Comprehensive Plan 2022

IDEA: EHR IMPLEMENTATION

Tony Damron

DEFINE DEVELOP EXECUTE

One of the biggest initiatives that a healthcare organization can take on is the replacement of the Electronic Health Record followed closely by the replacement of a revenue cycle system. Most major healthcare organizations have recognized the value in having all of that in a single platform, so tables are shared, and data becomes more mineable and meaningful.

As this business becomes more competitive and pay is based on performance, we must be able to function as a high performing organization and that means we need tools to assist in all areas of providing care and billing for the services that we provide. We believe that we leave money on the table each year due to bad processes and segmented systems. We also know that the future of healthcare is in artificial intelligence (AI) and how medical conditions are predicted and treated as a part of preventative medicine.

Adopting a single platform EHR and Epic is the one that will get us where need to be.

Move forward with implementation.

Begin Testing in Dec 2021

Develop training process to begin April 2022

Go Live June 2022

Training and go live readiness for the project ended on 5/28/2022

Epic Go Live occurred on June 1, 2022 as had been planned since the project kickoff

Go live was successful but issues occurred just as in any other implementation and were worked through

We currently still have lingering issues with our work queues working properly and also staff knows how to use. It's a split between workflow/operations and a few lingering IT issues. Imaging exams have returned to normal volumes but still need some work to make it more efficient.

We are now conducting post live visits and will transition away from being a project prior to YE

Epic is a single platform information system that will help us to decrease our IT application footprint and will get most things and most people into a single system at least as it relates to care of our patients. This product will replace systems such as CareVue, Wellsoft, Nextgen, STAR, Allscripts Surgical and Anesthesia. It will also give our patients a single portal to use called MyChart. Today, our patients must access 3 separate portals to manage their care and even then, they aren’t seeing everything and are limited in managing things such as appointments, registration details, or bill pay.

PROBLEM: Our Electronic Health Record systems are very segmented currently as we typically use a different software application in almost every department. In the ever increasing competitive healthcare market, executives need good data to make important decisions to support the business. If that data is not readily available, a lot of decisions are made based on “gut feel”.

DELIVER

Update as of September 2022

• Continue to work on making the new system more efficient for workflows

• Major push for MyChart and making sure the right features are enabled to help our patients and families

• Implement fast pass through MyChart which will allow patients to take earlier appointments as slots open up

• Implement express lanes for clinicians to improve efficiencies

• Work on OR room utilization as it appears to currently be low

IDEA: CHILDREN’S HOSPITAL SERVICE LINE LAUNCH

Aaron Crum

DEFINE DEVELOP EXECUTE

As Pikeville Medical center embarks on developing the region’s first pediatric hospital, we will proceed in serving the region’ s need by following a prescribed strategic plan that involves service line improvement and expansion, as well as key partnerships.

This plan will be modified as resources and partnerships become available and develop.

1. In partnership with UK Healthcare, develop outpatient specialty clinics that will be both on site and virtual.

2. Begin offering services such as pediatric endoscopy, EEG and pediatric surgery at PMC utilizing UK physicians

3. Begin utilizing specialty consultation services for inpatient care

4. Recruit or possibly jointly hire med peds trained physicians to run a pediatric inpatient ward

5. Begin utilizing the PICU for inpatients with tele ICU services

6. Expand to a full function PICU DELIVER

Update as of September 2022

The development of outpatient pediatric specialty clinics is well under way at this time. The ball is literally in UK’s court at the moment with contractual reviews and development. Our first service will be offered in October 2022 and will be in pediatric endocrinology. Following this service line in the coming months will be pulmonology, plastic surgery and a body mass index clinic.

Some of these models will be purely telehealth while others will be traditional in person care or combinations of telemedicine and on site care.

The models will vary per service line. Some will be a contracted services model while others will be leased space agreements. We are also exploring and negotiating for pediatric EEG reads provided by UK as well as a true pediatric diabetes clinic.

We are continuing to jointly recruit for a neonatology position with UK and have a med peds physician joining in 2023.

IDEA: AVA CENTER SERVICE AREA EXPANSION

DEFINE DEVELOP EXECUTE

Provide the AVA Center in Pikeville with an outdoor playground. The playground will allow our learners at the AVA center to work on turn taking skills, peer interactions, as well asappropriate play skills while engaging in gross motor movement.

