WATERTOWN — Samaritan Medical Center (SMC) and the North Country Family Health Center (NCFHC) last month announced details of a plan the organizations had devised to help “stabilize” the operations at NCFHC.

The New York State Department of Health back in October appointed SMC as the temporary operator of NCFHC as the clinic had announced plans to close.

The temporary-operator agreement is a six-month agreement, extending through the end of April, says Krista Kittle, director of marketing and community relations at Samaritan Medical Center.

“But we do expect it to go a month or so past that at this point,” says Kittle.

Based on a work plan that SMC and the health center submitted to the department, the organizations have outlined the “priority” focus areas and changes in processes and structure to help meet the objectives.

Their plan to increase revenue involves outsourcing its billing function and reducing no-show rates at the clinic.

The coding on a bill helps determine the amount of the organization’s reimbursement for a given patient’s treatment, Kittle says.

“So we want to make sure that we optimize and code correctly, so that we get the reimbursement for the correct level of care that was provided,” she adds.

NCFHC is outsourcing its billing to Visualutions, Inc., a Spring, Texas–based health-care-technology company that provides clinical, financial, and information-technology solutions to enterprise organizations such as federally qualified health centers (FQHCs), according to its website.

A patient no show means no reimbursement for the health center, Kittle says.

NCFHC is changing the way it schedules by building time into the schedule for additional visits, depending on what the centers determines as a percentage of no shows.

“It’s almost like overbooking but if you use that historical number based on the people who don’t show, you’ll have plenty of room in your schedule to make up for those no shows by those extra patients who are scheduled,” Kittle says.

In addition, they hope to certify the health center as a Level III patient-centered medical home, up from the current Level II status, and increase provider capacity for seeing patients, Kittle says.

Job cuts, funding

Besides the focus on increased revenue, NCFHC also intends to restructure and consolidate operations to reduce expenses. 

It won’t fill seven currently vacant positions and one expected retirement this spring. The plan also includes laying off five employees, three of which occurred in December as part of the billing transition. 

The organization also cut two management positions as of Jan. 13, including the adult-clinic manager and the dental clinic manager, according to Kittle.

“Those positions were consolidated into one person who will oversee all of the clinical services, and the title is clinical-services officer,” Kittle says.

The center hired a new person to handle those duties, she added.

The organizations will also pursue loan and grant opportunities to support the plan. The Northern New York Community Foundation awarded $100,000, the New York State Health Foundation awarded more than $32,000. 

Another request for $100,000 is also pending.

When asked to provide details about what organization is considering the request, Kittle had to decline.

“Because it’s pending, I’m not a liberty to say,” she says.

That request, along with the funding from the Northern New York Community Foundation and the New York Health Foundation are grants that the NCFHC will use to pay for services such as outsourcing billing with Visualutions.

“It’s being able to fund those without taking funds from the clinic operations,” Kittle says.

The plan also calls for dealing with financial obligations and debt, including the refinancing of the NCFHC mortgage. The health center also repaid two short-term loans to Community Bank and Watertown Trust in November, along with a short-term loan from SMC, Kittle says.

It also intends to address delinquent vendor-payable balances.

They also want to use electronic-medical records and improve data collection to monitor and improve efficiency and productivity.

The plan also calls for reapplying for designation as a federally qualified health center, and the funding that comes with it, as well as opening the Lowville dental / medical site and continuing to serve the homeless.

In addition, the organization intends to collaborate with community leaders to expand the NCFHC board of directors.

Under the plan, SMC expects the NCFHC to end 2014 with a “near break-even budget and positive cash flow” in order to continue operations without interruption in services to patients.

Background

The North Country Family Health Center, formerly known as the North Country Children’s Clinic, had announced its intention to close in early October. 

NCFHC had cited financial difficulties as the reason.

“It was really a surprise … to everyone including ourselves and the [New York State] Department of Health,” Kittle says.

At that point, executive director Daniel Wasneechak reached out to Samaritan CEO Thomas Carman to see if SMC could provide help.

The temporary operator agreement resulted following talks between the clinic, SMC, and the state Department of Health.

“We actually stepped in on the 10th of October,” Kittle says, noting the agreement was formalized on Oct. 31.

In that time, Wasneechak resigned, and SMC appointed Joey Marie Horton as interim executive director, who had previous experience with the clinic as part of its school-based clinic program.

“From the beginning, our role was … to find a long-term solution for the clinic’s stability,” Kittle says, noting clinic’s business model wasn’t sufficient to sustain its operations.

SMC brought in its officials with expertise in finance, communication, and other areas of need.

“Our CEO [Carman] was very active in assisting them as well to try to do what we could to keep the doors open temporarily until we could work together to come up with a long-term solution,” she says.

Contact Reinhardt at ereinhardt@cnybj.com