INDIAN RIVER COUNTY — The Indian River Medical Center last week formally announced it has hired a Tennessee company to help it communicate better with its stakeholders and with the community at large, acknowledging there had been lapses in communication that need to be corrected.
“We need less misinformation and more factual information,” CEO Jeff Susi said, after introducing Anne Hancock Toomey, a partner from Jarrard, Phillips, Cate and Hancock, a healthcare crisis communication firm.
With the communications consultant present front and center, it was no surprise that “communication” – and the need for the hospital to do a better job of it – was the main theme last week at meetings of the hospital’s finance committee and its full board.
From explaining a mysterious spike in indigent hospital bills, to conceding that being within budget for 2014 was partially based on an accounting trick, to acknowledging continued problems with the Emergency Room, hospital leaders seemed genuinely committed to getting the truth out.
Hospital CFO Greg Gardner provided a new explanation of what caused an unexpected 121 percent rise in indigent care bills given to the Hospital District to be paid with tax dollars.
Previously, hospital leaders had said that the number of indigent patients had simply increased as part of a national trend.
However, numbers produced by six neighboring hospitals did not show a similar spike.
At last week’s finance committee meeting, Gardner gave a more detailed – and to some observers, a more plausible – explanation: The numbers, he said, had risen because Emergency Room staffers are doing more than in the past few years to identify indigent patients.
What this means is that the hospital is not eating as much of the costs incurred by patients who do not have insurance and are not on Medicaid, but who have little prospect of being able to pay the hospital’s bills.
Instead, hospital staff is classifying more of these patients as indigent and then passing on the bill to the Hospital District, which pays for indigent care out of property tax money.
As a result, the Hospital District will have to spend about $1 million more of taxpayer dollars than anticipated in 2014.
District trustees did say at the latest hospital meeting that Gardner’s new explanation of the increase at least made sense.
“We’re absorbing some of your bad debt,” said District trustee Trevor Smith, summarizing Gardner’s explanation.
Because of the change in categorization of more of these patients from so-called self-pay to indigent, the Hospital District will need about $9.2 million in tax money for this year instead of the budgeted $8.2 million, which could lead to a tax increase.
“If I were the District, I’d also be looking at $9.2 million for 2015,” said Gardner.
Gardner did not have any response as to why, if the rise in indigent care bills came because the hospital has been doing a better job of qualifying indigents since September, the IRMC leadership originally blamed it on a nationwide spike in indigent patients seeking hospital care – an explanation which turned out to be incorrect.
On other financial matters, Gardner assured everyone that the hospital was within budget and “on plan,” as he had promised for fiscal year 2014.
However, Gardner said in answer to a question by board member Paul Nezi that adherence to the budget plan was dependent upon extending the amortization of pension fund costs from eight years to 22 years, which created the appearance of an extra $2 million in the plan that is not actual money.
Still, Gardner said he was “cautiously optimistic” about the hospital’s financial performance.
As for the Emergency Room, Susi said the hospital is “not making progress as fast as I had hoped.”
For January, he said ER patients waited an average of seven hours before being admitted and in February that number was just under seven hours. Both numbers are far worse than the state average, which Susi said the hospital was working toward.
“We’re going to push that harder,” he said.
Susi agreed with a recommendation from crisis communications consultant Toomey – first suggested in a Vero Beach 32963 editorial a month ago – to post ER performance numbers and other metrics on a website so everyone would know how the hospital was doing.
“By shining a light, I think we’ll improve our performance. We’re committed to admitting faults,” said Susi.
On the upside, he predicted that a hospital score of “C” for 2013, which was given by Leapfrog, a respected national rating service, will be improved to an “A” grade for 2014.
“We’re optimistic,” he said.
