LAFCO

Pioneers Memorial Healthcare District Service Area Plan

Local Agency Formation Commissions · imperial-msr-2015-pioneers-memorial-healthcare-district-service-area-plan · Msr · 2015-01-01

Read the report at Local Agency Formation Commissions ↗

Pioneers Memorial Healthcare District 207 West Legion Road Brawley, CA 92227 LOCAL AGENCY FORMATION COMMISSION (LAFCO) 1-7-marked to lapeo icarel Tistrict MISSION STATEMENT The mission of the Pioneers Memorial Healthcare District is to provide quality healthcare and compassionate service for families of the Imperial Valley. VISION STATEMENT A collaborative partnership of physicians and the organization, recognized nationally and by the community as the leader of quality healthcare and customer service. VALUE STATEMENT As community healthcare providers we are entrusted to give high quality care and service in a safe environment respect each individual's ethnicity and rights as a healthcare consumer ٠ preserve the individual's dignity and provide for their healthcare needs including the management of pain. As an organization we are committed to follow our strategic plan, which establishes our growth and direction. ٠ open and clear communication an atmosphere of trust, high morale, and a well-balanced environment free of undue stress. For our employees we are committed to ensure a sense of security and organization fair and competitive compensation ٠ safe working conditions just and ethical actions freedom to be creative, to make suggestions, to voice concerns, and equal opportunity for employment, growth, and advancement • Revised 7/20/14 Approved by the Board of Director's 8/2014 DNV HEALTHCARE INC. ERTIFICATE OF ACCREDITATION Certificate No. 159713-2014-AHC-USA-NIAHO This is to certify that Pioneers Memorial Healthcare District 207 West Legion Road, Brawley, CA 92227 Complies with the requirements of the: NIAHO® Hospital Accreditation Program Pursuant to the authority granted to Det Norske Veritas Healthcare, Inc. by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, this organization is deemed in compliance with the Medicare Conditions of Participation for Hospitals (42 C.F.R. §482). This certificate is valid for a period of three (3) years from the Effective Date of Accreditation. Effective Date of Accreditation: for the Accreditation Body: July 21, 2014 DET NORSKE VERITAS HEALTHCARE, INC. HOUSTON, TEXAS aprila Dom Patrick Horine Yehuda Dror Chief Executive Officer President Lack of continual fulfillment of the conditions set out in the Certification/Accreditation Agreement may render this Certificate invalid. ACCREDITED UNIT: DNV HEALTHCARE INC., 400 TECHNECENTER DRIVE, SUITE 100 MILFORD, OHIO 45150, OH, UNITED STATES, TEL: 513-947-8343 WWW.DNVACCREDITATION.COM DNV HEALTHCARE INC 1400 Ravello Drive 400 Techne Center Drive, Katy, Texas 77449 Suite 100, (281) 396-1000 Milford, Ohio 45150 (513) 947-8343 July 14, 2014 Lawrence Lewis Program: Hospital Chief Executive Officer CCN: 050342 Pioneers Memorial Healthcare District Survey Type: Medicare Recertification/DNV Reaccreditation 207 West Legion Road Certificate #: 159713-2014-AHC-USA-NIAHO Brawley, CA 92227 Survey Dates: June 3-4, 2014 Accreditation Decision: Full accreditation Date Acceptable Plan of Correction Received: 6/26/2014 Method of Follow-up: Acceptable Plan of Correction Effective Date of Accreditation: 7/21/2014 Expiration Date of Accreditation: 7/21/2017 Term of Accreditation: Three (3) years Dear Mr. Lewis: Pursuant to the authority granted to Det Norske Veritas Healthcare, Inc. by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Pioneers Memorial Healthcare District is deemed in compliance with the Medicare Conditions of Participation for Hospitals (42 C.F.R. §482) and awarded full accreditation for a three (3) year term effective on the date referenced above. Det Norske Veritas Healthcare, Inc. is recommending your organization for continued deemed status in the Medicare Program. This accreditation is applicable to all facilities operating under the above-referenced CCN number at the following address(es): Pioneers Memorial Healthcare District - 207 West Legion Road - Brawley, CA 92227 The Wound Care Center at Pioneers Memorial Healthcare District - 751 West Legion Road, Suite 205 - Brawley, CA 92227 Calexico Health Center - 450 East Birch Street - Calexico, CA 92231 Rehabilitation Services - 751 West Legion Road, Suite 101 - Brawley, CA 92227 The Cancer Institute at Pioneers Memorial Healthcare District - 205 West Legion Road - Brawley, CA 92227 This accreditation requires an annual survey and the organization's continual compliance with the DNVHC Accreditation Process. Failure to complete these actions or otherwise comply with your Management System Certification/Accreditation Agreement may result in a change in your organization's accreditation status. Congratulations on this significant achievement. Sincerely, Patrick Horine Chief Executive Officer cc: CMS CO and CMS RO IX (San Francisco) The Joint Commission January 6, 2014 Lawrence E. Lewis, MBA, Health Admin Joint Commission ID #: 9767 CEO Program: Laboratory Accreditation Pioneers Memorial Healthcare District Accreditation Activity: Measure of Success 207 West Legion Road Accreditation Activity Completed: 01/06/2014 Brawley, CA 92227 Dear Mr. Lewis: The Joint Commission would like to thank your organization for participating in the accreditation process. This process is designed to help your organization continuously provide safe, high-quality care, treatment, and services by identifying opportunities for improvement in your processes and helping you follow through on and implement these improvements. We encourage you to use the accreditation process as a continuous standards compliance and operational improvement tool. The Joint Commission is granting your organization an accreditation decision of Accredited for all services surveyed under the applicable manual(s) noted below: Comprehensive Accreditation Manual for Laboratory and Point-of-Care Testing This accreditation cycle is effective beginning September 20, 2013. The Joint Commission reserves the right to shorten or lengthen the duration of the cycle; however, the certificate and cycle are customarily valid for up to 25 months. Please visit Quality Check® on The Joint Commission web site for updated information related to your accreditation decision. The following laboratory services have been surveyed under Joint Commission standards in accordance with the Clinical Laboratory Improvement Amendments of 1988: CLIA# 05D0572029 for the specialties and subspecialties of Bacteriology, Mycology, Parasitology, Virology, Syphilis Serology, General Immunology, Routine Chemistry, Urinalysis, Endocrinology, Toxicology, Andrology, Coagulation, Hematology, Blood Transfusion Services, Immunohematology(ABO Group and RH, Antibody Transfusion, Antibody Non-Transfusion, Antibody Identification, Compatibility Testing), Histopathology, Cytology and Tissue Banking. We encourage you to share this accreditation decision with your organization's appropriate staff, leadership, and governing body. You may also want to inform the Centers for Medicare and Medicaid Services (CMS), state or regional regulatory services, and the public you serve of your organization's accreditation decision. Please be assured that The Joint Commission will keep the report confidential, except as required by law. To ensure that The Joint Commission's information about your organization is always accurate and current, our policy requires that you inform us of any changes in the name or ownership of your organization or the health care services you provide. Sincerely, Mark Pelleties Mark G.Pelletier, RN, MS Chief Operating Officer Division of Accreditation and Certification Operations 090000087 License: Effective: 10/28/2014 Expires: 06/29/2015 State of California Licensed Capacity: 107 Department of Public Health In accordance with applicable provisions of the Health and Safety Code of California and its rules and regulations, the Department of Public Health hereby issues this License to Pioneers Memorial Healthcare District to operate and maintain the following General Acute Care Hospital Pioneers Memorial Healthcare District 207 W Legion Rd Brawley , CA 92227-7780 Bed Classifications/Services Other Approved Services 107 General Acute Care Basic Emergency Medical 14 Perinatal Mobile Unit - MRI 12 Pediatric Mobile Unit - PET 8 Intensive Care Nuclear Medicine 7 Intensive Care Newborn Nursery Outpatient Clinics - Rural Health at Calexico 66 Unspecified General Acute Care Health Center, 450 E. Birch Ave., Calexico Outpatient Services - Oncology/Infusion at Cancer Institute at PMHD, 205 W. Legion Rd., Ste. 1, Brawley Outpatient Services - Primary Care at Pioneers Health Center, 751 W. Legion Rd., #103, Brawley Outpatient Services - PT/OT at Therapy Solutions at PMHD, 751 West Legion Rd., #101, Brawley Outpatient Services - Wound Care at Wound Care Center, 751 West Legion, Ste. 205, Brawley Physical Therapy Respiratory Care Services Approved Other Certifiable Parts Rural Health Clinic Calexico Health Center 450 E Birch St Calexico, CA 92231-2375 (Additional Information Listed on License Addendum) Refer Complaints regarding these facilities to: The California Department of Public Health, Licensing and Certification, San Diego District Office South, 7575 Metropolitan Drive Suite 211, San Diego, CA 92108, (619)688-6190 POST IN A PROMINENT PLACE 090000087 License: State of California 10/28/2014 Effective: Department of Public Health Expires: 06/29/2015 Licensed Capacity: 107 License Addendum 50 1070 1009 This LICENSE is not transferable and is granted solely upon the following conditions, limitations and comments: None Donna Oya Ron Chapman, MD, MPH Director & State Health Officer Donna Loza, R.N., District Manage Refer Complaints regarding these facilities to: The California Department of Public Health, Licensing and Certification, San Diego District Office South, 7575 Metropolitan Drive Suite 211, San Diego, CA 92108, (619)688-6190 POST IN A PROMINENT PLACE Pioneers Memorial Healthcare District 207 West Legion Road Brawley, CA 92227 OPERATIONAL PLAN Operational Plan Pg. 2 of a TABLE OF CONTENTS STATEMENT OF PURPOSE 3 MISSION STATEMENT..... 3 VISION..... 3 VALUES..... 3 PIONEERS MEMORIAL HEALTHCARE DISTRICT HISTORY..... 4 STRATEGIC GOALS AND MANAGEMENT OBJECTIVES..... 5 CUSTOMER SERVICE..... 5 OBJECTIVES..... 5 CLINICAL AND OPERATIONAL EXCELLENCE..... 5 OBJECTIVES..... 5 6 MARKET SHARE..... OBJECTIVES..... 6 6 RECRUITMENT AND RETENTION..... OBJECTIVES..... 6 6 FINANCIAL VIABILITY AND FISCAL RESPONSIBILITY..... OBJECTIVES..... 7 -25 -21 * Operational Plan Pg. 3 of 7 Pioneers Memorial Healthcare District STATEMENT OF PURPOSE Mission Statement The mission of the Pioneers Memorial Healthcare District is to provide Quality healthcare and compassionate service for families of the Imperial Valley. Vision A collaborative partnership of physicians and the organization, recognized nationally and by the community as the leader of quality healthcare and customer service. Values As community healthcare providers we are entrusted to: ŵ Give high quality care and service ÷ Respect each individual's ethnicity and rights as a healthcare consumer ÷ Preserve the individual's dignity and provide for their healthcare needs including the management of pain. As an organization we are committed to: ❖ Follow our strategic plan, which establishes our growth and direction. Ť Open and clear communication. ÷ An atmosphere of trust, high morale, and a well-balanced environment free of undue stress For our employees we are committed to ensure: A sense of security and organization Fair and competitive compensation Safe working conditions Just and ethical actions Freedom to be creative, to make suggestions, to voice concerns, and Equal opportunity for employment, growth, and advancement. Operational Plan Pg. 4 of 7 Pioneers Memorial Healthcare District HISTORY OF THE ORGANIZATION Pioneers Memorial Hospital is a highly recognized, 107-bed, acute care district hospital facility accredited by DNV, which stands for Det Norske Veritas - the Nordic Truth, is a hospital accreditation organization approved by the U.S. Center for Medicare and Medicaid (CMS) and has some of the most strenuous standards in healthcare. We are committed to providing state-of-the-art healthcare and the highest quality of community education. Located in Imperial Valley in southeastern California, Pioneers is the culmination of a dream. In the 1940s, many people worked together to plan and develop this hospital. Their hard work came to fruition when we opened our doors October 29, 1950, with 88 beds. The first patient was admitted at 7:30pm and the first baby was delivered on October 31st. From the very beginning, we have been committed to continually updating, upgrading and improving our facility and our care. We have invested in technological advancements not commonly found in a hospital of our size, most notably in Nuclear Medicine, Computer Tomography and Ultrasound as well as in laboratory testing. Our 16-bed emergency department was opened in 1999. We are a level 4 trauma center with an excellent reputation and board-certified emergency physicians. We offer specialized treatment through our Cancer Institute, Wound Care Center, Joint Replacement, and Physical Therapy Center. The Phyllis Dillard Family Medical Center houses both the surgical and obstetrical services. The deliveries at PMHD routinely exceed 150 per month and averages between 49-51 percent of all deliveries in Imperial County. Pioneers Rural Health Center in Calexico provides both primary and urgent care services to Calexico "after hours". Calexico Health Center opened in the summer of 2004 and has enjoyed a collaborative community relationship with the City of Calexico and the local Heffernan Memorial Hospital District Board. The tremendous growth of the business of this clinic speaks to the health care needs of this largely underserved community. Our newest Rural Health Center in Brawley will offer both primary care and specialty care and is expected to open in early 2015. Operational Plan Pg. 5 of Pioneers Memorial Healthcare District STRATEGIC GOALS AND MANAGEMENT OBJECTIVES Our mission guides the strategic goals and objectives to give an overall direction. Customer Service It is the strategic goal of Pioneers Memorial Healthcare District to ensure delivery of efficient services, building a foundation of satisfied customers. Objectives Maintain a customer service program that: a. Demonstrates commitment to building positive relationships with all customers i. In-patients Outpatients and ED patients iii. Clinics iv. Physicians v. Staff vi. Community b. Identifies and prioritizes a process to train health district employees in the skills and attributes of excellence customer service. c. Measure Success by: i. Satisfaction surveys: HCAHPS, CEP survey ii. Number of complaints and type trending iii. Physicians and Staff satisfaction survey Clinical and Operational Excellence It is a strategic goal of Pioneers Memorial Healthcare District to address the healthcare needs of our community through practices that embrace safety and quality as a customer focus theme. Objectives 1) Center of Excellence a. Joint Program b. Stroke Center 2) Update performance scorecard to enhance board participation in clinical and operational excellence Operational Plan Pg. 6 of 7 PMHD Strategic Goals and Management Objectives Market Share It is a strategic goal of Pioneers Memorial Healthcare District to be the premier healthcare provider to the primary and secondary service area. The hospital will aggressively pursue an increased share of the healthcare market through development of a marketing program, strong relationships with physicians, employers and establishment of new programs Objectives 1) Continuously improve premier status to promote market growth 2) Investigate opportunities to partner with physicians and joint venture groups to promote service specific growth 3) Build onto existing marketing program to include a. Pain Management b. Cancer Institute c. Digestive and Liver disease Recruitment and Retention It is a strategic goal of Pioneers Memorial Healthcare District to recruit and retain well-trained and competent staff, building on foundation of pride in excellent care. The District works tenaciously with the medical staff and local healthcare provider organizations to ensure the primary and secondary service areas have access to an appropriate mix of providers and services. Objectives 1) Initiate a medical staff development plan Initiate a staff recruitment and retention plan Financial Viability and Fiscal Responsibility It is a strategic goal of Pioneers Memorial Healthcare District to ensure that the District's financial condition is financially viable and adequate to support, maintain and expand to responsibly meet the health care needs and desires of its patient, physicians and staff. Objectives Operational Plan Pg. 7 of 7 PMHD Strategic Goals and Management Objectives 1) Develop and maintain financial controls to monitor safeguard Health District Assets. 