Hospital Administrator Joe Hammond announced at the Hospital Board of Governors meeting that Dr. Ahmad Saab has accepted the hospital's offer to become the new family practice physician. Dr. Saab and his wife, Ajla, have three grown children and will be relocating from Temeculah, Calif. He will be able to start with the hospital once his license application has been cleared by the state, a process which can take up to six months. He will utilize Dr. Kauffman's old clinic behind the hospital. "He will be in his clinic four days and one day in the ER," said Hammond.
The hospital is continuing its search for an internist, according to Hammond. "We are still looking for an internal medicine physician," said Hammond. "Dr. Peter Bee was the only internist we have looked at so far. The placement company has agreed to continue the search for another 60 days under the same terms of our original agreement to try and find us an internist."
Looking at the hospital's financial report, Hammond stated that the hospital's year to date loss as of January is $979, 570. Subtracting the use of contingency funds for needed hospital improvements from that total led to an overall loss of $655,027. It was pointed out by Board member Bill Pace that utilizing the contingency funds as a credit to the revenue statement was an incorrect accounting procedure, and that the actual loss of $979,570 should stand as the correct loss amount. The contingency funds being used by the hospital are left over funds from a construction project that has been earmarked for repairs and improvements at the hospital.
Hammond also added that the hospital has received the payable from Medicaid reimbursement from the hospital's cost report and used $50,000 of that to pay down the amount borrowed from the facility's line of credit at the bank.
In the statistical report, Hammond discussed the drop in revenue from the various departments. "As of January, laboratory is down $870,000 from the same period of time last year," said Hammond. "Inpatient is down $312,000. Emergency room has increased, up $48,000. The physician's fees which we collect are up $2,362. X-ray is up $129,257. Physical therapy is up $232,377. Central supply is down $326,000, pharmacy is down $327,000, and so on. A recent report from Modern Healthcare magazine said that by and large hospital revenues are down 61 percent, and last Friday's Arkansas Gazette stated that UAMS lost $1 million just last month. It's a very difficult time to be in healthcare."
In a continuing effort to cut costs at the hospital, Hammond discussed a merger of the business office and admissions departments, which has already increased efficiencies in billing. "In Nursing, we went from 40 hours to 36 hours, which brought our FTE (Full-Time Employee) count down this pay period by four," said Hammond. "That's not necessarily four people; it is just the full time equivalent of 80 hours in a pay period. The weekend incentive is 10 cents an hour. It is a 60 hour weekend period that amounts to six hours. During this time period, there are a number of people working this spot. That's a $6,700 annual opportunity. We're working one FTE short in housekeeping and that saves $22,280. We're going to give our grease away instead of paying someone to take out the grease from the grease trap, saving us $1,900 a year. We're reducing our exterminator visits from twelve to seven a year, saving $900. We adjusted the dietary department for a $7,700 savings. We put a cardboard bin out for boxes in order to eventually eliminate one dumpster to save over $6,000, and Maintenance has voluntarily foregone their $10 a night on call pay for a big savings for us. We tried to find as many opportunities to save as we can while preserving as many employees as possible."
One other potential cost savings was discovered connected to the new Paid Time Off policy that the hospital instituted in December. "Our paid time off, or PTO program, had a leak in it," said Hammond. "I have moved to plug that leak, where sick time was being used in some instances if a person worked 72 hours, they would take from sick time to make up an 80 hour week. Typically, any place I've ever worked, the first day of sick time comes out of your paid time, your vacation time. So I have added this policy in, to save the hospital some money in the long run."
Board Chairman Al Roork then asked to speak on behalf of the Board to the hospital employees. "On behalf of the board, we appreciate the job that the employees are doing, the sacrifices they've made for the good of the hospital," said Roork. "They make this facility what it is, and it is such a vital part of this community. It's survived a long time through many hardships, and it will survive this too. We have some lean times ahead for a while, but with that said, we appreciate all you're doing."
Next up was a discussion on the number of patients being admitted to the hospital, which has been on a steady decline this fiscal year. "If you just looked at the number of physicians who admit their patients, it's not a big number," said Chief of Staff Dr. Griffin Arnold. "We get a patient influx from a lot of doctors who are not at this facility. If we take care of other people's patients, we need to do so in a very good manner, so they feel comfortable sending people to us."
Administrator Hammond then brought up that Dr. George Thompson Grey had accepted a position with a facility in southern Arkansas and would no longer be readily available to the facility. "He would have time to come and work with us on occasion, but he didn't see the feasibility of purchasing extra insurance in order to work here one weekend out of the month, so consequently he said he can't be a help to Dr. Bozeman anymore," said Hammond. "Dr. Bozeman and I looked into the insurance issue, and found out that there is a slot-policy available, for a designated annual premium, where any physician that comes to work here would be covered under that slot policy to work here only. The first year's premium for this policy would be $10,383. The second year through fourth year is $20,864 and $24,622 any year following."
"I would be in favor of the hospital having the insurance, so we could cover whomever we wanted to," said Board member Jerry Blevins. "If we can get this implemented, it would help Dr. Bozeman recruit a physician very quickly, like as early as March," said Dr. Arnold. Seeing the advantage to the hospital, the Board voted unanimously to obtain the slot policy coverage.
Dr. Arnold then presented his Chief of Staff report to the Board. "Last month I stressed that I feel like, from the general medical staff, that to improve the strength of the hospital we need to improve the services of the facility to the outlying physicians," said Dr. Arnold. "I think that is a major goal. I don't know how to achieve it, but it's what we need to focus on. Historically, our outpatient services revenue has been twice what our inpatient is. We've got to improve our outpatient aspect of things. That's radiology, physical therapy and laboratory. Basically Fulton County Hospital would be utilized more often if the speed of our services was faster. The physicians will use us if they get results fast, bottom line."
On the medical records issue, Dr. Arnold reported that the number of outstanding records continues to get smaller, and that the new swing bed department has been doing very well. "We've had some growing pains, but I think it's a very good thing for the hospital, and with Dr. Saab coming here, it will be a big help on admissions."
Administrator Hammond then brought the idea of a Strategic Planning back up to the Board, an item that had been postponed from the last meeting. "With Dr. Saab coming in, it would be a good time to get together and discuss some things," said Hammond. "Strategic planning is very important for a critical care hospital. I would suggest we put together a strategic planning team including the chief of staff, myself, the chief operations officer and probably one or two others to put together the bones of a strategic plan, and then bring that to the board for further discussion. I think that would be a good use of our time." The Board agreed and Hammond hoped to bring additional information to the March meeting.