Alva Hospital Authority approves budgets, elects officers
July 1, 2022
Operating budgets for the FY22-23 year beginning July 1 were approved during the Alva Hospital Authority (AHA) meeting Tuesday evening. All trustees were present.
In a special meeting on June 9, the AHA approved a contract with Meditech as a service at $39,800 per month with a $150,000 implementation fee. The hospital had been seeking help in operating the Meditech software from the Duncan hospital. When that didn’t work out, they learned by changing their contract, they could receive the same help and training from Meditech, and it would cost them less than what they expected to pay the Duncan hospital.
Share Medical CEO Kandice Allen said the hospital will begin collecting information for Meditech in September and October with the service to kick off in January.
Allen said representatives for a pain management clinic will be at the hospital July 14 to meet with providers and staff. The hospital is also working to implement orthopedic surgery.
Beginning July 1, the Waynoka Clinic will be taking appointments on Monday and Wednesday. Karen Sagner, APRN will be at the West End Clinic at Share Medical on Fridays.
Share Medical participated in a MASH Camp with 37 students touring and getting some hands-on experiences. The camp gives students an opportunity to explore careers in health care.
AHA Chairman Jason Gaisford welcomed Angelica Brady to her first meeting. She will be handling CFO duties at future meetings.
CFO Chris Lauderdale gave the financial report for Share Medical Center. He said the summer months beginning in May generally show less activity with fewer patients. This was reflected in the hospital’s net operating loss of $343, 346 for the month. The hospital’s gross patient revenue for May was $1,359,844, a decrease of $348,840 from April. Total patient days for May were 72 compared to 66 in April. Total clinic office visits for May were 1,329 compared to 1,378 in April.
Lauderdale said while patient days were up, unbilled items made the revenue less. He said the $1.3 million in patient revenue was easily the lowest in the last six months.
BKD, the accounting firm helping Share Medical improve billing, has merged with DHG to form FORVIS. They are continuing to work with the hospital on the revenue cycle. Lauderdale said unbilled accounts are averaging around 20 days but the goal is around six days. He said accounts are being worked quicker, but that still needs to be improved.
Lauderdale reported Share Medical is scheduled for a charge master review to look at rates being charged and get them where they should be. He said that hasn’t been done since the hospital received critical access status. The review will be paid for by a grant that was obtained with the help of the Oklahoma Rural Hospitals organization.
Reporting on progress with TruBridge, the hospital’s patient billing service, Lauderdale said HRG acquired TruBridge. Now that one of the hospital’s TruBridge team is leaving, they have asked to be switched to an HRG team. The first meeting with the HRG project manager was June 28. Lauderdale said they have a reporting system called Helix that he thinks may be helpful.
Share Medical will give the service “one last shot,” said Lauderdale. “Hopefully it works out well. I’ve been very pleased with how they’ve started.”
To give Brady access to financial information, the AHA trustees approved having her added to accounts at three local banks so she can receive financial information and conduct financial transactions.
Lauderdale went over the proposed FY22-23 operating budget for Share Medical. He said it was the first year since he began as CFO that Covid-19 didn’t have to be considered. The budget projects operating revenue of $11,470,800 and non-operating revenue (mainly sales tax) of $1,264,800. The trustees approved the operating budget.
The capital budget is compiled from forms sent out to all managers at the hospital. Lauderdale said it is basically a wish list with items given priorities of A, B or C and projections for future years. Listed in the top priority column (A), was a $3,643 centrifuge for the laboratory; four hospital beds for nursing; an operating room table for $31,896, operating room lights for $23,416, an endoscopy tower for $137,516 and an anesthesia machine for $42,500 for surgery, and replacement of two hospital air conditioners for maintenance.
Lauderdale said the surgery items are for adding orthopedic surgery and would not have to be in place immediately. The A list needs total $284,058 with needs on the B list totaling $88,331 and C list items costing $22,079.
Any items costing over $25,000 would have to be brought before the AHA for approval before purchase.
Trustees voted approval for two reappointments to courtesy staff: Mathew Jared, MD and Adam Gardner, MD.
