Continuation of newspaper publications (2023)

A 2013 survey by the Iowa Hospital Association documented that the Hawkeye State's 118 public hospitals have a huge financial impact. Annually, Iowa hospitals employ more than 71,000 people and pay more than $4 billion in wages and benefits, according to the IHA. This places hospitals collectively among the largest non-agricultural employers. And only immediate employment.

When the additional jobs in communities across the state that exist due to hospital spending and the dollars spent by their employees are added, IHA estimates that approximately fewer than 130,000 jobs are directly or indirectly related to the hospital industry. The total economic impact on the state economy is estimated at approximately $6 billion annually.

Here in Iowa County, Marengo Memorial creates jobs and adds 149 jobs and adds nearly $10 million to the Iowa County economy, also according to the IHA report.

But the effect is even greater than that. Compass Memorial Healthcare employees support Iowa County businesses with $3 million in spending on Main Street. Hospital workers pay taxes that support schools, roads, parks and other vital infrastructure. Again, that's $170,000 in sales tax alone.

But Marengo Memorial is not about jobs, revenue, retail sales and tax revenue. And this is even more than the high-quality healthcare provided here every hour and every day.

Think about the employees who work at the hospital and what they bring to the community in our schools, churches and volunteer groups. Think of the many young professionals who come here to start their careers in the hospital and stay because in rural communities, hospitals are still one of the best places to develop a career.

Imagine them building homes, raising families, strengthening neighborhoods and putting down roots. Imagine how important — and challenging — that is to any Iowa community in this era of agricultural "brain drain."

There are many reasons to be proud of Compass Memorial Healthcare. It is no exaggeration to say that its success contributes significantly to the ability of our cities and region to thrive. Not only is it vital to the health of the people living here and in the surrounding provinces, but it also contributes to the ability of local communities to thrive economically.

Cindy Tindal, Chair of the Board of Directors of Compass Memorial Healthcare commented, "We are extremely proud of our significant financial contributions to Iowa County. Our success at Compass Memorial Healthcare reflects the pride of everyone who works here in providing outstanding service to the communities . We look forward to continued success and the support of the people we serve."

Local QRS groups are accepting donations

written by Brian Rathjen on JUNE 25, 2014

Tuesday, May 20, Compass Memorial Healthcare hosted a regional EMS appreciation dinner at the Marengo American Legion for EMS providers and their families. Area QRS (Quick Response Service) teams received a $250 check from Compass Memorial Healthcare that can be used toward training costs or the purchase of equipment.

Checks from the hospital were received by EMS personnel from Amman, Lador, Millersburg, North English, Victor, Parnell, Williamsburg, as well as Blairstown and Belle Plaine EMS. Iowa County EMS personnel also attended. After dinner, a training session was held for all attendees about the Cloverdale Stroke Project.

"The work of EMS and QRS providers across our region has a significant impact on patient recovery and the overall outcomes they experience during their post-emergency care," said Barry Goettsch, CEO. "We are fortunate to have trained volunteers ready to help those in our area when the need arises."

National EMS Week has been celebrated since it was first proclaimed by President Gerald Ford in 1974. It is an opportunity to recognize people who provide life-saving services on the "front lines" of emergency medicine every day.

Dr. Ben Miller, Mindi Jorgenson join staff at Compass Memorial Healthcare

Written by Jim Magdefrau on JUNE 25, 2014

Compass Memorial Healthcare has some new faces working with the public these days.
Mindi Jorgenson was recently hired as a hospital pharmacist. On July 14, Benjamin Miller will start with the hospital and work in family medicine, working at the Marengo Family Medicine Clinic and also doing a hospital stay.
Here are their presentations to the community:

MINDI JORGENSON

Mindi Jorgenson believes in providing the best and safest care possible to the people she works with.
"I love being able to visit patients in their room," she said, "and I'm looking forward to getting to know the community."

You can do that more freely in a small-town hospital, and when Jorgenson and her family wanted to move to Iowa, Compass Memorial Healthcare had the things she was looking for. Jorgenson started working as a pharmacist at the hospital in May. Her primary duties include reviewing medication orders for appropriateness, adjusting dosages and assisting with the hospital's diabetes program.

She has extensive experience, given her work with the program offered by Park Nicollet in Glenwood, Minn.
“Up there, I would see patients in the diabetes clinic and give insulin to people starting insulin,” he said. "I would provide education about diet, exercise, medications and labs. I would also add continuous glucose monitors to patients to adjust therapy and start an insulin pump."

Here at CMH, these will be just a few of Jorgenson's points of focus. Drug safety will also be part of things, such as helping patients taking warfarin for blood clots, strokes or heart attacks. "A lot of times the prescription management, the medication management that we keep in stock," he said. "Usually there are many drugs in a drug class, there is one that is cheaper than the others, so you can replace it with a more expensive alternative." Jorgenson, who earned a bachelor's degree in pharmacy from the University of Iowa, and her husband, Jeff, are Newton natives. The couple has two children: 5-year-old Olivia and 7-month-old Isaac. "I definitely prefer smaller critical access hospitals. I have more to do and time to get it right the first time," he said.

BENJAMIN MILLER, DO

Originally, Benjamin Miller — whose mother, Cindy, is the principal of Iowa Valley Elementary School — planned to study math at Wartburg College.

"I just knew math and science that I was a little bit better at in high school, so I decided, 'Let's look into it,'" he said.
He then began working as an attendant and eventually went into medicine and found that he really enjoyed working as a nursing home nurse's aide. He eventually earned a degree in biology. “I felt like I was taking care of someone else, but I wanted to be more than a nurse,” she said. "I wanted to give as much as I could to patients. It made me think about what I can do for people." And so, after considering a number of different options, she decided that family medicine was one of those specialties where she could have it all, but still work with specialists when needed.

“All the time at the end of medical school, I was very interested in rural family medicine,” he said.
Thus began the journey to the family doctor. After a year working as a patient care technician at St. Luke's Hospital in Cedar Rapids, graduated from Des Moines University in 2011 (where he was an assistant professor for a time), and completed a three-year internship at Cedar Rapids Medical Institution, his goal of becoming a family physician was on his way.

Now he returns to a place that is (almost) home. Marengo is not far from Miller's hometown of Van Horn, where he graduated from Benton Community High School in 2001 and excelled in track and field. He was the Iowa Class 2A State runner-up at 160 pounds his senior year in wrestling and was a multiple state qualifier in track. "I looked at the opportunities that were close, because my wife and I have a close family ... and Marengo was a great opportunity," he said. "I was drawn to the hospital, the size of the town and the people. And Barry Goettsch (CEO) was instrumental in (coming here). He recruited me and was able to really show us what Marengo had to offer."

