Board of Commissioners Meetingsummitpacificmedicalcenter.org/wordpress/wp-content/... · 2018. 2....

Renée K. Jensen, Chief Executive Officer322 South Birch Street, McCleary, Washington 98557-9522 • Ph. (360) 495-3244│ Fax: (360) 495-4274

Owned and Operated by Grays Harbor County Public Hospital District No. 1MRHD is an equal opportunity provider and employer.

Grays Harbor County Public Hospital District No.1

Board of Commissioners MeetingJanuary 31, 2013

Elma City Hall Council Chambers, Elma, WA

Special Meeting Agenda

1. 6:00 – Call to Ordera. Introductions as neededb. Public comment

2. 6:05 – Consent Agenda – See separate Consent Agenda

3. 6:07 –Committee Reportsa. 6:07 - Quality Committee Report – Louie Figueroa/Chad Searls

i. Follow up on provider complaintsb. 6:20 - CEO – Renée Jensen

i. Transition plan updateii. CEO Annual Report

iii. 2013 Strategic Planning Sessionc. 7:00 – CMO Report – Dr. William Hurleyd. 7:10 – Medical Staff Report – Brent Meldrume. 7:20 – Finance – Amy Thomason/Drew Hooper

i. Financial summaryii. Financial dashboards and statements

4. 7:35 – Commissioner Businessa. Commissioner electionsb. Website postings – Commissioner discussionc. Medical staff privileges – none for January

5. Adjournment


Owned and Operated by Grays Harbor County Public Hospital District No. 1MRHD is an equal opportunity provider and employer.


Board of Commissioners MeetingJanuary 31, 2013

Elma City Hall Council Chambers, Elma, WA

Consent Agenda

A very useful technique involves the use of a consent agenda. The board agenda planners (usually theexecutive or governance committee, but occasionally the board chair with the CEO) divide agenda issuesinto two groups of items. The first are those items that must be acted on because of legal, regulatory, orother requirements, but are not significant enough to warrant discussion by the full board. Such issuesare combined into a single section of the board agenda book; members review these materials prior tothe meeting, and if no one has any questions or concerns, the entire block of issues is approved with oneboard vote and no discussion. This frees up a tremendous amount of time that would otherwise besquandered on minor issues. Any member can request that an item be removed from the consent agendaand discussed by the full board. The success of the consent agenda is predicated upon all board membersreading the material in the consent agenda section of the board agenda book. If they do not, then theboard becomes a veritable rubber stamp. The second group of agenda items are those important issuesthat require discussion, deliberation, and action by the board. These are addressed one by one.

Executive Session JustificationExecutive Session is convened to discuss the following topics, as permitted by the cited sections ofthe Revised Code of Washington (RCW): Executive session (RCW 42.30.110)

– (a) national security– (b) (c) real estate– (d) negotiations of publicly bid contracts– (e) export trading– (f) complaints against public officers/employees– (g) qualifications of applicant or review performance of public employee/elective

office– (h) evaluate qualifications of candidate for appointment to elective office– (i) discuss claims with legal counsel

existing or reasonably expected litigation litigation or legal risks expected to result in adverse legal or financial

consequences presence of legal counsel alone does not justify executive session

– QI/peer review committee documents and discussions Final action must be in open meeting



Owned and Operated by Grays Harbor County Public Hospital District No. 1

Consent Agenda

Minutes – December 27, 2012 Regular Meeting Minutes

Payroll Warrants $ 427.794.00

A/P Operations Disbursements $ 396,252.00

A/P Construction Disbursements $ 2,035,122.00

Community Care $ 69,467.00

Bad Debts $ 133,047.00

Property tax Credit $ 513.00

TOTAL $ 3,062,195.00

NOTE: For the Period December 1-31, 2012

13 month Payroll

Operations A/P

Disbursements

Construction

A/P

Disbursements Comm. Care Bad Debt Prop. Tax Credit

Dec-11 $304,003.72 360,641.21$ $0.00 $5,878.26 $0.00 $250.17

Jan-12 $410,397.76 282,290.47$ $334,186.34 $77,998.07 $953.00 $368.88

Feb-12 $371,663.96 500,073.43$ $1,723,378.88 $80,507.27 $2,307.00 $207.70

Mar-12 $482,112.15 536,179.95$ $1,205,938.74 $93,723.00 $354.00 $1,503.00

Apr-12 $370,920.00 486,227.00$ $643,940.00 $43,925.00 $78,921.00 $617.00

May-12 $403,739.00 430,141.00$ $1,758,908.00 $77,913.00 $1,369,831.00 $551.00

Jun-12 $385,614.00 607,560.00$ $1,258,743.00 $71,130.00 $180,534.00 $575.00

Jul-12 $382,751.00 568,065.00$ - $112,388.00 $136,461.00 $747.00

Aug-12 $510,823.00 281,815.00$ $2,534,304.00 $128,735.00 $263,042.00 $404.00

Sep-12 $405,362.00 595,275.00$ $0.00 $35,591.00 $236,055.00 $235.00

Oct-12 $310,896.00 480,563.00$ $3,929,220.00 $55,662.00 $50,609.00 $701.00

Nov-12 $431,154.00 794,844.00$ - $106,818.00 $307,267.00 $984.00

Dec-12 $427,794.00 396,252.00$ $2,035,122.00 $69,467.00 $133,047.00 $513.00

Average per month $411,511.00 $487,559 $1,186,442.00 $73,317.00 $212,113.00 $589.00

