SPARTA COMMUNITY HOSPITAL DISTRICT BOARD MEETING MINUTES

Transcription

1 SPARTA COMMUNITY HOSPITAL DISTRICT BOARD MEETING MINUTES Date: October 17, 2017 Members Present: Gary Stephens, Kay Hapke, Claudia Kerens, Lynette Jalivay, Kevin Wilson and John Clendenin Others Present: Joann Emge, Angela Oathout, Paul Mueller, Kacy Guebert, David Holder, County Commissioner, Dr. Kelly Wood and Fred Helfrich, BKD Members absent: Dennis Ernsting, Alene Holloway and Chris Haury Meeting called to order at 7:00 p.m. by Mr. Wilson Item Discussion Action, Resolution, or Follow-up Approval of Minutes Mr. Wilson presented Board minutes from September 19, Ms. Kerens made a motion to approve minutes Mr. Clendenin seconded, motion carried. Annual Audit: Fred Helfrich, CPA from Baird, Kurtz and Dobson was in attendance to present the findings of the annual audit for Results of the Audit: Adjustments were proposed and recorded in the current year to patient A/R and contractual allowances and to employee health claims payable and related expense. Net impact of the adjustments increased operating income by approximately $279,000 Some adjustments proposed (which relate to the turnaround effect of prior year passed adjustment and current year adjustments, including debit balances in trade payables, credit balances in accounts receivable and revenue cutoff) were not recorded because their aggregate effect is not currently material; however, they involve areas in which adjustments in the future could be material, individually or in the aggregate. Balance Sheet Summary Total unrestricted cash and investments Total cash and investments were approximately $9.6 million at 6/30/2017, which represents a decrease of $ (3.3%) from Days cash on hand (ability in cash reserves to pay operating expenses) at 6/30/2017, is approximately 113 days. Partially due to delayed payments from Illinois Medicaid and state related payors, net patient accounts receivable increased $1,864,304 (31.7%) in 2017, after having increased 1,106,648 (23.2%) in 2016 and $706,779 (17.4%) in A corresponding increase in net days revenue inpatient accounts receivable from approximately 61 1

2 days in 2015, to 74 days in 2016, to over 92 days in 2017 has been experienced. Average age of plan (measurement of facility and equipment expressed in years) is 11.0 years at 6/30/17, compared to 10.8 years at both 6/30/2016 and Long term debt to capitalization (measurement of debt as a percentage of debt and net assets) is well below any peer group average. Long-term debt to capitalization has decreased from 20.6% in 2012, to 19.6% in 2013, to 17.4% in 2014, to 15.4% in 2015, to 13.4% in 2016, to 11.1% in Total net position (equity) represents 79% of your total assets Your balance sheet is strong Statement of Revenue and Expenses: Changes in 2017 Operating revenues increased by $2,749,029 (8.9%) in Net patient service revenue increased approximately $1,724,000 as decreases in inpatient activity continued, which were somewhat offset by increases in outpatient services, mostly clinic activity. Other operating activity increased approximately $1,025,000 which was mostly attributable to revenues attained through contract pharmacy services and the 340B drug pricing program. Operating Expenses, such as salaries, wages and employee benefits increased in Increase in operating expenses were noted in areas such as pharmacy and clinic. Employee compensation (salaries, wages and benefits) increased about $1.7 million (10.0%). Combined, operating income for 2017 increased by $115, 127, as compared to Non-operating revenues and expenses (consist primarily of property taxes, investment income, interest expense and noncapital grants and gifts) increased by approximately $86,000 (18.6%), as compared to 2016 Increases in investment income and decreases in interest expense. The bottom line, SCH had an increase in net position of approximately $1.1 million. 2

