[Editor's Note: This is part 2 of a multi-part series of articles on the work session and regular meeting of the commissioners on March 9 and 11, 2021. This author had planned to start the review of the work session with this article but plans to do so with part 3 or 4 or 5. Two long meetings require many shorter articles.]

By Mary Alice Murphy

At the Grant County Commission regular meeting on March 11, 2021, Gila Regional Medical Center gave its monthly report. Interim Chief Financial Officer Greg Brickner gave the key metrics for the month of January.

"Our volume shows flat trends," Brickner said. "We were 336 patients below budget for the Emergency Department. Year-to-date we are 10 percent down on visits to the hospital. We have a 1.32 case mix index, 54 days cash on hand and an average length of stay of 2.9 days is actually very good."

To a question about what the case mix index is, Brickner said it is a measure of how sick the patients are. "In rural hospitals, 1.32 is very good. At a larger hospital where they are doing things like brain surgery, it might be a 2 or a 3. The case mix is an indicator of reimbursement. We get paid more for sicker patients."

District 3 Commissioner Alicia Edwards asked if it could be an indication of the health of the community.

Brickner said: "Not really. We still have complicated cases in the community that because of the specialties of this hospital, they are likely being transferred somewhere else for care."

District 2 Commissioner Javier Salas asked what a daily spend at the hospital is.

Brickner said it is how much the hospital spends on average a day, but he didn't have the number and didn't want to guess wrong and said he would get back to Salas with the answer.

Edwards also asked why the hospital looks at EBIDA (earnings before interest, depreciation and amortization).

Brickner said for the month of January the hospital was behind in EBIDA, which was a result of timing. "We were conservative in the budget and delayed it until January, but special programs happened in December, which was kind of a good thing. But we're still behind budget year-to-date by about $375,000. EBIDA is a measurement of the operation of the hospital regardless of who owns it because of the capital structure. So, you can compare hospitals regardless of ownership or how they are operated based on EBIDA, because it's a common metric. We're still ahead in revenue year-to-date, versus plan."

With no other questions, Interim Chief Executive Officer Scott Landrum presented his report. "We'd like to reiterate what happened at our last board meeting for the public. But first, one of the things we hear a lot from the public that I want to clear the air on is about why our helicopter is so busy. It is not because we are transferring patients. The helicopter is based at the hospital and one of its functions is to transfer people, but sometimes, it leaves the hospital empty. We have questions about if we're transferring everyone out. Absolutely not. And we're also asked if now that we are a critical access, we are not doing as much at the hospital. Absolutely not. We are doing pretty much the same amount of business as before, given the effects of COVID. I've often said: 'Gila is a critical access hospital on steroids.' Cardiac cases can be seen here by our cardiologist, but those needing intervention, such as a stent, are shipped out. Neurological damage is sent out to Albuquerque or possibly El Paso. We only send out those that we cannot treat. The residents of Silver City are very lucky. They have a hospital that is close and ready to take care of them."

He then gave an overview of the last Governing Board meeting, which met on February 25, 2021. The article can be read at https://www.grantcountybeat.com/news/news-articles/63423-grmc-governing-board-held-meeting-022521

Landrum noted that the meeting usually has an executive session soon after the beginning of the meeting. "That's where the board members hear from the Chief Nursing Officer, who also later gives a public report, as well as the Chief of Staff and the Compliance Officer. The report to the board will also have a legal report and a liaison report. We will be adding a personnel report on the areas of recruiting and certain things the board has to approve in the later public meeting, which includes amendments to physician agreements and such things as an agreement with the mobile PET Scan that periodically comes to the hospital. The board approves credentialing of physicians per the HealthTechS3 recommendations. I have the ability to approve expenditures up to $50,000 and the CFO can approve up to $25,000. Anything larger has to come before the board."

He said the hospital is seeking a lot of positions and they are posted on the website at grmc.org. "The list is reviewed every day. Our organizational chart changes regularly, almost daily, because we have enough turnover and enough changes that we have to keep it up-to-date. We still have COVID so there are only two entrances open to the hospital, the emergency entrance and the one to the surgery center and canter center. We are allowing a little bit of visitation, especially for those who need help in the hospital. (Chief Nursing Officer) Kelly (Rodriguez) and I round at least once a week. We are paying attention to areas that need upgrading. Med Surg II still has carpeting and hospitals have been moving away from that. Although it muffles the noise, it also traps bacteria, so we're taking out a section at a time. It's happening in Med Surg II right now. We are very close to being able to take care of Veterans' Administration patients. We had to reapply, and now we're waiting for as much as 20 days before we are able to treat veterans. We had one yesterday that needed treatment and we're making phone calls trying to get it started."

On the Cancer Center provider, because the contract is about to expire, Landrum said: "I think we will continue on a year-to-year basis with the UNM Cancer Center, but we have made some requests, we have some requirements on our current provider that need to be changed, related to better patient care. To do our due diligence, we thought it only appropriate to look at both the former and current providers. I had a long conversation with Dr. Barbara McAneny of the New Mexico Hematology and Cancer Center, who was the original provider of cancer care at Gila Regional. We have asked for an RFI (a request for information). Three years, ago, the then-board of trustees chose to change to the University of New Mexico Comprehensive Cancer Center also in Albuquerque as the provider of care here."

"As the CEO, I spend a lot of time with medical staff," Landrum said. "This morning I participated in the Medical Executive Committee meeting, and the night before with the Peer Review Committee. The medical staff is very involved in everything we do at the hospital. I did a state of the hospital report to the MEC. We have decided we will bring the Chief of Staff onto the governing board as an ex officio, non-voting member. Physicians are our patients, too. We take care of them, so they can bring their patients to us to take care of."

He concluded his report to no questions.

The next article will likely (it could change) address the rest of the county reports that were given at the regular meeting, and perhaps the public input heard on issues on the agenda.

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