Wise Regional switches partners; Demand for access to bank account not acceptable

Last October, Wise Regional Health System made a deal to buy three nursing facilities owned by Sava Health Systems.

The “win-win” arrangement, sought by Sava, allowed the Decatur-based hospital system to be the owner and reap the profits while Sava continued to lease and operate the facilities – which would qualify for a higher reimbursement rate from the state once they were owned by a public hospital.

In fact, over the last few months Wise Regional has acquired nine nursing facilities under similar arrangements, purchasing them, then leasing them back to the operators.

But Tuesday, the deal with Sava got scratched.

“Sava Health Care came in at the last minute and said they needed to have a security interest in the operating account of those three facilities,” Wise Regional Chief Executive Officer Steve Summers told his board Monday night. “Our bond counsel advised against giving them the right to do that. We would basically have to get approval from every one of our bondholders.”

At Monday’s meeting, Summers proposed an alternative to his board to allow Wise Regional to acquire five other nursing facilities from Cantex Health Care if the Sava deal got scrapped.

It did, and they did.

“We gave them [Sava] until about noon,” Summers said Tuesday afternoon. “The paperwork had to be filed this afternoon – and it was a lot of paperwork.”

Summers said he was surprised Sava stuck with the demand.

“It’s a significant amount of money they walked away from because of their bank,” he said.

The five Cantex nursing facilities Wise Regional will acquire instead are located in Gainesville, Denison, Allen, Richardson and Flower Mound. Summers said they will bring in about half as much revenue as the three Sava facilities would have.

With a little advance notice, he added, Wise Regional could have easily done better.

“If we’d known even a month earlier, we could have replaced these dollar-for-dollar,” he said. “Cantex had some other facilities we could have picked up.”

The board on Monday authorized Summers and Chief Financial Officer Todd Scroggins to take whatever action was necessary to complete the transaction with Cantex if Sava withdrew. By late afternoon, that had been done and the documents filed with the state.

In his monthly financial report, Scroggins said he had already “booked” more than $900,000 from the nursing facilities, although the cash had not yet been received.

Administrator Donna Stowers, who is overseeing the nine facilities, reported to the board that all of the management companies have been “very cooperative” as she works to integrate them into the Wise Regional system.

“We’re working on a plan for reporting nursing home information,” she said. “You’re bombarded with a lot of data, automatically.”

Stowers is looking at data from a variety of sources, while also making personal visits to each facility at least once a month – standing appointments as well as drop-in visits.

“It’s kind of been a challenge to get it all set up, but it’s exciting,” she said.

2014 ENDS ON STRONG NOTE

Scroggins told the board December was the biggest month in Wise Regional’s history, by several measures.

  • Gross patient charges were $54 million
  • The average inpatient census was 74 – compared to 62 at this time last year
  • There were 838 surgeries performed in December, “definitely a record.”

He said the Parkway surgery center continues to do well, netting about $275,000 for the month of December. The Bridgeport campus, in its last month as a full-service ER, lost about $279,000. It reopened as an urgent care center Jan. 2.

The hospital’s net position increased by $8.2 million during the month in spite of the higher expenses that come with the higher patient volume. Overall, the hospital has $49.9 million in cash reserves.

“On a consolidated basis, we ended the year with 104 days of cash [in reserve],” he said. “That’s reasonably respectable, although not where we budgeted. But the debt service days of coverage more than covers our bond covenants.”

NURSES DEALING WITH HIGH VOLUME

LeeAnn Cummings, Wise Regional’s Director of Nursing, told the board in spite of the 20 percent increase in volume in the hospital’s medical/surgical unit, the facility is still below the national average for turnover in nurses.

Wise Regional employs 321 RNs, 62 LVNS and 173 ancillary staff – a total of 556 nursing personnel including 46 at the Parkway campus.

Cummings said staff training and education remains a major focus, including training hospital-wide on dealing with Ebola. Orientation for new nurses has been bumped up from 1 to 2 days, and staff are also getting trained for the addition to the dialysis center, which will have the ability to do peritoneal dialysis sometime in 2015.

She noted that Wise Regional had 597 babies delivered during the year, along with 25,571 visits to the Decatur Emergency Room and 5,197 visits to the ER in Bridgeport. There were 3,444 hospital admissions that came from ER visits.

The hospital performed 8,244 surgeries in 2014 compared to 7,694 in 2013.

They treated 1,364 cardiac patients, losing 67 of those. That volume was up 17 to 18 percent.

OTHER BUSINESS

The board also:

  • voted to purchase a 3M Patient Coding System at a cost of $514,891 for software, hardware, installation and training;
  • accepted medical executive committee recommendations on new appointments;
  • heard about two upcoming events – an open house for the new Wise Regional Sleep Wellness Center on the West Campus Wednesday, Feb. 4 from 11:30 a.m. to 1 p.m. and the Wise Regional Health Foundation’s “Hearts for Hope” Gala Saturday, Feb. 14 at the Decatur Civic Center, benefiting the hospital’s Critical Care Unit;
  • noted that Wise Regional is currently undergoing four government audits, two of which have netted returns to the hospital and two that are ongoing with results anticipated in February;
  • approved the appointment of Marti Hines to the Wise Regional Health Foundation board of directors;
  • authorized Summers and Scroggins as signers on behalf of the Decatur Hospital Authority for both the FICA and ICSA accounts and
  • approved Scroggins as treasurer of Wise Regional Health System.

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Comfort and joy: Hospital auxiliary pillow project has another record-setting year

When you are in the hospital recovering from surgery, a small measure of comfort can go a long way.

The members of the Wise Regional Health System Auxiliary make sure of that.

MADE WITH LOVE – Wise Regional Health System Auxiliary members Carol Burns (left) and Eva Ray Tindol display just a few of the thousands of pillows the group has made for patients at the hospital this year. Messenger photo by Jimmy Alford

Just take a look at this number: 3,400. That’s the number of pillows Auxiliary members have made and given out to patients in 2014.

About a quarter of the 86 volunteers sew the pillows, stuff them and then deliver them to surgery patients, as well as respiratory patients who have coughs or even patients with broken bones.

“People appreciate them so much,” said Eva Ray Tindol, Auxiliary president. “We have people come up to us and say, ‘I had my surgery five years ago, and I’m still using my pillow.’ They really are appreciated.”

The 3,400 pillows, an average of more than 65 per week, is a record high for the hospital auxiliary, a record that is broken pretty much every year. In 2013, the Auxiliary gave out 3,147 pillows.

With those kind of numbers, it’s clear that volunteers are kept quite busy keeping up with the demand.

“Very rarely do you go by the information desk that someone is not sitting there working on the pillow,” said Carol Burns, chair of the Auxiliary’s pillow committee.

The fabric for the pillows often changes with the season. Recent patients have received pillows with Christmas-themed fabric and before that, fall colors were used. Sports themes are also very popular, Tindol said.

Women at the Oak Grove United Methodist Church have also helped the Auxiliary stuff pillows over the years.

While you might think that the Auxiliary could stay busy just working the help desk and making thousands of pillows, those are only a couple of the many ways the group helps patients. They also gave out nearly 600 baby blankets this year and sent more than 2,300 cards to mothers reminding them of when to have their baby vaccinated.

And the lullaby you hear played throughout the hospital whenever a baby is born? You can thank the Auxiliary for that as well.

Made with Love 2

MADE WITH LOVE – Several members sew the pillows at home, and then they are stuffed at the hospital, as Tindol demonstrates below. Messenger photo by Jimmy Alford

This year the Auxiliary also donated $66,000 for on-site blood testing equipment and gave out seven $1,000 scholarships to graduating seniors in Wise County who are planning to enter the medical field.

“Several previous scholarship recipients are working in the hospital now, so that’s fun,” Tindol said.

Auxiliary members also hand out little bears made by members of the Decatur Church of Christ to children in the hospital.

“The little kids, their eyes will just light up when they see them,” Burns said.

But it’s not just the kids who benefit.

“You can’t help but feel good after you give a pillow or a bear,” Burns said.

