Title
Receive the Natividad Medical Center Financial Report for February 28, 2015
Report
RECOMMENDATION:
It is recommended that the Monterey County Board of Supervisors' Budget Committee receive the Natividad Medical Center Financial Report for February 28, 2015.
SUMMARY:
The Monterey County Board of Supervisors Budget Committee has charged NMC Administration to report monthly on the financial status of the institution.
For the month of February 28, 2015 the average daily inpatient census (ADC) was 103.9 compared to a budget of 109.5. NICU, Medical/Surgical, ICU, Mental Health, and OB/GYN patient days were below the budget for the month, while Pediatrics, Acute Rehabilitation, and Trauma were higher than budget for the month. Adjusted patient days (including both inpatient and outpatient volumes) totaled 4,406 compared to budget of 4,316, a favorable variance of 2.1%. Emergency Department visits were higher than budget by 15.4%.
Actual net income for the month was $0.4 million compared to a budget net loss of $371,000. Net patient revenues totaled $14.4 million compared to a budget of $12.6 million. The increase in net revenues by 7.3% resulted from improved payer mix primarily from patients with trauma service needs. Revenues from Government funding totaled $3.2 million compared to a budget of $2.9 million. Other operating revenue totaled $0.3 million compared to a budget of $0.4 million. Operating expenses for the month were $17.6 million compared to a budget of $16.3 million. Unfavorable operating expense variances were noted in the areas of Salaries, Wages, & Benefits of 462,000. Registry expenses of $406,000 related to supplementing radiology technicians, surgery technicians, emergency room nurses, labor and delivery nurses, and intensive care nurses. Expenses in Physician SWB were higher than budget by $93,000. Expenses in Purchased Services were higher than budget by $54,000 related to equipment repairs. Expenses in Supplies were higher than budget by $246,000 from surgical devices, medical instruments and surgical supplies. Cost per adjusted patient day was higher than budget by $385.00 or 10.3% while net revenue per adjusted patient day was better than budget by $198.00 or 5.2%
The average daily inpatient census (ADC) for the year-to-date ended February 28, 2015 was 94.1 compared to a budget of 98.5. Medical/Surgical, ICU, OB/GYN, and Pediatric patient days were below the budget for the period, while NICU, Acute Rehabilitation, Trauma, and Mental Health were higher for the period. Adjusted patient days (including both inpatient and outpatient volumes) totaled 34,612 compared to budget of 33,693, a favorable variance of 2.7%. Emergency Department visits year to date through February 28, 2015 were higher than budget by 7.2%.
Actual net loss for the year-to-date ended February 28, 2015 was $0.1 million compared to a budget net loss of $3.6 million. Net patient revenues totaled $105.1 million compared to a budget of $99.1 million. Net revenues improved by 6.1% from improved payer mix. Revenues from Government funding totaled $26.5 million compared to a budget of $23.1 million. Funding improved from new enrollees from Medi-Cal managed care during the period of Healthcare Reform. Other operating revenue totaled $3.2 million compared to a budget of $3.4 million. Operating expenses for the year-to-date ended February 28, 2015 were $134.7 million compared to a budget of $129.3 million. Unfavorable operating expense variances were noted in the areas of Salaries, Wages, & Benefits of $2,523,000, Registry expense of $1,902,000, Physicians/Residents SWB & Contract Fees of $224,000, Supplies of $1,596,000, and Utilities & Telephone Expense of $192,000. Periods of high census in ICU, emergency department, surgery department and medical surgical units required additional coverage from existing nursing staff. Physician costs increased by 1.2% as compared to budget due to additional on-call coverage for surgery. Supplies exceeded budget by 14.6% resulting from increased surgical procedures. Utilities increased by 10.2% as compared to budget due to increase in utility rate per unit. Cost per adjusted patient day was higher than budget by $54.00 or 1.4%. Net revenue per adjusted patient day was higher than budget by $96.00 or 3.3%
Year-to-date through February 28, 2015, the balance in cash including $3.2 million for the Seaside Clinics reserve was $44.7 million. This balance excludes the cash of $14.2 million in the County of Monterey's NMC Reserve Fund. Collections from patients and various payers were $13.6 million for the month. Expenditures for capital as of February 28, 2015 were $10.7 million. Remaining balance for capital expenditures for the year is $7.0 million
Patient receivables were $24.9 million. Distribution by payer: 15.6% Medical, 13.8% MediCal Managed Care, 14.8% Medicare, 54.7% Commercial, 0.4% Self Pay, and 0.7% Short Doyle. Distribution by aging: 26.1% In-House and under process, 54.3% between 0-60 days, 19.5% between 60-181 days and 0.1% over 181 days.
DISCUSSION:
NMC's Financial Statements as of February 28, 2015 are attached and will be presented by NMC staff at the scheduled meeting of the Budget Committee on April 29, 2015.
OTHER AGENCY INVOLVEMENT:
No other County agency participates in this reporting.
FINANCING:
There is no impact on the General Fund.
______________________________________
Gary Gray DO, Interim Chief Executive Officer
Natividad Medical Center
Date: April 9, 2015
Prepared by Daniel Leon, CFO
Attachment: February 28, 2015 NMC Financial Statements