Munroe facing budget biopsy

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By Amy Ryffel-Kragh

“This is my favorite subject,” said Steven Purves, president and CEO of Munroe Regional Medical Center (MRMC), after he was introduced by Pat Gabriel. He was the first guest of the New Year to speak to the packed house at the S.R. 200 Coalition’s monthly meeting.


During his presentation he discussed the challenges the nonprofit hospital faces, as well as the mission and the history of MRMC. The mission of the hospital is to keep the quality of patient care up, while keeping the cost of medical care down, he said.

However, in today’s rough economy, the medical facility is looking for ways to save money.

Purves asked the audience what could be cut from the budget, without causing the quality and the cost to change. He added, “That’s a daunting task.”

An audience member inquired about the elimination of Prestige 55, which is a program for seniors over the age of 55. “We are looking at that program,” he said. However, some changes have already been made, which has saved more than $100,000.

Though Presitige 55 has not been cut, MRMC’s Vital Signs magazine has been.

Purves prodded the audience by questioning the obstetrics program at Munroe. “I cannot imagine us not having an obstetrics program in Marion County” he said, “but it does lose a significant amount of money.”

The hospital loses more than $4 million a year providing obstetrics services. So how does the community hospital make up the difference?

On the other hand, the cardiovascular program is one of the few services that do make money, he said. The MRMC heart treatment services have been rated in the top four percent in the nation for the last two years.

As for the quality of patient care, Purves said there are many ways to measure it. For example, MRMC has been voted best hospital in Marion County by the public for the last six years in a row.

And Munroe has one of four intensive care units in the United States to win the Beacon Award, which is given by the American Association of Critical Care Nurses. “We’re proud of that,” he said.

Growth Pains

MRMC is currently 648,418 gross sq. ft., but by 2015 it is projected to need about 24 percent more. Purves said the facility needs to be expanded, but “we can’t do that right now.”

The oldest section was built in 1928. The latest expansion was completed in 2003, and the hospital went from 323 beds to 421.

At the present time, there is a planned expansion for the TimberRidge Medical Campus, but Purves said they have yet to be given state approval for the project. However, there are no current plans to expand to the vacant property around the center.

TimberRidge includes the Corridor’s emergency center, a place where many complain of waiting a long time before treatment. When patients arrive at the medical center they are “triaged.” The most severe people are seen first, while someone with the flu would be put at the bottom of the list.

Purves showed the five levels of patient care that are determined when entering an emergency room. A level-one patient is the most severe, life-threatening. Level four and five patients are the least ill or hurt.

Last year, 45 percent of the patients who visited the TimberRidge Emergency Center were level four patients and 17 percent were level five. “Four and five are the folks who really do not need to be in the emergency department,” he said. “It is not an urgent care center.”

How Does a Community

Hospital Work?

In 1965, the state legislature passed a law that allowed counties to create special tax districts. The Marion County Hospital District Trustees (MCHD) was created in response to the law. Today, there are seven trustees and six non-trustees, which are part of Munroe Regional Health System, Inc. (MRHS), a nonprofit corporation. Two of the seven trustees are physicians.

“The creation of the 1965 law was all about creating a dependent special taxing district,” he said. The role of the Marion County Commission is to appoint the trustees and to ratify the non-trustees, he explained.

The commission is also responsible for acting on requests made by the board of directors or trustees for public financial support. The board members do not receive any compensation for their work.

In addition, the responsibilities of the board are to handle any expenditures over $1 million, to approve the annual budget, and strategic plan of the facility.

Instead of having a question and answer session, Purves fielded questions from the audience as he spoke and ran his power point presentation. He also let members buttonhole him with individual questions after the meeting.

Contact Amy Ryffel-Kragh at 854-3986 or e-mail akragh@newsrlsmc.com.