working relationship between the CEO, Hospital Board and Commissioners' Court will build a stronger hospital.
Which brings me to my last questions? Who chooses the new CEO? Who receives the resumes from interested applicants? Who interviews the applicants? From listening at hospital board meetings, to me, it sounds like the current CEO.
And in reference to Dr. Malek speaking directly to the County Judge regarding cuts.....Calhoun County is still paying 100% (less 5% as stated in the State Handbook ) actual cost for indigent inpatient care and 51% actual cost for indigent outpatient care. Indigent Healthcare payments to MMC DID NOT GET CUT. Calhoun County is still paying their own County hospital more than Medicare or insurance companies pay. Our County Jail is also paying 100% of all medcal bills (no deductions) for county inmates...yes, the county jail also pays more than medicare and insurance companies pay.
Commissioners' Court does not cut MMC benefits...that is a decision by your hospital board and with the economy the way it is, wouldn't one rather have an increase in co-pays and other benefit cuts and be able to keep their job rather than risk the chance of pink slips having to be handed out? It was stated at the hospital board meeting that MMC provides more for their employees' benefits than the average in the area. MMC employees copay for doctor visits is $15. This seems low when most other companies have copays of $20, $25 or $30. No one likes to increase the cost of benefits to employees, but sometimes it is necessary in order to keep up with the rising costs and to keep employees instead of laying them off.
Why is it that I keep hearing about area plants and businesses cutting back, laying off and shutting down units and if you turn on the tv and listen to the news, you will hear that cuts and layoffs are being made all over the world, but it appears that the MMC administration and employees do not feel like this should happen to them? Are they living in a fantasy world? Why are they the only ones that seem to feel that they should not be affected by what is happening in our economy? I am not saying there should be layoffs, what I am saying is that spending needs to be watched more closely and items that are not necessary for running the hospital should be stopped. If one continues to spend as rapidly as MMC is, then pretty soon the bottom is going to fall out.
When things start going bad, as they are in our economy, it seems that the first things a good administraton would start doing would be to cut or stop things that are not necessary in the day to day operations of the business.
The administration keeps spending without any regards to their budget and the hospital board keeps approving everything. Why can't the hospital board say no to the administration? Mr. Currier says he can "justify" the expense....Well, anyone can justify an expense....the point is, will the money be there or is the money there for the expenses that keep piling up? And most importantly, Why should Commissoners' Court bail out the hospital when all the hospital keeps doing is spend, spend, spend! Why does the MMC administration, hospital board and employees feel that Commissioners' Court should give them whatever they want. Commissioners' Court has had to cut their own employees benefits to the point to where a man or woman cannot even afford family health coverage for their family because the cost is their whole paycheck! Do we like it? No, but unfortunately, it is just the way things are because of the economy and we are happy to have our jobs when there are so many others that don't have one. "
no way wrote on Dec 9, 2008 10:20 AM:
" why does this hospital even need an electronic documentation system? Like they care how long a patient waits in the ER ?? Just more money to spend. "
Taxed Taxpayer wrote on Dec 9, 2008 11:15 AM:
" Go, Peggy! Something needs to be done to get the money pit off the backs of the taxpayer.
Buzz has "justified" (usually a termed used to mean there is a payoff in the investment) so many projects that the hospital ought to be giving money to the county rather than the other way around.
Sam, you have an especially good point in your reference to all of the overhead positions.
Sell the hospital and let the chips fall where they may. "
Buzz has "justified" (usually a termed used to mean there is a payoff in the investment) so many projects that the hospital ought to be giving money to the county rather than the other way around.
Sam, you have an especially good point in your reference to all of the overhead positions.