While the majority of the Auxiliary is women, it also includes about a dozen men, including eight husband and wife teams. The men’s duties include servicing and stocking the vending machines in the hospital.

The Auxiliary’s projects are all funded through fundraisers throughout the year, including the annual holiday store, bake sales and quilt raffles.

For information about the Auxiliary, visit www.wiseregional.com/support/volunteering.

2014 AUXILIARY BY THE NUMBERS:

3,400 – Pillows made and given out, an all-time high

2,300 – Cards sent out reminding mothers when they need to have their babies vaccinated

1,584 – Bags of stuffing used in the pillows

1,000 – Teddy bears given to children by volunteers

600 – Baby blankets handed out by volunteers

86 – Current number of volunteers

7 – $1,000 scholarships given to local high school students

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Hospital takes over 2 more nursing facilities

Wise Regional Health System will acquire two more nursing facilities – but a brief discussion revealed some board members are nervous about the system’s entry into that business.

The board finally voted to take over two nursing facilities from Cantex Continuing Care Network. Acquisition of those facilities, located in Southlake and the Heritage Trace area of north Fort Worth, bring to 11 the number acquired by Wise Regional since June.

Under each agreement, the hospital becomes owner of the facility, then turns around and leases it back to the seller. An operating agreement keeps them running basically as they have, with Wise Regional’s Donna Stowers overseeing the facilities from this end.

Back in October, CEO Steve Summers explained that new state laws allow nursing facilities to qualify for a higher reimbursement rate if they are affiliated with a public entity, such as Wise Regional.

In June, Wise Regional acquired two facilities from Skilled Healthcare Inc. – Fort Worth Center for Rehab and Cityview Care Center.

In October, the Decatur-based hospital took on seven more, all in the Fort Worth area. Three of those were owned by Sava Senior Care, three by Kindred Health Care and one, DFW Rehab, by Ken Broussard.

“We were approached by Cantex about two of their nursing home facilities that are in Tarrant County, which is within the 1115 waiver area that the state has approved for us to be involved with,” Summers said. He noted Cantex management had come to Decatur last week to discuss the deal.

“These two facilities have five-star ratings across the board – the highest rating the state gives,” he said. He also noted their Medicaid census is lower than the other facilities Wise Regional has acquired, meaning less cash is required.

After a motion to approve the two purchases Monday, board member Loyd Jackson requested an amendment stating that no more nursing homes be acquired.

“I’m just thinking about the cash outlay that we’re putting out in this, what kind of situation we’re putting ourselves into,” he said.

But before a vote, board member Gary Cocanougher expressed reservations that the amendment might tie the hands of the hospital’s administration.

“If you wanted to revisit this situation, say, six months down the road, does that eliminate that opportunity if something presented itself?” he asked. “I don’t know if I understand the need for the motion. If six months from now, something outstanding comes up, does that mean we don’t look at it?”

Several board members said the board could always come back and reconsider. But Summers said the hospital is basically finished.

“With the timing of all this, there is really no more time to consider anything more,” he said. “The deadline is Feb. 28, so realistically it’s not a viable thing to do anyway.”

Hospital counsel Jason Wren also pointed out that the item on the agenda called for the board to simply vote on the Cantex acquisition, not go back and discuss or restructure the program.

Jackson’s amendment was withdrawn and the purchase was approved.

NO PROFIT IN NOVEMBER

Monday’s financial report showed the hospital system lost money in November – but with corresponding decreases in expenses for payroll and supplies, the loss was held to just $139,000.

Finance Director Todd Scroggins told the board the primary reason for the drop was the Thanksgiving holiday, since outpatient services were essentially closed during that period.

While inpatient admissions were down 7.7 percent and the rehab and behavioral units were down 34 percent, the facility as a whole was still busy compared to previous Novembers. Average daily inpatient census was 79 for the month, compared to 60 in November 2013.

Surgeries were down 8.3 percent from the prior month and non-surgical outpatient services were down 12 percent.

The Parkway campus was $97,000 in the black for November, while the Bridgeport campus lost $208,000.

Plans remain in place to reopen the Bridgeport campus as an Acute Care Facility Jan. 2, operated by Wise Regional. The move, which will close the ER, is designed to stem the losses incurred over the 20 months since Wise Regional bought the Bridgeport hospital in federal bankruptcy court.

Summers said in November that the Bridgeport facility had lost $6.2 million since Wise Regional took it over.

OTHER BUSINESS

The WRHS board also:

  • opted to go with the same workers compensation insurance for 2015, with no deductible and a premium of $609,000, from Texas Hospital Insurance Exchange. Wise Regional had 32 open claims last year, averaging approximately $9,000.
  • noted the Joint Commission has scheduled a survey in January for the hospital’s Primary Stroke Program. The hospital is anticipating its tri-annual Joint Commission survey next summer.
  • heard a building committee report from board member Mark Duncum on the new Fit-N-Wise facility. The committee is reviewing floor plans with architect Mike Hale and hospital staff.
  • approved the re-appointment of board members Carey Williams, Place 1 and Chris Forbis, Place 3, for two-year terms in 2015-2016.
  • approved medical staff recommendations for new active appointments including Monsunmula Babade, MD, Pain Management; Eric Eifler, MD, Orthopedic, and Lesley Richey-Smith, DPM, Podiatry.
  • approved a recommendation to include chemoembolization as a special procedure within the radiology core privileges, and
  • approved a recommendation by the Medical Executive Committee to modify the Bariatric Surgery core privileges language to exempt bariatric surgeons from Center of Excellence criteria if using the Parkway Surgical hospital, which is not currently a Center of Excellence approved facility.

The board’s next regular meeting is Monday, Jan. 26.

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WRHS to operate Bridgeport clinic

A plan by Wise Regional Health System to move its Community Health Clinic operation from Decatur to Bridgeport has been scuttled by restrictions in the Bridgeport hospital’s bond covenants.

A hospital spokesman said Friday that the Decatur Community Health Clinic, which is operated by Wise Clinical Care Associates on the West Campus on Farm Road 51, across from the main hospital, will remain open.

The plan had been to move that facility to Bridgeport.

Plans to convert the Bridgeport campus to an urgent care clinic will go forward, but Bridgeport’s clinic will be operated by Wise Regional Health System, not by Wise Clinical Care Associates as had been proposed.

The bond covenants require Wise Regional to operate the Bridgeport facility, not transfer it to another entity – even a wholly-owned affiliate like Wise Clinical Care Associates.

The affiliate will continue to operate the Community Health Clinic in Decatur.

The Bridgeport campus will transition to an urgent care facility, with no ER, but equipped to handle a wide range of urgent care needs including abdominal pain, allergic reactions, broken bones, breathing problems, burns, cuts, ear infections, falls, sprains, strains, flu and cold symptoms, migraines, pink eye, unexplained pain and swelling, urinary tract infections, wound infections and X-rays.

Starting Jan. 2, it will be open seven days a week from 8 a.m. to 8 p.m.

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Wise Regional takes over nursing operations

The directors of Wise Regional Health System voted Monday night to affiliate with seven nursing facilities in the area – at their request.

Hospital CEO Steve Summers said the move was requested by those facilities to allow them to qualify for a higher reimbursement rate, under new laws that make more funds available to facilities that are affiliated with a public entity.

The Decatur-based health care system will take ownership of three facilities owned by Sava Senior Care, three owned by Kindred Health Care and one, DFW Rehab, that is owned by Ken Broussard. All are within about an hour of Decatur, mostly in the Fort Worth area.

“We’ve been approached by these entities to be involved with them, to help them secure additional funding,” Summers told the board. “We’ve visited with them, vetted all that, looked at it, and we felt like it’s a reasonable approach to consider being involved with these facilities.”

Wise Regional’s Donna Stowers will oversee them and report back to the board.

“They all have quality standards in place,” she told the board. “It’s in their best interest to have the best quality they can.”

WRHS attorney Jason Wren said the Hospital Authority would actually become the owner of the skilled nursing operations.

“We’ll lease the facilities, then enter into a management agreement with the folks who are operating them now,” he said.

