February 11, 2010

Outdoor Corner

by Chris Feeney

Im a huge baseball fan, and I follow the various news circuits for Major League Baseball religiously. Some of my favorites include Peter Gammons, the crew at baseball America and the MLB website. Typically I start my day off, well at least my informational part of it, plugging into my computer and the World Wide Web. My start page is ESPN.com, where I check scores for my favorite teams and as Ive already mentioned, get my baseball fix. ESPN has a number of writers I enjoy, but recently Ive taken a liking to Buster Olneys particular style. In addition to his own opinion pieces and news stories, Olney offers a blog entry, which simply is an index to other interesting sports related articles he has come across that day. Okay so maybe it isnt truly representative of what the author can do, but it still is a valuable service in todays age when time is a premium. I may not have the hours it takes to peruse the headlines from all the major newspapers, so Buster does it for me, compiling links to MLB news from across the United States. I enjoy the format so much, I thought I might try it this week in my Outdoor Corner. The name Dr. Grant Woods may be familiar to local hunters and outdoorsmen. The renowned expert on anything hunting, was a guest speaker at a special banquet put together a few years ago in Memphis by outdoors enthusiasts. He entertained guests at the fire station with discussions on steps landowners could take to raise larger deer. That topic continues to be the theme for Dr. Woods, who recently launched a new internet endeavor called GrowingDeer.tv (online at www.growingdeer.tv) The website features a weekly streaming video program seeking to educate viewers on hunting topics and a variety of methods by which bigger and better bucks can be produced for our hunting pleasure. New episodes are aired every Thursday, with more frequent news releases when warranted. Viewers can pass the time between new shows with updated blog entries by Dr. Woods and can even ask the expert questions related to the project. My wife really enjoyed this weeks episode about reducing the number of predators on his property, which dealt in large part with trapping and the benefits it creates for other wildlife. This wasnt my first taste of quality streaming video of deer. Ive truly enjoyed watching the updates on www.midwestwhitail.com, including the footage of local archer Travis Trueblood bagging his trophy deer right here in Scotland County. The November hunt is still online under the Videos link in the Missouri Hunts on Episode #15. Another quality link Id like to share with readers is the Shooting Wire. This electronic newsletter hits my e-mail inbox several times week with the latest firearms related news. The latest edition has a local connection, as author Jim Shepherd posted a feature article reviewing the upcoming Shooting USA Impossible Shots feature on WWII veteran Ted Gundy of Memphis. You can read the reviw online at www.shootingwire.com The best part about all of these wonderful resources is that they offer to bring the service directly to you. All three sites provide the option for signing up for e-mail alerts. This system provides you a regular note telling you whats new on the site, complete with easy links to click and take you right to the news and videos. One of these days, hopefully in the not-to-distant future, the Memphis Democrat website will offer some of these options as well. Check out this article on our website www.memphisdemocrat.com in the editorials section and all you will have to do is click on the links to check out these other offerings.

Discouragement is the Launching Pad to Wonder!!! 

Everywhere we turn we are faced with discouragement, resentment, and sometimes even depression.  If not within ourselves, we see it to be true of our friends, colleagues, and relatives.  Being “blue” is epidemic in nature.  No one escapes the steady encounter of this Meany.  No.  One.

I speak with a bit of authority for I am persistent in my self-evaluation as to how nothing I am.  I was hoping for better than this by now.  Yet, I’ve learned a most fascinating truth.  Being low is precisely the launching pad God would use to provide us with incredible wonder.

Jesus makes a seemingly absurd statement as he opens his mouth at His famous Sermon on the Mount.  “Blessed are the poor in spirit”, He assures.  Really?  Blessed are the down?  Blessed are the discouraged?  Blessed are the failers?  Blessed are the confused?  Blessed are the losers?  Yes…very articulately…Jesus says that such a one is prime for the launching of incredible, actual, hope.

How.  Can.  This.  Be.

It seems that man’s nature is to find less need for God when experiencing the territories of what we could deem as successful.  It seems that we begin, in these “doing okay” parameters, to take on an attitude that we aren’t in need of God for we are strong enough to maneuver our way through the current jungle.  When we feel we are in control, there is less likelihood that we would depend on Him.  This truth plays out every day.

But when we are at the end of our proverbial ropes, we find that we have nothing more to offer to escape our nagging dilemmas.  It seems that we made our final effort…and made no progress.  It is here at this juncture that one begins to look up for help.  Our hands are empty of effectivity and our words seem to be empty of solution.

Poorer nations, such as zones in Africa, are coming to God in droves for their lifestyles are empty of self-provision.  And even in a territory as wealthy as the USA, even the richest of rich begin to turn to God when self-reliance, independent-sufficiency crashes.  “Blessed are the poor in spirit.”

