Healthcare survey: Hospital set to begin countywide community needs assessment

The North Big Horn Hospital board of trustees discussed an upcoming countywide Community Health Needs Assessment (CHNA) and other matters at their regular monthly meeting held on August 19.

The CHNA identifies ways to improve health care in Big Horn County. NBHH CEO Eric Connell informed the trustees that the federal government requires non-profit hospitals to conduct a CHNA every three years. This time, NBHH is partnering with Three Rivers Health, which is in the south end of the county.

“We are jazzed to work with our friends at Three Rivers Health on this important project,” Connell said.

In a more formal statement, printed in a draft summary of the project given to the trustees, Connell said, “I see the Community Health Needs Assessment as our roadmap to better health for the Big Horn Basin and Big Horn County. It identifies critical needs – like access to care and social support – through community input, guiding future initiatives. Through understanding the health needs of our communities, it helps us create healthier communities together, sharing resources with our partners at Three Rivers Health.”

Some of the challenges for rural health care include access to care, mental health access (and a relatively high suicide rate), high rates of chronic conditions like diabetes, COPD and heart disease, few local providers of maternity services, an aging population with complex needs and relatively long response times for EMS services in some areas.

Connell noted that the final assessment will draw upon input from the community (through surveys) to identify priorities. The input will also be used to guide future initiatives for the hospital. He added that a steering committee comprised of members of both hospitals is being formed, and the board chairs from each organization have been invited to participate.

Also during the meeting, Connell asked the trustees to approve the recruitment of a nurse practioner with cardiac experience to assist Dr. Kristin Scott-Tillery to provide cardiology services. He noted that he is already in discussions with a qualified NP who has interest in relocating to the area. He said the additional staffing would allow patients better access to cardiac services, since they are in high demand. The trustees approved Connell’s request to proceed with negotiations and an employment offer.

Connell also updated the trustees on his progress in negotiating upper payment limit (UPL) agreements with care centers owned by Rocky Mountain Care and Peaks Healthcare. Only hospital districts with a specific license are paid the upper payment limit for long-term care services. NBHH has this license. It partners with outside care centers in the state of Wyoming, allowing them to operate under the special license, which makes the facilities eligible to receive a higher payment from Medicaid. As part of the agreement, NBHH also helps the long-term facilities with the management of their care centers. In exchange for those services, NBHH receives part of the upper payment limit funds.

Connell said the agreement with Rocky Mountain Care, though not yet complete, is moving forward. He also reported that the Peaks Healthcare agreement is still in progress, noting that Peaks intends to move forward with an agreement for NBHH to manage its Douglas facility but it may not happen this cycle.

In the meantime, he said he is working with an insurance consultant to evaluate insurance coverage currently held by NBHH, noting that it may need to be modified to accommodate the additional UPL related operations. He also reported that he and Rick Schroeder, Darcy Robertson and Payton Gambill are collaborating on a business plan to accompany the district’s growth in this area.

In other matters, clinic manager Amber James reported that the clinic continued in July to be slightly above its goal of 1,300 patient visits per month, reporting 1,329 patient visits in that month. She also reported home visits conducted by the clinic’s visiting nurse staff at 299 in March, 336 in April, 358 in May, 347 in June and 335 in July. Though not technically a “same day” clinic, the clinic was able to schedule 108 same day visits in July, in keeping with its goal to schedule appointments on a same day basis whenever possible. James also reported 47 patients currently enrolled in the clinic’s chronic care management program.