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Daily Newspaper and Travel Guide
for Pecos Country of West Texas

Wednesday, May 26, 2004

RCH’s nurses OKed to screen patients for ER

Staff Writer

Patients visiting the Reeves County Hospital emergency room in the near future may be in for a surprise.

RCH board members approved a policy to allow registered nurses to conduct ER screening of patients for assignment of treatment. The board approved the change during their regular meeting for the month of May.

During the medical staff report portion of the meeting, Hospital Administrator Robert Vernor brought to the board’s attention the growing trend in emergency medicine. “In the past any patient that came to the ER had to be seen in the ER, leading to patients with minor problems clogging the ER,” Vernor said.

This policy will give “RN’s the authority to recommend that non-emergency cases go to a doctor’s office or to the rural health clinic next door,” he said. “The status of the patient will be based off of the rating of the nurses’ evaluation. If it is a serious problem I don’t think the nurses will take a chance.”

Vernor added that after hours patients would still be seen in the ER. With the rural health clinic next door, he said that if a patient’s condition worsens, then transferring them back would not be a problem. He emphasized that patients would still be seen by someone, not just sent home.

The change was one of several items the board discussed during their extended meeting on Tuesday. They also heard from Bill Parrish of the hospital’s accounting firm on the overall financial health of the facility.

Parrish told the board that despite a $100,000 drop in net assets, the hospital was well organized. He cited construction of the hospital’s new wing as one of the reasons for the drop in assets, most notably liquid assets, but added that the addition, which includes a new kidney dialysis clinic, would hopefully be a good source of income in the near future. But he did warn the board of some potential problems.

“There are quite a few reasons for the drop in assets,” Parrish said. “First, your contractuals and bad debt is up, and at the same time your Medicare Dispro payments and the number of privately insured patients have both dropped.”

“You still have a lot of cash on hand as compared to your counterparts, and your days of accounts reimbursable is doing better, about the same as your counterparts,” Parrish said.

“Contractuals and ‘other expenses’ are hurting you the most. RCH is different than other hospitals in that you are required to pay so much out for indigent care, much greater than other hospitals.”

Due to those costs, Parrish recommended that the board look into forming a Critical Access Hospital.

“From a reimbursement point of view, it will allow for Medicare to pay you cost plus one percent and will reimburse you for most of the cost of the facility,” he said.

Parrish said that the hospital had two options that would recover more of the money from the indigent care and contractuals where RCH is currently operating at a loss. Those are a Federally Qualified Heath Center or a Critical Access Hospital.

Parrish said the two main draw backs to the CAH was that the average number of days that a patient was in a non-swing bed had to be less or equal to four, and the number of beds the hospital could fill would have to be limited to 25.

He added that in his letter of internal control, he did see a conflict with the fact that the employee that did the payroll also had the authority to reconcile the bank account, but added that hospital Chief Financial Officer Bill Conger had already spoken with him and was ready to implement a plan to remedy the situation.

The board also heard from Vernor on the possibility of putting together a ‘Community Health Foundation’ board to look into the possibility of forming a FQHC. Vernor said that the hospital already had the grant, but the hospital board would have to approve the formation of a 501 (C) (3) community health foundation to look utilize the funds.

Board Chairwoman Linda Gholson said that she would prefer more time to fully understand the proposal.

Vernor said that the board needed to be put together last night, or there was a good chance that the government agency giving the grant for the hospital to look into the FQHC possibility, would withdraw it because the hospital had not taken any action as of yet.

“I understand that time is of the essence, but I just don’t want to jump to any decisions under the circumstances,” Gholson said.

The board decided to table the item, essentially letting the grant die for the year, with the possibility of reapplying for the same grant next year.

In other business, the board looked at the hospital’s contract with the city for ambulance service, but tabled the item after much discussion on the issue.

Mayor Dot Stafford and City Manager Joseph Torres were both on hand to answer any questions that the board might have.

However, the board decided to table that item when conflicts arose over the amount of money to be paid to the city.

In previous years, the hospital had paid the city $40,000 a year to run the service. However, this year the city is asking for more money in the new agreement, due to the fact that costs and uncollectible debt had risen so much recently. The city council is scheduled to discuss the contract during their meeting Thursday evening at City Hall.

Balmorhea horses’ illness could be costly for Dallas

From Staff and Wire Reports

Three horses in Balmorhea could end up costing the Dallas-Fort Worth area $30 million in revenue this fall, according to a report in a racing newspaper.

However, the veterinarian who first reported the three cases of vesicular stomatitis in Balmorhea and officials with the Breeders’ Cup say fears that the disease might spread out of southern Reeves County are overblown.

Kentucky's state veterinarian has indefinitely banned all Texas livestock from entering the state because of the outbreak.

The Breeders' Cup, scheduled for Oct. 30, is a group of eight races with $14 million in purses held on one day for thoroughbreds from North America and Europe. The race is estimated to have an economic impact of more than $30 million on the area.

D.G. Van Clief Jr., president of the Breeders' Cup, said the chance of moving the event "looks extremely remote."

"We're not involved in any planning process to move the event," Van Clief said. "We're planning for a successful Breeders' Cup at Lone Star."

But he said in a story on the Daily Racing Form Web site that if the vesicular stomatitis situation hasn't changed by the middle of July, formal negotiations about changing the location would begin.

Corey Johnsen, president of Lone Star Park, said speculation of a change of venue at this point would be an overreaction.

"We're going to monitor the situation and do a thorough investigation on every horse currently stabled at Lone Star and every horse that travels to Lone Star," Johnsen said. "In a month or two, we hope this is under control."

