Samaritan budget probably will include rate increase

MOSES LAKE - Samaritan Healthcare patients probably will see a rate increase in 2015.

Hospital CEO Tom Thompson said what he called "competitive rate increases" will be part of the discussion of the 2015 budget. He didn't elaborate, saying that will be part of future budget reviews. Thompson talked briefly about the budget during the hospital board's last meeting.

Thompson said the budget proposal will include capital projections, for possible remodeling and refurbishment.

Thompson said he expects current trends in payer mix to continue, with relatively high numbers of Medicare and Medicaid patients. Medicare and Medicaid reimbursement is relatively low, sometimes less than the cost of service. With that in mind, the hospital and Samaritan Clinic will have to find ways to save money and use their resources effectively, he said.

In other business, board members discussed specific practices that, according to hospital officials, provide a look at the facility's general health.

In January, hospital officials chose specific activities within the hospital to evaluate each month and report to the board. Some are evaluated as part of the hospital's Medicare and Medicaid reimbursement process.

They include the number of Medicare patients who live in extended care facilities who have been treated at the hospital and are readmitted within 30 days, called the readmission rate. Hospital officials also evaluate the number of people transferred to other hospitals. The time it takes to give an electrocardiogram (EKG) to a patient who comes into the emergency room and might be having a heart attack also is being monitored.

The hospital is trying to get the average time to 10 minutes or less, Thompson said. In September the median time was nine minutes, Director of Nursing Kathryn Trumball said. But it's not happening for all patients.

The ER staff is working to ensure there's a medical professional (a doctor, nurse or nurse practitioner being examples) who can do the test in a timely manner, rather than waiting for staff from the radiology department. In answer to a question from board member Alan White, Trumball said instructions to the ER staff take into account the different symptoms between men and women.

Dr. Jill Dudek-Bross, chief of the medical staff, said not all patients who are having a heart attack know it when they come to the ER. Sometimes it takes a while for the fact of a heart attack to be clear, she said, and that has an effect.

Trumball said the Medicare readmission rate is improving, with more emphasis on following up with patients after they're discharged. One of the lessons is that everybody involved in the care of the patient, doctors, nurses and pharmacists, must be involved in the process, she said. The hospital staff is working to ensure follow up appointments are made, and instructions from primary physicians are included, she said.

Dr. Jim Irwin, the chief medical officer, reported on the patient transfer rates, which were much higher than average in May. They've been dropping since, Irwin said. Part of the problem was a lack of nurses to take care of patients, but that's been remedied, he said. Additional orthopedic physicians have been hired; a lack of orthopedic treatment options was adding to the problem, he said.

Most of the patients being transferred in September were transferred because the treatment they needed wasn't available in Moses Lake, Irwin said. Either they were so sick they needed advanced treatment, or they needed specialized care that's not available here, he said.