Fleming County Hospital Success Story
This rural hospital did more than survive tough times. With help from QHR, the brave local team is now building a brand new facility - one that will enable more patients to get the care they need, close to home.
Determined to Serve
Replacing its outmoded 1960’s facility with a patient-friendly new one,Fleming County Hospital is giving its community what it wants – and needs.
“It’s all about service,”says CEO Carol Dozier.With support from a loyal staff,the team has nearly doubled the number of patients served annually over the last seven years. And with help from QHR, they’ve accomplished that impressive service expansion with impressive efficiency.
“QHR helps us in so many ways,” CEO Carol Dozier relates. “I think the most important may be the education. It helps us grow our next leaders, right here. We wouldn’t have access to that level of education without QHR.”
The growth trend began a decade ago.Then- CEO Bobby Emmons,a retired Army colonel, established a foundation,rallied community support and raised money to build a Medical Arts Center, to encourage more specialists to see patients in Flemingsburg.“The hospital could not have afforded it at the time,”points out Dozier. “It was a turning point for us.”
The medical office building did attract specialists to the eastern Kentucky town, slowing patient migration to newer facilities in the area.But the renaissance didn’t happen overnight.
“We had some very unhappy days,” remembers Board chair Ruth Rankin. “There was even talk of closing the hospital. But we were determined; QHR sent us wonderful administration and all the support they needed to get the job done.”
Reaching Peak Performance
Drawing on QHR consulting expertise, the team trained staff and tightened processes.
“We’ve benefited tremendously from a QHR productivity system and education for our case managers” describes CFO Ron Harrington. “QHR’s specialists also help us to manage out revenue cycle, with chargemaster updates, documentation reviews and outline coding training. And they implemented an electronic billing system, which keeps our A/R days low.”
The medical staff got involved in the renewal. “Long-term physicians took partners,” describes Chief of Staff Dr. Michael Dunaway, “We opened a new clinic and made alliances with groups in neighboring towns.” Together, the two initiatives stimulated a trend that continues to gain momentum; over seven years:
- Annual inpatient discharges rose by more than 80%
- Average daily census jumped 88%
- Outpatient visits are up 45%
- Operating margin climbed from -3.1% to 16.5%
- Gross revenue rose 175%
- Net revenue climbed 123%
- A/R days fell from 71 to 59
Outgrowing Accommodations
As the upswing in business strengthened financials, space constraints began to redirect strategic planning.
“Our hospital wasn’t built for the way healthcare is delivered today,”explains Dozier. “And not having private rooms makes it difficult to compete.”
Born in the hospital himself in 1966, chief of staff Dr. Dunaway admits,“It’s starting to show its age. The original block was added onto several times,so it’s a long walk for staff and patients. It’s just inefficient.”
The aging hospital also needed significant investment in its infrastructure. “We analyzed the cost to refurbish it,” explains Board member Steve Miller, who chairs the Board’s Building and Grounds committee. “It made more sense to build new.”
Seeing the need, the team also recognized the opportunity.
While the Medical Arts building makes office visits available for specialized care,patients still have to travel or many procedures.That inconveniences patients; it also means significant revenues are leaving town.
“Medically, this hospital has always done a good job, explains chief of staff Dr. Michael Dunaway. “That’s one reason we made the decision to rebuild…people don’t want to have to go elsewhere for care.”
Strong performance qualified Fleming County for HUD Rural Development financing;borrowing $38.5 million, it is building a facility for the future.
Next Generation Hospital
“Of course it will have private rooms,”Dozier smiles. The team went much further.“We’ve designed everything for patient comfort: healing colors, warm wood tones, and privacy moving from one area to another.” That’s the philosophy behind the new model. “There will be private waiting areas and an easy flow for patients and staff.”
Doubling current space,the new hospital includes a procedure room in the expanded OR area.
The 100,000 square-foot, two-story, L-shaped structure appears from the front to have a third level, with its raised façade hiding rooftop equipment.“ The hilltop setting adds to the effect,” Miller is pleased. A semi-circular atrium completes the mood, inviting bright spaciousness
into the lobby through an arching span of windows.
There was a consensus on the board,according to Miller. “We agreed that this was probably the only time in our lifetimes that we would oversee the building of a new hospital. We were determined to do it right!”
Carol Dozier is proud of her board’s dedication. “They see more than what the hospital is today,but what it can be. That vision is an important part of our strength as an organization.” Ruth Rankin shares the credit:
“Our board works very hard. And we’ve been helped along the way by a lot of excellent education from QHR. It not only keep us up to date… it challenges us.”
A Culture of Teamwork
Working together is a way of life at Flemingsburg. Both Carol Dozier and Ron Harrington take it seriously.“We try to show our appreciation,and make it fun,too.” Surprising night shift crews with hamburgers or pancakes, Ron is a good cook,she says. And they have both been known to deliver cupcakes on birthdays or wash employees’cars.
It’s part of the vision.
“Education, guest relations, customer service teams… I believe that an internal focus on staff translates to higher patient satisfaction.”Her staff is proud to be there: they stood in line to sign the new hospital’s final steel beam before it was welded into place, high overhead.
"This hospital is becoming more important every year. We have a lot of elderly here, and when winter comes, it's not an easy drive to the bigger cities. QHR helps us manage the hospital well, to keep healthcare local for Flemingsburg."