He and his wife, Bobbi, a principal at Kirkwood Community College in Cedar Rapids, have a daughter, one-year-old Ava.
"A lot of people say, you know how long your contract is, you can see if you like it ...," Miller said. "I kind of thought I want to find some place where I want to settle down and put down roots and stay. I want to find a place to stay, and Marengo has the potential to be that place."

HOSPITAL NEWS - Degen to be Registered Nurse at WFMC

By JANE BIGBEE May 8, 2014

Sarah Degen, Williamsburg, will be one of the registered nurses working at the new Williamsburg Family Medicine Clinic, 498 North Highland. The clinic opened on Monday, May 5. Will provide general patient care including settling patients, taking vital signs and medical history, administering immunizations and drawing blood. She is not new to Marengo Family Medical Clinic, nor to the other clinics located in the same building, where she has worked for most of the past 22 years. He holds certifications in Advanced Life Support, Pediatric Advanced Life Support, etc. In addition, Degen followed Dr. Mark Siebrecht at his podiatry clinics in Belle Plaine and Virginia Gay Hospital, Vinton. Dr. Siebrecht is an employee of Compass Memorial Healthcare.

Degen also works part-time as a paramedic for Iowa County Ambulance Service and volunteers with Williamsburg First Responders. Degen, a 1990 graduate of HLV High School, began working at the Marengo Clinic in 1991 as a certified medical assistant after completing the CMA program at Kirkwood Community College, Cedar Rapids. Through clinic ownership and transitions through University of Iowa Hospitals and private practice, Degen has maintained employment at the Marengo clinic. When Compass Memorial Healthcare resumed operations of what had been known as the Family Medical Clinic for several years, she returned to work at that clinic.

Meanwhile, Degen went to an emergency medicine school run by Mercy Hospital and St. Luke's, Cedar Rapids and now a member of KCC, graduated from that program in 1998. She has worked part-time for Iowa County EMS for the past 16 years as a paramedic. She took time off from full-time work to return to Kirkwood Community College to earn her nursing degree in 2002. During that time, she worked one or two days a week at the UIHC clinic in Belle Plaine. After graduating, she returned to work full-time at the Marengo Clinic. When he has time, Degen enjoys walking and exercising at the Williamsburg Recreation Center.

FAMILY

Sarah Degen's husband, Jon, has been an Iowa State Trooper for the past 23 years and is also one of the Iowa Highway Patrol pilots. Among other duties, the Iowa Hawkeye made traffic reports in the fall. Jon Degen is also currently Marengo Golf Club's Vice President, Past President and Board Member.

The couple and their two sons live north of Williamsburg. Son Jack, 13, is in seventh grade and Joe, 10, is in fourth grade, both in Williamsburg. Jack's interest in all sports keeps the family busy. Joe is a history buff and enjoys collecting coins. Jon also has a daughter, Amy, 27. The family attends St. Mary's Catholic Church, where Jon Degen serves as Eucharistic minister, Jack serves at the altar, and Sarah is a substitute religious education teacher. Sarah Degen's parents are Robert Pirkl and Sharon Huedepohl, both of Victor. Jon Degen grew up in Bancroft, north central Iowa.

HOSPITAL NEWS: Grand Opening of Williamsburg Family Medicine Clinic is Coming!

By BENJAMIN S. EVANS on April 16, 2014

The newest addition to Iowa County's local health care landscape, Compass Memorial Healthcare Williamsburg Family Medicine Clinic, 498 N. Highland St, opens for tours on Friday, April 18.

The clinic should be accepting patients around the first week of May, said the hospital's director of clinical operations, Denise Kaestner. The clinic will be open Monday through Friday, from 8 a.m. to 5 p.m. In the future, the clinic will add expanded hours, including Saturday hours, to better accommodate the schedules of community members.

The primary care unit will offer all services related to family medicine, from pediatrics to adult and geriatric care, including prevention, women's health, health maintenance, acute emergencies and radiology. The clinic will also be able to do lab work, which will be processed at Compass Memorial Healthcare.

Kaestner said the clinic will be able to serve the Williamsburg area more efficiently, as she said the hospital in Marengo has many patients in the Williamsburg area. The added benefit of connecting a local clinic with a local hospital, he said, is convenience.

"The Williamsburg area has grown exponentially over the years, and we thought we could help meet the demand here (through our concern)," Kaestner said.

But the new Williamsburg clinic won't be the only primary care clinic in the city limits, with Mercy Family Medicine of Williamsburg already making its mark on the landscape, along with several other specialty medical facilities in the area. Competition, it seems, comes with community growth.

"Competition is healthy in any market, including medicine," Kaestner said. "We all live in a world of practices, so to be able to call and be able to make an appointment the same day, something like that is big (for the community, too)."

Kaestner continually emphasized the clinic's main purpose: to provide local health care to local residents.

"We're in the community and we want to take care of that community," Kaestner said. "We're local and we want to give back to the service community we're in. We're really focused on keeping medicine in the (community) neighborhood."

Construction work on the new Williamsburg clinic began in August 2013, with an official groundbreaking ceremony on August 29. Despite the "persistent" winter, Kaestner said, the construction process went relatively smoothly. Kaestner emphasized the importance of the clinic's efforts to hire local contractors for the project, keeping local medicine in the local community.

Williamsburg Mayor Frank Murphy said Williamsburg is fortunate enough to have many options when it comes to health care, and the new clinic is just one more addition to that wealth.

(The clinic) is a great addition to the community," Murphy said. "Having two great clinics in town, along with an eye clinic moving to the plaza, we're blessed to have businesses move into town and expand the communities' growth ».

Kaestner said the clinic is open for tours at the end of the week and staff is happy to arrange tours if community members wish to call her or Mary Warwick of Compass Memorial Healthcare at (319) 741-6789.

"The clinic is here for the community. We are in medicine for the patient and for the patient," he said.

W'burg Clinic is looking forward to a new receptionist March 26, 2014

By JANE BIGBEE on March 26, 2014

Jessica Wardenburg, Williamsburg, will be the receptionist at the new Williamsburg Family Medicine Clinic, 498 North Highland, when it opens in mid-April after the building is completed.

