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2018 Year in Review and a Look Ahead

Hospital news | Thursday, December 27, 2018

Contact: Lynn Falcone, CEO

Cuero, Texas: Cuero Regional Hospital (CRH) just completed its fiscal year, September 30, 2018. Our leadership team thought it appropriate to share plans for the new fiscal year as well as many of the fiscal year 2018 progress. Cuero Regional Hospital exists to support healthcare in our communities – we have been trusted to care for patients in DeWitt County and surrounding areas. Cuero Regional Hospital is a 49-bed hospital and oversees five rural health clinics, Cuero Home Health, Bfit Cuero Wellness Center and emergency medical services, employing 286 team members across the organization. This includes four family practice physicians, two specialists; a general surgeon and podiatrist in addition to three contract family practice physicians.

Cuero Regional Hospital had a very busy fiscal year 2018 (October 1, 2017 – September 30, 2018) with significant progress in many important areas. Here are the highlights.

  1. Implemented Press Ganey patient satisfaction across the organization. Implemented leader rounding on patients and waiting rooms to enhance satisfaction of our patients.
  2. Opened a newly renovated and expanded Emergency Room – while this was shouldered by the ER staff; Materials, Facilities, Marketing, OP and our physicians were all apart of making this successful. This 1.5 million dollar renovation added 1,000 square feet of space, six fully private treatment rooms, additional private registration areas, as well as an upgraded nurses' station and new triage area to improve patient flow. This resulted in an eight percent increase in ER visits. Also, we changed our contract emergency department group of physician providers to Southwest Medical Group and have received positive feedback to this change in ER providers. Successfully recertified as a Basic Trauma Level IV Emergency Center
  3. Opened Urgent Care/After Hours Walk In Clinic to increase access to care and better serve our community.
  4. Held our first Heart Walk in February 2018 and Runway for a Cure Breast Cancer Fashion Show and Luncheon in late October
  5. Maintained our decrease in falls – just slightly over 2.0 falls per 1000 patient days
  6. SLT implemented monthly provider rounding to stay better in touch with the needs of our providers.
  7. Designed and implemented a new Mission and Vision statements created by a team of our engaged employees, "To provide compassionate care to those we serve with a commitment to excellence in all we do." Lynn Falcone, CEO Cuero Health 361.275.0510 2550 N Esplanade Cuero, Texas 77954 Page 2 Cuero Regional Hospital: A Year in Review more
  8. Hosted 17 Texas A&M Family Practice interns doing rotations in Cuero
  9. Recruited 2 new physicians: Dr. Kevin Denton (Jan 2019) and Dr. Cody Walthall (8/2019)
  10. Implemented new onboarding process for our new hires, new holiday pay policy and new attendance policy
  11. Achieved a 15 percentage point increase in hospital employee engagement – to 79th percentile!
  12. Major facelifts to the ICU, including new paint, flooring and new nurses station
  13. Day Surgery also received a facelift in terms of paint and waiting area renovations. Cuero Medical Clinic received a facelift and all new furniture in all of our rural health clinics
  14. The board approved a new $2 million MRI machine
  15. Focused on employee safety and security – active shooter education; safety education; quarterly fire drills and maintain staff at the switchboard 24/7.
  16. Achieved Stroke Ready accreditation from the American Heart Association and was recognized in the U.S. News & World Report's 2019 Best Hospitals special publication for receiving Silver Achievement Get with the Guidelines Stroke recognition. This speaks to our stroke diagnosis and treatment program to provide timely care to stroke patients
  17. Delivered 148 babies – a 41% increase!
  18. FY – a 4% increase in RHC visits; a 13% increase in admissions and a 7.5% increase in ED visits. Our best fiscal year in five years.
  19. Provided 200+ free flu shots to the community
  20. Had over 200 women take advantage of the $65 digital mammogram special in October. Early detection saves lives!
  21. Cuero Health staff donated 3,271 hours of volunteer time to DeWitt County, as well as surrounding counties.
  22. Sponsored free, public health education events to the community, topics included: mammography, nutrition, children's safety, childbirth classes, wellness and stroke care.
  23. Welcomed Dr. Quintero, board certified dermatologist, to our outpatient specialty clinic.
  24. Provided customer service training, clinical training and patient safety team training (Team STEPPS) to hospital staff, as well as implemented a STARS staff recognition program
  25. Hospital department leaders attended various leadership training opportunities with Methodist, including charge nurse courses, quarterly leadership training, Information Technology, and Human Resources
  26. Methodist hosted several of our obstetrics staff for hands-on-training in one of their busy labor & delivery hospitals
  27. Increased digital advertising efforts to better reach out audience where they spend their time – online. Increased engagement on social media platforms to better position Cuero Health as the area healthcare leader.
  28. There was a 21.2% increase in Total Operating Revenue for Cuero Health, equating to $36.1 million.
  29. In FY18 the hospital saw a 6.7% reduction in expenses by capitalizing on its purchasing group and efficiencies.
  30. Net income from hospital and clinic operations was $3.6 million, nearly 115% over prior year.
  31. Admissions were up 15.5%; Average Daily Census remained steady at 11.5; ER visits increased by 7%; Outpatient Visits remained steady; clinic visits increased by 3%.
  32. Initiated 90 in 90 in October with staff education to try to increase our patient satisfaction scores. Results of this initiative included increases in Would Recommend Scores: ER – 18% increase, Cuero Home Health – 25%, Cuero Health Clinics – 20%, HCAHPS – 14% increase. A recent highlight was Cuero Regional Hospital's ER –Texas Rank for month of November was in the 90th percentile or higher. Our ER scored 90% or better on their patient satisfaction scores compared to other Texas Hospitals. Page 3 Cuero Regional Hospital: A Year in Review

