Nov. 7 Review of Board Meeting

1.  Minutes from last month approved.  The open session was less than 1/2 hour long.  I don’t think that’s a good thing.  Perhaps I can nitpick, but fine toothed combs are preferable to rubber stamps when you have to delouse something.

2/3 Consent for changes to the pension plan and the SEIU-UHW West MOU.

4.  The Alameda Hospital Foundation is designated as the sole fundraising/charitable donation vehicle for the District.  The Foundation, just like the rest of the Board, is way too Hospital centric, but after a minor change to the MOU, the vote to approve was unanimous.

5.  September 2012 financials.  What can you say?  Management is always upbeat even when losing tens/hundreds of thousands of dollars.  The loss this month was 190k.  This does not bode well for the year.  The total loss so far this year is 672,229.  We can take a guess as to whether October will turn around this trend. 

First, add back in the Accucare fee of 16,000 and add another 14,000 just to be generous so that Wound Care in October would help make that number a loss of 160k.

Second, let’s add in the additional net census for Waters Edge + subacute (simplifying things here).  That works out to about 4.  We will assume that adds 50k to the bottom line by multiplying $400/day X 31 and assuming no net increase in expense (rounding up).  The loss is now at 110k.

Third, the acute care census was down but the case mix index was up.  Also surgeries were up so I will just assume that the September to October delta of dollars of this segment is flat.

Overall, the District still faces a deficit of 110k for October is my best guess.  The Orthopedic program opened October 22 and almost certainly lost money for that initial time period.  We can safely assume that October will be a negative result. 

We can furthermore assume that there is, at most, another 50k of monthly margin that can be squeezed out of Waters Edge and maybe another 20k out of the wound care.  This would still mean a baseline loss per month of 40k (and I think I am being somewhat optimistic here).  I think it would be unlikely for the new surgeons to hit their stride prior to January 1 with the holidays coming up.  So let’s assume that the cumulative loss as of December 31 is 670k (1st quarter) + 110k (October) + 80k (November + December).  That is a total of 860 thousand.  The Bank of Alameda is not going to be very happy about that unless the Orthopedic program is starting to show signs of generating large amounts of cash; it would have to generate over 210 thousand a month for the District to generate $1 of net income for the year.  I don’t recall the budget numbers for the ortho program, but that sounds high to me. 

So 2012/2013 is like every other year, unless a miracle occurs, the District loses money over and above the subsidy provided by the parcel tax.  And let’s not forget the non-economic cost the District incurs in the form of poor health outcomes.

6.  2011/2012 fiscal year audit.  The auditor would have to be hit over the head with a hammer to give anything but a “clear” opinion.  They know who butters their bread.  The major change was after a series of minor adjustments which made little difference in net income, grants and donations were reclassified to an income statement account rather than being driven directly to the balance sheet.  This made the loss less for the year, but did not change the underlying numbers or dynamic.

7.  Metrics plan was approved.  I think there may be some small chance of the participants getting the 25% for the seismic part of this plan, but I don’t see much chance of them reaching the thresholds for the other pieces.

8.  Election results remain the same as the previous post.  There will be an appointed Board seat available shortly. 

9-xx.  Not much more interesting to report.  Board packet and video available on the web.


About egorelick

Gadfly. Former City of Alameda Healthcare District Board member.
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