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Continued Dedicated Service to Our Community Administrator’s Bi-Weekly Review For Pay Period Ending April 27th If European tradition marks May Day as the beginning of summer, then I am all in for that, and I am glad we are there. Other traditions have May 1st as a meaningful celebration for workers. And that certainly resonates for us in healthcare as our annual celebration commences in a few days with Hospital Week. So this week calls for a welcome to summer, and a nice green beginning, thanks to recent rains. And also a big Thank You for YOU. It has also been a good week in that we have heard back from our visiting physicians of last Sunday, and I think we did a good job in piquing their interest about our quaint little town and a nice hospital team. We must be patient as they visit other sites, but I do think we are still in the game! More to come as things evolve. Since my last report, our Board has approved the replacement of our patient call system / code blue system, as well as an enhancement to our digital security system, which will afford many new features for after-hour lockdown and surveillance abilities. We are very hopeful for the approval of our application for the annual Kansas Tax Exemption Program to help fund this rather expensive project. The Board also authorized our purchase of a new replacement Blood Analyzer for our Laboratory. We should all feel proud of our ability to stay abreast of new technologies that enables our hospital to stay ahead of the obsolescence curve. Recapitalization is a very important component for the health of Critical Access Hospitals! So thanks to our Board for recognizing such! For some reason, I feel compelled to remind everyone that inflation IS taking its toll on most facets of our economy…we all feel it at the grocery store and when we have appliances to buy, or tires, or drugs, or batteries, or shoes, and so on and so on. It is really impacting all businesses as well, as those same supplies, service contracts, insurance, and labor that must be purchased are costing us all much more than 2-3 years ago. Pressures on bottom lines have never felt more real…yet if we remain innovative and smart about how we go about shopping for values in our needed resources…then I think we can relieve the margin pressure a bit. But we must each be cognitive of deploying smart buying practices! We cannot afford to plan poorly, run out of things, and have to pay premiums for essential items. This is my lesson for the week – please plan ahead and use our ever ready tools (smart phones for instance) to find where to buy our resources as efficiently as we can! We still need to use our Purchasing Department to authorize our buying commitments, but we can all help them in finding the best ways to replenish our shelves, and help our dollars go further and keep what we charge for our services under wraps. I again give my special thanks to all of our caregivers who make our patient’s experiences here as good as they can be! And do have a great week! See you at our Post Derby Employee Party this Saturday Night!! Kevin Leeper, CEO

Continued Dedicated Service to Our Community Administrator’s Bi-Weekly Review For Pay Period Ending April 13th April has again brought the full-fledged aroma of burning Flint Hills pasture, followed up with the annual prayers for rain to green up everything to its expected glory. Nice to see the rain received this week, but keep it coming. This is National Laboratory Week, and as such we wish to give extra thanks and praise to our awesome Lab Team, whom I can attest gives great customer service each and every day to a large percentage of our overall clientele, (I know as I am within earshot of most of their outpatient encounters}. Thank You Lab Team!!! If you have not yet heard, our hospital applied for and was awarded participation in a select group of twenty Kansas hospitals who will be specially trained on the priorities being addressed by the 2024-25 survey teams. These teams are currently being hired by the Kansas Department of Health and Education, who is the overseeing body in charge of MC/MCD credentialing for the State of Kansas. As part of this team, we will be led by Kevin Kepley to serve as a mock surveyor of a couple other similar hospitals, and others in turn will be conducting a mock survey on our hospital. The intent is to facilitate our hospital’s survey preparedness in the best possible manner. KDHE has assured Kansas hospitals that a committed catch up effort is in place to get us all surveyed in the next year or two. I think through Chelsea Cowart’s Quality efforts, we have gained in several areas that will be surveyed. So thanks Chelsea, on your way out, and we welcome Lynette Pate to carry these efforts on seamlessly. You can see for the past couple weeks that our metrics in green have had a nice surge, and are outnumbering those in red by a nice margin. Also operationally, we have at last put together a solution for our commercially insured Convenient Care utilizers, by having their billed services be processed as intended; as an after hour Clinic service. With the help of GPHA, our Cerner support group, and our Blue Cross Blue Shield rep, we have retooled our process, and as of Monday this week we are trusting that patients will only be charged their copays and/or Clinic deductibles moving forward. We welcome feedback from those testing this new process. Special thanks to all of our caregivers who make our patient’s experiences here as good as they can be! And do have a great week! Kevin Leeper, CEO

