NRMC appoints interim CEO, discontinues sports programs

Nevada Daily Mail

The Nevada Regional Medical Center appointed David Hample, of Montrose, Colo., interim CEO starting this week at the board of directors meeting Tuesday.

Hample served as CEO at Montrose Memorial Hospital in Montrose, Colo., since 2009 and as CEO at Jackson Hospital in Marianna, Fla., between 2005 and 2009.

Former CEO Judy Feuquay announced earlier this month she would step down from her position after 10 years with the hospital.

In her report to the board, Feuquay announced the closing of the sports medicine program, which opened in 1995 to treat sports injuries and the Show-Me Acceleration program dating back to 2004, which trained athletes. The administration reviewed cardiology services in regards to wait times and reimbursement issues for hospital right-sizing.

The cuts in programs come after an effort to reduce the overall cost of operations through cuts in labor, supplies, materials and contracts for services. With $575,000 in monthly losses, the administration set a monthly cost reduction goal of $350,000 a month. So far 38 positions have been impacted through attrition, retirements, hourly reductions, and position elimination. Feuquay said around 20 positions eliminated had been vacant.

Of the $350,000, $250,000 is expected to come through workforce cost reduction and $100,000 through operations cost reduction. So far $150,000 has been saved in labor, $58,000 in overtime and $4,000 in employee benefits.

Interim CFO Craig Stewart said the paid full-time equivalents, the number of paid hours, per occupied bed still needs reduction.

"FTEs declined during January to 315 from 331," he said. "We need to get to 280 range. We're getting there but it needs to go down. We need lower payroll."

Feuquay said the administrations goal is to break even by the fiscal year ending in June.

"So far, monthly losses have been cut in half, with the cash hemorrhage slowing to a trickle," she told the board. "We continue to focus on cost reduction, revenue growth, and payor mix improvement. For revenue, we're making visits at tertiary hospitals with patients we have transferred there, and holding those hospitals responsible for the transfer back of patients."

Stewart said the key to improving payor mix, the amount of privately insured patients to government insured patients, is making privately insured people stay in town for services. "Have them choose to come here," Stewart said. "You have to find the reasons why they aren't staying. The people are here who have the insurance, they're just not coming here. The Hospitalist program will help."

The board approved a $155,854 replacement contract with AT&T for Internet, saving $8,000 per month; a $40,000 Midwest Hyperbaric LLC contract to provide consultation and support for hyperbaric services; a $6,000 contract with Litton Pathology for pathology services, saving $45,000 per year; an amendment to the Cerner agreement to lower fee payments by $31,268 per month for the next six months and then add $2,054 more per month spread over the eight year period of the agreement; and a purchase not to exceed $56,000 for Cerner Meaningful Use Software to track and gather data required for meaningful use reimbursement.

Board member William Turner expressed his apprehension of buying Cerner products.

"We need this software to get $1,022,000," Chief Quality Officer Holly Bush said.

In other business, the board appointed CFO Greg Shaw to sign checks, contracts and paperwork and act as Medicare, Medicaid and bond trustee official contact for both the hospital and long-term care facility.

In the CFO report, Stewart pointed out total admissions were 209 for January 10 percent higher than last month. Year to date, admissions are 8.4 percent less than last year. There were 768 ER, 15.5 percent fewer than last month. So far this year, ER visits are down 5.2 percent from than last year. Surgery cases were 68.3 percent lower than last month. Currently surgeries are up by 4 cases compared to last year. There were 1,489 clinic visits, 8.7 percent lower than last month. So far this year, clinic visits are 15.8 percent less than last year. Outpatient visits went down to 3,928, 13.7 percent lower than last month. To date, outpatient visits are 2.7 percent higher than last year.

Stewart said gross patient revenue was $6.9 million for January, $573,000 less than last month. Year to date, revenue was $45.7 million compared to $49.1 million last year, 7 percent lower. Revenue deductions were 62.6 percent compared to 76.9 percent last year. Expenses were $3.08 million for January about $300,000 higher than last January. Wages were $53,000 lower for January than in December, 5 percent under budget.

"You've got a mixed bag of results," he said. "The ones that are down are down a lot more than the ones that are up. The main area of expense increase is under purchased services due to monthly maintenance fees for the Cerner computer system."

Stewart said the net loss for January was $224,000 compared to last January's $1,010,000 net loss. Year to date, the loss is $3.17 million.

"The loss for January is our smallest loss so far for this fiscal year," he said.

In other business, Bush said the hospital retained $552,667 from Recovery Audit Contractor reviews, Medicare subcontracted reviewers who pull records that have been closed for up to 3 years and look for inappropriate payments.

"We had 139 claims reviewed," she said. "We had at risk $632,000 in original payments and we haven't received five determinations totaling $6,421. Net impact was negative $73,249. We have been successful in retaining 89 percent of cash and have an 85 percent successful appeal rate."

Feuquay added progress had been made on building relationships and coordinating surgical outreach with Bates County Memorial Hospital, Cedar County Memorial Hospital and St. Luke's Hospital as well as the hospitalist program, medical physicians who specialize in the care of hospitalized patients and return patient care to family doctors once the patient is no longer hospitalized. The administration is working to fill openings for a psychiatric-certified nurse practitioner for Behavioral Health, RNs, mental health technicians, and acute care leadership.

In the Long-term Care report, Steve Branstetter announced Angela Barrett has accepted the position as administrator at Barone Alzheimer's Care Center starting March 15. She is applying for her temporary license and will sit for the test in the next 90 days.

Branstetter said the long-term care facilities have also hired a new housekeeping supervisor starting March 3.

"Our building looks good and I think she's going to get it where it looks great," he said.

He told the board long-term care will see a 3 percent increase in the Medicaid rate per day, a $40,000 to $50,000 back payment coming in March or April.