The board approved unanimously.

SLEEP LABS TO MERGE

The board also approved another affiliation – this one with Somnus Healthcare sleep lab.

“We’ve been in discussions for a while now,” Summers told the board. “This is an organization that’s located in Decatur.

“We have an existing lab service, and we thought we would fold in those labs together and offer one service, on the West Campus,” he added. “This way we can offer more services in one setting instead of them being split between the two different organizations.”

Summers said the short-term contract, which calls for a flat payment every month, had been looked at and vetted by the hospital’s legal staff. The sleep lab will continue to be located on the West Campus.

It was approved unanimously.

OTHER ACTION

The board also:

  • approved the purchase of a portable EEG unit for $75,419, making that service available in-house 24 hours a day rather than having to contract with a mobile service and schedule those procedures during the hours it is on campus;
  • approved the revised succession planning and development policy;
  • approved five new appointments to the medical staff;
  • approved 17 bi-annual reviews; and
  • approved three first-year reviews.

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Wise Regional gears up for Ebola

As national attention on Ebola intensifies in the U.S., and additional cases are identified, Wise Regional Health System in Decatur is taking precautions to make sure the hospital’s staff is prepared should there be a suspected case.

“The proximity of the initial patient to our hospital definitely increased our awareness of the disease and the need to be prepared,” said Kellye Souther, Emergency Room Director.

Souther said Wise Regional has held weekly meetings with staff from approximately 15 different departments since the first U.S. patient with Ebola was diagnosed in Dallas on Sept. 28.

That patient, Thomas Eric Duncan of Liberia, died Oct. 8. On Oct. 10, a nurse who helped care for him at Dallas’ Texas Health Presbyterian Hospital reported a fever and on Oct. 12 a diagnosis of Ebola was confirmed.

It is still unknown how the nurse, 26-year-old Nina Pham, contracted the virus – but medical personnel across the country are on high alert.

“The team meetings review our internal protocol procedures, supplies and department needs,” Souther said. “We also discuss the most updated guidelines and information from the CDC.”

In addition to Wise Regional’s staff, representatives from Wise County EMS also have been involved in the planning sessions. Local EMS has implemented precautions in dispatch to include CDC-protocol questions – asking patients their symptoms, travel history and potential exposure risks – so that crews are prepared upon arrival.

All of that information would also be relayed to the hospital. If an at-risk patient were to be identified, preparations would begin to receive the patient through an isolated entrance and into a negative-pressure anteroom.

The isolation room has a ventilation system that generates negative pressure to allow air to flow into the isolation room, but not escape from the room. Each floor of the facility has an isolation room that could be used to treat a patient, if needed.

“The hospital has a detailed infectious disease plan in place,” said Sally Stokes, Wise Regional’s Director of Infection Control. “We have included the updated guidelines and information from the Centers for Disease Control and Prevention to prevent the spread of the disease.

“Although the risk is low, if a patient exhibits symptoms of Ebola, we are prepared to follow infection control protocols established by the CDC, beginning with placing the patient in isolation,” she added.

Stokes also said that any suspected cases would be reported to local and state health departments and the CDC as quickly as possible, and the hospital would continue to follow the guidance of those organizations regarding the care of the patient.

She added that Dallas now has the ability to test Ebola samples locally, rather than send them to the state lab in Austin, allowing for quicker diagnosis and treatment.

Additional measures include preparing designated carts with all the needed protective equipment, so that it is readily available at triage – regardless of whether the patient comes by ambulance or the front door.

Wise Regional would also be able to call upon its designated Decontamination Team, which drills year-round on properly putting on personal protective equipment (PPE) and how to safely and effectively decontaminate patients who present to the Emergency Department.

“The hospital is taking the issue very seriously,” said LeeAnn Cummings, the incoming Chief Nursing Officer. “We participate in all scheduled conference calls that include the state health department, CDC and the North Central Texas Trauma Regional Advisory Council.”

Cummings said the hospital will hold a mock drill in the coming week to review protocols and processes, and to make sure communication between departments is running smoothly.

Wise Regional has placed additional information on Ebola and the Enterovirus-D68 on its website under Health Information on the main page at WiseRegional.com.

At press time, the nurse in Dallas was reportedly improving.

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Walker named Chief Medical Officer

Dr. Jon Walker of Bridgeport recently celebrated 25 years of service as a family medicine doctor.

Now there’s more to laud.

At its meeting Monday, the Wise Regional Health System Board of Directors recognized him as its new Chief Medical Officer.

In the new role, Walker will provide administrative support for medical staff leadership and be a resource to the medical staff and managers at the hospital for various projects or initiatives.

He will continue to work at his Bridgeport clinic two days a week, in addition to CMO duties and his duties as the Medical Director of Clinical Services for Wise Clinical Care Associates clinics.

NEW DOCTORS PRESENTED

Leon Fuqua, chief operating officer introduced Dr. Arsalla Islam of Texas Vascular Care.

Islam is a vascular, endovascular and bariatic surgeon. Her offices are on Heritage Trace Parkway in the Parkway hospital area in Fort Worth, and in Decatur.

She will provide services at both the Parkway Surgical & Cardiovascular hospital as well as Wise Regional’s main campus in Decatur.

Fuqua also mentioned that Dr. Ja’Near Anderson will provide primary care pediatric services at the new Clinical Care Pediatrics location in Bridgeport.

Anderson completed a fellowship in neonatology at the University of Texas Southwestern in Dallas and most recently worked as an attending physician for Newborn Intensive Care Specialist Group in Dallas.

IN OTHER NEWS

  • Steve Summers, CEO, reported that the hospital has met to discuss a potential relationship with the Sava Senior Care organization involving their nursing homes located in Denton and Tarrant counties. Sava currently operates four homes. Administration will continue to review the possible relationship to make a recommendation at a future board meeting.
  • It was reported that the Fit-N-Wise Fit Y.O.U.T.H (Youth Obtaining Ultimate and Total Health) initiative is actively working with local school districts to educate our youth on lifelong healthy habits. The program is funded through Wise Regional at no cost to the county’s school districts. The program director is Holly Berry, a former Paradise Elementary principal.
  • Jim Eaton, chief financial officer, was recognized for his eight years of service at Wise Regional. Eaton will retire at the end of the month and will be succeeded by Todd Scroggins, Wise Regional’s administrative director of accounting services.
  • Summers also mentioned that the new Air Evac facilities have been completed. There will be an open house at 4 p.m. Monday, Oct. 13.
  • In the August 2014 financial report, Scroggins said the hospital had a decrease in net position of $1.5 million. The month of August saw an increase in inpatient admissions and a slight decrease in outpatient services including a decrease in outpatient surgeries. Factors affecting the negative financials in August included several surgeon vacations and an increase in uncollectible accounts.
  • The governing board approved the recommendation from the building committee to extend a pool consultant contract with Counsilman-Hunsaker, Aquatics for Life for $75,000.

Following a closed session, the board approved several new appointments to the medical staff based on the recommendations of Wise Regional’s Medical Executive Committee.

The board accepted the medical staff’s reappointments and first-year reviews.

Medical staff recommendations for new appointments included the following practitioners:

  • Scott Campbell, anesthesia;
  • Jonathon DeVane, ER medicine;
  • Jacquiline Emmons, pathology;
  • Timothy Tye, anesthesia;
  • Christopher Villarreal, ER medicine;
  • Jason Willis, pathology; and
  • Jocelyn Zee, family med/hospitalist/NIPA.
  • The board’s next meeting is 6 p.m. Monday, Oct. 27, at the Administration Board Room at 609 Medical Center Drive in Decatur.

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Hospital board approves acquisitions, appointments

The staff, board and facilities at Wise Regional Health System all experienced a little growth as a result of Monday night’s board meeting.

The board that governs the hospital appointed Carey Williams to place 1.

Matt Joiner, Mary Williams and Linda Rios were named to the Wise Regional Health Foundation board, and three new physicians were also introduced.

