On Wednesday, Sept 11th, Murray County Medical Center’s (MCMC) Board held a special meeting/community forum concerning the management contracts being entertained by MCMC from Avera and Sanford. With more than 100 community members in attendance, we are very grateful for everyone who attended and shared their thoughts, feedback and questions regarding this pivotal decision. To maximize diverse input, the forum was a listening session, so no verbal questions were answered during the meeting. However, those in attendance were encouraged to submit their questions to be answered. The written questions with answers are listed below. Thank you again for providing your statements and feelings about these two organizations and MCMC. The board will be making a decision in the next few months.
What are the proposals from Avera and Sanford?
The proposals from Avera and Sanford were sent confidentially to Murray County Medical Center’s (MCMC) Board and MCMC is respecting this confidentiality. As shared in the Community Forum, MCMC is looking at the following criteria, data and input on what each of these two healthcare systems offer MCMC including but not limited to:
- Management contract cost
- Electronic Medical Record (EMR) System
- Community support
- Employee support
- Leadership/Management style
- Clinic services offerings (E.G. – Outreach Services/Telemedicine)
- Market share opportunities
What has Sanford done for MCMC?
Over the past several decades, Sanford has provided MCMC a multitude of resources and support. MCMC’s outreach services from Sanford currently include: Cardiology (Dr. Petrasko & Dr. Steffen), Ophthalmology/Cataracts (Dr. Vanden Bosch) and Pulmonology (Dr. Yu). MCMC currently receives purchasing power through Sanford’s supplier discounts. Each department, such as nursing, pharmacy, etc., has a resource at Sanford which aids them in creating and modifying policies, protocols and assessing/providing support with technology and equipment needs.
What agreement do the providers want?
The MCMC Board has met with the executive team, providers, department heads and the community. They have also reviewed letters from employees and community members. This input will be considered when deciding between the two partners. The Board plans to meet with MCMC employees the first week of October to receive their input and feedback.
How many years is a new contract?
The contract offers between the two entities vary which include three-year, five-year and ten-year terms.
Do all MCMC staff get to keep their jobs?
All MCMC employees will keep their jobs, regardless of if MCMC remains Sanford or if we switch to Avera. MCMC is not selling to either entity so organizational structure and number of positions will remain unchanged at this time. The decision to switch from Sanford to Avera would impact the Physical Therapy department, as those employees are all currently Sanford employees. If MCMC would select Avera as a managed partner, Avera agrees to offer employment to the current Physical Therapy providers and will recognize tenures they currently have with Sanford.
What would happen with the current specialists who currently come to MCMC?
If MCMC remains Sanford, there would be no change. Currently, because MCMC is an independent hospital, we have the flexibility to bring in outreach specialties from various healthcare systems. Currently, MCMC has outreach providers from Sanford in the areas of Cardiology, Pulmonology and Ophthalmology. MCMC also currently offers outreach services from Avera which include Podiatry and OB/GYN. If we did switch to a managed agreement with Avera, they are supportive of continued outreach services we provide and agree to allow the continuation of specialists from Sanford to MCMC. If we would switch to Avera, they agree to provide a full continuum of services and specialty outreach.
Does Avera or Sanford take over ownership of Hospice or support local Hospice?
In either management contract, we remain independent and there is no control or effect on the Hospice business. Murray County Hospice is its own entity and MCMC is very supportive of them.
What decisions does the management agent make that the board of commissioners should make or could make.
The managing healthcare system (Sanford/Avera) provides support, resources and operational recommendations to hospitals like MCMC, working together with hospital management to provide the best healthcare possible for rural communities like Slayton. The CEO of MCMC is currently employed by Sanford and the desire is for MCMC to employ its own CEO so allegiances are first and foremost to this community hospital over the partnering healthcare system. Both entities have agreed that MCMC can employ the CEO position.
What is the cost difference?
The management contract costs of each entity are different. The board is taking into account the objective data from Avera and Sanford and considering it along with the benefits each organization provides MCMC to make the best decision for Murray County.
How will the providers be held accountable in the future?
Providers are held accountable by a variety of things covered in their contracts including but not limited to:
- Quality of patient care
- Continuity of care
- Continuing education requirements
- Patient volume
- Patient survey feedback from the Rural Health Cooperative
How will the board be held accountable for issues?
The board is held accountable by the County Commissioners and ultimately, by the voters of Murray County.
Could taxpayer dollars end up going to hospital in future? If so, how?
Voting to use taxpayer dollars to support MCMC is definitely a possibility but not something MCMC is currently looking at.
Track record of the providers in small communities – success & failure evaluation historically. How did both providers behave previously in similar situations?
It’s a challenge for any rural healthcare facility to keep providers when the average stay is approximately three years. MCMC recognizes provider instability and turnover has been its number one challenge and has made a big impact on volume in recent years. Our current roster of family providers is stronger than ever with providers who are vested in this community.
Money and numbers are the issues. What is being done to ensure accurate and ethical accounting on the business side?
Clifton Larson Allen (CLA), a professional services network and the eighth largest accountancy firm in the United States, is currently providing consulting services, leadership and training for the business office on a number of fronts. CLA audits MCMC’s financial records and processes on an annual basis.
What does a Critical Access Hospital have to do with this?
Murray County Medical Center is a Critical Access Hospital (CAH), a designation for eligible rural hospitals by the Centers for Medicare and Medicaid Services (CMS). It is a designation that was created in 1997 to decrease the financial vulnerability of rural hospitals and increase access to healthcare by keeping necessary health services in rural communities. Because MCMC is a CAH,it receives benefits like cost-based reimbursement for Medicare services.
What can the current CEO/Board do for helping people heal from the past issues and move forward? I think this is important as to getting patients back, trust back and a willingness to use the current providers we have.
The anonymous individual who submitted this question provided the answer:
“Is it as simple as humbling ourselves, admitting the past was not our best moment to heal?”
Yes, it is as simple as that. There are many things in life we want to “do over” or go back and change. But we can’t. It’s important to recognize the past and acknowledge things could have been handled better, with the motivation towards the future of providing great healthcare for this community.