Board of Commissioners Meeting April 24, 2014 Summit Pacific Medical Center, Elma, WA

Transcription

1 Board of Commissioners Meeting April 24, 2014 Summit Pacific Medical Center, Elma, WA Grays Harbor County Public Hospital District No.1 Agenda 1. 6:00 - CALL TO ORDER a. Introductions as needed b. Business from audience 2. 6:05 - CONSENT AGENDA See separate Consent Agenda 3. 6:10 Committee Reports a. 6:10 - Quality Committee Report b. 6:30 CEO Renée Jensen i. CEO Report ii. McCleary Market Analysis iii. Board direction to CEO PHD#2 4. 6:50 Finance Will Callicoat a. Financial summary Drew Hooper b. Financial dashboards and statements 5. 7:10 Commissioner Business a. LEAPT update, Culture of Safety Mindy Portschy b. Board evaluations discussion Drew Hooper c. District investment options Will Callicoat d. Medical staff privileges i. Bonnie Anderson, PA-C, appointment to Family Medicine e. Meeting wrap up Drew Hooper 6. Adjournment Renée K. Jensen, Chief Executive Officer 600 E Main, Elma, WA Ph. (360) Fax: (360) Owned and Operated by Grays Harbor County Public Hospital District No. 1 SPMC is an equal opportunity provider and employer.

2 Board of Commissioners Meeting April 24, 2014 Summit Pacific Medical Center, Elma, WA Grays Harbor County Public Hospital District No.1 EBITDA Earnings before Interest, Taxes, Depreciation and Amortization WWRHCC Western Washington Rural Health Care Collaborative Consent Agenda A very useful technique involves the use of a consent agenda. The board agenda planners (usually the executive or governance committee, but occasionally the board chair with the CEO) divide agenda issues into two groups of items. The first are those items that must be acted on because of legal, regulatory, or other requirements, but are not significant enough to warrant discussion by the full board. Such issues are combined into a single section of the board agenda book; members review these materials prior to the meeting, and if no one has any questions or concerns, the entire block of issues is approved with one board vote and no discussion. This frees up a tremendous amount of time that would otherwise be squandered on minor issues. Any member can request that an item be removed from the consent agenda and discussed by the full board. The success of the consent agenda is predicated upon all board members reading the material in the consent agenda section of the board agenda book. If they do not, then the board becomes a veritable rubber stamp. The second group of agenda items are those important issues that require discussion, deliberation, and action by the board. These are addressed one by one. Executive Session Justification Executive Session is convened to discuss the following topics, as permitted by the cited sections of the Revised Code of Washington (RCW): Executive session (RCW ) (a) national security (b) (c) real estate (d) negotiations of publicly bid contracts (e) export trading (f) complaints against public officers/employees (g) qualifications of applicant or review performance of public employee/elective office (h) evaluate qualifications of candidate for appointment to elective office (i) discuss claims with legal counsel existing or reasonably expected litigation litigation or legal risks expected to result in adverse legal or financial consequences presence of legal counsel alone does not justify executive session QI/peer review committee documents and discussions Final action must be in open meeting Renée K. Jensen, Chief Executive Officer 600 E Main, Elma, WA Ph. (360) Fax: (360) Owned and Operated by Grays Harbor County Public Hospital District No. 1 SPMC is an equal opportunity provider and employer.

3 AGENDA CALL TO ORDER CONSENT AGENDA COMMITTEE REPORTS BOARD OF COMMISSIONER S MEETING March 27, 2014 DISCUSSION/CONCLUSIONS 6:00-CALL TO ORDER The Summit Pacific Medical Center Board of Commissioners Meeting was called to order at 6:00 pm Present: Commissioners present: Louie Figueroa, Chad Searls, Drew Hooper Amy Thomason arrived late (pre-arranged, excused) Gary Thumser was absent and excused Also Present: Renée Jensen, Brenda West, Will Callicoat, Jerri Peckham,Joy Iversen, Otis Leathers, Shannon Brear, Vicki Cambern, Shauna DePrato, Dr. John Rodakowski Introductions as needed Introductions were made Business from Audience No business from the audience CONSENT AGENDA-SEE SEPAR RATE CONSENT AGENDA Quality Committee Report- Louie Figueroa See separate quality report No hospital acquired infections Will receive recognition from WSHA for this One reportable trauma with no care concerns 9 drills were performed 731 patients in Emergency department in February Pharmacy and Therapeutics working on formulary RECOMMENDATIONS/AC TIONS/FOLLOW-UP A motion was made by Chad Searls to approve the consent agenda; ;Louie Figueroa secondeded the motion, and it was approved by a unanimous vote. Gary Thumser was absent and excused; Amy Thomason was not present for this part of the meeting.