2) Provide informed and timely financial guidance to the members of the Senior Management and the Governing Board. 3) Work collaboratively with Federal and State agencies to insure the Districts compliance with reporting requirements and to position the District to receive the entitlements earned through its compliance. 4) Provide timely and accurate financial reporting to all internal and external parties having financial dealings with the District. 5) Prepare and present an operational and capital financial plan to the Governing Board, annually. 6) Complete and annual financial audit with an "Unqualified Opinion". Pioneers Memorial Healthcare District 2015 Budget Proposal The Budget proposal for Fiscal year 2015 is the product of an intensive, but thoughtful review of current and future operations linked to key strategic initiatives designed to position PMHD to meet its foreseeable goals. The 2015 Budget proposal reflects an improvement in "bottom line" performance achieved thru marginal revenue growth off-set by carefully planned spending reductions. The primary initiatives reflected in the 2015 Budget are the following: a return to annual merit pay increases, reduced expenditures for professional fees, purchased services and contract registry along with a renewed focus on capital replacement. Pioneers Memorial Healthcare District 2015 Budget Proposal TABLE OF CONTENTS 1. Budget Assumptions and Comments 2. Income Statement a. Subsidiary Schedules b. Productivity and Ratio Analysis 3. Balance Sheet a. Subsidiary Schedules b. Changes in Fund Balance 4. Budget Statistics by Department 5. Staffing Budget Report (Sorted by Executive) 6. Total Hospital FTE Comparison 7. Capital Budget FY 2015-2017 8. Modified Income Statement a. Subsidiary Schedules b. Productivity and Ratio Analysis 1. Workload Assumptions Patient Days are expected to increase three percent while inpatient admissions will remain constant. The net effect will be an increase in the length of stay from 3.0 to 3.1 days. With the exception of the rural health clinics, outpatient ancillary volumes are not expected to increase. % % % 2015 Chg. 2014 Chg. 2013 Chg. 2012 Inpatient Admits 5,360 0.00% -2.76% 5,360 5,512 -11.24% 6,210 Patient Days 16,608 3.10% 16,108 -2.03% 16,441 -18.05% 20,062 Emergency Visits 43,699 0.27% 43,583 -0.71% 43,570 43,894 0.74% Outpatient Visits 42,259 0.05% 42,238 13.02% 37,372 -11.73% 42,337 Rural Clinic Visits 30,742 37.86% 17.93% 22,299 18,909 1.54% 18,623 Adjusted Pt Days 42.283 1.46% 41,673 1.14% 41,205 -9.63% 45,598 3.10% Ave. Length of Stay 3.1 3.0 0.75% 3.0 -7.67% 3.2 2. Rate Increase and Patient Charges No rate increases (prices), or new inpatient services, were planned for the 2015 fiscal year. Daily hospital service revenues along with inpatient ancillary revenues are projected to increase by 3% in line with in patient volume increases. Outpatient revenues are budgeted to increase just .3% over projected revenues. 3. Payer Mix (Patient Days) Medicare will remain the largest payer class followed by Medi-Cal & Medi-Cal Managed Care. It is expected that Medi-Cal managed care enrollments will continue to grow as new beneficiaries are drawn into the MediCal plans. HMO\PPO enrollments are expected to decline. 2015 % total 2,014 % total 2013 % total Medicare 6,706 40.4% 6,456 40.1% 5,803 35.3% M-Cal State 3,402 20.5% 3,602 5,817 22.4% 35.4% MediCal MC 2,437 14.7% 1,726 4 10.7% 0.0% Private Pay 1,173 7.1% 1,273 924 5.6% 7.9% HMO\PPO 2,890 17.4% 3,051 18.9% 3,893 23.7% 16,608 100.0% 16,108 100.0% 16,441 100.0% 4. Deductions from Revenue The Deductible ratio is expected to increase slightly from 80.36% to 80.43% of budgeted revenues. a. Medicare Disproportionate Share Hospital payments for FY 2015 are expected to match FY 2014 payments. In FY 2014 DSH payments were reduced ($1.098K) from FY 2013 as a result of the change in payment methodology mandated by the Affordable Care Act. b. Medicare inpatient reimbursement is expected to decline (1.5%) due to reduction in the CMS market basket rates. c. Medi-Cal reimbursement is expected to decrease approximately (2%) over the current year due to the transition to Managed Medi-Cal and a reduction in supplemental outpatient payments d. Charity Write-offs are expected to increase approximately $1.1 mil as PMHD makes a concerted effort to identify charity care incompliance with CMS mandates. Seventy five percent (75%) of future Medicare DSH payments will be based upon recorded Charity care. e. Provision for Bad Debts are expected to decline in proportion to the increase in Charity Care as potential bad debt write offs will be re-classed to charity. f. Other deductions are expected to be consistent with current year levels. 5. Other Operating Revenues Other Operating Revenues are comprised mainly of the following: cafeteria sales, child care revenue, and other miscellaneous rebates, which are expected to remain about the same as the current 2014 year. 6. Staffing Staffing levels were reviewed and tested against reasonable productivity standards. The productivity of each department was trended using a workload unit (WLU) unique to that area. See the Staffing Budget Report separately attached. Nurse staffing "grids" were reviewed and revised to insure that patient care staffing levels were consistent with volumes and compliant with California Staffing ratios. Total paid FTEs are budgeted at 671.89 against FY 2014 projected of 671.40. On a volume adjusted basis, paid FTEs budgeted is 5.80; whereas FY 2014 it was 5.88. 7. Salary and Wages Salaries and Wages are budgeted to increase 3.8%. Below are the key assumptions assumed in the budgeting of salaries and wages? A. The Salary merit program was re-instituted with an overall increase of five percent (5%) allocated between equity adjustments (2%) and merit increases to average (3%). В Holiday supplemental pay of $ 275,000 was reinstated. C. The budget includes $-0- for the PMHD incentive plan. 8. Registry and Contract Labor Registry and contract labor has decreased by 34.5% due primarily to the elimination of the Johnson Controls contract. The following are the major changes in contract labor: 2015 2014 Diff. Path Lab 0 80,000 80,000 Plant 0 403,061 403,061 Clinics 0 20,967 20,967 Resp Ther 0 18,868 18,868 Financial Serv 0 56,640 56,640 9. Employee Benefits Benefit expenses for PMHD are linked to salaries and wages. The following are the current projections as a percentage of Salaries: FICA Tax 2,916,460 7.30% SUI Tax 190,355 0.47% Health Ins. 4,700,000 11.58% Life Ins. 80,204 0.20% Pension 886,900 2.19% Workers Comp 1,208,850 2.98% Other Ben. 200,700 0.49% 10,183,469 25.21% 10. Professional Fees Total Professional fees are projected to decrease by 14.0% compared to FY 2014. The majority of the reduction is due to a change in Anesthesia Contractors, greater use of CRNAs and less reliance on Locums. The major changes in Physician's fees are for the following departments: FY 2015 FY 2014 Diff. Womens Serv. 722,400 853,901 131,501 Surgery 1,272,500 1,683,246 410,746 Anesthesia 1,500,000 2,511,912 1,011,912 11. Supplies Supply costs are projected to increase 3.09% in FY 2015. Blood products, pharmacy items and food were budgeted above the 3% range while most supply items remain between 2.5 to 3.0%. 12. Purchased Services Purchased services are budgeted to decrease 7.98%. The majority of the decline is in the areas of: Anesthesia (Doc Med), Case Management (JA Thomas) and Plant Maintenance (Johnson Controls). 13. Repairs and Maintenance Repairs and Maintenance consist mainly of maintenance contracts to cover equipment repairs, system support fees for software applications and general repair services. Most items are fixed and generally amortized over the life of the agreement. Repair and Maintenance costs are budgeted to decrease by 1.2% overall. 14. Other Expenses Other includes utilities, licenses, dues, subscriptions and travel. This category is expected to increase 7.5% due to increases in utility costs, physician dictation software and training. 15. Depreciation & Interest Cost Depreciation costs are calculated to decrease by $149K despite the sizable increase in Capital Spending. The decrease is due to the large amount of capital equipment that has aged beyond its' depreciable life, but remains in use and therefore on the books. The average age of capital for FY 2015 is 14.9 years, up from 13.5 in FY 2014. 16. Balance Sheet Key indicators Accounts receivable days are projected to improve from 41.4 days outstanding to 40.2 net. Days Cash on Hand (including settlements) are projected to decline from 142.1 to 126.2 as cash reserves will be used to purchase approximately $ 3.2 mil of the 5.2 mil capital budget. The current ratio will decline from 1.91 to 1.72 17. Non-Operating Revenue/Expense District tax revenues are projected to be $ 1,058,239 while the special tax assessment for the 1994 bonds debt service will be $ 1,910,188. The Hospitalist program expenses are expected to decline 20.3% under the new contract. Other non-Operating revenue (expenses) is expected to remain level with the current year. 18. Three Year Capital Plan Capital Budget Detail for 2015 (Separate Worksheet Attached). 5/29/2014 1:48 PM Actual 2012 $130,318,109 $405,254,776 $305,245,075 75.3% $47,985,106 $101,042,562 $11,858,016 $3,667,925 $100,009,701 $1,032,861 $38,212,459 $14,905,465 $4,685,060 $5,368,251 $1,190,717 $2,894,058 $4,588,105 $1,024,468 $1,809,973 $6,534,241 $1,847,461 $5,290,804 4.54% $214,888 $508,153 $5,096,258 $96,454,457 ($1,157,111) ($1,384,065) ъ 8 -8.8% Change 1.6% -11.3% 9.1% 1.6% -5.1% -9.0% 16.7% 23.9% -42.9% 21.6% -41.2% 2.5% -1.3% 4.0% 0.1% 18.2% 14.6% 2.4% -165.0% 20.7% 1.6% .9.7% -2.4% 25.9% 42.4% 31.8% -145.4% Actual 2013 $115,608,556 $247,563,732 $411,919,430 $320,935,350 $90,984,080 $48,747,142 $1,204,833 $92,188,913 -$2,983,253 -$2,313,568 77.9% $669,685 $39,750,804 $9,028,291 $2,092,887 $6,530,063 $14,915,536 $6,697,371 $3,419,534 $5,369,699 $1,891,333 $95,172,166 ($917,714) $1,041,149 $1,767,315 $700,527 -3.24% ($1,741,909) $520,844 $4,776,121 Proj vs Act ($1,678,174) ($310,163) ($1,988,337) ($807,075) ($1,181,262) ($901,348) Difference ($280,614) ($651,332) ($637,418) [$457,776] ($673,977) ($191,402) ($422,029) $3,444,291 $7,993,177 $31,441,697 $42,879,165 $44,557,339 $1,439,763 $503,353 $1,858 $177,145 $104,740 $279,914 $99,538 $225,372 $223,767 $11,851 % 0 Change 7.1% 6.9% 12.7% -2.2% 10.4% -13.9% -1.8% -25.7% 5.6% -1.6% 30.5% 22.0% 65.3% -1.3% -6.3% 0.1% -12.6% 39.6% 9.4% 2.2% -0.8% 24.4% 1.1% 2.6% -12.9% 53.9% 41.8% 39.0% Projection 2014 $123,601,733 $279,005,429 $454,798,595 $365,492,689 $52,191,433 $89,305,906 $894,670 $90,200,576 80.4% $9,531,644 $1,455,469 $7,969,826 $14,724,134 $2,068,478 -$4,164,515 -$3,214,916 $39,099,472 $242,751 $6,275,342 $3,421,392 $4,695,722 $94,365,091 -4.62% ($693,947) $1,053,000 $1,866,853 $240,230 $949,599 $4,880,861 ($1,516,537) Bud vs Proj ($502,239) Difference ($1,117,767) ($500,552) ($42,592) ($149,439) $5,278,979 $1,565,742 $3,708,051 $908,434 $903,248 $50,260 $953,508 $6,182,227 $1,477,808 $651,825 $17,000 $455,134 $216,724 $646,850 $83,522 $364,084 $736,784 $5,239 $43,335 $308,545 $7,920 $430,126 $65,087 S:VACCT/Budget 2015/Financial Reports/Board package/2.Income Statement and Subsidiary Sch 2015 Pioneers Memorial Healthcare District For the Budget Year ending June 30, Statement of Revenue and Expense % Of Change 3.0% 0.3% 1.4% -1.4% 1.0% 5.6% 1.1% -14.0% 3.1% -1.2% 3.0% 3.8% 6.8% -34.5% 7.0% -8.0% -3.2% 4.0% 7.5% 0.8% -5.2% 9.4% 0.5% 2.3% 20.3% 45.3% -20.1% -3.3% 2015 $53,757,175 $127,309,784 $279,913,863 $370,771,668 80.4% $90,209,154 $10,183,469 $460,980,822 $944,930 $91,154,084 $40,577,280 $953,230 $6,852,059 $15,179,268 $5,774,790 $3,378,800 $4,546,283 $2,152,000 $5,244,945 $95,101,875 -$2,568,066 $1,910,188 Budget $259,751 -$3,947,791 $1,058,239 ($1,207,992) $248,150 $1,379,725 -4.33% ($628,860) Less: Allowances & Est. Uncollectib Other Non-Oper. Revenue (Expense 8 Non-Operating Revenue (Expense) Excess of Revenues over Expenses Total Non-Operating Revenue (Ex Income (Loss) From Operations Daily Hospital Service Revenue Depreciation and Amortization Outpatient Ancillary Revenue Total Patient Service Revenue Net Patient Service Revenue Inpatient Ancillary Revenue Other Operating Revenue Total Operating Expenses Total Operating Revenue District Tax - G.O. Bonds Repairs & Maintenance Physician Guarantees District Tax Revenue Operating Margin % Hospitalist Program Operating Expenses Registry & Contract Salaries and Wages Operating Revenue Purchased Services Professional Fees Interest Expense Insurance Benefits Supplies Other 5/29/2014 1:48 PM 2012 Actual $47,985,106 30,318,109 178,303,215 226,951,561 $405,254,776 7,354,250 38,212,459 3,667,925 11,858,016 91,585,881 107,734,390 18,640,453 $305,245,075 $53,738,400 199,320,271 79,930,101 % Of Change 1.6% -7.8% 9.1% 1.6% 6.5% -0.1% 4.9% 5.1% 4.0% 22.9% -42.9% -5.3% -23.9% Actual 2013 115,608,556 $48,747,142 164,355,698 247,563,732 $411,919,430 97,529,752 101,597,298 199,127,050 19,553,818 98,227,595 39,750,804 4,026,887 $320,935,350 2,092,887 9,028,291 $50,871,982 2.Income Statement and Subsidiary Sch % of Change 7.1% 6.9% 7.0% 12.7% 10.4% 25.3% 26.3% 6.5% 25.8% 13.9% -1.6% -7.8% -30.5% 2.6% -1.5% Projection 2014 123.601,733 $454,798,595 122,234,875 $52,191,433 279,005,429 250,548,815 3,516,093 $365,492,689 1,455,468 9,531,644 20,829,829 90,597,952 39,099,472 $50,086,584 128,313,940 For the Budget Year Ending June 30, 2015 Pioneers Memorial Healthcare District Subsidiary Schedule 3.0% % O¢ Change 3.0% 3.0% 0.3% 1.4% 1.5% -6.1% 31.1% 1.8% 1.1% 1.4% 3.8% -34.5% 3.2% 6.8% Budget 2015 $53,757,175 127,309,784 181,066,959 279,913,863 $460,980,822 124,068,398 130,897,525 19,563,000 4,609,540 91,633,205 953,230 54,965,923 70,771,668 40,577,280 10,183,469 51,713,979 낆 Inpatient - Daily Hospital Servi Total Program Deductions Deductions from Revenue Total Inpatient Revenue Provision for Bad Debts Total Patient Revenue Total Staffing Expense Registry and Contract Outpatient - Ancillary Inpatient - Ancillary Salaries and Wages Employee Benefits Charity Write-Offs Other Deductions Total Deductions Expenses Medicare Revenue Medi-Cal 5/29/2014 1:48 PM 45,598 Actual 2012 $53,738,400 $1,179 $118 $26 $14,905,465 $2,894,058 $4,685,060 $5,368,251 $1,190,717 $63 $6,534,241 $143 $7,138,265 $2,115 $327 $103 $157 $96,454,457 Change % Of -5.3% 21.6% ~9.6~ 4.8% 34.6% -41.2% 0.1% -34.9% 10.7% 18.2% 30.8% 2.5% 13.4% 14.6% 26.8% -6.6% -1.3% 9.2% 3.4% Actual 2013 41,205 $1,235 $6,530,063 $158 $50,871,982 $14,915,536 $362 $700,527 $17 $3,419,534 $83 $163 $5,369,699 $130 $6,667,454 $95,172,166 $2,310 $6,697,371 $162 % Of Change -1.5% 1.1% -5.6% 22.0% 20.7% -65.3% -1.3% -65.7% -2.4% 0.1% -6.3% -12.6% 4.2% -7.4% -0.8% -13.5% -5.0% 3.1% Summarized By Natural Expense Classifications Projection 2014 41,673 $50,086,584 $1,202 $7,969,826 $6 $191 $242,751 $14,724,134 $353 $3,421,392 $82 $4,695,722 $113 $94,365,090 $6,275,342 $151 $6,949,339 $2,264 $167 For the Budget Year Ending June 30, 2015 Pioneers Memorial Healthcare District Schedule of Operating Expenses % Of 3.2% Change 1.5% 1.8% -14.0% -15.3% 7.0% 3.1% 1.6% -1.2% -2.7% -8.0% 0.8% 5.5% -9.3% -3.2% -4.6% 6.4% -0.7% 4.9% 2015 $6,852,059 42,283 $51,713,979 $162 $6 $1,223 $259,751 $15,179,268 $359 $3,378,800 $5,774,790 Budget $80 $4,546,283 $108 $7,396,945 $95,101,875 $2,249 $137 $175 Revenue Adjusted Patient days Depreciation and Amortization Total Operating Expenses Repairs and Maintenance Total Staffing Expense Physician Guarantees Purchased Services All Other Expenses Professional Fees Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Supplies 5/29/2014 1:49 PM Actual 2012 1.95% 36.7% 75.32% 5.04% 2.98 11.5 54.3 39.8 143.1 50.1 % Change 3.7% 4.6% 2.2% -51.8% 3.4% 21.3% -3.1% 11.7% 4.5% -149.8% Actual 2013 2.00% 35.6% 77.91% 55.9 62.9 41.3 1.44 11.0 149.7 % Change -18.4% 0.3% -5.1% 4.3% -41.9% -7.5% 0.3% 22.5% 3.1% 42.0% Estimated 2014 1.91% 32.9% 80.36% -3.56% 56.1 13.5 53.8 41.4 142.1 0.84 3. Ratio analysis I Pioneers Memorial Healthcare District Budget Year Ending June 30, 2015 Productivity and Ratio Analysis % Change -3.1% -11.1% -1.3% 20.2% -1.7% 6.0% 10.7% <math>0.1\%</math> -21.0% 2015 Estimated 1.72% 32.4% -2.82% 80.43% 1.00 14.9 59.5 126.2 40.2 53.1 Accounts Payable Days Debt Service Coverage Average Age of Plant Days Cash On Hand Net Income Margin Deductible Ratio Gross A/R Days Debt to Capital Net A/R Days Current Ratio 5/29/2014 1:49 PM Actual 2012 (49,254,678) $23,841,615 60,140,796 10,886,118 11,099,957 1,320,454 1,565,369 813,609 320,000 523,243 636,985 203,243 30,248,511 2,018,036 49,527,122 1,381,051 $82,316,912 $7,488,473 11,099,957 1,185,482 1,541,120 25,354,716 203,243 19,264,753 44,822,712 37,494,200 4,039,684 $82,316,912 Actual 2013 (64,078,219) 11,162,738 960,079 $24,594,157 10,298,232 1,438,014 300,000 74,376,451 25,567,873 795,285 $7,810,988 11,162,738 1,166,261 49,619,481 1,439,453 2,234,738 1,437,802 3,880,479 568,495 17,680,958 349,877 649,877 $78,071,969 24,860,502 42,891,337 35,180,632 $78,071,969 349,877 4.Balance Sheet Subsidiary sch Chg in Fund Bal Pioneers Memorial Healthcare District Estimated 2014 (56,990,659) (0.85) 11,917,233 67,027,325 10,036,666 411,100 1,482,565 1,435,803 $23,238,231 657,807 280,009 21,896,716 649,699 49,179,405 517,962 $7,926,310 11,917,233 1,469,258 1,410,112 2,059,811 $73,933,903 3,922,080 585,188 25,820,069 449,844 15,698,274 31,965,716 $73,933,903 1797,971 41,968,187 June 30, 2015 through 2012 Estimated 2015 (57.100,425) (0.85) 11,552,233 67,023,500 9,923,075 543,000 458,000 $19,986,000 1,235,000 1,185,200 260,009 44,882,508 562,963 822,972 504,112 1,243,115 $8,249,614 11,552,233 1,498,908 604,159 22,580,881 $70,033,588 26,089,914 40,635,938 4,185,000 462,937 29,397,650 $70,033,588 1,747,227 14,083,087 Balance Sheets Total Non-Current Assets Whose Use is Limited uncollectibles & third-party contractual retentions Patient accounts receivable, less allowances for TOTAL LIABILITES AND FUND BALANCES Estimated settlement from 3rd prty payors Net patient accounts receivable LIABILITIES AND FUND BALANCES - Net Bond Reserve/Debt Retirement Fund 8 Cash For Third Party Repayments Assets Whose Use is Limited: Property, Plant & Equipment Cost Report Payables and Reserv Current portion of long-term debt Other Accounts Receivable Assets Held for Future Use Total Current Liabilities Accrued Payroll & Benefits Other Limited Use Assets Cash & cash equivalents Unamortized Loan Costs Total Current Assets Long-term Debt - Net Current Liabilities: Total Other Assets Limited ECI Payable Deferred Revenue Current Assets: Prepaid Expenses Accounts Payable Total Liabilities TOTAL ASSETS Fund Balances Other Assets Bonds payable Other Assets Inventories ASSETS 5/29/2014 1:49 PM Actual 2012 (53,872,307) $1,515,980 45,055,677 5,448,744 83,717,118 31,696,717 403,700 29,844,811 $30,248,511 Actual 2013 84,707,404 (59,139,531) 0 $1,515,980 32,168,606 45,055,677 25,567,873 5,967,141 $25,567,873 Pioneers Memorial Healthcare District Balance Sheet - Subsidiary Schedule 4.Balance Sheet Subsidiary sch Chg in Fund Bal Estimated 2014 (63,355,006) 0 $1,515,980 45,055,677 6,219,154 21,896,716 85,251,722 $21,896,716 32,460,911 June 30, 2015 through 2012 Estimated 2015 (67,901,289) $1,515,980 6,294,154 90,482,170 0 45,335,677 37,336,359 22,580,881 $22,580,881 Detail of Property, Plant and Equipment Property, Plant and Equipment - Net Less: Accumulated Depreciation Land and Land Improvements Buildings and Improvements Major Movable Equipment Construction in Progress Fixed Equipment 5/29/2014 1:49 PM 2012 5,096,258 Actual $32,397,942 $37,494,200 . 