Cutting costs

With Van Diest Medical Center facing a $3 million loss, Interim Chief Executive Officer Lori Rathbun outlined a gap mitigation plan Tuesday night for the board of trustees in an effort to cut costs and save money at the facility.

“This facility is on track for a $3 million loss at this point in time. It’s very important that we initiate a gap mitigation plan and look for ways to minimize that loss,” she said.

Rathbun told the trustees that the hospital has a goal of 4 percent for a total margin, but at this time, it’s running a negative 15.4 percent margin.

She there are many reasons that the hospital is in this current position.

“There’s not any one reason – access, economics, health care policy changes, industry changes in the community,” she said. Patient days saw a decline by 8.2 percent while outpatient revenue declined 4.4 percent and surgery cases dropped by 5.2 percent.

Rathbun said the hospital was looking at various ways to cut and control losses. Staff overtime was one aspect cited. She said the goal would be to have overtime in the 2 percent range, and she added that in two pay periods, that figure had dropped from 4 percent to 2.6 percent. By hitting that 2 percent goal, the hospital would save $140,000 annually.

She stressed that the losses are not just a one department issue but rather something the entire facility must address.

“Everyone’s ownership in the solution is necessary,” she said.

Originally, the hospital was not going to act on staffing adjustments until April, but she said the conditions of recent months have shown that those adjustments can’t wait.

“Hospital managers have been asked to make cuts sooner rather than later,” she said. Managers have also been asked to propose other ways to control costs. Rathbun said she encouraged the managers to actively seek input from providers and the community on growth, expense control, staffing and the joint management of departments or to look for ways to partner with outside entities.

“To recover, we have to adjust our FTEs(full time equivalents) now, evaluate our contracts, services and expense management, strengthen relationships with providers and the community. And marketing is everyone’s responsibility,” she said.

She said all managers have been asked to look at a reduction of hours of at least a five percent.

“I don’t think we’ll be done at five percent,” she said. “Actually some managers are coming back with plans that are more than five percent because they think they can do it.”

She said that some of the positions are being absorbed through attrition or open positions, but added that none of the key positions would be left vacant.

Discussions are ongoing with the departments, Rathbun said to “right-size” the organization.

Other business

In other business, the trustees approved the medical directors for the various hospital departments. Those directors are:

Ambulance and emergency medicine, Dr. Subhash Sahai;

Cardiac and pulmonary rehab, Dr. J.X. Latella and Dr. Mark Dearden, alternate;

Diabetic education, Dr. Nikki Ehn;

General Medicine, Dr. Abhishake Kaapuraala

Obstetrics, Dr. Nikki Ehn; Dr. Dan Gabrielson and Dr, Emily Hill, alternates

Occupational therapy, Dr. Mark Dearden

Pediatrics, Dr. Sushma Sahai

Physical therapy, Dr. J.X. Latella

Radiology, Dr. Heggen

Respiratory therapy/Home Care, Dr. Don Woodhouse

Special care unit, Dr. Abhishake Kaapuraala

Surgery, Dr. Mark Andrew.

The board also approved a series of medical staff reappointments for active staff, consulting staff, contract ER staff and allied health staff.

The board of trustees went into closed session at the close of regular business pursuant to Iowa Code 21.5(1) (l) pertaining to discussions on marketing and pricing or similar proprietary information.