Dear Mr. Feeney,

Thank you for allowing me to respond to Cody Arnold’s Letter to the Editor.  I was devastated that Mr. Arnold took the opposite intent that was meant.  I called him and personally apologized for a printed communication that could have been better. The synopsis did not reflect my intent.  Mr. Arnold and his team did a great job of managing clinical informatics while here.  In fact, our clinical staff had become dependent on him and his team informing and reminding us of various tasks needed to achieve the incentives.  It was the absence of their contribution, which developed over a short period, rather than any lapse in their performance, that left a large void.  Despite our efforts to redistribute the tasks to others who were active with the EHR (Electronic Health Record) within the facility, the Hospital missed one criterion to earn this incentive.

However, the actual impact on the Hospital is not as serious as I thought possible at the time of the July board meeting.  We have confirmed that we can still participate until program end.  To clarify, Medicare INCENTIVES for EHR use only, and not payment for patient medical services, were impacted, and only for the 2017 reporting year, not for all future incentives.  This can be thought of as “bonus” money above and beyond payments from Medicare for hospital and clinic patient care services.  We are not kicked out of the program as a result of missing one criterion in one reporting year.  This is not like an elimination tournament in sports, once you lose you’re out.  I had feared elimination from the “game” when reporting to the board in July.

The transition to Electronic Health Records was and is such a complex and overwhelming task that the US Government incentivized hospitals & clinics to get on board and are now penalizing those that fall short.  Fortunately, we have not paid penalties, unlike other hospitals.  In 2015, 171,000 providers across the nation were penalized for failing to meet Meaningful Use (defined by the use of certified EHR technology in a meaningful manner) requirements.  Further, substantial numbers of physicians and hospitals across the nation failed to receive both Medicare and Medicaid incentive payments.  While regrettable, we lost this one opportunity.  I am proud of our team, past and present, for collaborating to receive all incentives we have applied for to date, except this one.

As Mr. Arnold stated, we have a great facility with fabulous clinical and support staff.  I am proud to work for them.

Finally, I beg readers’ help in supporting the Hospital by using our services,  participating with our patient portal at this critical time, feeding back how we can improve, and joining as a team to become a model community for rural healthcare.  Attend our Board meetings, learn about what we’re doing, share things you experience and read about elsewhere.  My door is always open, my phone always on.  Just call the Hospital to chat, or make an appointment.


Randy Tobler, MD, FACOG

Chief Executive Officer