April is National Stress Awareness Month! Here are a few tips to help ward off the negative impacts of stress: Take breaks from news stories: It’s good to be informed, but constant information about negative events can be upsetting. (Think about setting boundaries before this upcoming election!) Eat healthy. Have fruits and vegetables, lean protein, whole grains, and low-fat or no-fat dairy. Limit foods with unhealthy fats, salt, and added sugars. Cut back on processed foods and choose more whole foods! Get enough sleep. Go to bed and wake up at the same time each day to help you sleep better. Adults need 7 or more hours per night. Sleep is what helps to reset our emotions and stabilize our hormones. Move more and sit less. Every little bit of physical activity helps. Start small and build up to 30 minutes a day. Rome wasn't built in a day--add a few more steps today than you had yesterday! Limit alcohol intake. Choose not to drink, or drink in moderation on days you drink alcohol. Moderation means having 2 drinks or less a day for men or 1 drink or less for women. Continue with regular health appointments, tests, screenings, and vaccinations. Talk to your doctor if you're feeling overwhelmed or anxious. They are here to help and can find you additional resources if needed. Make time to unwind. Take deep breaths, stretch, or meditate. Try to do some other activities and make time for the hobbies that you enjoy. Connect with others. Talk with people you trust about your concerns and how you are feeling. Connect with your community-based or faith-based organizations. Spend some time outdoors.  Your mom was right--get outside! Research shows that being outside is good for us. Sunshine and fresh air can help our physical and mental health. We are having so much fun with chair yoga at the senior centers. If you haven't given it a try--now is the time! The Council Grove Senior Center meets on the 2nd and 4th Thursdays of the month and the White City Senior Center meets on the 2nd and 4th Tuesdays of the month.   Everyone is welcome to join us for some great movement (and it's a great stress reliever too!) Can walking be a super power? Join us on April 17th to learn more about how walking can affect our mood levels, our pain levels, and our overall health!  We will also create a plan to get started--no matter where your fitness level is today. Let's Start a Heart-Healthy Walking Program! Lunch is $6 and you do need to reserve your spot. You can call 620-767-6811 ext. 148 or email szeigler@mrcohosp.com to reserve a spot. This month we welcome The 36-Hour Day Group. It is a support group for  caregivers who are caring for those with dementia. It will meet every Thursday from 1:00 -2:00 PM in our Hospital Chapel. The group discusses various topics from the book, "The 36-Hour Day". You can email Stacy with any questions you have, Join us for an open house this week, Friday, April 12th from 3:00-5:00 pm at our Chase County Clinic in Cottonwood Falls.  We will be celebrating the retirement of Christy Watts, wishing her well, and thanking her for years of service to our community.  All our welcome! Morris County Assisted Living is an important part of our community and provides excellent housing options for our seniors. We appreciate your referrals as we look to rent our last couple of renovated apartments and we are looking for a few more great neighbors to call this unique space home. Call 620-767-5600 to schedule a tour.

The first quarter 2024 is now history, as well as the last first quarter of the 21st century’s first quarter…does that get you thinking about how long ago the Y2K scare was, and how time is flying? Kind of like how all the Big 12 teams flew right out of everyone’s brackets in no time at all. So much for our thinking we were on top of the B-ball food chain. Oh well, next year will be here before you know it☺, and we can fall for their hype again. Our January / February surge of “across the board” activity has definitely paused for a breath of air. March has not held up to the early pace, which perhaps should be expected, but is somewhat disappointing, especially as it appears we will not top March 2023’s revenue number. Some departments like the Clinics and related Labs and Imaging services are still bumping the green numbers, but other areas are a bit shy of targets. Rural medicine is so reflective of the environment of which it is a part, and it is what makes it a captivating challenge. Weather dictates the pace of our County’s economy, which is now ramping up to full throttle in these warming climes. I am convinced health needs take back seats in times where other priorities prevail – as they right well should. In rural Kansas, we for the most part, aren’t just city folks who can plan their lives outside of the nuances of weather, living their lives each season much like the season before. Anyway – this is my cheap 2 cents reflection on why our rural practice of medicine is so different than medicine in urban areas. I am waiting on the summary of our Strategic Plan update which was discussed last week. That and the results coming this summer from a Community-wide Health Needs Assessment which is being conducted by a team out of Wichita State University. If you get a chance to complete one of their surveys (sometime in June we are anticipating), then I sure hope you will give it some earnest thought and complete their questions. You do have voices in what services we choose to offer. I hope everyone had a special Easter with friends and families and that we can all now help our kids finish their school years in a strong and purposeful manner. And feel free to share your harvest of morel mushrooms with us, just any old time. Special thanks to all of our caregivers who make our patient’s experiences here as good as they can be! And do have a great week!

