Page 71 - CombinedTest_Neat

Site Performance Summary:
The Mercy Lorain Region is $906K Under budget in supplies for December 2017. The primary driver on the positive variance is $227K from
pharmacy inventory adjustments and 540K from non pharmacy inventory adjustements. The remainder is driven by lower overall volumes
(admisions -8%, patient days -12%) Pharmacy costs are also below budget due to a fully functioning 340B program which was not in place prior
year. There are also large budget allocations in December for office supplies (160K) which were was not consumed by expenditures and 90K of
uniform budget not consumed.
Although the region is significantly under budget there are areas of negative variance primarily driven by volume in Surgial specialties. Otrthopedic
total joint replacement were 59% over prior year, Spinal fusions were 38% over prior year. Prior to inventory adjustment supplies med surg were
61K over budget, primarily from MRMC OR due to the increased Ortho, Spine, GYN volume.

Key Challenges: 2-3 key contributors for each expense subaccount
MRMC surgery Urology case increase of 14 YOY utilizing Lithoview and
adjunct items. 12K
GYN case increase 8 YOY with use of Novasure 16 K, Ligasure 10K and
Lorain Leader's Summary
Myosure 9K
Med/Surg
Increase in Ortho cases (addressed below) added use of adjunct items :
mixing bowls, guns etc. Had to order new cement guns and accessories
due to non availability of product from Styker . 10 K of Zimmer Pulse
lavage.
8% lower than budget admissions.
Rx 12% lower than budget patient days.
340 B program fully functioning.
Orthopedics: 52 Total Joint replacements in the region CY vs 31 PY.
Incremental volume impact of 128K
Spine: 13 Spinal Fusions CY vs 5 PY Incremental Volume Impact of 61K. 1
Implants More neuro stimulator in CY than PY Incremental Volume inpact 16K

Impants other: small (6K) vriance driven by YOY incease in urology,
podiatry and vascular.
Instruments - Major driver of expense in 12/17. New Instrumentation
primarily for Neurosurgeon Dr. Yoo. Other instruments for Dr. Ozuner
(colorectal) . Dr. Nemeth Thoracic Vascular
Office suply large positive variance driven by non spread marketing office
supply budget for De. 2018
Other Expenses
Minor Equipment non medical 10K of minor equipement from AVI. 7 K in
computer equipment through IT. 21K of minor equipment PO's accrued
having been open for several months. Minor eqipment medical. 13K
accrued vital signs monitors ordered months ago - not shipped by Philips.
4K from practices needs to be reclassed.
Actions Taken/Planned:
Volume Data
Alt Sourcing
Capital Avoidance