Northwood Deaconess Health Center and
Valley Community Health Centers
• A partnership since 2003
Services offered at NDHC
• 12 bed critical access hospital
• 61 bed nursing home (10 designated as
dementia care)
• 6 assisted living apartments
• 10 independent living apartments
• Ambulance
• Rehab
• Outreach – schools, therapies, home care
NDHC Facts and Figures
•
•
•
•
•
•
•
•
•
•
112 FTE employees. 185 total
Annual budget $8,500,000
200 inpatient admissions
700 ER Visits
2400 Rehab visits
6800 lab/ xray visits
1,500 swing bed days
20,000 nursing home days
Assisted living (6). Rented up
Independent living (8)
FQHC – The appeal
•
•
•
•
It helps those who can’t pay for care
It addresses keeping people healthy
Provides funding necessary to do these things.
Filling the gap where insurances don’t cover or
for those without.
The Connection!
•Function as a focal point
for community health
education and wellness
VALLEY COMMUNITY HEALTH CENTERS
• Funded as a New Start: September 2003
• Operating in one clinic: January 26, 2004
• Operating in a second clinic full-time: May,
2004.
• Opened dental clinic: November, 2007
• Providers: 2 MD’s (family practice), 2 midlevels (FNP/PA-C and PA-C), 2 DDS, 1 DMD, 2
RDH.
FORMAL AGREEMENTS PAST AND PRESENT
•
•
•
•
•
•
•
Housekeeping and Maintenance
CSR
Phone System
IT support – hardware and wiring
Lab and x-ray
Ancillary services: PT, OT
Rent
HOW THE CONVERSATION WAS FRAMED
• Local ownership and governance
• Rural health is primary care and prevention
• Emphasis on quality and outcomes for
patients
• What we can share/pay for let’s. If not, no
harm no foul.
• Built on previous agreements – ER coverage,
medical directors/chief of staff services.
• None of us will get everything we want or
think we need.
RURAL HEALTH CHALLENGES
• Workforce issues
• We all can pay vs. sliding fee discounts
• Healthcare home-focus on primary and
preventive care in a specialty driven
healthcare system
• Enabling services
• Uninsured and under-insured.
Additional Challenges
• Operations
– IT – staff and equipment
– Business staff
– Cleaning and maintenance
– Ancillary services – PT, OT ST, Lab and x-ray
LET’S BE REALISTIC
•
•
•
•
•
•
•
•
Medical Culture
Recruitment and Retention
Community Culture
Market Share
How does the past shape the future?
CAH vs CHC requirements
The real amount of available resource.
Playing fair
The Hard Questions
• Community Need
• Actual vs “potential” use
• Population health improvement vs financial
stability.
• Demographics
• What can we do together that makes the
community a viable, attractive place to live?
How we get along
•
•
•
•
•
•
Talk to each other formally and informally
Acknowedge each other’s challenges
Meet with each other’s boards
Boards meet together
Collaborate on prevention and screening
Follow the hospital by-laws
What we don’t have that could get us in
trouble
• A formal arrangement regarding medical staff
• A formal way of addressing grievances arising
from medical staff behavior.
• A plan for what happens when the money
runs out.
Our next challenges
• Retirement of long-term provider/lessening of
patient load
• # of Clinic patients and # of providers needed
to staff the ER at NDHC
• Medical director support for Ambulance,
Cardiac Rehab, Nursing Home, City Coronor.
• Demographics
• Critical Mass
• CAH Viability in North Dakota
Healthcare relationships
Like a good potluck