2013 -2,313,568 Actual $37,494,200 $35,180,632 For the Years Ending June 30, 2015 Through 2012 4.Balance Sheet Subsidiary sch Chg in Fund Bal Statement of Changes in Fund Balances Pioneers Memorial Healthcare District Estimated 2014 -3,214,916 $35,180,632 $31,965,716 2015 -2,568,066 Estimated ($2,568,066) $3,252,231 $0 $5,230,448 ($3,252,231) $29,397,650 $31,965,716 $4,546,283 $1,978,217 9 Fund Balances, Beginning of Year Excess of Revenues Over Expenses Fund Balances, End of Year Cash from Operations Depreciation Total Cash From Operations Capital Requirements Cash over (Short Funding from Cash Reserves Add back: PIONEERS MEMORIAL HEALTHCARE DISTRICT BUDGET STATISTICS BY DEPARTMENT PROJECTED YEAR ENDING JUNE 30, 2014 AND ESTIMATED BUDGET YEAR 2015 Y-T-D Feb 2014 Department 2012 Actual 2013 Actual 2014 Actual Projected Budget 2015 Var % Occupancy 51.4% 42.1% 41.5% 41.2% 42.5% 3.0% ADC 55.0 45.0 44.4 44.1 45.5 3.0% Total Days 20,062 16,441 10,801 16,108 3.0% 16,608 Intensive Care Patient Days 2,008 1,644 1,126 1,720 1,772 2.9% Neo-Natal Patient Days 307 423 252 368 10.0% 409 DOU Patient Days 2,187 1,687 1,149 1,694 2.9% 1,745 Med/Surg Patient Days 10,409 8,187 5,396 8,101 3.9% 8,429 Gyn Unit Patient Days 342 130 53 115 -43.8% 80 Pedriatics Patient Days 1,365 1,062 450 779 -5.0% 742 Obstetrics Patient Days 3,444 3,308 2,375 3,331 2.9% 3,431 LDRP Rev ADJ Deliveries 1,951 1,957 1,451 1,922 3.1% 1,983 Nursery Patient Days 2,619 2,519 1,790 2,685 -4.3% 2,574 Emergency Rooms 99811 Total Visits 43,570 43,894 0.3% 29,181 43,583 43,699 99911 IP Visits 4,222 3,822 2,529 3.1% 3,620 3,736 99912 OP Visits 39,348 40,072 26,652 39,963 39,963 0.0% S.A.R.T. Cases 14 20 8 0.0% 19 19 Rural Health 99811 Total Visits 18,623 18,909 14,725 22,300 20,962 -6.4% 99912 OP Visits 18,623 18,909 14,725 22,300 -6.4% 20,962 Pioneers Health Ctr 99811 Total Visits 0 0 0 0 100.0% 9,780 99912 OP Visits 0 0 0 0 100.0% 9,780 24 Hr Observation 99811 Total Visits 918 1,210 968 -16.9% 1,576 1,348 99912 OP Visits 918 0.0% 1,210 968 1,348 1,348 Labor and Delivery Rev ADJ Deliveries 225 224 0.0% 167 228 228 Surgery 99803 Total Minutes 2,345 2,238 1,273 2,045 2,073 1.4% 99903 IP Minutes 1,157 1,006 601 919 3.0% 947 99904 OP Minutes 1,188 1,232 0.0% 672 1,126 1,126 99919 IP cases 1,924 1,615 1,091 2.9% 1,637 1,686 99920 OP Cases 2,843 2,724 0.0% 1,564 2,571 2,571 Recovery 99803 Total Minutes 9,290 8,402 5,064 7,982 1.0% 8,060 99903 IP Minutes 3,355 2,709 2.9% 1,741 2,612 2,690 99904 OP Minutes 5,935 5,693 0.0% 3,323 5,370 5,370 Anesthesia 99803 Total Minutes 3,905 3,733 2,126 3,459 1.3% 3,504 99903 IP Minutes 1,839 1,618 1,010 1,515 2.9% 1,560 99904 OP Minutes 2,066 2,115 1,116 1,944 1,944 0.0% Central Supply Revenue 99905 Rev Adj Days- IP 20,062 16,441 10,801 16,108 16,608 3.0% 99906 Rev ADJ Days- OP 25,539 24,765 16,753 25,169 25,675 2.0% Clinical Lab 99807 Total Procedures 4,073 4,256 2,986 4,488 4,552 1.4% 99907 IP Procedures 1,964 2,000 1,427 2,141 2,205 2.9% 99908 OP Procedures 2,109 2,256 1,559 2,347 0.0% 2,347 S:\ACCT\Budget 2015\Financial Reports\Board package\5.Budget Statistics ByoDapt BUDGET STATISTICS BY DEPARTMENT PROJECTED YEAR ENDING JUNE 30, 2014 AND ESTIMATED BUDGET YEAR 2015 Y-T-D Feb 2014 Department 2012 Actual 2013 Actual 2014 Actual Projected Budget 2015 Var % Pathology 99807 Total Procedures 8,297 6,988 4,612 0.9% 7,260 7,325 99907 IP Procedures 2,809 2,165 1,440 2,160 2.9% 2,225 99908 OP Procedures 5,488 4,823 3,172 5,100 0.0% 5,100 Blood Bank 99813 Total Workload Units 3,003 3,237 3,029 2.4% 4,646 4,759 99913 IP Workload Units 2,403 2,474 2,533 3,800 2.9% 3,913 99914 OP Workload Units 600 763 496 0.0% 846 846 E.K.G. 99807 Total Procedures 13,557 13,354 9,725 0.3% 14,299 14,337 99907 IP Procedures 1,645 1,349 865 1,298 1,336 2.8% 99908 OP Procedures 11,912 12,005 8,860 13,001 0.0% 13,001 Echo 99807 Total Procedures 3,939 3,504 2,402 0.2% 3,569 3,575 99907 IP Procedures 2,793 2,430 1,577 2.9% 2,366 2,436 99908 OP Procedures 1,146 1,074 825 1,203 1,203 0.0% E.E.G 99807 Total Procedures 1,013 1,076 587 878 1.0% 887 99907 IP Procedures 468 456 192 288 297 3.0% 99908 OP Procedures 545 620 395 0.0% 590 590 Radiology 99807 Total Procedures 40,741 39,008 27,214 41,146 41,342 0.5% 99907 IP Procedures 7,817 6,441 4,360 2.9% 6,540 6,736 99908 OP Procedures 32,924 32,567 22,854 34,606 0.0% 34,606 Oncology 99807 Total Procedures 0 635 2,348 0.0% 2,983 2,983 99908 OP Procedures 0 635 2,348 2,983 2,983 0.0% Nuclear Medicine 99807 Total Procedures 1,001 983 986 0.9% 1,484 1,498 99907 IP Procedures 353 331 321 482 2.8% 496 99908 OP Procedures 648 652 665 1,002 0.0% 1,002 M.R.I. 99807 Total Procedures 2,096 1,763 0.9% 1,110 1,734 1,750 99907 IP Procedures 606 531 325 511 3.0% 527 99908 OP Procedures 1,490 1,232 785 1,223 1,223 0.0% Ultrasound 99807 Total Procedures 10,359 11,815 8,568 12,819 0.3% 12,862 99907 IP Procedures 2,150 2,081 1,375 2,077 2,120 2.0% 99908 OP Procedures 8,209 9,734 7,193 0.0% 10,742 10,742 CT Scanner 99807 Total Procedures 13,103 11,813 8,925 0.6% 13,674 13,755 99907 IP Procedures 3,272 2,580 1,809 2,714 2.9% 2,795 99908 OP Procedures 9,831 9,233 7,116 10,960 10,960 0.0% Pharmacy Revenue 99905 Days- IP 20,062 16,441 10,801 16,108 3.0% 16,608 99906 Rev ADJ Days- OP 8,130 10,852 8,238 12,253 0.0% 12,253 Respiratory Therapy 99817 Total Treatments 25,490 19,328 11,950 18,348 18,831 2.6% 99917 IP Treatments 20,141 16,826 10,732 16,098 2.9% 16,581 99918 OP Treatments 5,349 2,502 1,218 2,250 0.0% 2,250 S:\ACCT\Budget 2015\Financial Reports\Board package\5.Budget Statistics \ByoD8pt BUDGET STATISTICS BY DEPARTMENT PROJECTED YEAR ENDING JUNE 30, 2014 AND ESTIMATED BUDGET YEAR 2015 Y-T-D Feb 2014 2012 Actual Department 2013 Actual 2014 Actual Projected Budget 2015 Var % Cardio Pulmonary 99807 Total Procedures 72 92 53 0.3% 85 85 99907 IP Procedures 33 1.0% 31 22 28 28 99908 OP Procedures 39 61 31 57 57 0.0% Acute Dialysis 99817 Total Treatments 691 592 470 705 2.9% 726 99917 IP Treatments 691 592 470 705 2.9% 726 Physical Therapy 99817 Total Treatments 24,787 18,494 11,784 0.4% 17,792 17,869 99917 IP Treatments 3,933 3,986 2.9% 2,562 3,843 3,958 99918 OP Treatments 20,854 0.0% 14,508 9,222 13,949 13,949 Occ Med 99811 Total Visits 5,796 5,486 -100.0% 4,269 4,269 0 99912 OP Visits 5,796 5,486 -100.0% 4,269 4,269 0 Wound care 99807 Total Procedures 4,648 5,078 0.0% 3,576 5,458 5,458 99908 OP Procedures 4,648 5,078 3,576 0.0% 5,458 5,458 Vascular Access Center 99817 Total Treatments 0 0 267 403 403 0.0% 99919 IP Treatments 0 0 15 22 23 4.3% 99920 OP Treatments 0 0 252 380 380 0.0% Speech Therapy 99811 Total; Visits 0 0 323 487 487 0.0% 99911 IP Visits 0 0 104 155 156 0.6% 99912 OP Visits 0 0 112 331 331 0.0% . S:\ACCT\Budget 2015\Financial Reports\Board package\5.Budget Statistics ByoD&pt Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 Chief Nursing Officer 3010 ICU Worked Hours* 53,840 55,036 53,887 52,487 35,943 29,099 43,867 Worked FTEs 25.88 26.46 25.91 25.23 25.92 20.98 21.09 Patient Days 2,728 2,552 2,008 1,644 1,050 1,126 1,772 Hrs/Stat 19.74 21.57 26.84 31.93 34.23 25.84 24.76 3070 NICU Worked Hours* 3,223 6,810 6,706 6,148 4,405 2,744 4,451 Worked FTEs 1.55 3.27 3.22 2.96 3.18 1.98 2.14 Patient Days 295 338 307 423 307 252 409 Hrs/Stat 10.93 20.15 21.84 14.53 14.35 10.89 10.88 3150 DOU Worked Hours* 0 18,245 35,395 34,794 23,824 18,807 23,817 Worked FTEs 0.00 8.77 17.02 16.73 17.18 13.56 11.45 Patient Days 0 853 2,187 1,687 1,142 1,149 1,745 Hrs/Stat 0.00 21.39 16.18 20.62 20.86 16.37 13.65 3170 Med/Surg Worked Hours* 135,736 143,818 139,240 115,667 79,852 72,175 118,144 Worked FTEs 65.26 69.14 65.94 55.61 57.59 52.05 56.80 Patient Days 13,926 13,013 10,409 8,187 5,466 5,396 8,429 OB$ Days 252 1,294 918 1,210 771 968 1,348 Hrs/Stat 9.57 10.05 12.29 12.31 12.80 11.34 12.08 3176 GYN Worked Hours* 2,330 5,255 5,220 2,305 2,326 372 562 Worked FTEs 1.12 2.53 2.51 1.11 1.68 0.27 0.27 Patient Days 530 497 342 130 68 53 80 Hrs/Stat 4.40 10.57 15.26 17.73 7.02 34.21 7.03 3290 Peds Worked Hours* 19,682 20,880 20,847 18,081 12,549 10,098 16,660 Worked FTEs 9.46 10.04 10.02 8.69 9.05 7.28 8.01 Patient Days 1,310 1,590 1,365 1,062 733 450 742 Hrs/Stat 15.02 13.13 15.27 17.03 17.12 22.44 22.45 3400 LDRP Worked Hours* 91,303 92,191 96,713 103,992 67,853 70,714 96,491 Worked FTEs 43.90 44.32 46.50 50.00 48.93 51.00 46.39 Deliveries 1,891 2,086 1,951 1,957 1,426 1,451 1,983 Hrs/Stat 48.28 44.20 49.57 53.14 47.58 48.73 48.66 4010 ER Worked Hours* 95,931 100,162 103,801 105,754 70,039 67,492 101,004 Worked FTEs 46.12 48.15 49.90 50.84 50.51 48.67 48.56 Visits 41,961 43,887 43,570 43,894 29,376 29,181 43,699 Hrs/Stat 2.29 2.28 2.38 2.41 2.38 2.31 2.31 4015 SART Worked Hours* 278 198 176 143 97 240 562 Worked FTEs 0.13 0.10 0.08 0.07 0.07 0.17 0.27 Cases 24 4 14 20 9 19 Hrs/Stat 11.58 49.50 12.57 7.15 10.78 30.00 29.58 4420 Surgery Worked Hours* 46,341 49,177 48,191 52,502 33,845 32,577 57,047 Worked FTEs 22.28 23.64 23.17 25.24 24.41 23.49 27.43 Minutes 2,682 2,835 2,345 2,238 2,073 1,436 1,273 Hrs/Stat 17.28 17.35 20.55 23.46 23.57 25.59 27.52 4427 Recovery Worked Hours* 24,722 26,367 25,133 28,108 17,101 18,805 29,619 Worked FTEs 11.89 12.68 12.08 13.51 12.33 13.56 14.24 Minutes 10,442 11,010 9,290 8,402 8,060 5,479 5,064 Hrs/Stat 2.37 2.39 2.71 3.35 3.12 3.71 3.67 S:\ACCT\Budget 2015\Financial Reports\Board package\6.Staffing Budget Report (sorted by Rg/±o)f 9 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 7190 Breast Feeding Worked Hours* 0 0 909 2,986 1,988 2,111 2,974 Worked FTEs 0.00 0.00 0.44 1.44 1.43 1.52 1.43 8720 Nursing Admin Worked Hours* 24,796 24,169 24,225 28,005 18,464 17,547 25,230 Worked FTEs 11.92 11.62 11.65 13.46 13.32 12.65 12.13 Nursing Paid FTEs 3,193 3,479 3,401 3,208 1,967 2,165 3,010 Hrs/Stat 7.77 6.95 7.12 8.73 8.53 8.92 8.38 8730 Nursing Pool Worked Hours* 3,912 3,797 3,208 2,545 2,369 460 687 Worked FTEs 1.88 1.83 1.54 1.22 1.71 0.33 0.33 Chief Nursing Officer Total Worked FTE's 241.39 262.55 270.99 266.11 267.30 247.53 250.54 <math display="block">S:\ACCT\Budget\ 2015\Financial\ Reports\Board\ package\G.Staffing\ Budget\ Report\ (sorted\ by\Rg\Eo)\Financial\ Report\Board\ package\G.Staffing\ Budget\ Report\ (sorted\ by\Rg\Eo)\Financial\ Report\G.Staffing\ Budget\ </math> 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 Chief Operating Officer 4500 Clin Lab Worked Hours* 56,428 61,183 68,350 68,449 45,702 45,224 67,046 Worked FTEs 27.13 29.41 32.86 32.91 32.96 32.61 32.23 Procedures 3,518 3,980 4,073 4,256 2,816 2,986 4,552 Hrs/Stat 16.04 15.37 16.08 16.78 16.23 15.15 14.73 4520 Pathology Worked Hours* 7,674 7,793 6,983 4,801 2,974 3,266 5,731 Worked FTEs 3.69 3.75 3.36 2.31 2.14 2.36 2.76 Procedures 10,171 8,584 8,297 6,988 4,288 4,612 7,325 Hrs/Stat 0.75 0.91 0.84 0.69 0.69 0.71 0.78 4560 EKG Worked Hours* 2,516 2,363 2,078 2,172 1,408 1,218 1,855 Worked FTEs 1.21 1.14 1.00 1.04 1.02 88.0 0.89 Procedures 12,879 13,460 13,557 13,354 8,850 9,725 14,337 Hrs/Stat 0.20 0.18 0.15 0.16 0.16 0.13 0.13 4590 ECHO Worked Hours* 1,856 1,889 1,846 1,764 1,078 1,789 1,165 Worked FTEs 0.89 0.91 0.89 0.85 0.78 0.86 0.84 Procedures 3,834 4,428 3,939 3,504 2,402 3,575 2,331 Hrs/Stat 0.48 0.43 0.47 0.50 0.46 0.49 0.50 4620 EEG Worked Hours* 259 225 213 219 145 143 229 Worked FTEs 0.12 0.11 0.11 0.10 0.10 0.10 0.11 Procedures 784 1,695 1,013 1,076 785 587 887 Hrs/Stat 0.33 0.13 0.20 0.21 0.18 0.24 0.26 4630 Radiology Worked Hours* 31,276 32,078 33,863 34,421 22,882 23,397 35,072 Worked FTEs 15.04 15.42 16.28 16.55 16.50 16.87 16.86 Procedures 39,447 41,838 40,741 39,008 26,187 27,214 41,342 Hrs/Stat 0.79 0.77 0.83 0.88 0.87 0.86 0.85 4650 Nuc Med Worked Hours* 2,443 2,585 2,447 2,238 1,451 1,507 2,270 Worked FTEs 1.17 1.24 1.18 1.08 1.05 1.09 1.09 Procedures 2,121 1,340 1,001 983 487 986 1,498 Hrs/Stat 1.15 1.93 2.28 2.44 2.98 1.53 1.52 4660 MRI Worked Hours* 2,763 2,973 2,925 2,719 1,852 1,777 2,794 Worked FTEs 1.33 1.43 1.41 1.31 1.34 1.28 1.34 Procedures 1,782 2,265 2,096 1,763 1,126 1,110 1,750 Hrs/Stat 1.55 1.31 1.40 1.54 1.64 1.60 1.60 4670 Ultrasound Worked Hours* 9,281 9,899 12,210 11,785 7,815 7,655 11,504 Worked FTEs 4.46 4.76 5.87 5.67 5.64 5.52 5.53 Procedures 9,335 9,942 10,359 11,815 7,521 8,568 12,862 Hrs/Stat 0.99 1.00 1.18 1.00 1.04 0.89 0.89 4680 CT Worked Hours* 12,710 13,029 12,696 10,537 6,937 7,035 10,716 Worked FTEs 6.11 6.26 5.07 6.10 5.07 5.00 5.15 Procedures 16,347 17,945 13,103 11,813 7,856 8,925 13,755 Hrs/Stat 0.78 0.73 0.97 0.89 0.88 0.79 0.78 4720 Respiratory Worked Hours* 13,782 14,223 16,187 16,060 10,785 16,329 10,162 Worked FTEs 6.63 6.84 7.78 7.72 7.78 7.33 7.85 Treatments 29,608 30,233 25,490 19,328 12,649 11,950 18,831 Hrs/Stat 0.47 0.47 0.83 0.64 0.85 0.85 0.87 4730 Cardio Worked Hours* 264 413 315 219 145 395 261 Worked FTEs 0.13 0.20 0.15 0.11 0.10 0.19 0.19 Procedures 88 89 72 92 53 85 60 Hrs/Stat 3.00 4.64 4.38 4.92 4.65 2.38 2.42 S:\ACCT\Budget 2015\Financial Reports\Board package\6.Staffing Budget Report (sorted by Report 9 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 4770 PT Worked Hours* 14,251 21,288 22,597 21,458 13,836 12,232 19,554 Worked FTEs 6.85 10.23 10.86 10.32 9.98 8.82 9.40 Treatments 18,398 24,852 24,787 18,494 12,409 11,784 17,869 Hrs/Stat 0.77 0.86 0.91 1.16 1.11 1.04 1.09 4780 Speech Therapy Worked Hours* 725 Worked FTEs 0.35 Treatments 487 Hrs/Stat 1.49 4790 Occupational Therapy Worked Hours* 0 Worked FTEs 0.00 Treatments 143 Hrs/Stat 0.00 8390 Pharmacy Worked Hours* 23,795 32,644 33,716 31,157 20,561 19,668 30,212 Worked FTEs 11.44 15.69 16.21 14.98 14.83 14.18 14.53 Rev Adj Pt Days 21,906 22,360 20,062 16,441 11,118 10,801 16,608 Hrs/Stat 1.09 1.46 1.68 1.90 1.85 1.82 1.82 8750 Case Mgmt Worked Hours* 12,450 18,785 22,665 21,395 14,936 15,607 23,025 Worked FTEs 5.99 9.03 10.90 10.29 10.77 11.26 11.07 Tot Rev Adj Days 45,437 47,304 45,601 41,206 27,481 27,554 42,283 Hrs/Stat 0.27 0.40 0.50 0.52 0.54 0.57 0.54 8751 Infection Control Worked Hours* 1,571 1,783 2,696 2,884 1,873 1,740 2,621 Worked FTEs 0.76 0.86 1.30 1.39 1.35 1.25 1.26 Tot Paid FTEs 7,604 8,015 8,286 8,355 5,577 5,399 8,177 Hrs/Stat 0.21 0.22 0.33 0.35 0.34 0.32 0.32 8752 Risk Mgmt Worked Hours* 2,009 1,851 0 13 13 24 0 Worked FTEs 0.97 0.89 0.00 0.01 0.01 0.02 0.00 Tot Rev Adj Days 45,437 47,304 45,601 41,206 27,481 27,554 42,283 Hrs/Stat 0.04 0.04 0.00 0.00 0.00 0.00 0.00 8754 Quality Worked Hours* 4,396 4,526 7,017 6,204 4,207 3,557 7,072 Worked FTEs 2.11 2.18 3.37 2.98 3.03 2.57 3.40 Tot Rev Adj Days 45,437 47,304 45,601 41,206 27,481 27,554 42,283 Hrs/Stat 0.10 0.10 0.15 0.15 0.15 0.13 0.17 8773 Community HIth Worked Hours* 1,633 