Mendocino Coast Hospital District Finance Committee March 27, 2018

Stepping over a dollar to pick up a dime!

While the Mendocino Coast District Hospital (MCDH) Finance Committee was unable to legally convene on March 27, 2018, without a quorum. Given there are only 6 actual members of this most vital committee, it takes 4 people to have a quorum. Mr. Knapp was understandably tied up with the Westport tragedy while Tom Birdsell and Chair Dr. Lucas Campos were missing in action.  We expected that Dr. Campos would at least call in from his San Francisco apartment, like he will for the MCDH Board meeting Thursday, March 29.

Fortunately, Dr. Glusker had the foresight to have Interim CFO John Parigi provide an invaluable Budget Narrative for the February Financials, clearly outlining literally millions of dollars in potential revenue and costly expenses, which MCDH is not maximizing.  While CEO Edwards choose to leave the meeting at this point, Mendocino TV sincerely hopes that MCDH Board Members will watch this video and carry forth Mr. Parigi’s plan, recovering much more money than the 1.7 million dollars a year that the $144 Parcel Tax will bring to our coffers.

Here is a sampling of items negatively impacting MCDH Financials and potential solutions:

  • Gross Patient Accounts Receivable has drastically increased this year!
    • Over 5 million dollars will “age out” if not worked case by case in the next 6 months.
    • Coding errors resulting over 3 million dollars un-billed, most of which is still recoverable.
    • The data input systems at MCDH are difficult to use effectively as the disparate programs do not communicate with each other, produce data needed and involve too much human contact, which creates errors, resulting in denied claims.
    • There is such a need for more accounting staff to follow up on aging accounts, un-billed accounts and coding. A short term specialized firm can help remedy this situation.  Need at least 5 more permanent staff.
    • In February Medicare claims from July were billed at over 3 million dollars, resulting in receiving over 1 million dollars, which offset the money Medicare currently deducts for previous over-payments.
  • Medicare patients, who are reimbursed at 99% of costs, have drastically been reduced, resulting in reduced revenue to MCDH.
  • Private Insurance company contracts need to be negotiated by contracted professionals, who specialize in doing that.
  • Inpatient hospital patients are down, while outpatient, clinic visits and home health have slightly increased, resulting in lower gross patient revenues.
  • Charge Masters must be updated as some services are being billed at a lower amount than what it costs the hospital to provide it.
  • A Materials & Supplies Manager is critical, as there is no oversight at a time when operating expenses are drastically increasing (over 2 million dollars more year to date over last year) and income is decreasing.
    • Charges need to be revised as some items are being billed at a lower cost than MCDH paid for it.
    • Need most efficient purchasing and inventory controls. For example, in February, two pacemakers were purchased and only one used, what happened to the other is unknown.
  • New Contractual Models need to be developed for the NCFHC and Home Health.
  • The Interim CFO is being let go before a replacement has been hired, so no training or transition support will be provided.

These are some items and there is more, so watch the video to understand the many financial opportunities available which potentially have a tremendous impact on the MCDH financial situation.  While in the short term it will cost more money to capture these losses and re-engineer the system, in the long run it can bring MCDH out of the red and increase trust and satisfaction with the community.

MCDH FEB Finance Report 1
MCDH FEB Finance Report 2
MCDH FEB Finance Report 3
MCDH FEB Finance Report 4
MCDH FEB Finance Report 5
MCDH FEB Finance Report 6
MCDH FEB Finance Report 7
MCDH FEB Finance Report 8

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