FREQUENTLY ASKED QUESTIONS. Q. Why won t the medical center in Trenton include an emergency room?

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1 FREQUENTLY ASKED QUESTIONS Q. Why won t the medical center in Trenton include an emergency room? Emergency room visits have continually dropped at Trenton s emergency room and a high percentage of visits are non-emergent in nature. There will be two emergency rooms in Gibson County and the medical center in Trenton will include extended after hours walk-in care. Q. Why leave the hospital in Milan instead of one in Humboldt or Trenton? Milan General Hospital has the most active surgical program of the three Gibson County hospitals. Also, Milan General Hospital attracts more patients from outside Gibson County than the other two hospitals. It has the most updated inpatient rooms, which are all private. It is the largest of the three facilities with the capacity to accommodate all services so it is the location that is best positioned to meet patient needs. Q. If the number of patients has gotten as low as 2.3 per night, why have you waited so long to make these changes? It has taken time to evaluate the best way to provide quality health care services that are the most useful to people living in Gibson County. We have also taken time to plan carefully so that we can keep most of our employees. While we are eager to get the new mix of services in place, we want as little disruption for people as possible. Q. Is this a result of the Patient Protection and Affordable Care Act? No. Changes for Gibson County health care delivery have been studied for the past few years as the number of patients have dropped. Q. What happens to the hospital buildings? Milan General Hospital will remain open. Humboldt General Hospital will undergo some changes as it becomes an emergency center operating as the north campus of Jackson General ER. We are still working on details in Trenton, but whatever facilities we use there will be no interruption in health care services. 1

2 Q. How many people will lose their jobs? The goal is none, and we believe most of our people will remain employed with us. Q. What are your plans for your employees in Gibson County? The first priority is to keep our staff working in Gibson County with the people they care for and know well. Second, we will match people with jobs elsewhere in our system. Finally, for people who are unable to find another job, or choose not to take another job in our system, there will be a transition/severance package for all eligible employees. We have several months to work this through, and with the number of openings and retirements we have on a regular basis, we believe most people who want to continue working at West Tennessee Healthcare will find a job. Q. How many employees do you have in Gibson County? The total number of people working in all West Tennessee Healthcare facilities (three hospitals, Pathways, Sports+ and other locations) in Gibson County is 285. Of those, 175 currently work at Gibson and Humboldt General Hospitals. West Tennessee Healthcare has nearly 1,000 employees who live in Gibson County. Q. Will this make it harder for Gibson County to attract new jobs? We ve talked to consultants who help locate industries and they ve told us that they don t see it as a problem. Companies want a world-class hospital nearby and basic health care available locally. Gibson County will have a hospital, a medical center, two emergency rooms and many other quality health care facilities. Q. What does this mean for my doctor? This will not change your access to your doctor. 2

3 Q. What about ambulance and EMS service in Gibson County, will it change? Those services are provided by Gibson County EMS (GCEMS). Any changes in those services would be up to GCEMS leadership. West Tennessee Healthcare will work to maintain a strong working relationship with GCEMS. Q. If I have a heart attack or stroke and call an ambulance, where will I be taken? To the appropriate medical facility as designated by EMS guidelines; generally to the closest emergency room that can care for you. Q. Is this just about increasing your profit? No. As a non-profit health care system our commitment is to the people and communities we serve. This is about responding to the way people use health care services. We are creating a system that can last for years to come and result in a healthier Gibson County. Q. How much money did West Tennessee Healthcare make last year? West Tennessee Healthcare is a not-for-profit entity. Successful not-for-profit hospitals work to achieve a certain surplus in order to make necessary long-term investments such as replacing and upgrading buildings and technology in order to provide the very best care for the community. According to our audited financial statements for the fiscal year ended June 30, 2012, West Tennessee Healthcare s total surplus last year was $8.3 million. A hospital s operating margin ratio tells us how much (as a percent) of the organization s operating revenue is left after all of the operating expenses have been accounted for. Last year, our operating margin was 0.9%. This is well below median of 3.0% for similar organizations listed in Standard & Poor s and 3.6% for those listed in Moody s. Although West Tennessee Healthcare is on track to improve results in the current fiscal year, we must make decisions and adjust operations to ensure financial sustainability for the long term. The decisions for Gibson County are important to sustaining a strong health care system for West Tennessee. 3

