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North Arkansas Regional Medical Center CEO/president Vince Leist told members of the hospital Board of Governors that the hospital will close on the Bear State Building at the end of August.

Last year, Leist told the board of directors that he estimated the community would need 10-12 more doctors. With that would come the need for more space for them to practice, about 1,200 square feet each.

Hospital officials had discussed the possibility of building a space, then they announced in October 2018 that they were looking at the Bear State Bank building on the north side of town on Highway 65. It was originally constructed as First Federal Bank, but Arvest Bank acquired Bear State Bank in August 2017.

In February, the board approved a resolution allowing Leist and/or board chairman Dan Bowers to execute all documents necessary to help North Arkansas Medical Services to buy the building subject to obtaining suitable financing.

The resolution said the purchase price is $4.5 million.

The hospital continues to recruit doctors. “We are actively recruiting a family doctor, a urologist, and a non-invasive cardiologist,” Leist said.

Board member Laretta Moore asked about the additional space with the purchase of the Bear State Bank building.

“Having space for our doctors is one of those selling points,” Leist said. “We’ve got plenty of people here to fill a new doctor’s panel. Some doctors do limit how many Medicare patients they allow because of the requirements and reimbursements.”

Sammy Cribbs, vice president of clinical services and CNO, added, “That’s why so many doctors are adding nurse practitioners.”

There was no quorum of board members present at the August quarterly meeting, so hospital administration had an informal chat session with the attending board members.

Most of the discussion centered around the dilemma the cost of providing quality care when costs are rising and reimbursement is lower.

Leist mentioned that 25% of all Arkansas Hospitals have some kind of county support for their ambulance service.

“We’ve provided the ambulance service here for 40 years and it continues to get expensive to operate. One basic ambulance is $150,000,” Leist said.

They talked about the problem western Carroll County has had keeping a service and when NARMC is called as a last resort, the response time can average an hour, by the time other services are contacted and they deny the request.

Leist introduced Ken Pennell to the group. “Ken is our new CFO. He’s very detail oriented and well trained. He’s only been here a month, but already fits in so well it feels like longer. Last year was a tough year, but we are seeing things turn around.”

Pennell went ahead and presented the financial report to those present.

“Admissions were down 1% in May over last year,” Pennell he said. “The trend is to not admit patients but keep them listed as outpatients.”

Cribbs explained, “To satisfy federal payers, we have to send patients home sicker, or sooner than we would like.”

“People don’t understand their insurance and how it works. It can be very complex,” Leist said.

“We are trying to make patients aware up front how the high deductibles will impact them,” Pennell said.

“It will take some business innovation,” Cribbs said. “How do we help them meet their financial obligations and provide financial services, too?”

The group was reassured, that finances do not come into play during an emergency. Patients are treated without any questions about payments.

Leist said, “We will continue to do it and provide care — even if it drains the well. The key for the hospital’s success is to have the community’s trust. We lose money on our emergency room, but we need it here.”

Cribbs also explained that to cut expenses, the hospital is using its own staff in over-time situations instead of the traveling nurses. “This way we can help our own people, but we have to be careful to provide enough rest time for them, too.”

The topic turned to recruiting board members. “I recently saw a survey of Arkansas hospitals and 76% of them recruit board members the same way we do,” Leist said. “I put together a list of skill sets needed when we have a vacancy. I look at the board as a whole to see what strengths are needed. For example, do they understand insurance, banking or finance? What are their strengths? Then we give the list of strengths needed to those on the nominating committee. They return a list of possibilities to me and I choose someone, primarily by their skill levels.”

“There is a system. A large percentage of hospitals use this same method,” he said.

“We are strategically doing everything we can to recruit quality doctors, refine our financial processes and reduce and manage costs to expand our services,” Leist said. “I believe the quality of care we are providing is very good. We appreciate the payer-mix in town from our different industries.”

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