Hospital board hears report from major audit

At the March 30 Hot Springs County Memorial Hospital Board meeting, hospital CEO Margie Molitor said they are about to complete Phase Four in their funding and are about done with the USDA loan application, which will be completed in the next week.

The remaining items are cosmetic work, including painting and carpeting. Around May 15 is when they close the loan.

Molitor wants the public to know that total joint replacements are possible here in Hot Springs County with surgeons Dr. Francisco, out of Lander and Dr. Caldwell who is from Denver. One does upper extremities and the other does sports medicine. Molitor expressed concern about the state legislator passing Medicaid expansion and said it’s important to move forward.

Currently, there is a 50%-50% split in funding. The new legislation would have the federal government pay 90% and then Wyoming would pay 10%.

The bill would also allow an additional $120 million for COVID relief funds to help pay for the 10% and what Medicaid is going to cost them. That money would cover the cost for about 10 years. They are in a wait-and-see with the Senate. 

The hospital recently went through a major audit performed by Michael Wright and his accountant team. They went through their financial statements and Wright said, “There’s a lot going on in your financial statements.”

In Wright’s package he presented to the board there were three audit reports. One is a financial statement audit that shows how they operate as a governmental entity and must meet those types of accounting standards and county policies. The data shows cleared or unqualified information. They also show compliance. Included in the data as they received $750,000 in grant money coming from the federal government and had $16.105 million in financing. 

Wright said the compliance audit was highly regulated using OMB regulations. They are used to determining intended control procedures in other grants. Wright said there were three findings. One is the carryover from the financial statement audit and that there was a lack of segregation of duties because of the small size of the hospital. Wright said the board is “the last line of defense.”

The second finding is a repeat of a finding from last year, which came from the USDA must be secured in a bank account. Wright found $17,000 in an unsecured account as an anomaly. That money was then sent to banks across the country to secure them in case they exceeded the insured limit and are not in compliance.

The last finding, Wright provided a commitment letter to the USDA. The reports are filed quarterly or annually. In the letter, he states some of the reports were late and could not tie into numbers that were not reconciled.

In Wright’s report under test on controls, he found a variety of minor errors, including not making timely filings and accuracy issues. Chief Financial Officer Shelly Larson made a response in the report. The hospital board voted and passed to accept the audits.

In the foundation update, Dan Powell said they filed a form with the Wyoming Secretary of State to update the trade name to the Hot Springs Health Foundation.

The 3D mammography imaging machine is in place and running. The foundation will do a presentation ceremony for it, highlighting the funds they raised to purchase the machine. That amount was $24,000 with $15,000 from a grant which was submitted with the Wyoming Breast Cancer Initiative, which is one of the highest grants this year.

The local hospice foundation has wrapped up their organization and transferred their remaining funds to the hospital foundation, which will be used to continue their mission of the hospice foundation. The amount is over $55,000.

They have started a new program called Foundation Fridays, which meets every month or every other month. The first will be May 14.

In the medical staff report, Dr. Hallie Bischoff said that COVID numbers in the county are improving. The number of vaccines in the county is around 18%. Bischoff also reported there is no more waitlist for getting the vaccine.

Dr. Bischoff is working to get their orthopedic care back to previous levels and is utilizing Dr. Francisco’s and Dr. Caldwell’s services to do that. She reported that the stress lab will be back up and running in April. They have a trauma survey coming up and will look at how to do things well and areas to work on. 

In the quality report, Nina Landis said that they are 75% compliant with their medication reconciliations for February and have almost reached their goal of 77%. They are getting their directors to work together so that all are using the same reporting format. 

In the service report, John Gibbel said their new facility in Shoshoni kicked off with an open house.  

In the financial report, Shelly Larson said the days in accounts receivable for February are 55.04 which is down one day from the last month. Currently, the hospital is at 50.65 All the clinics together are 65.5.  

In the people report, Linda Veylupek said that they updated and expanded their background investigations policy so that they ensure they have employees that are safe to be around patients and due diligence in hiring. The background checks screen for drug use, weapons violations, acts of violence and dishonest behavior. This action item to update the policy was voted on and passed by the board.

In new business, they received two quotes, not official bids, for a change over for finishing the parking lot across the street from the hospital. It needs work done and paving with asphalt.

One quote is from Owl Creek Excavation for $32,005.50 and the other was from Big Horn Ready Mix for $34,780. The quote from Owl Creek did not include the cost of the asphalt paving. The board had already budgeted funds at $45,000. The services of both quotes did not match.

A motion was put to the table and seconded, but there was hesitancy about going forward. The board wanted to see the quotes updated to have matching services so that they could compare “apples to apples.”

It was also noted that these were quotes and not formal bids and that they were from local businesses. The motion and second were withdrawn, and they want both companies to provide them complete bids before they can make a decision. Molitor will contact the businesses and get an update on the quotes.

The board passed a trauma resolution action item which asks the board if they agree with the recent trauma survey and allows Dr. Miller to oversee the program.

The board passed a change over to allow new construction in the admin area that would add four walls and separate private offices for staff. The cost approved would be less than $35,000. This would also allow a new drop ceiling, lighting, paint and VAV, air and heating.