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Senator Dan Hughes Meets With Home Health Director

September 14, 2018

Barbie Long, (center) Director of Community HealthCare and Hospice, Community Hospital’s home health and hospice department, meets with District 44 Nebraska State Senator Dan Hughes (second from left). Also sitting in on the interview were Karen Kliment Thompson, Community Hospital Vice President Ancillary Services, Kami Foster, Community HealthCare Clinical Coordinator and Troy Bruntz, Community Hospital President & CEO.

McCook, Neb.—State Senator Dan Hughes of District 44, recently sat down with Barbie Long, Director of Community HealthCare and Hospice at her invitation to discuss home health issues. During the interview, Long not only represented the Nebraska Home Care Association, but Community Hospital as well.

Long had hoped to take Senator Hughes on a home health visit with a Medicaid patient, but arrangements didn’t work out. She explained to Hughes that the Medicaid patients she sees “really are vulnerable adults or kids” as she discussed the new managed care Nebraska Medicaid program.

In responding to the purpose of caring for vulnerable people, Hughes said, “that’s what Medicaid was designed for. No question about that. That’s what government should do; that’s part of what government should be.

Long mentioned the hand the Nebraska Healthcare Association has played in working through issues the new Medicaid program has brought by arranging Town Hall meetings. She fears the program may change providers in the future, “and we have to start all over,” giving the example that Well Care just got their patient portal up after a year and half wait.

Hughes’ answer to why he was running for re-election was “to finish the job. I’ve learned a lot these past years and I’m still learning things to be a more effective legislator. I’ve invested four years in it already. I don’t like not finishing a job once I start,” he said.

The two discussed the broad areas they cover in southwest Nebraska. Senator Hughes, who is form Venango, explained District 44 is “a very big district” covering ten counties: Perkins, Chase, Dundy, Hayes, Hitchcock, Frontier, Red Willow, Gosper Furnas and Harlan. “When I get to Alma, I’m closer to Lincoln than I am to my house,” he said. Long understood the challenges of covering a large area as Community HealthCare and Hospice covers seven of the same counties including Chase, Dundy, Hayes, Hitchcock, Frontier, Red Willow and Furnas.

Troy Bruntz, Community Hospital President & CEO, who was also at the table, commented about the hospital’s home health business model, saying other hospitals in southwest Nebraska used to provide home health services. They no longer provide those services because they were losing money. He explained the long drives and time on the road, up to three-hour round trips to see one patient, which don’t make the service profitable. “We lose hundreds of thousands of dollars on home health services each year,” he said.

“So why do we do it? Our mission is Regional Healthcare Excellence. If we don’t provide home health services, it isn’t going to be offered in southwest Nebraska, other than maybe our county. But we can’t just focus on Red Willow County if we are going to be a cornerstone for health in the entire region,” he added.

He added that since Barbie has become director of the home health department, the amount of patients in home health have doubled and nearly tripled.

Community Healthcare and Hospice staffs seven field registered nurses who are also case managers. Long said the field nurses have 17-20 patients each. In addition to Long, department director, Kami Foster, is clinical coordinator. Nursing aides on staff also provide services. “We really are the eyes and the ears of the physician,” she said, “as well as advocates for the patient.”

Long added two important reasons for offering home health: The service can help to keep patients from re-admitting into the hospital, and home care is about one tenth the cost of caring for a patient in a facility, such as a hospital. “And we all want to stay home if we can,” she said.

Senator Hughes said if elected to a second term, his number one public policy priority will be property taxes, “because that’s what I’m hearing most about. If you look at the demographics of the 44th district, it’s predominantly agriculture. It’s hurting right now because of low commodity prices. The way we fund schools in this state heavily relies on property tax. This has created an intense burden on the ag community.”

Bruntz and Long said the ag economy has also affected the hospital financially more than it ever has before. Barbie mentioned knowing some farmers and ranchers with injuries who could not afford seeking medical care due to the extremely high deductibles and co-pays on their medical insurance.

They mentioned the hospital offers financial counseling service and social workers to assist people in those situations. Bruntz said the hospital gives away a million and half dollars every year in free and reduced services and is willing to work with patients with medical needs.

Hughes said he would consider who steps up to serve on legislative committees before he would consider whether he would change the committees he serves. “There are leadership positions that are vacant that I want to make sure we have the right people in place. If the right people step up, I’m happy to stay where I’m at as chairman of Natural Resources, and Transportation and Telecommunications. I hope to stay on the Exec Board as well,” he said. “I will go where I am needed. I’m a team player and I look at the bigger picture.”

Long asked if Senator Hugh’s understanding of the impact of home care services on his constituents has changed since he became a state senator. “I’ve had a little bit of exposure to the doctor side of the issue,” he said. “One of the things I enjoy about being a state senator is I do get to learn about so many things. I have learned a lot and have come to appreciate a lot more of what it takes to make southwest Nebraska work and the state of Nebraska. There are so many things that go on, that unless you are directly involved, you don’t think about.” He added that the more relationships he has, in areas of healthcare for example, if he doesn’t know the answer, he has someone he can call.

Bruntz added that “We are always here to help” and that he believes term limits have hurt.

Hughes agreed that senators need at least three, four-year terms. “I’ve never liked term limits and now that I’m on the inside, they are even worse than I thought of the devastation it’s done to Nebraska.”

Hughes said he is sympathetic to many state issues, but “we just don’t have enough money to go around. “Several areas have taken cuts and they want them back, and I certainly understand that, but the possibility of increased revenue is pretty slim outside of Internet sales tax revenue coming in January.”

On a different note, Hughes said he is not in favor of legalizing medicinal marijuana. “I’m in favor of whatever will alleviate suffering, but until the Federal government is willing to do testing to see what works, I can’t in good conscience allow anyone to (use it),” he said. “It’s coming back to the legislature. Every state which has started with medicinal has moved to recreation, but it’s not a path I feel morally we should go down.”

Senator Hughes closed the interview by applauding healthcare workers for their dedication to their profession. “Thank you for what you do. It is a critical part of what our society and our corner of Paradise needs so we can all stay here and enjoy life.”

Cutline: Barbie Long, (center) Director of Community HealthCare and Hospice, Community Hospital’s home health and hospice department, meets with District 44 Nebraska State Senator Dan Hughes (second from left). Also sitting in on the interview were Karen Kliment Thompson, Community Hospital Vice President Ancillary Services, Kami Foster, Community HealthCare Clinical Coordinator and Troy Bruntz, Community Hospital President & CEO.

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