HUMBOLDT GENERAL HOSPITALMay 23, 2017 · humboldt general hospital 118 east haskell street. w. innemucca, n. evada . 89445 . district board of trustees meeting agenda . meeting date:

HUMBOLDT GENERAL HOSPITAL

DISTRICT BOARD OF TRUSTEES

REGULAR BOARD MEETING

Tuesday

MAY 23, 2017

5:30 P.M.

SARAH WINNEMUCCA CONFERENCE

ROOM

HUMBOLDT GENERAL HOSPITAL 118 EAST HASKELL STREET

WINNEMUCCA, NEVADA 89445

DISTRICT BOARD OF TRUSTEES MEETING AGENDA

MEETING DATE: Tuesday May 23, 2017 MEETING TIME: 5:30 pm MEETING PLACE: Sarah Winnemucca Conference Room Humboldt General Hospital 118 E Haskell St, Winnemucca, Nevada PLACES POSTED: in Winnemucca, Nevada at: Humboldt General Hospital, 118 E Haskell Street Humboldt County Courthouse, 50 W Fifth Street Winnemucca City Hall, 90 W Fourth Street Humboldt County Library, 85 E Fifth Street United States Post Office, 850 Hanson Street www.hghospital.org https://notice.nv.gov PERSON POSTING: Melissa Lopez

A. CALL TO ORDER B. PUBLIC COMMENT

(This agenda item is designated to give the general public the opportunity to address the Hospital Board. No action may be taken upon a matter raised under this section until it is placed on an agenda for action. Public comment is generally limited to five (5) minutes per person.)

C. MEDICAL STAFF-HOSPITAL DEPARTMENT REPORTS (These agenda items are designated to give the opportunity to report and update the

Hospital Board on each group or department listed. No action may be taken upon a matter raised under this section until it is placed on an agenda for action.) 1. Medical Staff report 2. EMS Department report 3. Administration Department report

a. Quality Report

D. CONSENT AGENDA (The Board is expected to review, discuss and take action on this agenda item.)

1. Medical Staff appointments-reappointments

E. FINANCIAL REPORTS (The Board is expected to review, discuss and take action on this agenda item.) 1. Warrants disbursed - Monthly expenditures 2. Hospital Utilization report

E. BUSINESS ITEMS-OTHER REPORTS (The agenda items in this section are for discussion and for possible action. The action may consist of approval, disapproval, acceptance, rejection, authorization, adoption, review, recommendation, referral to staff, or any other action as appropriate. The items may be heard in any order and at any time unless a time is specified; two or more items

JoAnn Casalez - Chairman Michelle Miller – Secretary Bill Hammargren – Member Jennifer Hood - Member Richard Cook - Member Ken Tipton - Member-Humboldt County Commissioner

DISTRICT BOARD OF TRUSTEES MEETING AGENDA May 23, 2017 Page 2

may be combined for consideration; an item may be removed from the agenda; or, discussion relating to an item may be delayed at any time.) 1. Hospital District / public hearing / fiscal year 2017-2018 tentative budget / approval

and submission of fiscal year 2017-2018 final budget / Administrator-CFO 2. Hospital Administration-EMS / proposals for purchase of three Eagle transport

ventilators for the emergency department / Administrator-EMS Director 3. Hospital Administration-Physician Recruitment / physician inquiries, scheduled visits

and proposed terms and conditions for providing physician services / Administrator F. TRUSTEE COMMENTS-STAFF REPORTS

(This period is designated for receiving reports, information, department updates, board and committee updates and proposals by the board, administrator, chief financial officer, human resources director, director of nurses, and other staff upon request. No action may be taken upon a matter raised under this section until it is placed on an agenda for action.)

G. PUBLIC COMMENT (This agenda item is designated to give the general public an

opportunity to address the Hospital Board. No action may be taken upon a matter raised under this section until it is placed on an agenda for action. Public comment is generally limited to three (3) minutes per person.)

Notice: The Administrative Assistant at the Administrator’s Office located at Humboldt General Hospital, 118 E. Haskell Street, Winnemucca, Nevada, telephone number 775-623-5222 extension 1123, is the designated person from whom a member of the public may request the supporting material for the meeting and the Administrator’s Office is the location where the supporting material is available to the public. Notice: By law a public body may receive information from legal counsel regarding potential or existing litigation involving a matter over which the public body has supervision, control, jurisdiction, or advisory power and such gathering does not constitute a meeting of the public body. Notice: Members of the public who are disabled and require special assistance or accommodations at the meeting are requested to notify in writing the Administrative Assistant at the Administrator’s Office located at Humboldt General Hospital, 118 E. Haskell Street, Winnemucca, Nevada 89445, or by telephoning 775-623-5222 extension 1123, at least one (1) business day in advance of the meeting.

w w w . h g h o s p i t a l . w s

H U M B O L D T G E N E R A L H O S P I T A L 118 E. Haskell Street ■ Winnemucca, Nevada 89445

