Monday, March 3, 2014
Williamsburg Regional Hospital Board of Trustees is ready to take the next step in improving women's health. The board's approval to allow the CEO the authority to sign a lease/purchase for a digital mammography machine has been the hospital foundation's goal for the past few years. Williamsburg Regional Hospital and Williamsburg Regional Hospital Foundation have worked in tandem to bring digital mammography to Williamsburg Regional after two years of fundraising and planning.
Digital systems are the medically-recognized standard for mammography; digital mammography eliminates film and chemicals used in analog machines. The images are immediately available and can be transmitted from one physician to another. On the local level, Williamsburg Regional Gynecologist and Professor Emeritus of MUSC Dr. James Carter and Chief Medical Officer/Family Practice Physician Troy Gamble, now can send their patients directly to WRH instead of sending them elsewhere for mammography services. These patients, who previously have had to travel elsewhere for digital mammography, now can have prescriptions written to have the service performed locally.
The foundation raised $80,000 in donations that will be used as a down payment on the $280,000 digital system. Foundation Director Debbie Ipock believes that the community was integral in the success of this process. "Over the past two years, the foundation has had two dances, Party on the Porches, and several book and jewelry sales. In addition to these organized fundraising events, hundreds of unsolicited donations came from individuals, sororities, churches, schools, police/fire/city employees, and in the form of honorariums and memorials. This community made this happen, and we thank everyone who gave support."
Williamsburg Regional Hospital Radiology Director Johnny Bowen is excited to move forward with this life-saving technology. "We have had our room measured, and we have picked out a brand-new, state-of-the-art machine for the hospital. We are keeping up with latest technology in detecting breast cancer."
In other business, CFO David Kline had good news. He reported that in-patient revenues for January 2014, was $2.3 million. The average for last year was $1.7 million or an increase of $600,000. Outpatient revenues are up $56,000 verses the prior year. The total gross charges have historically run between $4.3 million to $4.6 million range; however, the January report showed $5 million in total gross charges. "For the first time that I've seen our total gross charges equal $5 million," said Kline. In addition, net revenues of $1.8 million reflect a positive change from $200,000 over the previous year. Kline also pointed to accounts receivable that, over the past five years, has seen increases. The improvements allow for the hospital to pay bills and come closer to stable financial ground. However, positive growth is a two-sided sword.
As a Critical Access hospital, the challenge is to balance strict guidelines with growth or get hit with a retrospective settlement. This year the hospital's good fortune was rewarded with a bill for about $377,000. Medicare determines reimbursements through a methodology. Since the volumes have increased tremendously, the cost to patient ratio formula used by Medicare to determine costs actually hurt the hospital.
Hospital CEO Sharon Poston explained that even though the actual overall costs did increase, Medicare's cost to patient ratio formula says the cost per patient decreased. Therefore, the hospital's costs were not increased but decreased due to the use of this methodology. "It doesn't take into affect the additional nursing and ancillary hours needed for the increased number of patients nor does it take into affect the additional medicines, food, heat, electricity and general overhead," said Poston. "The formula says our costs are more spread out due to the increase of patients. If we had no increase of expenses (like listed above), this would be a true statement. However, our costs increase as the patient volume increases due to increase of staff and materials. CMS determines what costs are valid for our cost report."
Administration has been discussing the possibility of converting back to Acute Care status. If the hospital converts back to Acute Care status it must be able to sustain itself financially for three months during the re-certification phase with Medicare. The cost over the three-month period is estimated to be between $4 and $5 million.