PROPOSAL FOR CHANGE
 
I want to say how sorry I am to have to make this announcement and that these decisions that follow did not come lightly. 
The hospital is in a serious financial situation and have reached a point that if we do not make change today we will not be here in about 65 days.  The problem is that our services are down, we do not have the patient base or referrals that we had in the past.  The new Electronic Medical Records system we brought in has not perfected the billing process for the permanent swing program for Medicaid and Medicare.  Therefore; we have been unable to fully bill for the permanent swing patients in the program.  The hospital has about $940K in Accounts Receivable we are waiting to be paid on; of which we will only receive about 65% due to contractual adjustments and even at that we will not receive it all at once, it will trickle in slowly. 
This billing problem coupled with the Cost Report payback that we are setting aside money for puts us in a very unstable position, so in order to be proactive the hospital has to make some tough choices. 
Here is the plan that I have come up with that I believe will help us sustain ourselves through these rough times.  Please keep in mind that this is drastic, it is difficult to hear and read but the bottom line is that we need to save no less than $125k monthly in expenses.

1. Effective March 1st we will reduce staff at the clinic to one provider, one receptionist, one nurse.  The Clinic days will be Monday-Thursday (Hours will be announced).  We will retain all 3 providers in the clinic, they will each run on a rotation so you can continue to see your preferred provider. 
2. Bring the other 2 clinic providers from the clinic on a rotating shift to work the ED – on call only on an on-call rotation.  This will reduce our agency usage to zero in the ED savings us on average $58,542 a month.
3. Wage Freeze until further notice
4. Overtime freeze – no overtime without prior approval
5. Stop Saturday outpatient services for Lab and Radiology 
6. Establish new hospital outpatient hours of 7 am to 4 pm Monday through Friday
7. Labor force reduction/layoff – each department will reduce their staff

With each of the changes listed above we should be able to hit the goal of saving the needed $125,000 monthly and being able to have a break-even margin.  This does not mean we are done; it is only the beginning.  We will reduce spending, and not spend any more than needed until we are seeing a recovery of our situation.  


Julie Leonard, Superintendent, CEO