CEO explains reasons for cuts
Refinancing will be included
By Bobbi Mlynar
Wednesday, February 25, 2009
Officials at Newman Regional Health are hoping that a restructuring of bonded indebtedness and eliminating some duplication of services will bring the hospital back to the black ink side of its ledger.
The administration on Wednesday presented a proposal to the Newman board of directors that they believe could ease the financial strain the hospital now is experiencing.
The reduction of services plan, which passed unanimously, includes eliminating Recovery Road/Employee Assistance Program (EAP) and Newman Home Health, 1015 Industrial Road.
Newman’s Hand in Hand Hospice, which operates from the same office complex, would not be affected by the change.
The second part of the plan, bond refinancing, was presented to the board by representatives of a company that proposed terms and options for the board to consider.
The refinancing, coupled with anticipated savings from downsizing, is expected to allow Newman to meet its payment commitments on the hospital’s debt.
“From an administrator’s perspective, I think our entire management team recognizes the impact these changes are going to have on the employees and their families,” said Newman Chief Executive Officer Bob Driewer. “You wish there could be a better option.
“I think we need to constrict our service, re-evaluate and focus on the ones where we have the opportunity to grow new services.”
In discussing options for changes, administrators kept in mind that their decisions on how to handle the budget deficit were likely to have far-reaching effects.
The guidelines used in the decision-making were these: Would the plan
— provide a seamless transition for the patients?
— provide options for NRH employees?
— Achieve industry standards for productivity and profitability?
The resulting plan was deemed the most promising to cut expenses and still provide quality care and needed services without eliminating more jobs than necessary.
The hospital ended 2008 with a deficit of about $1.6 million, and with no sign of improvement in January 2009, which showed a $547,000 operating loss.
“Our census in January was 38.5, quite a bit less than we expected,” Driewer said. “That just means less revenue. ...The reality of this is if we don’t get this corrected ... if we do nothing, eventually we will be in non-compliance with our indebtedness.”
Driewer said that Newman is not alone in its financial difficulties.
“Lots of smaller hospitals are experiencing similar challenges,” he said.
Bond refinancing, discussed last year with the Lyon County Commission, is expected to provide significant savings to the hospital over the next few years.
The term of the bonds would be decreased, along with the interest, for an anticipated savings of about $330,000 per year for the next 10 years.
Patient counts are down between 10 and 20 percent, and Driewer attributes some of that change to the economy downturn, both from local and national perspectives.
Layoffs from product recalls and general slowdowns in the industrial community may have been factors in the changes. The closing of Tyson Fresh Meats’ slaughter division and one shift of its production division also may have contributed to the Newman losses, Driewer said.
“I’ve got to believe those things had an impact on us, then the downturn helped drive that utilization for us locally,” he said.
While the school district did not lose a large number of students, and received additional state aid because it had more at-risk students, the former Tyson employees — perhaps still jobless and without unemployment and health insurance — may not be able to afford the medical treatments recommended.
“I believe that people are deferring health care,” he said. “It’s tough statistically to prove, but anecdotally ...”
He mentioned hearing about pregnant women going without pre-natal care and patients cancelling diagnostic procedures as two examples that appear connected to the economy.
Patient census was down last year in Obstetrics, which Driewer believes is more of a quirk in timing than a trend. The OB unit would be involved in changes, though, under the realignment proposed.
“What we are looking at and are going to propose to the board, is that we finish the remodel of third floor, which was started (six months ago) ... so that we have more private rooms,” Driewer said. “What we envision is that we could consolidate our patients off second floor on to those three remaining units, OB, third and Acute Rehabilitation Unit.”
The OB department has 14 beds, with only three occupied on Tuesday. In ARU, which has 12 beds, the average census is three, Driewer said.
Consolidating services onto three floors would give the hospital 31 beds on third floor, plus an additional eight beds on third that would be used for the Intensive Care Unit.
“We think there’s some efficiencies to be gained in consolidating our patients in three areas, rather than four,” he said.
Should a patient be admitted with a highly contagious disease, Driewer said other patients would be protected through standard procedures, like hand-washing, as well as with equipment that helps prevent spread of disease.
“We have negative-pressure rooms available,” he said.
Driewer expects the change to benefit patients, as well as the hospital’s financial bottom line.
“By consolidating, this will give us a chance to go to more of a registered-nurse model and they also play into the improvement of delivering health care,” he said. “When we get done, we want to do a better job.”
The plan also included evaluating the frequency of visits from outside contractors who provide services, often daily, to the hospital.
Those vendors include physical therapy and pathology services. Driewer said as an example that examining frozen sections for on-site scrutiny once were frequently needed.
“Now, it looks like we can probably schedule those on an as-needed basis,” he said.
Discussions are underway with vendors to determine what is needed now and what the schedule should be.
Administrators saw that they could eliminate some duplicated services because others in the community already have those services available.
“When funds are short, we have to ask if there’s duplication and if there is, why are we duplicating,” Driewer said.
In the end, they decided that Recovery Road/EAP and Home Health could be eliminated for that reason.
Driewer said he realizes that patients develop relationships with the care providers, particularly in the case of home health workers, who see patients regularly and often long-term. The assistance should still be available, though the service providers may not be the same people.
“I’m going to guess that the patient perception of the hospital and the health care deliverer is that their needs are met,” he said. “Not necessarily by a given provider, but their needs are met.”
Physical therapy would remain an option for area residents.
Under the proposal, the hospital will utilize professionals in the Acute Rehabilitation Unit to provide the intense rehabilitation needs that stroke patients might need — physical, speech and occupational therapies — as well as the narrower rehabilitation that might be needed, for example, by someone who as had hip-replacement surgery.
Diabetic education and cardiac rehabilitation also will continue.
“Those are services that are essential in the community and we’re going to continue to provide,” he said.
Driewer and the administration team envision the hospital’s recovery from its current economic distress, with a possibility of new services that currently are not available or an emphasis on needed services that provide income to the hospital, rather than losses.