$0.00

$500,000.00

$1,000,000.00

$1,500,000.00

$2,000,000.00

$2,500,000.00

$3,000,000.00

$3,500,000.00

$4,000,000.00

$4,500,000.00Payroll

Operations A/P

Construction A/P

$0.00

$200,000.00

$400,000.00

$600,000.00

$800,000.00

$1,000,000.00

$1,200,000.00

$1,400,000.00

$1,600,000.00

Comm. Care

Bad Debt

Prop. Tax Credit

BOARD OF COMMISSIONERS MEETING12/27/12

AGENDA DISCUSSION/CONCLUSIONS RECOMMENDATIONS/ACTIONS/FOLLOW-UP

CALL TO ORDER 6:00– CALL TO ORDERThe Mark Reed Health Care District Board of Commissioners Meeting wascalled to order December 27, 2012 at 6:00 pmPresent: Commissioners present: Amy Thomason, Brent Meldrum, LouieFigueroa, Chad Searls and Drew Hooper

Also Present: Renée Jensen, Brenda West, Will Callicoat, Dr. William Hurley,Otis Leathers, Richard Armstrong, Jean Cotton, Stephanie Jones, Paul Stevenson,Mary Stevenson, Ed Swalander, Ron Hulscher, Shauna DePrato, Shannon Wall

PUBLIC COMMENT Question asked if there would be any comment on the name change of thehospital. Brent Meldrum advised that it was on the agenda underCommissioner Business.

NOVEMBERMINUTES

A correction was made to the spelling of a community member’s name in theNovember minutes.

A motion was made by Chad Searlstoapprove the minutes with the notedcorrection; seconded by Louie Figueroa.The motion carried by a unanimousvote.

CONSENT AGENDA CONSENT AGENDA – See separate Consent Agenda A motion was made by Chad Searls toapprove the consent agenda; secondedbyLouie Figueroa. The motion carried bya unanimous vote.

COMMITTEEREPORTS ASREQUIRED

CEO – Renee JensenConstruction project update

The Certificate of Occupancy for SPMC is to be issued this week Working on the punch list Anticipate Graham Construction will remain onsite until February DOH recommended a couple of changes to our plan documents including

the function and process of patient call buttons CT machine arrived today and is being installed At this point the project is on budget

Strategic plan


The 2013 strategic plan review was presented The specific needs of our community need to be considered in

developing our strategic plan – sharing tool to help legislature, staff andcommunity to understand the need in our community

SWOT analysis (strengths, weaknesses, opportunities and threats) wasconsidered as we developed our tactics. There was a question on whatRPI stood for on the SWOT analysis. It stands for rapid processimprovement.

Transition plan was entered in the strategic planning software as well asMicrosoft Project and is posted in a Gant chart for staff

Administration will move January 18th

Renee described Ask the CEO and Executive Team Rounding and howthey are helping alleviate some of the concerns and stress of unknownsfor staff

The board would like a tactic added to the Strategic Plan for 2013related to them being educated on upcoming legislation issues

The board would like to add to the Strategic Plan for 2013 that theresponse rate for employees completing the annual survey to beincreased. There was a 50% response rate for 2012 and they would liketo see that percentage increase for 2013 when the survey is sent out tothe employees.

The board would like to be more involved in employee recognitionevents and requested a poll prior to setting the date for the companypicnic so they can attend and witness the award ceremony andcelebration

Renee described all of the work involved updating our policies andprocedures

Brent congratulated the team on a great group effort on the strategicplan

Ribbon cutting Invitations to the ribbon cutting and open house for SPMC were given to

A motion was made by Drew Hooper topass the 2013 strategic plan aspresented; seconded by Louie Figueroa.The motion carried by a unanimousvote.


the commissioners. The event occurs January 25th and the public isinvited to attend. Commissioners should contact Lauren if they havepeople they’d like to receive personalized invitations for the event.

Commemorative Scissors Commissioners should return the order forms to Lauren by January 3rd

if they wish to purchase commemorative scissorsCapital Campaign

We have received a written commitment to receive another eighty toninety thousand dollars by the end of the year from two separatecommunity members.

QUALITY COMMITTEE REPORT – Louie Figueroa Chad joined Quality Committee in November There was no report for Infection Control or Trauma Program due to an

employee illness The slight decline in percent of AM labs completed before 7:00 was due to

increase in number of in-patients No noted blood culture contaminations for the month of November Mark Reed continues to be well below national average for door to MD and

overall visit time with 14 minutes and 87 minutes respectively. No medication errors or drug recalls for October (no November Pharmacy &

Therapies (P&T) meeting) When a new drug is approved at P&T, the committee will alert HIM and

Finance to have it added to the charge master. Board of Pharmacy survey for SPMC scheduled for December 28th

Integration of formulary information to Pyxis has started Safety Committee reports no incident reports Fire drills completed for the quarter on all shifts Emergency Preparedness is working on updating and better defining MOUs

(memorandums of understanding) and what the process is When we transition to SPMC we will initiate Incident Command and use the

transition as an event


Medicare/Medicaid’s CAH (Critical Access Hospital) Measures for 2013were shared. We will add all to the quality dashboard

Committee recommended removing ED documentation from the dashboardas it will be collected 100% when we move to the EMR

Adding 100% follow up phone calls to dashboard broken out by clinic, EDand inpatient.

There was no patient satisfaction report for November due to patientvolumes.

