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NRMC finance committee meets: What a difference a year makes
Nevada Daily Mail
Mike Harbor, Nevada Regional Medical Center's chief financial officer, presented good news at Monday's meeting of the NRMC board's finance committee.
"In February of 2015 we had a one month loss of almost $1.1 million while February of 2016 saw a net gain of $38,708," Harbor said.
Committee chairperson, Larry Bledsoe hailed the news by saying, "While we're not out of the woods yet, this is an amazing turnaround."
Harbor cited several of the contributing factors to this significant change. "Compared to a year ago, we kept our expenses at the same level but boosted our income by just over a million dollars," he said.
That boost in income largely came from timely submission of claims and persistent follow-up.
"So far, for the fiscal year, we are showing a net loss of $618,296," noted Harbor, "compared to a year ago when, after eight months, our year-to-date loss stood at $1,783,203."
Following the meeting, and with four months left in the current fiscal year, the CFO was asked for his end-of-the year profit/loss projection.
"While the census is down at each of our four facilities (hospital, behavioral health unit, Moore-Few and Barone care centers), barring a great drop or some other unforeseen event, I think we will be very close for the year. Either we will have a small net loss or, as I hope, a small net gain for the year. Mr. Leeper and I have been working hard towards that outcome and I think it is bearing fruit," Harbor said.
The census figures that Harbor is referring to include the number of residents at Barone Alzheimer and Moore-Few care centers. The finance committee asked about the census -- the current number of residents at each facility.
Angela Barrett, Barone administrator, said, "We have a capacity of 40 with our break-even point being 35. Since we are just above that, we showed a small net gain for the month."
Steve Branstetter, Moore-Few administrator, said, "Our capacity is 108 with a break-even point of 76 with a current census of 73. We (Barone and Moore-Few) were budgeted at 114 residents but had a daily average of 108.8 which gave us a net loss for February of $3,371."
Harbor pointed out that "In the BHU (behavioral health unit) the number of patient days was down significantly due to not having the services of a psychiatrist for about half the month. This is being addressed."
While Moore-Few, Barone, and the behavioral health unit are all important components of the Nevada Regional Medical Center, along with its clinics as Harbor noted, "Even when put together, they are dwarfed by the costs and income generated by the hospital."
"As of the end of February, the year-to-date revenues for the medical center totaled $25,002,119 while expenses were $25,620,415, leaving the previously mentioned net loss of $618,296. Cash continues to be at a low level with a small increase in accounts receivable and only a small increase in liabilities," Harbor told the board
Bledsoe commented, "I'm pleased to see that on our contractuals, we are watching them much closer this year so that accounts receivable is staying at a much healthier level than last year."
Harbor concluded his presentation with a review of the report from Standard & Poor's, rating the quality of the hospital's debt. "As you may recall, our debt had been given a B- with a negative outlook."
That negative outlook is what can hurt an entity anytime it desires to enter the financial markets, often causing it to pay a higher rate of interest.
"I'm pleased to say we've been upgraded to a B rating with a positive outlook," said Harbor. "We have a ways to go but this is proof that an independent agency, looking over our books, thinks that, while we are not where we [had hoped] to be, we are indeed, well on our way."
The meeting opened with a review of 10 requests for capital expenditures. Eight needed only the approval of the finance committee while the other two were reviewed by the committee and given a recommendation prior to Tuesday's board of directors meeting.
Marci Hardin, information technology manager, told the board the hospital needs to replace and upgrade the information technology firewall. "We are required to have two firewalls and our present single wall is six years old, no longer supported and woefully lacking in protection and capabilities," said Hardin.
She told the board that the recommended system, which costs $25,093, is made by Cisco Meraki and would include licensing and upgrades for five years. The warranty includes a promise to replace and have a new firewall up and running within two business days.
"Hospitals in Missouri have been attacked by hackers and had medical and credit information stolen," said Hardin. "The newest wrinkle is called 'ransomware.' Hackers encrypt all your information and demand a ransom."
Hardin was asked about financing the firewall, including spreading out payments and a cash discount. She told the committee she would obtain and provide this at the next day's board meeting.
Next was a request from Hardin for a virtual network upgrade. Hardin said, "Currently, we are twelve upgrades behind on keeping our system up-to-date and this has impacted other projects."
Chief nursing officer, Corey Vokoun, told the board, "We have been preparing to have our infusion pumps have their periodic upgrades done wirelessly but this cannot be done until we first update our network; we are too out of date."
The stated cost for the necessary equipment, installation, licensing, upgrades and support for three years is $66,785. While this requires the approval of the board of directors, the finance committee again asked about financing options, especially any ways in which it could be expensed in the new fiscal year.
Other items brought before the finance committee included:
* Bariatric mat table with power elevation for bariatric patients in the wound clinic at a cost of $3,025;
* Repair and replace the roof at the clinic in Rich Hill. This includes shingle removal, labor and material to install rafters, deck flat roof area, and cover with exposed metal roof at a cost of $33,942;
* Endoscopy retrieval tools at a cost of $2,905;
* Compressor replacement on south tower air conditioning at $4,317;
* Contract (a change of vendors) for medications for hospice at 27 percent savings at $23,648;
* Contract (a change of vendors) for durable medical equipment for hospice at a two-year cost of $34,866.
The committee unanimously approved the above items.