Brownfield Regional Medical Center Board of Directors met Tuesday evening June 27, 2023, in a regularly scheduled meeting. This was the first meeting the Board had since moving the regularly scheduled meetings to the fourth Tuesday of each month. The meeting had previously taken place on the third Monday of each month. Board President Brian Paiva called the meeting to order and after the invocation, introduction, and recognition of special guests, the Board then went into the Consent Agenda.
Before the CFO Jim Koulovatos began his finance report, CEO Chuck Norris welcomed a staff member. BRMC recently decided to hire an outside person to do its marketing, and Kristin Wert was hired to do just that. According to Wert, she has been doing marketing for about 23 years and has helped several companies market and brand themselves with printed materials and social media.
The Board moved on to the finance report. Koulovatas began talking about the billing company. He told the Board, “We have a big issue. Our billing company and I don’t know if everybody knows this, but TruBridge is our billing and coding company, and they have since started probably in May… kinda assigned it to one of their subsidiary companies called HRG (Healthcare Resource Group). Well HRG in April did something… don’t know what they did, but messed up my general ledger going all the way back to January. So… I basically kinda had to redo the whole general ledger for four months… five months.”
Board member Chuck Nave asked, “Why do they have access to that?”
Koulovatas responded, “Well they are a part of CPSI (CPSI is the IT firm that BRMC uses.) I’m still not finished with that… I’m still going to have to go back and change some things because a lot of this was done, and I had to put it in manually. So I’ll have to go back and put in the correct balances in and CPSI is going to help me with that.”
Koulovatas moved on to talk about the rest of the finance report. He told the Board in April 2023 BRMC had a net profit of $148K to almost $149K. In the month of May 2023, BRMC brought in just a little over $2700 in net profit.
“I think we’re getting on the right track as far as hospital operations… as far as our revenue goes. I think we are keeping up. The only part of it, it’s not where we would like for it to be is out inpatient revenue. We’re still below our expectations. Now having said that, the trend has been going on 10, 15 years that inpatient revenue is really going down. More and more insurance companies are wanting you to do it, outpatient, again it’s a lot cheaper for them.” said Koulovatas.
Koulovatas mentioned to the board about the upcoming cuts that will help financially such as switching health insurance companies for BRMC employees. BRMC is also doing a staffing review for each department. They want to make sure that BRMC is not over-staffed or under-staffed. Koulovatas hopes this will help minimize overtime.
Koulovatas continued to talk about other issues that could potentially be causing less revenue. He said, “We do not have anybody in this hospital that knows coding… we have nobody. I think we did prior. But where that hurts us is we do not know if these people who are coding our charts, inpatient, and outpatient, if they aren’t doing it correctly, or if we are leaving any money on the table. If you don’t code correctly, you could be leaving thousands of dollars on the table.”
According to Koulovatas, he feels it would be good to hire a full-time coder for the hospital. The purpose would help if someone on site who codes, but does not understand what the doctor has put down, the coder can go directly to the doctor to find out so the coding can be done correctly and the hospital can receive the full funds from the insurance companies. The Board asked Koulovatas if he could come back next meeting with a proposal to hire a new in-house coder.
Koulovatas did end his financial report with good news. In the month of May, 20 babies were delivered and there were 18 surgeries. Also, the hospital had a 5.5 patient daily average census.
Next was the CNO report by CNO Janae Wright. According to Wright, when she first arrived at BRMC they were having a 40-60 medication variance. Medication variance is the failure to properly process a medication or treatment order as written by the prescribing authority. In the past month, it has been reduced to 16. She also told the Board, with the new barcodes on medications, it should be reduced more. Wright explained that she is working with the doctors to get them to put their orders in the computer. She said, “Of those 16, six were caused by transcription errors.”
The Board moved on to the CEO report. CEO Chuck Norris did not mince words when told the Board that BRMC will tend to suffer during the summer. He said, “Cash becomes pretty thin as volumes leave town with all the vacation crowd. Efforts to improve year-round cash flow must be investigated going forward.” Norris did show the Board a power point on what he hopes will help revenue.
According to Norris, the request for Tax Anticipation Note Funding will bring in additional funds and will be very important going through the summer months and into the fall. He mentioned in his presentation, that many expense cuts begin to take effect in July. As the CFO mentioned in his report, Norris told the Board the new insurance premium reductions begin in July. This is to save BRMC over $400K. Norris also wants to downsize contracts, and it will begin in July as well. Norris said, “Expenses must be cut.”
BRMC is also looking at some different revenue streams. Such as Da Vita inpatient dialysis, and continuing with surgeries, which BRMC has experienced a lot more lately. Norris ended on a positive telling the Board, despite ongoing cash flow disruptions at BRMC, also there are some significant possibilities for both expenses decreases as well as revenue increases. “The light may seem a little dim, but it is still out there.” Said Norris.
