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HomeMy WebLinkAbout1970 f AFM r y .44 rrr Fl? /N - -'~"a x- IY/ ra*-re- "rV F04 Rid?-/PA/ r~N Irl-, 4JGt1 h dN I ~?.*A1 11'e' /VAIN TO ' 4~ 0 UA) L, 1~ 1NP 7-1.1 k- 4 741440. q 74 .y I I I i 1 ~ °SVi'eiL• YIkM~'l~ty 4lfFr.n.,.... ~ r i MUM M a „ ■ s k SCMB THOUGHTS ON Tiix HOSPITAL EITTUATION (Hugh M. Ayer, January, 1571) The financi.sl probtema of Flrw Memorial Hospital must he resolved, ! The idea of the county slid City of Denton being without a hospital is eisply ineoneeiveable in thin age, Mors money for the support of the hospital must be made available, and this means that it must come from the poop'lr vbom ` I it serves, There arc several different ways this money might be raised, and I e number o£ them have bean sug,;coted in recont wooks by various individuals j and the press, The problem, than, is not whether eha money will be provided i j but, rather, what is the most equitable means of providing this money, to approaching Chia problem Wo basic thoughts should be kept in mindt (1) Flow Motrarial Hospital is available on an equal basis to the aitimens 6f the I entire county. (7) The residents of Denton are also :.itisoms of the eoutaty# j $ Amot>g the tugReetlions for xaselving the financial probterw of the hospital at# the do•hlgnialt (1) TIM adtabl iahwot of h ke"t al district, 3 { This Woull regoiwt VM4 spptro►Nl ot; a maj#rity of the, "it" "d has •le"Ay ~ boost Or xd .004 eaiWs t s4kiavsly doOU that "obhrr Vito at this sign would i resale iii tFstiffet"t setsegoo6 Thuer, the eatablishowt 61 a hoapitak Aietriat { at the aurto k tai gow not to, },w a feasible 4006604 (1) Payammu by F ~ the doctors who utilist the facilities oe the hospital.. whether this it a r I feaeibls anal ounsonablo ppc•p~oeal 14o noc kn.uw. itowavar, I.feet that tt to t worthy of inVeeti8otion, In phis connection I would like to :snot.-, for e;ratopl,a f J I , whethOr this is common practice in nkhar similar hoapitaln, and if so how stuoh : I revenue might be voal.i.aad frow such on aprror.ah, (3) Additional financial support froto the c,ty o@ Denton. At thin juncture the city does not have funtle avoilabiM ,Cnlr this purpose. 1. sizeable city apprypriation to the uupport of the ho►,pi Al would require either a si,ntabla worease in city taxes or a • r> 6~Yo'dY}bN~k{~f~6~l5w&.Y+ioiv,•,r.. ~ i 9RM«111.^•+: W 1. 048ni£ioattt reduction ,E services in other areas. It remains to be seen whethor the citizens of DonCou are prepared to taka this Approach, (4) Additional financial support from the county. The county government ornsiatently maintains that it is already vupporting the hospitaL to tha full logal lireit, it is ! my undorstattdip8 that thin interpretation of the law in a local one, that no opinion has ever been solicited from the Scate Attorney General. it should be re-emphasized that the citizens of Denton city are alto citizens of the county and that all ptoporcy owners in the city of Uanton i i1 aeanF 1 pay taxes, Titus a considerable proportion of whatever financial + support the county is extending to the Hospital at the present time dots + E f in o0feet same from the oitisens of the city. Itrthe city i ow' Uonton were to make on additiotwtl aoatribution to the hwpital them the oitioioms of the pity would in effsat be raying twice, par this resscn Y i I ! fee ,►;hat the ohly agmitoble approach to the finenoi of t ~ ~ he hospital is at the county-wide lsvrl, Let us remember that in appro"hing this problem f the pLtk*ry nonoern is not which government will provide the Eunds but ~ f r44has which epptboaah will provide the most equitable solution from the f standpoint of x11 of the citizens receiving Aarvica frdn the hospital, Wore any decision is stida on this importnnt matter thorn am a number of questions than used to bin raised and answered. (1) Nap the county t } government ever asked the pbato Attorttoy General for an opinion with respect to 14841 UmitatLolls, :;span -,j authority to provide indigent core? My undorstonding is that this has not been done, despite the fact that at a faint seating of the City GounclFthe Commissioner's Court nearly a year ago the porpmieeionsr's pourt promised to do so# (7) What pateentaga of the county tox revenues its received from the city of »antatt? (3) 'what paruantage of county ton pavpttues are expanded inside the litttits of the pity of Denton? f t yfj.y` yYYjj.. ,AV.'/~}): 1'igm aV: •r!YH . n_. Y.H. r1 n4 H JW Y r •a, ns~ ; j E ' J I (4) What percentage of the patiante gerved at Flow memorial Hospital liva outride the limits of the city of Denton?' I t ~ j t i ! 6 ~ fff f j j t , 1 j 5; ~ I 1 l+ r51 Ill Y.. If y t, cr I 1 r ! ~ tl' 1 f,r I 5 fl kr. r ~ 1!I I ~ a & L1' MfYgYC.~Fir)~'~I`K}5/F ✓ryrIVGL}NYlYOE~n;4 ..r., ~ t t ( n4.+.WNJmfMN1MHY t •iwyawq Krsre•- j Re Oita Ownty Support of Hospital* i ' ? Y. On 30«30 baaiel Cityl $155,000 + 40,000 $9.87 per capita i, Cuuntyl 1330000 + 76,000 per capita _ZLQI f Total for utty roeidcnte 7 per capita ! 116 On 40.60 baei,el r Cityl $124,000 + 400000 w $3.10 per oapita County I 186,000 f 76r-W " , par Capita f Total for city relidlntu ,-Off per capita J i, . t ~ f j xxz. On 33075 bloter Cityl 4 770500 + 40p000 $1.94 per capita do"Ay4 MOW # 760000 • total for city reatdents rg per *apt" pot Capitta No on 0«100 baiial i 23, $310,000 76,000 a 44.06 pax oapita for ,#U eot residents t, r~ *Ftswr6s baled on following) Hospital budget need of $310,000 i $4 Clay population of 40,000 3+ County population of 160000 vR ilk a 1 , , ll ' f it , l J i 4 i F 1 _ / r..i.fir.In+lty7lhilWt4'tf$;~111vF~:uar.Sav.~ur r., „ .7,., _ ))vas, ,v k•« 1 j I:r 1. (prepared by City Attorney, 1971) , At a very early data in the history of the State of TaXYa, the i ~ . Indigent in'Tezas "is Primarily a problem for Churches or private obaritieM , and relief was O von to the poor by there organisations largely in their f r a+rn hater, With the sharp rise in indiganoy following the Civil War, there vas the growing reeogni:ton that in puny oases private charity i was insufficient and with it grow the ides that somo governmental unit i should be teepunrible for the crra of the peer, The most logical unit. ' F in on agrarian oivilixation was the County, and the County Poor Farm was in Texts the first and for many years the only public charitable institu- tion, Such lbor Form has been gserifY exPrndn,l, and this authorixatian MIN today the OR 11 through which the Logisloeuri has provided for Ahs support of paupers end indigents within the state of Taxes, Article Y"' I ldl parse 4 4onst, of Tsxaso 'no Article ld section 9 of the Constitution of the state of Texas ' provides tor"the supplying of the wants of its indi nt sod r Re poor inhao ~ ==f. bitents". dwoh constitutional provi,aioa further ou ' thorieas attendaaae ~ i r to the wants and needs, "Lit such manner as may be oubeoribtd bS, law". f In response to said direction, Artlole 2,951 of Vernon's Anno6kted Civil Statutes wits ariaated by the Legialature, which anunaratsa the f . F specific powers antrustsd to the Comissionara' Court. S-abdtvlsion U of Artiio3n 2951, requires that the County Coasisol,onora+ ' provide for the support of paupers, residents of the County, unable to support thamsaivoo, An enlrly 444e defines the term resident to mean a person T,iho has boon a bona fide thbAbitant of the Couni','y not less than sLx months and of the a r ~ ,aye, 113A b I~ gtste not 1080, then one year, And, the term "support" used in said nob. division, paeans all that is necessary to bodily healti, and cowf.,,;!-, and i eepeeinlly to include proper care, attention and treatment during sickness, llonghon v, Vanzandt County, 3 App. C.C, Para, 198, The cars further st4tes that whore adequate provisions had nor been scads by the Copminsionrrs' Court for this purpose, the County Judge or any other Member of the Court could by contract, bind the County in any reasonable rue necessary for ~ i i the support of the psupor without a pravious contract, Said support I ` included professional services rendered by a medical doctor. t4oaghon we, ' R Vanitandt County, 9 App. 040, section 1584 :Although it is within the sound discretion of the CommigaLonarpt f Court to datomins where aedioal aid and medicine will be furnished to paupers snd the spanner in which such ewdioinee and all will be dispensed, (Opinion Attorney Mneral 1941) there saesas ~ 'little doubt froal earl y 8800 LOW that said Court was endowed with the full responsibility and obligation ' for the support of resident indigents, Further, Article 4438 of V,C,g, provides for the care of the indigent ' sick. 141E there is s regulery established public hospital in the County, the Comiseionses' Court shall provide for rending the indigent rick of ! i the County to the hospital. If awre than one such hospital exists in the County, the indigent patient shall have the right to select which one of i them he shall be sent to." "*tin# from the oos# of lfiliegg aM w. v'0,, 111g% Adgt&I 9"YLU10 at all 20 IV Rd 08, (19)0) the Court iodiat, plainly irpplLed that it is f tho duty and obligation of the Comaaia4ionars' Court to send the indigent sick to public hospitals within the County. Andp had there boon a public i hospital in Killacy.Courntp, and had the indiganoy facts in this case been A different, than the obligation for Willacy County to provide the indiganoy i -IT, NOR :es T ItAd,Y,r IJ1N&fP i y services would have boon present, 'the Court further indicated that the liabilities of counties are fixed by law and cannot be extended by the Court beyond the plain authority of the statuts. ' j (At page 4581) i This indicates that the statutes above stated, obligating the County to provido madioel aid and support for indigent residents are certainly plain on their face and obligates the County to provide said support, f Further, the Attorney General, in its Opinion No. V, 608 (1448 has ~ providad that hospital aid to the indigent sick of the County must be j ff paid out of general funds and no other fund, , Certainly, sanst public hosp£tala in operation throughout the State, ; j because of the ovsrwitele►ing cost of providing indigent care and support i could not woet their budgeto without this assumption of responsibility 2 by the counties. Sn fact, mane of the public hospitals could provide ' only a M tl at►nunt of the £nd.lgant care and services roodored Mitbout f indigent support from Goverutseatal Do4ies. ~~f l SSA OVU 2g4 (1%2)o E I I, qtr. ~ F JI , , " t j 4J I S 1 s t I r 2 i 1' 'V .Vf77i'pR"'l(~WY/rW.I~'sJM:KY4tisN utfr. - y~r 1 n I aw,w I o+v..n. x CITY OF OV14''VON 1*240RANUUll E, e r ! I DATE' 5eptombar 29, .19%a TO { Mernbars of, t}to City Council r FROM s Pnul C. Tshant l ,i' IUT3JT:Cl'= E4c~lio~al. Caa:o of CouuL,y Tncl.tr.Jentr3 j kt , . I ~t AttacJtrucl is the itt£ormv.t L-J.on Jerry Cobb rr-.ce.ived from 'the Attorney stt Genort:l re('7arding tho roquor,t for an opinion on tba liitb.i.lity fm tC~.;'. hoopiL•al care of rosident incligct,tts. 1 IA t 't a After rovlowi.ng th(! opitiion:s Snr)t to Jorr'y Cobb, x an} ,;till of the opinion that the Conmtisniuner.s Court of Dk,tton County i,n ronpon- t raiblo for rnocl,i,col corn, of reaidont indigents! t s~ y' Ca! F PCIs 1, l r r„ r ' ,,41!1 r ,h a 7014*iE*alraka'ltlkhr.'Yre~w::arr,.>•. I a ; ,~51r;i 1" 10"c 'i'he Attorney Gencraf of Tet-i sor~t.r, rohor .19, 1978 ri JOHN L. HILL AItorm,y Gnilsrml Mr. Jerry Cobb A Upremo Courl bulldima Disstriat County Attornoy { P.O boa 12346 P. O, Box 71.8 Denton, Texas 76201, d Dear Mr. Cobb: 701 Coniinorco, Huila 200 nau,r4,tiiz.2;,za2 x have ] ooeived your letter, reSueNtin s" 2t4r'r4z•E9an an Attornoy G ~nersal Opin:lon on the liability f of the Commissioners Court of Denton County 4e24Nbo,1a Avo.,suuoM for hospital oaro of res,ieleant insligerits. t to Paso, U. ze,cs olsrsa~•s4a4 in reviewing our files on t:hio subject, it appe:axs thtit we may have sevoral opinions r2a~tnin,s,lroato which addreus tho i,sssun £taid may make the slousio•.,~< ~rou2 issuance of a now opinion unnecosuary. I ` t 1`; . r,arzze•f,,'::I arm enclosing copir.s of Attorney Genera]. Opinions ` Nos, 11-703, M-1711 C-334, 0293 and S-126. } eoetaro,cv;ay,birnoala Some of the later opinions decal with ra county's L LUt ,k,ak.rs,o, rersponsibility When there i.s a hospital dlnLrict 1waY4r•5aa4 in t;hc countyr but ass x understand your aituat3.un there is no hospital dirtxict involved and ' 4; 4313 N,ronlr,,suneP lnnguago rol a'ting to the hospital. district +n,; sncnuen,rx. 6501 ansoming full reaponsibili.ty for medical care a,2isaz•4s,: would not h% applicable. ,f X. hope referonco i:o these opinions will ' s 2a0 Id,11n hazo, Sulto 400 r bnnAnlpnlo,7X.782p5 ans fiver the quantion and will, provide an oxpodi- W429.41a1 tious sollation to the p.robl.ew.", f furta'soa: xI action in nooded, howover, p dano lot us know. fry' k46+, An Fnualopporlnmity XOlsra O7.P 1y f AMIrmatlvoAcllon Emplopt rr, t?atioft lioatlt, eh=airm n Opinion Committee ti';` Cuts/mw 1 onclossurnos C•.293, H• r03, M..1711 r,:'-3341 5-'126 a 62 i r tt f"~~Fl Td 5 ii'i M 1 F. tai Fi; ~ 44~±it , r11' 1 waat r `4- 3 r ~ t 4 n, . 1 Nl tj''~~y>~i ~i'~h~ VJ iOJ~~~~l1i .ir>.\!~•.r; ~klJ~t'~.wil~i,.lr i•S. li~l :i.l~V )I)~:I:i.,'\•~.1 1 lfY11{i;l11'y1:1~ f7,~,a72t LRY1Ni'x'I(:N ~l.r 'lt'ii::'C.l.li I,tr. # Augu»t 111, 1964 Ilonorablo Ronald D. Stephens Opinion 140, Cw 293 County Attorney z Young County Courthouria no: Authorl.S;y or tr,c, county (~rahari, 'Pc,xars to 1"'MiSh npocial modlcal attention inthe trettt;mc;nt , >7c tr I1r, S1 ephonss of :trsdigent county xkioidants, I You have ,roquosted an opinion ;Lrom t,h office upon 1 the following goebtlonj s irl, IS t}te County under a duty asi{3 aathorized to omploy opeoial.istr3, riuch au a nuualo'-surgoon, :Ln the troatmetit of indi gent ronidont:j in the county? t t y "P. In the County authorized to tic-ouro the Korvioe[s of a rsouro-sur, goon who px'aotJ.cen i med;loine outeitle the oounty and-have the timi >o-. t surgeon Pe:vform oorvioes in ti pub'lio hospital 1 i5r I within the county where the indigent resident i•o rsid t~ e Y n l Artiolo 2351) Vornonlo Civil, Statutea reads in part i an followss riEmoh oomm.14oionero oourt ehall s ' n E ;'].l, provIde for the Bupport of pauporo 1 and r;Jr.>ah blots and lunabioNl as attnnot bo, ad- mitted into the ltsnat:la w4ylmq, rooictetztn of tt' ' their county,, who t,ru unablo to sbpport thrinl solvos, By tlio Corm ros:tdent nr+ used heroin) ~ ~t r 1' in meant a person who htts boon a bona f:,do ~ inhnibitant of tho county riot "Loorl than oi:c ' montho and of tho sta,to riot 10ria Winn one y u t c' . p S, ! r I `l t I+ `nil' Zvi} 1 Yl1fiSMF`h ~v. ~i 'ti l: 's f x i f , • Hon, Ronald n, Stophet,s, page 1 (C.•293) )3y the terifl "r+upport" i a, meant more than rruppl.,yinft, N food, clothing and 19.vinG quarters; it moano all that L.~ nercon•' wary to bodily health and oomfort incluclln3 proper care and treatment dttri.ng aiclcner~s. Mor,ghon v, Van %andt; Counl;y, 3 Willson Civ,Caa App., sec, 1135 t?~FIBF~Jj - auporn.. Section 3, p', G2Fi. Thus, a county, acting through itrs conm:lssionero court, it, under an affirmat. ve duty to properly caro for i;,s iiWlgent ci.t:lzonn. F,lirther, the case of Galvoston County v. 1Xw1e, 91 j Toy., 665, )15 S. 14. 796 (.1898), ho`!.%ftt"~iZ A'"coir,ii17w; orir;rs'court• may contract with a physician to phrfo m modical. servides on aupers vors:ldi.nl, in the county, No ai.1 to ooo arty die+tiricti.on f etwoen empl.oy:ing a physician and employing a nestro -sue. Gaon ab I i long as the Bervicors of the doctor omployod are neee:'nnary to raaintRin brie bodily hr-alth of ;lndigont reaidonto of 4hei oouDty, Irkierofore, we answer your firr,t question -in the ai'fi.rmati.vo. I In order to furnish proper treatment for certain r indigont ai it may become noocrsrsary f'or a county to employ spocial113tn.• such as a nouvo-tsurgeon. We fool that the place of residence of the phyu:io•lan is irrelevant as long, ass his ner-• (t vionn are nocanur.y to preserve bodily hoalth of the ind1gent . o:ltizeno. Therefore, your second question is also answered in the affirmativo, s~`, I 1 ~s~raMn~ The duty or a county to furAlsh wodi,oa,.1, oare for its indigent residents i.ne'ludos the Yc duty to employ medloal specialists when neoes sarv; such speotalinto need r!ot be rosidonts of 00 t ~~f I the county. P l,~j{ ,L I E!I ~ tf :e I Very trilly'youi•s, WANOWEP CATlit Attorney c;enei al. 1 ,yt B, Lawronco Merriman Are atant " BLA4 mt:ri t f f j f , f I+ Y any ~ „ ee y 1 1 tog MR" { l }Iona Ronn7.d I), Stonhomi q f- r, APPROVED: OPINTON COM• ITITul; l W. 0. Shultz, Chairman { !1 Malcolm Quick } Bob Floc ov.5 f Dob Smith " Iid 1301dAng APPRO 11D FOR '.CIII'sl ATTOMINY GENERA) ~ 't BY., .1 tant,on Stone 1 ~ I i a f ~ 140. ,s E 1. M (1 ~\..'111n )ly l()r}}~.1,.:11n}t'U.l :\)f.1 ?f;lt.1~,)';1'r).r;l~ Rt, :+,f.1'It',1'CV ~~YIf1'd'I;N~ 'JI'i..):.1fi 'dhi"yllA ~"l°~`UIt;\L11' 1f Fly >'71i.\Y, t)aco)i1k,Gr 19, 1967 lion, .7onte:; K. 41n7.1cc r 6 County Attorney .opinion No. t,t-7.71 ierton cin Cc~lltlt.y CourrthcYtlse 12a: Whothor C`ochx't1n C'ourr: Mot t, 'PeXc7; 7Pnrac;, har; AtIttlority to ptly k~llbiiC OtJrlE3rl horlpitalu OU Hi.du the county far hc);tlA tell and nledicra.l horva.cor; zcrncicll od to indirjant ir.habi.tants i I7Oar. Mr. Walker: of ttte county, undOr the oix' ~ r~ulnstanrels r3tutecl, 1 You have roquooi.clcl the opinion of thin off'i,c;r Whether Cochran to C.aultt}~, '('e!xr1r3, an 'nodicatl Cara of an indigont., re,3icanttofzCochran Cotnty, 'POxar1 1 .t1 t~ pulil.in 110.,pita7. out.si.do of Cochran County, %t'caxaS , the creation of the Cochran Memorinl liospitrA1, pirltxic~i ttWl aNO houndclr.ir--.,6 lira co- extansive with tile: boundut'icri of Cochran County, 'Pc.xrtr3, You t'tlrthex' Htate in yol,ty 1.ett',or that a mea- r ical, dcYator practicing in the Cochran Count:•y monlorilll Iloc;~ pittll hilt r0r0inrll0ncic3c2 that an indigent pati.rnt be cant to j the L1'01111 3r;aly 11013pi,tal• for care and ttclatmc3nt whir..h crannot he, ounpliod at thc;1 loua.l hos1pital Article IX, Section 9, of the '.t'oxciri Constitution prOVicle,s as FOl.lb4r;lr Sec. q. I The Legi alattfre Mot by law pzo- F vi,da for the croaLion, ostabl.irihmont, maintoriallae and Operation of hospital d.intzictts onmpo,hd of one or morca countian or all Or any ~ or 111=11 counties with powor to issue bonds f'or' f file plirchasn, conr!truction, tacqui'r3i,t,i,on, repair or renovation of buildings anO improvemorits and otJu,ip~>trlq Rime, for hoopitrai, ptirpoaenf p:rovicii.nt 1 roar tllo trallr;Por 1.0 tho hoapittal, diatriat: o; the tit-10 to zany 1.anel? huild.tngq, 1rnprove)Ite,rit!3 and J r.qu pmerti: loc;'ii:oQ Wholly within the di,str,'ict-which J may he joititiy nr e0l>clrat0+ or t'ount 1 01171100 by any city, dawn ~ y, pa ovicl5 nq ti7E0an c1J ~tri,ct f!n crr.,txtod ~ 1:1t]l rulsiilma f'u17; rrrl~onrlihl:`tX mUc2 (~rl l t sR.J..cti u,7rn oz i l rlnre; Ye)i ~lnf~ tantr anUSLIU( , t.j10 our"E;titncii.ncf`~"ndi~Jatci"cfno~in .tncu>:rec by elitiom, towers and counti,am for ho)a !.%t;a.l purer 1'OUWA pr:to), to the) croati,on or. thra c'ti atzrie!1:, if er ;r,o urn l.octlted wh6l.l.y wit in itti bottnditrA.081 i -8 18. i i r~• 'IVA IA I ))!att. ~resmea K. 4dall:or., pnytl 'r (N-17.1) g ar,~' a pro rata portion of: such i nclobt•.CdnC:'rl3 baSE:<t upon ti,o thun ltir.;+ approvod tax crrr.lc~rsrsment; rolls of the i,11el.uclod cities, l.•aww] anti uvutiiir:rr .if. loom than all. tlu territory thor-Uot ir, included within the di shr. i.ct, hou,idari es . " O_;nlph r;i,r.; Added.? 'Moreaftrr t.hc I,Gcii! 1tit,ure 'pa9 ied )lotwe M' 1 12 ".3 natFt 60th Lecfinlaturo, Regular f)'ession 1967, C'haptor: 494, pago LID (Axt, 4494cf, V,C. t.) , 1:11vam an the Cochran MoI'ar.)1.1 I )lor;p.it:al District )sill, pur.sutlnt to ArtivIc'. .[X, Section 9, and its 1•rortinont•. provisionE; rokl ar; io,llc;wst "SocU.nn 1, Authority to create. Purrtunnt to authority yrantod by the: provisions of Vect:i.on 91 Axtialo, 1X, C:ons7ti tution of the State of Texas, Cochr,m )tcmorita). ltospit:l), District io huroby au- thori,mld to ))c rroatod and Im orated shall have boundaries co-oxtom ive with the boundavies of Coohrt,n County, Toxat•) And pouscass such ri. jhtnj powees, and duties ups ratio horoinaftor prwi(4rihnd. 2, Purpmos; oi', dint:r.ibt. Thu diat:ridt. ~ horoi`rs nuthorizod to be crratecl ohall tak•a ove~))- And thda:o Shall, be tr.ansfurrod to it ti.tstn to all landri, bvildin~js, improvements, and oclui.ixiiont•. in I Emywimo part;aini.nji to the horepi.t'alm Or hospit:rt2 I syMt.urns ol•mac? b C;ovhresn county an( Any City or bi*m i t:he er;tab)'if Lctr the dis- trict, cl thr, t.riotrshall p county,An ro ^ provide "i ^ ti ieftt vii a ~ )tosni.t:nl syytoivi by tho purohasr., m . t ruction, nc•- efutEti.ti,bn, ra).wAr or rcanovati.on or buildin(lra and equipment, and o(litippinct thc, stlmo and the ztdmI.n.- i,st.crlt:ion tho).oof•' for hospital p"j;posr, ss, htt-.h i' d s3trict~Shal.l ElSfSUtnE; fLOl Y`C1t,r)b11~1~.1,t I~h for ,t cwic it%I inOrii; tll: 47wwmi)i t A ("C -o :ox' 3 tf tsuac.y xnhnl,s.itsnfy nn"c'M, l~1' i,k_;slit"o t~icf'oilT.*Iutiil.i.nq ill- oiitc`ilncasg t~ltich Ulicll). have bogs inc:urrod by arty city or town Or by Corhrall Cotint:y for ho6pita.l purposaon prie>.t, to l:ho croat:ion of Haiti ili ntric , 1 ~ 1 Sab, 9. Purc hacko.a and e.ypondit uvcs. .rho board of Oi.roc.~t_ot o ol; rtuc.^l; i?i(Ariat 01,111. havo t ho, www.+.uw.ww .r. . •r r 4.r.w. ..•..w .r.wrJ 1 •A l h' r, A, ; dul "ON1 1 ,I 1 Non. Jame, K. tdalkex, Page 01- l"n) Power {:o plc c cr, i.l~n the mathc,d rartcJ rnanr:F;,r, iii? mrt4 i.n Z purciac;~; an~i c {pcn~i~ t tarr<,,-1.)yy anil t,<ir iiucih. hussJii.~ 5 t,ttl di.atri.at, <~nc~ nf,c slia`ll be authari.zecl to pre•- rsurabe all accountincq and control, p,:uc;r_dtareica anc7 to mraka vocla rr7h<s ctltcl xrqut,ltic,a:rs ta, MAY be cla:frc d : to a r z k T _L Out . L'ne i'ruv n~nn~, c,L i~117;-rct....., a + "Sea. 17. Jet atri.rt a:l.ono to Incu i.ndetiteci- i } n0 s~ for ho<apa t.al purposes After vrc,,ttt,on of.; t'nchrait tdernoriu]. Jloei_t.cal Di.yt:'rci , neithc t <:ochran 9 akiiar Y, ty; x i<i i nor iiny irT" 'oi tsfic~rc~i:ti hha'J l { i Wi;`r c af:t.rr T.-sun bonds or other evidrnros of. r.n= e3ot,teclna r aruv tetxV<s fnr, ho^~>>tu1 Ptiznv_cr3s ax for mct! c:~tT c<+t'cj, fjrict 4he a3:ci'Caahran Mot nnxin-- z o,L~t aS I).a t tr.f of c~ha ll ttrar,ume Fiat 1 rc~rar,nn-qTb ,or tttt, j,nrat ol, q : all Fin<:4L Ea oyIi ca 0Fy ~i tic litxU of MO c fatzl tinci atospi l n]. o4tY~Cwot~, n oil. . i 11 (Emphasis'' nc9dotl, ) zn addition to the above quoted pro\oisiosis, the Act Provides for tale ,tnvyinq Of taxoa not to e roeaci cants ($,75) on tho one Ilundrod t)ollar, va).t~tlti.uts taut:hor.izcs . bonds to La i,s~~ttoc] i,ra acrax'danr:u with general Inif r'or tho ! building of ally Cacilitin naao scary to darxy otitt ttts pttr» i E sea) nt:aton plannor of enyh tlnc; a dopooitory bank for thc~ y d;trity' ictl oxomp,to the boncq' ;rq,tt taxation; cgives power of i ominent., ctomalm; and oroaf:G " Graanaa~orlc for sazacatri.ng patient ;a an indigtant,s, The rarjponraihi:lii.~ats oi' thea cornmi~,ci'onertt court i,n ! Ar.ticlo 2351, vernonIn Civi,l siratatos, and Article 4430, Vcr». nonts Civil. Statutoo nrl. s r now n the d at.~. t eta of Gc,ohr.rtta Mcamot;ital ! Jlospi.tal Dint;rict. Attorney Ctonoral'd Opinion No. C- c t 33~i.' (1;JG4) . 't'he qum4tion tshorofmm nacesonrily ails on a8 to thn authority f oi! this hoopital. dif tr;iat' to pf:y for indivotit Cara 1.11 it publ,io inat:4.tutl,on out:s;ido oP l.to boilnclar,l,cn, oithcr undor i,to ttnnumod powers of tlto domralstliolsoz:;t oottxt or pGWcarrs givort to it Under r~ the. Cor,,t :i,tuti.on and utatkiLe c.i:oat,ing its t f Tho leading case prohibiting tho pnynaont by :om- ' ta,isa ir, nears courts; for modiattl troatmont of an tndi,cgnnt: out- -820- i, pHon. .7~Utte.l l;, t4al.ker, p75Jo C}i.11nr Crnrnt v__ side, of tl e county in rr pr.ivatcl. hos,pi.tal is valley Daptist ticsr_pa.LaJ., ?.9 S.11.7<1 456 (M'ox,C;a.v.App. 1930, no wr',t }ta.rstory) ~~'1'hct CaU1't sP.-.tted on paq OB: n "Under t:hc provision,, of article 4,138, tho county tars under no duty to rsend iiarbos:r to any hospi,tO., the-e k)einq no pulA r, ho"pi.tal. in the i dOnllty, Ethel I,%-,der tho implinr:1 restricl:Son of this p ovision it is doubtful if the county could N' 1 r bourril by tho conuni.ssianers' oourt, cor.:ctinly noi: othexl•lise, to onnd him to a honpit:al, without the county, at public exponso. Dut the liabilitJas of. count:im; are fixed by law and cannot bo oxtenclocl by the cour lass beyond tho plain authority of t:he st Lut:e^; V n.n '1'ho Couxt:'s opinion above not:rcl is colll-.rollinct as to the: intorprotat:lon of the . mi, on tho facts and law ithnt ff,~ word prosdnted to the court at the time of tho declsion. . r I rr It irk our opinion, howovor., t1.1at Arti.clo TX, Soo- 'yt tiou 9, of the Consti.t:uL•i.on liar, enhancod tho poworts and dutios of; the hospital disti:ict, As orposod to the commins:ionerrs o, corlxts, nnn this is carried forward in the erlabl nca lcgisla- 1~1 tion. The po} t inen-L provision of Rri.i cle TX, $Ooti.on 9, J.8 - "thnt an d i F; Lr ict so rr oat cl r.h.ili3 tarssume rue 1 responaib-ilif ~ar ~ss nLLretily ~irti'aE~i ' ' for k3zov c nq In1acl r.~t K1`0 l11'Rottill Par, {3 Ind' 1Yra,a~.s ac~c3ccf Eii,rri 1 rtr finc}tilcait a ^ con- tiiirocl' in E;ect..4on 7, oi:' kt.k3, 1233 }prodicl3,ncj put:pose:s of t.}ut dirstricL, art i:ol.1mm- 5116 ctiot.zicst shall ttfisil'Am fu11 rasspo>7FSi bi.lit:~~ for provldi n; trlrc- ca'L and flu t ct c rtrn i < r _zt c~ ne irk rrll tU3"i'Ant s aclc~a~,.~_ M Sp ecif'im-Al.y, it is our opinion that tdlloll It hnrfpital. district s y i dist..notaosts ; i>7 urz atari it in no lonc,or bound }3Lhi j bc;tweaIs:n pauper, tlrt inclsc~ont t+r,Gy othor rar;ixtaticlla w}rioh con trout ljo valid for county purroscs. The Willttcy County cairns, , tp , orr ccrnuni.r ni.bnnrrs courts i.n countio s whol.U x, coluntyw'' llra hospital cli.si.rirts have not ))Coil crorxtrad, is net ;r } app ica, 10 to a L.Wit:uti.ons oil the au-- , ' 1 0 is aim Von, James Y. Walkor, panes 5, (ti-l'll} t r thority of a hospital cl.i.ntrirt ate doterminecl by the con;.tit:u•- t:ional. Xs::ov:L d.ori and t;tatuLe t~hr rcrundc:: it tadts formod and not. by tine ntat;ut.ory pat•scs:s and .t idtations thereof of commi„mi.oner;; Court:3. tt. oppears from Your .lot.t-.er: th,,t: there in no rmidi.a 11091):1 tal.'in Cochran C<iurst'y which can "c;trc" for, Win no(!ity inhubif;ant, either. woeiicaIly or as a hospital. 2'hcs c.l.istr:i.at's responsibility for 1)rovi•ding saoh Gaxcs can be rxorc.i.,r..d in Sending such needy inhabitant to et public. hospita). ous;sidc, of thcs district: and undl it Mich ai.rcuirtstancer, would havo the authority to'pay for tho 'iwno. S t) hf M A fi It Tho cochron Memorial 110s'.Atnl District, by virtues of the prov.i.nion:s Of P+ ticlo xr, Suction P' 9 of t:he. Const,itution'u." Tom is, and 'faction ? of Nous,o Bill 1233, Goth I,n~is].aLUxc, R98. 1967, (2!rt. f 4404c), V,C„O,) hers .tho ftG1 rw-,ponyibility for pro k viding me;)ionl Etnd hospital car(' 'or. thM needy in-- habitant•o of :such hogpit:r..L distri.at.. Whore thy, hos- petal distrl.ct cannot ct,scl,arg~ its '~u11 restson~si. bi.lity to such noddy inhahi.ta,7t: wi.thtrl the honpi.tal clint;rict ba,cnune oP a lAc:k of s6Pkicirnt tmadiaAl or hosj)..tal ftwili.ti,crst, it, may nonCl the .inhnhiuint: to a honpital facility outs.Lde tbo dint:s:i.c:t nn6t J.rcttil.ly pay for nucsh oxistngo,; itsrn vory truly, j ;lt}~ a2~1bl:D . Alt'.C.T,p1 ~ ~ • At ornoy GonornI of Tcssrr s 1>,ropnr{•td by Pot Cain Asnis Lant Att;or'neiy Cunene l E APPROVED ; ' o><yir1co, Iv., ri';:ic ;I llraiti+t.hrwnr. ;~1,:..l,lix~t~, Chait:mntt ?:erns Tay.l'or, Co-Chni rwvn t4. V. cic~Atiprrt -82,2- It f i 1J t ~Y -~~IiJ)W Ir~T~ J l~ rv lln~') M1'H'WMfr'1rt~Y~P. a i i 1 i I li Ism 1 . .f }Ion. ~Tan~ea Y. 41al.l:cz, p~zgr. G, (t7~•,l'1?.) ' f Pat Bailoy { Drock, Jonas }fill Allen A. 7. C11t2OUX, JR Staff ljoya?. 11ssista;ZL I~ I , a t if rl. r f' r ' 3 k J 1 F ~ 4 J 1 , r A yr~ „ 11.., 1 t,..•.Y v 1• v.[. .'f /T . ~.r f'l .x~'j, •.ii's JS . (Vogl Aauvwxly, ';i'u.:x.A►-I 1713V31A i A'ICA'fl~iNMa' fJi{N ISgA~. , Octobor 1, 197" Tho Honorable George N. Rodriguez, Jr. Opinion No. 11- 703 Comity Attorrioly Mal Paso County Re: Liability of a hospital diskrict Room). 201, Gity-Gounty Building for the coati of medical care of M Pa.uo, Texaa 79901 indigont prisorcra, f j Dear Mr, Rodriguez: ~ You Iv,%ve requez;t.ed our opinion concernhnf the circumotanr,ee urcclcz r ~T I which a hospital diufr"!ct would be liable for tho cw;to of mcaical care of inrligen t priaonerv. You note that he inava ie not whether prinonora ahall reccivo mcclz I cal«hoopital care, 11 for the 'F'ederal Conntltution requlrao priaonoi•r to he given rkoc,7tsnary medical care, Noum xn v. Alabarim,~ 503 V. 2d 1320 (5th Gir, 19741, cert. clan, 43 U. S. L. W. 5hapnll, 4611 10, 2r) 107?. (6th Cir, 1972); 7'olhcrt v, }yrfl, x,34 2ci ~l5 li iii T9lG}; U111tod State c, ox~ VOL IncJyi•,.~a.ni ?,Qovt!•~omo~~y:~Coltnty Prisoner. Board, 369 F. 5u}~ t17 (!i` 1S-155 7(Uli4 clv.ebt~vn_`n"WIC I pv~(C{c<rl Jiuliilivlrrlon,a if any, is liable for the cents of watch inediml Cara, i The M Paso County Hospital Diatrict wlza nreated under articla 4494n, n V, o C, f1, , 1>uxauant to a+.zthorit'y F;z,'mJ in article 9, saction 4 of the '1'ol Constitution, Both articles 9, secticm 4 and <<rticla 9, section 9 provide that hospl- tal dintricte; ohall aauume full ree onuibiliry for provirling medical Mid ho:,4 1101 care (toj ncody 'lnhubitantn (of the diotrict) , 1 "Inhabita.nt" hrau been held to signify a poraon who occupleal something more ov labs perimmont, on abode lamina I rna;n endi, a place whcz'e rz perooei livoll or fine} him hornet to which, when abeent, he inteada to rt,tuz'n, emd from which ho ha.a no prevent purpoac to ctcpnxt, Stl,azble v, 5trubloL 177 S. W. 2d 279J at 283 (Tax, f {y; nl,l>,`",: ,Inaz'illo 19430 era writ}, i rr Wo[ have dine.ovored rto 'Texan Cane affarilig a definition of ''ntlody;„ howeve-IlAt iV genevally acc;eptod to Iltoall "indigent, necr, aeitoun, vez+y poor, It lll.Cfclc'x as Dictionary, 4th lad, ; Bnlleatinoltj lAw Dictionary, 3rd old, ; Morwo v.r I , r r c38_It ~i z ntTiriNlon., 11.2 W, 20 X91 (Mu„Ai ! p; l1)~.r c ~eULIJ. ..~..Y..«.- ' Bee i . ',l.~stQ ru. , r1l 'i'~/ Co7 c.r~tnznlr,:zian of lviiar,ouzt, IG4 5; 1V !~?'78 t~iU ' {i fin~u tate 5r,c,~iil activity r „3nc;' n v, Sol, ,lTu,r<ru C,emtnty v IVr,U<! ('oullty, i £1r N, ~'t "(SrrNl1),M01}. We beliove the ward "nee(1y"'as con flitted Iii iirteci. coetlonn 4 and 9, uhould be given ltu rio4,mal meaning, indigont, In owl' view a 304! l 1 14 t r' ,l~ It 1, 1 i'~ ; xqLt, Idonoral>lc C 7c01•gc N. Rotlt•iguor. .7r, I'af{r; 2. (l1"'1D:i) , si , t~ ti;nnnlation of indlgency into Vrr.ci:,e income: lavela involver} factual tnattcrn, ~ ~r ? der article 9, nactiun:a 4 and 9, we. believe that, in the firut instance Under W as honpital diatric.t. nlhoulil rennonnbly determine. thin fif;ure, Where a t c:anostttblo standard of indig; nicy in in um: by a honpital district, that ertmo standard would be applic•.ttble to artlele 9, scetlons 4 and 9. Othurwisc the district would be 0a0nify11-1i; nimilar.ly nituated persona differently, and iat the absence of a rutionat bo.nis would be in violation of the equal protr,ctiors clatme of the 1401 amendment. Than, tha honpilml district is coranl'ilutir,nrAlly• ronponbible for the care of i are re iiclp.nta of tli3 district. `roe Attorney Owlicrl M-870 (1971); Rill(-'11 v• 7`arrant County I-loll ~strtk )Js attiet, ~•i6 ~,.1V, ? , c)50 ill nt -8{0(1971 who C7pillntotz tl ri0 ("Tex; C!v, App, -1 cz~ ' ~Yoit}~ I91LS afiintedl W6 v7 ?.6 1122 ('re-4, Sup. lls tric;t 4Ct£ S, W. 2dFi(12 {'!'er, C:iv. 1974); Arsew!au v, `Caarsant t' ountX I~Ia >it.l App. ,.;,~x or ~foAi.li ~`3~G, ~iicil rci'd n, x, c•~~ i sic thr. piinomir te, all indigent res idc,:zL : of another honpital dints: fct, in our opinion ihc•. district of which hc, in a rr.n- idunt 1 is cotlutitlMonall,y rooponsible for M5 care and in l.irtble therefor. Attorney C:,e;x:ras.l Opinion M-670 (971). If the 1Hoonor is a hen re;aircAele;nt ihnf the a cciorcutttatymr r, tat :.cncca} within A hospital district, that county to liable for ' net out in ncction 5 of article .,k94n, which pro~viden in part, The 13ostrd o£ Managorn, with the approval of the Comsninnionorn Court tilial.l be authorized to contract with r..ny county for Caro ttnd trot tment. of such county'e pick, diooaned trod WJnrod pez sostn. , If Cato or troatment ip Given to a resident of a county ou.tuido tho Hoopital 'Motrict which has not con j trascted with the Board of Mtanat"Cr6 for lttch ncrvicets, aiacl eni.cl non-renideiLt to wholly without finauct.~l means I f except mesh as are derived from charity, tb.at county 1 Ov.ll, upon pveurntation of a certMod Laater omit, that caret or trctitment was nccoseary for the preaiorstraion of, htsr:,au life'and wain actually pe 'formc d, bo bbligat:ad to fa- i freibu•roo the hospital Mstri.ct in an amount not to ea:ceed then actual Cost of the oex'vica vemlere 1, l hone tho t>=ora.tma»t of a prisottor doou eat fts11 thin th10 15rcavl13 101)> bol trod nt~ ltogpltal dinti"1ct i nncSsa caxaibuuie~sarhizi ti ),f sCarol lb37ru aiY~ 'Q 1tn~Tr. usGylof in- c chl'oe :ttiosn in 11ablo for Article lp,17 Vx•ovldnu 1!lach coursty shall b<; liable for all axpenrie inrurrcd. 021 i ttucoutst of Ow oafo keoping of pz'iuar~erH Cors£iszt cl in Jail or leapt undor , guard, oxcopt prio.unero brought from tmothc county for oafs keeping, ae ou ha bean aox'pttec or chengre of vtinunl in which canon, the courity fraxn which thn priuonor ; JO bs'aught 0h01 be 1141110 for then eXjson cu of hip ainfu lwap,- ing; r p, 3092 i rl / E The Honorable George N. ltodrff;uez, Jr.--ago 3 (13-703) f Article 10,10 provideu in part: Vor the safe keeping;, support and maintenance of priuonevs confined in jail or under guard, the aheriff shall he allowed the following chnvgunc Ivor nccounary modical bill and reaaunable extra compensation for attention to a priooner during sick. tress, auch all amount An the cornmtsviorrhre court of the county wham rho prisonr;r in confined may dutor- i ' Minn to be just and proper, In Attorney 0aneral Opinion M-870,(1971) it was noted that article 9, noction 9 provideri ducts i E niter{ a hoorital dlntrict'ul creation no other municf_ k pality or political nubdivioion shall have the power to levy taxon, for hospital purponen or :or providing medical care within tho boundaries of the dintrict, . , , Article 9, Qoction 4 provideu in parts countfoo and cation (within a hospital diotrict) shall not levy any other tai: for hospital purposon. , Thua it was ota.tod in M-870 that; the provloionn of Articles 103'1 acid X04fs., mriuat ' •yibld to the oxpe.van brbaWlangungv of Section 9 of article 9 M-870 dolt with a priaoner who was an inhabitant of a hospital dingy tzict vtliial: wan therofoi'a aoytdtituttonnlly r.cnpano1bld for hie ca, 5o' litzzitad wo belicv'o the voa,olntion hi' that opinion to be cbersct, 113,, xt promo Attdrney General Opinion 1.1454 (1974), Ilowavsr, wo do not believe that article q; "ymctions 4 and 9 i wore intended to roquire ct honpital dintrict to be reuponatble for the care of pritsoot 7 era who are not needy inhabitazlto of trio district. This would be beyond the coil., I { otitutirmal responsibility of the dititrict. In Attorney General Letter Advi'cory No, I 97 097,5) eve dealt vith a similar reutriction on the ass of state fundiu and otatvd: we boliove nectiotin 4 and 9 ware not`intrsnded to prevbnt exchangon of consfdaration betwoen state ag"clon and h.oitpitul dintrir.to whero a diAttict contracts to provldo p. 3043' f t 41 ,3, -ii e "awl ij The Honorable Gcorgo N. Rodriquez, Jr. Page 4 {h1-703) si SI services to the State which it is otlier•vriric under uo duty to provide, In out' view thin statement is also applicabin to as situation where a hospital district provitles service to <z county which it is under no constitutional. Ob- ligation to provide, The restvictiono on a cokuvy'a taxing power contained in sections 4 ,%nd 9 should in ou.r opinion be contArued as corripleni(tntar'y to the pro-' visions establishing tlic con:itiwtional re Rponsibil.ities of hospital ditstrion, and should riot be interpreted ns denying, the county tho authority to satisfy its ob- ligatlolts to prisoners under itrticles.1037 and 1040 ads well as itttdcr the ;tlirr;:il C;on' utitution. However, we bulieve the county of lnr.ttt'Carrttiott is liatbic only when no of:lic.v politici.il. subdtvision is sta.tutoril.y or cwnf+titutionally rosponsible for the prifio.7er'n cure. S If Ivi i✓ A It Y A hospital difttrict is 1i;ible for the rrsedical care of its noe(ly inhablmnts, that is, its Indigent residents. The dintr$ct rnuot oithor provido aach care to prisoners; within this clusa or must rocompon,so.tlic partieat who do provide such taro. i Where a prit;oner in not a rr.siilent of a hospital. dis- 1I trict, and coction 5 of .tirticlo 4494th V, T. G. S. , iii in- applicable) the cottrit.y of incarcoration iii liable for his medical enre under artielos 1037 and 1040, T. G, C. P. i Very truly youro, {III I ~ . r~ JOHN I~. III Attorney Ganoratl of Texas j A1'>PR0Vrj D! r weer fit' r `~~It/)~A/ ~ .