Members of the Mississippi County Quorum Court and a standing room only crowd heard a proposal Tuesday night from Ben Bloom of Affinity Healthcare, Inc. of Springfield, Mo., the firm that would manage South Mississippi County Regional Medical Center if the court transfers operations to the City of Osceola.
Osceola Mayor Dickie Kennemore told the court that the hospital's current manager, QHR, is cutting services at SMC without notifying physicians or staff. "The staff was told that they would be consulted before any cuts were made. They were not," Kennemore said.
QHR has suggested that emergency room physicians at SMC be cut in an effort to save money and instead staff the ER with nurse practitioners. While the nurses do a great job, Kennemore said, "We don't need to cut doctors."
The practice not only harms the general population that is served by SMC, but also the many industries located in and near Osceola that consider a fully-functioning hospital as a requirement for location of an industry in the area.
"One plant manager said (if the cuts continue) it would harm our industries," Kennemore said.
Kennemore went on to say that the county has already put more than $6.5 million into the hospital system and continues to pay QHR $135,000 per month to manage the facilities. If the county cut those payments to QHR, it would save more than $1.6 million a year.
Ben Bloom of Affinity Health Care, Inc., presented a proposal that would include an infusion of $2.2 million from the City of Osceola up front.
Bloom and Kerry Nobles, a native of Mississippi County who now serves as CEO of Pemiscot Memorial Health Systems in Hayti, Mo., explained the proposal.
SMC is currently operating at an annual deficit of $1.1 million with an average daily census of nine patients a day. Based upson their calculations,the addition of one patient per day in each category, or increasing the ADC to 12 patients a day, could result in more than $1.183 million additional dollars per year for the facility.
If the facility is transferred to the City of Osceola, the city will assume all financial risks. The transfer has received the unanimous support of all seven local physicians who have pledged to work with the city to ensure continued access to local medical care.
The transfer would also remove conflicts between the two county hospitals.
Under the agreement, Affinity promises to achieve a monthly break-even of cash flow within 90 days, Nobles said.
Payment for their services will be those earned through direct costs, not a monthly management fee, Nobles said. "We would not earn a dime above those pass-through fees until we are making a profit," Nobles said. And once that point is achieved, he estimated the additional funds would cost less than half of those now being paid to QHR for management fees.
Justice Michael White asked Bloom and Nobles about SMC's Critical Access Status, which means the facility gets reimbursed 101 percent of costs from Medicare and 100 percent of costs from Medicaid.
Bloom said that he "had it in writing" that the transfer of the hospital to Osceola's management would not affect that designation.
Nobles agreed, saying that as long as the facility is not changed or relocated, the status will stay. "Once you get that status, you can't lose it unless you change bed capacity," Nobles said.
Dr. Sherita Willis, Chief of Staff at SMC, told the crowd that changes had been made at the hospital without discussing them with her. "We were told after the fact," she said.
It is vital to the community to keep SMC open as a fully-functional facility, she said. "We have a huge population of people who will be cut out if we don't. Let us manage the hospital," she said. "If we can't do it, then at least we tried."
Bloom and Nobles also had some ideas for more efficient management of Great River Medical Center, but did not have specific information because they do not yet have all the financial information necessary to create a plan of action.
Justice Ken Kennemore moved that the court meet again in two weeks to further consider these matters. The motion was seconded by Justice Sylvester Belcher.
In the meantime, it was suggested that the court's Planning and Development Committee meet and discuss the matters before the full court considers any proposals.
"We don't want this to sit. We want to see action," Justice Kennemore said. "We need to do whatever we have to do to speed up this action."
Justice Barry Ball interjected that the court did not have any solid proposals to consider.
"I mailed that out to you," Mayor Kennemore answered.
"That doesn't mean we're going to just accept it. It has to be negotiated," Ball said.
The crowd roared, saying "No it doesn't."
County Attorney Dan Ritchey cautioned the court against quick action. "We have not yet been approved for our operating IDs," he said, which allow the hospitals to collect from private and government insurance plans.
"We can't do the transfer without those. It could take two to three weeks or two to three months," he said.
"There are serious issues to be discussed," Ritchey continued. When a person in the audience asked "Like what?" Ritchey answered, "The quorum court has a practice to discuss issues in committee meetings, for the purpose of allowing the public input."
Justice Kennemore asked Ritchey if he could be available to help discuss these issues within the next few days. Ritchey agreed.
Justice Kennemore than asked Bloom and Nobles if they would have time to get figures from GRMC to complete their proposal. The two estimated it should be done within two weeks.
Justice Kennemore amended his motion to request that the court's planning and development committee meet within two weeks, instead of the full court. Justice Belcher seconded the amendment.
The motion passed.
In other business, the court approved an appropriation ordinance providing $30,000 for new software and hardware for the county treasurer's office. the funds will come from the treasurer's automation account.
dhilton@blythevillecourier.com