Veterans Memorial Hospital experiences positive March bottom line, compares very favorably to other Critical Access Hospitals

by Brianne Eilers

The month of March ended on a positive note, financially, for Veterans Memorial Hospital (VMH) in Waukon, with a net income of $63,379 dollars, translating to a 5.1% profit margin. VMH Administrator Mike Myers noted that while acute patient days and skilled patients day were “essentially flat” for March, the area of deliveries continues to grow. For March, deliveries were up 14% over the same time last year.
He also pointed out that while surgeries are down 8.1%, last year was a pretty busy year for surgeries, and VMH is about where they anticipated being at this time for surgeries. Outpatient physical therapy is strong, up 29.1%, while Emergency Room visits are also flat. Myers also noted that last year, beginning in April, VMH lost approximately $180,000. This April looks like it will also be a strong month.
VMH continues to work on the number of days in Account Receivable, which is currently at 76.8. Myers explained that there has been a backlog, and in addition to the hospital being busier, it makes it harder to catch up on the backlog, but the hospital is working at getting that number back down again.
Myers also talked about the amount of debt VMH has, compared to other critical access hospitals (CAHs) in Iowa. The comparative data looked at a five-month period from July to November of 2013 to July to November 2012. The average critical access hospital in Iowa averaged $494,000 in that five-month period in tax support, but VMH received $0 in tax support. VMH’s average operating margin for the five-month comparative period was 1.4%, while other CAHs was -2.5%. When looking at depreciation and interest expense, VMH’s was $307,175 while other CAHs averaged $925,424.
“Basically, you can see that’s where our margin is. We don’t have much debt,” Myers said. “We aren’t carrying a lot of debt and we are getting supported by our patients who want to come here and our medical staff who treats them here.”
Myers also noted that he recently listened to a speaker discussing changes coming in the healthcare industry. Myers noted that it is an exciting time and a stressful time in the healthcare field. Communication with the public will be a key factor in what will be happening. Myers noted a big change that has come is that they have to pre-authorize many procedures and orders, like physical therapy, so they are looking at how to address that.
VMH continues to move forward with its electronic medical records project. Myers noted that they are on track, and have weekly telephone meetings. In May, they will be testing the lab interfaces. The electronic medical records will allow for patients to get results quicker. Results will go directly to patients’ charts now, instead of getting things printed out and sent out.
“Things are going well, but there will be glitches and processes that we will need to change and work on,” Myers noted, but he said that the medical staff is also providing good input on things they have seen and glitches they have seen so VMH can try to plan ahead. VMH is also evaluating, due to the increased numbers, the space needs for its OB department in the future.
Myers and VMH Board of Trustees member Dennis Lyons will be travelling to Washington, D.C. to hear what lawmakers have in store for Critical Access Hospitals. Myers noted that CAHs are once again being looked at for making adjustments, which could decrease payments to those hospitals and decrease their ability to participate in the program. “I personally believe that is devastating to rural America’s healthcare,” Myers said.
Myers also discussed the physical supervision provision, which mandates that physicians supervise certain procedures. Myers said that the Iowa Hospital Association and American Hospital Association are not necessarily in favor of that, especially in rural areas, where physicians have many patients at the clinics during the day, and would be expected to put all that on hold to come to the hospital and sit there and watch certain procedures taking place. “We are trained to do those things, and we are trained to call them (the physicians) to come over if we need them,” Myers said.
Myers also gave the example of a cancer doctor who might visit a hospital once a month. Theoretically, his patients could only receive their chemotherapy treatments that one day a month at their local hospital, and the rest of the time they would have to travel to another facility that can supervise the treatment, which could be more expensive, not to mention the travel and time that would need to be taken off from work and other arrangements to make those trips.
Myers also mentioned the strategic plan updates for VMH. Myers noted that 74 staff, physicians and board members and leadership provided input. Myers noted that there will be opportunities for education and also to make it so that everyone is communicating well. The plan goes out about three years, and will focus on customer service. Myers said that there will also be a mailing going out to people in the area to see why they might not be using VMH.
Board of Trustees member Dave Stangeland has resigned, and the Board will be appointing someone to fill out his term. That process is currently underway.