There were 4 patient complaints in November – all were addressed There were no provider complaints documented for November

CMO Report – Dr. William Hurley We are in the process of onboarding three new ED providers Working toward T-System (electronic medical record system for Emergency

Department) with online training ED volumes continue to be low – we have been encouraged not to advertise

our low ED wait times as Washington State is working to lower unnecessaryED visits across the state

Medical Staff Report-Brent Meldrum We held the 1st provider lunch meeting. These will be held bi-monthly

opposite of the full medical staff meetings where the executive teamattends for anexchange of information between providers and executivestaff. January 15 will be next regular staff meeting.

Finance – Drew Hooper Utility bill agreement settled Inpatient and swing bed volumes are up Emergency department volumes remain down Clinic visits continue to be respectable and EFM visits are nearly at budget

(affected in the prior two months by the electronic health records systemimplementation)

Gross revenue and expenses were under budget Bad debt continues to decrease due to improved efforts to recognize

discounted community care


The final state auditor’s office accountability audit report was receivedand posted on the State Auditor’s website. There were no changes fromthe drafts received prior.

COMMISSIONERBUSINESS

Medical staff privilegesLawrence Conover, PA-C, Family MedicineDavid Herrington, M.D., reappointment to Emergency Department

Community input follow upThe board met for a work session on December 19th for the purpose ofdiscussion of community input on the name change to Summit Pacific MedicalCenter. All commissioners expressed their views and agreed to have theexecutive team prepare a draft statement to be reviewed and discussed at thenext regular board meeting. A draft letter was shared and all commissionersgave input. Going forward the legal name of the District will not change. Theentities will be referenced as follows. Grays Harbor County Public HospitalDistrict No. 1 doing business as Mark Reed Healthcare Clinic; Grays HarborCounty Public Hospital District No. 1 doing business as Elma Family Medicine;Grays Harbor County Public Hospital District No. 1 doing business as SummitPacific Medical Center; and Grays Harbor County Public Hospital District No. 1doing business as Summit Pacific Healthcare Clinic.The Board thanks all whoparticipated and gave input to this process both formally and informally. Anattempt to send a copy of the letter to all community members who attendedrecent meetings will be made if addresses are on file.Emergency Entrance sign at SPMCThere was concern expressed about the Emergency Entrance sign at SPMCbeing viewable from the freeway and someone driving to the hospital prior tothe transition. Renee is working with the facility director to see what can bedone to turn out the lights on the sign to avoid any confusion.Notification of board meetings and materials

A motion was made by Drew Hooper toapprove Medical Staff privileges forLawrence Conover, PA-C and DavidHerrington, M.D. reappointment toEmergency Department.Louie Figueroaseconded the motion. The motioncarried by a unanimous vote. ChadSearls was absent from voting.

A motion was made by Drew Hooper toaccept the letter regarding SummitPacific Medical Center as presented andthat we attempt to mail to individualswho attended last meeting. Chad Searlsseconded the motion. Fourcommissioners passed the motion. Therewas one abstention by Amy Thomason.


A community member asked if board packets could be emailed and postedonline to all community members prior to monthly meetings and if noticescould be printed sooner in local papers. The board will discuss and decidewhich documents can be published prior to board approval, discuss options fornotifying the community of meetings and will put the topic on the Januaryagenda.

EXECUTIVESESSION

No Executive Session

ADJOURNMENT The meeting was adjourned at 1955 Drew Hooper made a motion to adjournthe meeting; Amy Thomason secondedthe motion and it carried by aunanimous vote.

__________________________________________________________________ __________________________________________________________________

RECORDING SECRETARY BOARD SECRETARY



Owned and Operated by Grays Harbor County Public Hospital District No. 1Mark Reed is an equal opportunity employer.

Preliminary Report The December 2012 financial statements are not considered final until the

Medicare cost report is filed in May 2013. Once filed, the contractual adjustments and due-to-third party liabilities will be considered final.

Finance Summary for December and 2012 Fiscal Year

Summary 2012 was a year of reconciliation for the District’s accounts receivable. The CBOcleaned up the aging accounts and retro-billed rural health claims for Elma Family Medicine.Gross accounts receivable reduced from $7.4 million in December 2011 to $6.0 million inDecember 2012. This process revealed a number of claims from prior years that were past thetimely filing period, thereby increasing the administrative adjustments amount. Theadministrative adjustments related to 2012 were $107,000, so the amounts in 2013 should bewithin normal limits. Bad debt experienced a reduction compared to prior years and theDistrict’s cash position increased compared to the same period last year.

Volume Acute inpatient days and swing bed days continue the yearly trend above budget andwere near double the prior year amount (1218 days versus 680). The average daily census was3.3 for the year. Outpatient visits were also well above budget (9,836 versus 7,538). EmergencyDepartment (ED) visits for the year were 13 percent below budget (5,617 versus 6,465). Clinicvisits rebounded towards the end of the year, but were still short of budget (13,808 versus 16,437).

Revenue Revenue for December and for 2012 overall was under budget by 3 percent. The mostsignificant driver of this is due to the ED volumes being below budget. Even though revenuewas under budget by 3 percent, revenue deductions and contractual adjustments were abovebudget by 1 percent (or $98,000). This was due in large part to the provision of Community Care,which exceeded budget by $81,113 ($947,249 versus $866,136).

Expenses Expenses for 2012 were under budget by 5 percent (or $539,000). Much of this wasdue to salaries and wages being under budget by 7 percent ($366,000).

