Representatives from Hughes, Welch and Milligan, a CPA firm, were at the Fulton County Hospital board meeting Nov. 24 for the year-end audit report and to answer questions and give an update on the hospital compared to other critical access hospitals in Arkansas.
According to financial consultants Bill Couch and John Ed Welch, the hospital is doing well. Compared with eight other critical access hospitals in the state, FCH ranked first in total inpatient days, fourth in adjusted patient days and the inpatient revenue was the highest inpatient revenue presented. "No one else has a profit from operations," Couch said.
"In your experience, is there one hospital doing better than the others that we can model on?" board member Jerry Estes asked.
Couch said he knew of several hospitals FCH could model on and it would be a good idea to make a phone call and set up some time with one of the hospitals.
Before discussing Richmond's CEO agreement, Richmond gave a speech on all the accomplishments the hospital has achieved.
"I am so proud of the FCH staff (and) how hard they have worked, and how much they have contributed," Richmond said. "They have been stretched and they have grown. There's a wonderful line from Coach 'Bear' Bryant. He said, 'If anything goes bad, I did it. If anything goes semi-good, then we did it. If anything goes great, then you did it.' Well, we have accomplished so much in this short time."
"I have given a lot of thought about what is next and best for FCH, and it's leadership. If I have the board's support, I would like to extend my current (employment agreement) until the end of this fiscal year or through June 2009," Richmond said.
The board was about to go into a closed session to discuss whether or not to keep Richmond as a part-time CEO and extend her employment agreement. However, Richmond waived her right for an executive session. "For my discussion, I would like to waive my rights for an executive session. I would like to discuss it here. This is my team. We've worked together. This is the community. They support us," Richmond said. The executive session was waived and the discussion continued.
"You know, since I've known this crew, I've seen so much transition here from complaints on the street, (such as) 'I wouldn't take a dog to that facility' to good things," Albert Roork, Salem Police Chief and board member, said. "I very seldom hear anything that's bad out on the street. That's real impressive to hear that. That's a result of you and the staff that we have here and the efforts that everybody has put forth. You know I don't have any replacement for you, but I'm going to say, for my part, I don't have any problems with (extending the agreement) at all. But some day, in that future that we're talking about, I'm going to ask you to consider working full-time. I think the facility needs a full-time administrator, and I would love for that to be you."
There was some opposition, though, in having a part-time administrator. "Well, I've got something to say. I'm not voting for a part-time administrator," board member Danny Perryman said. "If Angie wants to be a full-time administrator, that's great, that's just my opinion."
"Well, she's done better than any full-time we've had in quite a long time," board member Sue Hertzog said.
"I'm not voting for a part-time, either. I did the first time," board member Jerry Blevins said.
"Even after the report tonight and hearing what we've done?" Hertzog said.
"If the report was so great, why are we into our line of credit for $200,000 and something dollars?" Perryman said.
"You have made great progress in coming out of the hole. It was a lot bigger hole last year," Welch said.
Though board chairman Dr. Griffin Arnold is not yet allowed to vote on the board, he did have something to say. "I do agree this facility needs a full-time administrator. I really do, but at the same time, I don't think jumping ship with a different captain every year is a good idea either," Dr. Arnold said.
"I'm not (suggesting) that. I'm just trying to put the pressure on her (Richmond)," Perryman said.
Dr. Arnold did caution Richmond that when he does become eligible to vote in the meetings, he will be pushing for her to become a full-time administrator.
The board agreed 4 to 1 and 1 abstained to extend Richmond's employment agreement to June 2009.
According to hospital staff who were present at the meeting, the hospital is going to receive a new phone dictation system on Dec. 15 and 16. It will allow doctors to be in their offices and send a patient's information over any phone. This information will be typed up by at least three people at any given time the hospital staff said. Richmond said that about $60,000 a month is needed for all new equipment. "I'm very proud of the fact that we are able to function at least to the capacity that we are now and have this wonderful technology," Richmond said.
Last week was a bumpy week for the hospital, according to Richmond. "We had a backlog of medical records. We had equipment that was down. We were operating with some old equipment," Richmond said. She also said some hospital employees got sick, so they fell behind in their medical records by $700,000. Richmond said the usual backlog from week to week is about $350,000. She said the problem is now fixed.
Denice Innis, financial manager, said she still needs to pay about $64,000 from October. After payroll, she said, there would be $31,000 left in the hospital's line of credit.
"I'm tickled to death," Roork said. "I can remember when it was three and four months behind. We're current today as far as I'm concerned."
The board discussed what to do with the county sales tax reserve. "You had mentioned, as a board, not to use the county sales tax reserve," Richmond said. She said the board would have to go to the Fulton County Quorum Court to get money from the county sales tax to pay off some of the debt, but not the bond debt.
Welch explained what the bond debt is. "The bond issue cost is some additional costs that we had while we were putting the bonds together. The people who were handling the bonds (and) all the various expenses associated with the bond issue, and we have to advertise that over a period of years. It's kind of like depreciation," Welch said.
"Do we have money in the sales tax fund that we could be using?" board member Danny Perryman asked.
Richmond said, yes, and that the board would have to go to the quorum court to request it.
The board then made a motion, which was unanimously carried, to request the quorum court for anything over and beyond two payments from the sales tax reserve.
In the financial report Richmond said admissions are up 8 percent and swing bed patients are up 150 percent. Inpatient revenue is up from October of last year to $558,571. Swingbed revenue is up from the same time at $122,240 and outpatient revenue is up to $969,852.
Richmond said professional service fees had to go up by $20,000 from last year because the lab is now open 24-7.
An executive session was called to discuss the hospital's quality assurance report.
The next hospital board meeting is scheduled for Dec. 22 at 7 p.m. in the hospital's dining hall. The public is welcome to attend.