~i~w"'_ ; '•1 i s ~1~AYfU 1. ;",t~3~A~a'L ll irnt /ira:txnt,iixt ' i ~.i 7{W4~tAiL ~~rrJ.r}~1, L Ilttll'Xll 21n Opinion C=omrazittoe f nd: I`!ft .3144 1 i I j 3 6 r yN ` V1 -V w~`~fc -"}„l ! 11'llx(11!a l '717 i('t( lrnN]l!i~1~, C~ x Il!iiYll?ill:i[hl(.r /rig /r54 r ~;,;`~J~ d(D!ll V~.lfli l.ftc~L1\w..y ~S1trs ra'n ti, "I"na:~,arti '~7 tA , 1 l 3'. 'IYr5.1si.Qn.V1;12 (l,(~xt'.IA a October 1% 1964 llonorab.lr* O. R. Close Opinion No. 0-3311- Ccfunty Attorney pe; 1•10spital Carr- of indie'e, t Och:l:ltree County patients in Ochi'ltres ~ Parr, yton, Texas County . Dear Mr. Close: you request oup opinion on the abovo aubjcct matter and ask the following quentionc: I "upoci.ei.c:ally, my questions are Ar .fol.- lowsi (J. Can thEf lospital District make Ochil- payrr,entu o private hoh . pi..tals within (2) II tree County, '.Coxes for incligent care? Can the OclAlt;ree llorpital District pay prIvato physicians for in-patient and out-, 1 atiorit care of i, ndigente in Och;iltreo County, ~oxaa? (3) Your gonerol opinion as to the scope of rouponsi,bility and ruthori.ty of the hospital DJ.atrict under tho existing circum- stances regarding; indigent card?" you atate J.n your request that, purauant to Article 4491tq f 4. 'Vernontu Ci,vilStatutoo a hospital diotriet was created wi.th- I in the bnundarios -of Ochi.l.t,roo County and, a bond election hau, boon r' hold approving the Assuariao of bonds for the construction of c~ hoDpittt.1 and the HoDpital Metrict, contemplates that the oonstruc- ti.'on of a hospital will be commotl6ed within the year 1965 but it will not bo opevational, cor somo time. You furttcr state that at i, 'ehc present time thero aro no public hoapita:ls within the boun. iI darios of Ochiltreo County and that the only houpi,ta,lo pxu;,,zwit:ly operating within 1 h . County a.r. o two privately owned hoopita1q. € Seotion 9 of Articlo, :lx of the Constitution of Texaa pro.- vi.dna for the creation of hospital distriotu, aO provldn't in ! Part, as follows: i rl t , that after its croation itio othor rmun:ic;lg,a1.J ty or political subdivision chat l l:(Iv© the power t;o' levy ttaxoo or issue bonds i crr other obligations for hospi.tai: "purposes sir for PI'livid.-Ing medical rare within the tloui}dai'a~ o.f 'Ale dffltricti j 1 j4 ,S 4I ti A J t a . I 1 j Ion. (It. R. C,loso, paUu IR (C-3311) Section 13 of Artic:la 44911q-4, Vernon+n Civil Statute:;, prov,tder; in part- "Except an horein px ovi.de,d, no county that has been constituted a hospital Oistrict, and no city therein, shall thereafter J.evy any tax for hospita). purpoes; and' end such hcspita7, diotrict ohall. be dcojw.-i to have ast;umed full responsibility for the ur'nJ sh'.ng of modirr_al and hot3pita.l. care for 'r'at; needy and andi.trc7rxt 1 persons reuiding In i,uid hol-.pit,t:l, d:1.otrict from the data that; taxe?, qre collected for the hos- pita:l district." i In view of the facts submitted in youi.- request and they pro- 7 ( visions of Section 13 of Article 41194q-4., above-quoted, the I108- pitral D:U, trict assumes the iamte authority rotrarding the furnish Ing of medical send hospital care for the needy and i.ndiaent nor- i noes residing In the Hospital 1 t1 trict aa, therretofore` pocaossid I by the Commi.scinners Court of Ochiltree County: Article 11438„ Vornon+s civil Stututc:a, provides: t "If' thrrre is a regular eetabli.shed public s hospital in the county, the commi-solonurs court ' shall provide for sending the indigont fli.ek of the county to sv.eh hospital, if more than ono uuch hospital exists in the county, the :indigmnt pati6nt shall have: the right to select which one 1 'of, than he shall, be sent to." i E,: I In Attorney C,eneral+ta Opinions 0-PI79 (1910) and 0-4633 (:194?), it wtdt, h©i,d that the commit,sioncrs court of n county dial I not have authority to pay item.; of hospital treatmeent; Tor ,Lnd:1:- I gont sic, to any hospital outside of the r,:ourrty. These se canc7u- sioru+ wire, baabd upon the prInc iplor of :last announced in Willcicy Comity v Vall3, ,t,.sst I1oE',P)ttrCt., 29 S.Fl.2d 1156 (L'cx.Ci.v;Api>; x9jo, wn&;t F,in trw C---f:' s~ tti tiici, a "The powox,s and dutivs of county col mi:s» oicinoria t courts,, an[t the obligations of the ~ cauntic,a to paupers arc tlxecl by ot-aatuto) and ~ ctannot be enloar[,cd upon by urrnnce-Emary lifitpli- 1 Cfat:ion. Thene poweri3 and rlutioa, in so far at.-, tipplicable hare! are defined in and rest.rictcek } by the provisions of Articles 2351 And 44313) .-visod Statutes) J.925. J:n flrt;icle ?;351 It is ruvidcd that carp carmnassti y onerfr+ tia~fi.15. ~mbdi.vltxion :I 1, court tslYU1.7, their the riunport of pampers r) .,sridprnta rovide of for { * cuaulty, who JL' t t 1 J t WWI t 7 F; Hon, t., 11. Clo;;e, pfi(go 3 (C-:3311) arc unable to support: them,:,elve,rind ~st.ib•- divis lon 112 ''for the burial of pas!pez,s xn Article bl.'J3 ii' i;s provide-I that 'If there As a, regular erstatil.l.sh- 6 public ho,ipital in the county, the r,ommi ;:lonerrs' court shall provide for ioading the, ind:.(;ent sick to suc=h hospital l , In tho lattor pr. ovision , the duty tied tho ,authoriLy of tho covaissloners' court to send'tho lnd.ipl:n l; sick to hospitals is lImi.ted to public hospital,; within the county, which provision, by nocmt,,iry implication cx- cludos any duty or nutho.r:lty to send Stich par- i sons to private hospitals, or to public hospi- tals without thr, county. Even if Darbopa was within tho class defined as 'indigent nick,' i the commissioners' court, tar, a Body, muohl.ess the county Judge actin, singularly, weir, under I no duty, and was den:led tha authority to sond Barbosa to a hospital, e.Ltiher public or pri- vato, outai.de tho county. Under the prov:tsions r,f Article 14438, the county was under no duty to sons ! tarbosa to any hospi•t,al., thoro beiny,, no public ho,sl)ital in tho county, and under the'impliod restrictions of this provision it iu doubtful. if the county could bo bound by the commission era t court, certainly trot othcrlpisc;,, to send him to ahospital without the county, at psabl3.c encperr1S0 , 7,i:kewi,e, it was held in Att;o..rney General's opinion Cw ?.633 (18110) a "You are thoref'ort; respootfully rsdvirect that -it is the opinion of thi.rs dcpartrnont; that if the commi,sslonorss' court detorrni.nt: s that An lridi(;ent x it pauper 'It may furni.nh mcdi.ca`I. ai.rl f and modicines to him as such, rogardle-vi of whe;- I thor or not ho han bee=n placed upon tho paulicr roll or Who counl;y, inasmuch aft theme :lo no statu- tory requirenient for the makinG tip of a county I psulper roll,' tt is the further opinion of this i departmcnt, that, thy; commis,,siotsts.rs' court Szns t;llts nuthori.ty 't ) ald llndigont Sider, who may or may j not be tpnupcrn', by ;,ending r;uch rindl.gont Sink' E l tpubl.3c' hoFSpit.ail+s within the county. Tho ~ qur';tion of 'In(I.Sgoncy' is allm a tluESt;:ir`n of fact to to Qoterrn9ne,d by t;ho c•omUt,,tsionors' ctrurt',.I' ' I S,fi~1U~ I I E . fi l i y S l.rt .vy.. Mon. G.. 13. Close, pago l-1 (C-3311) 1'n Attorney renercalls 01)l.nion 0-2116 (1964), it was point- ed out 1°Somc%%,hat nimllnr to the. precedlnn gtrec- Lion, your sixth question also concerns the r contractual power grid authority of the Com- missioners Court; or Tarrant County. As staLed in anewurAn(5 your i'i.rst qua:;tl.on, whcr.e A duty is 1mpo:;ed or a Po woo conferred upon a r.ommis- ntonc;rs court, than the comml3sioners court has :lmp?.n'd authority to exorcise bror4d diocretion { to accompli:* the pure'+, ar,s intend-d. When the comm•Lxs loners couz-tn is oc expressly given the I power and duty 'to provide for the support of j paupors, I by, neccssar;, :impli_c&tion thry were elotilod with the authority to do all the i.nci- dental things nocea,sary to prov,idd for their support . Thus, while the comral ssioncrn court is not under a duty to placo Indigonts in a pri- vate fa:.ci.l_tty and pay for th0v cPar.e, ld1,11 acy Country Nt. VL-I e,y~Dap)t•tst Ho<pita:7, 29 rLMee the exercise of itd dicceotion) provide for the care of indi- gent•al whom it p:ltxca " in a private Paoi:lity. Hero, ~ I of 'course, the contractueil terms must not be j such as to amount to a donation by the County to the indl,vidual or corporation providinE; tho care, nor can the contract provide for payments ' by the Caen aunty vu of fu P.uro rovonues . i It was painted out .In Attorney General's Opinion C-216 tt~ thmt o "Your fimt; and second queationrs can be tanuvrca,red to(;ot.hor. Under tho provi.sj.onu of sec talon 11, Art lc:ln ?.351, Vornori t o Civil. 8to t utes, the Commie; icnori,' Court ha,,, the duty to. Provide for the ouprort of pauporn and such idiots and l+.m&t;ics a:; oannot be adm:lt- tea into the :lurnatic nsy.lum, ranidontm of their c1(,umt ) who aro unable to support. themselves . 4 1 "WtAle It Is true, that the L'att4htilsoienc~rg~ Co•irt I* a, court Of' 11MIlod jL10.8di.ct'I.on, i:t :i alco truO ,tl)at whcro a duty :ln imposod Or a pow-v contorrocl by statuto upon a, comni,snAmors; erupt within tho boundarl.e:k; of' power which' the: Conotitut .on has cY-oatud, tbean tho commis;:i.onera 159 4 t i a a lion. C4. li. C1c,se, pn.jie J (C- 3:)J4) court has I'VII) .ied r..uthority to cxercit;c b;'ofrd discrotion to accora4)1i.sn puj*posc,q, irntend2d, by Such atrAtute. "uun` y V. l~n,orll~E' ; 13M. 2d 393 1pOx.(jv. Pro. Mrarrl~all, _.:l S 4l.'2d 621, ('Cox.Civ~t fiji J IEl, di san ; And lr c)n V> 1'100d) ].3'7 Tex. `201) e:r 152 S.W.2d l.U£i~' (l1'}1 "Under t;he 1?rovi.sLons3 of- Sect-lon 11, Arti.- plo 251, a duty to provide fur tl)e t)upport of paupers, which :inc.l.udos tno Jnd.LC;ent aged, Is imposed 'upon ttte Commisslonei-i3 Court'', In vietr of the forc(foIn,, a.f the i.ndl[ oint crire -.efcrrcd to in your requost come tltutos the support oC paupars within the tnn.arr.rtc; of S c+,Ian l1 of Art.ccle 2351, Vernonta Civil St.atutvs, tho lldaplt.a.l District, under the withority of Sectital.s3asit1~3.r~ Article J4L~c)1}q-J;, may malcri payments ~ to J)Vi Vate heap:. , 0chiItre`64Aty ~Atoxricy penoral N Opi n:l.on 0-24 i96J4)7. :Cf' c 'the pupport the mcd,.~. to or ind:ltrent. s daecr 116t coiasl',itut of ptlu l ha~~ the meaning of ,,.cation 11 of Article 2351s the llapY' JI.kk , . J,.e,t;rict may not make payments to private hoopits:l.r, within c.:111.lt,re.o county, but; auch cane must be limited to .such i hot;pital trocltment an authoritod by Article 41,38, Vernon's Civil. 4. Stntutos, in public honp;ltal.a. 41illacy County V. VA.110.y, 73o.;')tisl, }I0~r•.1, w9 1;.4•J.2a 456, (Tox.Civ~ipP• ~ sul~sAnx i 4 A hospital. clittrict croatod under the pro- visions of Art!:clo 4494(1-4, Vernonto civil .Stag utos, aaraumes3 tr)~i 13(3.110 rosiponalbIlity for the medical care or indigents within mAid di;;t'.rict t &0 that provloayly _lmpoood on the cornmi.[auk~andr~ I court', ur)(icrr the provintonta of 5er, tion J_:l of Arta cle 2'5513 VC1`r)QGl's Civ!:i Stututo i and Article, F 41138, Vernon' a C1v1:l. S tat•cltc:,a , 4 ~ Youa'.y vory trla:,.;I, WAG(dONVP clkviY j Attorney Gcnewal. ' . i 135 . j6bn lleoveii c Asol1313. t 1 n't 4 f x room] iSors. Q. )t, C.lo e, pu~rc & (CW314) ArPROVEDi Orr.NTOrl cor~?~ rrF.F Y1. V. Ccppctlt, rhr~lr~san 1 t~falcolm l~uink Cfeni^gci Black S3a1}its ~tatah !'1''1,ORj-) 7 OWAMRAL AF'1'ROVk'I) FOR THE by; )togQr TyInil t i s t ~ F a , r~ , a tr ..1,,s)3~ i } i I b .yayx~tr! Nas:-; rinxx.t>rk.:nanp June 1 .n'A";I.ILYl51' <].:NHl1l, I,. ~ I 1, 1954 S Non, William Caven 001-11.011 No. ,7..126 County Attorney Harr` son county Vet Aut;hori.ty of a county to Mt,rsha7.7., Tex%zt+ len~Ah npano nr_d faa.llities from a pa~ivate hoepittil for tho purpobe o#' honpita.:lizing Ur~rir Mr. Cavens county paupers. You have 'requested an opinion of, thin off1e;e in anCwer to the following (jaestIon: "Is the Commlobioners' Court of Harrition County authoriVed to enter. into a loar3e agreement w:tth the Kahn Memorial hosnita.l, a private corporation, situated in Nrirriaon County, covrlrinr, such opace and faoilitiea as Would bo necotma'ry in the C-Are of paupers, whpro•it in shown that, htispAtalization is needed. You stage that there i.m no Country )to:~ital i.n r Xihrr,l on County and that XCnhn Memot'ial NoppItal is 011arterod as, a, chraritFable and benevolent non-profJtat)'ee inst.it',iit:lon ovgt.nimed for the porpope of promoting th,- gcnerrcl wolfart, of the ourrounding community n'nd fuxonishea hoopital t'aoil•; j ities to tho gonerral public. ~ i Commisc:tonors' Courts in this ot•,ate aro Courts of } limitnd Jurisdiction and have t)nlff such powers as aro ex•• j prorsnly ov implied:ly oonfdrred upon there by law. Chtldreus County v:...LStaLe 1.2"j Tex. 343; 92 5.1f.?.d .101,1. (y,93G7;';i'nn~ I I, o ien',c,rir v, 1,oyel L, 173 0.14. 508 (''ex.CivrA)p, :1915, error x'e 4 ii posvor In ex.pz)ei3oly coni'errea upon the Come ` ! minstoners' oomito by tstntuto ovoryt'hing neoe(mary'to malto it, ofi'retua) or that may be requislto to attain its slid is I Implied. As stated in `1'era'r 11, vtrP2q.1.lts, .104 '.Cox, 191,E .135 S.W. 51.9, 521. (1.9.11.) "'i~a i ~z~a~t. of rin exprosc power carries with it by neceut)ary impl:ioriti.at~ avery other powor noodan<,.ry ar)t3 prLopei, to tho exoGution of the power grantod," Soo a,1no blot.' \16 lt.truc2,, n('( 8.11. (alex.Civ Apr) 1,g2y orrorL distn.); t (:::1 t<£, v. acuvf!hlS,n 147 Tox. 169, ?,114 5.11; 2d 51 (19118). 1 i . i i r ,day i f 1i Hon'. William Coven," pago 2 (5-126) Al'ticlo 2351, VcrnOn'F! Civil Statutets, ' part: 1?rovicter3 1rx "l;ach Conminalones"a court rshrtllc Provido pox, the support or paupr,'x,a • recidentn of th,ir county, who rare unable to auppor't tl;ornoialvea, 33y this. torn, reHident as used horoin, in month ai person 1 who has boon it bona fide inhabitant of the County not, loria t;t,r,ii ai.x months And o1.' tho Sbato not :lase than one year." In dot'i.nltvj thh ;'lord "qupportr' an uoed in the above ntatuto the court In Mow-Non 8; S.laison v, V<zn 7,andt County, 3 Wil lr,on P40 (Tox aala=. "Supporfi l o as horc timed, . means more. than rsupplyine, therm „t,a~upet,g7 with food C.nd o,lothing and a hourse to stay in, It me lnn all bhat is nooo6va:ry to bodily health and comfort, and especially doer IC 'Include pro" por care, 11 attention and treatment durIng I agoknr,ad. It Dan hardly 1) r' doubtorl, partioularly In vlow' of the ranont ad'varrcernnnts I.n rmedictil neionce' and equipment, that hosp4tallzat;lon is `often noaer3<,n.t-y Tor proper onro, attention and treatmont dur..fng alcknesa. Thbreforu, itn:leoa roatricted by the Constitntion or pome other stc,tutej the 00"vnibMionert..+r Court would have bvorccl Msoret,lon rr•y poyrerri In rogard to the mothod and means to bo usod in .fu:vn.1bh1ng iiospi.tal ca qualMod pauper'a. 7'erp.. ril1 v, S rt'lca auprE3. xa; to w_ P I A county is prohlbttod from entorinrr .tr,f;o a joint venture with r.lriy :Indl.vidual, auBoalrttion or eox'p.aration what- caoovc,r,, 'fax, Vonst. Ai,,t. .1'1t, ,`.rco. 52; rind front rnZlcing lu;r/ j appropr:l,ntiori oil rl0riril,,1 ot,, or- Ill nn yw:l fle loaWligr its oreds t to any pr+:vat',e corpo Alon or htipoo,lut.lon, T1Ux, Conat., Ax,t. Xx, Soo . '3. yi Th4rePoi-cr, n county oaulcl nut ont(T into an rii;roew Inont pr'ovirlinp; roll the Joint b1)01`4ttion or r„ 6h h0lspit1Al, nor could At r,ui'eliase Q'(julpnjent Pot, tho tWu of (111011 13MVrafe tioa'• pS.t^:.i , fio'rrevar bona fide .tense t,+raa oY.c;4uL'UQ which dt,r!rtz E8 t6orn p1ace~l oxo'1•ua,ive domil on and oontxo:l of the xea 'c9 1,rerntr;ca 1n tho r"ursri,IH01.ai1ars' ourt• aril,), pt^ohiblt,.Unas wo;alcl not app:ly, u~an Att.or'ne,9 llond.rri.l 4inion No. V~-173 (100117}, I i 1 'f t( y "On. 1"'llitun Caven 7►t Att'arne:y Qencral Op.tnion No. 0569 (19~I2}, it I wan held that u ooitrlty Gould base ran entire houpital building, undoor the provJ.siorns of Article 11!1'(8, v.U.S., for tho eritab- 11131)ntetit of R oounty hof~p.ttrrx . No reaaon la apparent toffy tile oaunty oouJd not, If, itt tire' diuoret.t.on of the cnurt lerrri uiyaoc was needed, J.:14 se 3.0,R80 only a doulgnated mart of such j hospital buiJ.cif.nlr sc 10nlr, apt tite lca8rDd premiucH are under the exolur;ivt, mana%,ement and control of the county. Artiole 4438, V.C.S., provides; "7f there ire a regular establluhed public hoopi.tal in the oounty, no comminsionera oOtlvt shall provtde for send!.ng the indigent oiek of the county to riueh hospital, ; ' i In 14113avX Count !v. VKIJe IMpti,,st; HosLLzltal 2 S.14.2d 1156 ('lex.Clv.App. 1K 0}. Jt saes held tFitii E'above Flo' ntOtute authorized the CominiFisloneru' Court to netsd the Irld1Gunt biek to "public"' , hospitals in tht, oounty, and by neoeveary iu1plicWon exoludes any duty or authority to solid suo}l por lion,n to> p)'i.vate 'hosplta.la, or to publi(s hoopitalft without the oounty. The court furtYsor. rooohniced a dlotinotion boVicon priuporo and indigent rzi.clc" and a corrospond:ing dirstinotion i In the authority to provido for eaioh for after the above 1 '1.oldin~ in regard to %ndl'iont sJ.olc;b theAcourt eaidt j The prowls lon that they Comminni.onera' Court shrill nuppopt 'paupe.rd W10 are un. ble to support thanizolvors' is Inapplicable In this Oahe, for the pl,atJ.tz reason that the fautn do tact; put narbooa IfIthin that o1m)." Thi.r) d1utinotion between paui)'Irti and indigont prrrionti lo fully dluounsad and reoogolv.ed In. Attorney (Ionera:l Opinions 0-2633 (1940), 0.2933A (19)11) and 8-1538 09119) . It furt'herr, become-s evident that tha Legislature did not intorul to ,li.rrril:' tbo auchority of tho Commisslonors? Cotwt to "provido for tho nupport of paupo;,s" by Ar uclo 4438 101011 1 It a, oonoldomd that, tats oillj;fna2ly pasttnd t:heao atat,utOG, n(tr coai)'led ar3 Artio:10 ;2351) V.C.8., Mid 'Art ;t ia,'!IlI38, V.C486 uerv loth oontairm'd ID rho uaMc OnROWOnt 01r. a , Uen oral , r1'lw , of Texrts 1;.)r ~ l5az tl:on . .15th S,a~;J ls~.atur r., J.t3(G, prtga ~,;1) . `Sh s , . c olirlod wsn Artio l.e P351(11) urpaara. rt) Sub8ootloh g of Srotlon 4 ;of suoh Aot, whil'a, l;hh p< >rti.an ooclil.'ind am Article 1+1138... ~ i I V MAI Hon. 1411,11am Craven, page ~l (S'-lP6) mown appe8ra 1113 reetion 21 of the nante not. 1 ~tlt 1Joc,ma ovident that the Y egl.nlat~,uC'o by the utse of the word j)aupor^ in ilubtleotion 9 bi' 3ectlon tl and by one of the wordu '1.ndit,ent aiclr" In Section 2l or" tho Act recogmizod and Int;onded. that the wovda be given diffox-ent mear►ing s, an(i the mandatory duty placed on the; C'ommtrmforlorn' Court to pro- ~ vide for the support of prxupu.,u by Section tl imm neither modified nor .limited b tho by p..vUviai,Uttrs or i~r .,l;ofi.anri ?_l which only reguIre tho Court to "provido far' thu indigent ra:iok In their county by rjomlin,; much utol; portions to a, hogs )i.t [O." In If eras thcro la a Mgu.7.er dstabliohod EjLL) .Ics hntjpita In tho county. xt is theroforo the opinioh of thlu bf,t'3ce t;1►at the F Commttiai.onera I Court or narrloon' County would he authorizad to enter into a lonne. agr. oemont with the X.i'ahr► Memorial Ilod- ~ pttalj a private oorporati.on, uitva•tod in llarriuon County, 1 Pox. tsuoh uptloo and ftwilitiou as they Co1)mii nioneirts 1 Count r'' ! deems r'eluorably nocermary for the t:!tnport nrld horspitnllzttw tion of tpall iod, r ooUdent pauporm o the county. The datormi'nati.on as to uhethor a leauo oontraot meeta the tent j of placing the e,~oluoivo oontrol antl oupervialon of the leaned F prominetj in the Couuni.anionorn' Uaurt, 9r rrovidea for a joint I venture or clnnation prohibited by Joation 52 of Artiolo x1:1,' or SsotIon ,i of Article Xx of tho Conuti,tuti.on of Texan, µrquld f depend on the tcsrrim of vaoh partioular aF;rowneat, l i j .j SU61IdFlt1'Y A Commi solonara' Court it) authur:t%od i to lea tie r t , 11311 upaae ar+,cl f'aaiXitiou from a r iva_to # I hotapit;nl within the oourty au it deehm reanonably,nocearsary for the propv;o care:, and hotipUalizatton oil hual.i.fj.ee xx,i' `~Flont; pt►~c:z o of th a t` "Kit: 2351. iS Q(~ ♦ ti J.l, Y r~ 1'S e j 00 1660 ag t71~ 1 Wat~~l,l prominoa Oro under tho exaludive oontro,l and aitporviuion of S,he oounty. r. I r f ! ~ j MAW lion, William Novell, page APPROV1s1)f Youm very truly, J, C. Davi.fs, Jr, J01111 i1RN SJIEPP1,Fi0 County AY1.niru D vIalon Attorney General John Atchison Reviewer 5? Robert 80 'i'rotti Brady Vimt AonlutanU Auu:lutant Jq~fn Don She,,ppO,,d At;tornoy Oonor<<l ED m j i f I F f , t CY , M s + 1 k A RESOLI'TION by the Commissioners' Court of ~ Denton County, Texas, relating to provisions ~ to be made by Denton County Texas, with respect to the hospital operated by the Denton County-City of Denton, Texas, Hospital Board; making certain covenants in connection therewith, WHEREAS, the City Council of the City of Denton, Texas, and the Commissioners' Court of Denton County, have heretofore executed a contract effective October. 1, 1971, whereby both political subdivisions agreed to provide joini.ly i funds for the operation of the Flow Memorial Hospita.+.; and WHEREAS, the Denton County-City of Denton, Texas, Hospital Board, the operator of said hospital, as the joint Agent of paid City and County, is in the process of authorizing the issuance of bonds in order to provide for hospital f improvements and the prospective purchaser of one of the series of bonds has requested the existing arrangement of E the City and County be clarified; now, therefore, BE IT RESOLVED AY THE COMMISSIONERS' COURT OF DENTON COUNTY, TEXAS: i SECTION 1 The amount to be transferred annually to the Hosp tal Board by Denton County under the pprovisions of € paragraph numbered I of the contract between the'identical f pparties which was effective October 1, 1971, shall be the t lesser of: I" (a) an amount equivalent to the principal of f and interest on the Series 1975 and the Series 1975-A bonds (in the prooess of being issued by the said Hospital Board), or ' (b) the amount that a tax of 104 on the $100 valuation would produce on the County tax roll (assuming the then current rate of collection). SECTION 2: The amount to be transferred annually to f the Hosp to 1Toard by the City of Denton shall be an amount equal to the amount paid by Denton County under Section 1, SECTION 3: The covenants of Sections 1 and 2 shall be ~ effect~i'vee ur'Eng the time the Series 1975-A; bond re outst.and- ing and unpaid. E PASSED AND APPROVED this the 6 day of 0 ober 1.975, ounty Judge, ent55 oun"t~ e ATTEST t i ' ounty pr nntc'm ounty, 'k x s APPROVED: AT'TE9T': a u ty axes ecratary, City o£on, Texas 1 -166 11 A RESOLUTION by the City Council of the a City of Denton, Texas, relating to making provision for the operation of the Flow Memorial Hospital, t f WHEREAS, the nity Council of the City of Denton, 1 Texas, and tL Commissioners' Court of Denton County, have Ili heretofore executed a contract effective October 1, 19711 r I whereby both political subdivisions agreed to provide jointly funds for the operation of the Flow Memorial Hospital; and WHEREAS, the Denton County-City of Denton, Texas, Hospital Board, the operator of said hospital, as the joint went of said City and County, is in the process of authorizing the issuance of bonds in order to provide for hospital improvements, and the prospective purebasier of one of the series of bonds has requested the existing arrangement of the City and County be clarified; now, therefore, THE COUNCIL OF THE CITY OF DENTON HEREBY RESOLVES SECTION 1, The resolution heretofore adopted by the Commfss"fon xs' Court of Denton County, Texas, a true copy of E which is attached hereto as an Exhibit (and made a part hereof for all purposes) is hereby approved. SECTION 2: The Mayor is authorized and directed to (I) furni-a `a ertified copy of this resolution (with its attached Exhibit) to the County Judge of Denton County, and (ii) sign a copy of the attached Exhibit showing, approval by the City of f Denton, Texas, through this governing body, i SECTION 3; This resolution shall be in force from and I after its asFage and it is so resolved, I PASSED AND APPROVED, this the 7th day of October, 1975, 1 I I 1 ors tY exas ATTSST l 77 (r I X" Yom / K, I cify ra torYj eC t ~Y ~f)r Det1t0t1 (City Seal) j APPROVED AS TO LEGAL FORM r CITY ATTORNEY 1 t ~ h y , "WAII r Wok MINUTES PERTAINING TO PASSAGE + RESOLUTION RvlA'TING 7'0 1,fAKING PAND ROV1~OTpN ~pR OF A q OPERATION OF PLOW MEMORIAL 110SPITAL TF1[ R THE STATE OF TEXAS w w ! COUNTY OF DENTON CITY OF DENTON E ON THIS, the t City Council of the day of r the ty of Denton i 1975 t exeo n t e 8edeion at the xoSB' convened in public and notiasaid mthe entineking beingar meeking place open to tho s. prescribed by Article 6252.17, 89 ha ectionn1 been given as tile following members bein A, V. A, T. C, S. wit: 8 present and in attendance' with , to TOM JESTER f i 5 MAYOR ELINOR HUGHES f RAY STEPHENS VC, JOE MITCHELL ' TERRELL W, KING III) COUIVCILMZ;MBEI2S n and with the following absent'- constituting quorum; and Among: o er procee the following: nge Tia1 were £ui The presiding officer in `r lowing caption; kraduced it resolution with the ?Iris "A RESOLUTION of Denton by the City Council of the City Texas, relating to making provision 3i e ~ the operation of the Flow Memorial Hospital,'i for Theresolution-was reed in 'full , Thereup member y• t on, diner y be passe made p motion that kheresolution t~a,1'i: ' • ` andocsrri.edgbaeconded by Councilmember AYES: y the following vote: JestMier and Hughes ' 4 1 and King NOES : None. The Presidia e tF been finally passed, announced that the resolution had MINUTES APPROVED, this the E 1975, say of ATTEST: ay t j h, y exas x , r tart', ty o. eh" Tex t; (City Seal) ~x i Val it A RVSOLUTION by the City Council of the laity of Denton, Texas, ratifying and confirming the establishment of the Hospital Board; approving the ' proposed issuance of bonds by the Denton County- City of Denton, Texas, Hoapiral Board; approving; the sale thereof, WHEREAS, the Denton County-City of Denton, Texas, Hospital Board has been heretofore established under the provisions of Article 44941-1, V,A.T,C,S, and as the Agent of the City and County operates the flow Memorial hospital; and WHEREAS, the Board of Directors has entered into negotiations with and proposes to authorize the issuance of bonds, but the same may be delivered only if approved by this governing body; now therefore, THE COUNCIL Or THE CITY OF DENTON HEREBY RESOLVES: SECTION 1; The creation of the Denton County-city of Denton,"Texas, Hospital Board under the provisions oz jlrticle f;.I 44941-1 by the Cfy Council of tho City of Derit'on, Texas, and the Commissioners' Court of Denton County is hereby ratified 1 and confirmed, and tho contract heretofore executed by and y~ between the City of Denton Denton County and 'the Flow Memorial Hospital and the 1y-laws heretofore adopted by said Board of Directors and approved by said City and County are hereby a '`t•,., " ~ ~ pprnved, ratified and confirmed. SECTION l: That the authorization, issuance and delivery of the two series of bonds under the terms and conditions set forth in the attached resolution (Exhibit A) of the Board of Directors of tire said Board is hereby a pprovad. I I The Direct Loan Agreement by and betweFan the Board and I Secretary of Health, Eduilatior, and Welfare (Exhibit B) is hereby approved, 1 SECTION 2.s The sale ce the Denton `County-City of a Denton; Takes, Hospital Board Revenue Bonds, Series 1975, tc ~tthe Secretary of Health, Education, and Welfare at the price of par and accrued interest is hereby approved. SECTION [L: The sale of the Denton County-City of ilettton Iexas, Hospital Board RevAnue Bonds, Series 1975-A to ifitst-Denton Count National Bank and First State'Bank of 3 Wton I`.; at P pr Toe o 1 5hs3S 145 tiCexeet is , 'f f hereby approved, SECTION ~L: Thia resolution, shall be effective from and cif,}'M~ i 6i'tc~•c"'~~'~ug8&ge j PASSED AND APPROVED, this the 7th ~ r . 1. 1.475, day of October f 3t t y n xas t~ ' ATTEST: 'F ~~f;; tt sacretary_` ~~ity n enton ~`ex t as 1 APPROVED Ab TO LEGAL PORMs (City Beal) f . TY AT ORNEY h ~KMl1/p7 ...f f dww*K MINUTES PERTAINING TO PASSAGE AND ADOPTION OF A f;ESOLUTION APPROVING THE PROPOSED ISSUANCE OF BONDS BY THE CITY COUNCIL OF THE CITY OF _____DENTON ...TEXAS j THE STATE O TEXAS ~ Oki, COUNTY OP DENTON C CITY OF DENTON X k 3 ON THIS, the 7th day of October , 1975 the City Council of the ty of Denton, exaa, convened ins session at the regular meeting t".i""eoo n e ty !fill, the meeting basing open Cohalace public and notice of said meeting having been given as Y,- prescribed by Article 6252-17, Section 3A, V,A.T,C.S,, with l the following members being present and in attendance, to wit; TOM JESTER MAYOR ~ELINOR HUGHES 1 RAY STEPHENS ) ) i JOE MITCHELL I ) COUNCILMEMBERS TERRELL W, KING ITT) ~•y~{ and with the following absent: constituting a quorum; and aman@ ~"rr"" f I' the following: o tter proce~gs were The 107 ].owingoeptding on Officer introduced a resolution with the "A RESOLUTION by the City Council of the City of Denton Texas, ratifying and confirming the establishment of the Hospitoe Board- approving i, ' t the proposed issuance of body by the"Aentort 1 County-City of Denton, Texas' Hospital` Board;` approving the sale thereof. membuThe resolution was read in full. Thereupon, Council made a motion that the resolution be nngsed r na a Mon was seconded by Councfltnember kr ,I ..._.,W,. and carried b y the following vote; i , AYES; Councilmembers Hughes, Stephens, Mitchell and King NOES; None. h. The Presiding Officer announced that the resolution had ' ~•h been finally passed, { 3 MINUT88 APPROVED, this the 7th day of October I 1975. - ~ ~v a ty ent ATTEST; a as 4- ctm y ty o enton i5 ( exas ' (city Seal) { / 11 }f AEI } ' f y ~ S ITItIkVR . W NNHb 41#A 67,44 T+~6t C-n p n 1310 SCRIPTURE ENT ON, TEXAS 76201 ;JLOW Er120ZL~LL d ID 1387.5861 September 22, 1978 f Denton City Council , % Mr. Chris Hartung► City Manager 216 6 McKinney street J Denton, 'texas 76201 ~ j Dear City Councilmen; The publicized decision by the City of Denton to reduce the t I payment to Flow Memorial Hospital to one-half that of the County's contribution poses a serious problem to Flow's operation for the 1 coming year. P Our budget was prepared for, the coming year with a lot of time and effort and thought going into the preparation of the budget and took into consideration those things we would like to accomplish in the budget year. We had projected what our charity or indigent care would be for the coming year and had anticipated the City and County snaring in this reimbursement to us for this care as you have 16 the past. In our Board of Directors Meeting on Thursday evening; September A sT, 210 19789 the ppublicized decision of the City was discussed wtth,:a unanimous resolution being proposed Indicatin the disap 4intmant y the Board in the reduction in reimbursement for the oharity and indigent care from the City, It is also the attitude.of t~'ie Board. that it is not our concern where the money comes from but=only that j. we receive an amount appr6ximately equal to the amount of indigent f;.. and charity care that we provide, j }'r We ask that you give every consideration to the funding of the full $4680000 which we have requested in our budget, 'this has been f a practice that has worked well 16 the past. If we can be of any assistance or answer an our budgeted request, we would be happy to do soy questions regarding 471 Sincerely, j A. E. 41yatt Chairman of the Board .rt AEW.gm NOTE: Same letter m le t Co MOM" s io er ; rtv Lrn'ukott~y,. ~o r' r i i Ila- 1310 SCRIPTUR!~ ' ` • ~f.)G!T C E1~20 U~ DENTON, TEXAS 76201 y + (917)387.5861 I I Monthly Financial Report July, 1978 Patient revenue increased $39,500 in July. There was a decrease in Adult Patient Days from 2609 in June to 2602 in July and an increase in Newborn Patient Days from 291 in June to 521 in July. Departments contributing to the favorable increase were 09/Post Partum $7000, ' Nursery $5,000, tabor and Delivery $2,5001 intensive Care $6,000, central services $7,000, Laboratory $5,000, and Pharmacy $7,000. ~ j Deductions of revenue increased $3,000 due to slightly reduced recovery ; payments on accounts written oft in previous months. i Expenses for the month increased $25,000 with salaries and Benefits contributing $24,000 due to three payroll periods in the month of July, All departments exercised cost'saving procedures in holding expenses down for the month, in spite of increased patient activity, expenses in June consumed 90% of the revenue compared with 83% in July. The over- all operating lose for July was $7,000 and the non-operating revenue was $31,000 resulting in a surplus revenue of $24,400. Patient cash receipts were .10,000 lower than June. This is partly due + to a complete r+aorganization of the business' office, This change should ! result in a more efficient processing of patient billings. 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NNN i • N $ a ' t li ~ Q~a•~ ~ j NAA a 141 I r V 441 ~ i v tt, ! : r 1 ~ r` ' i V / ~ Y J f~ • i ~ ~t ~<Y~IIPiT: i4ryyyM1~{~~.k~41 GYM tI. .l; n.{+x}y..r..ui avti-~ ~•~k'o}a4.0'y ~4 tiPf ti<c'13d !•tt4J/< e~ r ~ ~ i9fO SCA1P1'URE L v r July 27, 1076 p i ~ i The Honorable Elinor Hughes Mayor, City of Denton 215 E. McXinney Denton, Texas " 70201 R Dear Mayor Hughes: Flow MOmortal Hospital has this month received a two-year accreditation from the Joint Commission on the Accreditation of Hospitals as a result of a survey made x} here In April, The Joint Commission made a few suggestions concerning changes in y the Bylaws of Flow Memotl,il Hospital, The Board of Directors has considered the r ' I I recommendations and passed the following amendments to the Bylaws at their regular meeting on July 22; Addition to Article X, Medical Staff, between first and second sentence: j The medical staff shall be responsible for developing a procedure r for processing, timely reappointment, and granting of privileges for medical staff members to be included in the medical staff bylaws, Change first sentence in Article VIII, Section 0 tot The Joint Conference Committee shall consist of the President,. Vice j President, And Immediate Past President of the Medical Staffs the Bxeeu- ~ri ' ttve Committee of the .Boardi and the Administrator, f Add at the beginning of Article X11, Amendments; j These bylaws f shall be reviewed annually and revised as necessary. Add a new Section 5 to Article III: Members of the Hoard of Directors are required to attend not less than 75% of the regular and special meetings of the Board during each fiscal ` Year, After missing 26% of the meetings, the Board member will be required to submit his resignation. As directed in our Bylaws, these amendments need to be approved by the City and the County. We would a ppreolate receiving the City's approval at the earliest convenience. ~ Sincerely, d t }a1 Wallace L. Duvall Administrator F ~ k z N4i d WL,Dtgm Se,av ns&tton Counby for 25 Y140 Y 11. 