Henry County Medical Center Board of Trustees Hears Update on COVID-19 from Pharmacy Director Bell; Brad Bloemer, New CFO, Introduced

CUTLINE – Pictured is Board of Trustees chairman Dr. Scott Whitby and board member Peggy Beasley at the November 2020 board meeting.

Paris, TN – Paula Bell, Director of Pharmacy, shared with the Board of Trustees at Monday night’s meeting about a new infusion therapy for COVID-19 patients and the COVID-19 vaccine.  HCMC has received around 20 doses of bamlanivimab for outpatient COVID-19 positive patients, and has used four doses of the new infusion therapy.

“Today, I received a phone call from one of the patients who received the new therapy, and she informed me she feels significantly better,” said Bell.  “We are excited to offer this drug and it is available to the medical staff to prescribe on a first come, first serve basis.  Additionally, we hope to receive the other outpatient therapy that President Trump received to offer to patients with mild to moderate symptoms to help them avoid becoming more severe.  We hope to learn more about this soon. ”

The COVID-19 vaccine from Pfizer is estimated to arrive at HCMC in around four weeks.  A Facebook Live event at 12 Noon will be offered to the community tomorrow, Tuesday, November 24 to help answer any questions that people may have about the vaccine, treatment and testing for COVID-19.  Bell discussed several details about the vaccine to the board during her discussion including the establishment of a COVID-19 Vaccine Task Force to develop education for partners and the community along with protocols and phases for providing the vaccine starting with healthcare workers and medical staff.  The vaccine is two doses and will not be mandatory, but encouraged for healthcare workers to take.

“This vaccine is not an experimental vaccine,” said Bell.  “The vaccine has a 94.5% efficacy which is unheard of along with very few side effects.  The FDA has approved the vaccine, and it is not experimental.”

Lisa Casteel, Chief Executive Officer at Henry County Medical Center, shared her administrative report with the board.  She discussed the value based purchasing measures where we outperformed both state and national scores.  Our positive adjustment factor increased from last year’s 1.0059 to this year’s 1.0076.  She also discussed the Readmission Reduction Program, with 83% of hospitals receiving a penalty.  The average penalty reduction is 0.69%.  The assessed readmission penalty to HCMC is reduced from last year of 1.32% to a low of 0.07%

Casteel also provided an update on COVID-19 statistics.  Over the last seven days, Henry County has seen a 33% increase in new cases and a 37% increase of active cases.  Our current positivity rate is 22.4%.  Currently all our COVID-19 available beds are full.  For over a week, Casteel has sent a daily text to the medical staff about our bed availability and our surgical capacity.  Outpatient and inpatient surgical cases are reviewed on a daily basis to ensure we have the capacity to accommodate these patients.

“We are going to do the best we can to take care of you,” said Casteel.  “But, as it has been stated, care may be delayed or delivered differently because of our resources.”

“Currently, we believe we can handle seven ventilator patients with the ventilators, staff, and supplies we have,” said Neely Ashby, Chief Nursing Officer at HCMC.  “We do have contingency plans in place to work through our COVID-19 patients.  To date, the most we have had on ventilators at one time has been five.”

As of the time of the board meeting, we have 23 patients in the Emergency Room with already nine testing positive.  Our ER has 12 bays available with overflow created with cots.  We have 18 COVID-19 inpatients.

“With the ER flow as it is, it sounds like we are going to surpass our resources very quickly,” said Kreg Kyle, HCMC board member.

“Our ability to transfer to other facilities is very tight right now because beds are full across the region,” said Casteel.  “Management of COVID-19 patients is becoming increasingly more difficult and will continue as we see people gather during the holidays.  Pressure will continue as we manage sick patients, surgeries, and beds with our resources.”

Casteel also discussed growth within the organization with the board.  We have joined with Rural Health Pain Management to continue and grow our Spine Clinic.  Additionally, we are now offering a new technology, Blue Light Cystoscopy, a procedure that allows for visual inspection inside the bladder to better diagnose, evaluate, and plan treatment for bladder cancer that our urologists are utilizing.

Brad Bloemer, Chief Financial Officer, introduced himself to the board.  He has been at HCMC for two weeks.  He has served as CFO at several hospitals including Murray-Calloway County Hospital.

“I am excited to be back home,” said Bloemer.  “My parents are from the Murray area and it is great to be back so I can be close to them.”

Bloemer discussed his evaluation of HCMC to date.  Being in TN is a huge disadvantage for any hospital because we did not expand Medicaid.  Most hospital closures have been in states who haven’t expanded.  Currently, there are only 12 states in the country to not expand Medicaid.  This impacts charity care and bad debts.  Additionally, we are in one of the worst paying rural Medicare rates, which impacts our financials.

On a positive note, Bloemer pointed out that we have excellent policies and procedures for our revenue cycle from scheduling, pre-certs, coding, and collections.  Additionally, Bloemer noted that 72% of our charges are outpatient.

“We have a busy ER, outpatient surgery, and many services that other hospitals don’t offer,” said Bloemer.  “This is positive because we are reimbursed more for outpatient services over inpatient services, which serves us well.”

Bloemer discussed in detail our balance sheet, which has seen a significant improvement from last year.  In October, we reported an operating loss of almost $66,000 and a bottom line loss of $92,135, but it was better than prior year of a loss of $681,327.  To date we have seen, over prior year, a $4 million improvement to our year-to-date totals, with a year-to-date actual of $1,336,757.  Our case mix index was 1.8, which is the highest case mix index we have ever had.  This means our patients are very sick.  Bloemer also discussed our grant funds from the federal government related to COVID-19.  We have until June 30, 2021 to designate the remaining funds we have received.

Bad debts for the month were approved for $825,842.  Additionally, a few capital equipment requests were approved at $809,160 for Cares Act COVID-19 purchases, with the majority of the expenses for respiratory care including two ventilators and four BIPAP machines, a portable x-ray machine, telemetry system for 3rd Tower, and infusion pumps. Also, telehealth grant purchases through the Delta Region Community Health Systems Development Program at $94,768 were also approved by the board.

Casteel, in new business, discussed the extension of terms for a loan we took out in 2018 for construction of our Cath Lab.  This is being granted by First Horizon Bank for 12 additional months because of COVID-19.  The board approved authorization of this extension to change the terms of the $9.2 million capital loan.  This will go to the Henry County Commission for approval.

To learn more about the growth at Henry County Medical Center, go to our website at www.hcmc-tn.org and read about all the services we offer to care for our community.

The next Board of Trustees meeting will be December 21 at 5:30 p.m. at Henry County Medical Center.  Please note that this is the Monday prior to Christmas and the meeting will be held in HCMC Classrooms 2 & 3 or via Zoom.

About Henry County Medical Center

Located in Paris, TN, Henry County Medical Center is a progressive, integrated healthcare organization committed to serving the healthcare needs of Henry County and the adjoining region. Including a 142-bed hospital and 7 other facilities, the medical center provides a variety of outpatient services, as well as inpatient care. Henry County Medical Center is a county-owned and operated nonprofit institution. For more information: www.hcmc-tn.org.