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Seneca has banner month; Inks deal for electronic medical records

M. Kate West
Chester Editor

“I’m going to say this is a heck of a board meeting we are having today from the standpoint of our financials and the decision the board will be making about an electronic medical records system,” Seneca Healthcare District Chief Executive Officer Doug Self said Feb. 23.

In what Self called a “banner month,” January revenue hit the $1,146,471 mark, a figure that tied with only one other January.

After paying $1,108,967 in expenses and adding back in interest, investment income and non-operating income, the district netted $262,000 for the month.

“The last five years in January the district experienced an average operating loss of $164,000.  Going back through 1980 there were only four other months in the last 30 years, four Januarys, when we operated a profitable margin,” Self said.

One of the reasons for the high monthly total was the receipt of $2,260,000 in patient revenue, which Self classified as “one of the best months in quite a while.”

Contractual allowances, charity discounts, other allowances and bad debt do impact the patient revenue total. After deducting in those categories, the district reached the reported $1,146,471 total.

Self said January patient revenue beat out the totals for many of the higher activity months of 2011 including April, May, June, October, November and December. Only March, July, August and September posted higher totals.

“It is actually amazing,” Self said.

In an interesting turnabout, Self reported on financial weaknesses that actually reflect well on the operation of the district.

He talked about tax revenue being one of those areas of weakness and said the district had received about 7 percent less funds than in 2011.

“Between 2008 and now, the district revenue is down about 20 percent in taxes, which is about $100,000. It is good the district is doing better and can take such hits in stride,” he said.

The tax income received was reported at $223,000.

“After paying the county share to collect the taxes, the district recognized $218,000 in revenue,” Self said.

In support of his statement about the district’s overall health he spoke about the district’s net cash balance. A review of the past seven months revealed a negative balance of $67,879 in November 2011, which bumped up to $196,984 in December. Today the district has a net cash balance of $247,750.

“Likewise with respect to revenue, our cash has not looked this good in a very long time,” Self said.

Another weakness cited by Self was the delay in getting patient accounts from the physicians’ offices. He indicated the problem had been identified and was being resolved.

Other statistics given included the activity levels for departments that directly support patient care.

Total patient days set a 12-month high at 540 while January admissions, at 19, was a six-month high.

A total of 222 visits were made to the emergency room in January, which gave the district an average of 251 patients a month over the past 12 months.

On the rise, laboratory procedures were up 608 over January 2011.

Clinic visits were down 124 over the same time period, the same with radiology. Physical therapy visit numbers remained fairly consistent with January 2011. Despite the lower numbers reported in January, Self said the overall primary care visits were about 7 percent higher this year.


Electronic medical records

“I do want to recognize all the hard work our people have put in on researching electronic medical record systems, especially Linda McCurdy who has done a tremendous amount of work in teaching herself about the system,” Self said.

He also expressed great pleasure about the teamwork that went into honing the process down to three vendors. In doing so he gave a special thank-you to Dr. Marc Nielsen, Chief Nursing Officer Linda Wagner and Cheryl Darnell.

“Through this whole process we looked at three different systems. Healthland and CPSI tend to deal with smaller hospitals. EPIC deals with much bigger hospitals; Renown is probably one of the smallest they serve,” he said.

Self said the team had carefully studied the document prepared by McCurdy that outlined each of the features offered by the three systems.

“CPSI works well with acute hospitals like Seneca. Its programs seem to work seamlessly as we learned when our team went out to visit a hospital in Shelbyville, Ill., a hospital about double the size of Seneca,” Self added.

He said the team looked for program inclusions of clinical application, laboratory information systems and even accounting capabilities.

The CPSI system integrates many programs that would keep Seneca from having to purchase separate programs or use a third party to perform specific tasks, he said.

In comparison of the 75 program tasks, administrative or support services offered by each of the vendors, CPSI only had a “no” checked by four items. Between EPIC and Healthland there was a “no” checked by 66 items.

“The cost and installation of this will be the largest project the district has undertaken since the building of the Lake Almanor Clinic,” Self said.

Board members David Slusher, Loretta Gomez, Bob Caton and Ron Longacre voted to pass Resolution No. 394 to go to contract for the CPSI system.

The district will be paying $1.6 million for the CPSI system, installation and hospital computer equipment updates.

The loan covering this cost, which will reach maturity March 1, 2017, is on a three-year schedule, with one payment due a year at the interest rate of 3.75 percent. If the district pays the loan in full on or before the three-year term, 10 percent of the original principal will be returned.

Self estimates it will take between six and seven months to complete the installation. The hospital will be completed first and offices last.


Potential for management change

The last of the big decision items was about the management of the hospital district.

Historically, the health care district has contracted with larger hospitals to provide a variety of services and CEOs.

For many years Enloe Hospital held the management contract, then it went to a private firm and then to the current management provider, Renown Hospital.

Included on the meeting agenda was a discussion about future management of the district. It was stated that Renown’s management contract would expire this coming July.

Self said Slusher and board member Rich Rydell have had several recent discussions with Renown.

It was decided at the meeting that Slusher and Rydell would continue their committee efforts in looking at a variety of management options. The options to be explored include the possibility of re-contracting with Renown, looking at other management or deciding not to enter into an agreement with any form of outside management.

The last option would entail the district hiring CEO Self directly to manage the health care district.

“The decision really comes down to the question of whether or not the district wants to continue a management type of relationship with a larger hospital or whether they are more interested in a personal relationship with a CEO, like is done with Eastern Plumas and Plumas District Hospital,” Self said.

As to whether or not he would be professionally open to such a relationship, Self said, “Professionally, I would be open to such a relationship. This past Feb. 4 marked my fourth year with the district. I’ve definitely enjoyed it here and enjoyed the accomplishments our team has made.”

He said he very much wanted to continue his relationship with the district whether a management team was involved or not.

If the board of directors makes the decision to not go with an outside management contract, Self would be hired as a district employee.

In accordance with common practice, Self and the board of directors would negotiate and sign an employment contract.

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