1,544 1,227 2,179 1,497 1,250 1,643 Worked FTEs 0.79 0.74 0.59 1.05 1.08 0.90 0.79 Tot Rev Adj Days 89 47,304 45,601 41,206 27,481 27,554 42,283 Hrs/Stat 18.35 0.03 0.03 0.05 0.05 0.05 0.04 Chief Operating Officer Total Worked FTE's 96.81 111.09 120.21 115.71 115.46 113.14 115.66 S:\ACCT\Budget 2015\Financial Reports\Board package\6.Staffing Budget Report (sorted by Repect 9 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 Asst Admin Clinic & Supp 4083 Rural Health Worked Hours* 45,581 49,237 61,438 69,179 45,937 46,213 57,583 Worked FTEs 21.91 23.67 29.54 33.26 33.13 33.33 27.68 Visits 15,733 16,262 18,623 18,909 12,672 14,725 20,962 Hrs/Stat 2.90 3.03 3.30 3.66 3.63 3.14 2.75 4183 Pioneers Hith Ctr Worked Hours* 14,504 Worked FTEs 6.97 Visits 9,780 Hrs/Stat 1.48 4640 Infusion Therapy Worked Hours* 0 0 0 8,400 4,344 8,186 12,637 Worked FTEs 0.00 0.00 0.00 4.04 3.13 5.90 6.08 Procedures 0 0 0 635 0 2,348 2,983 Hrs/Stat 0.00 0.00 0.00 13.23 0.00 3.49 4.24 4876 Occ Med Worked Hours* 11,777 11,649 12,370 13,132 8,772 7,944 0 Worked FTEs 5.66 5.60 5.95 6.31 6.33 5.73 0.00 Visits 5,005 6,128 5,796 5,486 3,747 4,269 C Hrs/Stat 2.35 1.90 2.13 2.39 2.34 1.86 0.00 4878 Wound Care Worked Hours* 12,494 12,610 13,638 14,475 9,093 9,670 14,601 Worked FTEs 6.01 6.06 6.56 6.96 6.56 6.97 7.02 Procedures 3,834 4,428 4,648 5,078 3,196 3,576 5,458 Hrs/Stat 3.26 2.85 2.93 2.85 2.85 2.70 2.68 7193 IVS Student Hith Worked Hours* 1,534 1,325 1,391 1,326 757 922 1,470 Worked FTEs 0.74 0.64 0.67 0.64 0.55 0.66 0.71 5321 Cafeteria Worked Hours* 5,845 5,584 5,478 5,589 3,862 3,608 16,473 Worked FTEs 2.81 2.68 2.63 2.69 2.79 2.60 7.92 Meals 192,192 204,387 217,734 223,265 144,397 154,703 233,571 Hrs/Stat 0.03 0.03 0.03 0.03 0.03 0.02 0.07 8340 Dietary Worked Hours* 35,830 36,441 37,153 34,313 22,641 24,257 23,795 Worked FTEs 17.23 17.52 17.86 16.50 16.33 17.49 11.44 Dietary Meals 79,185 84,731 83,677 69,615 48,464 44,287 65,438 Hrs/Stat 0.45 0.43 0.44 0.49 0.47 0.55 0.36 8350 Laundry Worked Hours* 1,943 1,863 1,922 1,967 1,293 1,259 3,536 Worked FTEs 0.93 0.90 0.92 0.95 0.93 0.91 1.70 Pounds 591,368 574,192 593,928 537,270 366,666 339,212 509,816 Hrs/Stat 0.0033 0.0032 0.0032 0.0037 0.0035 0.0037 0.01 8410 Grounds Worked Hours* 3,514 4,065 3,859 4,198 2,497 3,080 3,744 Worked FTEs 1.69 1.95 1.86 2.02 1.80 2.22 1.80 Sq Feet 2,100 2,100 2,100 2,100 1,400 1,400 2,100 Hrs/Stat 1.67 1.94 1.84 2.00 1.78 2.20 1.78 8420 Security Worked Hours* 10,735 9,931 11,359 10,866 7,140 7,176 10,296 Worked FTEs 5.16 4.77 5.46 5.22 5.15 5.18 4.95 Sq Feet 2,100 2,100 2,100 2,100 2,100 1,400 1,400 Hrs/Stat 5.11 4.73 5.41 5.17 5.10 5.13 4.90 S:\ACCT\Budget 2015\Financial Reports\Board package\6.Staffing Budget Report (sorted by Rg@cff 9 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 8440 Housekeeping Worked Hours* 55,783 54,936 56,172 55,532 37,125 35,664 52,526 Worked FTEs 26.82 26.41 27.01 26.70 26.77 25.72 25.25 Sq Feet 1,788 1,788 1,788 1,788 1,192 1,192 1,788 Hrs/Stat 31.20 30.72 31.42 31.06 31.15 29.92 29.38 8460 Plant Worked Hours* 26,681 26,745 27,097 27,058 18,020 18,602 35,241 Worked FTEs 12.83 12.86 13.03 13.01 13.00 13.41 16.94 Sq Feet 2,100 2,100 2,100 2,100 1,400 1,400 2,100 Hrs/Stat 12.71 12.74 12.90 12.88 12.87 13.29 16.78 8461 Minor Constr Worked Hours* 3,348 9,769 7,858 7,940 4,909 5,068 0 Worked FTEs 1.61 4.70 3.78 3.82 3.54 3.65 0.00 Asst Admin Clinic & Supp Total Worked FTE's 103.40 107.77 115.26 122.10 119.99 123.79 118.46 <math display="block">S:\ACCT\Budget\ 2015\Financial\ Reports\Board\ package\G.Staffing\ Budget\ Report\ (sorted\ by\Board\ package\G.Staffing\ Budget\ Report\ (sorted\ by\Board\ package\G.Staffing\ Budget\ Report\ (sorted\ by\Board\ package\</math> 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 Chief Financial Officer 5700 Med Rec Worked Hours* 39,778 36,399 34,433 33,564 22,230 22,975 33,987 Worked FTEs 19.12 17.50 16.55 16.14 16.03 16.57 16.34 IP OP & ER Admits 105,092 111,505 106,518 104,784 69,500 73,250 108,534 Hrs/Stat 0.38 0.33 0.32 0.32 0.32 0.31 0.31 8380 Central Supply Worked Hours* 10,898 10,854 13,578 13,851 8,983 7,791 7,540 Worked FTEs 5.24 5.22 6.53 6.66 6.48 5.62 3.63 Tot Rev Adj Days 45,437 47,304 45,601 41,206 27,481 27,554 42,283 Hrs/Stat 0.24 0.23 0.30 0.34 0.33 0.28 0.18 8400 Purchasing Worked Hours* 9,117 9,463 7,140 7,468 4,972 5,229 9,279 Worked FTEs 4.38 4.55 3.43 3.59 3.59 3.77 4.46 Tot Rev Adj Days 45,437 47,304 45,601 41,206 27,481 27,554 42,283 Hrs/Stat 0.20 0.20 0.16 0.18 0.18 0.19 0.22 8470 Communication Worked Hours* 10,076 5,838 5,590 5,656 3,790 2,517 3,702 Worked FTEs 4.84 2.81 2.69 2.72 2.73 1.82 1.78 IP OP & ER Admits 105,092 111,505 106,518 104,784 69,500 73,250 108,534 Hrs/Stat 0.10 0.05 0.05 0.05 0.05 0.03 0.03 8480 Info Sys Worked Hours* 20,021 19,292 23,192 24,342 16,123 13,897 20,363 Worked FTEs 9.63 9.28 11.15 11.70 11.63 10.02 9.79 Calendar Days 365 365 366 365 243 243 365 Hrs/Stat 54.85 52.85 63.37 66.69 66.35 57.19 55.79 8510 Accounting Worked Hours* 13,568 13,460 13,281 12,862 8,671 8,229 12,636 Worked FTEs 6.52 6.47 6.39 6.18 6.25 5.93 6.08 Calendar Days 365 365 366 365 243 243 365 Hrs/Stat 37.17 36.88 36.29 35.24 35.68 33.86 34.62 8530 Patient Acctg Worked Hours* 47,932 47,169 29,534 27,925 17,836 18,946 31,117 Worked FTEs 23.04 22.68 14.20 13.43 12.86 13.66 14.96 IP OP & ER Admits 105,092 111,505 106,518 104,784 69,500 73,250 108,534 Hrs/Stat 0.46 0.42 0.28 0.27 0.26 0.26 0.29 8550 Credit & Collect Worked Hours* 5,245 4,869 5,540 5,602 3,655 3,730 5,429 Worked FTEs 2.52 2.34 2.66 2.69 2.64 2.69 2.61 IP OP & ER Admits 105,092 111,505 106,518 104,784 69,500 73,250 108,534 Hrs/Stat 0.05 0.04 0.05 0.05 0.05 0.05 0.05 8560 Admiting Worked Hours* 42,289 44,936 43,898 42,099 27,561 28,564 44,928 Worked FTEs 20.33 21.60 21.10 20.24 19.88 20.60 21.60 Registrations 84,354 89,115 82,099 80,389 53,081 54,256 81,564 Hrs/Stat 0.50 0.50 0.53 0.52 0.52 0.53 0.55 Chief Financial Officer Total Worked FTE's 97.19 92.44 84.70 83.35 82.08 80.68 81.24 . S:\ACCT\Budget 2015\Financial Reports\Board package\6.Staffing Budget Report (sorted by Report 9 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 Chief HR Officer 8650 Personnel Worked Hours* 7,339 7,296 6,322 9,071 6,201 5,375 7,365 Worked FTEs 3.53 3.51 3.04 4.36 4.47 3.88 3.54 Total Paid FTEs 7,604 8,015 8,286 8,355 5,577 5,399 8,177 Hrs/Stat 0.97 0.91 0.76 1.09 1.11 1.00 0.90 8660 EE Health Worked Hours* 2,071 1,759 1,575 1,502 995 925 1,872 Worked FTEs 1.00 0.85 0.76 0.72 0.72 0.67 0.90 EE Health Visits 3,517 2,283 3,500 2,825 1,666 1,388 2,547 Hrs/Stat 0.59 0.77 0.45 0.53 0.60 0.67 0.73 8665 Back to Work Worked Hours* 1,079 2,139 984 1,901 1,011 1,376 1,972 Worked FTEs 0.52 1.03 0.47 0.91 0.73 0.99 0.95 8670 Volunteers Worked Hours* 1,818 1,692 1,771 1,775 1,179 561 1,872 Worked FTEs 0.87 0.81 0.85 0.85 0.85 0.40 0.90 Calendar Days 365 365 366 365 243 243 365 Hrs/Stat 4.98 4.64 4.84 4.86 4.85 2.31 5.13 8740 Training & Dev Worked Hours* 3,644 3,629 3,518 2,588 2,082 1,576 2,212 Worked FTEs 1.75 1.74 1.69 1.24 1.50 1.06 1.14 Tot Rev Adj Days 45,437 47,304 45,601 41,206 27,481 27,554 42,283 Hrs/Stat 0.08 0.08 0.08 0.06 0.08 0.06 0.05 8880 Day Care Worked Hours* 8,115 7,558 8,187 8,525 5,447 5,307 7,758 Worked FTEs 3.90 3.63 3.94 4.10 3.93 3.83 3.73 Child Care Days 7,318 7,215 6,565 7,006 4,470 4,288 6,824 Hrs/Stat 1.11 1.05 1.25 1.22 1.22 1.24 1.14 Chief HR Officer Total Worked FTE's 11.57 11.57 10.75 12.19 12.20 10.90 11.08 S:\ACCT\Budget 2015\Financial Reports\Board package\6.Staffing Budget Report (sorted by Re@c)f 9 5/29/20141:50 PM Pioneers Memorial Healthcare District FY2015 Staffing Budget Report Sorted by Executive * Includes Contract FTE's 2080 hrs FTE 1386.66 hrs FTE 1386.66 hrs FTE Actual Actual Actual Actual 8 Months 8 Months Budget 2010 2011 2012 2013 2013 2014 2015 Chief Executive Officer 8610 Administration Worked Hours* 14,479 15,744 14,056 11,944 7,739 8,749 13,265 Worked FTEs 6.96 7.57 6.76 5.74 5.58 6.31 6.38 Calendar Days 365 365 366 365 243 243 365 Hrs/Stat 39.67 43.13 38.40 32.72 31.85 36.00 36.34 8630 PR Worked Hours* 4,092 1,960 1,774 1,044 318 768 1,872 Worked FTEs 1.97 0.94 0.85 0.50 0.23 0.55 0.90 Calendar Days 365 365 366 365 243 243 365 Hrs/Stat 11.21 5.37 4.85 2.86 1.31 3.16 5.13 8710 Med Staff Worked Hours* 3,660 2,908 4,421 5,386 3,437 3,183 3,744 Worked FTEs 1.76 1.40 2.13 2.59 2.30 2.48 1.80 Active Med Staff 987 1,096 1,043 826 540 597 883 Hrs/Stat 3.71 2.65 4.24 6.52 6.36 5.33 4.24 Chief Executive Officer Total Worked FTE's 10.69 9.91 9.74 9.39 9.11 9.17 9.08 GRAND TOTAL Total Worked FTE's 561.04 595.33 611.64 608.86 606.14 585.21 586.07 Patient Days 21,900 22,360 20,062 11,118 10,732 16,608 16,441 Adjusted Pt Days 45,437 47,304 45,601 41,206 27,481 27,554 42,283 FTE's/APD (wrkd) 4.51 4.59 4.91 5.41 5.36 5.16 5.07 * Includes Contract FTE's 1.1 5:\ACCT\Budget 2015\Financial Reports\Board package\6.Staffing Budget Report (sorted by Rg\c) 9 5/29/20141:50 PM Pioneers Memorial Healthcare District 2015 Budget Total Hospital FTE Comparison As of: 05/27/14 Y I D April- 2014 Prod Budget 2015 Budget 2015 Rprt Total Dept # Department Total Worked Total Paid Paid FTE's BUD 2015 & FTE's (Excl Non Prod Contract FTE's (Incl. (Incl YTD Apr14 Contract) FTEs FTE's Contract) Contract) Paid FTE Var. Nursing: 6010 I.C.U. 21.09 3.16 24.25 24.76 (0.51) - 6070 NEONATAL ICU 2.14 2.14 2.38 (0.24) _ - 6150 D.O.U. 11.45 2.31 13.76 15.03 (1.27) - 6170 MED/SURG 56.67 7.54 64.34 60.28 0.13 4.06 6176 GYNECOLOGY 0.27 0.27 0.25 0.02 - - 6290 PEDIATRICS 8.01 1.31 9.32 8.27 _ 1.05 6400 LDRP 45.94 8.18 0.45 54.57 59.16 (4.59) 7010 E/R 48.18 7.65 0.38 56.21 57.23 (1.02) 7015 S.A.R.T 0.27 0.27 0.14 - _ 0.13 7420 SURGERY 27.43 5.00 32.43 28.81 - 3.62 7427 RECOVERY 14.24 2.59 16.83 16.23 0.60 - 7190 BREAST FEEDING GRANT 1.43 1.43 1.49 - (0.06) - 8720 NURSING ADMINISTRATION 12.13 2.37 14.50 9.87 4.63 - 8730 NURSING FLOAT POOL 0.33 2.39 2.72 2.58 0.14 - Total Nursing Division: 249.58 42.50 0.96 293.04 286.48 6.56 Total Worked FTE's + Contract 250.54 COO: 7500 LABORATORY 32.23 4.70 36.93 36.92 0.01 - 7520 PATHOLOGY LAB 2.76 0.24 3.00 2.74 0.26 - 7560 E.K.G. 0.89 - 0.89 0.88 0.01 - 7590 ECHO 0.86 0.86 0.88 (0.02) - - 7620 E.E.G 0.11 0.11 0.10 - 0.01 - 7630 RADIOLOGY 16.86 3.52 20.38 20.16 0.22 - 7650 NUCLEAR MEDICINE 1.09 0.15 1.24 1.24 - - 7660 M.R.I. 1.34 0.08 1.42 1.34 0.08 - 7670 ULTRASOUND 5.53 0.37 5.90 5.89 0.01 - 7680 CT SCAN 5.15 0.14 5.29 5.30 (0.01) _ 7720 RESPIRATORY 7.85 1.15 9.00 8.43 0.57 - 7730 CARDIO LAB 0.19 0.19 0.20 (0.01) - 7770 PHYSICAL THERAPY 9.40 1.61 11.01 10.29 0.72 - 7780 SPEECH THERAPY 0.35 0.35 0.35 - - 8390 PHARMACY 14.53 16.05 1.52 15.65 0.40 - 8750 CASE MANAGEMENT 11.07 1.49 12.56 12.79 (0.23) - 8751 INFECTION CONTROL 1.26 0.23 1.49 1.48 0.01 _ 8752 RISK MANAGEMENT 0.02 (0.02) - _ - _ 8754 QUALITY MANAGEMENT 3.40 0.60 4.00 2.95 1.05 - 8773 COMMUNITY HEALTH ED 0.79 0.21 1.00 1.11 (0.11) - Total Chief Operatin Officer Division: 115.66 16.01 0.00 135.90 134.52 1.38 Total Worked FTE's + Contract 115.66 Page 1 of 2 7. Total Hospital FTE Comparison Pioneers Memorial Healthcare District 2015 Budget Total Hospital FTE Comparison As of: 05/27/14 YTD April- 2014 Prod Budget 2015 Budget 2015 Rprt Total Dept # Department Total Worked Total Paid Paid FTE's BUD 2015 & FTE's (Excl Non Prod Contract FTE's (Incl (Incl YTD Apr14 Contract) FTEs FTE's Contract) Contract) Paid FTE Var. Support: 1250 CAPITAL PROJ. - - _ - 7083 RURAL HEALTH CLINIC 26.68 3.74 1.00 31.42 37.38 (5.96) 7183 PIONEERS HLTH CTR 6.97 0.70 7.67 7.67 - 7640 CANCER INSTITUTE 6.08 0.93 7.01 6.99 0.02 7876 OCC MED PROGRAM _ - 6.39 (6.39) _ 7878 WOUND CARE 0.71 6.31 7.02 7.03 (0.01) - 7193 IVC STUDENT HEALTH 0.71 0.05 0.76 0.74 0.02 - 8330 CAFETERIA 7.92 1.08 9.00 3.00 6.00 - 8340 DIETARY SERV. 11.44 1.56 13.00 19.45 (6.45) - 8350 LAUNDRY & LINEN 0.30 1.70 2.00 1.04 0.96 _ 8410 GROUNDS 1.80 0.20 2.00 2.54 (0.54) - 8420 SECURITY 0.95 0.05 4.00 5.00 5.30 (0.30) 8440 HOUSEKEEPNG 25.23 3.77 0.02 29.02 29.56 (0.54) 8460 PLANT MAINT. 16.94 1.81 0.00 18.75 14.62 4.13 8461 MINOR CONSTR. 3.78 (3.78) - _ _ - 8700 MEDICAL RECORDS 16.34 2.66 19.00 19.22 (0.22) ~ 8380 CENTRAL SUPPLY 3.63 0.60 4.23 6.15 (1.92) - 8400 PURCHASING 4.46 0.53 4.99 4.52 0.47 - 8470 COMMUNICATIONS 1.78 0.22 2.00 2.03 (0.03) - 8480 INFO SYSTEMS 9.79 1.21 11.00 11.17 _ (0.17) 8510 ACCOUNTING 6.08 0.68 6.76 6.81 (0.05) ** 8530 PATIENT ACCOUNTING 14.96 2.04 17.00 15.84 1.16 - 8550 CREDIT & COLLECTIONS 2.61 0.39 3.00 3.07 (0.07) - 8560 ADMITTING 21,60 2.11 23.71 22.49 - 1.22 8650 HUMAN RESOURCES 3.54 0.59 4.13 4.50 (0.37) - 8660 EMPLOYEE HEALTH 0.90 0.10 1.00 0.86 0.14 - 8665 BACK TO WORK 0.95 0.02 0.97 1.01 (0.04) _ 8670 VOLUNTEERS 0.90 0.10 1.00 0.64 0.36 - 8740 TRAINING & DEVELOPMENT 1.06 0.10 1.16 1.49 (0.33) - 0888 DAY CARE 3.73 0.77 4.50 4.72 (0.22) - 8610 ADMINISTRATION 6.05 0.70 0.33 7.08 7.41 (0.33) 8630 PUBLIC RELATIONS 0.90 0.10 1.00 0.56 0.44 - 8710 MEDICAL STAFF 1.80 0.20 2.00 2.63 - (0.63) Total Support Division: 208.21 27.31 11.66 247.18 252.94 (5.76) Total Worked FTE's + Contract 219.87 Total Hospital FTE's 573.45 85.82 12.62 671.89 671.40 0.49 Total Worked FTE's + Contract 586.07 Page 2 of 2 7. Total Hospital FTE Comparison Not Approved Yellow is left from prior year DRAFT FY 2017 $120,450 $477,153 $477,152.50 FY 2016 $50,123 $8,422 FY 2015 $66,000 $39,600 $23,100 $81,400 $43,010 $30,250 $41,250 $45,116 $33,000 This is an item that should be used much more often to avoid more invasive procedures on patients Total Care patients would benefit greatly from these beds Replace old beds that do not function properly This would help Dr. Krutzik perform more on waiting room. There are tears in the couches Plan is to remove closet doors in all rooms to utilize this space for hampers and trash cans. To build shelves and get rid of the bedside New call system and patient tracking that has Two monitors needed for patients being dialyzed. Will be installed in new dialysis room Continous and Contract-free monitoring of heart rate, respitory rate and motion. Aids in fall prevention and pressure ulcer prevention Replace existing IV Pumps. This is the total cost and can be split by all nursing departments and pharmacy CIC Monitors as requested by pediatricians for continuous O2 monitoring Need to replace our couches in the visitor drawers. This remodel is in efforts to give key functions to make the units run more time better guided procedures. Open up the DOU to 10 beds. Justification with Priority and holes from constant use once completed efficiently. S:\ACCT\Budget 2015\Financial Reports\Board package\8.Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan - _ N • 3 4 ~ ÷ ~ 4 8 4 FY 2015 Cost " 10% $66,000 $50.123 $954,305 $120,450 $39,600 $23,100 $43,010 $81,400 $30,250 $90,116 $41,250 $33,000 $2,105 equipment less tax and freight (I'll add those) Total cost of $60,000 $109,500 $867,550 $36,000 $74,000 $45,567 $21,000 $39,100 $27,500 $37,500 $30,000 $81,923 $1,914 Equipment needed GE MONITORS ULTRASOUND Construction Hill-Rom Vocera adding 2 New Construction on Med/Surg DOU Monitoring System adding monitors + 1 Central Station Beds Call and patient tracking EarlySense System Critical Care Beds Project Name Bladder Scanner Critical Care Stryker Dash Monitors SONOSITE Patient Beds CIC Monitor IV Pumps Couch's Dept # 6150 6150 6150 6010 6010 6170 6170 6170 6170 6170 4740 6170 6290 Hospwide Med Surg Med Surg Med Surg Dialysis Dept 000 DOG 200 PEDS 글 ᅙ M/S M/S DRAFT Not Approved Yellow is left from prior year <math>^{\circ}</math> FY 2017 $13,270 $56,654,40 FY 2016 $125,000 $11,931 $13,270 $6,600 $15,400 $42,490.80 $100,000 FY 2015 $7,188.72 $125,000 $110,000 $60,000 $40,150 $11,000 $13,270 $38,500 The current playroom is not set up to accommodate the children and the storage of the toys. We will be taking out the existing New NICU beds. Current beds range up to 25 Figure put out to 2015 but if funded in 2014 by foundation then move to fy 2014 Infant warmer for LDRP's. We currently have To increase the availability to provide service to multiple physiciens. Without compromising patient care. To provide the staff with a back with case of the provide the staff with a back was builder volume noninvasively as cabinets and putting new cabinets in with a Nelson would like to have these available for safety when concious sedation is performed Need to replace old gurneys that no longer Current monitors are aged and no longer supported - in addition to purchase of FY Infusion device with microchip capability are unsupported and biomed is no longer able to repair them To keep of all fluid during a procedure. yrs of age. Repair parts limited Justification with Priority 2013 monitors Stryker bed SNACCT/Budget 2015/Financial Reports/Board package/8.Capital Budget FY 2015-2017 work. 4 Beds Quantity Capital Equipment 3 Year Capital Plan - <math>\overline{\phantom{a}}</math> 1 ~ 4 N 2 9 N _ <del>~</del> <math>\overline{\phantom{a}}</math> FY 2015 Cost * 10% $100,001 $249,388 $11,931 $110,000 $14,164 $60,000 $40,150 $11,000 $6,600 $38,500 $15,400 $6,635 $3,594 equipment less tax and freight (I'll add those) Total cost of $10,846 $226,716 $90,910 $12,876 $100,000 $36,500 $10,000 $6,000 $14,000 $35,000 $6,032 $3,268 Equipment needed bundle with software, Playroom Remodel electrocaudery and Hysteroscopy fluid Management Bladder Scan BVI 9400 Big wheel gurney Endoscopy tower GE Core Fetal hardware, Monitors 10+ year New Equipment primary - 10+ year old equipment retained as backup led/Surg per year Panda Bedded Warmers Babytherm Infant Beds bs Fluid Management Project Name New Construction on M Fetal Monitors Gurney replacement 2 p Medfusion IV Pun Bladder Scan Capnography L&D Beds Perinatal Ç Dept # 6290 6290 6400 7010 8400 6400 6400 7010 6400 6400 7420 7420 7420 Surgery Surgery Surgery PEDS Dept Peds 믕 8 8 8 8 뜺 뜺 Not Approved Yellow is left from prior year DRAFT ო $220,000 FY 2017 FY 2016 $440,000 $24,200 $132,000 $143,000 $55,000 $27,500 $44,000 FY 2015 $104,500 $440,000 $132,000 $44,000 $38,500 Provide increase volume suction and accurate outputs, decrease cost in waste and risk infection increase storage for trays and helps decrease wrapping costs Increase use of machine to accommodate all physicians Replace with hand free sinks old ones keep No EMR system used. Increase regulatory requirements Help keep surgical scrubs available to the department (OR and OB) Replace obsolete equipment provide and increase surgical visualization Replace and upgrade to system that can interace, decrease risk to waste Increase Ortho trays with extra drill to increase efficiency of surgical cases Replace the obsolete and upgrade with current one Providing a less invasive approach for surgical patients with same outcome Replacement of old gurneys Justification with Priority Replace old one breaking S:\ACCT\Budget 2015\Financial Reports\Board package\8.Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan 3 <math>^{\circ}</math> <math>^{\circ}</math> 9 9 c) _ _ _ <math>\overline{\phantom{a}}</math> <math>\overline{\phantom{a}}</math> FY 2015 Cost * 10% $440,000 $104,500 $220,000 $440,000 $24,200 $132,000 $44,000 $132,000 $143,000 $55,000 $27,500 $38,500 $44,000 equipment less tax and freight (f'l) add those) Total cost of $400,000 $22,000 $200,000 $400,000 $120,000 $40,000 $95,000 $120,000 $130,000 $50,000 $25,000 $35,000 $40,000 Equipment needed 4 Suction System (Neptune/Dornoch) EMR Software and installation Power) locator) Instrument Storage Coffins Big Wheel Gurneys Medivator Processor Midas Rex System Project Name Hand Drill (Orthopedic Scrub Machine New PROP (Sentinode Video Towers Genesys HTA Scrub Sinks Gyrus Dept # 7420 7420 7420 7420 7420 7420 7420 7420 7420 7420 7420 7420 7420 Surgery Surgery Surgery Surgery Surgery Surgery Surgery Surgery Surgery Surgery Surgery Surgery Dept Surgery DRAFT Not Approved Yellow is left from prior year 寸 FY 2017 $187,000 $161,333.33 FY 2016 $187,000 $38,500 $15,180 $13,200 $13,750 $9,900 $80,666.67 FY 2015 $352,000 $27,500 $22,000 $11,000 $71,500 $13,750 3 anesthesia machines provided standard of practice Need to upgrade monitor system so it can be compatible with interfacing Testing of platelet function of patients for presurgical and oncology care. Testing will provide diagnostic information to physician in determining need for platelets. Anticipate Provide warm fluids at all time when needed in the OR Need for new Vascular Access Center in use Provide patient satisfaction while waiting for Safety concern and regulatory requirements when doing moderate sedation Have an extra ERCP scope available, only have one in house New service needed for new Gastrointerologist Justification with Priority surgery procedure Normal replacement to do procedures. Inbedding Unit Incubator S:\ACCT\Budget 2015\Financial Reports\Board package\8.Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan τ- S က 2 3 _ ~ 400 7 ~ FY 2015 Cost " 10% $242,000 $374,000 $352,000 $27,500 $38,500 $22,000 $11,000 $71,500 $15,180 $13,750 $13,200 $9,900 equipment less tax and freight (I'll add those) Total cost of $220,000 $25,000 $35,000 $340,000 $320,000 $20,000 $10,000 $65,000 $13,800 $12,500 $12,000 $9,000 Equipment needed Ultrasound Machine PFA-100 Instrument Replacement Replacement Replacement PACU monitors and central station solutions Jpgrade Pre op TV Installation Co2 detection module Ultrasound Machine Platelet Function Project Name Anesthesia Machine U ERCP Scope IV dock warmers for IV Inbedding Unit Microscope Incubator EUS Dept # 7420.1 7420 7420 7420 7420 7420 7420 7420 7500 7500 7500 7500 Surgery VAS Surgery Surgery Surgery Surgery Surgery Surgery Surgery Dept E E Гaр Lab Lab DRAFT Not Approved Yellow is left from prior year 40 FY 2017 $495,000 $137,500 $264,000 $19,800 $82,500 $715,000 FY 2016 $66,000 $192,500 $121,000 FY 2015 $198,000 $115,500 $121,000 Includes blood bank, microbiology, general lab, positive patient ID, HW, SW, training, implementation, interfaces, tranfusion patient ID and FDA validation process for Blood Bank Includes HW, SW, Training, Implementation, FDA validation processes and interface. HiGHEST priority for tab with dwindling Dwindling lab staff, added improved systems will minimize replacements needed Dwindling lab staff, added improved systems will minimize replacements needed Justification with Priority 8 years old, replacement Replacement 10 years old 8 years old workforce S:\ACCT\Budget 2015\Financial Reports\Board package\8. Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan <math>\overline{\phantom{a}}</math> - - T က ~ - - _ ~ τ- ₩. FY 2015 Cost * 10% $198,000 $715,000 $495,000 $115,500 $137,500 $264,000 $121,000 $19,800 $192,500 $121,000 $66,000 $82,500 equipment less tax and freight (I'll add those Total cost of $180,000 $650,000 $450,000 $105,000 $125,000 $240,000 $110,000 $18,000 $60,000 $175,000 $110,000 $75,000 Equipment needed Replacement Replacement Replacement C-Arm replacement - one replaced in FY 2013 DR retrofit San Diego Room x-ray System System ID and Antibiotic Automation Calexico x-ray room change DR retrofit Occ Med x-ray Microbiology Automation Blood Bank Automation Automated Urinalysis 2 Project Name Blood Bank Information Chemistry Analyze Laboratory Information Microtome Dept # 7500 7500 7500 7500 7630 7500 7500 7500 7630 7500 7630 7630 Imaging Imaging Imaging Imaging Dept Lab Lab Cab E P Lab Lab Lab Lab Not Approved Yellow is left from prior year DRAFT 9 $1,430,000 $495,000 $192,500 FY 2017 $110,000 $176,000 $53,500 $8,800 $7,700 $1,760,000 FY 2016 $192,500 $577,500 $53,500 $19,800 FY 2015 $110,000 $25,000 $15,157 Need 2nd unit to keep up with volume. Cutout already exists and current washer will need to be replaced in 4 years. We are currently renting 8 untis at an annual cost of approx $50,000 Dated equipment, impacting test results and patient care Advance budget - will need to replace in 5 Current dishwasher will probably last only another year or so Needed to seat more in the cafeteria Justification with Priority Waiting for EMR interface Installed 09/11/2006 Installed 1/04/2010 Installed 11/04/1997 Installed 11/04/1997 Installed 5/12/2008 Store EVS Eq years S:\ACCT\Budget 2015\Financial Reports\Board package\\B.Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan 150 ~ _ <math>\overline{\phantom{a}}</math> ~ ~ <math>\infty</math> 0 N - ~ ~ <math>\overline{\phantom{a}}</math> FY 2015 Cost * 10% $1,430,000 $1,760,000 $495,000 $192,500 $192,500 $110,000 $176,000 $16,500 $19,800 $15,157 $8,800 $3,850 $7,700 equipment less tax and freight (I'll add those) Total cost of $1,300,000 $1,600,000 $450,000 $175,000 $175,000 $100,000 $15,000 $80,000 $18,000 $13,779 $3,500 $8,000 $7,000 Equipment needed Storage Shed 20wx40t_x12H Focus BiPAP Machines Sterilizer Washer Central Service washer went out one more year but must be replaced in FY 2015 Mammography Replacement Central Service sterilizer MRI Replacement Cafeteria Furniture CT Replacement Portable X-Ray Portable X-Ray Project Name Dishwasher Sensilase IV Pumps None EVS Dept # 7630 7630 7630 8380 7630 7630 7720 8380 8380 8440 8340 8340 4878 Security/EVS Wound Care Imaging Imaging Imaging Imaging Imaging Cardio Dept Dietary Dietary <math>_{8}</math> S DRAFT Not Approved Yellow is left from prior year 7 $4,930,173 $440,000 FY 2017 $110,000 $70,000 $6,250,916 FY 2016 $440,000 $715,000 $450,000 $365,000 $125,000 $44,000 $44,000 $2,922,399 FY 2015 $375,000 $335,000 $50,000 $70,000 $80,000 $50,000 Exam chairs for 6 exam rooms in new wound care facility Replacing 2 existing chambers and adding a 3rd chamber for new facility West, South and PMC Parking areas require overlay as well as minor parking expansion Two phase project to put HVAC and CT on Emergency Power (include electrical circuits/switches/etc.) Furniture, fixtures and equipment for new wound care facility South Wing Roof, Pediatrics and ICU, roof Phase 1 of a 2 phase replacement project AIR HANDLER system improvements Remodel to OP service area PT Justification with Priority Water softners-hospital wide Convert Old OR to Storage Non Eng and IS totals Less foundation/Aux coating project S:\ACCT\Budget 2015\Financial Reports\Board package\8. Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan S 9 _ 2 <math>^{\circ}</math> - ~ ~ Ψ FY 2015 Cost * 10% $440,000 $715,000 $825,000 $700,000 $44,000 $110,000 $50,000 $275,000 $70,000 $50,000 $44,000 equipment less tax and freight (l'Il add those) Total cost of $400,000 $650,000 $750,000 $100,000 $40,000 $45,455 $250,000 $45,455 $40,000 Equipment needed South Wing Roof, Pediatrics and ICU Space Planning/Remodel Old PT Space Planning/Remodel Old OR Location AIR HANDLER NORTH WING Water softners-hospital wide Podlatric Exam Chairs Hyperbaric Chambers Lots Emergency Generator Boiler Replacement Project Name Wound Care Suite Re- Resurface Parking Dept # 4878 4878 4878 8460 8460 8460 8460 8460 8460 8460 8460 Wound Care Wound Care Wound Care Dept ENG ENG ENG ENG ENG ENG ENG ENG DRAFT Not Approved Yellow is left from prior year ø FY 2017 $100,000 $24,200 $100,000 $27,500 FY 2016 $220,000 $38,500 $29,000 $20,900 $100,000 $16,500 $27,500 $10,000 $22,000 FY 2015 $15,000 $130,000 $40,000 Conversion of play area to nursing storage Replacement of various facility signs and Legion/86 Monument Sign Upgrade Nurse Call Management System Expansion Joint Clinical Addition ER - NW Refurbishment of North Wing Air Handler components Upgrade of equipment servicing ER and Womens Center Expand nurse call to ER over-flow 믕 ICU, medical vacuum pump Justification with Priority Replacement of existing unit Replacement of old door Reduce Set Old Plans Hallway Showers Med/Surg NPC/SPC Project S:\ACCT\Budget 2015\Financial Reports\Board package\8.Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan <math>\overline{\phantom{a}}</math> _ ÷ _ - - + _ - - - ~ 4 FY 2015 Cost * 10% $220,000 $38,500 $44,000 $24,200 $330,000 $20,900 $16,500 $110,000 $40,000 $27,500 $22,000 $27,500 80 equipment less tax and freight (I'll add those) Total cost of $200,000 $35,000 $40,000 $22,000 $19,000 $100,000 $300,000 $15,000 $20,000 $36,364 $25,000 $25,000 Equipment needed fer Switch Expansion Joint Clinical Addition ER NW AIR CONDITIONER, MEG HOUSE over-flow Upgrade Nurse Call Management System Hallway Showers Med/Surg - CIP Pediatrics Play area/storage Penthouse Air handling Units refurbishment Auditorium separation door Medical vacuum pump Reduce Set Old Plans Exterior Signage NPC/SPC Project Project Name Electrical Circuit and Trans Upgrades Expand nurse call to ER Dept # 8460 8460 8460 8460 8460 8460 8460 8460 8460 8460 8460 8460 8460 Deb ENG ENG S S S ENG ENG ENG ENG ENG ENG ENG ENG ENG ENG DRAFT Not Approved Yellow is left from prior year o $165,000 FY 2017 $596,700 $2,342,300 FY 2016 $50,000 $15,400 $38,500 $55,000 $1,653,550 $302,000 FY 2015 $99,000 $80,000 $192,500 $13,750 $29,150 $15,400 $19,250 $38,500 Necessary software and equipment upgrades Replacement of current system, significant fimitations and maintenance Replace panels in old hospital, panels are obsolete Required to maintain our current system Proper evaluation of facility systems and expansion capabilities Create second procedure room in CDC Space Create additional licensed beds/space Two-Phase improvement project Justification with Priority Increase save capacity Virtual Memority Eng Totals Upgrade S:\ACCT\Budget 2015\Financial Reports\Board package\8.Capital Budget FY 2015-2017 Quantity Capital Equipment 3 Year Capital Plan S _ <del>--</del> • <math>\overline{\phantom{a}}</math> ~ ~ ~ - + - FY 2015 Cost * 10% $352,000 $220,000 $192,500 $39,000 $80,000 $13,750 $29,150 $30,800 $19,250 $38,500 $38,500 equipment less tax and freight (I'll add those) Total cost of $320,000 $90,000 $200,000 $175,000 $72,727 $12,500 $26,500 $28,000 $17,500 $35,000 $35,000 Equipment needed Expansion NEXUS Voicemail & Phone system Software Upgrade Calexico Space Planning/Remodel PACU Space Planning/Remodel NICU Fire Alarm Panel replacements Milestone Camera System Improvements Virtual Memory Upgrade Facility Master Plan Hardware Upgrade Project Name NEXUS Phone System - Milestone Camera Server Landscaping Dept # 8460 8460 8460 8460 8460 8460 8460 8460 8460 8480 8480 Dept ENG B ENG ENG ENG ENG ENG ENG ENG ENG DRAFT Not Approved Yellow is left from prior year 10 $5,526,873 FY 2017 $0 ٠ $8,593,216 FY 2016 8 $5,230,448 $275,000 $654,500 FY 2015 $137,500 $11,000 Time clock system replaced due to end of life Systems and implementation for 2 clinics Justification with Priority DATA CLOSET Hospital Totals S:\ACCTNBudget 2015\Financial Reports\Board package\8. Capital Budget FY 2015-2017 <math>\overline{\infty}</math> Quantity Capital Equipment FY 2015 3 Year Capital Plan - - ന Cost * 10% $275,000 $137,500 $11,000 Total cost of equipment less tax and freight (I'll add those) $250,000 $125,000 $10,000 Equipment needed DATA CLOSET eClinical Works Project Name ΑÞ Dept # 8480 8480 8480 Dept <math>\overline{\infty}</math> <math>\infty</math> Modified Income Statement The following financial statement is the Proposed Operating Budget for FY 2015 with the following Modifications: 1. 5% merit pay reduced to 2%. Savings $969K 2. Delay the hiring of open Director Position Savings $85K 3. Reduce three non-bedside nursing positions: Savings $275K 4. Discontinue Neuro Surg on call Savings $360K 5. Discontinue Earth Quake Insurance Savings $400K 6. Reduce 10 FTEs thru attrition Savings $606K Total Savings expected $2,695K 5/29/2014 1:51 PM 2012 $130,318,109 $405,254,776 75.3% Actual $47,985,106 $305,245,075 $226,951,561 $101,042,562 $11,858,016 $3,667,925 $14,905,465 $100,009,701 $1,032,861 $38,212,459 $5,368,251 $1,190,717 $6,534,241 $2,894,058 $4,685,060 $4,588,105 $1,024,468 $1,809,973 $1,847,461 $5,290,804 4.54% ($1,157,111) ($1,384,065) $214,888 $508,153 $5,096,258 $96,454,457 å % Change 1.6% -11.3% -9.0% 9.1% 1.6% -5.1% -8.8% 16.7% 4.0% -23.9% -42.9% 21.6% 41.2% 0.1% 2.5% 18.2% -1.3% 1.6% 14.6% 2.4% -165.0% 20.7% -2.4% 25.9% 142.4% 31.8% -145.4% -9.7% Actual 2013 $115,608,556 $320,935,350 $411,919,430 $48,747,142 $247,563,732 77.9% $90,984,080 $1,204,833 $92,188,913 -$2,983,253 $39,750,804 $9,028,291 $6,530,063 $14,915,536 $5,369,699 $95,172,166 -$2,313,568 $2,092,887 $6,697,371 $3,419,534 $1,891,333 $1,041,149 $669,685 $700,527 -3.24% ($917,714) $1,767,315 $520,844 54,776,123 ($1,741,909) Proj vs Act ($1,678,174) ($310,163) ($1,988,337) Difference ($651,332) ($457,776) ($807,075) ($1,181,262) ($901,348) ($637,418) ($191,402) ($422,029) ($673,977) ($280,614) $42,879,165 $3,444,291 $7,993,177 $44,557,339 $31,441,697 $1,439,763 $503,353 $1,858 $177,145 $104,740 $86,538 $279,914 $223,767 $11,851 $225,372 % Change 12.7% %6.9 -13.9% 7.1% 10.4% -1.8% -2.2% -25.7% -1.6% 2.6% .30.5% 22.0% -65.3% -1.3% -6.3% 0.1% -12.6% 39.6% 9.4% 2.2% 0.8% 1.1% 5.6% 41.8% 24.4% 53.9% 39.0% 12.9% Projection 2014 $52,191,433 $123,601,733 279,005,429 $454,798,595 $365,492,689 80.4% $89,305,906 $894,670 $90,200,576 $39,099,472 $9,531,644 $1,455,469 $7,969,826 $14,724,134 $6,275,342 $3,421,392 $2,068,478 -$4,164,515 -$3,214,916 $242,751 $4,695,722 -4.62% $1,053,000 $949,599 $94,365,091 ($693,947) $1,866,853 $240,230 ($1,516,537) $4,880,861 Modified Bud vs Proj Difference ($177,553) ($502,239) ($1,957,827) $455,134 ($500,552) ($1,477,767 ($42,592) ($149,439) ($316,478) $3,708,051 $908,434 $903,248 $1,565,742 $5,278,979 $953,508 $372,575 $17,000 $6,182,227 $50,260 $364,084 $2,911,335 $65,087 $5,229 $43,335 $308,545 $430,116 $7,920 $3,341,451 For the Budget Year ending June 30, 2015 S:\ACCT\Budget 2015\Financial Reports\Board package\10.Modified Inc St & Subsidiary Sch Pioneers Memorial Healthcare District Statement of Revenue and Expense ઠ % Change 3.0% 0.3% 1.4% 1.0% -1.4% 2.6% 1.1% -0.5% 3.9% 34.5% 18.5% 7.0% 3.1% -8.0% -1.2% -3.2% 15.3% 7.5% -2.1% -69.9% 0.5% 2.3% -103.9% 9.4% 20.3% 45.3% -3.3% 2015 $127,309,784 $53,757,175 $279,913,863 $460,980,822 $370,771,668 80.4% $90,209,154 $944,930 $91,154,084 $38,921,919 $9,904,219 $953,230 $6,492,059 $15,179,268 $5,774,790 $3,378,800 -$1,253,180 Budget $259,751 $4,546,283 $1,752,000 $5,244,945 -1.37% $1,058,229 $1,910,188 $1,379,715 $126,535 $92,407,264 ($628,860) ($1,207,992) $248,150 Less: Allowances & Est. Uncollectib ሧ ø Non-Operating Revenue (Expense) Other Non-Oper. Revenue (Expens Total Non-Operating Revenue (Exp Excess of Revenues over Expenses