Texas County Memorial Hospital board members approved 2010 capital and operating budgets at their monthly meeting last week. It came in at $690,818 — slightly less than the $755,533 approved in 2009.
“Almost all of the priority one capital requests are rollover requests from the 2009 capital budget,” said Wes Murray, TCMH chief executive officer.
Capital purchases at the county hospital totaled approximately $350,000 in 2009, according to Linda Pamperien, TCMH chief financial officer. Due to the decline in revenue in 2009, capital purchases were mostly limited to replacing items that could not be fixed and that had to be purchased to continue day-to day-operations. In a typical year, TCMH would spend about $700,000 on capital purchases.
The 2010 capital budget includes a $70,000 contingency fund and $115,222 for a centralized fetal monitoring system for the obstetrics department.
The budget also includes $47,000 for another component for the hospital’s electronic medical records system that will improve the interface between the existing one and the hospital’s pharmacy. Eighty-five thousand is also designated in the capital budget to maintain the current magnetic resonance imaging equipment and to upgrade the MRI software.
Capital purchases have been budgeted for the return of internal medicine to the hospital. A $23,000 bronchoscope and $55,000 portable bedside ultrasound and two special ultrasound probes will be utilized by Dr. Gretchen Price in the hospital’s intensive care unit when she begins work at TCMH in September.
“Dr. Price will bring some new revenue generating procedures with her when she comes to the hospital next year,” Murray said. “These items will quickly pay for themselves when they are put to use.”
Murray explained the hospital will have everything in place for Price before her arrival.
TCMH plans to purchase the centralized fetal monitoring system very soon, according to Doretta Todd-Willis, TCMH chief nursing officer. The special system will maintain high quality fetal strips that will not deteriorate over time and will remain a part of the patient’s permanent electronic medical record. The system will also allow hospital obstetrics physicians to do fetal monitoring from a computer when they are away from the OB department.
“Our OB department has been very busy this year, and the centralized monitoring will provide convenient access for our physicians and create a higher quality patient record,”said Todd-Willis. She added that the four obstetrics physicians – Dr. William Wright, Dr. Charlie Rasmussen, Dr. Tricia Benoist and Dr. Tammy Albrecht – all expect to gain obstetrics patients as Dr. Mike Busha leaves the Houston St. John’s Clinic practice in February.
The TCMH obstetrics department has delivered 347 babies to date, making 2009 one of the busiest years for deliveries in recent memory. Three sets of twins were also delivered.
The centralized fetal monitoring system was part of the 2009 capital budget, but the purchase was not made as planned due to budget shortfalls. The monitoring system will be bought in early 2010.
“We expect the system to take three to four months to implement after it is purchased,” Todd-Willis said.
The hospital’s 2009 operating budget projects a 1.08 percent profit margin with gross operating revenue of $54,840,468 and total operating revenue of $26,584,855.
“We have taken a very conservative approach with our operating budget, but we have also taken into consideration the arrival of new physicians,” Pamperien said when she presented the operating budget request.
Pamperien explained that the 2010 operating budget includes additional personnel expenses for the Mountain Grove clinic and ambulance base. Operating expenses are also expected to increase in the medical surgical and intensive care unit departments with the addition of physicians.
“Outpatient services will also go up with the addition of internal medicine in the hospital, so expenses for CT, MRI and ultrasound have also gone up,” Pamperien said. “We anticipate some growth in these services.”
The 2010 operating budget proposes a $286,787 net profit at the end of the year.
“We certainly hope to exceed our budgeted expectations,” Pamperien said.
Murray noted that while economic factors contributed to the hospital’s negative bottom line in 2009, Dr. Eugene Honeywell’s yearlong absence, due to health issues, most drastically affected the hospital’s bottom line.
“Our financial position would be much different if Dr. Honeywell and the Licking Clinic would have been contributing their usual volume to the hospital’s business this year,” Murray said. “Dr. Honeywell’s contribution to our hospital’s success for so many years has been missed. It was a factor we couldn’t project.”
Murray is hopeful that the additions of Dr. Russell Huq at the Licking TCMH Family Clinic in 2009 and Dr. John Paulson and Dr. Gretchen Price at the Houston TCMH Medical Complex in 2010 will turn the hospital’s bottom line back in a positive direction, helping TCMH achieve the projected budget for 2010.
Huq began work at TCMH in September. Paulson is slated to arrive in July, and Price will begin working in September.
In other business, Murray reported that TCMH received a $8,650 grant from the Small Hospital Improvement Program, an arm of the Missouri Department of Health and Senior Services that receives federal money allocated for specific programs. The SHIP funds will be used to purchase equipment and training software for physicians and other hospital staff to utilize when learning the electronic medical records program at the hospital.
The Missouri Department of Transportation also provided TCMH with an $82,354 grant to offset expenses for the TCMH Medivan service through 2012. The grant funding, known as the New Freedom Program, utilizes Federal Transit Administration funds to provide funding for transportation services that assist people with disabilities.
“The SHIP funding and New Freedom Program grant will help us continue to grow and to provide important hospital services,” Murray said.
TCMH is very close to finalizing a deal with United Healthcare, an insurance company. TCMH employees will have health insurance through United Healthcare in 2010 and in return, all TCMH healthcare providers will become part of the United Healthcare network of providers and receive a better reimbursement from the private insurance company.
Murray reported that the Youth Ambassador Program at TCMH has taken off in December. “Young adults can be found all over the hospital from 3:30 to 8 p.m. during the week and throughout the day on weekends,” Murray said.
The Youth Ambassadors are an extension of the TCMH Auxiliary, providing area high school and college students with the opportunity to volunteer in the hospital.
Pamperien presented the financial report for November. Although inpatient and outpatient volumes were down for November, overall expenses were also down by $250,876 for the month.
TCMH had a positive bottom line of $55,381 for the month. The hospital’s year-to-date bottom line remains negative at $882,843.
Present at the meeting were: Murray; Pamperien; Todd-Willis; Dr. Charles Mueller, chief of staff; Joleen Senter Durham, director of public relations; and board members Omanez Fockler, Janet Wiseman, Jane Kirkwood and Mark Hampton. Board member Mark Forbes, was absent.
The next meeting of the TCMH board is noon Tuesday, Jan. 26, in the downstairs meeting room of the hospital.