Phone 775.623.5222 ■ Fax 775.623.5904

May 3, 2017

Brad Granath, M.D. Ref: Med Staff Meeting I have completed files for the following:

Reappointments:

Bradford Granath, M.D. Active Staff- Family Practice/ OB Timothy Hockenberry, M.D. Associate Staff- Hospitalist Thomas Rembetski, M.D. Courtesy Staff- General Surgery

Thank You, Melissa Lopez Administrative Support


FINANCIAL STATEMENT of April 30, 2017 FISCALPROFIT or ( LOSS ) CURRENT MONTH YEAR

Current Month & Year-to-Date 2 * 0 * 1 * 7FISCAL YEAR 2017

PERIOD July 1, 2016 - June 30, 2017 Period Actual Period Budget Variance $$$ % Variance Apr-17 Apr-17 Actual/Budget + ( - ) Budget

OPERATING REVENUES:

ROOM / BED CHARGES REVENUE:ACUTE CARE 618,142$ 622,956$ (4,814)$ -1%

NURSING HOME (Harmony Manor) 136,365$ 179,364$ (42,999)$ -24%

MEMORY CARE (Quail Corner) 54,725$ 34,724$ 20,001$ 58%

** TOTAL ROOM / BED CHARGES ** 809,232$ 837,044$ (27,812)$ -3%

ANCILLARY CHARGES REVENUE:

IN-PATIENTS 1,930,460$ 1,716,590$ 213,870$ 12%

OUT-PATIENTS 3,805,755$ 4,342,467$ (536,712)$ -12%

NURSING HOME (Harmony Manor) 195,553$ 132,914$ 62,639$ 47%

MEMORY CARE (Quail Corner) 12,320$ -$ 12,320$ #DIV/0!

**TOTAL ANCILLARY SERVICES REVENUE** 5,944,088$ 6,191,971$ (247,883)$ -4%

** GROSS REVENUES **** FROM SERVICES TO PATIENTS **

** (LESS) CONTRACTUALS TO REVENUES ** 2,738,807$ 2,571,353$ 167,454$ 7%

** NET REVENUE FROM SERVICES TO PATIENTS ** 4,014,513$ 4,457,662$ (443,149)$ -10%

** OTHER OPERATING REVENUES ** 323,669$ 80,610$ 243,059$ 302%

** GRAND TOTAL **** OPERATING REVENUES **

6,753,320$ 7,029,015$ (275,695)$ -4%

4,338,182$ 4,538,272$ (200,090)$ -4%Page 1 of 4


FINANCIAL STATEMENT of April 30, 2017 FISCALPROFIT or ( LOSS ) CURRENT MONTH YEAR

Current Month & Year-to-Date 2 * 0 * 1 * 7FISCAL YEAR 2017

PERIOD July 1, 2016 - June 30, 2017 Period Actual Period Budget Variance $$$ % Variance Apr-17 Apr-17 Actual/Budget + ( - ) Budget

** OPERATING EXPENSES **

PROFESSIONAL CARE of PATIENTS 2,205,874$ 2,739,018$ (533,144)$ -19%

NURSING ADMINISTRATION / QUALITY IMP. 83,414$ 101,401$ (17,987)$ -18%

DIETARY DEPARTMENT 74,639$ 99,693$ (25,054)$ -25%

HOUSEKEEPING/LAUNDRY-LINEN/JANITOR 58,366$ 85,561$ (27,195)$ -32%

PLANT OPERATION & MAINTENANCE 80,034$ 82,636$ (2,602)$ -3%

MEDICAL RECORDS 44,637$ 56,295$ (11,658)$ -21%

ADMINISTRATION 895,898$ 1,067,543$ (171,645)$ -16%

PROVISION FOR DEPRECIATION 1,864,787$ 438,702$ 1,426,085$ 325%

CHARITY CARE 17,341$ 43,321$ (25,980)$ -60%BAD DEBTS, NET OF RECOVERY 574,844$ 609,140$ (34,296)$ -6%

** TOTAL OPERATING EXPENSES ** 5,899,834$ 5,323,310$ 576,524$ 11%( ) = Under Budget

** OPERATING REVENUE over (under) EXPENSES: (1,561,652)$ (785,038)$ (776,614)$ 99%

** NON-OPERATING REVENUES **

AD VALOREM TAXES 316,150$ 321,228$ (5,078)$ -2%

CONSOLIDATED TAXES -$ 74,157$ (74,157)$ -100%

NET PROCEEDS OF MINES TAX -$ -$ -$ #DIV/0!

INTEREST EARNED 3,883$ 3,842$ 41$ 1%

** TOTAL NON-OPERATING REVENUES ** 320,033$ 399,227$ (79,194)$ -20%

** CHANGE IN NET ASSETS: (1,241,619)$ (385,811)$ (855,808)$ 222%

NOTE: April - $357,035 attributed to Employee Benefits under "Administration".

