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by Brenda Grose
Ringgold County Hospital’s board of trustees met Monday, August 16, with new CEO Joe Mangiameli, at the helm. No vaccine mandates for staff and operational changes under new leadership topped discussion for the regular monthly meeting.
After a brief conversation regarding mandating the COVID-19 vaccine for RCH and Mount Ayr Medical Clinic staff, board members unanimously voted not to mandate the vaccine at this time. Reasoning expressed by board members included the understanding that 25 percent of the staff are not vaccinated by choice, and it is their right to make that decision. Also raised was concern for potential liability from adverse reactions to the vaccine. Several board members shared that while they are not against the vaccine, they do not feel comfortable or that it is their right to force that decision for staff of RCH and MAMC.
In outlining transitional changes, Mangiameli stated his new operational plan will utilize seven pillars which include: relationships, standardization, technology, quality, service experience, growth and stewardship. Big focus beyond the operational plan will be developing a two-year strategic plan with two or three major initiatives each year. For his first year, Mangiameli will look to update technology and expand the visiting physicians clinic.
In the area of updating technology, Carrie Main, IT specialist, provided a detailed presentation and formal request to explore and review items presented. The update of technology would ideally look at moving from multiple vendors providing technology services to a single electronic health records system (EHR).
Historically, RCH began in 2010 looking at electronic health records systems in accordance with federal requirements and went live through incentives provided by federal funding. At the time, no single EHR system existed to provide complete “communication” between all systems. Given what was available, RCH selected multiple providers for needed technology, went through 3-6 years of a transition period, settled into an optimal working phase for years 2017-18 and in 2019 dropped into a lull phase with nothing new put out for staff or patients other than adding tele-health. Currently the system consists of three software providers – Paragon, Greenway and Papervision. Upgrades are either regulatory, functional or enhancements to existing systems. Current systems lack consumer integration as more consumers become active and fluent in technology and a single system option is now available. The idea would be to explore those available opportunities, to review systems and vendors and make the change at an approximate investment of $1 million over a period of seven years. Remaining with the current technology systems and making upgrades as needed would incur a similar cost over that same seven year period of time, placing the hospital now at a pivotal point. After discussion the board made a motion to form a committee to explore looking into moving to a new one EHR solution. Tessa Barnes will be the board representative on the committee.
In the area of expanding visiting clinic physicians, Mangiameli stated they would look to add specialists in branches of medicine not currently provided at the visiting physicians clinic at RCH. Mangiameli added RCH has available space to expand additional visiting clinic physicians services offered.
Mangiameli also touched on a 2017 code change for board of trustee terms. Populations under 400,000 are to have a four-year term for those serving on local boards. It was decided current board members for RCH with six-year terms will complete those terms and then board members will go to serving four-year terms.
On the financial side, CFO Missy Walter stated it will take some “catching up” on revenue in the months to come, after reviewing the first month of the new budget. Walter stated revenue in all areas was down $379,000 below budget with Dr. Homedan, visiting physician orthopedic surgeon, gone for the majority of the month making an impact. Fees and supplies were down as well, directly related to the lack of orthopedic services. Salaries and benefits, contract labor and contractuals were all under-budget. Depreciation trends were a bit higher than budget with the COVID money assets purchased not originally figured in. Walter said this variance could be expected to continue. Overall, a net loss of $256,00 over-budget was reported for July.
In miscellaneous items—
Amy Mobley, CNO, stated RCH is once again partnering with Southwestern Community College (SWCC) nursing school and new RN students will be arriving on September 7, with instructor Rena Cheers. Students will be doing their clinicals on Tuesdays and Wednesdays.
Dr. Scott Bland, D. O has arrived and is seeing patients and new physical therapy assistant, Hayley Wyatt will be joining the physical therapy department.