HRMC Board looks for growth

By Caroline Klapper | Dec 07, 2012

While questions about the future of MedWest group continue, the business of providing health care to the people of Haywood County must still go on, and at MedWest-Haywood, the focus is on growth.

Haywood Regional Medical Center’s governing board met last week to go over some of the key performance indicators for October, the start of this fiscal year and to look at projections for 2013. Teresa Reynolds, chief operating officer for MedWest-Haywood,  presented the report, which indicated numbers were up in some areas while others were down.

Adjusted discharges in October were nearly equal to the numbers during the same month last year at 1,116 patients, and annualized estimates show that those numbers are expected to remain steady in 2013 with about 13,394 adjusted discharges. The same holds true for the number of observation days of patients in the hospital, which was down slightly this October at 109 compared to about 115 in October of last year, but again, annualized estimates show 2012 and 2013 are expected to have similar numbers.

The real differences in numbers can be seen in inpatient versus outpatient visits. Inpatient acute discharges were down from about 460 in October of last year to 431 in October of this year, but outpatient visits have seen growth from just under 12,000 in October of last year to 12,175 this year. Estimates for the rest of the fiscal year show that growth continuing to about 146,100 for the fiscal year, an increase of 11,860 outpatient visits.

Those numbers are also reflected in the surgery arena. Total surgeries are up slightly for HRMC, but that gain is coming from outpatient procedures, which have seen a spike of growth every year for the past five years. That trend is expected to continue in 2013 with estimates showing growth from 3,739 outpatient surgeries last year to 3,888 in the coming year.

However, inpatient surgeries have dropped by about 15 patients compared to October numbers from last year. Over the course of the year, that could mean hundreds fewer inpatient surgeries get done at HRMC in the next year.

Reynolds said some of the shift can be attributed to the new Outpatient Care Center that opened up earlier this year, and some is because more and more surgeries are becoming outpatient procedures.

“A lot of things now are outpatient,” she said. “I think from an industry perspective, a lot of it is moving to outpatient. Surgery is our biggest money generator.”

“And that is a positive place over there,” added HRMC Board Chairman Cliff Stovall, referring to the new Outpatient Care Center on the hospital’s campus.

“They’re getting a positive response from their patients over at the outpatient center,” Reynolds agreed.

Emergency department visits are also up slightly and are expected to continue that trend through the rest of 2013.

Deliveries are seeing a big decline with 27 deliveries in October this year compared to 37 in the same month last year. If that pattern continues, it would mean an estimated 42 fewer deliveries at HRMC in the next year.

“A lot of it is out-migration,” Reynolds said, explaining that Mission offers a wider selection of delivery services.

MedWest-Haywood Chief Nursing Officer Dwayne Hooks said that while patients seem to rate HRMC’s delivery services highly, the outdated appearance of the delivery unit is less appealing.

“It needs some updating, and the marketing is very limited, so we really need to build that up,” he said.

Overall, the board discussed the need to make the various projects that were completed in the past year, including the outpatient center and the Urgent Care Center in Canton, profitable.

While the outpatient center is seeing growth, money was used from operations to outfit the facility, which has initially caused a loss. The urgent care is so far “breaking even,” Reynolds said, but that was expected in the facility’s first year.

“We were not expecting any growth in the first year,” she explained.

“They were investments. They were strategies to attract more patients,” said board member Dr. Henry Nathan, but he added, “The only way these (projects) are going to be a good idea is if there’s growth.”

MedWest-Haywood is part of an affiliation with hospitals and medical offices in Jackson and Swain counties. The organization's third anniversary is approaching, a time when the partners agreed to re-evaluate the affiliation. MedWest-Harris has expressed discontent with the arrangement and wants to change courses, an action that will be part of the MedWest governing board discussions next year.