Audit report reveals Veterans Memorial Hospital "doing well"

by Brianne Eilers

The bulk of the monthly meeting of the Veterans Memorial Hospital (VMH) Board of Trustees for September was taken up by the results of the hospital's most recent audit.
VMH Administrator Mike Myers noted there was some discussion regarding IPERS and the adoption of GASB Statement No. 68, Accounting and Financial Reporting for Pensions, and GASB Statement No. 71, Pension Transition for Contributions Made Subsequent to Measurement Date. These standards have been put in place by the Governmental Accounting Standards Board (GASB) to help improve pension accounting and financial reporting of public employee pensions by state and local governments and more appropriately reflect pension expense for the reported time period.
Myers noted that the stock market is a huge variable when it comes to Iowa Public Employee Retirement System (IPERS), and is beyond the control of the realm of the hospital. Myers pointed out that every time the stock market goes down, that does affect IPERS. Other factors that impact IPERS benefits are how much is contributed by employers and employees and how much is paid out, other factors over which the hospital has little control.
While IPERS reporting and accounting is a component in the overall financial scope, the board at VMH has decided that it would be better for the hospital to focus more on operations. "Focusing on operations is based on components of finances we can control," Myers explained.
Myers also noted that the audit report showed how VMH ranks against other Iowa Critical Access Hospitals (ICAH). He pointed out that VMH is much lower in the comparisons than other ICAH, but those hospitals do receive tax funding, where VMH does not. "The auditors said that for us not getting any tax money, we are doing well," Myers noted. Looking at VMH assets, the cash and investments balance at the end of the 2015 Fiscal Year was $2,284,000. VMH decreased the long term debt by about $451,000 from last year. The hospital ended FY2015 with an operating margin of 5.6%.
Looking to the month of August 2015, the books show a profit of $104,577, which translates to a 6.4% operating margin. Myers noted that acute and skilled patient days were both strong in August, as were deliveries, outpatient lab and outpatient x-ray. Emergency Room visits were also up over last year. Inpatient revenue was at $826,650 for the month, and outpatient revenue was at $1,772,905. Expenses also tracked right about where they were projected.
Myers noted that the days of revenue in accounts receivable is down to 91.6, compared to being over 100 last month. "That number should drop again in September," he estimated. Myers also noted that October 1 was the beginning of the ICD-10 coding system for medical records. This will involve more detailed notes on patient records.
VMH staff is learning to use the new 3-D ultrasound machine, which will provide more detailed pictures with ultrasounds. "I saw my first 3-D ultrasound, and it really brings clarity to ultrasounds, it is unbelievable," Myers said. "We are excited for that and the staff is continuing training for using this."
Myers will also be attending the Iowa Hospital Association annual meeting, which is coming up. He noted that a topic of discussion will be population health. Jeff Mitchell, EMT-PS, Paramedic/EMS Supervisor will be presenting at the meeting regarding CCAST, which stands for Community Cardiac Arrest Specialty Team.
In other matters, VMH is looking into re-working its network agreement with Mayo Clinic Health System-Franciscan Healthcare. The hospital is also working on a new Balanced Scorecard, using the areas of likelihood to recommend, days in A/R, falls, medication errors, hospital acquired infections and readmission rates. Myers reported that the Women's Health Day event, held September 29, was "a huge success." He noted that tickets for the event sold out.
Myers also addressed the use of the birthing tub at the hospital. In August of this year, Mayo Clinic Health System-Franciscan Healthcare announced that it had decided to discontinue water births. In following this decision, VMH had to also discontinue the allowance of this service, but has since been able to find a way to continue using the birthing tub as a way to help alleviate the pain and discomfort that comes with giving birth.
"We have determined a way to allow the mother to labor in the tub, but not give birth in the water," Myers said, adding that after the mother gives birth, she can return to the water in the tub if she would like to.
 

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