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Daily Newspaper and Travel Guide
for Pecos Country of West Texas

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Wednesday, September 22, 1999

RCH seeks to cut loss on home heath

Staff Writer

PECOS, Sept. 22, 1999 -- Home health has not been a big money maker for Reeves County Hospital in its first year of operation, Jason Bullard told the board of directors in their regular meeting Tuesday. In fact, it lost money.

Bullard represents Arapaho HealthCare Resources, who contracted to develop the home health agency in March, 1997.

Admissions have averaged five per month, with 126 billable visits generating $16,784 in billable revenue. But direct expenses of $19,982 make the gross margin a minus 16 percent, he said.

The good news is that average visits per patient is 44.24, as compared to the state average of 87 for Texas in 1997. The national average is 46 visits per patient.

The current census is 17.

A ridiculously low referral percentage of RCH patients being released have contributed to the low census, Bullard said.

Out of 806 hospital discharges, only 12 were referred to RCH's home health agency, he said.

"Referrals from RCH to its home health agency represents only 2.4 percent of its parent hospital 369 Medicare discharges," Bullard said.

"Compared to average U.S. referral percentages, this difference represents more than $186,000 in lost hospital revenue," Bullard said.

Of non-Medicare discharges, only 0.6 percent were referred to home health, representing $70,000 in lost revenue.

Transfers to larger area hospitals account for a large number of the discharges, Bullard said. And they are not being referred back to RCH's home health agency.

"We have a lot of work to do," he said. "We need to see the doctors…it doesn't look like a big effort was made to make referrals to us. I'm dismayed that we only had 2.4 percent of Medicare discharges."

Board member Marcella Lovett said that hospital employees who "have not bought into the program" may be partly at fault.

Bullard said he would sit down with administrators and physicians to go over the problems, as well as contacting discharge services at Odessa Medical Center Hospital.

The agency got off to a slow start, he said, because President Clinton placed an illegal moratorium on any new Medicare home health agencies just two days before the hospital's Medicare certification survey.

That moratorium was lifted in February, 1998. On May 22, 1998, the hospital became Medicare certified, after passing the Texas Department of Health Survey.

Another big hurdle came with financial restrictions of the Medicare Interim Payment System that caused more than 600 HHAs in Texas to close.

Pecos Home Health was one of the victims of IPS, and RCH bought that local agency in February.

Outreach blood pressure clinics were established in Pecos, Balmorhea, Toyah and Mentone (in progress).

The main focus of RCH's home health agency has been to provide home care assistance to the indigent population, Bullard said.

"It gets them home quicker and gets them out of the hospital. It is cheaper to take care of them at home than in the hospital," he said.

Private pay home care has also been added to the services, along with primary home care and personal assistance services paid by Medicaid.

This is not skilled nursing, but provides baths, cooking and light housekeeping, for which Pecos has a large patient base, Bullard said.

Hospital shortens long-term debt list

Staff Writer

PECOS, Sept. 22, 1999 -- Reeves County Hospital's vendor aging report has changed so dramatically over the past year that one half of the pages are blank.

That's because bills are being paid on time, and none are shown in the past-due columns for 31-60 days, 61-90 days, 90-120 days and over 120 days.

In previous years, those columns had been filled with numbers.

"It looks good to see it blank on the right side," said administrator Charles Butts.

"We have been current on our bills ever since I have been here," said Richard Mathis, chief financial officer.

Board president Greg Luna commented on the electric bill of $10,560.

"It's been awfully hot," said Marcella Lovett.

Director of Nursing L.G. Crawford said that one bill is for work on the ambulance.

"The rear end of our new ambulance went out," he said. "We don't know why. It was not neglect. It has been in for all of its maintenance visits."

The ambulance was purchased in March, 1998 and has 65,000 miles on the odometer, he said.

In presenting the financial statement, Mathis said that the operating loss for the first eight months of the year was $520,000, up $200,000 from last year.

Of that, $332,000 is tied up in bad debts and indigent care, he said.

"If you pull that out, we have made somewhat of a gain of $130,000 on other services. Bad debts and indigent care are eating us alive," he said.

