Thursday, May 29, 2014

Hospital Board considers daycare

By Will Bublitz

A draft plan for Lincoln Community Hospital (LCH) to open a daycare center in Hugo was presented at the hospital’s Board of Directors meeting last Thursday, May 22.

Monika Wilkins, LCH’s Chief Executive Officer, presented the board with the four-page “Daycare Business Plan.” The proposed daycare center would be staffed and operated by the hospital.
“The hospital is pursuing the possibility of opening a daycare center in Hugo,” Wilkins said. “This is still very preliminary. We’re only considering it because of the hardship that would result if minimal licensed daycare is lost in this town.”

Wilkins developed the business plan for the proposed daycare center in response to a request made by Hugo Mayor Patsie Smith at the board’s March meeting. Smith asked the hospital to consider opening a daycare center because she had learned that Hugo’s only licensed daycare provider is moving away this summer.

In her Daycare Business Plan, Wilkins said the proposed daycare center could be designed to provide affordable, safe and reliable care. A licensed daycare provider hired by LCH would manage the facility.

Wilkins’ plan envisions setting up a daycare center that could handle up to 25 children ages three months to 10 years. To deal with that many children, the center will require a building that has a minimum size of 900-square feet. In addition, the building has to be located adjacent to an outdoor area about 1,900 square feet in size that can be used as a playground.

The daycare center’s initial startup costs are estimated to be about $35,000. Some state funding is available to assist with those costs. After it opened, Wilkins said the daycare center would “probably make enough to pay for itself.”

While operating a daycare center is feasible, Wilkins said one major obstacle still remains, which is finding a building large enough to meet its space requirements. She said a number of locations had already been looked at, but none of them were suitable.
“This is still up in the air,” Wilkins said.

Moving onto other business, Patsy Shields, LCH’s Chief Financial Officer, informed the board that Lincoln Community Hospital is going to be reimbursed more than $760,000 by Medicare this year.
“Medicare owes us the money,” she said. “That’s a bit of good news that you should know.”

During Shield’s report on the hospital’s finances, Director Steve Burgess raised questions about how the financial statements for LCH’s Care Center (aka Nursing Home) are being calculated. He said the formula being used to develop its balance sheets had to be incorrect.

The issue of the Care Center’s finances has been a concern for the past four years after its resident numbers dropped into the mid-20’s, which is well below the 30 residents that hospital officials say is required for it to “break even” financially.

Citing the numbers from the March financial statement, Burgess said the formula had to be wrong because the financial losses still remained very high despite the Care Center being only three residents short of the 30-resident break-even point. He called for a review of the formula.

Responding to those questions, Shields explained that she was still using the formula developed years ago by the hospital’s former CEO/CFO. Shields was appointed the hospital’s CFO last year.

After some discussion, the board passed a motion directing Shields to recalculate the Care Center’s financial statements to allocate more of the county funding to the center based upon its square footage.

Also during Thursday’s meeting, the monthly reports on patient numbers were presented to the board. In his report, Dan Walker, the Director of Nursing, said the hospital’s in-patient numbers declined from a daily average of 1.5 during February and March to 1 in April, but the census of swing-bed  patients rose to 3 in April compared to 2 during the previous two months. The number of observation patients remained steady at an daily average of 0.5 for the second month.

Walker also reported that the Emergency Room visits were down from a year-to-date high of 208 in March to 188 in April. To help the board understand the types of cases dealt with by the ER staff, he divided the April patients into the following categories – 116 medical, 6 motor vehicle accidents, 22 falls, 12 chest pains, 5 lacerations, 6 abrasions/contusions, 8 strains/sprains, 1 burn, 5 shortness of breath, 5 head injuries, 2 fractures, 2 suicide attempts, 1 farm injury, 1 myocardial infarction, 1 insect bite and 1 farm animal accident.

The number of ER transfers to urban hospitals fell last month. During March, LCH transferred a total of 34 patients compared to just 25 in April.

Surgeries and procedures performed by the hospital’s specialty doctors shifted slightly. A total of 28 procedures were performed in April compared to 24 in March. The number of surgeries took a dip from 11 in March to 9 last month.

Walker detailed the surgeries performed in April, dividing them into the following categories – 5 plastics, 2 cataract, 1 gall bladder and 1 tubal.

Wilkins continued the census reports by informing the board that the Care Center’s patient numbers had taken a slight drop last month. During April, it had a daily average of 25 residents compared to 27 in March. She said that as of earlier that day, the Care Center’s census stood at 26 patients.

Cerina Cunningham, the director of LCH’s Home Health & Hospice, was present to present her department’s report. During April, there were 16 Home Health and 5 Hospice patients. During that month, the department’s nurses had made a total of 124 visits to Home Health patients and 46 visits to Hospice patients. had 21 patients compared to 18 in February, while Hospice had 6 in March compared to 3 in February.

The overall number of patient visits to LCH’s four satellite clinics took a slight dip in April with a total of 1,200 compared to 1,233 in March. However, March’s numbers were still below the year’s high of 1,344 visits made in January.

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