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The Heart of the Rockies Regional Medial Center (HRRMC) Board of Directors Tuesday received reports on the process of medical credentialing and a 2021 Critical Access Hospital Evaluation by the Center for Medicare and Medicaid Services (CMS) along with other regular monthly reports.

HRRMC Board Chair Jeff Post, swore in four new board members Tuesday, May 17, 2022. From left are Dr. Lydia Segal, Susan Dunn, Bill Alderton and Dean Edwards. Photo by Dan Smith.

Vice President of Fiscal Services, Lesley Fagerberg reported total patient revenues for the month of May were $19,592,894 against a budget prediction of $18,969,820 and at $98,933,332 year-to-date compared to the budget of $93,517,644 with net patient revenues $9,127,876 for the month and $45,669,841 year to date.

Inpatient revenues were pegged at $1,272,083 for May, lagging a budget estimate of $2,179,089 and $8,461,633 year-to-date, trailing the budget estimate of $10,605,355.

Outpatient revenues fared better, at $18,320,812 for the month against the budget estimate of $16,790,731 and $90,471,699 for the year compared with the budget amount of $82,912,288.

Fagerberg said the change in net position for the month was an increase of $640,537 for the month against a budget figure of $660,912 and an increase of $3,121,827 year-to-date compared to the budget estimate of $3,724,659.

Kendra Black, Medical Staff Coordinator, presented a report on medical staff credentialing for the board members, including the process of assessment and confirmation of medical provider qualifications.

That process involves validation of a provider’s education, licenses and certifications, detailed work history and references, via primary source verification, Black stated, to meet requirements of accreditors such as The Joint Commission and ensuring the quality of patient care and avoiding potential legal liability problems.

She also explained privileging, which determines which diagnostic and treatment procedures a hospital is equipped to staff and support; the minimum training and experience required to competently carry out procedures and whether the credentials of applicants meet minimum requirements to carry out requested procedures.

Black cited examples of medical horror stories elsewhere involving medical providers who were incompetent, unqualified or who falsified qualifications and had sometimes disastrous outcomes for patients and severe financial liabilities for hospitals, including bankruptcy for one unqualified facility in New Mexico.

The approval process rests with the hospital board to grant providers medical staff membership and privileges to work at HRRMC. The Medical Executive Committee evaluates each provider applicant and makes recommendations to the hospital board.

Black quoted The Joint Commission on the critical nature of credentialing;

“Determining the competency of practitioners to provide high-quality, safe patient care is one of the most important and difficult decisions an organization must make.”

HRRMC CEO Bob Morasko reported to the board members that cost estimates, preliminary drawings and a pro forma for a new wound center have been completed, subject to modifications to try to reduce construction costs. He expressed concern because of recent turnover, about recruiting a nurse director with wound care experience.

Cost estimates for proposed employee housing and a hospitality house are still in process, he said, and awaiting infrastructure drawings.

A revised pro forma from Cassia, a faith-based organization from Minnesota that if it proceeds would increase assisted living units in the county, and eliminate independent living units is awaiting release from Cassia, potentially providing such living units locally, he also reported.

Morasko also provided the board with the Annual Critical Access Hospital Evaluation report for 2021, as required by the Center for Medicare and Medicaid Services (CMS) Conditions of Participation for Critical Access Hospitals.

In other action, the board approved capital purchase requests for a Hill-Rom Progressive Bed for the Intensive Care Unit at a cost of $23,495 and a Dose Edge Compounding Management System for the hospital pharmacy at a cost of $31,329.

The board also approved an emergency request for four sets of replacement orthopedic surgical equipment. The equipment cost was listed as $235,792.

Featured image: Heart of the Rockies Regional Medical Center. Dan Smith photo.