Audit report

Facing the largest deficit in recent hospital history, the Texas County Memorial Hospital board members looked at projected inpatient and outpatient revenue for 2009 and received a physician recruiting update at their monthly meeting.

In July, the hospital had a negative bottom line of $436,473, doubling the 2009 deficit to $858,713. Overall revenue for the hospital was down by $1 million for July.

“We have taken our biggest hit for the year this past month,” said Wes Murray, chief executive officer at TCMH.

Linda Pamperien, chief financial officer at TCMH, described a July with a very low census and decreased inpatient and outpatient revenues in the hospital.

“There’s no way to compensate when inpatient and outpatient services are just not utilized,” Pamperien said. “We have met one-on-one with our department managers and our employed physicians. We are not making any capital purchases unless absolutely necessary.”

Pamperien presented financial information to board members showing hospital revenue numbers from 2004 to the present and the concurrence of hospital physicians on staff and increased revenues.

“TCMH is provider driven,” Murray said, explaining that the hospital relies on physicians utilizing TCMH services. “Our expenses today are the same as they were in 2006, but our revenue has dropped.”

In 2004, TCMH had 14 physicians on the active medical staff with inpatient revenues of $17,501,730. In 2009, the hospital has eight physicians on staff and projected inpatient revenue of $12,582,442.

The loss of Eugene Honeywell, D.O., family practice physician at the TCMH Family Clinic in Licking has hurt the hospital’s bottom line; he was one of the hospital’s top admitting physicians. Honeywell planned to return to work in mid-2009 but was unable to do so because of illness.

“I don’t think we would be talking about a loss of any kind with an average year from Dr. Honeywell,” Murray said. “The loss of our admitting physicians from St. John’s in Mountain Grove – Dr. David Barbe and Dr. Nancy Hayes – has also hurt our bottom line.”

Murray explained that the average physician generates $2.5 million in revenue for the hospital.

“If we can increase our physician numbers by two, we can theoretically generate an additional $5 million in revenue for the hospital,” he said.

Dr. Russell Huq, a family practice physician, will begin seeing patients Sept. 10 at the TCMH Family Clinic in Licking. Dr. John Paulson, a family practice physician, will begin working at the TCMH Medical Complex in Houston next July.

“We have the physicians in place to begin to turn our finances around,” Murray said, “and we are actively recruiting.”

Joleen Senter Durham, director of physician recruiting at TCMH, is hopeful that two internal medicine physicians may join the staff in 2010. She is actively recruiting for the Mountain Grove clinic that will open next year.

“I have recruiting events coming up in Columbia and Springfield,” Durham said. “If a physician expresses just a little interest, I will do whatever I can to engage them about our positions.”

Durham is available in the evenings and on weekends in addition to the usual daytime hours to talk with physicians and to bring them in for visits to the hospital and community.

“Our hospital physicians and department managers have also gone above and beyond in meeting with interested physicians, welcoming them to our hospital,” Durham said. “We try to create an informative and impressive experience for every physician that is interested in TCMH.”

Murray noted in addition to incoming physicians at the hospital, August looks to be better with increased hospital inpatient census.

“We faced an unplanned setback with Dr. Honeywell not returning to practice as planned,” Murray said. “However, our short-term plan is in place, and we are moving forward.”

In addition to halting capital purchases, the hospital has not added any new positions at the hospital and has cut some non-revenue producing community services, such as reducing hours at the fitness center in Houston.

TCMH will not proceed with awarding merit raises as part of the annual evaluation process at the hospital in September to save an additional approximate $269,000 annually.

“We will come back to our employees with the raises if we can in the future,” Pamperien said.

TCMH is gearing up for a stronger flu season in 2009 and 2010. The hospital is stockpiling certain items that could be in high demand at the facility such as face masks.

“If there’s a high demand for healthcare services due to a higher than average fu outbreak, we need to be prepared,” Murray said.

Omanez Fockler, board chairperson, complimented hospital administration for the “upbeat and amazing” groundbreaking Aug. 13 in Mountain Grove. TCMH broke ground for a new ambulance base and three-provider clinic to open in 2010.

The Mountain Grove project was made possible through a USDA loan to Se-Ma-No Electric Cooperative that was given to TCMH to add healthcare services in Wright County.

At the time of the board meeting, 68 companies – including 15 general contractors – had requested blueprint information for the Mountain Grove construction project. Bids are under review.

Ambulance service by TCMH began Aug. 23 in Mountain Grove. The ambulance and staff are temporarily located in a residential duplex being rented on a monthly basis until the new TCMH base and clinic is built.

“After beginning the service on Sunday at 7 a.m., the ambulance in Mountain Grove has had the most runs of all the TCMH ambulances,” Murray reported to the board.

TCMH continues to work with the USDA to potentially fund the hospital’s 52,000 square foot expansion project.

“We are still going through the examined financial forecast required by the USDA,” Murray explained. “Last month’s financials may have a bearing on our eligibility for the project, but I still believe in this project.”

“The representatives from the U.S. Department of Agriculture were very positive about working with us,” Fockler said, adding that the USDA helped TCMH expand the hospital in 1976 when the intensive care unit and operating room were added.

“With this project in Mountain Grove and the loan/grant they gave us for electronic medical records, we have a good working relationship with the USDA,” Murray agreed.

Present at the meeting were Murray; Pamperien; Durham; Doretta Todd-Willis, chief nursing officer; Dr. Charles Mueller, chief of staff; and board members, Fockler, Mark Forbes, Janet Wiseman and Mark Hampton.

Board member Jane Kirkwood was absent.

The next meeting of the TCMH board of trustees is noon Tuesday, Sept. 22, in the downstairs meeting room of the hospital.

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