Name: Lynn Csernotta

Occupation: Registered Health Information Administrator

Relevant Experience: 30 plus years of health information management experience; Velocity Health, Information Management Solution Coordinator; IBM Consultant, managed hospital software installations, best practices/data governance consulting; Health Information Services Director: multi-hospital systems, community, rural and teaching hospitals; Senior Research Associate at Joint Commission on Accreditation of Healthcare Organizations

1. Grays Harbor Community Hospital serves a population that often ranks high in terms of chronic health problems and has a high percentage of patients who pay with government-backed insurance. On top of that, recruitment of health professionals has been a long-time problem. Given those conditions, what actions can the board take to overcome those obstacles?

Chronic health problems

Chronic diseases (diabetes, hypertension, asthma, etc.) are very costly in terms of health care expenses and quality of care for our community. Some ways to combat chronic illnesses is to promote wellness programs, provide community educational and out-reach programs and increase access to physical fitness programs/facilities.

I believe GHCH has an obligation to promote wellness and has an opportunity to partner with organizations like the YMCA or other area health care facilities. Together they can conduct community health screenings (diabetes, bone density, blood pressure) and/or educational sessions which help promote early disease detection and wellness in our community. These events can be held at local senior centers, Elks/Lions clubs, the YMCA, or local businesses throughout Grays Harbor. Or GHCH can partner with local cities to hold health fairs. Vendors can be invited to the events to promote their services, products and/or programs.

GHCH can tap its own health care professionals and community leaders in their fields to conduct lectures at the hospital that address healthy eating, physical fitness, substance abuse, smoking cessation and other topics for very little cost to the organization. The benefits reaped from these programs are not only increased health for our residents, but goodwill, community outreach, increased visibility and community involvement on the part of GHCH.

Government insurance payments

Most of Western Grays Harbor has been declared a Medically Underserved Area and/or Medically Underserved Population and the entire county is a Health Professional Shortage Area. These designations are important because there are more than 30 federal programs available based on these shortage designations to determine eligibility or funding to increase the number of physicians and other health professionals who practice in these areas. It is important to investigate what federal programs GHCH many be eligible for based on these criteria.

It’s critical to continue to identify opportunities to influence reimbursement rates on a local, state and national levels and actively work with representatives to bring legislation to the forefront that will assists rural and underserved populations.

Finally, we need to work with our legislators to assist GHCH in identifying and writing grants that will provide funds to support our goals such as expansion of services, wellness programs, scholarships for medical professionals and physician recruitment.

Recruitment

Physician shortage continues to be a growing issue and hits rural and inner-city areas hardest. Therefore, GHCH has to get creative and find ways to entice physicians and other healthcare providers (nurse practitioners, physician assistants) to fill the gap.

GHCH needs to accommodate candidate interview schedules, provide competitive compensation packages (not just monetary but other benefits such as time off, flexible scheduling, part-time employment) and be highly responsive and creative during the recruitment process.

We need to pull out all the stops when interviewing candidates and provide personal tours of housing opportunities, schools, local attractions and restaurants. Set up meetings with community business leaders, meet with Greater Grays Harbor staff and provide links to websites that introduce them to all that Grays Harbor has to offer. We need to spotlight Grays Harbor and show the candidate and their families why they should live and work here.

Invest in the development of clinical providers by continuing to partner with the Grays Harbor College Nursing Program and participating in medical student and residency programs. Help to “grow-our-own” clinical providers by assisting with scholarships to help nursing students and encourage and support educational efforts to help students progress to becoming nurse practitioners.

2.What are your ideas for a strategy that will put the hospital on better financial ground?

Comprehensive and structured financial planning is critical to providing and sustaining high-quality care to patients.

I recommend reviewing the existing financial plan to ensure it is up-to-date and provides ongoing accountability and strategies for success.

Ensure specific parameters of GHCH’s financial performance and goals/benchmarks for each are in place (i.e. days cash on hand, gross discharged not final billed, operating margin, claim denial rate and other critical financial indicators). Additionally, create an accountability process for reporting results: set goals and performance targets and require explanations for variances of performance. On a monthly basis, require those responsible, to report to hospital executives and commissioners on their performance target results, explain variances and develop action plans for correcting variances.

It’s imperative to have efficient claims management and billing practices in order to improve cash flow. GHCH needs to evaluate the current claims processing and revenue cycle management. This includes evaluating pre-registration and pre-authorization practices/processes, evaluating coding compliance, improving clinical documentation and providing efficient billing services (customer support, collections, follow-up). Efficient debt collection and a robust denial management process are also critical. After the evaluation, issues can be identified and processes for improvement can be developed and implemented.

It’s also important for hospital administrators and department heads to evaluate expenditures and identify opportunities to save money. No cost savings is too small.

3. In terms of priorities, what direction would you, as a commissioner, give the hospital administration?

Focus on improving the financial security and viability of GHCH.

Evaluate and expand urgent care and other health services to currently underserved areas (North Shore) and work with community leaders and legislators to assist with funding these services/facilities.

Improve access to substance abuse and behavioral health programs.

Increase visibility, transparency and communication from the GHCH executive team and commissioners to the community.

Evaluate/update IT data security/privacy practices, data storage, backup protocols and data recovery processes/practices.

Develop robust programs to recruit/retain physicians and other healthcare providers.

Promote health/wellness initiatives in Grays Harbor.

Update the GHCH website and include real time ED wait times.