Page 2 of 4


FINANCIAL STATEMENT ofPROFIT or ( LOSS )

Current Month & Year-to-DateFISCAL YEAR 2017

PERIOD July 1, 2016 - June 30, 2017

OPERATING REVENUES:

ROOM / BED CHARGES REVENUE:ACUTE CARENURSING HOME (Harmony Manor)MEMORY CARE (Quail Corner)

** TOTAL ROOM / BED CHARGES **

ANCILLARY CHARGES REVENUE:IN-PATIENTSOUT-PATIENTSNURSING HOME (Harmony Manor)MEMORY CARE (Quail Corner)

**TOTAL ANCILLARY SERVICES REVENUE**

** GROSS REVENUES **** FROM SERVICES TO PATIENTS **

** (LESS) CONTRACTUALS TO REVENUES **

** NET REVENUE FROM SERVICES TO PATIENTS **

** OTHER OPERATING REVENUES **

** GRAND TOTAL **** OPERATING REVENUES **

JULY '16 - APRIL '17 FISCALFYTD 2017 YEAR

2 * 0 * 1 * 6

YTD FY17 Actual YTD FY17 Budget Variance $$$ % VarianceJULY '16 - APRIL '17 JULY '16 - APRIL '17 Actual/Budget + (-) Budget

6,021,861$ 6,312,633$ (290,772)$ -5%

1,824,613$ 1,817,557$ 7,056$ 0%

64,625$ 138,895$ (74,270)$ -53%

7,911,099$ 8,269,085$ (357,986)$ -4%

18,386,051$ 17,394,578$ 991,473$ 6%

39,000,741$ 44,003,821$ (5,003,080)$ -11%

1,983,965$ 1,346,867$ 637,098$ 47%

12,320$ -$ 12,320$ #DIV/0!

59,383,077$ 62,745,266$ (3,362,189)$ -5%

30,528,630$ 26,067,467$ 4,461,163$ 17%

36,765,546$ 44,946,884$ (8,181,338)$ -18%

1,055,861$ 816,850$ 239,011$ 29%``

(7,942,327)$ -17%

67,294,176$ 71,014,351$ (3,720,175)$ -5%

37,821,407$ 45,763,734$ Page 3 of 4


FINANCIAL STATEMENT ofPROFIT or ( LOSS )

Current Month & Year-to-DateFISCAL YEAR 2017

PERIOD July 1, 2016 - June 30, 2017

OPERATING REVENUES:** OPERATING EXPENSES **

PROFESSIONAL CARE of PATIENTSNURSING ADMINISTRATION / QUALITY IMP.DIETARY DEPARTMENTHOUSEKEEPING/LAUNDRY-LINEN/JANITORPLANT OPERATION & MAINTENANCEMEDICAL RECORDSADMINISTRATIONPROVISION FOR DEPRECIATIONCHARITY CAREBAD DEBTS, NET OF RECOVERY

** TOTAL OPERATING EXPENSES **

** OPERATING REVENUE over (under) EXPENSES:

** NON-OPERATING REVENUES **

AD VALOREM TAXESCONSOLIDATED TAXESNET PROCEEDS OF MINES TAXINTEREST EARNED

** TOTAL NON-OPERATING REVENUES **

** CHANGE IN NET ASSETS:

JULY '16 - APRIL '17 FISCALFYTD 2017 YEAR

2 * 0 * 1 * 6

YTD FY17 Actual YTD FY17 Budget Variance $$$ % VarianceJULY '16 - APRIL '17 JULY '16 - APRIL '17 Actual/Budget + (-) Budget

20,813,347$ 20,896,733$ (83,386)$ 0%

746,253$ 750,583$ (4,330)$ -1%

734,697$ 877,705$ (143,008)$ -16%

556,836$ 664,664$ (107,828)$ -16%

760,055$ 778,104$ (18,049)$ -2%

669,256$ 529,184$ 140,072$ 26%

9,532,716$ 10,093,821$ (561,105)$ -6%

4,894,032$ 4,320,845$ 573,187$ 13%

261,677$ 433,210$ (171,533)$ -40%5,040,774$ 6,178,396$ (1,137,622)$ -18%

44,009,643$ 45,523,245$ (1,513,602)$ -3%( ) = Under Budget

(6,188,236)$ 240,489$ (6,428,725)$ 104%

3,701,874$ 3,212,283$ 489,591$ 15%

449,403$ 741,572$ (292,169)$ -39%

661,344$ -$ 661,344$ #DIV/0!

34,965$ 38,416$ (3,451)$ -9%

4,847,586$ 3,992,271$ 855,315$ 21%

(1,340,650)$ 4,232,760$ (5,573,410)$ -132%

Note: Fiscal Year-to-Date - $3,899,348 attributed to Employee Benefits under "Administration".

