Paris, TN –At a busy meeting Tuesday night which saw Henry County Medical Center board members addressing challenges facing the hospital, board members recognized Sabra Fuller for her six years of service on the board.
Fuller was attending her last meeting and said, “I would like to thank all the employees at HCMC for all they do. Please hang in there and don’t let people sway you to make bad decisions about this hospital.”
Board President Dr. Scott Whitby said, “Sabra is a quiet leader and an outstanding leader, and we are going to miss her.”
At last week’s Henry County Commission meeting, Tiffany McCutcheon was appointed to replace Fuller and Dr. Whitby was reappointed. Both are for four-year terms.
At last night’s hospital meeting, board members heard from the firm LBMC on the independent audit for FY2021. Andrew Bissonette, Senior Partner with LBMC, along with Laura McGregor, Senior Manager, presented the report. The report was a clean audit for the organization, with only one adjustment that is an entry calculated by the State Comptroller’s Office and given to HCMC concerning the pension actuarial accrual. This is an entry calculated by the State and given to HCMC each year, as well as other entities who participate in the TCRS program.
“The Accounting team is always wonderful to work with,” said Bissonette. “They are timely, responsive, and we have no issues working with the organization.”
In the independent auditor’s report, LBMC’s opinion of the HCMC financial statements is that financials are presented accurately by management. There was a net increase in financial position of the organization of $5.6 million, with net revenue increasing $2.0 million and a decrease in long term debt of $4.4 million. Patient net revenue has remained stable over the past few years. There was a decrease in salaries and employee benefits mainly due to changes in anesthesia from a status of employment to a contracted service.
LBMC discussed in detail the magnitude of the impact of the pandemic to HCMC from a financial perspective. HCMC received assistance from the CARES act, Provider Relief Fund, PPE loans, CMS advance payment program, and other grant sources. The notes to the audit report explain each of these funding sources in detail.
“This is a public report that is submitted to the State Comptroller’s Office and can be accessed publicly on their website,” according to Bissonette.
HCMC had a positive bottom line of $5.6 million. HCMC purchased equipment totaling $2.9 million, and had investment income of $1.5 million.
Dr. Whitby asked several questions of LBMC, including, “Compared to other clients, is our hospital in poor financial condition?” Bissonette answered “No”. HCMC is in a good position with a positive bottom line over the past two years, he said.
Chief Financial Officer Brad Bloemer provided the financial report for October. This fiscal year, the hospital is not faring as well because of the continuing COVID-19 crisis. “Tennessee just experienced yet another wave of increased COVID-19 cases causing us to yet again pull surgical services. We are being asked to do unordinary things to take care of patients including providing more expensive drugs, buying more equipment and PPE, as well as taking care of higher acuity patients requiring us to take surgeries offline. Currently, year to date we are at a loss of $1.5 million. And yes, with the clinical crisis, we now look to receive more stimulus funding with the American Rescue Plan and the Provider Relief Fund.”
He reported that the hospital recorded a loss of $486,000 in October. In October we had a negative cashflow of $1.3 million due to accounts receivable backlog. Surgeries were 15% below budget as well as a volume of 5% below budget in the ER. Other services experienced decreases in volumes. There were some positives in October with receiving state stimulus funding and having positive investments. Just as October was better than September, the hospital anticipates November to be a better month based on growth in surgeries and patient volumes.
Dr. Amanda Finley gave an update on the graduate medical student program. Everything is on track to have residents beginning in July 2023. For the services we do not offer such as Endocrinology, several Jackson providers have been very accessible and have offered to be a part of the teaching environment for the students.
“From being at the Rural Health Association of TN (RHAT) annual meeting, we are definitely ahead of the curve in the state,” said Dr. Finley. “We are a gem in the State, and we are very excited to offer an Internal Medicine Residency Program.”
“We have graduated eight doctors, with two or three wanting to come back to Paris to practice,” said Lisa Casteel, CEO. “We are a model in the State and building our healthcare and economic development for the community.”
Hospital CEO Lisa Casteel began her report with her regulatory and healthcare news. With President Biden’s Vaccine Mandate, HCMC sent out a policy with the vaccine mandate and approvable exemptions to staff. Due date for those who require vaccination without an approved exemption is Dec. 4 with the second dose by Jan. 5, 2022. If HCMC did not abide by the federal mandate, she said, it would not be able to care for approximately 80% of the population we serve.
The Biden Administration is looking to cut some portion of the Medicaid disproportionate share payments and federal uncompensated care pool funding and HCMC is working with the Tennessee Hospital Association to understand how non-Medicaid expansion states will fair with these potential changes in reimbursement.
COVID-19 hospitalizations have substantially decreased in the state and Henry County, she said. “We are seeing one inpatient at this time. Our County current positivity rate is 7.4%, which is up slightly from 6.7% last month. HCMC has had a wonderful response to vaccination by providing access to vaccine with community clinics and PODs. HCMC held its last community clinic on Nov. 19.
“We are so glad we have been able to grant access and provide education to the community,” said Casteel. “We will continue to provide education for vaccination, not to say that you need to or not need to get a vaccine, but information about the vaccine. Part of our mission is to educate the community about healthcare. We are ending our community clinics because we believe there is substantial access with other entities at this time. Should we need to assist in the future, we stand ready to serve our community.”
Casteel discussed the Surgery Center and continues discussion on repairs with the owners. “People have asked if we are paying rent during this time, and the answer is no we are not paying rent at this time.”
Henry County Health Care recently had a state inspection with a very good report yielding only two deficiencies. “I am extremely proud of my staff and the hard work that they have done,” said Sandra Ray, HCHC Administrator.“We were deemed a low-income community by the federal government in 2016,” said Casteel. “Our bad debts are this amount due to many reasons such as the ability to pay co-pays and insurance deductibles, access to care only through the Emergency Room, and not insured at all.”
“So basically, we provided over $7 million in care and services last year to the community,” Dr. Whitby said. “We are proud of this because it is a part of our mission. That is why we are here.”
Bloemer presented the capital equipment requests for anesthesia equipment and an air conditioning unit for HCHC, for a total of $39,307.
The board member self-evaluation was discussed. In unfinished business, leadership evaluations were discussed. Troy Buttrey has interviewed four companies and working through scope of practices and will bring back to the board in December.