To expand the AVA Center service line to new areas to allow additional learners and comprehensive services.

1) Provide a dedicated speech language pathologist as well as an occupational therapist who is solely dedicated to the AVA Center.

2) ProvidelearnersAppliedBehavior Analysis (ABA), speech, and occupational therapy sessions at the new location.

3) Include a multisensory gym which will allow for sensory integration, as well as gross motor movement for our learners

4) Provide an outdoor playground. The playground will allow for our learners at the AVA center to work on turn taking skills, peer interactions, as well as appropriate play skills while engaging in gross motor movement.

All goals mentioned have been accomplished.

We have a speech and occupational therapist starting in Pburg .

We will include a gym in the Pburg location.

We have funding and design for the outdoor sensory playground, just waiting on equipment.

Pburg will be completed in October and will open in November with the opportunity to accept 24 new learners. We will have 2 new BCBA, 12 RBT, Speech, OT and Feeding therapy, and an office manager at this new location.

DELIVER

Update as of February 2022

1) As projected the center now houses 80 learners, with the intent to grow to 96 by mid year. Covid has had an impact on the growth over the past few months with almost ½ of the staff out at one time or another with covid.

2) Hired a new speech language pathologist that starts in April but is still looking for an occupational therapist. We have found these positions to be difficult to recruit.

3) Providing ABE, feeding, occupational and speech therapy sessions.

4) Waiting to receive the funds for the outdoor playground. assuming Congress adopts the budget in March, who how so see funding soon thereafter? The design has been completed we are awaiting the funding

5) All construction of the existing AVA center has been completed with a new HVAC and elevator.

6) New project will be to construct the new satellite center on our property in Prestonsburg. design is almost complete and will soon be going to quote and then construction. the new center will be located on our urgent care property and will consist of a gym, feeding room, therapy rooms and offices. the center will allow us to treat 24 additional learners from the Floyd County area offering the same type of aba services. construction is projected to be completed by August or September.

7) The center currently has 5 fellows BCBA in training. 3 are expected to take their boards in 2022 and the other 2 in early 2023. we will continue the fellowship program in order to produce the BCBAs necessary to operate the center and grow.

Donovan Blackburn

8) Currently signed a new psychologist that will be able to administer ADOS testing for the center. With over 300 kids still on the waiting list and over half not being diagnosed with ADOS, this will allow us to add another valuable service will providing the necessary testing to allow more kids in the center as staff grows and spots open. the new locum psychologist is expected to start towards the end of February. We are hoping to recruit him here. he currently resides in the London KY area and has a wonderful background in administering ADOS along with other services that would be valuable to our learners at the center. we will still have dr. Ford performs ADOS 1 day per week as well.

Update as of September 2022

1. We are at 90 learners, waiting for our RBT staff to be trained and will soon be at 96.

2. The building and services in Pikeville are now operating.

3. Focus is on getting through and improving the EPIC launch for the center.

4. Waiting on equipment for the sensory playground. Will install in March of 2023

5. Grant funding also paid for a mural on the building.

6. City has donated an autism ceramic BEAR that will be presented in October to the center.

7. New statue is expected to be dedicated in November.

8. All expected BCBA Fellows have either graduated or are on target to graduate.

9. As Fellows graduate, we are backfilling for new fellows into our program to build our bench strength. Takes 2 years to grow a BCAB from within.

10. All construction projects on the Pikeville location have been completed other than the playground

11. Pburg is under construction and will be completed in October with an opening in November.

12. Director is working on selecting Learners who live in Floyd County or are close to being transferred from Pikeville to Pburg. This will happen with staff as well. We have 2 new BCBA graduating and will soon take their boards. 1 will go to Pburg and 1 in Pikeville.

13. Once Pburg gets up and operational, will start looking for the next market more than likely being Salyersville, Hazard or Louisa.

14. We hired our new NP who is now administering ADOS testing to Medicaid families only.

15. Private and or commercial insurance requires a psychologist to administer the ADOS before they will pay. We are working with Kay Webb to get her psychology license in Kentucky. Once she does, she will be doing our commercial kids.

16. Working on developing a new policy book that will pertain only to AVA Center.

17. AVA Center had a recent full audit by commercial insurance and passed with flying colors. No major issue and only a couple of small recommendations. Not bad for a new service line we built from the ground up.

