BOARD OF COMMISSIONERS MINUTES
SEPTEMBER 24, 2015
REGULAR BOARD MEETING – 4:00 PM
RIVERSIDE MEDICAL CENTER
CAFETERIA
Item No. 1- Call to Order -Chairman Jones called the meeting to order and established a quorum.
Item No. 2- Invocation -Board Member King gave the Invocation.
Item No. 3- Pledge of Allegiance –Chairman Jones called for the Pledge of Allegiance.
Item No. 4- Roll Call –Board Clerk Sherae Killingsworth called the roll. Those present: Barry Kennedy, Gerald King, Violet Tate, Lavern Jenkins, James Thomas, Pamela Breland, Rachel Gill, James Knight, and Lionel Jones. Members Absent: Frank Voelker, M.D. Board Member Tate was in attendance at the meeting at 4:15 p.m.
Item No. 5- Approval of Minutes -Board Member King offered a motion seconded by Board Member Knight to accept the minutes of the August 27, 2015 regular meeting as presented. Roll call vote as follows: YEAS: (8) Kennedy, King, Jenkins, Thomas, Breland, Gill, Knight, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Item No. 6- VOIP Telephone System- Board Member Jenkins stated that current telephone system is 15 years old and we have outgrown the system. We have no extra lines available. He stated that this system will expand the much needed system and also provided two wireless telephones for the hospital. Board Member Jenkins offered a motion seconded by Board Member Breland to approve the purchase of the VOIP Telephone System from Executone in the amount of $87,695.00 with monthly payments at $1,572.00. Roll call vote as follows: YEAS: (8) Kennedy, King, Jenkins, Thomas, Breland, Gill, Knight, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Breastfeeding Policy- Board Member Jenkins said the Breastfeeding Support Policy is being implemented to encourage all of our pregnant and postpartum team members to consider breastfeeding their children as a means of promoting the health of both child and mother. We encourage and support team members in their efforts to combine working and breastfeeding. Board Member Jenkins offered a motion seconded by Board Member Gill to approve the policy as presented. Roll call vote as follows: YEAS: (8) Kennedy, King, Jenkins, Thomas, Breland, Gill, Knight, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Item No. 7- Chief Financial Officer Report for June 2015
Mr. Magee said the cash balance as of today is $633,000. We expect to receive FMP payment in October for the hospital. Mr. Magee stated there were 23 admissions for the month compared to a budget of 49 and prior year of 46. There were 2 swing beds for the month compared to a budget of 5 and the prior year was at 0. He reported that there were 44 observation stays compared to 49 last year. For the total admissions, there was 10% decrease for the month and 6% decrease for the year. There were 89 acute and 22 swing beds patients’ days. Mr. Magee reported that during August the acute average daily census was 2.87 compared to 4.97 for the prior year and 5.10 budgeted. The average daily census for swing beds for the month of August was 0.71 and the prior year was 0.00. The average daily census of all admissions including swing bed, acute and observation for the month is 5.45. The average length of stay for acute during the month of August for the hospital was 3.87 and for swing bed is 11.00. The average length of stay for acute Medicare for August is 4.25 days which was an increase from last year at 3.09.
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Total equivalent patient days for the month were 1,885 compared to a budget of 1,816 and prior year of 1,182. Total emergency department visits were 1,269 for the month, compared to 1,335 for prior year and 1,302 budgeted. The emergency room visit average per day for the month was 41 with year to date at 41. There were 95 surgical procedures performed during the month compared to budget of 66 and prior year of 68, with 562 surgeries year to date.
