WAYNESBURG – On Jan. 31, when Southwest Regional Medical Center closed its Hematology and Oncology Center after three years, Cindy Cowie, SRMC’s chief executive officer, said, “We are at a pivotal crossroads with even more changes coming our way.”
Nine months later, those changes became a reality. Facing unprecedented challenges with reductions in payment from insurers and increases in bad debt, the hospital announced it was laying off 29 employees.
The employees were from different areas of the hospital, from nurses to cafeteria workers, but as part of the Service Employees International Union contract, the employees were given the opportunity to take a voluntary reduction through retirement or resignation and 14 chose this venue, reducing the impact of nonvoluntary layoffs to 15.
Cowie explained that in today’s healthcare environment, community hospitals, like SWMC, are revising their service offerings to focus on outpatient testing, emergency care services, wound care, home health care and scheduled surgical procedures.
In addition to the layoffs, the hospital also announced it would only be performing scheduled surgical procedures and that other regional providers would accept patients that need this level of care where onsite physician monitoring is provided around the clock.
Also, the current intensive care unit will transition to an Intermediate Care Unit, to allow for specialized treatment and monitoring of hospital patients.
Southwest Regional is also following a national trend by opening an outpatient observation area. This observation area will serve patients who (because of insurance standards) do not meet traditional admission criteria, but still need additional monitoring or testing within the hospital setting. While some outpatient observation patients still stay overnight in the hospital, the level of care provided is different than a traditional admission.
“Because of changes in reimbursement, hospitals across the country are adding observation areas,” Cowie said. “The medical and nursing staffs have created standardized processes for outpatient observation patients, which are based on their conditions. We expect this new process to create efficiencies and help us to survive the massive reimbursement cuts by insurance companies which have been made, while also providing greater consistency and outcomes for patients. This outpatient observation area will allow us to provide faster feedback and address patient needs more effectively.”
Conditions such as congestive heart failure, pneumonia and chronic obstructive pulmonary disease are sometimes classified as outpatient observation patients. All insurance companies require the use of observation status for patients who do not meet inpatient criteria.
The Affordable Care Act has led to reimbursement cuts at Southwest Regional equaling $3 million a year. “Changes in how patients are classified as observation versus admission is the biggest hit,” Cowie said. She also said the hospital gets penalized for someone who is readmitted within 30 days of being discharged, regardless of whether they followed their discharge plans, took their medications, followed up with their physician, etc.
Then, a month after these changes were announced, the hospital was served with a lawsuit from a former employee, alleging the hospital failed to provide adequate care, refused to report purported inadequacies and was terminated because she raised these matters.
Several weeks after the federal lawsuit was filed the Pennsylvania Department of health conducted an inspection and analysis of care provided, and according to the hospital, the DOH investigation revealed the allegations to have been misplaced and unwarranted. Nonetheless the hospital must still defend the suit in court.
But it’s not all doom and gloom for Southwest Regional. It was awarded a Redevelopment Assistance Capital Assistance Project grant in 2001 and is being used to:
• Paint and remodel all patient rooms, which are now all private. Rooms are also complete with Wi-Fi and new Isogel mattresses
• Enhance and redesign the emergency department and the nurse’s station.
• Upgrade the kitchen.
• Create new private post-surgical family recovery areas.
“We still have to move forward,” Cowie said. “We have a $19.2 million annual payroll, we employ 400 people and we pay a half a million dollars in taxes,” she said.
Dr. Jamie Boris, chief of medicine at the hospital, said, “Having the support and faith of our community is imperative to the future of Southwest Regional Medical Center.”