18. Just a note, the center now has over 500 kids on the waiting list. We do have criteria set of standards that prioritize those Learners for our program. It IS NOT first come first serve.

19. All else is going well. AVA Center is now operating in the BLACK, which is a huge accomplishment.

IDEA: STREAMLINING EMPLOYEE HIRING PROCESS WITH KRONOS

DEFINE DEVELOP EXECUTE

Due to continued growth in service line offerings and regularly expected turnover, it is a strategic imperative that PMC be able to process the hiring of new staff in an efficient manner.

The goal would be to seek improvement in the non technological aspects of the hiring process.

To re examine all aspects of its hiring process to identify areas of potential improvement and implement solutions.

Form multidisciplinary team processing of new hires.

DELIVER

Update as of February 2022

This project is complete. Multiple changes have been made to streamline the hiring process including implementation of new jobs website, expansion of the quick application feature, renaming of job titles in job listings to a more common language, moving reference check deadline to 3 months post start, making all applications accessible by all hiring managers, only listing one job when there are multiple vacancies in the same position, training management on the use of the hiring stage buttons in Kronos that generate automatic communication, expansion of slots for physical exams, and instructing recruiters to be proactive in encouraging hiring managers to move candidates through the process. We have also created a new department for external recruiting whose work is ongoing.

Update as of September 2022

While we have made substantial improvements in revamping our process, this will always be an ongoing project because we will always be on the lookout for ways to improve. The next items that we are working on are to reconfigure office locations within HR to consolidate all recruiting personnel into the same area, revise the hiring workflow to take more burden off hiring managers and return those functions to HR personnel where appropriate, and consider not requiring references for certain entry level non clinical positions.

Erich Blackburn

IDEA: GROW SPECIALTY & RETAIL PHARMACY SERVICES

DEFINE DEVELOP EXECUTE

Continue to grow our services in the retail market, we need to provide courier services within a 20 miles radius and mail order.

for more opportunities

Distribution

Billing

Clinical Services

reporting

Customer Service

opportunity

analysis

leaders

DELIVER

Update as of February 2022

The Specialty Retail Pharmacy did meet our projections for the Specialty Pharmacy in year 1 and year 2 we are continuing to grow in that area. We are working hard on getting the oncology trials platform. We do have the data team in place and if we don't have enough data by the end of April then we will be pushed to August. However, we will hopefully meet those requirements by the end of April.

As for data collection, if we get the Pfizer platform for oncology that will be huge for the Specialty Pharmacy. We are working closely with the clinical groups and talking to the oncology doctors one on one. Most of the scripts are coming from the oncology department.

As for the retail side, we are offering home delivery or a mail option, but we have to be extremely careful with the mail option we can’t go over 10% of their total volume or it changes our state licensure and also changes our contract with our payers, and this is checked monthly. An aggressive marketing plan is in place for both the specialty pharmacy and retail pharmacy. The team is working with CPS and Amerisource.

Update as of September 2022

The Growth of the Specialty and Retail Pharmacy continues to exceed the original proforma. Several key wins have occurred:

Specialty Pharmacy got access to Pfizer portfolio. Starting date 04/01/2022.

Specialty Pharmacy was able to execute ACCELERATE contract which allows us to bill to several insurances we did not have access to.

Inflammatory: Dr. Sizemore joining the Clinic increased the inflammatory diseases portfolio exponentially. We also found out there are more opportunities to increase our volume within rheumatology clinics by shifting prescriptions

from contract pharmacies to PMC Specialty. Lina addressed the missed opportunities with Clinic Manager Kenneth, who in turn met with providers to work on the requested change.

➢ Cardiovascular: a big win to Specialty pharmacy we are among the first pharmacies to dispense Leqvio successfully, a breakthrough injection for hyperlipidemia. Leqvio is a hybrid drug in terms of billing and it is very tricky in prior authorization and benefits coordination. Novartis medical field manager was using PMC Specialty efficacy as a model to follow in other specialty pharmacies.

➢ Specialty pharmacy is now staffed to volumes.

➢ Patient Care services phone calls and education continue to be high satisfaction drivers.

