Page 102 - Mercy MOR All Regions_FinalwithVideo

Lorain
Key Performance Indicators Metric $1,139 $1,325 31 % Variance 13.5% $22,632,000
Prior
Actual
Budget
Variance
$3,964,107
$3,710,590
$501,242
Supply Expense
$3,209,348
Net Patient Revenue
$24,953,270
$22,285,639
($2,667,631)
-10.7%
Supply Expense % Net Patient Revenue
-3.4%
14.4%
17.5%
-0.5%
14.9%
$186
14.0%
Supply Expense per EIPA
$1,432
1,018
1,064
3.0%
1,049
Total Admissions

4,661

4,781

4,797
-2.5%
Total Patient Days
(120)

0.6%

Total EIPAs
2,768
2,818
18
2,800

98
IP Surgeries
OP Surgeries
703

705
20
2.8%
-2.7%
843
844
821
(23)

Total Surgeries
(6)
-6.5%
86
92
66

Outpatient Cath Lab Procedures 723 140 (42) -30.0% 138
Site Performance Summary
January 2018 began with very high admissions and census which continued for the first two weeks and then dropped, with admissions
ending 3% above budget. ER visits ended 2% over budget. Much of this was driven by the flu outbreak which in turn, increased
consumption of lab testing and PPE, totaling $24K. The market ended $500K below budget due to lower volume in procedural areas:
Surgery 30% below budget IP cases, 2.8% above budget OP cases. Surgical procedures were up year over year in spine, general, podiatry
and urology. Of note in the surgical area is that a neuroscience center of excellence is being established and we expect to see continued
increase in that area. Additional neurosurgery instrumentation was acquired in January for Dr. Yoo. OP cath procedures were 6 % below
budget but 23% over PY EP procedures were 8 below PY creating a favorable expense variance in the CRM line. Another contributing
factor was $135K of rebates earned in 2017 and applied in January (111K over budget). Other areas of note were in facilities, wherein
we experienced several roof leaks, steam line problems and pneumatic tube breakdown. This drove a supplies maintenance variance of
$19K. Lab supplies were $30K over budget due to both the above noted flu effect and the overall high admissions at beginning of month.
Although RX is under budget, a $341K Prevnar bulk buy was made by the practices to avoid a 6% price increase. This is being spread
forward.
Key Challenges
Overall under budget for the region. Variance in practices due to flu testing acquisiton. Lab
testing supplies in the practices are expensed to supplies med surg which is where the budget is
allocated.
General surgery was up in the market (+13 cases) We acquired additional supplies from XS
Lorain Leader's Summary Rx $341K bulk purchase of Prevnar in physician practices to avoid 6% price increase. RX is still under
Med/Surg
medical for supplies endomechanical but moved them to inventory
Home care supplies med surg are 4K over budget however Home care visits are 76 over budget.
budget for the region, however this needs to be spread forward.
340B is fully functioning
Appears to be no Oncology drug spend, investigating with Pharmacy director. Could be referral
reversal from private Oncology practice.
(+6) volume in fusions and higher Neuro stimulator volume (+4) lead to an 18% budget variance
in Spinal implants. New Neuro science service line being established with exisitng surgeons and
new surgeon ( Dr. Yoo)

Implants
Implant other - under budget, however there was an Impella unit implanted (25K) in the cath lab
and SPACEOAR prostate implants (26K) at the Cancer center. Also a very expenseive Novastep
walking ring- Podiatry at MRMC
Supplies physical plant maintenance - seveal roof leaks, steam line repair sna tube system repair.
Supplies-Lab Heavy ordering due to flu season and higher admissions/ER visits especially at start
Other Expenses
of month.
Supplies instruments - Instruments for Dr. Yoo. Supplies minor equipment non medical - 2
vaccine refrigerators for pharmacy accrued. (both had to be replaced due to high volume of
vaccines ordered)
Actions Taken/Planned:
Supplies Endomechanical Purchased 8K of supplies from XS medical - expensing as used.
Supplies RX Bulk buy of Prevnar 341K to avoid 6% price increase, being spread forward
Supplies Lab Requested move of $20K of expense to move to balance sheet due to heavy ordering
Supplies Instruments Stopped 40K of requests that were capital related