Poor in spirit considers humility to contain a power–as super-natural power–of which we lean toward only when in great need.  Our independent muscle seems to have atrophied.  Our insight has gone blind.  We must have Other help…and in steps Father, Son, and Spirit.

I urge you today to become unstuck.  One does so by one simple move; change your mind.  This is known as repentance. Don’t walk a life of doom; but arise to a life of potential and possibility… right… now.  Try to open your eyes and peer through the dim veil of frustration.  Begin to notice actual hope.  See that your trauma is serving you by leading you to a new zone; a new kind of life of which you had always imagined.

Yes.  Yes.  Yes.  Trade the “poor-me doldrums” for a better call; “blessed are the poor in spirit”.  Yay God!  Yay us!

Living Life Over

FIVE YEARS AGO

The Scotland County Health Department was among the recent MFH grant recipients.  The funding supports nonprofit organizations that work to improve the health of thousands of Missourians.

The Tiger Trail in Memphis was approved for a $9,993 grant through the MFH and the Scotland County Health Department.  The grant will help improve access to the walking trail, located on the northeast corner of the Scotland County R-1 School District Campus.

The local mini-grant was made under MFH’s Community Health and Prevention (CHP) funding program.  The goal of CHP funding is to establish communities where good health, healthy behaviors, and the healthy choice are the norm.

TEN YEARS AGO

The Memphis Area Chamber of Commerce will kick-off the 2007 Holiday Season with a debut of new Christmas lights.  When the switch is thrown at dusk, Friday November 23rd, the organization’s newest decorations on the Memphis square will be illuminated.

Santa Claus will be present again this year to meet with children.  He will open Santa’s House on the courthouse lawn to receive letters to Santa.

The Chamber will host special entertainment for the crowd and a number of promotional gifts will be given away.  The winners will be announced for the Chamber’s Memphis Bucks giveaways following the lighting ceremony.

20 YEARS AGO

A Knox County man died of an apparent heart attack while deer hunting during opening weekend of the fall firearms season.

Maurice D. Walker, 46, of LaBelle was discovered by Missouri State Highway Patrol officers two miles south of LaBelle at approximately 7:00 p.m. November 16th.

A friend called to inform law enforcement officials that Walker had not returned from deer hunting Sunday afternoon.  Officers located the body shortly after being contacted.

30 YEARS AGO

Kathy Jenkins and Orene Downing, operators, will be holding their grand opening at DeRosear’s House of Beauty in conjunction with DeRosear’s Open House, November 28th.

Jenkins, a native of Granger, is a graduate of the Wyaconda High School.  She is a graduate of the Tri-State Beauty Academy, Keokuk, IA.

Downing came to Missouri from DeCatur, IL, in September 1987.  She is a graduate of the DeCatur School of Beauty Culture and brings to DeRosear’s House of Beauty 25 years of experience in the beauty business.

40 YEARS AGO

With the increasing number of employed mothers there is a critical need for licensed day care homes.  Parents need to have assurance that the homes in which they leave babies and children meet at least minimal standards.

Standards have been set by the State of Missouri regulating the provision of day care.  It is required by Missouri law enacted in the public interest that anyone caring for more than four children, not related to them, must be licensed.  The purpose of licensing is to protect the health, safety, and emotional development of young children.

50 YEARS AGO

A vagrant weather balloon was reported to have sailed over Quincy early Tuesday afternoon, heading eastward and traveling at a good clip.

Apparently the same balloon was sighted here as the balloon sailed over Memphis slightly to the south and high overhead to the east at about that time on Tuesday.

It was visible for some time.  It was reportedly apparently a radar-equipped balloon sent up by some station to gather weather data.  The FAA station at Kansas City was tracking it, but reported to have no information as to its origin.

It must have been traveling high because the weather station at Kirksville was able to sight it when it was east of the Baldwin field at Quincy, traveling at an estimated speed of 70 knots.

60 YEARS AGO

A report from Jefferson City claims fish scales may become part of our diet.  It has often been said that the meat industry has learned to utilize everything about a hog but its squeal.  Now it seems that’s been carried into the fish industry.

According to word reaching the Conservation Commission, the U.S. Fish and Wildlife service is carrying on research studies which may ultimately produce food from fish scales.  Experiments with rats have proven the scales to be readily digestible.  Seems a bit far-fetched, but we soon may be sitting down to a nice hot dinner of fish scales!  Pass the catsup, please!