Wardenburg, who has four years of prior medical experience, currently works at the Marengo Family Medical Clinic, a position he started Dec. 1, in preparation for the opening of the new clinic. As a receptionist, she will answer phones, book appointments and register patients upon arrival at the clinic.

She was an administrative assistant at Williamsburg's Mary Welsh Elementary School for eight years, so she knows and has worked with people in the community, especially those associated with the school. He also previously worked in retail at Tanger Outlet Mall.

Wardenburg will be close to work. She and her husband, Rick, and their two daughters, Kenady, 15, and Madison, 12, live next door to the clinic.

Rick has worked for Monsanto for the past 25 years and is a volunteer firefighter in Williamsburg. Compass Memorial Healthcare, owners of WFMC and MFMC, recently created a health clinic for the Williamsburg Volunteer Fire Department.

The family is active in Immanuel Lutheran Church, Williamsburg County. The couple is also active in the Williamsburg Booster Club.

Daughters Kenady and Madison have been cheerleaders with Iowa Elite Cheer for seven years and have competed many weekends.

Growing up Jessica Wardenburg was a member of the 4-Leaf Clovers 4-H club and was a competitive swimmer from second grade through high school. Now she enjoys going to flea markets and auctions, scrapbooking, gardening, and spending time with her family at Thunderhead Lake.

Her parents, Gary and Vickie Williams, recently retired and moved to Missouri, Thunderhead Lake near Unionville, a place the family enjoys visiting.

HOSPITAL NEWS - Andersen will be a mid-level provider at Williamsburg Family Medicine Clinic

By JANE BIGBEE on March 19, 2014

The staff who will work at the new Williamsburg Family Medicine Clinic, 498 N. Highland St., have been working and training at the Marengo Family Medicine Clinic since late fall. The Williamsburg clinic is expected to open in mid-April after the new building is completed.

Katherine Andersen, R.N., M.S.N., will be a mid-level medical assistant at the new clinic, treating patients and serving as a provider. Andersen, who began training to work at FMC's new Marengo clinic in November, said she liked the local resources.

Two registered nurses and a receptionist are working and training at Marengo FMC to prepare for the move to the new Williamsburg clinic.

Compass Memorial Healthcare is actively recruiting a physician for the new WFMC.

excercise

Andersen earned her Master of Science in Nursing, Family Nurse Practitioner (ARNP) degree from Clarke University, Dubuque in August 2013. Prior to that, she graduated from the University of Iowa, Iowa City in 2011 with a Bachelor of Science in Nursing. , with honors, and in 2009, earned a bachelor's degree in nursing with high honors from Kirkwood Community College, Cedar Rapids. In May 2006 she received the title of associate of the arts with high honors.

Andersen received his Family Nurse Practitioner certification from the American Nurses Credentialing Center last September, is a member of the Phi Theta Kappa honor society and was the faculty's nominee for Kirkwood's 2009 Outstanding Nursing Student.

He is the recipient of the Anna Purna Ghosh Fellowship, as well as the Iowa Hospital Education and Research Foundation Fellowship, the Rohde Family Fellowship, and the Sara and Henry Katz Fellowship.

Andersen had advanced clinical rotations in family practice, surgery and dermatology. held an RN preceptorship in the trauma department at Mercy Medical Center. conducted research on the impact of patient education on stress and pain perception. has experience interacting, teaching, assessing and working with children in multiple settings, including teaching semesters in Cedar Rapids Community Schools along with a variety of other skills and experiences. She is also proficient in the use of multiple software programs, including EPIC, which will soon be rolled out to CMH and clinics this summer.

In the summers of 2012 and 2013, she worked as a registered nurse at a summer camp in Pennsylvania where her daughters spent two weeks the first summer and four weeks the following summer. Many of the children, who were at the camp all summer, were from cities where their parents worked all day and lived in apartments.

She worked as an office nurse and had various other responsibilities for Dr. John Vander Zee, FACS, Cedar Rapids, from 2000 to the end of December.

Other work experiences, some part-time, included working as a campus nurse at KCC, a registered nurse at All Heart Staffing, Inc., the Helen G. Nassif YMCA for Childwatch, UI Family Care, a multi-provider family group clinical practice and vocational of health care for adults with disabilities in the workplace and conducted occasional health clinics for the US National Guard and the US Army Reserve. She also worked part-time as a legal secretary for Ackley, Kopecky and Kingery, LLP, Cedar Rapids.

FAMILY

Andersen and her family currently live in Cedar Rapids while selling their home before purchasing one in Williamsburg, where they have been house hunting and attending schools.

Her husband, Darrell Andersen, works for Alliant Energy. Older daughter Jessica is 25, lives in Iowa City and is getting married next fall. The three youngest daughters are Eleanor, 14, Madalyn, 11, and Elizabeth, or Libby, 9. In the fall, Eleanor starts middle school, Madalyn will be in sixth grade and Libby in fourth. All the girls are dancers, and two of them swim.

Andersen stayed home with her children when they were younger, taking several classes at the same time. When it was time to begin her nursing studies, she immediately enrolled in nursing school with the goal of becoming a nurse.

Kathryn Andersen was born in New York, moved to California when she was 4, and grew up in Southern California. Her mother and father are teachers and her stepfather is a dentist. All three went to UCSC. The family moved to Los Angeles where her stepfather attended dental school.

There wasn't much snow or ice where he lived in San Diego and then moved to Orange County, California, so he experienced snow and ice stress several times in February while driving from Cedar Rapids to Marengo.

Her father moved to Puerto Rico and she attended two years of high school there. She didn't know the language and was immersed in an unfamiliar culture. He says he didn't learn as much Spanish as he should have, but he was able to talk and get by. English was taught in schools. When he gets there now, he finds that the people don't speak English that much.

Attending school helped her develop empathy for people from or other cultures and their languages. She is trying to get her Spanish back and can understand some of it, but not as much as she would like. It makes a difference if a person tries to understand and makes an effort to communicate with the person in a language they are more comfortable with and willing to share information with, she says. She would like to take a Spanish language course.

Andersen lived in New Mexico for several years, first spending a few summers with aunts who lived there, before moving to Albuquerque at age 18.

She worked full time as a legal secretary and owned a family restaurant with her husband while they lived in Albuquerque and just outside the mountains in Tijeras where his mother and stepfather live.

He describes it as a beautiful geography and a fun place to live, but with problems - lots of crime, drunk driving, bad schools, high teenage pregnancy rates and tough economic times, depending on people's comfort level moving forward. A major newspaper article he saw while there a few years ago reported that more than 50 percent of the men were dropping out of high school.