Saeid Aryan, M.D., a neurosurgeon, Arshad Mustafa, M.D. a rheumatologist, and Cynthia Hartman, D.O. and OB/GYN, provided brief backgrounds and were welcomed to Wise Regional. Six other physicians, two nurse practitioners and physician assistant were also approved for staff privileges upon recommendation from the Medical Executive Committee.

The board also approved the acquisition of a physical therapy clinic in Argyle and the purchase of two pieces of equipment for spine surgery at the Parkway Surgical Hospital, which opened earlier this year.

A Stryker Sonopet dissection tool was purchased at a cost of $172,195, and a Stryker navigation system for spinal implants was purchased at a cost of $118,739.

In planning for a future Fit-N-Wise fitness/therapy/sports medicine complex, the board OKd a civil engineering contract with Adams Engineering for $65,000, allowing them to begin work on developing the facility, which will sit just north of the main hospital east of Farm Road 51.

OTHER BUSINESS

CEO Steve Summers told the board there has been some interest expressed by representatives of the Wise County Veterans Group for the Veterans Administration (VA) to provide some services in Wise County – possibly at the Bridgeport campus. Summers said he would welcome an opportunity to discuss the issue with VA representatives.

He also told the board the Siemens Healthcare Software division is being acquired by the Cerner Corp. Since Wise Regional uses primarily a Siemens platform for its information technology system, he is anxiously waiting to see how the change impacts the hospital.

CFO Jim Eaton gave the board a financial report, noting the hospital had an increase in net position of $273,000 for July, with patient charges and other revenues of $45.6 million. Both inpatient admissions and outpatient services were up for the month.

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Wise Regional performs its first therapeutic plasma exchange; Patient doing well following lifesaving procedure

John Foster of Chico was the first patient to receive a therapeutic plasma exchange at Wise Regional Health System in Decatur.

This lifesaving procedure “deep cleans” a patient’s plasma, the fluid that carries red and white blood cells and platelets around the body.

Lifesaving Machine

LIFESAVING MACHINE – (from left) Katherine and John Foster and nurse Lisa Lambert, RN, show off the machine used to perform a therapeutic plasma exchange on Foster last month. Messenger photo by Bob Buckel

The procedure is necessary when a patient presents with critically high protein levels in their blood. High protein levels can be caused be a variety of conditions involving the blood, nerves or kidneys.

Previously, patients had to be transferred to Dallas to have this advanced procedure.

When Foster was admitted to Wise Regional July 15, his creatinine, or protein, levels were 22 milligrams per deciliter. A typical adult has a creatinine level below 2 mg/dL.

“John had the highest creatinine levels I’ve personally ever seen in more than 20 years of practice,” said Dr. Aamir Zuberi, medical director at Wise Regional’s dialysis clinics.

Initially, Foster had only presented with recurrent diarrhea, but soon after being admitted he began developing additional symptoms, including neuropathy, or numbness, in his hands and feet, as well as vision problems.

“I went to see my family doctor first because I’d been having digestive issues on and off,” Foster said. “[Dr. Richardson] sent me to Wise Regional for blood work. After the blood work, I went to the pharmacy to pick up some medicine he had prescribed.

“Before I even left the pharmacy, the lab at Wise Regional had called me to say I needed to come back and be admitted.”

Zuberi ordered emergency dialysis to filter some of the toxins from Foster’s body, but dialysis alone wouldn’t remove the proteins that were quickly clogging his system. Zuberi also performed a kidney biopsy, which led him to diagnose Foster with multiple myeloma, a condition that results in high plasma cell production.

The plasma cells produce protein, so as their numbers increase, so does protein production.

After consulting with the Critical Care Unit staff and Dr. Maddukuri, medical oncologist with The Cancer Center at Wise Regional, Zuberi decided Foster was a good candidate for Wise Regional’s first use of therapeutic plasma exchange.

Wise Regional acquired the equipment to perform TPE several years ago, and several members of the CCU staff recently underwent training to learn how to administer the treatment. Katy Anderson, RN, and Lisa Lambert, RN, both attended the training and were on duty when the decision was made to treat Foster.

Foster received a total of six plasma exchange treatments over the course of a week. Each time, his blood was removed through a catheter in his neck, filtered and simultaneously replaced with fresh, frozen plasma and human albumin – a common protein important in the growth and repair of tissue.

“During the first treatment, the waste that we filtered out of John’s blood was milky white,” Anderson said. “The process took close to four hours, and we went through three filters.

“The final treatment took about half the time, the waste was clear and we only had to use one filter.”

Foster said other than being cold during the treatment, he experienced little discomfort. After the third treatment, his symptoms had improved significantly. He went from being unable to hold a pen to being able to hold and drink from a cup. His vision also returned.

“When we saw that he was able to read the numbers on his remote control, we were all a little choked up. It was amazing to see how quickly he improved,” said Lambert.

Foster also began receiving additional treatments to eliminate the abnormal plasma cells. He was discharged July 31. He’s continuing dialysis and he and wife Katherine are confident he’ll make a full recovery.

“We trust in God, not only that he’ll heal John, but also that He gave the doctors and nurses the wisdom they needed to provide the best possible care,” said Katherine. “It’s exciting to see that this kind of technology is available so close to home.”

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Wise Regional hires architect for Fit-N-Wise facility

Wise Regional Health System has hired an architect to begin design and engineering work on the new free-standing Fit-N-Wise building to be constructed on the hospital campus off Farm Road 51 South – just north of the current facility.

The hospital’s recent refinancing of $87.6 million in bonds from its 2004 construction project allowed the borrowing of an additional $10 million for the project, while receiving a better interest rate and lowering its payments by about $100,000 a month.

That money, as well as savings, is available for the construction of the new facility which will house therapy, wellness, aquatics and sports medicine.

Marketing director Shannon Puphal said moving Fit-N-Wise is the first step toward being able to add on the hospital’s patient towers.

At Monday’s board meeting, directors approved a service contract with architect Mike Hale to provide architectural, civil engineering and structural engineering services for the project.

Hale recently met with the hospital’s building committee and provided a timeline overview on the project. He said the next few months will include additional site visits, interviews with pool consultants, development of site schematics and interviews with general contractors.

Construction should begin in January 2015.

OTHER BUSINESS

The board also:

  • heard from CEO Steve Summers that the sale of the property near the Dialysis Center in Decatur is expected to close in August after required re-plats are approved. Summers also said Wise Regional’s Dialysis Center in Saginaw had its initial survey by the Centers for Medicare and Medicaid Services (CMS), passed its inspection and has begun accepting Medicare patients.
  • heard from Summers about a collaborative effort with local pediatricians to dedicate an area on the second floor of the Decatur East campus specifically for pediatric patients. The new pediatric area will have a dedicated nursing station and pediatrics-trained nursing staff.
  • heard a financial report from CFO Jim Eaton, who noted the hospital system saw an overall increase in net position of $316,000 for June. That was after recording $2.8 million in bond issuance costs related to refinancing the 2004 bonds. The hospital system’s net revenues were $16.2 million in June, with volumes down in all major services except surgery, compared to the prior month. Outpatient surgery volume was up 13.2 percent.
  • heard from Chief Nursing Officer Sue Sewell that the retention rate for nurses is improving. Tracie Inglis, RN was appointed the Cardiovascular and Stroke Coordinator and Daniel Aranda, RCIS, was selected as the new Director of the Cardiac Cath Lab in Decatur.
  • heard a report from Sewell that Pre-Op Assessment has moved to a new suite on the second floor of the East campus Fit-N-Wise building and will include radiology and laboratory. The change is designed to allow patients to address all their pre-op needs at one location within the hospital.
  • approved proposed amendments to the bylaws, as well as a resolution designating and assigning places to board members.
  • after a closed session, approved several new appointments to the medical staff based on the recommendations of the Medical Executive Committee. They also accepted reappointments and first-year reviews.

The next regular meeting is Monday, Aug. 25, at 6 p.m. in the Administration board room at the hospital.

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Wise Regional to acquire nursing facilities

Wise Regional Health System will acquire and operate two nursing facilities in Fort Worth after action at a Monday meeting of the hospital’s board of directors.