70 YEARS AGO

Arthur Found broke the small bone and dislocated the large bone near the ankle of his right leg Saturday morning.  He was hit by a buck sheep at his brother, Ray’s farm, 1 ½ miles north of Arbela.  Dr. A. M. Keethler was summoned and he was sent to the Laughlin hospital at Kirksville.  Mrs. Found and daughter, Helen, accompanied him and brought him home after a cast was put on his leg.  He will have to remain in bed for three weeks and then return to the hospital for removal of the cast.

8th Grade Girls Claim Tourney Title

The Scotland County 8th grade girls brought home first place from the Putnam County Tournament with wins over Milan, Putnam County and Schuyler County. Pictured in the back row (L to R) are Alayna Whitaker, Abby Curry, Emiley Dial, Baileigh Phillips and Haylee McMinn. Front row (L to R) are Hannah Feeney, Emily Terrill, Ayla Humphrey and Vikki Huber.

Scotland County Senior Nutrition Center

MENU

Thursday, November 16 – Salmon Loaf, Scalloped Potatoes, 3 Bean Salad, Buttered Corn, Cornbread, Fruit Salad

Friday, November 17 – Turkey, Mashed Potatoes/Gravy, Dressing, Cranberry Sauce, Green Beans, Hot Roll, Pumpkin Dessert

Monday, November 20 – Beef and Noodles, Mashed Potatoes, Lima Beans, Mandarin Oranges, Hot Roll, Cookie

Tuesday, November 21 – Meatloaf, Cheesy Hashbrowns, Italian Blend Vegetables, Bread, Pears

Wed., November 22 – Fried Chicken, Mashed Potatoes/Gravy, Green Beans, Hot Roll, Fruited Jell-O

Thursday, Nov. 23 – Center Closed, No Meals, Happy Thanksgiving!

ACTIVITIES

Wednesday, Nov. 15 – Board and Business meeting at 1:00 p.m.

Thursday, Nov. 16 – Card Party at 5:00 p.m.

Thursday, Nov. 23 – Center Closed Today, No meal or cards.

SCR-I School Menus

Breakfast

Thursday, November 16 – Breakfast Burrito, Choice of Cereal, Toast/Jelly, Orange Wedge/Grapes, Juice/Milk

Friday, November 17 – Sausage/Gravy Biscuits, Choice of Cereal, Apple Cinnamon Muffin, Banana, Juice/Milk

Monday, November 20 – Chocolate Chip Pop-Tarts, Choice of Cereal, Toast/Jelly, Fruit Medley, Juice/Milk

Tuesday, November 21 – Scrambled Eggs, Choice of Cereal, Hash Browns, Toast/Jelly, Apple Rings, Juice/Milk

Wed., November 22 – No School.

Thursday, November 23 – Happy Thanksgiving, No School.

Lunch

Thursday, November 16 – Lasagna/Ground Beef, Chicken Wrap, Hamburger Bar, Green Beans, Garlic Bread, Applesauce, Fresh Fruit.

Friday, November 17 – Pizza Roll-Ups, Ham and Cheese Sandwich, Peas/Carrots, Blueberry Jell-O, Sliced Pears, Fresh Fruit

Monday, November 20 – Ham and Beans/Cornbread, Bar BQ Pork Sandwich, 5th/6th Grade Chef Salad, Candied Sweet Potatoes, Cole Slaw, Fruit Cocktail, Fresh Fruit

Tuesday, November 21 – Chicken Patty/Bun, Juicy Burger/Bun, 5th/6th Grade Taco Bar, Curly Q Fries, Buttered Corn, Sliced Pears, Fresh Fruit

Wed., November 22 – No School.

Thursday, November 23 – No School, Happy Thanksgiving!

Honoring Local Veterans

Dear Editor,

Saturday was Veterans Day. All around the country, groups of people and organizations paid tribute to our veterans. In Scotland County there are many to be recognized and rightly so.

But have you ever asked yourself, what about Charles Thomas Moore? He was killed in Vietnam saving many lives as a combat medic and posthumously awarded the second highest award the Army gives for bravery. (The Distinguished Service Cross).

Did you ever ask yourself why isn’t there a street named in his honor or a park or a building? He is the only soldier from Scotland County to receive this medal.

What about Roy McDaniel? Known as Missouri’s most decorated soldier from WWII. Not a single thing to recognize his service in Scotland County while his uniform and medals are on display in a museum in Jefferson City.

Did you ever ask yourself why the local VFW never made an effort to honor these soldiers?

Gerald McDaniel

SCH  & Clinics Observe National Nurse Practitioner Week

Did you know that there are 234,000 solutions to the primary health care shortage facing the United States today?  There are 234,000 nurse practitioners (NPs) licensed in the U.S., and NPs have been providing primary care for more than 50 years.   November 12 – 18 is National NP Week.  If you know a nurse practitioner, please take a moment this week to say thanks and send an email to one of our many NPs at Scotland County Hospital & Clinics at caring4u@scotlandcountyhospital.com or send an eCard at http://scotlandcountyhospital.com/make_an_ecard.aspx.

