Veterans Memorial Hospital experiences positive October; Decision on Critical Access funding looms

by Brianne Eilers

The month of October ended on a positive note financially for Veterans Memorial Hospital (VMH) in Waukon, with a net income of $58,962. Skilled patient days, acute patient days and deliveries were all up in comparison to last year. Outpatient lab, outpatient radiology and outpatient physical therapy were also all areas that experienced increases over last year.
Some areas were down, including emergency room (ER) visits, total surgeries, outpatient MRI and cardiac rehab. VMH Administrator Mike Myers commented that in some areas, like ER visits, there may not be a lot of growth for the fact that both Gundersen Lutheran and Mayo clinics have a full staff of physicians, which makes it easier for patients to get in and see someone if they are having problems.
Expenses were kept under budget by 2.7% in October, which also helped keep a good bottom line. Myers anticipates that November will not be as strong of a month financially. "October was a good month, and since June, we've done well financially," Myers noted. Myers also announced that VMH will be receiving the Guardian of Excellence award from Press Ganey for patient satisfaction scores in the ER department and inpatient services (see article on front page in this week's edition of The Standard).
The project to remodel patient rooms at the hospital continues on, but Myers said he thought that it should be wrapped up before Christmas. Funds from a contingency budget approved earlier in the year will be used to repair some areas of the roof that are leaking, including an area on the administration side and another over the lockers by the Emergency Room. VMH is also in the process of finalizing work on a CT scanner upgrade, which should take place after the first of the new year.
The annual Christmas Fantasy was again successful. "It had a very strong revenue, had a lot of donations," Myers noted. "The support was phenomenal, it was a tribute to all the businesses who support us and all the people who come and support us."
Beginning in October of 2014, a new coding system called the ICD10 will be used for medical records at VMH. Staff is already beginning to learn about that system, which is more detailed than what is currently used. Myers noted that the new system will require physicians to be more specific in their documenting of patients. Myers gave the example of a patient coming in with a cut, and explained that physicians would have to document how long the cut is, how many stitches were required, etc.

Myers also discussed information on Critical Access Hospitals (CAHs) in America. VMH is designated a Critical Access Hospital. There are 1,330 CAHs providing essential medical care to rural communities in the nation in 45 states, each maintaining 25 beds or less but contributing an average of 204 jobs to local economies. It is estimated that seven million patients are treated in CAH emergency departments each year. In addition, 38 million patients use CAH for outpatient services, and 900,000 patients are admitted to CAH annually. CAH deliver 86,000 babies each year.
Myers noted there is discussion at the national level about making changes to the way CAH are funded. Currently, 38.1% of CAH have a negative operating revenue and 30.67% have a negative total margin. Compared to some other CAH facilities, VMH is "doing okay," according to Myers.
He noted that CAH make up nearly 30% of the acute care hospitals in the country but receive less than five percent of the total Medicare payments. "That's why we have to make sure and why I fight to make sure they don't mess with the CAH program," Myers explained. "Quite honestly, if the CAH program would go away, I'm not sure what we would do." He further noted that if the CAH program ceased to exist, VMH would lose between $800,000-$900,000 of revenue each year, and this is an issue that Myers has been monitoring closely and will continue to monitor.