Font ResizeThe cost report is a unique feature of Medicare-Medicaid funding in which medical institutions such as the Jerold Phelps Community Hospital are reimbursed for services through a system that allows audits of those reimbursements after the fact to determine if they were consistent with costs. If, as seems to always happen, the determination is that the reimbursement was more than the actual cost, Medicare then demands the hospital return the overpayment and a new reimbursement schedule is made reflecting the change in costs.
At the district's regular Jan. 26 meeting, District Administrator Harry Jasper said that he had set aside $1.91 million to allow for the maximum demand. At this meeting he said the actual overpayment demand had been calculated to be $715,300 which is very good news for the district. Jasper said that he had already contacted the County Treasurer to take that amount out of the district's reserves and expected to cut the check to Medicare as soon as the county check was received and deposited into the right account. He added that a second demand following another audit was possible and that he had set aside another $30,000 to prepare for that contingency. The district will still have $1 million in the County Treasury, where interest rates are very good. The new reimbursement rate based on the cost report will be established in two to four months, he said.
A number of proposed projects presented at the January meeting had been put on hold, pending the receipt of cost report. With the cost report in hand, the board members and staff discussed which of their many identified priorities should go forward.
Board member Barbara Truitt said that she favored taking a long-range view and wanted money set aside for the long-range goal of building a new facility by 2025.
Jasper said that his goal of bringing a “Dream Team” of experts to the district would help implement a long-range plan.
Board president Nancy Wilson asked about using the parcel tax money for the building. Jasper said that the hospital operates at a loss and that the purpose of the parcel tax is to subsidize that loss.
”The common goal and intent of the parcel tax was to cover operations,” he said. He referred again to his “Dream Team” which he said would help them develop an operations plan that would eliminate the operations loss.
”If we really understand the finances,” he said, “we can create a smooth financial machine and get close to eliminating the loss.”
He said it hadn't been done before but that he felt they could develop a relationship with the experts and have a smoothly running system.
Jasper reminded everyone that the parcel tax expires in 2017 and that the most important thing to the taxpayers was for the district to demonstrate good stewardship. As for building a new facility, it was felt that a bond measure would probably be needed to accomplish that goal.
In response to questions from Wilson and board member Mary Krissie Branzei, Jasper said he was planning to hold two all-staff meetings to solicit input from the staff on priorities.
One priority mentioned was a dollar-an-hour raise for all staff. The estimated cost of this would be between $150,000 and $156,000 a year. Jasper resisted the idea of an across-the-board raise for all staff members. He said that was one possibility, but they could also focus on bringing up the wages of the lowest tier workers and establish a performance review system for wage increases. He said that he and Human Resources Manager Linda Feretto were working on gathering information relevant to a pay raise policy.
There was much discussion about the importance of paying good wages. Jasper called everyone's attention to the district's benefits package, which he said was a good one. Truitt pressed the issue of pay raises and asked Jasper and Feretto to get the data together for presentation at the March board meeting.
Prioritizing technology improvements was also discussed at the meeting. Operations Manager Kent Scown reported that the facility was on the verge of access to the new fiber optic line necessary for establishing the telemedicine capacity. It was decided to keep pressing on bringing CT capacity to the hospital. An update on a CT facility and where it will be housed will be on the agenda at the February meeting,
It was also announced that a new radiologist has been hired and that mammograms are once again available at the hospital.
At the conclusion of the meeting, Branzei asked Jasper if she could assume that a wage increase was a top priority. Jasper said that the district has a lot of priorities, but he identified wages, consistently available mammogram services and physician recruitment as the top three priorities.
He said also that the patient survey that is being prepared might bring a different set of priorities.
The next regular meeting of the board will take place on Feb. 23. Meetings are held in the Dimmick Room of the hospital at 1 p.m.