Income Net revenue of $10.23 million combined with an operating expense of $10.37 millionproduced an operating loss of $135,000. When $980,000 of non-operating income is accounted forthe District experienced a net gain of $844,000 year to date.

Balance Sheet The district’s days of cash on hand increased from 57 to 64, though the accounts

payable and payroll liabilities increased by an amount equivalent to those 7 days of cash. Thecurrent portion of long-term debt decreased by $387,000 because the second land payment wasmade to the county and because the CT lease is scheduled to expire in March 2013. Days in ARheld steady at 89. The electronic T-System in the ED, and the Pyxis system will allow for morepoint of entry charge capture, so this will help drive days in AR down by mid-2013. The amountreserved for third party payers increased from $490,000 to $648,000.

W. Callicoat 1-28-2013

1/31/2013

CURRENT LAST DECEMBER 31, CURRENT LAST DECEMBER 31,

MONTH MONTH 2011 MONTH MONTH 2011

ASSETS LIABILITIES

CURRENT ASSETS CURRENT LIABILITIES

CASH - LTD 1,154,437 957,448 590,587 NOTES PAYABLE - - - - - -

LGIP-INV 648,012 647,882 37,061 ACCOUNTS PAYABLE 282,782 209,577 386,016

ACCOUNTS RECEIVABLE 6,011,594 6,076,465 7,404,201 OTHER PAYABLES 17,939 143,027 202,903

ALLOWANCE FOR BAD DEBTS (1,120,656) (1,498,505) (1,794,131) PAYROLL & RELATED LIAB 552,048 455,502 490,822

ALLOWANCE CONTRACTUAL ADJ (2,486,300) (2,143,496) (2,920,164) OTHER ACCRUED EXPENSES 2,228 363 4,386

RECEIVABLES - TAXES 62,536 121,612 62,260 EXCISE TAX PAYABLE - - - - - -

RECEIVABLES - OTHER 49,336 55,287 55,288 DUE TO THIRD PARTY PAYORS 648,000 490,000 230,095

M & M RECEIVABLES - - - - - - PATIENT REFUND PAYABLE 10,746 2,836 12,178

INVENTORY 106,008 106,008 106,008 CURRENT PORTION LONG TERM 325,142 712,550 712,550

PREPAID EXPENSES 7,942 10,785 4,950

TOTAL CURRENT ASSETS 4,432,909 4,333,486 3,546,060 TOTAL CURRENT LIABILITIES 1,838,885 2,013,855 2,038,950

BALANCE SHEET

AS OF December 31, 2012


BOARD DESIGNATED ASSETS

FUNDED DEPRECIATION - - - - - - GROSS LONG TERM DEBT

DESIGNATED CONSTRUCTION - - - - - - BONDS PAYABLE 16,331,867 14,297,607 1,653,035

XRAY EQUIP PAYABLE 35,144 46,674 167,691TOTAL BOARD DESIGN ASSETS - - - - - -

TOTAL GROSS LONG TERM DEBT 16,367,011 14,344,281 1,820,726

PROPERTY, PLANT & EQUIP

LAND AND IMPROVEMENTS 803,993 803,993 803,993 LESS CUR. PORTION LTGO/CT (325,142) (712,550) (712,550)

BUILDINGS 1,120,169 1,120,168 1,120,168FIXED EQUIPMENT 1,701,083 1,701,082 2,082,947 NET LONG TERM DEBT 16,041,869 13,631,731 1,108,176