7 4f ; " ~ ► ,~h~. r,, , _ faro scaif)(A& f3ENTON, 1'fXAS)62pr t ti ~et»~r•srst r 7 June 29, 1070 Mr, John Lawhon r County Attorney I County Courthouse 1)ettton, Texan 76201 i Dear Mr, Lawhon: 'r per As a follow-up to our meeting this morning, 1 want to outline the facts ~ i p taming to our request that the. State Attorney General render an opinion on a question. The proposal that Is being considered is that the CFty-County ~ Hospital BoaM lease land to an individual or firm who Is interested in eon- strutting a professional office building on the hospital property, This buildin would be a multi- ' j story building of approximatsl B 000 s g ;k sit on approximately 10, 000 square feet of the hospital land and febe adjacent et and woao +s tha east wing of the hospital, with a bridge at each level, The proposal Involves r3 at proposed and long term lease with the construction managing of the building in the hands of another iindividual hefi construction There would be a reversionary, clause that wound cause the title of the building to raver to the City-County Hospital Hoard upon completion of the lease, t The question that we would like answered is whether or not the statutes rr permit the City-County Hospital board to enter Into a long term lease for a «g professional office building. If this Information is lacking in any wa feel free to call on me, y, please ? Your assistance in this matter is sincerely appreciated, # ^ Sincerely, ; . ~ Wallace L. Duvall WLDtgm Administrator cot County Judge Den Trammell Mayor limner Hughes r City Attorney Paul Isham ity Manager Jim White ' Dr. Charles Saunders for YfQn K BUSINESS MINUTES onii January 20, 1077 ~r I Pnga 1 I' The final inspection on the -renovation project was scheduled for January 10; 1 i e however, dive to the weather conditions the 11, H, W, representative and some others j, could not travel to Denton on that date, Since the final inspection could not be.con- ducted, the state representative made another payment inspection, This should enable us to get some more of the grant money. The final inspection will be scheduled as goon as the state and federal people can reschedule the meeting, [ There are still some small things to be completed by the contractor. t All of the color television sets have been Installed. i We continue to be concerned about the patient census. Last week, as expected, the census increased to a level that wou Id enable us to meet our expenses, However, the patient census has not maintained a constant level. We are continuing our efforts Yfl i. to find ways or Increasing our'mv~ nue either through Inpatient or outpatient uttliza- tion and to reduce our expense level commensurate to the patient load, ~I I continue to hear that we'ean expect more and more restrictive and regulatory legislation at the state and national level. On Wednesday, a report was made at the }+lY~+ I Dallas Hospital Council meeting that the Bureau of Health Insurance had sent Instructions to hospitals that emergency room physicians could only be reimbursed l for charges equlvatflnt to those rendered by the private practitioner. Fortunately, f ° II tho -13ureau of Health Insurance has reconsWered this matter and will do a study i ff which will take six months or more, As these and other matters are prevented' I! will try to keep you Inforrued so that perhaps we can call on our representatives to let them know the importance of such matters on our hospital, Respectfully submitted, 1 Wallace L. Duvall Administrator WI.Dogm t.n FEB 2 6 1977 ,a CITY OF DENTON w MANAGER'S 0F'ICE I i r 1 , YY 'V !C p y a 430ARD O1~ DIitEC'I'OR BUSINESS MINUTES DO* January 20, 1977 Page The Board of Directors of Flow Memorial Hospital met at 7;00 p.m. on Thursday, January 20, 1077 with Dr, Charles Saunders, Chairman, presiding. All other Board members were present, 1, e„ Mr, John Carter, Mr, Robert Henzler, Dr, George Holladay, Mr. Brad Moore, Mr. Billy Self, and Mr. A. J, Testa. Also present were Mr. Wallace Duvall, Dr, S. T. Love, Mrs. Gloria Madewell, and Mr. Bill Vokonas. 1 Dr, Holladay moved that the minutes of the previous meeting be approved as ` submitted; this was seconded by Mr. Moore and passed by voice vote, Mr. Testa reviewed the Wlnance Committee's minutes of January 17, 1977, noting that they had discussed ways of reducing expenses with the emphasis placed upon reducing staffing to be commensurate with patient load. Mr. Testa emphasized that the e the financial strength of the hospital is strong; the cash flow is directly attribu- table . patient census, Mr, Carter moved that the Finance Committee's minutes be approved; this was seconded by Mr. Moore and passed by voice vote. The Charity Charge-Off List in the amount of $8, 242. 16 and the Bad Debt Charge-Off List In the amount of $16,231.21, which had been recommended for approval by the Finance Committee, were presented; Dr. Holladay moved that they be accepted; this was ru seconded by Mr; Carter and passed by voice vote, Mr, Testa moved that the financial ' statements.as presented be approved; this was seconded by Mr. Moore and passed by C voice vote. Mr. Testa read the minutes of the called meeting of the Finance Committee on r} January 4, 19774 That ineeting had been called to discuss the financial status of the hospital, some person net matters, and the data processing system conversion. Mr, Testa stressed his concern over the non-professional way in which the conversion was handled by Medical Dimensions; Inc, Mr. Duvall added that he has since met with MDI representatives and expressed his dissatisfaction with the conversion, The personnel matters were discussed with the conclusion that the referenced departments ,a are operating properly, In a further discussion of billing problems and errors, Dr. Love related his personal experience with the billing system. He stated that his L z r i, current bill--as billed through the new computer--was lncorreot; furthermore, In the et k past, ha has had errors on his bills, in order to determine whether or not errors on patient bills are widespread or just isolated instances, Mr, Self suggested that a sample survey be taken. A survey of 104 patient bills could be taken, asWng such questions as (1) Was your acco tint handled correctly? (2) Are you satisfied with your * r" account?. (3) How many times did you have to contact the hospital to eorrect'any ' errors? and (4) Is the itemized statement of any value to you? This survey could then R be, used to evaluate whether or not a problem exists with the patient bills, Mr. Carter 10") moved that the Finance. Committee's minutes be approved] this was seconded by Mr. rk" Self and passed by voice vote, i The Foundation's minutes were read by Mr. Henzler. He noted that the payment ta5 from PIret City Realty Company for the Forester tatate had been received, The Foundation had agreed to purchase a transformer for the radt-camera, an arterial pressure monitor, a fetal monitor, and a laparoscope. Thre9-year director forms for Mr, Henzler, Dr. Holland, and Mr. Lea were renewed, and the following officers wepe elected: Mr. Walter Lea, Chairman; Mrs. Lou Nelson, Vice Chairman; 1Vir, We C, Orr, Jr, Treasurer; and Dr, J. W. Holland, Secretary, Mr, Moore moved that the Foundation's report be approved; this was seconded by Mr. Self and t, passed by voice vote, 1, ,r i ~~11°°4taocm _Q A BUSINESS MINUTES Data ' January 20, 1977 } Y r page 2 The Joint Conference' Committee~s minutes were read by Mr, Duvall, Asa ; A 4 result of the Committee's suggestion, Mrs, Linda Brown presented a general review of the audit process and a detailed review of the acute gastroenteritis audit to the Board members, Dr. Holladay moved that the Joint Conference Committee's report j be approved; this was seconded by Mr, Iienzler and passed by voice vote, Dr. Holladay moved that the medical audit on acute gastroenteritis be approved; ? this was seconded by Mr. Self and passed by voice vote. d Mr. Duvall read the Adininistratorfs Report and explained that the final Inspec- tion on the renovation project by the state and federal representatives had been post- poned because some of the officials had been unable to travel to Denton because of the snow and ice conditions. However, the Texas Department of Health Resources representative had conducted a payment inspection at that time, and some more of the r grant money will be forthoomings Dr. Holladay moved that the report be approved; ,j this was seconded by Mr. Mooro and passed by voice vote, ate ' ' Dr. Love presented the M-edlcal Staff Report reviewing the Medical Staff meet- ings held that week. He stated that he felt that the patients receive good care presentl fi43 1 at Flow. Mr. Testa moved that the report be approved; this was seconded by Mr, Self and passed by voice vote. ~ 2~ 5 1;~f The application to the Active Medical Staff of Richard W. Williamson, M.1),, orthopedic _surgeon, was distributed for review. Mr, .Testa moved that the ,application a* be approved; this was seconded by Mr, Self and passed by voice vote. 'qA Physicians for re-appointment to the Active and Courtesy Medical Staff and dentists for re-appointment to the Dental Staff were individually reviewed. Each • application was individually considered for physical and mental well being, Where f 4 , were no exceptions' taken. Mr, Carter moved thet the applications be approved; this was seconded by Dr. Holladay and passed by voice vote. A complete list is attached, There was a discussion concerning recent newspaper reports of city employees being taken by ambulance to other hospitals and possible reasons why, Whenever a person is picked up by the Westgate ambulance, it is felt that that person. is more likely to go to Westgate hospital than to Flow, Also, it was noted that utilization of the Nuclear Medicine and Xeroradiography units is down--probably due to the fact ` that Westgate and Lewisville Hospitals have similar unite. ' A proposal has been received from Energy Controls, Inc. to install electrical devices, which would purportedly decrease electrical consumption through controlled regulation; of the voltage. This proposal will be investigated further, as well as ~f y verifying installations of similar equipment at other locations. ✓ Mr, Duvall reviewed the utilization Review fie ports `Seventy-two Medicare and 17 Medicaid admissiona+ as well as 21 Medicare and 1 Medicaid' extension of stay 's cases had been reviewed and ,justified, Dr, Holladay moved that the report be approve ; k this was seconded by Mr, Henzler and passed by voice vote, Otis' _ Dr, Holladay agreed to begin providing the Leglslative Report, whenever there is something of interest to report, Ile reported that he had learned at a recent TMA ' 'F r j . ~0 Yf • L~TW^..'._.Y'.~..~.~'~~Y:'T!Y.-:~.... Y'[Y..t_L:._9.2~!!_..,.~ W(It~4iq`,kdd.!S}S'fi.ir,~rt{k3'ir_arFp ter. A •IAUARU UF' DIItEC'i'UR - BUSINESS MINUTES _ DN, Japuary 20, 1077 page 3 I ~L:`.'.Y:."'~..i'~.w~~F Y.-...__~.~...~. "~.~._:L__-_•_-_._•_.1.~.=.1"`L. -.~.~.:3:.:.Y:=T.'_'~=1 .._~....._.r._~. r_ Legislative Update Meeting the TMAIs complaints against the proposed nurse practice act and optometrists being able to use drugs, A TMA malpractice act which is pro- posed to be introduced this year would limit recovery amount to $600, 000; limit pain and suffering amount to $100, 000; deny lump sum custodial payments (not death); ~ provide an arbitration panel which would not be binding; set lawyers' fees at a percen- tage similar to workmAnls comp; and would not deny the persons the appeal process, i Also,. AMA will propose Its own national health insurance. Mr. Mesta moved that the Legislative Report be approved; this was seconded by Mr. Moore and passed by voice vote. As a part of the Denton ecord Ch nielels, "Progress Edition, " there will be an advertisement from bpi w Memorial Hospital, Mr, Self, Mr, Moore, ano Dlr. Lov asked to review the proposed advertisement prior to its publication. 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E , . _ . ~ _ _ S. a,.. r. i ~ i..;_ ~ - :,.,,.~~"w~..... ~ _ OA 0 6944 - / 1910 SCRlP1 UA6 04FNfON, fEXAS76?Of rani sear I I 1 , April 28, 1978 i , The Honorable Dan Trammell County Judges Denton County Courthouse Denton, Texas 70201 j Dear Judge Trammell 1 As you know, Flow Memorial Hospitalts Board of Directors and staff have been doing considerable review and analysis of way A of enhancing Flow Memorial Hospital, In fact, a great deal of thought has been given to ways to sustain Flow Memorial Hospital--not just enhance it--during the last two years, For almost two years, there has been considerable interest on the part of the Board of Directors of the Hospital in constructing or having con- structed a professional office building adjzcent or tied into the hospital build i ing, Such an office building is believed 46 be one of the keys to success--not t only of this hospital but any hospital. There is a trend on the part of physicians y to establish their practice as close as possible to the hospital for the obvious convenience factor, It is not adequate to be a block or two from the hospltal, If a physician has an office connected to the hospital, this obviously determif,es where he will admit his patients. If his office is located even a short distance away, this will not `give him the incentive to admit his patients to any particular hospital, I am enclosing a copy of an article that discusses hospital-adjacent i medical offices and the resultant efficiency for patients and doctors, There is no problem in obtafning the money to build a professional office building. We have had investors from Denton, Dallas, and Houston who were anxious to make an investment in such a building here at Flow, Although there is still a few office spaces for physlclans now Available, tho new physiclans coming into Denton desire to be located in an office which is attached to a hospital, and many of the physicians currently practicing in Denton desire more spaoe, Those people tnter6stad in investing in office buildings would be willing to sign a forty-year lease with a roversionary clause, This arrangement would provide a building which would eventually revert to the hospitals but, more importantly, it would provide a place for 20-3$ doctors who would be presented with a place for their office that -would certainly contribute to the well being of Flow Memorial Hospital. One investor informed us that Westgate officials had recently offered land to him for building another professional office building. i Sdrn+ttq na tm cmtM y for 35 Yes . axy •~c~vsz~~+ r y S Page 2 Judge Trammell 4.28-76 There is one little problem. I have been told that several years ago, a physician or physicians desired to build such a building on the prop ! by Flow Memorial Hospital, and they were told that it was note all rty owned to do so. I consulted L. A. Nelson, and he gave me an informal opinion to the effect that it is legally possible. Before proceeding further and perhaps expen- ding effort that may or may not be profitable, I would like to get a determination from the County and the City concerning the legality of constructing a building on a long-term lease basis with a reversionary clause, if we can resolve this legal question, a building could become a reality very quickly. Again, this should be a tremendous financial asset to Flow Memorial Hospital and to the County and City. Please call me at your convenience to furthor discuss this subject. Sinoerely, ' ~ Wallace L. «vall Administrator cc; VIVlayor Elinor Hughes Mr. Jim White ' Dr. Charles Saunders ~ WLDigm C; Enclosure i n _ A i 1 theare March 1976 t i Hospitalwadjacent medical offices I k On-campus medical Mark M. $two j 4ffIC@ buildings heh the far aouth•$ide neigh- department, and physical therapy make medical care surroundingSouth department le brisk. more efficient for Wborhood ago Community Hospital be. Utility of an on-campus medical atients and doctors gan changing, adminietratoit were office building is not restricted to p in is quandary. The draAdA the hoSpItAls facing problems. Special- typical cycle of urban decay Ists in healthcare facilities unani- pbysiclAns fleeing the community, mously agree that the trend toward I declining occupancy, tkiltny- reve• centralizing medical services will nuea, and fofced reduoVins In pa. continue" PhysW'Ant Increasingly tient services, instead of fitting, need to be 06:M to a host of spa. back and watching the decline of clAllaed, sopphlsticeted`~ equipment, a once-fine Institution, farsighted Tho. speelallsts advWe rtll hoepltAl hospital staffers swung into action, administrators at leaat,to be think- The solution they opted for key. hag about the possibility of an ad. stone of which was building a jaeont me4i9At office bullding• medlcal office building Adjacent to Suzanne Batko, American Hospi• their hospital is part of a trend tat Association staff pssoolAte who ! e!hAa that Is gaining momentum natlon• lasat year ran 14 seminpre on hospi to fay', wide, tal•based medical office buildings, "It is the only way to go to keep says the trend In such that even prl- i physicians in a changing communl• vats developers are locating their atlnp 11 says Robert Thompson, execu• now, medical office pro dots "with- tive vice-president of the hospital, In a block of the hI pitaL" She Zettle I ' The three-floor building, cempiet• adds it Is better it the hospital itself ad early In 1071, with underground dovelopt the building, or leases parking is' fully occupied by 26 land; for It on a restricted balls to physicians and one dentist, Tho physicians for`devefopment of their hospital's four chiefs of service own office facility. "'the hespltal have offices there." should malntale some control of I The building was not built to the Way the building is run," she make a profit -W In fact, a small says,' "They probably couldn't pro. subsidy Is nodded each year to op. hIM physicians from having an X. erate It. But ita location, attached ray or small lab In thdlr owd of- 14 the hospital by A covered, soeurl floes, but they could bar an Inde• ty patrolled, all-weathet• bridge, pendent x-ray clinic or frewetAnd• } has Increased occupancy and en ft 01InlcAl lab." couraged greater use of -hospital Batko believes the on•cAmpus of- Ancillary servlcos, The 400 hod boa. Pon building results in tremendous i petal now averages a healthy 92.6 payoffs for patfents As well As the per cent occupancy rate; business hospital. A recent study of 66 hem. at the pharmacy, x-ray department, pltals compiled for AHA by Consul- outpatient labs, reeplratory `hovapy tanks Drexel Tolend and Asaocl- COfITINUab : • Modem Hoatthesfe/hlemh 1978 1Ss 1 Y I MW CAI. Of'FV~ ACC gl11OINS ales, Inc., MomphIs, Tenn„ found Increases revenue to the hosppital," Chicago firm that the Meme hospital stay for Batko says, The highest billings three on•campua buildings In a patients whose physicians were of• flood on are on the Aral da that has developed •eampus wail reduced from ning when the greatest number begin. adjacent office building can faollf• 7.94 days to 6,86 days "The shorter diagnostic and ancillary ser0 es tatotshiftingi expensive, e, heav a out. stay reduces the coat to the patient are ordered." but the quicker turnover of rooms Frank M. Whlston and Co„ a clans' offices. Whistonrexpert Jack Brennan adds that the building can contribute to the hospital's total pa. l' 5, ; tient care image and can foster closer cooperation between hospital staff and physicians. Thomas Zirkie, of Zirkie, Lee Hospital-owned and Associates, , h w -,~~r~+ ba .nom o„ con I td., Larkspur Col , ' t Ion can ~nventory s A` tends Ehat from a phflo• I t; Nti a physician' Iciaftr ay far tits standpoint and practical economic ditbf elfish #41F ..l r 3Y/t point there are low hospitals that Shouldn't be considering an servtaa,abGujlty, t' < t1Ns }O tifl:U bon i on-campus office building, "Unless #sl I D~►kl "Malt!, „ ^capital i flnanelal commitments have direct. f she ntOt : ! t' A n; ed all of a hospital's available capl. p sl,t. f ti ~WItR~ 1i tal to other projects, or unless the fMA landlordis the ' hospital's land Is limited, an office tmalntalt~sft ivy Idspr project should be eonalderod," he { I►Wp r' 7 1 ! t l ti,?- I SAYS. Willa adds that In metropoll• tan areas, land for parkfng la what h*u- • usually hangs up a project part(ou• i aita AIL i' tr laxly it zoning laws torbid atruc• duppaa ~ aabc~< {0 '.x tured parking, "it a hospital is in osdcllla, 7a a restdential area, which many are, traffic and ambulances may be a problem already. Residents may ralso objections to expanafon „ he Physician-owned days. ' Zirkle notes that In sl ospital the hppojec 1', ~ S h yh fO~trN ,t~~ tv "i1~ q^1 .>~q r YP,m' be had consulted on, most hospital „ , 1ihy~ECl~n~ , 4,~n~ r `H sldhston}iolof ! itself doesn't develop the building ' ~r ti ry i IJ1g'lebb, AIthOUgttit lessee the land to sag physicians fti w, rtG►lot5 , be to develo an office building them. t'}iot selves, gip TNe hospital often wants i.. ~p{eat , to avoid being landlord to Its phy ~ 't' yrA ~ee)t' dlelans It also ma like to keep Its capital free, ho says, "Beaides; It 4~I Vf~gldr'~ a phyaiolan ties up his stoney, he I loUfkaaa, ' ttlr wants the hoapI I to stay vital, Ile i Is more likely to take An active In- At In medical staff activities," Attracting ph ysfolan•tenants can Private developer be a stumbling block, Brennan em- ;~s~ur r , , phaslzes, Generally conservative, DIP ~t4ed torn' t lrn,. phyafolans often will reslat movin flakra h ,t , ;,l„ j, All tl td} bfir! s ! unless it la absolutely necessary to operatlonat ny, move) But often they can be oyes. ~t , y' (~t~~ vineed. . don't believes have tlms to waste driving between hospital and office. Their saved a trip to a labtfor tests be cause the hosppital's services are on. ! f sitoi hospital god patients feel more secure knowing their physician is I g nearby. Dovolopment of ancillary i physician facilltles also has been given a boost by the new fedora( lot , g Kom e 1 r,'i>iri1 * a* r MINNIAM In emphasis on hospital admission re- year or later). Even if the hospital that on building a fnd ree g a• view, The Alm is to encourage Is not going to develop and own the Ing medianycale building Im "invlEin•atA an treating individuals with relatively building Itself, Zirkle suggests, It white elephant" there are con li• minor allments ae outpatients in should consider budgeting, say, slderatione that could sour a hosppl• 3f physicians' offices, With the hos- $10,000 As Seed money for the proj• tal on the Idea. The Whleton Co, 01W backup right there, this Is pcs- set, "1t takes work to cultivate the cautions there is a reasonable pos. rk sible'for more: asea,11 Brennen says. phymlofan Interest. Money for the sibillty, that the property Involved nn herald Farley, aaalstAnt program effort should be allocated, perhaps may go onto the W roles, Medical ~'A. diroetor, American Medical Asaooi• with the agreement that it the proj• staff members may look on the ter Atlon Department of Practice Man- ect goea through the hospital can building as A hospital attempt to (tal agement, says the "blggo^t buga• recover the Initial cost," gain more control over them, And j I boo" for physlelAns In a fear that It the project looks good, a pre. if the project Should not be readily moving Into an adjacAnt office will liminary plan should be outlined, accepted by staff physicians on its ` or, bring them under the control of the At this time the o ership of the own merit, it may be necessary to to. hospital administrator, He meet this building should be dooided, It can work harder At 'convincing phyel• nlc fear generally being overcome, but be owned by the hospital, by phy clana to move in, "Once a financial 118 adds that some office arrangements Melons AS condominiums, by a commitment is made to develop, can be worked out to eliminate It group of physicians, or by a private and a building Is conatruatsd, It cMs entirely, He urges his member phy developer; Physicians and the hos• can't just sit `there, It has to be of( a>to to consider owning the final Should discuss the options rented," Brennan LAys, til• building themselves or working out and, depending an what is chosen, The hospital also may not wish the a straightforward lease with the decide what rest: fctiorm are to be to get Involved with the specialized i j lee hospital, "One thing that must be included; Zirkle, for instance, urges headaches of developing, renting 1 cite stipulated In the leAbe !s thAE the all nonhealth•relAted enterprise# to and operating a medical office, physician la. not bound to use the hAt hospliAl's Ancillary s e r v 1 o e m, dealt Tricky with design Include have to be i cue Though they can be a convenienc) The A IpeelAl nclude plumbing and uc• for the patient, they often are mor<~ biggest bUga tlonboo is , gag, j and i expensive than independent lams or the fear that moving Into acoustics, ramps and wheelchair 1 1 j;re the nnhyalelAn's aive than own," access, and fully flexible heating ' a he ereya, an adjacent office building and humidlflcAtion systems, Oper• Where Are significant advan• ating the Wilding presents robe a~ takes," Parley Says, "Phyalelaits can will bring physicians p ! give better aervice to their own under hospital control. isms, too. Cleaning must be provide emergency patients; with road time od six days a week. Floors and I acs out, more patients can be soon walls must be scrubbed more often 1 Iltal which will increase the availability be prohibited. The type of building carend dioffice ce building than etcher a regu• 1 1191 of medical service as well as In, should be determined, A rollmi• ng or a home areas. Ans crease physician Income," He Adds nary budget should be drawn up corny IS a problem In some Areas, j Community relations em• that having Mn offices aluStered At And initial flnanclat inquiries made. ticklish The cARA ae' present into a hospital can give even A series of Clearance must be sought from lo- problems; The may S Bon ,hy+ eofo prACticea the aura of a'group cal health planning bodtem, says Area reAltora may be eon. its praetlee white reducing the prob. 'The process at this stage should corned that the on-alto boffla us, will It lams of joining A multlepeclalty be entirely out In the open, In one ee he comnoting with their pecfolly if it does not have to hs group, It Also facilitatoa consults- came, the physician' determined make A profit. Brace and limb He tions between physicians, " Farley there would be no group prectlees shops, or neighborhood coffee In. SAYS' permitted, In other places, physl. Ahors, may feel Aimllar concerns Launching an on•eampua office clans often want to keep out Woo. About unfaiompetition. It the con development to - a complex project paths, or dentimts, or Chiropractors, r c ~em. that mUmt be carefully weighed, sometimes the hospital wants to building Increaaea traffic and lye, Zirkle and Brennan advise the hose prohibit exterior signs for medial Imaberm neighbors,the could ou s ~,Ing pltAl administrator Aeat to evaluate groups, Theme restrictions ma mage in the community could safe 'Y to his land and begin to figure how work out, but they must be oz fen cony many MDe he can Attract, He should plained And discussed above- B°t oven though the effort is not time explore the Idea with board," to be It cpitfalls. rested In the continue Physicians, TIrAll t nal urges. to bo Interested In the idea, Look• rmal opal tlonnelNeWhat faelll fe' are they the bulidltt ices beatartedtArchl. Ing forward, many see Cho govern. i i lot in nowt What kind of building loofa are eailod in. Land conteAttS ment And third-party insurance be.. Wright they consider moving Intot are signed, AnAncing is lined up, carelorm eontinufng to press' for one What kind of ownership option Written c6mmitments are sought more centralized care either pore would they profert Brennan adds from futUPe tenants, Construction hospltAl•eontered or delivered by n is that the survey should find out Starts, large groups, perhaps prepaid, that Lary whether physicians who own their Although the on•camppue medical Are Attached to hospitais. An on, peen offices tire near the and of tax Ad. efflce ib a trend Zirklo's partner, eampuA medlcal building could be (erAl vantages (usually In the eighth architect Wayne Lee, SayA flatly readily adopted,■ 19^4Arn 4lnnnhrgrp/MArAh 1976 itlu f: s IP ~~glelY.r.... r Nti.tl{~ BOARD OF DIRECTORS IUSINESS MINUTES oa+a larch 18, 1876 Page 2 F A proposal to raise the private and semi-private room rates by $6.00 each was discussed. . Mr. Wagner pointed out that this rate inorease is based on an operating lose per patient day in February of $4, 453. This would raise the private rates from $63 and $65 to $68 and $70, and It would raise the semi-private room rates from $56 and $58 to $61 and $63. Flow's room rates would'still, however, be the lowest in the area for comparably sized hospitals. After a discussion and expressions of regret at needing to raise the room rates, Mr. Carter moved that the proposed rates be approved; this was seconded by Mr. Henzler and passed by voice vote. n Mr. Duvall reviewed the Utilization Review Committeels minutes and noted that i that Committee had reviewed 87 Medicare and 12 Medicaid admissions, as well as 27 ` Medicare and 9 Medicaid extended stays. In all cases, the Committee had found 'them! E to be justified. Mrs. Simpson moved that the report be approved; his was seconded by Mr. Henzler and passed by voice vote. { Mr. Duvall explained that the Nursing Aduit Committee had not reviewed charts this past month. Instead, they had met and constructed outcome criteria for vaginal and abdominal' hysterectomies which can now be used in auditing nursing care. Mr. Carter moved that the report be approved; this was seconded by Mr. HenzIer and -passed by voice vote. The Legislative Report was presented by Mrs, Simpson, who discussed a recen article which expressed some East Texas physicians' concerns about,the new Health Systems Agencies and the power that they,might have. These rural general prao'tttio ers are apparently concerned that the new HSA+s will force them to, d.trect their patien to go to specialists in the metropoliiian areas and, in some cases,. close faCllities, They have also expressed some concern about not being adequately represented on the new HSA's board. Mr. Henzler moved that this report be approved; this was second by Mr. Carter and passed by voice vote. The applications for the Courtesy Medical Staff with privileges In the .Emergersc„ Room of Dr. Paul Kornu and Dr, hoary Murchison, Jr, were distributed. and reviewe'.,. Mr. Honzler moved that they be approved; this was seconded by Mrs. Simpson and passed by voice w ft. Dr. Saunders pointed out the copies of the f'flospttals: Fact or F'ietion,Nhich were sent to the City Councilmen and the County, Commissioners. This is the second ` I one to be sent in the series. The meeting was adjourned at 8:05 p, m. Respectfully submitted, A. J. Testy { Secretary i gm .c: ~'.'..•"CJtyCC= ",^*~•••~•w••••}py...~~a~ ~yyr l-_ ,w:tet"..:C.'^3`.ti~C -+>z+--="CY:~d1Y2.1.'YYTI•YSSYSCYM2dGtllYtMltitlflRtJCACM i S L.n Q.A ~d VMIHL14b111 td10 C0., aI.. YNr IllIY 011 ~a .,IYlU Il tl 1 A. 4p ri,e I I i BUSINESS MINUTE na - Q ~a arch I ? 978 1 The Hoard of Directors of Flow Memor(al Hospital met at 7100 day, March 18, 1977 with Dr. Charles Saunders, P. m. on Thurs- Chairman, presiding. Other Hoard members present were Mr. John Carter, Mr, Robert Henzler, and Mrs, f son. Also present were Mr, Wallace Duvall, Dr. J. W. Holland, Ms. Dins. Nut sky, Mrs, Gloria Madewell, Mr. 811.1 Vokonas, and Mr. Dale Wagner, The minutes of the previous meeting were reviewed, and Mr. Carter moved that they be approved as submitted. This motion was seconded by Mr., Renzler and } passed by voice vote, i Mr. Carter read the minutes of the Finance Committee, and these I He noted that the excess of revenue over expenses for the month of February was cuss d, $46, 000, and the average dally census had been 94, Mr, Charity Charge-Off amount of $18, 471. 04 and the lead Debt Carter mov that the Charge-Off amount of v7, 026, 82 be approved, This was seconded by Mr. Honzler and passed voice f vote. voote. Mr. Carter moved that the financial statements for the month of February be approved; this was seconded by Mr. Henzler and passed by voice vote, Mr. Carter' i moved that the financial report as a whole be accepted; this was seconded by i Mrs, Simpson and passed by voice vote. j Mr. Duvall presented the Joint Conference Committee's report, He discussed the "current status of ambulance ne otlations--g viz, only a'vert' remote'ehance that negotlations will be completed for a Joint service wYth Westgate, application has boen filed for an emergency frequency, Motorola coThereforej,an mmunidatlons ll equipment' have been revloWed, and-,a demonstrator ambulanc e is at the hospital tod ay A 'decidlon from Westgate concerning a, joint`agireement is a p''o6ted`on Maich i tentative meeting with the C ity and the County has been sched a uled for Ma or 29 and , E Mrs. Simpson moved that the report be approved; this was seconded by Mr, Henxier I and passed by voice vote. Dr. Holland reviewed the minutes of the previous meeting of the F6Q;tdati4'n Hoard and discussed the proposal from First City Realty Company concerning the not on the Forester Ranch, He explained the trondltions under which the Foundation would approve the modifications. He also noted that he had been elected Secretary of the Foundation, Mrs, Simpson moved that this report be approvedt this was seconded, by Mr. Henzler and passed by voice vote. In the Administrator's Report, Mr, Duvall further discussed' the ambulance service question and the ramifications of the three and one half month delay in negatia tions. He also noted that hospital personnel are Involved In 1077 budget preparations and preparations for the Joint Commission on Accreditation of Ho'spital's survey scheduled for April 1 and 2. He urged the 13oard members to attend the summation. conference following the survey which will be hold at 2;00 p. m. on April 2. M moved that this report be acceptedl this was seconded by Mrs, Simpson and passed by r , voice vote, • The Report from the Medical Staff was presented by Dr, Holland, and h r the minutes of the previous Executive Committee meetin a evlew cl had been a proposal made to have separate staff meotingss at Westgate and Vlow. hi would involve twice as many meetings required for the physicians, and he feels that 7tl 4 the majority of tho physicians will not a I j*Ub= pt~ 4 p .~gpprove the proposal, Mr, l•Ienzler moved r..,..w-......4..,:,.,.-. 1,1 RItO CO.If`',.,Ymr, ~-4>~x' I.~~i,~~~.YO .r.a4kra i. 1 7 i l I A GBNDA BOARD OF DIRECTORS FLOW MEMORIAL HOSPITAL APRIL 221 1976 , Ii Minutes j lit Committee Reports i A, Finance Committee - Mr, Testa H. Joint Conference Mr, Duvall III, Administrator's Deport - Mr, Duvall i. IV, Medical Staff Report - Dr. Midgett I V. Old Business Vi. New Business A, Utilization Review Report B. Nursing Audit Report F, C. Legislative Report VI1. Adjournment f • ,i ! 1 „f~ MLIY i.F { I j ~ /r ~~*r~t ~ / fJfO SCRIrTNRE /M~+ywi~r aV.'1.1iAfl,i•R~l+ fir/.j,~,`~MA`/ D~7YfON, T$xl{s1B?Cr I rer» J~rss~sr February 19, 1976 The Honorable Tom Jester i Mayor, City of Denton ~ 216 B. McKinney Street Denton, Texas 76201 f I Dear Mayor Jester: : Our audit firm, Touche Ross and Company, in their examination for f the fiscal year ended September 30, 1976, included'in their report s letter on internal control comments and recommendation. ! Ili{ In response to their letter, we have formulated recommendations ~ for procedural adaptations to implement these recommendations. Please ' find 'attached these new procedures. We feel that these new procedures' not ath?y respond to our auditors comments but provide greater strength to our internal controls and increase our operational efficiency, ( Sincerely, If f Charles H. Saunders, D,n, s. Chairman, Board of Directors Enclosure CHStgm (i ( f I j I S#"iq Dbrtton Counr3,y for 21 'Kao j ",,,,yx ~y,~:e(•Na,:...., ..i«....a,... ...•.>-r,.N.~.,,an..ara o,.r.- 'r. ~~F~~FF.~~ va t~gMaatw aa+(rpa:wY.iaLWnMeM~FI+~w.i»eVMN1iMM!.NNhorfi+VRIe VBt+{e+i G1}~hNl~id'b4bX{ik 1•. r owl t ; It W1.1-16 T ON INTERN-44- 0, ONTA01, AECOMMILNDA'It1QNS i ,-4,ANVAIRY 41i 1076 , r, t. rift'-site 13xvkytl, of Data Proap q ~igppurcep A moat dv lrable la to s Of e C i` I~,ttRttp{a /3,1000 capability to etQre mat~lur j r cigoa. flle$ a~ru1 tits progralats IA Q , orea needed..,to prooo4q those t irll on thu 14111n0 physinlal stomps jim 3 st1►t4a4 d4ak-p40k?, This Cat~bility wr>olcl allow' us to t ku one. "back*up" O~k~"ieQgtl~ t►4p~ l ~ater;ditta fiins~ tamoreme, and flit. "c)rl" to I'll h thy, programs ta; Any otf NO 0WAtr 0 04odel 10 or 16? and, rap Jobs with i. I this anm { f rr oU80 ON if we wore .J4 l'hiN (:'Lvahitity makes th'o itTot411l baokup of the entire Kysteip. which ulwej.~ I rl~ ellruhlr +mtuarfl,y reai ble to aQaopipllph. " the procedures to be Litilixed in creating and malntuinitig (utull~ f r;urfpenl li: kilt, oirU must insure thq integrity and "workability" of wuc:h prucerliwvr~, I'tic Ic,l:rti rir wlr r'r ilia backup ie to be stgrod mupt be avullable ull of tho timo th,rt'I>swi lip-; will 1w Irikcii anti therefore w111 need to be exchanged. It atysuld also ha csrrv6.11111-u ~ r r~~rrri,H ilrrl it w„u1:1 always bo utilized and the "system" not rr,nyprrsrnliA by III( 1, i -o' (l io. rlilfiotili ur,conditiono ptweather, Ifeol tilalt the IloapltNl Cornplux 1,i Irrr'r; 191011g$1 t 1al a kuitable location Wiilfin the building'could btu found, Ef o Yiro rir+ r>li"'"- rt"r3rr o.oj- wru o to prove severe enough to destroy both flip data pr<~c;u,~xtng drrt~iari torrid u"rl H11, rlntu backup located inlet remote area, It to doubtful that lhu Imitmill s1,1 1hu'II' wrnrld ;,urvlvU* in view of , j tltlte@ Copaideratiena, the following Nrnco,lorv, whiff t. miolr.l prorvido I0n% total etlrrgat b4akup fpll systems and dutu is I'voo tm nd6l; l r R. ..,...,...a.,......,.