Physician recruitment is underway, through Newman or local doctors’ groups, to bring in a full-time urologist, an internal medicine specialist and a radiologist. The hospital will try to improve services without duplicating existing ones, and will look for other opportunities to strengthen the hospital’s operation.
“I think there’s great opportunities for growth,” Driewer said. “We just have to take advantage of those down the road.”
dayjob55 (anonymous) says...
With paychecks on the line I find it interesting that jobs are cut but remodeling goes on. How about cutting back on some of the office jobs? Why is nursing always the first thing cut when it is the one thing that every patient has contact with? Duplication of services? There are other physical therapy offices here in town but it wasn't cut. Is it possible that physical therapy was untouched because the administration is trying to run the other PT business out of town? Did anyone stop to consider that patient census is down because Newman's has managed to run so many specialists out of town that when services are needed those patients take their business elsewhere & then find other doctors for their other needs in the town where their first specialist is located? Did I miss the recommendation to at least cut the salary of anyone in administration? In this case (like in politics) maybe the cuts should start at the top instead of cutting vital services.
February 25, 2009 at 6:49 p.m. ( permalink | suggest removal )
justthinkin (anonymous) says...
I also remember the on-going remodeling --- years & years of it --- I guess that is just blown money. It would be interesting to know the salaries of the top (CEO, CFO, Director of Nursing, and the various Dept Heads) --- I bet they could afford a reduction better than others could afford losing their job or even cutting their hours ---- but, if you cut work hours enough, then you can cut full-time benefits --- I sympathize with the displaced workers & I think that the administration of NRH (past & present) should be ashamed they let this happen and then offer this as the solution.
Reference the salaries, they will probably not disclose that information as they are not even Hospital employees, but the hospital is owned by Lyon County and is non-profit, so even though it isn't supported by taxes, I think the owners - Lyon County residents - have a right to know these figures ---- I bet they are higher than most people would imagine.
Maybe the Gazette could ask - the worst they could hear is "no"
February 25, 2009 at 7:50 p.m. ( permalink | suggest removal )
nurse4hire (anonymous) says...
Justthinkin nailed it perfectly!! NRH is owned by the people of Lyon County, however was anyone that isn't on the Hospital board or administration even asked what their thoughts about these cuts are???
February 25, 2009 at 8:12 p.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
It's really too bad the the employees at NRH had to find out about these cuts through the newspaper. They did not even get told from the CEO. It was hush hush and had to be found out about through reading the paper.
February 25, 2009 at 8:16 p.m. ( permalink | suggest removal )
nurse4hire (anonymous) says...
Another thought, Did the CEO, CFO, or Director of Nursing even go with these Home Health nurses on a visit to actually see their work in progress ? I can answer that, NO!!!, if they had they would have seen the people of Lyon County that these nurses served and trully made a difference in their lives. There are patients who are unable to leave their homes due to physical limitations, have no money for the bus or taxi, have no family in Emporia to take them to their doctors appointments, but what they did have was Newman Home Health to provide them with teaching on their medication changes, draw their blood for their required blood test and deliver it to the hopital, provide them with life saving antibiotics through IV lines, the list goes on and on and on. My biggest concern is for these patients. Maybe Mr. Driver needs to apoligize to them and tell them that because their insurance company or Medicare doesn't pay the Hospital enough, you are unworthy of this top notch care.
February 25, 2009 at 8:22 p.m. ( permalink | suggest removal )
cheymobo (anonymous) says...
I am a nurse at NRH..... I was totally disgusted by the fact that for the last 2 weeks we have been told "don't worry... continue to do your job the way you are... it will be ok"...etc. So then the big meeting is today...not only was I totally disgusted by the fact that I had to read that I may possibly lose my job in the newspaper, but was totally disgusted by the fact that the board allowed this to go through. According to our hospital the #1 priority we have is to our patients and the care they need, deserve and receive. Well that all gets put on the back burner when you are dealing with $$$. I feel the people of Lyon County, the owners of our hospital, need to stand up for the services that are being taken from them. Not only are they ripping jobs away from us, but they are taking from people who TRULY need this help. As far as the wages paid to our CEO I believe that is public knowledge as we are county owned, but I could be wrong.
February 25, 2009 at 10:06 p.m. ( permalink | suggest removal )
emporialady (anonymous) says...
We are lucky that the hospital is making a plan to keep from closing altogether...the economy has been hit hard all over, and the more people who can not afford to pay for urgent or emergency care must be devastating to the hospital. With insurances paying such a small percentage of the actual cost to provide care, all of our local healthcare providers are being hit hard. Preventative care has gone out the window, and now the sickest and least able to pay eventually make it to the hospital, and are not turned away.
The new administration is making some very hard decisions, and they are utilizing every resource available to ensure Emporia maintains and improves the health care available in our community. These decisions have not been made lightly, and there have been management changes and cuts.
If Emporia wants to have any type of hospital care available it is time to rally around the hospital, and offer support and concern for those directly affected. The hospital has a very strong core of dedicated, professional and caring staff and if we want those staff to continue to offer health care here,we need to support the hospital.
February 25, 2009 at 10:16 p.m. ( permalink | suggest removal )
create (anonymous) says...
I keep hearing noises from the horses. Neigh, neigh, neigh. I wonder what advice they have to make sure the hospital doesn't fail? "It is much easier to be critical that to be correct." Dale Carnegie.
February 26, 2009 at 7:27 a.m. ( permalink | suggest removal )
gooseylucy (anonymous) says...
"Preventative care has gone out the window, and now the sickest and least able to pay eventually make it to the hospital, and are not turned away." Yeah, emporialady you will not be turned away, but they will also hunt you down and take your last penny to pay for the bill. They will take every dollar they can from a single mother with 4 kids to support. They will take a struggling student to court and even take their student loan money to pay for the bill. Whatever it takes, they don't care who it hurts.
