COVID-19 testing, PPE's, and ventilator access discussed at NRMC board meeting

During a brief teleconference meeting of the Nevada Regional Medical Center's Board of Directors on Tuesday, COVID-19 (coronavirus disease 2019) testing, access to ventilators, and donation of Personal Protective Equipment (PPEs) were discussed.

In his C.E.O board report, Steve Branstetter noted, “Our current focus has been the ever-changing updates surrounding COVID-19. Changes to our patient and visitor policies, staff and physician management, as well as overall daily operations are continuously discussed to ensure best practices and safety for everyone. Adjustments have been made to the operations at our Rural Health Clinics to better serve our patients and protect our healthcare workers.”

Branstetter also added that there have been numerous calls at the city, state, and national level to discuss needed supplies, testing, action steps, etc. Some other key points Branstetter touched on are as follows:

• Dr. Compton's last day will be April 14. “We thank him for the medical services he has given to our patients and our community during his tenure with NRMC,” stated Branstetter.

• Jody Pryor, FNP started in the Wound Clinic on March 23. She will train with Dr. Compton until his departure with assistance from Dr. Dodd.

• The Pharmacy project is currently on hold due to COVID-19. “We are hopeful progress can resume in the next three to four week,” noted Branstetter.

• Telehealth services have started in a couple areas. Psychiatry and rural health clinic basic follow-up care (health screening, psychiatric care, mild illness, medication refills requiring an appointment) have been implemented.

As far as supplies, Branstetter stated, “We’re in real good shape supply-wise for right now. If we have a big surge, we’ll be having some issues. We did get some N95 (respirator) masks from Cottey — about 700. And, today, we got about 1,000 from 3M. We did get a partial supply from the state, too. Overall, everybody in the community has really helped us out.”

In regards to COVID-19 testing, Branstetter noted, “We have done 20 tests here in the hospital. Seventeen have been negative and three are pending. We request that they get those back in 24 to 48 hours.” Board member Wayne Reinert also asked, “How many ventilators does our hospital have for use?” Clinical Administrator Tara Garrett responded, “We currently have two ventilators that we can use. We also have the ventilators that are in our OR (operating room), so there’s four of those — making six total.”

In hospital financials, the net operating income in February was $86,915 which was $15,637 higher than the budgeted $102,552. Billed charges for Feburary were $8,069,588 which was $1,908 higher than budget and $373,072 higher than prior year. February expenses of $3,027,023 were over budget of $2,944,994. February 2020 expenses were $133,001 over February 2019 expenses. The fiscal year 2020 net operating loss of $238,044 is $177,333 better than budget and $1,028,860 better than fiscal year 2019. Expenses are $82,029 over budget for the month. Physician salaries are $41,991 higher than budget for the month because of the addition of Dr. Fox. Employee benefits are $60,000 higher than budget due to health insurance claims. Contract labor is $30,000 over budget due to agency nursing.

Patient Volumes

• February acute inpatient admissions of 62 were under budget of 76 admissions and were below February 2019 admissions of 81. Revenues for acute inpatient were $3,929 above budget for the month.

• Behavioral health admissions of 92 was on budget of 92, and above February 2019 admits of 85. BHU revenue was above budget by $169 for the month.

• Emergency Department’s 775 visits were above budget of 763 and above prior year visits of 765. Emergency Department revenues were $1,667 below budget for the month.

• The 58 surgical cases were below budget of 68 and below the 68 cases of February 2019. Operating room revenues were $1,428 below budget for the month.

• Obstetrics had 20 births this month which is lower than the budgeted 23. Revenue was $3,207 above budget.

• Hospital based clinic volumes of 1,233 visits were over budget of 865 visits and over February 2019 visits of 895. Hospital based clinic revenues are $11,098 above budget for the month.

• Rural Health clinic volumes of 2,000 visits were over budget of 1,851 and over the February 2019 visits of 1,496. Rural Health clinic’s revenue is $1,309 above budget for the month.

Also, today (Wednesday, April 1) marks the day that the new sales tax takes effect. The half-cent sales tax was passed by voters in the Aug. 6, 2019 special election. The measure passed, 1,020 to 128. The ballot measure drew a nearly 25 percent voter turnout with 88 percent approval. The sales tax was in support of NRMC’s outstanding debt. The estimated $800,000 generated annually from the sales tax will be used solely for the purpose of paying down NRMC’s 1.5 million dollar annual bond responsibility. It will sunset once the debt is paid. This sales tax, however, was delayed. It was supposed to begin on Jan. 1, 2020, but was subsequently delayed until April 1, 2020. In the Tuesday, Jan. 28, NRMC board meeting, Interim City Manager Mark Mitchell stated that the actual tax revenue that the hospital would have received, based on a five-year average if it had been implemented Jan. 1, 2020, would have been an estimated $693,000. “So, actually, the $800,000 wouldn’t come until around Christmas — we’re always like two months behind,” stated Mitchell at the time.

During yesterday’s board meeting, it was asked when the hospital would begin seeing that money — April 1 or the end of April. “The first check we’ll see is in May,” stated Branstetter.