4 BOARD OF COMMISSIONER S MEETING March 27, 2014 Shortage of IV fluids to purchase currently which could be a serious problem in our Emergency department. Environment of care has been meeting and is merging with Emergency Preparedness Committee Safety committee is contributing to LEAPT project for Culture of Safety The patient satisfaction process has been revamped. 2 patient complaints in ED; one patient felt she had been treated poorly because staff were discussing the Super Bowl at the nursing station. Another patient felt she had been pegged as a drug seeker; our Edie program was explained to the patient Action plan for Department of Health was approved CEO- Renee Jensen CEO Report Nursing contract: meeting with nurses and their representation on March 31 Western Washington Rural Healthcare Collaborative (WWRHCC): working on reference lab proposal for Quest and for PacLab. AWPHD: has released eight minute video showing work that public hospital districts do. Includes CEOs, commissioners, physicians, and community members. Available on the AWPHD website Mental Health integration project: Working with executive director of Choice to get this project revitalized. Washington Rural Health Association- Renee Jensen nominated by President Jon Smiley and elected to WRHA as a board member. Department of Health visit: Representatives from DOH visited to discuss how SPMC was transforming and responding to the pressure of healthcare reform. Grays Harbor Community Foundation: Hosted GHC foundation board meeting at SPMC. Renee presented on the current state, what has changed, and what the future holds for the organization Primary Care Team development: Training provided to primary care providers as well as support staff Mary Ellen Biggerstaff plans to stay at SPMC for the next eight years Tammy Davis will do a thesiss on provider satisfaction and retention Gary Thumser had his new commissioner orientation

5 FINANCE BOARD OF COMMISSIONER S MEETING March 27, 2014 North West Rural Health Conference: Renee was a speaker for a break out session at the NW Rural Health Conference in Spokane this month. Blue house: Inspections pending McCleary site: hosting Behavioral Health Resources for a tour to determine if the old hospital space might be a good option for additional office space for them. Internal Medicine update: providing limited treadmill testing for observation and medical unit patients. Hiring a RN to support these services. LEAPT projects: full update will be provided later in this meeting Deadline approaches to submit policies to DOH: new hospital licensing rules require certain specific policies to be submitted to DOH Replacement EMR: Committee working on this Strategic Plan: Management team incentivized for team performance on strategic plan which has had a dramatic positive impact on the management team s engagement with the plan Annual CAH Program Evaluation Report in Board packets Critical Access Hospital legislative policy update and highlights Summary in Board packets GHCH PHD#2 presentation, update, and discussion The Board of Commissionerss plan to meet with Grays Harbor Community Hospital Board to help them with their bid to become a Public Hospital District while supporting the long term welfare of SPMC & its Strategic Plan. Plaque follow-up discussion A donor has been procured for the purchase of the plaque. The donor wants the donation to go through the Foundation, remain anonymous and decide the content of the plaque with the board s suggestions in mind. The Board agreed Finance-Will Callicoat Financial Summary February inpatient and swing-bed days fell short of the budget but gross revenue was higher due to high outpatient and clinic volumes. Medicare s two-midnight rule is impacting inpatient days. CHPW owes us in excess of $45, Auditing of other payer contracts was discussed

6 COMMISSIONER BUSINESS BOARD OF COMMISSIONER S MEETING March 27, 2014 Cost report information is being collected Clinic visits were up Visits per provider data will be provided in the future Days in A/R increased by a few days. CBO will be helping with Emergency Department coding/chargingg to help reduce these days An in-person-assister has been hired full time to help public enroll in health care. Expenses were 1% below budget CBO is wanting to offer a service called Robo-call that would contact patients to remind them that they have a balance Will said that CBO is doing a good job with our billing Amy Thomason asked to table the discussion regarding District investment opportunities until next month Payment of mortgage begins in April. Next Finance meeting is April 17 th at 11:00 am Financial dashboards and statements LEAPT Update, Culture of Safety Update-Renee Jensen Data from Culture of Safety was shared LEAPT Update, Sepsis presentation-brenda West Brenda gave a presentation regarding the Sepsis project Board bylaws approval-renee Jensen The bylaws were previously reviewed by the commissioners. A final draft was reviewed and edited by legall counsel, Skip Houser. Final version presented for approval. A motion was made by Louie Figueroa to approve Board bylaws. Chad Searls seconded the motion, and it carried by a unanimous vote. Gary Thumser was absent and excused. External Conference Room Policy discussion-renee Jensen A community member has asked to rent our conference room to hold a political-type rally. Renee Jensen asked for discussion about whether or not we should restrict uses for our conference room for such purposes. There was discussion regarding placing a limit of the size of the groups that can use this room so that patient care and parking would not be impacted. Renee asked that the Board members consider what language should be in this policy and