Mathis said because of the Balanced Budget Act of 1997, the hospital faces other cuts in the coming year. A change in Medicare reimbursement from cost-based to a fee schedule will cost the hospital about $150,000 for the Year 2000.

And state reimbursement for "disproportionate share" will be down, creating a loss of about $395,000.

"We have some trying times ahead," Mathis said.

The changes are hurting small rural hospitals while large urban hospitals are prospering, he said.

Trained employees who know how to code medical bills can generate more revenue, he said.

Administrator Charles Butts reported for the medical staff, whose members recommended removing four doctors from the consulting staff. Dr. John Young asked to be removed, Dr. Roberto Spencer resigned, and three physicians who worked in the emergency room are no longer employed by Spectrum, the ER contracting agency.

Crawford reported that Saturday's disaster drill went well.

"We accomplished what we needed to accomplish," he said. "The hospital did well. We had good response from staff. We need to work on the little things so we will be ready for a disaster."

Assistant administrator Iris Rives said the staff did a wonderful job of taking care of the 19 "injured" who were brought to the hospital from a simulated truck-van wreck.

"We took good care of the patients," she said.

Butts said that five companies were invited to submit proposals for a nurse call system, and that the architect will work with the hospital and medical staffs to draw plans for a new emergency room.

Board member Chel Flores, who was the subject of discussion last month because of absences from meetings, said he would like to be contacted in the future "instead of spreading it all over the newspaper."

County seeking change to juvenile center

Staff Writer

PECOS, Sept. 22, 1999 -- The Reeves County Juvenile Detention Center is the "biggest unknown factor" as far the general fund is concerned, county commissioners were told Monday at a budget hearing.

Commissioners adopted the budget and set the tax rate for Fiscal Year 2000, during the 10-hour session on Monday, during which the Reeves County Juvenile Detention Center was discussed in length.

"Mr. (Alberto) Alvarez and I have had many discussions concerning the detention center," said Reeves County Judge Jimmy B. Galindo.

Alvarez, the county's juvenile officer, told the group that the RCJ has been in operation since 1986. "It was in an era that Reeves County was in dire needs of a juvenile detention center," he said.

Back then there were no state standards or guidelines that needed to be in compliance, but due to the many changes in the law pertaining to juveniles, the detention center is currently only a holdover facility.

"Reeves County was recognized as being number one per capita and has also had largest number of referrals," said Alvarez. "Since that time a number of standards and regulations have been implemented and the detention center hasn't been operating as a detention center because of the inability to comply with those standards."

"Our problem right now, is what is going to happen to this facility?" he said.

Juveniles facing changes are currently being sent to other facilities in the area, such as Midland and Odessa.

"It's mandatory that we spend about $300-$400,000, it's the staffing issue that gets you," said Alvarez.

One juvenile has to be watched over by about six staff members, according to Alvarez. "It has to be 24 hours a day surveillance and would cost about $14,500," he explained.

"When we could take that juvenile 60 miles away at $60 per night," said Galindo. "This is kind of the magnitude of this problem."

"Why spend $330 per day here, when we can pay $60 per day elsewhere," said Galindo.

Alvarez said he, the juvenile board and Galindo have gone over the situation and as of now, plans are to open the doors of the facility as a pre-detention facility on Oct. 1.

"With a post-adjudication facility you're detaining those kids before they go to court and a pre-adjudication, you're detaining those kids that have already gone to court," he told

"We need to make sure the money is being spent appropriately and the next question is whether there is a need for such a facility," said Alvarez. "Obviously, there are some concerns pertaining to juveniles in this county."

"The plan is to move towards long-term placement of kids and break even," said Galindo. "We need to bring outside business, but there are other facilities that are trying to do the same thing."

A pre-service unit to evaluate inmates before going to larger juvenile facilities is one of the options, according to Galindo. "If plan A doesn't work, there's the possibility of just using $150,000 for the center and using the facility for something else that will benefit the community," he added.

Alvarez told the group that parents of these juveniles would rather have their children in a facility in town, where they can visit them, and that sending them to other facilities sometimes poses a hardship.

"They keep asking me, well you have a facility here, why can't you keep them here, and we have to explain that it's not for detention purposes," said Alvarez.