Spring is definitely in the air with longer days of daylight ahead and, Spring Break, with its time-off-tug on a few of our staff and providers, is now in our review mirror. It was a quieter week, business wise during Spring Break, but not quite the lull we have experienced in the past. We enjoyed a nice flow of residents during our 3-D Mammo Open House last week and that new service has been greeted with a pent up demand wanting to utilize the better technology during its first couple weeks of being operational! Our other new service, Pulmonary Rehab has been very busy as well, and Vanessa has already reached her weekly visit targets after only a few weeks of operation. Another new patient service, this one being offered by our revenue cycle team and called AblePay, was introduced recently and has secured at least eight participants in its early going. You can learn more about this service on our website and I think it will be a beneficial program for lots of our patients as they deal with their coinsurance payment obligations. A busy week is ahead as we prepare for our monthly Board meeting, preceded this month with a review of our 2022-2024 Strategic Plan, which we conducted nearly three years ago – time certainly flies. We expect to fine tune some of the goals that may need to be redirected since lots has changed in our market over the last three years. That and we have four new Board members since conducting that latest Plan. We hope to have a good discussion. As I am sure many of you are enjoying the heating up of March Madness this weekend, I also remind you that coming up is Holy Week, and I hope you take some time to count the Blessings that our loving Lord has offered to us who follow Him. A big thanks to all who strive to make our Hospital remain the local place of choice for healthcare needs. Have a great week with all that is going on.

As spring is in the air (around here that occurs once Grove Gardens opens), we do know that winter will have another round or two with us, but the lengthening of daylight is certainly a welcome sight. Another welcome sight is March’s return of College Basketball’s Big Dance and the crack of Royal’s bats once again. And perhaps we can finally get and keep our cars clean for more than a few hours before the next salt splash. (At least I’m trying to be easy to please). It was also nice to see this week that the town of Council Grove has been nominated for the Top 10 Communities in the Midwest, competing for that distinction with twenty other communities. We can all vote once a day between now and April 1st, so please toot our horn and stack your votes. Go to: https://www.10best.com/awards/travel/best-small-town-in-the-midwest-2024/ to participate in this contest, and do it frequently!A thanks needs to go to our Chamber Director, Zoey Bond, for getting us prompted and directed for this nomination! Business remains steady for our various locations, and we are at least teasing most of our metrics’ higher 2024 targeted numbers. Our larger MCH focus is still really to help our patients understand and improve their health conditions, and support or encourage their efforts to live healthier lives. We are welcoming a few new employees this past week or two and saying goodbye to others who have found new opportunities. A more transient attitude seems to have been adopted by many in our post-pandemic labor environment. Spring break hits our Community next week, so I encourage travelers to be safe! On the following week I am happy to announce an Open House for our new 3-D Mammography service, as well as our new Pulmonary Rehab service, and we will show them to the public on March 20th, from 5:00 to 6:30PM. We really are indebted to or Morris County residents who pretty well funded the entire expenditure of the 3-D Unit, which has been serving patients for nearly a week now!! A big thanks to all who strive to make our Hospital remain the local place of choice for healthcare needs. And all – do check out our revamped website, still at mrcohosp.com