February 26, 2009 at 8:46 a.m. ( permalink | suggest removal )
slvrnblck (anonymous) says...
goosey--
If you receive services, you should pay for them. It is unfortunate that sometimes students or single mothers get sick, but if they receive treatment, they should pay.
February 26, 2009 at 9:01 a.m. ( permalink | suggest removal )
gooseylucy (anonymous) says...
slvrnblck, I agree and the single mom and student were trying to pay. They tried working with the financial dept at the hospital to no avail. Perhaps you don't know this but, the hospital dictates what they consider to be a "fair" payment per month. However single moms and college students have very little "extra" money just laying around. The hospital does not accept $50 or $100 per month. They told these folks they had to pay $300-400 per month. And when they couldn't pay that amount, they were taken to court and then the hospital takes it's money however it can and at any cost. These folks were NOT trying to avoid their obligations!! They just simply could not make the payments the hospital told them they would have to make.
February 26, 2009 at 9:41 a.m. ( permalink | suggest removal )
dick (anonymous) says...
No one likes to lose their jobs, but you might put your shoes on the other foot. If you haven't done so in the past take a look at the vehicles in all the parking spaces around the NMH area during the week and then again on the weekend. Does this tell you anything. If you are paying all the bills and being in business for yourselves you will not and cannot afford to have this many employees with a limited amount income coming in. Now I have been in that hosipital on many occasions to visit patients and more then once the nurses station has been full with employees doing nothing but visiting. Now of course you will come back and tell that this is necessary and times I'm sure it is, but when a patient has pulled the cord for service and it takes a long time for a nurse to get there is nonsence. Perhaps you are bringing a lot of this on yourselves and you talk about the wages some of the exc's are probably getting just what does a RN draw in wages plus benefits. We all know this is no a small chunk of change.
February 26, 2009 at 10:16 a.m. ( permalink | suggest removal )
PeanutButterJellyTime (anonymous) says...
Remember as a child playing the game where you pass on the phrase that was just whispered in your ear and by the time it gets to the last person it has changed? I think this happens a lot when adults gossip about things, such as telling stories about another person’s experience at NRH. Comments about NRH hunting down patients to take their last penny are a little dramatic. It is these types of public statements that misinform the general public and creates a lot of ignorant and negative publicity. I wonder how many people have heard the story about how NRH will hunt you down for money owed and expect $300 monthly payments? I wonder how many of those people have not come in for needed medical care out of fear? Not only does this hurt NRH financially, it is extrememly harmful to the patient’s well-being.
NRH DOES provide affordable repayment options and payments of $50 a month ARE available. I know this because that is what I pay and when I spoke with my financial counselor, she DID ask me how much I could afford monthly. Of course, this is not the only reason NRH is having a difficult time right now. With the state of the economy and the rising cost of healthcare, people can’t afford to get sick. I am sure the physician offices are seeing a decrease in patients too. I have said it before and saying it again; the Tyson lay-offs had a major impact on NRH revenue. Not just the loss of patients coming in for routine and elective exams, but keep in mind the amount of work-comp cases Tyson was referring to NRH. I believe Administration is doing exactly what needs to be done at this time and they have the best interest of their patients AND employees in mind. However, I will agree that they need to work on their communication with staff and the public; and in turn we (the public) need to stop the displays of negativity and support the hospital before their doors close for good.
February 26, 2009 at 12:04 p.m. ( permalink | suggest removal )
irritated (anonymous) says...
Okay, as i read this article I found myself terribly irritated. First, to the individual who spoke of the nurses chatting at the station, really? I have worked as a nurse for years, and chatting is the least on the list. You have no idea what is really going on as you simply walk by. Are they chatting about patients, are they discussing work related issues, maybe giving report to another nurse? I can not even count how many days I have worked 12 hours without eating, or eating a bite as I am running down the hall or charting. There are days I held my bladder until I was walking hunched over. Nurses don't become nurses for money, there are much better paying jobs that you don't work nights, weekends, and holidays. They become nurses to help people, to make a change in someones life. I would not change being a nurse for anything, even working on Christmas when my children open presents without me.
February 26, 2009 at 1 p.m. ( permalink | suggest removal )
irritated (anonymous) says...
Secondly, I do think Newmans has not been fair to their employees. They should have been the first to know, not the last. This is not fair on so many levels, and the level of trust that the staff must have with the hospital has to be at an all time low, which is sad. The economy has effected the hospital, there is no doubt. They have made some very silly and obvious errors. Why would we have sign on bonuses up to $10,000 RN's instead of just trying to keep the ones we have. Training new staff is a huge loss of money, we do not have to have a MBA to know that. Plus the construction, yes it is nice to have new rooms but not a must. A must is having happy staff which then makes happy patients. Just as on our national level, the budget has to be addressed to this degree because we have spent and spent when we should have saved and saved. It is a national problem not only with Newmans. However, for the board or the CEO to say that it is all from the economy is just bull. It was from bad budgeting.
February 26, 2009 at 1:02 p.m. ( permalink | suggest removal )
irritated (anonymous) says...
Do you know they pay some PRN II RN's $45 an hour? They do. And they will send home the RN, or LPN which makes much less before because that PRN II RN is more experienced, or has been there longer. They aren't supposed to, but they do. As far as the RN model, this is just another crazy move. Lets think, we pay an LPN between what $9 to $15 an hour we pay an RN $20 to $45 an hour. We have 18 patients on the floor. If we staff with 2 RN's and 1 LPN we have saved a great deal of money by having the LPN and not a 3rd RN. So, we are cutting everywhere and now we are going to use only the most expensive level of nurses out there? Newman's also had agency nurses, this was a huge issue. First please know that agency nurses, or traveling nurses as you may have heard them referred to, are much more costly to employ. I would bet almost double the rate of a normal working nurse. Not only did we hire them but when census dropped they worked the agency nurses and placed our own nurses on-call. By the way to be on call means you sit by the phone for $1.50 an hour until someone calls you to tell you can work now. However, you can not go do anything because if they need you, you are required to be on the floor because it is your scheduled day to work. Many of our home town nurses had to seek employment elsewhere due to this. It makes me sad to see Newmans now, it used to be the most awesome place to work. Now it breaks my heart to watch it crumble.
