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Kloster elected chair of MMH board


John Kloster, Marengo, was elected chairman of the Marengo Memorial Hospital Board of Trustees at their Dec. 17 meeting.

Kloster will replace Dr. Susan Davis who has served two years. Board bylaws limit the number of years a person can serve in one position.

Dr. Davis will be the vice chair. Marvin Carney will be board secretary-treasurer.

Four board members, a quorum, attended the meeting – Carney, Davis, Jeremy Gerrish and Kloster. Committees will be appointed in January.


The hospital showed a net income of $6,348 for the month of November because of non-operating revenue of $19,896, according to the statement of revenue and expenses provided trustees by chief financial officer Nancy Kohrt, CHFP.

In opening her report Kohrt said the hospital has $4,728,408 in cash. It also booked additional receivables in current assets of $144,000 from Medicare and Medicaid during the month.

November figures showed total patient service revenue of $1,157,343, down $340,121 from the budget of $1,497,464.

“Both acute and skilled patient days were low in November, bringing unfavorable variances in all categories except ECF (extended care),” Kohrt said. Inpatient ancillary had the biggest variances in X-ray and physical therapy. In the outpatient services there were unfavorable variances to the budget in laboratory, X-ray and outpatient surgery. There were 16 outpatient surgeries. Visits to the Family Medical Clinic, she also noted, were down as flu cases receded.

Contractual adjustments were $17,607, or under budget by $178,273 due to the receivables booked from Medicare/Medicaid, and below the budget of $195,880.

“This variance,” Kohrt continued, “is due to the receivables booked for

Medicare and Medicaid from the cost report being offset to the contractual line.”

Bad debt and charity care was $14,706. There was $22,899 in other operating revenue.

Net operating revenue was $1,147,929, compared to the budget of $1,275,745, or $127,816 below budget.

On the expense side there were total salary costs of $563,685, under the budget by $75,089 due to management’s control of hours and not filling open positions, Kohrt said. For the year-to-date the hospital is under budget by $123,997 for wages. Employee benefits and IPERS were $102,735, above budget by $10,321 for the month due to employee physicals and unemployment compensation payments, Kohrt noted. Work compensation contracts for the next year are being reviewed, she continued. For the year benefits were above budget by $52,678.

For November Kohrt’s report showed supplies - $75,064, professional fees - $3,250, drugs - $21,374 were all below budget, with the latter due to patient volume decline, she said. Costs for: utilities - $15,626, interest/service charges - $43,223 and contracted services - $172,290 were also under budget.

The November report showed maintenance - $8,569, advertising/marketing - $8,266, insurance - $29,490, depreciation - $97,800 and other expenses - $20,104 were above budget. Kohrt said the category other expenses included payments for care learning and Studer Group.

Total expenses of $1,161,477 were below budget of $1,259,846, by $98,369 for November and below by $107,049 for the year-to-date.

Non-operating income from maturity of investments was $19,896. For the year-to-date the hospital has over budgeted non-operating revenue by $19,989.

The operating loss for November was $13,548 with a net gain of $6,348, resulting in a margin of .55 percent. For the fiscal year-to-date the net income is a loss of $175,274, with a margin of minus 2.94 percent.

Net patient days in account receivables were 61.20 compared to 60.87 the preceding month.

Contractual adjustments were 11.2 percent, a decline from the previous month. The average full-time equivalent number of employees was 147.04, also below the preceding month.

In concluding her report Kohrt said net revenue for the year is 12.2 percent below a year ago. The statistics report shows the volume declined for the month of November. 

Salaries were under about $300,000 at the total salary cost line and all other expenses with the exception of depreciation were below last year. Total expenses are down 7.2 percent from a year ago. “We have been working at holding costs,” Kohrt said.


Revenues reflected statistics for November. The number of acute, skilled and extended care admissions was down as was average number of patient days. There were 33 acute patient days of care, compared to the average 48 for both this year and last year. The 129 days of skilled days of care was below the 211 days average for this year and 226 days a year ago.