Page 4 of 4

HUMBOLDT GENERAL HOSPITAL MARCH 2017 FISCAL

** BALANCE SHEET ** YEAR

2*0*1*7FISCAL YEAR 2017 - 10-MONTHS (JULY'16 - APR'17)

CURRENT PRIOR FISCAL YEARFISCAL YEAR 2017 FISCAL YEAR 2016 FY 17 TO FY 16 2017 / 2016

ACTUAL ACTUAL DOLLAR % VarianceAS OF APR.30, 2017 AS OF APR.30, 2016 VARIANCE: + (-) Change

A S S E T S :

CURRENT ASSETS:

CASH - UNRESTRICTED 2,937,577$ 2,199,039$ 738,538$ 34% ACCOUNTS REC. NET OF DBTFL. ACCTS. 9,669,023$ 10,294,291$ (625,268)$ -6% INVENTORY 1,424,481$ 1,321,063$ 103,418$ 8% 3RD PARTY RECEIVABLE FROM MC / MD -$ -$ -$ #DIV/0! PREPAID EXPENSES 327,850$ 319,970$ 7,880$ 2%

TOTAL CURRENT ASSETS: 14,358,931$ 14,134,363$ 224,568$ 2%

RESTRICTED ASSETS:

RESERVE FOR HEALTHCARE SERVICES 6,519,771$ 12,506,729$ (5,986,958)$ -48% RESERVE FOR ICD-10 IMPLEMENTATION -$ 10,000,000$ (10,000,000)$ -100% RESERVE FOR ACUTE REMODEL & ADDITION -$ -$ -$ #DIV/0! RESERVE FOR PHASE 3 - MODULAR/MEMORY/SNF 829,490$ 1,521,591$ (692,101)$ -45% RESERVE FOR PHASE 4 - OBSTETRICS/CLINICS 1,182,280$ 2,909,035$ (1,726,755)$ -59% RESERVE FOR PHASE 5 - SURGERY/ER REMODEL 5,612,166$ 3,163,267$ 2,448,899$ 77%

TOTAL RESTRICTED ASSETS: 14,143,707$ 30,100,622$ (15,956,915)$ -53%

PROPERTY, PLANT & EQUIPMENT, NET OF DEPRECIATION 68,682,697$ 54,891,130$ 13,791,567$ 25%

TOTAL PROPERTY/PLANT/EQUIP: 68,682,697$ 54,891,130$ 13,791,567$ 25%

DEFERRED OUTFLOWS OF RESOURCES:

PENSION DEFERRED OUTFLOWS 2,124,668$ 1,921,513$ 203,155$ 11%

TOTAL DEFERRED OUTFLOWS OF RESOURCES: 2,124,668$ 1,921,513$ 203,155$ 11%

TOTAL ASSETS: 99,310,003$ 101,047,628$ (1,737,625)$ -2%

REPORTING DATE:

Page 1 of 3






REPORTING DATE:

L I A B I L I T I E S :

CURRENT LIABILITIES: ACCOUNTS PAYABLE (1,189,507)$ (465,649)$ (723,858)$ 155% ACCOUNTS PAYABLE - RETAINAGE (41,039)$ -$ (41,039)$ #DIV/0! ACCRUED PAYROLLS (724,441)$ (533,090)$ (191,351)$ 36% ACCRUED PTO & SICK LEAVE (911,588)$ (867,157)$ (44,431)$ 5% DEFERRED NET PROCEEDS REVENUE -$ -$ -$ #DIV/0! DEFERRED DSH TAX REVENUE -$ -$ -$ #DIV/0! 3RD PARTY PAYABLE MC / MD (203,552)$ (469,421)$ 265,869$ -57%

TOTAL CURRENT LIABILITIES: (3,070,127)$ (2,335,317)$ (734,810)$ -31%

LONG-TERM LIABILITIES: NET PENSION LIABILITY (22,270,270)$ (20,252,636)$ (2,017,634)$ 10%

TOTAL LONG-TERM LIABILITIES: (22,270,270)$ (20,252,636)$ (2,017,634)$ 10%

DEFERRED INFLOWS OF RESOURCES:

PENSION DEFERRED INFLOWS (4,196,571)$ (6,844,870)$ 2,648,299$ -39%

TOTAL DEFERRED INFLOWS OF RESOURCES: (4,196,571)$ (6,844,870)$ 2,648,299$ -39%

RESTRICTED ASSETS PAYABLE:

SNF TRUST FUND DEPOSITS PAYABLE (6,189)$ (8,778)$ 2,589$ -29%

TOTAL A/P RESTRICTED ASSETS: (6,189)$ (8,778)$ 2,589$ -29%

TOTAL LIABILITIES: (29,543,157)$ (29,441,601)$ (101,556)$ 0%

Page 2 of 3






REPORTING DATE:

F U N D B A L A N C E S :