Fort Worth Center for Rehab and Cityview Care Center are currently owned by Skilled Healthcare, Inc.

Wise Regional has been studying the proposal for several months. Their external accounting firm, BKD, LLP, provided a “due diligence” report on the facilities for the board to consider, and the hospital’s outside legal counsel, RCMH, Law PLLC was the primary negotiator in the sale.

The hospital will enter into a formal management relationship with Skilled Healthcare to continue providing all aspects of operational management at the two facilities.

Also at Monday’s meeting, Chief Financial Officer Jim Eaton told the board the hospital system overall had an increase in net assets of $329,000 for May, on gross patient charges and other revenues of $49.9 million.

Inpatient admissions were up 6 percent, while outpatient services decreased 2 percent from the prior month. The system’s new Parkway campus opened May 5.

The board made a special presentation to Sheila Boggs, RN for being voted “Best Nurse in Wise County” by readers of the Wise County Messenger and to honor her for 37 years of service to the hospital and community.

Hospital CEO Steve Summers provided an administrative report, outlining ongoing internal leadership training for Wise Regional’s managers and directors. Programs are presented throughout the year on topics including management strategies, retention and organizational development.

He also discussed the recent presentation made in Dallas on the 1115 Waiver program by Paul Aslin, Chief Operations Officer for Wise Clinical Care Associates.

Summers said through Aslin’s leadership, Wise Regional has been recognized as a leader in navigating the Delivery System Reimbursement Incentive Project (DSRIP) initiatives.

He noted the upcoming Texas Hospital Trustee educational meeting in July that will be held in Dallas for board members.

OTHER BUSINESS

Other matters coming before the board included:

  • Summers announced a contract had been finalized with a new OB/GYN physician. Cynthia Hartman, D.O., will join Russell Edwards, D.O. at Array Women’s Health in Decatur in September.
  • Summers congratulated Wise Regional’s Marketing & Communication department, which recently won two national design awards by APEX Awards for Publication Excellence for its community newsletter, “HealthScoop” and the hospital’s re-designed website at WiseRegional.com.
  • The president of the Bridgeport hospital auxiliary reported to the board on membership, hours of service and the presentation of five $1,000 scholarships to students who plan to pursue medical training.
  • The Decatur auxiliary reported they recently donated $61,100 to the hospital for the purchase of a new piece of lab equipment. Representatives also attended a state volunteer convention and placed second in the scrapbook and first in the tray favor competitions.
  • The board approved new appointments to the medical staff based on the recommendations of Wise Regional’s Medical Executive Committee and accepted the medical staff’s reappointments and first year reviews.

The next regular meeting is Monday, July 28 at 6 p.m. in the Administration Board Room at 609 Medical Center Drive.

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Education, not moderation: Assault on diabetes focuses on lifestyle

”Moderation in all things, and all things in moderation.”

That may be a good philosophy in some ways – but it is not Dr. Brad Faglie’s motto.

Dr. Faglie, a board-certified family physician, does not recommend moderation when it comes to attacking diabetes – a disease that is attacking Wise County residents in increasing numbers.

Teaming Up

TEAMING UP – Chris McKown (left) with Renew Home Health and Dr. Brad Faglie discuss a case earlier this week. Diabetes is the seventh-leading cause of death in the United States and the sixth-leading cause of death in Texas. It’s estimated that 10.6 percent of Wise County’s population has diabetes, and that number is projected to rise to 17.1 percent by 2020. Messenger photo by Joe Duty

“It all boils down to diet,” he said Monday as he waited for the monthly diabetes support group members to arrive at the classroom on the second floor of Wise Regional Hospital. “When all else is said, it’s what we eat.”

What Americans eat is killing them. Dr. Faglie should know – he used to weigh 290 pounds.

He also used to have diabetes. He no longer has it, and today he approaches diabetic education with a zeal that borders on evangelistic.

“I run into a lot of misconceptions,” he said. “That unhealthy food is OK in moderation – they’ve been told that.

“That’s being overturned slowly. The research is out there, but the interpretation of the research is just now coming out into the mainstream. Unhealthy food is not healthy in any amount. It’s not OK.”

The support group, sponsored by Wise Regional, Renew Home Health and the Wise and Montague County Medical Society, has been meeting since January at 6:30 p.m. the third Monday of each month – but it’s not the only way the local medical community is attacking diabetes.

Dick Gilley, R.N., a board-certified critical care nurse, works in the ICU at Wise Regional and Baylor. He’s also diabetic and a certified diabetes educator.

“I work with people individually and as a group,” he said. “I teach a group class on Thursday nights – I had eight people for the spring, and I’ve got 25 for the summer.”

The monthly support group is open to all, but a doctor’s referral is required to get into Gilley’s class.

“When we get our program certified, it will be billable to Medicare, Medicaid and private insurance – and it bills at 100 percent because it’s preventive care,” he said. “Right now, we’re working with grant money, and it’s free.”

The program’s application for national certification went in the mail last Friday.

“To be where you can be certified in six months, I’m very proud of that,” Gilley said. “We started with nothing.”

Nothing but need, according to the statistics.

A GROWING MENACE

Diabetes is the seventh-leading cause of death in the United States and the sixth-leading cause of death in Texas. It’s estimated that 10.6 percent of Wise County’s population has diabetes, and that number is projected to rise to 17.1 percent by 2020.

“It is truly an epidemic of the worst proportion,” Dr. Faglie said, citing a sharp uptick in cases in just the six years he’s been practicing medicine. “I’ve actually seen the rise in diabetes and its associated symptoms – obesity, hypertension, hyperlipidemia, heart disease – at younger ages.

“I have 13-year-olds who are getting diagnosed with type II or adult onset diabetes. It’s crazy,” he said.

Diabetes is a serious illness that can and does kill. It’s the primary cause of death for 71,382 Americans every year and contributes to the death of another 231,404.

“Diabetes affects every system,” Dr. Faglie said. “Chronically elevated blood sugar affects the small blood vessels in all systems, so diabetics typically experience chronic kidney disease, peripheral neuropathy, leg swelling and therefore ulcers and subsequently, amputations.

“Their vision goes because the blood vessels in the eye are affected,” he said. “Heart disease, the small blood vessels around the heart, and then, dementia. It’s a difficult illness to treat, and it’s become more and more serious.”

Many of the folks in the support group have just been diagnosed. Faglie’s goal is to get them to make immediate and drastic changes in their lifestyle.

He recommends a “paleo” diet that takes humans back about 10,000 years, before food began to be processed.

“What I tell people is, if you can’t pick it, peel it or kill it, it’s probably not healthy,” he said. “If it’s got any sort of processing that takes place in the preparation of that food – such as bread, the milling of grains – it’s not ideal.”

Processed and refined carbohydrates – not just sugar, but bread, rice, pasta, cookies, chips – are the big offenders.

“Essentially, that’s why people are diabetic,” he said.

“Honestly, the patients who are diebetic aren’t bad about eating cherry pie every day. They’ve largely cut out the obvious. It’s the things they’re told they can have in moderation, like bread, that are hard to cut from the diet.

“But that perpetuates it, keeps the diabetes going and even worsens it.”

EDUCATION, BLOOD TESTING THE KEYS

Community-wide education and regular blood testing are making a difference, Dr. Faglie said. He enjoys the classes, where there is a lot of question-and-answer time, because they allow him to teach when he’s not trying to also keep up with a schedule of patient appointments.

Chris McKown of Renew Home Health said some people come straight to the group within days or hours of their diagnosis.

“Most of the people, if they are coming under home health, they have us to teach them,” he said. “But somebody who’s not, the only real education they get is with their physician, in the office – so they run into a time constraint.

“With this program, they can come in, ask questions – it’s been really great. The first one we had was seven people, then 15, then 20, then 28. Every month, it’s grown.”

For most, the diabetes diagnosis comes as a result of a routine physical that involves a blood test. The key number is the hemoglobin A1c.

