At its recent annual meeting, the Southwest Health System board touted a list of future priorities for Southwest Memorial and applauded a renewed commitment to cooperation between the acute-care facility’s two governing boards.

The most critical of those goals is the hiring of another surgeon at Southwest, required to end the two-month long "surgery divert" that is forcing Southwest to send some trauma patients to hospitals in Farmington and Durango for emergencies that occur during uncovered shifts. The staffing shortage has left Southwest with just two full-time surgeons, which is not enough to cover trauma emergency surgery 24-hours per day, seven days per week.

Regularly scheduled surgery has not been affected by the shortage.

"We cannot be successful without the right number of physicians, and we certainly need to bring one on board very soon," said Bob Peterson, chief administrator for Southwest.

Doing so means attracting the right kind of physician, one who is willing to trade in high-paying opportunities offered at big-city hospitals for the chance to practice medicine in a rural community set in a recreation-rich area known for its quality of life.

"We need a community person, not one that is looking to work for 15 years, sock away a bunch of money and then leave," Peterson said. "Rather we’re seeking someone who wants to come here because it is a great place to live."

Peterson said that hospital officials have learned that staff members and doctors alike need to be allowed to take time off in order to enjoy the quality of life that encouraged them to move to the area.

"It’s one of their priorities," he said.

Based in part on information gleaned from a community-wide health survey, SHS also vowed to expand its same-day surgery ward, improve its billing process, target the indigent-care population and to "re-invest" in employees by returning benefits, bonuses and raises that were taken away from them in order to cut costs in the past two years.

"Our employees have gone through some significant and traumatic issues, but we are re-establishing some of those things that were taken away," said SHS Board President John Greenemeier.

Financially, Southwest Memorial is facing the same woes that most other hospitals in the country must deal with — shrinking reimbursement for government-subsidized Medicare patients in a competitive environment of constantly rising costs. Medicare claims, for which Southwest is reimbursed as little as 50 percent of its total cost, represent 60 percent of patient revenue for Southwest.

"We just do not get full charges for Medicare claims," a situation that makes it difficult to get out of the red, said Chief Financial Officer George Brisson.

"Our revenues went up by $1.5 million, but our revenue reductions (for Medicare reimbursements) also went up by $1.5 million."

Much of Montezuma County is financially poor, leading to high indigent-care bills which Southwest must assume, and which last year topped out at $2 million, Brisson said. Reducing that charity care, of which hospitals are required to pay a portion under the Hill-Burton Act, means increasing efforts to ensure that people who qualify for government-care programs actually sign up for them. More aggressive collection procedures for Medicare and private-pay customers will also reap benefits, the board said.

Profits for 1999 would have reached $150,000, Brisson said, but because of a $475,000 write-off on last year’s books, Southwest showed a loss of $325,000 for the year. The loss is attributed to initial start-up costs related to a failed plan that would have constructed a $10 million medical office building adjacent to Southwest.

Keeping pace with a staggering amount of medical technology had Southwest Memorial investing $16 million in assets last year for equipment in radiology, surgery and outpatient services.

"It was a tough year financially, but we put more into keeping the facility modern," Brisson said, adding that the hospital is in a good cash position to turn a profit by the end of this fiscal year.

Greenemeier said that providing for the elderly and poor in the county is a medical need that deserves more attention from the board. That goal that may be more achievable, thanks to a recently expanded emergency department and a plan to expand non-medical services into the Vista Grande Nursing Home, thus freeing up space for more services at the hospital.

This plan, however, is contingent upon ongoing negotiations to have Vista Grande’s management company, Continuum, build a new nursing home on the Southwest Memorial campus.

The board credited cooperation among the health district’s dual governing boards for recent successes. The SHS and Montezuma County Hospital District boards have had tumultuous times in the past, but lately they have been working together better.