The Mountaineer

Haywood Regional Medical Center has made a lot of strides in the past year, CEO Michael Poore told county commissioners last week. 

The year held numerous challenges following a February 2008 federal action decertifying the facility as an eligible Medicare and Medicaid provider. Most private insurers followed suit, also refusing to cover procedures or services.

The hospital spent $13 million in savings to stay afloat for the three-month decertification and subsequent return of cash flow.

However, the institution has bounced back, Poore said, with patient numbers similar to the year ending in 2007, and a $900,000 net margin, an amount considerably ahead 2007’s $1.3 million loss.

In the fiscal year that ended Sept. 30, Haywood Regional exceeded its goal of a 1 percent margin, which was within goal.

In addition, many of the top hospital posts left vacant after a rash of resignations following the decertification are all filled, Poore said, and 15 key leadership positions have been filled. Employee satisfaction now stands at 72 percent as opposed to 64 percent a year ago. Poore told commissioners he would like to hit the 75 percent target this year and move to 80 percent next year.

“Quality and patient safety has been proven over and over again,” Poore said, and cited a state business magazine that reported Haywood Regional was among three in North Carolina recognized for clinical excellence.

“They look at 26 procedures and outcomes and compare those to other hospitals,” he said. “We had to have 19 in the top 5 percent. This is actual outcome data.”

Followup surveys by an accreditation committee and Centers for Medicare Services also showed quality is a top priority, he said.

Commissioner Kevin Ensley asked Poore to speak to the emergency department situation, which he said has been the topic of numerous complaints he’s heard in the community. Ensley said he hated to mention the issue publicly, but noted he even had family members who would rather not use the Haywood Regional emergency facilities if they had a choice.

Poore said the emergency department is the “front door to the hospital” and, as with all emergency facilities, there are many issues to confront.

The hospital tracks all complaints and grievances, he said, and there have been 238 grievances filed, which is less than .96 percent of the 24,700 patients seen annually, he said. Numerous strides have been made.

“That doesn’t mean there weren’t people who didn’t complain,” he said. “We’re not satisfied with where we are. The door to doctor time was running 95 minutes and we moved that down to 61 minutes. That is good, but not where we’d like to be.”

Poore said a physician had been removed from the ER because of failure to meet standards, and noted many who use the department don’t have true emergencies. About 23 percent of those seen have no insurance.

“By law, we must see everyone,” he said, later adding a lot of patients are getting good care.

“I know you came in at a tough time,” Ensley said. “That’s just what I’m hearing and it needs to be said sometimes.”

Poore said there were 4,476 surgeries in 2009 at Haywood Regional, which slightly exceeded the numbers of 2007; and patient discharges were at nearly 5,400, a number almost at the pre-decertification level.

In addition, the hospital recruited four new physicians — a cardiologist, an internal medical practitioner, a medical oncologist and a family medical practitioner. That’s in addition to purchasing Haywood Women’s Medical Center and employing its three physicians. This is part of a national trend to keep obstetricians in a community in the face of skyrocketing liability insurance.

The hospital’s average daily census was 59.9 in 2009 as opposed to 59 in 2007 and 43 in 2008.

“We’re happy with this progress, but not satisfied,” he said.