Spike in COVID-19 Requires Tightened Restrictions

Texas County Memorial Hospital has reviewed and revised hospital policies and procedures due to the recent spike in COVID-19 hospital board members and administration heard at their monthly meeting last Tuesday.
“We have reverted back to automatic testing of all our admissions for the protection of all patients and staff,” Ms. Amanda Turpin, chief nursing officer at TCMH, said. “This will help diagnose asymptomatic COVID positive patients who would otherwise not be caught prior to admission.”
Mr. Chris Strickland, chief executive officer at TCMH, mentioned that MHA (Missouri Hospital Association) announced they are estimating the peak for our area to be in late August to early September.
“Since the first of 2020 to the first of June 2021, we have had 15 COVID deaths total,” Ms. Turpin said.
“In just July, we had 6 of those deaths.”
Ms. Turpin mentioned during that same time frame, we averaged 9 COVID admissions per month. She further stated that in July we had 15 COVID admissions in just one week, and even had 7 in just one weekend.
“Once a COVID patient is intubated and we have maxed out all we can do, they are then transferred out to another hospital,” Ms. Turpin noted. “In June, we transferred 2 patients, and so far in July, we have transferred 9 patients.”
Ms. Turpin stated that our ER volumes have really increased due to COVID as well. Our normal ER volume averages 675-750 a month, and last month we had 965 ER visits.
“The increase in ER visits is directly related to patients waiting to get tested, and then getting really sick and needing to go to the ER,” Mr. Strickland said. “We are encouraging those experiencing symptoms to get tested at the clinics prior to an ER visit, as it is better to catch COVID early to start treatment.”
“The Delta strain is much more contagious and aggressive,” Mr. Strickland noted.
Dr. Jonathan Beers, DO, chief of staff, mentioned the different patterns we are currently seeing with COVID and the Delta strain. Prior to the Delta strain, people were hypoxic, but not really short of breath and now they are air hungry. Dr. Beers further mentioned that we are seeing a lot of actual mechanical
ventilation failure versus just hypoxic failure, so we are having to adjust what we are doing. Dr. Beers noted that patients are getting extremely sick faster and much worse.
Mr. Strickland expressed his concern for our TCMH staff and morale due to our staff being tired. He noted that all resources are being utilized to assist with stress management and show our appreciation.
“We have submitted an application to SEMA for staffing assistance,” Mr. Strickland stated. “Bennie Cook has been a great help in fighting to try and make this happen for the hospital.”
Ms. Linda Pamperien, chief financial officer at TCMH, presented the financial report for the month of June.
“Overall revenues were up by $929,642 for the month, which is a 14.4 percent increase from our budgeted expectations,” Pamperien said. “We also had a 13 percent increase in our inpatient volumes as we were up by $180,820.”
Ms. Pamperien mentioned outpatient revenue was up again at $696,578 for the month. The Emergency Room continues to be up, which directly reflects to our ancillary departments such as MRI, CT, and all Radiology. Ms. Pamperien noted that our Operating Room/Recovery is up this month, which is another
great contributor to the increased outpatient revenue.
Bad debt for the month of May was $500,111.01.

Ms. Pamperien noted that the contractual adjustments were down this month at 59.9 percent for the month and 63.5 percent year to date.
“Our overall expenses were down slightly from our budgeted expectations this month by $40,561,” Ms. Pamperien said.
“The hospital ended the month of June with a positive bottom line of $190,262 and year-to-date with a loss of $478,991.” Ms. Pamperien said. “The increase in our revenues and decrease in contractual adjustments affected these results.”
In old business, Mr. Strickland mentioned the CARES funding has been depleted. We have received our PFT machine, four ambulance cots, COVID medication, and two ultrasounds. Additional items that have been purchased and awaiting arrival are an OMNI cell for ICU, another ventilator, ultrasound for PICC lines, 10 IV pumps, BIPAPS, PPE, portable X-Ray, CT, MRI, and several other smaller items.
Mr. Strickland noted that the Licking Ambulance Base will be moving into a temporary location next month until a new base is constructed.
In new business, Ms. Courtney Owens, quality management director, discussed the HAC (Hospital Acquired Conditions) measures which are reported publicly and cover several different categories.
“During the time period of July 1, 2018 to Dec 3, 2019, there were 733 eligible discharges that were reflected in the 2021 report,” Ms. Owens stated. “Out of all 733, we had one patient that counted against us.”
Ms. Owens shared the 2 nd quarter QA report from other departments. She mentioned that several departments such as Emergency and Cardiopulmonary have implemented good measures to show ways that they have improved on different aspects such as COVID.
Ms. Helania Wulff, director of public relations, mentioned our physician recruitment efforts are ongoing.
She noted a Wichita visit is scheduled in August to potentially recruit residents.
Mr. Strickland mentioned we were awarded the Rural Health Clinic Vaccine Confidence Program grant to
increase our vaccine marketing efforts.
Mr. Strickland noted that the new generator will be installed in August.
Mr. Strickland mentioned that Dr. Baldwin is credentialing at Salem Memorial District Hospital. He further stated that Dr. Baldwin would be seeing Obstetric patients in Salem, along with doing GYN procedures.
Mr. Strickland noted seven $1,000 TCMH Foundations Scholarship winners have been named and awarded.
Mr. Strickland mentioned that he will be attending all the area city council meetings and presenting the 2020 annual report.
Mr. Strickland stated that we have an upcoming Texas County leadership roundtable quarterly breakfast scheduled at the hospital for August 6 th . These meetings will be utilized to partner together for the betterment of our communities.
Present at the meeting were Linda Pamperien, chief financial officer; Helania Wulff, director of public relations; Amanda Turpin, chief nursing officer; Courtney Owens, quality director; Chris Strickland, chief executive officer; Jonathan Beers, DO, chief of staff; board members, Jim Perry; Joleen Durham; Steve Pierce, Allan Branstetter (via phone).
The next meeting of the TCMH board of trustees is Tuesday, August 24 at 12 p.m. in the Jayson Gentry Community Safe Room. Due to COVID-19 and social distancing restrictions, you may attend the meeting via teleconference. To attend the meeting via teleconference, please call (417) 967-1236 and you will be placed into the teleconference meeting.