Juveniles go through a hearing and then a court order before they are sent away, according to Alvarez.

"And now if a juvenile gets expelled from Carver (the Pecos-Barstow-Toyah Alternative School), they are referred to us," said Alvarez.

There is a legitimate concern of how we can deal with the problem without spending a lot of money, or what else to do with the facility, according to Alvarez.

"Another option is converting the facility into an adult facility," said Galindo. "As a post-RCDC facility and targeting INS, I think would help bring in money into the general fund," he said. Increasing bed space and using the building to house U.S. Marshal's Service inmates was another idea the group is talking about.

The facility is currently a 12-bed facility.

"The main concern right now is the juvenile problem in the community, there are a number of cases to be heard in court," said Alvarez.

The budget for the Reeves County Juvenile Detention Center was set at $410,000 for FY 2000.

Baby contest entry deadline set for Friday

PECOS, Sept. 22, 1999 -- Entry deadline for the Pretty Baby Contest to be held during the Reeves County Fall Fair is this Friday.

Age limit is birth through two years and pictures can be taken to Deana Lara at the Security State Bank.

The event is sponsored by the Women's Division of the Pecos Chamber of Commerce.

For more information call Lara at 445-9000.

Clerks' meeting will shut offices on Friday

PECOS, Sept. 22, 1999 -- The Reeves County Clerk and District Clerk offices will be closed throughout the day on Friday, but will resume normal working hours on Monday, Sept. 27.

The offices will be closed to allow all clerks to attend an area-wide meeting.

Applications for requests for ballots by mail are still being accepted at the county clerk's office.

Anyone needing more information or help filling out the forms can contact the clerk's office at 445-5467.


Water gushed from a main line in the 1000 block of West Fifth Street this morning and ran into a ditch dug by city employees in search of a manhole.

Utilities Director Octavio Garcia said the crew began digging Tuesday and accidentally ruptured the water line this morning. They expect to have it repaired this afternoon.

Time not changing isolated roadside cafe

Carlsbad Current-Argus

On the El Paso Highway between McKittrick Canyon and Pine Springs in the Guadalupe Mountains, the Nickel Creek Cafe comes into view as though forgotten in time.

Nestled in a grove of mature deciduous trees near the mountain base, this mid-1940s structure is so unassuming that many travelers could pass by without as much as a glance or a thought.

The somewhat remote location shrouds the cafe, on U.S. 62-180, 95 miles northwest of Pecos, from modern intrusions such as flashing neon signs and fast food drive-thru service. And Y2K glitches will have little, if any, effect on the exchange of currency at the hand cranked cash register.

A two-story building jetting up from an arroyo directly behind the cafe was once home to those who lived or worked there. Today, it offers shelter to the area's homeless critters.

An abandoned three-room motel adjacent to the cafe once offered rest for weary travelers. It now provides shelter for domestic chickens and game roosters.

Resident canines, unaffected by the presence of a motor vehicle or the voices of strangers, often have to be disturbed to gain entrance into the cafe.

The cafe's proprietor, Jo Kincaid, is as unpretentious as she is neighborly. It's difficult for her to admit that she's famous in these parts for her homemade jalapeno chili that she serves with chips before her patrons have made a menu selection.

"I serve chili with everything," she said. "And everyone tells me how good it is. If I'm famous for anything, I guess it's my chili."

The cafe's menu doesn't tempt the palette with chicken a la king, pheasant under glass or grilled salmon with lemon dill sauce, it's just good, down-home cooking.

Early morning hunger can be satisfied with a breakfast burrito, chorizo and eggs, pancakes or the favorite American staple, bacon and eggs.

The lunch menu offers a choice of hamburgers with or without cheese, tacos, grilled cheese, enchiladas and flautas.

However, it's Kincaid's weekly surprise special that breaks the hum-drum of the limited menu for regulars.

"My regulars are park service personnel and working people who travel the highway," she said. "If I have any tourists, they're sent here by the park.

"My first customer seems to set the trend for the day," she added, with a smile. "So my Tuesday special is to get my park service customers out of the regular routine of just burgers and tacos."

Previous specials have included brisket, chicken fried steak and chicken with rice. All of the specials include a salad and hot bread.