After much discussion about where to live and raise their family, their conscious decision was to move to Iowa. Her husband is from Cedar Rapids. It's a decision she's very happy with.

"It doesn't get any better than this - Iowa with healthy, happy people," according to Kathryn Andersen.

There are places to visit the family—California, the mountains of New Mexico, the beaches of Puerto Rico, and grandma living in upstate New York—after the Andersen family moves to Williamsburg.

"Williamburg is a neat city, we've been there to visit and we're very optimistic that we'll be happy there. It's so positive and friendly and enjoyable," Andersen says. It will be an opportunity for her to take on a new challenge and she is optimistic that it will be a great place to live and work. "It's very impressive how everyone is talking about Williamsburg. Visiting it as a new place is extremely positive."

HOSPITAL NEWS - Watts offers cataract services at CMH

By JANE BIGBEE on March 19, 2014

Dr. Chris Watts, an ophthalmologist, will begin seeing patients and performing cataract surgery at Compass Memorial Healthcare on March 20.

Cataract surgery is the most common and most necessary eye surgery, he pointed out. "Ophthalmic surgery is an area of ​​medicine that helps people restore or improve their vision, a large aspect of their quality of life and a vast area of ​​medicine in which to practice."

Through his practice at Eye Physicians and Surgeons, LLP, Iowa City, he has already seen many patients who live in the area and come to Iowa City for eye surgery. Dr. Ryan Striegel, Williamsburg Eye Center, et al. Paul Hottel, Eye Associates of Iowa City, who also has a practice in Williamsburg, has referred many patients to the office where Dr. Watts has surgery. He has been working with these doctors for the past two years. Dr. It was Striegel who approached CMH CEO Barry Goettsch with the suggestion that Dr. Watts came to CMH.

When it is determined that cataract surgery is necessary, Dr. Watts will see the patient in Iowa City where he has equipment for preoperative testing. Screening equipment is not currently available at CMH, although Dr. Watts is looking for portable equipment to bring here.

He suggests thinking of the eye as a camera. In cataract surgery, it replaces the lens with a clear artificial lens implant fitted to the eye so that the person can see well without glasses. To be able to do this, it is necessary to take measurements, he continued.

Cataract surgery has gotten much better than it has in years past, according to Dr. Watts, so the average surgery should only take about 15 minutes without pain or discomfort for the patient.

Cataract is an outpatient procedure, continued Dr. Watts. Ophthalmologists are capable of performing post-operative exams similar to what he would do in his Iowa City office, according to Dr. Watts. So the patient can stay in the home area without traveling to Iowa City. Patients feel comfortable and confident with the team approach when seeing their optometrists and surgeons. If anything unusual appears during the post-operative examination, the optometrist calls Dr. Watts.

Cataract surgery patients, he added, are very happy, thankful and grateful that their vision is back to how they remember it and that the surgery only takes a short time. Dr. Watts finds it very rewarding to actually improve the quality of life for his patients.

Dr. Watts also sees patients with macular degeneration who come to his Iowa City office for injections, sometimes every four weeks. In the future, he expects to also be able to perform macular degeneration injections at CMH.

He hopes to expand other services at CMH. In addition, he performs diabetic retinopathy operations and laser operations in glaucoma patients, as well as blepharoplasty.

Dr. Watts visited Marengo Memorial to see the facilities, meet the staff and see how they approach business. Initially, he will come to CMH once every three weeks and then more often as needed.

Dr. Watts completed an eye surgery residency at the University of Iowa Hospitals and Clinics Department of Ophthalmology, a year of fellowship at Deaoness Hospital in Spokane, Washington, medical training at the University of Washington School of Medicine in Seattle and his college in Montana.

FROM SPOKANE

Chris Watts grew up in Spokane, Washington, where his father was an obstetrics and gynecology (OB/GYN) doctor for about 35 years. The early family of the now retired Dr. Watts was originally bred in Nebraska. then his father's family moved to Peoria, Ill. From there, the elder Dr. Watts went to Tulane University, New Orleans, La., for medical school.

Chris Watts is the youngest child in his family. An older sister is an emergency physician in Billings, Mo., and a younger brother is a firefighter in Seattle. Their mother was a homemaker while the children were growing up, then went to law school and is now a judge. With his medical studies in mind, he considered himself fortunate to have the help and guidance of both of his family physicians.

Chris Watts was an all-state basketball player in high school. The 6'6" Watts received a scholarship to play basketball at Carroll College, Helena, Mont., where the team went to NAIA play. He described Carroll as a sister college to Gonzaga University, Spokane; both were Jesuit schools with similar programs .

Carroll had a very good pre-med program, he continued, and earned a degree in biology and chemistry. The demands of playing basketball and studying were a good background for medical school, where he found he could concentrate on his studies.

He returned to his home state to attend the University of Washington School of Medicine in Seattle from 2003 to 2008, graduating with honors.

He received a one-year research grant from the NIH (National Institutes of Health) Investigator Training Program from July 2005 to June 2006.

In medical school, he thought he wanted to be an orthopedic surgeon or work in sports medicine. First one has to be a general practitioner, he continued, with fairly broad training that includes delivering babies and working in the emergency department. During this training he "ran into eye surgery." He revealed that he "loved it with a passion – it was what I wanted to do for a career".

When he knew he wanted to do eye surgery, a consultant at the University of Washington School of Medicine told him that one of the best places to train was the University of Iowa, in fact one of the best places in the world to do an eye. surgery specialty. An added advantage, he adds, is that it's a smaller city and area, unlike Seattle.

He had the opportunity to spend a month during medical school at the University of Iowa Hospitals and Clinics (UIHC) and not only did he like the university but also Iowa. He was offered a place to stay for training.

However, prior to his internship at UIHC, he took a gap year at Deaconess Hospital in Spokane from 2008 to 2009 and was able to work with his father before he retired, delivering babies, working in the emergency room and other sectors or as a general practitioner. .

Within a month of arriving at UIHC, he realized how much he loved Iowa and Iowa City. "I feel lucky to have moved here," he added.

In his first year he met his future wife, Dacia, from Keokuk. She is a family practice nurse. They have a seven-month-old daughter.

IHA: CMH contributes greatly to the economy of Iowa County

March 19, 2014

Compass Memorial Healthcare creates 149 full-time jobs that add $9,992,493 to the economy of Iowa County and surrounding communities, according to the latest Iowa Hospital Association study.

