I would like to take this opportunity to address some of the misinformation and half-truths that have been circulating lately about Cedar County Memorial Hospital (CCMH) and their campaign to increase their tax levy. First of all, it is amazing to me that people who never sought care at CCMH, or bothered to attend a board meeting to gain information or get questions answered, can campaign with such vitriol. Secondly, the board of trustees, in all their discussions and decisions, has always had the welfare of our patients, staff and community as our primary concern.
I have seen remarks by those opposed to the levy increase regarding hospital administrative costs, as if those costs were strictly administrator salary. Administrative costs cover a broad range of salaries (at least 9 individuals)and services including IT staff, equipment and maintenance contracts, all small equipment for the facility, employee health insurance costs and much more. Comparisons of expenses year to year over a 5-10 year period without a broader knowledge of what those expenses cover does not show the entire picture. Recent years have brought mandated upgrades to our Electronic Medical Record (EMR) system in order continue to participate in the Medicare and Medicaid programs. Those upgrades came at a cost of over 2 million dollars. The nationwide shortage of nurses has affected CCMH, at times necessitating the use of “travel nurses” who come at a premium price.
The board tries to keep salaries, across the board , competitive with other rural Critical Access Hospitals (CAH) in the state as a means of retaining staff. Same goes for the administrator’s salary. In recent days the administrator’s salary has been the point of discussion. Her salary was last increased in January of 2018. And although the board voted recently, without the administrator’s knowledge or presence, to increase her retirement compensation, she, immediately upon learning of it, declined the increase.
The hospital is often compared to other businesses. But healthcare, for better or worse, has many unique aspects that are quite different from other businesses. You wouldn’t expect to receive a meal at a restaurant without paying for it, yet we are required to serve patients regardless of their inability to pay or their lack of third party coverage. Other businesses can set their prices and expect full payment. Hospitals set prices and know that they will only receive partial payment from both government (Medicare and Medicaid) and private insurers.
Increasing expenses, uncompensated care, costs associated with aging infrastructure, and increasing IT and EMR requirements are not unique to CCMH, but are common to most CAH across the country. In fact, 10 rural hospitals have closed in Missouri since 2014 due to similar problems. Opponents say we should reduce services to save money but complain about the fact that we cut Obstetric services (which has also been a common occurrence in rural hospitals nationwide for years). Opponents complain about reduced hours of service at the Health Dept (a department of the hospital) office in Stockton, but utilization there does not warrant 5 day a week operation. Opponents complain about a “revolving door” of doctors when in fact our medical staff has been quite stable. One might see different faces in the ER at times, but that is because CCMH contracts with a service for our ER medical staff, the same board certified ER staff that services Mercy Hospital in Joplin and other larger hospitals in the region. Opponents ask why we don’t seek tax relief in another form or from residents of surrounding counties who utilize our service, but we are not legally allowed to do those things. Opponents ask why the county should be in the hospital business at all or why county taxpayers should subsidize the hospital. The hospital was established 60+ years ago. We did not choose the way the hospital was organized and funded, but we are trying to make the best of those long ago decisions. Same goes for the hospital taking on the responsibilities of the health department many years ago. Where nearly all other health departments receive their own tax levy or sales tax funding, none has ever been provided for the Cedar County Health Department.
The hospital’s problems are complex and we are constantly seeking solutions. We regularly seek guidance from the Missouri Hospital Association. And we were recently awarded a grant from the Texas A & M Center for Optimizing Rural Health who is assessing our situation and providing guidance. We appreciate our dedicated staff and loyal patients and hope to continue serving our community, providing both quality patient care and employment opportunities for our neighbors.
Cedar County Memorial Hospital
Board of Trustees, Vice-President