Rural Missouri Hospital Focuses on Next Generation of Providers

by HCE Exchange on April 14, 2014

Rural-Hospitals-thumbScotland County Hospital was first established in 1970 in Memphis, Mo., as a non-for-profit district critical-access hospital. Since the beginning, its focus has been on families, both the families of its employees and of its patients.

SCH was originally a 19,000 sq.-ft. campus that offered inpatient care, a surgery room, lab, and X-ray. Over time, these offerings were expanded to three hospital-based rural health clinics in Scotland, Clark, and Schuyler Counties; a state-of-the-art 24/7 surgery center; specialties ranging from orthopaedics to obstetrics & gynecology to ENT & podiatry to rheumatology; a women’s center staffed with five physicians; and an ER that offers round-the-clock physician care.

As the only hospital within a five-county radius, the importance of offering premier care to its community cannot be underestimated. It’s also imperative that SCH is always looking to the future, embracing the latest ideas and projects and taking stock of what its communities’ needs really are.

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SCH continues to be successful thanks to an engaged leadership and employee base that believes in the organization’s mission “to improve the healthcare of our communities with services close to home.”

“Close to home” also means close to home for the leadership and employee base. Many of SCH’s personnel are residents of the surrounding communities who have grown up there and in many cases, returned there to raise families following college.

This employee base is extraordinarily stable, with many having worked for SCH for three or more decades, and it’s this core of employees that provides the heart that is needed for a family-focused facility like SCH.

Furthermore, SCH employs or has relationships with approximately 20 physicians who were born and raised within 50 miles of the hospital. These professionals love rural areas and have a passion for providing the best care to their families and friends.

Nurturing the next generation

Currently, SCH is working on a grant initiative called Med Club, a program that reaches out to young people in the community for the sake of educating them on the different career opportunities, especially in healthcare, that are available to them locally. Med Club also works to encourage students to seriously pursue math and science and seeks to give young people perspective on potential careers, mapping out what their day-to-day lives would look like in such a career, how many hours they would work, salary potential, etc.

The goal is to keep the youth in the area committed to settling locally and contributing to the future of these communities. Med Club opens students’ eyes to the many healthcare careers beyond becoming a doctor or a nurse, such as medical technicians, IT techs, coding experts, dieticians, and receptionists.

Approximately 300 students across four counties are enrolled in Med Club. These students meet monthly and also go on field trips to larger learning institutions throughout the year where they spend the day with different specialties, whether it is in a cadaver lab or IT.

The hospital then remains in touch with those students who decide to pursue a medical career over the course of their education. SCH wants them to know the offer to practice with the hospital is open for them.

Defining the rural hospital

SCH is the very definition of a rural hospital. Located in the extreme northeast of Missouri, it is a healthcare oasis in an area that has to travel one-lane bridges and state highways to arrive at the nearest cities. The elderly population is higher than the state and federal averages, and the payer mix is about 62 percent Medicare and between 11 and 12 percent Medicaid.

Because SCH is in a farming community, local industry is centered largely on agriculture. As a result, SCH does not have the luxury of accessing the group insurance that is normally provided by other industries. Roughly 20 percent of its patient base is covered by insurance and five to seven percent is self-pay. SCH also offers an income-based sliding-fee scale that allows people who do not have insurance to better manage their medical coverage.

Right now, SCH is at the mercy of whatever the reimbursement system is going to become. It is also at the mercy of rapidly evolving medical technology. The technology is expensive, but if the reimbursements are cut, SCH suddenly finds itself battling a catch-22.

This catch-22 has the potential of impeding the hospital’s passion for providing the same level of care available at every other facility. The nearest hospital is 45 miles away. SCH isn’t close to a four-lane highway. There is no time and no space for the kind of wrangling currently going on with healthcare reform. Organizations like SCH need to know what healthcare is going to become in the next several years.

Whatever happens federally, however, community will come first at SCH. In the late 1990s, obstetrical care was vanishing from rural hospitals, but not at SCH. Instead of removing obstetrics, SCH chose to build out these services and constructed a women’s center and began developing a birthing center.

This is only one example of the SCH philosophy, for at SCH, it’s always about community.

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