Additionally, CMH employees themselves spend $2,812,386 in retail sales and contribute $168,743 in state sales tax revenue.

"In addition to directly benefiting employee wages and spending, hospitals make a significant contribution to the quality of life in a community, which is vital in attracting new residents and businesses. Local spending on health services also helps strengthen community by keeping dollars in circulation in the local economy for longer,” said Craig Hamilton, executive director of the Iowa County Economic Development Commission (ICEDC).
The IHA study looked at the jobs, revenue, retail sales and sales tax generated by hospitals and the rest of the state's health care sector. The study was compiled from data provided by hospitals on the American Hospital Association's annual survey of hospitals and software used by other industries to determine their financial performance.

The study found that Iowa hospitals directly employ 71,437 people and create another 57,792 jobs outside the hospital sector. As a source of revenue, hospitals contribute $4.2 billion in wages and benefits and generate another $1.8 billion through other hospital-dependent businesses. Overall, Iowa's health care sector, which includes salaried clinicians, long-term care and nursing homes, pharmacies and other medical and health care services, directly and indirectly supports 307,402 jobs in Iowa, or about one-fifth of the total workforce of the state. agricultural employment.

"People often ignore the contribution hospitals make to their local economies, including the number of people they employ, the importance of hospital shopping with local businesses and the impact of their employee spending and tax support for the entire region," he said. . Kirk Norris, IHA President/CEO; "Just as no one provides the services and community benefits that exist in community hospitals, there is also no substitute for the jobs and businesses that hospitals provide and create."

The Iowa Hospital Association is a voluntary membership organization that represents the interests of hospitals and health systems to business, government and consumer audiences. All 118 hospitals in Iowa are members of IHA.

Compass Memorial Healthcare is a critical care hospital located in Marengo.

IOWA COMY BOARD OF SUPERVISORS - Supervisors, Hospital Review of Ambulance Contracts

BENJAMIN S. Evans March 6, 2014

The Iowa County Board of Supervisors met with representatives of Compass Memorial Healthcare to discuss an ambulance contract that would restore the countywide service currently provided by the two partners on Friday, February 28.

The two sides presented two very different contracts, but the main point of contention between the two sides centered on the ownership of the ambulance service, specifically the size and style of the decal on the side of the ambulance.

Representatives from Compass Memorial Healthcare presented a proposal for a new design for the slogan on the side of a county-provided ambulance in late 2013. The design mentions Compass Memorial Healthcare, but Iowa County does not.

Compass Memorial Healthcare CEO Barry Goettsch said the hospital owns a majority stake in the ambulance service, and the new contract submitted by the hospital recognizes that ownership.

"The contract provides for reduced cost, fixed cost, continued excellent EMS service provided throughout Iowa County," said Goettsch. "Continuation of the contract we're in now, which in our opinion is a smaller contract on the part of the taxpayers."

However, the county council's consensus was that the hospital did not have a majority stake in the ambulance service, but that the partnership was split 50-50.

"We found nowhere that (the contract) made (the service) better for taxpayers, I don't know what you're basing that on," Board of Supervisors Chairman Ray Garringer said.

The debate quickly shifted from the ambulance contract to which party has the majority stake in the ambulance service.

"We have absolutely no idea where this (idea) came from that a hospital has an emergency room and you can call it whatever you want," Garringer said. “First we heard from (a third party) that you told them you own the clinic and you can call it whatever you want. Nobody told us and it's a surprise to us that If we're not our owners, if we're not a contractor, then people ask me (about the role of the board of supervisors), "does that make you rich Uncle Joe, do you just give them stuff?"

Goettsch disputed that the hospital owns a majority stake in the ambulance service, specifically that the hospital has an "80% investment in the service".

The CEO said the ambulance service provides excellent care to the county, but the hospital has concerns about compensating the 26 workers and competitive payment, with increased workers' compensation insurance and the risk borne by service providers.

"What I'm asking for is recognition that we have a greater share (of the risk required to run an ambulance service)," Goettsch said.

Goettsch said the county owns the ambulance, but the hospital is covering most of the costs the owner would incur. Goettsch stressed that the county's partnership with EMS is always appreciated, but since the hospital provides operators, EMS, drivers and paramedics, as well as other employees who help run the service, Goettsch said the hospital "has the biggest skin in the world". .

"Last time I checked, an ambulance wasn't on its knees in a ditch taking care of somebody," Goetz said.

Supervisors said they do not recognize the hospital as the owner of the service, as the county provides all the equipment, dispatch service and fees associated with the County Auditor and County Treasurer's Office to process requests or orders.

"We also have a lot of 'soft costs' that (the district) didn't bring up (in the negotiations)," Garringer said. "The ambulance service is a great burden on the dispatch service and every year it grows larger, which we carry without complaint because it is also part of the contribution to that service."

Without a contract decision, the discussion boiled down to a dispute over whose name would be on the side of the ambulance, and Goettsch said Compass Memorial Healthcare does not have equal representation in the partnership to provide the service.

"I think you split up because we had a good working relationship, it worked for the taxpayers and the people of Iowa County," Supervisor Dale Walter said. "And now all of a sudden, you want to change it because you want your name on the side of the vehicle versus Iowa County on the side of it. As far as I'm concerned, we buy (the ambulances), we pay for them our name will be on their side".

The board emphasized that the Compass Memorial Healthcare name will continue to be on the ambulances, as it is now. The board also emphasized that a public vehicle must be designated, by law, as a public vehicle, pursuant to Iowa Code section 721.8.

"From what I'm hearing, the problem is getting the name on the side of the ambulances," said Jenifer Mein Goettschu, who said the main problem is adding the Compass Memorial Healthcare name to the side of the county-owned ambulances. "To me, it shouldn't be about the name on the side of the vehicle, it should be about the quality of service provided, and it sounds like it's being provided. To me, it shouldn't be, 'We want a bigger name identified on ambulances.'

The rest of the board members echoed this view.

The two parties decided to consult professional design firms to come up with and design a new slogan in which both partnerships are equally represented in the slogan. The two parties further decided to propose the renewal of the ambulance contract until the issue of signs and slogans is resolved.

HOSPITAL NEWS - CMH looks at its future needs

By JANE BIGBEE March 6, 2014

Compass Memorial Healthcare board members led by CEO Barry Goettsch and Dean Schmuecker, director of facilities services, toured the hospital facility for nearly two hours at their January meeting.