CONSTRUCTION IN PROGRESS 17,193,571 15,165,874 2,293,512

TOTAL PROP,PLANT, & EQUIP 20,818,816 18,791,117 6,300,620 TOTAL LIABILITIES 17,880,754 15,645,586 3,147,126

LESS: ACCUM DEPRECIATION (2,388,648) (2,371,589) (2,566,349) EQUITY

NET PROP, PLANT & EQUIP 18,430,168 16,419,528 3,734,271 UNRESTRICTED FUND BALANCE 4,146,482 4,146,482 3,622,623

EXCESS REVENUE/(EXPENSE) 843,930 969,470 523,859

DEFERRED FINANACING COSTS 8,089 8,524 13,277 TOTAL UNRESTRICTED FUND 4,990,412 5,115,952 4,146,482

TOTAL ASSETS 22,871,166 20,761,538 7,293,608 TOTAL LIABILITY & EQUITY 22,871,166 20,761,538 7,293,608

RESTRICTED FUND BALANCES RESTRICTED FUND BALANCES

MEMORIAL FUND BALANCE - - - - - - MEMORIAL FUND BALANCE - - - - - -

DEFERRED COMP. PLAN - - - - - - DEFERRED COMP. PLAN - - - - - -

TOTAL RESTRICTED FUNDS 0 0 0 TOTAL RESTRICTED FUNDS 0 0 0

1/29/2013

VARIANCE VARIANCE

CURRENT % YTD %

OVER OVER

ACTUAL BUDGET PRIOR YEAR VARIANCE BUDGET ACTUAL BUDGET PRIOR YEAR VARIANCE BUDGET

GROSS OPERATING REVENUE

244,791 173,741 182,449 71,050 41% INPATIENT REVENUE 2,566,141 2,009,791 1,732,296 556,350 28%

507,547 519,052 550,290 (11,505) -2% OUTPATIENT REVENUE 6,130,872 6,154,308 5,416,082 (23,436) 0%

124,196 131,954 131,454 (7,758) -6% MRHC OUTPATIENT REVENUE 1,285,380 1,565,854 1,565,013 (280,474) -18%

92,879 98,496 88,939 (5,617) -6% EFM OUTPATIENT REVENUE 1,293,860 1,169,811 824,443 124,049 11%

1,138,815 1,244,639 941,975 (105,824) -9% EMERGENCY REVENUE 13,580,805 14,736,627 12,412,708 (1,155,822) -8%

2,108,228 2,167,882 1,895,107 (59,654) -3% GROSS PATIENT REVENUE 24,857,058 25,636,391 21,950,542 (779,333) -3%

REVENUE DEDUCTIONS

490,570 384,224 684,518 106,346 28% MEDICARE CONTRACTUALS 5,438,671 4,531,784 4,037,485 906,887 20%

804,360 380,945 191,104 423,415 111% MEDICAID CONTRACTUALS 3,825,597 4,512,999 3,559,966 (687,402) -15%

50,648 230,691 146,035 (180,043) -78% OTHER CONTRACTUALS 2,525,750 2,731,685 2,416,246 (205,935) -8%

(260,266) 164,809 11,526 (425,075) -258% BAD DEBT EXPENSE 1,364,040 1,951,499 1,981,204 (587,459) -30%

69,467 77,855 62,891 (8,388) -11% COMMUNITY CARE 947,249 866,136 703,347 81,113 9%

195,094 20,860 16,131 174,234 835% ADMIN. ADJUSTMENTS 823,167 232,071 196,813 591,096 255%

INCOME STATEMENT

December 31, 2012

CURRENT MONTH YEAR TO DATE

1,349,873 1,259,384 1,112,205 90,489 7% TOTAL REVENUE DEDUCTIONS 14,924,474 14,826,174 12,895,061 98,300 1%

15,619 11,635 10,651 3,984 34% MRHC ENHANCEMENT 222,355 138,064 231,753 84,291 61%

1,566 0 1,685 1,566 OTHER OPERATING INCOME 12,180 0 17,868 12,180

0 0 0 0 DISPROPORATIONATE SHARE 63,561 0 8,317 63,561

775,540 920,133 795,238 (144,593) -16% NET OPERATING REVENUE 10,230,680 10,948,281 9,313,419 (717,601) -7%

OPERATING EXPENSES

483,938 493,520 514,789 (9,582) -2% SALARIES AND WAGES 5,197,141 5,563,485 5,018,652 (366,344) -7%

137,325 93,252 116,936 44,073 47% EMPLOYEE BENEFITS 1,078,245 1,077,341 1,024,977 904 0%

110,905 101,666 (20,975) 9,239 9% PROFESSIONAL FEES 1,180,265 1,203,745 1,019,181 (23,480) -2%

51,652 61,752 16,338 (10,100) -16% SUPPLIES 601,133 731,362 597,107 (130,229) -18%

7,230 15,327 10,856 (8,097) -53% UTILITIES 101,283 182,410 196,892 (81,127) -44%

111,261 101,977 120,413 9,284 9% PURCHASED SERVICES 1,370,322 1,203,988 896,403 166,334 14%

10,867 13,787 12,232 (2,920) -21% INSURANCE 137,489 165,336 133,916 (27,847) -17%

18,980 28,809 29,345 (9,829) -34% OTHER EXPENSES 309,536 340,159 316,070 (30,623) -9%

13,486 8,207 14,071 5,279 64% RENTALS AND LEASES 118,580 96,890 90,786 21,690 22%

4,730 3,975 6,245 755 19% INTEREST EXPENSE 60,959 47,700 77,165 13,259 28%

17,492 24,413 33,791 (6,921) -28% DEPRECIATION & AMORTIZATION EXPENSE 211,084 292,956 307,839 (81,872) -28%

967,866 946,685 854,041 21,181 2% TOTAL EXPENSES 10,366,037 10,905,372 9,678,988 (539,335) -5%

(192,326) (26,552) (58,803) (165,774) 624% NET INCOME (LOSS) FROM OPERATION (135,357) 42,909 (365,569) (178,266) -415%

NON-OPERATING REVENUES

65,879 54,332 44,269 11,547 21% TAX REVENUES 803,694 651,984 740,257 151,710 23%

910 4,781 (6,724) (3,871) -81% MISC. NON-OPERATING REV. 175,593 57,372 149,170 118,221 206%

66,789 59,113 37,545 7,676 13% TOTAL NON-OPERATING REV. 979,287 709,356 889,427 269,931 38%

(125,537) 32,561 (21,258) (158,098) -486% NET INCOME OR (LOSS) 843,930 752,265 523,858 91,665 12%

-1-

STATISTICSDecember 31, 2012

ACTUAL BUDGET PRIOR MO. ACTUAL BUDGET PRIORINPATIENT STATISTICS

13 8 14 ADMISSIONS 147 89 8936 19 37 PATIENT DAYS 402 216 2238 5 9 EMERGENCY ADMITS 107 58 61

2.8 2.4 2.6 LENGTH OF STAY 2.7 2.4 2.5

SWING BEDS8 6 9 ADMISSIONS 72 66 4879 43 101 PATIENT DAYS 816 519 457

MONTH YEAR TO DATE

79 43 101 PATIENT DAYS 816 519 457

OUTPATIENT STATISTICS268 307 190 OBSERVATION HOURS 2,110 3,285 3,866441 547 413 EMERGENCY ROOM VISITS 5,617 6,465 6,006698 795 703 MRHC CLINIC VISITS 6,875 9,596 8,617509 576 557 EFM CLINIC VISITS 6,933 6,841 5,259808 588 776 OTHER OUTPATIENT VISITS 9,836 7,538 8,458