Continued Dedicated Service to Our Community Administrator’s Bi-Weekly Review For Pay Period Ending September 2nd Well, despite a rather ignominious defeat for our opening day Chiefs (and the recent cooling day(s) of rain), we have now officially embarked into the Fall of 2023…where better Chief’s sporting days are ahead. Sorry I am late with this report, as I was out last week at the annual KHA convention, which afforded some excellent speaker messages and considerably effective networking opportunities. KHA does listen to our hospital challenges and certainly attempts to bring solutions to the table. Most of us 124 Kansas hospitals are experiencing very similar issues, and some simply respond to some of them better than others, whereas each of us have focused on something that can assist the rest of us, if we make time to talk with others. One common theme addressed this year is the accelerated conversion of our patients from traditional Medicare to Medicare Advantage policies, which are totally managed by the CMS sanctioned commercial insurance carriers. One should not look at these plans as a Medicare replacement product, but as a true alternative to Medicare. For our 2-3 Counties book of residents, we will be planning some significant educational opportunities to share the differences between the two with prospective new MC beneficiaries. It matters because MC Advantage does not reimburse CAHs the same way as MC assures us to be paid, and those taking MC Advantage plans are not assured the same cadre of benefits that Medicare offers, even though enrollers may be enticed by some perks Medicare does not provide. The second table below (comparing actual August volumes to budgeted August volumes) reveals one of the busiest months in a long time, including successful cash collections and record revenue numbers, fed by very busy departments across the board. Hopefully it will translate into an August income statement that looks similarly positive. I’d like to thank everyone, including our patients for their trust in us, for stepping up to the increased work demands! Growth in services delivered is really the only way we can help offset these inflationary times, so we should all be grateful that we can step up to higher volumes. This week, we celebrate and honor those associated with National Assisted Living Centers, National Suicide Prevention efforts, as well as National Farm Animals Awareness Week, which brings attention to so many of our area residents! We extend our appreciation to those directly involved in such. And mostly, I thank you again for putting our PATIENTS FIRST each and every day at MCH! Kevin Leeper, CEO

September is Prostate Cancer Awareness Month. Did you know 1 in 8 men will be diagnosed with prostate cancer? With age being one of the biggest risk factors for developing this cancer that usually has no warning signs, it becomes very important to detect any trace of the disease early. At age 45 men need to begin speaking with their physician about screenings. The PSA (Prostate Specific Antigen) blood test is the standard of care for screening prostate cancer. Your healthcare provider will draw blood and then possibly perform a DRE (Digital Rectal Exam). More than 80% of all prostate cancers are detected when the cancer is confined to the prostate or region around it, so treatment success rates are high compared to most other types of cancer. The 5-year relative survival rate in the United States for men diagnosed with local or regional prostate cancer is over 99%. In other words, the chances of the cancer spreading or men dying from prostate cancer are generally low if the disease is caught early. Early detection is key! The Clinics will be closed on Monday, but Convenient Care is open from 9:00 am - 3:00 pm for any minor illnesses and urgent care needs. September is a great time to start a new routine with your exercise, and chair yoga is a great place to start! The Council Grove Senior Center meets on the 2nd and 4th Thursdays of the month from 11-11:30am and the White City senior center meets on the 2nd and 4th Tuesdays of the month from 10:30-11:00am. Everyone is welcome to join us for some great movement. Health Wise Lunch Bunch meets on the 3rd Wednesday of the month and on September 20th, Mallory Villalobos, RN, BSN will be talking about the differences in Medicare versus Medicare Advantage. As we get closer to open enrollment, this is a great time to learn about the differences in coverage and especially the differences in provider coverage. You will find this information to be a great resource in navigating the choices in coverage. Lunch is $6 and you do need to reserve your spot. You can call 620-767-6811 ext. 148 or email szeigler@mrcohosp.com to reserve a spot. The 26th Annual MCH Golf Benefit Tournament may have taken place on the hottest day of the year, but we sure had a lot of fun and a great turnout! Thank you to all of these great sponsors who played a big part in making the tournament such a successful day! Dr. John Price and his family have settled into Council Grove and he is currently accepting new patients at the MCH Medical Clinic in Council Grove as well as the Chase County Clinic in Cottonwood Falls. You can schedule an appointment with Dr. Price in Council Grove by calling 620-767-5126 and in Cottonwood Falls by calling 620-273-6131. In August, we had a fun group of students and their sponsors from FCA join us for some card games. We always love a good card game and enjoy it when groups stop by to volunteer and/or just visit! Do you know someone who would benefit from joining this active group? We have a single and a double apartment open and ready to move in! Contact Laverne for a tour and more information. 620-767-5600. Contact Stacy Zeigler with any questions concerning MCH Foundation events, to register for an event, or to book a speaker for your group or organization. Email: Szeigler@mrcohosp.com or call: 620-767-6811 ext. 148.