➢ Lina has begun her new role as pharmacy liaison and will be working directly with patients and physicians to increase the growth of the Specialty Pharmacy. Focus on Oncology to start. Goal of 5 new specialty prescriptions per week. She will also be working with the new dermatology service line. We expect the same success we are seeing from inflammatory.

➢ Lina did a primary visit to Dr. Reed’s office to discuss the use of Specialty Pharmacy for their patients. She sent authorization requests to allow the team to handle P.A on behalf of the office.

➢ New drive thru policies have been hardwired at the outpatient retail pharmacy. Customer prescriptions taking lower than 5 minutes are asked to pull around to color code spots in the front lot. The color sheets are carried with this patient’s script thru the process, so the tech is aware of the time the patient is waiting.

➢ We are continuing the med synchronization project.

➢ Patients deliver to the 41501 zip code continue to grow.

➢ All pharmacy techs have completed the Good Neighbor Customer training modular.

➢ Pioneer App launch was a success and has increased patient satisfaction.

➢ Call Abandonment Rate is down to 2.4% acceptable level is 5%.

➢ E scripts are up with Epic. Working toward total migration with all PMC physicians.

➢ We have hired two new pharmacists.

➢ Executed a marketing plan with updated graphics.

Items in progress:

1. Need to have Capture rate reports from Epic (we have lost the feed)

2. Need to set up MSOT in Epic to punish volume on specialty drugs

3. Need to understand the very low volume of Pfizer oncology drug scripts- we have only had one since April. We could lose this, very hard to get access back if we lose.

4. Aligned strategy with the medical insurance contracting team

• This work has been on hold with EMR Conversion

UHC Discussions

Drug lists have been exchanged

Cigna

Ongoing discussion

Anthem

Drug lists have been exchanged

IDEA: WIRELESS NETWORK INSTALLATION – MAIN CAMPUS

Tony Damron

DEFINE DEVELOP EXECUTE

Along with the process of planning, designing, and implementing a wireless network in a hospital and associated medical buildings on the hospital campus. Information Technology (IT) will be installing wireless network throughout PMC’s main campus.

The wireless project was completed prior to the end of May and just in time for the Epic go live event. This has strengthened our wireless network tremendously in order to support the new mobile devices that are being utilized by staff throughout the main hospital. This is a definite win as we previously had many dead spots for wireless and were running on outdated equipment that wouldn't work with the new devices.

DELIVER

Update as of September 2022

The plan now is to take some of that equipment and repurpose it at some of the offsite locations that do not currently have a wireless network.

IDEA: CANCER CENTER DESIGN, BID AND BUILD

DEFINE DEVELOP EXECUTE

Pikeville Medical Center recently received an AML grant to expand the Leonard Lawson Cancer Center (LLCC). The 4.27 million in funding will allow the LLCC to increase by an additional 7,000 square feet on the 11th floor of the PMC Clinic building.

The area is conveniently located next door to our recently opened laboratory drawing areas and Cancer Specialty Pharmacy.

The overall goal is to provide world class cancer care to our patients

1. Provide an additional 18 exam rooms for the oncology provider team to see patients on the current 10 floor clinic space.

2. Provide 24 chemotherapy treatment spaces which include 14 private chemotherapy suites and an open space with 10 state of the art treatment chairs.

3. Adjoin the new state of the art chemotherapy pharmacy which will provide easier access and transport of chemotherapy medications to the chemotherapy treatment space

4. Provide new motorized reclining chemotherapy chairs equipped with heat, massage, and built in USB ports to maximize patient comfort.

5. Install in each room an exciting new product called Sky Factory that will provide a calming, sensory experience for the patients during treatment

DELIVER

Update as of February 2022

1. Complete plans and timeline.

Cancer Center Expansion on the 10th will move chemotherapies up to 11th We will have 24 stations for chemotherapy. Plans and design are complete it has been submitted to AML and AML has approved and sent it on to OSMRE once approved we will start putting the bid packets together. Meeting Feb 17 at 3:00 with the Architecture team to view plans. The architect was already approved so we can move ahead with the design, and we sent it on the AML 75% of the bid packets are finished and waiting for final approval

Update as of September 2022

The 11th floor Cancer Expansion project bid opening was on 8/16/2022. We had one contractor bid. It was Elliott Contracting. The bid came in at $1,960,000. There is an alternative ($116,400) for med gas to the area, we will take this. Total of $2,076,400 for construction. We had a budget of 2.8 construction for the grant. The total AML grant is $4,270,000 the remaining funds will go to furnishing and equipment. Approval has been granted by AML and the PMC Board of Directors to move forward. Construction will begin on 9/26/22. The estimated completion is 1 year.

