[Editor's Note: This is part 7 of the Grant County Commission first work session of the month held April 9, 2024. This continues the review of the April 11, 2024 regular meeting, beginning with reports given and decisions made at that meeting.]

By Mary Alice Murphy

The review of the Grant County Commission April 11, 2024 regular meeting at the April 9, 2024 work session continued and brought two Gila Regional Medical Center reports at the Thursday meeting.

The first came from Dr. Fred Fox, GRMC Board of Trustees chair. He said that he and GRMC Chief Executive Officer Robert Whitaker would report in conjunction because he had missed a meeting and some of the things happening. He noted that the new board member, Jason Amaro, has been actively involved. "We are working collaboratively with local health care providers and the state on reestablishing the family residency program to bring more primary care providers and primary care residents to the area."

Whitaker said: "In regards to the board report, I'm appreciative of the board on the things they've been doing in regards to capital, so we can improve and keep the building and equipment up to date."

District 5 Commissioner Harry Browne said he appreciates the work on reestablishing the residency program.

District 4 Commissioner Billy Billings asked about the goal of what the residency program will look like when it's reestablished.

Fox replied that some of the details are still under consideration, but "in general, we're looking at alternative funding sources to keep it going. Family residency programs are three years, so we're looking at the 1+2 model, with the first year at Memorial Medical Center in Las Cruces, and the second and third years in Silver City. We're looking a collaboration with the local providers, the hospital outpatient clinics, the hospital and HMS (Hidalgo Medical Services). We are looking at two residents going in the summer of 2025 to Las Cruces and then to here in the summer of 2026. That pattern will continue each year."

District 3 Commissioner Alicia Edwards confirmed that after the first year in Silver City, "we would have four residents, two second-year residents and two third-year residents each year."

Fox said there is some discussion on increasing that to three a year, but "that's down the line. In addition to the four residents, the faculty member would also be available to provide care."

Edwards said if they needed the county to help "let us know, because it is obviously of huge value to the community."

Fox said he would keep the commissioners up to date. "We are meeting almost weekly and good progress is being made."

Edwards asked why the program went away in the first place, and Fox said the primary reason was the loss of the residency director. "HMS could not continue an accredited program without a director. The challenge is to attract and retain quality faculty and preceptors, as well as administrators, for the program."

Whitaker then began the hospital report. He presented volume statistics for the month of February, the prior February, the current year-to-date encompassing 8 months, the prior year-to-date and the differences in the numbers.

For February, discharges totaled 92, compared to February 2023 at 78. Year-to-date 698, compared to 787 last YTD, a difference of about 90.

Surgeries for the month were 244 compared to last year's 256, present YTD, 1,909 almost 90 fewer than the previous YTD of 1,996.

Deliveries for February were 17, compared to last year's 16, current YTD 192, about the same as last year's 199.

ER (emergency room) visits for the month were 1,338 compared to 1,302 last year, with current YTD at 11,080 compared to last YTD of 11,586, about 500 fewer this year.

Outpatient visits for February stood at 5,154 compared to last year's 4,539, current YTD at 41,550 and last year's 38,268, an increase of almost 3,500. He said outpatient visits continue to increase.

In finances, Whitaker reported that net operating revenue was $8.2 million in February compared to $6.53 million in February last year.

Operating expenses in February were $7.93 million compared to $6.5 million last year.

Operating profit for the month was $273,000 compared to $30,000 last year, which puts the hospital year-to-date at a negative $42,000 compared to a negative $1.7 million
last year. "That puts us this year almost at the break even point. You notice that operating revenue, as well as operating expenses from last year to this year are significantly up, but that's primarily due to the growth of our cancer center. We see increased visits in the cancer center, and the pharmaceuticals are expensive. However, they are reimbursed."

The operating days of cash on hand are 120, with another 28 days in long-term investments.

He noted the hospital provided $114,000 in charity care in February, compared to $96,000 last year.

Capital purchases and renovations actual dollars spent stand at $2.85 million for fiscal year 2024. The Labor and Delivery renovation continues with an expected completion at the end of May. For the Operating Room HVAC, the hospital is finalizing federal grant verifications with the contractor for the $1.4 million project, and the orthopedic clinic renovation has started at a cost of $125000. Equipment purchases will begin in early May and include $100,000 for wireless LAN, $525,000 for a new telephone system. "Those need to be completed, so we can move to the next two—$1.2 million for a telemetry system and $450,000 for a nurse call system. Those expenditures are not included in our year-to-date capital spend."

Whitaker said that the hospital is just kicking off its Community Health Needs Assessment, which must be done every three years. "We've had a preliminary call with the contractor. They will have three visits here to reach out to people."

"We published our inaugural Community Benefit Report," Whitaker said. "It shows our impact on the community. It is available on the website, and available for anyone to look at. Hospital Week is May 12-18, with recognitions and events."

He commended the board for helping the hospital make some changes at the emergency room. "We've had some challenges with how the schedule was built with physicians and providers. We've switched some things around and there is a physician in the ER 24/7."

Fox commented that the cancer center is functioning as a significant positive for the hospital. "The board recognizes how beneficial it is to the community to have the cancer center to provide local treatment. Having it available locally provides a significant benefit to the patient to have the quality of care, which also provides for better outcomes. It also alleviates family and financial strain. The board is very pleased about that."

He noted that when he was practicing at the hospital the emergency room had 24/7 physician coverage. It was changed, at some point in time, to 12 hours of physician and 12 hours of advanced practitioner. "The new contract will have physician coverage on site 24/7, and advanced practitioner coverage backup during the busy times. This will provide much better quality of care. I'm also happy that we are providing capital for expenditures to address equipment and facility needs, now that we are on a better financial foundation."

District 1 Commissioner and Chair Chris Ponce said: "One thing that had bothered me for the past few weeks was that you didn't have ER coverage 24/7. I don't want it to happen again. It was disheartening to me to hear comments from the public. I'm glad someone is on top of it now."

Edwards asked for a clarification. "It sounded to me like that you said you had always been able to cover the situation with physicians available in the facility." Whitaker confirmed that was true and that the contracted ER provider had agreed to the contractual changes.

Billings noted that he was a recent visitor to the ER. "I'm glad we have our county manager, Charlene Webb, on the board, as a non-voting member. She was able to get me some information relative to my visit, so I didn't have to bother you. I know that some people have thought she was a plant. I think it's really good to have the coordination between the county and the hospital board."

Fox said he believes it is important to have the county involved. "I appreciate her presence as a valuable member."

The next article will continue with the work session review of the regular agenda and county reports at both meetings.

To read the previous articles, please visit https://www.grantcountybeat.com/news/news-articles/84008-grant-county-commission-holds-work-session-040924-part-1; https://www.grantcountybeat.com/news/news-articles/84035-grant-county-commission-holds-work-session-040924-part-2 ; https://www.grantcountybeat.com/news/news-articles/84075-grant-county-commission-holds-work-session-040924-part-3 ; https://www.grantcountybeat.com/news/news-articles/84093-grant-county-commission-holds-work-session-040924-part-4 ;https://www.grantcountybeat.com/news/news-articles/84136-grant-county-commission-holds-work-session-040924-part-5 ; and https://www.grantcountybeat.com/news/news-articles/84221-grant-county-commission-holds-work-session-040924-and-regular-meeting-041124-part-6