Income (Loss) From Operations Daily Hospital Service Revenue Depreciation and Amortization Total Patient Service Revenue Outpatient Ancillary Revenue Net Patient Service Revenue Inpatient Ancillary Revenue Other Operating Revenue Total Operating Expenses Total Operating Revenue District Tax - G.O. Bonds Repairs & Maintenance Physician Guarantees District Tax Revenue Operating Margin % Salaries and Wages Registry & Contract Hospitalist Program Operating Revenue Purchased Services Operating Expense Professional Fees Interest Expense Insurance Benefits Supplies Other 5/29/2014 1:51 PM Actual 2012 $47,985,106 130,318,109 $405,254,776 226,951,561 18,640,453 7,354,250 91,585,881 199,320,271 $305,245,075 38,212,459 3,667,925 11,858,016 79,930,101 $53,738,400 107,734,390 % Of Change 1.6% -11.3% -7.8% 9.1% 1.6% 6.5% -5.7% 4.9% -45.2% 5.1% -0.1% 22.9% 4.0% -42.9% -5.3% -23.9% Actual 2013 $48,747,142 115,608,556 164,355,698 247,563,732 $411,919,430 97,529,752 101,597,298 199,127,050 19,553,818 98,227,595 4,026,887 $320,935,350 39,750,804 2,092,887 9,028,291 $50,871,982 Modified 10. Modified Inc St & Subsidiary Sch % Of Change 7.1% 6.9% 7.0% 12.7% 10.4% 25.3% 26.3% 25.8% 6.5% 13.9% -7.8% -1.6% -30.5% -1.5% 5.6% Projection 2014 $52,191,433 123,601,733 175,793,166 279,005,429 $454,798,595 122,234,875 250,548,815 20,829,829 3,516,093 90,597,952 $365,492,689 39,099,472 9,531,644 1,455,468 $50,086,584 128,313,940 For the Budget Year Ending June 30, 2015 Pioneers Memorial Healthcare District % Of 3.0% Change 3.0% 0.3% 1.4% 1.5% 2.0% 1.8% -6.1% 31.1% 1.1% 1.4% -0.5% -34.5% 6.8% -0.1% Budget 2015 $53,757,175 127,309,784 181,066,959 279.913.863 $460,980,822 130,897,525 254,965,923 124,068,398 19,563,000 4,609,540 953,230 91,633,205 $370,771,668 38,921,919 $50,058,618 10,183,469 Subsidiary Schedules Inpatient - Daily Hospital Servi Total Program Deductions Deductions from Revenue Total Inpatient Revenue Provision for Bad Debts Total Patient Revenue Total Staffing Expense Registry and Contract Outpatient - Ancillary Inpatient - Ancillary Salaries and Wages Employee Benefits Charity Write-Offs Other Deductions Total Deductions Expenses Medicare Revenue Medi-Cal 5/29/2014 1:51 PM Actual 2012 45,598 $53,738,400 $1,179 $118 $26 $5,368,251 $14,905,465 $2,894,058 $1,190,717 $63 $143 $4,685,060 $103 $7,138,265 $327 $6,534,241 $2,115 $157 $96,454,457 % Of Change -5.3% %9.6- 21.6% 4.8% -41.2% 34.6% -34.9% 0.1% 18.2% 2.5% 13.4% 10.7% 30.8% 14.6% 26.8% -6.6% 3.4% -1.3% 9.2% Actual 2013 41,205 $50,871,982 $1,235 $6,530,063 $158 $700,527 $17 $14,915,536 $362 $3,419,534 $83 $163 $6,697,371 $5,369,699 $130 $6,667,454 $95,172,166 $162 $2,310 Modified % Of Change -1.5% 22.0% 1.1% -2.6% 20.7% -65.3% -65.7% -1.3% -2.4% 0.1% -6.3% -1.1% -7.4% -12.6% 4.2% 3.1% -13.5% -0.8% -2.0% Summarized By Natural Expense Classifications Projection 2014 $7,969,826 41,673 $50,086,584 $1,202 $6 $242,751 $14,724,134 $353 $191 $3,421,392 $82 $6,275,342 $113 $151 $4,695,722 $6,949,339 594,365,090 $2,264 $167 For the Budget Year Ending June 30, 2015 Pioneers Memorial Healthcare District Schedule of Operating Expenses % Of Change -0.1% -18.5% 1.5% -1.5% -19.7% 7.0% 5.5% 3.1% 1.6% -1.2% -8.0% -3.2% -4.6% -2.7% -9.3% -1.8% 0.7% -3.2% -0.8% 2015 42,283 $50,058,618 $1,184 $6,492,059 $154 $6 $15,179,268 $359 $3,378,800 Budget $259,751 $80 $5,774,790 $4,546,283 $108 $92,686,514 $137 $6,996,945 $165 $2,192 Revenue Adjusted Patient days Depreciation and Amortization Total Operating Expenses Repairs and Maintenance Total Staffing Expense Physician Guarantees Purchased Services All Other Expenses Professional Fees Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Per A.P.D. Supplies 5/29/2014 1:51 PM 2012 Actual 1.95% 2.98 36.7% 75.32% 5.04% 39.8 143.1 11.5 54.3 50.1 % Change 3.7% 4.6% 2.2% 21.3% -51.8% -3.1% 11.7% -4.2% 3.4% -149.8% Actual 2013 2.00% 35.6% 77.91% -2.51% 1.44 62.9 41.3 55.9 11.0 149.7 Modified % Change 0.3% -18.4% -5.1% -4.3% -41.9% -7.5% 11. Productivity & Ratio Analysis-2015 05.21.14-Mod 0.3% 22.5% 3.1% 42.0% Estimated 2014 32.9% 1.91% 80.36% -3.56% 41.4 13.5 53.8 142.1 0.84 56.1 Pioneers Memorial Healthcare District Budget Year Ending June 30, 2015 Productivity and Ratio Analysis % Change -1.3% -3.1% -8.4% -9.9% 144.4% -1.7% 8.3% 10.7% 0.1% -103.9% Estimated 2015 1.72% 32.4% 80.43% 0.14% 2.04 14.9 53.1 40.2 130.1 60.7 Accounts Payable Days Debt Service Coverage Average Age of Plant Days Cash On Hand Net Income Margin Deductible Ratio Gross A/R Days Debt to Capital Net A/R Days Current Ratio Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 1 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration Collaborating Departments: Nursing and Keywords: Care, Treatment, Scope of Service, Ancillary Mission, leadership Approval Route: List all required approval MARCC 7/29/2014 PSQC Other: Administrative Team Clinical Service MSQC MEC BOD 8/2014 1.0 Purpose: 1.1 Mission/Visions/Values 1.1.1 Mission Statement: 1.1.1.1 Quality healthcare and compassionate service for families of the Imperial Valley. 1.2 Vision Statement: 1.2.1.1 A collaborative partnership of physicians and the organization, recognized nationally and by the community as the leader of quality healthcare and customer service. 1.3 Value Statement: 1.3.1 As community healthcare providers we are entrusted to: 1.3.1.1 Give high quality care and service 1.3.1.2 Respect each individual's ethnicity and rights as a healthcare consumer 1.3.1.3 Preserve the individual's dignity and provide for their healthcare needs including the management of pain. 1.3.2 As an organization we are committed to: 1.3.2.1 Follow our strategic plan, which establishes our growth and direction. 1.3.2.2 Open and clear communication 1.3.2.3 An atmosphere of trust, high morale, and a well-balanced environment free of undue stress. 1.3.3 For our employees we are committed to ensure: 1.3.3.1 A sense of security and organization 1.3.3.2 Fair and competitive compensation 1.3.3.3 Safe working conditions 1.3.3.4 Just and ethical actions 1.3.3.5 Freedom to be creative, to make suggestions, to voice concerns, and 1.3.3.6 Equal opportunity for employment, growth, and advancement. 2.0 Scope: Hospital-wide 3.0 Policy: Not applicable 4.0 Definitions: Not applicable 5.0 Procedure: 5.1 Scope of Care, Services, and Treatment The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 2 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration 5.1.1 Pioneers Memorial Healthcare District's (PMHD) license includes a hospital with 107 acute care beds, a full complement of ancillary services, and out patient clinic settings. Approximate annual volumes within the District include 5,500 inpatient admission, 43,000 emergency visits, and nearly 25,000 outpatient clinics visits. 5.1.2 Patient services at PMHD are accomplished through an organized and systematic process designed to ensure the delivery of safe, effective, and timely care and treatment. Providing patient services and the delivery of patient care requires specialized knowledge and judgment derived from the principles of biological, physical, behavioral, psychosocial, nursing and medical science. 5.1.2.1 Patient services are planned, coordinated, provided, delegated, and supervised by professional health care providers that recognize the unique physician, emotional, and spiritual needs of each person. Patient care encompasses the recognition of disease and health, patient teaching, patient advocacy, spirituality and research. 5.1.2.2 Under the auspices of the Medical, Nursing and Allied Healthcare professionals along with the Administrative Representatives, the needs of patients and referral sources are discussed, reviewed, and addressed in a collaborative manner or as part of a multidisciplinary team to achieve optimal patient outcomes. 5.1.3 Each patient care service department has a defined scope of care document available which is completed during the annual process improvement activities. 5.1.3.1 The departmental scopes of care include: 5.1.3.2 Staff needs, mix, and necessary skills as appropriate 5.1.3.3 Scope of care, treatment, and services needed by patients reflecting the needs and expectations of patients and as appropriate of the families and referrals sources 5.1.3.4 Types and ages of patients served 5.1.3.5 Types of services most frequently provided 5.1.3.6 Hours of operation and method using for ensuring that those hours meet the needs of the patients served 5.1.4 Definition of Patient Focused Services (care) and Organization Focused Services (support) 5.1.4.1 PMHD defines Patient Services (care) as those departments focused on patient care through direct contract with patients/clients in outpatient or inpatient settings: 5.1.4.2 Patient care professionals are those who are responsible for the assessment of patients/clients; provide patient care, and the planning of care based on findings from those assessments. 5.1.4.3 Licensed staff supervises patient service and patient care. 5.1.4.4 Departments focused on patient services/care include: 5.1.4.4.1 Calexico Health Center (CHC- outpatient rural health clinic) 5.1.4.4.2 Definitive Observation Unit (DOU) Emergency Department (ED) 5.1.4.4.3 House Supervisors The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 3 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration 5.1.4.4.4 Imaging Services 5.1.4.4.5 Infection Control 5.1.4.4.6 Intensive Care Unit (ICU) 5.1.4.4.7 Medical Staff 5.1.4.4.8 Medical/Surgical Unit 5.1.4.4.9 Nutritional Services 5.1.4.4.10Oncology - 5.1.4.4.11 Peri-operative Services 5.1.4.4.12Pathology and Laboratory Services 5.1.4.4.13Pediatrics 5.1.4.4.14Pharmacy 5.1.4.4.15Rehabilitation Services 5.1.4.4.16Respiratory Therapy/Cardiopulmonary 5.1.4.4.17Sexual Assault Response Team (SART) 5.1.4.4.18Social Services 5.1.4.4.19Volunteers 5.1.4.4.20Women's Services 5.1.4.4.21 Wound Care 5.1.5 PMHD defines Organizational Services (support) as those provided by a variety of individuals and departments, which may or may not have direct contact with the patients, but who support the care provided by the direct care provider. 5.1.5.1 Department focused on organizational/support services: 5.1.5.1.1 Administration 5.1.5.1.2 Bio-Medical Engineering 5.1.5.1.3 Case Management and utilization 5.1.5.1.4 Continuing Education 5.1.5.1.5 Environmental Services 5.1.5.1.6 Facilities Services 5.1.5.1.7 Finance Services 5.1.5.1.8 Health Information Management 5.1.5.1.9 Human Resources 5.1.5.1.10Information Services 5.1.5.1.11 Materiel Management 5.1.5.1.12 Patient Registration (Admitting) and Patient Financial Services 5.1.5.1.13 Public Relations 5.1.5.1.14Quality Resource 5.1.5.1.15Risk Management 5.1.5.1.16Security 5.1.5.1.17Volunteers 5.2 Staffing Needs and Plans 5.2.1 For many departments, in addition to a brief description of staffing in their individual Scopes of Service, staffing plans are developed based on the level and scope of care that needs to be provided, the frequency of the care to be provided, and a The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 4 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration determination of the level of staff that can most appropriately provide the type of care needed. It is the responsibility of management to ensure that all staff is competent to provide care to assigned patients in each department service. 5.3 Integration of Patient Services/Care and Support Services 5.3.1 A collaborative multidisciplinary team approach, which takes into account the unique knowledge, judgment, and skills of a variety of disciplines in achieving desired patien outcomes, serves as a foundation for integration. Open lines of communication exist among all departments providing patient services and support services, and as appropriate, with community agencies to ensure efficient effective and continuous patient care. 5.3.2 The CEO, COO, CFO, CHRO, CNO, and Associate Administrator for Clinic and Support Services actively participate and/or collaborate with Board members, facility leadership, and Medical Staff leadership in developing the strategic direction and the plan for patient care. The COO acts as a liaison between the Medical Staff. administration, and clinical services. The CNO acts as a direct liaison between nursing staff and the Medical Staff. 5.3.3 To facilitate effective interdepartmental relationships, problems solving is encouraged at the lowest levels possible within the organization. Managers have the authority to mutually solve problems and seek solutions within their spans of control; positive interdepartmental communications are strongly encouraged as a part of our philosophy. This is accomplished through meetings such as; Nurse Executive Council, Leadership Council, Continuous Survey Readiness, and Patient Safety Quality Council. 5.3.4 When identified problems/issues involve two or more areas providing patient care and patient services, managers may elect to establish a team of personnel from the areas involved for the purpose of identifying mutually acceptable solutions. The Patient Safety Quality Council reviews and prioritizes existing teams or formation of new teams based on a patient-centered care approach. 5.4 Departments and Services Overview 5.4.1 Administration: 5.4.1.1 The administrative team consists of CEO, COO, CFO, CHRO, CNO, and Associate Administrator for Clinics and Support Services. During normal business hours, there is a minimum of one of the administrative team on- site. The CEO is the highest officer. In his or her absence the COO, CFO, or other administrative team member is the designated authority. During off-hours and weekends an administrative team member is either on-site or on-call and available by cell phone. House Supervisors are the designated on-site administrators after hours and on weekends. 5.4.2 Biomedical Engineer: 5.4.2.1 The Department of Biomedical Engineering provides for a safe hospital environment 24 hours, 7 days a week. Clinical Engineers work within established standards for testing and servicing clinical and some non- clinical systems to insure against equipment failure. All newly purchased The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 5 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration equipment is tested for compliance to the American Association of Medical Instrumentation Standards. Education is provided for the facility staff in operation, problem-solving and care of new equipment and on an ongoing basis for equipment already in use. This department also monitors and repairs communication equipment such as telephones. Biomedical is a sub-department of engineering, which is under the direction of the Associate Administrator for Clinic and Support Services. 5.4.3 Calexico Health Center (CHC): 5.4.3.1 The Calexico Health Center is a PMHD department and is designated a Rural Health Clinic. It is open 7 days a week. CHC provides Urgent Care and Primary Care services to patients aged newborn through geriatrics. Radiological Services and waived testing are available on site. The CHC is under the direction of an Assistant Administrator for Clinics and Support Services. 5.4.4 Community Education: 5.4.4.1 Within the community, we provide education for diabetics, prenatal and lactating mothers, cardiopulmonary resuscitation, as well as wellness and health promotion programs. Community Education is under the direction of the CHRO. 5.4.5 Continuing Education: 5.4.5.1 The Department of Training and Development provides in-service education to the PMHD staff, maintains an equipped classroom, and warehouses the competency program. Training and classes include: BLS, ACLS, PALS, in-service training, and continuing education for staff. Educational opportunities are based on the assessed needs of the staff and the leadership. Annual assessments of competency are maintained in an up-to-date electronic data file for all employees and for all educational opportunities provided at PMHD. The Training and Development Department acts under the direction of the CHRO. 5.4.6 Environmental Services: 5.4.6.1 The Department of Environmental Services works in collaboration with the Engineering and Infection Control to provide facility patients, guest and employees with a clean environment 24-hour, 7 days a week. Environmental services aides are specifically trained in aseptic techniques, chemicals preparation for cleaning on a daily basis, terminal cleaning after discharge, and transporting or disposing of medical waste to holding area. The Environmental Services act under the direction of the Associate Administrator for Clinics and Support Services. 5.4.7 Facilities Services: 5.4.7.1 The Facilities Services Department provides for a safe facility environment 24 hours a day 7 days a week. Programs for testing and servicing non- clinical systems are in place to insure proper operation and emergency support should the occasion arise. Engineers provide education for the The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 6 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration hospital in operations, problem solving and care of new equipment as the opportunity presents itself. The Facilities Services department acts under the direction of the Associate Administrator for Clinics and Support Services. 