Hospital Board reviews accountability audit

The State Auditor’s Office presented the initial draft of the accountability audit to the Adams County Public Hospital District No. 2 Board of Commissioners on Jan. 25.

The Spokane-based audit team submitted the audit to the state for approval, where it will be publically published with the complete report, as well as information about the findings.

The accountability audit is for the calendar years of 2015 and 2016. During the report, it was stated there were no exit items or findings, but there was one management letter. The next audit is scheduled for 2019 and is expected to cost the District $11,400.

Weston Fink presented to the Board regarding the management letter, which addressed the financial condition and credit card disbursements.

In regards to the financial condition, Fink said it is a reporting issue but not a finding. The auditors have warning indicators if the operating margin increases by more than five percent.

Fink explained it appears the drastic change is due mainly to the addition of East Adams Care Center, but since the closing of the facility, he expected the margin to return back to the previous level as long as the administration continues to have plan on how to maintain the operating budget.

The second portion of the management letter addressed credit card disbursement, which Fink explained the District needs to follow their policy by requiring employees to have accurate reporting of purchases. Fink suggested the District update their policies to improve accuracy.

Fink explained there were $1,900 worth of purchases that did not have an original invoice or support documentation of the purchase. Fink recommended the District improve how purchases are recorded and that all original receipts and invoices are filed.

The accountability audit included the financial condition, credit card distribution, pharmaceutical inventory and payroll personnel. There were no findings in any of the areas. The previous financial report was completed by Dingus, Zarecor and Associates and will be linked with the accountability audit when published.

In the financial report to the Board, CEO/CFO Gary Bostrom said the unaudited numbers show the District made a net income of $95,726 for the current month and a year to date income of $169,933. Last year the District recorded a year to date loss of $263,081 at the same time.

Bostrom explained the District is currently at 121 net days on Accounts Receivable (AR), which is an increase of nearly seven days from the previous month. Bostrom stated he is concerned about that amount of days sitting out waiting for collection and his recommendation was to hire additional staff to assist with collection.

There is currently around $5 million in AR and Bostrom said the District needs to lower it to at least $2 million. Bostrom said he would like to hire to additional employees in billing and assist primarily with private and self-pay patients.

Inland Northwest is currently collecting for the District for anything over 90 days billed through insurance. Bostrom said there is currently too much outstanding in the 180-day billing.

When hiring the new employees, Bostrom and COO Dina McBride explained it is there plan to bring in a professional billing consultant to assist with training. Commissioner Jerry Crossler stated AR collection has always been a problem in the District, and it is high time the District takes new steps to fix the issue.

The Board moved on to approve four resolutions for the District, starting with the automatic transfer payment for the LTGO Bond. The transfer covers the bond interest and principal on the bond, and amount of transfer from the operational account totals $22,141.25. The payments will be made on the 10th day of every month from February to November of 2018.

The Board also approved the transfer of $260,761.03 from the EMS Levy Fund to the EARH general operating account for reimbursement of 2017 EMS services.

The final resolution for a transfer of funds was from the EMS Investment Fund to the EARH general operating account for $104,622.14. The amount helps to cover the majority of the cost of a new ambulance purchased for the District, which totaled over $111,000.

The Board also approved authorized signers for warrants, which will be Bostrom, McBride, Kandice Heimbigner and Jennifer Peppered. All warrants require two signatures for approval.

Committee assignments for the Board members were Finance, Crossler and Ross Heimbigner; Quality Loan Improvement, Stacey Plummer and Heimbigner; Compliance, Plummer and Heimbigner; Building, John Kragt and Eric Walker; Physician recruitment, Kragt and Plummer; and CEO recruitment, Crossler and Walker.

The Board is currently in need of community members to serve on the Finance Committee, which meets at 2:30 p.m. on the Tuesday prior to Board of Commissioners meetings. Interested volunteers can contact EARH, and individuals with financial experience and knowledge are preferred.

Bostrom also announced that Peppered has been hired as the CNO, after previously serving as the interim in that position.

As part of the Northwest Rural Health Network (NWRHN), Bostrom explained EARH will now be able to contract with Forefront for tele-behavioral health services. He explained they will bill out to patients for the services, and the District will provide a room and staff for the patients.

At the same NWRHN meeting, Bostrom added they voted to partner with Western Governors University (WGU) to promote online degree programs for staff. Bostrom said this will assist in medical education opportunities, and all staff will receive a five percent discount and scholarships are available.

The next Board meeting is scheduled for Feb. 22 at 5:30 p.m. in the hospital conference room.