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The Board of Trustees for Ringgold County Hospital and the Mount Ayr Medical Clinic met for the annual fiscal year 2022-23 budget meeting on March 14.
Presenting the budget was Missy Walter, CFO. Walter began the budget presentation with a mix of both decreases and increases in specified departments estimating a $1.4 M loss for the upcoming year.
Decreases in hospital in-patient revenue is expected due to decreasing Covid 19 patient numbers.
On the out-patient side, Walter stated volume will be lost with the cataract and oncology services earlier provided pulling out.
Additionally, Senior Life Solutions have not at this time bumped up units of care as once expected and orthopedic services have also adopted some decreases.
In other income, 340B income generated from pharmacy agreements is predicted to continue to decrease as eligible discounts become more restrictive.In Clinic revenue, a 3% decrease is predicted with the loss of providers resulting in a net patient increase of $25M and total gross patient revenue budgeted at just over $30M. On the expenses side, contractual payouts have been lowered for this upcoming fiscal year, which at times are “unusually high”, due to the new EMR system which will quickly flag contract differentials.
Charity care and bad debt will also be carefully watched to bring those write-off expenses more in line as Covid 19 cases decrease.
In other areas of budgeted expenses, some salaries show increases, benefits will be increased by 7% and new provider insurance will increase.
Total operating expenses are estimated at just over $27M with an operating loss of $1.4M. Taking a look at the overall picture a $1.5M tax ask will be included in the budget. The budget was approved and the board immediately moved into their regular monthly meeting.
In regular monthly meeting business, CEO, Joe Mangiameli shared the chief of staff report from Dr. Katie Wilcox, D.O. Wilcox indicated she had an initial phone interview with a provider interested in practicing in a small town setting regarding the ongoing search for new providers She also noted, Erin Leonard, ARNP has returned from maternity leave resuming her regular schedule.
In other changes, staff meetings limited to providers only will be opening up to include other staff with the goal of creating more transparency within both facility’s administration and staff.
Amy Mobley, CNO, outlined organizational priorities and patient care goals within her role in her report. The first priority listed is readmissions reduction and care transmission. In that area, care providers will continue to ensure patient support at home.
Next up, Mobley listed patient safety and harm reduction specifically addressing severe sepsis and sepsis shock. A team has been established and Molly Kayser, R.N. Director of EMS and Acute/ER patient care manager will pull new ER physicians to be part of that team, as well as reworking the staffing matrix for med surg and ER to meet post Covid needs.
More patient care outreach will focus on the rehab department partnering with the community to stop falls and Senior Life solutions will help with providing opportunities for older adults to increase physical strength and referrals. As well, Natasha Gourley, MA, ATC, LAT, EMT-PM, is providing stretch training for students at local schools.
In the February report of financials given by Walter, in-patient revenue was ahead of budget by $96K for the fifth month in a row and out-patient and clinic revenue showed a slight decrease under budget by $444K due to shortage of providers. This resulted in a net patient revenue of $1.7M.
Expenses were reported at $1.69M, under-budget by $464K with a bottom line loss of $137,464.00. In the short month, February finished off a better month than priors but Walter attributed this mostly to reimbursement of delayed claims expense and recognition of stimulus funds.
Mangiameli rounded out the meeting sharing the vision goal for both RCH and MAMC to be the “Best place to work, Best place to get care”. Priorities shared by Mangiameli included: retention of staff, good service experiences, increasing wellness through education, strategies and enhanced offerings and reduction of number of readmissions. Additional focus is placed on building patient/provider relationships and trust, creating inclusivity in decision making and increasing communication and accountability.
Candidates for leadership positions are being interviewed and the list of director positions are as follows: Director of Support Operations, Director of Human Relations, Director of Revenue Cycle, Director of Diagnostics and Therapeutics, Director of Nursing and Directory of Ambulatory Services.