UNRESTRICTED FUND BALANCE:

CHANGE IN NET ASSETS 1,340,652$ (3,938,205)$ 5,278,857$ -134% NET WORTH - OPERATING FUND (71,107,498)$ (67,667,822)$ (3,439,676)$ 5%

TOTAL UNRESTRICTED FUND BALANCE: (69,766,846)$ (71,606,027)$ 1,839,181$ -3%

RESTRICTED FUND BALANCE: -$ -$ -$

TOTAL FUND BALANCES: (69,766,846)$ (71,606,027)$ 1,839,181$ -3%

TOTAL LIABILITIES andFUND BALANCES COMBINED:

Asset & Liability Balance check: -$ -$ -$ ckd ckd ckd

(99,310,003)$ (101,047,628)$ 1,737,625$ -2%

Page 3 of 3

1

1

Financial Narrative Fiscal Year 2017

Period Ending April 30, 2017

FISCAL YTD BALANCE SHEET Current Assets report above last fiscal year-to-date in total with a positive variance of 2%. This is attributed to the increase in Unrestricted Cash and the decrease in Patient Accounts Receivable. Restricted Assets (cash designated for Capital and special projects) post below last year with a negative variance of (-53%) overall, or ($15.95m). This decrease is attributed to the posting of expenditures and pay-outs for Phase 3, 4, 5 and LTC-remodel construction projects. Property, Plant and Equipment (Net of Depreciation) exceed last year this period by a positive 25% or $13.8m. Construction Phases 3 & 4, along with applicable fixed equipment purchases, have been finalized and booked to assets as of the end of this reporting period. It looks like a part of Phase 5 (new Surgery) and the LTC remodel in total will be closed out in May. Overall, TOTAL ASSETS post below the same period last year with a negative variance of (-2%), or ($1.7m).

2

2

BALANCE SHEET continued………. Current Liabilities: Overall, Current Liabilities are reporting this period above last year with a variance of 31%, or $734,810. This is mainly attributed to timing issue of accounts payable posts at month-end, which will be paid during the first week of May. TOTAL LIABILITIES have increased over last year by $101,556. Total Liabilities and Fund Balance reflects a decrease of (-2%) or ($1.7m), due to a swing from a positive Change in Net Assets year-to-date to a negative, as compared to the closing of this period last year.

FISCAL YTD PROFIT & LOSS STATEMENT

Room & Board Revenues posted below budget projections by (-4%). Ancillary Revenues are below budgeted projections by ($3.4m), a negative variance of (-5%). Total Gross Revenue from Services to Patients posted below budget projections in total with a shortfall variance of ($3.7m) or a negative variance of (-5%). Contractual Adjustments to Revenues reported above budgeted expectations with a variance growth of $4.5m, or 17%. During the month of January, the posting of the Ambulance Medicare payment reimbursements for FYs11-14 of $618,107 and the Fiscal Year Cost Report settlement Amount Due Medicare of $1,290,500 contribute a total of $1,908,607 as part of that increase alone. GRAND TOTAL OPERATING REVENUES (inclusive of "Other" Revenues) post under budget projections with a negative variance of (-17%) with actuals posting at $37.8m as compared to a budget of $45.8m, or (-$7.9m). This variance is attributed to netting the decline in overall patient revenues against the increase in contractual adjustments.

3

3

PROFIT & LOSS STATEMENT continued ……….

Operating Expenses have posted below budgeted appropriations YTD with a below budget variance of 3%, or $1.5m. Operating Revenues over (under) Expenses (Operating Profit) reflect an Operating – Actual – (Loss) of (-$6.2m) as compared to an Operating – Budget - profit of $240,489. Depreciation took a $1.4m hit due to the booking of Construction Phases 3 and 4 during April. Non-Operating Revenue (Tax Revenue & Interest Earnings) exceed budgeted projections for this period by a positive 21%. The receipt of Ad Valorem Property, Consolidated (Sales), and Net Proceeds (Mines) tax revenues will fluctuate from month to month and are posted when received via Humboldt County’s monthly tax revenue distribution. The Change in Net Assets (actual) reflects a YTD earnings decline of ($1,340,650) as compared to a Budgeted Change in Net Assets YTD earnings growth of $4,232,760, reflecting a negative budget variance of ($-5.6m) or (-102%) (m = millions of dollars) (k - Thousands of dollars)

FISCAL YEAR-TO-DATE REVENUE PAYOR MIX

The April 2017 revenue payer mix posted as follows: Medicare 33%, Medicaid 25%, Insurance 30%, Private Pay 9%, and All Other 3%. Medicare decreased by 1% from March, and Insurance increased by 1% from March.