~ra..t.x..t.wt.ti++v+s "1 6-01 Y i'ho itnNl~,rnents►tlon of th:i# 4 lg,requfrq th(I purphaee of t2 V adclitiennl disk packs, the deaignAtlP4-0 it ofg .9.' p Atorago Area, and the purch.one, £ cuntttructicun, or modification of 1; gjtA~E~ st ~ et,irl,Which to stare the baokup disks and related ducumenfatlon, DawTgT~,., C{~J~ ~r~ ~~PCl~vl~lrs All progrume and assggiat i~9 rep will be stores} and m4i, r4 irrcd ut a ourrunt level on the disk ak.h ' .0400 of system) 004upytt►g xc►ot'e that, f, une pack) w►ih tnaster data 414044, 0„lctl +itl be gopted at the grid bf each praoesHil ' ' ~r " 'a~ir ~ -r, • w , ~ cycle, (ac,ncu systems are p 4fgR t} Yq'Mb*r4 Wltekly, bl-weekly, and monthly) ~ or whenever elianges are made i ra m**,, or.oparating systems, xheau copies will thou bo removed from the deparpt%gnt and taken to a data backup storage area, lot;utud In nool ►nr area of the hospitalo At the data backup storage area, these packs f will lie ugullunpud l'ov the backup packs placed there at the erki of the preVious p>~c~cwstrin~ cyclo. 'Pilo "old" backup packs will then be returned to Data Processing where they will Ice uvt1ilablu to receive a "new" copy at the end of the next cycle, using this systecl, tbi- ii irviuil Imckup is always secure in the data backup storage area and never (111dor , my cond(tkln, in t ur Data Processing Department and subject to common dcetruclion 'I'ho litchi, to hu vopiud and the "frequency of backup" are listed below. lhitu Pack Nomw Con~tents~ Frequency of, li,ickui, j Fl I11 I''1 `Iyatein pack; the majority of A/R object pro- weekly grams, A/JR system operating procedures and 1110 5Y9/3 operAtl.ag system , A lth 151; A I R Master pack► A /,1i Master Pile, A I It dully Uuarantor file# revenue usage file A'it'1'ZAR A/h trane4atiopp and "rinhouse" transactions daily C hUlluk Charge paokl 'Ch*rgg.qPgs&ster file$ programs and dally "perailho11, A for 4pe»half of the daily A/R s,ysiem A11I fRSA ti.: • f, •i,~1~j I ~ur~ti ''r~ zl ~'.r. .'f I: 4 y1 I NRLDSK 1'aYroll systen}t ` ~ ~ ` files a t i}'491a~ AaYlf flats bi-Weekly . j and op9rafin Myq 4 t1LU1'SK clenural ledgers elf" +1 •t le gqr ap'epupt+o payable, mopthly and capital 1}sset ilep and opersatlpg systems i ' COPACK Charge-off packs .64"0 #>i 1po.6 f~ Bata Files (Charge-QIt weekly prograrrmn aA 0", r rRQl~",6pAro located on the system i luck?r APO hack,:' a +Poyrep rtMma P 4 ? w'eWY 11, AdditWnp~ Charge-Ott rYds+4' ! it ilk 1 Speciflit procedures Yrq f} ' pigmented.pert !t}#!i +tkl~ I I R u Collection and charge-oft pros oOlt I ~ 1 r ` 'prt►gO>ree for the new -Qittient'Accalint. fiepreSentative System have beep N 1 en ed The d#t41lOO procedures are being written as they Ore develpppd ~tnd tprtad.' The bAsio 'procedurep are attachod k` ~ two lJnclutlures N 1, In additlon, we voceive daily an aged recap of our accounts receivable. This ► - f j f ul5fr Is formulated by ftnakiciai classification, We also receive daily a cash recclpis { f ,ac;hc:dulc In tht: anmo format as our daily A/R recap. This provides ug with tha infov- mutlun on which to reach decisions on What areas of the A/k noed more collectIon uOlvity. A4 wo notiolro a greater data base, we will recommend specific allowance rot, oi,oh rinunuial clusHificution and age factor as required byotsr collection experionct`. Ws, line ulwo ImIldirig a data base on our charge-offs by a demographio basis, This J w111 provida wLi with the information to develop policies and proceduroa ou this basis, nwdt purtlc'ruluril,y diruated to charity patients from outside of Denton Coutity. 1 'Ili, Detall '1'rimm action Luting II ~ We havfr ciutn ud fiat detail trans ' i g atio 11 !n to r , q p st g p ovIde tha gcnoral ledger I revenue distribuilon and included this fop oral ledger node on the final patient hill, JIJI iK,•... . a.;,,e n. w<.:..Ia~ti.raa.,Id4.;R, M'i4C'1~ ! 4 In order to provide a more aceesstbl'e audit trail. We, have begun work on sorne new, reports which wtll provide each reveniie producing department a daily listing of all charges by procedure code, and by patient number, This will not 'only improve our control over revenue charge tiokets,.but will provide valuable in6rmation pertaining , p to utilization of each revenue department by daily activity and by Mix of specific procedures done, This information will allow us to make determination on more productive utilization of our total resources. I ~ i Z' j I ~ j 1 r w r r, A CITY OF DENTON MEMORANDUM i DATEi May 27, 1976 4 i TO= Mayor Elinor Hughes & Members of the City Council FROM: Paul C. Isham, City Attorney SUBJECT, Proposal to Construct a professional office Building Adjacent to the City-County Hospital i have been requested to look into the legal ramifications of Flow Memorial Hospital participating in the construction of a profes- sional office building adjacent to or tied into the hospital. My comments are general because it is not known what type of arrange- ! ment the Hoard of Directors of Flow Memorial Hospital is consider- I ing. It is not indicated whether they plan to build the building ' and lease it on a long term basis to various physicians, or whether they intend to lease property to a group of investors so that they t may construct the building. The powers of Mow Memorial Hospital are set out in Article 44941-1 3oint`County-City Hospital Boards", Section 4 of that Article states "said hospital board shall be authorized to purchase oon struct, receive, lease, or otherwise acquire hospital facil.lties, and to improve, enlarge, furnish, equip, operate and maintain the same, Purther, the hospital board shall be authorized to own, hold title to, receive, encumber, sell, lease, or convey any interest in real or personal property, including gifts, grants, and donations from any source". There is a'provision in Section 5 of the Article that states "it is provided, however, that said hospital board shall not be authorized to encumber, sell, lease, or convey any real or personal property unless such encumberance, sale, lease, or convey- ! anoe is approved, prior to the final oonsumation thereof, by reso- lutions of the Commissionerts Court of said county and the governing body of said City, respectively". f The term "hospital facilities" is not defined by the Actor any oases thereunder. Thus, it could be argued that hospital facilities would also include all related activities including the construction of an office building, on the other hand, this particular Act is part of j a general chapter dealing with County Hospitals and it could be argued that the powers of the City-County Hospital Board ware limited to hospitals. A restrictive interpretation of the Act would result in an conclusion that the City-County Hospital Board could not par- ticipate in the leasing of property for the construction of an office Maw i j Mayor Elinor Hughes & Members of the City Council May 27, 1976 Page Two 3 building or in finanoing and constructing the building. i If the Board is considering renovating or remodeling existing facil- ities at the hospital in order to provide office space, then current funding obligations maybe affected. It is my understanding that part of the funds provided to the hospital has been supplied by the Department of Health, Education and welfare and that conditions in that financing would prohibit the conversion of hospital facilities f to office facilities. j Another problem is the type of financing that will be used for the construction of the office building. The Attorney General of Texas has already ruled that a joint County-City Hospital Board is not authorized to borrow money to finance its operation, except by rave- { nue bonds. if the Board provided all or a portion of the financing, they would violate Article 44941-1 unless such financing was pro- vided by revenue bonds. I in 1975, the Texas Legislature passed the "Hospital Project Financing Act", and it is possible that the contemplated project can be accomplished by following the procedures set out in that Act. There is a question in my mind as to whether or not the City-County Hospital Board is actually an "Authority" as defined in the Act. If it is, the Act speoifibally.states that office buildings are con i sidered hospital projects, and it would be possible to construdt the building. I have two reoommendation:i concerning this matter. First, it would i be beneficial to know exactly what the board is contemplating re- garding the construction of the office building and the means and methods they think will be used for that construction. Secondly, after receiving this information, Y would likii to meet with Mr. Elbert Morrow, the Bond Attorney for the City-Oounty Hospital Board and disouss this matter with him and get his thoughts on the legal problems, if any, that would be encountered with this project. Respectfully submitted, Paul C. Isham f ~ PCT:js cc: Dan Trammell, County Judge Wallace L. Duvall, Administrator Flow Memorial Hospital i p.naa,iwv.r~ayKitJtP~~g4{.'3~'A.r Nx r., r. . „y:~. 1 I N N N 1 ~ ~ N i 1 Nto OD W.W.JNtp fOQ ~WIP~ Apop dW H I ~ a v r{ ~ ~ ' ti ~ p FF++ 0101 N tlp' W 1 I ((p,1~1 ~ Q ~ d! ~ IJ r~ r~ Ia., N 1 I I~ 1 • 1 1 • • , OD ~ O1 jV'V ~ 1~ ~ ~y *4w ' rW }a~U Pte' :1 0l7 ,~p ~j . 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Ih !C N V W V V W V V w V V N 1 , 1 FLAW MEMORIAL HOSPITAL SUMMARY OF CASH RECEIPTS AND DISBURSEMENTS MAY 31, 1978 Month Year to Date Beginning Balance $ 298, 088.48 308, 393.17 Cash Received From, Active patient accounts $ 390, 880, 37 Had debt accounts 80 089,08 3. 064, 847, 68 Cat`eteria 8► 263.19 43, 204.88 Other 1 _ 9,14147.38 80, 319, 20 - _289 g71 f 1080.89 3, 427LL, 806 ToEa1 Cash Available ~ f 700, 707.17 30 731, 148, 22 Cash Distributions } Payroll 188, 787. 03 Payroll taxes 1, 418, 920. 93 0 181, 488.84 Other 1901 278,27 Refunds 18, 8100 28 it 802,146, 24 -Fixed assets ! 18, 828, 4 Noted payable 10o367.01 81,180.34 ( Medicare program 8, 848, 83 3, 417~g 84 Cash ZBalanas, May 31, 1976 318 408 58 318, 408. 68 ~ Gross patient revenues Allowances 412 787 3, 3780 912 Net patient revenue ! 12 888.) ! 87 878 ) 40 2 Cash received on patient accounts Collection expense withheld by agency 998' 048 3, 098, 082 Refu►fds_ ! 18 e7s_) ' I Net cash an patient accounts ! 116 826 $ 3 7 , Ors 2, 9 ) w ) Cash received as a 1 % of revenue 93g'o Cash received as a 82go % of 3-month average revenue 880 l 1 A-11.79 ~~6'M~~YhfM7`A`!:11ldrMHWuWiAfao NpruriNM.Y.;Y~°.,y. 4~~ AIG{dA1kINAUM'1/e4 '...,e4e.:A 1>1ipkV.vhrAMli k++earyV.\1 . f'tsY,'/'YSR r''YIA y, pi a -1 M FLAW MEMOMAL HOSPITAL STATEMENT U1^ CHANGES IN FINANCIAL POSITION OF UNRESTRICTED FUND MAY 31, 1976 Working capital Aas provided byr Month Year to Date Operating revenue (net) Operating expense $ 378, 366 3, 1 938 04 Lose from operations (410, 4:9 ) { 3, 288 230 ) It ems in operations not requiring fundsi r Depreciation 1 Funds provided by operations 19 321 148, 602 16o 789 Nonoperating revenue Increase In long-term debt (net of 1$, 118 current port) 24' 886 236, 686 Donated assets 34870 Disposal of fixed assets f Total funds provided 420 8 003 Zlffir Working capital was used fore Reduction in long-term note Additions to plant and equipment It 242 81 781 Due from plant :fund 74,134 Total funds used 46 038) fit?"`" le ff..., i Net increase in working capital f ! ~ -..10_.873 191 686 1 j Changes in working capitals Increase (decrease) in currant assetsi Cash j Rr eplvables $ 21o352 30,#374 DUe from health care programs ( Bi 277) 2310 317 inventories 39, 838 ) Other current assets ( 7► 324) ( 3► 222 ) ~ 2 68? 49 183 Increase Neorease) in current liabilitiesr , Accounts payable Accrued expenses ( 18, 817 } ( 844803 ) Current portion of long-term debt 41, 148 ( 60 021 00 ) Other current liabilities 36, 488 ( 24 88 ) 1...,,.06 187 O r9 10 Net increase in working capital $ h 1910688 g., a 8.11-7$ ! ~A~~f/;+Yea})dlk~lflGlildtfsViPiNM17.#IN.6 ~n • ,•\ieLt rd i'\if<1hdfNw 41 4.M' . r .qf/YY 1:h4\iJyi.. t 1..L nLN.A iJ,l 4ij fi P);t tl' s. 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(NQJ 'r 01 N O~D dtJBd Oa Nir ~iP W yOe~00 'Nm~iiN W 1~0 SI~OiJA l~ a r u~ • rw (JI 11' i a►~ mho ` - JTF' M l+ a y pw aye pip T':':° .mi S' ~ ~w~►5. 4iHlNil tltp ~m"' ~ "mJ Ur Y N• r r • • • • • ~•N•J .N rJ 40 J 00 Ob ,pJ ~1N{p~~ ~t. ~Ogpl Ny00 N w~H J •J WrO .pOHN W•O rN •tf 0 ~ pp H J 01 " N N ' a ~ 5 •J jppApp rm 00 r~~yy ryy0 ~ ~ ;Cj ~ fr1 mww t yi MrW W aC++N00~►~+EO ~Ir II. OOm~,p'hmi~ ~ I f amaeu w~ f, Id 0, FYI Gyp V ~ ' ~ ' N tl M ~ rqW{ ,`W'• ~ O> ~ ~ ~i ~ ~ I YaM~ Y~ ./rJ!~ ~Hr H i~i-1 i" " [•"~'l ~ ~A ~ 1 W V•4I Vm~~ NW I•i IM ~VI yy~~p~ t' •.wv t I~t I~. V VVW W V IA Y+m , 1 1 w ^ • IJ 44 4A , V 1 V b rK •yI V W V ~ M ' ~rl:'!>kYIA.J y3.nN. 11 ~r .l 1' . ..a,. ,.:H 1. I f El ; i FLOW MEMORIAL HOSPITAL F SUMMARY OF CASH RECEIPTS AND DISBUHSEMENTS i F'EBR UARY$ 1976 r Beginning Balance Month Year to Date .266A 3.7.46. 3 8, .171 Cash Received From! Active Patient Accounts 346s920,37 It 770, 790.38 , Bad Debt Accounts 3 430.81 24; 786. Cafeteria 08 i ~ 7, 711.18 Other 8,, 8894 39, 388,'78 . _ 164, 878. 00 Total Cash Available 383 718.28 1 999 66 b' Cash Distributions Payroll 268, 780.74 860, 082, 32 r payroll, Taxes 120, 889. 28 . Other 106, 968, 48 , Refunds, 9670309, 87 ( Fined Assets' 10, 683.80 ti9, 388.78 21, 807. sX 49 948.x8 Votes Payable Medicare Program 1.226.4! 6, 081.98 386t 125s04 } ...`~~r'........ 2, 08 2~ 0910* 0 Cash Balance, February, 1978 ; 243 030 70 243 030.70 J Gross Patient Revenues 458, 881 !Allowances 2, 083, 028 9s 102 46 a 6 Net Patient Revenue Cash Received on Patient Accounts 349, 961 Collection Expense withheld by Agency 1. 796, 618 'Retundrt ; t {`r Net Cash on Patient Accounts ! 1, 8lj4 1 ( 89 987 ) 398,x' 2 4 Cash Received are a % of Revenue 78 9b Cash Received as. a % of 3-month Average Revenue 83 96 ' 3/0/7!1 44 1 ( \ ' S Ar rlFb , • N r YII 'LOW MSMORIAL HOSPITAi, STATEMENT OF CHANGES IN FINANCIAL POSITION OF ' UNRESTRICTED FUND FEBRUARYo 1976 Month Year to Date ~arking capital was provided bys Operating revenue (net) $ 423s431 10 920.922 r Operating expenses (404, 008) (2, 003, 898) . ' Loss from operations 1%425 92. 974) F Iterns in operations not requiring fundss ~ ' Depreciation I Funds provided by operations 37.848 i I Nossoperating revenue 28.888 Increase in long-term debt (net of $18, 118 current portion) 140.427 Transfer from restricted funds 3, 870 r ''fatal funds provided 84 812 1 1 Working capital was used tors , Reduction th long-terse debt 1, 228. as 080 ~ ` i Additions to plant and equipment 17 179 69, A2y Due from plant fund 0 Total funds used 19 4405 xa, e9e,} Net Increase In working capital .4.0 L2 0 7 1371L.517 huuges in working capitals Increase (decrease) in current assstsr $ , . Cash , 1 Cash ablea 72,407) ( 600009 ) t Due fronn health care programs: 2, 282 3910 399: Inventories f 381 Other current assets ( 64$) ( 2, 431;) , $ 6+1~' Increase (decrease) in current liabilities ' Accounts payable ( 7.908) ( 43, 280 Accrued expenses 99, 739 ' Currsnt portion of long-term debt 39, 664 Other current liabilities ( 2600511 j 1 78~ ' 773 1700 050 Net DIncrease in wor t king capital $ 46 207 137 617, 1 31917$ =1~~ , 1 v..yqu~<.rJ,x.a wn<., Lweq..ew.rv:w ..n -•.rek,rydF ` i r✓r FN C•NH YI i:.14 JAV:..: I:1: .'I.W..f^(,1'I14rY fM l,SJR V41, YlndrtiMLfNS1RJ~16~1Y~vJf. •nai t?hr.~ . tno ~ j(ppp.ff' ~ ~ ~ ~ W M Po~ 1 t Fl, j 1 a 40 lit~ 0 -1 W $ $ P J , smIt 1 19 8 I t l • I 1 f to F.. W N f . +ti r:-, •p.i. a .La ifirb.nd. ♦M1 u. t ps.~1•~dr r x y n t~ C~'' n~ r 09 J, PIT a a ~ ~ r ' w ~F+F+ N <0 N. W'. tpp ppW~~ ~ M1.~1 ~ t / ' 06 tt 0o f+p Qf{ 10 1 1 w NC' '~A Oi to 06 M 1y~ 1~ W v 0 p w f ~ ~1 II {tv~f f~ ppp~ W N 01 !p ppp~ y 40 t N EO USN ~f. I y 1 1 . ID~•t OD lh y 00 C N h7 00 I~p y p~'j • w ~ F W N €J iA ~pWb~ ' W O 1 1 1 1 1 W N I O t40 o fny ~ ~y ~~N+1 ~Apl ete~~o Ww UMW ` ~ v O N 03 J..p 00 IA ~ h j { M N N (A W Lei M.. O 1 •i 1 go V b 10 1 C G I! O YI p~ .44 t4 F'~i N10 N R ~I W N 1 W 1 Otd. j+ 1.110. { IV ~1 00. I 1 O~W fpp 41 1 W I C I 1 f W 1 1 Oe b ~ 1 1 I w N 00 N N y 'low -Y! 1 .~.a past lip CA M i "Nw e~e to000i1 wM{i N E :im i I ~ 1 Ito, n~n I j 1 I 1 ~ A l l m~~ Ir I~ ~ N 1►~ 4~ i iI tivr COO Nv 1 a 00 W a p f 4t! 5 .40 PO a "N (A pp~~ to JtAi W Nd01 v 0 0$ ~W. AO~ raCv p 1 Iy14yg71Y I Owl I H 11 14 O ~ d n tit 't » •d ~b• ~t ~ 's g f~ PP ~ IO V f ;j INs• M VP b, CA f~ Oh Pf W w Chi {W71 GD W Q OI W N p t~ Oj ~w CA W ' N I 1 1 to 0 .i ~,1n1~ ,gyp w1 Li 1r fpN ' o. 10 rA I 1 rP IWIr y ffi N , ' 0~NO w N C I ' t~J Q7 VI ` • IW~/I Nd WA ri. V00 /O. •J UN 1 tailNy tl I? 1 GV N Q IA N 1 N fA !•I ,F• O N I co OI W© N 1 !uD IW W '.i w OO IOIN JaOyIWO 3 44 11~I Nm10 k ( r n~~ 1 r 1 o a moew~ ww~;b".~um : I. Sup {fD1 ~j Icy t~ ~ ] N V 00 I O 00 f0 N W.rP rig G w 1 1 41t1t •A N I co C4 w to PA s +.t W IC ~ ' C V I tNG as 4J N rA ~1 N W 1 V N rWA .f (p m SID I t~Io1 ,p t~ I i W rP Oo goo <b W W W Sb : W W tIS O rA N t,~• + 11 r'I O.i,. ~ bEO N rF V (D N4~ I I {AHD 'r • '1 M OA 11 m N A y fD O W to N rh rA V tip. >f 1 NM••Mk6Kf+~1:CX4figN~'G..:<.•e+vA.w,:wro.w ,,.H U>.n n:+a: I Y , , a... vn s . onr'ratKV~P In •rs. ,.aw,.e_ (Can ; y w a ZI KID M j N I to N r u ~ A Afi , i wo"I Wei phi ~ Bel/a~ 1310 SCMPTUpE' oENrON, rEXA$ M01 ~~~r~KJ'~AGff~~~QyFy""`nr""' ll11JJA111i~1 ~ ~ AA l ' May 26, 1976 Mr. Jim White i City Manager C Denton, Texas 76201 Dear Mr. White: c E Ii i The 1976-1977 budget for Flow Memorial Hospital, as approved by the Board of Directors c-n May, 20,-1976, is attached for your review. Thfa 1977 Financial Plan is organitzed in four sections: Seotfon I--Comments C Sf.Ctfon 11--Financial Statements E Section 11I--Capital Equipment { Section IV--Salarl3s Detail E ~ a This master budget has incorporated format presentation changes to agree with our audited financial statements and the American Hospital Acsoefatlon's Chart of Accounts, This change in presentation will provide the same financial statement format as used in our monthly financial statements and our audited financial state- ments. The gross revenue and expenses were' developed on a statistical utilization base, thereby providing the means of utilizing asemi-variable budget fluctuation f t { based upon actual volume utilization. We have forecast a total of 31, 766 adult patient days, representing an increase F of S. 1% over 197618 estimated actual patient days, Accordingly, revenue, expenses, and related cash receipts and disbursements have been increased to reflect these t u ! additional patient days, Included within the total gross revenue of $6, 978, 06.0 Is a I rate Increase of $3161000, which represents an average increase of 6, 6%. This re- venue rate increase is necessary to cover our increased expenses such as salaries and wages due to the Increased minimum wage and inflationary market conditions, significant increases in Insurance, interest expense, utilities, and other operating expenses, i Because of our forecast of increased utilization, we were able to offset our total expense increase of $610, 000 with a rate increase of only $316,000 and still provide a breakeven total result. This breakeven budget will provide the cash necessary to pur- chase the capital assets approved in the financial plan In the amount of $466.000, After intensive review ot our capital asset requests by the hospital's Administration, Medical Staff, and Board of Directors, the total request o $666, 000 was reduced to the amount 1 ~ S" q Dt,Itton Cain for 21 Y rs WOW f h Page 2 of $468, 000, Projected capital expenditures for 1978, 1979, and 1980 are $478, 000, $482,000, and $610, 000 respectively, This 1977 Financial Plan represents the minimum increases necessary to pro- vide the resources essential to the proper delivery of health care for the members of our community. p'low's management has made significant effort to reduce the expenses of providing health dare in each and every department of the hospital, Only t. those resources necessary to the proper delivery of health care are Incorporated within this budget. t f He pectfully eubm d, Charles H. Saunders, D. 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O•A A bO•d 00 V V rlr N 00000) W O0r0r V • Y Y V V Y Y V V Y V 1• V Y V a 1 r V W Q7 rWw V 1 00tOW N r 1 YN00rNArW0 V ' I : U( V 00 V W00 O\ N !7•NV V O NO NOOO N"~D O O6 O Obd O tld00 O OOCi00tl000 W i I+ i ~ M O p H Gf •q rr h W U I.U { A• W rOt O a a , t-/ M M M W a ro A w to ' ~ r w C(' O A O O ~ H j -ro ONO N W N r U 46 4A +b O co W a a 92 o O o h. o i i i _:.,..ai..4 WticAw..u».e.wusAV4rv W„mpr,.».-.. . .n., ...M., o-. hn 3 ' y rsatny BOARD OF DIRECTORS BUSINESS MINUTES oafs April 22, 1916 Pogo 1 The Board of Directors of Flow Memorial Hospital met at 7100 p.m. on Thurs- day, April 22, 1976 with Dr. Charles Saunders, Chairman, presiding. Other Board members present were Dr. George Holladay, Mrs, Paul Simpson, and Mr. A. J. r Testa, Also present were Mr. Wallace Duvall, Dr. Alex Finlay, Ms..Diana Kutsky, Mrs. Gloria Madewell, Dr. William Midgett, Mr. Bill Vokonas, and Mr. Dale Wagne The minutes of the March meeting were reviewed. Dr. Holladay moved that the minutes be approved as submitted) this was seconded by Mr. Testa and passed by I voice vote. Mr. Testa presented the financial reports and the minutes from the Finance Committee meeting, Ile noted that patient days for the month of March were 6, 3% above l,udget and that a contract has been signed with Medical Dimensions to provide data processing services, pending final determination of termination of the present E equipment contract. Dr. Holladay moved that the financial statements, the charity charge-off list of $12, 982, 94, and the bad debt charge-off list of $32, 3106 29 be approved; this was seconded by Mr. Testa and passed by voice vote. Mrs. Simpson 1 + moved that the Finance Committee's minutes be approved, this was seconded by Dr. Holladay and passed by voice vote. Dr. Finlay was asked to provide information concerning a petition which had been submitted to the Denton City Council recently calling for appointment of a phy- sician committee to study the feasibility of the Emergency Services Plan at Flow " n Memorial Hospital, It had been discovered at the Monday night meeting of the Joint Conference Committee that he was involved in some way with the petition, and he was asked to attend this meeting to determine his involvement, Dr. Finlay explained that his main concern was with the City Council in that they had no method to evaluate the proposals for funding a share of the proposed joint ambulance service. He said he had been approached by a City Council member (Dr. Finlay chose to keep the name con- f fidential) asking how such information could be obtained and that he had made the a recommendation concerning the petition, The Aoard recognized the fact that it was understandable that Dr. Finlay would have logically been approached since he had been Mayor of Denton at one time; the Board also felt that Dr. Finlay was the logical one to talk to about the petition since he had been a previous Chief of Staff and is f presently on the Executive Committee of the Medical Staff, Dr. Finlay explained that he may have been wrong in suggesting that the petition was needed and that maybe he rhould have suggested that the City Council just contact the present Chief of Staff, Also, he stated that he felt that he had not done anything wrong in suggesting the pets Lion as it means of obtaining the desired evaluation, Ile further stated that he had told the Council member to contact the Administrator of the Hospital to obtain a list of the physicians on the Medical Staff for the physician committee, Dr, Saunders stressed that any information is always available to the City Council upon request. 1 Other Board members expressed strong feelings regarding the manner in which the petition had evolved and reiterated the fact that information is readily available and willingly supplied to anyone, Dr. Finlay was asked what action should be taken at this point; however, he left the meeting and offered no further suggestions. The Joint Conference Committee minutes were read by Mr, Duve.ll, who ex- plained some of the surveyors} comments following the Joint Commission on Accredit- tation of Hospitals survey, All recommendations from the JCAH had involved rather MAW 130ARD OF DIRECTORS BUSINESS MINUTES oa+.- 970 Flag. unimportant items and had not dealt with some important factors of patient care. it n way the consensus, on the basis of the summation conference, that the hospital is In good condition, Dr. Holladay moved that the report be approved; this was seconded by Mrs. Simpson and passed by voice vote. Mr. Duvall presented the Administrator's Report and further discussed the JCA survey, He also noted that the renovation project is continuing very well, despite the delays in receipt of convector units because of a Trane Co, strike, Dr. Holladay moved that the report be approved; this was seconded by Mr. Testa and passed by voice vote. Dr. Midgett gave the Report from the Medical Staff. He announced that a rep- resentative of a newly forming malpractice Insurance compaay had talked to the medic stuff at their meeting on Tuesday; this new company would be controlled by the policy holders--I, e. , the physicians. The new SMAC unit is now installed and operating at Medical Laboratories. This new machine, Dr, Midgett noted, will perform 20 labor- atory tests from a single specimen and should be more reliable because the machine v6D automatically calibrates itself. Dr. Holladay moved that the report be approved; this was seconded by Mrs. Simpson and passed by voice vote. Dr. Midgett also presented the applications to the Courtesy Medical Staff with privileges in the Emergency Room of Dr. Kenneth M, R. Warnock and Dr. William Richard Weaver. After the applica" tions were reviewed, Mrs. Simpson moved that they be approved; this was seconded by Mr. Testa and passed by voice vote, r The Utilization Review Committee's Report was discussed, Mr, Duvall noted that 99 Medicare and 15 Medicaid admissions and 41 Medicare and 9 Medicaid extend stay cases had been reviewed and justified. Of special notice Is that the number of G both Medicare and Medicaid patients is increasing, Dr, Holladay moved that the repo ti be approved; this was seconded by Dr. Holladay and passed by voice vote, Ii Mr. Duvall reviewed the Nursing Audit Report, which had dealt with hysterec- tomy charts. One point noted was that the graphic sheets were not being utilized; J however, in the main, the charts were found to be in good' order, Mrs. Simpson 3 moved that the report be approved; this was seconded by Dr. Holladay and passed by voice vote. I Mrs. Simpson discussed legislative news and noted that changes have been made in the Medicare allowance concerning the amount of the deductible and the hospital service rates after the 81st and 91st days, She also noted that North Carolina has filed a auit to invalidate the Health Systems Agency In that state,, citing interference o ' status rights. This suit apparently, also has the backing of the American Hospital Association, Dr. Holladay added that a new law is being proposed to establish a federal agency to set and control standards of all medical devices--from toothbrushes j to the very sophisticated places of equipment; this would be similar to the FedoraI Food and Drug Administration, It Is feared that such an organization would increase 1 the costs of all medical devices, Dr. Holladay moved that the Legislative Report be s n approvedi this was seconded by Mr. Testa and passed by voice vote, The meeting was adjourned at 8116 p, m, Rep ctfu _ gm _ J. 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F,v 11 1 .1 ~ . -nor-.MO.•ner•:jvlk<>1,~4k+Yid/CILSIFnfA+UrY.iV• ! ! , ~s14'R!4 "won FLOW MEMORIAL HOSPITAL SUMMARY OF CASH RECEIPTS AND DISBURSEMENTS f APRIL 30, 1976 Month Year-to-date Beginning balance $ 321, 306, 44 306, 393.17 s Cash received from i Active patient accounts $ 468, 636. 98 2, 683, 967.19 Bad debt accounts 70223.68 38,145.63 Cafeteria 6,390.30 54, 065.28 Other 49, 258.42 266, 946, 35 822, 308. 38 3j 02 20 5W. 36 Total cash available 842o613. 3, 28, 50 . Cash distributions r^ 11011 232, 269, 96 1, 260, 133, 90 t-.x;yroll taxes 70 793, 67 101o456.86 Other 21ff 90 026.04 114030 869, 87 f Refunds 19, 981, 10 98 647, 47 Fixed assets 4,260,02 70o793,33 I Notes payable 10236.65 8o549.63 Medicare program 647, 557.34 '31 033 451 05 Cash balance, April 30, 1976 295, 56 48 8.48 Gross patient revenues $ 4124238 29 9691 126 Allowances ( 1) { 75 310) Net patient revenue 394, 094 2^- ! received on patient accounts 466, 760 20 7020 103 Cor eetion expense withheld by agency Refunds ( 19 981) ( 96 6.47) Net dash on patient accounts $ 445 7 Cash received as a % of revenue 113% 90% 1 I Cash received as a % of 3-m6nth average revenue 102% b-12.78 r I' 4. j I, -y F'L,OW MEMORIAL HOSPITAL STATEMENT OF CHANGES IN FINANCIAL POSITION OF I UNRESTRICTED FUND APRIL 30, 1976 i 'Working capital was provided by; Month _nt^h a Xear-to-date , Operating revenue (net) f Operating expenses 388, 151 2,726, 684 i Loss from operations (4140 843) ( 2, 887, 383 ) { ( 48, 492) 130,7 7 9) Items in operations not requiring funds, Depreciation Funds provided by operations 18, 921 1~ ry~81 ( 2,571) { 3,818 ) j Nonoperating revenue Increase In longterm debt (net of 180 116 current portion) 40, 946 211, 022 Dnnated assets 3 3,870 .i...., posal of fixed assets ~ Total funds provided 434 34 7 683 11 1 - Working capital was used for= Reduction in long-tei-m.debt Additions to plant and equipment 110,, 367 237 748,34 Duey from plant fund ,1134 F Total funds used ( 46 098 ) 41194 e Net increase in working capital V ISO ) 181 012 Changes in working eapitali Increase (decrease) in current assets, Cash f Oecetvables 3( 18, 431) 8, 022 Due from health care programs (1141 746) 239 694 Inventories Other current assets 00 4,102 f . 43 971 48 878. j sr ( 9- 9o 716 ) Increase (decrease) in current liabilities, " Accounts payable Accrued expenses 161 637 ( 36,886 ) Current portion of long-term debt (118, 892) ( 48,166 ) ;t Other current liabilities 360 496 38, 488 ( 2_se) 124 833 f' Net increase in working capital $ 160 r,t, v 28^~0 t a-12~7t3 ' !NGYKbN4FlvYro.... 4 r`l,. 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N ' n. ~j ONyN M,Y,pp N b 'tl L. i S Y s; t~ ~ ~ v ~ I r .4 14 M W, W ti►~ p .t pgn~v ~ I + Y M M j f t?:V N I. ra 1h N f~ Et d I WR ~y 7Rty I ~fy¢~ ~ r I ~ U JJJ ffps] { j IA kA W + N t r.. 1 r t, y 5~tly A~MiiYi%N.14nM..v.yyI11W/MWIeYY Iiw.~ w ~ Vr~ ~'r ~ , I. r~F+,. ....'vaY/.. • aw mua rnr, nnn~µ. ..rrxwwa. n•... i ryr` r Y a r "Owl r ~ FLOW MEMORIAL HOSPITAL MONTHLY STATISTICAL REPORT APRIL, 1976 ~ i . This This Mo. This Yr. Last Yr. j Patients remaining last report: 112 Month Last Yr. To Date To baCo Admitted: t Adult 274 276 1,485 1,920 i Pediatric 40 44 337 296 Obstetrical 85 91 619 638 Sub Total 11 :0941 . Newborn 62 76 503 544 1 Total 461 Medicare (Included in Adult)........... 90 37 618 560 Medicaid (included in all Categories).. 18 25 150 166 Total Patients tVGdtadi 573 p. i ;~DisAharged: ~ ~,Ault 287 276 10992 1,934 k~~} • Pediatric......................... 43 46 345 247 ` Obstetrical 87 89 617 638 , z Sub Total I 2,961 Natrborn.' 66 . 72 SOI; x547 d Total 401 0 Medicare (Included in Adult).......,,,, 101 79 625 561 Medicaid (Included in all categories),. 24 31 153 167 I Total Patients remainingt---90 ,I i Discharge Dayst { Adult...,. 29201 1260 14.406 14,1OS sj• Pediatric......... a 149 1.1487 1,452 `;.:;bstetrieal 283 298 20070 63 y9G3"" `Y7;TOL~"' j Sub Total ~k Newborn 234 254 2,078 20178 s X4; TOTAL ' Medicare (Included in Adult)..,........ 950 591 6,4b0 5,480 ~h*:.• Medicaid (Included in all categories),. 94 170 819 909 l .f sS. Average Length of Stay: Adult ....................4,..... 7,6 6.5 7.2 5.6 7.2 Pediatric 3.4 ; 4,3 Obstetrical...........:.......... 3.2 4.8 i 3.3 3.3 3 3 gi Total. 5:9W 5.4 5,8 8 ,5.R xru; Zr tledicnra (Included in Adult)..........., 9.4 7.4 Hadicaid (Included An all categories)... 3.9 5.4 15.3 5 9 6 .4 1 ip,,•< 1 . ~ ..+.,~•.n.-hawr...}.n~eirl5rwfer.Ad-a>5. Z -tip. Ott,;, R l M RII 197~~ MONTHLY STATISTICAL REPORT S: Page 2 This This No. This Yr. Last Yr. r Census Patient Dayst Ho nth Y,nsC Yr. To Date To Date Adult 2,,145 1,847 14,464 13 Pediatric.,, 151 247 s455 1,460 156 ~ Obstetrical 276 293 2 079 2.048 Sub Total X572 Newborn X224 2280 18,003 16,957 Total,59b ,6 7 200075 19,121 Pfadic,gx a (Included in Adult)........... 922 677 6,464 5,281 Medicaid (Included in all categories).. 72 151 817 901 Average Daily ceneust Adult 72 62 68 63 E Pediatric,,,, 5 8 7 7 f Obstetrical 9 10 10 10 Sub Total ..F6 80 85 80 llewbcrn 7 9 10 10 Total 90 i i dw'Aadicare (included in Adult)........... 31 23 30 25 dicaid (Included in all categories).. 2 5 b 4 Percentage of Occupancyt Adult 64A~d4....... 84% 72% 79% 73% pediatric yp6~j....... 71% 133% 100% 1172 Obstetrical..... *44 AP44....... 36% 402 40% 40% Sub Total 73X 68. 72 682 Newborn. ............24 ,8mwte 27Y 35% 38% 311_, Total 5 ti3X ; Medicare (Included in Adult)`.36% 27% 352 292 Medicaid (Included in all categories).. lX 3% 32 3% Deaths: - Over 48 huurar dlll~ Adult... 8 5 44 Pediatric 0 0 42 Obstetrical 0 0 Sub Total 8 5 44 42 Necaborn 0 0 0 Total 8 W 5 44 42 Medicare (Included in Adult:)........ 6 5 38 35 Medicaid (Included in all categories) 0 0 l 1 Under 48 hours: Adult, 2 2 2t 15 I Pediatric 0 0 0 0 { Obstetrical 0 0 0 Sub Total 2 - 2 21 15 ' Newharn 0 0 4 Total 2 _ 25 - 1~ tfodicare- (Included in Adult)....... 2 2 16 14 Nedicaid (inaludedin all categories) 0 0 1 0 r, Autopsica 1 5 6 Not Autopsy Rate, 10% 14.3% 7.22 9.8% YF6Y.MV.xn aa~` dy1f~twu• va... it Wroni, r. v, u..~. ~..y, , 174}8 This This Mo, This Yr. to Xntebaive Care VnItt (Figures of this Month Laa yr. To Date To Last Date Patients Admitted category are included" mother cntQgoriea Patients Discharged 40 30 265 226 p Patients Expired....,.... 35 29 228 207 Censue Days..,.,,,,, 101 2 39 17 Average Daily Ccnsua 83 808 703 Average Length of Stay., 3 3 4 3 Parcentage Of Occupancy.... ,9.pade,..... 2.6 2.8 3,0 2.9 Medicare:(Included in above totals). 49X 44X 43X Admissions...,,,,,,. 20 Discharges 16 138 15 104 111I Expired,. 15 112 90 1 Census Days 45 2 26 16 J Medicaidt(included in above totals) 39 453 311 j Admissions..: 1... 2 Discharges, . . . . . . . . . . 2 2 10 14 Expired......•........,........... 0 2 8 13 Census Days,,,,: 0 2, 0 3 5 3b 45 ' OparationssOR---Ma,~art Sl , Major 66 ' F,, 70 491 Minort Minor 451 100 136 L&D--Majors 1 Total 803 912 Minor M' Blectrocardiogramas..t..~.~...~.v....TOti~1 267 ~ In-Patiente:.r................ 267 210 - I,864 1x409 Out-Patients 7 209 1,8~~ 1,364 1 45 Laboratory TeaCet....................Total 14,897 10 125 In-P9tieIltet........... 10,083 ' 105,017 76p419 Out-Patients: 1,490 123 6► 76314480390 50,419 123 Emergency Room Patients:...... 1,152 Physical Therapy Treatmer(pst......,.,Total 1,547 In-Patients: 1,389 1,949 120277 10,848 j but-Patientst 158 19588 10,199 81897 3 361 20976 10951 j DiCryr (Meals 9erved)...,,..,.Cgfeteria 3,446 3o079 Patient 7,668 7,107 53508 5 21, 0825 4 Other 10789 1.979 13,676 139814 t Total 12903 . 12,165 95, g Laundry Lbas 44,920 419633 Per Patient Day 16.0 I5,6 3190765 301,070 15.9 1$.7 Emergency Room Visitas 703 726 5,355 4,555 Respiratory Therapy Traatmentar...... Total 2,227 1'163 29211 100799 10,212 I' I,I61 10,637 10,172 YFGt 16 2 162 40 13 15 91 66 X-Ray Examinations: ##.Total 10305 1,316 In-Patientat 721 100053 g,gG4 . Oat-Patients 584 700 5,313 4.282 t 616 41740 4,262 Pharmacyt (Prescriptions Filled) *.Total 19,673 10,489 740240 71124 In-Patientat 050 9'776 ' Out-Patientat 723, 0713 690141 65 770 5,099 '5,354 I' huf'ti im.}81 Ids fig , A ~ J T BUSINESS MINUTES n.;. z~_~.., _F• June 24, 1978_,sz" ,'-=qtr 4 Page Y " The Board of Directors of flow Memorial Hospital met at 7;00 m ~I June 241 1078 with Dr, p• on Thursday, f. ! Charles Saunders, Chairman, prosi at t present were Mr, John Carter, Dr, George g• other Board members present were Holladay, and Mrs. Paul Simpson. Also r l Mr, Wallace Duvall, Ms. Diana Kutsky, Mrs. Gloria Madewell, Dr. W, M. Midgett, Mr, 73111 Vokonas, and Mr. Dale Wagner. The minutes of the previous meetings were resented. minutes from the regular meeting field on May 20 and the called meeting on June 3=be the Y approved; this was seconded by Mr. Carter and passed by voice vote. t Mr. Carter presented the report from the Finance Committee and read the minutes ~ of their meeting, lie noted that the total result of the month of May w ng as an operati loss of $7, 400 and a year-to-date sur lets Of reviewed, and Mr. Carter moved that the ~ a3, 400" The financial statements were seconded b Dr, Y bpproved presented, This motion was by Holladay and passed by voice vote. Thease harity and bad debt charge- motion off lists were reviewed. Mr, Carter moved that the charity charge-off list In the arum of $110 111, 92 and the bad debt charge-off list in the amount of $33, 488. 