Pecos vet Dr. Ronald Box, who first diagnosed and reported the Balmorhea outbreak, agreed that the concerns were overblown, but added, “They did the same thing to us 6-7 years ago when we had the last outbreak of vesicular stomatitis.”

“Lots of times with handling of diseases they swing too far in terms of caution,” Box said, adding that the animals in question already are recovering from the disease.

The rarely fatal viral disease causes blisters to form in the animal's mouth and on teats or hooves. It can affect horses, cattle, pigs, and occasionally sheep, goat and deer.

Texas Animal Health Commission officials said the infected animals have not been off the farm in a number of months, and Box said, “My understanding is 30-40 days after we diagnosed this vesicular stomatitis they’re going to lift up the quarantine.”

“Texas is a big state. If there was a state line between here and Dallas, it wouldn’t be a problem. They could hold the Breeders’ Cup in Carlsbad, N.M., which is 80 miles from us and they wouldn’t have thought anything of it, because it’s across a state line,” he added.

Lone Star Park is spending about $8 million to prepare the facility for the event. Some of the renovations have already begun. The event is expected to bring a crowd of about 50,000.

Changing the site of a Breeders' Cup has happened in the past. But locations that have lost the Breeders' Cup have been allowed to host the races another year.

Churchill Downs in Louisville, Ky., was tapped to host the event this year, but it was moved to Lone Star Park a year early because of an expansion project at Churchill. The last cases of vesicular stomatitis before the current outbreak were discovered in Reeves County and sections of New Mexico six years ago. Box said along with Kentucky, New York State also banned the transportation of horses from Texas due to that outbreak, though he added there are no federal guidelines on the control of animal shipments from where the disease is discovered.

“If I’m shipping animals, I’ve got to follow the guidelines for that state,” he said.

“The main problem we have with vesicular stomatitis is with dairies,” Box said. When the quarantine was first announced last week by the Texas Animal Health Commission, Box explained that the dairies in the area were the ones most at risk from the disease.

“The disease spreads easily in the confined space of a dairy. Milk production would drop, and due to the antibiotics administered to the animals to prevent secondary infection, milk would have to be dumped,” Box said. “It could possible shut down a dairy for two to three months, a possibility that could bankrupt a dairy.”

He said the symptoms of the disease include the characteristic mouth sores, lameness from a lack of eating, excessive salivation, severe weight loss, and a drop in milk production in dairy cattle.

“Adopted” soldier tells class of Iraq injuries

Staff Writer

A Pecos soldier who was injured recently in Iraq is grateful to be alive and happy to be spending time at home with his family and friends.

Spc. Adrian Herrera was injured in a tank accident about a month ago and is spending time here in Pecos with his family after first being treated at Fort Sam Houston Hospital in San Antonio.

“We’re still having to go to San Antonio to the hospital, but we’re just glad he’s here,” said his mother Hazel Herrera.

Adrian paid a special visit to Heather Scheier’s third grade class at Austin Elementary Tuesday afternoon and talked about his experiences. The third graders had “adopted” Herrera before his injury, as part of a class effort to adopt local armed forces members, and were in contact with them while they serve their country oversees.

“We had been e-mailing and in contact with seven,” said Scheier, whose third grade class last year also adopted members of the military. “Four of those have come home already.” Herrera, who was stationed in Iraq, while serving in the United States Army, was injured in a tank accident. He was transferred to Fort Sam Houston Hospital where he underwent shoulder surgery.

“I’ll probably have to undergo one more surgery, dental work,” said Herrera, who has been with the Armed Forces for five years and had been stationed in Iraq since January. “I feel pretty good right now,” said Spc. Herrera. “It was great to see everybody and appreciate what everyone in Pecos has done and is doing for me,” he said.

Herrera received a big welcome home two weeks ago, when he was released from the hospital.

“I’m just happy to be alive,” said Herrera. “I appreciate the big welcome home I received and I want to thank everyone.”

He said that the accident occurred when his tank crew was going over a bridge and a track broke. The tank went over the overpass and fell 50 feet and unfortunately, the tank commander died during the incident.

“There were three people in the tank and my driver and I both survived,” said Herrera. “We feel really lucky.”

The students asked many questions during his visit to the class Tuesday afternoon. Among those included, what do you eat? Do you think the war will stop? What type of training do you undergo? And, are you going to have more surgery?

Herrera said that the soldiers eat MRE’s (Meals Ready to Eat) and showed some of them to the students. The war depends on what the government officials decide to do. Each department undergoes different training depending on what they are sent out there to do and yes, he will probably need to have more surgery.

“A bone in my shoulder was shattered and I lost my teeth,” said Herrera, who is a gunner in tank crew.

“It was great seeing all the things you guys did for me,” said Herrera. “I was very surprised and pleased.”

One student asked if they had nuclear bombs. “No, that’s what we’re trying to find out there, is their weapons of mass destruction, so that they don’t do any more harm,” he said.

The students had been busy making cards, banners and even took up donations for the injured soldier. Now, they have set up a special account to help with medical and travel expenses.

The account is set up at Security State Bank and the number is 261262, for anyone who would like to help the students and their hero.

One young lady in Scheier’s class raised some money for Herrera on her own, by holding a bake sale.

Cataina Hinojos raised $21 and was very happy about her contribution.

Hazel Herrera said, “To all the wonderful citizens of our community, we would like to thank you for your prayers and support that you showed our soldier. The parade was a very touching moment for us all, and just reaffirms us that our community is ‘the greatest’ for helping each other out.”

“There are so many people that pulled together to make this event happen in such a short time. We will never forget the hard work that you did in making this welcome home parade a huge success,” said Herrera. “May God bless each and everyone of you,” she said.

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