7 BOARD OF COMMISSIONER S MEETING March 27, 2014 what, if any, restrictions should be placed on external use of the conference room. The board directed the executive team to gather more information about how other PHD s handle this topic. iserp District Policy approval-renee Jensen Drew Hooper abstained from any participation in discussions or voting on this topic. The Vice Chair, Louie Figueroa, conducted this part of the meeting. No decisions. A motion was made by Amy Thomason to approve the iserp District policy. Chad Searls secondeded the motion, and the motion carried. The Board members were polled, and Amy Thomason, Louie Figueroa, and Chad Searls voted yes. Gary Thumser was absent and excused.. Drew Hooper abstained from voting. The motion carried. Board Evaluations discussions-drew Hooper Tabled until next meeting Commissioner conference attendance discussion/decision-amy Thomason The Commissioner events for 2014 were discussed. Amy Thomason asked for suggestions on reducing event expenses in order to achieve the predetermined budget. Two commissioners will attend Chelan conference (Chad Searls and Gary Thumser have first choice; Drew Hooper and Amy Thomason are alternates) All commissioners will attend WSHA annual meeting and Strategic planning One commissioner will attend Rural Advocacy Days (Louie would like to attend) All commissioners would like to attend the Patient Safety Summit training 2014 Stroke Center Categorization update-brenda West 2014 Cardiac Center Categorization update-brenda West Brenda shared that it is time to recertify for Stroke Center and Cardiac Center

8 BOARD OF COMMISSIONER S MEETING March 27, 2014 Medical Staff privileges- Jaekyung Song, M.D. Initial appointment, hospitalist Mary Ellen Biggerstaff, ARNP reappointment, Family Medicine William Hurley, M.D. reappointment, Emergency Department Usha Emani, M.D. initial appointment, hospitalist Amy Thomason made a motion to approve Jaekyung Song, M.D. Initial appointment, hospitalist;mary Ellen Biggerstaff, ARNP reappointment, Family Medicine;William Hurley, M.D. reappointment, Emergency Department;Usha Emani, M.D. initial appointment, hospitalist; Louie Figueroa secondeded the motion, and it carried by a unanimous vote. Gary Thumser was absent and excused.. Ken McElroy, PA- courtesy privileges Tabled from February. Clarification of privileges being sought was needed. Dr. Rodakowski was at the meeting to explain how the credentialing process works. He explained that when someone applies to work here, a background check is performed focusing on their education, Board credentials, and whether or not there have been complaints or malpractice claims against them. He also explained the different levels of privileges that could be granted to a provider. The recent Medical Staff meeting was discussed. Several providers from Grays Harbor Community Hospital attended. A motion was made by Amy Thomason to approve Ken McElroy, PA, courtesy privileges. Louie Figueroa secondeded the motion and the Board members were polled. Drew Hooper, Amy Thomason, and Louie Figueroa voted yes; Chad Searls abstained from voting, and Gary Thumser was absent and excused. The motion carried. Meeting Wrap-Up- Drew Hooper Board Evaluation Discussion Amy Thomason mentioned that the Board will be involved in budgeting in July Chad Searls asked about the status of new Board member Gary Thumser s length of absence due to his illness

9 Executive session ADJOURNMENT BOARD OF COMMISSIONER S MEETING March 27, 2014 The meeting was moved to executive sessionat 8:49 pm for (RCW ) The regular meeting resumed business. at 8:59 pm and was adjourned with no further RECORDING SECRETARY BOARD SECRETARY

