Share Medical making progress on unbilled accounts
June 5, 2022
Share Medical Center in Alva has been having issues with patient billing and working with electronic patient records software. When the Alva Hospital Authority (AHA) met Tuesday, May 31, they heard updates indicating the hospital is getting a handle on both situations.
During her report, Share CEO Kandice Allen reported that working with the Duncan hospital on MediTech software problems was no longer possible. The two hospitals have been in talks but had not finalized plans. Now Duncan has experienced the loss of eight IT staff members and can no longer take on working with Share. “They didn’t feel like they could do us a good job,” said Allen.
Allen said the hospital is paying almost $20,000 for the MediTech software. Having the Duncan hospital help with software support would have cost around $53,000.
Instead, Allen said she learned contracting with MediTech as a service, not just for software, meant “they’re going to provide all the support that the staff needs for that product.” She said that’s currently not the case. MediTech initially agreed to train “super users” at the hospital, but now those trained staff members have left. “It became very challenging to service that product,” Allen said.
In addition, it’s time for the hospital to upgrade the software. Allen said contracting with MediTech as a service would cost the hospital $39,000 a month. “We feel like that is the best option,” she said.
“And that $39,000 does include their type of storage,” said AHA Chair Jason Gaisford. “Right now we don’t have that. We have servers that we have to replace. We spend a half-million dollars every five years (replacing servers).”
Allen said the service also includes what the hospital doesn’t have right now – mirror image backup. She said this would give the hospital redundancy. In the case of a hacking incident or data corruption, a recent backup would be available.
She asked board members to contact her with any questions they have about the service, and they will have the item on the agenda for a vote in the near future.
Allen said a new staff member, Jentry Lancaster, RN, recently began working at the hospital.
She reported the HR staff is creating a new hire orientation process presentation. “We feel like this is a very important process that we’ve never gotten very good at,” Allen said. HR has also begun reviewing and updating all job descriptions which they plan to implement in June.
The AHA recently voted to contract with BKD, the firm that handles the AHA audit, to take a look at patient billing problems. A lot of the problems seem to be tied to the hospital’s difficulty with TruBridge, the company hired to handle patient billing.
CFO Chris Lauderdale said a lot of accounts were sitting unpaid that should have gone to the collection agency. Those have been moved to bad debut so there will be more action to collect. He said BKD is focusing their energy mainly on unbilled accounts.
Allen explained that most of the unbilled accounts are from three physicians who are behind in getting their paperwork completed. She said two are “going away” and the other, a hospitalist, has been warned.
Lauderdale said a lot of the unbilled accounts go back to coding. When BKD came to the hospital, they found the individual doing the medical coding does not have a backup. They are working to have someone help with that on a part-time basis who can help when needed and to provide an extra set of eyes.
Share Medical Center had a net profit for April of $468,458. Lauderdale explained that bad debt is figured on a percentage of accounts receivable. When accounts receivable goes down (patient bills are paid), bad debt also goes down. Collections in April lowered the accounts receivable and the bad debt.
The hospital accounts receivable balance at the end of April was $3,874,477, a decrease of $595,640 during the month. Accounts payable balance for April was $457,247, representing 36.7 days of operating expenses excluding the costs related to salaries, benefits and depreciation.
Hospital gross patient revenue for the month totaled $1,598.684, a decrease of $36,117 compared to March. Total patient days for April were 66 compared to 62 in March. Total clinic office visits in April were 1,378 compared to 1,516 in March.
Looking at financials for Share Convalescent Home, Lauderdale said the operating cash balance for April was $412,934, representing 44.3 days of operating expenses, excluding depreciation. He said the nursing home also has another $400,000 to $500,000 in Covid funds not used.
The convalescent home had a net profit of $137,933.
At the Homestead retirement facility, Lauderdale said the census was down so revenue was down with a net loss of $41,240 for the month. However, he pointed out much of that was because the Homestead paid out $39,377 for the recently purchased van.
Share Convalescent Home
Administrator Kelly Parker went over some of the highlights from his written report on the convalescent home. He said staff has been involved in online training by Leading Age on state surveys. The nursing home hasn’t had a survey since 2018 due to Covid. With almost four years since the last survey, the staff is getting updated on what to expect.
“Nursing homes have more regulations than any other industry on the planet,” said Parker. He expects the survey, whenever it happens, to be “considerably better than it was in 2018.”
Parker said one of the biggest challenges facing the nursing home is staffing shortages. Right now they need 25 people in the kitchen, housekeeping and direct care of residents. He said a lot of the reason for the low number of residents is they are trying to maintain a good staffing ratio so “we can take good care of the people we have.”
Parker said the census is a little bit down at the Homestead, but they hope to remedy that with stepped up marketing activities. He said the Homestead is unique because there are not a lot of independent living facilities in northwest Oklahoma and southern Kansas.
Homestead residents are enjoying the new Chrysler Pacifica van. The facility is working on scheduling more activities.
Parker said they are trying to get the pond finished. They have a liner but need to get it put in. The project was put on hold during the pandemic.
Erosion has made the northeast corner of the parking lot unusable. They plan to have the concrete torn out so the space can be filled and stabilized for new concrete.
Parker said the SMC Foundation chose two students from nine applications to receive scholarships. Kaden Slater of Alva and Nancy Klippenstein from Burlington are the recipients. One plans to major in physical therapy while the other wants to be a nurse.
Gaisford announced that the June meeting will be the last one for Rick Cunningham as the AHA attorney. He is retiring.
Cunningham said he started in 1998 and has 24 years as the AHA attorney.
The audit for the hospital authority arrived the day of the meeting, May 31. It was emailed to the trustees before the meeting. Gaisford said the finance committee saw a preliminary report before it was finalized. Due to the timing, the audit was discussed under new business.
Lauderdale reported it was considered a clean audit with no big issues. He said the main notation is one common to rural hospitals. Sometimes only one person handles all the responsibility for a job as discussed earlier with the medical coding.
It was explained that the audit took longer than usual due to accounting for Covid relief funds and the extra work involved with the facility being a critical access hospital. The trustees voted to approve the audit.
It will be good news for the City of Alva since the AHA audit has to be completed so the city can include it in their final audit.