Mountains Community Hospital (MCH) provides high quality, lifesaving healthcare to the residents and visitors of the San Bernardino Mountains, one of the most densely populated mountain areas in the United States, and the most densely populated urban forest west of the Mississippi River. From Crestline to Green Valley Lake, this small mountain hospital serves a population of 26,000 people. If you take into account the influx of seasonal visitors and part-time residents, the number sometimes doubles!
Despite its small size, MCH is a full service hospital with a 24/7 emergency department, 20-bed long-term care unit, 17-bed medical/surgical unit, full laboratory and radiology services, two surgical suites, physical therapy and rehabilitation office, dental clinic, and two health clinics located in Lake Arrowhead and Running Springs.
Critical Access Hospital Serving the San Bernardino Mountains
Critical Access Hospital (CAH) is a designation given to certain rural hospitals by CMS (Centers for Medicare and Medicaid Services). This designation was created by Congress in the 1997 Balanced Budget Act in response to a string of hospital closures in the 1980s and early 1990s.
The CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. This is accomplished through cost-based Medicare reimbursement.
To ensure that CAHs deliver services to improve access to rural areas that need it most, restrictions exist concerning what types of hospital are eligible to the CAH designation. The primary eligibility requirements for CAHs are:
A CAH must have 25 or fewer acute care inpatient beds.
It must be located more than a 35-mile drive (or, in the case of mountainous terrain, a 15-mile drive) from a hospital or another CAH.
It must maintain an annual average length of stay of 96 hours or less for acute care patients.
Emergency care services must be available 24/7.
Joint Commission Accreditation
MCH is proud of its Joint Commission accreditation. Only 27% of Critical Access Hospitals are accredited by the Joint Commission. This shows that MCH is in compliance with regulatory standards and that we meet the highest standards of quality and safety.
Healing | Empathy | Accountability | Resolution | Trust
Did you know that going to a hospital is one of the riskiest things a person can do? It is estimated that more than 250,000 Americans die each year from medical errors. At Mountains Community Hospital (MCH), patient safety is a core value. To reduce the risk of patient harm, MCH is collaborating with its insurance carrier, BETA Healthcare Group, in a program named “HEART.”
HEART stands for Healing, Empathy, Accountability, Resolution and Trust. The program helps member hospitals to create a “culture of safety” by encouraging staff and patients to speak up about issues that have or may lead to patient harm, and by developing reliable systems for providing safe care. The program also promotes a “Just Culture” which focuses on fixing “systems issues” that affect staff performance, and holding staff accountable only when conduct is risky or reckless. We believe that our HEART participation will take MCH from “good to great.”
In our year of participation with HEART, we have made significant progress. Hospital leaders and managers now hold daily huddles to improve communication among departments about safety and operational issues. Community members attend our monthly board meetings to review our safety reports and provide a patient/ family perspective on our efforts to prevent patient harm or dissatisfaction. Hospital departments develop improvement projects that promote patient safety. As an example: in 2017 the Rural Health Clinic developed a process that reduced the wait time for X-ray insurance authorization from 3 weeks to just 4 days.
HEART emphasizes accountability and empathy when patient harm actually occurs. Such incidents are investigated thoroughly, with a focus on understanding all perspectives, and preventing recurrence in the future. If harm occurs as a result of medical error or inappropriate care, every attempt is made to resolve the matter in an ethical, humane way that instills trust among patients, patients’ families and caregivers. The HEART approach also supports caregivers, who are often deeply troubled when a patient is harmed under their watch.
In 2017, MCH conducted a staff survey (“SCORE”) which provided many valuable insights into staff perceptions and concerns. As a result, several departments created action plans and began making improvements right away. Many departments identified “culture of safety” champions: front line staff members who promote the HEART message among their peers. We hope to see improvement over last year’s results, and will continue our efforts to make MCH a GREAT hospital: one that is safe for patients and one where staff feel proud to work.
ABOUT MOUNTAINS COMMUNITY HOSPITAL
Mountains Community Hospital is a District Hospital as well as a Critical Access Hospital located in a rural community. The hospital experiences approximately 45,000 visits per year. Fifty percent of the hospital’s visits are from Medi-Cal.
Mission Statement: Mountains Community Hospital makes possible essential quality medical services to the residents and visitors of the local mountains.
Vision Statement: Providing peace of mind by securing the health of the community.
BENEFITS OF THE 340B PROGRAM
The Hospital experienced approximately $30,000 in savings under the 340B Program during the Fiscal Year ended June 30, 2019. These savings helped to fund emergency and primary care services to all members of our community regardless of their ability to pay.
The Hospital has established a 340B Oversight Committee (the Committee) that is responsible for the oversight of the 340B Program. The Committee consists of the CEO, CFO, Pharmacist, Pharmacy Tech, Patient Financial Services Manager and the Clinical Informatics Specialist. The Committee follows the Hospital’s written policies and procedures to oversee 340B Program operations and to maintain a compliant 340B Program.
IMPACT IF THE PROGRAM WAS SCALED BACK
If the Program was scaled back, this would greatly negatively affect our long-term vision of expanding services & increasing access to a neighboring community which is in our sphere of influence and is primarily a low income area. Currently this community represents approximately twenty eight percent of our business at the Hospital. Our long term plans include expanding services to that community by possibly opening a clinic. We plan to fund a portion of this project with future savings under the 340B Program. We plan to increase our utilization of 340B drugs under this Program and increasing our savings.