Texas County Memorial Hospital ended 2017 with a loss of $534,874, hospital board members and administration heard at last week’s monthly meeting. The number represents an improvement of $668,932 over the county hospital’s deficit in 2016.
David Taylor, senior manager at BKD, LLP of Springfield, and Stephanie Weis, partner at BKD, presented the annual audit report at the monthly meeting.
“TCMH had a strong year in 2017 despite the difficult operating environment in healthcare,” Taylor said.
He said in 2017 TCMH had gross revenues just over $72.6 million, an 8.27 percent increase over 2016, but expenses increased by only 1.1 percent.
“This is a good sign of management making good decisions throughout the year,” Taylor said.
Taylor said the final, audited numbers show about a $237,000 increase to the bottom line reported to board members before the audit.
“The numbers you are seeing every month are accurate,” Taylor said. “However, in our audit we get to see concrete information because all of the final numbers have came in, and they are no longer based off of estimated numbers.”
In 2017, grants and donations to the TCMH Healthcare Foundation totaled $193,782. In 2016, grants and donations totaled $200,006. Although the healthcare foundation funds are designated for specific purposes, the numbers are included the overall year end fiscal results.
Cash and investments increased by $402,291 in 2017. Long-term debt at the hospital decreased by 3 percent in 2017 with TCMH paying down the current debt and not taking on any new long-term debt.
Taylor said the hospital’s current debt of $17 million is “not an alarming amount.”
“TCMH is strong, independent and has cash in the bank, all of which are true signs that TCMH has been managed well for a very long time,” Taylor said.
Taylor called 15 years of management by the same administrative team, “not common in the hospital industry.”
Taylor said the hospital pressures that TCMH faces, noting that they come from two main areas — bending the cost curve, or lowering the demand for healthcare services and lower reimbursement rates for services rendered.
“TCMH is profitable on Medicare business, but it is driven from our low costs of care that we strive for,” Taylor said. “Not all hospitals are able to show a profit on Medicare reimbursement rates.”
Taylor said the coming years there will be a demographic shift toward a higher Medicare/Medicaid population supporting the trend that the spending will continue to rise along with the federal deficits.
“TCMH is well positioned for the demographic shift as Medicare becomes the larger payer,” Taylor said.
Taylor said that as long as there are not significant changes to Medicare, TCMH should not experience a large impact as the Medicare payer group grows.
BKD sends an audit team to TCMH each March, spending about a week pouring over hospital financial information from the previous year. The firm takes about a month to complete the audit information including expense statements, balance sheets, statement of cash flows, and other information that comprises the financial report documents presented at the April board meeting.
BKD uses historical TCMH data and data from other healthcare facilities for comparison purposes during the audit. BKD also has access to the latest information regarding hospital payers which helps the firm reach concrete numbers in the final audit report.
FINANCIAL REPORT
Linda Pamperien, chief financial officer at TCMH, said overall revenues were down $132,378 from budgeted expectations in March. Inpatient volumes were up $93,650, but outpatient revenue was down $206,488. TCMH ended March with a negative bottom line of $496,742 and a year-to-date loss of $420,895.
HAUENSTEIN RETIRES
In his administrative report, Wes Murray, TCMH chief executive officer, reported that Dr. Lynn Hauenstein, emergency department physician, is retiring. Her last day at TCMH was April 27.
Murray said TCMH providers Dr. Steve Hawkins, Dr. Jonathan Beers, Sheena Painter, FNP along with other hospital and clinic staff traveled to Mississippi to view CPSI, the clinic version of TCMH’s hospital electronic medical record software in action.
According to Murray, the feedback from the group was positive.
“We are moving forward with the electronic medical record change in the clinic. The hospital and the clinics will use the same system which is better for patient care,” he said. The change will also save TCMH money over time.
FINANCIAL ISSUE WITH COUNTY
County prisoner bills totaling over $200,000 remain unresolved. Murray said he has not heard from the Texas County Commission about the issues discussed at the March board meeting. A letter about the issues was sent to area newspapers, but a copy was not sent to TCMH, he reported.
Murray said John Hammons, legal counsel for the hospital, is working with an attorney for the county on the matter.
On Friday –– after the press release from TCMH was released –– the hospital said the county commissioners have met with Murray to begin discussions on the issue.
Present at the board meeting were Murray; Pamperien; Doretta Todd-Willis, chief nursing officer; Anita Kuhn, controller; Renina Pearce, administrative assistant; board members, Jim Perry, OD, Omanez Fockler, Janet Wiseman and Mark Hampton; and guests Taylor and Weis.
Board member Jay Loveland was absent.