83 be appror as submitted; this was seconded by Dr. Holladay and passed by voice vote. Mr. Carter Tmovedtithat the report of the Finance Com,aittee be a r rs, Simpson and passed by voica vote, pp oved; this was seconded by The Joint Conference Committee's report was presented b Mr. Duvall. committee had discussed the Emergency Room services and had been informed that. the loss in operation of the Emergency Room had been significantly red used compared to ! fast year. Also, they had. discussed the still unfunded joint ambulance service and had decided to ask the City and/or the County to obtain the financial information from West- gate Hospital concerning the ambulance service. negotiations with the City and the County for the fundssforf Plows p would be am 'helpful in service. Mr. Carter moved that this report be approved; the motion was o seconded by n Dr. Holladay and passed by voice vote. 4 AMOMr. Duvall gave the Administrators Deport aryl explained the beneeits of a new ..f CET.. (Comprehensive Educatlon'and Training Act) program for`trainipg nurse aides and orderlies which started at Flow Memorial Hospital this week. for the Instructor and also pays the 24 students who are enrolled in thCTA pays the fee e course the m! i- mum wage. He also hopes that Cr, TA will be able to offer an operating room technician course its the fa11. Concerning the renovation project, construction has slotted at the present, he expects the coMr. said that while ntrttotdr~to meet the end of the August deadline for the project. Mr. Duvall announced that at a meeting of the City Council this week, they had endorsed the concept of teasing land for the construction of a professional building on the property of Flow Uemorlal Hospital. The City Attorney had suggested, however, than an opinion from the State .Attorney General be solicited, and Mr Duvall ,stated that he is optimistic' that we will be able to get this. This would settle any questions of legality before financiers become Involved. Mrs. that the Administrator's Report be approved; this was seconded by Mr. Carters rid move , f passed by voice vote. Dr. Midgett gave the report from the Medical Staff and reported that a ma[n topic of discussion at the Joint Medical Staff Meeting this week had been the Emergency Rootn K •U6M1M1'yllrNMU.K'~Li{Ap~idt.~ 40 : rj/• ~ ARD F DI BUSINESS MINUTES Delsl ,rune 24. 1978 Pag• 2 services. The Medical Staff was polled, and they had voted to send a letter to the City Council stating their approval of the Emergency Room operation as it now stands--this action taken as a result of recent adverse publicity about the Emergency Room. In response to a question concerning the quality of patient care, Dr. Midgett responded that he has been pleased. Also, Dr. Midgett outlined the reorganization planned for the Nursery and the Pedlatric Unit and stated that he felt that the plan is very good. Dr. Holladay moved that the report be approved; this was seconded by Mr. Carter and passed by voice vote. , The Utilization Review Committee's report was presented by Mr. Duvall, who also explained briefly the utilization review process of the Medicare and Medicaid charts.. I Eighty-seven Medicare and 14 Medicaid admissions, as well as 34 Medicare and 3 Medi- caid extended'stays had been reviewed and justified. Mrs. Simpson moved that the repo I I be approvedj this was seconded by Dr. Holladay and passed by voice vote. Mrs. Simpson presented the Legislative Report and reviewed some current legis tive news. She stated that the new bill concerning medical devices regulations had I become law. Also she reported that some of the states are having problems with tho Health Systems Agencies and that Texas Senator John Tower has introduced a bill in the Vnited States Senate to repeal the HSA legislation. Mrs. Simpson said the health care insurance companies we're wanting to raise premiums because of the higher health care service costs, and there was a general discussion concerning some of the reasons why such costs have risen. There was no further business, and the meeting was adjourned at 8s49 p.m. Respectfc1ly submitted, John L. Carter, Jr. Vice Chairman { gm I 1 t y Oil 1 ADMINISTRAT'OR'S REPOR,r BUSINESS MINUTES _ June 23, 1976 t f o) We have an aide/ordeally training program just started under the auspices of Jay (Comprehensive Education and Training Act). CETA pays for the instructor and pthe student minimum wage while they are training, This program will provide us with a group of people who are exposed to the proper training, rather than us having to em- ploy people and then train them. Approximately 35 prospective applicants were inter- viewed with 24 accepted for the program, We are also discussing the possibility of an operating room technician course being offered through the CETA program. The construction project has slowed to a "snaills pace, " The Trane Company is still on strike, With the exception of the convector units from the Trans Company,. I believe that the contractor "will be able to complete the project within the alloted time, The expected completion date is the later part of August, There has been no change in the status of the request to the City and County for funds for the ambulance service, The last action taken was a vote by the County Commissioners to ask the City Council to determine what action they intend to take ~M1 and then at that time, the County would make their decision, The City Council has made no decision on the matter, At the City Council meet, ng on Tuesday, June 22, the City Council unanimously I endorsed the concept of leaslag land for the construction of a professional building on the property of plow Memorial Hospital, We will probably have to got a more definitiv legal opinion so that the prospective financiers will be secure in not being faced with questioning this in the courts, We are continuing to actively pursue this. ,i Respectfully submitted, f Wallace L, Duvall Administrator WLDigm. r S j ry . • f py y}' q+ 0.\ tit 14^L'I~f1~ " Va iktf7+it%SY'N1k4rn,lWltil.'fi;"Y/^i:vy~a'~`~I iy~„?Fj P 4 y j' ~'yFLOw MEMORIAL HOSPITAL .:JNTHLY ST'ATTSTICAL REveORT W JUt1C, 1976 This This Mo. 'atienta remaining last reports 90 M ast Yr. This Yr. Last Yr. onth L Tom p~tt_ To Date ~dmittedi " Adult PediaL~io 213 306 2,471 2,499 Obstetrical 42 46 412 378 91 76 803 $02 Sub Total 346 2 6 Newborn 71 63 ' 650 ~67) Total Medicare (Included in Adult).66 107 ' Medicaid (Included in all Categories).. 23 15 759 756 194 190 otal. Patients treatedr 507 f ; isr'--jrged t r.wult... 229 Pediatric 39 4 23 2,417 2,574 ~ f Obstetrical 92 43 ~i17 374 Sub Total 360 82 800 805 415 3j718 Newborn. .'......0 0 72 30679 J Total 432 486 4,362 k,60 360 Medicare (Included in Adult)........... .69 j id 108 No c df a 7 7 (Included in all categories).. 25 2 759 ~ 12 193 187 otal Patients remaining: 7W 5 ischarge pays: ` Adult 11118 ~+(r' Pediatric , , }118 1,379 18;355 17P78 . 2A4 totiidai X14 r, r J 136 1,734 291 1, y/. z 693 Sub Total 20293 2 399 Nawborn 261 303 22, 782 2,,142 TOTAL 25 2'702 2 584 747 ~ 25 66 2 j g Medicare (Included in Adult).,,,,,,,,,, 783 929 $144 7,081 Medicaid (Included in all categories),. 110 e` 54 10006 990 ; i veraga Length of stays ` Adult 8.1 6.3 r. Pediatric 3.0 7.3 7.1 Obstetrical 3.4 6.G 4,1 4,9 1.7 3.3 3.1 Total Medicare (Included in 11.3 ' He~lieaid (Included in all ctitopries),,, 4.4 3.5 1 5.22 5 9 .2 5. 2 h „ . . - ANIai1P NN.I Ir1.Y Yn_>fi[ 's'uL#n~4ti3s3}f~`tS+ s•. - r L.~.-: . • 'i~ui,Y 5TAT151'iCAL ki1Ri'UICf 1'ngo 2 I 'Census Pstieut bays: ~ Thts This.' This Yr. taat Yr. Month Last y~r-'- T i7ate To Date j Y Adult....., ......................1,732 2,106 182 7 17,133 kedfetric 119 Obstetrical,..................... 322 132 1,702. 1,706 2G0 2.:710 2 S93 Sub Total 2,~, 0 , 2 ,632.. Newborn 294 295 2 ~i3~J ' Total 3,~+'6Y--`______-~'..~' 2 73G i ~~I , b , Dtedicare (Included in Adult),....,,.,,, 789 Dfedicg~si (tncludod in all categories).. 78 996 1,007 1,028. j Average baily Census: f Adult 58 7p _bb G3 pediatric . 4 4 b 6 Obstetricni 11 9 10 g Sub Total Necaborq.......~ 10 ltl 9 10 r Total 2 g 9 89 ! rs k Medicare (Ynoluded in Adult).......... 2G 32 29 ~ ~ej icaid (Zncludad in all categories),, 3 3 k ~ I ercetttaga of Oonupancy: 3 Adult .:............:..~d.kads.:.... 672' 81Y, 73~ pediatric .............~J.zhd~...... 772 Obetetxical. , ....:.....?S.~nd~... , . 44/. $6x • . 57Y. 3G/, _40/., 1367 L ; Newborn, ...........118 Weds 5µb Total 61/. 71Y. b9x 68x .2G.Bassinets... 38"/. 38x 35x 3g 144, gads & Basalnets Total 57x 65x G4;G 62 •rfedicare (Included in Adult)..~4,~@~$„ 30x• ~ ..377 34x 29X Medicaid (X dad fa all care o ies)r7~. 2~ 3x 3x 3x (~.4~i Heds & Bnasitte~s~ euthe: ~ Over-4$ hours: Aduit.,....~ 3 3 Pediatr~.c 0 51 p 0 ObsteCYical 0 0 p Sub Totial n r 3 gl 50 Newborn 0 p p 0 7 ota 1 BO , • , ~lediesre (Included in Adult).,,..,.. 3 3 45 42 • tSedicafd (Yneluded #n all categories) 0 p l l iJndar' 4$ hours: ~ ` nd~~lt 3 l Pe'dtatYic.......:'~...,...,.... tl 24 23` j. 0 1 p Obstetrical 0 p 0 p Sub To t a 1 ...'w'..~"_`...._......._ 1- 25 ' i'ta l,bOrn.... f . . tl 23 9 27 t[odicare (lacludod'iii Actult)..~.... 2 1 lU llodlcnid (Includadin all cateporlas) 0 p 22 1 -o, ~1LItO~nia9 ................1..,.....,. D p 5 .Nat ~~rd~,ay Ra•ta.~...~....,....., tl~ $ ~ o: b.2;S l0.kx ~ • r r . ; ~ ..•u-a ak4Y4tN.WmSF,.LW!A~iNhCfs'3.~'ylipj~{,!,}~"~ i~_ r • } i' ~ ,max; i i i 1P ~1AVtM.7W This Thin Ito.. This Yr, Last yr. intensive Care Unit. (Fig M n th Laet. To Date To bate ures 6t this catogory are included in other categorios Pationts Admitted......,. 37 41 Pationts Discharged,, 34 331 301 Patients Expired 38 293 201 Census bays 1 1 too 116 10.8 23 Average Daily Census 4 4 19045 911 Average Length of stay, 4 3 ......3,3 Percentage of Occupancy,,,,,,,,,,,,,,,, 44% 3 3.7 3.1 Medicaret(hncluded in above totals) 57 ~ 44x 437 Admissions.,-,,, .17 23 Discharges 17 169 147 Expired 21 143 123 Census 'baya..... 69 0 27 21 Medicaid:(Tncluded in above totals) 60 592 429 Admissions i. ! 0 11 Discharges 0 0 14 Expired.'....., 8 0 13 POP Census Days,,,.,,, 1 2 0 1 0 31 45 OperetionstOR--- Majorr 56 Maj or 77 70 Minor: 82 635 1 Total ino 93 110 10000 1, ~ L&b--Mai or:wfr' M 70 Maori= 0 , Eleatrocardiogramat..................Total. 231 228 2 TnwPetieotet 221 228 2,352 1,863 Out~Petienta 10 0302 1,828 0 50 45 Laboratory Testet ........:...........Total 10,149 10 970 In-2'atients 71622 ' 128,206 97 8OO Out-Patientss 7,957 93,172 750252 +i 489 143 4,283 1,892 Emergency Room Patients:.,,,,, Physical Therapy Traatmantst-........'total 1,956 20266 Yn-Patiaettet ,954 160069 140834 Out~Patientat . 11597 11954 130228 12,110 359 312 20842 29724 DI, stary: (Beale Served) ..Cafeteria 3#410 Patient 6,501 7 197 6735,350 28,1 Other 1,804 lj642 ,350 64,521 17,335 179401 Total 110715 129191 119,994 110,057 Laundry Lba: 42 s 155 55,014 406,543 398093 Per-Patient Day 17.0 19.7 16.1 16.3 F k Emergency Room Viats:.. 729 796 6,908 5,961 Respiratory Therapy' Treatmontat...... Total 912 860 12,956 120129 Yn-Patf•flnts:..,........,.,~.,. 908 Out-Patiantq 4 86U 12,781 12,033 EEGs' b 175 46 11 12 107 88 IX-Ray Examinations: a & 6*...Total 10129 1 412 1 Yn-Petiontst $64 X703 12,465 110363 Out-Pntientst 565 709 6,502 5,645 5,963 5,718 Pharmacy: (Prescriptiona Filled) Totnl 104123 9o983 E xn-Pntionts 9$12 90293 95,498 91,050 3 Out-Pationts 611 ' 890036 ft4,288 685 6,462 6,762, 4 . kI.Wh MOM I m~ N 40 N p W NAf~N W 0 W V O WW 0) f0 W {~yy~ W W 4 N W N W p a 01 10 W NW W ' ED CI ~ ~ fO ih OO O J W O N OO. N O1 ~p r0 H N V Yr~~! Yr1 ♦ • • •Oe .Opp. r Y • Yef •fOb • • • •~p Y,CpA W YtC,wpf V ' 1,~ r Y ~Wy fyn l00 Y W W Wp•lp t, ,lb 06 ~tf Oi W A10O1 W O~OI tD O{!OI tOJ W f0 Y M^M^ Y. ♦ Y. Y 'Y Y Y . Y Y • Y • YfA r W V N 0011 N W w fd O O N N NM W O gobw cow COW f+W~w -4 ai IWOW OOO i ~ . fig a M N H i W W W f. ~ O db O.Oe d5 ul ~Lf r~ ~'a N ~P w W wwNm ~ ~ r N W "'~0/.1 W W.S.d! ~~yp. 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OO ~ OD W 7D t+ W fP V IO C! tll' 6 "84 I Y C YONp1 Y - r ,Yp Y Yr1 •tJ • tJ tO~~ r~lG. r •pWy Me`~i r Yt6llt Y.W7. ~Cf1 Yt,, 1!p •t0np • ' Y Y • Yy 4 t~ HNIJ V bO V W JO+WO w Of 7l W tO 60i lO0 t Id tOp OOD P~Otd r ..f W N Ie~p K K tWy ~j OOt I~~+ OpI d7 fWe~ MI(0N/D0~ f[W1pJ r(ONQn1 ~ ~O YtlN7 rt00 (I~~J jA t1D (/QNI {Ny/I YlOpQp Y[EO~QI 1~' 1µy ~ t' ~^`w.. ~ N C !P $ h7 '•1 ~P M WW N V 00 ° In N 1~ 41 N i• st y ~ 1 ~~Wpp lNp tp tt,~~ t~ y+ ~ ' 4t ~V ~D W - tvl .w1 W IW+ 00 N N tWJI q N hl tO W O Vt ~ rt~!I ~r. ~ r • r Y r r r • •r r N ~a N m~ t W0r1t td'V epp itAp NN y lw+ ~ b N D OD 1 C 1 N cm VW NOChofN+INNYfi 8to 1.4JWa~'la OR j r K irl Irr K M1 h W 1(r1 K Ir K (~t i i1 t0pf~ dtp W WA ~y WW O IP 1 00 W W W n~ N enP W OD N W W v MI M th hf N Q P! 61 IO bOD to tD {rv Ifi ~p ~p bS O rP N. j+ w W N+ A O tD IO ~ N ~ Y. • r • r Y Y•• Y 1 I• Y•• Y r r r Y•• Y {~,~1 py t~~p1 O ~Wp ~0.t7 1y0 yN tJ,r~ O tt,0~ rpJ ttp+ N I apt W my W.Oi tppp tI~D N H ppr pry! W V W y tO Of OO +1.W V ►1 tOT W O~ W ~ir~~ WN W.~~H+ID IO .AIM W iJl ~ C V V V V V yV V V V V V O 1tt'y~.tf K h t~ K ~1 K h ~ K ,Ip11 {/t,•~~~ ^x w C* 0 N I.C (o (4 ul .4 v r . r . • iO Y Y Y . • Y . . . .1 . . O gw owotl~~'WawRi`~t3`$YritW~n"'Wibi*MvMo 44 0) 00 00 a 0446 -j 60 ..1 v y w V wyr:n •iyvy ' .+.-n.n N.. n..arrvw.W~e •WI>V .I 41 v._r~.rn i.... q . 11t13;i~~¢X.b+~A.+ y'l.'A[1rA tiil'Y~4i1.4~'.lr~ftYN~lAn~`%W.~~~/M1'ittt4~lY{r~'i1rIB'1~. I FLOW MEMORIAL HOSPITAL SUMMARY OF CASH RECEIPTS AND DISBURSEMENTS JUNE 30, 1976 ? I E Month Year to date t Beginning balance 3161 408, 68 3061 393. 17 Cash received from: Active patient accounts $ 346, 469. 68 3, 401, 317.14 Bad debt accounts 6, 314.71 48, 619.29 { Cafeteria 60386.83 66,708,03 J Other 147p266.46 606r427.68 4160 660. 173, 833,192.63 j 1 Total cash available 821, 836.16 4, 2391 686, 80 C .h distribution; Payroll 172, 680. 03 it 691, 600, 98 yroll taxes x91, 468.86 PK Oth6r Refunds 08/ 878.76 1/1824, 406, 124,406,51 1~ ixed assets 90, 000.00 171s:160,84 Notes payable 2,488,78 11,038.31 Medicare program - 474, 649.86 3, 882,399.30 Cash balance, June 300 1976 347"186,6.0 3470 186, 60. j Gross patient revenue 881p871 3, 7611 783 Allowances ( 10623) ( 98~ 401) Net patient revenue 371.348 3, 683, 382 j Cash received on patient accounts 346j470 3, 444, 622 - Collection expense withheld by agoncy Refunds ( 808,79) ` ( 124..406) ' Net cash on patient accounts 337, 691 3, 320 11,7 Cash received as a % of revenue 91 91 Cash received as a % of 3-month average revenue 8716 7.13.78 ~ j i F7 FLOW MEMORIAL HOSPITAL k STATEMENT OF C14ANGES IN FINANCIAL POSITION OF UNRESTRICTED FUND j JUNES 1976 f ; s Month Year-to-date. Working capital -f~as provided by, € Operating revenue (net) ~a 3450805 30460. 744 I Operating expenses (403 132) (3 671, 362) Loss from operations 579 327 ( 22 , 818 ! Items In operations not requiring funds; Depreciation 190 321 186 823 Funds provided by operations { 39, 008) 54> 7 6 Nonoperating revenue 27,991 283,879 Increase In long-term debt (net of 18, 999 current portion) 74o753 78s423 I D ~osal of fixed assets - 80,003 Total funds provided 84r 738 2960_11 Working capital was used fors j Redaction in long-term note 9, 791 Additions to plant and equipment 930862 1670 788 Due from plant fund 20 065 ( 24 973) Total funds used 113 rJi 162t804 f Net increase in working capital $ (48 979 .142, 7b8 Changes in working capltalt increase (decrease) in current assets; Cash $ 170 420 470 794 '?eoelvables ( 38,184) 193,!63 ""&e from health care programs ( 9, 140) ( 484 918) Inventories 6o487 _ 2,246 Other current assets ( L205) 47 888 f ( 26o712) 241'o 6H increase (decrease) In current liabilities: Accounts payable 5m206 49j298) Accrued expenses 230 729 18, 707 Current portion of :long-term debt I8, 989 640466 i Other current liabilities ( 24, 888) 750001 3,, Net increase in working capital $ 4.8879 142, 706 '7-13.78 { . r. ..,..o. ..N..n,.«n...uuewa..iaw..s.:.ReabW rr<4@r;Nfi:Ff 11..; y ` M e m N A :-1 w 0 f4 #A W ~ ~ w o O w w O t / I ~ w t ~ ~nnjnff' ee.~~~ ~ fir, fp$p ,~p '~C d+ F3 .5 W w N w t,1 N ~ymyy fp3p pV 01 r O 4f tO -4 i ! 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EGAD/ ' BOARD OF DIRECTORS BUSINESS MINUTES , Dais June 3. 1976 `-^L Page 1 The Board of Directors of plow memorial hospital met in a called session at 7$00 p, m, on Thursday, June 3, 1976 with Dr, Charles H. a'lding, Other Board members present were Dr, George Holladay, Saunders, d Mr. Chairman, pre. Mrs, Paul Simpson, and Mr, A. J, Testa, Also attending were r. LarBry Barrrore, (Denton Record Chronicle), Mr, Y Kutsky (Denton Record Chronicle),,aMrs. Gloria Madewell,1 Mir. Bill iVokonas,banda Mr, Dale Wagner. ( Dr, Saunders explained that the meeting had been called to discuss responding to the unsupported allegations made by the City Council which were printed on the front } pages of the local newspapers, The City Council had raised some questions about expenditures for present Emergency Room services and the proposed funding of a point ambulance service--these questions appearing In the newspapers with no prior attempt by Councilmen to seek answers. The Council had acted in reaponse to a petition sub- E mitted anonymously to them calling for a committee of physicians to examine the E Emergency Services Plan of Flow Memorial Hospital, It was the oonceneus of the Board that the City Council be requested to publish on the front page of the Local newspapers their full and unequivocal endorsement of the hospital, and a draft of this request was prepared, After some dlecussion and a few changes, Dr, Holladay moved that the statement be accepted and mailed to the City Counelli this motion was seconded by Mr. Testa and passed unanimously, The state. ment reads as follows I "During a called meeting of the Flow Memorial Hospital's Board of Directors on ± t- Thursday, June 3, 1878, the following statement was unanimously agreed upon. In view of the questions that have been raised by the City Council members.re- garding blow Memorial Hospital and the subsequent articles on'too front pages of the Der,~nton; Record Chronicle and the Lnterprlse, we feet that it is imperative that the dooq Denton MY Counoi give a full and unequivocal o al endorsement of the hospital and assure that it gets on the front page of the local newspapers, We believe that the City Council has a responsibility to make some inquiries F , s rather than give such credence to a statement made by someone or some give such prominence to unsupported statements as the Council did last weep creates s questions in the mind of the public, These questions need to be answered. r The Board and Administration of plow Memorial Hospital. have provided and are always happy to provide full information tin,1 explain any aspect of the hospital to the Council at any time, {s ; Furthermore, we t-equest that a procedure be prepared so that in the future when questions rise concerning the operation of Plow Memorial Hospital--as they surely must-the can be satisfactorily answered without embarrassment to the Administratio , f 4 the Board of Directors, the Medical Staff, and the loyal employees of our community hoapltal. " Mrs, Jenkins expressed the appreciation of the nursing staff foi, the Board's { ' pasltlve action against the unsupported allegations. ~r-~ •.•.se. .-avs~-o.-w.-n-z :.e,x t_- v,_- 1. 4 FWWI BOARD OF DIRECTORS FLOW MEMORIAL, HOSPITAL BUSINESS MINUTES Day. May 20, 1976 t; The Board of Directors of Flow Memorial Hospital met at 7 00 p, m, on Thurs- day, May 2U, 1976 with Dr, Charles H. Saunders, Chairman, presiding, Other Board members present were Mr, John Carter, Mr, Robert Henzler, Dr, George Holladay, Mr, Brad Moore, Mrs, Paul Simpson, and Mr. A, J, Testa, Alao present were Mr. Wallace Duvall, Ms, Diana.Kutsky, Mrs, Gloria Madewell, Tor. Bill Vokonas, and Mr. Dale Wagner, The minutes of the previous meeting were reviewed and discussed. Dr, Hollada E moved that they be approved= this was seconded by Mr, Henzler and passed by voice ' ' vote, The Finance Report was presented by Mr, Carter, and he noted that expenses " had exceeded revenue for the month of April b 8, 000, Mr, Y $ Carter also read the i minutes from the Finance Committee, The Finance Committee had reviewed the 1977 Financial Plan and had recommended its approval. Mr, Carter moved that the ffnan- ? vial statements be approvedi this was seconded by Dr. Holladay and passed by voice vote, Mr, Carter then moved that the Bad Debt Charge-off amount of $19, 761.28 and f I I the Charity Charge -off amount of $0,891, 47 be approvedl this was seconded by Dr. Holladay and passed by voice vote, Dr, Saunders reminded the Board members to let F Mr. Wagner know If they can help In reclaiming a bad debt, The Finance Committee had recommended acceptance of the amended contract from Medical Dimensions, Ino, k for data processing services, terminating the contract with Decision Data, Ino, This contract involves Flow's acquisition of the data processing equipment at a coat of $901 000, plus the conversion fees of $6, 000, Dr, Holladay moved that the Board acne t the MDI contract and authorize the Administrator to negotiate with a lending instltutlo 1 to purchase the equipment at the current lending rate not to exceed 10% for a period not to exceed 80 months, This was seconded by Mr. Carter and passed by voice vote, Mr. Carter moved that the minutes of the Finance Committee be approvedi this was seconded by Mr, Henzler and passed by voice vote, E The minutes from the Joint Conference Committee were presented, Mr, Duvall E explained that the County Commissioneru at their meeting this week had voted to re» quest the City to indicate the action they would take concerning funding of a joint ambu lance agreement, and then the County would attempt to secure their portion of the fund , The Joint Conference Committee had discussed the need for training materials for the nursing staff, e, g, , the ROCOM series, Also, it was noted that we are losing several nurses due.in part to the semester completion at the universities, Mr. Vokonas added 4 that F'low's Personnel Offloo is working very closely with the Personnel Office at Lewisville Memorial Hospital In exchanging extra a li(ations Mrs PP Henzler moved that this report be approved= this was, seconded by Mrsa Simpson and passed by voice vote, Mr, Moore read the minutes of the Foundation Board meeting, Mrs, Kenneth Smith had resigned because she is moving to Colorado, and the Foundation had honore I her at their last meeting and given her an enscribed plaque, Dr, Saunders said he had received a letter of resignation from Mrs, Smith expressing her appreciation In being able to serve on the Foundation, Also, a now slide presentation was reviewod for use in fund raising efforts, Mr. Moore added his compliments concerning the quality of the slides and the presentation, Mr, Henzler moved that the Foundation Report be apprDVedt this was seconded by Mrs. Simpson and passed by voice vote, r ti',` , "owl IWAWAN" Y; I ~~wf Y 1ST ~ d ~ I ~ [E r7 ~ a f 7 4 ~ ' I CORREC ION ~ r E nr~ t~ f THIS DOCUMENT HAS BEEN REPHOTOGRAPHE , Q ri . 10 ASSURE LEGIBILITY ~1{ }I Y r 1 y sg Sri ~ ; c t `t ~ Y 1;4~y ? ~11Y U1~ iAIVI f401 7 v ism r rll 'f Y 11 ~y{,nn. r.... .««q4 tl, Alper-. ;;iAldStii.Ok.~#,S /fatSJ+iN•n".. ,v ..,,rr F lilvo •qns. - 888 tl anti,. txdt BOARD OF DIR.ECIORS BUSINESS MINUTES o,i, June 3 2 978 Pala, # The Board of Directors of Flow Memorial Hospital met in a called session at f 7s00 p, rn, on 'Thursday, Juno 3, 187(1 with Dr. Charles H. siding. Other Board members present were Dr. George Holladay,~s' Chairman, re, Mrs, Paul Simpson, and Mr, A. J. Testa. Also attending ~vera3 lVlrMr1~ Hy core, (Denton Record Chronicle), Mr. Wallace Duvall, Mrs, Johnnie Jenkins, Ms, Diana Kutsky (Denton Record Chroniole), Mrs. Gloria Madewell, Mr, Hill Vokonas,andMr. Dale Wagner. r i Dr, Saunders explained that the meeting had been called to discuss t esponding to 7 the unsupported allegations made by the City Council which were printed on the front f pages of the local newspapers. The City Council had raise some questions about i expenditures for present Emergency Room services and the proposed funding of a joint i 1 ambulance service--these questions appearing in the newspapers with no prior attempt by Councilmen to seek answers, The Council had acted in response to a petition sub ' mitted anonymously to them calling for a committee of ph sicia If 'y ns to examine the Emergency Services Plan of Flow Memorial 140splta It was the concensus of the Hoard that the City Counoll be requested to publish , on the front v ` page o_ the local newspapers their full and unequivocal endorsement of the j hoapitai, and a draft of this request was prepared. After some discussion and a few t, changes, Dr. Holladay moved that the statement be accepted and mailed to the City Council; this motion was seconded by Mr, Testa and passed unanimously, The_state- ment reads as followsi 'buring a called 'meeting of the Blow Memorial Hospital's Board of Directors on £yt Thursday, June 3, 1978, the following statement was unanimously agreed upon In view of the questions that have been raised by the City Counoll members re« garding plow Memorial Hospital and the subsequent articles on t" front Dentot acrd G'hantale and thelnter rise we feel that it is lrciperattvo thnt th0' f ethe 17ontoy ouncil give a ful ivocal that it on the front page of the'loea anew pap rosrsemertt of the hospital and assure r, . a We believe that the City Council has a responsibility to make some in uir rather than give such credence to a statement made by someone or soma persons To give sura prominenoe to unsu questions In the mind of the public. These questions need o to be an we edeek creates The Board and Adminl9tratlon of Ylow Memorial kIospital havo provided and are, always happy to provide full info -nation and explain any aspect of the hospital to the 00uncil at any time. i Furthermore, we request that a procedure be prepared Fo that In the future when questona arise y E concerning the operation of Flow Memorial Hospital-.aa they surel must--they can be satisfactorily answered without embarrassment to the Adntinlstratto the Board of Directors, the Medical Staff, and the loyal employees of our communit , hospital, y r Mrs. Jenkins oxpressed the appreciation of ti,e nursing staff for the Board IS ,5 f•r positive action against the unsupported allegations, Y- ~~3i - - a,.ti+!vF`en~ rK2a,M~,yyj«fikxktr,3s`s'~1,5'.S,t, 'i y~}, BOANQF XDIftRCTO$"ti J BUSINESS MINUTES Doo June 3, 1976 p419+ 2 y There being no further business, the meeting was adjourned at 7s30 p, m. Respectfully submitted, I i r A. J. Testa 'r Secretary B gm St !I i i , a s s f , CS, 'f a ' i rryPi ; 3~ Itr, t' . Fs~' ! 4 r ~s~T 5 + 1 ts' i v{ ....,..»+rrrt.r..+>„s ..,n..,<.. ,,-.•,anzs-,:;ba..:1"ttPldd~wrJw.+w`v~ksY,A~,:waFh'nifa+N4)14k".u1"~TFtG'~tt7T.r~*Mv 1111 ,r Rr N 14 t4r ;:w .xar J - Fw BOARD OF DIRECTORS FLAW MEMORIAL HOSPITAL, AHypq BUSINESS MINUTES cat. . - ay Zo, " 1976 The Board of Directors of Flow Memorial Hospital met at 7100 p.m. on Thurs- t` n days May 20, 1976 with Dr, Charles H. Saunders, Chairman, prosiding, Other Board members present were Mr, John Carter, Mr, Robert Henzler, Dr. George Holladay, Mr, Brad 'I loore, Mrs. Paul Simpson, and Mr. A. J. Testa, Also present were Mr. Wallace Duvall, Ms, Diana.Kutsky, Mrs. Gloria Madowell, Mr, Hill Vokonas, and Mr. Dale Wagner. 6 The minutes of the previous meeting were reviewed and discussed. Dr. Hollada moved that they he approved; this was seconded by Mr. Henzler and passed by voice vote, i The Finance Report was presented by Mr. Carter, and he noted that expenses { S had exceeded revenue for the month of April by $8, 000, Mr, Carter also read the ' minutes from the Finance Committee, The Finance Committee had reviewed the 1977 Financial Plan and had recommended its approval. Mr, Carter moved that the finan- cial statements be approved; this was seconded b Dr, Holladay I vote. Mrs Carter then moved that the Bad Debt Chargo-offamount of $19, 761, 28iand the Charity Charge-off amount of $9, 891, 47 be approved; this was seconded by Dr, Holladay and passed by voice vote. Dr, Saunders reminded the Board members to let Mr, Wagner know if they can help to reclaiming a bad debt, IiI I The Finance Committee i had recommended acceptance of the amended contract from Medical Dimensions,' Inc, for data processing services) terminating the contract with Decision Data, Inc, This ';contract involves Flows aoquisitior of the data processing equipment at a co ! $90, 000, plus the conversion fees of $g' of of , 000. Dr. Holladay moved that the Board coos t the MDI contract and authorize the Administrator to negotiate with a lending institutio to purchase the equipment at the current lending rate not to exceed 10% fora period not to exceed 80 months. This was seconded b Mr, S' Mr, Carter moved that the minutes of the Finance Committee be appro edi thvoice is waste, Carter and passed }It 's seconded by Mrs Henzler and passed by voice vote, ka : The minutes from the Joint Conference Committee were presented, Mr. Duvall l { f explained that the County Commissioners at their meeting this week had voted to re- ` quest the City to Indicate the action they would take concerning funding of a joint amb lance agreement, and then the County would attempt to secure their u portion of fund ` The Joint Conference Committee had discussed the need for training m teri lstfor the j nursing staff, e. g,, the ROCOM series, s It was noted that nurses dueAn part to the semester completion at the universities, we are losing several 1f rr that Plow Is Personnel Office is working very closely with the personnel Office atadded Fos. Lewisville Memorial Hospital in exchanging extra appli$ations, Mr. Henzler moved that this report be approved; this was, seconded by Mrs. Simpson and passed by voice vote, i Mr. Moore read the minutes of the Foundation Board meeting, Mrs, Kenneth ' a Smith had resigned because she is moving to Colorado, and the Foundation had honore k her at their last meeting and given her an ensoribed p1 ues Dr. a letter of resignation from Mrs, Saunders said he ha Smith expressing her appreciation in being ' able to serve on the Foundation. Also, a new slide presentation was reviewed for use F, in fund raising efforts, Mrs Moore added his compliments concerning the quality of the slides and the presentation, Mrs Henzler moved that the Foundation Report be s' approved; this was seconded by Mrs. Simpson and passed by voice votes i. ir• ....rte.>---..............~_-.-.._. fy r it .@p::U iVJ 6'kht(M(:YRj {i }DN.`Wr .Y!.'P t'`i`c'A.'t~; . (L vi.Yi~l.••.• 1 I i .~1 Rte. ,?.•e~. w« `rb OF' DIRECTQP-~, S MINUTES Dada May zo, 1976 Papa 2 n r, Duvall presented the Administrator's Report. The hospital had observed ! Hospital Week last week and had several activities, including an employee a department head versus departmental team softball game, a lobby display of s of babies born at Flow, and an Auxiliary luncheon and styleahow, He announ- ! t the renovation project is approximately 70% complete--both In terms of mane ed and construction completed. The project is, however, approximately one ehind schedule, due largely to a strike of the Trane Company and having to r other materials. Mr, Duvall announced that the hospital has receiv ed a ental grant of $400 198 from the Texas State Department of Health Resources for the project, Mr. Carter moved that the Administrator's Report be a t { ! this was seconded by Dr. Holladay and passed by voice vote. approved; f ' Dr, Holladay presented the Report from the Medical Staff as Dr, Mldgett had a j patient in Labor and Delivery, Dr, Holladay reviewed the minutes from this week's 3 R f Executive Committee meeting and presented the medical audit criteria for abdominal and vaginal hysterectomy, Dr. Holladay moved that the report, including the medical t 3 (D audit, be approvedf this was seconded by Mr, Henzler and passed by voice vote. s , t ' The applications to the Courtesy Medical Staff of Dr, David,M, Cooke with j privileges in the Emergency Room and Dr, James Richard F'ancher.with privileges in otolaryngology were distributed for review, Mrs, Simpson moved that their appoint i mente be approved; this was seconded by Mr. Moore and passed by voice vote, Under old business, Mrs, i ~ Simpson asked about the status of the proposed pro- II ~~i feasional building, Mr. Duvall explolned that he had written both the City and the r County asking for a legal opinion about constructing such a building.' Dr, Holladay j asked about the status of the Health Systems Agency designation for this region, Mr. Duvall said that the deadline fo'r'the third submission of proposals has passed, and there have been two applications submitted- one from the Governor's committee sari . and the one from the health ,planning unit of the North Central Texas Council of Gov- 4, , ernrnents. In addition to the State of North Carolina filing suit against the HSA stating Lit violation of state's rights, a group in East Texas is organizing to seak repeal of Pl:, Mr. Wagner presented the 1077 Financial Plan and discussed the contents of this j budget, Mr, Testa commented that it is an excellent presentations He did suggest, I ' however, that the pages be numbered and an index be prepared, Mr, Testa moved tha the budget be approvedi this was seconded by Mr. Carter and passed by voice vote, The budget will now be mailed to the City and the County, The Utilization Review Committee's Report was presented by Mr, Duvall, Ninety-eight Medicare and 18 Medicaid admissions,' as well as 40 MedLeare and 7 E Medicaid extended stay oases had been reviewed and fuetified, Mr, Ouvall added that Ie the number of Medicare patients is still increasing, Mrs, Simpson moved that the j report be approved) this was seconded by Me, Carter and passed by voice vote. Mrs. Simpson reviewed some legislative news, She said she was told that the County taxes which are collooted after the year they are due are kept in reserve and P 't not distributed to the county-funded organizations, such as Flow. Dr, Saunders a suggested that this matter be looked Into further, Mrs, Simpson announced that the ,l t. .`rlfkxv"V .v1rq: f vJ •:n. •~f~r _ r . i...., i.. r.i. u. 'i'4+ lWa.1.4\,'.IM1Y.: 1.,..N ~ ' I I <,µ;r,ar14c.~;it4^ad~Nari.,ev.x; ~~a fit? .fie. WOW ~ ~ ARC O>i hrras~rf., BUSINESS MINUTES Deis °~'=--mss f - ' Ma 20, 1976 rlaboreduotlonunioin Medicare and Medicaid funding had been passed andiscussed a rep' n Problem At the Baylor (lnivereit n t should be aware of such problems and guard against an ha thae ance ward to Austin, she reported, is ex Y Medical School, She Endlcated that Blow i plorin any Peening here. The Insur- costs# br. Holladay added that he had learned at aareoen pTexaaeMedieal Also meei ting that the majority of all maladeoe cults filed, as well as the g msociaton F awarded ciation tt , have occured since 1872, Dr, 13olladA arno be aPProvedt this was seconded b dollar ne unts Y waved that the Legislative deport by Mr. Henzler and passed b nr }J j The meeting was adjourned at 8115 Y voice vote, p, rA, Respectfully submitted, A, J'. Testa r4~; Secretary gin xr1 1 i r~Y F yy r 77 Y }f~. y t 7T p4. y ! ~ u f , >l t JN P O yynr fff...vFLL//) 1 i : t,n' zr~yy~rf~v--L n]'arnal : //TJJ 1^-Si CCrILf~'hQ^^9'}311T. 44 bJAifaf.V4\Y, Af.. f t`}~ 471,ia7tskes,~ r t y 1 al'tAMR ADMINISTRATOR'S REPORT t . BUSINESS MINUTES - o•►• May 20, 1978 Pleased P.p, 1 As you recall, National Hospital Week was observed during the week of May T n 16, Y was leased with the activities that our people planned for this observance, F 'obby display of Pictures ofba bies born at flow Memorial Hospital was very The Other activities such as the employee plenic at McKenna Park on Saturday and the soft 0 ball game between the department heads and other employees popular, Also, one day was designated as patient's day, and another day was delsignated asp ` Auxilian's Day. A proclamation designating the week as Hospital Week was signed by Garland Wade, State Department of Health Resources, held a payment ins $ of the renovation project on Wednesday, Ma 19, peetion which the work to being done. We are at approximately 7"o completion; this inspectio experienced some delapys but thiseIso not cr t cal at thietgirtae,t funds to ua, We have month, the Trans Company, which supplies the heating and coolAs I ing nitsiforthes oome ! ! is on strike, This could cause significant delay, but the strike could end without undue i delay, The alternative is to change su ppliers, but this could result In no sa 1 j r tine. We will watt for awhile before changing su v ng of not become critical concerns the metal casework whichrhad to behreorderedhbec use t #rl. , Geneva Company sold their company, he now supplier of casework is St, h a welt established firm, We have been very fortunate that other delays of aCmorees, fit, ! serious nature have not been experienced, Funding of our ; portion of the ambulance service expenses relating to a joint F ' agreometit with Westgate Hospital and Plow Memorial Hospital Is in the heads of the City and County officials. On Monday of this week, the Commissioners Court review' the estimate of expenses which had been updated to reflect the cur providin the ambulance service, e r, g They voted to request the City toIndicate theonotion 1 they would take and then the County would attempt to secure their portion of the fundln Respectfully submitted, t I~` Wallace L. Duvall rk" " Administrator WLDsgm 4/ I 9 , ~F Y111 it ()I '1 1 r Nt~{ ! ~.