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Sustainability Plan

Elbert Memorial Hospital develops Sustainability Plan and implements changes

Elbert Memorial Hospital is making great strides in developing a sustainable plan to keep our hospital in this community. In the summer of 2014, the Elbert Memorial Hospital asked the Elbert County Board of Commissioners for financial support for Charity Care for Citizens of Elbert County. In the last four months, the Hospital Leadership Team, its Authority Board and Medical Staff, have spent a considerable amount of time developing an overall "sustainability plan" with strategies designed to reduce costs and increase revenue. Leadership has been looking at several different options to determine what is best for serving the current and future healthcare needs in our community.

Under the leadership of our Elberton-Elbert County Hospital Authority Board, Hospital CEO Jim Yarborough, and the Hospital Executive Management Team, numerous changes have taken place as a result of cost analysis, evaluation of scopes of services, profitability and feasibility of existing inpatient and outpatient services lines. Consideration was given to finding the right sustainable levels of local healthcare services lines and the future Mission of Elbert Memorial Hospital.

Staff has come up with numerous ideas and savings to make the hospital financially viable and more sustainable. A number of initiatives and changes have already been initiated or implemented such as:

  • Developing fund raising initiatives to help fund Hospital Charity Care for local citizens
  • Obtaining financial support to help fund Charity Care from the Elbert Memorial Hospital Foundation and Hospital Auxiliary
  • Pursuing City of Elberton financial support for Charity Care for local citizens
  • Liquidate surplus residential rental property to help fund Charity Care for local citizens
  • Participate in legislative and media initiatives to get attention and support to help improve funding of Charity Care Services provided by Hospitals to help Save Our Rural Hospitals throughout the State of GA and the USA
  • Seek State funding of Charity Care - Ga Income Tax Refund Garnishments
  • Seek State funding of Charity Care - Ga State Tax on Lottery Tickets
  • Seek additional State flexibility to use SPLOST for Charity Care or hospital operational expenses
  • Seek increase in Georgia State Sales Tax 1% to fund Charity Care throughout Georgia
  • Additional State of Georgia "commitment" to help fund Rural Hospitals to offset costs of Charity Care/Private Pay Bad Debt (in lieu of expanding Medicaid)
  • Continue seeking Medicaid Expansion in Georgia or viable alternatives such as a demonstration waiver for Federal funding of Medicaid Expansion alternatives
  • Renegotiate BCBS Contract Terms to improve reimbursements for BCBS Patient Services
  • Engaged Bottom Line Systems, LLC to do retroactive audit of past claims and "$11,846 underpayments" by commercial Insurance payers to recover funds from underpayments and improve future payment processing and results
  • Implemented managed care contract software to audit all future commercial/managed care payments for comparison with contract terms to limit future underpayments
  • Enhanced Bad Debt Collections to include legal action and Payroll Garnishments
  • Engage a Financial Accounting Consultant Services for Financial Analysis and Support
  • Recruit and Hire Chief Financial Officer for Financial Executive Leadership, Analysis, Support
  • Enhance collaboration with Elbert County EMS to meet and continually improve joint efforts to meet Health Service needs of Elbert County Residents

The Elbert Memorial Hospital Auxiliary recently purchased 15 motion activated sensors throughout the hospital at a total cost of $451.65. The Auxiliary thought that one way to cut costs would be to "automatically" turn off lights in areas not in use.  Since there's no control over when someone needs to use the facilities, a motion detector to control the lights in the public restrooms made a lot of sense.  Plus, without the need to touch a physical switch, the spread of germs is lessened. By installing these motion activated switches in all public restrooms in the hospital, it is estimated that the annual savings in utilities cost is approximately $1,600.

The Hospital appreciates the Auxiliary's support in purchasing the energy saving motion sensors.

Hospital Leadership, Medical Staff, Hospital Staff and Authority Board have all participated and had input into deciding the best options and solutions to determine changes and future scope of practice and services offered. Departmental, Service Line and Financial Performance and Sustainability Analysis have been discussed, and continue with numerous actions and changes being made or anticipated.

To date, cost analysis and evaluation of scope, profitability and feasibility of existing Inpatient and Outpatient Services Line (Consider "right" sizing services and future mission) have been completed and changes have been planned and/or implemented in the following areas of focus:

Departmental FTEs, Productivity and Staffing - A complete analysis was done and recommendations were developed. In November the Hospital Authority adopted the Productivity Standard with analysis to be done for each department with implementation of a "staffing budget" that Department Directors are held accountable for.Department Directors all met individually to review and provide input to their department scope of service and staffing needs. Minimal staffing requirements were established and after a review of the final recommendations, the Board gave final approval for adoption, implementation, and enforcement of the individual departmental staffing standards and budgets. Changes were made effective with the beginning of the pay period Dec. 8, 2014.