All NPs must complete a master’s or doctoral degree program, and have advanced clinical training beyond their initial professional registered nurse preparation.  Classroom instruction and clinical courses prepare nurses with specialized knowledge and clinical competency to practice in primary care, acute care and long-term health care settings.

In the state of Missouri, NPs work collaboratively with a physician through a collaborative practice agreement.  A collaborative practice agreement is a document outlining this joint practice relationship between the nurse practitioner and a physician.  In a clinic setting, NPs can be a patient’s primary care provider or they can treat a patient of any other primary care provider in order to open up access, which provides a solution to the primary care shortage facing America today.  Scotland County Hospital and Clinics recognizes the following collaborative practice agreements: Jessica Christen – Shane Wilson, DO; Marilyn Day – Julia McNabb, DO; Stephanie Henley-Pippert – Jeff Davis, DO; Teresa Kirchner – Jeff Davis, DO; Tabitha Rohr – Julia McNabb, DO; Sonya See – Randy Tobler, MD; Haley Shrum – Neil Hoyal, DO; Jenna Williams – Julia McNabb, DO.

NPs are proven, expert, patient-centered clinicians because of their unique combination of medical and nursing expertise and skills. NPs diagnose and treat acute and chronic conditions such as diabetes, high blood pressure, infections and injuries; they order, perform, interpret and supervise diagnostic tests such as lab work and x-rays; and they prescribe medications and other treatments.   In addition, NPs partner with their patients, providing health education and counseling, thus guiding patients to make smarter health and lifestyle choices, which ultimately may lead to reduced health care costs.

Hospital Board Discusses Nursing Shortages at October Meeting

The governing board for the Scotland County Hospital met October 26th in regular session in the SCH Library. Those Present included Curtis Ebeling-Chairman (5:45pm), Joe Doubet – Vice Chairman, Robert Neese – Treasurer, (6:04 pm) and members Dwight DeRosear and Lori Fulk. Judy Wilson was absent.

Others present included  Dr. Randy Tobler; CEO, Dr.  Jeff Davis, CMO, COS Dr. Lisa Rollison, Michael Brandon, Controller, Elizabeth Guffey, RN, CON, Missy Smith, HR Coordinator, Lori Nelson, RN, Clinic Supervisor. Suzie Lister Financial Navigator, and Brenda Prather, recording secretary.

Consent Agenda

Approval of Minutes 9/28/17, Special Meeting 10/30/17 and consent agenda.  Motion by Doubet to approve open session minutes of 9/28/17 and consent agenda items B-K which are attached.    Second to motion offered by DeRosear.  Motion approved by majority vote. Highlight by L. Nelson of MIPS measures in the clinic.  Report period is 10/1/17-12/31/17; CNO Nursing Report; Disaster Committee-agenda only; HIM Update; HR Update; Material Mgmt. Report; QI/Safety Committee; RHC Report; Supervisor Mtg; P&P/P&T Committee-Med Staff Approval; Contracts; External audit by EC First; Internal and external cybersecurity audit; Therapy contract with Regional Home Care, Inc.

Financial Report – Michael Brandon, MBA

Finance Report, Balance Sheet, Income Statement, Stats-AR were presented by Brandon. Reminder that representatives of BKD will be presenting the 2016-2017 FY Audit next month at the November 27th meeting. Supervisors and Medical Staff will be invited.

Approval of October 2017 A/P.  Motion by Fulk to approve A/P listing.   DeRosear offered second.  Motion approved by majority vote.

Joint Advisory – Dr. Lisa Rollison, Chief of Staff-

Medical Staff Meeting was held Monday, October 23rd.  Staff Attendees included: J. Christen, J. Davis, J. Hassen, N. Hoyal, S. Henley-Pippert, T. Kirchner, J. McNabb, C. Miller-Parish, T. Rohr, L. Rollison, R. Tobler, J. Williams, and S. Wilson

Presentation regarding MIPS (Merit-Based Incentive Payment System) was given by Heather Ayer, RN BSN. Lengthy discussion regarding the involved MIPS Quality Measure Points and their capture (or lack thereof) by our EMR was conducted.

Submitted CNO report included an article relating to nationwide nursing shortages. The staff engaged in a discussion involving ways to show appreciation to nurses and to attract and retain quality nursing staff.

The topic of chart completion and provider performance expectation was raised. A vigorous discussion ensued.

Factors contributing to non-compliance were voiced including walk-i volume challenges, IT/EMR pitfalls, time management practices, and lack of efficacy of our current policy toward non-compliers. Strategies for offsetting these factors were discussed.

