Valley Beat December 2013 - EvergreenHealth Monroe Foundation

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A Message from Eric Jensen, CEO Financial Turnaround Update Previously I reported to you that Valley General was surprised in late summer by a large unexpected repayment liability to the State of Washington. We have been able to negotiate a repayment plan with the State of Washington that requires us to repay only 50% of our 2012 liability of $850,000 in 2014 with the balance in 2015. We continue to look closely at our operations and last month needed to make additional FTE reductions of about 10 FTEs. We are also working hard on the revenue cycle, through several special projects. We have had several temporary staff here this past three months working on collecting on our self pay accounts. We recently had a charge audit that identified significant opportunities to improve our charging and therefore revenue in the ED and we have hired consultants to work through our denied claims for opportunities to re‐bill. I am also pleased to report that Valley General received over $1 million in Meaningful Use dollars from Medicare in November for EMR implementation work, and expects to receive an additional $400,000 from Medicaid this month. Fairfax Behavioral Health We are in the process of negotiating a letter of intent with Fairfax Behavioral Health to lease most of our “F” Wing to them for a 34‐
bed inpatient psych unit. They do require Certificate‐of‐Need approval from the State in order to do this and that process will take until early summer. As part of this deal they would buy a number of services from us including: housekeeping; meal service; pharmacy; laboratory and imaging. Their utilization of ancillaries is not likely to be very high as a psych provider. They will also need hospitalist coverage of some type for H&Ps and consults on their patients. We anticipate that lease payments will bring in over $500,000 annually for Valley General beginning mid‐year. Physician Update Dr. William Andre Silva will begin office hours weekly beginning in January in our second floor clinic space. He is a uro‐gynecologist December 2013
who is practicing here as well as in Arlington and Mount Vernon. He intends to perform surgery here. Dr. John Beck, a Proliance hand surgeon, recently began seeing patients out of Dr. Swenson’s office one day a week. He recently received hospital privileges here at Valley, and also intends to perform surgery on Monroe patients here at Valley. I am also pleased to report that Dr. Suzanne Hopkins is now employed by the Evergreen Medical Group here in Monroe. Evergreen plans to add another practitioner or two to her office. They are expected to start providing pre‐natal care again and will be on‐call for the hospital ED. Once they are on‐call we will be able to re‐start the Chemically‐Using Pregnant (CUP) women’s service at the Recovery Center. Affiliation Update Discussions are well underway regarding the next stage of our affiliation with EvergreenHealth. We are anticipating working through the structural options for that next stage over the next several months. I anticipate that Valley General’s Board will be presented with a recommendation for action as early as March 2014. Year‐end Thoughts Thank you to all of the employees, physicians and volunteers for everything you have done this year to provide excellent patient care and services to our community. It has been a very difficult year and every employee has contributed in some way (low census, unpaid furlough days, FTE reductions, restructures, etc.) to help Valley be a successful organization. Although there are still many obstacles to overcome, with our continued efforts, VGH will become the hospital of choice for our community. Wishing you
& your family
Happy
Holidays and
a happy,
healthy 2014!
Holiday Cheer
VGH Foundation Open House The VGH Foundation hosted an Open House Event December 3rd in honor of the levy volunteers and supporters. Barbara Todd, Foundation Executive Director, and Eric Jensen thanked the community and local business for their support of the hospital during the recent levy campaign. Dr. Strub’s quartette, Under the Radar, provided a spark of musical entertainment.