Dietary and Food Services - A complete analysis and discussion centered around developing alternatives and plans, obtained quote for full dietary and food services contracted services, obtain alternative quotes for inpatient meals only from external source, develop recommendations, and make final decisions. The final decision was to work with Health Care Services Group (HCSG), a national food service vendor specializing in providing food service to Hospitals to meet Dietary and Food Services for Patients. HCSG's intent is to also continue cafeteria service to the general public.

Intensive Care Unit (ICU) - Leadership team did a complete analysis, developed alternatives and plans, and developed recommendations and made final recommendations for the Authority Board's decision in having consolidation of "monitored unit beds" on the Acute Care Unit (ACU). The final decision was to provide monitored patient services in the Deluxe Rooms on the Acute Care Unit. This change would enhance patient experience, and make a more family/visitor/patient friendly environment for Intensive and Higher Acuity Patients with vital signs being monitored. The Elbert Memorial Hospital Foundation assisted the hospital in a donation of $5,000 to fund necessary changes such as relocating patient vital signs monitors, purchasing remote cameras, monitors, and other necessary expenses for the deluxe monitored critical care patient rooms.

REHAB SERVICES (Physical Therapy) - Joint efforts and/or partnership and a revised contract and terms were considered. A decision was made to revise the rehabilitation scope of service and payment terms with the rehabilitation contracted services. These revisions and changes occurred and became effective Dec. 1, 2014.

SURGICAL - OPHTHALMOLOGY - Completed a thorough analysis, considered and developed alternatives and plans, with final recommendations and and recommended changes. Ophthalmology Surgical Services will continue with an initiative to revise the schedule to ensure a minimal number of cases are performed on each "scheduled Ophthalmological surgical day" to ensure this service line is profitable and sustainable.

SWING BED - Completed an analysis, developed alternatives and plans,  recommendations and make final decisions. Swing Bed Services will continue with scrutiny and individual case analysis for each admission to ensure the patient scope of service needs can be performed "cost effective."   

PHARMACY - A complete analysis and development of alternatives and plans were considered and developed. Pharmacy Scopes of Service were revised to reduce in house staffing and increase PharmD Remote Services with an estimated annual savings of $95,000. 

CARDIOPLUMONARY AND RESPIRATORY SCOPE OF SERVICES - A complete analysis was done and recommendations were made to reduce staffing hours.

GRANT INITIATIVES AND DEVELOPMENT OF NEW SERVICES - In addition, the Hospital Staff is developing and expanding outreach programs through grant opportunities. One grant application has been submitted to the U.S. Department of Rural Health to expand healthcare services in the community. Part of this initiative includes: Urgent Care or After Hours Clinic (AnMed Health or EMH Initiative) to provide "convenient local" after-hours alternatives for non-emergency care nights, weekends, etc. Another Rural Healthcare Planning Development grant is being written to create a new community "planning network", to fill a "gap" for our rural area, to unify healthcare professionals in a rural area, and to help rural residents."

This is an Executive Summary of key initiatives and changes, but many other initiatives have occurred at departmental levels. Ongoing and continuation of other Scope of Service and Financial Feasibility Analysis Initiatives will continue to be prioritized and pursued.

Other potential new services under consideration include:

  • Hospice Unit - Inpatient Services
  • Geriatric Psychiatric Services (Inpatient and/or Outpatient)
  • Consider Feasibility of AnMed Health Medical Staff Specialty Rotations
    • Orthopedics (MD)
    • Urology (MD)
    • EENT (MD)
    • Pulmonology (MD)
    • Cardiology (MD)
  • Wound Management Clinic
  • Contracted Correctional Medicine (County Jail Inmates)
  • "Aggressive" (On Site) Preventive and Occupational Medicine for local Industries
  • Cardiac Nuclear Stress Test Feasibility
  • Cardiopulmonary Rehab Services Feasibility
  • Evaluate the Feasibility of "Alternative" Innovative Rural Health Care Models

The Hospital Leadership, Medical Staff, Hospital Staff and Authority Board have taken great strides in recent months to keep our Hospital financially viable and sustainable in our community. Your continued support and recommendations are always welcome and appreciated. Let's continue to work together to provide healthcare in our community.

© Copyright 2009 Elberton Memorial Hospital. Joint Commission Information.