Alva Review-Courier -

Kiowa District Hospital Board President Pat Myers called the regular March 15 meeting to order with all members present including: Chantae Simpson, Miranda Allen, Jeff Miller and Jim Parker. New Hospital Administrator Ronda Thomas took her seat at the board table for the first time. Also attending were: Janell Goodno, CFO; Heidi Courson, DON; John Fonang, Manor Administrator; Robyn Whitaker, RN; Judy Schrock, foundation president; members of the KDH staff; members of Cohesive Healthcare and members of the public.

One agenda item regarded the Dec. 31, 2017, cost report, which involves Medicare reimbursements. KDH received the latest cost report draft the day of the board meeting from BKD, auditor for the hospital. Goodno said KDH’s payable status to Medicare was less than expected at $199,000. Cohesive CEO Mike Hand added that comparing the hospital’s daily census (which involves Medicare reimbursements), in 2016 it was 1.4, it was 1.7 in 2017, and so far in 2018 it’s 3.1. Expenses for 2017 were up about 25 percent and the stats about 22 percent. The daily rate will decrease as expected, he said.

Margaret Grismer has been hospital administrator until recently and continued as CEO. She became an employee of Cohesive management and consulting company when the KDH board contracted with them last April. Grismer arrived mid-meeting and said she was late due to her meeting with Cohesive administrators.

Grismer said it’s become apparent that the new chain of command is not working in her role as CEO. Now that Thomas is administrator of the hospital and Fonang manor administrator, Grismer said she’s “moving up to other things with Cohesive.”

KDH Board Action from Spending to Saving

As the hospital is now with Cerner for electronic health records an interface is needed. The board approved Novarad that will provide a needed interface between Cerner for radiology images. The expense is $12,722 plus $321 monthly.

The KDH Hiring Policy was amended by the board. Since Kiowa is a small town it’s difficult to not hire employees from the same family. The approved amendment makes it so family members can be hired as long as they are not directly supervised by a member of their family.

A contract with CRNA with Superior Anesthesia received board approval. The last provider retired and a new company was formed. The contract was renewed with the same terms.

Remi is a maintenance company that provides service agreements for equipment and is endorsed by the Kansas Hospital Association. The board voted to go with Remi, which will result in savings of almost 18 percent on several of their equipment contracts now due. Whenever Remi can save KDH money, they’ll replace existing service agreements.

Manor signature cards were updated with Fonang at the manor and Thomas at the hospital.

Department Heads Report, Dog Issue Settled at Manor

Manor Administrator Fonang said the patient census there was 17 the day of the board meeting. He said they are trying to fill positions to reduce the amount of the more expensive agency nursing. Providing quality care is a top priority, he said, and added that the residents are “very, very happy.”

Fonang said that “the dog issue is taken care of.” He was referring to a dog, “Buddy,” who lived at the manor for a while and was a friend to some of the residents. However, when it was decided it was time for the dog to leave the manor, there was a frenzy on social media over who would take the dog. Buddy was returned to the people who trained him.

“There was lots of inaccurate information on social media,” Fonang said, and added, “I love dogs.” President Myers thanked Fonang “for working with me on this.”

Giving the Cohesive monthly report, Jamal Bandeh said that as of March 1 the hospital had five referrals with two pending. He expected a new admission at the manor the following Monday with two more referrals pending. The Senior Strong program to help seniors deal with grief, unhappiness and a variety of other issues currently has seven patients with a target goal of ten. He said marketing for Senior Strong will be expanded to 50 miles.

Reporting on the hospital, Director of Nurses Heidi Courson said they are training with the Cerner launch.

Administrator Thomas said they are revamping the telemedicine program to expand it to other specialties such as endocrinology and infectious disease.

Grismer said that she, Simpson and Myers attended a Critical Issues Summit, which she described as “the best one I’ve attended in three years” and added, “We all need to give more time.”

Hospital and Manor Statistics and Financials

Goodno presented statistics and financial information for the hospital and manor for February. The hospital had 21 total admissions. Those admissions resulted in 104 days of combined acute and swingbed care. Of those, 90 were swingbed days.

Outpatient visits totaled 579. The clinic had 361 visits.

The hospital ended February in the black by $8,200. After total contractual adjustments of $37,505 and revenue of $19,767 from the 340B drug discount program and other, total operating revenue was $475,075. Total operating expenses were $545,040.

This made a loss for the hospital of $69,965. The addition of $78,166 mainly tax revenue made the hospital’s gain $8,200.

The manor’s total operating revenue was $94,977. Operating expenses were $118,324 which made a loss of $23,347. The addition of $5,652 mainly tax revenue curbed the loss to $17,695.

Using the comparative balance sheets for the hospital and manor, Goodno said that year-to-date the combined loss is $148,638.

She said total cash on hand was $659,692. Uncollected taxes total $388,736.

Total net patient accounts receivable was $1,496,356. Goodno said the Amnesty Program has reduced the accounts payable by $53,633.

KDH total liabilities and net assets totaled $9,617,041 on the balance sheet.

Action Following Executive Session

After about a three-hour executive session, the board took several actions in open session:

• Approved payment of bills and bad debt accounts

• Approved the one financial assistance case

• Approved the Manor quality assurance (QA) and performance improvement plan and program

• Approved the Manor medication administration times

The next monthly meeting for the KDH board is Thursday, April 26. The board set a tentative date for the KDH Annual Meeting for Thursday, May 24, at the Kiowa Community Building.