3 Financials Mr. Helfrich was very complementary of the team lead by Paul Mueller, CFO. He continued that the staff from BKD received a very high level of service from the SCH staff. Mr. Stephens shared the treasurer s report. Paul Mueller, CFO shared the financials for the month of September. Balance Sheet Cash and Investments Cash decreased $178,594 or 2% in comparison to August. Day s cash on hand decreased to 90. We Measure favorably to the performance indicator established at 90 days. Accounts Receivable Total system gross accounts receivable increased $1,092,619. Total system Days in A/R (excluding claims reimbursed by the State of Illinois) increased from 70 in August to 71 in September. Our performance indicator is 62 days. Hospital patient gross accounts receivable increased $982,212. Hospital Days in A/R (including IL State) increased from 116 in August to 119 in September. Hospital Medicaid gross receivables are $7,606,365 Hospital gross receivables from State of Illinois self-funded insurance plans for its employees and retirees is $3,790,673 Of the hospital gross A/R, 55% is greater than 90 days old from discharge, with 59% and 81% of Medicaid and the State of Illinois self-funded insurance plan greater than 90 days, respectively. Clinic gross accounts receivable increased $13,842 or 1%. Clinic gross A/R is 2.8 times current clinic revenue. We measure unfavorably to the performance indicator of 2 time s current revenue. Ms. Kerens made a motion to approve the Treasurer s Report as presented and file subject to audit. Mr. Wilson seconded and motion carried. 3

4 Physician s Report Account Payable Accounts payable decreased $58,092. Current month has 12 days non-salary expense in A/P, August had 14. We measure favorably to the performance indicator of 30 days. Income Statement Revenues Inpatient revenues decreased $139,924 or 34% compared to August. Outpatient revenues decreased $293,306 or 8%. Emergency service revenues increased by $68,212 or 4%. Swing bed revenues increased by $8,120. Physician office revenue decreased by $4,296 or 1%. Total system gross revenues decreased $361,194 or 6%. System net revenues decreased $211,853 or 7%. Gross revenue per calendar day is $202,289 vs. $205,190 budgeted. Allowance of revenues is 52% vs. 52% budgeted. Total system gross revenues, year-to-date are $381,611 or 2% below budget. Expenses Salary and fringe benefit expenses decreased $138,135. Our performance indicator is 50.5% of net patient revenues; salary and fringe benefit expense is 55% for September. Bad debts, we measured favorably (3.9%) to the performance indicator of 5% of gross patient revenues. Total expense per calendar day is $91,051 vs. $96,100 budgeted. Expenses year-to-date are $476,507 or 5% under budget. Dr. Kelly Wood presented the physicians report: The new surgery program is working very well and Dr. Wood she has received positive input from the medical staff. The Pre-op clearance process has improved and Dr. Wood felt that it was working well. Covered Lives Dr. Wood shared that she felt the number of patients on the SCH panel is increasing over time. 4

5 CEO Report FINANCE Volumes: Med-Surg Medicine 53% for September Average for Average length of stay 2.78 days Average daily census 3.33 patients Average observation census 1.13 patients / day Average Swingbed Census 1.50 patients / day Total average daily census on Med-Surg 5.97 Emergency Department 787 patients (26.23/day) 7.12% admitted to inpatient/obs Transfer Out Med-Surg 11 patients Emergency Department 53 patients Surgery 129 Procedures General Surgery Cases 11 Kurzweil 6 Hinze 1 Baghmanli 4 Home Health Record High 51 Admissions Specialty Clinic Visits 585 Rural Health Clinic Visits 4873 Rehab Pool Utilization Expenses for Approval: 1. Ligasure Generator o Cost $ 20, Emergency Department Renovation Painting: $13,

6 Flooring: $25, Countertops/Cabinet Refacing: $11, Furniture: $8, Total: $60, Power Door Opener (3 on campus clinics) o Door Service: $ o Stanley: $13, Two (2) firewalls provider by Crossrealms: o $32, Project Update: 1. IT Cooling Project Project is complete and we await IDPH approval. Once we have received approval the final 10% will be paid to H&N, the contractor responsible for the project. 2. Dumpster Enclosure The Broadway Plaza location is still in need of an enclosure. We are currently working with the City of Sparta for a resolution for the placement of the dumpster and enclosure. 3. Home Health renovation completed 4. Demolition of Building on McClurken o Awaiting IDPH Approval to use for fire department training. SERVICE: 1. Cardiac Rehab - The patients have transitioned to the North Campus without any issues to report. 2. General Surgery Team The new surgery program is going well with positive input from providers and staff. 3. SIU Specialty Physicians We have entered into an agreement for the SIU Healthcare to provide neurology services here. Dr Wood shared that this is a significant service to add for our patient population as the availability of Neurology in this area is minimal. 4. Pediatric Telemedicine Planning/Implementation. We have started the planning phase to implement the telemedicine program. 6