It’s beginning to feel a lot like the holidays around VGH! Dianne & Richard Forth generously donated a beautiful 9 foot artificial tree for the front lobby. Our equally generous medical staff provided the funding for the decorations on the tree, as well as the lighting in the Healing Garden and in the front entry of the hospital. Barbara Todd and Janie Botting selected the tree decorations and decorated the tree. They did a wonderful job creating a warm, elegant, cheerful holiday welcoming to the front lobby for staff, patients, and visitors to enjoy. Not to be a Scrooge …. but ….. Please remember that the hospital has to adhere to many regulatory and legal requirements regarding just about everything that occurs within the facility. These requirements are to protect the safety and wellbeing of you and our patients. With all good intentions, some unapproved decorations have been used in decorating work areas. We appreciate you wanting to add color and cheer to your work environment; however, this has to be done in a safe and legal manner. VGH Policy 5.3.6 “Holiday Decorations and Fire Procedure” defines the do’s and don’ts of decorating. Please refer to that policy when selecting any decorations, and when selecting where or how to display those decorations. Roof Top Air Handling Unit Replacement of the RTU‐1 (“roof top unit”) air handling unit occurred on November 17th. RTU‐1 is a 105 ton HVAC unit (heating / ventilation / air conditioning) that was lifted onto the roof using 130 ton Trane crane. The unit supplies air for Surgery, CCU, ACU, OB, and the second floor where the Oncology and Pediatric offices are. The new unit will provide 100% coding redundancy and increased energy savings. 2013 VGH Holiday Celebrations The traditional VGH week‐long holiday celebration this year included decorating holiday cut‐out shapes; candy grams; hot cider / cocoa; and an ugly sweater day. The highlight of the week was the banquet, which was funded by the VGH medical staff this year. As always, our Dietary staff outdid themselves! The Senior Leadership Team did an excellent job of carving and serving us as we ventured through the line of temptation. A huge “thank you” to all that worked so hard to coordinate the event and put on a splendid gathering! ValleyBeat is intended to be a newsletter that provides VGH staff (you!) with information and updates. We would like to hear what information you would like to read more about, or what topics you would like to see in the ValleyBeat. We may not be able to provide everything that’s asked for, or may feel the ValleyBeat is not the best venue for the information suggested, but every request will be considered and responded to. Send an email to Norma Walker or write your suggestion and leave it in her mailbox. New Emergency Signage Have you seen the new, bigger, brighter sign in the Emergency parking lot? A new emergency entrance sign is something VGH has needed for a long time; especially since the PUD removed the trees. The sign has an optical sensor that will cause the sign to illuminate when it gets dark outside – no matter if it’s a dark, rainy NW day or the middle of the night. A big thanks to Damien Fannin, Plant Operations Manager, for his persistence in accomplishing this project. As sometimes happens, this project had more than it’s share of difficulties and set‐backs. Did You Know?
Documentation Impact of ICD‐10 By Zach Gongaware If a patient were to arrive today with a fractured femur, he or she would receive a diagnosis from one of our physicians, which in turn would be translated into an ICD‐9 diagnosis code. Within that code is valuable information that helps our staff coordinate and document that patient’s care. Once their treatment is completed, that code assists our coding and billing staff interpret that care into a summation of the services that were provided. This allows the hospital and our physicians to be compensated by the patient’s insurance provider. Likewise, all that documentation must support the use of that diagnosis code in order for the provider to accept the claim. One year from now, all that will be the same. However, the diagnosis code will require a level of specificity that far exceeds what is needed now. Using the example of a fractured femur, there are 16 possible ICD‐9 diagnosis codes that might be assigned to the patient. Under ICD‐10, that number explodes to 1,530 possible codes. ICD‐10 codes factor in etymology, laterality, treatment stage, and many other details that typically are not captured by ICD‐9. ICD‐9 16 Possible Codes for Femur Fractures 82111 – Open fracture of shaft of femur ICD‐10 1,530 Possible Codes for Femur Fractures S72351C – Displaced comminuted fracture of shaft of right femur, initial encounter for open fracture type IIIA, IIIB, or IIIC This means that while all the treatment of a patient may remain as it is today, the documentation of that treatment must be expanded to adequately support the diagnosis assigned to that patient. In the upcoming year, this must be an increased focus of our care providers and the staff that support them. By improving our documentation habits, we not only prepare ourselves for the advent of ICD‐10; we set our entire organization up for success by increasing clarity and reducing risk throughout the patient’s care process. Do you have questions about ICD‐10, and what it means to you? Please do not hesitate to contact me or any member of our ICD‐10 team. Did you know????