Continued Dedicated Service to Our Community Administrator’s Bi-Weekly Review For Pay Period Ending August 19th Weather is hot and so is our level of services. Not sure there is a correlation, but extreme heat issues are dangerous if not respected and treated with an intentional level of preparation. Hopefully our region’s high pressure zone finds a new place to go in the next few days. Dr. Price is seeing more patients week to week and our overall Clinic volumes are at record weekly highs going back through six years of data. So thanks to our Clinic teams that are stepping it up during what is normally a softer time of the year. Congratulations also go to the Lab Department this week, as Thomas Buttrey endured a CLIA inspection through to a zero deficiency outcome for this year’s review! Thomas indicated it was his first rare zero deficiency inspection, and we should all feel proud of the work our Lab Team delivers!! The Foundation’s annual Golf Tournament was again a successful event, despite the sordid afternoon temperatures. Proceeds will continue feeding the project account of the 3D Digital Mammography Machine, which we are fully planning on being amply funded to get the unit placed into service by the end of 2023. There will be a nice matching opportunity in early November that will double or possibly triple any end of the year contributions locals may wish to make to send us closer to our goal. We greatly appreciate any size contribution. See Stacy, whom we also thank a bunch for her successful golf tournament! It feels good that by my next newsletter, we will have seen our first football games of 2023 (I don’t count preseason). So here goes my first shout out: GO CHIEFS, GO CATS, go jayhawks, GO FROGS, and GO BRAVES! And mostly, Thanks for putting our PATIENTS FIRST each and every day at MCH! Kevin Leeper, CEO

On August 8th KSNT released a report written by the Center for Healthcare Quality & Payment Reform (CHQPR), which spotlighted the number of rural hospitals nationwide, State by State, which had a loss from patient services in their 2022 fiscal year. Because Kansas has the most rural hospitals of all 50 States, other than Texas, and has the highest percentage of those rural hospitals who lost money per their 2022 patient services study, we, Kansas, made the headline news as the leader in having the most “hospitals at immediate risk of closing”, (see KSNT website for list if interested). This report also spotlighted the fact that most of those States having the highest percentage of hospitals at risk, were also those States that had not opted into the Medicaid expansion opportunity made available in 2014, under the Obama administration. Indeed, since 2014, Kansas Hospital Association’s estimate of Federal Funds forfeited for not expanding Medicaid in Kansas is $6.51 Billion and counting. These dollars would have helped every rural (and urban) community in Kansas, many of which through dire measures are trying to hold onto their local hospitals. The good side to this story is that Morris County Hospital, though not frequently in the black through its patient services alone, has always had a positive margin when we add in the modest County tax support, grant support, active participation in the 340B drug program, contributions, and having the good geographical location of being able to draw patients from a very broad area. We have enjoyed great cash flows through the years and have been able to recapitalize our equipment and technology, staying abreast with the medical world that is constantly changing. We are also one of the few hospitals in the State that have carried the County’s EMS services, and have had to subsidize this costly service for many years, although the County does help out considerably. We are of course proud to have such a first class ambulance service. If you would like to assist in protecting your local hospital’s vitality, I can ask two things that won’t directly affect your pocket book. The first is to tell your State Representative and Senator to vote for Medicaid Expansion (only 10 States have yet to opt in), which would add an estimated $350K margin a year to our patient operations. The second one applies only to Medicare age patients and may appear to be more personally costly, but it most likely isn’t when you look at a full year of out of pocket costs: Consider staying with traditional Medicare and its supplemental insurance options. The Medicare Advantage plans may lure you with perks and lower premiums, but their coverage restrictions lead to higher copays and drive times to fit within their more limited networks. Often your premium savings are going to be offset with inconvenience, uncertainties, and hidden costs. And Medicare Advantage plans compromise the reimbursement formulas that traditional Medicare guarantees for its Critical Access Hospitals, like MCH, and we will likely choose not to contract with the underperforming ones! I hope these words will give you considerable confidence in your local hospital, despite the ongoing challenges of staying vibrant in a time of inflation and economic uncertainty. And remember that the best way to support us is to come see our doctors and use our services! We are here for YOU! Thank you, Kevin Leeper, CEO – MCH

