STANISLAV AVSHALUMOV, DO, MD, JOINS TOTAL ORTHOPAEDICS AND SPORTS MEDICINE, LLP, AT NUMC, AS DIRECTOR OF JOINT REPLACEMENT AND HIP PRESERVATION SURGERY
September 24, 2009
Contact: Shelley Lotenberg
(516) 572- some of the more notable accomplishments in 2007 were:
– Avoided potential NYS budget cuts of approximately $12 million, annually
– Continued to retain 100% of the Federal Disproportionate Share payment of approximately $26 million, annually.
– Continued to receive Hospital Based Status for A. Holly Patterson (AHP) of approximately $5.5 million incremental revenue, annually.
– Continued to maintain 95% occupancy at AHP resulting in Bed Hold reimbursement of approximately $1 million incremental revenue, annually.
– Raised the Case Mix Index (CMI) pf AHP from 1.01 to 1.07 resulting in approximately $1.2 million incremental revenue, annually.
– Secured HEAL funding of $23 million to assist and enhance NHCC’s multi-year major modernization.
These inititatives had a $45.7 million favorable revenue impact for NHCC in 2007 and secured a future Capital Improvement infusion of $23 million. This capital will mainly be used to fund NHCC’s new Emergency Room, Hempstead and Freeport Community Health Centers and NHCC’s ongoing Information Technology upgrades.
The budget is balanced by a series of new Programs to Eliminate the Gap (PEGs) which together total $12.2 million in new net revenue or expense reduction for the Corporation:
• The addition of 72 new behavioral health beds, on line for a full year, will improve the Corporation’s bottom line by approximately $2.0 million.
• Disproportionate share payments and group price appeals amounting to $7.0 million, are expected to be received in 2008 as a result of an appeal to the federal Medicare and Medicaid programs. The group price appeal is subject to state approval and State Senator Kemp Hannon today introduced legislation to support such an appeal. Should approval not be forthcoming on the group price appeal, management and the board will identify other revenue producing initiatives and other cost cutting measures.
• Approximately $1.8 million in revenue cycle improvements, including coding initiatives for inpatient rehabilitation are expected to be implemented during the 2008 fiscal year.
• Hemodialysis expansion of four chairs at A. Holly Patterson Extended Care Facility will help to increase its ventilator census and generate approximately $375,000 of incremental revenue.
• Staffing patterns surrounding its one to one requirement are being restructured, resulting in net saving of approximately $1.0M.
The $532 million budget for the NHCC includes a total number of 3,584 employees, including 2,860 at the NUMC, 614 at the AHP and 110 at the various Community Health Centers. The 2008 budget for NUMC is $434 million, for AHP it is $61 million, and the budget for the Community Health Centers is $17m. In addition, the 2008 budget includes $11 million for the faculty practice plan distribution to physicians, and $9.4 million for the captive malpractice insurance fund. The budget includes pension expenses of $18M or 8.94% of payroll, while health insurance premiums have been budgeted to increase by an additional 8.5% in 2008, or $3.0 million.
The key operating indicators such as discharges, average daily census, average length of stay and full time equivalent (FTE) have been conservatively incorporated in the 2008 budget utilizing the most recent 2007 trends. The Corporation’s bad debt expense has been lowered due to improvements to the revenue cycle and an associated reduction in self-pay volume:
• Discharges: NUMC’s projected volumes are based on 2007 actual levels (22,982) and discharges in the 2008 budget are predicated on 2007 actual discharges, with an addition of 1196 discharges, of which 877 are from behavioral health, 169 related to physical medicine and rehabilitation and 150 from surgical.
• Census: The average daily census, currently at 364 through August of 2007, is projected at 425 in the 2008 budget. New programs will add approximately 70 patients to that census by the year-end, increasing the census to 425 during 2008.
• Average length of stay: Length of stay is consistent at 4.48 days in adults and pediatrics.
• FTE’s: With the addition of new programs with 70 new behavioral health beds, the FTE’s per adjusted occupied bed will be right in line with industry norms at 4.71.
• Bad Debt Expense: The revenue cycle at NUMC has been improved and bad debt as a percentage of patient revenue is 14.1%. NUMC’s bad debt expense was $70 million in 2000, $51 million in 2001, and it is anticipated to be $49 million in 2008.
Mr. Gianelli concluded by saying: “The 20078budget re-invests in important clinical departments, builds on enhanced Medicaid reimbursements, includes achievable gap-closing initiatives, and relies on reasonable performance assumptions. Management has put in place the beginnings of budgetary monitoring systems, and it is continually reviewing areas of possible expense reduction and revenue enhancement. The breakeven budget for 2008 puts the Corporation, in the near term, on reliable fiscal footing, while giving us the breathing room necessary to implement the Updated Strategic Plan, the Community Health Center Reform Plan, and the $240 Million Modernization Program.”