10 Finance Summary for March 2014 Summary March 31 signaled the end of the open enrollment period for the Affordable Care Act. Summit Pacific s Enrollment Specialist began on March 25. In the three weeks since, she has enrolled 31 people onto a qualified health plan and Apple Health (the state s Medicaid plan). The following table summarizes the towns of these new enrollees and illustrates the reach of our service area. # of Township Enrollees Elma 9 McCleary 5 Hoquiam 4 Oakville 4 Montesano 3 Aberdeen 3 Shelton 1 Humptulips 1 Roy 1 An estimated 18.3 percent of the county is uninsured. Based on this, we estimate approximately 2,500 uninsured in Elma, McCleary, and Montesano, so there is still a ways to go. To that end, Summit Pacific Medical Center is working on a mailing to educate the community that enrollment for Apple Health can occur any time during the year, and that we have a resource to help. March 31 is also the end of the first quarter of the fiscal year. To date, inpatient and swing bed days and revenue are short of budget by 191 days and $518,764. The Centers for Medicare and Medicaid Services have issued stricter standards for inpatient admission criteria. Thus more and more patients are being treated on an observation status versus being admitted to the inpatient floor. Observation patients are technically considered outpatients, thus the outpatient revenue is exceeding budget. Primary care in the clinics are also far exceeding budget. There were 5,800 total clinic visits compared to a budget of 4,367 for the quarter. Volumes There were 37acute care patient days, 48 swing bed days, and 33 observation days, creating an average daily census of 3.8 overall. The budget called for a census of 6.4. There were 869 visits in the Emergency Department (ED). ED visit statistics dating back to 2005 are readily available and March s ED visits were the most noted in the past 9 years. There were 1,990 rural health clinic visits, or 95 visits per weekday in March. RevenueGross revenue was $3.9 million, exceedingthe $3.6 million budget by nearly ten percent. Expenses Expenses (excluding interest and depreciation) are over budget by 7 percent. More research is being performed by the department managers, specifically in the area of supplies and purchased services. There is a plan through the Collaborative to obtain a better reference lab contract, which will significantly lower costs. That should be finalized and in effect within a few months. During the March close, we discovered an error that understated the wages and benefits of the February income statement by $153,000. These amounts are now accurately reflected in our March year to date values. Finance has implemented an additional closing checklist to mitigate this error from occurring again. Renee K. Jensen, Chief Executive Officer 600 East Main Street, Elma, Washington Owned and Operated by Grays Harbor County Public Hospital District No. 1, SPMC is an equal opportunity provider and employer

11 Balance Sheet The District s cash position increased from$2.9 millionto $3.2 million. $1.8 million of the total is in reserve for our debt obligations. Days cash on hand increased from 72 to 74, which is two days below our target. Days in Accounts Receivable (AR) decreased from 89 to 84. The ED coding and charge entry is now being performed by the billing office, and there is a ramp up period, so we anticipate days in AR to increase in April before coming back down again. W. Callicoat Renee K. Jensen, Chief Executive Officer 600 East Main Street, Elma, Washington Owned and Operated by Grays Harbor County Public Hospital District No. 1, SPMC is an equal opportunity provider and employer