For people without diabetes, the normal range is between 4 and 5.6 percent. Hemoglobin A1c levels between 5.7 and 6.4 percent indicate an increased risk of diabetes, and levels of 6.5 percent or higher indicate diabetes.

“A lot of people feel normal, but the blood work shows an elevated A1c,” Dr. Faglie said. “Some people come to me for neuropathy – that’s tingling in the legs – or a lot of times they have fatigue, they just don’t feel like they felt 10 years ago.

“And then a lot of times they have spouses who bring them in,” he said. “They see how they eat, and they just know something’s wrong.”

The ultimate goal is to prevent diabetes.

“We want to try to catch the younger crowd,” Dr. Faglie said. “Unfortunately, diabetes doesn’t just hit – it grows over the course of years and decades.

“It grows out of a lifestyle, and lifestyle modification is the only true treatment for diabetes.”

CLASS TIME

That’s why a class, a support group – education – is such a key element of the attack.

“A lot of people were coming to the diabetic education classes, and they expect to learn how to use their pump, how to use their insulin, how to take more medicine,” McKown said. “This is completely different. They come and start learning how to eat, how to do even better, and some of them do that very well.”

As Dr. Faglie starts Monday evening’s class, he asks the group, “What is diabetes?”

“Something you don’t want,” says one woman, drawing nervous laughter.

“The inability to make insulin,” says another, and the doctor says yes, but he still wants more.

“The inability to process sugar,” comes the answer.

“That’s right,” he says. “Adult-onset diabetes is the inability to process sugar – or more specifically, carbohydrates.”

And although carbohydrates are the fuel your body needs to produce energy, research is showing that processed, refined carbohydrates are the culprit in diabetes and possibly other diseases.

He draws a modified “food pyramid” on the whiteboard.

“This is what I recommend my patients eat: meat, veggies, beans, nuts, dairy – minus milk – then fruit,” he says. “The carbohydrates in these groups are not bad.”

He said that after years – decades – of processed carbohydrates, the body becomes less able to process that, and the result is chronically elevated blood sugar.

“Basically what happens is, your cells get inundated with too much blood sugar for too long,” he said. “They start pulling those sugar receptors out of the cell walls, and you become insulin-resistant. That’s hard.”

He recommends cutting those carbs out completely.

“If food is unhealthy, it’s unhealthy,” he says. “This food group is really not OK in moderation.”

And when you think about it, that sounds right.

Attacking a killer is no time for moderation.

For information about the Diabetes Support Group at Wise Regional Helath System, call Chris McKown of Renew Home Health at 940-395-7205.

DIABETES AT A GLANCE

  • Nearly 26 million children and adults in the United States have diabetes.
  • 79 million Americans have prediabetes
  • 1.9 Million Americans are diagnosed with diabetes annually
  • Nearly 10 percent of the U.S. population has diabetes, including more than 25 percent of seniors.
  • As many as 1 in 3 American adults will have diabetes in 2050 if present trends continue.
  • The economic cost of diagnosed diabetes in the U.S. is $245 billion annually.

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‘Home run'; Hospital’s bond sale saves $11.4 million

Wise Regional Health System will save almost triple what it expected to save by refinancing its 2004 construction bonds.

The hospital on Wednesday refunded $87.6 million in bonds on which it was paying an average of 7.1 percent interest, while borrowing an additional $10 million for future construction projects.

Even with all the costs of the transaction folded in – about $2.8 million – Wise Regional still got a 5.39 percent interest rate that will save them $11.4 million over the life of the bonds.

They had expected to save between $4 and $5 million.

“Essentially, we’re lowering the payments about $100,000 a year from where they are right now – and getting another $10 million,” Chris Janning, senior vice president at First Southwest, told the board in a special meeting Wednesday afternoon.

“The net present value savings is $11,406,059, which is just under 13.5 percent of the bonds,” Janning said. “That’s the principal we’re refunding.”

The Governmental Finance Officers Association (GFAO) has a benchmark that says if an entity can get 3 percent net present value savings or more, it’s a good deal.

“We got four good deals,” board member Gary Cocanougher said. “At that last meeting, we thought $5 million [in savings] would have been a home run – this was a grand slam in the bottom of the ninth.”

So how did Wise Regional get such a favorable rate?

Janning said the hospital’s state-of-the-art facilities are impressive – and one firm actually sent a representative out for a tour in Decatur, Bridgeport and the new Parkway facility in Fort Worth. He also credited hospital administration for their openness, answering everyone’s questions.

But the market also played a huge role.

“What’s happened since March is that rates have come way down – almost 1 percent in the general market,” he said. “All these bonds are maturing, and no one’s borrowing money for new projects.”

That means Wise Regional’s $99 million in bonds was one of the best deals on the U.S. bond market that day. When traders started making calls Wednesday morning, they found 17 times as many orders as they had bonds to sell.

When $1.7 billion is available to buy $99 million in bonds, the cost goes down. It’s a seller’s market.

“What you had was essentially a separate auction for each bond,” board member Mark Duncum observed.

Janning agreed.

“It was a negotiation where the Bank of America and Cain Brothers sales people were talking to these buyers, people were putting in orders … then they’ll go back and say, ‘Hey look, we’ve got all these orders. If you really want these bonds, we’d consider a lower rate.’ Then they’ll put in another order.”

He said the firms that don’t get bonds will not be happy.

“Nobody’s going to be happy – except us,” he said.

The board passed a resolution approving the sale and authorizing the issuance of the bonds. That completed the sale, which closes June 25.

“When we pass this resolution and you vote to approve it, you have a hard contract,” Janning said.

Cocanougher commended Wise Regional CEO Steve Summers and his staff for their hard work.

“I think the staff and everybody did a great job getting this done,” he said. “It’s going to be a great thing for the hospital and the whole community.”

Janning said Merrill-Lynch and his firm, First Southwest, will both brag about this transaction coast-to-coast for a long time.

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Bond refinance to save hospital $4 million-plus

Wise Regional Health System is about to save more than $4 million in interest.

The hospital system’s management team visited Boston May 20, presenting its case for a $98.2 million deal to refinance just over $87 million in 2004 bonds and issue another $10 million for future capital projects.

Bond adviser Chris Janning, senior vice president at First Southwest, was at Tuesday’s Decatur Hospital Authority board meeting to report on how that visit went, and what Wise Regional can expect when the bonds are sold next Wednesday, June 4.

“Your management team did a great job,” he said. “The underwriters are getting fabulous feedback. There’s a lot of interest and a lot of demand.”

He said 14 bond firms attended the presentation in Boston and eight more were on a live teleconference. One firm, in fact, was planning on visiting Decatur to look at the hospital and community prior to the bond sale.

The bonds were recently rated BB+ by Wall Street bond firms Standard & Poors and Fitch.

“We see all that as very encouraging,” Janning said.

The next step is to see how the bond markets close on Tuesday evening, June 3. After a conference call with Janning, two underwriters and Wise Regional’s management, everyone will have an idea of what rate the hospital can expect to get.

The following morning, the bonds will be sold – probably by around 11 Decatur time. That evening, Janning will come back to the board in a 6 p.m. meeting to present the results of the sale for the board’s approval or disapproval.

In the current market, the interest rate should be around 6 percent, well below the original 7.15 percent rate when the bonds were sold in 2004.

“Right now we see the savings, the current cash benefit of refinancing, at just over $4 million,” Janning said Tuesday.

But, he noted, “every 1-100th of a percent is about $100,000 of savings” – meaning even a slight movement could alter that.

“Bond markets have improved since we put this together,” he said. “The best-case, they gave me a set of numbers including savings up to about $5.3 million.”

The hospital board approved publication of a bond resolution and distribution of a preliminary official statement on the bond sale. They will meet again 6 p.m. Wednesday, June 4, to consider final approval of the bond refinancing.

MORE EQUIPMENT FOR PARKWAY

The board also approved the purchase of seven more Arthrex orthopedic sets for Parkway Surgical and Cardiovascular Hospital, which just opened May 5.

That $140,740 expenditure, which was unbudgeted, is prompted by higher-than-expected volume at the facility, which is located on Interstate 35 at North Tarrant Parkway in Fort Worth.

