NRMC still in the red

Nevada Regional Medical Center's financials sank further into the red, with a net loss of $741,942 for June and $5,654,864 year to date.

"$440,000 of this loss is because we needed to adjust contractual allowances and revenue was over recorded because we didn't have good numbers out of the system," Chief Financial Officer Greg Shaw said at the Financial Strength Committee meeting Tuesday.

After reviewing the new numbers, Shaw said he increased contractual allowances, the difference between what the hospital bills and what it receives in payment from mainly government programs.

Shaw blamed the Cerner billing system for incorrectly classifying insurance payers and aging accounts, causing the Patient Financial Services department to pull out and analyze financials by hand.

"I'm not sure how they are going to fix it, if it can be fixed," he said. "This (manual analysis) is kind of a stop gap measure so that we can have accounts receivables (payments due) that we can trust."

IT director Chris Crist said one of the IT department's employees would work with the PFS department to resolve the Cerner issues.

"There's a lot of problems from the Cerner perspective," Crist said. "Service requests, work orders, take a lot of time to stay on top of, and if you don't respond to Cerner within a certain amount of time, they close the request. This individual will be the go-to person to deal with those requests and resolve those 21 problems identified from the PFS standpoint."

Shaw said the PFS department is still in the process of closing out for the year, and by the end of June all the accounts will be reconciled.

"Once we get the financial statements closed and the year end closed, that's when we start the budget process in earnest," he said. "Every section of the income statements is up for grabs. You have to look at every line item on this thing in order to make improvements."

Shaw said the good news is volume increased from the depressed levels seen in February.

Discharges are now 6 percent below the prior year, compared to 12 percent below in February. Outpatient visits have increased from 4 percent above prior year to 5 percent above in June. Clinic visits were down by 15 percent in February and are now down by 7 percent.

Interim Chief Executive Officer Dave Hample credited general surgery services and overall atmosphere to the increase.

"I think the orthopedists will help even more," Hample said. "I think you just got to keep working the word of mouth thing so the community feel like they're comfortable coming to NRMC. We still hope the hospitalist will retain more inpatients than we have in the past. It's the attitude of the people, physicians and community coming together. I hope we're just starting to see the first of this upward trend taking place."

Hample suggested making up the hospital's losses by increasing revenue by $2 million, decreasing contractual allowances by $2 million and decreasing expenses by $2 million.

In other business, approval items to be brought before the NRMC Board of Directors include a $4,800 agreement for medical directorship of Cameron Crymes for Home Health and Hospice, a $2,400 agreement for backup medical directorship of Rick Kellenberger for Home Health and Hospice, renewal of lease agreement for podiatry services by Glenda Young and renewal of lease agreement for cardiology services by Freeman Hearts.

In the technology committee meeting, IT director Chris Crist said IT reduced expenses by $519,131 with $449,160 of that in annual expense reductions.

"My goal by December is to hit the $750,000 mark, and my ultimate goal is to reduce expenses by 65 percent from what it was when I first got here," he said.

In the long-term care committee meeting, administrative officer Steve Branstetter said Moore-Few Care Center and Barone Alzheimer Care Center had a very good budget year.

"We had an average daily census total of 113 versus budget of 112," he said. "That's the first time we've been over budget in more than a year. Medicare census was 12.53, which is the highest for the past seven months. We had good payer mix and good census, which resulted in a net income of $48,087 for the month."

Year to date the facilities gained $147,826, compared to last year's $563,439 loss.