Molitor announces retirement as CEO

At the January 25, Hot Springs Health board meeting for the growth report, CEO Margie Molitor announced that she is retiring on July 1 and they are beginning the process to find her replacement. Molitor has been working in health care for forty years with five and a half years in her position as CEO. 

Molitor added they are still looking for a new CFO and a CRNA. Molitor continued and said, “Our service inpatient scores continue to be awesome. We’re sitting at 95% of our patients this year are saying they would definitely recommend us, which is in the 99th percentile. So we’re doing an awesome job on our inpatient scores.”

“Our specialty clinic, one of the big drivers of the community, said what they wanted with this building project was a larger specialty clinic that could recruit and get more visiting specialists in. And so at the present time, we have 14 different visiting specialists coming into our clinic, and that has increased. That’s doubled since we opened up the clinic. So, you know, we only had seven and now we’re up to 14. It’s working really well.”

CPA Michael Wright presented their audit reports. The audit reports are required since the hospital is a governmental entity and has received more than $750,000 in funding. Wright also presented a compliance report and highlighted any weaknesses he saw. One issue that often is highlighted due to the small size of the entity is the segregation of duties. Another issue Wright identified was a deposit that was $1,800 over the amount insured by the FDIC. Outgoing Chief Financial Officer Shelly Larson did provide a reply and remedied the issues. Her statement was in the audit report. Chairman Bill Williams did mention how when money was given to them, the rules were not set in place until later, which made things challenging. The board voted and passed to accept the audit report.

The board also voted and passed approval to submit the 990 document, which is required by the IRS since the hospital is a 501c3 tax entity and governmental entity. This document contains compiled information and is not an audit.

Doctor Mattson Mathey presented the medical staff report and said his, “overall feeling like things are headed in a fairly positive administrative direction,” and there is “a lot of positive troubleshooting communication.” Mathey also said that staffing for both the clinic and hospital has been challenging. For their patient scores, Mathey said they are working hard to make patients happier. Also, for the past couple of weeks, there have been some new staff and traveling providers, which include an oncologist provider. 

For the critical care medical staff, they are reviewing protocols for medications. Their conversation led to fruitful conclusions in their policymaking. One issue Mathey highlighted was if the family of a patient is declining a transfer, they have them sign some paperwork acknowledging the risks of declining transfer to a higher level of care. 

Scott Alwin gave the quality report and said they are “looking at our organizational goals of readmission within 30 days and then also the percent return to the emergency department within 72 hours. The average for the last quarter of 2021 for readmission within 30 days was 7.2%. The percentage rate for December had a slight increase at 10%, compared to 8.1% in November. And then our goal for the year is a 6% readmission rate. Now, when you look at those readmission rates, you realize that it impacts a lot with the number of patients that we have in-house and how many are being dismissed. The actual number of readmissions from November and December is exactly the same at three, but the amount of discharges had changed. And so that impact of that percentage on the percentage return to the emergency room within 72 hours, we had reduced from 4.4% in November, down to 3.8% in December. We averaged for the last quarter of 2021 was 3.5% and then our goal for the year is 2.4%.”

Alwin added they will have their mock survey on March 28 through March 30. Alwin continue and said, “Currently, we are planning and working on action steps to get prepared for that. We are setting up some specific action plans for department directors and managers with assigned tasks and assignments. That way, we can achieve a successful survey. And currently, we have all the department managers working on reviewing and modifying policies and procedures based on last year’s survey and then also looking at updates over the past year. We are also preparing for the Cerner move to model a launch that’s going to occur. That launch date will be March 19th.”

Steve Miller, Interim CFO, presented the amended cost report and said, “There were two principal reasons why we had to file an amendment to the cost report. The first was that some additional entries had been posted to the general ledger as a result of the audit. And the other was that there were some assets that were purchased that were depreciated in the cost report, but they were paid for through grant funds. And so we can’t use those items as part of our reimbursable cost if we paid for them with grant funds. So we have to choose one way or the other. And so we elected to retain the grant funds and to exclude those items from our cost. So those adjustments after they were posted resulted in a net decrease in our reimbursement of about $34,000, as I recall. And so that was presented in the Finance Committee, and I think the Finance Committee would be recommended for approval.” The board voted and approved the amended cost report.

Miller then presented the monthly financial report and said that in December, “there was a net surplus of about $160,000. The budgeted expectation was $73,000. For the year to date, it was approximately about $2.2 million net surplus, which is principally being driven by our nonoperating revenues, up about $2.2 million and so on operation since it’s almost a break-even operation, we’re a little bit to the good at about $108,000 year to date versus the budget of an actual breakeven of about $7,500.”

Miller added, “In terms of the balance sheet, the most significant thing that occurred during the month was there was a decrease in our cash of about $2 million, which really was driven by the payback funds to the federal government where we have received, as you know, under the CARES Act, a significant amount of assistance from the federal government and we weren’t able to use all of those funds up within the time allotted. And so we had to send back a significant amount of money in the month of December.”

“The days in accounts receivable for the month, they were up to about 57 from our goal, as you know, is 40 part and they were up there, 57, which was really being driven principally by an issue with Medicaid and that Medicaid has changed their clearinghouse.”

“Days cash on hand remained very strong. The goal here is 42 with COVID funds. We have days cash on hand of approximately 155 as of December the 31st. If you exclude the COVID funds, then it’s about 89.”

There was a significant discussion with the board about the goal of the day’s cash on hand being too low. CEO Margie Molitor said she believes the industry standard should be a goal of 200 days. Molitor was also hesitant to officially change the goal, as it might negatively or positively affect the evaluations of the various directors, but they could address changing the goal in their strategic planning meetings.

Molitor also noted, “When Miller said the $2.2 million is what is ours, that includes all the restricted funds that are allocated just for paying off the debt and the debt service from the special purpose tax and everything. So I just wanted to reiterate that our bottom line is that $2.2 million, that money is all set aside to pay off the debt. Our actual operating bottom line through six months is $108,000.”

Dan Powell gave the Foundation update and said they have been awarded the grant they requested from Burlington Northern Railroad Foundation for $2,220. 

Linda Veylupek gave the People report and said that there are more travelers providers available but they are struggling to get them in specialty positions. However, Veylpuek said they are starting to see an increase in applications. 

In new business, Scott Alwin, presented to the board they plan on starting a new high school paid summer internship program that will give students a well-rounded exposure to the health care system at Hot Springs Health. It would be an eight-week program from June 6 until July 29. The interns would work 20 hours per week and would be paid competitively. There will be two openings available. Hot Springs Health will accept applications from April 1 until April 15.