There were 1,908 outpatient registrations during the month with 13,992 year-to-date which is an increase of 91 registrations from prior year. The outpatient registration average per day for the month was 62 with the year to date at 58. There were 209 FTE’s for August compared to 207 for the prior year and 209 budgeted. The accounts payable was at 105 for August, with last month at 96 and for the prior year at 69 which is an
increase of 36 for the year. Mr. Magee provided details and stats by individual physicians for the surgery procedures. There was discussion regarding the length of hold time for patients that are being left on the telephone at the clinics. Mr. Lott said he will look into the matter and report back to the Committee. Mr. Jenkins reminded Mr. Magee about the monthly departmental cost reports being submitted in the Finance packet. Mr. Magee reported that we continue to have issues obtaining the reports from the new system. He hopes this will be address within the next couple of months.
Total Patient Revenue for the month of August was $5,135,774.92 which was more than budget by $38,275. Total Other Revenue for August was $585,195. Total Gross Revenue for August was $5,720,970. Total Deductions from Revenue for August was $3,415,477. Mr. Magee reported that the reimbursement amount owed to Medicare is due back in October. There was a brief discussion regarding inpatient admissions to the hospital. There was general discussion on the perception of the hospital. There were several ideas presented by the Committee and Mr. Lott said he will provide the information to Kristi Knight the Outreach Director. We continue to reach out to the community and participate in all events within the Parish.
Net revenue for August was $2,305,494 which was above budget. Personnel expenses totaled $1,390,142 for the month which was above budget by $74,280. Mr. Magee stated the investments are finally starting to slowly pay off for the new services implemented. Other operating expenses were $881,760 during August this was above budget by $31,288. Total operating expenses for August was $2,271,902 which was above budget by $105,568.
The net operating profit for the month of August was $33,592 compared to a budgeted profit of $71,405. The hospital experienced a net loss for the month of ($81,363) and a net income of $719,557 for the year. The current assets were $5,762,636 with current liabilities at $4,169,605 providing a current ratio of 1.38 for August, with the prior month at 1.48 and the prior year at 1.22. Mr. Magee stated that the current ratio measures the ability of the hospital to rely solely on its liquid assets to pay current liabilities.
Mr. Magee presented a Cash Flow Statement for August 2015 which identifies the activities of the hospital that are generating or consuming the cash. The Beginning Operating Cash on Hand is $709,124 with the ending balance is $114,988. He said cash expenses per day average are $67,325 for August and the prior
month was $66,983. The daily operating revenue is $67,307 with the prior month at $66,274. The Daily Net Operating Margin was at (-$18) and the prior month was at (-$708). The Daily Net Operating Margin Percent for August is (0.03%) and for July at (1.07%). He stated that the Daily Operating Expense
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amounts are based on cash expenses calculated by removing all non-cash expenses. He presented a graph of cash on hand on a day by day basis for the month of August. The day’s cash on hand average for the
month was at 6 with low at 2 and the high at 13. Mr. Magee presented the deposits verses the expenses for the month of August, a copy of which is on file with these minutes.
Mr. Magee presented a cash projection statement for January through August being actual and September through December 2015 is projected. He stated that the projected average days cash on hand for the year was 13 with the highest at 44 and the lowest at 2. The projections reflect the payments for the grant funds that we received for the month of August and then adjusted for October. The average deposits for August were $56,948 with the daily expense at $67,325. Mr. Magee reported that there were two capital expenditures during the month of August for the Trophon EPR and a Glidescope in the amount of $22,231. The Total Capital Expenditure for the year was $3,070.674.35.
Mr. Magee reviewed the Accounts Receivable Analysis totals and graph. The hospital Gross Accounts Receivable as of August 2015 with CPSI is $1,727,806 which reflected a decrease of ($416,998) and with Cerner at $9,770,824 which reflected an increase of $1,292,445. Mr. Magee provided details for the remaining CPSI accounts. The grand total receivable is $12,089,213 with an increase of $949,787. The
Gross A/R Days is at 76.86 with the prior month at 74.92 which is an increase of 1.94. There was discussion regarding the increase in AR days with the Committee.
Mr. Magee presented and discussed the daily cash collections to the Committee, a copy of which is on file with these minutes. Total days of gross revenue uncollected were 76.86 compared to 74.92 for the prior month. Net days uncollected were 89.68 compared to December 31, 2014 of 68.83 days. He reported the State average benchmark has been updated to the 2013 median which is 72.47.
