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The interim staff from Minnie Hamilton Health Systems continues to sweep the corners for loose change, make hard policy decisions and look to a more efficient billing system as they work to stabilize multi- troubled Pocahontas Memorial Hospital.

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ﾓThere has been a lot of talk that the hospital has struggled for a long time, and people want to know why we canﾒt keep on like we are,ﾔ Interim CEO Barbara Lay told the PMH Board at Thursday nightﾒs meeting.

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Lay presented financial information which spelled out very clearly why ﾓkeeping on like we areﾔ is not an option.

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In 2005 PMH had $4.5 million in equity and showed an operating loss of $102,000 for the year.ﾠ In 2006, equity dropped slightly to $4.1 million but the loss increased to $531,000.

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Year after year the losses grew and the equity went south.

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The equity dropped to $3.6 million in 2007 with an operating loss of $565,000; 2008 showed $3.1 million in equity and the ﾓcheckbook overdrawnﾔ by $712,000.

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By 2009 the equity had dropped to $2.4 million with an operating loss of $739,000; and 2010 reflected a very grim scenario, with equity standing at $1.7 million, a number nearly matched by the operating loss of $1.2 million.

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ﾓIf we continue this path, this is the year the sheriff knocks on our door,ﾔ Lay said.

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ﾓWe cannot continue.ﾠ We must change.ﾔ

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To help facilitate that change, the auditing firm of Arnett and Foster had earlier prepared three financial projections or options for the boardsﾒ consideration.

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Option I, the Status Quo, continuing as in the past, was rejected for obvious reasons.

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Option II, moving toward Rural Health Clinic status, but not totally, projects an improved bottom line, and Option III, 501-C3 status, which involves collaboration with Minnie Hamilton Health Systems would be the most desirable.

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ﾓOption III is a wonderful option, but we have to see how we can get there,ﾔ board president Dr. Robert Must said.

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The board agreed to pursue Option II, while studying Option III.

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Lay informed the board that Boone Memorial Hospital is currently working toward becoming a 501-C3 facility.

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The board will do some legal research and watch that hospitalﾒs progress as PMH moves forward.

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Tending to business in the present, the financial report for October showed that although income revenue was down year-to date, reducing the inventory in the pharmacy, a one-time adjustment to sick leave and the advance payment of $75,000 from the Pocahontas County Commission made for a more favorable bottom line.

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Without the policy change and the money from the county commission, the hospital would have shown an $82,000 loss, CFO Chad Carpenter told the board.

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An expected boost for the November financials will come in the form of $50,000 from the Health Care Authority.

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In addition, PMH has moved billing back in house thereby relieving the budget of the $134,000 per month payment to former billing company HMS.

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ﾓThe current ratio (assets vs. liabilities) is trending upward,ﾔ Must noted.

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That ratio was .6 in September and had increased to .8 for the period ending October 31.

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Our Ambulance showed a minor, but welcomed, profit of $987 for the month.

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This, too, was due in part to a one-time adjustment in ﾓsick time.ﾔ

As expenses are trimmed for the ambulance service, ﾓthe sleep rooms have been moved out of the facility,ﾔ Lay told the board.

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Days in AR or Accounts Receivable are still too high, moving up to 113 for the month of October.

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ﾓWe started the billing on November 1,ﾔ Carpenter told the board.

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ﾓThings have changed since we sent it out of house [HMS].ﾠ Billing is overwhelmed, they are working hard, trying to see what HMS has done and hasnﾒt done on the accounts.ﾔ

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ﾓShould we see a change in Days in AR?ﾔ Must asked.

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ﾓIt should change in about 45 days,ﾔ Interim CEO Steve Whited said.

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ﾓSo this is a little tidier than when HMS had it,ﾔ Must offered.

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ﾓTen times better,ﾔ said Whited.

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ﾓPeople are paying,ﾔ said Lay. ﾓThey are working to help the hospital.ﾔ

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Patients are paying on accounts, even though their bills should have been paid by insurance.

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ﾓOne of the most disturbing is the Medicaid,ﾔ Lay told the board. ﾓThere is a lot of Medicaid money out there.ﾠ They have tightened it down.ﾠ But that is money we should not have lost.ﾔ

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ﾓTruly and honestly, it is their fault [HMS],ﾔ said Whited.ﾠ ﾓIt is out of our hands.ﾔ

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Fortunately Whited got his hands on one important matter, and just in the nick of time.

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The hospital must reapply each year to Medicare in order to participate in their program.

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That paperwork is due in July, no later than August, Lay said.

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The previous administrator failed to apply.

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Whited got right on it.

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Medicare gave PMH 30-days notice, allowing them until November 20 to file the application.

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ﾓThatﾒs some of our alligators,ﾔ Lay laughed. ﾓThat almost gave me the big one!ﾔ

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Although the MHHS staff continues to work on the bottom line and will be implementing new, ﾓcleanerﾔ billing software, Lay told the board of other areas that are receiving attention, as well.

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The staff will become more involved in outreach into the community to help improve the health and well-being of its residents.

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Communication between offices and departments is improving and some employees have agreed to be on call to help resolve issues.

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A Strategic Thinking Group, made up of employees, department heads and board represetatives, has developed a Draft Mission Statement for PMH.

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ﾓThe purpose of the exercise was to figure out what we are all about, then decide what we want to be in the future,ﾔ Must said.

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