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by Brenda Grose
Ringgold County Hospital’s board of trustees met, Monday, February 15, for a fairly short regular monthly meeting. Topics discussed included evaluations of current processes and functions in both the hospital and Mount Ayr Medical Clinic, progress of the ongoing construction project, change in allergy services to be provided and January’s financial report.
Director of Nursing Kathy Schuster brought up the topic of evaluating post COVID processes and procedures within the hospital departments and areas and what the COVID changes initially put in place will look like going forward. The need for two ER’s or not was discussed as well as looking at procedures in clinic visits, separations of services made to accommodate COVID protocols and other areas that might need to be evaluated.
In line with evaluation of processes and functions as changes happen, RCH administrator Gordon Winkler, informed the board it had been decided to utilize the services of Eide Bailley at a cost of $25,000 to evaluate and review Mount Ayr Medical Clinic. Winkler stated, “Having grown from a one provider clinic to a seven provider clinic, it’s time to look at scheduling, clinic efficiency, provider efficiency and other clinic processes.”
Regarding changes to how allergy services are provided, Winkler has been in discussion with United Allergy service due to recent contract and rate changes. It was decided that the change in costs are prohibitive to providing services. United Allergy Services will continue providing services for immunotherapy, while RCH/MAMC staff will be trained to provide other allergy services. Tasha Drake from United Allergy will be working one day per week to train clinic staff. Kate Smith will work with Drake during the training.
With the fiscal year trending in a fairly steady line, Missy Walter, CFO filled the board in on January numbers. Detailing the revenue, Walter reported inpatient revenue under budget by $33,420 with inpatient days numbering 49, just one less than the budgeted 50 for the month. Several inpatient departments were under budget including orthopedics, other joints, IV’s, X-ray, Respiratory Therapy, Physical Therapy, Occupational Therapy and ST. Skilled days of care went the opposite direction totaling 58 days—over budget by 21 days. Outpatient revenue was over budget by $86,912 with many departments exceeding budgeted utilization while Primary and Specialty Clinic revenue came up short by $34,466. Clinic visits were down with 933 visits, 217 short of budget—accounting for the lower revenue. The 340B program brought in $52,411 in revenue, slightly over half of the budgeted $96,211. Juggling the over and under budget revenue figures, overall gross revenue was still up by $19,026 and a total operating revenue of $1,747,898 was recorded for January.
On the expense side, Walter noted salaries and wages were slightly over budget by $1,022 with positions over budget including Acute Nurse, ER tech and ER doctors. Benefits; however, was the “real outlier” according to Walter as she explained the overage due to insurance claims and accrued paid time off paid out to MAMC providers. Provider PTO resets each January and PTO is front loaded, so all PTO is accounted for in one month. Taxable wages are also restarted making FICA and IPERS expenses higher. Contract labor was also over budget by $47,287 due to lab, CRNA, the Orthopedic clinic and IT contract help. Fees for the month were right on target at $216,771 and supplies were over budget by $74,515 due to acute supplies, surgery supplies and minor equipment, oncology drugs, labs and food costs.
Walter also listed four new assets put in place which were all COVID capital items. These items were a BioFire analyzer, telemetry receivers with wireless coverage for vital signs in Acute care and ER and a portable X-ray machine. Total operating expenses for the month were over budget by $423,692. Year to date bottom line showed a “pretty significant loss” of $667,821, in Walter’s words, but she looks for that number to come more in line as lost revenue due to COVID restrictions and protocols is recognized. Walter concluded her report noting improvement in contractuals as they are falling more in line with expectations.
Winkler finished up the meeting with a construction project update and a statement on COVID test kits. The outside work for the ongoing construction project has come to a halt, due to the extremely cold temperatures, but all steel and trusses are up and 80% of all exterior walls are up. Arrangements are being made for tenting outside the walls for heat so that wallboard can be installed. Interior work is also in progress on the hospital pharmacy. Heating and cooling ducting and all plumbing and underground electrical have all been relocated. Carpet has been torn up and cabinets have been removed. Quite a bit more interior work is getting done as crews have been redirected inside during cold temperatures.
In miscellaneous items Winkler stated the State of Iowa is no longer providing COVID 19 test kits for rapid tests at no cost. It will now be necessary for RCH/MAMC to purchase kits through Abbott Laboratory. The increased cost will reflect in the charge structure currently in place. Winkler added both RCH/MAMC will use all state kits first.