• Construction Drawings Complete

• Drawings Sent to AML for Approval

OSMRE Approval

14, 2022

7, 2022

14, 2022

Michelle Rainey

N

IDEA: DEVELOPMENT OF RN PROGRAM WITH SCHOOLS AND STATE

DEFINE DEVELOP EXECUTE

On top of a nursing shortage, there is a rising global population of individuals 65 and older, a group that will surpass the population of children 5 and younger for the first time in human history.

Low nurse-to-patient ratios stemming from a shortage could exacerbate the problem through burnout and a greater turnover within the nurse workforce.

Expanding the nursing workforce is crucial to meet their increased healthcare demands in all settings.

Work with state and local government to ensure that the expansion runs smoothly and to anticipate as many potential challenges as possible

The addition of an RN program will have to use a methodical and purposeful approach to create the required infrastructure and processes to support the expansion

The RN program will sustain a high quality educational environment with exemplary student outcomes

DELIVER

Update as of Feb 2022

THIS PROGRAM HAS BEEN LAUNCHED AND A CONTRACT WAS EXECUTED BETWEEN UPIKE AND PMC.

OUR EDUCATION DEPARTMENT IS CURRENTLY WORKING WITH UPIKE TO OFFER ENROLLMENT TO EXISTING STUDENTS. WE WILL SOON START THE BEGINNING OF NEW ENROLLMENT, WHICH IS WHERE WE EXPECT THE CLASS SIZE TO GROW TO BETWEEN 90 TO 120.

THE GOVERNOR EXECUTED AN EMERGENCY ORDER THAT WILL PERMIT UPIKE TO EXPAND ITS ENROLLMENT REQUEST. WE ARE ALSO WORKING WITH BIG SANDY, GALEN AND OTHER NURSING SCHOOLS TO OFFER THEIR STUDENTS A $20,000 RETENTION BONUS ALONG WITH OUR NEWLY ADOPTED $29.00 PER HOUR STARTING RATE.

WE WILL SOON BE NAMING A NEW POSITION THAT WILL FOCUS ON RN RETENTION, RECRUITMENT AND EDUCATION FOR RN’S AS WELL AND WILL WORK WITH OTHER AGENCIES TO INCREASE OPPORTUNITY AND ENROLLMENT.

Update as of September 2022

PROGRAM HAS BEEN FULLY IMPLEMENTED AND WILL NOW BE MOVED AS AN ONGOING PROGRAM.

1) WITH THE ASSISTANCE OF THE EXECUTIVE ORDER UPIKE HAS EXPANDED ITS RN CLASS SIZE THTHROUGHOUTHE STATE TO 120 SEATS WITH THE OPPORTUNITY TO GO OVER BY 15%. IN AUGUST THEY ADMITTED 74 RN STUDENTS TO THEIR FIRST COHORT AND EXPECT TO DO THE SAME WITH THEIR DECEMBER CLASS. PMC AND UPIKE HAVE SIGNED A CONTRACT IMPLEMENTING THE RN FELLOWSHIP PROGRAM. FOR A 3 YEAR COMMITMENT AFTER PASSING THEIR BOARDS UPON GRADUATION, PMC AGREES TO PAY UP TO $40K OF THEIR OUTSTANDING TUITION ABOVE WHAT THEIR STUDENTS RECEIVE FOR SCHOLARSHIPS OR GRANTS. UPIKE WILL ALSO INCLUDE EPIC TRAINING AND 3 MONTHS OF

Donovan Blackburn

ONBOARDING TRAINING AS PART OF THEIR PROGRAM. UPIKE WILL GO FROM 60 RN STUDENTS PER YEAR TO BETWEEN 120 TO 140.

2) WITH PMCS RETENTION BONUS OFFERING WE ARE ALSO WORKING WITH BIG SANDY TO FILL THEIR CLASS. WE WILL HAVE OUR FIRST COHORT OF 26 STUDENTS, LOCATED IN THE AVA CENTER BUILDING, GRADUATE IN DECEMBER. WE EXPECT TO HIRE 90 TO 100% OF THOSE WHO PASS THEIR BOARD.