4 Q. How much money were the hospitals in Gibson County losing? Altogether, the three hospitals in Gibson County are projected to lose $4.8 million in the fiscal year ending in June. This compares with a loss of $3.2 million in the two previous years. These losses exclude one-time non-recurring meaningful use funding from the government for investments in technology, which will not be received in the future. Losses for the hospitals in Trenton and Humboldt make up over $3.8 million of the total. Q. Are the other hospitals owned by West Tennessee Healthcare losing money, too? If so, how much? Excluding one-time, non-recurring meaningful use funding, Bolivar General Hospital is projected to lose approximately $1.3 million in the current fiscal year. Camden General Hospital is projected to have a small loss or may break even after receiving an additional reimbursement from the government because it is designated as a critical access hospital. It is the only West Tennessee Healthcare hospital with this designation. Q. What about West Tennessee Healthcare hospitals in Camden and Bolivar? We have no plans to close those hospitals. Gibson County is unique in having three hospitals and being so close to Jackson. It is important to understand that the decision about realigning services in Gibson County isn t as much about purely addressing the losses sustained in these facilities as it is about identifying a more sustainable way to deliver care in the community. Q. If people from Gibson County are not going to the hospitals in Gibson County where are they going? Information from the Tennessee Hospital Association shows that in 2011 almost 60% of the hospital discharges for Gibson County patients were from Jackson Madison County General Hospital. Our own records show that an average 58 patients per night at Jackson Madison County General Hospital last year were from Gibson County. Q. What about the West Tennessee Healthcare Foundation chapters in Trenton, Humboldt and Milan? These chapters will remain in place and continue to focus on the needs of each community. 4

5 Q. Why don't you build a new hospital in Gibson County? We studied building a new hospital in Gibson County and it is not feasible at the present time. We will continue to study the health needs of the county and the usage patterns for medical care. Q. Why do so many people choose to go to Jackson Madison County General instead of going to the local hospitals in Gibson County? A recent study by BlueCross BlueShield Health Institute found that many people in rural parts of the state choose to go to larger hospitals even when there is a smaller hospital closer to them. Improvements in transportation including rapid-response helicopters have changed things since the days when community hospitals were established. The explosion of technology in the medical care industry requires a large patient base to support the investment. People choose to go to hospitals that have the most capabilities and cutting edge technology. Q. Will there be enough hospital capacity to take care of people in Gibson County? Yes. The number of beds in Milan is more than enough to meet the demand in Gibson County and surrounding counties. Q. Why is the target date January 2014? We want to take the time to carefully transition our employees and preserve jobs. Additionally, there are a number of regulatory filings and other items to address. We believe that this target date will allow time for all necessary items to be in place. Q. Will Pathways Behavioral Health Services be affected? Our Pathways operations in Milan will continue without any change. The Turning Point Program in Trenton is operated under a statewide grant program that may or may not be continued by the state next year. 5

6 Q. What if I need my medical records from Gibson County General or Humboldt General Hospital, how will I get them? Contact the release of information department at Jackson Madison County General Hospital at Q. How did you decide which services you were going to offer and where? We looked at years of data on what kinds of medical treatment and health care services people in Gibson County communities have utilized. We ve looked at the patterns of where people go to get various kinds of care. We also relied on a community health needs assessment that surveyed and interviewed people throughout Gibson County in West Tennessee Healthcare is following the Institute for Healthcare Improvement s Triple Aim approach. Triple Aim means improving patient experience in terms of both quality and satisfaction, improving the health of the population and reducing the per capita cost of health care. Q. How does this fit in with West Tennessee Healthcare s vision? The vision is to be chosen by our staff, our physicians and our community as the best place to work, the best place to practice and the best place to receive comprehensive care. To achieve that vision we have to make sure the way we provide healthcare is sustainable so that we consistently provide the highest quality healthcare and our employees can have a secure future. While this is in line with all our values, it especially is tied to stewardship responsibly using the resources entrusted to us, adding value to the communities we live in and serve. Q. Explain what you mean by a medical center in Trenton. It is a new concept that will bring together the health care services that people in the community need and use most often. In addition to primary care, walk-in after hours care, post hospital discharge care, x-ray and a lab, specialists will rotate to the clinic bringing the types of medical specialties that the community utilizes most. 6

7 Q. Why not put a medical center in Humboldt like the one that is planned for Trenton? There are seven primary care providers, a pediatrician, dermatologists and other specialists already in Humboldt. Humboldt is minutes away from extended after hours care in Jackson and Trenton, and it will have an emergency room that is the north campus of the Jackson General Hospital ER. 7