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| ed. note: The
below brief was extracted from the TVHD CEO's Communique
for September 2010. |
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Community
Advisory Committee-Update and Community Interactions
The July 24th meeting was attended
by eight community members. Our next meeting will be on August 28th,
2010 at 8:30 AM in the TVHD hospital conference room.
Construction
UpdateArchitectural Design –Our project manager/owner’s representative, Norm Clendenin, and our Architectural/Engineering/Design firm, Stephen Wen Associates (SWA), have received permission from OSHPD for “phased review.” They are also requesting a two-year extension to our seismic deadline. All plans except Civil engineering have been submitted to OSHPD and Civil will be submitted shortly. Allowing eighteen months for OSHPD approval, we hope to go out to RFP for construction in late 2011 or early 2012 with project completion in 2014. Bond Issue(s) – As previously reported, we had approximately $16.5 million in the bank (with accrued interest) from the sale of the 2004 GO Bond authorization to sell $15 million. Along with contributions and gifts these monies totaled approximately $17 million before we started paying for design and project management services on the new hospital. We expect the full cost of the new hospital, including soft costs and equipment, etc. to total approximately $71 million. We sought and won a $50 million GO Bond authorization approval on November 3rd, 2009 to allow us to build the new facility, with the balance of funding to come from operations. We don’t anticipate selling the $50 million in bonds until that money is needed and/or when the bond interest rates are most favorable to minimize the burden on taxpayers. California Environmental Quality Act (CEQA) –Karen Northcutt is under contract to perform our CEQA review and compile our report. Now that we have our site and alternate site plans and designs finalized, Karen is working to complete the CEQA study and will provide us with her observations and recommendations as soon as possible. Then the Board will need to determine whether they can make a “negative declaration” or, more likely, proceed with an Environmental Impact Report (EIR). Scott Navé, Norm Clendenin and I have all been in contact with Ms. Northcutt and are working with her to expedite the review and/or report. In July we met with Ms. Northcutt and her associate in a joint meeting with SWA and the City of Tehachapi. Capital Hills Site – We continue to work closely with Tehachapi City officials to work towards making the Capital Hills site the home of our new hospital complex. The City has designated our new hospital a street address of 2000 Magellan Drive. We have also been offered the donation of a site in Golden Hills, as an alternate site should one be necessary. It is very clear that Capital Hills is our preferred site and expected home of the new hospital. As soon as possible we will proceed with rescheduling the Land Development Committee meeting with the City of Tehachapi. We have met since the board decision with City officials and will continue to meet with them on an ongoing basis until the new hospital is completed. Skilled Nursing
Contract
Negotiations
Blue Shield – Blue Shield
notified us that they want to renegotiate their contract. Joe Demont
and Mary (Carleen) Warrack analyzed the numbers and were working with
Blue Shield. Right now, it does not appear to be in our best interest
to renegotiate rates. GemCare – Joe Demont and Carleen Warrack are still working with Stephen Linesch to revise our MOA with GemCare for the new members and all GemCare beneficiaries/participants. There has been very little progress this past month, and still no final contract is in sight. IMG Contract – Independence Medical Group (IMG) has a contract with the TVHD Rural Family Health Clinics. They notified us that we were in violation of our agreement because we were sending their patients to IMG-contracted facilities for lab and x-ray services even though we had the ability to provide these services at our hospital. We had our contract reviewed by legal and that review confirmed we had a contract for clinic services ONLY and NOT for hospital based services. Mr. Demont wrote back to IMG informing them of our disagreement over their concerns, sharing our position, and requesting that if they want to include our hospital services in the contract we renegotiate the contract and our rates; alternatively they could take our rejection of their argument as notice of Termination of Contract and serve 120-day notice. They chose the latter. Since then, Gary Bohamed and I have emailed back and forth and met to try to salvage our contractual relationship. Pharmacist’s Contract –Kim Hoffman, PharmD is our contract pharmacist. Her current contract expired last October and we are working with her either to renew her contract this year or go out to hire a full-time pharmacist’s services and then contract for on-call pharmacist only. Andrew Petty, RN supervises this service and heads this negotiation. Residents’ Prescriptions – Kim Smith, PharmD and Andrew Petty, R.N., released an RFP on April 28th, 2009. Sav-On was the only proposal for the pharmacy contract for our LTC patients’ prescriptions at that time, but they never followed up with a contract. K-Mart elected not to submit a revised proposal. Andrew and Kim reviewed proposals from “OmniCare” and from “Dawn’s Pharmacy” in Tehachapi. After careful analysis, they selected “Dawn’s Pharmacy” and they were working with Scott Navé, Joe Demont and Mary (Carleen) Warrack, to finalize a contract. Dawn’s Pharmacy has since closed, so we are reaching out to other area pharmacies. Meanwhile, we work with K-Mart’s pharmacy, without the benefit of a contract. Hospital Information System
Our current and projected health information system needs exceed the
capabilities of our current Mardon Health Information System. We are
exploring their new product and other vendors’ products to determine
the best long-range solution to our HIS needs (including a “meaningful
use” electronic health record or EHR) for the future. We had nine
Hospital Information System (HIS) vendors’ responses to our Request for
Proposals for a replacement HIS. Joe Demont, Eric Tescher and Dusty
Colvard have taken the lead over this lengthy initial review and
evaluation process; Taqueena Hall will now join the review team. The
final selection process will include clinical visits to sites using the
proposed systems. The selected vendor will have to be approved by the
TVHD Board of Directors. The conversion is expected to take at least a
year and be very costly (as much as $3 million), but much of the cost
will be reimbursed either under the patient protection and affordable
care act (PPACA), ARRA or under our Medicare cost-based reimbursements,
etc.Physician
Services
As discussed previously, SB 726 was pulled from the Assembly docket in
return for guaranteed support from Assembly Speaker Perez when it is
reintroduced (see attachment). This week the key players met and
discussed the proposal and ways to modify it so all the parties could
agree to support it (by limiting the number of MDs to be hired per
facility to two, by limiting which facilities could do so, etc.). The
bill was subsequently approved by the State Assembly and is now back in
the Senate where the California Medical Association has launched an
all-out effort to defeat the bill. Meanwhile, we have had inquiries
from physicians interested in practicing in Tehachapi: a pediatrician
whose husband will be working in Bakersfield and who expects to be
moving to the Hart Flats area, a cardiologist who wants to do
echocardiography locally and see cardiology patients in Tehachapi, and
a gastroenterologist who wants to perform colonoscopies in our present
hospital. We have been without the services of a podiatrist to care for
our LTC residents that occupy our “swing beds” for nearly six months.
We have contacted nearly every podiatric group in Bakersfield,
Lancaster and Palmdale. I personally contacted a podiatrist I had met,
and we now have a podiatrist, Dr. Holly Spohn-Gross, DPM, from the
Kernville area who is (finally) providing these services to our
residents.Surgical Services
So far, none of the local gastroenterologists or surgeons have shown
any interest in pursuing a conscious sedation (colonoscopy) business
line in our current operating suite. I will be taking on this project,
but right now other priorities supersede this initiative. We still need
to move a few functions around to accommodate re-opening surgery.Sincerely, Alan J. Burgess, FACHE, CFAAMA Diplomate in Healthcare Administration Chief Executive Officer, Tehachapi Hospital Tehachapi Valley Healthcare District 115 West "E" Street, P.O. Box 1900 Tehachapi, CA 93581-1900 Work (661) 823-3001 Fax (661) 823-3082 |
26August2010 |