Hospital board accepts preliminary budget

Tuesday evening, the Hot Springs County Memorial Hospital Board of Trustees accepted a preliminary budget for the fiscal year ending June 30, 2017.

Among the highlights Chief Financial Officer Shelly Larson shared are: an expected increase of 2.5 percent in total operating revenues -$16,477,570 - and an expected two percent increase in total operating expenses - $16,645,830. She noted they are budgeting for an operating loss as well as a net loss.

Also included in the budget is a request to the County for $50,000; if it's not received, it will be marked as a loss.

Another item of note is a Capital budget of $948,000, Larson said, noting they did go through the process of prioritizing items with managers, based on factors like safety, equipment age and the potential to increase. They were very much a part of the process, she said, and requests are in the budget.

Larson pointed out there are estimates in the budget for contracts for which they are currently negotiating positions.

The budget must be before the county commissioners by May 1. A budget hearing, during which there is request for funding, is typically scheduled for June, with the commissioners informing the board of what funding will be. That information is used to make any necessary revisions.

Larson said something they continue to see is pressure on revenues, with payers wanting to pay less, and pressure from providers and vendors who want increases. These pressures are also coupled with watching market rates to keep quality staff at the hospital.

Board Chair Bill Williams expressed appreciation to Larson and all those involved in compiling the budget.

Also during the meeting, outgoing hospital CEO Robin Roling introduced to the board Margie Molitor, FACHE, who will be the interim CEO beginning June 6, 2016. Molitor, who is coming to Hot Springs County Memorial from the Big Horn County Hospital District in Basin, Wyo., has worked as a registered nurse, 14 years as a chief nursing officer and more than 10 years as a CEO.

Roling, who announced her retirement in June, said she has known Molitor for about six years, and is excited to have her at the hospital.

Molitor said she'd excited to be with Hot Springs County Memorial Hospital, and she already knows several people who work at the hospital and the board.

Business Office Director Larinda Bushur spoke to changes made to the billing process. Among them are the welcome brochures given to every patient. The brochures give run-down of how things work, including what they need for registration, how they pay their bill and what happens if they can't pay they bill. Inability to pay a bill is something now being addressed early on, Bushur noted, rather than waiting for them to go to collections.

Regarding registration, she said photo identification is now a requirement. Patients without photo ID do not register. Of course, she added, it is handled differently with regard to the Emergency Department, as it is a different situation. Requiring identification up front also helps prevent people from getting to the registration room and not having it on them.

Also new to the billing process are itemized statement, to which Bushur said she has heard good feedback, as well as changes to the notification system for bill payments.

Patients receive a statement reflecting any payments made within the first 30 days. On day 45, they receive a phone call if no payments in full have been made or there has been no discussion regarding assistance or a payment plan.

At 60 days, patients get another statement, and a second phone call at day 75.

At day 90, they get another statement, with the third phone call on day 105. At that point, they still have 15 days to set up a plan or seek financial assistance.

On day 120, the account is returned to the hospital as "no payment," or with a notice the payment plan has been broken.

Accounts are researched to determine if appropriate measures have been followed to notify a patient of his or her bill, before it is sent to collections. Larson noted close to $1.4 million is sent to collections annually.

John Gibbel reported the health fair went well, with a good number of people attending. The community health needs assessment is about 80 to 85 percent complete, Gibbel said, and he plans to have it ready to peruse at the next board meeting. Small groups are also being conducted regarding the talking points of the master facility plan, so everyone is sharing a consistent message with regard to where things are with regard to county health care.

Bookings for the new MRI are going well, Gibbel noted, and there is an ice cream social planned for 5-7 p.m. Thursday, May 12, to allow people to view the new MRI, tour the hospital and get more information on the master facility plan. The social is also done in conjunction with Hospital Week. Roling later added there have been more than 20 MRI exams since the first week of April.

Roling, Williams and others recently attended a HealthTech conference, which covered topics such as misdiagnoses and order errors, cyber security, event reports, patient satisfaction, safety and the importance of an open, safe culture in which people can share information.

Williams said many of the issues faced in Wyoming are happening nationwide. He encouraged others to start planning now to attend the next HealthTech conference, scheduled for May 1, 2017.

HealthTech President Neil Todhunter presented information on the value added support services HealthTech provides: including consultation, fiscal, clinical, strategic planning, supply chain resources, patient financial services. According to a report, from January-December 2015, cost savings were achieved and value was added totaling $326,355 via the HealthTech management relationship at no additional costs.