The Charleston Area Medical Center will join numerous health care providers around the state in participating in the West Virginia Center for End-of-Life Care's e-Directive Registry, a growing resource for accessing patients' last wishes.
The agency's e-Directive Registry, which allows users to file online for advance directives related to end-of-life care, has seen a spike in filings since its launch in 2012. Advance directives a patient can file include Do Not Resuscitate orders, living wills, medical power of attorney forms and Physicians Orders for Scope of Treatment, or POST, forms, which are written based on agreements between a doctor and patient on what medical steps will be taken during a medical crisis.
Edwin Welch, chairman of the Quality Committee and president of the University of Charleston, told members of the CAMC board of directors Wednesday that the move would help the hospital to better serve its patients and offer doctors another resource for helping patients file advance directives and for accessing those directives.
“We want to do what we can to increase the number of people who file advance directives ahead of time, so that we can give them the care that they deserve,” Welch said. “A lot of people here have pitched in to expand information on those documents and make them available.”
Welch said the committee also discussed changes to the hospital's policy on allowing family members to be present when a patient “codes” — a reference to the hospital codes used to indicate a patient needs resuscitated or requires other life-saving intervention.
“On one hand, there is the feeling that things may get hectic or messy when codes are called and you're trying to care for a patient; on the other hand, the family wants to know what is going on,” he said. “We are developing a protocol and a policy on this, and are moving toward the idea that the family can be present when a code has been called, and that the bottom line is that the educational value for families perhaps outweighs the experience we've had that chaos be kept in private.”
CAMC Health System is also in the process of shifting to a new accrediting company for its hospitals. According to Dr. Glenn Crotty, executive vice president and Chief Operating Officer of CAMC Health System, said the agency now has provisional accreditation with Det Norske Veritas Healthcare, a deeming authority that will allow CAMC Health Systems to bill the Center for Medicare and Medicaid Services. CAMC Health System was previously accredited by The Joint Commission.
DNV Healthcare is one of only a few federal deeming authorities available to hospitals, although many hospitals in the state use the Office of Facility Licensure and Certification, a branch of the Department of Health and Human Resources. DNV Healthcare reviews the hospital's standing every year, whereas the Joint Commission conducts a review every three years — something Crotty said CAMC Health System took into account when it decided to make the switch.
“We were looking to continuously improve our performance,” he said. “The frequency of visits helps us to stay ready, and helps us to keep up on the key issues related to Medicare licensing requirements.”
Chief Financial Officer Larry Hudson said CAMC had exceeded its projected operational income for March, in part due to the large expansion of the state's Medicaid program. CAMC had projected to make $6.8 million for the month, and instead cleared $8.1 million, although income is still lower than projected for the year to date due to a $4.2 million loss in January.
CAMC Health System had a projected operational income of $5.8 million, and instead cleared $8 million. It has cleared $9 million since Jan. 1, and has nearly caught up with its year-to-date projection of $9.9 million. Hudson said CAMC Teays Valley's merger with CAMC Health System March 1 helped generate some of that income.
“The way merger accounting works is when you have a merger, you fold the entire time period into the statement, so that for March's statement, you had the entire first quarter of CAMC Teays Valley folded into those March numbers,” Hudson said.
Reach Lydia Nuzum at