Dickinson County Healthcare System releases restructuring update

IRON MOUNTAIN, Mich. (WLUC) - The following DCHS Restructuring update stems from details and items discussed at Thursday’s Dickinson County Healthcare System Hospital Board of Trustees meeting as well as the Finance and House Committees meetings held earlier this week.

The main points of interest:
The Hospital Board of Trustees voted in the 2019 Officers:
Margaret Minerick – Chairperson
Dave Brisson – Vice Chairperson
Sally Blom – Secretary

Margaret Minerick said, “Thank you for the opportunity to serve as the DCHS Hospital Board of Trustees Chairperson. I am committed to stabilizing this health system and to ensure that DCHS provides care for the people of this community for years to come. Special thanks to Bill Edberg for his years of service as the Board Chairperson and we will look to his experience as he continues to participate as a Board Trustee. Also, thank you to Dale Ward Sr., Dick Berlinski and the former Board Members, for the time and effort they have put into helping to manage this health system. Finally, thank you to John Schon, for without his vision and hard work, DCHS would not have grown into the health system that it is today.”

The revenue cycle process at DCHS has been a major focus, specifically Hospital Billing. Interim CEO Jeanne Goche commented, “The Hospital Billing process at DCHS is complex, but the bottom line is we have begun to get money in the door sooner. One practice that has been identified and implemented is to capture charges and send bills out more timely. Another improvement implemented is more consistent completion of prior authorizations for procedures. The initial results of the procedures have shown an increase in the gross billing dollars. More to come.”

On December 18, 2018, the Dickinson County Healthcare System (“DCHS”) and the Michigan Nurses Association (“MNA”) met to bargain the MNA’s successor Collective Bargaining Agreement (“CBA”), as the current CBA expires on February 28, 2019. The parties discussed the Healthcare System’s financial situation, possible restructuring needs and changes anticipated in the future. Following this discussion, the parties agreed that negotiations related to economics are ill-timed. Therefore, the parties extended the CBA until August 28, 2019. This allows the Healthcare System to focus on addressing financial needs and concerns, anticipating a more stable financial position in the near future. With this extension, the MNA and the Healthcare System will have a better ability to negotiate economics.

The MNA will provide more in-depth updates to members directly during a membership meeting on February 6, 2019. Jeanne Goche expressed appreciation for everyone on the negotiating teams, “Action in these negotiations is part of the successes we are beginning to see in stabilizing our finances. This hard work also underscores for me the strength and character of the clinical staff at DCHS. We look forward to more successes in the days ahead.”

Venable LLP, representative Bart Stupak reported that thanks to the hard work of Jeanne Goche, Dennis Smith, the new Interim staff members, the team at Venable, the DCHS staff, and the local community who continue to support this health system, the decision has been made to suspend a request for a line of credit to assist with short-term cash flow shortfalls. Mr. Stupak stated, “The County Board of Commissioners has been informed that we will not seek a line of credit at this time, but we may need to revisit the request sometime in the future. It will just depend on the cash flow and as of right now, DCHS is ok.”

Mr. Stupak also reported that he was able to extend a Centers for Medicare and Medicaid Services (CMS) reconciliation payment of $2.5 million over a 36-month period as opposed to a lump sum payment that would have been due just prior to January 1, 2019. CMS determined that they had overpaid Dickinson County Healthcare System during the 2017 fiscal year, thereby initiating the payment due. This helps the organization with its short-term cash retention.

The accounting firm, Eide Bailly, LLP, (also DCHS’s auditing firm), has been engaged to begin a 5-year financial projection for the organization. The projection is one of the required elements in the Rural Development refinancing application.

A motion was made and approved to appoint a Pension Board comprised of three persons, none of whom are participants in the plan.

A hiring freeze is still in effect, however, positions are being filled as deemed necessary by the DCHS Restructuring Team, particularly in primary care areas.

With the closing of the Wausaukee Clinic, January 18, 2019, PA-C, George Wuensch will begin seeing patients at the Florence Medical Center three days a week (Wednesday – Friday), and will soon begin seeing patients at the Dickinson Family Practice Center located in Iron Mountain. George is inviting all of his patients to visit him at his new location. The Wausaukee Clinic property will be listed for sale.

In other news:
A review of patient activity throughout the month of November showed the following:
- Cared for 201 inpatients;
- Cared for 13,383 patients in the outpatient hospital setting including the Emergency Department;
- Cared for 10,666 patients in physician offices;
- Cared for 943 patients in the Emergency Department; and
- Uncompensated Care provided for the month totaled $514,649.

The hospital board also reviewed and approved the financial report for November of 2018. The healthcare system had $8,617,449 in total operating revenue and expenses totaling $8,636,083 that resulted in a loss in operating income of ($18,633). After the calculation of non-operating revenue and expenses, November closed with a negative bottom line of ($77,812).

November’s performance brought the year-to-date for 2018 to a loss in operating income of ($4,106,052). After the calculation of non-operating revenue and expenses, through November the 2018 year-to-date bottom line is a negative ($4,759,029).

DCHS will continue to provide updates on a regular basis and as new developments occur.



 
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