Sell the hospital and let the chips fall where they may. "
Anonymous wrote on Dec 10, 2008 8:06 AM:
" As a prior employee, I can tell you that the upper crust of staff get to have expensive tests, ie, MRI and ultrasound, for free. They are not documented in their charts because, well I think you can figure out why. Account numbers are not even set up. Their families and themselves are privvy to this type of treatment. They don't even file insurance for these tests. I don't know how departments tally the costs of these tests or even justify them. I do know that at the lower end of the payscale, housekeepers, etc., if they owe a bill to the hospital, they are harassed by department heads to have the costs taken out of their checks, which is okay, but not quite equal treatment. Also, these are the people who cannot afford the insurance that the hospital offers. There is a lot of visiting among the upper levels, and even jests made to come and visit with their friends and get paid. Let's face, how much work is there to do. It is well known throughout the hospital, it is the cafeteria and the outpatient services that generate money. The administrative portion of the hospital staff definitely need strict overseeing and some of them even eliminated. I know of one head of department who spent most of her time at her home while it was being redecorated for her daughter's wedding and hospital employees from maintenance were recruited to do the work, all the time receiving their pay from the hospital district. Isn't that interesting. Wake up Calhoun County and clean that closet. "
Anonymous 2 wrote on Dec 10, 2008 10:46 PM:
" Mr. Currier, your job must be so easy! All of these individuals criticizing apparantly know more than you do! Lets let taxed taxpayer, peggy, and sam take over! "
Peggy Hall wrote on Dec 11, 2008 4:13 PM:
" FACTS speak louder than "sour grapes".
Everything I have said has been misunderstood. When one doesn't have the facts (which is public information), one does not understand and will believe what they are told. "
Everything I have said has been misunderstood. When one doesn't have the facts (which is public information), one does not understand and will believe what they are told. "
Chief wrote on Dec 14, 2008 1:29 PM:
" Keep up the good work Peggy. We need more taxpayers to take an active interest in the spending by governmental agencies. Just look at the jail costs compared to what we used to pay to farm out the prisoners. Taxpayers were misled on what our costs would be for the new jail.
The hospital needs to be sold as the board doesn't seem capable of reining in costs and our commissioners just know how to spend money. "
The hospital needs to be sold as the board doesn't seem capable of reining in costs and our commissioners just know how to spend money. "
Taxed Taxpayer wrote on Dec 5, 2008 10:44 AM:
First of all, the so-called “outside advice” about running the hospital is coming from persons elected to represent (though not doing a very good job, I might add) the owners of the hospital: the taxpayers of Calhoun County. How can it be “outside advice” when you represent the owners? Apparently, those entrusted to run the operation are not doing a very good job, thus necessitating the need for advice.
For what self-serving purpose did Currier even feel compelled to bring this up? I believe that the lame donkey, I mean, duck, should keep what appears to be political editorial comments to himself or be left to the parts of the personnel application process that should be revealed only in the closed sessions of the hospital board wherein private personnel issues would be discussed. I would go further to say that he should not even be involved in screening the applications in light of his past poor business recommendations and decisions. He should not even have a donkey, I mean, dog, in this fight.
The administration is not operating the hospital in a fiscally responsible manner. It is ludicrous, for example, to provide ill-afforded (no pun intended) personnel benefits to “remain competitive.” With whom are we trying to remain competitive? Is it privately owned medical facilities that do not enjoy the perk of a taxpayer subsidy? This hardly qualifies as a level playing field for the competition.
The major argument for competitive salary and benefits that I have heard is for attracting and retaining high quality personnel. This is bunk. Calhoun County, as well as the City of Port Lavaca, is only attractive, with rare exceptions, to people who have ties to the area, such as family, or those wanting to get experiences that will qualify them for a more desirable position elsewhere. Money and benefits alone are not adequate for retention. This has been true for firefighters, law enforcement personnel, hospital personnel and a host of doctors who have moved in and out of our area.
One of the most irksome examples of fiscal irresponsibility by our hospital administration was the increase of retirement benefits retroactive to the employees’ starting dates. Assuming you could afford to implement an increase (by afford, I mean you are profitable without being subsidized by taxpayer dollars), for whatever reasons, would it not be a prudent business decision to make the increase from that point forward? Persons employed by the hospital at the time were aware of the extent of the benefit and still chose to work there. This example simply constitutes an extremely poor business decision.
Another thing that fries me is the amount spent on indigent health care. From the numbers in the article, it calculates that an average cost of $6000 per indigent patient is accumulated. Guessing that a great portion of the patients are minor illness/injury cases, it seems that our generous hospital is providing more than the care required by law – an easy thing to do when it involves someone (the taxpayer) else’s money. [Don’t even get me started on the issue of providing all types of health, welfare and education benefits to illegal aliens, the likes of which most likely comprise as portion of the indigent patients (remember, it is illegal for us to ask or determine the status of their citizenship), across our United States.]
Elroy, hang up your spurs (or perhaps more appropriately, halter) now. Your time for the pasture is long past. We cannot afford you. Commissioners, sell the hospital. Make it a private enterprise entity that will sink with poor management similar to the present regime or swim based on free market forces and good management and business practices and decisions. "