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Kirkpatrick steps down from board


Marengo Memorial Hospital Trustees approved submitting the names of Randy Fry, Marengo, as a new member of their board and Chuck Merritt, also Marengo, to another term at their March 25 meeting. The names will go the Marengo City Council for official approval of the three-year terms, Chief Executive Officer Genny Maroc FACHE, reminded trustees.

Don Kirkpatrick, Williamsburg, is retiring from the board of trustees after serving 11 years. He was presented with a certificate of appreciation and a gift at the meeting.

Fry is director of operational excellence at the University of Iowa Hospitals and Clinics. His professional skills and experience include strategic planning, capital planning and acquisition, measuring/improving customer satisfaction, public speaking, facilities planning, process improvement, community relations and workforce planning.

Asked why he was interested in serving on the board, he wrote, “I feel that the hospital provides a valuable service to Marengo and the surrounding areas.”


The balance sheet shows total cash of $4,775,167 and is “holding strong,” chief financial officer Nancy Kohrt, CHFP, told trustees. She said the hospital received an additional payment in March from Medicaid which they had not anticipated.

The operating income gain for February was $43,680, or 3.65 percent, with a net total gain of $45,606, or 3.81 percent total income margin, Kohrt said. The total net loss for the year-to-date was $194,487 or a minus 2.05 percent.

Gross patient revenue was $1,260,416, below budget of $1,497,464 by $237,048. Only the extended care patient and ambulance revenues were above their budgets. Gross revenue for the year-to-date was $10,472,475.

Outpatient revenue, $550,622, had the biggest variance from budget; it was down by $61,098.

“Emergency room visits and therapies were down substantially,” Kohrt said, “which impacted the outpatient revenue.”

Contractual allowances were down to $55,456, versus a budget of $195,880, due to additions to the Medicaid receivable and improved reimbursement from Medicare, Kohrt continued. This is a trend that is expected to continue, she added. The contractual adjustments had a favorable variance of $140,424.

The deduction for bad debts/charity care was $37,801.

The net patient service revenue was $1,167,879 compared to the budget of $1,247,959 or a shortfall of $80,080. There was other operating revenue of $30,458.

The net operating revenue was $1,198,337, compared to the budget of $1,275,745, or a variance of minus $77,408. Year-to-date net operating revenue was $9,489,944, or $610,675 below budget.

Total expenses were $1,154,657 compared to the budget of $1,259,846, or a favorable variance of $105,189. Year-to-date expenses total $9,780,826, compared to the budget of $10,078,773, of below budget by $297,948.

Employee wages and costs were $548,173 for February, compared to the budget of $638,774, or under budget by $90,601 for the month due to not filling open positions and fewer days in February. Supplies, $67,443, were down by $18,869 due to a decline in outpatient volume, Kohrt said.

Employee benefits were $100,879 compared to the budget of $92,414, or above budget by $8,465 as anticipated, Kohrt continued.

Maintenance, $11,098, was above budget by $4,014. Depreciation, $97,800, was above budget by $4,499. Contracted services, $189,867, were above budget by $9,453. According to Kohrt contracted services were up due to physician expenses in the emergency department and hospital.

Other expense areas were below their respective budgets.

The net patient days in account receivables was 54.87 days, up mostly due to switching to provider-paced clinic from the Family Medical Clinic and holding accounts until having the “proper authority” to start billing. Last month the net patient days in account receivables was 49.78.

The contractual adjustment was 8.7 percent of revenue.

The average full-time equivalent for number of employees was 145.34, compared to 162.4 in February a year ago, or 17.1 fewer employees, Kohrt said. 


There were 17 acute patients and 11 skilled patients plus three extended care patients admitted to the hospital during February. The number pf acute and skilled patients resulted in 48 and 230 days of care, respectively, for the month. Both are over the average number of patient days for the current fiscal year, and the acute is the same average as a year ago while the number of skilled days is slightly over figures for a year ago.

