At the Dec. 21 meeting of the hospital's Board of Governors, it was discussed that Dr. David Kauffman has been helping the facility with its utilization review process. According to Tammy Friel, every morning Dr. Kauffman and Christy Busby review the charts of the patients on the floor to make sure they meet medical necessity based on the Medicare guidelines. "They are reviewing the charts to make sure they meet medical necessity so that Medicare won't take money back from us," said Friel. "Dr. Kauffman also helps with medical records, and if anyone has an issue with coding, he can help sort the coding out."
Hospital Administrator Joe Hammond said Dr. Kauffman also serves as a resource for other physicians regarding the details of qualifying the admissions or ongoing stays. "He makes sure we meet Medicare guidelines for admissions and treatment. And he ensures that we are doing the correct documentation," said Hammond. "He's been a tremendous help."
The process of ongoing utilization reviews has been outlined in a new plan presented by Chief of Staff Dr. Griffin Arnold, to the board members. Administrator Hammond noted that proper documentation is crucial to the hospital's future. "Regardless of what the future holds, the bottom line is the future of medicine and provision of health care in this country is going to be more strictly regulated," said Hammond. "To the degree that we are able to control the utilization of resources within our facility, we will be in a better position moving forward. I am very pleased that we are this far ahead of the curve."
Dr. Arnold also commented on the staff's progress with the back log of charting discussed at last month's meeting. "Last month we had about $800,000 out in charting to be billed, and we have halved that to around only $400,000 in charting to be billed," said Dr. Arnold. "We are continuing to work that down. It's a constant influx of new charts coming in and then trying to complete what was previously existing."
Dr. Arnold also extended a warm thank you to the board from the ambulance crew for the new equipment they've received, including the larger ambulances. "The big ambulances allow them to much more effortlessly transport two people at a time to the same facility," said Arnold. "It's nice for them to have room to work with."
Moving on to the financial report, Hammond pointed out that the hospital dipped into its sales tax revenue fund to cover payroll, taking out $73,000 and later depositing the $24,695.81 allocated this month by the county quorum court. The balance currently stands at $39,482.94.
Last month, the hospital posted a loss of $119,497. Looking at the year to date numbers, the hospital stands at a loss of $496,815. However, Hammond pointed out that by utilizing the money in the hospital's contingency fund, the actual year to date loss is only $199,526. "When you take into account the fact that when Kauffman dropped out we lost 40 percent of gross revenue, and when Dr. Bozeman went into the hospital shortly thereafter, we lost another 20 percent," said Hammond. "So for six weeks, we lost 60 percent of our gross revenue. That's where these lag numbers are coming from."
The hospital is continuing its search for a new physician, keeping the lines of communication open with Dr. Peter Lee Bee and setting up interviews with two additional potential physician candidates in early January. Hammond stressed that he is working hard to find a way to bring Dr. Bee to the hospital, even though there are some hurdles to jump through to achieve that. "We are trying to clear the way for him to be placed here," said Hammond. "I'm working right now with various offices in Washington, but our next approach is to get HRSA to waive the penalties and interest on his loan so we can bring his financial obligation down from $286,000 to $175,000 on principal alone, at which point, I believe it will be allowable for us to amortize that and get him placed here." However, as pointed out by Board Member Danny Perryman, the hospital would still have to wait for Dr. Bee to arrive until May 1, 2010, and that may be too long of a wait.
Hammond is also scheduled to speak with an area podiatrist about adding Salem to his visitation list and working out of the hospital to see local patients. "With the nursing homes in the area and a number of diabetics, it would be a big benefit to the community," said Hammond.
The board then went into executive session to discuss personnel issues. No further action was taken following their discussions.
Before adjourning, the board did vote to declare the old Ford ambulance as surplus property, and to advertise for sealed bids at a date to be determined.
The board then adjourned for the evening.