We are excited to announce that MCH now offers in-house Nuclear Medicine services. Appointments are available every Thursday. Nuclear medicine uses small amounts of radioactive material to diagnose or even treat a variety of diseases in many different organs. Small amounts of radioactive material are given and images are then created by special computers that receive the emissions from the radioactive substance. The most frequent studies requested are those to evaluate your thyroid, bones, and gallbladder, but our services also include the digestive tract, cardiovascular stress testing, lung, and kidney testing too! Hang out in the AC and get some great movement with chair yoga! The Council Grove Senior Center meets on the 2nd and 4th Thursdays of the month from 11-11:30am and the White City senior center meets on the 2nd and 4th Tuesdays of the month from 10:30-11:00am. Everyone is welcome to join us for some great movement. Health Wise Lunch Bunch meets on the 3rd Wednesday of the month and in August, Stacy Zeigler will be talking about how to "Control Your Cravings" and balance your snacks and meals. If you feel like you are low on energy and depending on caffeine and processed snacks to keep you going, you will find this information to be a great resource. Lunch is $6 and you do need to reserve your spot. You can call 620-767-6811 ext. 148 or email szeigler@mrcohosp.com to reserve a spot. We are bringing back the Golf Ball Drop! It is a 50/50 raffle with the golf ball that falls closest to the pin winning half of the sales. (You DO NOT need to be present to win!) We will be selling a maximum of 250 golf balls, and you still have time to get yours. You can purchase golf balls for the raffle at the hospital front desk, by calling Stacy at 620-767-6811 ext, 148 or you can purchase them online --> here. The golf tournament has room for two more teams and then the roster will be full! A big thanks to all of these great sponsors for helping to make this a fun day for a great cause--the 3D Mammography machine! "The best part of Assisted Living is good neighbors and great friendships!" Do you know someone who would benefit from joining this fun group? We have a single and a double apartment open and ready to move in! Contact Laverne for a tour and more information. 620-767-5600. Contact Stacy Zeigler with any questions concerning MCH Foundation events, to register for an event, or to book a speaker for your group or organization. Email: Szeigler@mrcohosp.com or call: 620-767-6811 ext. 148.

Continued Dedicated Service to Our Community Administrator’s Bi-Weekly Review For Pay Period Ending August 5th What a great first week for our new FP/OB, John Price, and our now seasoned, but relatively new FP/OB, Sydnee Nelson, who personally lead the delivery of two newborns into our Community within a 24 hour period! It was a hectic few hours for many, but all played out safe and sound, and thanks go out to all of the hands who were on deck! You are a great team and I hope we all learned something useful from the day! Congratulations to the two new growing families! Dog days for our youth and littler ones ends this week, as school soon opens the door of the next season of this fast moving year. Summer just seems shorter every year, and that proverbial vacation will be pushed back a bit further for me in 2023. I do hope most of you grabbed some well-earned time off. Our in-house nuclear program has started on time with two cases in each of its first two weeks – only minor bugs of seamlessly routing the images to the correct place remains to be ironed out. The Pulmonary Rehab program has not quite gotten out of the gate as anticipated, because we have been unable to land the lead technician to drive the train. Any RT Tech out there that would love to end taking call and work a regular day shift job should be calling me for more information about this attractive opportunity! I am attaching a public service announcement written for tomorrow’s newspaper that I want everyone to have an opportunity to read. It was driven by a newscast on KSNT Topeka last night which called out threats of closure for a large number of rural Kansas hospitals. A look behind the intent of the article needs to happen as hearing only headlines will usually confuse and cause angst. I welcome any questions you may have after reading my personal response to the article and my suggested takeaways that our readers might consider. Thanks for what you do each and every day at MCH! Kevin Leeper, CEO