After eating too much, your hearing is less sharp. If you’re heading to a concert or a musical after a big meal, you may be doing yourself a disservice. Try eating a smaller meal if you need to keep your hearing pitch perfect. VGH Board of Commissioners Since the creation of Public Hospital District No. 1 of Snohomish County in May 1960, there has been a three‐member Board of Commissioners. Discussions have occurred several times since then on whether or not it would be advantageous to expand the number of Commissioners to five. For the residents of our District, having a five member Board provides for a wider range of experience and background, and it also provides for broader representation of the residents of our District. For the hospital, it allows two commissioners to participate in committees or meetings without creating a legal meeting. In the past, if two Commissioners were to be in the same room at the same time discussing hospital business, that created a quorum (majority). Having a quorum is only legal if the meeting is a regular or special meeting of the Board of Commissioners. This year, the Board of Commissioners decided it was time to expand to a five‐member Board, and passed a resolution placing a proposition on the ballot this past November to create a five‐member board. That proposition passed easily. The Board must now appoint two new members to serve until the next commissioner election date. The Board is now interviewing members of our community who have expressed an interest in becoming board members. The Board of Commissioners is expected to appoint two new commissioners in January. At the same time, one of our current commissioners, Neil Watkins, elected not to run for re‐election at the end of his term (December 31, 2013). We were fortunate to have a community member that was interested in filling the vacated position. Tony Balk, who was one of our devoted levy supporters, ran for election in November. His election was successful. Tony will be sworn into office in mid‐January. In short that means we will have a five‐member Board of Commissioners starting January 2014; and that three of the five will be first time VGH Commissioners. Have you ever wanted to explain a process that you do so that
others could understand your job better? Is there a process that you have always wondered about? Why or how something is done? Are there changes in the way your job will be done because of regulation changes or any other changes that might interest people? Send me an email if you have ideas or questions that would be good candidates for this section. The more each of us understands about our VGH world, the better co‐worker we can be. Norma Walker
VGH FOUNDATION ANNUAL EMPLOYEE SHARING CAMPAIGN The Foundation’s Annual Employee Sharing Campaign begins in January. Look for more information in your paycheck and plan to "PARTNER FOR SUCCESS 2014". This past year the Foundation purchased the new Communication Boards now in every patient's room. The Communication Boards allow for improved communication between the patient and medical staff, the patient and family members and family members and medical staff. Also, we recently purchased much needed new Surgical Helmets for our surgical staff. The Helmets provide a more sterile environment for both the medical staff and the patients, and have already been used in recent surgeries and are greatly appreciated. Lastly, for those who may not know, our annual projects include:  Cancer Patient Comfort program providing snacks and juices for the cancer patients during treatment;  Chaplain Services ‐ counseling patients when needed, leading Grief and Loss classes and assisting as needed in the Recovery Center;  Scholarship Awards to Employees and High School Students majoring in the Healthcare Field. The High School Scholarships are offered to each high school in our hospital district. For more information about the services of the Foundation, please email Barbara Todd at [email protected] or call me at 360.805.9446 Thank you to all those who supported us this past year. Your handprint is on each project we complete. We hope to double our support next year so please think about joining us. WELCOME TO THE VGH FAMILY! Please welcome these new management staff members: MaLisa Westlund Chief Financial Officer MaLisa joined Administration and the Senior Leadership Team on September 30. MaLisa brings with her more than twenty years of experience in healthcare operations. In addition to having a strong financial background, MaLisa also has extensive experience and knowledge in the revenue cycle and IT implementations. Dustin Greer Controller Dustin joined the Accounting department on November 18. Previously Dustin was a financial analyst at both Providence Health & Services, and Overlake Hospital. In addition to his expertise in hospital accounting, Dustin brings strong budgeting skills, long range planning experience, and a wide range of software skills. Scott Crader Information Technology Director Scott joined the Information Technology department on December 16. Scott comes to us from Providence Health & Services in Portland. Scott has an MBA and graduate certificate in Biomedical Informatics. Scott has also earned both RHIA and CPHIMS credentials. Shelly Simpson Quality Manager Give the gift of memories! As a VGH employee, you are eligible for discounted tickets / reservations to the following events and entertainment. One of these might make a perfect holiday gift for your loved ones!  Great Wolf Lodge (10% off best available rates)  Disney Junior Live on Tour: Pirate and Princess Adventure at Comcast Arena on Sunday, January 19th (up to $8.00 off per ticket)  X‐TREME International Ice Racing at Comcast Arena on Tuesday, February 7th (up to $5.00 off per ticket)  The Original Harlem Globetrotters at Comcast Arena on Sunday, February 16th (up to $7.00 off per ticket)  Celtic Woman: The Emerald Tour at Comcast Arena on Tuesday, March 25th (up to $6.50 off per ticket) Contact Human Resources for details. Shelly has worked in the Emergency Department since October 2010. She will begin her new position in the Quality Department on December 30. Shelly will be responsible for overseeing our performance improvement program, core measure abstraction and monitoring our goals and achievements. Happy December VGH Anniversaries to:
Linda Melnick Patty Johnson Debbie Jacobson Norma Mencias Diana Gregory Jayson Stotts Kathy Bean Jim Knight Karen Jenkins Kristina Ahles Laboratory ACU Dietary Mammo Housekeeping CT Dietician ER CT MSTU 37 26 21 14 11 10 9 9 8 8 Kristy Ford Lisa Miller Nancy Steele Robin Stake Mike Gillett Jessica Garbutt Elvira Castaneda Mark Reierson Corina Vickers Jennifer Jungmann ACU ER CT UR Surgery Recovery MSTU Recovery Surgery MSTU 8 8 8 8 8 7 6 6 6 5 Brian Franz Sharon Patterson Julie Studley Jaqueline Davison Faith Lykken Charles Njenga Joanna Wied Doug Clevenger Kami Leidholm ER OT Radiology MSTU ER MSTU ER Imaging Imaging 4 4 3 3 3 2 2 1 1