[Editor's Note: This is part 8 of a multi-article series on the Grant County Commission work session of June 8, 2021, and regular meeting on June 10, 2021. This article reports on the GRMC monthly update at the June 10, 2021 meeting.]

By Mary Alice Murphy

At the regular meeting on June 10, 2021, Grant County commissioners heard the monthly update from the Gila Regional Medical Center.

At the invitation of District 1 Commissioner and Chair Chris Ponce, Interim Chief Executive Officer Scott Manis read from a letter to the editor that he had written to the Silver City Daily Press. "It was a reflection back on the Governing Board meeting of May 27, 2021."

He noted that almost two weeks after the Governing Board meeting of May 27 "there had been no report on the news we presented. We were excited to report the tremendous progress the hospital has made over the past year. Here are a few highlights in case you missed them: GRMC reported an over $11 million improvement year-to-date compared to the prior year. GRMC also reported a profit of just over $200,000 on a year-to-date fiscal-year basis. While we may not finish the year in the black, this is tremendous progress over the prior year, particularly since we had lower outpatient volumes and emergency room visits due to Covid-related issues. In addition, we announced our new collaboration with Hidalgo Medical Services to provide a cardiology clinic in Lordsburg. Dr. Ratliff is on fire about the opportunity."

In his letter, Manis also expressed how the hospital will continue to make progress. "We continue with a 4-Star Quality rating from CMS (Centers for Medicare and Medicaid Services). We are one of only two within 100 miles and one of eight of 68 hospitals within 200 miles. I wish the Silver City Daily Press would be supportive of its community hospital rather than focusing on negative news. There is certainly a lot of work ahead, but GRMC is a vital community resource that values the support of the community and of the people we serve. If we didn't have the hospital here, there would be fewer people, and you would have a lower readership. Finally, we want to sincerely thank the staff for their work on these improvements over the past year. There will be continuous challenges, but we look forward to what GRMC will look like in the coming year." He said that was the substance of the letter.

"I want to add that the improvements we've made are sustainable," Manis continued. "We have made concrete improvements that won't slip backward. We have taken actions that could have been done in the past but weren't."

He announced the job fair [which took place yesterday at the Grant County Veterans Memorial Business and Conference Center]. It had job openings ranging from entry level to professional jobs. He also said a recent blood drive held at the hospital had every appointment slot filled and actually had to cancel some appointments.

District 5 Commissioner Harry Browne commended Manis for sending the letter. "Holding the Press accountable is as important as the Press holding us accountable."

District 3 Commissioner Alicia Edwards noted that the last paragraph thanking staff members was omitted in the Daily Press print publication of the letter.

District 4 Commissioner Billy Billings said that the Daily Press has been admonished by the GRMC chief of staff, by the chief medical officer and now the chief executive officer. "I guess I would kindly ask the Daily Press to be a community partner, instead of as they may see themselves, as the attack dog. I know that there's a riff between the publisher and the editor and some of the governing board members, maybe all of us. But I ask Mr. Seibel to look beyond that. Invite them to publish the good that's going on. They need to realize that the people deserve the good news, instead of just trying to hold us accountable. I wanted to publicly thank you. Perhaps we can bring the Daily Press in as a partner and bring GRMC into a different light in the community and get the good news out."

"We are committed to having a positive relationship with all members of the press, and I echo your comments and look forward to having that," Manis said.

Ponce said he asked Manis to read the letter, because "we're always talking about community, about economic development and jobs, about health care. GRMC is a vital part of the community. It's not just about us, Grant County, it's about Luna, Hidalgo and Catron counties, because they depend on the services. We still have work to do, but we do this for the community. I ask the community to support Gila Regional. Many people can't afford to travel to Las Cruces or Albuquerque."

District 2 Commissioner Javier "Harvey" Salas also thanked Manis for the letter to the editor. "Sometimes, it's best to ignore a bully, but in this case, it's probably good to confront him. I don't know how many people realize the hospital was within days of closing its doors. We're talking about an employer that has as many employees as Tyrone. We see it as that aspect. It allows people to get care here. It's such a vital piece. I want all the people to know how important to Grant County the hospital is. I think it's being shown in the people that are going back to the hospital. We really want to thank you and HealthTechS3 for saving our hospital."

To continue his report, Manis said: "We are doing well. I hear in the community that a person may not want to work there, because they might not get paid, because we were so close to that last year. Without federal funding, we would have closed, but now we have 63-65 days of cash on hand. When I go to work in the morning, I'm not worried about whether we will make payroll. I've been in that situation in hospitals, and it's no fun. We're so far past that, we are in a stable situation, and we're prepared to grow."

Interim Chief Financial Officer Greg Brickner said he would be showing April's numbers. "We're crunching numbers for May and will present that to the governing board at the next meeting. Our recent volume trends are ever so close to pre-Covid levels, except for the discharge numbers, because of the closure of the behavioral health unit. We are still behind last year, but we have risen in the financial strength index from last years negative 8.9. We're still negative, but at negative 1.8, we've risen quite a lot. April was a good month. We are $3.8 million better in EBIDA (earnings before interest, depreciation and amortization) from last year at this time. We are also $200,000 in the black for the fiscal year, which is $11.1 million better than the prior year."

He said he has been asked by members of the community about the effectiveness of the hospital's revenue cycle. "It's all the way from making an appointment for an outpatient procedure, you walk into the ED (emergency department), to checking in, to having a procedure, to being discharged, all the way to getting the bill. When you look at all the work going on, it's a challenge. A colleague said: 'We are making rapid, incremental improvement,' and that's exactly what it is. We're making tweaks and fixing things. In January when I got here, it was difficult to get an appointment. We've fixed that. It's not perfect, but we're getting there. All our volumes are down across the board, but our net patient revenue is off only 1 percent. You can't have all that volume decline and be off by only 1 percent if we're not making rapid, incremental improvement. The critical access hospital designation gave us a big lift; the setting up of the rural health clinic designation will help; we're starting trauma billing. Every one of these is a big project. We've taken them all on. My team is phenomenal, and it shows in the numbers."

Edwards said: "To you and your team, I think what you're doing is great. I hear from people: 'what are they doing? why isn't it fixed yet?' What I try to explain is that the revenue cycle is incredibly complex, because it's from credentialing of doctors and insurance and from the door to the bill. In reality, the progress you're making is phenomenal. We as the community should be doing a better job thanking the staff for what they have been doing under what may be less than ideal conditions. We're getting to the root cause so that we can be sustainable."

Brickner said that part of the complexity is: "We don't ever shut down. I struggle to find another industry that never shuts down. Retooling has to be incremental, because we can't do it by closing down. Even nuclear plants shut down to retool, but we're working on the engine as the car is going down the road. It's not a just flip the switch and it's done."

Billings thanked Brickner for his clear explanations and "for the confidence you inspire in the staff at GRMC. Thank you for hanging in. I hope the staff understands and sees how things are getting better. We thank them and you."

The next article will start with elected official reports and will dive into the regular meeting agenda.