NRMC board discusses possible impact of health care reform

"It's frustrating. There are certain meds I can't use, even though I know they are effective," as a result of changes coming about in health care reform. "They say the expense is too high. ... Rationing of care" is coming, says Dr. William Turner, and there's little that health care workers seem to be able to do about it. "This is going to short-sheet my patients," Turner said.

But a realignment of how health care services are delivered in the United States is coming, "whether we like it or not," said Nevada Regional Medical Center CFO Cindy Buck.

The exchange was part of a discussion about health care reform and part of its impact on the hospital during a meeting of the NRMC Board of Directors on Tuesday. Rules across the board are changing, and the financial picture for doctors and the hospital is likely to change with it.

In response to questions posed by a board member, Turner acknowledged that those willing and able to pay out-of-pocket will still have access to treatments of all sorts, but noted that does little for those who rely on public health plans, and some treatments he knows works but aren't the "approved treatments" will be less available -- or companies could opt to cease producing them altogether -- due to less market demand, Turner said.

Board member Bill Denman said he was recently at a conference relating to health care reform, and that the cost must be managed in some way. Health care providers are being asked to provide high quality care at a lower cost.

A QHR representative at the meeting said, "There are a lot of hospitals that may not make it." So, health care providers in general and NRMC in particular will have to boost their market share, through quality of staffing, quality of care and customer service.

"This is one of the most turbulent times I have ever experienced in health care," said NRMC President and CEO Judy Feuquay.

In other business, Buck presented an overview of plans to improve the use of technology at the hospital under a federal program that encourages this activity. Several steps must be accomplished over a period of four years for the hospital, and five to six years for physicians. The effort could mean as much as $2.5 million over the course of the program to the hospital.

Buck also presented the August financial report to the board, with a net loss for the month of $74,696; but noted that the hospital still has cash on hand equivalent to 176 days.

Feuquay said the hospital is working to improve collections, improve the hospital's case management program and increase volume.

Long-term care administrator Denise Sloniker said income also was below expectations for the long-term care facilities, in part due to an accounting adjustment, rental equipment expenses, and fewer patient days than budgeted.

Sloniker also noted that employee retention has been a challenge of late, and that the long term care facilities are taking steps to address this, such as additional training, building more communication opportunities into the system for new hires and so on.

Feuquay announced that Dr. Dan Barnes will be providing primary care services in the NowCare Clinic, beginning Oct. 5. Hours at the clinic also are expanding. Monday, Wednesday and Friday hours will remain unchanged, 8 a.m.-5 p.m.; Tuesday and Thursday hours will increase to 7 a.m.-7 p.m., and Saturday hours, 8 a.m.-noon will be added.

Physician recruitment continues, Feuquay said. The hospital is seeing a primary care/emergency department physician, psychiatrist, a visiting urologist and a visiting ear, nose and throat specialist.

Feuquay said the hospital also hopes to resume hospice services within a few months.

Also on the agenda was a report from NRMC Foundation chairman Bob Beaver, who reported that during the past year, the Foundation had raised $56,528. The seventh annual Caring With Pride Golf Tournament raised $13,272; the fourth annual gala was attended by 180 guests and raised $4,100 -- an amount that surpassed income from the previous gala by $1,300. For this year's gala, to take place Saturday at the Elks Lodge in Nevada, the Foundation had sold 191 tickets at the time.

The Foundation also is sponsoring free PSA screenings (a blood test to help detect prostate cancer) on Thursday, and plans to give $50,000 to fund an infant security system. Other goals for the Foundation including increasing awareness in the community, and identifying other, unique fundraising avenues.

Glenn Rogers, NRMC board chairman, expressed thanks to the Foundation, saying its members are "an important form of contact between the hospital and the community we serve."

In other business, the hospital board:

* Heard a report about progress of plans for the North parking lot. Bids have been received and are under review.

* Heard a report that the hospital's MRI machine is getting old, so a committee is looking into replacement options.