Team Care was discussed with reference to how the system affects chart completion. During the initial learning curve, more chart time is actually required, with time eventually improving to below baseline.

Factors contributing to the urgency of timely chart completion including patient safety, financial/billing punctuality, and maintenance of accurate legal record were stressed.

Development of more effective policy that better aligns with industry standards will be pursued. Such policy may include provider fines for late chart completion, initiating at 14 days post-due.

The concept that timely chart completion is an expectation of employment, an existing stipulation of all staff employee contracts, and a matter of professional responsibility was discussed.

Peer Review, including the recent committee meeting, was reviewed. Process streamlining is in progress.

4th Quarter Credentials were reviewed.

Report on Child Care Committee was presented.

Administrative Report – Randy Tobler, MD, CEO

Operations

FY’16 cost report adjustment of $161,702 due to SCH notice received from WPS Informatics – We have engaged a Meditech exclusive consulting vendor to assist with solutions requiring more help than our internal staff can provide.  Sonya See, SHNP, will assume managerial oversight, and Heather Ayer, RN will be trained by Tammy Scearce to assume some quality reporting duties she carried over from her Q/I position to the informatics position.

Thelma Norton, RN, will add training and background Meditech duties to her educational and infectious disease roles. We have a defined retainer contract of 80 hours monthly through end of ’17 as a pilot, with the option to continue if the arrangement is efficient and productive.  The priority list, emphasizing revenue cycle functions with some priorities reserved for clinical matters, has been developed and work on projects is in the early progress.  Many thanks to Sonya, Heather and Thelma for “filling their buckets’ as we move forward.

Pharmacy – We have reconfigured pharmacy staffing with redefined Pharmacy Technician roles, and transferring all supervisory functions to the Pharmacy Director, Ginger Ertel, Pharm D. We anticipate less clerical work involved in inventory and billing as a result of the enhanced Pyxis integration with Meditech. Pyxis implementation and sign off on full operational signoff expected by end of November.

SLS (Intensive Outpatient Geriatric Psychiatry) contract executed.  Kickoff meeting to introduce personnel and plan implementation slated for November. Program opens in March.

Monthly Safety Rounds with CEO, CNO, Q/I Manager, Maintenance and Housekeeping supervisors started 10/4.  Many cosmetic and few safety issues identified and are either rectified or in process.  E.g. New concrete on walkway between Women’s Center and MMS replaced.

Sidewalk and ramp to small parking lot between Surgery Center and Annex poured.

Meeting with Maintenance Dept. 10/17 to discuss expectations for projects, to include project scope, drawings, materials list and timeline.  Discussion, relayed to Supervisors 10/25, about the importance of advance notice of projects to allow time to develop required plans.

CareSync (Chronic Disease Management for Medicare patients) program has launched with enthusiastic patients and several clinicians.  Another momentum/check in call with their team scheduled early November.

Medical Staff/Allied Health

Interview with FP Resident at the SIU program (Dr. Dixon faculty) in Quincy. Further discussions for possible employment in 2019 ongoing.

Interview with FNP trainee who will be graduating in winter.  Discussions ongoing.

Personnel

Tammy Scearce, RN, Informatics, resigned, with last day November 9th.

Nursing shortage continues to challenge staffing. Thanks to supervisory and the other staff who have picked up empty shifts and duties aside from their administrative and core nursing schedules.

Personal

A physician targeted video focusing on the opioid crisis and its maternal/newborn impact I recorded is on the MHA website.

I recorded a podcast with Hadley Health Manning, Director of Policy Studies for the Independent Women’s Forum on the Opioid Crisis.

I will be attending the MHA Annual Conference next week.  Request permission for travel, food, registration and lodging support.  Motion by Fulk to approve CEO Tobler’s attendance/expenses. DeRosear offers second.  Approved by majority vote.

CMO ReportDr. Davis

Quality Assurance

Attended QA and discussed results and employee satisfaction surveys

Reviewed dashboard details and discussed MIPS

Reviewed 1 patient complaint

Senior Management

Met with Senior Management discussing strategic plan and management.  Focused on alignment and ACO opportunities. Reviewed recommendations for strategic plan.  Attended Board Retreat on Strategic Plan and Alignment

Meetings with Dr. Tobler and Michael Brandon regarding recruitment, retention, employee satisfaction and personnel management.

Meetings with Lori Nelson, RN, Clinic Manager regarding clinic work flow, Team Care, personnel/staffing, schedule and physician relations.

Clinician Relations

Communicating with clinicians on clinic and hospital workflow/HER, etc.

Working with Kristin Hyde and Dr. Heather Martin, Secretary of Medical Staff, regarding inpatient/OB/Peds physician coverage.

