The Gazette-Times,' Ifeppner, Oregon, Thursday, June 21, 1979 SEVEN
County off iciah respond to questions
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Editor's Note: The following
questions and answers were
submitted by the County
Court. They reflect citizen as
well as official positions taken
by county officials.
Q. Some equipment replace
ment and improvements that
were budgeted for this year
have not been purchased (i.e.
walk-in cooler and delivery
room table). What is the
reason for this?
A. The hospital did not
generate $926,266.00 as pro
jected in the 1978-79 budget.
This required that expenses be
curtailed approximately 14
percent. All items on the
expense side of . the budget
were curtailed wherever pos
sible. Cuts were made that
least affected health care.
This included the walk-in
cooler and the OB table. The
failure to make these pur
chases did not make any extra
cash available because the
money that wasn't spent was
money that wasn't there.
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Q. Is our hospital staff
adequate and well-enough
trained to give patients the
care prescribed by our doc
tors? A. Yes.
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Q. Is Mark Murray paid for
delivering medications to the
hospital besides being paid for
medications?
A. There is a provision of $600
in the budget for pharmacy
consulting services. The State
and Federal laws require that
the hospital drug function be
supervised by a registered
pharmacist. The pharmacist
also provides other profes
sional services to the medical
staff, monitors drug compata
bility, drug reactions, helps
maintain the hospital drug
formulary and is a member of
the hospital pharmacy and
therapeutic committee.
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Q. Does the hospital pay any
other supplier for delivery
besides paying for products
delivered?
A. No. (Usual freight charges
are paid when applicable.)
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Q. What is the rate per
patient-day at the hospital?
A. The hospital is presently
charging the following hospi
tal rates : $105 for accute care;
$27.50 for nursing home care
in the lower level; $29.50 for
nursing home care on the
. upper level.
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Q. How many federal tax
dollars has the hospital
brought back into Morrow
County?
A. It is not possible to
calculate any precise amount
but the hospital board feels
that the hospital is responsible
for bringing a substantial
number o( federal dollars
back into Morrow County. The
large portion of the funds used
to construct the hospital came
from the federal government.
At present, the hospital ex
pects to receive an estimated
$205,000 in grant money for a
new wing and x-ray equip
ment. The county has received
federal grant monies for the
acquisition of ambulances
presently being used in both
north and south Morrow
County. In addition to grant
money, the hospital receives
payments on behalf of patients
from medicare on a regular
basis.
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Q. What alternatives are being
considered in the event that
the hospital budget is not
passed on June 26?
A. The hospital board and the
county court are committed to
doing all that is within their
means to keep the hospital
operating. The county court is
going on record, however, that
it will not call for or accept the
resignations of hospital board
members or of any hospital
officials. The court has com
plete confidence in the board
and the hospital officials and
does not wish to be engaged in
any brinksmanship personal
ity struggles in which the ,
hospital's budget is held
hostage for personnel
changes.
It does not appear to be at
all feasible for the hospital to
operate without some tax
levy. County officials with
hospital-related . responsibili
ties are convinced that if the
June 26 election fails the
following problems will be
experienced immediately:
GAZE
Credit financing will not
be possible because of the
constitutional prohibition
against creating debts or
liabilities, in excess of $5,000.
Officials with fiscal auth
ority and responsibilities may
be reluctant to act at all
because of the statutory
provisions requiring monies to
be budgeted before they can
be expended and, further,
making them civilly liable for
expenditures in such cases.
Hospital employees will
be faced with an employment
situation of considerable un
certainty and may find their
situation intolerable and,
hence, seek employment
change.
. Potential hospital patients
may turn elsewhere for hospi
tal service, thus exacerbating
the decline in hospital utiliza
tion. Alternatives under consid
eration are: (1) close the
hospital; (2) keep the hospital
operating with a 5-7 week
budget using nontax revenues
such as accounts receivable,
fees and donations, while a
third hospital budget is pre
pared and put to the voters;
(3) same as (2) except
utilizing, in addition to all
available nontax revenues,
contingency money from the
county's general fund budget
if that budget election passes
on June 26; (4) same as (3)
except utilizing also any
revenue sharing monies which
might be made available if the
Revenue Sharing Committee
is willing to make an except
ion from its policy of not using
revenue sharing money for
operating purposes ; (5) other,
as suggested.
No alternative has yet been
developed which is deemed to
be acceptable. None of the
alternatives eliminate the
problems mentioned above
and none of them assure the
county's ability to continue to
operate the hospital.
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Q. Will it be necessary to close
the nursing home if the
hospital closes?
A. It probably will be neces
sary to close the nursing home
if the hospital is unable to
continue to operate. Without
the hospital, the nursing home
til)
uality Printin
Everything from business forms
and stationery to wedding and
social announcements...Fastl
dependable service!
The Heppner
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Heppner
alone would have to absorb all
costs of administration,
kitchen and etc. This would
result in a sharp escalation in
nursing home costs, probably
to the extent that it would not
be feasible to continue to
operate the nursing home.
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Q. If the hospital does not pass
on June 26, who will have the
say as to what budget reduc
tions will be made?
A. The ultimate authority to
make these decisions is vested
in the county budget commit
tee. That committee is com
posed of the 3 county court
members and 3 additional
persons appointed by the
court. The budget committee
relies heavily upon the recom
mendations of the hospital
board. The hospital board will
propose a budget which it feels
is reasonable and necessary.