3) WE HAVE LAUNCHED A NEW AGREEMENT WITH GALEN COLLEGE OF NURSING. THROUGH AN OFFERING OF A BUILDING FOR $1.00 PER YEAR, GRANTS AND EQUIPMENT, GALEN WILL LAUNCH A NEW LPN PROGRAM AT THE END OF SEPTEMBER OF THIS YEAR. GALEN PROGRAM WILL OFFER A MINIMUM OF 100 LPN SEATS EACH YEAR. THEY WILL ALSO OFFER AN RN BRIDGE FROM LPN AS PART OF THEIR PROGRAM. SINCE WE HAVE NO CURRENT PROGRAM OFFERING AN LPN PROGRAM, THIS WILL BE A NET GAIN OF UP TO 100 LPNS. WE ARE WORKING IN CONJUNCTION WITH EKCEP, OFFERING SCHOLARSHIP FUNDING FOR THOSE STUDENTS WHO ATTEND GALEN ALONG WITH A RETENTION BONUS TO RETAIN THOSE WHO GRADUATE FOR NOW.

4) WE RECENTLY SIGNED A PARTNERSHIP AGREEMENT WITH ANU. ANU WILL BE RELOCATING TO THE OLD PAULEY BUILDING AND WILL BE OFFERING THE FIRST ALL DISTANCE LEARNING RN PROGRAM IN THE STATE LATER IN THE YEAR. ANU HAS FOCUSED AND HAS GOTTEN THEIR PASS RATE UP. THEY NORMALLY GRADUATE 8 10 RNS EACH YEAR. THIS YEAR THEY HAVE 30 AND PMC IS COMMITTED TO HELPING THEM BUILD THEIR RN PROGRAM.

5) WE HAVE IMPLEMENTED A NEW DEPARTMENT FOR RECRUITMENT. WE ARE ACTIVELY RECRUITING FROM ALL SCHOOLS THAT HAVE AN RN IN OUR SERVICE AREA. THIS HAS BEEN EXTREMELY SUCCESSFUL. LED BY CHRISTIAN HAGY, THIS PROGRAM WILL CONTINUE. WE HAVE ALSO RECENTLY HIRED BOBBY JONES, PIKEVILLE ELEMENTARY RETIRING PRINCIPAL. UNDER CHRISTIAN’S LEADERSHIP, BOBBY AND THE ENTIRE RECRUITMENT TEAM WILL CONTINUE TO VISIT ALL SCHOOLS SYSTEMS MULTIPLE TIMES A YEAR, IN ORDER TO SHOW STUDENTS THE PATHWAY TO NURSING AND OTHR PROGRAMS. WE DID THIS IN 2022 RIGHT BEFORE SCHOOL WAS DISMISSED FOR SUMMER BREAK AND WAS SUCCESSFUL IN HELPING ALL SCHOOLS MENTIONED ABOVE FILL THEIR OPEN SEATS. WE WILL CONTINUE TO DO THIS IN THE FUTURE.

6) WE ARE RUNNING AN ADVERTISMENT CAMPIGN TO RECRUIT NON TRADITIONAL STUDENTS INTO THE GALEN LPN PROGRAM. AGAIN, THIS HAS BEEN HUGELY SUCCESSFUL BY THE FACT GALEN PLANNED ON OPENING THEIR FIRST CCOHORTOF 25 STUDENTS. THEY ARE LOOKING AT POSSIBLY DOUBLING THAT NUMBER DUE TO THE INTEREST.

7) DUE TO THE VARIOUS PROGRAMS WE HAVE HIRED 123 RN’S THIS YEAR WITH A GOAL OF AT LEAST ANOTHER38 BEFORE THE END OF THE YEAR. 112 HAVHUGELYE HAVE BEEN HIRED & 11 ARE PENDING WITH 4 MONTHS TO GO BEFORE THE END OF THE YEAR.

8) OUR PREVIOUS 5 YEAR TREND HAS BEEN PRODUCING 45 BOARD CERTIFIED RN’S IN OUR MARKET. WITH OUR NEW PLAN WE EXPECT THAT TO GROW TO 300 STUDENTS AND WITH AN 80% PASS RATE WE EXPECT AT LEAST 240 NEW RN’S AND LPN’S IN OUR MARKET EACH YEAR GOING FORWARD.

