Recruitment, finances remain forefront of Hospital Board discussion

The Adams County Hospital District No. 2 Hospital Board of Commissioners continued discussion on recruitment, as well as discussing upcoming changes to the healthcare industry and the current financial report for the District.

CEO/CFO Gary Bostrom provided information regarding Washington State House Bill 1520, and the upcoming disbursement of funds for hospital districts within Washington Rural Health Access Preservation (WRHAP).

Each of the 13 districts within WRHAP will receive $145,048, and the funds will be released at the end of July.

The reimbursement is for Medicaid only, Bostrom explained, and the District has to meet milestones to receive the funds. The first milestone is set for July 31, when the District must have a care coordinator or a behavioral health specialist delivering services to Medicaid clients for one month.

CNO Jennifer Pepperd explained the District is in compliance, as a care coordinator already provides services for the facility. The District will receive $42,872 for meeting the first milestone.

The second milestone must be completed by Sept. 30 for a $25,544 allocation. The goal is for staff to deliver services for 90 days and achieve quality benchmark of 28 percent of patients screened for depression, or 30 percent of ED discharges contacted.

The third benchmark to complete for the end of the year is for 53 percent of patients screened for depression or 40 percent of ED discharges contacted. The final two benchmarks for 2019 have yet to be determined.

Recently, Bostrom and a few Board members attended the Washington State Hospital Association (WSHA) healthcare conference in Chelan. Bostrom provided updates regarding potential changes to rural healthcare in the future.

Bostrom said the Joint Selection Agency is paying the State $400,000 to start looking into different payment models for rural hospital districts.

The conference also provided board member education and training. Bostrom explained a few important components are that the CEO is the main point of contact, the Board must speak in a unified voice, and they can only discuss business during public meetings and not in private amongst one another.

Bostrom said another main point of discussion of the conference revolved around gun control within hospitals. The Rural Health Alliance and WSHA received feedback on firearm restrictions, and the majority of districts were in favor of restricting firearms within hospitals.

Chairman Eric Walker explained it is planned to move ahead with a universal firearm policy for all hospitals, which would be similar to school district policies.

Bostrom added other changes for hospital districts include now being able to own and operate other health facilities, such as gyms. He explained another change is the law now allows the superintendent of a district to be hired or fired within one board meeting, instead of two meetings as it was previously.

The Open Public Meeting law has also been changed to allow one or more board member to participate in a meeting via phone or video.

The District is also currently responding to an extensive public records request from the Seattle Times, Bostrom explained. The request was sent to all public hospital districts in the state, asking for all contracts with collection agencies and collection fees charge per year. The District gave 45 days to fill the request.

Bostrom said the contract for mammography services from Assured Imaging to come to EARH still has not been signed. The service was supposed to be started in July, but will be delayed until the contract is agreed upon.

Medical students from Washington State University will be job shadowing Dr. Timothy Bryant during the summer and Bostrom said the District still needs lodging for the students.

Any individual who is interested in hosting a student for a week in August is asked to call Tanya Rodriguez are 659-5415.

Commissioner John Kragt added he would still like undergraduate students to have the opportunity to job shadow at EARH. He stated he understands there are insurance restrictions, but if there is a possibility of the college to provide the insurance like the medical schools do, he believed it would be a benefit to the District.

Kragt added it is too late to pursue for this summer, but would like to move forward to see if it could be implemented by next year.

In the financial update, Bostrom explained the audit is complete, but the presentation has been postponed until July due to scheduling conflicts. With the audit adjustments, the District recorded a contractual adjustment of a roughly $600,000 loss for 2017.

Bostrom said the Deductions of Revenue are almost $195,000 higher because of the reverse entry made by the auditors to the May 2017 financials. He added the nearly $1.9 million change to the yearend financials for 2017 is due significantly to the write-offs from the swing bed patients pharmaceutical reimbursement billing error.

The District currently has a net income of $137,858 for the month of June and a year to date net loss of $395,970.

Inland Imaging has been working on Accounts Receivable (AR) collection for EARH since May 2017. The District signed the $2.1 million contract with Inland Imaging, with the company focusing on collecting revenue aged over 90 days.

Bostrom said the District recently asked Inland Imaging to work on collections over a year old, instead of 90 days. With recent training and hiring in the EARH billing department, Bostrom said the EARH employees will work on collecting payments under a year old.

Kragt inquired if Bostrom was satisfied with amount Inland has collected in the past year, and Bostrom explained he was not happy with the rate of collection. The total payments made from Inland Imaging collections are $1,288,574.11.

In terms of recruitment, Bostrom explained the physician position salary has been increased to $250,000 in hopes of attracting an additional doctor. The position requirements were adjusted down to four days a week, with one weekend on call and working one night a week.

He added the District also is using a new recruiter, with seven recruiting agencies being contracted to help find a doctor. Bostrom explained the recruiters are not paid a fee upfront, only after hiring a candidate.

Kragt also asked about the potential of having a sign-on bonus, as many area hospital districts offer sign-on bonuses as incentives. There are currently three nursing positions open, and the Board will discuss the potential of adding sign-on bonuses for all positions during the July 26 board meeting.

The Hospital Board had a special board meeting on July 3 to discuss the sale of the East Adams Care Center property. The outcome of the meeting occurred after press time of the July 5 edition of The Journal.