The Future for Cuero Health

For fiscal year 2019 (October 1, 2018-September 30, 2019) Cuero Regional Hospital will continue to face the challenges of all Texas rural hospitals, specifically, continued reductions in government funding. Rural and Community Health Institute at Texas A&M reports 21 of Texas rural hospitals have closed since 2010 and the driving force behind the closures is cuts and underpayments to rural hospitals by Medicare and Medicaid.

However, Texas rural hospitals provide much needed services, many in counties of less than 10,000 people; and some parts of Texas are more than 75 miles away from the nearest hospital. Moreover, rural hospitals have a narrower patient revenue margin than urban hospitals and do not provide more profitable advanced services medical procedures. Therefore, the cost of care in a rural hospital can be higher on a per-patient basis because of the challenging dynamics such as low patient volume, dramatic swings in patient numbers from day to day, recruitment difficulties which can drive up payroll costs, and a general lack of an economy of scale due to size.

So, how will we combat continued government reimbursement challenges? In addition to continuing to petition our state legislature, our focus in the year to come will be on enhancing quality, safe patient- centered care – care that is respectful of and responsive to individual patient preferences, needs and values. Through greater partnership with physicians and staff alike, the organization will also look at operational efficiencies that support quality, clinical services and financial stewardship.

Cuero Health's promise to you is to provide the very best clinic and hospital care as you would expect in larger cities. Many positive changes have occurred in the past few years to improve the financial sustainability of Cuero Regional Hospital. However, we do have a request of you…when you next need health care of any type, please consider your community hospital and clinics. You will not find better and more convenient care anywhere else.

Major Initiatives for Fiscal Year 2019 (other than a continuing emphasis on quality care and patient experiences in every service)

  • Continue Tele-Stroke Program which brings valuable stroke services to our community 24/7. Highlyqualified neurologists can remote in using a video-enabled examination located in the Emergency Department. Tele-Stroke provides a synchronized video and audio system so that the patient and neurologist can both speak and see one another as if they were in the same room.
  • Launch Tele-Cardiology in early 2019 and in the development phase to launch Tele-Psychiatry to the hospital.
  • Patient centered care focused on patient safety and experience
  • Continued employee engagement and retention efforts, including weekly email to staff from leadership, senior leadership rounding, focus groups and quarterly forums
  • Continued operational efficiencies and ongoing financial sustainability
  • Launching a new, responsive designed website in first quarter of 2019 –
  • Continued community educational offerings and events - follow our Facebook page and website for updates!