ANCILLARY STATISTICS3,648 4,011 3,731 LAB BILLABLE TEST 46,783 47,963 46,998257 278 254 XRAY RVUS 3,227 3,308 3,155123 117 113 CT EXAMS 1,462 1,387 1,013

OTHER STATISTICS DEC 31,2011DAYS IN A/R 89 123

9 15DAYS IN CASH 64 24CURRENT RATIO 2.4 1.7

DAYS IN PAYABLE EXCL 3RD/DEBT

1/29/2013 CURRENT _____________PRIOR __________________BUDGET _ _ _ _ _ _ _ _ _

December 2012FINANCIAL DASHBOARDS

LEGEND

$350

$400

$450

$500

$550

$600

$650

J F M A M J J A S O N D

Salary & Benefits

1,500

1,600

1,700

1,800

1,900

2,000

2,100

2,200

2,300

2,400


Gross Patient Services Revenue

-

25

50

75

100

125

150


Days Cash on Hand

$4,000

$9,000

$14,000

$19,000

$24,000

$29,000

$34,000


Overtime $

$650$675$700$725$750$775$800$825$850$875$900$925$950$975

$1,000$1,025$1,050


Operating Expense

$(200)

$(150)

$(100)

$(50)

$-

$50

$100

$150

Operating Income - Loss

$(150)

$(100)

$(50)

$-

$50

$100

$150

$200

$250Net Income-Loss

70

80

90

100

110

120

130

140


Days in A/R

52.5

57.5

62.5

67.5

72.5

77.5

82.5

87.5


FTE'S Paid FTE'sWorked FTE's

J F M A M J J A S O N D$(200)


$(150)

J F M A M J J A S O N DMark Reed Cockpit Finance December 2012 New Charts



Owned and Operated by Grays Harbor County Public Hospital District No. 1Mark Reed is an equal opportunity employer.

Preliminary Report The December 2012 financial statements are not considered final until the

Medicare cost report is filed in May 2013. Once filed, the contractual adjustments and due-to-third party liabilities will be considered final.

Finance Summary for December and 2012 Fiscal Year

Summary 2012 was a year of reconciliation for the District’s accounts receivable. The CBOcleaned up the aging accounts and retro-billed rural health claims for Elma Family Medicine.Gross accounts receivable reduced from $7.4 million in December 2011 to $6.0 million inDecember 2012. This process revealed a number of claims from prior years that were past thetimely filing period, thereby increasing the administrative adjustments amount. Theadministrative adjustments related to 2012 were $107,000, so the amounts in 2013 should bewithin normal limits. Bad debt experienced a reduction compared to prior years and theDistrict’s cash position increased compared to the same period last year.

Volume Acute inpatient days and swing bed days continue the yearly trend above budget andwere near double the prior year amount (1218 days versus 680). The average daily census was3.3 for the year. Outpatient visits were also well above budget (9,836 versus 7,538). EmergencyDepartment (ED) visits for the year were 13 percent below budget (5,617 versus 6,465). Clinicvisits rebounded towards the end of the year, but were still short of budget (13,808 versus 16,437).

Revenue Revenue for December and for 2012 overall was under budget by 3 percent. The mostsignificant driver of this is due to the ED volumes being below budget. Even though revenuewas under budget by 3 percent, revenue deductions and contractual adjustments were abovebudget by 1 percent (or $98,000). This was due in large part to the provision of Community Care,which exceeded budget by $81,113 ($947,249 versus $866,136).

Expenses Expenses for 2012 were under budget by 5 percent (or $539,000). Much of this wasdue to salaries and wages being under budget by 7 percent ($366,000).

Income Net revenue of $10.23 million combined with an operating expense of $10.37 millionproduced an operating loss of $135,000. When $980,000 of non-operating income is accounted forthe District experienced a net gain of $844,000 year to date.

Balance Sheet The district’s days of cash on hand increased from 57 to 64, though the accounts

payable and payroll liabilities increased by an amount equivalent to those 7 days of cash. Thecurrent portion of long-term debt decreased by $387,000 because the second land payment wasmade to the county and because the CT lease is scheduled to expire in March 2013. Days in ARheld steady at 89. The electronic T-System in the ED, and the Pyxis system will allow for morepoint of entry charge capture, so this will help drive days in AR down by mid-2013. The amountreserved for third party payers increased from $490,000 to $648,000.

