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Youngstown    Variance  % Variance 1.0%  $14,901,486
                                                                                      Key Performance Indicators  Net Patient Revenue                           $1,875  $71,128,973  ($2,349,650)  -3.3%  $69,202,224
                                                                                                                             Budget
                                                                                                                  Actual
                                                                                         Metric
                                                                                                                                                              Prior
                                                                                                                  $14,967,311
                                                                                         Supply Expense
                                                                                                                             $15,121,578
                                                                                                                                         $154,267
                                                                                                                  $68,779,323
                                                                                                                      21.8%
                                                                                                                                 21.3%
                                                                                                                                            0.5%
                                                                                                                                                       2.3%
                                                                                         Supply Expense % Net Patient Revenue
                                                                                                                                                                 21.5%
                                                                                         Supply Expense per EIPA
                                                                                                                                                                 $1,867
                                                                                                                                $1,837
                                                                                                                                                       -2.1%
                                                                                                                                            ($38)
                                                                                                                                3,794
                                                                                         Total Admissions
                                                                                                                                                       -0.9%
                                                                                                                     3,759
                                                                                                                                             (35)
                                                                                                                                                                 3,827
                                                                                                                     26,079
                                                                                                                                                       1.8%
                                                                                                                                            460
                                                                                                                                                                 26,074

                                                                                                                                25,619
                                                                                         Total Patient Days
                                                                                                                                                                 7,983
                                                                                                                                            (251)
                                                                                                                                8,232
                                                                                                                                                       -3.0%
                                                                                                                     7,981
                                                                                         Total EIPAs

                                                                                         IP Surgeries
                                                                                                                                1,215
                                                                                                                     1,345

                                                                                         OP Surgeries
                                                                                                                                                                 1,295
                                                                                                                                            130
                                                                                                                                                      10.7%
                                                                                                                                                       -2.5%
                                                                                                                     1,738
                                                                                                                                             (44)

                                                                                                                                1,782
                                                                                         Total Surgeries
                                                                                                                                                                 1,882
                                                                                                                                                       3.6%
                                                                                                                                                                  140
                                                                                                                                 169
                                                                                                                                              6
                                                                                         Outpatient Cath Lab Procedures                               393                              568                            (175)  -30.8%                              587
                                                                                                                      175

                                                                                                                     Site Performance Summary
                                                                                          Mercy Health Youngstown expense arrived at budget for the month at $110K (0.7% variance).  Gross revenue fell short of target by
                                                                                          $610K (.2%) despite admissions flat to budget and surgery volume that fell just short of expectations, (44 procedures, 2.5% below
                                                                                          target).  Med Surg supplies came in $150K (3.4%) below budget including a one-time $172K expense related to exiting the OSC joint
                                                                                         venture.   Blood expense was under budget for the region with a wide variance of expense across the acute care sites.   Supply expense
                                                                                          per EIPA finished slightly above budget, driven in part by extraordinary expense related to the flu response.  Drug  costs exceeded
                                                                                         budget by $30K (.5%) on Patient Days that were over plan by 1.8%.   Cath Lab at SEYH remained strong with volumes exceeding budget
                                                                                         by 3% and prior-year by 28%.   Overall implants came in signficantly under budget ($215K, 7%) on I/P surgeries that fell 175 (31%) short
                                                                                          of plan and strong volume at  St. Elizabeth's Cath Lab (3.4% over budget).    TAVR volume (7 procedures, $228K)  was in-line with
                                                                                         recent volume trends and exceeded PY by two ($65K).   Implant Other exceeded budget by $70K, mainly driven by CardioMEMS ($39K)
                                                                                                      and Occluder PFO expense ($20K) as well as six EVAR/AAA procedures totaling $112K.
                                                                                                                         Key Challenges
                                                                                                                $87K expensed on several high-dollar treatments/devices at SEYH Interventional Radiology
                                                                                                               including $48K Sirtex SIR-sphere radiation therapy seeds (consider coding elsewhere) as well as
                                                                                      Youngstown Leader's Summary
                                                                                                                                 11 ea. ($31K) in EKOS catheters
                                                                                                                   Significant  increase in Intuitive Surgical expense compared to PY ($69K vs. $36K).
                                                                                                Med/Surg
                                                                                                               Corresponding decrease in expense expected over next 2-3 months as instrument have 10-20
                                                                                                                                uses before requiring replacement.
                                                                                                               Intuitive Surgical robotic surgery consumable expense exceeded PY by $106K on 58 additional
                                                                                                                                  procedures (91 vs. 33 PY).
                                                                                                                 Drugs that saw a significant increase over PY included antineoplastic agents ($568K) and
                                                                                                                                   thrombolytics ($124K).
                                                                                                  Rx           Decrease in expense was noted for antirheumatic agents ($185K) and hematopoietics ($51K)
                                                                                                                 At St. Elizabeth's, TAVR volume was in-line with budgeted expectations, no Intuity valves
                                                                                                               installed vs. 3 ea. PY ($36K impact).  ICD/pacers exceeded budget by 18K on similar volume to
                                                                                                                          PY.  Two SICDs were implanted at a total cost of $52K
                                                                                                               Boardman continues to experience total joint savings comapred to prior contract as evidenced
                                                                                                 Implants
                                                                                                                      by average total knee replacement expense of $3,858 vs. $4,330 PY
                                                                                                               Spinal implants at St. Joseph's were under budget by $68K (92.1%) on one primary neurostim
                                                                                                               implants for the month.  The facility did, however, implant five pain pumps totaling $47.500.
                                                                                                               $21,425 reclassed from fixed asset to expense - Org 6176 Youngstown Physicians due to FF&E
                                                                                                                                 entry from practice acquistion
                                                                                               Other Expenses  $176K expense related to our exiting the OSC Surgery Center JV - expected one-time charge.
                                                                                                               IV and IV set expense shows a wide variance from budget based on IV catheters and start kits
                                                                                                                           that were previously expensed to Med Surg supplies
                                                                                                                      Actions Taken/Planned:
                                                                                                              Flu supply expenses were scrutinized with portions of late-month deliveries accrued to February
                                                                                                                                       expense.
                                                                                                               Blood transfer expense booking, St. Elizabeth's to sister sites is under review as current process
                                                                                                                          frequently results in wide expense variances by facility.
                                                                                                                         Medtronic DES trial is underway at St. Elizabeth's Cath Lab.
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