12 4/18/2014 INCOME STATEMENT March 31, 2014 VARIANCE VARIANCE CURRENT % YTD % CURRENT MONTH OVER YEAR TO DATE OVER ACTUAL BUDGET PRIOR YEAR VARIANCE BUDGET ACTUAL BUDGET PRIOR YEAR VARIANCE BUDGET GROSS OPERATING REVENUE 282, , ,544 (341,343) -55% INPATIENT REVENUE 1,146,396 1,665, ,205 (518,764) -31% 1,189, , , ,839 57% OUTPATIENT REVENUE 3,167,605 2,230,289 1,616, ,316 42% 182, ,116 90,080 73,758 68% SPHC OUTPATIENT REVENUE 524, , , ,307 73% 96,250 93,945 53,082 2,305 2% MRHC OUTPATIENT REVENUE 305, , ,205 32,593 12% 67,628 72, ,490 (5,312) -7% EFM OUTPATIENT REVENUE 186, , ,444 (25,077) -12% 2,094,868 1,908,327 1,754, ,541 10% EMERGENCY REVENUE 5,899,165 5,591,670 4,129, ,495 5% 3,913,602 3,564,814 2,953, ,788 10% GROSS PATIENT REVENUE 11,229,915 10,274,045 7,451, ,870 9% REVENUE DEDUCTIONS 973, , , ,257 28% MEDICARE CONTRACTUALS 2,627,595 2,256,099 1,405, ,496 16% 856, , , ,545 47% MEDICAID CONTRACTUALS 2,070,297 1,680,582 1,066, ,715 23% 244, , ,774 (73,622) -23% OTHER CONTRACTUALS 1,019, , , ,827 11% 259, , ,920 (55,524) -18% BAD DEBT EXPENSE 1,094, , , ,360 21% 50,003 86,792 66,735 (36,789) -42% COMMUNITY CARE 179, , ,992 (70,543) -28% 23,824 71,538 85,137 (47,714) -67% ADMIN. ADJUSTMENTS 45, , ,980 (160,981) -78% 2,407,568 2,136,415 1,532, ,153 13% TOTAL REVENUE DEDUCTIONS 7,037,015 6,218,141 4,226, ,874 13% 50,715 12,100 34,027 38, % CLINIC ENHANCEMENTS 127,742 36,300 49,626 91, % 8,652 3, , % OTHER OPERATING INCOME 19,215 9,752 1,560 9,463 97% #DIV/0! DISPROPORATIONATE SHARE #DIV/0! 1,565,401 1,443,699 1,455, ,702 8% NET OPERATING REVENUE 4,339,857 4,101,956 3,275, ,901 6% OPERATING EXPENSES 747, , ,032 50,112 7% SALARIES AND WAGES 2,022,375 1,938,337 1,620,233 84,038 4% 126, , ,691 (12,001) -9% EMPLOYEE BENEFITS 393, , ,935 7,444 2% 161, ,190 85,643 10,029 7% PROFESSIONAL FEES 479, , ,987 35,880 8% 114,270 98, ,737 15,839 16% SUPPLIES 314, , ,074 28,911 10% 24,394 31,861 30,345 (7,467) -23% UTILITIES 72, ,485 96,652 (28,897) -28% 133, , ,651 (11,478) -8% PURCHASED SERVICES 412, , ,654 67,335 20% 15,448 15,458 26,124 (10) 0% INSURANCE 48,202 45,314 52,020 2,888 6% 45,675 21,760 31,667 23, % OTHER EXPENSES 138,459 65,244 79,863 73, % 8,156 9,432 13,076 (1,276) -14% RENTALS AND LEASES 23,925 28,298 31,935 (4,373) -15% 0 #DIV/0! 1,377,270 1,309,607 1,109,966 67,663 5% EXPENSES SUBTOTAL 3,905,196 3,638,755 3,120, ,441 7% 188, , ,594 54,039 40% EBITDA 434, , ,163 (28,540) -6% 37,110 66,281 2,222 (29,171) -44% INTEREST EXPENSE 169, ,839 6,473 (29,588) -15% 143, , ,482 35,374 33% DEPRECIATION & AMORTIZATION EXPENSE 429, , , ,941 33% 1,557,455 1,483,589 1,234,670 73,866 5% TOTAL EXPENSES 4,503,495 4,160,701 3,268, ,794 8% 7,946 (39,890) 220,890 47, % NET INCOME (LOSS) FROM OPERATION (163,638) (58,745) 7,313 (104,893) 179% NON-OPERATING REVENUES 49,723 60,150 64,254 (10,427) -17% TAX REVENUES 137, , ,006 (43,040) -24% 2,387 1,377 1,297 1,010 73% MISC. NON-OPERATING REV. 8,429 4, ,042 4, % 52,110 61,527 65,551 (9,417) -15% TOTAL NON-OPERATING REV. 145, , ,048 (38,737) -21% 60,056 21, ,441 38, % NET INCOME OR (LOSS) (17,802) 125, ,361 (143,630) -114% -1-