February 26, 2009 at 1:03 p.m. ( permalink | suggest removal )
mimi13guerrero (anonymous) says...
I am extremely saddened to see The Home Health be let go. If it was't for them, I wouldnt feel so comfortable having my daughter who was born with Down syndrome, a heart defect, intestinal problems and so on and on, be releasd from the hosptital. Knowing that we would have 1-2 visits a week from a nurse, knowing that if we had a problem in the middle of the night or during non-office visit hours, that we could call her, helped us to sleep alot better at night. I could call this nurse at any time with any kind of questions and she would do her best to answer or if she was unsure, she would find the answer for me. Now that we don't have that kind of communication, I sort of feel lost. You can call the doctor's office to ask questions but they are not so fast on calling you back. At least with the home health nurse, she got to see our daughter in person and address any of our questions. I felt more comfortable with her coming to our home than taking her to the doctor all the time because she had a higher chance of getting sick from being around others. I can't take that risk with her getting sick because we would end up right back in the hospital. We spent 13 weeks in the hospital because of her condition and knowing that we could be released and still have someone checking in on her was a great relief. But now what are we to do??
February 26, 2009 at 1:04 p.m. ( permalink | suggest removal )
irritated (anonymous) says...
So, to the person who wrote stating that everyone is clucking but not offering ideas, here are a few. Stop the construction, stop the sign on bonuses and help support the loyal staff you have, if there are any left. Stop the spending on agency nurses, cut the PRN II people. Use your LPN's wisely, to the fullest of their ability. The saddest thing is, at this point I think the budget is too far blown to save by these things now, but if you would have heard the cries of your LOYAL employees for the past several years and put these things into play....today would be much brighter.
February 26, 2009 at 1:04 p.m. ( permalink | suggest removal )
slvrnblck (anonymous) says...
Thank you PB&J. I was going to say the same thing about the minimum payments. I too have paid $50 a month to the hospital when times are tight and have never been harassed. They work with you if you work with them.
Instead of bashing the officials at the hospital, I think the community would better be served by finding out what it can do to help those that may find themselves without jobs. I am sure that the cuts that the hospital made did not come lightly and I can not imagine the immense stress that the new CEO, the CFO and others have been under when they look at the books and see they are in the red. They know that they are going to have to shut down departments and lay off people, including people they might consider friends, in order to continue to be of service to the people of Emporia. In my opinion, it is better to have a hospital with a few less services than not one at all.
Best wishes go out to those who have been or will be laid off and good luck to those that are in charge of turning things around. It will be a tough task but it is achieveable.
February 26, 2009 at 1:10 p.m. ( permalink | suggest removal )
PeanutButterJellyTime (anonymous) says...
Irritated- From all that you have wrote it is obvious you are, well, irritated. I can't help but assume that you must be an RN at NRH, having the knowledge you have about the pay scales of PRN II RN's, RN's, and LPN's...and of course the frustration you seem to have about RN's being sent home when census is low. Assuming that you are a hospital employee, and of course you do not need to confirm nor deny this, I have to question your loyalty to NRH; if in fact they do employ you. If you were loyal you wouldn't take part in such a negative public attack. This type of attitude is not doing the hospital any good and is only causing potential patients to question the quality of care at NRH. You stated that happy employees make happy patients, doesn't sound like we would get good, quality care if you were taking care of us at NRH.
February 26, 2009 at 1:28 p.m. ( permalink | suggest removal )
butterfly (anonymous) says...
wow. i am not sure about all the details here. but i do know - from being here my whole life - if people have a chance to get help anywhere else and can get there without dying - they ask to be referred out to another hospital in another town.
so i guess that does just leave the people who have no resources pay or money for transportation or insurance to get services some where else - left here - to get help - and then can't pay.
i would say keep the ER open and close everythign else - but honestly - if i can survive the drive - i will not even go to the ER here.
sorry - just being honest.
February 26, 2009 at 3:45 p.m. ( permalink | suggest removal )
justthinkin (anonymous) says...
To PB&J - Yes, it appears that irritated is / was an employee - I appreciate the insight they have given. But, to say a loyal employee wouldn't take part in a negative attack - it seems to me it is a counter-attack to the horrific treatment the NRH employees received. Loyalty goes both ways, and irritated was not the one that broke the loyalty. NRH broke the loyalty - to the employees & to the public / owners. Eliminating Home Health is a great injustice to the citizens. It is an essential service that needs to be continued. I understand that there are other HH agencies - how long can we count on them being in business, and then what do we do? Discontinue bonuses, remodeling, retreats, etc. but keep home health. While I'm at it.... Kudos to the EAP personnel that had the vision to read the writing on the wall & jump ship while it was still afloat.... and to Paula Taylor who retired at just the right time. Does that smell like a rose or something else?
February 26, 2009 at 3:56 p.m. ( permalink | suggest removal )
PeanutButterJellyTime (anonymous) says...
As a former NRH employee, I have to laugh at the phrase "horrific treatment."
Closing Newman Home Health is unfortunate to NRH employees and patients, and yes it is an essential service...and it WILL be continued...by other agencies.
When there isn't money for a "retreat", which are actually educational seminars, no one goes.
Remodels were scheduled back when NRH was turning a profit; many of them are wrapping up completion now. You will notice in the months to come that projects at NRH will cease.
As for remarks about bonuses and administrations salaries, why don't you contact their management and consulting service, QHR. NRH has been in contract with them since 1986. NRH budgets/pays for the consulting service...not for their salaries or bonuses.
I bet if Lyon County residents were being taxed in order to keep services from being dropped at the hospital, the community would start complaining and demand that services and staff be cut back in order to fit the budget. Some people are just never happy.
