Fairfield Memorial Hospital: Keeping Faith in Difficult Times

by HCE Exchange on January 13, 2014

Michael-Williams-thumbIn spite of the many federal and state pressures being placed on rural health-care facilities, Fairfield Memorial Hospital, a 25-bed critical-access hospital located in Winnsboro, S.C., has not wavered in its devotion to providing quality health care to its patients in the best way possible.

Even though Fairfield is facing many daunting challenges, it continues to hold its own, expanding and fine-tuning its services to meet the expectations of its patient population.

For example, the hospital started a new program called Senior Connection, designed to reach out to Fairfield’s primary demographic, seniors. As part of this program, the hospital hosts two Senior Connection Days each year, one in April and one in October, with the first event having been held in April 2012.

Although there is plenty of fun to be had at this event, with Bingo and door prizes, its purpose is to educate the seniors and their caregivers on the various departments and services available at Fairfield. A newsletter is also distributed at the event, and vendors who specialize in senior services are on hand.

Fairfield has also put together a Screen Team that attends around 25 health fairs each year, screening for cholesterol and blood pressure.

The ultimate goal of these programs is the prevention of readmissions through education.

“With the Affordable Care Act, they are looking at how you’re going to deal with senior readmissions,” Michael L. Williams, chief executive officer, said. “We’re looking at transitional care, where you work with the patient when they go home.”

This level of dedication is nothing new for Fairfield, however. In spite of enormous odds, Williams and his team are determined to keep faith and keep pressing forward.

Confronting reimbursement cuts and chronic diseases

Compounding Fairfield’s challenges is a recent decision by the state of South Carolina to reject the Affordable Care Act’s Medicaid expansion, which will rob providers of $11 million over the next six years.

The majority of Fairfield’s patients who visit its Emergency Department have no insurance, nor do they qualify for Medicaid, under the current requirements.  In fact, one out of every four patients at Fairfield does not have a physician. If the state had accepted the expansion, these patients would have insurance and Fairfield could be reimbursed, at least in part, for these patients’ visits.

This is no small matter, for patient volume within the ED has increased approximately 100 visits per month. As Williams pointed out, this means more bad debt and charity care.

On the positive side, Fairfield’s rural health clinic is in its second year and doing exceptionally well.

The Fairfield Life Improvement Program (F.L.I.P.), whose purpose is to work with patients suffering from chronic diseases, diabetes, heart disease, and COPD, received a grant of $2 million three years ago from The Duke Endowment.

Williams said the hospital was more than grateful since F.L.I.P. represents a great need in its community. Fairfield County is among the highest regions in the state with deaths related to chronic illnesses.

Bringing patients back

With many localized issues to tackle, Williams said he was looking to improve the hospital’s marketing to areas far outside the county. He said the hospital was planning to advertise in local magazines and put up signs in an effort to attract new patients to Fairfield.

He believes the hospital’s improved services, such as its $1.8-million EMR that went live in September and its newly opened dermatology and orthopedic clinics, would draw many people back.

“One of our biggest challenges is just replacing capital equipment,” he said. “We got state-of-the-art equipment now. We’re in the process of installing a digital-mammography unit. We do have an MRI system, which a lot of small critical-care hospitals don’t have.”

This ambition to be as up-to-date as possible, he said, enables Fairfield to stand out from the other five critical-access hospitals in the state.

Williams has been with Fairfield for 30 years and CEO for five. During his tenure, the hospital has seen increased revenue over the last five years, going up 25 percent.

“We are increasing our volumes, and we are trying to decrease the out-migration of patients leaving the county,” he said. “We’ve come a long way, and I think we’re doing exceptionally well.”

However, Williams said he is anticipating the ensuing years will be difficult. Even so, in the next three to five years, Williams said he would like to begin collaborating and affiliating with another facility.

“The reason why you want to do that is because of the resources that the tertiary hospitals have. The buy-in power is there and you can work with staffing or sending specialists here.”

Fairfield also wants to reopen surgery, Williams said, adding, “Hopefully, one day we’ll be building a new facility.”

The accountability of small-town health care

Williams is well aware of the implications of running a hospital in a smaller community.

“Working in a small community is a different ballgame than working in a large one,” he said. “You got to focus on your patients. In a large hospital, a lot of times a patient is just a number. In a small hospital, everybody knows everybody.”

The imperative to provide quality care is even higher. After all, health-care professionals see their patients at church, school, the grocery store, the hardware store, etc. Therefore, to keep the hospital on-course with patient satisfaction and safety, Fairfield recently signed a contract with Press Ganey to do its inpatient survey.

“With the new health-care reform, we’re changing the way we’re practicing,” Williams said. “We’re not just flipping a patient when they come into the hospital. Now, we’re trying to track these patients when they go home.”

-by Pete Fernbaugh

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