Meetings with Dr. Tobler regarding clinician contract development.

Service Line Development

Team Care project at MMS is underway and going well

NPs have moved to a 10-hour, 4-day work seek.  Still have chart incompletion issues.  Working through dynamics.

Walk-in clinic at MMS and LMS continues to go well Numbers strong.  Still widely utilized.

Memphis Community Pharmacy continues to see increased numbers and providing great service to our patients

Onsite collaboration with Haley Shrum, NP in the ER, Stephanie Henley, NP and Teresa Kirchner, NP at MMS and SCCC and Lois Quenneville, PA at MMS and SCH.  Jessica Christen, NP on pediatric issues in the clinic

Dr. Daniel Schneider has started with Urology services at MMS

Dr. Wolkowitz has started with pain management services at Surgery Center

Dr. Jost will replace Dr. Garriga in November for Rheumatology services.

Recruitment and Retention

Contract presented to Kelsey (Davis) Humes.  2nd year FP resident form Quincy, IL

Other interest from current Urgent Care physician resident from Kirksville with interest in OMM

Interviewed a NP who is seeking us out for job opportunities.  Ongoing discussions with her

Old Business

Strategic Plan follow-up.  Board member responses to worksheet.

Goal on financial performance. Lengthy discussion on pillar priorities, long-term goals, quality, financial, culturally, community. Next month final analysis of pillar expectations will be tabulated and presented.

New Business

Employee Financial Aid Request – Guffey presents request from Chrissie Burkhiser for assistance to attend and complete a BS degree. This is a twelve-month online BSN Degree program through Chamberlain’s School of Nursing, Downers Grove, IL.  She is requesting the full amount of tuition with full expectation to continue working full time. Following discussion and review of letter of recommendation, Motion by Fulk to approve Burkhiser’s request in full with a commitment of eighth years employment from date of financial aid contract. DeRosear offers second.  Motion approved by majority vote.

Revenue Cycle Supervisor Update.

Suzie Lister presented her experience today with a meeting of billing and coding personnel.

Shared her wonderful experience in her meetings with counterpart at Blessing.

Reviewed multiple areas at Blessing, bringing her ideas back to SCH registration staff, billing and coding.  Example: Shadowed HIM personnel at Blessing and brought back question and concept of establishing a discharge check for billing. This has been incorporated by IT. Realizing time of discharged had not been documented/billed appropriately.

Received a tremendous amount of advice, policies, training tools, form template, discipline techniques, suggestions on resolving cultural issues, etc. to bring back and implement.

Established time study of each employee in billing/coding.

Claim denial is a top priority; scheduled for improvement in billing staff efficiency and bottom line.

Meeting with registration next week.  Full staffing should be completed next week with another hire.

Poor consistency to financial arrangement/contract.  They’ve made a payment plan, not performing.

Question: Can patients be fired for consistent non-compliance-failure to pay.  Researching an answer

Board Education Series – Part of annual educational requirement of Public Boards per RSMO §105.666, 1-4.

Module I.  Discussion on Handout “Leadership Habits” and questionnaire.

Reading handout of “Best Practices for Building a High-Performance Board”

Length of this review/discussion approx. 30 minutes.  Reading expectations with completion of check list handout=approx. 1 hour.  Series will continue at November and December meetings.

Nursing Shortage-Literature distributed from Reuters. Interesting article on the current shortage of nursing, how smaller hospitals must compete with large institutions money on recruitment and retention. https://www.reuters.com/article/us-usa-healthcare-nursing/short-on-staff-nursing-crisis-strains-u-s-hospitals-idUSKBN1CP0BD

Bonus – Discussion

Recent Missouri State audit in other hospitals directs bonuses be tied to performance metrics, defined before the eligibility time period.  The traditional Christmas Bonus will now be a retention bonus based on achieving Board-defined tasks, job performance expectations:

Full time employee-past probation period- $150

Part time employee-past probation period- $100

No active disciplinary action or action taken between this date and 12/9/17

Participated in insurance open enrollment in November

CareLearning up to date

Employed through 12/9/17.  Motion to approve criteria and amounts listed above by DeRosear with Fulk offering second.  Motion approved by majority vote.

Mo. Hospital Audit-Board Alert- The arrival of this resource material from MHA is excellent material to contribute to the educational series for the board members.  Lengthy discussion reviewing key points outlined in MHA Resource and Support documents pertaining to State Auditor conducting a series of audits of county-owned hospitals.  CEO Tobler led discussion on three main areas of focus. (1) State Audit Learning outlining specific objectives of the state audits. (2) Trustee Education and Resources and (3) Community Health Needs Assessment.   Board oversight importance on management of contracts, management compensation, service contracts/billing practices, loan agreement, travel reimbursement, CEO reportable wages, inpatient psychiatric care units, financial condition and computer security to name a few.  B Prather will request webinar material from MHA’s upcoming educational sessions.   Discussion time is allotted for educational purposes. 30 minutes.”

