2009 Dynamic Dozen, No. 11: Citizens Memorial Healthcare

At Citizens Memorial Healthcare in Bolivar, growth doesn't happen by accident.

Armed with a detailed strategic plan, a solid database of up-to-the minute information on day-to-day performance and an electronic medical records system that provides instant access to patient information, CMH is positioned to meet the needs of patients in an eight-county service area.

The small rural hospital system that opened it doors in 1982 with a staff of 78 has grown to more than 1,600 employees, while the number of patients served grew by an average of 7 percent to 9 percent in the last two years. In 2008, CMH posted revenues of $196.4 million, up from $181.7 million in 2007.

Other recent signs of growth include the 2007 addition of a $7 million cancer center, in partnership with Central Care Center of Salina, Kan. In the last year, CMH opened a $9 million surgical center and medical office building and added 11 new physicians, including a cardiologist and a medical oncologist/hematologist.

At the hospital, CMH is approaching the 10,000th baby delivery in obstetrics, and in the last few months, the entire radiology system has been upgraded with new equipment. CMH's Web-based Picture Archival Communication System, or PACS, allows physicians instant access to X-rays, MRIs and other information via computer.

"We're excited about what we've been able to do in being able to grow the organization - not just the acute-care side, but in outpatient services, in long-term care, residential and independent living, home care, hospice, transit services and medical equipment," said Donald J. Babb, CMH executive director and CEO.

At the heart of CMH's growth is its strategic plan.

"The organization, I think, will always continue to grow because we do a lot of planning and focusing on the future," Babb said, "And its not just next year; it's the next five years."

While the strategic plan gets a lot of attention for the first six months of each year, "in between times there are lots of groups that meet to work on special projects with different areas of the hospital for improvement, and that feeds right back into the next planning segment," said Tamera Heitz-Peek, CMH director of marketing.

Moving ahead, the biggest challenge is reimbursement. Government belt-tightening and local job losses mean more charity care, Babb said. CMH gets much of its business from Medicare and Medicaid patients, and in tough times, those programs "typically don't give you more money; they tend to take it away from you," he added.

As a result, CMH is taking a cautious approach and is cutting costs wherever possible.

"We are not allowing out-of-state travel," Babb said. "We're very cautious about seminars that we send people to because of the cost involved in the overnight stay and travel."

As positions come open, CMH considers whether to fill them or hold off, with strong emphasis on preserving positions directly related to patient care. Once again, the key is having a plan and reacting appropriately.

"You kind of look at what's being affected, and if it doesn't affect the things you have planned, you continue with those, because that's new growth, and that's new service and that's new volumes," Babb said.

Meanwhile, CMH is focusing on growing its long-term care segment.

The hospital system also is strategically adding medical staff and, in the future, will add a free-standing imaging center and will expand the hospital intensive care step-down, obstetrics and geriatric wellness units and add new patient rooms and expanded support services.

"I think with the economy being what it is, there are still opportunities for growth, and we always look at those," Babb said.