There were 214 emergency room cases, down from the number in January and below the 295 average for this year.

Outreach clinic visits numbered 153, down one for the average this year but below fiscal year 2009.

Surgical procedures, 11, were the same number as January and compare to the average for this year of 14 per month.

There were 547 visits to the Family Medical Clinic compared to an average 637 for the year and the 713 visit average a year ago. Numbers for March are up and expected to be strong.

Radiology exams, 351, were above the number for January, but were below the average 374 for the year. Laboratory tests, 1,565, also were down below the average for this year, 1,922.

There were 48 EKGs, below the 59 average for this year, and 52 visits for cardiac rehabilitation, above the yearly average, 44.

Respiratory therapy procedures were up considerably from the previous month, 624, compared to 156 in January, and the average for the year of 471. Other therapy procedures, 897, were down from January, 1,149, and 936 average for the year.

There were 109 dialysis treatments, 36 services to patients and nine case-managed patients.

The Iowa County Ambulance Service reported 88 calls, compared to 108 in January, and 109 average calls for the year.

There were 1,728 meals served during February.

Statistics to mid- March were stronger than they had been in February, Kohrt said.


Credentials were approved by trustees for providers:

Renewing credentials – Michael Chandra, M.D., Todd Langager, M.D., Subhi Halawa, M.D., and Boothapuri Venkatesh, M.D., and Harron Afridi, M.D., all courtesy, all cardiology; Mark Irland, M.D., active, emergency room; Gregory Neyman, M.D., active, family practice/emergency room.

Withdrawal – Brian Williams, M.D., courtesy, emergency room.

In addition to credentials minutes from the previous meeting and policy review were approved as part of the consent agenda.


Mikaela Kienitz, assistant administrator, reviewed the February report card results as follow:

Service, increase inpatient satisfaction to at least the 50th percentile - 77 percentile, an average 85 percentile for the year-to-date.

Quality, increase performance of the Center for Medicare/Medicaid core measure for acute myocardial infarction to 70 percent - no cases recorded.

Financial, maintain a favorable one percent variance to the budgeted gain/loss as recorded on the income statement - minus 3.23 percent.

People, decrease employee turnover to 15 percent or less as measured internally - 7.65 percent.

Growth, perform at least 364 surgical procedures annually, 30 per month - 11 performed in February, for an average 14 per month for the year-to-date.

Growth, increase visits to the Family Medical Clinic office to 7,500 annually or an average 625 per month - 529 visits in February, for an average 573 visits per month for the year-to-date. With those previously scheduled the clinic expected to reach about 640 visits in March, Kienitz said.

Community, maintain current level of community benefit activities at 25 annually - one addition in February for a total of 30 for the year-to-date.


CEO Maroc told trustees the Iowa Hospital Association annual economic impact report had arrived showing not only MMH’s impact but that of the health sector in the area and also in Iowa.

Maroc said the hospital’s Web site, which had gone on line the day before the meeting, has been updated, rearranged and has a fresh look.

The spring newsletter will be accessible on the Website as will articles on other upcoming events including the baby sitting clinic information, a calendar and MMH Foundation events.

Articles from The Pioneer-Republican Fit for Life section on some success stories in the therapy department have been added on the Website.

A Google service provides a statistical report on numbers who are accessing the Web site, whether or not the visitor is a new one, how long the visitor stays on the site, track visits to clinic, services, employment, etc., parts of it.

An article from The P-R written prior to Dr. Edriss Estime’s visit to Haiti was also to have a link on the Web.

Dr. Susan Davis chaired the meeting in the absence of chair John Kloster. Also present were board members Marvin Carney and Don Kirkpatrick with Chuck Merritt connected to the meeting via telephone.


The board went into closed session under Iowa Code 21.5.1 to consider marketing and strategic planning. No action was taken at the conclusion of the meeting, according to Maroc.

UPDATED April 10, 2010 11:03 AM

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