Hospital Board Approves 2019 Capital and Operating Budgets

Texas County Memorial Hospital board members approved a $1.2 million capital budget at their monthly meeting on Tuesday.  The majority of the funds are allocated to purchase a new ambulance, fund the 5th annual installment for the surgery infill, implement a new electronic medical record (EMR) for the emergency department and replace switches for the hospital network.

Linda Pamperien, TCMH chief financial officer, presented the budget data for 2019.

The capital budget is a decrease of $172,062 over that of 2018.

Included in the capital budget is $135,000 to be used to implement an EMR in the emergency department.

According to Pamperien, the implementation of an EMR for the emergency department is critical to improving patient care and will increase the staff’s efficiency both in the emergency department and on the inpatient side.

Amanda Turpin, quality director reported that there is some really good work occurring behind the scenes to make improvements in the emergency department.

“Teams have been established to work on initiatives to improve all different aspects of the emergency room care,” Turpin said.

“We look at statistics every day so we can measure how we are doing.  Since July we have significantly reduced the amount of time that our patients have to spend in the emergency room,” Turpin said.  “We started out with an average number of 158 minutes per patient spent in the emergency room, and in November we cut that down to 130 minutes.”

According to Turpin, the established teams meet regularly and they are continuously working on things that will improve patient care even more.

Pamperien explained that by implementing an EMR in the emergency department, it will also help the patient experience by expediting the admission process and it will reduce potential errors that can occur in dealing with paper, leading to better patient safety.

Also in the 2019 capital budget is $140,850 to be used to purchase a new ambulance for the emergency medical services department and $100,000 to replace switches that keep the hospital network running smoothly.

The surgery department will require a few new and replacement items in 2019 in addition to the $110,000 that has been allocated for the infill of the new surgery center.  The items will include two new anesthesia machines that will cost $45,000 and two new scopes for the surgery department that will cost approximately $39,000 each.

Other major expenditures in the capital budget were $125,000 to purchase a new 3D mammography unit, $43,332 to strip and seal the hospital parking lot, $40,000 to be used to purchase a new intensive care unit (ICU) bed, $32,005 to purchase new peripherally inserted central catheter (PICC) line equipment and $70,000 has been allocated to be set aside for any emergent capital needs that require replacement in 2019.

For the 2019 operating budget, board members approved a net operating budget of $84,335,881 that projects excess revenue over expenses of $109,909.

“With this year’s budget we are accounting for increased revenue from the addition of Matthew Brown, MD and Tricia Benoist, MD.  We are also anticipating that all three of our brand new physicians that started this past summer will become much busier in their practices,” Pamperien said.

According to Pamperien, there are additional costs with the start of new physicians, but when a physician practice is established, the return on the investment is good for the hospital.

“Currently each of our top four primary care physicians are generating an average of $2.9 million in inpatient revenue and $1.7 million in outpatient revenue,” Pamperien said.

The 2019 operating budget anticipates a 6.2 percent increase in inpatient revenue, a 12.9 percent increase in outpatient revenue, a 5.5 percent increase in emergency department revenue and a 3 percent increase in swing bed revenue.

“We are budgeting again to have a positive bottom line of $109,909 and we anticipate that revenues will continue to be very good as we look ahead into the new fiscal year,” Pamperien said.

Pamperien anticipates the “contractual adjustment”—the difference between the hospital charge and the portion of the charge covered by insurance, Medicare and Medicaid—will decrease by .7 percent in 2019.  The 2019 operating budget anticipates a contractual adjustment of 62.5 percent.

Inpatient revenues were up, but our outpatient revenues were down in the month of November resulting in a negative bottom line of $276,201 and a negative year-to-date balance of $456,219.

Present at the meeting were Wes Murray, chief executive officer; Pamperien; Doretta Todd-Willis, chief nursing officer; Rachel Davis, director of public relations; Turpin; Jonathan Beers, DO; board members, Jim Perry, OD; Omanez Fockler; Janet Wiseman; Mark Hampton and guest, William Mahoney, CoxHealth Representative.

The next meeting of the TCMH board of trustees is Tue., Jan. 22 at 12 p.m. in the hospital board room.