The initial projection called for around 15 such surgeries per month at Parkway. After only a few weeks, the facility now expects to serve 50 to 60 orthopedic patients per month.

CFO Jim Eaton said the Parkway hospital was projected to net about $150,000 above expenses for this year but should show a profit of around $2 million next year and be up to around a $5 to $7 million profit by its fifth year.

“The May financials should look a lot better,” he said.

The board also:

  • approved six new appointments to the medical staff – including three hospitalists – and accepted six reappointments and eight first-year reviews.
  • heard from Eaton that the hospital system overall had an increase in net assets of $616,000 for the month of April on gross patient charges and other revenues of $46.6 million – a strong month for both inpatient and outpatient services.
  • heard that surgery volumes at the Bridgeport campus had picked up in April, but the campus still showed a loss of $236,000.
  • voted to continue negotiations with Skilled Healthcare, a national nursing home and rehabilitation organization, for control of their two Fort Worth service locations.

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Wise Regional aims to reduce readmissions

Under the Affordable Care Act, the federal government places a heavy emphasis on forming alliances to avoid return hospitalizations as a means to improve the quality of patient care and lower Medicare program spending.

Improving transitions of care, reducing readmission, and improving patient outcomes are the cornerstones of the initiative that Wise Regional looks to address to better meet the needs of the communities we serve.

Wise Regional Health System is continuing discussions with Skilled Healthcare, a national nursing home organization with two facilities in Fort Worth, to lease their two Fort Worth facilities and establish operating licenses for the services provided there.

In return, Wise Regional would contract with Skilled Healthcare to continue managing the day-to-day operations. Wise Regional will also proceed with a “due diligence” review of the facilities in Fort Worth.

In the event that this relationship is brought to completion, it would enable Wise Regional to work directly with other major hospitals located in the hospital district of Fort Worth to develop systems to improve the continuum of patient care from one facility to another.

“A health system problem in today’s environment is that hospitals are often isolated providers of care,” said Steve Summers, CEO, Wise Regional Health System. “Long-term care facilities play a vital role in building an effective continuum of care for Wise Regional patients. Our goal is to develop relationships that support positive clinical integration with nursing homes and other organizations addressing care after discharge from the hospital.

Summers said Wise Regional wants to build alliances.

“Similar agreements between other organizations have shown positive outcomes,” he said, “such as fewer patient hospital readmissions, shorter hospital length of stay for patients transferred to nursing homes and fewer cancellations of tests and surgeries for patients transferred from long-term care.

“We need to establish greater coordination of resources of nursing homes, skilled nursing facilities, assisted living facilities, hospices, home health agencies and other providers to meet the needs of our patients. This is one of the steps in that process.”

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Parkway opening due in early May

Parkway Surgical and Cardiovascular Hospital – Wise Regional Health System’s latest satellite hospital – is expected to begin seeing patients the first week of May.

Wise Regional CEO Steve Summers told his board Monday at their regular monthly meeting that the facility is waiting for finalization of its pharmacy license.

The new hospital is located on Interstate 35 in Fort Worth on North Tarrant Parkway. It is designed as a state-of-the-art surgery center with an array of facilities for elective surgeries as well as emergency procedures.

Summers introduced Denise Scurlock as the administrative director for the Parkway campus. Scurlock has more than 20 years’ experience in health care.

Even though Parkway isn’t generating income yet, the hospital system still had an increase in net assets of $150,000 for the month of March on gross patient charges and other revenues of $44 million.

CFO Jim Eaton told the board the volume for inpatient and outpatient services increases in March compared to the previous month, including a 20.1 percent rise in inpatient admissions, driven by a nearly 40 percent increase in inpatient rehab and behavioral patients. Outpatient services were up 5.7 percent from the prior month.

The Bridgeport campus continues to show losses, with lower surgery volumes and all other outpatient services lower than expected. The campus lost $253,000 in March – but adjusting that number for depreciation brings the cash effect at Bridgeport to a loss of $126,000.

Eaton said operations there continue to be monitored to see what further efficiencies can be gained.

The board also heard the 2013 audit report from CPA Michael Oatman. Overall, he said the hospital is in excellent financial condition.

Summers updated the board on efforts to re-finance a significant part of the hospital’s debt. A board meeting is planned in early June to make that official – a move that will save WRHS millions of dollars in interest payments due to an improved bond rating.

Also at Monday’s meeting, Chief Nursing Officer Sue Sewell, RN, reported to the board on retention strategies for nurses.

Currently Wise Regional’s vacancy rate is 6.9 percent, and the turnover rate for nurses is 20.7 percent. Both of those are below state averages, but Sewell said they are working on strategies to get them even lower.

“It is the consensus that the longer our nurses stay at our facility, the better it is for patient care,” she said.

She also pointed out that the Obstetrics department earned recognition recently for being in the 99th percentile of the Press-Ganey patient satisfaction ratings for six consecutive months.

Summers expressed his appreciation to physicians and staff after it was noted that Wise Regional was named a recipient of the 2014 Outstanding Patient Experience Award from Healthgrades – a leading resource that helps consumers search, evaluate, compare and connect with physicians and hospitals.

He said the award places WRHS in the top 5 percent nationally for patient satisfaction based on 27 different questions that encompass 10 distinct measures – ranging from cleanliness and noise levels in patient rooms to factors like pain management and responsiveness to patient’s needs.

The measures also include whether a patient would recommend this hospital to friends or family.

The board also approved new appointments to the medical staff based on recommendations of the Medical Executive Committee, and accepted the medical staff’s reappointments and first-year reviews.

The next scheduled meeting is 6 p.m. Monday, May 26, in the Administration Board Room at 609 Medical Center Drive in Decatur.

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Wise Regional earns top marks in ‘patient experience’

Wise Regional Health System has been named a recipient of the 2014 Outstanding Patient Experience Award from Healthgrades, a leading resource that helps people search, evaluate, compare and connect with physicians and hospitals.

The award places Wise Regional in the top 5 percent nationally for patient satisfaction.

Healthgrades evaluated 3,582 hospitals which submit patient surveys to the Centers for Medicare and Medicaid Services (CMS), covering admissions from March 2012 through April 2013. Of these, 3,000 hospitals met additional clinical quality requirements to be considered for this Healthgrades distinction.

“We are extremely proud to receive this award,” said Steve Summers, CEO of Wise Regional Health System. “It further validates the tremendous efforts our staff and physicians put forth every day to provide the very best medical care and a hospital experience that exceeds our patients’ expectations.”

Healthgrades evaluated Wise Regional’s performance as assessed by the hospital’s patients across 27 different questions that encompass 10 distinct measures. Ranging from cleanliness and noise levels in a patient room to factors such as pain management and responsiveness to patients’ needs, the measures also include whether a patient would recommend this hospital to friends or family.

“As consumers are becoming more active participants in their healthcare, measured performance surrounding the patient experience at a hospital is an increasingly important consideration for patients in choosing where to receive their care,” said Evan Marks, executive vice president of Informatics and Strategy for Healthgrades. “Consumers can rest assured that these hospitals demonstrate a commitment to exceptional focus on the needs of the patient during their stay.”

This national recognition, determined by clinical excellence across multiple service lines, and direct patient feedback about quality of care provided, is further validation that Wise Regional is meeting its goal of providing a high level of care and service.

For more information about how Healthgrades determined recipients of the annual award, a full copy of the report is available for download at: www.healthgrades.com/quality.

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Wise Regional ranks high in safety survey

Wise Regional Health System had top scores among North Texas hospitals in a recent Consumer Reports study on hospital safety.

The maximum score was 100, and the highest score for any hospital in the country was 78. Wise Regional scored a 56, ranking it 12th among 47 hospitals in North Texas. The national average was 51.

The annual Consumer Reports list of hospital rankings uses federal data to grade 2,591 U.S. hospitals on their patient care, overall safety and capacity to save lives. It includes measures of patient outcomes (avoiding infections, readmissions, avoiding mortality, and adverse events in surgical patients), patient experience (including communication about hospital discharge, communication about drug information and other measures) and hospital practices (appropriate use of scanning, and use of electronic health records). Several of these measures are then combined to create a safety score.

