“Everything that was moving in the wrong direction in April moved in the right direction in May,” CEO/Administrator Mike Marshall told the Tombigbee Healthcare Authority board at its meeting Thursday.

Outpatient admissions at Bryan W. Whitfield Memorial Hospital were strong, length of stay dropped and the promised Medicaid payment from the state came through to show a positive balance of $758,973.

He said the hospital is “working feverishly” to prepare the office and clinic for Dr. Tony Tropeano, the orthopedic surgeon who will arrive in August, to build the facilities for the new CT scanner and to make changes in the emergency room.

The Emergency Room now is fully staffed with the company EDCare in charge of providing physicians. Marshall received board approved for a policy the company uses in its other sites to refer non-emergency uninsured patients to a local free clinic.

He said patients without insurance who live in Marengo County and use the ER for clinical visits will be given the option of paying a $25 co-pay or using the Rural Health Medical Program on Cedar Street, a federally funded free clinic. Non-insured emergency patients will continue to be treated at the hospital. Out-of-county patients would have a co-pay of $50.

Marshall admitted there probably would be some problems. “When we go through with it, there’s going to be some consternation.”

Board member Tom Perry questioned the effect the policy change would have on “community capital.” Marshall said it shouldn’t affect things greatly since the patients who take advantage of the hospital’s service already owe their own doctors or have a chronic problem.

“We’re writing off a good amount now,” he said.

Chief-of-Staff Dr. John MacLennan said the ER would have to be staffed with confident physicians who recognize when a patient is trying to get free drugs. A physician has no obligation to treat chronic pain.

Marshall said two Ear, Nose and Throat surgery teams are completing their training. Dr. Lee Loftin will begin ENT surgery at the hospital later this month.

He also reported the hospital has received a three-year, $400,000 grant from the U.S. Department of Health and Human Services for a rural health outreach program for Sumter, Greene and Hale counties.

With the success of the grant, the hospital is looking into setting up a program in the hospital to be devoted to applying for grants to fund health care program.s

He reported vision coverage has been added to employee health insurance, and for the eighth year in a row, premiums have remained the same.

The board approved the Medical Staff recommendations presented by MacLennan. The include Dr. Seydi Aksut reappointed to the consulting staff and the initial appointments of Drs. Sai Namburu and Maureen Muecke, emergency medicine, and Drs. Bradley Brobeck and Henry Lusane Jr., radiology consulting staff.

MacLennan also announced he is retiring next month from practice.

Marshall said the 2007 budget process is beginning. The hospital is expected to pick up an additional $800,000 in Medicare, and at worst the state Medicaid reimbursement will remain the same.