Disposition of Surplus Equipment- Permission to schedule surplus equipment via auction or” yard-sale”. Department supervisors were asked to make a cursory inventory of saleable equipment by Nov. 1.  Motion by Doubet followed by Neese with second.  Approval by majority vote.

Joint Meeting & December Meeting-  It was agreed upon to keep the regular monthly meeting date for December, which falls on Thursday, December 28, 2017 with February 22, 2018 meeting for Annual Joint Mtg. with Medical Staff.

Credentialing Report – Medical Staff has approved the following list of credentialing documentation.  Per recommendation and approval by Medical Staff, Motion submitted by DeRosear to approve.  Second by Fulk.              Motion approved by majority vote.

Full Privileges Given 9/19/17 – Maggie Barnidge, D.O. DWC Associate; Joseph Bass, M.D. HRHS Consulting; Andy Bukaty, D.O. DWC Associate; Christopher Gifford, D.O. DWC Associate; Karl Harmston, D.O. DWC Associate; Daniel Jost, M.D. PSN Associate; Senthil Krishnasamy, M.D. IEC Associate; Farukh Mian, M.D. Argus Consulting; Gary Morsch, M.D. DWC Associate; Christina Pinkerman, CRNA MB Anes; Allied Health; Tabitha Rohr, NP LMS Allied Health; Lorenz Schielke, M.D. Argus Consulting; Michael Turner, M.D. DWC  Associate; Richard Wolkowitz, M.D. PSN  Associate; Jamey Wright, M.D. Argus Consulting

*Dr. Wilson made a motion on 9/19/17 to approve the above listing for full privileges to the SCH   Medical Staff.  Dr. Rollison seconded the motion; motion carries.

Extended Temporary Privileges 10/9/17:

Karolyn Cook, M.D.-DWC

Theodore Cook, M.D.-DWC

*Temporary Privileges will expire 1/7/18. Dr. Martin made a motion to extend temporary privileges on Dr. Karolyn Cook and Dr. Theodore Cook. Dr. Wilson seconded; motion carries.  If there is no activity by expiration date, privileges will not be renewed per Dr. Rollison.  DocsWhoCare are requesting to keep their privileges active at this time due to being their emergency backups, if needed.

Temporary Privileges 10/19/17: John Fortner, Jr., CRNA MB Anes. Allied Health

*Temporary Privileges will expire 1/17/18.  Dr. Wilson made a motion on 10/19/17 to approve temporary privileges on John Fortner, Jr., CRNA.  Dr. Martin and Dr. Rollison both seconded; motion carries.

Full Privileges Given 10/18/17: Eldon Frazier, M.D. for Family Practice-ASSOCIATE; Andrea Graham, R.D., L.D. for Dietician-ALLIED HEALTH; Daniel Schneider, M.D. for Urology-ASSOCIATE

*Dr. Rollison made a motion on 10/18/17 to approve the above listing for full privileges to the SCH Medical Staff.  Dr. Martin seconded the motion; motion carries.

Re-Appointment and Privileges given 10/18/17: Jeffrey Davis, D.O. for Family Practice/Special Procedures/CRNA Supervision-ACTIVE; Marilyn Day, FNP-BC for Family Nurse Practitioner-ALLIED HEALTH; Maria Evans, M.D. for Pathology-ASSOCIATE; Belinda Fender, M.D. for Pathology-ASSOCIATE; Deborah Holte, DPM for Podiatry/Special Procedures/CRNA Supervision-ALLIED HEALTH; Neil Hoyal, D.O. for Emergency Medicine-ACTIVE; Julia McNabb, D.O. for Family Practice-ACTIVE; Jessica Christen, DNP, RN, FNP-BC for Family Nurse Practitioner-ALLIED HEALTH; Stephanie Henley-Pippert, FNP-BC for Family Nurse Practitioner-ALLIED HEALTH; Sonya See, WHNP for Women’s Health-ALLIED HEALTH; Lisa Rollison, D.O. for Surgery Services/Special Procedures/CRNA Supervision-ACTIVE; Lois Quenneville, PA-C for Family Practice

*Dr. Rollison made a motion on 10/18/17 to approve the above listing for re-appointment and privileges to the SCH Medical Staff.  Dr. Martin seconded the motion; motion carries.

