HERMANN —  Officials of Hermann Area District Hospital (HADH) are hoping they’ve found a cure for a longstanding headache — ensuring around-the-clock Emergency Room staffing by doctors.

Beginning Nov. 1, HADH’s ER will be staffed 24 hours a day, 7 days a week by doctors working out of Missouri University Health Care. Hospital Administrator Dan McKinney at Monday night’s Board of Directors meeting formally announced the agreement between HADH and MU Health Care.

“MU Health Care has a proven track record of success providing emergency department staffing at rural community hospitals,” McKinney said. “We believe this partnership will ensure our patients receive the highest quality care possible and offer a level of provider stability that has become a challenge for many community hospitals.”

MU Health Care is providing doctors for other Missouri community hospitals.

“Connecting Hermann Area District Hospital to the MU Health Care academic health system will link HADH patients to doctors and clinicians who are on the leading edge of health care at central Missouri’s only Level 1 Trauma Center,” said Dr. Matthew Robinson, MU Health Care’s Emergency Medicine chairman. “This partnership aligns with MU Health Care’s commitment to ensure continued access to health care in Missouri’s rural communities.”

If the ER staffing issue has been resolved in the long term, that would be most welcome news to the hospital board, which still faces plenty of personnel and program hurdles to clear as it works to remain fiscally viable during a time when other rural Missouri hospitals are shuttering their doors.

For instance, directors spent some time Monday night hearing about upgrades needed in the hospital’s Cardiac Rehabilitation Department. Staffers there are using old equipment and are able to serve only one or two patients at a time, rather than three or four, because of inoperable equipment.

This particular program appears to highlight some of the questions surrounding the possible lease of HADH to AVEM, an Oklahoma-based investment management company looking to extend its presence into the community hospital industry. There was some discussion that AVEM might want to drop the cardiac rehabilitation program, preferring to have that service performed at other facilities. Staffers of the department voiced skepticism about obtaining upgrades to equipment, partly out of uncertainty of the department’s future under AVEM management.

But some board members say better equipment means an increased ability to see more patients, which, in turn, means more revenue for the hospital. Director Trigg Render voiced support to make the necessary improvements to see additional patients during the department’s Monday-Wednesday-Friday schedule. “I can’t see a reason why we shouldn’t proceed,” Render said.

“I guess we proceed,” added board President Dale Ridder.

Dr. Michael Rothermich, chief of the hospital’s medical staff, suggested Cardiac Rehab personnel present the administration with a formal, detailed proposal of what is needed in order to service additional patients. 

“A proposal, based on your extensive experience, to the board probably would be well received, as it will be by the medical staff,” Rothermich said.

As for a possible trimming of the service by AVEM, Ridder said he was skeptical.

“I would see no reason they would want to cut such a program.” he said. However, his position contained a caveat.

“We’re going to have to look critically at opportunities” to cut costs, he said, and added that likely will mean cutting some services.

McKinney also noted during the meeting that as he prepares an operating plan for the coming year, he will have to be mindful of the possibility of staff cuts as a way to save money. That is, unless more money that is owed to the hospital can be brought in.

To that end, McKinney tossed the board a proposal for collections: Hire an in-house collector to focus solely on improving the accounts receivable (AR) numbers.

“It’s a huge amount we try to collect all the time,” the administrator said. “We could spend some money and hire a collector in house.”

Without given a formal endorsement to McKinney’s proposal, Ridder did voice encouragement. “I know a year ago this board was pretty adamant about looking at AR,” he said.