~'y.=."',`-"~YRHS!`xrt~i-.'`2'eY:Yy;TY[Cyy~Sy t Y Igy,.nNU .wsxnym ' v F~~ r,.uuwt~' :e,W AI;..:4:/d+4 tw t r,C„p ~a;si~p4vA.rnc~,e;x;l,~, 5x W:.NYY'1✓ ~,IAFP.1Mi V54VAU } 1',i1ti5T,Y T s BOARD Z,JIRECTORS BUSiNBS MUTES o.t. Wcember 14 1978 P+9• The,Board of Directors of Flow Memorial Hospital met at 7;00 p,m, on Thursday, December 14, 1978 with Mr. A, E. Wyatt, Chairman, ppresiding. All Board members were present--i.e., Or, A. M, Finlay, Mr, Geprge Hilz, Mr. Brad Moore, Mr, Bob Nichols, Mr, Billy Self, and Mr. Gray Shelton. Also present were Mrs. Carolyn Flowers, Miss Hilly Hervey, Mrs. Wilma Fritz, Mrs. Margaret Lester, Mrs. Gloria Madewell, Mrs, Cokey Millar, and Mr. Leonard Watson. The minutes of the previous meeting of November 16, 1978 were approved as presents s, following a motion by Mr. Moore and a second. Mrs. Fritz reviewed the Monthly Financial Report. She reviewed a comparison of f the patient census for the month of November during the past eight years, and since. t; 1916s the census has been increasing.with the average daily census in November, 1978 being 81:2. There was a loss of operation in November of $46,226 due in r%rt to an ad4ustment made to.show the decrease expected in the City's funding for this year. In an wer to'a question concerning the operation of the 36 Unit, Mrs. Fritz stated that , for November there wa a net . curplus of $8,000; details next month conce),lin the operation of Mrs' Fritz will provide additional 1 ~ 9 the 36 Unit. Mrs._Fritz also reviewed the financial statements,attd the Charity Charge-Off List in the amount of x30,766.76, Mr. Hilz moved that the fiiancial report, including the Charity Charge-Off List be i I i approved;`this motion was seconded and passed by voice vote. The !Utilization Rjview Report was given by Mr. Watson, who reviewed the Utiliza- tion Review Cotittee's minutes for the October 24, 1978 and November 28, 1978 meetings All cases reviewed were justified by the committee, as well as extensions of stay, j Dr. Finlay moved that the report be approvedi this motion was seconded and passed by voice vote, Mr, Watson presented the Joint Conference Committee Report and annouhced.that in campliaqce with the Medical Staff Bylaws, the chairmanship of':that committee had rotat t to th'p C4airman of.the Board of Directors, Mi%!Wyatt. The Joint Conferenoe'Cowittes had discussed 6 1e'tter received from County Judg e Dan Tramm@ concerning i the centrals;e,the investigation of charity,Y eligibility. Judge Trammell had reco*ended that the City/County Medical Seryicos Officio be the central agent for this investfgatio The Joint Conference Committee had also discussed a letter received from the City of Denton expressing the City's plans to provide only half. wor $114,800---of`the funds requested in Flow's budget. Steps which are being taken to keep down expenses during low census--and low rev@nue--periods were discussed. Mr. Watson'commo ni;Q that other ' hospitals in Texas are experiencing low census also. Mr, 811z moved that the Joint Conference Committee Report be approved; this was seconded and passed-by voice vote. t Representatives from Northwestern Life Insurance Comppany, Mr. Bill Barbas and, ti Mr. Emmett brown) were introduced, and Mr. Watson asked them to uxplain their proposal for group health and life insurance. Mr. Watson reminded the Board members that the ! premiums charged by Blue Cross were to increase this year from $2A.66 per month to $42.18 per month for individual c0arage,and that glue Cross had:gFanted.Plow an ektenm i. Sion of-,the;1978 coverage until January 1, 1979. Me. Barba$ explained that the North- western Life Insurance Company's ro osal 10golved tthe new c c t of golf-fund Mr. Barbas and Mr. Brown were excuse from the met Ago and e~ proposal was khher discussed. Mr. Shelton moved that the proposal front Northwestern National Life Insur- ance Company for group health and life insurance be approved with the deletion of the $12,311 per year charge for individual excess risk at $16000, This motion was seconde -4 by W. Hill and passed byy unanimous voice vote. The new insurance, therefore, will go into effect January 10 1979. , Mr. Watson explained that he will communicate with Mr, Donny Erwin with the City of Denton Ambulance Service concerning better accountability of the types of patients received at Flow Memorial Hospital through the ambulance service. r F ,pnurr~fi91 .y~ N Nth - r i ,mow, BOARD OF DIRECTORS M13:~ BUSINESS MINUTES Do ecem er 4 X978 Pogo The Medical Staff Re to the medical pport was given by Or, Lee, who distributed five applications staff which had been approved Executive Committee. These applications werebyrom Jennifer ffl,l 1larharetitArmstrong, tee and thM Court ,D,, esyy Mod ical Staff with privileges in family Active Medical Staff with privileges in internal medi Courtesy Medical Staff with cine; W1111amaVN~Narfnrd MMb " prtvtlages in gastroenteriogy and interns" medicine ,ig Allen Lehman, M,D., Active Medical Staff with privileges in radiology; ' Cora Taylor, Q.O Courtesy Medical Staff with privileges in family practice, and Dr. Lee Dr. Lee C re- viewed the Wnutes.of the December 11, 1978 meeting of the Executive Committee, Executive Committee had recommended the discontinuance of the xerorediography equ phmgent and the acquisition of gray scale ultrasound equipment. The completed audit for the diaggnosis adenotonsillect ed, Mr, Medical Staff Report inciu dingsthesfiveeappticattonseandWtha medical audit Moore moved that the k this motion was seconded and passed by voice vote. Mr, Moore j be approve of ette appreciation from the Board of Directors for his assistance and sup ort durin tenure as President of the Medical Staff and ex oPftot presented Dr, Lee a o member of the Board, g his Direc A proposed contract with Dinesh P. Kagat, H.O. to perform the duties of Medical a] f. n moved tfhatfthhecCardiopulmonary fee of Department was reviewed and discussed, Dr passed by voice vote. p th be approved; this motion wesns b MCI) d Proposals from three emergency room physician groups were discussed, Mr,tWa s explained that t e present roue had not met their verbal gg two ad th fu l g ton l time physicians; Instead they have only aone one staff he ER wit ' The proposal from Numed Inc.•to provide:24 hour hysician covers ime physician, E Room using' two fu]] time physicians residing in the Denton area, as wets as 'some enncy r time physicians was approved followingg a motion from Mr, Nichols and a second Dr. Fin AY, Mr. Shelton moved that the motion to approve the proposal froumed Ino, r be amended to Change the notification of termination of contract from 90 d6ys to 60 d t' .written notice. t9is amendment was seconded by Dr, ":inlay,and passed by voice vota. Mr, Wation invitri the Board members to attend the Employee Christmas Luncheon o ; Wednesday, December 26from 11100 a.m. until 2100 p,ra Where was no further busiheis, and the meeting was adjourned at 9.-65 p.m.. i R8910e01`01y submitted, Rray Shelton # - Secretary i f• I. I 'e.,..e ..9Aa.•a....,h11sYh!~'rY M.4.o, ycrr«r 1 ~,Ia a! Owl itlK{ ~ ^1 ~ ~ ~ryL~~ O IV 'M{ ~ W ~•yy w :s ty F-9 N 'A ' 90 -j l: k ~ N~ W fV ~ ~ Fw 4A l ~ N Fr W~V ~ OOIO IV OV1 +~p A WV6yl1~~ ~ ~ 't IVY NIV~ # 4A (~~yv E3 a ado ; . 1 i I ypy~y}' Q . ~ ~ ~ ~ Cy G7 V ~ y~VQ V b ~~Q1 ) ~ ~ rj~. ~A Q I R + E `ems' H I 5 ~ "b ry~ I1 sy -•1 r w t~g~ ..err do i rVI ryry~~ 00 «b ~ f"' 'tf ..r C~Wlja~ r n ~ N iA I s N W H l A tv 1i -14 a , r 4 J. ' A Y + !_442 F., V + ~ p N b b Yt r b c'Y G7 N ~~0.fD~yCynNC~`~w.,tl~~~ b~ro~b~~~N~ r,ZNOb V ~~9tlOAr'W~roe~+rt~A~,n ~yN~.A~n•J `3 ~y~'y~~~.}~~l~ a a °tl qi su ^i 10 N is 0 (n "W""44 Iwo m 04 Eq. 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(pJ7 ply H O t S ~ ,{{u~ ~ lVNA1 N..r W N..~ 0 3~ F' a a ~ EP i ro to aQp 2>4~~ fin! -1 i w a~a g Q r 44i 3K ro , , W ~P ~N tY+ w A w 4p p M w ( FS 1 fi f W o N k ti , r; Fr ' Y „ oe ~ G C1 ~3 1 , I llr Y Aw~ 0.4 ;~f Y r` At r I' , r r rte. r u h 'Mal NMI rVft S r a ^J f~1 O j cG A$ p h ~ f0 ~ ~ E3 ro µ a ro 14 ro w ro { N ~ H S 4OPr WW .I. 1w71 O t7 V O A W O~D Y ro W V1 Val !V N V 0 i~ VAT N N W VI , a "OD E H N ~ j +o. 14 v t~ 1e ~5 N w o ~ ~ ~ M w FJ V ~ ~ ~ Al T.r ~ ,o b N ro V i wp,. 40 << ~b4 1 v p, G3 g iTl W N Oo ro x• $ M 14 *4 t to :A .YrFVF rwoi0~+s C+ yy! .b illl p FLN MEMORIAL HOSPITAL CHARITY CMAROE~OFF LIST DECEMBER 31, 1918 Guarantor's Nave Patient's Name OuarantOrIs Address Mcount N, Discharge Date Accoynt Balance Explanation L Baker, Michael Same $ 8.60 Balance after Texas Rehab, i' 11213 Locust, Denton 4093176, 9.7.78 f Barnett, Vicki Sao" 30.00 4 in family; $382/month. Route 20 Aubrey 37036841 7.4-78 None r, Joe 37~46e971, 11-23-78 114.00' Denton county Ja11,' a B194e1S, Bobby Same 30.60 Denton County Jail. None 3749322, 12.1.78 Blake, William Bloke Annie 672,26 62 year otdrexpiredi husband on 1309 Mozingo, Denton 1649617, 6.16.70 S.S.1 eledically indigent. t Blake, William Blake, Amnia 6,811.46 Same 4s above, t 1309 Motingo, Denton 1643370, 6-0.78 t k Britton, Brill Saab 72.00 Cumbarlend Children's Nome resident, E NOUN 4097473, 10.19-78 le, Frank 5ama qq 10419.70 $273/Mooth1 1 1,p,faoily. 140 619 Bennett, Lewisville 1676339, 10.27-78 Clay, Kathy Cley Brandon 6.60 Balance after NW101d. 1303 No:ingo, Denton 37196890 8-21.78 32. so aontofto6unty J411',; . E Nonoe, hart 373986, 10.27.18 ` Cross, Larry Same 14.60 Unempioyld ' 126 Collins, Denton 3704668, ,'-7.78 I ` Crossland Kaiher ` S I f Box 294, Justin 37263, 1028.78 4.00 Balance after Medicaid. , Donley 00 ilia $igma 88,60 Current Madiaid 'patient, Route It Justin 37166100 8.12.78 Donley, Georgia Some 4,80 Balance after YAdi4aid, j: Route 10 Justin 1672769, 9.2648 Dantey Sandy Same 167676 Current Nedictid Patient. Awts It Justin 16722131 9.24-18 Darrou0h, Herman Same 4.00 Bolero after, MediNld. { 304 Rvddall. 1 70, Dsncon 3736481, 10.11.78 ' Darrou'h, Mary Some 4.00 lalance after Flydieold, 304 Rad9da11. 1 7B, Denton 3734712, 10.9.78 iMVls, LaMelds Davie la1haba 4,00 slllanej often Iledidatid, 24417 Louissi Denton 3719136, -20-78 ` 1iY, Ruth Downey Audra 16.00 Bolonde,~ftlr M~df4ild. + 201 S. Uldi11, Denton 36B246f, 11-6-70) 326~belefii, Gaston 1671868, 10.10.18 B~~ Ntanee aftlr.iNdiaaid. ' Uwe,Justln "Ekwo Florence 10191,66 7 Iq fomilyI 1aid;iff from 101 S. Wood, Denton 181998, 11.9.18 $494/month iOb. Eit+st Ailed' Some 10460 Balance alter Medicaid. Sundial Nursing NOW. Pilot Point 1611464, 10.6.78 i1 Smith Dorothy ppaqg~an, Renoe 4,00 Balance after Medicaid. u Box 161, $anpor 3726304, 9.11.78 g Foster Charles Foster Jim 4.00 Balance after Medicaid, r, A.O.Wl, Lot 21, Dentoh 3717781, 8.16.78 ' .,r.Y..;swvs~n uMr~YMCMWA' 1,M.9/'ibx .»wn,.:~,1yrx~fitswiiealUrN,,.OrTaYAd3.MAddc{~y a+ , xmaw ...YY r~nc. Page 2 j, Charity Charge-off List December, 1978 i Guarantor's Hama Patient's Name Guarantor's Address ccount sc ar4e Date / Account Balance H anatSon I Fry, Willie Same 62.60 Denton County jail. f None 3746823, 11-22-78 Fuentes, Joe Cara, Jessie 4.00 Balance after Medicaid. 309 Hattie, Denton 31206630 8-24-78 nzpplas, 61isa Same 4.00 Balance after Medicaid. I 403 Bryan, Denton 3730587, 9.26.78 GrooA, Barbara Same 4.00 Balance'aftor Medicaid. Routed, Box 147, Denton 3719622, 8.21-78 Green, Willis Green, Linda 4.00 Balance After Medicaid 626 Uland, Denton 37330520 10.3.78 j ! Breen Willis Same 4,00 Balance After Medicaid. 626 U e'0d, Ornton 3121164, 8.26.78 Green Willis Sam 4.00 Balance after Medicaid, 626 Ujond, Denton 3726064, 9.10.78 1 19 nn a~e 4.00 Balance after Medicaid. 66220 ofand,lDenton 2718780, 8.19.78 } rain aWillis nd, Di S+aio 4.00 Balance after Medic '326 Utand, Denton ,3722659, 8.•30-78 ! nf,earbara Same 20.76 Balance after Medicaid. 16 6 5. Kbaly, Lewisville 36060640 6.14-78 Hardin LpViu Same 4,122,65 Wwptoyedi in body cast, 2428 UmUs, Odntem 1678301, 12.1-78 diabetic, H4r rove Ann4 54~e 231.40 2 in famiiyl $1681menth. 1 111 Woodrow, Oentort 1668310, 9.2-78 1 i I ? H4+ppMey, Min ie Hearvey, Barry 4.00 Balance after Medicaid. II P. 0,. B4 672, Denton " 3732989, 10.2.78 # arvot Ninnis HtarveY Harr 1101 C' Oak, Denton 3719218; 8.20-78 4.00 Balance after Medicaid, s SElnchconb Charles Henryy Myrtle 16.00 Balance after Medicaid. i i M. Bradshaw, Denton 369680, 6.18.78 i "e,~slay, Pet "ansiev, Barbaro 10.76 8+tanee after Medicp . 412 6eatar, Denton 3i33t2~, 10.3.76 Herrlnn99 ppe~r+1d}}ne dame 1716 Mowae, Dentgn 3718624, 8.18.78 4.00 Balance after Medicaid. J4ckfon Alicia Same 4.00 balance after Medicaid. f1 8011, DentOh 3729324, 0.21.78 j ! ,~1ohLobart So!" 4,00 Wance Of to Medicaid, a >fd2tsE ` WrYs Nrt Worth 7770003, 7-19.18 + 4>1 10 ~eriurd; pMton 3711201, 8.4.78 3.0 Balance after Med1441d. I 920fNiitten, Note" 3701>07, 6.30,78 66.96 Balance after MadiAid. f j King, Juanitl Same 4,00 Balance after Ned icaid. Rau"id 2, Bdx 277, bray 3722378, 8.30-18 R{rkeby,%Ma12~nSahrer i669BA91 4.26.78 2,679.26 MadieailY lndlpenEi 2 in C G ab 8 familyi $300)0enth. {once, Martha Lance Steve 36,00 Balance after Medicaid. 702"Paialey, Dentan 3704012, 1.6.78 a Mr Page 3 . Cha%ty Charge-Off List December, 39 78 f {S Guarantor's Name Patient's Name " ¢ renter's Address keoant h oischarce Date Account balance Explanation tofler Robert Lefler Beverly ; 87.60 6 in familyl approximately ? Route 21, Denton 3711892, 7.29-78 $500/month when employed. Lefler Robert Letier Beverly 42$.90 Same as above. " Route 21 Denton 16b23Ff, 11.21.78 Y Lefler Robert Lefler Beverly 35.00 Some as above. } Route Denton 3642916, 6-6.78 Lefler Robert Lefler Beverly 89.20 Same as above. Routd ft, Denton 3746127[, 11.16-78 ltflar Robert Lefler Beverly 1,824.65 $amr as above. t Route 2, ntoo 1533386, 2.18-)6 kotsosp Ellen Same 32.60 Paranoid edhirophrenie t i Ayf None' $742798, 11.6.78 in M 46 information, ? l iidpe Jerry tookrfdge, William 27.35 11 in familyi $141780 68, ~anper 37296141 9.21.78 annually. 1 ckpjdgej Jerry Lockridge~ Page 81126 Sane as above, B6'x 7 , anger 3161761, 2.10-78 a lynch , fbara Same 4.00 Bala»w'after Medicaid. 2400 6L son$ Denton 3723434, 9.2.76 Martin, Jackie Spp~ee 61.00 Denton county jail. } None 37493301 12.1-78 McCory, John SAM - 114.15 Denton County Jail. None 3762466, 12-13.78 i RltchlY Elixabeth Mims frank 4.00 Selene! after Medicaid. I gfi,Noi00 Denton 3734142, 10-7.78 81 dys Some 4.00 Balance After Medicaid. sox, Sanger 3714417, 8.6.16 ; Moore, Jessie same 34.6d Balance after Medicaid. ( 402 Cardinal, 1 62, Denton 37010670 6.28.78 j Moore Georgia Moore Oyango 4.00 Balance After Medicaid, 610;M11le, Gainesville - 3729316, 9.21.78 11 Mo A", Gary MO~~gQen Joyce .40 1014K+ after Witaid. Mark We, Denton 3724141, 4.10.78 Norris, Charles MorCriis Betty 3,142.70 Medicaid patient, 30 days 1801 fkry. 121 S,! WSY111e 16303Y31 2-6-78 previously "used. WI Rebecca thhfoot female Nicholson 16,00 Belonee after Medicaid, Whgate Apts.► 11.00-Gainesville 16676701 7.8.78 ouellatta► Lucite 102.75 U year old patient brought' M4M 1663236, 11.24.78 here NO'' Ws At* E91 brat" coo e ed by ~nSohippraai/f's.offieet wanted j Pattertonl Nancy Sable 321 60 OentOA; hty Detention Cent t' 306 frais Denton 8731908, 0.29.78 atzers er ion,pNf~en6y in? g~p 147~ p 97.90 Denton Co Detention center6o, liar aty on 9, I0170 111.00 Sant as above. . Macke ► Ruth Pe~den Ro}eYn 4,00 841enoe after Medicaid, i 2818 111, Denton 37171~2► 9.14.18 Pinkordi Yenesse Serra 38.00 Balance after Modicoid, ' 60 Loop 288, K-9, Denton 37169190 8.10.79 Porter Arthur Some 18.70 Balance after Modicald GensrA{ Delivery, Sanger 15691690 9.13.78 .rt pp 6 "oil Pape 4 Charlty Charge-Off List December, 1918 f Guarantor's Name Patient's Name i Guarantor's Address Acco~nt 0. Discharge Date account palanco LXglanatitn Porter Arthur Same $ 20.70 Balance After Medicaid, Genera{ Delivery, Sanger 1674920, 10.17-78 Ramirez, Diane Same 4.00 Balance.After Medicaid. 608 Crawford, Denton 3136671, 10.12.78 Reynolds, AIWO Reyynolds, Tarry 4,00 Balance after Medicaid, 1008 Reev, Denton 3736628, 10.12-18 ; Re Ids, Travis Reynolds, Timothy 4.00 Balance after Medicaid. 1008 Reed, Denton 3729762, 8.21-78 Richard, Letice Sao 66,11 Balance After Medicaid, 117 S. Crawford, Denton 16164206 10-21-78 A~ 604 SknnerenDenton 3121846, 9-6.18 3.20 Balance alter Medicaid. { 613 Pah Lane, Denton 3666683, 2-12.78 81,26 Current Medicaid patient. I EE AOY (11ttson> Denton 35724116 9.4.78 4.00 Balance Alter Medicaid. rd, C Audie 4,00 Balaf>ceafter Mtdita 814"LAkly, ~nton 3 37764, 10.19-18 S ppard, Claudio SaaAe j fe1199 Lakey, Denton 3724664, 9.6-18 4.00 BeiencA After Medicaid, f Shoulders, Claude ace 87.76 Medl Gaid patient, too lA; 1114 8rlokwood, Denton 3700168, 6.26.78 t0 film, SiON$, Mar S{{mms Vipki 61,05 y+ both 601 Loop 288, Denton 371736, 8-14.78 In YAAhebpl A . parents Ilms, Fannie SAma 16.00 Balance after Medicaid, 014 8. Hickory, Denton 37124620 7.30-78 jWb#qpy, Mildred SAM 786,66 Uneapl0 unmarried, Village East, #103, Denton 1682931, 11.28-78 prooW diabetic, and rlq,{uu{eiff{y.a patient from ' Stacy Barbara SAme 4,00 Bh1Abe! after Medicaid. 1909 Iona, Denton 37064390 7.12.78 Roberta, J1~aQ~~ 3910 Ruddelli # 212, Denton 16796$I,Ad m8•78 26.05 balance after Medicaid. f talays Catherine Stanley) C11- hrtttapher 4,00 BAlance after Medicaid. , y ~ 13 S. Mood, Denton 37122661 7.29.78 , 3tlpily, Catherine tantey, Christopher 4,00 ealAnee after Medicaid. < f 313 S. Mood, Denton 1134498/ 10-8-A 1. Miin,bLi+ynlsvlll• 33 2 26, 8-22.78 16,36 6eceosedt admission prior' to Medicaid elisibil~ty. Tiber, Rita; SAW 4.00 '$Alone# 'ftor Medicaid. r~W~~O fproo,, Denton 3704614, 7.1.76 sox 1 ~lrgyte 9739471, 10.26-78 , 4.00 Oilinae after Medicold, a"4,00 tt Yer Max1n! 4,00 silence after Medicaid, 3394 1, 0.10.78 Tate DAV1d` Same 169.26 y~ar.old 38 patient now f 400 f,010.P40 Denton 1674144, 30.6.78 ip pith to Falls Slate 110sp4 JIMMAA, Raymond Same 261J6 42 r. o d currently in k~oo a 1, Box 71A6, Krum 1661372, 7-23.78 Wichita Ails State Holpltel . f k h 1 Page 6 Charit Charge-Off List Decem , 1978 r Ruarant is Na* Patlent's Name 's ey~~rantor's_Address Account 0lscharae Date ccoun alanca Cxia a i l r Walker Judy Same , P!wte Box 26, Denton 3715588, 8-9.78 S 4,00 Balance after Medicaid. t Waiters Olen Walters, Daniel 10,16 Medfcelly indigent. i 1118 Nclor~nick, Denton 3160166, 12-3.78 l 2op~naA, Bonnie Same 2406 Louise, Denton 3695251, 6.14.78 32,76 Currently to hallway louse 405 Louise. LiseBonnie Same 2 16,00 Currently in halfway house, t x405 , Denton 4102943, 8.10.78 ! West Sherry Same Box 1630 Sanger 9677986, 4.23.78 70,00 Current Medicaid patient. I W111~as, Theresa Wi ljama, Qunt;n 4.00 Balance after Medicaid. 613 ark Lane, Denton 37 7996, 1tl0.0-8 Woods, Clarence Some ~ 610 Park Lone, Denton 1658472, 7.19-78 14314,65 Med}celty indfgentl now a yEi medicare patient, +r I" infant Maio Same 983,06 l Bone 1586669 12=14-78 Abandoned baby (waiting en ' , approval from Medioeid,) York Marcella Stine 700 4.00 Balance alter NeditAid; i Ih4nbers, Penton $744844, 11-14-78 York Marcella Same 4.00 Balance ce after Medicaid , r , . 700 Chaebers,.Denton 3720562, 8-24-78 TOTAL S 280777.63 r A Aak r 1 i t art, 1.8.79 , MAKI 11\(/. ADMINISTRATOR'S REPORT BUSINESS WNU TES Date November 15, 1978 _ Page 1 t This report will be devoted to my assessment of our financial operations for 1978- 1979 caused by the City's 60% reduction in anticipated funding. First, a look at 1977-1978 fiscal year, which ended with a $206,162 unaudited profi . This, profit was made with a $210,600 fundin :from the 'City. If we had only received 60% of this amount from the City we would stir show a profit of $100,000; but it would als mean that we wouldvhave had -105;000 Iasi cash flow, This was accomplished with an average daily census of 83.3 for this per',od. The loss in cash flow could have been by increasing our daily service charge by $5.00 per day. In other words, we 'made la could ve adjusted operationally to compensate for decreased revenue and cash flow. Our budget for 1978-79 totals $8,210,080 divided as follows: $7,5690700 patient revenue, $177,300 non-medical revenue, $339,080 from the City and County, and $74,,000 from donations. There is deduction from revenue of $1,344,770, expenses of $6,693,870, f leaving a profit of $171,440. The patient revenue amount is based on an average daily census of 89. Due to a change in policy of the Cityy, which has, been in effect since 1971, the City is only going to contribute 60% of the amount contributed by the County, { j This means that we can 'anticipate receiving from the City and County only $281,897--not E E the budgeted amount of $339,080; This is $1179183 less than anticipated reducing the projected profit of $171,440 to $84,257--with all other projections remaining as pro- e I i How will we be able to absorb the $117,183 reduction in cash flow in our operation? ! j Included in the budget is,$327,44Q foo capital equipment and $75,OQ0 for building am fixed equipment. The reduction in anticipated cash flow would mean that we woquld have less money to spend for capital equipment and building and fixed equipment. Our not , I purchasing all of this eq ipment would not effect the quality of, care that we would provide. Some of the equipment is additional equipment, some is replacement equipment. There is one item in the building and fixed equipment category that I feel is urgent, an that is the replacement of the roof at a cost of $40,000. ` In regards to.other items in the budget, patient revenue should remain the same, if 1 we maintain an average daily census of 89. Hopefully, this will be 92 or 93. For each day above 89 revenue increases $200. If our average daily census is 91, we should have an additional $146,000 in revenue for the year. One item that was not considered in the budget was the cancellation of the Cardiopulmonary contract. This means a reduction in expense of approximately $200000 per month for six months, or $120,000 for the year, lm provemant in our collection percentage will increase our cash flow position, and this is a good possibility, The payroll amount in the bud at 1s $3,184,350, and with the proposed salary in. creases, we are on that number. The number of employees in each department is set, and new employees will be replacements. E Our daily service charge was increased 85.00 effective October 1, 1978 to take care of the increase in salaries and health insurance, j In summary, our profit margin for 1976-79 probably will be as follows; Net margin from budget $ 54,267 E Net margin from census 146,400 Net margin from Cardiopulmonary 12b 000 Net margin for year If the census of 89 falls to 85, what action could be taken to compensate? 1. Reduce hospital staff 2. Increase daily service charge $5 which would add approximately $1260000 In revenue '•...u.Y.••~"-1iY91 fC~"1..Ca''~ 1YL ".,K"•'•i`Cttt~"--~"•Y n p I i. r...p.,♦ n. .p.pi. • , tat:.,.. s w ADMI`NIS7RA70R'S REPORT' i 6USIN~SS MINUTE5 n.~. v e i9 8 t.v. , ~ Y« r 1 7 _ • Based on the above net margin, which I feel is valid, we would nat ga under if the ' City contributed nothing. 'fhe margin would be'reduced to about $205,000, In view of this fact, f stiTT feel that we should be compensated for the charity services. We have budgeted charity of $464,460, Due to tfse Nill~Ourton requirements, we are tp pro-' vide $156,000 in uncompensated services, leaving $310,460 that I feel someone should com pensate us for. f In the final analysis, I feel that the utilization of the hospital wi11`increaseK- not decrease; that-improvements w111 be made in hospil;aT operations; net margin'to remai r at about $200~000~ and our cash investment wi1T be increased. E the following information is interesting and would indicate where we will place a gootl part of our time and efforts: The source of our cash reCnived Tast year is as i } follows: E Patients 90,6 f~ City 3.3~ County: 2.4% ~ ~oundatior 5X Contributions .i% " i Cafeteria 1.5~ -0thar i.4% Yh1s wnuTd indicate that wA should do everything possible to m4ximize our pAyments frdn I ~ ~ .patients. ' C Respectfully submitted, I r `t n Leonard E. Watsen ' - Administrator 1 E.EW: gm , .i ~I' rf ~ I € ' I 7 E f ~ r ~ I~I ~ { i „ ~ i ~ E F II f r C Z ~ ~ ' i. r ar r.. e,. .r i~,. n u~ 1".~ tY. Y'LVl'Y u.n : emu. a ~ ra 1 WI.i~ nu .n..~.......•.~.✓ ADDENDUM TO ADMINISTRATOR'S REPORT 9USINESS MINUTES o.i, NoYEmb r.q• I called King Cole, Assistant City Manager, this morning regarding the City's financial commitment to Flow Memorial Hospital. I related to him that 1 needed the information in order for us to make some decisions as to our operations, He stated again that the $114,600 was in their budget for Flow, but that if they received the Attorney General's opinion stating that it was the County's obligation to take care of: charity, then this $114,600 would be withdrawn. I asked if the opinion had been requested. He stated that it had and that they had received a reply. I asked what was the reply. He stated that he had not seen the opinion, but that he understood that it was rather indefinite. He stated that copies of several 'cases had been sent, but that Denton's situation was not really answered. He stated that he understood that the information received Indicated that charity care was an obli- ' gatloo of the County, I commented that in that case, we could'not expect any financial assistance from the City. He stated that the City was still obligated for their part of the bond indebtness. As I stated earlier in this report, I feel that we can survive without any City i assistance, but I strongly feel that we should be compensated for charity by some ' s J governmental agency and not place this additional burden on the paying patients. I recommend that there be a meeting with the Commissioners Court to discuss this matter. r Respectfully submitted, LeonarE, Watson Administrator 1 LEW:gm j . )s.. 4 , it i f , x r r k pw o•n..Ine.r rn ba.a nr'. . ...ux .,rets♦.r.,b.,..,. ..t4tar p. 4irfrP Jr.k:Ar:'~ r Mal I N ~ d ~ ~ ccpri~ C H ~ } W O M N <a ryhb Oi 00 IWI c y co 2~n it 7 C 04 A 9 o Q° ~ y N ~ ~ °i S -p y f rn m ro t+ a oil (A a to I UtzA Cf VV W NsA N { T y w r N 1 } r Y~ ~ to ~y WVV ~Y y~ y I^'Y~~~w~Q~ M'1 E ' I"~ ~w b ?I Ot r w 1Q 44 O(A } N W' {S1 W W Wes ; N d'W w yy I~ Y y y w (p~1 Vey r r' _ E UI W N V O vl 11 S~b +i a a i w Poll 00 € y r~~ `.ro loss, !fl W.. w w. ( 1, ;i O' W ~ r G7 W Y , . j.a r`'' ~ 4r0 r 1Ji d1YhS a ma I ' 16 lootos.lo N, W ~ w wM W. w N 3 y;, W A r~' Vg y', Yi. w~r jYl~y YV At is VJ V. (c~t'f; v /-M`MI+, `jW+77. {..i Cd O •(jIO,~J N lb lD F~ l0. 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SL( .4r 'i sy Q aa~ ro rt + ~ ro n~ I'll i VO -N CD 0) (A -j 94% (A H~ a ro I• ~ ~ ~ r A) ~64 Y y y Y y~~•~`ee a th b~ N c7f po V w s u w x~ Q 8 Lm w 40 -VIP (n di f ~ p N k N' • b+R pVppp 'mil ~ ~ w w ~ ~ f~R ~ to ~ Y , 4+ ~ ~ Oa w VV i l ~ sa L ,y . ~c+!!.K«.k ~.w.kN+,oi3~rNMl•usie+W3MdSavP V~Afi/~J~V~di~'. f2+v'~4M~K~.tWt,A~.`;"CW$',y~ ~ ....xo-v.a.:~,y vati. ~oM11i4...:Q:4 hY.'vdr tiYA'I14)u{.,~.1 aafh`h'•ae. . r ors ~Ih„ram.. ' - a FLOW MEMORIAL HOSPITAL t CHARITY CHARGE-OFF LIST NOVEM84A 30, 1978 Guarantor's Name Patient's Name ' Guarantor's Address Account 1, Qisc.harne Date Account Balance Explanation Arnold, Irma Same $ 16.34 Balance after Medicaid, 609 Rose, Frisco 3717238, 0.14.78 i( Atteberry, Betty Atteberry, buwayna 122.26 Balance after Medicaid. r 2800 Fort Worth Drive, Denton 1540236, 3.29.18 Baker, Michael Some 8.60 Balance after Texas Rehab. None 4093176, 0.7.78 Barnette Shirle Same 8100 Balance after Texas Rehab. Route 2, Pilot Point 1569260, 9.11.78 Shrum, Joseph Same 4.00 Balance after Modicaid., Route t, Sanger 3713807, 6.3-78 8erree, Ethel Barree W1111am 4.00 Balance after Medicaid. j 109 S, Ruddell, Denton 312449 , 9-448 Coyner Lela Same 2,448.70 One In family/$237 per mo. 1 j Route i, Denton 1678285, 11.14.78 F Oster Arthur Same 667.60 Patient at T8 Hosp., Tyler,{ 323 Hanle, Denton 1649666, 6.17-78 I ~I E 1 Goldsmith Duane SAM X6.00 Denton County Jail. 3 304 Audde~l, Denton 3701204, 7.3-78 Green, Susan Same 68.35 Denton County Jail. i 304 Ruddate, Denton 3141714, 11-3.78 Griffith, Clarence Sam 45.10 69 yr, old male/unoip'oyed,~ 13110 Normal, Denton 3141036, 11=1-78 Gutierrez, David Gutierrez Kathy 666,96 4 in family, $386/month. 992 S. Charles, Lewisville 1648312, x•1.76 Heckler, Johnny Hock or Jayne 1,069.76 6 in family, $400/month. { Box 948, Argyle 151310, 10.22-77 Hardy, James $me 719.85 ~O yr. old male/unemployed.; 1009 Wi11sOn, Denton 1841466, 4.6.78 Hargrove, Arleen HArprove, Michael 108.85 Unemployed. 910 S. Locust, Denton 3693349, 8.8.78 i Hill, John Hill Jr,.02. John 118100 Presently on Medicaid. Nou 3666416'19.78 ; Howard Donald same 30809,00 Unemployed, 38 patient. Box 1130, Sanger 1663460, 7.3.78 Munter `W40611 Hunter Davy 16.66 Frequent Medicaid patient. Route 3, BOX 93, Denton 3704471, 7.6.78 Ingram David Ingram Mary 40606,66 40% discount, 1 in family, Route 1, 0ordo,wiite 153111 , 6.11.78 :1328/month. King, Juanita Same 96.40 Presently on Medicaid. Route 2, Box 213, Aubrey 3715838, 8.22.78 Lockridge Pam Same 64.60 11 in family, $14,180 Box 768, Sanger 3742244, 11.6.15 annually, ! r Luster, Willie Same 2018.00 10 in family, 5146/month. 1226 Tahoe, Lewisville 1616626, 11-10.77 MereheIII Clyde Marshall, Amanda 940.26 2 in family, 1332/month. Box 114, Roanoke 2578020, 11.2.18 . .,„w ....a,v _...w:.p....,..w..z urct.w M+atMlr,.,(NV.vniy,gy ,r I 1 Charity Charge-Off List November 30, 1978 = Page 2 6uarantor'S Name Patient's Name 1 Ouarantor's.Addrgss _ Account f, Discharge Date Account Aalance E pianatlon Marshall, Clyde Marshall, Amanda $ 648.95 2 in family, 5332/month. Box 114, Roanoke 1681438, 11-17-78 f McCrory, John same 62.46 Denton County Jail. None 37448511 11.14.18 Medeafe Eddiest Same 102,25 4 in family, 5440/month. ! 1224 Mcbonald, Denton 3676335, 4.18-78 Medcafe Wiest Same 80.10 Some as above, i 1224 Me~Onald, Denton 36944601 6-11-18 i Madcafe Eddiest Same 21.00 Same as above. 1224 Mc6unald, Denton 4101317, 6.19.78 Ideafe Eddiest Medcpfe, Kerry /I.Ob Same as atiove. 1224 Mc6onald, Denton 3698222, 6-22.78 Medcafo, Eddiest Medtafeo Shannon 51.60 Same as above, 1224 McDonald, Denton 37321041 9.30.78 Millar Dan Miller, Anna 303,70 3 In family, 5400/month. r $16 Smith, lot 2, Denton 1676867, 10.21-78 Miller Don Miller Anne 167.76 Sam! as above, 816 Smith, lot 2, Denton 168246, 11-20.78 11111er4 Don Same 90,00 Sam as above. Sherwood MNP, Lot J60 Denton 3668563, 2.25-18 Miller Don Some 34.60 Same as above. 1123 Windsor, Denton 3666817, 3-16.78 Reed, Irene Same $0.00 Denton county kealt6 Route 31 Box S2, Lewisville 4096723, 10.11.78 Dept., patient, unemployed.1 Renshaw, Mark Same 232.40 Unemployed 3B patient; 661 dreenland, Lewisville 1682461, 11-20.78 transferred to Wichita Palls Roogqers, troy Same 61160 Madlcald filed too late. 60B Park Lane, Denton 3684545, 6.13.78 f Smelser, Robbie Some 4,036.66 Medlcafd. atientl 30 days Box 198, Lake Dallas 1660424, 0.19.78 previously used. SDDr~e~yb6jpy, Mildred Same 30.00 l In family, unemployed, 1b04 Village gait, Penton 3738481 Sppr~e~ybaery, M114red Some 770.00 1 In family, unemployed. 1604 V111494 East, Denton 16802731 11-13.78 Stacey ale r'r 60A Raliroad, Denton Staceyy Samuel 32,76 patent Medicaid patient. 371957, 8.22.78 {4 +,G Starnes, Jack Starnes, Thelma Route t 98.60 64 Yr. old; no Medicare It Sox 67, Aubrey 3721842, 8.28.78 or Medicaid. Starnes, Jack Starnes, Thelma 41.00 Same as above, Route 1, Box 670 Aubrey 3724291, 9.4.78 Stephenson, Wilford Sams 303 god 69.60 Denton County Jall. Street, Denton 3742467, 11.6.78 Sweatman, Aubrey Same 149.50 Medicaid patient not 418 Mafn, Lewisville 3726262, 9-11.18 eligible at date of service.! Stanley, Katherine Same 4.00 Balanoe after Medicaid. 313 Woods, Dentoa 37271120 9.14.18 Stepphenson, Linda 1 19 Cedar Keys, Lewisville 3r3t403, 9.28.78 4.00 Balance after Medicaid, Stanleys, Katherine Some 4.06 313 Wood Balance After Mndieaid. Denton 311787, 8.14.78 Ixe.Mhw+w ~~YY '+w.iawgsY~MW.wIpNNi~plN11Y1iltlvfln. WVBYYb/jM~~~~}. t Aw ' Charity Charge-Off List November 30, 1910 Page 3 x Guarantor's name Patient's Name Guarantor's Addre s Account A, plsch,arge Oate Ac o n B lance x Lana 1 n P Sims, Fannie 1014 E. Hi Same $ 36.00 Medicaid filed too late, Hickory, Denton 4109286, 8.1-78 Scott, Gladina i 404 S. kuddell, Denton Same 3704939, 7.8.78 10.60 Balance After Medicaid. 111 Scott, Kennon Same 4.00 Balance after Medicaid, 2902 E. Keist, Dallas 3705811, 4.10.78 1 Shop rd, Claude Same 819 Lakey, Denton 3712072, 7-29-78 4,00 Balance after Medicaid. Shepppard, Claude Same 819t:akey, Denton 26;60 Balance after Medicaid, 3710985, 7-25-78 t; Swoffodd, Hentfe Same 16.00 Balance after Medicaid, 732 Greenwood, Denton 3673290, 4.9.78 18 Main, Aubrey same 4 Balance after Medicaid. 418 Main, Lewisville 16486920 6-16.76 24,00 ` " Sims, Fannie Same ~»J1 1014 t. Hickory, Denton 3732393, 10-1.18 8,00 Silence after Medicaid. Theard Cecelia Same 3666 Elmore, Colorado Springs, Colorado 1578608, I0-31.78 239.70 Unemployed, no family, 36 petl4nt transferred to j Thomas, Hike Same Wichits tells. None 1648826, 6.11.78 364'68 Dsnton,County Jail, balance after MSUrAnca, Thomas, Tiniki Same 4,00 0314004 After Medicaid, + 107 Bow-n-arrow, Dallas 3936347, 10.11-78 I I sseryy, James 688,60 Insurance only effeotiv0 1708 Ros4lawn, Denton 1635186, 3.1-78 6 days, Medicare patient j Walters, Mann Walters, Oanny here 12 days. j 1118 McCormick, Denton 168-976, 11.16.18 439.80 Medically indigent, Nerd Carri/ Ward Mark 310 industrial, Denton 166486 1,0901 Combination of several j Werimao, Bonnie accounts, currently on I 412 Fry U 2 Fry, Denton Same 3,349.48 Medicaid, 1817726 Unemployed, single, , I1-21.78 transferred to halfway i West, Sherry ' ,00 910 S. Locust, Denton 31.32609, 10-2.78 4 09190c e after Medicaid. .4 Nhee er, Julema % 910 Locust, Denton 3Same 6067310 6.16.78 49.00 8016nce after Medicaid, f 4i Wheeler, Zulema Wheeler, Robert 910 S. Locust, Denton 3711026, 7.26.78 4,00 8alance Altar Medicaid, Same 613lPark' Line, MO(08 3713039, 7-26.78 4.00 8410ce After Medicaid, TOTAL 30,766.76 19.6.18 , 1 r .ifUW.,WWVI . ......rr . Y .r....r> ..r. s..W .,..K ♦r h,v, •wrt.Ws i{,~i. !L.' rim" 1P(GItYA YIV.G`AMq 00" AMtew ' BOARD OF DIRECTORS BUSINESS MINUTES Date November 16 1978 pays a-- - l The Flow Memc,4a1 Hospital Board of Directors met in regular session at 7:00 p.m, on Thursday, November 16, 1978 with Mr. A. E. Wyatt Chairman presiding. Other Board members present were Or, Ar M. Finlay, Mrr. Robert Nichols, and Mr. Gray Shelton, Also present were Mrs. Carolyn 'Flowers, Mrs, Wilma Fritz, Miss Holly Hervey, Dr. R. J. Lee, 'r Mrs. Margaret Lester, Mrs, Gloria Madeweli, and Mr. Leonard Watson. The minutes of the October 19, 1978 meeting were reviewed and approved with three minor'coreettions. At the request of Mr. Shelton, who had haired the'Finance Committee Meeting, Mrs. Fr tz reviewed the Monthly Financial Report. She reported,that the average daily census for the month of October Was 98,6, an increase from 83,4 for September. The grOSS'patient revenue for October had increased $29 000 from September to $666,000, due f tin part to 'the increased hospital servied'eharge which became effective Qctober 1. { Excess Of re Venue over expenses for October was $16,483, The financial statements were eoviewo_ , as well as the Charity Chargga-Off List in the amount'df;$56,601, ' Mrs. Fritz pointed out that the Bad Debt Charge-Off List is to be submit-cod quarterly instr>ad of monthly and that a 9.8% reserve for bed•debts was expensed ;in odtob'er for th J quarterly charge»off. Mr. Nichols moved that the Finance Report be approved; this mots was seconded and passed by voice vote, Mrs. Fritz, Announced that the auditors plan to complete the hospital audit soon, after having worked here at the hospital for four weeks. She announced that the target ' date for the computer change to the new Health Care Data Systems has been set for March 1. A proposal from,Trans-World Accounts for collection efforts was presented and dis- cussed , Mrs...Lester'suggested that the hospital cduld turn over accouunts which are I felt `t6 be colt :bible•and which hospital employees have already`tried'to col,l;ect for a ; period of 60 days, She pointed out that TWA guarantees to collect at least the amount which the hospital ic,ys to them for the collection effort, Mr. Nichols moved that the Board approve d contract with TWA on a trial basis for 200 accounts at a cost of $5.60 per account. This motion was seconded and approved by voice vote, r Mr: Nichols presented the Foundation Report and reviewed soro&-of.the efforts the Foundation has taken tO keep their money invested at high interest rates. The Administrator's Repoet was` rimbri.l Mr. ' y Watson.,s'. a`sses'sment of the 'affect of t the City's reduced funding and the alternatives for absorbing the resultant reduction in cash flow. Mr. Watson pointed out that even if the City provides nb funds at all this year, the; hospital would not suffer ggreatly. The City's reduced funding would probably meah'fhhai; less new equipment could ba purchased and that the daily hospi'tal service rate would have to be increased $6,00 per day. Mr, Watson emphasized that he I felt that Flow should be compensated for the charity services, which is peodected to be an amount greater than the combined funding of the City and County--if roceived, Dr. Finlay pointed out that the agreement with the City end County was to provide fund. ing for an up-to-date, adequate hospital for the paying patients and that providing fun for charity care is not the intent of the agreement. Dr. Finlay moved that the Adminis trator's Report be approved; this was seconded by Mr, Nichols and passed by voice vote. There was a discussion concerning increasing the daily service charge an additional $5.00 per day to compensate in part for the funding from the City which may not be received, Mr. Nichols moved that the hospital service charge be increased $5,00 { effective as soon as possible; this motion was seconded and passed by ` voice vote, Dr. Lee presented the Medical Staff Report. He requested that the Board of 1 Directors act on the recommendations presented to the Board in October for ".