Hospital board deals with challenging 2017 budget

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GMH expects a budget shortfall in the 2017 fiscal year due to new government regulations on Medicare reimbursements. (Press photo by Molly Moser)

By Molly Moser

The June meeting of the Guttenberg Municipal Hospital board was called to order at 5:30 p.m.  on Tuesday, June 28. Present were board members Doug Reimer, Janice Andregg, Bill Allyn, Karen Merrick, and Sue Osterhaus. 

Board members heard a presentation from Ann Cannon, GMH director of marketing, and Laura Rainey, regional director of marketing for UnityPoint Health. “Ann has been working with Kim for years, assisting Guttenberg with marketing efforts,” Rainey explained, introducing Cannon for her first board meeting. Cannon was hired after the retirement of Leigh Ann Judge, and splits her time between Dubuque and Guttenberg.  

Cannon reported on her efforts since officially joining GMH staff, including marketing for providers and a brand new website set to launch this month. The new website incorporates enhanced features like pages for classes and events, expanded clinic and specialty clinic content, and a ‘find a doctor’ search. Each provider has their own page which contains a video interview with the provider. 

The board then discussed renewal of the UnityPoint Health Finley/GMH Management contract at a three percent increase in cost, which would be an estimated $73,000 for the year. Merrick requested more information about what is provided by the agreement in the form of a presentation from a UnityPoint representative, citing portions of the contract other board members were unaware of such as required board approval for hiring UPH/Finley employees. “I would be a lot happier if this was a six month contract,” Merrick stated. Reimer agreed, and Allyn made a motion to give CEO Kim Gau permission to sign a six-month contract. The motion carried unanimously. 

During a presentation of the fiscal year 2017 budget, Gau noted the hospital’s expected negative operating margin. Declining reimbursements from Medicare, due to new regulations and the fact that GMH is a Critical Access Hospital unrelated to a larger entity, means the hospital is unable to cover its operating expenses. “This is a new reality for the hospital. The board is grappling with the decision as to the best way to right the course for the organization,” Gau told The Press. “Do we become related parties with a health system, (which will increase our Medicare reimbursement back to traditional levels), or do we remain independent and make decisions related to operations that might reduce expense and/or raise revenue to make ends meet?”

In the interim, Gau said, the board has suggested supplementing the negative operating margin for the 2017 fiscal year using cash reserves. “This strategy will work in the near term but is not sustainable year after year. The Sustainability Study that was produced by Eide Bailly LLC out of North Dakota last fall suggests that if we do nothing to change our course, and if we lose our impending appeal with Medicare over their new interpretation of the regulations that guide reimbursement to Critical Access Hospitals, then we will be out of cash in six years. These are challenging times for the hospital and the board.”

Meanwhile, the hospital is attempting to expand services to increase income and still provide quality care. A chronic pain management clinic, opened this May, has been well-received. The clinic is held bi-weekly and is staffed by pain management nurse anesthesia practitioners from the Iowa Pain Clinic and managed locally by Deb Preston. 

A third emergency department provider has been offered a position for Monday through Friday E.R. coverage. “The third provider eases the scheduling process for 24-hour coverage.  With adequate emergency department coverage, the physicians are available to focus on keeping the clinic schedule moving along in a timely fashion,” said Gau. “It's a pretty competitive market to find a practitioner who wants to specialize in emergency medicine.”

Patient surveys rate Guttenberg Municipal Hospital in the 85th percentile, with the E.R. scoring above benchmark and the trend for recommending the hospital on the rise. In the most recent month, there were zero patient falls, zero hospital-acquired infections, no re-admissions, and excellent patient survey results in rehabilitation services, the emergency department, and ambulatory surgery.

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