Murray County Medical Center: Mel Snow, Chief Executive Officer

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Rural critical-access hospitals are facing uncertain futures as policymakers examine ways to cut costs. With increasing focus on high-quality, patient-centered care, rural hospitals are often setting the bar higher than major medical facilities.

But this shouldn’t come as a surprise. In close-knit communities, small hospitals have always been focused on the patient–who is often a friend, neighbor, or family member–long before patient-centered care was a popular buzzword.

In Murray County, Minn., one critical-access hospital is excelling in high-quality, patient-centered care. Murray County Medical Center is a 25-bed facility serving a rural population comprised mainly of farming area and a predominantly older population.

It provides mostly generalized healthcare, some trauma, and orthopedic surgery and also has one community clinic and one on-site clinic for primary and specialty care.

Focus on Quality over Quantity

Although small, Murray County Medical Center has impressive quality metrics.  In the past few years, the hospital has received three safety awards. In 2012, the surgery department had no sentinel events and only one surgical infection, and the hospital had only one incident of hospital-acquired infection.

In 2009-2010, the hospital was named as one of 35 Gold Standard Performers by Larson Allen, which reviews the financial sustainability of critical-access hospitals. Hospitals that have achieved this status generally adhered to the following guidelines for success: pricing that provides for financial success; greater revenues from non-Medicare payers; superior cost performance; strong procedural and ancillary services; outstanding physicians and excellent relationships with medical staff and the community; and initiatives to aggressively grow revenues and manage costs.

The hospital was also named as one of the top 32 hospitals in rural health by the University of North Carolina at Chapel Hill in 2011.

To assist with excellence and safety initiatives, Murray County Medical Center has a management agreement with Sanford Health out of Sioux Falls, S.D. However, the hospital still maintains autonomy and is responsible for its own financial success, which Chief Executive Officer Mel Snow says has come by focusing solely on what’s best for patients.

“We are a county hospital, so we’re more patient-centered and more healthcare-centered,” he said. “We don’t worry as much about the bottom line, and by creating a positive work environment and focusing on what our patients need, the bottom line has taken care of itself.”

Expanding Community Care

Since the bottom line has taken care of itself, the medical center is now undergoing a building project to double the size of the facility. In the past seven years since Snow has taken charge, the hospital has recruited six new physicians–no small feat as many hospitals struggle with physician recruitment.

Snow said the work environment at the hospital is what has attracted most of the physicians.  For example, the medical staff and leadership all work together in decision making and reviewing financials.

Through this shared-leadership process, Snow said all hospital employees and physicians have developed an obligation to the facility. The hospital also has a strong nursing staff with an area pool of nurses who want to work for the organization.

The new building project will add six more offices with exam rooms to the clinic to accommodate the new physicians. But, Snow said, the building project is really centered on patients. The building will have a new patient area with all-private rooms and a nutritional area in the room for families; and all inpatients will receive free massage therapy.

Other upgrades include an expanded imaging area to house increased capabilities from a 64-slice CT scanner, digital mammography and bone-density equipment, ultrasound equipment, and a new MRI machine.

“Our new imaging equipment has really helped us continue to increase the level of healthcare we provide here,” Snow said.

Overcoming financial challenges

As with all rural facilities, there is little “extra” capital coming in and looming cuts to reimbursement. Since Murray County Medical Center sees a primarily elderly population, the majority of its revenue comes from Medicare.

However, the hospital has remained strong through quality initiatives and a focus on reducing medical waste. Throughout the recession, the hospital did not lay off employees and continued to give raises. Employees even agreed to forego raises for two years to help with the $12.5-million building project.

The nurses are part of a union in Minnesota, and this creates some challenges in communicating to the union the quality of the work environment provided at the medical center.

“We have one of the best nurse-to-patient ratios in the state at 2.7,” Snow said.  “We struggle to have the union recognize that at times.”

As reimbursement changes are issued, the medical center is focused on reducing readmissions by improving wellness and primary care. The hospital has a bus that travels the county to provide wellness screenings. It also has a team instituting a healthcare home.

Through its efforts, Murray County has done exceptionally well in remaining financially viable

and looks forward to a strong future. Because of its success, Snow is able to emphasize the need for rural hospitals.

“Rural healthcare is good healthcare and is often cheaper for everyone while still achieving national quality standards,” he said. “Everybody deserves healthcare, and we need to find affordable, accessible ways for everyone to get it.”

-by Patricia Chaney

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Concerned Citizen February 26, 2014 at 11:22 pm

Wonder what people in Murray County would say about this article now?


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