13 4/18/2014 BALANCE SHEET As of March 31,2013 CURRENT LAST DECEMBER 31, CURRENT LAST DECEMBER 31, MONTH MONTH 2013 MONTH MONTH 2013 ASSETS LIABILITIES CURRENT ASSETS CURRENT LIABILITIES OPERATING CASH 1,323,612 1,028,546 1,012,055 ACCOUNTS PAYABLE 346, , ,623 LGIP & RESERVE 1,873,970 1,873,970 1,873,970 OTHER PAYABLES 26,917 6, ,675 ACCOUNTS RECEIVABLE 10,530,705 10,463,335 9,654,468 PAYROLL & RELATED LIAB 954, , ,503 ALLOWANCE FOR BAD DEBTS (2,563,097) (2,563,097) (2,438,097) OTHER ACCRUED EXPENSES 324, , ,987 ALLOWANCE CONTRACTUAL ADJ (3,779,252) (3,779,252) (3,354,657) DUE TO THIRD PARTY PAYORS 1,112,444 1,049,444 1,054,098 RECEIVABLES - TAXES 161, ,418 61,822 PATIENT REFUND PAYABLE 8,489 3, RECEIVABLES - OTHER 10,559 12, ,535 CURRENT PORTION LONG TERM 1,103,793 1,083, ,639 INVENTORY 163, , ,342 PREPAID EXPENSES 53,771 66,143 25,706 TOTAL CURRENT ASSETS 7,775,246 7,390,594 7,157,144 TOTAL CURRENT LIABILITIES 3,876,745 3,484,888 3,520,950 BOARD DESIGNATED ASSETS FUNDED DEPRECIATION GROSS LONG TERM DEBT DESIGNATED CONSTRUCTION LAND & BONDS PAYABLE 20,701,421 20,701,421 20,560,849 TOTAL BOARD DESIGN ASSETS TOTAL GROSS LONG TERM DEBT 20,701,421 20,701,421 20,560,849 PROPERTY, PLANT & EQUIP LAND 1,623, , ,846 LESS CUR. PORTION LTGO/CT (1,103,793) (1,083,639) (908,639) LAND IMPROVEMENTS 65, , ,906 BUILDINGS 18,118,655 18,118,655 18,111,655 EQUIPMENT 3,696,162 3,658,661 4,615,537 NET LONG TERM DEBT 19,597,628 19,617,782 19,652,210 CONSTRUCTION IN PROGRESS TOTAL PROP,PLANT, & EQUIP 23,503,569 23,466,068 24,415,944 TOTAL LIABILITIES 23,474,373 23,102,670 23,173,160 LESS: ACCUM DEPRECIATION (3,180,794) (3,037,719) (3,765,322) EQUITY NET PROP, PLANT & EQUIP 20,322,775 20,428,349 20,650,622 UNRESTRICTED FUND BALANCE 4,641,449 4,641,449 4,742,682 EXCESS REVENUE/(EXPENSE) (17,801) 74,824 (108,076) TOTAL UNRESTRICTED FUND 4,623,648 4,716,273 4,634,606 TOTAL ASSETS 28,098,021 27,818,943 27,807,766 TOTAL LIABILITY & EQUITY 28,098,021 27,818,943 27,807,766

14 4/18/2014 Financial Dashboards March 31, 2014 CURRENT PRIOR BUDGET LEGEND _ 4,000 3,500 3,000 Gross Patient Services Revenue $1,000 $900 $800 $700 Salary & Benefits Days Cash on Hand 2,500 $ ,000 $ $2,500 $2,250 $2,000 $1,750 $1,500 Operating Expense FTE'S Paid FTE's Worked FTE's Days in A/R $1, $1,000 $ $ $300 $100 $(100) $(300) $(500) $(700) $(900) Operating Income - Loss $35,000 $30,000 $25,000 $20,000 $15,000 $10,000 $5,000 Overtime $ $300 $100 $(100) $(300) $(500) $(700) $(900) Net Income-Loss Cockpit Finance March 2014 New Charts

15 4/18/2014 Cockpit Volume March 2014 Volume Dashboards March 31, 2014 LEGEND: CURRENT PRIOR BUDGET. _. _. _. Acute Care Patient Days Swing Bed Days Lab Tests , , , , ,000 Observation Hours Emergency Dept Visits X-Ray - RVU's Ultrasound Exams CT Exams MRI Exams MRHC Visits vs. Budget EFM Visits vs. Budget 1,100 1, SPHC Visits vs. Budget

16 STATISTICS March 31, 2014 MONTH YEAR TO DATE ACTUAL BUDGET PRIOR MONTH ACTUAL BUDGET PRIOR YEAR INPATIENT STATISTICS ADMISSIONS PATIENT DAYS EMERGENCY ADMITS LENGTH OF STAY SWING BEDS ADMISSIONS PATIENT DAYS OUTPATIENT STATISTICS OBSERVATION HOURS 2, EMERGENCY ROOM VISITS 2,384 2,265 1, MRHC CLINIC VISITS 1,746 1,466 1, EFM CLINIC VISITS 987 1,196 1,811 1, SPHC CLINIC VISITS 3,067 1, ,416 1,175 1,268 OTHER OUTPATIENT VISITS 4,001 3,537 2,609 ANCILLARY STATISTICS 5,997 4,893 5,158 LAB BILLABLE TEST 16,999 14,259 11, XRAY RVUS 1,824 1,618 1, CT EXAMS ULTRASOUND EXAMS MRI EXAMS OTHER STATISTICS Goal December 31, 2013 DAYS IN A/R DAYS IN PAYABLE EXCL 3RD/DEBT 8 < 15 8 DAYS IN CASH CURRENT RATIO