Executive Session

Motion by DeRosear to enter Executive Session pursuant to Sunshine Law Sections 610.021 to discuss matters that pertain to: (1) Legal, (3) hiring, firing or discipline of employees, negotiated contracts and (13) individually identifiable personnel information.  Fulk offered second to the motion.  Motion approved by roll call vote:  Fulk yes, DeRosear yes, Doubet yes, Neese yes.   Time is 10:10 pm.

Those Present: Ebeling, Fulk, DeRosear, Doubet, Neese, Dr. Tobler, Dr. Rollison, Dr. Davis, Michael Brandon, Suzie Lister, Missy Smith, and Brenda Prather.

Approval of Executive Session minutes of 9/28/17. Motion by Neese and second by Fulk to approve.  Motion approved by roll call vote: Fulk-yes, DeRosear-yes, Doubet yes, Neese-yes, Wilson-yes.

Motion to exit executive session and adjourn regular open session by DeRosear.     Fulk seconds motion.  Motion approved by roll call vote: Fulk-yes, DeRosear-yes, Doubet yes, Neese-yes. Time is 10:58 p.m.

Adjournment

Motion by DeRosear to adjourn, with second by Fulk.  Motion approved by majority vote.  Time is 10:58 pm.

Thanksgiving

Now as I sit here writing this, I find that this week is already the middle of November. Thanksgiving activities are just around the corner.  We are forced to look at Halloween decorations in August, and Christmas in September and October. We almost forget that Thanksgiving is in there someplace.

I love fall and enjoy decorating for it. I hate to see the end of November come, meaning colder temps, and much to be done for the holiday season celebrating Christ’s birth.

Many of us have been seeing and watching Bald Eagles diving around the fields and roadways after their prey. Rabbits beware. Road kill is a popular item for them as well, as there are many deer. Recently, one of my friends counted 12 on the way home from Columbia. Lots of battered autos I’m sure. They do eat carrion and clean up the remains of many deer killed on the road, but they are skilled hunters. And they are a skilled food thief also.

On June 20, 1872, the Continental Congress adopted the Bald Eagle as our national emblem.  It is so much fun to watch them, and I feel they are a very majestic bird. Some say they are lazy due to the fact that they can sit on a branch for hours on end. I think they are watching for prey. Nevertheless, I enjoy getting a peak when possible.  Especially fun when they release a Bald Eagle at the ballgame to fly over the stadium during the national anthem. Gives a person chills to watch that. Our country is still the greatest.

Along the Mississippi River and running creeks, you will find many of them feasting on fish, muskrats, other small mammals, water birds, and of course, road kill.

Another bird I enjoy watching at the feeder in the winter, is the Pine Siskin.  They are in the finch family, who hold their own at the feeders.  They often flock with their more colorful cousins, the American Goldfinch, next to whom they seem a bit more drab.  They are mostly brown and have a touch of yellow on their wings. They are fleeting, so you may see them one day and not again for a while.  So keep watch over your feeders and you may see them, there with their cousins, and then disappear.

Please take care out there during the firearms deer season, if you go out and about, wear something bright.  Be safe you hunting folk.  Until next time, good bird watching.

Ward Among 18 Students Named to  Iowa Corn Collegiate Advisory Team

Iowa Corn proudly announced the 18 Iowa college students who will make up the eighth Iowa Corn Collegiate Advisory Team (CAT). Comprised of Iowa students pursuing degrees in agriculture, CAT will assist the Iowa Corn Growers Association (ICGA) and the Iowa Corn Promotion Board (ICPB) in developing targeted programs to enhance the organizations’ relationships with individuals pursuing careers in agriculture production and allied industries. CAT achieves this by fostering the knowledge and skills of these future leaders and providing them the tools to advocate for Iowa Corn and other commodity organizations’ role in the success of Iowa agriculture.

“The future of Iowa Corn depends on the organization’s ability to offer relevant programming, advocacy and services to new stakeholders entering Iowa’s agricultural sector,” said Iowa Corn Promotion Board Director Larry Buss, a farmer from Logan who chairs the committee overseeing the team. “We are excited to work with these 18 bright students, who are pursuing a broad facet of careers in agriculture, on ways we can cultivate and promote our organization and the corn industry.”

The team includes agriculture students from several colleges, community colleges and universities from across Iowa.  Tori Ward of Memphis, a student at Indian Hills Community College, is part of the team.

The Iowa Corn Promotion Board (ICPB), works to develop and defend markets, fund research, and provide education about corn and corn products. The Iowa Corn Growers Association (ICGA) is an 8,000-member strong grassroots-driven organization, headquartered in Johnston, Iowa, serving members across the state, and lobbying on agricultural issues on behalf of its farmer members to create opportunities for long-term Iowa corn grower profitability. For more information, visit iowacorn.org

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