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Key Performance Indicators  Metric  St. Elizabeth Youngstown Hospital  % Variance -2.0%  $29,056,687
                                  Prior
  Budget
            Variance
 Actual
                ($418)
                            0.0%
   $7,443,118
                                   $7,621,376
 $7,443,536
 Supply Expense
 Net Patient Revenue
              ($595,380)
  $30,267,450
 $29,672,070
 25.1%
      24.6%
                                      26.2%
 Supply Expense % Net Patient Revenue
                            2.0%
                 0.5%
 Supply Expense per EIPA
 $2,418
                                     $2,523
                 ($25)
                           -1.0%
     $2,393
                                      1,626
      1,625
                  11
 1,636
                            0.7%
 Total Admissions

 Total Patient Days
      8,032
                                      8,243
 8,564
                            6.6%
                 532

                  (32)
                           -1.0%
      3,110
 Total EIPAs
 3,078
                                      3,021

 IP Surgeries
                            6.7%
                                      284
       313
 334

 OP Surgeries
                                      574
 Total Surgeries
 549
       603

                           -9.0%
                                      140
                            3.6%

       169
 Outpatient Cath Lab Procedures                               215                              290                              (75)  (54)   21 6  -25.9%                              290
 175
 Site Performance Summary
 St. Elizabeth Youngstown's expense arrived at budget for the month at $418 under budget (0% variance).  Net revenue fell short of
 target by 595K (2%) despite admissions and surgeries that closely tracked with budgeted expectations.  The primary driver of this
 variance was Medical Surgical supplies, Blood and Other Non Medical expense.  O/P registrations came in 7.9% under budget while
 O/P revenue fell short by 3.9%.  Supply expense per EIPA arrived right at budget, indicating overall approriate use of supplies during
 the period.  Drug expense exceeded budget by $124K driven by increased antineoplastic and thrombolytic purchases.   Despite the
 O/P shortfall Cath Lab remained strong with volumes exceeding budget by 3% and prior-year by 28%.  Stent expense and CRM
 compared favorably with PY on similar product utilization.  Surgical volume exceeded budget on strong outpatient volume with I/P
 falling just short of plan.   Implants were over budget $24K (1.3%) on the increased volume, while the facility was able to hold the line
 on MedSurg spend, with this expense expense coming in $82K (3.4%) under budget.  TAVR volume (7 procedures, $228K)  was in-line
 St. Elizabeth Youngstown Hospital Leader's Summary
 with recent volume trends and exceeded PY by two ($65K).  Implant Other exceeded budget by $53K, mainly driven by CardioMEMS
 ($39K) and Occluder PFO expense ($20K) as well as three EVAR/AAA procedures totaling $62K.
 Key Challenges
 Significant  increase in Intuitive Surgical expense compared to PY ($69K vs. $36K).
 Corresponding decrease in expense expected over next 2-3 months as instrument have 10-20
     uses before requiring replacement.
 Special Procedures up $87K on several high-dollar treatments/devices including $48K Sirtex SIR-
 Med/Surg
 sphere radiation therapy (consider coding elsewhere) as well as 11 ea. ($31K) in EKOS catheters
 Drugs experiencing an increase in utilization include the folloing: Herceptin (antineoplastic, up
 $206K, $0 PY), Activase (thrombolytic, up $99K, 642%), and Neulasta (hematopoetic, up $11K,
             12%)
 Rx
 TAVR volume 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
 Implants  Average stent cost decreased $144 ea. vs. PY on improved compliance with the Ministry's
 contract strategy.  Abbott vs. Boston Sci market share is 82%/17%
 A $31,500 AAA case was performed - case included a rare hypogastric component.
 Reimbursement for this procedure is under review.
 Laboratoy supplies exceeded budget by $75K on flu-related volume increase, Austintown ED
 came in $24K oover budget, Microbiology $28K over, Chemistry $18K over).
 Other Expenses
 Out of period expense of $25K for Linde bulk O2 invoices.  SEYH Respiratory Director retired in
 late 2017, some invoices in the transition not processed.
 Actions Taken/Planned:
 Medtronic DES evaluation is planned for 2/1 - 2/14.  Physicians are engaged and actively
           participating.
 Working with Strategic Sourcing team on impacting price of the approved clinical trial of the
 Vigilant X4 device.  Cases held pending Ministry-approve pricing.
 Reviewing utilization/inventory levels for daVinci disposables as well as account coding: 2018:
 $29K Endomechanical, $28K Instruments, $12. K Med Surg                                                      2017:
         $36K, all to Med Surg
 Reviewed Red Cross blood handling process after extreme spikes/credits in expense were
   encoutered throughout MHY in Q4, 2017.
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