There were 300 emergency room cases for November, 125 patients in the outreach clinics, 16 surgical procedures – compared to 36 in 2008, all below a year ago. The Family Medical Clinic had 610 visits, also below average. Radiology exams, 371, and laboratory tests, 1,894, were down. There was a marked decline in CT scans, she said with 56 in November and an average 66 for this year and an average 86 last year. EKGs were above the average number for the year. Respiratory and other therapies were down due to the lower number of inpatients, Kohrt said. There has been an increase in the number of outpatient therapies, she added.


Credentials were approved for the following with membership and specialty:

Initial practitioners, both courtesy and both emergency medicine – Phillip Wynn, M.D., and Richard G. Highstead, M.D.

Credentials renewed, all courtesy – Kim Lozier, DPM, podiatry; John Wollner, M.D., dermatology; Darren Davenport, M.D., Jay Friesen, M.D., Michael Hanigan, M.D., Laura Hemann, M.D., William Scheible, M.D., and Paul Schneider, D.O., all radiology.

Emergency credential ratification/temporary privileges, all courtesy – Phillip Wynn, M.D., emergency medicine; William Barnhill, CRNA, anesthesia; Richard Highstead, M.D., emergency medicine; Bradley Bodell, CRNA, John Vana, CRNA, Daivd Huether, CRNA and Mark Odden, CRNA, all anesthesia.

Addition of privileges, all courtesy, all anesthesia – Bradley Bodell, CRNA, John Vana, CRNA, David Huether, CRNA, and Mark Odden, CRNA.

Also approved with minor modifications were the policies for December.

Monthly report card

Mikaela Kienitz, assistant administrator, gave the monthly report card for the following:

Service – inpatient satisfaction, measured by Press Ganey survey, 84 percent; goal is 50 percent, average for year-to-date is 88 percent.

Quality – increase performance of the Center for Medicare/Medicaid core measures for acute myocardial infarction, 100 percent, goal is 70 percent, the average for the year is 73 percent.

Financial – maintain a favorable one percent variance to the budgeted gain/loss as recorded on the income statement, minus 12.69 percent, average is minus 12.69 percent.

People – employee turnover, 4.88 percent, goal is to decrease turnover to 15 percent or less, average 3.03.

Growth – surgical procedures, 16, goal is to perform at least 364 surgeries annually or 30.34 per month, with 64 surgeries year-to-date.

Growth – Family Medical Clinic office visits, 568, goal to have at least 7,500 per year, or 625 per month, with a total 3,055 so far this year.

Community - level of community benefit activities, two, goal is 25 annually, have reached 27 for the year-to-date.               


Terry Brecht, chief operational officer, reported 75 employees took part in a service project and collected 121 pounds of coats, caps, mittens, etc., for area school children. The garments were divided equally and distributed between the school districts in Iowa County: Iowa Valley, HLV, Williamsburg, English Valleys and Clear Creek Amana.

Kienitz said $480 was raised in the casserole project in which frozen casseroles made by the employees were sold at the Holiday Collection. Money goes toward the $500 scholarship to be awarded to a high school senior pursuing a nursing career in the spring.

Chief Executive Officer Genny Maroc, FACHE, reported they recently received three “really nice” letters of thanks from those who have been patients or family members and a member of the staff.

She noted earlier the hospital has a “really good medical staff and is really blessed” with its staff both at the clinic and the emergency room. Maroc also said, MMH currently has three practitioners from the emergency medicine fellowship at the University of Iowa.

Trustees heard a short report on progress with electronic medical records (EMR).

Kohrt said they had gone “live” with the second phase of EMR in August with the clinicals including the addition of radiology, laboratory and nursing side and a web station for physicians with the records. Microbiology was not included at the time but now has a method for getting results to these records. The newest phase, for which implementation has begun, is a base for the Family Medical Clinic system. Physicians at the clinic will be able to electronically order tests at the hospital and to create a pre-registration for the patient at the hospital. Results will be returned to the clinic. Work on this phase is expected to be complete by the end of February. The first phase included registration and the financials. Special training has been included for each step.

Board self-assessments were distributed to the trustees.

UPDATED January 6, 2010 11:10 AM

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