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Heart of the Rockies Regional Medical Center (HRRMC) is starting the year off on good financial footing and approved a number of major capital request purchases at its Board of Directors meeting on Tuesday, February 23. The board was also updated on construction at the Buena Vista Health Clinic, the groundbreaking of the new Solvista Health facility at HRRMC, and on a few analyses and evaluations of hospital performance. 

Starting off strong in the new year

Lesley Fagerberg, VP of Fiscal Services, reported on January’s operations, saying that while the hospital saw a reduction in gross revenue by about 2.5 percent (which translated to a 1 percent reduction in net operating revenues), HRRMC was also down 2 percent on expenses. Additionally, some above and some below budget variances from department to department balanced out well. Fagerberg also reported that the medical center saw 318 outpatient surgeries, one of the highest one-month counts in the hospital’s history. 

In spite of the success so far, the board is still assessing the impact of some of the COVID-19 precautions, which may result in an under-budget position as the year goes on. 

The hospital saw just over $320,000 of cash outflow in January and has 250 days cash on hand, putting them in a good position based on previous benchmarks. The hospital is also preparing to return $8.7 million in Medicare advance payments in April. 

“We are in a good position, cash-wise,” Fagerberg said. “Even with [the Medicare advance payment return] coming, we will still be in a strong position.”

The hospital’s net days of accounts receivable also dropped slightly from the end of the year. 

Heart of the Rockies Regional Medical Center is an officially accredited Critical Access Hospital by The Joint Commission. Courtesy logo

“[There are] lots of activities going on in that department … to reduce medical necessity denials and other reasons that we might not recover monies that we should,” Fagerberg explained. The hospital is also “over the top” on operating and profit margins. “It was nice to see that, at the end of the year, we pulled out to a positive status and hopefully won’t have any concerns with that as the year goes on.”

The hospital is currently seeing a better-than-budgeted increase in its net position, coming in at $565,867 for the month of January compared to the budgeted $473,836.

Capital purchase requests and a new breezeway for the BVHC expansion

The board heard and approved six major capital request purchases, including a construction project at the Buena Vista Health Clinic (BVHC).

A high-speed scanner was approved for purchase to replace one that is no longer in production, and a new microscope was requested for the BVHC’s on-site labs in order to increase testing efficiency instead of sending specimens back to the main lab. Additionally, the board gave the green light to the purchase of 63 new laptops for use in the field to replace broken and failing devices currently in use. 

The board also approved two new vehicle purchases, including an all-wheel-drive courier vehicle and a utility terrain vehicle (UTV) with a snowplow. The courier vehicle will help the driver make more efficient and safer trips in poor weather conditions, and the snowplow will help keep hospital roads and sidewalks clear for patients and staff. 

The board approved a request to pay for an additional breezeway connection at the BVHC expansion. While the original BVCH expansion designs included a breezeway connecting the existing clinic to the new additions, “further review of new workflows and growth opportunities for the walk-in clinic has shown that an additional connection between the old and new buildings will be beneficial,” according to the request. 

Construction of the additional breezeway was approved in November 2020 in order to open access to the additional exam rooms added to the northwest clinic in the expansion and enable the waiting area to be observed by two nurses’ stations.

The adjustment will also allow the walk-in clinic to be separate from the main clinic during weekends when the entire building isn’t needed while still keeping access to outpatient services in the new building. It is also intended to make social distancing easier as part of the COVID-19 pandemic response. The new breezeway will be added to the construction already contracted through Colarelli Construction. 

Analyses, Evaluations for 2020/2021 presented, other initiatives introduced

CEO Robert Morasko estimates that the remodel for the BVHC will be fully completed in early May and that Marketing and PR Director Allison Gergely will coordinate the groundbreaking for the Solvista facility on the HRRMC campus in April. Peter Edis reported that Solvista will be moving into its new space at BVCH by the end of February. 

April Asbury, Vice President of Patient Services, presented the Hazard Vulnerability Analysis (HVA), which analyzes the hospital’s position in cases of major risk occurrences. 

“It’s something that we have to do every single year,” Asbury explained. “Once we have it pretty much done, we take it to the board just so [they] are aware of the potential hazard vulnerabilities that were identified in the assessment.”

Some of the main risk occurrences identified were severe blizzards and snowfall, staffing shortages, and extremely cold temperatures, while some of the most vulnerable areas for risk response included nuclear or radiological attacks and national disasters. 

Asbury and Morasko also presented the Critical Access Hospital (CAH) Evaluation for 2020. The hospital was aiming to get Joint Commission accreditation in 2020 and met that goal in September of 2020, despite the COVID-19 pandemic. 

Morasko commended HRRMC for completing more than 1,200 vaccinations by the time of the meeting and on HRRMC’s and BVHC’s and other clinics’ quick adjustment during the pandemic to address the spread of COVID-19 in the community.