New Equipment, New Color Code System & More

KATIE MARTIRE/The GDH

All Board members, medical staff, new board member and the Texas County Commissioners were in attendance for the monthly Board meeting, the 2010 budget presentation was the on the agenda.

By KATIE MARTIRE
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New equipment and the 2010 budget presentation were just a few items on the agenda for the Medical Board meeting held Tuesday evening. The compliance report was given by Julie West, RN, all was well and the board approved the report. Christine Kirk, Quality Inspector, presented the quality report to the board also. The color coded system was spoken about. "The hospital is using the recommended National Guideline for Fall Precaution, any hospital you go to, the yellow bracelet indicates the patient is a fall risk," said Kirk. "There are flyers around the hospital to serve as a reminder to the family and staff that this patient should not be walking alone without assistance. We are also following Red Rules, this is just a name for the rules we follow everyday. The first one is that every patient will have an I.D. bracelet in place before we do any patient care, we check two identification factors, being their birth date and their name, we do time-outs before any surgical or invasive procedure and two licensed staff check before any administration of high risk medication or pediatric medication is given, the flyer is in the cafeteria to remind people of the procedures used here. A time-out is when the entire surgical team stops to make sure the correct procedure is administered to the correct patient by checking birth date and name. Then we make sure the patient is aware of what is being done to them. This is just to make everyone aware of what we are doing and we are correct in our actions."
The May financial report was presented by Steve Stewart, CFO of the TCMH. During the month of May, the hospital is reporting a net loss of $173,095 compared to a budgeted income of $24,450. Net income year to date is $255,436 and is favorable to last year's YTD income of $1,119,796. The net patient revenue of $1,554,878 is $332,991 or -18% under budget. Home health and hospice revenues are $10,124 under budget, Texhoma Clinic is posting a net loss of $19,361 which is $5,935 under budget. High Plains Clinic is posting a net income of $687 which is $1,645 over budget. Panhandle Pediatrics is posting a net income of $8,704 which is under budget by $22,551. Total operating expenses of $1,721,826 are $181,947 or 10% under budget. Bad Debt expense of $423,904 is $21,309 or -5% over budget.
The 2010 budget presentation was handed to all of the board members to review. Steve Stewart, CFO, gave the presentation along with the help of Jim Grocholski, CEO. "This report I manually created from our patient account system," said Stewart. "I want to touch on some of the assumptions, in regards to a patients service revenue,  I assumed a seven percent price increase that will begin starting July 1. I did not apply this to everything, I din not apply this to the clinics. We had to look at not increasing things that were already priced accordingly according to National guidelines and averages, when you take all of that into account, it leaves us with about a 5.9 % increase over the 2009 projection. Contractual allowances, I have adjusted those according to the price increase, I did do a 7% increase. From payers such as Medicare and Medicaid, our reimbursement will not be any higher if we raise prices. So our contractual allowances are just going to increase in proportion to what the price increase is, so if you factor that in, overall that is going to generate 1.4% increase on the contractual allowances in 2010. Direct expenses, we applied a 3% salary increase across the board, no discrimination, we wanted to be conservative, not everyone is going to get a 3% pay raise but we have to assume that for budgeting purposes. We also 3% price increase to FICA, this was with consideration to market adjustments and new hires. When you factor all of that in, we basically budgeted in an 11.8% increase for 2010. Supplies, I didn't apply a factor across the board for all supplies, just office supplies, paper, pens, ink cartridges, just things like that due to price increases. Medical supplies received a 5% increase, with all of the literature we have read, a 3-5% increase is called for. Bad Debt, we are basically looking at  4.4% increase there, in the near future, I just can't see that going down, in my experience it is just always there. We try to to remain conservative as possible. Factoring all of that in, we also need to touch on Dr. Faltus' clinic opening July 6, he will not add anything to the bottom line and will not take anything away. Double direct increases are 9.7% overall and indirect expenses are 2.8%, right now, we are budgeting a net income for the hospital of $314,00 for the year, right now we are projecting a $278,000 for the 2009 year, so we are basically $19,000 profit." The hospital is replacing a 50 pound washer for an 80 pound washer for $15,220, this was budgeted in the 2009 proposal, this shows the necessity of budgeting. The hospital's MRI machine is 6 years old and that is also an area of concern for the CEO and CFO. The Board voted to approve the proposal of the 2010 budget.
Next, Stewart presented the 2010 Capital Equipment Request. "We always use a three-year projection on our capitol, I want to emphasize that this isn't just needs, there are also a few wants," said Stewart. "There are a lot of I.T. items in the budget as well, there are definitely items on there that are in the near future, beds being one of them, such as medsearch beds and O.B. beds, we feel as though this will be coming up very soon. The hospital has to be doing financially well to make capitol purchases, one we will be looking at is the I.V. pumps and poles, the I.V. machines are definitely a item we are going to have look at replacing in the near future. What we are basically doing, we are asking you the board to look at our proposed budget, we know it is a bit lofty but I know the staff would like to make their lives easier along with the patients stay easier. There a lot of items in this facility that are very dated. You all know as much as I do, technology changes every month, as soon as you receive a piece of equipment and it is literally out of date in three months. Everything the hospital purchases costs three times more than normal because it is stamped for hospital use only. With new physicians coming in, we will be able to afford the new equipment. This isn't the board approving us to purchase all of this equipment but approving our budget for it. The Board also approved the capital equipment request.
Dr. Chris Slater was in attendance to present the medical staff report but reported they did not have a forum. The Board did approve the credentialing of Donna Johnson, RN to advane to provisionals, Stepehn Gilliand, MD, ER, was advanced to courtesy, Philomena Osimiri, MD, ER, was advanced to provisional, William Reid, MD, ER, was advanced to provisional, Muhammad Uddin, MD, PED, was reappointed to active and Robert Williams, MD, RAD, was reappointed to active.
The Board ending the meeting by giving a plaque and a farewell to Dr. Countryman for his last meeting and 12 dedicated years on the medical board. John Board is the new member and was present at Tuesday's meeting.