That was in response to a report on facility space needs prepared by hospital leadership and presented by Goettsch at their Dec. 4 meeting.

Commissioners also had a floor plan of the existing hospital and floor plans of the site which they used as a reference when touring the premises.

Senior leadership - including Goettsch, Mikaela Gehring, COO. Teresa Sauerbrei, Nursing Manager; Mary Warwick, Administrative Assistant; and Matt Murphy, chief financial officer, - compiled a list of what they saw as needs and presented it to Goettsch at the December meeting.

Goettsch explained that the administration discussed the institution's needs and problems. They reviewed financial reports and statistics.

It's not about having staff to care for patients, it's about having a facility that cares for them, Goetz pointed out.

"We're maxed out," he continued. "We moved the waiting room for physical therapy patients into a shared waiting room, which is also a lab and radiology waiting room." The former laboratory and radiology waiting room is now used for other purposes.

"We have situations where we can't schedule outpatients because we don't have the space. The doctors we hire as busy providers are family physicians. The people we hire and look for will make us an A+ player in today's healthcare world. We talked about obstetrics again . We've had a doctor on staff since July 1st (Dr. Ben Miller) who wants to do obstetrics; he's from this area. He's passionate about providing health care. He can do it."

Goettsch said they were working with another doctor who would also like to do the stacking. "It doesn't matter if he gives birth to 150 babies a year, he wants it because (it's) part of his abilities.

"These are the people that are going to take us to a level that people never dreamed we would be. We have to keep thinking to stay on top of these things and we have to keep evolving. We have a project going on in Williamsburg ( This it does not mean waiting until this project is finished to solve the problems with the installation here,” he continued.

After discussing the needs over several months, Goettsch said they spoke with their Omaha-based auditing firm, Siem Johnson LLC, represented by hospital auditor Brian Green, about how to strategically launch a project like this. , remaining in the main Critical Access Hospital (CAH) Services. This will include linking the depreciation to the project in such a way that it is recovered through the associated costs as CAH.

"It's something we can capitalize on," he added.

Goettsch explained that they also have ongoing EPIC training with computers installed not only in the hospital but also in the training center in the emergency building - "they're everywhere."

"It's a big problem, but we have to stay ahead," he commented.

At the December meeting, he said the next step is to look at what resources they can bring to help write the plan. They have plans and designs from the renovation of the hospital and the new building - 2005-2006. - to get involved where they predicted the need then and where the real need is today. There are similarities and changes.

There is a need for a common registration area for outpatients and all visitors. There are now three places where you can check in at the hospital.

In response to a question at the December meeting, Goettsch said they assumed that when the new square footage was added, the building was structurally sound to handle the second floor. Is not. Any growth would come through the expanded square footage, but the foundations would be built on proper footings so they could go up to the second floor.

LIST OF NEEDS

Following are the needs suggested by the leadership.

Sauerbrei, head nurse:

• Number of beds - There are currently 25 beds. Obstetrics could take four; would be part of the number of hospital patients. This unit would be closed.

A room is now used for infusions. Sleep studies also take up a room. Sauerbrei suggests taking them outside so they don't get beds and moving them elsewhere.

• Outpatient Clinical Area - After speaking with Tina Welsh, Sauerbrei proposes an outpatient clinical area with two sections - one with three rooms, one with three rooms and two treatment rooms to be used for chemotherapy/blood patients. Treatment rooms can be "comfort" rooms with sunbeds. Overall, this will allow two doctors to have clinics at the same time. The space is currently at full capacity.
• Interior rooms - the beds are very small, i.e. close, because the rooms are designed very small. Special beds have been ordered and bed extensions are used for most patients.
• Hospital toilets must be the same. Some of the current ones work well, some are poorly designed.
• Respiratory therapy should be closer to the care area.

The operating theater should have more space in the center for the equipment needed for orthopedic surgery. Perhaps a separate orthopedic OR should be considered.

Schmuecker suggested the need for a separate space for heating/cooling equipment for these rooms. Glass doors to separate rooms were also discussed.

• Emergency Department - Stream must be replayed to register. There are too many entrances to the emergency room. In order to provide the necessary overflow space for urgent care, it is proposed to open up the current ambulance space for direct urgent care.
• Cardiac rehabilitation must be separated from the field of therapy.

Suggestions from Gehring, COO:

• Laboratory - it is very small. The micro lab is across the street. they must be together.
• X-ray - space will depend on services. If more space is needed, we can move down the street so the current space doesn't move.
• Treatment - must be regulated differently. If a brand new space were to open, that space could be opened for radiology.
• Pharmacy - if obstetrics is added, more storage space will be required. There is also a problem with the space around the fridge. Closing the gap between pharmacy and nursing was discussed for pharmacy expansion.
• Waiting room - you need more space.
• Central registration - better flow needed. Once EPIC is up and running, every incoming patient will need to be registered. It was suggested that we see how Jones County, Anamosa Regional handles this.
• Toilets - need more.
• MRI (imaging) - If not taken to the hospital, the truck should be near the x-ray. There has to be a better way to get people on the truck.

Schmuecker, director usluga u objeku:

• The cafeteria, if expanded, could be opened to the public, but admission would be required for outside visitors. Placing the area near the medical-surgical area "would be nice."
• Parking is now a problem. it is necessary to provide adequate spaces. The location of the helipad was discussed. If moved, this space could be used for parking. If it was to be installed on the roof, snow removal should be considered.
• The market should be somewhere at the back of the building next to the reception road.
• The equipment/machinery space will need to be re-examined with external overhead power lines and a new electrical space will be required.
• The maintenance garage needs to be expanded.

Mary Warwick, Executive Administrative Assistant:

• The waiting room is too small and the walk from the main lobby to the patient ward is too long for visitors. It is necessary to assess the flow of the patient.
• Storage - needs more. The marketing warehouse is across the street. It would be useful to have it in one area.
• Meeting space - more needed.

Murphy, Chief Financial Officer:

• Business premises - there is nowhere to accommodate someone.
• The business office/HIM can be moved anywhere, but it would work better if it wasn't so separate.
• Receptions must be coordinated and shared. There are currently too many inputs. If the clinics are organized, all registrations could be done together.