~"sLY:' Y'?.XYC _x"stft-~2Z .~:1:Y't~-~1.~5x'vCTl~Y .L• L-. 1000 1 (W AI ox Co., 1 t1t"111 f •T 11r s -4~.rt^ tornrra t4 WJJ. rd +)7.y^N 71; v1 rrii, .tt tK. t4 ~t i'-.',~i iiW.9/ ODW BOARD OF DIRECTORS s BUSINESS MINUTES Dd. November 16 1978 re-appbintments to the Medical, Staff and Dental Staff of Flow Memorial Hospital. The recommendations of the 8x'ecutive Committee, Credentials Committee, and the chiefs of the respective,departments were considered. Dr, Finlay moved that the Board of Directors re-appoint those physicians and dentists listed (see attached list) and not re-appoint those physicians and dentists who had not'applied for re-appointment. This motion was seconded by Mr, Shelton and passed by voice vote. Mr. Watson proposed that newspaper space be purchased for the purpose of presenting a summary of the operation of the hospital at the end of fiscal year 1977-78, He out- lined his suggestions for the content of the ad which would include probably two pages. It was the consensus of the Board members that it would be beneficial to purchase .such ' an advertisement. Mr. Nichols and Dr. Finlay wr.fe asked to help Mr. Watson in skVrring~ funding 'for ,the advertisement. Mr, Watson annouwced that Blue Cross had info ~d him that the p,romiums would be increasing,for the hospital's group health insurance coverage since utilitotion had been 12$%. He has asked Blue Cross for,an ex'tonsion of one month from the December i'anniversary date to allow hint timo to aiimine other alternatives ands costs, 1he'FIoW'Memorial Mospital Auxiliary has pledged to purchase five sleep chairs for the pediatrics unit and pledged over a three year period to purchase a bife Pack 6 defibH11 ator/monitor. Mr, Watson Informed the members that the general contractor for 'I the new peterbilt plant,, -Brown and Ro6t,Inc. 0 will be using Flow Hospital for 'their, iIndustrial accidents for their 400500 employees. ( The meeting was adjourned at 9:15 p.m. for an executive session. At 9:20 prm.,"the Board met in executive session pursuant to Article 6262417, Section 2,(g) V.A.T.C.S. Immediately following the executive sesslon,,Dr.'Fin'lay made a motion to increase t,e,edministratorls salary to $33,000 per year. This motion was seconded and passed by voice vote. The salary increases @s proposed by the Administrator Would nisan',an increase in payroll expenses of $146,000. In view of the uncertainty regarding the tl♦y`s'contri- bution,means of reducing the amount of the ircrease were discussed. It was decided ~k: n p to $100,000 fr the, 10 muthb raga vg will b'e 197x1 - September, 1479 The details as ` LJ workedh6utdbinther Administratthe or. The increases mottohnwas uch each em loyee i t period, December, Y n made by Mr. Nichols 'thet this plane adopted. The motion was seconded and passed by voice vote, III The meeting was adjourned at 11:16 p.m. Respectfully submitted, F Gray Shelton secretary gm I `/:seLYaela WssYZrn:antas't~L.-^^sYZ~.~:~-...-- ~s~.~..~t••,-~.ax~.. ..1QH O.Of /nMq.a ai<f.a to Rr..l. i„i ~ .a=s.. y.uv ...sr~ •~!h r~l rr r r s RECOMMENDATIONS FOR RE"APPOINTMENT TO THE 3 MEDICAL STAFF AND EtITYEAR BEGINNINO AL STA ,OF FLOW EMORIAL HOSPITAL EMBER 1978' r Approved by Credentials Committee, Chiefs of Respective Departments, and , Executive Committ:e f ACYIVE MEDYCAL ST FF ~s G. E. Adami, M.D. V. R. Alvarez, M.D. E. P. Ka ai M D. . M, Taylor, M.D. J. R. Anderson, M. D, R. E. Kelly; M,D, J. C D. Thomas, M.D. H. M. Axtell, D:' 0. C. L. Kinard, M, D. T. J. Thomat, M.D.D. N. Bailey, M.D. F. D. Kurrus, M.b, M. W. Via 'M. D. k T. 0.'Blucker~, M:D: R. J. Lee, M.D. R. L..While, M.D._ R. B. Boatwrigflt, M.D. R. M. Lockwood, IQ. A. S. Wiley, D.O. J..P. Brown, M.D. S. T. Love, M.D. R. W, Williamson M N. M. Burgess, M.D. C. A. McAdams; M4.' A. E. Wyss, M.D. { W. E. Coleman, M. D, N. M. McClendon, M,D. D. M. cooks, M. D. W. C. McCormlCk A 0. W. M Boots Cooper, M.D. J. H. M11 er, M.DA R. S. Croissant; M.D. P alb D. R. 0: Dents M:. P. J. Mgntabo, M.D. J. K. Dowling, D D. Virginia Moreland, M.D. P. J. Dyer, .D. R. D. Nunn, M.D. f J. J. Feldman, M.D, J. H, Oliver, M. D, A. M. FinlayM. D. T. V. Patterson, A. D. G. P.Flahaj M.D.' T. A. Qurtshfi, M.D K. L. Ford, M.D. B. V. Ramakr,ishna, M.D. S00tt haggard M.D. J) M. Rampoldt,'1LD: J. D. Harvey, M'.D. F. A. Remillard, rM)D,• G. E. Noliadey", M, p, EM. C. Rittenhouse, M.E) ` r, J. W, Ndllaay . C . $ach.er; M.D) D F. Holt; M. D, Barry Sandere, M. D' J. A. Horne.. M. D, C. O. Sa ttler M. D:' M. Y. HoroYhz i M.D: A. D. Short,:I~.D. J L. Jackson, M. D4 M. E. Smith, M.:D. j 0. b. Johnson;M.D. DJ. P. Spencer, F1.D. i J. H, Jones, M .D. E. . LH. Tabod. aboada~,er I~:Db. J . COURTESY MEDICAL STAFF M. A. ArMstrong, M.D. J) R. Lo,)gg , bleb, { Bedfiola Badie, FI,D. M i9, H. Bakker, M. D. W. S. Miller, M,D. T. R Barth, Mr, H. V, Norgaard, M.D. R. J. Boron, M,D, R. P. Norgaard, M.P. D. K. Boyd, M:D, E. A. Riedweg, M. ti. L. B. Roberts, la,D, E R. Burkhalter, M.D. J W. Sears, N.D. B. E. Davis, hJ,b D. G. Swanholm; M°D. J. W, Dunn, M.D. J. R. Toledo, 14,0, Sender Groswirf, M.O. R. M. T,ovar, f4;D. r N. H. Huang Hsu, M.n, y' ' 'J. h. 1'16nnacot , b1.D. E bale Jackson M,b, K. L. Wright, M,D. i r. ~g,Wr/Qk,Y>`.kMi.'w+.w,.r.r. ...r. . • , 'r. ° M1W:lk.tiS'IN..~ApJi1~'4h},y{~ly~{1~ i6 5 PAM NiN.1.,1E1 [ 1 Page 2 COURTESY MEDICAL, STAFF. PlazRGEPI Y ROOM PHYSICIAPIS J. M. Aguirre, M.D. D. D. Lorimer, M.D r A. T, Bangale, M,D. R. A. Murchison, M.D, 0. R, Biggers, M.D. W. G. Murchison, M.D. J. A. Conyers, M.D. M. R. Sherrody M.D. D, F. Davis, M.D. L. F. Russell, M.D. L. L: Duffy, M.D. Ab' E. Thurman, M.D. I To L. James, M. D. H. H. Weisner, N.D. A. J. Lanier, M.D. i hUDIA1'RY STAFF ' ` j C H. M. Caplan, 'D.P.M,' PSYGf3OLOGY S1AF~ { Harold To Parry, Ed.D, j DENTAL STAFF John Bryant, D,D.S. R Frank A. COP,,. D.D.S, R, D. KindricL, D.D.S.. W. A. Crawford, D.D.$. J, L. Pavelka, D.D.S, Hamilton JonesD,D,$ W. E, Penley; D.O,S C: H. Saunders,.D,.p.5, 8enO,G. Morris, D.D,$~ G. L, 5lmmons, p.G.S,, I ~ f } r The below listt3cf,phyalcians 'and dentists were not approved `for re-appointment because they Ntd not apply: J. H, Damono M.b.' E. F. DeSei M. D; W, E, Boynton, D,D,S,.' F. W. Cothern, D.p,S. Kira» Narpapet; M.D. Ralph Davis', OtO,S. M: A: Nendere¢n A. D. driffin }luay, °a, Eugene Manus; M, D, R. J. Fletson, D,D,S. A; J, R. Jones, M.D, R R. H. Hugo K11nt, M; D. Read, D.D.S. i No L. Mc6rayer, M,D. P. B, Silvernala, Ox S. H, 1. McSwain, M.D, D, F, Speck, D.D.S. Horatio Pena, M,D, J. G. Quarry, M.D, R. L, Ridley, M.D. H. F, Schlegelm, M,D. i _F t Um ,.L.ac.rv-Wwdvati.%r.Mn^xwU anw».a.•.. n we BUSINESS MINUTES Oefe October 18, 1978 1 Our fiscal year ending September 30 was a good one. A good census was maintained throughout most of the year. By the number of compliments that we receive this is an indication that we are providing the kind of patient care that our patients deserve. i We do receive some complaints, so we continually have to wort. at being a "little bit better" each day. I~feel that we have an excellent staff; we have all of our department directors who are conscientious and dedicated to working for Flow, I feel that the attitude of the employees is; positive; however, we have had some dissatisfaction--particularly among some of the nursing staff. We have had some nurses who are more comfortable r 1 with old problems thanwith new solutions, but we see improvement in this area. We plan to have "Hilltop Happenings" activated again with the first issue due about the middle of November. I feel that this communication tool will improve employee relations,} f Another session of the Legislature has dust come to a close, without any type of CAP or cost control legislatioH being enacted; however, we have not heard the end of this because Mr, Carter still plans to attack hospitals in his program on inflation. Mr. Kennedy will still be introducing National Health legislation next year. I would like to mention, disregarding 'political preferences, that Mr. Tower and Mr. Gammage have been friends of the hospital industry and deserve our support. In the absence of CAP or cost control legislation, we at the local level should I work hard to keep our costs at the lowest level possible without compromising patient care, We are monitoring our FTE (full-time equivalents --employees) very closely and only authorizing those that are absolutely necessary. Another area that we are actively working on is the reduction in our inventories, and l feel that significant progress will be made in this area. f We feel that there will be greater demands for beds in the next two to three months, and we are making plans to put more beds into a ready status, as will be report- ed later in the agenda, More physicians are coming into the area--two this week and others in the next few weeks. l The past eight months of the past fiscal year passed rapidly. I feel that it was a Succesiful and satisfying eight months, and we eagerly look forward to this year as being one of greater community acceptance, a greatly improved financial picture--particularly cash flow, and improved employee relations--employees looking for and being part of the solutions to the problems rather than being part of the problem, We will be working to recognize different employees at different times during the year We will begin this program next week, as next week is National Nurses Week, and j we will recognize a Nurse of the Year next Monday, We are also working on a Christmas program for the employees, serving dinner, a possible musical.program, and a gift for eac employee. Respectfully submitted, 4onaille4d Wts an Administrator LEW;gm ( 10 v. Min rrD n c Cori ° c b ts n 8 `y Ji ~ FL -0 CD 1-2 ID V V 'S O C 7° d. o XI `7 IA I a' a o a U3 -s rD '0 00 J. n Y ro s~ N y r^~ bi 'T 0. rt A a rt n c t~ i~f V~ ID xy p~ {L r J. tD 4' N c Rv ~ (D U r~ 0 eD m C+ (0 t+ C+ i «C+. p HMO j tN1t (.J (0~(z~p twN,T N Al .p, V~ ~GNy 44A~ 'tl Z M N F+Y Ch C7 V (D O1'V N O by 00 tC O ,p Y YpQlGpQ Y Y VU(AJ1~ Y p0p0 Yomf~,, Y1t~j1~ V 4 V V V t 01 1~ W .AY W 4,n li1 `v W tit taV 01 M w 01 OD 44 W fV fV N~ fJ 7 ~ ~ ~ ~ppp. l0 FN M ~W Y N Gf F~f W Cj ~ N tm/r w G: p0 v '1 f~f 0~0 N r-4 tJ ~11 Cn ,hp II ~Mp c~lf~ x.11 Vf Y Y Y1W~f aP.O N Y p4 YWO tlf V I W 00 ~G 00 WHO l M w~ O A l0 yy tit -I -1 ro -n wr n r o - ro Coo' . ~fw~p, ~p y r.~~r}t y 40 -(Dh ie J rh C N ~ ~ O . f• PY• f0.tD f f €1. N ~ W ~ 126 0i. 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N W 0 M+ C !f1 ~ .A W N e► to ~ as re rr, . ~ r `r ) u~7C r E Oo w ON .j 4 V' V ~Yc~ W V Y~V V WVp v to W 'W V CA 14 n' t -W 44 4A v Www~•ac~iiotlwd o a,*o~vl~av~iad , V Y V V Y J Vvv V Y Y V V 'Y V(~V{a V Y A V V V Y Y ~ ~ '[ryy~~~~jjr ~ ~.N wvV~ F~'pA t1,OU. I ~ W, J+~ 01 I ..~pa.W r•+~~ ~~eSI .r.~ .~p•1 ` o~ C tll ~ C1 w ~ 00 /G ~ ~ r+ tV G O~ cD W h+ 1~ •Pi f~ f►1 ~ y' ee..n! vf' W *s 0w0 C*$ lwlf cm + 1wp w V t9,O) 9 4b Co w tLf W r 4b w W w W etl ~ V V V V V' V Y V Y' V Y V Y Y Y V Y Y Y 'Y Y Y Y Y 0) co f{f{f{ 0* f4 P4 .09 chOt~'~~fIV00 ~~itn$•iy~Ow~•P~Jr 4.A~CY to t4v 40 "Lo i j fW~f N N f^~1 A t74 r.~ N l~+~~f 0 0 e,J1 0~O ~O O W N ►w CW1 w W w r+ tJ ~y Il Y Y V 11 V J V Y Y Y V V Y V V J V J V V Y Y Y J J Y Y 8 !A V Y Y V J ~i~~pp9 ~Ti ' j J fv A frnV IV Kf~ ~ W w W tl1 V N''S ~ cnww •A w~I~oWGtiW 0<17 t~~v~o~+•lo[riC~~~~w ra+~ ~ I I , v 1 n•,I LW`l1 Nl r...,.,r Y t =r 1.4 v (A o~o n ca+rov ~ a t7GO a a a a W7 ~4,~ ~~f~7n ~r i , n v+ %I L4 a ~..y eyy w rro -a a q+ `n O ~y.4 i N~. N~ C~ I ~Oro a•.~ SD ~D WWW W s ro a a s a G romp°< ~m a I c o `pro J m }f'/~~' QQ a r+ fi a V) V) y . • H G 1'~ 11 J t+ (D m g els C 0 0 4. .may. .44 r i ttpp y CD Wb.- 40r'OO W 1~1 f r r: W j -#A '4400 4A -b4 4A 4A Fj i 10 OfV N : IWV V1 C N w j %so j { 1. ~,Y. •~ry~~ ~ N Y11kIk3Ail9lYlRtn. .I. i..v. r.. .....w..ao- sq.i..~;u.eaaa..W nerosa rw moo. r.rn. ......~n..q. ~..in.MM.t~N4tWgww,r,... Y -Y V o n ^ yY ro ~ [8J re fD ~ i a ro m r~ ' r~r o I ( I ~ ~ ~ W W T N 14 ~A' I I N. ~ p w ~ i N b N w r I~M11M11V{ r ✓~.uf2'ra..211N iAja4 I\OV.R~InN 3'H Y,:il!v ~+Ar.IlAll!\1'NJMJi..'11.i~Alr2ldrj~`Y.t11J11K:[ItAtlWm.lN.~~~.. ~f F 9 -01 i no o ct w rpzrp r+ tin tr' a ro~ Ib lti1 .may ~ ' %4 N N N N CT ~ ! ur N ~ er ; ~ b L] W M ~ . W of ~O .P H to -4 rw b , i4 cm a ' n f ~ 00 ~ ~V W ~ is w I-A v ~ ~ C y ~ 4t vu' ~ ~ , { i I •..•.+~N,ve..,to.amn+.u. ,:aae«v.n,... r a ~ FLOW MEMORIAL HOSPITAL ` CHARITY CHARGE-OFF LISP OCTOBER 310 1978 Guarantor's ,lame patient's name W 1, Guarantor's I dress Aocount Otsfhorde Date 14§caunt Balance Lillie io J Aideco, A1Vir Same $ 34,50 Denton county a A18 Bernard, Denton Ja1l. 3737418, 10.17-76' #n 4rrea, Ethel' ; Same 16,00 106 S. Ruddell,.Penton '3705340, 7.9.78 Balance 'after-Medicaid. ' 'firma' $ edsoe 01en8. 8 edsoe, sshatema 72,60 Currently Medicaid pe 2M Rud A , Denton 3$6336, 3-18.78 ; &Othr;ai I. Arthur 1 003 Eagle, Denton same E0,26 3734555, 10-8-78 0nemployedi medically indigent. Bothwell, Arthur 80thwell, Opal 32.60 Boltance after Medicaid. ' 603 Eagle, Denton 3680676, 4-30.78 Sounds Elfshe Same (,6SS,30 Dn";1 oyedt:4o Yearold on 3B sox 3013, Songpr, 1S5002, 7.1078 for months, owns, mark Sam 'Bbx'308, Sanger 1665308, 8-20-78 821,26 Dnomployodt Multiple drug abuses; i Brice, Regyina Same 4.00 Balance after Medicaid. 200 1. Waddell, Denton . 3716695, B-10-yB Bruce, Bern4M Same 1,226 N 12.80 Balance eft4r workman It eW,, W. Oak, Denton 1666462, 6.29-78 CETA`fmployse at NTS1i. Bruce, sernie Bruco Key 12.80 1229'N. Oak 1664116, 8.15.76 Balance after, insura>?ae, sub- Standard 100000d, indigent.' Bruce., Beinte Brruce Key 60892.85 S$verat apcounts on family, subo 1225 N. Oak. 163306, 2.12.78 standard income, Berryt Jett lone ckory Campball, Christopher V4.00 3113 . Hickory, Denton ' 71b305, 8-11.78 Balance After N dfceid. CWntu, Hilda Cantu Isroe Route 40 1 2B, Denton 2-12-78 16.00 Balance After Medicaid. 366638, , Chastain' Roy Spore 2407 Louise, Denton 1677$27, 10.25-76 226,85 Two i n femilY, 5293/abnth. Chastain ploy S ate ,00 2407 Louise, Donlan 497281, 10-17.76 21 Two to fahliy, ;293/a~onth. Chew ,Earl 11,74S.3O 33 year old emplo,yyes~ by City 326 Mlll~enton 1b66363, 9.23-78 through'CrIA proof;/GSN. i Chavwl, Dorgthy ~ i 32 H. Wood, Denton ISO Rodney 16400 AafaHce after Hedleatd, 3711J63, 7.2778 I~ Co hran, Louise Cothrran, reef 16,00 Balance after Modleaid. 73 Alexander, Denton 3700478, 6.28.78 i Cntty{{n, Wi~.ltem. Co}4in Pamel.p78 • A 16,00 Balance After Radieaid, 71 6 8 radshaii, Denton 3746 7~, 7.122 t,olwick, Perry Some 23,96 Balance after Fedicatd. 310 kettle, Denton 3704798, 7.7.78 orn, 6ronda Con poll am"I $9,60 Four in family; $600/month, 600 Fort Worth Drive, bonton 3729118, -20.78 Coxenr Paniola Cowen, kindy9 16,00 Balance after Modicatd. 71G H Aradshaw, Denton 37022?20 7`1.79 Darrough, FIarY _ Darrough, Herman 16,00 304 8al onco attar Nedlcaid. Ruddbll, Denton 36986100 6.23-70 « A ~TER,i1N. I r 1 . i Page 2 Charity Lharge•Off 10.31-70 Guarantor's Name Patient's flame Guaras;tar's Addres Account E, Discharge Date Account Balance Explanatl.on Davis, Janis, Davis, Dirk $ 16.00 Dalance after Medicaid. 78 Box 968, lake Dallas 336mr90062695, , 65-.2029.-78 Davis, Janis 397 16.00 Balance After Medicaid. Box 958, lake Dallas ,A Dayis Wield& Davis laschaba 16,00 Balance after Medicaid. 2417 Louise, Denton 37040;5, 7-6-78 } Di910xonS.. Constance Some 82.85 tlnaraploy~. KNO patient. Locust, Denton 37360060 10.13-78 DOrmey Ruth Row6sy 'Audra 16,00 Balance after Medicaid. ' 201 Ruddell, Denton 369323{. 6.7.78 Dye, Jesefk Dye, Thomas 16.00 Balance after Medicaid., 109 Massey, Denton 36950040 6-13.78 Emory; Ophalia Sane 8100 Balance after medicaid. 816 erosstifaber, Denton 3714672, 8-6-78 + Ft inq •tutissa Fleming, Torrence ,16.00 Balance if w, Medicaid 40 Cardinal, Denton 3691144, 6-1.78 i ' s Rena !fe don 6 'OO Balance N's 1`1141 Flemfn s1 1 -after aiAdlceid. 404 Card~nal', Denton 3704384, 7-6.78 Flowers afettfo Flowers, Carolyn 16.00 Balance after Hedicsid. 40 ' E: Q th' , Olinton, 3693389, 6.8"78 F1 rs' Hattl+a. F oaers, Eric 16,00 Balance after Hedl¢aid. 407 EAMSth, Denton 301745, 6-30-78 Gomez, Vella Same 25.00 Unemployed, DOID patient. 5 614 Cook, Denton 4104204, 0-29-78 Wwz, Velia Gamer xulema 23.50 Unemployed; DCBD patient. s 614 Cook, Denton 369%25, 6.19.76 j Grr<y Bruce Oarza Ale1a 16,00 Balance after F'sdiceld. 1 367997 29.78 619 04Y tRosararford, Denton Garza, Alicia 18,00 in Waddell. Denton 3690146, 6-29-78 Balance after Medicaid. « . Oar}a, Ruben Garza Sharon 4.50 Balance after Medicaid. i 6W Cardinal, Denton 3roz231, 7-1.78 6ar s1, Sime 16,00 Balance after Medicaid. 642YterQrdaal°►nantan'' 3703592, 7-4.78 ibibk; Linde Garza. Sharon 32,50 Recent'P:edlcald patient. 602 Cardinal, Denton 3719663, 0.21-78 z Some ;326,80 29 nvear aid found 002 ' ~d3;CndS, Lewisville 1676299, 10-1248 dir ctind trAfflc on 11q. 35i trap;forl,d to Wichita Farts,; Reed, 111116 Goodall , bnrrick 16,00 8alunco after fledicaid, 700 Doerdllalk, Dentor, 37112, 7.26-70 f Gray, Brute Gray Noy ; 406,70 4 in family, $480Jmbnth, r 809 P,uddelI, bonton 15Y0~09, 9.16-Y8 dl ay Orueo Crag, f;osalinda 227,20 5overAl occountsl 4 In family; o o Auddoll, Denton 371 74Y, f~• 21-70 S480Jr,ionth. Orean, Susto Green `Goon 1G,00 8alanct• after Hedicald. 304 Ruddell, Denton 3697B1, 6-2.1-90 f4 OremY, Rose Organ WoArd 16100 ha)anco after Medicaid, 1208 HCUnnald, bonton 370105, 7-7-70 1 '••",W NRA?rsM'AM rvl+wliM.. r+..+.um r.,w ,r...... . r....._.••.. 'y "pia.d,., t.vARS /4 hlA:idi.~•J 441 rlAbla.i,S,rvr+re=..r N-1 Page 3 Chan tyy Charge-off List 10-31-78 Guarantor's Am Patient's Name Ouarantor'pddess c oun Discharge Date Accoynt Balance Ux anat o ' Green, Willis Green, Linda ;f i 16.00 Balance after Medicaid. 626 Uiend, Denton 3706082, 7-11.78 `r Green, Susie Green John 48,60 Frequent Medicaid patient, k Route 2, Aubrey 37087714, 7-18.78 j Green, Willis Green, Shawn 16,00 Balance after Medicaid. 626 )Hand, Denton 3713005, 7-31.7a Griffith Mae Griffith, Clara 23.00 Recent Medicaid patieott not i 70S Pats{e;•, Denton 3723169, 9.1-78 eligible now, mother unemployed, Nelpein, Oreda HalDein, Donald 16,00 Balaete after Medicaid. j 1 i! Box 633, Sanger 37121868, 748»78 Williamson, M. D. HAM01on, Richard 16.00 Balance after Medlsatd. I Route 1, Argyle 1661630, 6-29.78 f Harris, Johnny Same i II No»e 37376090 10-19-18 99'~ Denton`eounty Jaf1. I _ Hensley, Brenda Same 1;641.65 -Medicaid ended 2-7 A$ 9 in faM ly, Box 944, Sanger 1654088, 6.29.78 t48000nth, i Hensley, Brenda Some 918 ;40 Sauce as abode. Box 844, Sanger 1666001, 8.19.18 Hensl Box 844 ey, Brenda Hensley, Toga 32.60 Same as above, , Sanger 3648011, 1.1 5.18 Hanson, Tiuothy Same 209,85 Denton County Jbil, star Rt,,.Kingaton, Oklahmna 3134233, 10-7.78 Marring, Geraldine Same 16.00 Balance after W$Icild, 1316 Ftors6,,Denton 3690393,'6-30-78 Hill John Same 1,136,70 4 in elf-in fif11ct liste staed sta]g yr, 918 iornard, Denton 16162300 10-20-78 old, sel b wound, I Jackson, E: H. $ame 151.00 WOO after Medicaid. 2207 N. 2Jmo Denton 1668b42r 7-11-78 Johnson Paula P ` J 326 M11{, 4enton 1708682; 7 18-7a her 16100 6a7eoce after Medicaid, Johnson haute ,1ogson, Dana 16.00 Balance after Medfclfd; 32266 Mi1i, twon 3708690, 7-18.78 Juarez, Olga Same ,4,06 Balance after Medicaid, 106 Avenue E, Denton 3712403, 7.3079 E Kesf, Dawn Kest Michael 26,60 800a after Hedfcafd; 1273 Palisades, Lewisville 369863, 6.22.76 Lance, MarEha Lance, Franklin 16.00 Balance after Medicaid. 702 Paisley, Denton. 3109227, 7.2048 Lance, Martha 55 24;00 Balance after !{odf'caid, 702 Paisley, Denton 369610, 6.12.78 Lee, Jerry Santa 144.00 Dohton County Jail. 610 . 3739273, 10.24-78 Lockridge, Jerry Lockridge William 42,00 11 in family, $14,78p annually, box 766, Sanger 36961920 1.16.78 Lockrtdge lorry locY.rldge N1111am 3640 Same as above. Box 766, danger 3698735,-23.78 , MacDonald Sherry Same 110.85 2 in family, unemployed,, Box 2140 tittle Elm 3731734; 9-29.78 Maddox, E1nar Santo . 3400 Follmeadow, Denton 1663628, 6.8-78 24 00 Ba1aneo aflor icaid ~,r,;H,.~....... _ Had ....,,r,,. .,:.,A„.,,,,..,..,o-a,e.a.,w,a 1 - , age 4 P A Chdritq Charge-Off List 10-31-78 Guarantor's Name Patient's Name Guarantor's Mdr@ss Account 0lscharne pate count Balance fyjA ati0n Mageson, Leslie Some = 34.26 Balance after Medicaid, 602 E, Grove, Cranbury 1664140, 6.16-78 Mann, Mark Mann, Cody 61.69 Balance after Medicaid. Route 1, Decatur 16547650 6-18-78 Faginto Julia Manuel, Michael 16.00 Balance after Medicaid. 606 Ruth, Denton 36716660 4.4-78 McCrory, John Same 47.60 Denton County Jail, Mont 3737617, 10-18-78 McBepp, Ora Lee Same 16,00 balance after Medicaid, } 616 Skinner, Denton. 3694064, 6.11-78 Ii Baker. Linda Miller misty 16,00 Balance after Medicaid. Route 1, 86061, Denton 37084690 7-18-78 Minor, Cathy Saarb 720 16.00 Balance after Medicaid, Bailey, Denton 36964360 6-22.78 Naarrwtt, Jaraes Moreno JuAn 16,00 Balance after Medicaid. 723 franc, Denton,,, 3699704, 6-25-78 Parker, Gary Sam 229.60 Several ac 2800 ft, ,North DriVe,.Denton 37620, 9-9.78 ievera, counts, sub-staid Parker, Jimoy Some 2417 Louise, Denton 37341831 10-7.78 13, D0 lMempioyed. Parker,'Jiaaty State 89,78 Several 2417 Louise, Denton, 366366, 6.17-78 eccounti{ unemployed. 1 4 Parroore, Me1en 18.00 Balance affer•Medtcaid; 502•Janie, Denton , 3113179, e.1-7e ? Patterson, Janette Same 1617 llhltaoak, Denton 1,241.Os 28 years old; divorcedl 30 . 1674094, 10-17-78 patient, unemployed, ' Perez, ,,l1eans biencn}ant 1,0:2.9b sib rrIeddard yearen d 166)6) 2, 10.11-78 t p+rents 714 Oollk Jesus Potty$ Joyce 0 MPet,yq Cajsandra 16,00 balan"0 Nter Medicaid. r. 1236 McDonald, Denton 369oZ~3, 6.29-78 2M MODOaacld, Denton 689221, 6.27-78 16.00 Balance after Fledica/d, Petty, Susie 16,00 Batanea after Medicaid. 3236FioDorrald, Denton 3609261, 6-25-78 Punch Leonard Sege 6>2.BP 604 Shnner, Denton : 1655648, 7-3-78 Warp aft' insurance; 10 504/month.. In family, Raratrez, Antonio Ramirez, Roselle 24 00 Balance after Medicaid. 3617 Redstone, Denton, 3705118, 7.8.78 Ramirez Teresa Same 2.2o Balance After Medfcald. AOz 18140 Denton 1664343. 811.78 #a9, rug he Rey Tenna 29,00 100 >4 Nljtoo, Denton 3696672, 6.11-78 Balance alter Medicaid. Rar1, tPene : Same 46,10 Unemployed; DCMO gallant, Route 30 Lokisvllie 3135099, 10.10-78 Resynoldss Horace Reyyno ds, Titmothy 1008 Reed, Denton 36 913 4 6.2.78 16,00 Balance after Medicaid . Stacy Barbara Aidle Marshal 16,00 Balance after Ffedicoid. 190 ma, Denton 370180 , 6,30-7 Rftchey, Elfraboth Same 16,00 baianco after Medicaid, ± 826 Rose, Denton 3689167, 6.28-78 1111 1 Page 6 Chanty Charge-Off List 10-31.78 Guarantor's Nance Patient's Mama Guarantgr' Address ccount Dlscha a Date Fount Baia~ee Exolagatlon__ Robinson, Malcom Robinson, Ella $ 16.00 Balance after Medicaid. 1224 McDonald, Denton 3703683, 7-648 Robinson, Dona d Robinson, Wanda 9.60 8810nee after Medicaid, i Route 6, Box 9~, Denton 16590380 7.16-76 i II Rogers, Patricia saQirober, Denton 369 Rogers227;, 6J..44- -78 16.00 Balance after Nedieeld. 816 Cro Ira, J, R, Same 76.00 61 year4old,"frequently on 416 Crosstimber, Denton 4105714, 7-10.76 Medicaid. j Rowani:Kenneth, Sr. RoNan Kenneth P. 14.60 Balance after Wiciu, f Route 21R.D,Ii,E, ,Benton . 372304, 9-1-78 Ro9 X. W Wooo6 Royce It 16.00 Balance after Medicaid. 41N. d, Denton 36963!;6, 5 22-78 Sande s, Barbara Sanders, Victor 16,00 Balance After Medicaid. 2'426 [Nile$ Denton 3100653 6.26.78 ; ti UndoEI, Barbara Sander l: Victor 16,00 Balance After Medicaid. i 2121 Stella, Denton 310656, 7-9.78 1 kot,t, pi.04ine Same 19.20 Delano after Medicaid. 404 S. id,ddeil, Denton 1665316, 816.18 Scott, Giadi~1 ¢ Same 16.00 Balance after Medicaid. 404 S. Ruddel, Denton 369S526, 6.15-78, Brown, Elale Seott Kennon 16.00 Balance after'Nediceid, k n 404 S. Ruddeil, Denton 3696 g3, 6-17-78 'I I Shaw Curran Same 10.00 Balance After Medicaid, j Box 2334, Denton 4107637,'7-11-78 SbenArd, Claude Denton Same 16.00 Balance After Medicaid. 819"Lakay, Denton 3688266, 6.23.78 Sia , PAp11111 Same 16.00 Balance after Medicaid: 101 Midkory, Denton 3701919, 7.1»18 A utesf~ Aubrey "6x80, 8-X3-78 433.36 2 in family's $3301month I? S~ yba 60,00 W.atornlty olinlo Want, 6 in 607 N. 6ra++ford, Denton 4f 5623, 9-20.18 family, 114480/mAJ. Spp yy reyberr M tale, Same ~i 32,66 Wxllcefd peNenta 910 Ruddol~, Denton 3666296, 2.11-78 1 19yNo"r~no 6eenton 3691745, 6.20.78 16,00 Balance After Medleaidti 5PO,Ne harry, Tommy Same 27492, 9-16-78 Denton 37 86000 Denton County Jai L Stacy, Barbara Same 16.00 Balance after Medicaid. i 1909 Sena, Denton 36916241 6448 Stacy Barbara Same a 1909 gene, Denton 3703378, 7.4-78 11,60 Balance after Medicaid. R~beets, Sheila Sseggqs Jossie 16,00 Balance After Modtcaid. 1 10 Ruddell, Denton 371442, 8.6-78 i " Stanley, Katherine Stanley, ChCfstophor 16.00 Wanda after Medicaid, { 313 N. Wood, Denton 3694338, 6-11.78 { Stanloy, KatberliA Staoloy,. Tollita 50,80 Balance after Medicaid, R 313 N. Wood, Denton 1557629, 7.4.78 r . ~.~tea+ Page 6 } Charilyy Charge-Off List 10-31-78 Guarantor's Name Patient's Name Guarantor's AOdresy ACCOUht Otscharae oate account Balance x to atio Stanley, Katherine Stanley, Tollita $ 16.00 Balance after,liedicaid, 313 N. Hood, Denton 3701414, 6-29-78 9604f~rLocust. Anton '563698149, 18149,, b-21-52111878 16.00 Balahce After Medicaid. hdef1, Darla Darla/ Infant 612,30 16 year old, parents deceased, reenwood, Lewisville IW681'8, 6.4.78 lives with brother and his family Taylor. Mary Taylor; Jason of 6. 205 E. Vine, Kellar, r 3702736, W-79 16.00 balance after Medicaid. ~ Y~yfor eXX 2TC r0 Shirikirl Denton Taylor Kir,'ber ey 4,00; Balance aft& A6jiceid, 370142, 6,29- ~9 $03 L L prl2 Jon Mande 603 jr1ff 'Ira 16.00 Balance after Medicaid. eop 26~, Dot 3676499, 4-f6•7A Raialne>t, Sharon Mauyyhn Date 16,Do BaLlnce After Medicaid. Awto 2, Box 974, Denton 369765, 6-20-78 j aliace C,~on+ Wallace, Annetta ,33.00 Balance after Medicaid, (Z4 E. Areirle, Denton 3692021, 6-4-78 , I Y ilm Mike N+1len Becky l 11 Hunters Creek Bend, Denton 371631, 8.11-y8 43'0 Current Madicatd patient. ! wf+ile M!k Na 1en~, Hel ssa 41,60 J 14 lm"4`s 1reek Bend, Denton 36 8601 2- •78 Same is above. {{~~a~ leA ` Mik44 46.00 ' I9 Nunfers Creek Bend, Denton 43013Uo 77.18 Same as eboue, JJJ "j hV eni,tMikDenton Same 19.60 Some as above 3610692,.4-1»78 welch William Some 122,86 Benton toky Jail. Loop W, Oont0h 3707411, 7-16-78 i W111 0"t Thereaa wi111aftmo Quentfn j 61 Ark Lane, Denton 36901k3, 6.29»18 64,00 Mother une~nplnyedi no father, i 1011114"0 Betty, 1+111 ama, Christopher 16,00 1130 Morse, Denton 360 32, 6-9148 Bhfance After Medicaid, Me4ath, ,+rth; M7 i~1so2f Martha 19.15 Betence after Nedicod. y 620 Mart n; Dint" 7-16-78 Yof'k Marcella York Pay 16.00 Balance After Medicaid, 700 4a6ers, Denton 31H136, 7.2-78 Y iLta 16,00 608 Perk Lane, Denton 3693769, 6.9.78 1619nce after Medicaid, 36,601.17 ! j 1 11.8.78 { t w.A, µN... rv..rytNI.LAdir'T: c'A ..rHNIr4a •a4 .N,xn,•a.,.x.vU.rA~,:pn','.yy rN$U/, 171N1».g1 MRe" Ma L ,z PLOW MEMORIAL HOSPITAL 4V23 1978 MONTHLY FINANCIAL REPORT SEPTEMBER 30, 1978 { CITY OF DENTON MANAGER'S OFFICE We experienced an average daily census of 83,8 patients during the month r of September, This is an increase of 9.3 patients per day from September, 1977. s Gross patient revenues were $638,686 for the month, an increase of $82,000 over September 1977, Since this is the final month of'.our fiscal year, an annual analysis of j our financial activity is presented below; !I Statistics 1977 1278 Tncr. _ eaee Admissions 6,769 60230 4 Discharges 5,751 69227 46 Length of Stay 6.2 i Adult Patient Days 260916 303965 3,4803 Newborn Days 3,$85 31977 392 I Emer. Room visits 9,482 90681 199 Patient Days of Care Actual Budget Actual Variance by Nursing Unit 1977 1978 I978 tQ Budget 2 A' 20230 20738 20776 38 I. 2 C 100642 9,746 10,492 746 E 3 B ) 3 A 79868 3,654 2,962 ~I690 Post Partum 41500 59037 4,569 468 IntenTOTALsive Unit 16 316 N41 1 687 45 30~, 9i 32 The Behavioral Medicine Unit obtained 81% of budgeted patient days with only I 8 months of operation, Had this wing been in operation for the full year, the projected patient days for 1978 could have been obtained, Our census has increased an average of 9!6 patients per day during the year, which represents a 12.9 percent increase, I RA,:in, Ue ; f hur ~:'rie year ending September 30, 1978, we generated gross patient revenues j of $790a00430 with 30,36 adult patient days or an average of $233.18 per patient day, Revenues increased $1,419,430 from 1971! A comparison to prior year and budget Is presented below; Daily Care Revenue to '1977 A tai 78 B d e 978 j Medical R venue 3$5066 j 36,000 631000 JJ9$1 ' 0 Total venue Revenue , 7086000 j Non-Medical Re Revenue ( 0 3 129 Total Revenue "o Mr 49-IMF Departments contributing a significant portion of this revenue increase compared to 1977 are the following; 4 , •.M4l Fey Hl pt"AW4~1i14; ✓.i'4`nMY91i1~. a t , f I 1 11 I e Page 2 Monthly Financial Report September 30, 1978 Department Increase % of Increase Daily Hospital care $492,400 22% Operating & Recovery 86,000 39% Emergency Roam 650000 22% Central Service 1260000 66% f Radiology 154,000 50% Pharmacy 143,000 42% , Anesthesia 70,000 36% Cardiopulmonary 2179000 50% f Laboratory 1630000 24% Revenue Deductions j Our revenue deductions are effected by an increase in revenues. As our EI revenues increase, our deductions should increase at the same rate. Last year, { we had revenue deductions of $892,000. This represents 16,7 percent of gross revenues, Our actual deductions for year ending September 30, 1978 were $1,246 000 or 17,6% of revenues, an increase of 1,9% to prior year, This was due manly to a change in the percentage of deductions for charity and bad debt from 12% to 16% for fiscal year 1978. Expenses I} Fisc6l year 1977 recorded total gxpenses'of $5,3800000 and $6,158,000 for 1080 an increase of $178,000 or a 14.4% Increase. Salary expense accounted for $526,000 of our total increase in expenses, A'comparison to prior year and budget is presented below Department 1977 ct al 1978 Actual 1978.8ugaet Nursing Services $1,889,000 $29231,446 $2,064,000 Professional Services 1,614,000 1,834,014 1,109000 General Services 1,0680000 19148,085 111090060 Administrative & Fiscal Services 654,000 707,559 745,000 Depreciation 225,000 237,241 T OO ~1 Total Result The tonal operating results from 1977 were much improved. Operational 'loss for 1977 was $466,282 as compared to $207,624 for 1978 or a 46% improvement. Non- operating `revenues _for 1978 were $412,186, This consists of $32,412 from 'Flow Foundation, $362,804 from city county approprintiont,`and $17,570 from other donations and revenues, This resulted In a surplus' for 1978 of $206,162, compared to a loss for 1977 of $87,364. Balance Sheet r I t We ended the ybar with oath And investments of $184,844, an increase from last $ year of $26,742, Part of this increasv is due to $6,000 Aetna shares i7orfeited by ' employees in, our retirement plan. Our accounts receivables at September 30, 1978 t ' rI.w v.. hrt3q(.jFnl ihlk/h•SWyI +ew Page 3 Monthly Financial Report September 30, 1978 ' showed $1,965,659, an increase of $3490020 from prior year. This is a 21.6% increase which resulted from a 24% increase in patient revenues in 1978. We experienced a shift in billed accounts receivable this year, A comparison by percentage ofd of payor is presented below: 1977 Increase ecrease Medicare 1978 $1 f8X . Medicaid 3,9% 2.6% 3% Blue Cross 11.0% 7.2% Commercial 26.5% 28.4% 119% Self pay 39.0% 14343 % _ 4.3% ! lisif~" ~ I I Total liabilities decreased $127,000 from prior month due to a good collection month. We collected 84.8% of our net revenues N the month of September. Total ! ! liabilities still show a slight increase of $17,000 to 1977, but with the improved i collection efforts of the hospital, this should continue to show improvements. ' Summary The year 1978 has seen many changes in the structure of our hospital from management, improved re-organization, cost containment by departments, dnd improved t census, which are reflected in our financial thana in the,curren, year, it is hoped that with the continued progress, the ye,jr 1919 will produce an operational profit for the hospital. I Respectfully submitted, (Mrs.) Wilma Fritz Fiscal Affairs Manager I t WF:gm t. j 1 i r I tY . -Y 1 H 21 93 +a (D (D rF M LA:3 Yr N _ q C1 a w ~9- n M0 m lu 0i ' m rn-i.m v N kv 11 X (D (D r+ M '0 (A a a m~ z m < ro ~n C+ n no 0 Er ct -1 in JA ! N C 00 fD 'Lf < Rp (D y N 01 a a (A romm (4 LA 1 V c iD ~ , . vi t , 4p j 44 14A 4A 404 ! 4^ +A by { w NrnwN N pW O~ C to y WWr ~fWph 1 w N o /WNyW U7CV /Ny `b1 V? wC7 Cri wf~ W W. 1 CTY V Y Y y V~ 1 I W o~ 44 40 4A f"~ UI W:. N t!1 N fV N $ + tltl~ tp M E i N O b NWOVip~O.V ~IVas t~GO~i M N . w ~~~III V V V y y y Ch IQ m J ob Ul c~4 ym W ~ g ! ety w N v C ? p - ;v M i 0 :bp 0+4 1w 1-4 H ro 46 r•~ M K ^ 1.4 H 4h4 IV Y C U~ W tnH~ OCpf ,A t?~ Wp (N~ g'1 9 V !!~h 00 8" tp Cf d Ypp,, ~ Q~ QQ a+ V7 o w tot A Y N OS(Nryy(lp1VWd1V(yl O CQ~fV' W 1 p 4QpWQW 10 A NCO WCWWUI W O~ ~ 1W+ 1 W M~PWO i JA {A 64 EA 44 tt+ w w W p.. 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IMAM. yI i VIUM FLOW MEMORIAL HOSPITAL BAD DEBT CHARGE-OFF LIST ' SEPTEFIBER 30, 1978 Guarantor's Name Patient's (lame grantor's Address Account P. DischargU_OaIt Account Balance Ex21anation Aldridge, Richard some f 45.50 Proallsed payment, no follow through Route 16 Roanoke 1625872 Ali Rana Sam' 60.00 1/$ returned; unable to locate, 1314 W. Oak, Denton 4101697. j Ansbary, Michael Amsbary, Mary 11369.80 Skip, unable to locate. s l 106 Avenue E. Denton 1668626 Andrews, Richard same 138.40 MLNA, unable to locate 307 Bryan, Denton 3711504 j j Arnold Frank Arnold Patricia 739.00 No response to letters. Box 168, Basye, Virginia 1627114 Arrington, H. W. Same 82,00 No response to collection efforts. Route 2, Box 652A, Denton 3652708 l Baldwin, Tom Baldwin, Wade 1,891.86 No response to collection efforts, i 621 Austin, Denton 1657735 Ball, Madeltna Ba~l Laura 1,047.14 No response to collection efforts. 604 Mission, Denton 4 5456 Barer Horaayoun Same 34,75 RLRA, unable to locate. 3203 6verland, Los Angeles, California, 9672426, 8-31-78 I Bartel, Gary Same 636.26 Discontinued paymentsl droved out j 309 E. Elizabeth, Clovis, New Mexico 1626806, 5-6.78 of state, E~ Beasley, John Same 7.00 KRA, unable to locate. E 603 Loop 268, Denton 4085734, 8-6.78 Beck, Barry SAmn 82.50 Skip, actable to locate. Route 20 Pilot Mot 4100941, 8.6-78 Bell, Wanda Same 226,OD Skip, unable to lbeite. 