Houston, MO—Texas County Memorial Hospital ended 2020 with total operating revenues of $33,360,469 hospital board members and administration heard at their monthly meeting on Tuesday. The number represents an improvement of 3.01 percent over the county hospital’s total operating revenue in 2019.
David Taylor, senior manager at BKD, LLP of Springfield, MO and Stephanie Weis, partner at BKD, presented the annual audit report at the monthly meeting.
“As in past years, TCMH had excellent cooperation during the audit with information being timely, accurate, and was overall a really good process to get through,” Taylor said.
The hospital closed out 2020 with improved operations of $1.3 million.
“TCMH has done an outstanding job of managing through the pandemic in terms of trying to capture the revenues that were out there and watching expenses,” Taylor said. “All of this together amounted to great results.”
Taylor explained significant amounts were received in 2020 from the CARES Act and Federal Covid programs that impacted financials. Uncertainty remains on federal programs, especially the Provider Relief Funds. These funds were distributed by the government without the request of the hospital and were high in comparison to our size, so it does create an elevated risk of repayment. Guidance and regulations around the federal funding is still evolving, so a conservative approach to retaining those funds has been made.
“TCMH received $9.6 million from the Provider Relief Funds,” Taylor said. “To date we have only recorded $3.3 million from the PRF as revenue, which is quantified with our Covid related expenses.”
“Our hospital received more funding compared to other facilities as we qualified for a PPP (paycheck protection program) loan,” Taylor noted. “We are doing our very best to retain those funds as an application has already been completed for forgiveness of the loan.”
Taylor explained that in 2020 TCMH had gross revenues just under $75 million, a 4.24 percent decrease over 2019, while our net revenue increased 3.01 percent to just under $34 million.
“It is quite remarkable that TCMH managed to increase net revenue while gross revenue went down,” Taylor said. “It reflects that a lot of proactive management was put in place to capture and collect what we could, along with securing extra funding from prior years.”
The days cash on hand for 2020 was 230 compared to 54 days in 2019.
Taylor explained that the significant impact to the increase in days was largely due to the advanced payments and federal money that came into the financial statement.
“Overall the finance team and entire TCMH staff is doing a great job,” Taylor said.
“I want to congratulate Wes on his upcoming retirement and commend everything he has done for the organization and his leadership,” Taylor said. “He is leaving TCMH in great financial and physical shape.”
BKD sends an audit team to TCMH each March, spending about a week pouring over hospital financial information from the previous year. The firm takes about a month to complete the audit information including expense statements, balance sheets, statement of cash flows, and other information that comprises the financial report documents presented at the April board meeting.
BKD uses historical TCMH data and data from other healthcare facilities for comparison purposes during the audit. BKD also has access to the latest information regarding hospital payers which helps the firm reach concrete numbers in the final audit report.
Joleen Durham of Bucyrus was sworn in for a new five-year term for the TCMH board of trustees. Jim Perry, OD, TCMH board of trustees’ chairperson, administered the oath of office to Durham.
TCMH Board of Trustees elected their officer positions for the upcoming year with Perry as chairperson, Loveland as vice chairperson, and Durham as secretary.
2021 Medical staff reappointments were reviewed and approved by the board of trustees.
Linda Pamperien, chief financial officer at TCMH, presented the financial report for the month of March.
“Overall revenues were up by $284,971 for the month, which is a 4.4 percent increase from our budgeted expectations,” Pamperien said. “We had an 11.3 percent decline in our inpatient volumes as we were down by $156,331.”
Pamperien mentioned outpatient revenue was up $513,108 for the month, which is a significant turnaround after experiencing declines the first two months of the year. There were substantial increases in surgery, anesthesia, radiology, CT, and MRI for March.
“Our overall expenses were down this month,” Pamperien said. “We were under budget by $255,673, so we are continuing to manage our expenses well.”
Bad debt for the month of March was $327,391.75.
Pamperien noted that the contractual adjustments for the month were 62.2 percent for the month and 61.5 percent year to date.
“The hospital ended the month of March with a positive bottom line of $20,911 and year-to-date with a negative bottom line of $239,540.” Pamperien said.
In old business, Wes Murray, TCMH chief executive officer, reported the roofing repair project will begin soon with completion taking approximately four to six months.
Murray mentioned Covid lab tests were down with only 200 in-house tests, 38 tests sent out, and only 11 positive results.
“TCMH is at a 4.6 percent positivity rate, which is really low compared to our high of 37.39 percent.” Murray explained. “Being under 5 percent is very good and we hope that continues.”
Amanda Turpin, TCMH chief nursing officer, reported that TCMH’s first ever drive thru Covid vaccine clinic was held April 15 and 91 Moderna vaccines were administered. The 2nd dose of the vaccine will be given on May 13 to those that received their 1st dose on April 15th.
“TCMH has given 2,483 Covid vaccines overall,” Turpin said.
“The local interest has dropped off considerably,” Turpin mentioned. “Going forward, we will be shifting away from the big mass clinics and working to administer Covid vaccines in the clinics.”
In new business, Courtney Owens, quality director, presented the QAPI (Quality Assurance and Performance Improvement) report. All quality reports for 2020 year end, the 2021 plan, and the first quarter are completed and up to date.
“I feel all of our departments have excellent plans in place for TCMH to be successful,” Owens said.
Helania Wulff, director of public relations, marketing and physician recruitment mentioned that TCMH hosted a potential internal medicine physician visit on April 5 and 6.
“We are also currently seeking a general surgeon and two family medicine with OB,” Wulff said.
Pamperien mentioned the Sleep Lab was recently reaccredited, as it is a requirement to be recertified every three years.
“We had a couple of deficiencies that were noted and fixed,” Pamperien said. “Overall the accreditation went very well.”
Murray mentioned the USAC (Universal Service Administrative Company) funding program and that it has been very beneficial to TCMH.
“Since 2014, we have received over $300K in funding assistance for fiber optic network cost through USAC,” Murray stated.
Murray mentioned that an application had been submitted and approved to FEMA for a new 450KW Cummins generator to replace the oldest one we currently have.
Murray mentioned the TCMH Healthcare Foundation has been working with the Missouri Department of Public Safety to get funding on two more MOSWIN radios for the ambulances. The cost of these radios is $17,804. They will allow access to all channels including 911 services anywhere throughout the state in the event of Homeland Security or an area disaster.
Turpin mentioned the upcoming Nurse’s Week May 3-7. We will provide skills labs, scrub sales, and a celebration luncheon announcing our Daisy Award winners on Friday.
Murray mentioned Hospital Week will be May 10-14 with several activities throughout the week to show appreciation to our staff.
Present at the meeting were Murray; Pamperien; Turpin; Wulff; Owens; Chris Strickland, chief executive officer; Linda Milholen, chief of staff; Anita Kuhn, controller; Renina Pearce, administrative secretary; board members, Perry; Branstetter; Durham; Loveland; Pierce; guests, Taylor; Weis; John Casey, Texas County Commissioner; Brett Huffman, representative from Jason Smith’s office.
The next meeting of the TCMH board of trustees is Tuesday, May 25 at 12 p.m. in the Jayson Gentry Community Safe Room. Due to COVID-19 and social distancing restrictions, you may attend the meeting via teleconference. To attend the meeting via teleconference, please call (417)967-1236 and you will be placed into the teleconference meeting.
