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Announcement of the retirement of long time administrator Gordon Winkler, updates on COVID 19 vaccination distribution and taking a closer look at a higher than normal trend for contractuals were all topics discussed at Ringgold County Hospital’s regular monthly board of trustees meeting, Monday, January 18.
RCH administrator Gordon Winkler began his report announcing his retirement, effective July 31 after 34 years at the helm.
Winkler commented, “It has been a difficult decision as there always seemed to be more things I wanted to see through, but I think the time is right, now.”
The board congratulated Winkler on much accomplished during his tenure and thanked him for his years of service.
Giving an update on the process of distribution for the COVID 19 vaccine distribution, Winkler outlined the tiers of distribution set up within Phase 1B which is set to begin soon and will be led by Becky Fletchall from Public Health. The initial receipt of 200 vaccine doses for health care workers have all been distributed to 118 employees, with the second dose set to begin January 19. A meeting was also planned and attended on January 19 to receive information on amounts of vaccine expected to be received, when it will arrived and distribution guidelines. Varying news reports have indicated distribution will begin in the general population with 65 or 75 (age has not been verified at this time) or older and by tiers, the following vulnerable high risk individuals—those with disabilities in home settings and with attendant care; staff of individuals living in congregate settings like shelters, silver lining homes and detention centers but does not include college dorms or other areas where cluster outbreaks have been identified. Also included would be Preschool K-12 school staff, child care workers, in home providers, first responders, firefighters, police and state workers. It was indicated the Phase 1B would give 50% to this first population named (most likely over 65-75) and the other 50% to other identified populations within the Phase 1B group.
Winkler stated that nursing home vaccines received through private companies. Iowa is believed to be in the top 10 of states for distributing received vaccines. Ringgold County Hospital is still testing and getting positive patients and also still admitting positive COVID patients for hospital care.
CFO Missy Walter shared financials for the month of December, reporting another good month of revenue with a total operating revenue $1,700,000 for the month, of $99,000. Total operating expenses were over budget by $253,000. Revenue was boosted by $172,000 due to 101 inpatient days—51 more days than budgeted. Skilled care days were also over budget at 52 days, 16 days over budget. Salaries and wages were over budget by $118,000 with $117,000 in incentive payments made to employees on December 30. Benefits were also over by $46,000 due to self insurance claims totally $322,000. Other departments over budget were contract labor, fees, and supplies. Bottom line for the month was a loss of $241,000.
Contractuals (billing adjustments and write offs) continue to be a higher than expected number. Year to date there are $3,700,000 in contractuals. In comparison, $2,300.000 was reported for December 2019, a $1,400,000 difference. Walter shared there are two sets of entries made manually. She has looked at these and they have been sent to Marty Dubas at Seim Johnson Accounting for review.
Board member Tessa Barnes asked for clarification on charity care and bad debt. It was explained that charity care is when a patient comes to the hospital and says they can not pay their bill. A process is used to determine the patient’s eligibility for charity care. If a patient does not request charity care, but simply does not pay their bill, the bill then is sent to bad debt.
Regarding miscellaneous financial information to the board, Walter stated a $10,000 grant was received and used for Senior Life Solutions to cover wages of staff when they were unable to meet for group therapy. Walter will work next month on reconciling lost revenue and COVID payments. The annual audit is still in process of being finalized. COVID monies was used for appreciation/incentive payments to employees. The application for PPP loan forgiveness has been submitted with correspondence from the bank recommending full forgiveness but no official word has been further received.
Updates on the ongoing construction were also shared by Winkler. Concrete slabs are poured and blankets were removed on Monday, January 18. The final pour was completed Tuesday, January 19 and the parking lot will be poured later in the spring. Metal studs and materials were delivered to the site and exterior walls were expected to start going up last week with metal support beams and columns put in place before the interior walls go up. The electrical is completed from the panel through the Hospital.
The retail pharmacy remodel began on Monday, January 25. Crews will clean and demo with removal of carpet, ceiling tiles and cabinetry. Floors are scheduled to be cut the weekend of February 5-6 and plumbing installed in the positive-negative rooms.
Winkler continues to work with Medicap staff to make sure needed licensing is received, as well as setting up phone and Internet services. Medicap is also working with hospital staff on the 340B agreement and as it is needed for the application, a new address has been established for the retail pharmacy. The new address is 504 Cleveland St, Suite 100. First draft of the lease agreement has been received for review.
Mobile shelving has been installed in the hospital pharmacy for storage for COVID supplies. A new mobile X-ray machine has been received due to the need for more mobile extras and high imaging. A new digital machine was purchased to allow for immediate visual on the screen, less radiation and fewer repeats. It will also detect lightness and shading in areas to look at.The machine has artificial intelligence that will identify and notify of other things like pneumothorax. CARES Act funds were used for these COVID related purchases.
The meeting ended with a March 8, 5:00 p.m date set for the next regular board meeting. The meeting adjourned and went into executive session for the annual administrator evaluation.