5.4.8 Finance: 5.4.8.1 The Financial Services function is responsible for budgeting, accounting, and reporting all financial activities. The specific areas of accountability include: 5.4.8.1.1 Development of operating, capital, and long term budgets in accordance with the District's Strategic Plan and the facility needs assessments, and in collaboration with all Department Managers based on input from Administration, the Medical Staff, and final approval from the Board; 5.4.8.1.2 Monthly reporting of all financial activities via financial reports, departmental operating reports, productivity reports, and payroll reports. 5.4.8.1.3 Preparation and submission of all regulatory financial reports, including Medicare, Medi-Cal, and County Medical Services Program, State Uniform Accounting (OSHPD) Reports, Tax, and miscellaneous reports; 5.4.8.1.4 Maintaining and reconciliation of all the District's assets, including cash, bank accounts, property, plant, equipment, accounts payable, and disbursements 5.4.8.1.5 Maintaining all insurance coverage and policies for the District, maintaining and negotiating all facility contracts 5.4.8.1.6 The Financial Services departmental staff generally maintains working hours Monday through Friday, 8:00 A.M. TO 5:00 P.M. 5.4.9 Food and Nutritional Services: 5.4.9.1 The Food and Nutritional Service Department supply meals for patients, staff and visitors 7 days a week. Patient's meals are prepared, which support the assessed physiological needs and are delivered in a timely manner to meet not only our own standard of excellence but that of State and Federal governments. The Nutritional Service Director and the registered dietitians review the appropriateness of nutritional support. High- risk patients are identified and are seen in consultation by a Registered Dietitian. Patient care providers may refer patients for consultation based on established guidelines. The department of Food and Nutritional Services reports to the Associate Administrator for Clinics and Support Services. 5.4.10 Health Information Management (HIM): 5.4.10.1 The Health Information Management Department provides physicians, hospital staff, and outside agencies, when authorized, with records to assist in patient assessment and treatment. The staff consists of a The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 7 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration Registered Health Information Technician, Health Information Clerical Staff, Health Information Coders, and Medical Transcriptionist. The Department is staffed from 8:30 a.m. to 5:00 p.m., Monday through Friday. During those times when the department is closed, the House Supervisor has access to the department to retrieve needed medical records. All patient records, including inpatient, emergency room, outpatient surgical and other outpatient services performed in the facility are collated and stored within the department. The Health Information Management Department works closely with the quality resource's staff in providing needed data to identify and support quality improvement efforts; this includes but is not limited to clinical pertinence, timely completion of medical records, and indicator data as identified by the facility and medical staff. HIM acts under the direction of the CFO. 5.4.11 Human Resources: 5.4.11.1 The Department of Human Resources is responsible for hospital wide recruitment, hiring, and assistance in retention of employees. The hours of operation for this service are 8:00 a.m. to 5:00 p.m., Monday through Thursday and 7:00 a.m. to 4:00 p.m. on Friday. The Department of Human Resources provides screening of applicants and referral of qualified candidates to department managers and recordkeeping for hired personnel. They provide guidance and support to all department managers, supervisors and employees in regards to: writing policies for other related human resources issues; compensation; benefits and employee relations; consultation in the handling of unusual personnel issues. Human Resources assist in monitoring of employee competencies, reporting of employee activities to the board and assist in the Employee assistance Program participation. The Employee Health Nurse is staffed from 7:30 a.m. to 4:00 p.m., four days a week, in coordination with the Human Resources Department. 5.4.12 Imaging Services: 5.4.12.1 The Imaging Department supplies inpatients and outpatients of all ages with diagnostic imaging, using roentgenograms, fluoroscopy, computer tomography, ultrasound, magnetic resonance imaging, bone densitometry, and a full complement of nuclear medicine. Radiologist, nurses, radiology Technologists and support staff provide services. A patient's condition, or the type of exam ordered, may necessitate the procedure be done outside the Imaging department. This could occur on the patient unit, the operating rooms, nursery or any area where emergency imaging is ordered by a physician. Radiology services are available 24 hours a day, with routine procedures scheduled from 8:30 a.m. to 5:00 p.m. Nuclear Medicine technologist is on-call for emergency studies between 5:00 p.m. and 7:00 p.m. there is a contractual agreement for specific radiographic image readings after hours. Imaging services are under the direction of the COO. The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 8 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration 5.4.13 Information Services: 5.4.13.1 Information Services provide oversight for the acquisition, installation and support for the hardware and software acquired by the hospital. The department helps ensure the proper functioning and design of the system needed to provide timely, reliable and valid information that supports effective patient care decision making. The department assists in planning for future application and technologies that will enhance care providers' usage of the system. The clinician usage will improve the clinical documentation efficiency and effectiveness. The Director of Information Services collaborates with the Leadership team, hospital staff and medical staff through a multidisciplinary team approach and other formal and informal communication. The Director of Information Services reports to the CFO. 5.4.14 Materiel Management: 5.4.14.1 The Department of Materiel Management is responsible for acquisition and distribution of all supplies and equipment, hospital-wide. The purchasing of supplies and the materiel used in the hospital is guided by mandates of the Det Norske Veritas (DNV), the California Department of Health Services, and Title 22. Central Supply functions as a part of the Department of Material Management. Central Supply personnel stocks inpatient supplies, which are replaced daily to a central location on each patient-care unit and reprocess surgical trays and equipment. Rental of specific medical equipment is coordinated through Materiel Management. The CFO is the division head for this department. 5.4.15 Medical Staff Services: 5.4.15.1 The Medical Staff organization and structure is directed by their Bylaws. 5.4.15.1.1 Clinical Services of the Medical Staff include: 5.4.15.1.1.1 Anesthesia 5.4.15.1.1.2 Emergency 5.4.15.1.1.3 Medicine 5.4.15.1.1.4 Obstetrics/Gynecology 5.4.15.1.1.5 Pathology and Clinical Laboratory 5.4.15.1.1.6 Pediatrics/Neonatology 5.4.15.1.1.7 Radiology 5.4.15.1.1.8 Surgery 5.4.15.1.2The scope of care of each practicing and licensed members of the medical staff is delineated through the Medical Staff. 5.4.15.1.3All departments providing patient care have established lines of communication with the medical staff. The CEO, COO, and CNO attend Medical Staff Committee meetings in order to facilitate administrative issues. Medical Staff serves as chairs for the Patient Safety Quality Council Committee and other facility committees. The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 9 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration 5.4.15.1.4The Medical Staff is supported through the Medical Staff Office, which is open Monday through Friday 8:00 a.m. to 4:30 p.m. The division head for this department is the CEO. 5.4.16 Nursing Services: 5.4.16.1 Under the direction of the CNO, nursing is accountable and responsible for the provision of nursing care within the organization, provides care to inpatients from newborn to geriatrics, and outpatients from newborn to geriatrics, 24 hours a day. Nursing care is accomplished through the nursing process. 5.4.16.1.1 The Nursing Division includes at least the following 5.4.16.1.1.1 Emergency Department 5.4.16.1.1.2 Intensive Care 5.4.16.1.1.3 Medical Surgical 5.4.16.1.1.4 Women's Services 5.4.16.1.1.5 Pediatrics 5.4.16.1.1.6 Peri-operative Services 5.4.16.1.1.7 Direct Observation Unit (DOU) 5.4.16.1.2Those providing nursing care are Registered Nurses, Licensed Vocational Nurses, Certified Nursing Assistants and other caregivers. 5.4.16.1.3Areas where nursing care is provided have a mechanism in place for determining requirements for care on the basis of demonstrated patient needs appropriate and necessary intervention and priority for care. The patient care requirements, staff expertise, regulatory requirements, and unit geography determine staffing for each patient area. 5.4.16.1.4Management ensures a sufficient number of competent Registered Nurses are scheduled at all times to render nursing care requiring the judgment and specialized skill of a registered nurse. Staffing is sufficient to assure prompt recognition of an untoward change in the patient's conditions and to facilitate appropriate intervention. Core staff levels are designated to meet the needs of the patient's complied with state mandates for minimum staffing and have been developed by a number and staffing mix based upon historical requirements of the unit. 5.4.17 Laboratory Services: The Pathology and Laboratory Main Lab is where specimen processing and testing take place and is located on the first floor. The Laboratory draw Station area is also located on the first floor. The Laboratory provides services to both inpatients 24 hours and outpatients of all ages, Monday through Friday, excluding holidays. The services provided include routine chemistry, hematology, serology, bacteriology, Mycobacteriology, Mycology, Parasitology, Virology, Syphilis, General Immunology, Urinalysis, Endocrinology, Toxicology, ABO&RH Group, Antibody Transfusion, Antibody Non-Transfusion, Antibody Identification, The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 10 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration Compatibility Testing, Histopathology, and Cytology, therapeutic drug testing and toxicology screening. The professional staff providing services is clinical laboratory scientists, medical technician and medical laboratory assistants under the medical direction of the Medical Director. The department is accredited by The Joint Commission and is licensed by State and Federal agencies. This department acts under the direction of the COO. 5.4.18 Patient Registration (Admitting) and Patient Financial Services: The Patient Registration Service assists patients in entering the hospital system and provides information about patients to the hospital and medical staff members who will be interacting with the patient. Patient Registration Services are available 24 hours, 7 days a week. Patient Financial Services provides insurance billing and follow-up for the billing of patient accounts. Patient Financial Services are available 5 days a week from 8:30 a.m. to 4:30 p.m. These two departments act under the direction of the CFO. 5.4.19 Pharmacy: The pharmacy provides service 7 days a week from 7:00 a.m. to 7:00 p.m. Pharmacist is on-call daily from 7:00 p.m. to 7:00 a.m. daily to patients ranging in age from premature newborns through geriatric patients. Licensed pharmacists are assisted by pharmacy technicians in a single location and assist in the preparation and delivering of medications. All pharmacy services are guided by the mandates of Det Norske Veritas, Inc. (DNV), California Department of Public Health and Pharmacists Standards of Practice. The pharmacy service routinely monitors select medications and prioritizes medications monitoring based on high volume, high-risk problem prone and high cost to promote increased patient safety and improve patient outcomes. Pharmacists are involved in appropriate committees to ensure the development, coordination and review of all professional standards, procedures, policies and controls relating to the procurement, storage, dispensing, and safe use of medications within the organization. Pharmacy reports to the COO. 5.4.20 Quality Resource: The Quality Resource Department provides direction for the organization's improvement activities and continuous survey readiness activities. Department staff includes licensed nurses and support staff that is available from 8:00 a.m. to 5:00 p.m., Monday through Friday. This department reports to the Director of Quality Resources, who in turn reports to the COO. 5.4.21 Rehabilitation/Physical Therapy Services: The Rehabilitation/Physical Therapy Department will have a Physical Therapist available at Pioneers Memorial Hospital, 7:00 a.m. to 7:00 p.m., Monday through Friday. There will be a Physical Therapist available on the weekends and holidays to see the inpatients as needed. The Physical Therapist will leave when all patients for the day have been seen. A speech language pathologist is available per diem, Monday through Friday 8:00 am to 5:00 pm and Saturday to Sunday 8:00 am to 12:00 pm. The therapists providing the service are registered and/or licensed in their respective disciplines. Physical therapy aides assist Therapist in the care of patients. The Rehabilitation Department reports to the COO. The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 11 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration 5.4.22 Respiratory Therapy/Cardiopulmonary: The Department of Respiratory Therapy provides comprehensive services under medical supervision for the treatment of the neonate through the geriatric patient 24 hours, 7 days a week. An Echocardiogram Technician is available for emergency testing on an on-call basis between 7:00 a.m. and 7:00 p.m. Respiratory Care services and therapies provided are currently the accepted modalities of intervention, including the administration of nebulizer medication, ventilator support, nasal CPAP, mechanical and bronchial hygiene maneuvers, oxygen therapy and aerosol/humidity and pulses oximetry. Diagnostic services are performed for inpatient and outpatient needs and include pulmonary function studies and cardiac diagnostic studies. Respiratory therapists are assigned and respond to all code blue calls and are responsible for the patient's ventilator support. This department reports to the COO. 5.4.23 Risk Management Program: The Risk Management Program is a hospital wide program designed to identify risk factors within the facility and eliminate these exposures and/or to reduce the frequency and severity when risk events occur. A process is in place for prioritizing and disseminating the analysis, actions, plans of correction and follow-up. Risk Management is under the direction of the Quality Director. 5.4.24 Security: The Security Department provides surveillance and the crime prevention necessary to ensure a safe environment for patients, visitors and hospital staff. Security is considered a 24 hour, 7 days a week commitment and personnel are on duty continually. After hours security personnel are contracted. Security is a sub- department of the Facilities Services Department that reports to the Associate Administrator for Clinics and Support Services. 5.4.25 Sexual Assault Response Team: PMHD is the designated acute-care hospital in Imperial County to provide forensic examinations to victims of sexual assault. Specially trained, Sexual Assault Nurse Examiners are on-call 24 hours a day, 7 days a week. This service is under the direction of the OB/GYN specialist/physician. Services provided are forensic examinations, evidence collection and expert witness testimony. The SART team members work in collaboration with local law enforcement agencies as well as the District Attorney's Office. The SART Advisory Committee consists of representatives from the County Board of Supervisors, PMHD board members, Victim/Witness Program, Rape Crisis Center, Sexual Assault Nurse Examiners, D.A.'s Office, PMHD Women's Auxiliary, and all local law enforcement agencies. SART is under the direction of the CNO. 5.4.26 Utilization and Case Management: The Case Management Department encompasses the following functions for patients placed in beds within Pioneers Memorial Healthcare District: care coordination, utilization review, transition/discharge planning, and psycho-social needs as they relate to the individual hospitalization and discharge plan. Case Managers screen all patients, except postpartum and well-baby nursery, for medical necessity and care planning needs. Between all members of the clinical team, all patients are screened for discharge planning needs within 24 hours of being placed in a bed. Medical Social The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 12 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration Workers assess those patients identified as high risk and implement a discharge plan with the input from the physician, patient and/or patient's family/friends within 72 hours of admission. They also receive referrals from members of the clinical team for other patients with discharge planning needs. They also provide traditional social work services when there is an issue creating a barrier to a smooth transition through the care continuum. 