M. Kate West
Chester Editor
12/30/2009

    Christmas, in the form of an outstanding audit, came two days early for the Seneca Healthcare District.
    Certified Public Accountant Jerel Tucker, of TCA Partners, LLC, shared details Dec. 23 during the routine district meeting.
    In giving his report, Tucker said this was the fifth year in a row his firm has audited SHD. He also introduced background on his firm and said TCA audits 50 percent of all critical access hospitals in California.
    In reference to the first two years TCA performed local audits, he said the district’s operating losses and days in accounts receivable resulted in his firm’s issuing of a cautious opinion of the district’s ability to continue to operate.
    In the audit for the year ending June 2009, he said no material weaknesses had been identified
     He also said there were no reportable findings: no errors or illegal acts.
    “There were no disputes or disagreements between management and (the) accounting firm,” he said.
    “I’ve noticed a real turnaround from five years to now. It’s really positive when you have only a $39,000–$40,000 operating loss. You are fine and better off than most hospitals,” Tucker said.
    One change he singled out was the district’s past reliance on tax assessment money.
    “You used to have to subsidize operations with tax money; now your net income after taxes is $400,000,” he added.
    He credited working with Chief Executive Officer Doug Self as one of the success factors.
    “This is the first time I’ve dealt with same CEO two years in a row. You need to have continuity in administration,” he advised the board.
    He also spoke of past Seneca CEOs and said he felt many of them were on the right track, the issue lay with their short tenures and the fact they didn’t have time to implement their plans.
    He spoke of good management skills and improved practices by the business office. He was especially complimentary of the work done by Cheryl Darnell and her staff.
    “Seneca has done a better job of managing expenses—a very good job of controlling and managing expenses,” he said.
    He also said, “If the special assessment hadn’t dropped off, the hospital would have made a million dollars.”
    “When you think about the lost revenue and still holding the bottom line, it’s obvious you are holding the line,” said Tucker.
    In other discussion he referenced Seneca’s accrual of $10 million in net patient revenue a year; that the business office was doing a much better job of billing and collecting; and that denials are down. He called the process good revenue cycle management.
    He said the biggest change for the hospital was controlling expenses and revenue collections.
    He also said Seneca’s 41–42 percent spent on wages and benefits was lower than most hospitals.
    He also recognized that Seneca is at 7–8 percent supply costs where most hospitals are at 10 percent or higher.
    “2009 was a good year. I see only positive things in the future for Seneca,” Tucker said. “Everything is trending the right way. What this means: don’t rest on your laurels, keep up the good work.”
    Based in Fresno, Tucker refers to his organization as a boutique firm with eight accountants.