Hospital to no longer accept Title 25 patients

During the Tuesday evening meeting of the Hot Springs County Memorial Hospital Board of Trustees, Dr. Jason Weyer reported the big day — Oct. 1 — is coming up with regard to Title 25 patients. Starting that day, the hospital will no longer accept Title 25 patients as the hospital is not an appropriate facility for that. He further added the hospital will make sure such patients are medically stable, but will not be the accepting facility.

Weyer explained Title 25 is the statute that people who are suicidal can be held against their will for their own protection and sent to a proper care facility.

Weyer wanted to make the board aware of the situation, as it could create some havoc. Accepting Title 25 patients puts staff, as well as patients, in unsafe situations. After ensuring such patients are medically stable and not intoxicated, Weyer said, they will initiate getting them to the Wyoming Behavioral Institute or other such facility.

Weyer also reported there have been a couple things done with the function committees. Through Patient Care Services he said, there was discussion as to whether radioactive decontamination were to become an issue. Weyer further pointed out Wyoming has uranium mines, and something could also happen if radioactive material were being transported through the area as we are the bottleneck of the southern Big Horn Basin.

Regarding Trauma Committee, Weyer said the Code Red will be set up not just for motor vehicle accidents but also large animal injury, as they’ve seen injuries from, for instance, being thrown off a horse. Such injuries can include broken bones, punctured lungs and more.

The Critical Care Committee is updating the myocardial infarction and stroke book protocols. This is done once every couple years, to ensure we’re up to date with the standards of what they’re doing at Wyoming Medical Center.

Also being looked at is obstetrics, Weyer said, particularly with regard to where patients go and at what gestation time. For instance, if someone is 10 weeks along in a pregnancy, they don’t necessarily go to the OB floor because of survivability of the fetus and will likely stay in the emergency room. Once a patient gets to the point where there is more survivability, Weyer said, it also means better monitoring and information gathering with regard to the baby.

The obstetrics committee is also clarifying some different dressings needs for Cesarean sections that will improve post-op incision care. Weyer said there haven’t been any issues, and this process helps ensure there won’t be any.

Hospital CEO Margie Molitor said the past few weeks have been successful in regard to recruiting registered nurses, with two officially accepting positions and a third who is very interested. Molitor further added two of the nurses are experienced and already in the Big Horn area, and the third is a new graduate but is a nontraditional student who was an educator and also did some pastoral care.

Molitor also reported the SLIB grant request has been submitted. The request is for $1.5 million for the hospital addition and renovation, to supplement the project due to unforeseen expenses regarding asbestos abatement, the need for deep foundations and inflation factors.

Molitor also informed the board the Certified Registered Nurse Anesthetist (CRNA) Ryan Shedd, who is board-certified in pain management, plans to begin services Oct. 4. She noted the hospital has already received calls as to when Shedd is starting.

In board action, the infection prevention report was approved. Chief Nursing Officer Sarah Aliff said there were some revisions to the language in the report, but the prevention processes remain the same. The report cover topics such as measures for prevention of communicable disease outbreaks as well as response to bioterrorism attacks.

Chief Financial Officer Shelly Larson reported the days in accounts receivable for August were down slightly from July. The number of days dropped from 42.76 to 42.48. Larson also pointed out the number of days cash on hand was up, going from less than 51 to 52.13.

Larson explained in July the hospital changed to a different clearinghouse, and they’re starting to see a rebound from that towards the end of August. September is also looking better from a cash collection point of view.