February 26, 2009 at 4:47 p.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
If the Lyon Co citizens want to help support their hospital then next time you go to the doctor at Medical arts or Internal Medicine and your doctor wants you to have blood work or a radiology procedure insist on having it done at the hospital. The very doctors that rely on the hospital to send their patients to do not send them there to have lab work, x-ray, ultrasound,mri, nuclear test or even a cat scan. When you have a procedure done in your doctor office a lot of the time your doctor is charging you for that procedure and charging you to look at the pictures, they are not even trained to do that. Insist on having your exam done at the hospital. Maybe if our own doctors would start supporting the hospital instead of trying to make an extra dollar this situation would not be as bad. By the way if you have insurance and are an Internal Med patient the doctor will insist you get your procedure in their office if you don't have insurance they will send you to the hospital. Ask your doctor this next time.
February 26, 2009 at 5:42 p.m. ( permalink | suggest removal )
irritated (anonymous) says...
PBJ- You are correct in your assumption. I am a good nurse and I would give you the best care that I could possibly give you, that is what I do, I'm a nurse. However, with your comment about my statements scaring people off, you may think a moment. They are laying us off, they are cutting our hours, they are changing how we work and at the same time they just CUT our employee assistance program. So, if we are feeling irritated, angry or non loyal we now have no one to go speak with. I am not so sure at this point that I or anyone else working there can give the best care possible. WE are all stressed, and no one works at their maximum potential under stress. And as far as being loyal, NRH was not loyal to its employees. Loyalty goes both ways, when someone is not loyal to you it does tend to make you question your loyalty to them. The things I stated are not new, I have been crying them out for years as well as many others. It is so hard to watch NRH fall when you could see it occuring for such a long time and no one would listen to the "little people". If I have learned anything from having children, it is to ALWAYS listen to the "little people", they often have the simplest and best ideas.
February 26, 2009 at 5:47 p.m. ( permalink | suggest removal )
LifeGoesOn (anonymous) says...
herea a idea to help save NRH some money, let the patients bring thier own Toliet paper,Glass & Pitcher and this way newmans wont have to continue buying those $300 plastic pitchers and $40 rolls of TP. It will also save the patients money, they wont be charged for those things either!
February 26, 2009 at 5:47 p.m. ( permalink | suggest removal )
cheymobo (anonymous) says...
Life goes on.... that was just silly... PB&J it's easy to talk about not being loyal when you are obviously not being affected by this........why did you leave if it's such a great place? They were not loyal to anyone in our community, not just the employees. Irritated speaks the perfect truth and obviously that was something that hit a sore spot with you. They limit the LPN's which they can utilize to a far more extent, and save money there. This would take stress off many nurses. Not to mention it could give better customer satisfaction to the patient that has to wait 20 min to get their pain medicine through their IV, which NRH doesn't want the LPN's doing... not that they can't by the LPN scope of practice but it is not allowed there. So, now the RN has to give pain medication to 3 of her 5 patients and 2 of the LPN's 5 patients. Let's see someone is going to have to wait....But not only in the patient's perspective which should be the #1 priority but the LPNs are way less expensive and can be utilized way more for the type of hospital we have. We are not the Mayo clinic and our truly critical patients get transferred most of the time This is because we have a major lack of specialty doctors in this town, and the lack of many other things to take care of these people. So I have to ask is there really a need for that much RN coverage, in my opinion -no. But we need to learn to utilize what we have, and for some unknown reason we cannot do that.
February 26, 2009 at 6:41 p.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
lets take advantage of the hard workers at the hospital. Just because you are charge nurse does not mean that you cannot get up and go answer a call light. Just because you are department director doesn't mean you can't fill in for a shift needing filled one day or that you cannot do patient care anymore. It doesn't mean just sitting at a desk or in an office all day. If the hospital is doing layoffs lets keep the hard workers and get rid of the ones that think they are too high status to get their hands dirty.
February 26, 2009 at 7:42 p.m. ( permalink | suggest removal )
spectator (anonymous) says...
Irritated is correct. NRH has sent the regular employees home on-call for years. Do you not realize, pbj, that the NRH employees DID stand by, and were faithful to, NRH for so long and that's what kept it going ? My wife was one of those on-call nurses when the traveling nurses were guaranteed a job at twice the rate. The things the public DOESN'T know about the day-to-day disfunction of NRH would curl your hair. NRH functions (sort of) BECAUSE of dedicated employees like Irritated even though NRH has dumped on, and taken advantage of, them for YEARS. Sorry to burst your happy little hospital bubble, but you don't know the half of it and NRH's DEDICATED employees like Irritated have just touched on the issues.
February 26, 2009 at 9:48 p.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
This comment was removed by the site staff for violation of the usage agreement.
February 25, 2009 at 8:33 p.m. ( permalink )
LifeGoesOn (anonymous) says...
cheymobo, my last statment may have been a bit silly but it is also true. Whens the last time You looked at a bill to see what Newmans charges for That little plastic pitcher or a roll of TP. It's a bit over the top!
February 27, 2009 at 6:10 a.m. ( permalink | suggest removal )
beenthere (anonymous) says...
Interesting posts. Some are incredibly uninformed though. Hospitals and providers have a huge number of unfunded mandates. Medicare and Medicaid don't pay the cost of providing services. And the overwhelming majority of patients are in those two groups. Hospitals can charge what some of you think extreme amounts for aspirin, toliet paper, etc. They will not be paid those charges and they will struggle to break even. Focus on the big picture.
Combine that financial struggle with a shortage of all types of health providers, an aging health care work force, increasing education costs and decreased salaries across the board and you have the making of a health disaster happening before your eyes. This in turn will be an economic disaster for the community. We have a growing aging population and a decreased number of young students willing to go into health care. How many current health care providers do you think are encouraging kids to go into health care?
These issues have been discussed for decades. The Congressional Budget Office stated many years ago that by 2020 all tax revenue would go to pay for Medicare, Medicaid, and Social Security. No money for health care, the military, infrastructure, etc.
Before you assign blame to providers and hospitals, look to your political leaders who have been promising a health care free lunch for decades. The bill has now become due.