Dessert? Just ask.

Kincaid makes a different homemade sweet course from scratch every day such as red velvet cake or fruit cobbler. And for those after lunch coffee drinkers, she'll oblige them with a fresh pot if they have the time to sit a spell.

The serenity of the mountains is home and a way of life for Kincaid and her husband, Jack, a lead animal-packer for the park service. His job entails transporting supplies and equipment into the mountains with pack mules. He also fights forest fires.

The Kincaids have lived on their approximately 10 acres at Nickel Creek since 1981, moving from a ranch in the Big Bend area of Texas. They purchased the property and buildings from David Ligon.

The cafe has quite a history. Ligon said the cafe was originally owned by W.R. Hegler and called the Cherry Creek Station. It was located in Pine Canyon along the Butterfield Overland Stage Line two-rut road and the first highway to El Paso.

Ashton R. Ligon purchased the cafe and station from Hegler in 1941 and moved the wooden, one-room shack to the Nickel Creek location in 1943 with visions of grandeur following the construction of the new El Paso Highway.

Although the cafe and gas station never reached the expectations of the early owners, Kincaid's in-laws, Noel and Lucille Kincaid, did make it a lucrative cafe, gas station and motel business from 1967 to 1970 when they leased it from David Ligon, Noel Kincaid said.

During the time Jo and Jack Kinchaid have lived at Nickel Creek, they raised two children who were bused to school at the El Paso Natural Gas Camp until it was automated. They were then bused to Dell City to finish their education.

Their son, Jason, was killed in a car accident in 1996 while going to college on a rodeo scholarship in Uvalde, Texas. Their daughter, Jessica, is married and the mother of their first grandchild.

"Living out here and running the cafe keeps me from having to commute to work," Jo Kincaid said, with a laugh. "I'm not lonely because I stay busy. Anyway, I'm kind of a loner when it comes to work."

For those 18 years, the cafe has sustained her and being in business for herself, out in the middle of nowhere, is personally satisfying, she said.

It certainly isn't a get-rich scheme.

However, prosperity does come around once a year during late October and early November, she added, when visitors from all over the desert Southwest come to stare in awe at the hidden beauty of the fall colors in neighboring McKittrick Canyon.

"I'm busy during that time because people love to go to McKittrick to see the fall colors," she said. "When a crew is working on the highway or a nearby drilling rig, business picks up then, too."

The cafe once was home to gas pumps, but eight years ago she got out of that business because she didn't like dealing with the Environmental Protection Agency's rules and regulations.

And although she graduated from Sul Ross University and worked for the New Mexico Department of Human Services on two different occasions, she enjoys being in business alone with her "hamburger joint."

"I'm open every day but Sunday from 7 a.m. to 2 p.m." she said. "If I'm here, the gate will be open."


AUSTIN (AP) — Results of the Cash 5 drawing Tuesday night: Winning numbers drawn: 2-10-16-19-27. Number matching five of five: 4. Prize per winner: $21,236. Winning tickets sold in: Austin, Decatur, Houston, Wichita Falls. Matching four of five: 305. Prize: $418.


AUSTIN (AP) — The winning Pick 3 numbers drawn Tuesday by the Texas Lottery, in order: 0-3-2 (zero, three, two)


Alyce Voges

Alyce Voges, 77, of Pecos, died Tuesday, Sept. 21, 1999, at Odessa Medical Center.

A memorial service will be held at a later date.

She was born Jan. 13, 1922, in Scranton, Pa., was a homemaker and had lived in Pecos since 1978.

Survivors include her husband, Chester Voges of Pecos; two sons, Gary Price of Fort Ludlow, Wash. and David Price of Damascus, Pa., and two grandchildren.

Pecos Funeral Home is in charge of arrangements.


PECOS, Sept. 22, 1999 -- High Tuesday 71; low last night 54. Rainfall trace. Tonight, fair. Low in the lower 50s. Light and variable wind. Thursday, mostly sunny. High in the mid 80s. South wind 5-10 mph. Extended forecast, Thursday night, fair. Low in the mid 50s.

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Pecos Enterprise
York M. "Smokey" Briggs, Publisher
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324 S. Cedar St., Pecos, TX 79772
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