Hospital reaching out

Reaching out to the community to provide more than simply emergency medical care is the growing plan for Abbeville General Hospital.

Ray Landry has been the hospital administrator for the past 15 years and began a lunch meeting last week by explaining how the hospital serves the community and plans to continue and expand it’s health coverage in Vermilion Parish.

Landry said, “Over the past three to four years, we’ve implemented an advisory board where we invite recommended citizens to sit in on a luncheon meeting to hear just what the hospital does in regard to the people we serve. The hospital is actually owned and operated by the Vermilion Parish Police Jury.”

“There are also seven members of the hospital board of directors that are Police Jury appointed for six year terms,” Landry said. “These are business men in our area, bankers, financial advisors and from the agricultural sector.”

As with any business, knowing where the money comes from is an important part of running the hospital. He showed the percentage of revenue breakdowns for the years 2006 and 2007 as:

Revenue 2006 2007

Medicare 49.3% 50.8%

Insurance 18.2% 18.6%

Medicaid 17.5% 16.1%

Self Pay 15.0% 14.5%

The hospital has begun a program of moving out into the parish with their rural health facilities with two locations already operating near capacity, according to Landry. “There’s the clinic right behind the hospital where we just added a second psychiatrist on staff to help with the increased need for counseling. And the Maurice clinic is just as busy.”

He commented that adding additional staff to the clinics has much the same problems as staffing the hospital where the volume of medical assistance can never be predicted. Eventually, we would like to be able to have the clinics open into the early evening and Saturday hours.”

“Future plans also include a clinic in Erath to serve the eastern section of the parish as well,” continued Landry. “We’re about to retire our debt with only two more payments remaining to make, but, at the same time, we’re always looking for grant money that’s available to help improve the hospital and the equipment we need to provide the expected level of care.”

According to hospital records, the biggest demand on the hospital happens through the doors to the Emergency Room.

Figures from 2007 show 12,760 patients were seen through the ER department, “and each patient comes in believing that their case is an emergency,” said Landry. “And we have to view their treatment from their perspective. However, we cannot predict when a crunch will ever hit and that’s what causes the backlog in the ER room sometimes. Unfortunately, we don’t have the (financial) resources to staff ER with additional doctors around the clock, but we are looking at bringing in additional mid-level practitioners that will be able to take some of the load off the doctor on duty.”

“One areas of the hospital that has been in constant demand is the psychiatric ward. In 2007, we had 528 patients treated in the hospital and another 1,900 through out-patient services. The psychology department opened in 1994 and almost always operates on a filled capacity. However, there is a difference in patients if they need help with substance abuse. We can treat them for substance until they’re stable and can be taken elsewhere for counseling services, but we can’t operate as a substance abuse facility.”

Landry also explained that the hospital operates with 60 licensed beds, broken down into 33 medical/surgical, five obstetric beds, 16 psychiatric beds and six intensive care beds. In the coming months, an outside medical provider is planning to utilize a section of the third floor to establish a Long Term Acute Care (LTAC) Unit. They will be operating in the hospital, but handling their own staffing resources and billing procedures.

Troy Hair is the Chief Financial Officer for Abbeville General Hospital. He explained that “managing the funding for the hospital is a challenge with so much of the funding coming from reimbursements. The majority of our money comes from Medicare and Medicaid patients and while the patients need the medical help now, the hospital doesn’t get reimbursed until almost 18 months after the service has been provided. In 2007, Medicare/Medicaid reimbursed the hospital $4.8 million; for this year, we’re anticipating reimbursement of about $5.2 million.

Hair also talked about AGH as being a safety net for the Charity Hospital system run by the state. “The rural hospitals help to take the load off the four major charity hospitals in the state and then reimburse us for the patients we treat. However, we have to wait for the annual legislative session to have the dollar amount introduced to be paid and then to be voted on by the legislature.:

Nursing Supervisor Denise Noel explained that the hospital is working with the Gulf Area Technical College to help teach and train future employees. “We’ve been very fortunate to not have been hit with the staffing problems that some of the larger hospitals are facing.”

Abbeville General is facing a change in its financial structure as well. With the remaining $1.5 million loan on the hospital ending after two more payments, it will no longer be included in the annual millage included through property taxes.

And, while it will no longer will have the loan note to pay, it will also not have the income that could have been used to purchase additional equipment or to provide other services.

“Finances are a big struggle,” said Hair, “especially when you look at the unaudited section that shows we had almost a $1.5 million deficit for 2007.”

When the hospital’s 2008 Planning Objectives are considered, finances are included in four of the top eight areas under consideration.

“Whether or not we approach the community for any additional tax issues will have to be determined by the board of directors,” said Landry. “Right now, planned capital improvements include $600,000 for Electronic Medical Records, $325,000 for Nuclear Medicine, $300,000 for an expanded X-ray room and $56,000 for replacing the carpeting.”

The state legislature approved House Bill 77 that provides for the creation of Hospital Sales Tax District #2 that may levy and collect a sales and use tax not to exceed one half cent within the sales tax district for the purpose of building maintenance and emergency room operations. This bill became Act No. 88 when Gov. Mike Foster signed it into law. A possible proposed local tax is projected at an annual yield of $1.5 million.

“Our business is like any other. If we have a problem, then we’d like to know about it first hand and at the earliest opportunity so we can correct the problem,” commented Landry. “That way, we can make sure employees are trained properly and reprimanded if necessary.”

The hospital also has a web site at http://www.abgen.net. The information online includes services available, a listing of the doctors on staff and the fields they practice to verify patient insurance procedures.

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