Persons or employees who are
directly affected by the budget
proposals will have the oppor
tunity to present their views to
the hospital board. Anyone
who is interested in the
hospital's budget, can attend
the sessions of the hospital
board and the budget commit
tee and will be given an
opportunity to be heard at all
public hearings on the budget.
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Q. If the hospital's doors are
closed, will employees be paid
for accumulated vacation
time and will their contribu
tions towards retirement be
refunded or frozen?
A. Yes. Krebs: "I presume
that the county will follow its
normal policy in pay for
accrued vacation time if that
is its normal policy. As to
accrues in any county retire
ment, I assume that the
employee's contribution can
be refunded but I am not sure
at all what disposition there
might be as to the employer's
contribution. This would need
to be verified with the
manager of the fund."
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Q. How many elections can be
held on the hospital budget?
A. Realistically, the hospital
board and the county court do
not expect to be able to hold
more than one additional
hospital budget election. Tax
levying bodies are required to
notify the assessor by July 15
of their tax levies. The
assessor is authorized to allow
an extension of time, but any
such extension would be
limited. Approximately 35
days must be allowed between
elections. Eventually, the tax
levies must be made and once
they are extended on the tax
rolls they cannot be increased
until the next budget year.
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Q. The hospital board has a
contract with the Oregon
Association of Hospitals. The
purpose is to complete short
term and long-range planning
required by Public Law 93-641.
Does the hospital board feel
that it can devote the time
necessary for meetings and
other functions to fullfill its
end of the contract?
A. Yes. Serving on the hospital
board entails a broad range of
duties which extend well
beyond simply attending reg
ular monthly meetings. The
board entered into its contract
with the Oregon Association of
Hospitals in good faith, in
tends to hold up its end of the
contract, and believes that it
is fully able to do so.
O-O-O
Q. Will Medicare pay for my
care in the Pioneer Memorial
Hospital Nursing Home?
A. No. Pioneer Memorial
Hospital Nursing Home is an
Intermediate Care Facility.
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Q. Will Medicare pay for
nursing home care in any
nursing homes?
A. Yes. Medicare pays for
much of the care in Skilled
Nursing Facilities if the
patient meets all five of the
following requirements:
1. You have been in a
hospital at least 3 days in a
row (not counting the day of
discharge before you trans
fer to a participating skilled
nursing facility.
2. You are transferred to the
skilled nursing facility be
cause you require further care
for a condition which was
treated in the hospital.
3. You are admitted to a
facility within a short time
(generally within 14 days)
after you leave the hospital.
4. A doctor certifies that you
need, and you continue to
receive, skilled nursing or
skilled rehabilitation services
on a daily basis.
5. The facility's Utilization
Review Committee or the
Professional Standards Re
view Organization in the area
does not disapprove your stay.
HEW Publication No.
(SSA) 79-10041
When all five conditions are
met, hospital insurance can
help pay for your care for up
to a maximum of 100 days in
each benefit period only if
this level of care is needed for
that length of time.
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Q. Why is Pioneer Memorial
Hospital nursing home not a
Skilled Care Facility?
A. 1. There would not be
enough call for a skilled
nursing home care in this
rural area because most
nursing home patients do not
qualify for skilled nursing
care.
2. The increase in require
ments (personnel & facility)
would increase the cost of
health care in the form of
daily service charges and
taxes. A study by the Pioneer
Memorial Hospital Board of
Trustees indicates that the
increase in personnel require
ments alone of a Skilled
Nursing Facility would be
approximately $1,382 per
week.
3. The increased number of
health care professionals nec
essary to meet the Skilled
Nursing Facility require
ments are not available in the
Heppner area at this time.
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). Are there any insurances or
agencies that provide finan
cial help for Intermediate
Care Nursing Services?
A. Yes. Welfare will help pay
for much of the care for those
who qualify.
Q. What type of a contract
does the hospital have with its
administrators?
A. The hospital board has
developed a job description
for the administrator. The
administrator was retained by
the board to perform those
duties contained in the job
description. He serves at the
pleasure of the board, mean
ing that he does not have a
written contract of employ
ment. The board evaluates his
performance by measuring
the job he does against the
criteria established in the job
description.
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Q. Is it true that Pioneer
Memorial Hospital charges
higher nursing home rates
than any of the other 5 nearest
nursing homes? If true, are
there any plans being formu
lated to make a rate reduction
possible?
A. The hospital t)oard has
recently studied comparative
figures for nursing homes and
has found that its nursing
home rates are generally
competitive with those of
other nursing homes in this
area. The board feels that its
rates are as low as possible
under present circumstances
and has not found any
programs which would enable
it to reduce rates. In fact, the.
hospital's auditors have sug
gested a rate increase of 10
percent and the proposed
budget incorporates this sug
gestion. The hospital board
feels that any rate reduction
from what is proposed would
have to be offset either by
reductions of service or by
additional tax dollars.
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Q. What are the duties of the
Director of Nursing?
A. The Director of Nursing
Service plans, organizes, dir
ects and coordinates the
activities of the Nursing
Department, Ambulance and
Emergency Medical Services,
Housekeeping and Laundry
services in support of medical
care to meet the needs of the
patient, medical staff, and
pursuant to administrative
policies.
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676-9228
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147 West Willow