Hospital board approves final budget

Tuesday evening, the Hot Springs County Memorial Hospital Board of Trustees approved budgets for the year starting July 1.

Chief Financial Officer Shelly Larson explained earlier this year the budget had to be sent to the County, which approves the amount it will fund to the hospital. Each year, she said, it’s unknown what funding will be given. In addition, Larson noted, there were major contracts with physicians that were going on — Red Rock Family practice for the emergency department and the hospital, a radiology contract that was being negotiated, a contract with Big Horn Basin Bone and Joint that is still being worked on and a contract with regard to a call for general surgeons.

Taking such factors into account, the initial net loss from the preliminary budget was $56,600; this did include $50,000 funding from the County for the coming year.

There were also changes seen in regard to physician contracts. Larson explained there was an estimate for the emergency department coverage by Red Rock Family Practice. However, when all was settled it meant a budget increase of about $18,000. There was also an added physician surgical call expense of about $90,000.

With regard to the contract with Big Horn Basin Bone and Joint, Larson explained it has to be in place in order to retain orthopedic surgeons here. If the contract were to go away, the hospital would lose about $200,000 in referral services.

With the contracts in place and put in the Operating budget, it resulted in a net loss of $330,000, so work was done to find areas where changes could be made.

One of the goals for the hospital, over the next year, Larson said, is to reduce the number of full-time employees. Salaries were looked at, and open positions were identified that might be eliminated. CEO Margie Molitor pointed out no positions are being cut. Rather, they looked at budgeted open positions they could do without.

A total 4.25 full-time positions were eliminated from various departments, and salary expenses were reduced by about $194,000.

Additional reductions included $4,000 from employee recognition programs, $31,000 from the budget for travelers, $26,000 from consulting fees and purchase services, $4,000 from minor equipment purchases, $32,000 from other operating expenses. With all of the reductions in place, it brought the net Operating income to just over $1,000.

As for the Capital budget, two items were added, including a $7,500 condensing unit to provide air conditioning for the lab. Larson noted it gets very hot very quickly in that area, making it uncomfortable for people to work and causing equipment failure. The second item was a $39,500 adjustment with regard to operating room lights, as current lights are too low and cannot be adjusted to better view patients being operated on. The total Capital budget is $980,316.

The board also accepted a lease agreement with Red Rock Family Practice, and contracts with Gottsche and Renner. Transaction documents regarding the new MRI were also approved, as well as the purchase price of $1,196,390.

County Commissioner Brad Basse reported all three municipalities — Town of Thermopolis, Town of Kirby and East Thermopolis — expressed support regarding placing the specific purpose and excise sales tax on the ballot. Support from at least two of the three entities was required to have the proposition on the ballot.

Marketing Director John Gibbel reported recognition programs now involve rounding that’s done and instant recognition. He noted an area has been set up, with a box through which people can compliment who they choose. As for the rounding recognition, Gibbel said it is voted on in the activities and recognition group and those selected go above and beyond to do things that add value to the hospital.

CEO Molitor reported how the hospital did with its 2016 goals. She emphasized the performance on these goals does filter down into the evaluation of the CEO and the managers. As 2017 goals are established, Molitor said, it’s important the staff is educated with regard to how important their parts are in achieving those goals.

With regard to service, Molitor said the goal was to ensure seven of nine composites on the patient satisfaction survey were in the 75th percentile or higher — meaning 25 hospitals out of 100 are higher than Hot Springs County Memorial and 74 are lower. Molitor noted there are actually a total 11 composites, and the hospital was in the 75th percentile on five of those — communication regarding medications, responsiveness, cleanliness, care transition and whether patients would recommend the hospital. Those where the goal was not hit were the overall rating, communication with nurses, communication with physicians, pain, quiet and discharge information. Though not meeting the 75th percentile on every item, Molitor noted there are improvements and the hospital is moving in the right direction.

As for quality, Molitor said the hospital met 31 of 32 items, but that one missed item meant the hospital had a score of 96.88 and missed the 98 goal. She couldn’t say the hospital did a bad job, but pointed out there are high standards when it comes to quality and the hospital had a high goal.

Moving forward, among the focuses for the 2017 scorecard are a blended score of inpatient, emergency patients and outpatients — inpatient was the focus for 2016 with regard to service — emergency department transfers, employee and patient health and medication reconciliation so patients go home with understanding of their medication and surgery checklists.