Alva Review-Courier -

Preliminary audit report presented to hospital board


November 4, 2018

The Alva Hospital Authority heard a preliminary report on audit results for the last fiscal year ending June 30. CPA Andrew Hejtmanek, a director of BKD, LLP, gave a summary. Earlier he presented a more detailed report to the finance committee of the board.

Issues of concern addressed with the committee include continued operating losses, working capital deficiencies and negative cash flows from operating activities. Board Chairman Jason Gaisford said the committee discussed the concerns along with remedies.

Balance sheets were helped by the forgiveness by Share Trust of $1.5 million in long term debt. Net patient revenue was down $661,106 from the previous year while operating expenses increased by $567,606. The facility showed an operating loss of $2,435,061, which was about twice that of 2017. The loss was offset by city sales tax appropriations, other non-operating revenues, capital gifts and grants, to show a $378,492 increase in net position.

A year ago, Share Medical averaged 25.6 days of cash on hand, which fell to 14.2 days in 2018. An average of all Oklahoma hospitals is 10.4 days while those with less than $90 million revenue showing 105.9 days.

Hejtmanek suggested the hospital work on collection efforts with an average of 51.6 days revenue in accounts receivable compared to 45.1 days a year ago. In all Oklahoma hospitals, the average is 57.6 days with those under $90 million at 48.6.

Another concern is the average age of the plant (physical facilities). With 17.53 years, Share is higher than the state average of 8.7 and the under $90 million category of 10.46.

Share’s operating margin shows a decrease of -9.5 a year ago to -20.3 in 2018. “You’re not alone in the struggles,” said Hejtmanek referring to other hospitals in the state.

CEO Report

CEO Kandice Allen reported a firewall had been changed out in the electronic health records. After a few bumps it seemed to be working successfully.

There were ten swing bed admissions in September. Three were acute care patients from Share and seven were transfers from outside facilities. Average length of stay was 13.2 nights for three patients. Five remain in the program with an average length of stay of 14 nights. Allen said nursing staff, therapy staff and other support staff have been working hard to make the transition into taking more swing bed patients. She said the staff meets weekly with patients and family to review goals and progress as well as discharge needs.

Allen said six risk management occurrences took place in September. Four were falls, three patients and one visitor. Two were medication events which included a medication patch that fell off.

She said Dr. Kris Mullins had 12 patients. Nurse aides are being hired due to the increase in census. The hospital continues to advertise for licensed staff. The NWOSU junior class nursing rotations are going well.

As of Dec. 1, the physician clinics will no longer prescribe narcotics due to recent changes in legislation.

CFO Report

CFO Kevin O’Brien reported the operating cash balance in September was $202,259. This represents 7.7 days of operating expense, excluding depreciation. The hospital accounts receivable balance of $4,078,917 is an increase of $409,786 from August. The accounts payable balance for September was $1,290,692 representing 119.6 days of operating expenses excluding the costs related to salaries, benefits and depreciation.

Hospital gross revenue for September totaled $2,116,070, an increase of $277, 258 compared to the prior month. Total patient days were 241 compared to 92 in August. Total clinic office visits for September 2343 1,251 compared to 1,572 in August.

Accounts written off to collection agency for September were $143,189. Charity care in September totaled $7,494.

Hospital salaries and wages in September totaled $407,340, an increase of $12,059 compared to the prior month.

The hospital net loss for September was $6,822 based on the numbers currently being used for Medicare reimbursement. O’Brien said this was the best he’s seen in a long time.

Share Convalescent

Rita Goodrich reported that Share Convalescent Home had an operating cash balance for September of $39,171 representing 4.1 days of operating expenses excluding depreciation. The accounts receivable balance of $583,551 was a decrease of $62,263 from the previous month.

Accounts payable balance for September was $353,350, representing 73.8 days of operating expenses.

The Convalescent Home gross patient revenue for September was $309,665, a decrease of $46,535 from the prior month. Total patient days were 1,639 in September compared to 1,798 in August.

Operating expenses excluding salaries, benefits and depreciation were $93,603, a decrease of $47,516. Salaries and wages for September were $150,033, a decrease of $13,999 compared to the prior month.

The Convalescent Home had a net income of $13,420 for September.

Goodrich said they welcomed five new CNA staff members in September. Eight certified medication aide employees were accepted into the practical nursing program at Northwest Technology which puts a large hole in their CMA staffing. They will be sending CNA’s to medication aide training.

The Homestead

Kelly Parker reported the occupancy rate at The Homestead increased by a half percent compared to September of last year. The average paid nights is increased by 1.8 residents or guests per night from last September. As of Sept. 30, 45 residents are occupying 43 apartments including two Share Medical providers. Four residents are on unoccupied status, three due to health or medical issues and one for family time.

During the month there were 25 resident emergency calls. Of that number 11 were test calls, four were handled by staff, seven required response by EMS and three were false alarms.

During the first quarter of expanded services offered, approximately $5,800 was charged. An additional full time position is now being sought to help fulfill the addition resident obligations.


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