Veterans Memorial Hospital receives annual audit results, posts positive July

by Brianne Eilers

The Veterans Memorial Hospital (VMH) Board of Directors met for its regular monthly meeting August 25. The results from the hospital's annual audit that was completed in June of this year were available, and the hospital ended the last fiscal year with a revenue over expense difference of $586,700.87.
Looking at the statistics for the month of July 2015, VMH ended up with a net income of $33,600. VMH Administrator Mike Myers noted that acute and skilled patient days were up, compared to last year-to-date. Acute patient days were up 37.4% and skilled patient days were up 94.7%. Myers noted that the number of deliveries was down. “We are still on pace to be over 130,” he said in regard to deliveries.
Looking at outpatient services, the areas of outpatient lab, MRI and physical therapy were very strong for July. “That is where we made our $33,600,” Myers said.
The number of days in accounts receivable is still up over 100, at 105.7. Myers said he anticipated that the number should be below 100 next month as the hospital will be implementing some new procedures to address that issue. VMH has $1,823,000 in cash reserves and has been working on a five-year capital budget. The capital budget for five years will be over $3 million. The Board approved $333,000 for this year.
Myers discussed a bit about how VMH has been working on increasing transparency of the hospital, especially since many people have higher deductible health care plans. He noted that many with the higher deductible plans are paying the first $2,000 to $4,000 of medical expenses out of pocket and the hospital is looking at how to be more transparent and being able to answer questions to help patients understand what the costs are and what they are paying for.
Myers said that the hospital is continuing to look at ways to increase transparency, as is the Centers for Medicare and Medicaid (CMS). Myers gave the example of looking at the cost for a hip replacement or a knee replacement at hospitals across the country, and the cost can range from $5,000 to $250,000, depending on the facility. “The danger is that they (CMS) slant everything toward the $5,000, and how they are doing that I don’t know, but it might not be feasible to have the ‘one size fits all’," Myers said.
Myers also discussed a change proposed by Senator Chuck Grassley for reimbursement to rural critical access hospitals with a minimal inpatient census, in order to allow those facilities to keep providing services to the communities they serve. “That is a good step for those hospitals that have low inpatient census,” Myers said. He further noted that this wouldn’t apply to VMH because the hospital has been having a decent inpatient census, and Myers said that the downside of what Senator Grassley is proposing is that the hospitals can’t have many inpatients, which VMH does not want to do. “It’s a great step to maintain services in those smaller communities that only see one or two patients, but provide other important outpatient services,” Myers explained, and they will continue to see what happens with that legislation.
Emergency Room volumes and testing at VMH continue to be strong. Myers also said that the hospital is continuing with the succession planning. Three employees will graduate from Iowa Hospital Association Leadership classes in October and one employee graduated from the Executive Academy in June. Myers noted that two more employees will be attending the Executive Academy in the next year. He also noted that the hospital is continuing to send employees to educational and leadership opportunities and meetings to develop their growth and leadership.
VMH has changed job descriptions to better reflect the duties that the jobs entail, so that when they do have to make new hires, the job titles reflect the qualifications. He gave the example of changing director of nursing to assistant administrator for patient care.
Myers also addressed the fact that Mayo Health Systems will no longer allow their providers to do water births as of September 1. Myers noted that this is a big change and the hospital is still coming to terms with the fact that the water birth service will no longer be available. The laboring mothers will still be able to use the tubs in the OB suites to soak in to try and relieve some of the pain and pressure experienced during labor, but the actual birth won’t be able to happen in the tubs.
“We hope that in the future, somebody will take an unbiased look at the safety in water births and reconsider the position statements of the accrediting bodies of the OB/GYN and pediatrics, which are basing their decision for the potential of a bad outcome,” Myers said. He further explained that when a system makes a decision, the employees are obligated to follow, and the hospital will not be able to offer water birth as an option until the position is changed.
Myers also noted that there was recently a statement published from Mayo Health System, as well as a letter to the editor from Mayo Health provider Dr. Benjamin Ross, M.D. in  The Standard explaining and discussing the decision made by Mayo Health Services. VMH had been using birthing tubs as a birthing option since 2002.
VMH will be switching its electronic medical record (EMR) vendor from Razor Insights to Athena Health. Myers said that Athena Health is the eighth largest EMR vendor and this change will “greatly enhance” the EMR process at the hospital. “They are an up and coming company, and their CEO is recognized as being visionary,” Myers noted. Staff will be completing training to use the new system, and Myers believes the hospital will have a better EMR product than what they currently have when the transition is finished.
 

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