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The Heart of the Rockies Regional Medical Center (HRRMC) Board of Directors heard updates on the district’s financial status as well as several pending construction projects during their Tuesday meeting.

Salida Health Center capital projects, become Antero Pavilion

Among major projects was the approval of a remodeling project for the Salida Health Center, 550 U.S. 50 at a total of $567,439. The work will be managed by Colarelli Construction and bid out directly to HRRMC.

The roofing project at the Salida Health Center facility was also approved at a cost of $210,000. Both items were handled separately from the expenditures approved under the consent agenda.

CEO Bob Morasko briefed the board on the move to employee providers at First Street Family Health at HRRMC. The facility will be renamed the Antero Pavilion as no family practice physicians will be located there after the remodel is completed at the Salida Health Center. There are plans to relocate other providers from the Hospital Pavilion to the First St. building, but CEO Bob Morasko reported some potential providers may not move until mid-2024.

Employee housing, family hospitality house plans move forward

Also in his report, Morasko said two cost estimates have been received for an employee housing project and a patient family hospitality house. A plan by Colarelli Construction met with the approval of the Facilities Committee and the Hospital Foundation Board. He said he is working with attorneys on plans to proceed with the projects.

Facilities Manager David Colarelli has submitted plans to the state for review for a wound center and hyperbaric chamber. Estimates on providing oxygen for the chamber will be provided prior to a proposal being submitted to the district board for consideration. A grant proposal from the hospital foundation to offset costs was not approved but is being sent back for reconsideration.

Financial reports

Morasko also recognized the work of Fiscal Services Vice President Karen Miller, her Revenue Cycle Team and Human Resources for progress in restructuring the department and recruiting staff.

Heart of the Rockies Regional Medical Center Executive Summary presented at August board meeting. Chart courtesy HRRMC

Miller’s Financial report showed overall good revenue trends generally, with some exceptions. Total patient service revenues were up slightly at $25.5 million for the month of July, and year-to-date revenues of $172.5 million exceeded budget estimates by 9.5 percent.

Net patient revenue for the month of July was $11.1 million against budget expectations of $11.9 million and slightly unfavorable for the year-to-date at $74 million against a budget estimate of $74.1 million.

Inpatient revenues were $2.5 million for the month, a 13.4 percent increase, and $17.2 million for the year against a budget of $14 million. Inpatient surgery volumes, however, were 32 percent under budget projections reported Miller.

Outpatient revenues were $22.9 million for the month, against a budget estimate of $23.1 million and $155.3 million for the year against a budget projection of $143.5 million.

Surgery statistics vs. budget over a five-year span at Heart of the Rockies Regional Medical Center. Graph courtesy HRRMC

Net operating income for the month of $1.2 million, compares unfavorably with the budget estimate of $1.7 million, Miller stated. Net operating income for the year-to-date was pegged at $6.3 million, a 0.6 percent increase over budget estimates.

Miller reported “We are continuing to hold an additional contractual allowance of (about) $700K to provide for an identified issue within the “charge master” relating to Observation stays.” AVV asked Miller to expand on the issue, the upkeep of which is a common problem in hospitals.

“The charge master issue was identified last month,” she said, “and relates to the hourly rate established (which appears to be in error), and when paid for by the insurance company, causes a higher contractual allowance than what our historical rate would indicate. Thus, as these claims are paid, higher amounts are disallowed. Due to payment timing delays, we want to be certain to have an appropriate allowance for this issue,” she added.

Miller’s report also noted net operating income included Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) supplemental payments for the state Medicaid program amounting to $695,000 for the month and $4.7 million for the year, as an offset to contractual deductions, meaning an overall contribution of $239,000 for the month and $1.6 million for the year, exceeding budget estimates by 0.6 percent.

The district’s net position increased $1.7 million for the month against budget estimates of $1.8 million. Year-to-date, the net position increase $8.8 million  compared to a budget figure of $6.6 million. Total profit margin for HRRMC was listed at 10.3 percent against the budgeted margin of 8.6 percent, Miller stated. Total days cash on hand was pegged at 228.

Aside from the major remodeling project funding approved separately, the board gave a green light to other equipment acquisitions:

Equipment acquisitions

Approved was the unbudgeted purchase of IT equipment for the former First Street Family Health building for staff including personal computers, laptops, phones, wireless access points, switches, a firewall and associated licensing from Microage/Flair Data for more than $38,600.

A new nurse call light system for MRI dressing rooms as well as removal of a nurse call unit from an old inpatient area, from Beacon Communication at an unbudgeted cost of $42,116 was also approved.

Other capital purchase items approved included a second Omni Retractor set, requested by surgeons, at a cost of $24,817; and a Ortho Titanium Small Fragment set for surgery as requested by surgeons at a cost of $66,677.

The board also heard a delayed focus topic review from Ear, Nose and Throat physician Dr. Brandon Bentz, who has an extensive background in that discipline as well as surgical cancer treatment, spanning a number of medical facilities.

Dr. Bentz said he also intends to become involved in the future with the effort to bring assisted living facilities to Chaffee County.

Featured image: Heart of the Rockies Regional Medical Center, June 2022. Dan Smith photo.