Hospital board accepts audit report

During the Hot Springs County Memorial Hospital Board of Trustees regular meeting, the board accepted the audit report from Michael Wright. Hospital Chief Financial Officer Shelly Larson noted the audit provides a fair presentation of the hospital’s financial statements.

According to the financial highlights of the audit, total assets were $13,860,563 at fiscal year end (FY) 2018. It should be noted that this includes the special purpose tax received, though those funds are restricted. Total liabilities were exceeded in amounts of $10,208,005. The hospital’s net assets increased by $1,282,771.

Capital asset purchases were $2,598,724. Total operating revenue increased $3,460,362. Total operating expenses increased $3,305,435. Total non-operating revenue increased $1,269,799, though again this reflects $1,024,236 in revenue gained through the special purpose tax and such revenue is restricted.

Wright further reported on the segregation of duties at the hospital, noting most of the time that segregation is in place but there are times when it is not and the board has to do things to mitigate the risk that comes from the lack of segregation.

There was an additional audit finding having to do with compliance with Wyoming statutes. Wright further explained the statutes require all deposits be held in banks or financial institutions have to be secured at all times, either by FDIC insurance or additional bank security pledges.

What was found, Wright noted, was that $12,000 has not been so secured.

In other action, the board approved the officers and committees for the next year, with no changes. Officers are Board Chair Bill Williams, Board Vice Chair Heath Overfield, Secretary/Treasurer Dan Herdt. Overfield and Herdt are on the Quality Committee, board members Melissa Johnson and Dave Koerwitz are on the Finance Committee and Williams is on the Medical Staff Committee.

Chief of Staff Dr. Vernon Miller reported that there will be two positions made to fill the duties formerly handled by the EMS Director. There was a question by the State as to how that would work, Miller noted, and he is working on that.

Miller also reported on the hospital’s recent Trauma Day, during which staff can learn about and practice procedures such as ultrasound, intubation and IVs. Miller also shared about a new technique for introducing IVs. Rather than trying to locate a vein, he said, new equipment allows for drilling into the bone and the IV can be put directly into the marrow.

In Critical Care, Miller said there are 12 charts being reviewed. Theses things were flagged not because somehting bad happened, he said, but because they are setting up quality indicators, audit filters and other procedures to better track areas. There is regular review of the tracked items, which will then be divided to the different staff to address.

Miller also noted the hospital’s obstetrics volume has doubled since last year, which is good for everybody’s experience level and gaining comfort in the procedures.

In her Quality report, Nina Landis noted the Medicare readmission rate has dropped to 15.79 percent, and she expects that to level off as the fiscal year comes to a close. Med scanning stuff

In Financial, Shelly Larson reported the days in Accounts Receivable is lingering around 58 days, though the goal is to get them down to 45. She noted new staff has been hired and it will take some time to get them trained, but she does have some staff to help bring the AR days closer to the goal.

As for days cash on hand, Larson said it’s on a positive trend at about 42, noting an interim loan has been received for the construction and the QRA payment has been received from the State of Wyoming, the latter of which was used to pay off the hospital’s line of credit and interest.

Hospital CEO Margie Molitor reported she did all staff meetings, during which they discussed the building project updates, so people had the facts, as well as what is meant be medical students and residence. Job descriptions are also being updated, Molitor said, and will be ready by April.

Telestroke is becoming a reality, Molitor also reported, with the maching here and training happening at the end of February. Once it’s being used, she said, the hospital will be able to get a neurologist on the phone right when EMS responds to stroke patients so those patients can be taken directly into CT when they get to the hospital. Molitor added in the future the system can also be used for other areas such as cardiology and infectious disease.

Also during the meeting, Kelli Hoblit caught the board up on the compliance work plan for the year. She has done risk assessments with department directors, and from those plans to identify the risk areas that will be presented at the board’s February meeting.