Hospital finance committee discusses losses

Wednesday, February 24, 2016

Nevada Daily Mail

At the monthly finance committee meeting Monday evening for Nevada Regional Medical Center, Chief Executive Officer Kevin Leeper said, "January was simply not good."

Chief Financial Officer Mike Harbor said that according to the CDC, the flu vaccine was "spot on," and that acute admissions are down by half since last year as he explained that low patient volumes contributed to a year-to-date loss of $650,000.

Year-to-date admissions are down by 19.5 percent, patient days are down by 27.8 percent, with medical/surgery patient days down by 43.8 percent, and the average daily census, or patient count, is down by 24.8 percent. Behavioral Health Unit admissions are down 14.4 percent for the year.

For January, births were down 48.2 percent, medical/surgery patient days were down by 25.3 percent, Intensive Care Unit patient days were down by 63.4 percent, and the average daily census was down by 33.9 percent from budgeted levels. Admission totals for January were down by 34.9 percent.

According to Harbor, Home Health and Physical Therapy had good numbers for January.

For fiscal year 2016, total patient revenue is $8,073,778 less than the projected income and $1,658,498 less than last years year-to-date amount. January was $2,644,637 under projected patient revenue and $1,598,014 under last year's January patient revenue. By comparison, as of Nov.30, 2015, patient revenue was below budget projections by only $1,673,090 while total expenses were under budget by $998,034.

In his written report to the committee, Leeper outlined a number of areas that he wants to focus on including physician recruitment, promoting the price discount program, and furthering a culture of compassion amongst other initiatives.

Leeper said, "I am grateful for our pretty darn good fortune in hanging with last year so far" in reference to NRMC's financial condition.

The committee unanimously approved the purchase of a video laryngoscope, which will allow easier endotracheal tube placement by physicians. Endotracheal tubes, or ET tubes, allow physicians to establish and maintain an airway for patients that have suffered trauma to the throat, need help breathing from a ventilator, or are undergoing a surgical procedure. Cost of the handle, disposable blades, five lithium-ion batteries, and a three-year warranty is $2,500.

The committee unanimously approved an upgrade to the digital dictation system. According to Leeper, the current one is at the end of its lifespan and has been experiencing repeated outages lately. Cost is $8,500.

The committee unanimously approved $6,378 to replace the water heater for the Behavioral Health Unit.

In other business, long term care director Steve Branstetter's reported a $17,450 net gain for January is overshadowed by a year-to-date loss of $24,510 on net income with a lower than budgeted census for both Moore-Few Care Center and Barone Alzheimer Care Center.

Moore-Few had a net gain of $9,859, and the Barone Center $7,596 for January. There were 21 admissions in January and only 17 discharges. A daily census, or patient count, of 117 was budgeted for but actual census numbers totaled only 107.5.

Long term care is under budget on total expenses $112,483 but net operating revenue is under budget by $152,219 for a year-to-date loss of $24,150.

The board unanimously approved an additional $6,019 towards roof coating and HVAC replacement at Moore-Few due to the roof area being calculated incorrectly. The project total is still lower than the next highest bid.

The last of the copper cold water pipes have been replaced with PVC pipes. Branstetter hopes the hot water pipe replacement can begin next year.

Replacement of windows at Barone, including the upper north, solarium, patient rooms, and dining room, should be completed before summer by the same contractor that replaced the windows at Moore-Few. Replacement windows will have low-E glass, which reduces the amount of solar energy entering the building through the windows. There are a total of 60 panels and 135 glass panes. The project cost $121,134, but was budgeted for $140,000 saving long term care $18,866.

Long term care's goal for the coming months is to increase the daily census and to increase the payor mix. Seven staff members are currently attending certified nursing assistant class. Branstetter also wants to focus on reducing turnover in first year employees.

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