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The Heart of the Rockies Regional Medical Center (HRRMC) Board Tuesday reviewed and approved a Quality Management and Performance Improvement Plan.

The annual process was explained by Christine Blaney-MacMillan, Director of Quality, Patient Safety and Risk, as a continuous improvement framework to prioritize improvement initiatives, and identify processes for monitoring and establish oversight of organizational performance.

Heart of the Rockies Regional Medical Center. Dan Smith photo.

The initiatives will be customer (patient) and safety focused, she outlined, with the goal of safe, efficient, and effective patient care. To that end it will include monitoring by the Quality Alliance Committee, Quality Director, V.P. of Patient Care Services, V.P. of Operations, Medical Staff Performance Improvement Committee and the Board of Directors.

Blaney-MacMillan outlined at length how the plan is centered on a format to define, measure, analyze, improve and control (DMAIC) processes. This will be managed by involving quality improvement teams that will identify improvement strategies after extensive data gathering.

The board unanimously approved the plan.

Financials in Good Order

Fiscal Services Vice President Lesley Fagerberg reported that for the first month of the year, “we’re off to a good start.” adding that “the budget was set pretty high for this year, and in many instances, we are exceeding the budget …”

She reported that inpatient census figures were under budget estimates, with January inpatient revenue down about four percent. But she added that outpatient services “were off to a great start,” representing $17.6 million in gross revenues versus the budget estimate of $15.8 million; 11 percent over budget.

Ancillary services exceeding budget/revenue estimates included the imaging lab; which had the highest volume month ever. Rehabilitation services were up about three percent, she added.

Fagerberg reported that district clinics, while many showed good performance, were under revenue projections overall by about $200,000 or 9.4 percent, but she said this was not ‘overly concerning’ in the first month of the year.

The district was 8.3 percent over budget for total patient revenue at $23.2 million. Deductions from revenue were in line with budget estimates, she said, and other operating revenues are slightly above budget, bringing total operating revenues to $11.1 million, about five percent over budget.

Expenses, Fagerberg said were slightly above budget estimates. “But to a lesser degree than net revenues were above budget: 5.2 percent above on total operating revenues, versus about three percent up on operating expenses.

Net patient revenues versus operating expenses for the month were $645,000 against a budget estimate of $410,000 along with an increase in investment income.

A positive cash month meant that HRRMC has 226 days of operating cash on hand. Net days in accounts receivable saw ‘creep’ reduced, she reported.

CEO Bob Morasko briefed the board on the long-anticipated expansion of management and services at South Park Health Care in Fairplay, which got underway on Feb. 28. He credited employees for “all doing their part to make this a success.” There are signed contracts with a physician and nurse practitioner and all support staff has agreed to their compensation levels.

MRI Purchase Expenses Exceed Budget

The board also approved a costly change order for the purchase and installation of a Canon Magnetic Resonance Unit (MRI) and an uninterruptible power source (UPS). Fiscal Services Vice President Lesley Fagerberg explained that from original design to construction contracts, engineers missed some factors that will add additional costs to original estimates of about $400,000. Originally estimated last fall at about nearly $878,000 the unit will now cost a little over one million dollars. The board approved the first change order, electing to table three other potential change orders.

Fagerberg warned the board that other cost adjustments are anticipated with other projects, including the Pharmacy build-out.  Board chair Jeff Post said the MRI unit had arrived and that construction assembly was targeted for completion by May 6.

Post also told board members that the U.S. 50 remodel was proceeding but that a new roof will be needed  apparently to accommodate the installation of new HVAC units.

In other action, the board approved capital purchase requests for equipment including a shoulder arthroscopy instrument set, a Borescope optical tool, laptop computers to replace aging units, a GE integrated care unit for women and babies, interface and hyperlink to PACS, and pediatric ophthalmology instrumentation.