DD had several boyfriends over the years. None of them had been “The One” and when he or she would dump the other, a large percentage of the time I saw them stay friends. I wasn’t like that. When a boyfriend and I would have a parting of the ways, I had no further use for him. There were dirty looks involved and derisive remarks. If one of my friends dared date an ex, it was nigh onto unforgivable. Not so with DD. She took the high road. I couldn’t understand it but I admired her for it.
We had our weekly conversations and she’d update me on the goings-on at college. She was a big senior and along with that went special occasions. There were banquets and get-togethers. She’d had an active social life through the other three years, too, but this year was different. It was her last year there.
She’d talk about this guy and that one but I began to notice there was one she mentioned more than anyone else. She denied that she had more feelings for him but I was beginning to wonder. I had drilled into her head that she needed to complete college before she married and it looked like it was going to happen. When I’d told her to learn from my mistakes, she said she wanted to make her own mistakes but I believed this was one time she would do as I asked. I hoped.
Meanwhile, back at the hospital, things were tight. There was a consultant who was pretty savvy about what was available for small rural hospitals. He’d apply for grants and, more often than not, we would get them. Then he started telling me about a designation he had applied for. Critical Access. It sounded like it would be something for a larger hospital. He explained for a hospital to be a Critical Access Hospital, it had to be a certain number of miles away from another hospital and be a small facility. There were advantages, reimbursement and grant-wise since the object (at least one of them) was to support healthcare (sickcare?) in rural areas.
Stress was at an all-time high. Our business was booming but it seemed the overhead ate up any funds that came in. There were times we didn’t know if we were going to get paid but, some way, the owners would come through. If we could become a Critical Access Hospital, it would be a real plus.
The paperwork was done and sent in and all we could do was wait to see what would happen. The weeks seemed to crawl by. Finally word came that the designation had been granted. It was time for celebration? Well, that was a mixed bag. With the new status came new requirements. There were limits on how long a patient could stay. The 72 hour rule no longer applied to us. That was a good thing except—we were going to have to completely revamp the billing system to accommodate the changes. There were new codes and bill types. I was going to have to educate myself about the ins and outs of being a Critical Access Hospital.
My head was spinning. I was up on most of the regulations regarding hospital billing and what I didn’t know, I could find out. Now, the rules had changed and I was in a completely different world. It would be a better world but it was up to me and the staff in the Business Office to make it work.
I had to study on my own. There wasn’t extra money to send me to workshops and seminars on the subject. The year before, there had been a conference for the hospital computer program users. It was in Branson, MO, and we were housed at a swanky resort complete with a beautiful golf course. The other person who went from our facility and I shared a two bedroom condo. We each had our own rental car and went our different ways when we weren’t in meetings. I’d taken in a couple of shows—Dino Kartsonakis and Shoji Tabuchi. Everything had been paid for by the hospital except for the tickets. That was then. This was now.
Stress was getting me down. I was trying not to let it bother me but the fact of the matter is that I felt like I was in over my head. I was used to searching billing and reimbursement manuals but it took on a whole new aspect. I was in a foreign country.
November came and there were a few days away from the hospital when I could catch my breath. I spent Thanksgiving with DS1 and his family. DS2 and DIL came over and brought a fake turkey roll with pineapple. I’d been staying away from soy but I figured one slice wouldn’t hurt anything. I ate it and felt like I was in a stupor the rest of the afternoon.
The weekend passed much too quickly and I was back home. The phone rang and it was DD. I settled in for our conversation. She seemed nervous. There was something in her voice that wasn’t characteristic. What was going on? It was to be a most interesting visit.