W. Callicoat 1-28-2013

1/31/2013

CURRENT LAST DECEMBER 31, CURRENT LAST DECEMBER 31,

MONTH MONTH 2011 MONTH MONTH 2011

ASSETS LIABILITIES

CURRENT ASSETS CURRENT LIABILITIES

CASH - LTD 1,154,437 957,448 590,587 NOTES PAYABLE - - - - - -

LGIP-INV 648,012 647,882 37,061 ACCOUNTS PAYABLE 282,782 209,577 386,016

ACCOUNTS RECEIVABLE 6,011,594 6,076,465 7,404,201 OTHER PAYABLES 17,939 143,027 202,903

ALLOWANCE FOR BAD DEBTS (1,120,656) (1,498,505) (1,794,131) PAYROLL & RELATED LIAB 552,048 455,502 490,822

ALLOWANCE CONTRACTUAL ADJ (2,486,300) (2,143,496) (2,920,164) OTHER ACCRUED EXPENSES 2,228 363 4,386

RECEIVABLES - TAXES 62,536 121,612 62,260 EXCISE TAX PAYABLE - - - - - -

RECEIVABLES - OTHER 49,336 55,287 55,288 DUE TO THIRD PARTY PAYORS 648,000 490,000 230,095

M & M RECEIVABLES - - - - - - PATIENT REFUND PAYABLE 10,746 2,836 12,178

INVENTORY 106,008 106,008 106,008 CURRENT PORTION LONG TERM 325,142 712,550 712,550

PREPAID EXPENSES 7,942 10,785 4,950


BALANCE SHEET

AS OF December 31, 2012


BOARD DESIGNATED ASSETS

FUNDED DEPRECIATION - - - - - - GROSS LONG TERM DEBT

DESIGNATED CONSTRUCTION - - - - - - BONDS PAYABLE 16,331,867 14,297,607 1,653,035

XRAY EQUIP PAYABLE 35,144 46,674 167,691TOTAL BOARD DESIGN ASSETS - - - - - -

TOTAL GROSS LONG TERM DEBT 16,367,011 14,344,281 1,820,726

PROPERTY, PLANT & EQUIP

LAND AND IMPROVEMENTS 803,993 803,993 803,993 LESS CUR. PORTION LTGO/CT (325,142) (712,550) (712,550)

BUILDINGS 1,120,169 1,120,168 1,120,168FIXED EQUIPMENT 1,701,083 1,701,082 2,082,947 NET LONG TERM DEBT 16,041,869 13,631,731 1,108,176

