Mississippi County Hospital Systems is bracing for a significant drop in revenues which began in October and will continue to occur for some time due to the recent passage of the Affordable Care Act and the Medicare expansion in Arkansas.
According to a report from CFO Randy Nichols, the system will eventually experience an 18 percent reduction in Medicare reimbursement, which adds up to approximately $750,000 a year. The only possibility the system has of getting these funds back, he said, is through the slow and not-guaranteed process of people signing up for government-sponsored policies and coming back into the system as insured patients.
"Some of them may eventually trickle back in with insurance," he said, "but it is still going to be a loss."
As of the end of September, the system had cash and equivalents in the amount of $538,030. GRMC showed a net income of $127,076, and SMC showed a net loss of $136,561. For the nine month period ending in September, the two campuses and the system's physician services showed a net loss of $1,691,420.
Staffers at MCHS are also working to address a drop in HCAP quality scores which were reflected after the system changed the vendor company which offers the quality surveys to the hospital's Medicare population. According to clinical services director Connie Ash, the significant drop in scores was expected, and have come in areas such as communication with nurses, information about medication and followup treatment, and cleanliness of rooms.
The surveys, which are sent to all of the system's Medicare patients after their release, are now being offered in writing by mail as opposed to over the phone, and were expected to offer up more realistic scores, which can now be broken down into even more specific question categories than before.
"Now we even know which unit of the hospital is being implicated, and can specify and focus our efforts on areas that need improvement," she said.
C.E.O. Ralph Beaty added that the administrative team works with staff without addressing the need to raise scores, but by focusing on making things work the way that they should; however, the scores are important, as they are tied to Medicare reimbursement.
New machinery is on the way for both hospital campuses. Chief operations officer Chris Raymer said that ultrasound machines at both hospitals, as well as the CT machine at Great River in Blytheville will be replaced with new equipment from Toshiba. Raymer said that it was cheaper to purchase the new equipment than it would be to maintain the service contracts on the older ones. Raymer also told the board of governors that GRMC will once again be conducting sleep studies as of some time in November.
In his report to the board, Beaty discussed the system's employee situation. A recent employee satisfaction survey showed an increase in overall scores from one that was conducted in the fall of 2012: on a scale of one to five, with five being the highest, the average score given by employees to describe their overall job satisfaction was 4.1. Staffing is an issue of concern for the hospital financially, however, and Beaty said that departmental reviews have been underway to look at ways of sharing employees across the system and cutting down on traveling staffing groups.
"We've had to take a hard look at our staffing," he said. "We have a patient volume increase recently, but it's seasonal and it's coming on the heels of a very slow summer ... salaries are a controllable expense and one we have to look at."
Beaty also told the group that a new surgeon, Dr. Steven Mason, is planning to relocate his practice to Blytheville and will be ready to practice by the end of January 2014. Mason will require a salary guarantee at first, but does not wish to be a long term employee of the hospital system and will eventually set up his own billing system.
The board also approved a batch of new and revised HIPAA policies, including new policies on removal of patient information from electronic equipment, student immunization, and disclosure of psychotherapy notes.
Special permission was granted for Morris Sue Woods, a representative of the Osceola Hospital Auxiliary, to address the board before their dismissal. Woods wished to express her disappointment and unhappiness with the way the system is handling its Osceola campus.
"I do not understand why when something has to be cut, it has to be replaced with something else, and the buck always stops with Osceola," she said. "We don't have a switchboard anymore, people are calling and asking for departments and being transferred to Blytheville, and they don't even know it. Our front desk cannot be managed by just one person, jobs are being taken away from Osceola and sent to Blytheville ... things are going back to the way they were forecasted to be in 1967 when they said we would be an emergency room only. Osceola started out in the black back in those days, and had departments and other things taken to get Blytheville out of the red, and when Blytheville has old equipment it gets sent to us when they get new replacements. I am just very disappointed with the way things are being handled."
Beaty told the board that he would set up a visit to SMC to hold a question and answer session with staff and volunteers to better explain the reasoning behind recent changes.
sharris@blythevillecourier.com