South Central Kansas Medical Center will not be subject to a penalty from Medicare payments this year due to Hospital-Acquired Conditions (HAC).

Photo by JENI McGEE

Photo by JENI McGEE

For the last two years, the Centers for Medicare and Medicaid Services (CMS) has withheld 1 percent of the funds due to SCKMC. The penalties were the result of CMS’ attempt to cut some Medicare costs.

CMS created an algorithm that calculated the lowest performing 25 percent of hospitals nationwide.

Hospitals designated as Critical Access are not subject to the possibility of being penalized for HAC.

Ironically, the “improvement” in SCKMC’s medical statistics from fiscal years 2014 and 2015 to fiscal year 2016 was due to a new hospital-acquired infection when none had been reported previously, marketing director Clayton Pappan observed during a meeting of the SCKMC Board of Trustees on Sept. 22/Thursday.

This infection, Clostridium difficile, is caused by bacteria found in the colon. Until this year, that type of infection was not included in the overall calculation to determine if a hospital is subject to the CMS penalty.

By having just one infection in an area that CMS estimated SCKMC would have more than three such infections, the hospital scored well in a category that previously had been thrown out because it did not have any infections to calculate.

The algorithm used is broken into two categories — the first is worth 15 percent of the overall score, while the second is worth the remaining 85 percent.

In the first category, SCKMC had four accidental punctures (out of more than 2,000 possible cases), some of which could have been as small as breaking the skin while attempting to remove a splinter.

The new hospital-acquired infection resides in the second category, which is much more heavily weighted.

Prior to this year, the 85-percent category had been zeroed out, causIng the hospital to fall into the 25 percent of lowest-performing hospitals.

“I can argue for almost everything that Medicare requires of us, but this I can’t wrap my head around,” said SCKMC Director of Quality Performance and Risk Management Jane Campbell, who has criticized the program as targeting expense reductions instead of truly trying to improve actual patient outcomes.

Issues with reporting

The SCKMC Board of Trustees and several hospital staff members expressed concern about how certain facts about SCKMC were presented by a local media outlet after recent board and City Commission meetings.

The first issue brought up by staff was regarding the recruitment of two potential new physicians.

“Let me say this correctly so the (The Cowley CourierTraveler) can get it correct this time,” said SCKMC CEO Virgil Watson. “I have given (the recruits) an October 31 deadline. That doesn’t mean that we won’t continue to work to recruit them, but we will start to diversify our (recruitment) efforts.”

SCKMC has been courting Drs. Slack and Strickland for an entire year, a time period that should be sufficient to know whether the two doctors intend to come to Ark City, he indicated.

The second issue brought up by staff had to do with clarifying reports of a possible complication with the Oct. 1 implementation of the one-cent SCKMC Sales Tax that was voted into effect by 80 percent of Arkansas City voters in May.

“Cowley County District Judge Jim Pringle has granted a motion to withdraw an earlier opinion supporting sales-tax funding of the South Central Kansas Regional Medical Center because of threats of a lawsuit by an unnamed Ark City resident,” the CourierTraveler reported recently.

In the same article, the CourierTraveler stated, “It’s unclear what the final effect, if any, withdrawal of last month’s judgment will have on the sales tax.”

This statement caused concerns for Dr. Perry Lin, chief of the medical staff. “(Do) we need to make a statement to reassure the public that the sales tax is on track to proceed?” he asked the board.

SCKMC attorney Otis Morrow said he wasn’t sure that was necessary, but acknowledged it was the prerogative of the board if it wished to do so.

The sales tax still is set to take effect Oct. 1, according to City of Arkansas City staff, unless the Kansas Department of Revenue were to say differently.

“Can we just ask our representative of the press (CourierTraveler reporter John Shelman): How are you going to report this conversation right now?” inquired board member JoLynn Foster.

Shelman said he would confer with and supply a recording of the meeting to his colleague, Cody Griesel, who was the person who had written the article about the sales tax.

“We’ve tried everything we can to figure out what is going on with this situation,” Shelman said, noting the city and revenue department had declined to comment.

Morrow also said he would call Griesel, at Shelman’s suggestion, and request a correction for something else in his article. He said Griesel wrote that the Kansas Department of Revenue would challenge Pringle’s findings legally if it was named as an adverse party in the motion, but Morrow clarified that the revenue department only had threatened to challenge its status as an adverse party, not the judge’s findings themselves.

The citizen who previously had threatened to file a lawsuit regarding the tax has remained silent since Pringle granted the motion to withdraw his earlier opinion, according to Morrow.

But that motion still contains the same findings indicating the 2008 half-cent sales tax is general in nature, and the revenue department has indicated previously it will accept that reasoning and allow the simultaneous collection of both taxes starting in October, city officials said.

Board member Dr. Jerry Old was absent from Thursday’s meeting.

In other business, the SCKMC Board of Trustees:

  • heard a financial report from chief financial officer Holly Harper.
  • approved $28,174.05 in bad debt and charity care write-offs.
  • heard an update on the Quorum Health Resources operational analysis of SCKMC, which is drawing to a close.
  • heard executive staff reports from Campbell, Lin and Watson.
  • heard a report from Pappan on the recent SCKMC Landrush fundraiser, which he said had about the same amount of participants as last year and is expected to raise about the same amount of money. He said the hospital will host the event again next year.
  • held an executive session to discuss risk management.