CONSTRUCTION IN PROGRESS 17,193,571 15,165,874 2,293,512

TOTAL PROP,PLANT, & EQUIP 20,818,816 18,791,117 6,300,620 TOTAL LIABILITIES 17,880,754 15,645,586 3,147,126

LESS: ACCUM DEPRECIATION (2,388,648) (2,371,589) (2,566,349) EQUITY

NET PROP, PLANT & EQUIP 18,430,168 16,419,528 3,734,271 UNRESTRICTED FUND BALANCE 4,146,482 4,146,482 3,622,623

EXCESS REVENUE/(EXPENSE) 843,930 969,470 523,859

DEFERRED FINANACING COSTS 8,089 8,524 13,277 TOTAL UNRESTRICTED FUND 4,990,412 5,115,952 4,146,482

TOTAL ASSETS 22,871,166 20,761,538 7,293,608 TOTAL LIABILITY & EQUITY 22,871,166 20,761,538 7,293,608

RESTRICTED FUND BALANCES RESTRICTED FUND BALANCES

MEMORIAL FUND BALANCE - - - - - - MEMORIAL FUND BALANCE - - - - - -

DEFERRED COMP. PLAN - - - - - - DEFERRED COMP. PLAN - - - - - -

TOTAL RESTRICTED FUNDS 0 0 0 TOTAL RESTRICTED FUNDS 0 0 0

1/29/2013

VARIANCE VARIANCE

CURRENT % YTD %

OVER OVER

ACTUAL BUDGET PRIOR YEAR VARIANCE BUDGET ACTUAL BUDGET PRIOR YEAR VARIANCE BUDGET

GROSS OPERATING REVENUE

244,791 173,741 182,449 71,050 41% INPATIENT REVENUE 2,566,141 2,009,791 1,732,296 556,350 28%

507,547 519,052 550,290 (11,505) -2% OUTPATIENT REVENUE 6,130,872 6,154,308 5,416,082 (23,436) 0%

124,196 131,954 131,454 (7,758) -6% MRHC OUTPATIENT REVENUE 1,285,380 1,565,854 1,565,013 (280,474) -18%

92,879 98,496 88,939 (5,617) -6% EFM OUTPATIENT REVENUE 1,293,860 1,169,811 824,443 124,049 11%

1,138,815 1,244,639 941,975 (105,824) -9% EMERGENCY REVENUE 13,580,805 14,736,627 12,412,708 (1,155,822) -8%

2,108,228 2,167,882 1,895,107 (59,654) -3% GROSS PATIENT REVENUE 24,857,058 25,636,391 21,950,542 (779,333) -3%

REVENUE DEDUCTIONS

490,570 384,224 684,518 106,346 28% MEDICARE CONTRACTUALS 5,438,671 4,531,784 4,037,485 906,887 20%

804,360 380,945 191,104 423,415 111% MEDICAID CONTRACTUALS 3,825,597 4,512,999 3,559,966 (687,402) -15%

50,648 230,691 146,035 (180,043) -78% OTHER CONTRACTUALS 2,525,750 2,731,685 2,416,246 (205,935) -8%

(260,266) 164,809 11,526 (425,075) -258% BAD DEBT EXPENSE 1,364,040 1,951,499 1,981,204 (587,459) -30%

69,467 77,855 62,891 (8,388) -11% COMMUNITY CARE 947,249 866,136 703,347 81,113 9%

195,094 20,860 16,131 174,234 835% ADMIN. ADJUSTMENTS 823,167 232,071 196,813 591,096 255%

INCOME STATEMENT

December 31, 2012

CURRENT MONTH YEAR TO DATE

1,349,873 1,259,384 1,112,205 90,489 7% TOTAL REVENUE DEDUCTIONS 14,924,474 14,826,174 12,895,061 98,300 1%

15,619 11,635 10,651 3,984 34% MRHC ENHANCEMENT 222,355 138,064 231,753 84,291 61%

1,566 0 1,685 1,566 OTHER OPERATING INCOME 12,180 0 17,868 12,180

0 0 0 0 DISPROPORATIONATE SHARE 63,561 0 8,317 63,561

775,540 920,133 795,238 (144,593) -16% NET OPERATING REVENUE 10,230,680 10,948,281 9,313,419 (717,601) -7%

OPERATING EXPENSES

483,938 493,520 514,789 (9,582) -2% SALARIES AND WAGES 5,197,141 5,563,485 5,018,652 (366,344) -7%

137,325 93,252 116,936 44,073 47% EMPLOYEE BENEFITS 1,078,245 1,077,341 1,024,977 904 0%

110,905 101,666 (20,975) 9,239 9% PROFESSIONAL FEES 1,180,265 1,203,745 1,019,181 (23,480) -2%

51,652 61,752 16,338 (10,100) -16% SUPPLIES 601,133 731,362 597,107 (130,229) -18%

7,230 15,327 10,856 (8,097) -53% UTILITIES 101,283 182,410 196,892 (81,127) -44%

111,261 101,977 120,413 9,284 9% PURCHASED SERVICES 1,370,322 1,203,988 896,403 166,334 14%

10,867 13,787 12,232 (2,920) -21% INSURANCE 137,489 165,336 133,916 (27,847) -17%

18,980 28,809 29,345 (9,829) -34% OTHER EXPENSES 309,536 340,159 316,070 (30,623) -9%

13,486 8,207 14,071 5,279 64% RENTALS AND LEASES 118,580 96,890 90,786 21,690 22%

4,730 3,975 6,245 755 19% INTEREST EXPENSE 60,959 47,700 77,165 13,259 28%

17,492 24,413 33,791 (6,921) -28% DEPRECIATION & AMORTIZATION EXPENSE 211,084 292,956 307,839 (81,872) -28%

967,866 946,685 854,041 21,181 2% TOTAL EXPENSES 10,366,037 10,905,372 9,678,988 (539,335) -5%

(192,326) (26,552) (58,803) (165,774) 624% NET INCOME (LOSS) FROM OPERATION (135,357) 42,909 (365,569) (178,266) -415%

NON-OPERATING REVENUES

65,879 54,332 44,269 11,547 21% TAX REVENUES 803,694 651,984 740,257 151,710 23%

910 4,781 (6,724) (3,871) -81% MISC. NON-OPERATING REV. 175,593 57,372 149,170 118,221 206%

66,789 59,113 37,545 7,676 13% TOTAL NON-OPERATING REV. 979,287 709,356 889,427 269,931 38%

(125,537) 32,561 (21,258) (158,098) -486% NET INCOME OR (LOSS) 843,930 752,265 523,858 91,665 12%

-1-

STATISTICSDecember 31, 2012

ACTUAL BUDGET PRIOR MO. ACTUAL BUDGET PRIORINPATIENT STATISTICS

13 8 14 ADMISSIONS 147 89 8936 19 37 PATIENT DAYS 402 216 2238 5 9 EMERGENCY ADMITS 107 58 61

2.8 2.4 2.6 LENGTH OF STAY 2.7 2.4 2.5

SWING BEDS8 6 9 ADMISSIONS 72 66 4879 43 101 PATIENT DAYS 816 519 457

MONTH YEAR TO DATE

79 43 101 PATIENT DAYS 816 519 457

OUTPATIENT STATISTICS268 307 190 OBSERVATION HOURS 2,110 3,285 3,866441 547 413 EMERGENCY ROOM VISITS 5,617 6,465 6,006698 795 703 MRHC CLINIC VISITS 6,875 9,596 8,617509 576 557 EFM CLINIC VISITS 6,933 6,841 5,259808 588 776 OTHER OUTPATIENT VISITS 9,836 7,538 8,458

ANCILLARY STATISTICS3,648 4,011 3,731 LAB BILLABLE TEST 46,783 47,963 46,998257 278 254 XRAY RVUS 3,227 3,308 3,155123 117 113 CT EXAMS 1,462 1,387 1,013

OTHER STATISTICS DEC 31,2011DAYS IN A/R 89 123

9 15DAYS IN CASH 64 24CURRENT RATIO 2.4 1.7

DAYS IN PAYABLE EXCL 3RD/DEBT

1/29/2013 CURRENT _____________PRIOR __________________BUDGET _ _ _ _ _ _ _ _ _

December 2012FINANCIAL DASHBOARDS

LEGEND

$350

$400

$450

$500

$550

$600

$650


Salary & Benefits

1,500

1,600

1,700

1,800

1,900

2,000

2,100

2,200

2,300

2,400


Gross Patient Services Revenue

-

25

50

75

100

125

150


Days Cash on Hand

$4,000

$9,000

$14,000

$19,000

$24,000

$29,000

$34,000


Overtime $

$650$675$700$725$750$775$800$825$850$875$900$925$950$975

$1,000$1,025$1,050


Operating Expense

$(200)

$(150)

$(100)

$(50)

$-

$50

$100

$150

Operating Income - Loss

$(150)

$(100)

$(50)

$-

$50

$100

$150

$200

$250Net Income-Loss

70

80

90

100

110

120

130

140


Days in A/R

52.5

57.5

62.5

67.5

72.5

77.5

82.5

87.5


FTE'S Paid FTE'sWorked FTE's

J F M A M J J A S O N D$(200)


$(150)

J F M A M J J A S O N DMark Reed Cockpit Finance December 2012 New Charts

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