February 27, 2009 at 8:59 a.m. ( permalink | suggest removal )
create (anonymous) says...
At the same time, it needs to be stated that the medical care industry has been socking it to insurance companies for years. True, Medicare or Medicaid won't let them charge exhorbitant amounts for many services or items, but they have made very comfortable beds for themselves along the way. I can remember when I was carrying Blue Cross/Blue Shield years ago and BCBS didn't blink an eye, they just paid $65 for one Tylenol!
The hospital pharmacy buys Tylenol in lots of a thousand pills. Yet charges $65 for one? Yeah, yeah, I know, that fee is supposed to cover all the personnel costs involved with giving you that Tylenol, but get real. $65 for one tablet? No way. Years and years of taking advantage of insurance companies has been a part of the entire problem from the beginning. Premiums go up, up, up to keep up with the charges for medical care, like a never-satisfied animal gobbling up more and more. When does it end? The health care industry is due for a giant overhaul and it's gonna hurt because business as usual is a thing of the past.
February 27, 2009 at 9:39 a.m. ( permalink | suggest removal )
seriously (anonymous) says...
I think all hospital employees need to pull together. If you are a hospital employee change doctors to the ones that support the hospital. Internal Med and Medical Arts keep all the lab, x-ray, ultrasound, & nuc med at their offices. The equipment at the hospital is much more advanced than at these offices and not to mention these doctors have went to school just to read these exams. I think these doctors are trying to break the hospital. It is time for administration to tell these doctors NO more. Its ok, they are not GOD. They dont have to drive those 50,000 dollar cars and live in those 400,000 dollar houses. They dont need to be so greedy or they wont have a hospital. Tell everyone you know to stop supporting these doctors and go to the ones that do support the hospital. These doctors are Dr Cook, Wright, Schmid, & Hrabik. They support our hospital & are happy with the services that are provided. The radiology dept wants to put in digital mammography, but the internal med doctors say no because it might take away from thier business. TOO BAD, What about the quality of care for Lyon Co. residents. We need to provide the most advanced services for the community that we can. Also, why do we employ the Ortho doctors and put in thier equipment and pay thier tech & the hospital gets no revenue for this. Do you know that the hospital put in a brand new x-ray machine for these doctors & all they had to do was walk across the hall to radiology and get exam done here. What are you thinking Holly French? Was this in your budget plan? Once again, lets take care of the doctors who are making all the money, but lets break the hospital in the process. What are the doctors with no nurses, lab, radiology, cardio pulmonary, rehab, surgery, er, and other staff that keeps this place going. The most important thing is patient care. Sending pts all over the place just makes it hard on pts. Internal Med doctors will not even do a nuc stress test at the hospital. They send their stress test to Kansas City that they are unable to do in their office, so that they can get a cut off of this. Cotton o Neil clinic will atleast do the nuc stresses at NRH using a topeka cardiologist. NRH employees stick together!!! Lets make sure everyone we know, stops supporting Internal Med(doctors pockets) and Medical Arts (stormont vail).
February 27, 2009 at 10:01 a.m. ( permalink | suggest removal )
beenthere (anonymous) says...
You stated: "The health care industry is due for a giant overhaul and it's gonna hurt because business as usual is a thing of the past." You are exactly right. And it will hurt everyone. Part of the overhaul will be limiting access to health care, rationing, and denial of care. Former Colorado Governor stated years ago that older people had "a duty to die." More recently nominated HHS secretary Tom Daschle proposed a federal health care panel that would take hard decisions away from physicians. Those hard decisions involved denying care. And Monday afternoon President Obama stated healthcare reform would involve pain for everyone. You might want to take time to fully realize what that means.
As far as taking advantage of insurance companies goes, many insurance companies have a contracted amount they will pay regardless how much is billed for "Tylenol." The provider writes off any amount over and above the allowed charge.
February 27, 2009 at 10:14 a.m. ( permalink | suggest removal )
LifeGoesOn (anonymous) says...
beenthere
you said
"Hospitals can charge what some of you think extreme amounts for aspirin, toliet paper, etc. They will not be paid those charges and they will struggle to break even"
Sorry dont believe it. as create said, $65 for one Tylenol? and they wont break even? Whatever!
With that said, my fisrt post where I brought up the plactic pitcher and glass was meant to be more of a joke than being serious. But now that you have defended it, maybe I was on to something, I mean if the hospital wont even break even on thoe things, why not let the patients bring thier own. the hospital wont have to furnish it and it will save them some money. Golly maybe I'll bring my own Tylenol next time and give it to myself saving even more money!
February 27, 2009 at 10:21 a.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
you nailed the donkey on the tail Seriously! The doctors need to start supporting their own hospital so they have a hospital to send their patients to instead of worrying about making an extra dollar for themselves. Lets start thinking about the patients.
February 27, 2009 at 10:39 a.m. ( permalink | suggest removal )
beenthere (anonymous) says...
As I said before , many uninformed statements. Hospitals are liable for medications you take. How do they know what you bring from home is appropriate? I've seen many patients switch meds with spouses and friends, put meds in different pill bottles, etc. Are you willing to release the hospital from liability?
You stated: "Sorry dont believe it. as create said, $65 for one Tylenol? and they wont break even? Whatever!"
Believe whatever fantasy you want. Your local hospital did not set up the national health care reimbursement or billing system but do have to deal with it as it is. The fact is most hospitals are losing money and care will be limited. And some of you will be the first to complain when the call light is not answered as quickly as you like.
February 27, 2009 at 10:55 a.m. ( permalink | suggest removal )
anyonesdr (anonymous) says...
It seems that some of you would want to get your facts straight before entering the firing range. The ortho doctors AND the staff that work there are all employees of the hospital. The xrays done there, generate revenue for the hospital. It would not be logical or time efficient to send a patient from the office to the hospital for the xray (it is all going to the same pot). True many of the offices are doing labs, xrays, etc. in their place and not all at the hospital. This unfortunately is business. Some of the offices do use the hospitals outpatient services extensively, as well as the radiologists (who are NOT hospital employees). One group of internal medicine providers do essentially nothing at the hospital as far as outpatient procedures (labs, xray, Nuc, stress test, etc); while other groups do those things there. It makes me wonder if administration needs to be taking all of the heat for these decisions, when they have been talking with Middle Manangement for months seeking ideas and input from them on ways to correct these problems to avoid this type of maneuver. Did middle management (dept heads) do their jobs effectively? Is it time to start looking at that area to consolidate departments?? Lets all try to be proactive and turn this around. We know that NRH will never be a tertiary care center, and it does not need to be, but we need to make and keep what we have as viable and good as it can be. Before you start to gripe, you might ask what can I/We do to turn this around?
February 27, 2009 at 12:53 p.m. ( permalink | suggest removal )
seriously (anonymous) says...
Anyonesdr-
I think we are really on the same page. My whole point was why buy another xray machine, so we can duplicate services if it is going into the same pot. It seems like a waste of money. Yes, it might not be time efficient to make the patient walk a few extra steps, but it would of saved about 500,000 dollars for the hospital, who already has the equipment and the staff. We are glad to have the ortho doctors that are employeed by the hospital. We need more doctors or all doctors employeed by the hospital. Look at Burlington, Council Grove, Eureka, and Newton Hospitals. These hospitals have support from the physicians and this helps the hospital revenue. As for internal medicine, if they cared for the patient they would send them to the hospital where the equipment is better and it is read by a radiologist. Middle Managment has no control over the doctors. For some reason Internal Med has ran the show from day one. They cry and get their way. It did not help that Dr Barnett bashed the hospital. He needs to decide whether to be in medicine or politics.
February 27, 2009 at 1:40 p.m. ( permalink | suggest removal )
LifeGoesOn (anonymous) says...
beenthere, the call light thing, I have no problem with that, the nurses have always been on the ball as far as I'm concerned, so I have no complaints with that. Back to the cost of a plastic pitcher, You cant tell me that the national health care reimbursement billing system mandates that the Hospital charge so much for a pitcher or TP. Is that what your telling me? If it is then my answer is YES, I would release the hospital from any and all liability if they let me use my own plactic pitcher, cup and TP instead of paying a huge fee to them to use thiers. I would also like to comment on something "mrwho" said. And I may catch heck for this but I just dont give a S,
People here in violation of our Immigration laws should be refused service period, if they kick the bucket because of it, Oh Well, they should have stayed in thier own county or came to this one legally. This is one reson our health care costs are so high, We (America) KEEP taking care of those in our County Illegally for FREE while we (Americans) foot the bill.
February 27, 2009 at 3:48 p.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
Administration may seek advice from middle management but they do not put in action what middle management and directors tell them. Ultimately it is up to Administration to call all the shots. It would be nice if Middle management was allowed to call their own shots. At least middle management sees what goes on in a clinical setting everyday, unlike Administration who sits in their office or meetings all day and has their secrateries answer all their calls. Maybe if Administration would actually follow through on some middle management advice we would not be in this situation. Administration is all about a big power trip. One of our Administratiors started off as transcription and just worked her way up to the top. What clinical experience is that.
February 27, 2009 at 5:49 p.m. ( permalink | suggest removal )
beenthere (anonymous) says...
You stated: "You cant tell me that the national health care reimbursement billing system mandates that the Hospital charge so much for a pitcher or TP. Is that what your telling me? If it is then my answer is YES, I would release the hospital from any and all liability if they let me use my own plactic pitcher, cup and TP instead of paying a huge fee to them to use thiers."
I'll try this one more time. Hospitals can charge $1,000 for a plastic water jug but they're not going to get it. Again, in most cases there is a fixed price for a service provided. Focus on the big picture.
As to the immigration thing, as it stands now, illegal immigrants can't be turned away if they show up in the E.R. It isn't as simple as you seem to think.
February 27, 2009 at 7:10 p.m. ( permalink | suggest removal )
justthinkin (anonymous) says...
About the lab & X-ray thing ---- Let's see, this started with the justification that Home Health is provided by others, and therefore can be cut from the hospital --- If essentially all medical clinics have lab & X-Ray, let's eliminate those services at NRH, and if only 4 docs or so don't have those services, maybe they can pitch in together & get their own. I was justthinkin that if so many other places provide those services, then the community wouldn't feel the hurt and services wouldn't be duplicated.
February 27, 2009 at 8:07 p.m. ( permalink | suggest removal )
LifeGoesOn (anonymous) says...
beenthere, when I get a Bill from NRH for services, (a pitcher or TP) I write the check to NRH, so YES they do get my money. Try to see the picture in front of your face.
So I'll try one more time, Lets say NRH sends me a bill, there is a line item that says (water jug, $1000) I write the check to NRH for that $1000, Who cashes that check?
Are you saying that when a person goes to the hospital, gets treatment,uses items (TP, Water Jugs,etc) Gets taken care of by nurses and doctors employeed by NRH that the statement that the person gets and Pays to NRH, does not go to NRH? That what your telling me?
"As to the immigration thing, as it stands now, illegal immigrants can't be turned away if they show up in the E.R. It isn't as simple as you seem to think."
I never said it was simple Reread my post, What I said was
"People here in violation of our Immigration laws should be refused service period, if they kick the bucket because of it, Oh Well, they should have stayed in thier own county or came to this one legally. This is one reson our health care costs are so high, We (America) KEEP taking care of those in our County Illegally for FREE while we (Americans) foot the bill." I was stating my opinion NOT, saying NRH was allowed to turn away illegal immigrants and dont
February 27, 2009 at 8:27 p.m. ( permalink | suggest removal )
beenthere (anonymous) says...
