Health Care District discusses property taxes

The property tax received by the San Juan Health Service District has been in question lately and was discussed by the district board at their April 19 meeting.
“It’s not a good idea to take away the tax,” said District CEO Phil Lowe, who reported that losing the tax would take 9.5 percent of the total cash flow.
In just a few months, Lowe reports that the district would have a hard time making payroll. Lowe said that the district puts nearly $4 million back into the county in salaries every year.
Several board members expressed concern that the tax may not be necessary if Blue Mountain Hospital was more interested in keeping money in San Juan County by sending lab work to the hospital and using the surgeon at San Juan Hospital instead of sending their work to Salt Lake City.
Board members said that there are many circumstances where the two entities could collaborate, but they don’t. They added that there is a need for the two entities to work together and find ways to keep money in the county.
Board member Steve Simpson said he disputes the theory of an “even playing field” existing between San Juan Hospital and Blue Mountain Hospital.
“If they are interested in playing on this field, if they would like to keep money in San Juan County, they should be using our surgeon, they should be sending us their lab work,” said Simpson. “There are all kinds of ways that they could sequester that money here in San Juan County instead of sending it to Salt Lake, which is what they are doing.  They are a huge hemorrhage when it comes to losing revenue in this county.” 
It was reported that Blue Mountain Hospital uses Eagle Air Med to fly a patient out almost daily, often for cases that could be treated locally at San Juan Hospital.
The board discussed the charity care program the hospital provides. District CFO Lyman Duncan said that the charity care provided will be around a million dollars by the end of the year. Duncan said that the program is running well and is good for the district and allows them to provide care that is needed for county residents.
“We are an importer of medical dollars from out of state and from Washington, DC,” said Duncan, “and that’s a great scenario to employ San Juan County residents. It puts us to work and gives us benefits and opportunities.”
Lowe said that as a safety net hospital, the district has an agreement with the federal government that their door is open at all times to all patients. He said that if that were not the case, the Federal Health and Human Services office would not reimburse the charity care. “We have that role and that mission and it has worked out well for us,” said Lowe. 
In other business, Lowe reported that of 187 visits to the ER in March, 40 percent came from the Monticello area, 39 percent from Dove creek and areas east, 11 percent from Blanding and areas south, and nine percent from La Sal and areas north.
Duncan presented the financial report, showing 140 patient days for March, which is up from 137 the month before. Duncan said there were 481 bed days from January through March, which is up from an average of 300. Board members said the number of bed days clearly establishes the need for San Juan Hospital.
Duncan reports that “swing bed” days dropped from 15 to 3 in March, but is going back up in April. March ER visits are up to 187 from 142 a year ago, with 483 ER visits for the year, which averages 402. Ultrasounds were back to normal at 75 in March, up from 45 during a slow period in February.  CT is above average for the month and the Lab was up to $209,000, up from $146,000 a year ago.
Duncan reports they are well above average since the new lab opened. Duncan added there was nearly $1.5 million in revenues. It has been several years since they have seen that kind of revenue.
Duncan reported that with increased use, the salaries and expenses go up. They are $110,000 higher at $1,008,000. Overall, the district reported a net loss of $62,000 but with the property tax subsidy of $64,000 there is a small net income of $2,200.
Year to date, Duncan reports $4.367 million in revenues, which is $251,000 higher than budgeted and with salaries $120,000 under budget. Year to date shows a $559,000 net income with the property tax subsidy. The budget predicted a $31,000 loss at this point in the year.  
The board received a report from Quality Assurance Manager Colleen Shinkle regarding surveys of impatient visitors to San Juan Hospital.  Shinkle said that she attempts to call all hospital admissions to check on how they are doing following their stay in the hospital and ask about the quality of care. She reports that in more than two years of conducting surveys, she has never talked to anyone who didn’t like their doctor and has had no major complaints from patients.
Shinkle reports that personnel are a huge factor in people choosing to come to San Juan Hospital. They report being happy with the way there are treated and the care that is taken with them. There is a great deal of patient satisfaction that comes from the personality of the doctors. Patients from Colorado have referenced continuity of care as a reason to coming to San Juan Hospital. They enjoy getting to have the same doctor all the time who knows them and their problems, which has changed with Southwest Memorial Hospital, where they never know who is going to treat them.