ANCILLARY VISITS

For the month of April, total Ancillary visits were 4,611, a decline of 770 visits below the 5,381 reported in March. A breakdown of the April ancillary visits were as follows: Hospital (Lab, Radiology, Other, etc.) = 1,874; Telemedicine = 14; Dr. Perkinson = 439; Dr. Li = 476; Jeremy Hurst = 302; Echo Mathews = 230; Resident(s)-Dr. Westling Clinic = 147; and the Walk-In Clinic = 538. The Emergency Room took care of 591 patients during the month of April, a decline of 6 patients below the 597 seen in March. Patients admitted to the hospital from the Emergency Room during the month of April were 23, a decline of 29 patients below the 52 reported in March.


RATIOS FOR THE PERIOD ENDING April 30, 2017:

<<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< < FY2017 <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< <<<<<<<< < FY2016

Standard APRIL MAR FEB JAN DEC NOV OCT SEPT AUG JULY JUNE MAY APRIL MAR FEB JAN DEC NOV OCT SEPT AUG JULY

CURRENT RATIO >2:1 4.68 5.35 4.62 4.89 3.00 2.00 2.73 2.80 3.04 2.25 2.90 5.14 6.05 6.56 5.06 4.92 5.93 7.64 2:24 6.47 6.75 8.66

Measure of short-term

debt paying ability

(Current Assets / Current Liabilities)

Assets are 2x as large as Liabilities

DAYS CASH ON HAND >150 152.74 146.9 148.81 146.92 196.8 225.77 242.1 243.21 235.02 258.94 274.55 305.70 300.57 312.13 345.10 344.08 340.90 351.35 372.53 388.59 386.56 400.01

Cash + Temp Investments + Investments DAYS

divided by Total Expenses (less Depreciation AND

Net Bad Debts), divided by Days in Period

DAYS RECEIVABLES < 70 57.37 58.33 57.29 60.14 69.73 73.10 62.72 63.21 71.68 64.66 81.42 77.40 68.18 79.46 76.72 81.91 78.20 83.03 82.60 85.48 91.13 88.95

Measure of worth as well DAYS

as billing and collection

performance

Percent

OPERATING MARGIN > 3% -9.20% -7.64% -9.30% -9.71% -1.79% -0.24% -0.50% -2.44% 2.75% 4.72% -4.13% -3.84% -5.11% -2.87% -3.32% -2.23% -2.01% -0.57% 0.62% 5.71% 9.84% 21.26%

YTD Operating Profit (Loss) divided by

YTD Gross Revenue from Services to Patients

(Guide to Hopsital's profitability)

Op Margin = measurement of what proportion of revenue is left over after paying for operating costs

Humboldt County Hospital District PAGE 1/6

STATISTICAL REPORTING

Report Period: APRIL, 2017 rev050317ed.

FISCAL YEAR 2017

____________________________

* *

* DAYS IN *

* PERIOD: 30 *

* *

HGH Stats, Period Ending 04/30/17: * _______________________________*

TOTAL AVERAGE FACILITY

BEDS ADMIT DISCH. PATIENT DAILY %%% LENGTH MONTH

PATIENT DAY RECAPS: AVAIL. #'S #'S DAYS CENSUS OCCUPY OF STAY DEATHS

(Includes

SERVICE CLASSIFICATIONS: Deaths)

AC02 MEDICAL/SURGICAL 16 47 45 157 5.23 32.71% 3.49 1

AC03 OBSTETRICS 6 29 28 44 1.47 36.67% 1.57 0

AC04 NEWBORN NURSERY 6 25 23 40 1.33 22.22% 1.74 0

AC05 INTENSIVE CARE UNIT 3 10 9 12 0.40 20.00% 1.33 0

TOTAL ACUTE CARE: 25 111 105 253 8.43 38.33% 2.41 1

( # of beds do not include Nursery) ckd

Monthly Average Length of Stay 2.13

AC01 NURSING HOME / MEMORY CARE 42 1 3 752 25.07 83.56% 1

.

FACILITY GRAND TOTALS: 67 112 108 1,005 33.50 64.42% 2

ckd ckd ckd

APRIL 2017

Humboldt County Hospital District

HGH Stats, Period Ending 04/30/17: PAGE 2/ 6

Apr-17 Apr-16 CURRENT PRIOR Y-T-D

CURRENT MONTH FY 2017 FY 2016 Amount

OUTPATIENT/EMERGENCY ROOM STATS: MONTH PRIOR YR Y-T-D Y-T-D Inc.(Dec)

ADMITS FROM EMERGENCY ROOM 23 19 304 268 13%

SHORT OBSERVATION 31 15 263 213 23%

TRANSFERS FROM EMERGENCY ROOM 29 44 311 320 -3%

DEATHS, EMERGENCY ROOM 1 0 7 8 -13%

DOA'S (Dead on Arrival) 0 0 0 0 #DIV/0!