Lifegoeson:
I'm not arguing with you. A common mistake people make in trying to understand health care billing by comparing it to any other business. Big mistake. If you walk into Walmart and buy a $1000 T.V. Walmart doesn't care who you are, you pay $1000. If you walk into a hospital and get an appendectomy and and it costs $1000 the hospital will be paid anywhere from nothing to all the bill depending on whether you are self pay, no pay, Medicare, Medicaid, Mutual of Omaha, or Blue Cross Blue Shield. So the hospital charges everyone $65 for Tylenol knowing full well it won't get anywhere near that amount but will get some extra in some cases to offset the no pay or low pay. When there are more and more no pay, Medicare, or Medicaid and fewer patients with good insurance, the hospital loses money which has been the case for years across the USA.
February 27, 2009 at 10:14 p.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
Go ahead and get your lab and x-ray done at the doctors office you can pay them the hundrends of dollars to read your exam and it may be read positive or negative. They are not trained radiologist. And if you are in the hospital and need a x-ray or an ultrasound or a nuc study or lab drawn sorry we can't do that because the doctors office put us out of business so you can be shipped to another hospital or you can be wheelchaired over to the doctors office and get your lab drawn and then wait a week on your death bed to find out the results. The doctors office equipment is old and not up to date. They rely on the tech to tell them the outcome of the procedure because they do not know. If it was my family I would want them to go to a place where the equipment is up to date and the exam is being read by a radiologist. A lot of times the docotrs don't even know the correct exam to order for the patients symptoms and the radiologist has to correct them. So if you think duplicate os services need to be taken away at the hospital such as lab and radiology and just have it in the doctors office then close the whole hospital cause you can't come in the ER sick and not have lab drawn and you can't come in the ER with a broken arm and not have a
x-ray!
February 28, 2009 at 8:17 a.m. ( permalink | suggest removal )
susieq (anonymous) says...
As a former employee of NRH, i left there after being a loyal employee for many years. The daily care of patients was getting to be quite sloppy. I was also a patient in the hospital several times. There is none of the little nicities, like offering a wash cloth to wash the face before breakfast. Hopefully you can sit up and feed yourself, otherwise the tray is set on the table and left there. Also, hopefully you can take your own bath, because if not, the staff is too busy documenting you did on the computer. As one of the comments said if the employees are happy, the patients will be happy also. I have heard a lot of comments by former patients, saying they would never darken the door of NRH again, because they could get better nursing care elsewhere. As nurses, lets get off the computer and take care of the patients and make them more comfortable and assist them in their recovery, instead of standing around the nursing station and talking or working on the computer.
February 28, 2009 at 11:02 p.m. ( permalink | suggest removal )
CRAZE (anonymous) says...
I totally agree with susieq. There have been many of times that I have noticed a call light going off and all the nurses are at the nurses station and no one is getting up. If you go and say I need help with so and so in rm 385 the nurse looks up and says that is not my patient is is this nurses. What happened to taking care of the patient no matter what. Lets not play the games of it is not my patient so I will not help. As for the LPNs they are the ones that actually get up and answer the call lights. If we go to just RN status call lights will be going off all day long. The patients only get checked on if the call light is going off. If not I never see nurses going in the room to just ask how are you feeling can I get you anything? They only go in if they have to give the patietn something. More and more I hear from the public that they did not enjoy their stay and that the nurses were rude and not very caring. All nurses need to be involved all day in patient care. This means the charge nurses too that sit and give orders all day!
March 1, 2009 at 8:21 a.m. ( permalink | suggest removal )
SFIns (anonymous) says...
This all comes down to a free market marketplace. The quality of the staff goes down and the market decides to take their business else where. Maybe the staff needs to quit complaining about everything and start looking after the patients. Is this so hard to understand?
March 1, 2009 at 8:28 a.m. ( permalink | suggest removal )
susieq (anonymous) says...
I agree, the quality of patient care goes down, the market goes somewhere else for their medical care. The students in nursing are taught leadership, computer skills, and how to look after the machinery, but what about the patient care. This is labeled patient care, not computer care. Granted computerized medical charts are the going thing in health care, but patient care should come first, then the documentation, leadership. I have heard many students say, I've got to document on the computer, or make assignments for the next day, while the patient is waiting in their room for a bath, bed change, walk, or pillow fluffed. I was a patient in the hospital not too long ago, I was there for about a week, and not once was i offered a pre breakfast washcloth to clean my face or a back rub in the evening. Also, I agree that when a call light goes off, that is anyone's patient, not just "not my patient". Anyone can answer the call light, and provide the care for that patient. The Charge nurses are also nurses, who can provide the basic and on up nursing care. But there is an old saying from an instructor who was very wise, "you only rise to your own level of incompentence", and on a day to day basis, I have seen this in all aspects of hospital staff.
Along the line with that is the idea of management, when census is low, give staff "on-call" days. Sitting by the phone for $1.00 an hour or give them supervisor request day, at no pay. At least with an SR day, one could do errands, or go to another job, if there was one. I don't see management taking cuts in pay, maybe they would go home early, but when they are on salary, that doesn't affect their pay. Granted people go into nursing for the satisfaction of helping patients to recover from illness and injury or to make their days more comfortable, but there is also the monitary side of it. The staff must also pay their bills to survive. If one has to take one, two or more days off without pay per payday, the bills cannot be met and one is forced to go elsewhere to seek enough money to meet those bills. I know the supervisors try to rotate the SR and on calls, but when the staff is limited, the supervisors have to choose who gets the multiple days off. How can a nurse, whether it be an RN, LPN, or a CNA give happy patient care when he/she is worried about how to feed the children at home, or provide heat, lights, etc like pay the bills. If upper management would look at how to keep the staff working, it would make the staff more satisfied, the patients happier and more supportive of the hospital, and maybe even the recruitment of doctors easier. Management needs to figure out a repair for the problems at the hospital, not just a quick bandaid. Thank you for reading and listening to my comments.
March 1, 2009 at 11:04 a.m. ( permalink | suggest removal )
glarson (anonymous) says...
Moving to a forum:
http://www.emporiagazette.com/forums/...
March 2, 2009 at 1:01 p.m. ( permalink | suggest removal )