It's time again for the KVHD "Finance Commit me" meeting, Wed. Aug. 26

It's time once again to look over the financial condition of the Kern Valley Healthcare District. We remember from last month that our pharmacy is on COD with the vendors and we are all to call first if we require any "unusual" medicine.

Strangely, though, Rite Aid pharmacy and the Drug Store in Kernville are able to make ends meat with their drug dispensaries, in fact, Rite Aid says the pharmacy carries the whole store.

What's the matter with our pharmacy, who is milking that cash cow?

So, I'm thinking tonight about how to cut the budget at the hospital and not short staff ourselves.

I've come up with a few ideas which could bring in a little dough.

Number one: Does a small hospital such as ours really need to have a full time chief financial officer?

We currently pay our CFO, Mr. Beedle, full time salary at or about 115,000. He also gets housing paid as he lives out of town. What if he goes Part time? There's almost $50K right there.

Then we have another potential money saver, why don't we change our contract with our hospital surgeon where he is paid per surgery or procedure or some other modification? He's a great surgeon, I admit, but can we really afford to pay him the money he's been getting? And the surgical nurses, can we cut back there too? Maybe put them on a Per Diem basis?

How can we get back on track with the pharmacy? At the last board meeting we were told in no uncertain terms there was nothing we could do about our pharmacy situation. Maybe we should ask the other pharmacies how they do it. Knowledge is power.

Mr. Beedle said we began losing money when the government made changes to Medicare Part D. Without elaboration, I asked Rite Aide if that was a problem for them, and they said no. I'll have to ask more about this at the meeting.

And certainly any of you with questions about the pharmacy or other financial issues should remember to stop by at the meeting, Wednesday, Aug. 26, at 9 am, in the trailer.

Since our surgery department is less a department and more of a loser at this point, why not gut the staff there until the time comes that the surgery actually does surgeries and not just endoscopy's.

Now there was this creation of a cardiac department where billing from pulmonary, who does EKG's, is moved into the cardiac department. I'm not sure exactly why this is, so yes, I will ask.

I spoke with Sharon Brucker, about a quality issue earlier this year, where there were used syringes on the ground, one was stepped on by someone with me at the hospital. I asked Mrs. Brucker what title she holds at the hospital now that she is no longer the Chief Nursing Officer.

Some of your commentary sounds like Administrative concerns but included in my title is as follows: Utilization Review(Case Management), Quality Improvement and Cardiology. My role as Quality Improvement centers around Quality Indicators set up for departments in the hospital. Each department decides on areas they will work on annually, of this could include quality assurance items (maintaining) or areas of improvement. I assist departments in collecting data and making sure reports are timely and sent to the appropriate committees. Administration has recently selected a Risk Manager, (I'll have to find out who that is too) who falls under Sherry Deppermann. Quality is everyone's responsibility.
There is no alotted time for a report coming from Quality in normal Board meetings. I can tell you that quality issues go to the Board through the meeting called the Med Quality committee. Two board members sit at this meeting.
Often I find myself as a facilitator for concerns. I certainly do not have any power to change policy but am able to make suggestions for change.
I also oversee the very small area -Cardiology. Currently we do echocardiograms and an occasional Stress Test. We currently only have a Cardiologist available on certain days, making it difficult to expand. But we do provide a service for the community. Cardiology does provide a positive cash flow for the District.
Sharon Brucker RN
QI
Now, I'm still not sure what Mrs. Brucker does, and what experience she has in this type of area, but it sounds like maybe we could do more of this melding of personnel.

At the last board meeting, new CCO, chief clinical officer, Cynthia Burciaga, told us that they were looking for "flexible" staff who could work in several areas as needed.

So, first we begin cutting, and I'm hoping that we have gone over all the contracts currently with the hospital to see if we can renegotiate or cancel anything that may not suit us anymore. Remember we paid $60K to a public relations firm, and I would like someone to quantify for me how that contract helped us.
(I'm going to hang out around outside the hospital, because money keeps getting thrown out the window, I could make a good living just on the waste from the hospital.)

Once we make the cuts, the choicest ones come from the top layer, cutting CNA or phlebotomy is pennies, we need to cut dollars.

And finally, how can we make money like they do at the darn thrift store? They're rolling in it.
I've never seen a hospital which relies so heavily on an auxiliary thrift store and not a pharmacy. But I guess using volunteers to make money is cheaper than paying for employees.

The auxiliary and the hospital foundation, have purchased equipment and many things to upgrade the hospital. Without them, I don't think this hospital would still be up and running (running is an exaggeration, let's say crawling).

We need an overhaul here. I still think a forensic audit is in order. And an audit committee would be a good start.

The CFO told me during one finance meeting that they don't need an audit committee because they have the finance committee meeting. If you haven't attended one of these you need to come and see for yourself. There's little or no open talk about solutions to problems, and it seems to be just more of a report.

Come on we need to bring in the public and talk about these problems. One member of the audience at last month's meeting said, we need to bring back the hospital breakfasts inviting "the movers and shakers" from the valley. I agree.