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Hospital audit shows improvement in 2023 operating revenues

Texas County Memorial Hospital ended 2023 with total operating revenues of $39,613,651, a 10.49 percent increase over 2022, the TCMH board of trustees heard at their monthly meeting on Tuesday.  
David Taylor, senior manager at Forvis, LLP of Springfield, MO, presented the annual financial audit report at the meeting. “TCMH had a loss of $1.9 million in expenses over revenue; however, this was an improvement of $385,514 from the prior year,” Taylor said. 
Taylor explained the hospital received $2.7 million in grant money in 2023 for the surgery center, Licking Family Clinic, and other capital projects. Therefore, the financial statements must reflect this funding support as revenue to the hospital. The hospital also had $2.2 million in depreciation for the fiscal year. 
“The hospital’s operations, excluding the $2.2 million depreciation, were positive $222,773, reflecting a $799,387 positive increase in unrestricted net position,” Taylor said. 
Taylor noted that TCMH has been very active with capital projects, so the depreciation presents financial statement challenges for the bottom line. Few similarly sized hospitals invest at this level in their capital projects.
“It is good to see the hospital actively investing in the plant and new equipment. A key differentiator that sets TCMH apart from its peer hospitals is the ability to raise additional funds through outside donations and grants,” Taylor commended TCMH, “Over the last decade, the Healthcare Foundation has brought in over 8.4 million from outside sources.”
Taylor reported that the hospital’s liabilities decreased by $1.6 million compared to the previous year. “The hospital was able to pay down debt last year without incurring a lot of new debt,” Taylor said. 
TCMH’s net cash decreased by $2.5 million in 2023. TCMH earned $80,077 in interest, offsetting the facility’s debt interest.
Taylor noted that not many hospitals, big or small, have enough money in the bank to cover their financing costs. TCMH is in “a good position,” earning five percent on most of the money invested. 
Taylor reported that the days cash on hand for 2023 at year-end was 108 days.
“This metric reflects the hospital's ability to operate for three months without collecting anything from patients or insurance companies,” Taylor stated. “You have essentially doubled your bank balance compared to pre-COVID.”
Taylor praised TCMH for its outstanding financial management as a rural hospital. “As a rural hospital, you face many challenges, but your position is strong enough to face them,” Taylor said. 
Forvis sends an audit team to TCMH each March, spending about a week poring over hospital financial information from the previous year. The firm takes about a month to complete the audit information, including expense statements, balance sheets, statements of cash flows, and other information from the financial report documents presented at the April board meeting. 
Forvis uses historical TCMH data and data from other healthcare facilities for comparison purposes during the audit. It also has access to the latest information regarding hospital payers, which helps the firm reach concrete numbers in the final audit report.  
In other business, Jennifer Hugenot was sworn in for a five-year term on the TCMH Board of Trustees. Jim Perry, OD, TCMH Board of Trustees chairperson, administered the oath of office to Hugenot. 
The TCMH Board of Trustees voted unanimously for their officer positions for the upcoming year, with Perry as chairperson, Ross Richardson as vice-chairperson, and Joleen Durham as secretary. 
TCMH has been waiting since the February board meeting for the Texas County Commission to appoint the fifth board member to complete Steve Pierce's term. Bill Bridges, interim chief executive officer, has met with the Commission weekly regarding the appointment and the hospital board of trustees' recommendation for the person to complete the term. 
Department of Health and Senior Services conducted an on-site inspection of the new surgical center on April 15, and on April 16, TCMH received a letter of “no deficiencies” from DHSS. On April 16, the surgery center was deemed safe for use, and the first surgery was performed on the same evening. 
Bridges reported to the board that the Licking Family Clinic will be completed by June 14. A grand opening and ribbon-cutting ceremony is scheduled for Thursday, July 11, from 2:00 p.m. to 4:00 p.m. The ribbon-cutting will include a public open house with tours of the new clinic.
Linda Pamperien, TCMH chief financial officer, presented the financial report for March. Overall revenues for the month were up $253,079, a 3.2 percent increase. Outpatient revenue was also up $667,507, a 10.3 percent increase from budgeted monthly expectations. 
According to Pamperien, the hospital had 69 admissions in March, up 57 from the same time frame in 2023.
Pamperien reported that overall monthly expenses were down $125,564, a 3.4 percent decrease. 
The financial report reflected that the hospital's profit/loss report showed a negative bottom line for March, with a loss of $270,228 and a year-to-date loss of $135,744. The earnings before interest, depreciation, and amortization (EBIDA) for the respective month were negative at $35,245, and the year-to-date EBIDA was positive at $559,132.
Present at the meeting were Taylor, Hugenot, Perry, Bridges, Pamperien, Courtney Owens, chief nursing officer; Helania Wulff, marketing, public relations, and physician recruiting director; Anita Quick, controller; Tricia Benoist, MD, chief of staff; and board members Perry, Richardson, Durham, and Hugenot. 
The next meeting of the TCMH board of trustees is Tuesday, May 28, at 12:00 p.m. in the hospital board room.
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