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Budget matters, values on hospital board’s agenda

By Staff | Jan 24, 2020

Budget matters topped the list of discussion priorities at Heart of America Medical Center’s regular board of directors meeting in the center’s Fox Auditorium Monday evening.

After the board approved its agenda and minutes from December’s meeting, Chief Financial Officer Melissa Shepard presented financial information.

“At Haaland Estates, we are current with our accounts payable at $21,052.30,” Shepard said.

Shepard reported the hospital’s accounts payable balance at “$753,635, most in current, $639,000. There’s just under $100,000 in 31-60 days and $12,000 in 61-90 days.”

Board member Jason Lee asked Shepard questions about revenues and expenses.

“The budget is not that accurate, but our operating revenues for the month of December – we missed our budget by quite a bit,” Lee noted.

“That means our budgeted revenue was in for a higher census than we had and then we will see those reductions,” Shepard answered.

Shepard said the budgeted numbers assumed a higher number of patients for the medical center than had actually stayed at the facility.

Shepard said while expected revenues had been projected at $283,000, “we only had $233,000.”

“Is our revenue trending up or down?” Lee asked.

“Down,” Shepard answered.

Board member Craig Zachmeier asked for an explanation of financial reports for December 2019 and the current fiscal year, which ends in March.

“$230,000 is the loss for the month,” Shepard answered. “We had a net loss.”

“Where that came from was projected revenue was $2.7 million and we only had $2.1 million (for the month). For the year, what you’re seeing for total revenue is $19.4 million. So, you have a variance of $2.8 million dollars.”

“The budget was already $600,000 off for the month,” Shepard added.

“For the year, you’re already $3.8 million short, for the year that ends in March. So, you’re at a deficit,” Zachmeier said. “So, any ideas how we make up that $3.8 million?”

Shepard said payroll and contract labor costs pose the biggest budget challenge for HAMC.

“We’re also getting hit with a lot of maintenance – large, expensive items that are coming up that are broken and need to be replaced immediately,” Shepard said, noting the facility’s elevator needed $250,000 in repairs, and the facility’s oxygen system had a cost of $240,000.

Shepard said the number of employees at HAMC had increased with rehires and employees had received pay increases over the year.

However, the increase in employee numbers also includes formerly outsourced positions, such as medical coding and billing that had been moved back to HAMC, saving the facility money.

“It sounds to me like there are things that have to be looked at,” board member Wayne Trottier said.

The board also voted to accept a bid for the former Windshield Doctor building, which the hospital had purchased last year for $253,000.

Local businessman Craig Wollenburg told the Tribune he had submitted the winning bid in the amount of $245,000.

Board members Deanna Marchus and Annette Leier presented human resource and marketing information.

The marketing and human resource committee suggested spotlighting providers and departments, patient testimonials and health awareness and prevention tips in print, radio and social media.

Marchus pointed out a need for activities to boost employee morale and show appreciation for employees.

HAMC Marketing Director Darcie Rose told the board about the employees’ internal media system and efforts by employees to help their community. Rose said employees have started a clothing drive for the Johnson-Dupuis family, who lost their residence and property in a fire.

Interim CEO Jerry Jurena presented surveys that he said indicated issues with employee values and culture. He recommended consulting with Joe Tye, a values coach, for ideas on changing the culture among employees at the facility.

Board member Dick Anderson asked more finance-related questions. Jurena recommended consulting with Darrold Bertsch of the North Dakota Center for Rural Health for insight and financial solutions.

“There are a couple of hospitals that make money year in and year out. The majority of hospitals don’t make money across the state,” Jurena said.

Jurena pointed out rural hospitals meet unique needs in their communities, and no two are exactly alike.

“Everyone has their own niche,” Jurena explained.

Dr. Edward Fogarty presented information on how HAMC’s radiology services could meet patient needs both locally and near the hospital’s Dunseith clinic.

Heart of America Johnson Clinic Provider Dustin Hager presented information on rural health clinics and rural health clinic finance.

Hager outlined Medicare reimbursement processes and regulations for the board.

Hager and board member Anderson also discussed improving appointment scheduling wait times.

Hager also discussed ways to engage employees and spark passion for serving patients in their community.

The board will next meet Feb. 17.

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