Share Convalescent Home
Share Convalescent Home Administrator Kelly Parker discussed the financial report for the nursing home. He pointed out the operating cash balance for SCH is $393,428 for May. The accounts receivable balance is $1,616,429, a decrease of $18,815 from April. Parker said they have been working on collecting some old accounts. SCH also has a refurbishing account of about $800,000 they’ve been putting back from Covid funds to use for their HVAC project.
Parker said the biggest change in the last six months has been in Medicare reimbursementa. He said they went from 141 skilled nursing days in April to just 60 in May. Medicare pays a higher rate for patients receiving skilled nursing. He said that really impacted the revenue. The nursing home had a net loss of $41,349 for May.
SCH has been staffing more people at the direct care level such as nurse aides and med aides and fewer licensed nursing. “We’ve got more people taking care of people, but they come in at a lesser salary,” he said. Allen asked if this wasn’t a reverse of what they tried earlier.
Parker said they first tried hiring more qualified staff (higher level of licensing) and put more qualified staff on the schedule to see if they would have better outcomes, but they didn’t. The emphasis now is getting more people altogether on the schedule. The nursing home is hiring more of the aides who do 95 percent of the direct care of residents, he said. This results in getting more of them in and out of rooms more often. He said they’re finding this is good for the budget and provides good outcomes for the reasidents.
Parker noted the average response time on the nurse call system for May was just below three minutes. That’s about half of what it was three months ago. He said he’d like to see a slightly longer response time which would indicate spending a little more time in residents’ rooms.
Parker went over the FY22-23 operating budget for the nursing home. He said the current year’s budget was used for a basis with a consumer price index increase of eight percent added. With operating revenue of $3,975,273, non-operating revenue (interest) of $130 and operating expenses of $3,942,538, the budget projects a profit of $32,865. The budget was approved.
The capital budget consists of items carried over from last year. Parker said the big item is the HVAC project, and it is the greatest need. He is discouraged with the current engineering firm. They are now on a third engineer. Parker said he can’t get return emails let alone return visits.
The other capital items for the year are a couple of rolling recliners/gel chairs for $6,000 and shower conversions in the west wing. He said the shower conversions are part of the move toward private rooms. The conversions would allow for a shower located between each two rooms. The trustees approved the capital budget.
Parker also gave a brief report on the Homestead facility. He said occupancy is down a little. He presented the operating budget for the next fiscal year. It also includes an eight percent increase with revenue of $725,209, expenses of $638,667 and a profit of $86,542. The operating budget was approved.
With the resignation of Rick Cunningham, the AHA was faced with finding a new attorney. Gaisford said Drew Cunningham, Rick’s son, is interested in the position. Rick Cunningham laughingly said, “I’d like him to be employed.” He then listed some of Drew’s qualities, saying he has the professional skills to do the job. Dr. Halah Simon made the motion to employ Drew Cunningham as the AHA attorney, seconded by Dr. Bo Hannaford, and the motion was approved unanimously.
Election of Officers
Gaisford announced it was time for election of officers and suggested they “lock the doors.” Jay Randels immediately nominated Gaisford as chairman, seconded by Simon, and the motion passed unanimously. Hannaford was elected as vice chairman, and Simon was elected secretary.
Gaisford noted that Rick Cunningham has been the AHA attorney for longer than any of the trustees has been on the board. Gaisford said his first meeting was almost 19 years ago, and Cunningham was already there. “His son will have some big shoes to fill,” he said.
Allen said, “Rick has never failed me.” She said he always answered her phone calls, no matter what time of day or night.
Gaisford handed Cunningham an envelope with a parting gift from the board, a $1,000 travel voucher he and his wife can spend on their planned cruise. After the meeting, everyone enjoyed a cake honoring Cunningham.
No Cheesecake Again
Gaisford announced there will be no board meeting in July at which Simon protested loudly. Once again she would get no cheesecake in her birthday month. The hospital’s food service provides meals for each meeting, and Simon has made it known she expects her favorite cheesecake in July.
Gaisford acknowledged this would be the second year that Simon had been prevented from enjoying her favorite dessert during her birthday month. He promised, “In August we have to have cheesecake for dessert.”
A video of the meeting may be viewed at http://www.AlvaReviewCourier.com.