Income, construction, COVID on RCH agenda
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by Brenda Grose
A look at August finances, updates on construction projects and continuing efforts to handle COVID-19 testing as flu season looms filled the agenda at Ringgold County Hospital’s board of trustees regular meeting, Monday, September 20.
Missy Walter, CFO, opened the meeting with financials for August. Walter reported in-patient revenue under budget by $33,000, inpatient days down by four days, swing bed days over by seven. Outpatient revenue did come in over budget leaving gross revenue by $9,000.
Total operating expenses recorded were over budget by $274,000, with salary and wages under-budget by $61,000 and benefits over by $74,000. Walter explained the rise in benefit cost due to increased cost of self insurance and what Walter termed, “an enormous amount of claims.”
In summary, Walter stated three areas had significant impact on the income statement for August. Contractual adjustments are likely overstated and will be adjusted back after audit. Employee health claims were very high this month. Third, supply costs have increased dramatically with COVID.
Finishing out the final numbers for the month a $371,000 loss was recorded. Good news a long time coming was announced in the signing of contracts with Coventry/AETNA Medicare Advantage plans. Claims held for some time waiting on the finalizing of these contracts can now be processed for payment.
Additional good news reported by administrator Gordon Winkler is the well-received addition of surgical services in the ophthalmology clinic headed by Dr. Matt Raeker. The first scheduled surgeries were performed September 2 with many more cases booked and scheduling already running into November.
The additional/remodel project continues to move forward. An owner review meeting was held recently with the architect, engineering specialties (via phone) and RCH staff present to go over individual pieces of the project. September 4, documents were finalized and several topics were discussed including site and building, bidding processes, contractor parking, trailer locations, material delivery access, dumpster locations and infection control. It was determined that workers on the project will be required to be screened daily. Work time hours will be 7 a.m. to 5 p.m. with some after hours and weekends not yet determined. Particular attention will be paid to noise notification and limiting that might interfere with Senior Life Solutions hours.
Davis Brown Law firm has reviewed the general conditions documents which spell out responsibilities, insurance, bonding (100 percent will be required) and the process for laying out any corrections of work as needed. A pre bid tour was scheduled Sept. 30 and a virtual bid opening is set for Oct. 7 at 2 p.m. As customary with virtual bidding, any bid with an electronic stamp time prior to the acceptance time will be allowed. Oct. 14 is the date set to finalize contracts with contractors and April 15, 2021 has been set as the substantial completion date. April 15 is the date that must be met to meet waiver requirements earlier granted. The concept price model (price tag for the project) is $2-2.5 million.
As for the ever changing environment dealing with COVID- 19, RCH received an email from the state that they will no longer be receiving supplies through the state for COVID-19 tests. Supplies will now be obtained directly from the vendor and the hospital will be in charge of ordering their own tests. With a high of 6,000 tests received in one day, the state hygienic labs will look at sorting samples differently as well as adding analyzers. They have also ask facilities including RCH to register as a user on their data storage/retrieval system. This will allow RCH test providers to login, enter the order (sample and patient information) into the system saving considerable time for the state lab.
With the coming flu season, hospitals and clinics are looking for ways to prepare including testing to differentiate respiratory illnesses. The Biofire diagnostic testing machine is expected to arrive in October. This testing will allow the differentiation between respiratory panel illnesses as well as gastrointestinal illnesses diagnosed by the GI panel that will also be on the machine.
Changes on the COVID-19 testing front for nursing homes will impact staff testing. Staff testing must now be done based on county positivity percentages. Nursing homes have been provided one machine and 240 tests. This could cause a problem if case positivity should rise quickly. Winkler indicated the hospital will support the local nursing homes and help them find new avenues for testing supplies.
Rounding out the meeting, new signage for the hospital was presented. The entrance signage is being provided by Podium Ink.
Southern Iowa Orthopedics has made a name change. The orthopedic practice has been named Rural Partners in Medicine. As a rural health clinic provider, the orthopedic clinic will be sharing clinic space with Dr. Ed Wehling. This move will provide a more favorable cost report impact for the hospital. Nursing and support staff assigned to Dr. Homedan will also move with Dr. Homedan to the new location within the hospital.