CEO Goettsch:

• Physiotherapy - a new field is needed.
• Medical Surgery - new construction and remodeling of all private rooms with one or two configured for bariatrics, OB unit, new activity/meeting/multipurpose room.
• Respiratory therapy must be located nearby or in a medical surgical unit.
• Surgery - should be new and remodeled with additional surgical kit, before and after surgery.
• Special clinics - arrangement of the existing administrative corridor. Occupational health protection could also be applied in this area.
• Administration, human resources and organizational performance will be transferred to the former therapeutic space with remodeling.
• Main entrance - new entrance and registration in the expanded area.
• Gift shop - bigger and expanded.
• Laboratory - Expand the laboratory in the former specialist clinic space with remodeling.
• Dining and Dining - Remodeling to include dining room for public services and second rear entrance. This would be a new and remodeled department.
• Infirmary - widen exit to allow for a garage door to protect patients.
• Heliport - move on the roof above the ambulance.
• The second floor will include a meeting/banquet area above the dining room. Use the elevator to access the helipad.
• Registration - Go to shared registration and shared waiting room similar to Jones Regional Hospital, Anamosa.

BORROWING CAPACITY

Brian Green, controller of Siem Johnson's Compass Memorial Healthcare, told board members he was asked to do an analysis of a potential construction project and how much money could be borrowed, about $15 million.

Green provided what he described as conservative baseline statistics for the critical access hospital based on historical data using the past three years of data for Compass Memorial Healthcare.

Long-term debt decreased to $6.79 million for 2013. This is down from $9,035,354 in 2011 when the debt was refinanced.

The data show that in 2013, 50.15 percent of costs were reimbursed through Medicare, and the percentage is slightly higher when Medicaid reimbursement is included.

Revenue available for debt service in 2013 was $1,772,387. The required debt service coverage ratio was 1.50 - the required covenant is 1.25.

Including revenue available for debt service, a required debt service ratio of 1.50 and assuming a 25-year bond term at a 5.50% interest rate, the potential for additional borrowing is $14.691 million, according to Green.

That 5.50 percent is probably higher than the USDA, he said.

His notes also show that the figures are based on CAH's ongoing reimbursement. interest rate of 5.5 percent; required contract ratio of 1.25, given the 70-day cash contract, excluding bond funds. They do not reflect any additional tax support and do not reflect the result of the capital campaign.

VILLAGE HEALTH Ambulance

Green also explained reimbursement to medical clinics in terms of Medicare and Medicaid. That's important, he told board members, because 60 percent of Family Medicine Clinic's business is Medicare or Medicaid.

There are four types of medical clinics, he continued.

Of the four, the stand-alone clinic has the lowest fee and all are based on a fee schedule.

One step ahead is a stand-alone rural clinic reimbursed at a maximum of $70 per visit.

The next step forward is a provider-based clinic, a hospital-affiliated clinic with some kind of hybrid reimbursement program with reimbursement for the professional component and cost reimbursement for the technical component, like FMC.

The best reimbursement is a fourth provider-based rural health practice affiliated with a hospital.

The key, he said, is that rural health clinics have some special privileges with some special conditions and requirements that only certain counties can have rural health clinics.

The 2013 change creates an opportunity for an Iowa County physician clinic to become a rural health clinic. With the change, both FMC and the new Williamsburg clinic have the potential for the best reimbursement available.

A provider-based rural clinic would be reimbursed for the total cost of clinical services—both professional, including physician salaries and benefits, and the costs of its support staff, so they could all be pooled into a pool that would divided by the number of clinic visits, which is how you would arrive at Medicare and Medicaid payments.

He said the FMC analysis this year had a cost per visit of $157. A stand-alone rural practice will be capped at $70, even though the cost is $157. Based on the numbers, it looks like FMC will have at least $100,000 in additional charges with the new type. For the Williamsburg clinic with a fee-for-service plan, reimbursement will be based on volumes. The latter clinic will be reimbursed according to the rural clinic reimbursement model.

Potentially, he continued, the new classification is "a very positive thing. There are some issues that need to be overcome, like licensing, research, certification, etc." Work on them has begun. There are four different agencies to work with, he added.

He also noted that the hospital's 340B drug program, which makes drugs available to outpatients, will also be available to clinic patients with physician visits.

HOSPITAL NEWS - CMH Receives iVantage Recognition for Care Excellence

By JANE BIGBEE JANUARY 15, 2014

Compass Memorial Healthcare received Excellence in Efficiency and Excellence in Quality recognition for the best results in these categories among all acute care hospitals in the country.

The award is presented by the National Organization of State Rural Health Offices in partnership with iVantage Health Analytics. Using iVantage's Hospital Strength Index, CMH was selected as a top rural hospital reflecting top quartile performance.

CMH was one of 15 rural hospitals in Iowa recognized for excellence in quality and one of 25 recognized for excellence in efficiency.

"We now live and work in a more dangerous, dynamic and complex healthcare environment," iVantage noted. "Federal and state governments are increasing regulatory requirements, employers are reshaping employee benefits, and consumers are weighing new health care decisions. Health care reform is here, ushering in an era of change that requires providers to be more informed, flexible and flexible.

"As providers strive for accountability and sustainability, the new healthcare environment requires them to simultaneously expand access, manage care and optimize efficiency while improving the patient experience, increasing quality and reducing costs. The Path to succeed in this new environment requires the ability to integrate and interpret a complete picture of operational, financial, clinical, population and market data,” continued iVantage.

Top Quadrant performance status is based on quality, outcomes, patient satisfaction, efficiency and overall performance. According to their publication, the rankings are determined by the Hospital Strength Index, the nation's first rating system for all providers in rural areas.

iVantage, a privately held company, serves more than 500 hospitals in the United States. Provides comprehensive and objective information products that help hospitals and health systems improve performance and access by linking expectations, dashboards, hospital- and system-level purchasing, analytics, clinical benchmarking, physician scorecards, and offering quality-cost analysis to provide new management perspectives new health care.

HOSPITAL NEWS - Irland is interim director of CMH EMS
written by BRATHJEN on JANUARY 8, 2014

Dr. Mark Ireland assumed the role of interim director of Compass Memorial Healthcare Emergency Medicine on January 1st.

This role was previously held by dr. Tim Momany, who has stepped down after 21 years as medical director of Compass Memorial Healthcare's EMS and Iowa County EMS.

"The Iowa Department of Health requires all emergency medical services to have a licensed physician to provide medical supervision. We are grateful to Dr. Momany for serving in this capacity and donating his time for the past 21 years," said Adam Rabe , Director of Emergency Medicine at CMH. -in. .

