Turk had prepared a presentation for the board on the importance of San Juan Hospital in Monticello, specifically to the residents of Blanding.
“You don’t arrive at that understanding by retreating to the emotional side. We need to be informed by the data,” said Turk.
Turk said it is his opinion that decisions made based on emotions are generally flawed, and the best decisions are those that are based on data. The numbers that Turk presented to the Health Board are based on data he had requested during the last meeting regarding the impacts of San Juan Hospital, specifically on the community of Blanding.
According to his research (using 2010 data), the total budget of the San Juan County Health Service District was $11,102,641, of which $773,734 was a tax subsidy.
Turk added that charity care in 2010 totaled $356,293. Turk said that as a government hospital, San Juan Hospital is obligated to provide charity care. This type of care differs from bad debt, as it is provided to those that have no ability to pay.
Turk said that Blue Mountain Hospital in Blanding also provides charity care, but the amount and decision to do so is the decision of the hospital rather than a legal obligation.
According to 2010 data, 46 percent of the tax subsidy collected by San Juan Health District was spent on charity care. Turk reported that the charity care given to people living in the 84511 zip code for 2010 was only $7,249 less than the total tax subsidy paid into the system by residents of Blanding.
Already in 2011, charity care to residents of Blanding has exceeded the amount of the tax subsidy paid into the system. The anticipated 2011 health service district taxes that will be paid by Blanding residents is $71,050, with the current amount of charity care given to citizens from January to June being $86,881.
Turk said that if the trend continues into the second half of the year, charity care for zip code 84511 will exceed the tax subsidy paid by Blanding City residents by nearly $100,000.
In addition to the amount of money returned to Blanding in charity care, Turk pointed out that in 2010, the salaries paid by San Juan Health District to residents of Blanding was $1,580,899.
“Residents of Blanding City will pay $71,050 in tax subsidy for the San Juan Hospital in 2011.
“However, the economic benefit coming to Blanding from San Juan Hospital includes salaries of $1,580,899 to zip code 84511, which is properly compounded by an economic multiplier of 1.67 to understand the full effect – resulting in an economic infusion of $2,640,101 into the City of Blanding and its inhabitants. This is a return of more than $37 dollars for every tax dollar paid,” said Turk.
Turk admits that data does not deal with the “philosophical underpinnings that are involved in the decisions of whether to tax or not to tax, or how much to tax”.
Turk mentioned the debt load of San Juan Health District to the Community Impact Board, which is equal to 19 percent of the 2010 budget total and suggested that the San Juan County Health Service District should cautiously consider any further debt.
In his closing statement, Turk referred to a phenomenon that is referred to as the Lobster Barrel Effect by political scientists. The basis of the idea is that lobsters can be kept in a barrel without a lid on it because individual lobsters try to get out by pulling other lobsters down.
“The result is that because they don’t cooperate they eventually all end up on the dining table,” said Turk, “This concept can be extended to communities that don’t cooperate, but instead spend their time pursuing their individual aspirations.”
He recommended that San Juan Hospital and Blue Mountain Hospital move away from a “lobster barrel mentality, and learn to cooperate and to collaborate” in order to provide a more improved health care system to the citizens of San Juan County and enhance the local economies.
In other business, the Health Care Board approved the issuance and sale of $400,000 in lease revenue bonds in order to purchase equipment including a laparoscopic camera, anesthesia machine, auto clave, bone saw and drill, and cardiac telemetry equipment.
Lyman Duncan presented the Board with financial information. Duncan reported that patient days for August are down in 2011, as they have been in each month of the year so far.
He said that some of the decline can be attributed to economic trends. Duncan said that they are seeing less illness in the clinic, and reminded the board that the swine flu in 2010 contributed to higher numbers.
Board Member Gail Johnson said that there is more to consider than how many people are filling beds in the hospital, and the financial statement shows a better picture. It was pointed out that nationally and at San Juan Hospital, the trend is turning to outpatient care being the big economic contributor to hospitals.
Duncan said that in August, San Juan Hospital showed $1,213,000 in revenue, with all areas bringing in more revenue than budgeted. The most significant is outpatient care, with $170,000 more revenue than budgeted and the emergency room, showing $74,000 above budget.
Duncan was asked about the amount of cash on hand being lower than the national average and if it caused him concern. Duncan said that with the equipment and doctors the hospital has in place that the “future will be better than the past.”
Duncan said that the district has gone through some really hard times in the past several years, but felt they have more control of their destiny than they did in the past and he is optimistic for the future.
CEO Phil Lowe pointed out that the district will receive a check between $700,000 and $800,000 in late November, so the picture will change drastically overnight, bringing the cash on hand back in line with the national average.
With a total revenue for the year to date of $9.4 million, Duncan said that they are on pace for $14 million in revenue for the year. Lowe pointed out that would be a 27 percent increase over the previous year.