Brengard shies away from CMH

The Drs. Stone, seem to like a challenge

by C.F. David

The Cimarron Memorial Hospital met in a special meeting on Monday night. They gathered to hear from Bob Brengard, of Brim healthcare Services and if Brim might take over management of the Boise City facility. He wasn't hopeful.

Brim, according to its website, was founded in 1971 to manage small community hospitals.

Brim's management along with a lot of state money has helped to turn Clayton's hospital around. The board hoped a similar success story awaited Cimarron Memorial.

Brengard, a company V.P., explained that he tried to attend every board meeting Union county Hospital had.

“We really don't want to come into a hospital if we don't think we can make a difference,” he said.

He turned to Cimarron Memorial's CFO, Kevin Conner, “We haven't received your financials, I'd be shooting in the dark so to speak.”

“I don't know anything about your financials except what I've read in the paper,” he added.

Conner apologized and said that the papers weren't together yet.

Brengard explained that Brim managed hospital's across the U.S. from California to Flordia, with budgets ranging from $5 to $100 million.

“It's a challenge to manage a hospital. The health care delivery system is in a turmoil. We get calls all the time from hospitals that are struggling he explained. Quite frankly we are quite particular on the size of the hospitals we choose to manage. Unforutuntly, we are choosing to manage fewer and fewer small hospitals.

“We don't want to be in a hospital where we can't make a difference,” he reiterated.

Chairman Ralph Warren asked if Brim might be interested.

“It's highly unlikely we'd be interested. We are a for profit company. It's highly unlikely that with your gross revenues. It would be difficult for the hospital to pay Brim,” Brengard said.

Warren asked what the lowest scale was for small hospitals.

“It's $125 thousand and up. some are less, but they've been with Brim for 30 years, and we don't want to abandon those hospitals,” he said.

Board member Dwilene Holbert told Brengard, “We were a thriving hospital when we had a surgeon. We have a good nursing staff, a good nursing home...we have a good clinic.”

“It's difficult to find surgeons,” Brengard said. “They are in short supply. “Your best scenario is to find a retired surgeon to move to Boise City .

“We have been thinking of trying to share a surgeon with another community.”

“Most medical staffs discourage this,” Brengard said. A circuit-riding surgeon can lead to poor quality medicine. If you don't have good quality medicine, I'd suggest you close your doors,” he said.

With tears in her eyes, Holbert told Brengard that without a turn around in the hospital's finances that might occur.

Asked by The Boise City News should the hospital close was making an assisted living center from it a viable option, Brengard said, “No.” “The best setting is not an old hospital or nursing home. It [an assisted living center] needs to be new.”

Brengard explained that if an adult was expected to give up their home and move to a place that charged them $2 to $2,500 a month, it needed to be nice.

“They have different regulations,” Donna Cain added.

With those remarks, Brengard left the meeting.

In other business Clinic Manager Tammy Avent told the board that Dr. Prameela Yoga had terminated her contract with Texas Tech, and was open to returning to Boise City .

Avent added that those interested in trying to influence Dr. Yoga to return should e-mail her at .

Asked by board member Don Stark as to why she left, Board member Frank Lynch responded that she had a better offer.

“That, and there was a handful of people who drove her out,” Avent added.

“I think we need two doctors plus Dr. Wheeler,” Warren said.

“So do I,” said Lynch, Holbert, Stark and Lois Nelle Burkhalter.

Conner reminded the board that Dr. Warrick, of Docs Who Care was not adverse to moving to Boise City .

“He [Warrick] says we are doing it right, by offering a salary and incentives,” Avent said.

“If we lose this hospital the county will blow away,” Warren said.

“We've had several different businesses turned away...I guess because they wanted to bring in the wrong kind of people,” Stark pointed out.

Avent turned that discussion to a possibility of making the clinic into a “ Federal Healthcare Center ”. She pointed out this could mean as much as $650 thousand in Federal money could be pumped into the clinic. The clinic with this title could pull indigent patients from surrounding states.

“We have a lot of people living in Cimarron County who don't go to the doctor because they don't have the money,” Avent said.

“It would handle meds, oral and behavorial,” she said.

Avent said the program would help with physician recruitment, and loan repayment among other things.

After a short recess, Dr. Jimmy and Monica Stone arrived to address the board.

The Stone's told the board that they felt they should address them since the departure of CEO Patsy Shields.

“We thought, oh my maybe there are other things we can do to help you,” said Dr. Monica Stone.

Monica Stone has been to the clinic for women's health and she also does cosmetic work.

Dr. Jimmy Stone will return on Oct. 27 to perform several upper and lower scopes.

Jimmy told the group he planned to come up at least once each month for scopes and hoped to do more surgeries at CMH.

“We have a whole gamut of out-patient surgeries we could do, gall bladders, hernias and after attending a seminar, pacemaker insertion,” he said.

“We are getting a new color imaging Doppler Ultra-Sound we'd be willing to bring up each week,” he added.

“I think there is a lot of potential,” he said.

Both doctors have degrees in hospital administration, Jimmy, an M.B.A., both have worked in hospital administration and bounced the idea that they as a couple would be willing to manage the facility.

“We are flexible, we can manage that,” said Jimmy.

“I must add we practice evidence based medicine,” he said.

“You are not going to get a shot to generate medicine,” Monica said. “Medicine today is about service and development,” she added.

Jimmy Stone pointed out that with proper equipment, a variety of cosmetic surgeries could be done. We could do a tummy tuck with an overnight stay.” he motioned to his wife, “Dr Stone does beautiful work. Fifty percent would be paid for by the patient up front, and 50 percent within 30 days,” he added.

“It sounds exciting to me,” Warren said.

“Like a breath of fresh air,” Holbert said.

“Would you also consider taking over the primary care in the nursing home?” asked Administrator Donna Cain.

“Yes.” the Stone's answered in unison.

The board agreed to meet with the Stone's on Oct. 26 to go into Executive Session for furthur discussions.

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