Irland, an emergency department physician at CMH, will serve as a liaison between the service, other physicians, hospitals and the medical community served by the program and will continue to develop and oversee quality improvement processes. Ireland joined the CMH in July 2007.

Irland received his medical degree from the University of Iowa School of Medicine in 1996. He completed his postgraduate studies at a Cedar Rapids family practice from 1996 to 1999. He is also currently the chief of staff at Compass Memorial Healthcare.

"Dr. Irland will be a great asset to our team and his qualifications will contribute to this vital service until a permanent replacement is found," Rabe continued.

Iowa County EMS is a division of Compass Memorial Healthcare and employs 26 full-time and part-time paramedics. This service also helps oversee the rapid response teams of all local communities known as QRS. QRS teams consist of volunteers in each community who are called upon in emergency situations to assess/treat patients until EMS arrives. Compass Memorial Healthcare and Iowa County are partnering to provide these services to Iowa County residents.

HOSPITAL NEWS - Appointment limits proposed by CMH board

By JANE BIGBEE

Compass Memorial Healthcare Board members were scheduled to hold a special meeting Monday afternoon, December 23, to hear the Board's report and discuss the bylaws.

At the November board meeting, held Dec. 4, member Randy Fry, now in the first year of his second three-year term, asked to discuss the board's bylaws, which limit a member to two three-year terms, and to consider the structure to move away from term limits.

Fry said he looked at the makeup of the board, noting that several people had served on the board in the past with extensive experience. Jeff Ritchie, who previously served as board chairman and is currently vice chairman, will complete his second term in the spring. That, Fry pointed out, makes him the most senior board member with less than four full years on the board.

Fry asked if there was any information from other hospitals about restrictions on board members. He noted that seminars at Iowa Hospital Association meetings discussed the issue and seemed to move away from term limits.

CMH CEO Barry Goettsch said board composition and skill sets vary as they look for the person in their community and professional skill sets to bring to the board.

Goettsch said he contacted 12 hospital directors and received mixed responses. There were three, one of which was Vinton, who had no term limits and had organizations that flourished. Three applied for two-year terms and two four-year terms.

A three-year term doesn't seem so daunting, Fry agreed, commenting that the Iowa Valley School Board, where her wife Jane serves, has struggled to get people to serve four-year terms.

Adam Grier commented that with a three-year term, people don't feel obligated for that long, and Fry agreed that there's a sense that they can't get people to serve if they feel like they can't get off the board.

Board President Cindy Tindal added, "Nobody likes change, but people like change."

Wayne Parizek added that he has people who are educated, willing to serve and can do a good job (that's a good thing), he liked the idea of ​​a term, but maybe 10 years, "pretty short."

It takes a while to go through all the situations, to get to know the boards, Fry replied. He pointed out that when he first joined the board, they were considering certifying members, a process that then took two to three years with a six-year term limit. Productivity lasts two to three years, he continued. The board should also consider how it assesses itself and how it will deal with problems.
It takes a while to go through all the situations, to get to know the boards, Fry replied. He pointed out that when he first joined the board, they were considering certifying members, a process that then took two to three years with a six-year term limit. Productivity lasts two to three years, he continued. The board should also consider how it assesses itself and how it will deal with problems.

Fry said they should look at: how they re-evaluate, training when bringing a person onto the board, requirements, webinars, potential board members who have served on the board or the CMH Foundation board in the past, people older or newer ones.

"We have a good record," Fry continued. "There's something to be said for people knowing history beyond the last five or six years."

He added that expanding the pool for board members from the service area helped.

Ritchie noted that advertising for new board members brought in six to seven qualified candidates. He said he will refrain from making a decision since his term expires in the spring and has not decided whether he will stay on beyond his current term if there are no other term limits.

Before the discussion ended, Goettsch said, in light of the new medical clinic being built in Williamsburg and the pace of growth in hospital and clinical services, “It's great to have this team together as we focus on what we do and keep things moving forward. for the next five years. It would be beneficial to have the same team dynamic with this development.”

The management and bylaws committees were to meet.

New since 2013

CMH BOARD OF TRUSTEES - CMH Board Hears Service Updates, W'burg Clinic

DECEMBER 3, 2013 By JANE BIGBEE

Digital mammography will soon be offered at Compass Memorial Healthcare, trustees were told at their Oct. 23 meeting, along with reports of increased hours for ultrasound services, cataract surgery and news of a new Williamsburg clinic.

The space is being renovated for new equipment so the hospital can offer in-house digital mammography, Mikaela Gehring, chief operators, told administrators. The service will be provided by Shared Medical, whose staff will conduct tests and train local staff who will provide diagnostic services. Goering explained that this will allow a patient to have an ultrasound when needed without a long wait or go home only to have to return.

The hospital will schedule and bill for the service. The seller is currently undergoing an MRI at the hospital. Mercy's mobile van did mammograms at the hospital twice a month.

Available hours for ultrasounds are increased to four days per week.

Gehring also told trustees that a nurse has been hired for the new Williamsburg clinic. Katie Anderson is expected to begin working soon in Marengo in training to open the clinic. Other staff are also employed. New clinic staff are invited to a staff meeting at Highland Ridge, Williamsburg.

CEO Barry Goettsch said the specific road, curb and sidewalk work should be completed by the end of the week of the meet, weather not being a factor. Goettsch also noted that early in the planning, hospital dean Schmuecker went door-to-door in the neighborhood to hand out business cards to local residents and invite them to call if they had questions or problems with the project.

Teresa Sauerbrei, chief nursing officer, said Chris Watts, MD, Iowa City ophthalmologist, and Rick Striegel, OD, Williamsburg optometrist, met with the medical staff to discuss cataract surgery at the hospital. Dr. Striegel made the recommendation as the two doctors looked for ways to bring more patient care to rural areas. Their mission fits well with that of CMH, Sauerbrei pointed out.

With the recent introduction of ultrasound equipment, providers have had visual demonstrations. Sauerbrei also mentioned that they were working on processes related to admissions from the emergency department to the inpatient area and streamlining them.

Several attended the fall sessions of the Iowa Hospital Association, he continued. Patient satisfaction was the topic of the day along with utilization review tools and topics on reducing readmission rates and keeping patients at home longer. The second day focused on nurses, including accountability, quality and satisfaction. The Studer Group, Portland, Oregon, which has held presentations at the hospital for several years, was the main exhibitor for the day. The hospital's literary club, using Clint Studer's book, continues with wit