7 A meeting has been scheduled for October 24 th with a tentative startup date as January 1, At Home HealthCare - 20 year anniversary a. Open House planned for November 15, 2017 QUALITY: 1. Patient Family Advisory Council o Has started to meet quarterly, Ruth Holloway is chairing the committee. 2. At Home Health Care: o The Home Health Consumer Assessment of Healthcare Providers Systems (HHCAHPS). Top 25% of Fozzi s National Patient Satisfaction. PEOPLE: 1. Sports Physical Donations (Enclosed Listing) o Total of $1, was donated back to the participating school systems. 2. Crisis Prevention Intervention Training (CPI) We will offer training to the Emergency Department, Customer Service staff as well as house supervisors, training will take place on November 7 th and 21 st, Nancy Metcalf has received the training to become a certified trainer for our organization. Executive Session Regular Session Paul Mueller, CFO; David Holder, County Commissioner and Dr. Kelly Wood exited the meeting. Minutes Executive Session minutes from September 17, 2017, April 18, 2017, October 18, 2016, April 19, 2016, April 21, 2015, April 15, 2014 and October 21, 2014 were reviewed in executive session. Ms. Kerens made a motion to go into Executive Session at 7:45 p.m. for the purpose of discussing Real Estate and Employee Matters, Mr. Clendenin seconded. Motion carried. Ms. Hapke made the motion to return to regular Session at 7:50 p.m. Mr. Clendenin seconded, Motion carried. Ms. Kerens made the motion to approve the minutes from September 19, 2017 and Ms. Hapke seconded. Motion carried. 7

8 Committee Reports Quality Council: Mr. Wilson shared the highlights from the September, 2017 Quality Council Meeting. Finance Committee: Mr. Stephens gave the finance committee report. Ms. Kerens motioned to release the minutes from October 18, 2016 and Ms. Jalivay seconded, motion carried. Mr. Clendenin made the motion to defer the minutes from April 18, 2017, April 19, 2016, April 21, 2015, April 15, 2014 and October 21, 2014 and Ms. Kerens seconded and motion carried. Approval of Expenditures Approval of Medical Staff Applications: Mr. Clendenin shared the provider credentialing applications: Appointments: Matthew Jones, Nurse Practitioner- Cardiology (Joining Dr. Reilly s group) Re-appointments: Elvira Salarda, M.D. Family Practice Nancy Wiebke, Nurse Practitioner Cardiology Karen Phillips, M.D. - Teleradiology Joshua Sokol, M.D.- Teleradiology Mr. Clendenin made the motion to approve the medical staff applications, Ms. Hapke seconded, motion carried. Approval of Expenditures: Emergency Department Renovation: Painting: $13, Graham Painting Flooring: $25, RFC Perryville Mo. Countertops/Cabinet Refacing: 11, Wolters Custom Cabinetry. Furniture: $ 8, Total: $60, Mr. Stephens made a motion to approve the Graham Painting for a fee of $13,384.00, Richart Flooring for a fee of $25,665.00, Wolters Cabinetry for countertops and cabinet refacing for a fee of $11, and Furniture from 8

9 Ligasure Generator: Cost: $20, Power Door Opener (3 on campus clinics) Door Service: $ Two (2) Firewall for IT Crossrealms $32, Approval of the Annual Audit: Staples for a fee of $8, Total cost of the renovation $60,092.50; Ms. Kerens seconded and motion carried. Mr. Stephens motioned to approve the Cost of the Ligasure generator for $20,335.04; Ms. Kerens seconded and motion carried. Mr. Stephens motioned to approve Door Service to provide the three power door openers for a cost of $9,795.00; Ms. Kerens seconded and motion carried. Mr. Stephens motioned to approve the two (2) firewalls for IT for a cost of $32, provided by Crossrealms. Ms. Kerens seconded and the motion carried. Ms. Kerens motioned to approve the annual audit and Mr. Stephens seconded, motion carried. Adjournment A motion was made by Mr. Stephens to adjourn at 8:00pm and Ms. Jalivay seconded and motion carried. Kevin Wilson, Secretary Gary Stephens, Treasurer 9