The Regional Medical Center Board of Trustees has unanimously approved applying to the S.C. Department of Health and Environmental Control for certificates of need to upgrade radiology special procedure room equipment and to create a vascular surgery suite.

The board also approved a proposal to develop a Healthplex wellness and fitness center in Branchville.

Hospital officials tout the projects as improving the quality of patient care and increasing market share through use of the latest technologies and services.

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Radiology room

Trustees voted to pursue a CON to replace 14-year-old special procedures radiology equipment to provide fully digital interventional radiology, fluoroscopy and radiography examinations.

"As we look at the new equipment, it will give us the ability to increase our market share ... and also provide better quality and low chance of equipment failure," hospital Chief Financial Officer Cheryl Mason said.

A CON is required prior to expanding the type or scope of health services or undertaking any new health service.

The project is also touted as providing greater convenience in that X-rays and fluoroscopic exams will be performed in the same room.

The total capital cost for the radiology project is about $1.44 million. The purchase of the capital equipment and renovations was approved in the hospital's 2008 budget. Trustees agreed to a budget amendment for the equipment purchase.

Contribution margins (net patient revenue minus total direct expenses) after five years are projected to be $379,242.

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Vascular operating room

The hospital would convert its current operating suite to a hybrid vascular suite.

The new suite would include upgrades to 26-year-old equipment and facility, and enhance capabilities for providing vascular stents, lower extremity bypass, carotid endarectomy (plaque removal from carotid artery), and carotid stents.

The hybrid facility aims to offer enhanced imaging technologies allowing for both elective and emergency procedures in the same room.

The total cost of the project is $1.36 million.

Contribution margins after five years are expected to be $747,614.

The project could also include dialysis access procedure capabilities, which would increase procedure volume and contribution margins.

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Healthplex Branchville

The proposed Healthplex Branchville facility would be located in a 2,288-square-foot building referred to by residents as "The Hut." The building is near the Horton Ball Field.

The Healthplex would be a joint effort between the hospital and the town of Branchville. It would provide wellness and fitness activities, including weight training, exercise routines, personal training, nutrition and education classes, and weight-loss programs.

The center will also offer blood pressure, cholesterol, blood sugar screenings, as well as education on chronic illnesses.

RMC would be responsible for the exercise equipment ($57,000), staffing for 2.5 days per week, the monthly lease fee and two health education sessions a month. The facility is to open from 10:30 a.m. to 6 p.m. initially.

An exercise physiologist would be employed.

Branchville Mayor Tim Cooner said the town has not committed to the project as yet, with further discussion due at the next town council meeting.

"I don't know where it stands at this point," Cooner said, noting that more information will be forthcoming.

Should the project proceed, Branchville would be responsible for the capital to finish upfitting the existing building and providing volunteer staff during the week.

Total hospital capital expenses would be $67,359 and an annual operating expense of $59,860. The Orangeburg Healthplex is expected to see a decrease of 111 members equaling about $4,440 a month.

The project is expected to come on line in May 2009.

Trustees voted to revisit the project about six months after its inception and then revisit it again in a year to determine whether a similar project in Holly Hill should be pursued.

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Hospital liabilities

Trustee Danny Covington, a frequent critic of hospital procedures and financial transparency, expressed concern that the hospital's days to pay off its liabilities have increased by 31 or 121 percent over the past two years.

With a prepared graph in hand, Covington noted that in December 2006, the hospital was paying off its liabilities in 25.3 days.

In January 2009, the liabilities were being paid off in 56 days. The 56-day payment period is right at the hospital target rate.

"This concerns me greatly," Covington said, expressing his "alarm" that the payment period has increased that much without the matter ever being brought before the board. "We are not paying about $3 million worth of bills that we would have been paying if we stayed on the same line of 25 days. There is no way to tell you how much this is costing us. It does not look real good to me. Can you explain how we went up 121 percent in two years?"

While not immediately having an answer to Covington's question, Mason in a followup said current liabilities are more than unpaid bills. They include items such as third-party settlement reserves, deferred revenue (quarterly payments for disproportionate share), and grant revenue.

About 20 days of the 31-day pay period increase or $9.5 million of current liabilities are related to Medicaid, Recovery Audit Contractor payments and other third-party settlements.

The hospital has a total current liability of $25.6 million.

Mason responded to Covington's contention that materials have never been brought before the board by saying the matter is always before the board.

"Each month in the finance packet they (board members) receive copies of the balance sheets, which include a listing of all liabilities both current and long-term," she said.

Covington initially speculated as to whether the hospital was paying its bills on time. He later retracted, saying he was not insinuating the hospital was behind on payments.

Taking Covington's lead, trustee Millie Brunson posed the question directly to Mason. "Is this institution paying its bills in a timely manner or are we postponing the payment of bills?"

"No, we are not postponing the payment of bills," Mason said.

Trustee Athaniel Badger questioned why Covington did not bring his questions before the finance committee.

"Because he would not get the press," Trustee Milton Dufford said.

"I did not ask a question," Covington said. "I just presented the board information."

Board Chairman James Amaker encouraged trustees with a question or concern to provide staff with information prior to a meeting so an answer is readily available for the entire board's monthly meeting.

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T&D Staff Writer Gene Zaleski can be reached at gzaleski@timesanddemocrat.com and 803-533-5551. Comment on this and other stories at www.TheTandD.com.

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