"News From the Field" is a regular column from the Texas Hospital
          Insurance Exchange and can be found in Texas Hospitals' magazine.

When you hear about injuries in the workplace, the vast
majority of incidents result from a slip, trip or fall. In fact,
according to the U.S. Department of Labor Bureau of
Labor Statistics report from 2016, 77.5 percent of all nonfatal
occupational injuries and illnesses involving days away from
work in a hospital setting were due to slips, trips and falls.
But what about the other 22.5 percent of nonfatal occupational
injuries and illnesses?

Let's say a team of employees at a behavioral health care
facility are participating in a physical training that requires
them to learn how to do proper holds on patients in the safest
way possible. A staff member volunteers to demonstrate a
move with the instructor. In an odd turn of events, the
employee falls, twisting a knee and tearing a muscle. 

The staff member undergoes surgery and afterwards develops
a post-operative complication that leads to a serious infection.
The infection is a result of the individual's own immune system
as a response to the surgery. What was once a routine claim
has shifted into a high-cost claim that includes a higher cost
antibiotic and a long-term absence from work while healing. 

An employer can never be absolutely certain that a slip, trip
or fall is the only risk of injury to your employees. Extenuating
circumstances can create risk and it is vital that administrators
 ensure their facilities are covered. 

Workers' compensation is not required in Texas, so many
groups elect to assume that risk themselves. While self-
insurance programs cover many facets of workers'
compensation, there are some benefits that may be missing.
And it is imperative that health care entities ensure the best
possible protection for both their employees and the facility.
Insurance carriers like the Texas Hospital Insurance Exchange,
that are regulated by the Texas Department of Insurance,
follow guidelines set by the Workers' Compensation Act. By
 following the Texas fee guidelines, THIE can pay the bill while
managing the claims cost. 

THIE's workers' compensation protects beyond general slips,
trips and falls. Anything can happen and facilities should be
prepared for anything. Ensuring proper coverage of your facility
ensures that your health care entity and your employees are
safe and protected. 

The Fight for Rural
with Ari Stuerzel

When I began work with the Texas Hospital Insurance Exchange,
I understood that they insured hospitals and health care facilities.
I learned that for 40 years they had a strong focus in the rural market. 

Let’s stop there. Insurance just for rural health care facilities? Why so specialized and focused? What niche` did we (THIE) have that larger companies don’t? I never knew that such a specialized need existed.

Fast-forward nine months. I’m still learning, but it sure makes a world of sense now! As THIE is beginning to branch out beyond Texas and is spreading its limbs beyond just rural hospitals and into health care facilities as a whole, their roots in insuring rural hospitals still ring true and make THIE the best at what they do.

THIE goes beyond just insurance. We have created a community with our subscribers. Rural health care can be tough; facilities can be small and financial stability can be threatening especially due to Medicare and Medicaid reimbursements. But we do things to help.

First, our subscribers own us; we are a reciprocal exchange. When THIE profits, we distribute the surplus back to our subscribers. Should rates rise, this helps our insureds maintain stable insurance costs and lets them focus their energy on their patients and less on rising costs.

Second, we train! We interact incredibly close with our hospitals. We come in and do full training's on Risk Management and more, ensuring our health care facilities function as safely as possible and therefore resulting in less claims.

Third, we train even more! THIE offers educational forums over the year and travel to different areas of Texas. We train on new trends, new legislation, how to be prepared in case of a disaster, how cyber liability can hinder your facility and other topics that effect our facilities.

THIE cares. We believe in the mission of rural. We support our people and consistently grow and stay ahead of insurance trends to guarantee we are always offering our subscribers the best products and services. In doing so, we also keep up with legislation and do our part in stepping in and being an additional voice on the importance of rural.

Recently, I truly learned what that importance is. THIE Board Member Adam Willmann, President and CEO of Goodall-Witcher Hospital Authority, worked tirelessly leading up to elections in his area. He saw an opportunity and a need to create a Hospital District in Bosque County. By doing this, it would ensure the future of Goodall-Witcher Hospital and ensure its doors would not close to residents of the area. Should this hospital close, residents would have to travel an upwards of 55 miles to get to the closest city to receive medical care.

