In tough times, Washakie Medical Center CEO is optimistic

WORLAND – Two months of COVID-19 restrictions have led to a steep decline in revenues at Banner Health Washakie Medical Center, according to Chief Financial Officer Jennifer McMillan.

McMillan gave her report to WMC’s Board of Trustees in their regularly scheduled meeting on May 5. The meeting was held remotely by means of the Skype conferencing software.

McMillan said that the financial outlook seemed promising in the first half of March, but it took a steep nosedive when federal, state and county-level guidance for preventing COVID-19 transmission came into effect. WMC hospital operations missed budget in March by $238,000, as numerous surgeries were postponed and others were rescheduled to be performed in other facilities. Overall, inpatient revenue was below expectations by 30%. Outpatient care performed well, but it did not exceed budget enough to make up for the loss of inpatient revenue.

Insurance adjustments were somewhat higher than budgeted compared to WMC’s gross patient charges. This was due in part to a negative Medicare allowance adjustment. Late last year, WMC had estimated its 2020 Medicare allowance based on adjustment rates seen in the first three quarters of 2019. In the fourth quarter, however, Medicare adjustments were more conservative than expected. This may lead to long-term effects. “This year, we may have quite a few months in which our contractual adjustments are higher than anticipated,” McMillan said.

McMillan reported that year-to-date, the clinic was a bit in the red, missing budget by $13,000 in revenue and going somewhat over budget on expenses too.

If WMC’s March financial picture looked bad, it only seemed to get worse. “April is looking pretty dismal right now,” McMillan said. “It looks like we missed our gross revenue budget in April by $1.2 million,” she continued.

However, a little bit of help did soon show up from the federal government, with WMC receiving approximately $700,000 in federal funding through the first installment of the CARES (Coronavirus Aid, Relief, and Economic Security) Act. “Banner is going to ask us to spread that out over one-to-three months, probably three,” McMillan said.

What other funds may be expected from the effete East? “None of the Wyoming Banner facilities received any funding in the federal government’s second payout,” McMillan said. “The feds went back over their calculations and are trying to balance it,” she continued. “They feel like they overpaid us, according to their new algorithm.” McMillan said that Banner Health had hired a consultant to help the organization apply for additional types of funding from the federal government and other sources.

WMC Chief Executive Officer Jay Stallings provided some context for WMC’s current financial situation. He explained that for most hospitals across the country, the principal revenue sources are emergency room care and elective surgical procedures. “When we literally cut off this stream from surgeries, this had a significant impact on our facility,” Stallings said. “We managed expenses incredibly well. But if there’s no income, that’s where the true challenge begins.”

WMC did not care for any COVID-19 patients. Stallings explained the paradox therein for WMC’s finances. “One would think, if you don’t have any ‘COVID’ patients, you should be fine, and the opposite is actually true,” Stallings said. “This has had a much greater impact because we cut off surgeries. The only ones we’ve been able to do, under the guidelines, are urgent and emergent, those that absolutely had to be done.”

Another sad irony that Stallings described was in regard to N-95 medical masks and other personal protective equipment. The official rationale for greatly restricting hospital care nationwide in the past two months has been to ensure there was adequate supply of PPE at each facility, in the event that large numbers of people with COVID-19 infection would present for care. This did not happen at WMC, of course. Stallings said that the hospital was currently “in a really good spot” in regard to PPE supplies, thanks to the generosity of local community members and philanthropists.

With so little patient care being done over the past couple of months, Stallings described some of the ways WMC has sought to retain its personnel so that in due course they can come back to work. “We can’t just send our team home,” he said. “We’ve done everything we know to ensure that our people have income. That includes putting people on furlough, for example. And in that furlough time period, we pay for all their benefits. When they apply for unemployment, we don’t challenge that. We also have an opportunity for individuals who want to go out for a period of time, to be absent without pay; they can do that as well,” Stallings concluded.

Stallings estimated that three, possibly four WMC staff had been furloughed. He said that leadership across all Banner facilities had received 10%-20% cuts in pay.

Even with all this tough news, Stallings was optimistic about the future. “I think we’re in a good place to be able to start up again,” he said. “As of this week we’re able to start doing elective cases.”

Stallings was also optimistic about the potential for new funds becoming available from the federal government. “They recognize that critical access hospitals and rural facilities are in real danger of being woefully harmed,” Stallings said.

OTHER BUSINESS

The next order of business at the monthly meeting was to discuss bids submitted for re-paving the WMC parking lot. Three bids have been submitted: two from well-known local contractors and one from a Casper contractor. WMC Plant Operations Manager Steve Wiecki spoke of the need for exceptionally strong due diligence, in order to serve the community well. “Thirty or 50 years from now, I would like it to be a good reflection on the decision these board members have made,” Wiecki said.

Wiecki felt it was crucial that one particularly icy area on the north side parking lot be dealt with for good. “From when the first snow flies until three weeks ago, that place is an accident waiting to happen for slips, trips and falls,” Wiecki said. He described an approach that would solve the problem.

The Board will decide on a contractor when it meets again on May 26.

The Board also recognized two WMC Employees of the Month. These were Lori Nissen in radiology (March) and Tasheen Anderson in laboratory (April). The Board also celebrated Employee of the Year, Mandy Feather in medical imaging. Board members spoke in very glowing terms about all three ladies.