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Financials from the 2019 Ringgold County Hospital audit and September monthly figures were the focus at the regular Board of Trustees meeting held Monday, October 21.
Marty Dubas, CPA and audit partner with Seim Johnson, audit and consulting firm for the hospital presented the prepared audit. Dubas reported to the board on RCH performance compared with peer group benchmarks, performance compared to RCH audit numbers from 2018 and recommendations to the board.
Dubas identified the biggest area of revenue coming from outpatient services at 88% and found it comparable to peers. Dubas also identified inpatient payor mix as high on the Medicare side with 84% of inpatient services provided to Medicare beneficiaries. With the Medicare reimbursement percentage lower than the cost of care, this leaves a very small margin for revenue from inpatient care. Dubas explained the payor mix falls somewhat higher on services provided for Medicare beneficiaries than peers and is not a controllable factor. Dubas also noted the significant write off loss of approximately $300,000 in 340B program revenue due to
Shopko’s bankruptcy has an additional impact to the bottom line audit numbers which in the overall financial picture were less favorable than a year ago.
Recommendations issued as a result of the audit included continued monitoring of expenses, cash on hand and accounts receivables. While Dubas did note the decreased favorable numbers for 2019, he reminded the board of the 340B program impact along with the reissuance of bonds in 2018 which was a positive move for the hospital but also resulted in a notable penalty.
The September monthly figures from CFO Missy Walter shared similar findings with gross patient revenue under budget by $337,000 and net patient revenue short by about $69,000.
On a good note, Walter also reported cash was beginning to flow in from the recent new partnership between Hy-Vee Pharmacy and Ringgold County Hospital in the 340B program.
Net 340B revenue of $56,708 September was recognized.
Walter reported a net bottom line loss of $59,000 for September.
Miscellaneous items rounding out discussion included:
• Kathy Schuster, director of nurses announced LPN students will once again be doing clinicals at RCH beginning November 1 with Amelia Baker as the clinical instructor.
• Gordon Winkler, administrator reported the hospital had received a bid on lot#9 with closing contingent on board approval. Closing is expected to occur by February 3, 2020.
• A letter was received from the Iowa Board of Pharmacy granting the petition by RCH for delayed compliance until April 30, 2021 for required pharmacy changes.
• Ann Nelson, PA who has provided dermatology visiting clinic services concluded her services October 30. Conversations are currently underway to provide those services through Radiant Complexions out of Des Moines.