Page 89 - Mercy MOR All Regions_FinalwithVideo

Key Performance Indicators Metric $2,648 Lima $2,227 Variance ($421) % Variance -4.5% $2,139
Actual
Prior
Budget
$7,734,415
-13.6%
$7,122,188
($1,048,944)
Supply Expense
$8,783,359
3.5%
Net Patient Revenue
$1,564,593
$40,936,464
$44,714,858
$46,279,451
17.4%
9.8%
Supply Expense % Net Patient Revenue
19.0%
17.3%
1.7%
-18.9%
Supply Expense per EIPA
1,778
1,688
1,711
67
3.9%
Total Admissions

7,783
Total Patient Days
7,275
7,177
7.0%
508
3,317
(156)

3,330
3,473
Total EIPAs
IP Surgeries

0.9%
1,045
9
1,040
1,031
OP Surgeries
1,307
(63)
-4.8%

1,318
1,244
Total Surgeries
161
171
Outpatient Cath Lab Procedures 204 276 (72) -26.1% 273
112
(10)
-5.8%

Site Performance Summary
St. Rita's is over budget by $1 million primarily due to strong volumes in cardiology, spine and orthopedics. These three service lines
account for $817K of the overall variance due to the need for the high cost implants and supplies for the procedures. Cardiology
accounted for a total of $421K of our variance with a 44% increase in Cath Lab volumes ($22K), Impellas ($70K), and Endo AAA ($41K)
making up $133K of the Cardiology variance. Then, new Cardiology procedures like Neuro ($129K), Watchman ($108K), Aneurism Coils
($31K), and CardioMEMS ($20K) contributed the remaining $288K to Cath Lab supply expense variance. Spine volumes were up 44%
contributing a total of $248K to our variance across Spine Implants and Implant Other. Ortho/Total Joint volumes were up 82% ($62K),
and we continue our recent strong revision volumes as we did 6 in January 2018 vs 1 in 2017 ($69K). Flu-related expenses added $100K
in variance across Medical/Surgical supplies ($20K), IV supplies ($16K), and Lab Supplies ($65K). Last, drug expenses were over budget
by $132K due to heavy utilization of oncology drugs vs prior year.
Key Challenges
Over budget by $230K.
Cath Lab- new Neuro volumes totaled $129K, primarily 7 Solitaire Revascularization Devices
Med/Surg ($46K), 7 Emboshield ($10K), Lvis JR Intraluminal Support ($22K). Incremental Impact: $129K
OR- IOS negative variance ($63K). Purchasing own perfusion supplies ($16K). Megadyne
Lima Leader's Summary Rx Higher oncology drugs utilization in antineoplastic agents ($284K) and hematopoietic agents
transducer pad replacement ($13K). Increased urchin positioners for open heart cases. ($6K).
Incremental Impact: $104K
($120K).
Cardiology Implants over budget by $110K. Used 5 Endo AAA Stents ($41K); Cath Lab volumes up
41% ($22K); EP case mix required more loop recorders and leads ($47K); Open Heart Volumes up
181% ($25K). Total Impact: $135K
Spine Implants over budget by $135K; Spine volumes up 44% ($178K). Ortho Implants over
budget by $76K also driven by 82% increase in Ortho volumes ($62K). Ortho Revisions continue
strong volumes, up 500% over PY ($69K). Total Imact: $310K
Implants
Implant Other over budget by $482K. In OR, Spine volumes drove increased tissue use ($70K);
Specialty Podiatry Implants for one case ($23K). In Cath Lab, strong Cath volumes ($22K), Impellas
($70K), and new service lines for Coils ($31K), Watchman ($108K) and CardioMEMs ($20K).
Stryker coils incorrectly classified as owned ($75K). Total Impact $419K.
Dietary expenses over budget by $61K. Pending feedback from Nutrition Director.
Other Expenses IV expenses over budget by $43K. 15 skus formerly charged to Med/Surg ($27K), Flu ($16K).
Lab expenses over budget by $52K due to additional flu kits/supplies ($65K).
Actions Taken/Planned:
Multiple Journal entries correcting errors, totaling $232K in corrections
Met with OR leadership on instrument spend. Well behind Joint Commission requirements on
instrument flashing, requiring more instruments. Expect variances of $15K per month through
Q1, but replacements should be caught up in Q1.
Met with OR leadership on podiatry spend. Pending final reimbursement numbers on multiple
cases. Will finalize plan accordingly.
Tracking CardioMems reimbursement. Pending final reimbursement and will report to Cath Lab
leadership.