As someone who lives in a city surrounded by hospitals and thousands of health care specialists, I could not fathom having to travel far to receive care. This is rural. This is the importance of rural health care throughout the country.

To be part of a team that cares about its hospitals and that specializes in such a niche` of insurance—doing what we can to help and support these health care facilities is amazing to witness.


For more information about regarding the positive
effects of rural health care and to learn about what
this vote meant to Bosque County, click the
"Vote Yes" button, above.
(Voting has closed, this is informational). 

Slips, Trips and Falls: Prepare for the Unexpected at Your Hospital

With Randal Wilkerson

Slips, trips and falls are one of the leading causes of injury in the workplace and at home. In 2016, according to the U.S. Department of Labor Bureau of Labor Statistics, 77.5 percent of all nonfatal occupational injuries and illnesses involving days away from work in a hospital setting were due to slips, trips and falls.

As an insurance provider, the Texas Hospital Insurance Exchange, understands the real injury and true cost of a fall. Sometimes these are scrapes and sprains. Others are more serious, and include fractures of the wrists or ankles. Then there are those that result in hip or shoulder fractures, and probably the most serious, head injuries. Statistics show that as we age, our reflexes degrade and we are at a higher risk of falling when we lose our balance or trip over and object. For individuals over the age of 65, head injuries and the associated complications that often follow, are a leading cause of death.

These are just a handful of ways that hospitals can help prevent slips, trips and falls. But underlying each is the need for communication among the hospital team. Ensure all levels of staff share their observations, know who they can contact, and then take action when needed to improve the safety of the facility. After all, preventing an injury is the goal. Contact one of our risk management professionals at riskmanagement@thie.com 

Bill Aston Award for Quality: Rural

Rankin County Hospital District is the recipient of the 2017 Bill Aston Award for Quality in recognition of its initiative to provide each patient with accessible, effective, efficient and safe care. The hospital is achieving these goals through the implementation of its quality assessment performance improvement plan, which includes three quality and performance elements that will improve health outcomes and reduce medical errors. 
In 2011, the Centers for Medicare & Medicaid Services began integrating quality assurance and performance improvement plans to better access quality assurance deficiencies and the steps taken to improve performance. Rankin County Hospital District’s QAPI plan is focused on reducing hospital readmissions, improving the use of antibiotics and implementing a patient education program. 
The hospital is reducing readmissions by enhancing post-discharge communications, which will reduce unnecessary return visits. To improve the use of antibiotics, the hospital is monitoring antibiotic resistance in urinary tract infection cultures and monitoring the number of antibiotic prescriptions filled in the pharmacy. The third focus, which includes implementing a patient education program, includes a monthly newsletter, health and wellness classes and patient forums.

Adam Willmann's Q & A with the Rural Monitor

Adam Willmann, CEO and President, Goodwall-Witcher Hospital Authority and T.H.I.E. board member, participated in a Young Rural Healthcare Leader Q & A series with Kay Miller Temple, MD of The Rural Monitor. Read the article here.

Complying with the new Do Not Resuscitate Statute

Jackson & Carter, PLLC provides information regarding complying with Senate Bill 11 also known as the DNR Statute that takes effect on April 1, 2018.  Also included in the legal update is guidance regarding texting of patient information among healthcare providers.  Get the update here.

Construction underway at Nocona General Hospital

a $3.5 million renovation project has begun that will provide expanded patient rooms, a new entrance and nurse's station at Nocona.  Phase one of two is expected to be the larger project and is expected to be done later this spring.  You can read more here.

Boatright Named to Prestigius Rural Hospital CEO List


Congratulations to THIE Board Member Donna Boatright, RN. The Rolling Plains Memorial Hospital administrator was named one of the “50 Rural Hospital CEO’s to Know” in Becker’s Hospital Review. Boatright has served as administrator of Rolling Plains Memorial Hospital, located in Sweetwater, since 2009. According to Becker’s listing, “She started her career at the hospital as a staff nurse in the intensive care unit in 1977, just a year after the hospital first opened. Ms. Boatright managed the hospital's project to have 100 percent of patients' medical records computerized. In addition to leading Rolling Plains, Ms. Boatright is president-elect of the Texas Midwest Chapter of the American College of Healthcare Executives and is on the board of several other professional and community organizations.”