AMA'S / ELOPEMENTS 7 7 75 92 -18%

LEAVE WITHOUT BEING SEEN 6 10 62 37 68%

******************** ******* ******** ******** ******** ********

EMERGENCY RM VISITS 591 571 5,924 6,022 -2%

OUTPATIENT VISITS (All Other) 1,874 1,844 18,585 18,826 -1%

CLINIC - DR. LI 476 402 4,723 4,572 3%

CLINIC - WALK IN CLINIC 538 568 6,340 6,447 -2%

CLINIC - RESIDENT CLINIC 147 90 2,186 942 100%

CLINIC - JEREMY HURST 302 286 2,670 3,230 100%

CLINIC - ECHO MATHEWS 230 265 1,615 2,703 100%

CLINIC - DR. PERKINSON 439 403 3,745 4,621 -19%

TELEMEDI CI NE 14 0 111 0 #DIV/0!

TOTAL EMERGENCY/OUTPATIENTS: 4,611 4,429 45,899 47,363 -3%





ACUTE/SKILLED NURSING STATISTICS: MONTH PRIOR YR Y-T-D Y-T-D Inc.(Dec)

PATIENTS ADMITTED:

ADULTS & PEDIATRIC 86 40 676 650 4%

NEWBORNS 25 15 185 231 -20%

SNF / MEMORY CARE 1 1 16 18 -11%

TOTAL PATIENTS ADMITTED: 112 56 877 899 -2%

ADULTS & PEDIATRIC 82 39 648 652 -1%

NEWBORNS 23 16 183 235 -22%

SNF / MEMORY CARE 3 1 16 16 0%

TOTAL PATIENTS DISCHARGED: 108 56 847 903 -6%

TOTAL PATIENT DAYS:

ADULTS & PEDIATRIC 213 121 2,262 2,164 5%

NEWBORNS 40 24 294 382 -23%

TOTAL ACUTE PATIENT DAYS: 253 145 2,556 2,546 0%

TOTAL SNF / MEMORY CARE PATIENT DAYS: 752 780 7,881 7,723 2%

TOTAL FACILITY PATIENT DAYS: 1,005 925 10,437 10,269 2%

TOTAL FACILITY DEATHS:

ACUTE HOSPITAL 1 0 8 6 33%

SNF / MEMORY CARE 1 0 8 2 300%

TOTAL FACILITY DEATHS: 2 0 16 8 100%

Humboldt County Hospital District PAGE 4/ 6

HGH Stats, Period Ending 04/30/17:



SURGICAL OPERATIONS PERFORMED: MONTH PRIOR YR Y-T-D Y-T-D Inc.(Dec)

General 28 27 249 258 -3%

Gynecological 0 0 3 6 -50%

C-Sections 11 2 44 60 -27%

Orthopedic 11 18 188 176 7%

Podiatry 0 0 0 0 #DIV/0!

Opthamology 0 0 20 11 82%

ENT 0 0 0 0 0%

Plastic 0 0 0 0 0%

Oral 0 0 0 0 0%

Urology 0 0 0 0 0%

Other 0 0 0 1 -100%

TOTAL SURGERY: 50 47 504 512 -2%



SURGICAL PROCEDURES PERFORMED: MONTH PRIOR YR Y-T-D Y-T-D Inc.(Dec)

Colonoscopies 11 16 156 138 13%

Gastrointestinal Procedures 17 14 177 197 -10%

Sigmoidoscopy 1 0 9 22 -59%

Bronchoscopy 0 0 0 0 #DIV/0!

Anesthesia Blocks 0 0 0 0 0%

Epidural--Lumbar 0 0 0 0 0%

Epidural--Thoracic 0 0 0 0 0%

Epidural--Cervical 0 0 0 0 0%

Oral 0 0 0 0 0%

Plastic 0 0 0 0 0%

Pterygium 0 0 0 0 0%

Other 1 0 52 73 -29%

TOTAL PROCEDURES: 30 30 394 430 -8%

TOTAL SURGERIES AND PROCEDURES: 80

***Number of above surgeries and/or procedures

that were laparoscopic. 8 11 68 92 -26%



SURGERY SURGERY SURGERY PROCEDURE PROCEDURE PROCEDURE

SURGICAL HOURS/PROCEDURE HOURS HOURS HOURS HOURS HOURS HOURS HOURS

PERFORMED: INPT: OUTPT: TOTALS: INPT: OUTPT: TOTALS:

Fiscal Year 2017: 7/1/16- 6/30/17:

2016

July 9.83 26.50 36.33 0.87 13.47 14.34

August 19.43 11.53 30.96 0.00 14.02 14.02

September 7.05 20.22 27.27 0.22 14.62 14.84

October 35.53 18.48 54.01 0.92 8.70 9.62

November 13.87 23.48 37.35 0.50 18.73 19.23

December 21.03 19.47 40.50 0.43 18.42 18.85

2017 ****** ********** ****** ****** ****** ******

January 17.85 17.47 35.32 0.88 15.18 16.06

February 10.87 15.30 26.17 0.77 16.72 17.49

March 37.37 23.72 61.09 0.57 11.32 11.89

April 34.60 14.62 49.22 0.13 13.82 13.95

May 0.00 0.00

June 0.00 0.00

FY 2016 Y-T-D HOURS: 207.43 190.79 398.22 5.29 145 150.29

Humboldt County Hospital District PAGE 6/ 6

HGH Stats, Period Ending 04/30/17:



ANCILLARY UNITS OF SERVICE: MONTH PRIOR YR Y-T-D Y-T-D Inc.(Dec)

LABORATORY, ALL:

INPATIENT 1,757 1,141 16,617 15,096 10%

OUTPATIENT 5,488 5,579 53,122 59,977 -11%

RADIOLOGY, ALL OTHER:

INPATIENT 65 51 588 694 -15%

OUTPATIENT 708 701 7,551 7,661 -1%

RADIOLOGY, CT SCANS:

INPATIENT 8 8 104 126 -17%

OUTPATIENT 130 141 1,296 1,496 -13%

RADIOLOGY, MAMMOGRAPHY:

INPATIENT 0 0 0 1 -100%

OUTPATIENT 47 52 575 557 3%

RADIOLOGY, MRI:

INPATIENT 4 1 29 30 -3%

OUTPATIENT 44 39 475 497 -4%

INPATIENT TOTALS: 1,834 1,201 17,338 15,947 9%

OUTPATIENT TOTALS: 6,417 6,512 63,019 70,188 -10%

GROSS PATIENT REVENUES: $83,466,105

(LESS) CONTRACTUAL ALLOWANCES & ($34,970,967)

MEDICAID DSH UPL IGT

NET PATIENT REVENUES: $48,495,138

OTHER OPERATING REVENUES:

RENTAL INCOME $122,500

MISCELLANEOUS - HOSPITAL $74,325

MISCELLANEOUS - AMBULANCE $151,500

MEDICAL RECORDS FEES $3,250

DIETARY MEALS $108,350

CAFÉ'RX $13,750

CASH OVER/SHORT $0

GRANT REVENUES $52,522

DONATIONS $6,000

SALE OF ASSETS -$5,000

$527,197

TOTAL OPERATING REVENUES: $49,022,335

OPERATING EXPENSES:

PROFESSIONAL CARE OF PATIENTS 22,935,784

DIETARY SERVICES 879,186

GENERAL SERVICES 4,014,899

ADMINISTRATION SERVICES 12,756,762

DEPRECIATION 5,362,670

BAD DEBTS NET OF RECOVERY $6,632,934

52,582,236

($3,559,901)

NON-OPERATING REVENUES:

ADVALOREM TAX $3,855,107

CONSOLIDATED TAX $796,777

NET MINES TAX $0

INTEREST EARNINGS $19,900

$4,671,784

$1,111,883

TOTAL OTHER OPERATING REVENUES:

OPERATING PROFIT / (LOSS):

GAIN (LOSS) IN NET ASSETS:

TENTATIVE OPERATING BUDGET

FISCAL YEAR 2018 ***TENTATIVE*** BUDGET

PERIOD JULY 1, 2017 - JUNE 30, 2018

TOTAL NON-OPERATING REVENUES:

TOTAL OPERATING EXPENSES:

Page 1 FY18 FINAL BUDGET DETAILED DUE 060117

Transport VentilatorsHGH EMS

Current Transport Vents

4 “Eagle” Vents

13-15 years old

Parts availability & service problems

Dials difficult to adjust

Cost: $37,263.75 for three EMV ventilators

$8,000 trade in credit for current Eagle Vents (4)

Total Cost: $29,263.75

Also will trade out current vent circuits for new

model specific ones.

Zoll EMV+

Multiple operating modes

(vent, CPAP, BiPAP)

Easy to adjust controls

Weighs less than 10

pounds

Rugged MILSPEC all

weather construction

10-hour battery run-time;

recharges in 2 hours

Cost: $17,290.00 for one ReVel ventilator

No trade in credit for current vents

Total cost $17,290.00

ReVel

Breath modes: AC, CPAP

plus PS, BiPAP (NPPV), apnea

backup

Size: 11.3" (h) x 7.1" (w) x 3.3"

Weight 9.5 lb

Battery: ~4-hour battery run-

time

Cost: $14,571.25 for one LTV ventilator

No trade in credit for current vents

Total cost $14,571.25

LTV 1200

Breath modes: Control,

Assist/Control, SIMV/CPAP

and NPPV

Size: 14.5 lb

Battery: ~6 hours on two sprint pack batterys

Recommendation

Purchase 3 Zoll Vents

Best value

Most durable

Used demo twice with outstanding results

Documents

HUMBOLDT GENERAL HOSPITALMay 23, 2017 · humboldt general hospital 118 east haskell street. w. innemucca, n. evada . 89445 . district board of trustees meeting agenda . meeting date: