Salem Memorial Hospital Board of Directors met April 22 for its regular meeting.
Present were CEO Brooke Bollman, board members Mike Swyers, Karen Brown, Zach Moser, and Dr. Leigh Ann Price. Not in attendance was board member Frank Barnitz.
Bollman reported zero deficiencies in the long-term care survey, a successful Patient Connect implementation, and the hiring of a revenue cycle manager and a case manager.
CEO Report
Bollman reported she attended a Missouri Hospital Association (MHA) Critical Access Hospital (CAH) network meeting, where she was grateful for the opportunity to meet with several other CEOs of critical access hospitals.
The affiliation with Phelps Health is underway with negotiations ongoing, with more information to come next month.
The implementation of Patient Connect has been successful with less “no-show” appointments, as the software allows for appointment confirmation.
There has been a renewed focus on education and training, with a recently completed staff survey where staff identify what education and training they’re hoping to see implemented. Customer service training has also been completed.
A revenue cycle manager has been hired and onboarded. They will correspond with the EMR system, coders, and drive some of the aging AR down, said Bollman. They will submit statements and answer questions for billers and work with department staff. This will be a month-to-month agreement.
Referral bonuses have been initiated and have been increased significantly as a greater incentive for staff to refer to SMDH. Bollman is actively working on physician and AP recruiting.
Marketing and strategic planning is being worked on with Bollman informing board members to watch for a date follow-up to begin strategic planning.
SMDH is partnering with the Dent County Health Center on a health needs assessment, and it will be open until July with hopes that community members will engage and help assist in identifying areas to focus on during strategic planning.
The operational and capital budget is underway with Bollman working with several department managers on its preparation. She’s hoping to have the input ready for the June meeting, prior to the end of the fiscal year.
Lightning damage to the building was reported, due to the recent storm. Staff have identified lightning struck one of the cameras, which then back fed into the hospital. Several pieces of equipment have been harmed, including cameras and ambulance radios. Insurance will be contacted regarding damages.
Bollman has been tracking several pieces of legislation and will continue to update on their progress to the board. One that is at the top of her list for monitoring is prior authorization reform.
“Prior authorization healthcare system is going to be our demise,” warned Bollman. “We continue to be denied prior authorizations, and it’s for very medically necessary cases.”
Another piece of legislation she is continuing to track is Senate Bill 187, regarding the federal 340B program.
Meanwhile, Bollman also gave dates for upcoming events:
• Lab Week, April 21-25
• Nurses’ Week, May 5-9
• Hospital Week, May 12-16
• Golf tournament, June 6
For Hospital Week, Bollman discussed with the board possible routes of celebration to pursue for staff members.
Summary of Operations
For the month of March, there has been a total of 42 in-patient admissions with 15 acute, three swing bed, and 15 observation. Observation is a little higher than anticipated due to prior authorization issues, noted Bollman.
Inpatient census days were 117 compared to 181, down for the month of March. There have been 1,114 outpatient registrations compared to 1,076 in the month of February.
Emergency room visits were at 653 for March, up from 627 in February. Ambulance runs were at 249 compared to 207.
Income Statement
Another positive month was noted for March with a gross revenue of $5.3 million. This is an increase but fairly consistent to the last few months, noted Bollman. Allowances and uncollectible were at $3.3 million, bringing the total net patient revenue to $1.9 million. Total operating revenue is $2.2 million, with a FY 2025 year-to-date of approximately $23 million.
Operating expenses had a line item of total salaries and fringes at approximately $1 million. At the service contract line item, it was noted that the Cerner settlement has been in negotiations for a period of time, but it has recently settled with SMDH paying out $50,000 to Cerner, contributing to an increase from $88,387.69 in February to $132,046.04 in March.
Another noted line item pertained to general administration, miscellaneous expenses, noted as $44,641.28. This is primarily due to paying out capacity building grants, such as for Healthy Dent County and Aging Best.
The accrual report has been fully updated by Hannah Harris, executive assistant.
The line item for insurance has also notably increased, as it has come up for renewal—increasing from $19,774.00 in February to $96,626.41 in March.
The total operating expenses was $2.1 million for March, with a FY 2025 year-to-date at $19.6 million.
TORCH funds were received in the amount of approximately $181,000, with charitable contributions at $2,100 to the EMS department for the 100 Acre Wood Rally.
The profit for the month of March was $266,000 with a year-to-date profit of $5.3 million.
340B for the month of March was $165,571 in gross revenue. The profit was $87,399. The total net profit for FY 2025 was $528,418.
The days cash on hand was reported as 32, year-to-date 2025.
“We continue to drive that up little by little, so I’m very pleased with today’s cash on hand,” said Bollman. “It’s a significant improvement.”
The income statement was approved by the board.
Chief Nursing Report
Amber Hogan was called to the ER, so Bollman reported in her stead. Hogan is working on the EMT-B training entity and is working on getting policies and procedures updated, accordingly. She is working on organizing an education committee and updating the emergency operations plan.
Several full-time positions are open in the ER, including a RN full-time float which has recently been added after discussion with plenty of training and onboarding orientation planned.
A case manager was recently been hired and started Monday, April 21. She will be assisting with the TORCH program.
Human Resource report
There have been two new hires, including a full-time monitor technician and part-time dietary cook. Three employees departed, including a full-time physician, full-time medical assistant, and PRN clinic manager.
Bollman introduced Kendra Mobray as a quality-risk director, who has been busy working on projects and actively communicating with staff to assess needs.
Old business
With the review of the policies by board members Moser and Price, there were a few noted grammatical errors and discrepancies between policies and procedures, but they were further noted as minor.
Moser moved to approve the policies for the year, with the caveat that inconsistences within policies and procedures will be corrected and consolidated next year. Swyer seconded, and the motion passed with all in favor.
New business
A purchase request was submitted for a Pyxis upgrade, as it is required for continued utilization. The cost to upgrade the equipment is $12,600. After discussion, the board approved the purchase.
Originally on the agenda for the meeting was the election of officers; however, due to two members not being physically present, Barnitz and Brown, the board tabled the item for the following month.