5.4.26.1 The Case Management office hours are M-F 7am-5:00 pm. There is one Access Case Manager position that is covered 10am to 10pm 7 days/week. The Access Case Manager's primary responsibility is to ensure that the billing status of all patients is appropriate at the time of referral for admission or observation/outpatient services. They also develop discharge plans for patients who are being discharged from the Emergency Department who need services or placement. Case Management reports to the COO. 5.4.27 Volunteer Services: Comprised of trained volunteers who provide assistance to hospital staff, patients, family members and visitors throughout the day as assigned, including weekends. The volunteers range in age from 15 to 75 and bring their own diversity and unique contribution to the hospital. Volunteers are also assigned to assist in special projects to aid the hospital. The Volunteer services reports to the CHRO. 5.4.28 Wound Care: The Wound Care Center is a diagnostic and therapeutic center for acute and chronic problem wounds as well as non-wound related injuries such as Osteoradionecrosis and soft-tissue radio necrosis. Wound Care Center offers advanced wound care and hyperbaric oxygen therapy in an outpatient setting at PMHD. The office hours: Monday through Friday 8:00 a.m. - 5:00 p.m. The Wound Care Center operates under the direction of the Associate Administrator of Clinics and Support Services. 5.5 Staff Recruitment, Retention, Development, and Continuing Education 5.5.1 All employees receive a general orientation to the hospital which includes, but is not limited to an overview of the mission, vision and values, employee benefits, sexual harassment and violence in the work place, security and safety programs, Performance Improvement Program, infection control, and national patient safety goals. Employees receive a formalized orientation consistent with the scope and responsibilities defined by their job description and the patient population that they will be assigned to provide care. Each department is responsible to ensure competency is validated for each employee. 5.5.2 Voluntary and mandatory in-services are offered on the main campus. A variety of topics are offered according to the direction of the Administrative Team, PSQC, and/or needs assessment. Each department holds in-services on an as needed basis. Nursing Educators coordinate educational programs with specific departments and with the Continuing Education department. The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 13 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration 5.5.3 Recruitment and Retention is an on-going endeavor. Efforts are facilitated through the collaboration of key leaders in each division and on request for specific challenges. 5.6 Resource Management 5.6.1 Financial Resources 5.6.1.1 Annually each department leader is responsible for participation in the budgeting process for capital requests and staffing allocations. 5.6.1.2 Monthly each department leader is responsible for reviewing and reporting on variances from the budget for capital purchases, staff, supplies, etc. 5.6.2 Human Resources 5.6.2.1 They provide assistance to each department leader in processes related to hiring; such as screening, compensation alternatives, benefits discussions, and reference checks. 5.6.2.2 They provide guidance to each department leader specific to disciplining, promotions and handling of unusual personnel issues. 5.6.2.3 Employee Assistance Programs are accessed through the HR department with collaboration with the department manager and the CHRO. 5.6.2.4 Employee Health Nurse Services are available for all employees as well as her guidance in matters such as workplace ergonomics. 5.6.3 Performance Improvement Processes and Outcome of Care 5.6.3.1 Performance Improvement Model 5.6.3.1.1 The organization utilizes the Plan Do Check Act (PDCA) methodology for process improvement 5.6.3.1.2 Outside benchmarks are selected whenever possible through the Midas Datavision system or through industry references. Internal benchmarks are selected when necessary. 5.6.3.1.3 The organization participates in the CMS and Inpatient/Outpatient Hospital Quality Measures (Core Measures) as well as required indicators as outlined in DNV standard. 5.6.3.1.4 Departmental and hospital-wide indicators are designed to measure performance or process improvements with the ultimate goal of patient care outcome improvements. 5.6.3.1.5 Data from each department/service is reported at least quarterly to the Quality Resource department with an analysis and actions for improvement. 5.6.4 Affiliation with Educational Facilities: 5.6.4.1 PMHD assists educational facilities to provide on-site clinical experiences for students based on a sense of commitment to community, patient-care education and research, but also as part of our recruitment effort. 5.6.4.2 Formal written agreements are in place for each school with regular and on-going affiliations and special agreements. These agreements stipulate that PMHD will retain ultimate responsibility for the care of the patient. 5.6.5 Patient Rights and Responsibilities: The electronic version of this policy supersedes any printed copy. Pioneers Memorial Healthcare District Title: Policy No. ADM - 00158 Hospital Plan for the Provision of Patient Care Page 14 of 14 Current Author: Stephen Campbell, COO Effective: 3/1986 Latest Review/Revision Date: 07/2014 Manual: Administration 5.6.5.1 Assuring patient rights is the responsibility of all hospital employees and members of the Medical Staff. The multidisciplinary Ethics Committee is accountable for assuring that appropriate policies, procedures and activities are in place to ensure all patient rights are met. 6.0 References: Not applicable 7.0 Attachment List: Not applicable 8.0 Summary of Revisions: 8.1 1.1.1 Mission statement was revised. 8.2 1.2 Vision statement was revised 8.3 5.1.1 Revised the annual volumes and outpatient clinic visits 8.4 5.1.4.4 Added departments: Definitive Observation Unit (DOU) and Oncology 8.5 5.4.1.1 Removed HealthTech Management 8.6 5.4.4.1 Removed COO and added CHRO 8.7 5.4.13 Removed HealthTech Solutions Group (corporate information services 8.8 5.4.17 Removed Pioneers Occupational Health Center (POHC) 8.9 5.4.21 Removed – Note: entire section. 8.10 5.4.26 Case Management updated hours of service. Deleted section where it states that Director of Case Management is available after hours and on weekends. Also removed staffing section 8.11 5.4.27 Added: The Volunteer services reports to the CHRO. 8.12 Retiring policy ADM-000166 Purpose Organization Structure - An Overview - Covered under this policy. 77. . . The electronic version of this policy supersedes any printed copy. DNV Healthcare Inc. Accreditation Application COMBINED NIAHO® AND ISO 9001 APPLICATION: INDIVIDUAL HOSPITAL WITH RELATED SERVICES AND/OR SITES Applications must be completed electronically (Handwritten applications will not be accepted) Type of Application: ☐New Application ☒ Application Update* ☐ Renewal Application* Application Date: 08/28/2013 *If this is an application update or renewal, please highlight changes in yellow. Organization Contact Information Legal Entity Pioneers Memorial Healthcare District Doing Business As (DBA) Pioneers Memorial Healthcare District DBA Address Street: 207 West Legion Road City: Brawley State: CA Zip: 92227 Name/Title of Primary Contact Gina Parker (please list only one contact) Quality Director Primary Contact Telephone 760 351 3484 Primary Contact Email gparker@pmhd.org Internet URL http://www.pmhd.org Organization Information Facility Type Acute Care Hospital ☐ Psychiatric Hospital Rehabilitation Hospital Critical Access Hospital w/Distinct Part Unit(s): Psychiatric Rehabilitation LTAC Ш Specialty Hospital (Cardiac, Orthopedic, Surgery) ☐ Other (please define) Organization ☐ For-Profit ☐ Not-For-Profit ☐ Government Type ☐ Physician-Owned (Please describe): Total number of FTEs at main campus only 609 (not including off-site location employees if applicable) Average Daily Census at main campus only 45 CMS Certification Number (CCN) 050342 (Medicare Provider Number) Is this a Change of Ownership (CHOW)? ☐ Yes ⊠ No If yes, is the new owner: ■ Accepting the current provider number (CCN) (please enter the current CCN above) OR Applying for a new provider number (855) enrollee) (please complete the next field) ICP-12-4-i1-f1 041913 DNV Healthcare Inc. Accreditation Application If no CCN (New Medicare Enrollee) has an 855 Yes No application been submitted to the FI/MAC? If 'Yes" - has the FI/MAC declared the 855 application to be complete: $ \subseteq \text{Yes} \subseteq \text{No} $ (The organization should have documentation or other means to verify the notification from the FI/MAC regarding the status of the 855) Please include a copy of the current application on file with CMS Number of Licensed Beds 107 Application Request Please indicate Accreditation and/or Certification that you are requesting. Comprehensive Stroke Center Certification ☐ Primary Stroke Center Certification Please indicate any other type of ☐ TJC ☐ HFAP ☐ CARF ☐ State Accreditation and/or Certification you ☐ ISO 9001:2008 (Quality Management System) currently hold. ☐ ISO 14001 (Environmental Management System) Other (please define): If currently ISO certified, ISO certificates must be attached. Has anyone representing DNV provided ☐ Yes you with Accreditation/Certification related ⊠ No management system consultancy (generic If yes, what was supplied and by whom? sales presentations do not apply)? Organization Leadership Chief Executive Officer/President Lawrence Lewis, MBA Vice President of Medical Affairs/CMO Travis Calvin Jr, MD Nurse Executive Robyn Atadero RN, BSN, MPH Director/Manager of Quality Gina Parker RN, MS, PHN Invoicing Information Invoicing Contact Name Gina Parker Invoicing Contact Telephone 760 351 3484 Invoicing Contact Email gparker@pmhd.org Invoicing Address 207 West Legion Road City: Brawley State: CA Zip: 92227 ICP-12-4-i1-f1 041913 DNV Healthcare Inc. Accreditation Application Services Provided Ambulance Service Open Heart Surgery Alcohol-drug abuse or dependency inpatient unit Palliative Care Program Alcohol-drug abuse / dependency outpatient services Pediatric Intensive Care Services Burn Care Services <math>\boxtimes</math> Physical Rehabilitation Services Cardiac Catheterization Laboratory <math>\boxtimes</math> - Physical Therapy <math>\boxtimes</math> Diagnostic Radioisotope Facility Occupational Therapy <math>\boxtimes</math> Emergency Department <math>\boxtimes</math> - Speech/Language Therapy <math>\boxtimes</math> Extracorporeal Shock Wave Lithotripter (ESWL) - Audiology <math>\boxtimes</math> Hemodialysis Psychiatric Partial Hospitalization Program <math>\boxtimes</math> Magnetic Resonance Imaging (MRI) Radiation Therapy <math>\boxtimes</math> Neonatal Intensive Care Services Substance Abuse Treatment Services <math>\boxtimes</math> Obstetric Services Swing Beds <math>\boxtimes</math> Occupational Health Services Transplant Services Oncology Services <math>\boxtimes</math> Urgent Care Center For Multi-Site Facilities Only Please check the box below that best describes your management system: Ιí Our multi-site facilities are all under "corporate governance" meaning that common procedures apply to all while allowing some variation at the site based on activities performed at the site. Top management for all sites is at the corporate sites and all locations adhere to the same top level manual. Additionally, our procedures for internal audits and our corrective/preventive action program are identical at all sites and all information is funneled to corporate where it is reviewed and acted upon by top management. - 1 Our multi-site facilities are all under "corporate governance" but each of the sites are operated as autonomous units and are guided by the management at that site. Each site has their own management system manual. If one of the above scenarios does not match your organization please contact DNV Healthcare so we can help devise an accreditation strategy that best suits your needs. Exclusion Dates Request - One week per month (M-F); 4 per calendar year Please enter requested exclusion dates (note: exclusion dates are not guaranteed, however, DNV Healthcare will make reasonable efforts to accommodate. NOTE: DNV SURVEY PROCESS IS UNANNOUNCED ICP-12-4-i1-f1 041913 DNV Healthcare Inc. Accreditation Application For renewal applications only - you must document your answer below: Do you want ISO Certification or are you requesting Compliance only? (There is no difference in the Standards with which you must comply. There is no difference in the survey process. If you want to advertise that you are ISO 9001 Certified you must do Certification.) ⊠ Certification ☐ Compliance Only or (If Certification is requested, there is a one-time additional fee of $3,500, charged at the time of ISO Certification or Recertification) If requesting ISO Certification please complete the section below: Please select or list a scope of services statement – this is a brief description of the scope of services provided by the organization and will be printed on the ISO Certificate: П Provider of healthcare services including acute medical, surgical, intensive, coronary, rehabilitative, occupational health, obstetrical, pediatric and emergency care. П Acute care hospital provider of medical and surgical inpatient and outpatient services. Provider of healthcare services including acute medical, surgical, critical care, rehabilitative, obstetrical, emergency care, laboratory and radiology services. <math>\boxtimes</math> Other (please describe): Provider of healthcare services including acute medical, surgical, intensive, rehabilitative, occupational health, obstetrical, pediatric and emergency care. ICP-12-4-i1-f1 041913 DNV Healthcare Inc. Accreditation Application Off-Site Locations (Ambulatory Sites, Physician Offices, etc.) All off-site locations that are under the hospital's Medicare Provider Number (CCN Number) are required to be surveyed and listed below. Any additional off-site locations not under the CCN Number may be included for ISO certification/compliance only as applicable. An off-site location is a physician practice, clinic, service or other location that is identified with a separate address as the hospital. The off-site locations to be listed first are those that are recognized by CMS under the same CCN as the hospital. Such off-site locations will likely have a separate NPI number but may be under the same CCN as the hospital as indicated on the most current 855 application on file with CMS. Note: If the off-site location is not under the same CCN as the hospital and is included under the hospital quality management system, you may choose for the site to be surveyed in accordance with ISO 9001. Please indicate "ISO-Only" for these sites. Total number of off-sites: 5 Please enter information for each site on the following sheet. If this is an application update or renewal please highlight any sites which have been updated since the previous application. ICP-12-4-i1-f1 041913 Distance Campus from miles <.25 miles <.25 miles miles miles <.25 <.25 25 Operation Days ō S S <math>\sim</math> S 5 Number of Shifts Accreditation Н - <math>^{\circ}</math> 2 Н Number of FTEs 37 10 <math>\sim</math> 3 <math>\sim</math> Application CA 92227 CA 92227 Brawley, CA 92227 CA 92231 Brawley, CA 92227 City State Zip Code Calexico, Brawley, Brawley, 9 751 West Legion Road, Suite 205 751 West Legion 205 West Legion 751 West Legion Road, Suite 103 Road, Suite 101 450 East Birch Address Street Road s, copy and paste table onto new page. ot∰ An o+⇒ Pa (incl. ISO) to Apply - Standard ISO Only NIAHO NIAHO NIAHO NIAHO NIAHO 6 Services Provided Chemotherapy Description of Rehabilitation Wound Care Rural Health Rural Health Urgent Care Out Patient Out Patient Center and Services Center Care Center Pioneers Health Center The Cancer Institute at Calexico Health Center Rehabilitation Services Memorial Healthcare District Healthcare District Pioneers Memorial Name For additional off site location Site DNV Healthcare Inc. The Wound at Pioneers application? Remove or No Change previous Change Change Change Change Change Added since Add, ICP-12-4-i1-f1 041913 ž ž ž ž Off-site Yes/No Same CCN? under Yes Yes Yes Yes Yes