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KH to create lithotripsy center

Posted: January 27, 2011 5:11 p.m.
Updated: January 28, 2011 5:00 a.m.

KershawHealth trustees unanimously approved a $126,000 project to convert one of the older operating rooms into a lithotripsy center. Lithotripsy uses non-invasive shock waves to crush kidney stones. The vote came during a KershawHealth Board of Trustees meeting Monday evening.

KershawHealth got into the lithotripsy business about a year ago when the Hospital Foundation contributed $300,000 to the purchase of a lithotripter, the device used to administer the sound waves.

Since then, the health care system has successfully treated 163 patients, said KershawHealth Vice President and COO Mike Bunch. The problem, Bunch said, is that the lithotripter hasn’t had a permanent home in the hospital.

“Currently, the lithotripsy machine is set up as needed in the operating rooms in the new portion of the hospital,” said Bunch. “This is not ideal, because the lithotripter machine has to be moved in and out of the OR rooms when it really needs to have a designated room.”

Bunch said the machine is also very heavy, bulky and sensitive, requiring careful calibrations.

The proposed space is in the older portion of the hospital. Bunch said the foundation will once again be helping out. He said the foundation board voted Jan. 18 to provide more than $91,000. Half that money will come directly found the foundation, the other half from 2010 Carolina Cup proceeds, said Bunch. The remaining nearly $36,000 will come from money left over from the lithotripter’s Jan. 2010 purchase.

A question was raised about the lithotripsy’s placement in the older portion of KershawHealth’s main campus, away from the main operating rooms. Bunch said that was why an adjacent room will also be renovated to serve as a post-litho procedure room. Another question was -- with OR staff in a different part of the hospital – would there be sufficient staff to assist with procedures.

“We have them,” said Vice President and Chief Nursing Officer Gloria Keeffe. “Right now, we’re having to put such cases at the end of the schedule. They’re finishing late -- 7 or 8 p.m.”

Keeffe indicated having a dedicated lithotripsy room should help alleviate that problem since patients, doctors and staff wouldn’t have to wait for a regular operating room to become available.

Mechanical work will be handled by low bidder McCrory Construction.

Financial challenges continue

November was a break-even month while December was “more complex,” according to Trustee and Finance Committee Chairman George Corbin.

For November, Corbin reported total net income at a slim $2,000. But that was compared to an expected net loss of $331,000 and a prior year net loss (Nov. 2009) of $94,000.

“We had a better month in November than budgeted or anticipated,” said Corbin.

While inpatient admissions were up 10 percent over those a year ago, most indicators were lower in December. Births were just below prior year and emergency department visits were down 12 percent. Corbin did note that Elgin outpatient visits were up 3 percent.

“Management feels people who are not going to the emergency room (at KershawHealth’s main campus) are going to Elgin,” Corbin said in response to a question.

After a short discussion over exactly when trustees should receive financial reports prior to a board meeting, Corbin moved on to December’s financial report.

“It’s not quite as bad as it looks, but volumes are all down significantly,” he said.

Most significant were a 20 percent drop in deliveries (births) at KershawHealth from December 2009 and a 21 percent drop in surgeries. Corbin said the surgery drop was due to a surgeon being on vacation most of the month.

KershawHealth President and CEO Donnie Weeks said the surgeon was an ear, nose and throat (ENT) specialist, but that a new ENT surgeon was coming on board. Weeks also gave a second, possible reason for the drop in surgery cases.

“With the economy … people are delaying elective surgeries,” Weeks said.

Although about a year out of date, Corbin also noted statistics from a financial “dashboard” the board has used to gauge KershawHealth against other hospitals. The dashboard is based on financial benchmarks used by bond rating companies such as Moody’s, Standard and Poor’s and Fitch. KershawHealth’s Fiscal Year 2011 to date statistics compared poorly to the national averages from calendar year 2009.

One half of the dashboard is dedicated to income statement markers, such as operating margins and personnel costs. Among those, only one KershawHealth statistic was better than average: average length of stay at 4.3 days, compared to Moody’s 2009 benchmark of 4.8 days.

The other half of the dashboard looks at balance sheet statistics such as the number of days of cash on hand, cash to debt ratios and debt to capitalization. KershawHealth fared better here with four out of seven markers from Dec. 31, 2010, beating the bond rating companies’ averages.

“We have a strong balance sheet,” said Corbin.

A little later in the meeting, Weeks addressed financial, especially Medicaid-related, challenges KershawHealth is still facing. He spoke first about South Carolina’s hospital tax. According to the S.C. Comptroller General’s website, “every hospital licensed as a general hospital by the S.C. Department of Health and Environmental Control is subject to the payment of an excise, license or privilege tax.” The tax is used to help pay for indigent care in South Carolina.

“The dilemma is that at the state level they are trying to draw down federal tax dollars and the challenge at the federal level, especially with Medicare, is that health care is a large percentage of the gross national product,” said Weeks. “That’s really a crisis for the hospital industry. It’s a challenge without many solutions.”

Weeks said the biggest challenges for KershawHealth will be:

• Medicare/Medicaid reimbursements;

* the need to have size and scale (to be able to offer services to citizens of Kershaw County) while reducing costs;

• to work with other providers while not giving up local control; and

• changing relationships with physicians.

“Some physicians are coming out of school who want to be employed rather than in private practice,” Weeks said.

In the recruitment arena, Weeks said Chairman Jody Brazell suggested the board be brought up to date on what specialties need to be recruited during the next five years. He said an update to KershawHealth’s Medical Staff Development Plan would be presented to the board in the near future.

Weeks also praised hospital staff for dealing with a Dec. 30 incident where a group of hunters was brought to the emergency department after being exposed to a chemical in Lee County.

“It was very well handled by this organization,” said Weeks, who noted that KershawHealth has held drills to deal with such situations. “It was very important to treat these patients and protect other patients from being contaminated. I very highly commend our employees.”

Weeks pointed out he was not actually in Camden -- or even South Carolina -- when the hunters, including a 9-year-old boy, were brought to the hospital.

“I was in touch and I told (staff), ‘I sure couldn’t handle an emergency without you, but you showed you can handle an emergency without me.’ That shows that we have a strong organization.”

Weeks also expressed thanks to law enforcement for helping to get staff, especially physicians and nurses, to and from KershawHealth facilities during this month’s snow storm.

“Law enforcement and the fire department -- they were incredible,” he said.

Weeks said some employees stayed overnight due to weather conditions.

The KershawHealth Board of Trustees meets on the fourth Monday of each month at 6:30 p.m. at the Health Resource Center on Battleship Road in Camden. The meeting is preceded by a meal at 6 p.m. All meetings are open to the public. 

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