Performance improved last year at PMH
Greg Gibbs with the accounting firm of Arnett and Foster presented the year-end financial statement to the Pocahontas Memorial Hospital board of directors at Thursday night's meeting.
"Performance was a lot better this past year," Gibbs told the board - and more improvements are expected going into the current year.
Although the county hospital did not build up a lot of cash reserves, going forward staff will work on that.
Gibbs reported that cash and cash equivalents stood at $355,207 at the end of the year, up from $184,108 in 2010.
Even with accounts receivable coming in a few thousand dollars under last year, days in accounts receivable were down, and revenue for the hospital was up compared to the previous year.ﾠ To add to that good news, Gibbs reported that accrued expenses were down significantly.
"Operating expenses were down from last year due to the management contract," said Gibbs. "Money was saved by bringing billing back in-house.ﾠ That savings amounted to approximately $120,000.
Although the hospital showed an annual operating loss of $375,463, it was an improvement over the $1.2 million-plus loss in 2010. Adding in non-operating revenue brought the loss down to $263,000 for the year.
Gibbs complimented staff on its use of the positive cash flow in paying down debt, interest on debts and paying down the hospital's Line of Credit at Pendleton Community Bank.
The hospital established a $300,000 LOC a few years ago as a safety net, and those funds had been used regularly to bolster the checkbook. However, under the new administration, the LOC has remained untapped since January.
Going forward, the auditor's report identified changes within the last year that helped to improve the financial health of the facility, such as improved capture of charges, training of registration staff, reduced overtime and re-engaging with the community, just to name a few.
"The full annualized impact of these changes were not realized in fiscal 2011, but should return the Hospital closer to profitability in 2012," the report said.
As with most businesses, PMH faces an ongoing financial requirement in funding retirement and post retirement for it employees, which is accrued, based on future payout.
PMH pays about $55,000 per month for future payment in the employee compensation line item, CFO Chad Carpenter told the board.
Gibbs complimented staff for its work and recommendations.
"There were no unusual items, no unusual transactions, and no disagreements with management," Gibbs told the board.ﾠ "We felt the audit went well."
Carpenter presented the November financial report which showed a $58,000 loss for the month. That number would have been reduced by $26,000 with revenue from charges that were noted after the books were closed for the month.ﾠ That amount will be included in the hospital's December revenues.
Total patient days were down for the month, but the daily in-patient charge was up by more thanﾠ $300 per day.ﾠ And days in Accounts Receivable has improved to 100, the shortest period of time reported since April 2010.
The facility continues to write-off bad debts, sending in excess of $111,000 to the collection agency again this month.
Although the billing office has contacted patients whose accounts are more than 120 days in arrears, they have had very little response with regard to payments.
PMH Ambulance showed a loss as well due to a reduction in the number of runs for the month.
"Runs are down," said Carpenter. "We are keeping more patients here since Dr. [Frank] Puckett is on board.ﾠ We are treating them here rather than transporting them to another facility."
An increase in the ambulance payroll was due to the addition of an on duty paramedic during the Thanksgiving holiday.ﾠ The hospital staffed for possible emergency care needs because ofﾠ Snowshoe's ski weekend.
"If you have a critical patient, an EMT cannot transport them," CEO Barbara Lay explained to the board.ﾠ "It takes a paramedic to do that.ﾠ I'm sure the hospital had long stays, especially when the helicopter can't fly. We don't do surgery. We don't have intensive care.ﾠIt is vital that we can transport; it is for the lives of our patients."ﾠ
This is a recognition of standard care that is required," said board member Dan Lewis.ﾠ "The hospital is now providing a standard of care that for the last six to eight years was not funded."
Lewis referred to the county commission budget pertaining to funding for the county hospital.
Oversight, adjustments and reduction in overtime cut the costs of PMH Ambulance by about $110,000 for a five month period in 2011, compared to the same time frame in 2010.
Administration and the board agreed that the expense of ambulance service must be met for the benefit of the hospital and community.
"There is a minimal standard of care that we need to support, a minimal amount of staffing to get people where they need to go," Lay told the board.
"In a small rural area, most people need to work because they need to be paid," said Lay.ﾠ "We have to have a level of staff that can provide care."
"We had, this past month, a $58,000 loss," said board president Dr. Bob Must. "Can you tell us what hope there is to not have a loss?"
"We are reconnecting with the community," said Lay.ﾠ "We spent a year fixing broken processes.ﾠ When you had people with a bad perception [of the hospital], it takes awhile to change and rebuild that trust.ﾠ The community needs to support the hospital by receiving services here."
Finances aside, the CEO reported on employee participation of 22 employees in a recent Leadership Development institute with a Studor coach, held at the Marlinton Presbyterian Church, the new Worksite Wellness Program andﾠthe continuing efforts in Provider Recruitment.
Chief Operating Officer Terry Wagner reported to the board on the success of clinics being offered at PMH.
Dr. JeffﾠFindling, a Morgantown based-podiatrist, saw 17 patients during his November clinic here, and will see patients again on December 29.
Dr. Rebecca Schmidt, also from Morgantown, conducts Nephrology clinics at the hospital.
These clinics help to improve access to healthcare by bringing services into the county,ﾠ and PMH is reaching out into the community, as well.
PMH Physical Therapist Tom Melko reported that he works with the Marlinton/Edray Senior Center on Thursdays, overseeing a low-impact exercise program for seniors.
A remodeling project is in the future for the facility.
Although county residents are familiar with the facility, Lay told the board, there is a lack of signage which makes navigating the facility difficult for new patients.
Plans call for a registration area just off the front lobby, staffed by registration clerks for out-patient services, who will also serve as information specialists for new patients and visitors.
Thursday night's meeting was a first for new board member Freda Hefner Jackson, appointed by the county commission to fill the unexpired term of long-time board member Neal Kellison, who died last month.
The board will hold a special meeting Wednesday, January 4, at 6 p.m. to approve policies for the rural health clinic, and will hold its regular meeting Thursday, January 26, at 6 p.m..