9) WE HAVE ALSO PRODUCED A NEW WEBSITE WWW.PMCJOBS.ORG THAT IS INTERACTIVE AND SHOWS INTERESTED PARTIES HOW TO BECOME A RN OR LPN ALONG WITH THE SALARY AND BONUS OFFERING. THIS SITE WILL BE UPDATED AS INFORMATION CHANGES.

10) WE ALSO HIRED A SOCIAL MEDIA SPECIALIST WHO IS FOCUSED ON RECRUITMENT OF EXISTING AND NEW RNS VIA AN AGGRESSIVE MARKETING CAMPAIGN AND GEOFENCING ALONG WITH USING AN ALGORITHM.

11) WITH THE PASSAGE OF THE GOVERNORS EXECUTIVE ORDER IN DECEMBER OF 2021 AND SB10’S PASSAGE DURING THIS PAST SESSION, THIS HAS ALLOWED US TO DO WHAT IS NEEDED FOR OUR SUCCESS.

12) GOALS GOING FORWARD IS;

A: TO COMPLETE OUR AGREEMENT AND PROGRAM WITH ANU AND TO MAINTAIN OUR PARTNERSHIPS AND PROGRAMS AS MENTIONED ABOVE.

B: TO LOOK FOR GRANTS AND WORK WITH THE UPCOMING SESSION TO PROVIDE AN AVENUE FOR ADDITIONAL FUNDS FOR SCHOLARSHIPS AND TO PAY FOR TEACHERS FOR THESE PROGRAMS.

TRANSPORT SERVICE FOR PIKEVILLE & PIKE CO HOUSING

DEFINE DEVELOP EXECUTE

To assist our patients to and from appointments. Transportation challenges prevent patients from receiving medical care each year. This will reduce no shows, expand access, and improve our patients’ experience by offering them free or reduced cost for rides to and from their appointments. This will also increase patient referrals and revenue.

• First, legally establish the transportation company. Depending on how the company is set up (Incorporated, LLC, Sole proprietor, etc.), the company may be required to file with the Kentucky Secretary of State's Office.

• Second, the transportation company must apply for State Motor Carrier Operating Authority (certificate) which allows the company to operate as a for hire passenger motor carrier in Kentucky. To do this, call the Division of Motor Carriers at 502 564 4127 and request an application for either Taxi Authority or Disabled Persons Vehicle (DPV) Authority. The only real difference between the two authorities is that under DPV, all vehicles must be wheelchair lift or ramp equipped. The transportation company can still transport non wheelchair people in those vehicles; but the DPV vehicles must be wheelchair/ADA accessible.

• Once the transportation company is notified of its approval for authority/certificate, the transportation company will have to qualify vehicles through the Division of Motor Carriers. Once qualified, the Division of Motor Carriers will issue a license plate and fee receipt card for each vehicle.

• After operating authority is obtained and once all vehicles are qualified through the Division of Motor Carriers, the transportation company is ready to apply to enter into the Medicaid Transportation Provider network.

• First, the transportation company must contact the Regional Broker for the county in which the transportation company intends to operate. Region 14 Floyd, Johnson, Magoffin, Martin, Pike Sandy Valley Transportation Services (SVTS) 1 800 444 7433 606 886 7039 SVTS Transportation

• The transportation company will notify the Broker that the company has obtained a certificate and wants to subcontract with the Broker. The Broker will schedule a time to review the contract, inspect vehicles, obtain copies of insurance information, obtain copies of vehicle registrations, obtain worker's compensation insurance verification, and obtain copies of the operating authority certificate(s) and fee receipt card(s). All employees/drivers must be entered into a statewide drug and alcohol random pool. Background checks and pre employment drug and alcohol tests will have to be completed for all subcontractor safety sensitive employees; minimum trainings must be obtained as well. The Broker will walk the transportation company through this process.

• One of the last steps to take is to Apply for Medicaid Provider Identification (billing) Numbers for each service type the transportation company wants to transport.

