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The Heart of the Rockies Regional Medical Center (HRRMC) Board has approved a 2021 budget of $98,701,200 and voted to raise the hospital district mill levy from 1.784 to 1.864 mills to raise $1,006,398 to balance the budget.

All this is to be accomplished under the challenging shadow of a surging COVID-19 pandemic locally and across the state.

Vice President of Fiscal Services Lesley Fagerberg reminded board members that revenue estimates could be adversely affected if the coronavirus surge forces a shutdown of emergent and elective surgeries and other services at the hospital and clinics within the district, as occurred earlier in the year during the initial outbreak of COVID-19.

Fagerberg’s summary expects gross patient revenues to increase 20.2 percent; 15.9 percent attributable to volume increases and 4.3 percent to rate increases.

Total revenues from hospital operations and property tax are projected at $98,701.200.

Projected revenue deductions in the new budget are pegged at 51.6 percent compared to 51.1 percent estimated in the current year, including bad debt, contractual deductions for hospital and clinic services, charity and indigent care program write-offs.

Property tax revenue from Chaffee, Fremont and Saguache Counties assessed property tax valuations, expanded by the allowable 5.5 percent and a levy of 1.864 mills, stated Fagerberg, is expected to increase by 7.4 percent over current year revenues to contribute one half of one percent of total gross patient service revenues.

Net patient revenues are estimated in the new budget to increase more than 19 percent. Other projected revenue growth includes a robust 70.3 percent hike in the Outpatient Pharmacy in its second year of operation

Personnel costs, a major portion of the hospital expenditures are scrutinized and analyzed against projected volume changes, any new services to be offered and industry productivity targets, said Fagerberg.

The 2021 budget will include market-driven salary adjustments and a three percent increase in overall employee pay, awarded based on performance evaluations on the employee’s anniversary date.

Salaries are budgeted to increase by 11.2 percent and fringe benefits by 11.3 percent.

The 2021 budget reflects a six percent price increase for inpatient room charges, Fagerberg reported, except for the Family Birthing Center and Intensive Care, which will have no increases.

Ancillary service charges and their planned increases include a 15 percent hike for Operating Room and Endoscopy; 10 percent increase for the Emergency Department; six percent for the Imaging Service, except MRI/CT, Infusion, Patients Supplies/Implants and Cardiopulmonary; a four percent hike in MRI and CT; four percent for Rehabilitation Services and two percent increase in Laboratory services.

Fagerberg said there are no price increases budgeted for Internal Medicine, Oncology, Urology, Psychiatry, Neurology, Gynecology, Pain, ENT, Allergy, Cardiology and Orthopedic Clinics. The Salida, Buena Vista, Saguache and Custer County Centers as well as Pharmacy services will reflect no price increases.

Unforeseen costs can also be a factor in budget planning; for example, the announcement by Tom Eve of the Facilities and Strategic Planning Committee that pipes connected to the main hospital boiler are damaged and will have to be replaced. Cost estimates are expected in about a week.

Among the purchases approved by the board was a extreme cold chest freezer for storage of Pfizer COVID-19 vaccines, once they become available.

HRRMC has already been selected as a site for vaccine distribution, but no details have been worked out as to if and when they may be distributed to the hospital. The Pfizer vaccine, once released must be kept in very cold temperatures.