Another hospital levy anticipated in 2020
November 28, 2019
By Caroline Moore
POMEROY–The final Garfield County Hospital District (GCHD) levy results were announced at the recently special meeting with 58.29 % votes received of the required 60% that was needed to pass the levy. The President of the Garfield County Hospital Board (GCHDB) affirmed that the hospital district is not closing and anticipates running another levy in 2020 which can be held in either February, April, August or November. Money received from that levy would not be available until 2021. It was suggested a levy committee be formed to help promote a strong outreach. The last levy that was run was three years ago and an annual levy will most likely be needed to sustain the operations of the hospital.
To temporarily remedy the lack of available revenue due to the loss of levy funds, the GCHDB, co-CEOs Matt Slaybaugh and Jayd Keener and CFO Jim Heilsberg, met with the Rural Program Manager of Washington State Hospital Association and the new Executive Director of Association of the Washington Public Hospital District (AWPHD) last week to discuss the Washington Rural Health Access Preservation (WHRAP). This program was designed to set aside money to help rural hospitals through March of 2021.
The GCHD will be receiving $109,000 no later than January 2020 and will receive additional money each quarter for a total $192,000. In March of 2021, the last payment will be $10,000. There is an additional $400,000 available to all the Washington Hospital Districts for technical assistance.
The Executive Director of AWPHD has extended the funding to pay for the District’s CFO’s salary at 40 hours a month. The CFO and a CPA from Dingus, Zarecor & Associates are researching different government models that would produce more revenue.
Allevant, a clinical education program, was discussed as a tool to increase the use of Critical Access Hospitals bring in more revenue. Another avenue to cut costs is to alleviate the need for locum providers in the ER and replace them with providers employed by the District. Other discussions included the 340B Drug Pricing Program as ways to increase reimbursements and cost report reallocation strategies.
A financial modeling was prepared by the CFO to help predict when the cash could be exhausted. A low estimation of day’s cash-on-hand with AP deducted would be 47 days; without the AP deduction it would be 77 days. An average net in-and-out flow is at 2.03 days decrease each month. If this remains status quo, it could be 2021 before the cash is depleted but this is based on several variables.
Other predications using some of the avenues previously discussed were factored into a separate model that would result in eventually extending day’s cash-on-hand. Another idea is to explore the option of forming a relationship with other facilities with the possibility of sharing providers. The Co-CEOs will be meeting with the CEO of Dayton the first week in December to exchange collaborating ideas.
Challenges that GCHD will face in 2020 include a new set of CMS regulations through the conditions of participation for all hospitals starting January 1, 2020 to include measures tracking infection control, quality assurance, and disaster training.
Another area of change will include the implementation of scheduled breaks and uninterrupted meals breaks for every shift that is worked by CNAs, RNs, and Lab techs. Another significant change will be the new global payment plan for hospitals across the nation that may begin as early as the spring of 2020.
A research on mortality rate studies was done recently based on distance to the nearest hospital. There is a 5% increase to every five minutes of extra driving time, an increase of 25% mortality rate which is fairly significant increase in lieu of a serious medical event.
During the special meeting, several questions from the public were asked and answered by the GCHDB and the co-CEOs.