• There are four (4) recipient, or, service types of transportation:

o Type 02 Ambulatory (for profit) Provider Specialty 263 (no special assistance or needs required);

Michelle

o Type 04 Ambulatory Bus (non profit) Provider Specialty 262 (no special assistance or needs required);

Type 07 Common Carrier Ambulatory Provider Specialty 264 (disoriented recipients who may require an escort);

Type 08 Common Carrier Non Ambulatory Provider Specialty 265 (Wheelchair).

• A provider will apply for up to three provider numbers depending on if a for profit or non profit entity. (02, 07, 08 or 04, 07, 08). The Broker can assist the transportation company with this process.

• Three (3) separate applications (one for each type of service) are required to be submitted if the transportation company intends to transport all three passenger types.

• The transportation provider's contract is with the Broker, not the Commonwealth. The Broker receives all trip reservations and then dispatches trips out to approved providers. Providers will invoice the Broker once the trips are complete; and the Broker will issue payment to the transportation provider.

• Please note: Transportation providers are prohibited, per regulation, from soliciting Medicaid trips.

DELIVER

Update as of September 2022

Based on the findings in the development,

decision was made to provide a shuttle service free of charge.

We have worked with Erich and found that we can only provide a bus run schedule to these areas with no real marketing. We have also worked with Melissa to provide a bus schedule for patient access. Currently, there is no way to flag induvial living in these locations.

The project has been broken down into three phases and a bus has been purchased. Phase 1 started on 8/1/2022. To date, we have only had one person utilize this service. Working with the housing authority to promote schedule.

Phase One is:

Points:

Phase Two: Pick Up Points:

Shelby Valley

Carl D Perkins

Douglas Park

Phase Three:

Elkhorn City

Phelps

IDEA: IMPLEMENTATION OF PRESS GANEY HRO PLAN

DEFINE DEVELOP EXECUTE

PMC has engaged Press Ganey to assist in the implementation of High Reliability Organization (HRO) principles.

1. Efforts to improve patient safety through a commitment to the Zero Harm goal are at the forefront of this initiative. However, this program also aims for enhancements in the areas of patient experience, workplace safety, and process improvement.

2. Through the adoption of HRO principles, PMC seeks to transform its corporate culture for the betterment of patients, staff, and overall operations.

3. The workflow of this project is divided into phases: assessment, planning, implementation, and sustainability.

DELIVER

Update as of February 2022

Although the engagement is for three years and has already begun, it is expected that the planning phase will conclude, and the implementation phase will commence during the next year.

This is a long term project. Initial training modules are complete. We are now in a skill building phase to enhance the effectiveness of the adoption of HRO strategies. An overall plan is in place and a dedicated HRO officer has been named. Multiple workgroups are working on different aspects of the project including developing additional education sessions for skill building, communication items to keep HRO skills at the top of employees’ minds and refining measurement metrics. Additional specific training sessions will be forthcoming on leader skills and specific topics such as root cause analyses. Further progress in the short term is likely to be impacted by COVID 19, labor shortages, and the beginning of Epic training.

Update as of September 2022

Project on hold

Erich Blackburn

IDEA:

DEFINE AND DEVELOP

To expand a chest pain observation area for an emergency department. Patients are increasingly being seen in the ED for chest pain. A patient observation service rather than being admitted to the hospital in need. Chest pain is the leading diagnosis among observed patients.

DELIVER

Update as of February 2022

The project is ON HOLD due to construction costs.

Update as of September 2022

The project is ON HOLD due to construction costs

IDEA: PHYSICIAN CLINICAL DOCUMENTATION IMPROVEMENT PLAN AARON CRUM

THACKER

DEFINE AND DEVELOP EXECUTED DATE

Physicians understand the need to make documentation legible, timely, complete, precise, and clear. However, the lack of specificity on a hospital record can affect payment. A physician’s clinical documentation improvement plan will improve communication, increase recognition of comorbid conditions that are responsive to treatment, validate the care that was provided, and show compliance with quality and safety guidelines.

DELIVER

Update as of February 2022

This plan has been replaced by the implementation of EPIC EMR. It appears most of our documentation concerns will be addressed post implementation.

Update as of September 2022

Physician documentation has been replaced by EPIC

Miners Bldg

Lighting Replacment

Bldg

May Tower

Clinic Building

Clinic Building

Clinic Building

Clinic Building

Clinic Building