“I’m tremendously proud of our standing on the Consumer Reports list,” said Stephen Summers, CEO of Wise Regional Health System. “Wise Regional has worked diligently to provide the best possible care to our patients, and we have received regional and national awards and accreditations for these efforts.”

Some of the highlights from the report included:

  • Wise Regional reported only one surgical-site infection in 93 surgical procedures among its patients between April 1, 2012, and March 31, 2013. This is 51 percent better than national rates for the surgical procedures reported by other hospitals.
  • 97 percent of patients said that doctors always or usually communicated well.
  • 98 percent of patients said that nurses always or usually communicated well.
  • 95 percent of patients said that their pain was always or usually well controlled.

Wise Regional also ranked higher than other hospitals nationally for appropriate use of abdominal scanning and chest scanning. Only 7 percent of scanned patients received double abdominal chest scans and only 1 percent of scanned patients received double chest scans.

Wise Regional has two campuses on Farm Road 51 South in Decatur, another in Bridgeport and a new one about to open on North Tarrant Parkway, off Interstate Highway 35 in Fort Worth.

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Hospital directors get facilities review

Among the news flashes you hope you never hear from a hospital are “fire,” “tornado,” “hostage situation,” “power failure” and “active shooter.”

But you can be sure that Wise Regional Health System has a plan in place for all those situations, and a few more.

As part of an annual facilities review presented to the hospital’s board Monday evening, David Wright, vice president for facilities, reviewed those kinds of plans as part of the array of possibilities Wise Regional may have to deal with.

“The emergency operations plan is about 30 pages,” he said. “It covers just about every contingency we can think of outside of the typical, routine things we respond to. This could be anything – internal or external, a major equipment malfunction or service outage, or it could be a mass casualty event or a terrorism-related event.”

Part of Wright’s job is to anticipate virtually every scenario and plan for it. The hospital has personnel who are trained to deal with those types of events, but they also involve local law enforcement agencies in the planning and practice drills for each location.

“We have an organizational structure in the hospital by area of expertise and names assigned to those, and we exercise that plan twice a year,” Wright said. “It’s pretty involved, and there’s a lot of activity that goes along with doing that. That plan is under perpetual inspection and update.”

Wright’s report covered things like hazardous materials, fire safety, weather-related emergencies, hostage situations – even what would happen if someone attempted to abduct a baby from the nursery.

And with the imminent opening of the new Parkway Surgical and Cardiovascular Hospital on Interstate 35 at North Tarrant Parkway in Fort Worth, all those plans have to be in place at four campuses: Parkway, the east and west campuses in Decatur and the Bridgeport campus.

“There’s a lot of activity, as you can imagine,” he said. “Security threats are everywhere.”

In addition to disaster planning, Wright’s report on the overall “environment of care” also include tracking maintenance on the medical equipment at each campus and a host of other items.

“Most of these are perpetual plans,” he said. “They live and breathe every day. We make changes to these as conditions may change.”

One of the more routine items he’s looking at is “alarm fatigue” among nurses.

“That’s one of the hottest topics in health care equipment this year,” he told the board. “It’s when nurses have fatigue from all the different types of equipment you find up and down the floor – whether it be an IV pump, a patient monitor, a respirator or something like that – all these different alarms going off throughout the day.”

He said there’s a nationwide effort going on to review the various alarms and get rid of the ones that aren’t critical to patient care.

VOLUMES DOWN EARLY IN YEAR

A financial report showed the hospital posted a decrease in net assets of $466,000 for the month of February on gross patient charges and other revenues of $40 million. CFO Jim Eaton said both inpatient and outpatient volumes were down from the previous month.

The Parkway surgical center showed a net loss of $172,000 for the month. It is expected to open for patients sometime in April.

The Bridgeport campus had higher surgery volumes, but showed a loss of $93,208 for the month of January. That deepened to $207,000 in February after a decline of 33 percent in ER volume. Eaton said personnel there could not pinpoint any one cause for the drop, but he speculated that perhaps flu cases, which were high in January, tapered off in February.

“It looks about the same this month [March] as it did in February – lower than it has been,” he said. “Cash decreased about $1.5 million – down to 108 days – mostly due to improvements and capital equipment purchases for Parkway and Decatur.”

Chief Operations Officer Leon Fuqua noted Wise Regional has approximately 600 surgeries scheduled and completed for the month of March, which puts it a little ahead year-to-date over last year.

Eaton also noted a donation of $245,000 from Wise Regional Health Foundation in February to offset the cost of the new digital mammography machine that was purchased for the Woman’s Center.

New Board Members

NEW BOARD MEMBERS – Wise Regional Health System CEO Steve Summers welcomed two new members to the Decatur Hospital Authority board at Monday night’s meeting. From left are Dana Manoushagian, Summers and Ray Cook. Cook, a CPA in Bridgeport and a former member of the hospital’s board, was appointed by the Decatur City Council in January to fill a vacant seat. Manoushagian, a Bridgeport attorney, was named to the board this month after the resignation of Lesa Warren. Messenger photo by Bob Buckel

OTHER BUSINESS

Wise Regional CEO Steve Summers reported on several ongoing issues to the board. Among them:

  • He noted Wise Regional’s Intensive Outpatient Behavioral Services did very well in its final review by the Joint Commission on Hospital Accreditation.
  • He said a study by the Hospital Authority’s bond adviser concluded that the Authority could achieve approximately $3 million in savings by refinancing the current bonds. He said he has contacted the law firm of Fullbright and Jaworski, and “we’re going in that direction.”
  • He pointed out that several policy changes have to be reviewed and updated to be sure their language includes the new Parkway surgical center.
  • He suggested moving the board’s April meeting to the 21st rather than April 28, due to a conflict with a meeting. The board agreed.

Board president Andrew Sandford nominated board member Ray Cook to the Wise Health Services board to fill the unexpired portion of Lesa Warren’s three-year term.

The board also:

  • tabled a proposal to construct an underground drainage system on the Decatur West Campus that would be cost shared on an equal basis with Aamir Zuberi, MD, who owns the building. WRHS is likely to put their part of the property, which is used for outpatient dialysis service, up for sale and would like to coordinate the sale and the drainage improvement.
  • approved both a sublease and management agreement with MVP Alliance, LP for the imaging center, equipment and operation of the center nearby the Parkway hospital facility.
  • approved the purchase of six Fukuda Denshi monitors, at a cost of $165,185, for patient rooms in the Emergency Department to better monitor higher acuity patients as the need has grown.

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Hospital board to meet Monday

Three days before a grand opening reception at Parkway Surgical & Cardiovascular Hospital, the Decatur Hospital Authority board will approve contracts to equip and operate the imaging center near the hospital at Interstate Highway 35 and North Tarrant Parkway in Fort Worth.

Those are two of the items on the agenda for a 6 p.m. Monday meeting at the hospital board room at Wise Regional Health System.

MVP Alliance, LP is the company that will lease the equipment to Wise Regional and provide services to operate the imaging center.

The board is also expected to approve the construction of an underground drainage system on the West Campus in Decatur – the former main hospital facility located across SH 51 from the hospital. Wise Regional will share the cost of that construction with Dr. Aamir Zuberi, who owns the building which is currently used for WRHS outpatient dialysis service.

The hospital’s share of the cost is $64,960.

The board will also consider the purchase of six monitors that will enable six of the ER patient rooms at the hospital to be used for higher-acuity patients. Pricetag for those is a total of $165,185, which was budgeted.

The hospital’s annual Infection Control and Quality Improvement plans are also up for approval, along with new medical staff appointments, reappointments and first-year reviews, administrative and financial reports and a proposed change to move the April meeting to the third Monday.

The board will also consider a nursing policy on patient transfers and appoint a member to the Wise Health Services, Inc. board to complete the three-year term of Lesa Warren, who resigned from the hospital board last month.

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