There were no recipients that qualified for the Charity Program during the month of August. The year-to-date written off balance for the Charity program is $11,890.72. Accounts written off as bad debts during August 2015 totaled $362,016. The year-to-date bad debt is $3,095,598. Board Member Jenkins offered a motion seconded by Board Member Breland to approve the bad debt list as presented. Roll call vote as follows: YEAS: (8) Kennedy, King, Jenkins, Thomas, Breland, Gill, Knight, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0). He reported that the accounts written off as uncollectible in August for the Riverside Family Care Clinic were $814.14. He reported that the accounts written off as uncollectible in August for the Pediatric and Internal Medicine Clinic were $4,458.33.
Item No. 8- Medical Staff Report- Chairman Jones called for the Medical Staff Report to be given by Luis Alvarado, Chief of Staff, a copy of which is on file with these minutes. The last meeting of the Riverside Medical Center Medical Executive Staff was held on September 17, 2015.
Those Present: Luis Alvarado, M.D., FACP, Yasheka Nicholson, M.D., Joseph Perdigao, M.D., Kyle Magee, M.D., CEO, Ben Lott, COO, Lesia McQueen, DON, and Sherae Killingsworth, Executive Assistant to the CEO. Those Absent: None.
The Quality Council Committee continues to review monthly dashboard indicators for all departments.
The Dobutamine Stress Echocardiogram Policy was approved as presented by the Quality Council Committee.
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The MEC approved the following policy and manual as presented from the Quality Council Committee:
Revised Drug Storage Refrigeration & Freezing Policy
Medication Management Process Review
Revised Medication Management Policy
Medication Administration Guide
Pharmacy Department Policy & Procedure Manual
Infection Prevention & Control Program
The Revised Autoclave-Testing, Cleaning & Maintenance Policy was approved as presented.
The MEC approved the reappointments as follows:
Robin Fisher, NP Allied Health
Steven Becnel, PA Allied Health
The MEC request approval from the Board of Commissioner for the policies, manual and Allied Health Professionals as presented. Board Member King offered a motion seconded by Board Member Thomas to approve as presented. Roll call vote as follows: YEAS: (9) Kennedy, King, Tate, Jenkins, Thomas, Breland, Gill, Knight, and Jones. NAYS: (0) ABSENT: (1) ABSTAIN: (0).
Item No. 9- Patient Care Report- Chairman Jones called for the Patient Care Report to be given by Lesia McQueen in Ben Lott’s absence, a copy of which is on file with these minutes. Ms. McQueen provided details on the Cerner Implementation and The Joint Commission follow up. We are preparing for the fair next month. The hospital will sponsor the First Aid Booth again this year. In addition, we will have a table setup to provide handouts. Attached you will find a list of employed providers at RMC per your request, a copy of which is on file with these minutes.
Item No. 10- Attorney Report- Chairman Jones called for the Legal Department Report to be given by Matthew Brown, the hospital attorney. Mr. Brown deferred his report to executive session.
Item No. 11- Management Report- Chairman Jones called for the Management Report to be given by Kyle Magee, M.D. Dr. Magee said the Bogalusa Blues & Heritage festival is this weekend and the shirts only has two sponsors which is RMC and Our Lady of the Angels. He reported that Brittany Dillon and Kristi Knight have been very active within the community with several civics group presentations as well as attending Rotary. He expressed his appreciation for all the hard work and going the extra mile for the hospital.
Item No. 12- Public Participation- There was no public participation.
Board Member Knight offered a motion seconded by Board Member Breland to close the public participation at 4:55 p.m. Roll call vote as follows: YEAS: (9) Kennedy, King, Tate, Jenkins, Thomas, Breland, Gill, Knight, and Jones. NAYS: (0) ABSENT: (1) ABSTAIN: (0).