2522 Louise, Denton 1644220, 4-17-78 Black, Ronald Aleck, kart 611.50 Skip, unable to locate. 6111 Runyon, Lewisville 4071981, 2-11-78 Bledsoe Tim Some 112160 Unable to locater University City Apt. P 4, Denton 4107843, 7-13.78 BeisellI Candy Same 32.60 Unable to locate. Route S, Box B, Denton 3685576, 5-16.78 r 1000iS. Charles, Le+rlsville 3711097ar9.14-7B 43,90 Unable to locate. harris, Jason Batt Rarbara 34.59 Unable to locate, 1090 S, Charles, Lewisville 3711616, 7-.29.78 Bowens,,Goldie Some 7:00 MLRA, unable to locate, 603 Loop 208, Dontoo 4085726, 8.6.78 boyd,•Loo W, - Sane 650137 Default on noto; no response to Route 4, Box 68, Denton 1529676, 1-10.70 collection Worts, r Broitkroutx, Douglas Some 92.10 No payments) proved out of state. Roulo 9, Spokane, Washington 36114511, 5-1378 Brow)), Paul Snme 30,50 Unable to locate, 2508 CharlotLo, d 10, Denton 3710969, 7.25.78 Cmaoron, Chades Callowon, foul 47;50, No respnnr,e to collcc.Hon effai,ts, 1000 Lindsay, Dcnton 36'/11?0, 44.70 r yrt. .,ur~r .u: a.e Alyyd,yy.. Y : 9 I~ 1 Page 2 r Bad Debt Charge-Off September 30, 1978 Guarantor's Name Patient's Rama Guarantor's Address flccount l Discharge Date Account Balance Explanation Campbell, Cecil Same S 312.70 No response to coilection.offori Route 2, Aubrey 1537836, 3-10.78 Cantu, Guadalupe Cantu Meda Kelly Street, Lewisville 3)05829, 7-IO-78 49.00 MLIUI Caquelin, Mychael Same 57.60 No response to collection effort $07 Walden, Allen 3691987, 6-348 Carroll, Salm~y Carroll,` Connie 69.00 No response to collection effort 449 W. Matn, Lewisville 3699246, 6.24-78 -Chadwick, Danny Chadwick, Dianna 49.00 MLNA 992 S. Charles, Lewisville 3703931, 7-6-78 Chandler, Elizabeth Sane 34,26 MLHA, terminated maployN"t, Box 208, Sanger 3711983, 7-29-79 unable to locate. I Davis Donald Davis, Carla 644.16 No follow througgh on arrangemeet! Box 64, Pilot Point 1540673, 3-29-78 no response to letters; no pho"i Davis Joe Bill Davis, Patricia 1 6e~5.90 No response to collect;ofor: Box 15, Kruse 1540772, 4-4-78 no follow through on arr'n., .mac, Denton, James Deaton, Tiny 138.50 Unable to locate, I; Route 1, Bakersfield, California 3652600, 1.29-78 Dodd, Jeanette Dodd Harold 2,51Y.05 Unable to locate, 109 Lakehaven Est., take Dallas 3707698, 7-19-78 Cagle, Ban Doweard, Steven 67,76 Unable to locate. 622 E. Corner, Eastland 3671096, 4.2.78 Downs, Charlotte Some 11120.20 No follow through on arrangearent p31111 Jagoe, Apt. t, Denton 16363416 3-1-78 817 Es Jroadway, Gainesville a or, Ruth 818.85 No planet no response to letterer .635822, 3-2-78 Eekhoff, Doyt WWII, Jason 2,0157.80 No follow through on arrangenrertr 210 Mill Lake Dallas I Eptirl Nike Eptingg Arneda 487.50 No response to cotlecti0 arty Box 1604, Denton 146721, 1-12-77 lives with In-laws; told ;to , call residence, rabela, 104 Eabala, Julie 331:40 No response to letteFs/cells. 921 Ruddells Denton 1484773, 42247 1 Famipu Ch{~arles Win Alice 460,85 Promised payment, he follow 2611 Charlotte, Denton 150727,;, 4.9.77 through. Ford Barbara San;a lox 665 Sanger 73.00 No follow through on arrangements . ..362704, 6-22-78 ] Garrett, Vanessa Game 11127,10 Ito follow through on 4rrangements~ 2421 Louise, N 9, Ontun 1535806, M-78 unresponsive; 0rah m Tarntiv S@me 110 nt~th. Denton 3718087, 8-16.10 47.00 Unable to locate, F" Griggbs, Michael Griggs, Cynthia 1r 762,55 Ito follow through on orrangements;` 966 E. Celost, Garland 1519950, 11-9-71 aged account. 6udltis, Richard Some G'03 Cokcrnft, Denton r 660,35 No follow through on arrangcmentso 1522226, 12-10.77 agod account. F hefaanniah, Mi•fg,rr'i Same 32.50 Urmblo to locate, 2403 W, Prairie, Daimon 3619825, 5.29.70 t , r M • e.sy..•. ...'IwwrG LF lir i. P51\'K ,Slat tSn/ C 1 tt 1 S } Page 3 1 Bad Debt Charge-Off September 30, We i Guarantor's Name Patient's Name Guarantor's Ad re tcCOUnt 1, Discharge Date' &count Baiance Ex lanation Harper, Leonard Same $ 736,45 Made one $300 payment. Route, 4, Denton 1628495, 1-2048 Harris, Jason Same 37,76 Unable to locate. a 8riarwond Apts„ tewisv1110 37131200 8-1-18 Harrison, Jack Same 1,868,40 No follow through on arrangaeients Box 1536 Argyle 1623091, 12-22-77 f Hart, Timothy Hart, Harriet 670,00 No follow through on arrangements. F Route 3, Box 348AA, Denton 1611336, 10.4-77 1 Harwell, Fisher Harwell, Rita 340,74 No follow through on'arrangowts. J 1910 S. Josey, Carrollton 1611104, 10-2-77 i E Hays, Jaynes L. Same 269.19 Unable to locate. 1 364 Edwards, Lewisville 1535137, 2-27-76 If Hecbuan, dames 0. Hocknan, Diane I Route 5, through on arrangements. } Denton 1521264, i.7-.,J 1,120,01 ' HO follow i i Henley, Pat Hensley, Jeanette 760,60 No follow through on arrahoewts. ; Box 872, Lewisville 1522276, 12-11-7i f Hickey, James Hickey Lorraine 33,55 Refused to pay over telephone. 2622 Louisa, Denton 3618980, 10.16-77 , 1 E Hooten, Mike Same 40:75 Unable to locate, 1 108 CAYroll, Denton 3671276, 4-22-78 Hootenti Jerry Hooten, Frances 667,05 Hoved from 'Arkansas end of January; 216 4th Sanger 1532019, 2-6-78 moved back to Arkansas in February; unable to locate. Wghton, DannY Same 924.60 Made $300 deposit but no follow box 651, Sanger 1602939, 8-20-77 through on erranpdnenti. H1son ,Donn a WWI rna 333,20 No follow through on prrangemants. 1403 T4m6erlake, Arlington 1486436, b-4.77 Jarrell, Ding., Some 648.30 Unable to locate believed to be 1814 yier, Denton 16365660 3.2-79 In Jaf1 in Eastexes) i Oenninq}} Bobble Same 125.60 Refused to pay, 126 Co11{ns, Denton 4017857, 6-19-18 82D Se+tte- 57,25 Unable to locate. J%yco, Rose, William Denton 3682671, 6.7-78 DaYls ,Glem+nad Justico, May 11284.20 NO follow through on arrangs"Ats; 2410 University, 4Aton 1524503; 12.25=77 unresponsive. khaoiioh, Novant Same 50.60 unablo to locate. Box 96655, NTSU, Denton 3638118, 12-15-77 sv11some 66,50 Unablo to locate; Pioneer,YilNvid lage Apt. "lowi 49 , 3713310, 81-78 llggon, Larry Some 1,141,45 Unable to locate or contact; moved to 612 Smith, Wanton 1b626360 $ 4.79 Colorado, l Li on, Larryy Ligon, Roboeta 16,60 Some as above, 612"$14fth, ponton 3100404, %•12.16 L1geu, Larry Ligon, Robrrta D21,2$ 5ar;o as above, 512 Smith, Denton 15GD303, 7.6-78 { 00nn, Larry Ligon, Brandon 32,50 Sar:e ac above.' 512 51111th, Denton 3904400, 7-6.7D d ,417Stwkuxasr+,..~.__. .,....ar.,-.o-,.,. ..vw ti-i...r,.usauvnG. F3 MC. . Y .'og" page 4 Bad Debt Charge-Off September 30, 1978 Guarantor's Name Patient's Name Ou. arantor' Address Account f, 01Scharae Date Account Balance Exnla'rill tton Lipsey, David Lipsey, Christal f 91.00 Unable to locate. Route 2, Box 117, Argyle 3696408, 6-17.78 Lynch, Jessie Same 98,90 Unable to1contacti refused to coma to 40S W. Mulberry, Denton 3683257, 5-848 office; moil returned; phone out of order; relatives 0cooperativel address Lynch, Jessie Some 40.50 incorrect when Ivan at hOspitak the 405 W. Mulberry, Denton 410431, 7-24-78 patients are related to Mildred Ellis, "does not have timo to cline to hospital."' Lynch, Jessie Lynch, Kathy 39,00 See above. 40~'V. Mulberry, Denton 3724564, 8-30-78 40h Mulberry, Denton 372789, 9-76-78 34.76 See above,. Ellis, Mildred Lynch, Deborah 32.50 See above. 405 W. Mulberry, Denton 3692852, 6-6.78 LLyArch, Mildred Synch, Deborah 32.50 See above. jIII 405 W, Mulberry, Denton 3714466, 8-8-78 atterson, Cathy Patterson, Erich' 75:00 See above. t 405 W. Muiborry, Denton 3706506, 7-9-78 r Lynch, Kathy Patterson, Erich 32.50 See above. 405 W, Mulberry, Denton 373;11,43, 8.20-78 t Lynch, Kathy Patterson trice 46.00 See above . 406 W. Mulberry, Denton 3719978, A-22-78 i I tynch, Kathy Patterson Woe 33.16 See above. 405 M. Mulberry, Denton 37",69730 6-14-78 Lynch) Kathy Patterson Erica 41,05 See above. f 406 W, Mulberry,.Ponlur, 3727450. 4-16-78 Lucas, J63Fte Saab $6.60 Address unknown. 0 105 Stonegete, Lewisville 3663530, 3-8.78 Mostro. ?1ar uin Mostio Oastnga 100. Left Lown and no forwarding address, : W nns Trailer Village / 6, Denton 36917970 6-3.78 Mostro 0 prge' Seate 63,60 Left town and ne forwarding addre' { Wyans frailer village 16, Denton 3665940, 3.16-18 Mastro, Marvin Mostro Oorningo 32,50 Left torn and no forwarding Address. +ynns railer Village 061 Denton 3664653, 3-12-78 1 Minor, Kathy Same 330.00 Moved to Oklahaaao unable to locate..' 720 Bailey, Denton 3699022, 6.24.78 Morgan Dary Same b 42' 0 144 nai a ta phone out of orAOr; 2121 Stella, Denton 3696301. 6.14-78 una ble to o lootatef ~ ' Mar an Dory Same 66,00 Same as above. 2121 Sta11a, Denton 3705050, 7.8.78 Morgan,_Gary Same 32,80 Same as above, i 2121 Stella, Denton 3660628, 2.2648 1 Mo'r an Oary Sama 81100 Some as above, W $10110, Penton JG97166, 6.19.70 Nottinglram, Wild NDtila ham, llandall 32.60 Moved and loft no address; unable to 114 Avenue l', A 205, Puritan 369721[, 6.1978 rim. Patterson, Gary Potl.arsori, 541movl 37,40 Unable to lotatef 1115 Norman, Uenlon 36M111llM1, 1?.-25.77 • •rteiM..flf~l.}#~ffhfV♦W!♦%r4:.:4YM♦v~♦.n N.AWa.r`.. rA.. 1 ♦ S 1 i ""mill i f , Page 6 Bad Debt Charge-Off September 30, 1978 Guarantor's Name Patient's Name { l Guarantor's Address Account F. Discharge bate' Account Oalanco Explanation { Porter, David Same - S 47.00 Mail returoedl moved; no address. 11 903 McCormick, Denton 36491910 1.20-78 + i Quiros, Carman Same 39.50 No longer at this address; unable 2511 Charlotte, Denton 3665296, 3-13-78 to locate.. i Rahimzadeh, Nesri Rahimzadeh, Nasemen 613.16 Unable to locate. a 2320 N. Prairie, Denton 15486680 6-10.78 { Rawl Olenn Rawls Barntce 629:90 No follow through on arrangements. ew , Gbbrey 161465, 10-24-77 I Reid, Lee Raid, Sarah 413.25 Unable to locate. I 624 Elm, Denton 1546779, 5.1-78 { i Richardson, Frances Same 30.00 Unable to locate, j 1109 Hillcrest, Dallas 3722055, 0.29.78 ~Roberts, Jim Same 47.60 Unable to locate. 1 f,r 1 Route 2, Box 1035 3688397, 6-24-78 Robinson, 11hrlin Same 49.00 Unable to locate, t eO5 Cross Timbers, Denton 3694577, 6.12-78. Rogerg a Rogors, Sandra 182,40 Unable to locate. 2116 SCy1i h "'k11as 3716604 8.0.78 Ruth, Am+ Ruth, Sherara 3930 Unable to locate. + 311 Jagoe, a Al, Benton 3674646, 4.13.78 Shanks• Christine Some 722.55 Unable to locate., Route 7L, Box; 232, Sanger 1519388, 11.23.77 5irmon E Sirinon Charles Route , Jlryyte 163160 Liada 1,785,70 No resoohse to demand letters. } kr.. , 2.1-78 Skagggsc William • Skigggs 7hercCpp 1,459.05 No rogponst to demand letter, 1421 Harris, 0ainesville 152690, 1-10+78 ` Smith, Diana Same 61.10 Unable to locate. # r 2608 charlotte, 1 3, Denton 3660562, 2-2648 Sparaco, Lisa Same 178.00 Unable to locate, 1112 Johnson, 12, Cwnton 4016116, 4-19-78 Sparks, Richard Same 66.00 Unable to locate, I 726 Idlewood, LewisvII1a 3680881, 6-1.78 l Sppeencer, Danny We 10131.60 Unable to locate. 2D3.Coronado, Denton; 1633264, 2-14-78 Splawn, Mary Spplawn Noligsa 32.50 Unable to locate.' Dor 526, Sanger 3664246, 3-11.78 Sg~+ing, Vernon Same $7.00 Unable to locate,. 693 Stenmons, Lake Dallas 36654114 3.14.78 Stprnos, Billy Same 53.60 Unable to locate,' 910 South Locust, Denton 3657640, 2.16.78 + Stephenson, Randall Some 2,768.25 Unable to'locote. i 213 Avenue 00 1 22, Denton 1656679, 7-29-7D + Stroud, Judy Saa,o 4d,00 Unable to locoto, if 114 Avemie G, 1 229, Denton 3709043, 7.8-18 Swift, I'inkio Same 67.60 Unable to locate. Loop 315, i1023' Croenville 4107819, 7.13-78 I Swink, Wilda Swink, Micl;y 175,00 Unable to tocat4t- 502 S. Haley, 1 209, Denton 36514152, 1-26-70 y '~i }yp,4W . s. N•.r+~.w.nyi.,e{iy~NigSf : +A 1 %elm Page 6 Bad Debt Charge-Off Septe'i,ber 30, •1918 Guarantor's Name Pal tent's Name Guarantor's Address count 1, Oischarae Date Account Oalance Explanation Taylor, James Taylor, Dennis ; 16,00 Unable to locate. 3672 Dilido, Dallas 3675527, 4.16.78 rr leton, Tim Temppleton Leslie 766.60 No response to demand letter. b~ 2 Roakwtiod, Denton 1605800, •3.77 Thomas, Michael Same 45.64 Unable to locate. 711 Bernard, Denton 3665072,,3-13-78 7haras, Ricky Thomas, Reichelle 1,399.95 No response `to demand letter. 9111;S,.locust Denton 1627985, 1.13.78 th*Son, Michael Same 6160 Unable to locate. 223 Avenue G, Denton 3701331, 6.29-78 Thompson, Harvey Thompson, William 47.50 Unable to locate, ' 817 Logan Wood, Dallas 3669885, 2.23-78 1 Thbotson, C. N. same 129.75 Unable to locate, 4040 E. Belknap, Fort Worth 3716000, 8.7-78 P~ 4411010, Damn Vallejo, Ernesto 42.10 Unable to locate, 1^` 4910 Eagle, Denton 3718178; 8-17-78 Walden, Russell Walden, JoAnn 965.30 Unable to locate, 1 Route 6, Lot A10 Silver Doom 16503189 5-22-78 Walden, Russell Spine 49.50 Unable to Idebte. Route , Lot Al, Dentod 3701190, 6-29.18 ! Walker, Jay A. Saafa~ee 36.50 Unable to locate. 1932 Chestnut, Denton, 36 OM, 2.578 t W4r4o Ginger Same 32.60 Unable to locate, MLNA.: General Oelivery,.Like Dallas 3677669" 4.23-78 i i. Wa hi"too, Fred Washington, b rl 63,26 Unable to locate, MLNA, ~ ! 17 1-Testley,Lanai a 266, OePton 3680916, 6.1.7.8 i Wat.;Cr Sheile, Matson cerolyn 6'8,60 Unable to 162ate. Route 71, Lewisville 371236, y40-78 Weatherford, Velba Same 3230 Unable to locate, 370 W. Main, P 18, Lewisville, 3668472, 3.25-78 Welchel, Alex Welchel, Barbara 32,90 Unable to locate 1803 Eagle, Denton 3664001, 2.3,78 Welch Sherry Same 16,50 unable to locate, j 2221 A. 9011 Avenue, Denton 3666103$ .16.76 1 I W tt Thomas Same 34,00 Unable to locate;' ' 68 60livar, Denton 466G1)9, 3.17-78 r'iitemon Levan Whitemon, cenola 1,728,78 Unable to locate; MLNA. { 26 'Northwood, Denton 1622432, 12.19-77 ( Williams, elizaboth Same Mod, Unable to locato,M0A 1 146 N. Kealy, Lewisvillo 3669371, 3.28.78 i w111fams, boil01as W{ 111ams, Kathy 50.60 Unable to locate. i 517 E. Main, Lewisvilla 3$91600; 6.3478 Wilson, Sharon YlIcon Cynthia 47,16 - Unable to locate. 10 Thor,as, Penton 3G8313i, 5.0-70 Hoodall, Dilly Same '801.50 Unable to Iodate, 110A. 1000 Sa+ pass p N-3, Dalton 1532795, 244-78 t_.....-rr.. ..>..a.. v.vn:.agrv;..A4-..avda4ti...rrtKKiwsP,~YCke..,ro:W Si;~.rird14M5tii{!r{.p.Y's IYKMi tii Lpn._.•,• AUKehiK•xaTa±fB~}YiaSNFfF• r 1. a "Owl j page 7 Bad Debt Charge-Off September 30,•1978 r I 0uarantoe's Name Patient's Name t f Guarantor's Address AccovnL6, Discharge Date Lcc0unala__nce Explanation Woods, Bobby Woods Ric 52.00 unable to locate, 3711 N. Clm, Apt. 3, Denton 3653747, 2-3kyy••76 Woods, Franklin Woods, Wanda 40,60 Unable to locate. 909 N. W. 12, Oklahoma City, Ok. 3668671, 3-25-78 Woolaver, James Woolaver, Dolores 162.35 HL", unable to locate. 450 Hickory, Lewisville 1431631, 7.6.76 ' TOTAL S 62,478.39 l SO-11.78: \ Y r FLOW HARITYNCHARGENOFFJLIST SEPTEN9ER 30, 1978 Ouarantor's Name Patient's Name Guarantor's Address Account 1. Dlscharr a Date Account Balance Explanation Barnett, Carroll Some S 24730,20 UnixrtPtoyed, Route 21 Box 923, Aubrey 1630989, 2-9.78 Barrett, Vicki Same 38,50 4 in familyl 53;82/rwnth• Route 2, Aubrey 3688801, 6-25-78 Bays, Teresa Satre 188.50 tlneliployed= overdasr,. WO Fro*, Denton 3696549, 6'-17.78 R~arirtye,.l,~denton 1554e847, 7.6-78 30.40 Balance after Nedfcaid. Bothwell, Arthur Some 2,947,911 603 E491e0 Denton 1667908, 9-7-78 UnaaWloyed. Bothwell, Arthur Seine 115,50 tMeeployed. 603 Eagle, Denton 3120349, 8-23.78 1 ' Brazil, Robert Same 65.60 1,144"10*. 331,E, Main, Lewisville 3120455, 8-24.78 f C ge, Spei'la two 32,50 Ulid"Jeyed, Denton County Jail. No" 3700663, 6-27.78 Corn, &Womin Same 1,043,66 4 in family; $00/month 2600 Fort Worth Drive, Denton` 354880, 6-20-78 Farris, Joe Some 56.60 'Denton County Jail, , 954 Verena, Fort ;forth 3718228, 8-17.78 E Farris, Joe Some 32,60 Denton County Jail, 964 Verena, Fort North 37204485 8-23.70 Freeland, Carol StrAne. 68.86 Denton County Jail. Mono, 3728730, 9.19.78 Nasty, Robert tame 32,60' Denton County Jail, We 372216819.19.78 K4ap Dorothy Some I,321,70 Medicaid patient, 30 days t. ! 106 chopmeyer, Gainesville 1569244, 7-26.78 previously used. Sanger AG"n partments, i7, SA "or 7 249,30 Unemployedl 29 year old 'd6 nqer I T033, patient. Lewis, Haskell Some 34,25 Denton County Jail. 2309 Wlndsoe, Denton 3720489, 8-24.70 Mgison, Janet Madison, JA on 5,50 Balance after NadiFeid. 2 Wilson, Denton 569 130, 6-~9-78 Meyers, Kenneth some 32,50 Denton County Jail. None 3712769, 7-31.78 Nosdalo, Fronk Spine 48;60 Denton County Jail. Nona 3718236„8-18.78 Delabure Stephen Orlabure, Teresa 8,644,26 4 in family, 5400/month. 2426 Louise,, Dantun payno, Harvey Payno tinelila 45,00 Uncoployed. j 701 Driftwood, Denton 4101231, 7.6-78 Porter, tugono Snare 107.40 Denton County Jail, Nona 3717048, 8.13.18 Raninos, Ooyee RowIllos, lntont 2,b10.35 6 in family`` $6G4/month, iHfPiit Houte 1, 8ox 9470 Banton 1G48O49, 6 1?-70 oxplred; all uthor cliildroil an AFDC. , y I r 14 F Page 2 Charity Chargo-Off September 30, 1978 Guarantor's Name Patient's Name -O ~A uarantor's dyes Account / Discharge Date Account Galante planation Shea, Johanna E: Same 66.85 Non* 3728722, 9.14-78 = Denton County jail, Smith, Vincent Same 39.00 Denton County Jail. Hone 3719952, 8.22.78 SSppanninato, Maria so" 58.75 Denton County Jai). 3728748, 9-19.78 Nooneer, Howard 3727222915, 8.30-78 102.60 Benton County Jai), .3 HellenMike liallen Melissa 218,36 Currently on Medicaid. 1 9,9 Hunters Creek Bend, Denton 3676264, 4-18-78 Haden, Mike Natlen Melissa 21.00 Currently OA Medicaid, f ( 19 huntrs Creak Bend, Denton 4074981, 4-17-78 11 Walters, Glenn Halters, Danny 346,85 Medially indi 1118 McCormick, Denton 1570845, 9-19-78 9eAt, Moods,Mitdred Moods, Anya1a 16.00 931 BRIAR @ 4 e after ~ Pra r e Den Methcaid i _ , , )03681766 5 r n 78 -4- Hoods, Clarence Same .60 Medicatt a b19 .P110 Lope, Denton 3617747, 4-23»78 166 y ind~yent. { i TOTAL ; 71.627,46„ 11 ' I 7 1 J y a f ' 1071-7d i nhh;~nro:i.F'W.YdKl.tv'i+8'.Hr.II1Yl.NYY.?iiMlifM'~~'Mirril140rAiAlit/eM1HNr6:-YrFi..•~ Y r ~ ~i~ ---AP.'ll~il ff f~t~fl'~!_j!S_1 L1'_ !;1' 8U51NESS MINUTES bate June 22, Pap 1 I One of the items that was mentioned in my "immediate Plans" last month 1 was the suggestion that we investigate the possibility of building or having someone build an office building adjoining the hospital. I feel that there is sufficient interest among physicians regarding office space in such a building as it is rnuch more f convenient for them, If we could have a builds f ng built with the owner not expecting to have the building completely filled on the day of completion, I feet that it would be I' I a good Investment for him. As the area Is growing and'the projection Is for its continued growth will mean more people and, consequently more physicians, efans, coming to the area. Of course, office space is one of their prime considerations, I feel 1 fr + that their preference at this point of time Is to be to a building adjacent 1) to the hospital% I will be glad to pursue any Ideas that you have regarding this subject, f~ ~I Respectfully submitted, f Leonard E, Watson i Administrator f LEWigm ,h . • • 4.n.rw.Al3kfdAmlY~1NJ,YiY'.MIM4.AAO h'dfN ' abtl+M1`M11NM/k2 "A~p+~ 'I(NI~Mi4r~J ~p~ z' ti a ~ J1 1 FLOW MEMORIAL HOSPITAL 1 a :ONTHLY STATISTICAL REPORT MAY, 1976 - +a S L This This Mo. This Yr. Last Yr. Patients remaining last report: 90 Month Last Yr. To Date To Date Admitted: Adult., 273 275 20258 2,195 Pediatric 33 36 370 332 Obstetrical 93 88 712 726 Sub Total 349 399 30340 3,253 Newborn _76 -70'579 614. Tonal 475 469 30919 39867 - Medicare' (Included in Adult)........... 75 89 693 649 Medicaid (Included in all Categories)„ 21 9 171 175 Total Patients treated: 565 Dis har+,ged: f ult. 280 276 2,272 20210 Fediatric 33 34 378 331 Obstetrical 91 85 708 723 Sub Total 404 395 30358 3,264 Newborns 71 63 ~.T2 Bin Total 475 458 3,930 39874 Medicare .(Included in Adult)......'..,.. 78 84 103• 651 Medicaid (Included in all categories) 15 8 168 175 Total Patients remaining: 90 Discharge Days: 20088 10699 16,494 15,804 Padistrin... 129 112 10796 16564 Obetetrigal 399 269 219 20375 Sub Total 2,526 , 209489 , 143 awborn............,............., 45 266 ,323 20444 TOTAL 20771 2;346" y 812 Medicare. (Included in Adult)......,.,.. 401 672 70361 61152 Medicaid (Included in all categories).. 77 27 696 936, Average, Length of Stayt Adult..............:...... 7,4. 6.1 7.2.X Pediatric. 3.9 3.2 4.7 4.7 Obstetrical. 3.3 3.1 31~ 3.2 Total E8__ ' 541 5.8 517 Medicare (Included in Adult).,.,,....., 11.5 8.0 10.4 9.4 Hadicaid (Included in All categories).., 5.1 3.3 5,3 5.3 - .wa ♦i .r..V!t:6.4fJ MhM4.V...'~'~ .v+.s• w. Hn\: k.iMp i. : E MAY, 1976 MONTHLY STATISTICAL REPORT Page 2 This Thito. This Yr. Last Yr. Census Patient bays: Month Last--Yr. To Date To Date Adult 2,011 1,770 16,475 15,225 Pediatric 123 118 1,583 1,574 Obstetrical 309 287 2 *388 2,333 Sub Total 2p443 2, 75 20,446 19,132 i Newborn 261 277 2,336 2,4G1 Total 2,704 2,452 220782 21,573 Medic, re (Included in Adult)........... 832 704 70296 50985 Medicaid (Included in all categories):. 112 31 929 932 Average Daily Census: Y Adult...... 65. 57 67 63 padiatric 4 4 6 6 Obstetrical 10 9 10 10 Sub Total 79 70 84 79 Newborn.......• 8 9 y r' f Total ~87 79 93 - 89 ~I Medicare (Included in Adult)...,- 27 23 30 25 edicald (Included in 'all categories).. 4 1 4 4 41 Percentage of Occupancy:' Adult................,86.ede...... 75X 66% 78X 73% Pediatric,,,.,,., s # a . 7.8edd.,.... 57% 67% 86% 100X Obstetrical ..,.........ZS.Q~p....,. 40% 36X 402 4 118 Beds Sub Total 60A 71z 67Z Newborn . : . . . . . . . . .%6. pi:44lApts . t o o 31% 35% 35% 381 144 Heda & dassinsts Total --lut 532 942 Medicare (Included in Adult),$§.4gd4... 31% 27% 35% 29X Medicaid (Included in all categories)., 3% .6% 3% Deaths: Over 48 hours: Adult 4 5 48 47 1'ediatrlc 0 0 0 0. Obstetrical p Q Sub Total 4 48 7 Newborn 0 0 - u. 0 Total 4 48 , Msdicara (Included in Adult),4 4 42 39 Medicaid (Included in all catagorieb) 0 0 1 1 Under 46 hours: Adult, 0 '1 22 22 Pediatr.ic........... 1 0 1 0 Obstetrical 0 0 0 Sub Total .1._..._ 7 22 Newborn, 0 0 4 Total ' 7 26: Medicare (Included in Adult)..,.... 0 7 Lb 21 Madicaid (Includodin all categories) 0 0 1 Auto0sies 0 2 5 8 -Net Autopsy' Rate 0 16.6% 6,7% 10.9% 1• • e... .a; r..r 4.nulxa awJ~¢aJ,,A<,R,.bw1aM4rid.Y 41rW.5fiYk.iA~$'y"~yiJtieL: r. , F . M, 11lO ,r,u.rlnt t alwilstx~ew xcruxt Page 3 3 r This ThisThis Yr. Last Yr. Month Last To Date To Date intensPatientsiVe Unit; „ (Figures, of, this. category are included in other categories dm, Patients Discharged 29 40 294 266 r 31 36 259 243 # Patients Expired 0 5 39 22 Census Days 121 100 929 803 Average Daily Census... ~'l................ 4 3 4 3 Average Length of $tay.......6......... 3.4 1.8 3 0 2.7 Percentage of Occupaacy....9.8ed8...... 442 432 442 432 I Medicaret(locluded in above totals), Admi sions 14 20 152 • 124 Discharges 14 15 1 26 102 0 21 Expired R, Cenaua Daga 70 58 523 369 Madienids(Included in above totals) Admissione 0 0 10 14- ' Discharges....., 0 0 8 13 Expired 0 0 2 0 Census l~►qe 0 0 30 45 6parationssolk-r-Majort 49 Major 67 65 558 516 Minors 9 Minor 104 126 407 1,038 u --Majors 2Total 171 1 , Mirrors _ 9 Ylectrocardiogrsaest ..................xottl 257 226 21121 10635 Yn-Patiantas 254 226 21081 1,590 Out~Yatiants 3 0 40 45 4 Laboratory T~~tes ....................Total 130040 10,583 1180057 860830 Yn-.Patiantlt 9,160 69876 85,550 67,295 { out-Potiantet 346 597 3,794 10749 { ftergancy Room Patientst...... ! r Physical Therapy Traatetetrtat ........Total 10836 10120 14,113 129568 . rnY+atientat...►............r. 1,432 10259 11,631 10,156 Out~Patiantet.....:..~....'.... 1404 461 20482 2,412 Diet#ryt (Heals Served) ...,~~...6fateria 3,195 30088 31,999. 240568 Patient: 1,341 60504 60,849 57,324 Other 1,855 1,945- 15,531 15,759 Total 12,391 110537 1080279 9 , 6 Laundry 1,bs:. 44,623 42,909 364,388 343,979 Per Patient Day............`... 16.5 17.4 15.9 1549 1wergeney Room Viaitel 824 810 60179 50165 Respiratory Therapy Troatmentsi..s...Total 1,245 10057 12,044 11,269 In-Patients: 10236 10051 11,873 119223 Out~Patiantsl 9 6 171 46 BEtlt,........~ 5 10 96 76. X-Ray L%aminationst.... ....o..... ...xotal 1,283 10407 11,336 90951 Xa~•Patientas:..,.'............, 625 660 5,938 4042 out-Put antss..~ 658 747 5,398 5,009 Pharmacy: (Prescriptions Filled).....Total 11,135 9,943 85;375 81,067 Xn-Patiantss.,...,,.,......... 10,383 9,220 79,524 74094. Out~Yatiental t 752 723 5,851 6,677 r. . _ ..r.... .e..,, l.._., ,r. r. e.. r.., w. wsM1Hr1 Mme,.... .vltiiiY}ty, .nv Y I1 1 f FLOW MEMORIAL HOSPITAL Monthly Financial Report June 30, 1978 i Gross revenue for June,. 1978, was $588,000, which exceeded the budget by $28,000, a favorable variance of 4.9 percent. Departments contributing to this favorable revenue variance were: Intensive Cpre Unit - $60000, { Labor-Delivery - $4,000, Emergency Room - $29000, Pharmacy - $14,000, and Anesthesiology - $49000, Year-to-date, we have produced total gross revenue of $6414,000. This was an increase of $1,064,000 over our year-to-date amount at June 30, 1977, This increase, by department, is shown below; Gross Rev. Gross Rev, YTD YTD De artment 06-30-78 06-30-11 Increase Percent i1 Medical-Surgical Units $1,250,400 $1091,100 $159,300 14.6 % ~I Psychiatric Unit 139,200 .0- 139,200 100.0 $ Post Partum 242,900 244,400 (1,600) (0.6 I' Nursery 138,600 129,000 9400 7.4 % i Intensive Care 235,800 192,500 430300 22.5 % Labor/Delivery 1299400 989100 31,300 31.9 % Operating/Recovery Room 227,300 1830500 43,860 23.9 % Emergency Room 2230500 194,900 28,600 14.7% . Central Services 386,100 330,500 66,600 16.8 % i Laboratory/Blond Bank 630,400 54,1;400 89,000 16.4 x Radiology/Moleae Medicine 400;100 290,600 1090600 37.7 % Pharmacy 366'0300 270,900 84,400 31.2 % Anesthesiology 1910100 1669800 354300 22.7 % Cardiopulmonary 520,000 326,400 194,600 $918 % Physical Therapy 133,700 910000 36,700 37.8 % Cafeteria 63,600 47,306 16,200 34.2 $ Television 12,400 81700 3,700 42.6 % Gift Shop 9,600 7,400 20200 29.7 % Other Operating Revenue 24,700 41_,, W ,600 j-160900) 40 % 5 314 000 4 260 000 1 0 4 0 25 % f y ..y.`~A,attkf ruw,.«...u -..::........w~w.~+-r.4 W..'M.a✓av_ I~ . ' Y.O P 9M'1M:lyy}{IYIrLY+,"fI YAIYN'SY4G!.Wlr.i.iYAN4Ati.~llH,faJ.ly'+N''r!: k'i9l,r, r.. K i Daily Care nursing units account for 33 percent of the gross revenue increase; Cardiopulmonary accounts for 18 percent, and Radiology accounts for 10 percent of the increase., Revenue deductions for June, 1978, were $98400, which was 17.0 percent of our gross patient revenue. Year-to-date, our revenue deductions, expre:.sed as a percent of gross patient revenue, were: Charity - 6.3 ` Contractural - 3.6 and Bad Debbts - 9.7 Bad Debt Recovery -1.5 % s i (Net of 8.2 Our year-to-date actual write-of of accounttso expressed as a percentage of gross patient revenue, was. Charity Contractural - 3.7 and Bad Debts - 9.1 Gross Recoveries - 2.0 Expenses for June; 1978, were significantly less than expenses were for ? April and May. A significant portion of this decrease was the result of the change in the Laboratory contract; this department's average expense E for April and May was $61,000 per month, while the June expense was Expenses in total, ~ $3b,000; thereby, effecting a decrease of $21,000. i decreased $450000 from the April and May average of $656,000 per month. ` We achieved an Operating Loss for June, 1978, of $21,000; our Non Operating Revenue was $37,000, resulting in a Total Result of a surplus of $16,000, For the nine month period ending June 30, 1976, we have a Total Result of $117,000, providing an average of $13,000 per month. i Our average daily adult census for June, 1978, was 87.0 patients per 922 an increase of 69 percent a were day, Emergency Roan visits for June over our budget forecast. Year-to-date, the imergency Room visits have I exceeded the budget forecast by 1,660 visits, which represent a 30.0 1 percent favorable variance. Our average daily census for fiscal year, 1 1977 and 1978 is shown below: Month Percent Increase FY 978 FY 1 77 October 75,8 6910 9.9 % November 75.6 60.9 24.1 % % 74.9 63.0 18.9 -December January 88.8 73.6 20.8 % February 91.7 77.3 18.6 % { March 84.8 79.8 6.3 % April 19.6 % 89.1 74.5 May 80.7 8018 (0.1)% June 87.0 78.7 10.6 % July 68.2 August 72.3 September 74.6 Page 2 i ' va :.aw. Ji itr,.ti~s•rv:V"!sMSLiIYb'~{A~`11S a ~I r i Year-to-date, peryday,~swhichsresurpassed presents an einsome creaser of d13.8 percent. Patient cash receipts continued to show improvement, compared to previous months. The first seven months of this year averaged $480,000 per month l3 in receipts; Mays receipts were $515,000, and June's receipts were $516400, an increase over the average of $35,000 and $36,000 respectively, While we have made considerable improvement in patient cash collections, r compared to the previous fiscal year, and the first seven months of this i year, we can still make a material improvement in our collection of patient accounts. Year-td-date, we have collected 81.8 percent of our gross patient revenue, Analysis of our gross patient revenue indicates that approximately 4.0 percent will be uncollectible due to contractural allowances, and approximately 6,0 percent will be uncollectibie due to Charity allowances. This provides us with a maximum collection of 90.0 percent of our gross patient revenue, Bad Debts, at a minimum, would account for 2,0 to 3.0 percent of gross patient revenue; thereby providing us with an attainable collection rate of 87.0 to 88.0 percent of gross r patient revenue, The Balance Sheet at June 30, 1978, reflects improvement over the prior months', Both Accounts Receivable and Accounts Payable show decreases from the prior month. The composition of our aged accounts receivable has improved since the first of this fiscal year. The attached schedule shows this composition of our accounts receivable. The Self-Pay classification has decreased three percentage points, indicating the overall receivable 'is more collectible. The age of the accounts has improved with 68.percent of the receivable being within the first ninety days from discharge; an improvement of two percentage points, The most significant change in total dollars, by age category, , was the•$92000 increase in the 31.60 day category, This increase was due, primarily, to the lack of discharge diagnosis being available; this problem appears to have been corrected, in that, in the past week we have been receiving a large number of the diagnosis we needed to file the insurance claim. In summary, the major improvement in the accounts receivable is the decrease in the amount of self-pay receivable, when compared to the total receivable. Respectfully submitted, { Dale Wagner Assistant Administrator i for fiscal Affairs Page 3 i AWiI QQQ S i S S a i , nl ~f b b N C ~I C I 3~,. ro ~ a d a w. a a I ,-.gypp pp VV in yVy Lti ~O 00 V .P N Ul N M /A b1 A W E ae b as V O i m 44 4* 4A 4A 44 00 .P W ~ ~ Dy1 V W - dt Ch 0 W tl O ON1 W W A O O.l01 N J O Imo. sp ee ea ae ~ as aQ t+a an as so r 1NIWNOV11V r f I , p~~~s. ,~ti~Fy~lup /y~{f'.k~16hlYKrY.,. .......e.._. ..,-n ~ _ rwrnu....... u✓ t✓,a+w+rA.VIW> l.a.n.. r i l Milo N Sr Gr r-1 ~i of D ro Ib~ ~ o ~ ~ 4 1 N r c ~s h- GY C -ilA :S~ too ro J N N 1 1 V a b1 b4 to M kA ~ 1 t7N' V W 1.11 O N ~0 00 ~ W W V ..Wpp W W 01 V W Ol a H d1 EA 6'► 64 44 b4 !A 1 14 r w ~tf1 W".~~YEW•PP f'71VN A00 ~.^~1.. tt ~ W H 64 -C 00 1 I WW N W V ~ ~ ~1 ~ ~ W 10 tl W ~ '4'f /••1 f~D A Nfb fD W fff~YLLr "J. A :fj IA _ t0~ F• t+ Gf G . G7 O W W ~OJ d w am { N fD ~ Li 0~0 -i ' 7. 1 C+ ro N ro q XP ro ro rrt 'C7.. t+. m N .d. 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Ga. ..t 60 O OQ b Y V q~p m Gq k3 P3 ~ a a • ~ j 1 . ~IItA1a~Y~ qw,..:nn.wMI.TNr..»wairW,ypvre.y,N~; r . ~~M~iaxua~a;t:+t&N at4tr;~~k~y';a~rst4ir~'i UUfnsaaiu,~t,AYfiNt3tit~ ' . y. r . Wool (p :3 0 :3 z -3 om ID 00 ro rF Cri CL :3 V) o O Y. V Y Y R ~S O J.Y' ~ x e ~ m cn LA :j CA N 1 r O N w 14" ]J~~~y P +=y„• ~ LN C W f. W 00 d a. ro I ~ i i l i .44 j w+ 4 ro L~a o~ c~~ N A 4 1 { j r r 00 t ; I b r fI i Ir. .,.e.._.. . ~:•M1-„ .w. ~n~'..4\4llt\.wY✓.~.~W~N.'W.\.A/n.1.IY.nIG: H.Y'~{II~{v3. ~/fa alt{N'aN>Ine. y n~ r _ADMINISTRATOR'S REPORT 4 BUSINESS MINUTES Date May 1$~ 1v~78~ Pere 1 This report will present my views as to what we should consider as our { immediate, intermediate, and long range plans for Flow Memorial Hospital. This ; plan, along with your ideas and also those of the medical staff, will enable us to chart the course of the hospital in an organized and united way, Immediate Plans, Period from 6-1-78 to 9-30-79 1, Continually monitor the health needs of the community and eval'u cte the method and involvement of the hospital to meet these needs, 2, Continue to work and cooperate with TW U, NTSU. and Cooke County Junior College using Flow as a ,clinical area for, their health cane. programs, Investigate the possibility of expanding these programs, 3, Continue to pursue a broad base financing plan for the hospital, such as a hospital district including the entire county. i 4. Investigate the feasibility of converting the 2B Unit into a ;step-down CCU unit, leaving the present TCU-CCU as a post-operative and trauma ICU, 6, A plan for financing the above project would have to be worked out, 6, improve the financial position of the hospital so that all items in our budgnt can be met. 70 Continue to work for a permanent and equitable solution to the ambulance a problem. 8. Continue to work with and support COO In the EMS communications progra LJ 9, Pursue the possibility of blow being designated as a regional center for the treatment of the mentally and emotionally' disturbed, Aggressively work with k MHMR in this regard. 30. Follow-up on a plan for a professional office building at Flow. s 11. Explore the possibility of developing and organizing a Denton County Mood Center. 12. Explore the possibility of being a teaching hospital for a Family Practice Residency Program. M 13. Continue to work with local and regional planning agencies,, city and county governments on local problems and issues. 14, Evaluate our contracts with outside contractors providing services in the { hospital with the Idea of doing these services ourselves. 16. Aggressively work on a cost containment program, maximizing 6.,r revenues and reducing our cost, but continuing to provide quality medtcat cars in an effective manner, . K 3 f rd1:4a1{. .viRr`Lep:; : e w » n....e y ,w 1 . i` ADMINISTRATOR'S 1ZLPPORT BUSINESS MINUTES DO* MA 38 1978 Page t -•~"a_=_.s_:_ -~•-rte.- y:t~- =-~•_W..__.-.._~~.:.._... _-ei..~_r.---•-.. 16. Develop an effective program for communicating our hospital program to { the public. I t Intermediate_ Plans, Period 10-1-79 to 9-30-8I Ix 1, Initiate discussions regarding the adding of additional beds and services. s i 2. Continue to work on the unfinished items and programs in the immediate plan, Ung Range Plan: Period 10-1b81 to 9-30-84 f ~ 1. Begin the building program of adding' additional beds and expanding service areas 2.~ Continue to work on the unfinished items in the above two plans. Your, comments and suggestions will be apprebiated. 1 Respectfully submitted eonard Li Watsone laACEr ' ' Administrator f i LLW,gzn II j i h t w iuw gtllA .ri y. nr. en ,.r Y`~~~Y+ 2AA(iAYU4M.i4b+W:+4niWr-.H..: r.a: .aiwnww..r,.,r. < . .....v rn,.e w. R,.l 1f ri\. :J....w.aro~1•aat j~ ns•. ''~M. Mea..r,1.bia;avnykc»rF~krtkti4nwf"s~i^wN r+~h a .ow .R It i FLOW MEMORIAL HOSPITAL Monthly Financial Report t May, 1,978 j 1 , The average adult daily census for May, 19780 was 80.7, a decrease of 9,0 patients per day, from April. Year-to-date, for eight months, our average daily census of 82.67. Improved utilization of the Surgery Unit and Intensive Care unit contributed to the increase in patient day. April's level wasg$234.21ti or revenue per per patient day, and May's increased,$22,73 per patient day to a level of $256.94, I per patient day. May's financial operations were similar to April's in total, The Total Result increased from $14,000 to $20,000, the result of a decrease of $2,000 of expense, and an increase ! .r 1. in Non-Operating, Revenue of $4,000, Year-to-date, we have generated a total surplus of $1010000, The Balance Sheet remained in the same position as the previous month. Cash i reflected a decrease, which was offset by.an increase in I Accounts Receivable. We have seen our Accounts.ReceivabI6 increase $167,000 during the last two months. This is primarily the result of claims being held for a longer period of time, due to the late receipt of a discharge diagnosis from the physician. It is anticipated that this problem will be resolved in a short period of time. Current Liabilities remained unchanged from the previous month, in j total, Currant Liabilities represent 43.6 days of expense. The attached graphs illustrate the change in the finano.ial position of the Hospital from May, 1077 to May, 1978, dross Patient Receivables have increased $247,000, which is a 16% - increase from last' years however, dross Patient Revenue has increased $9220000 or 258, during the same time period. Our Current Liabilities have increased one percent or $11,0`00. Our Expense shows a $555,060 increase or 16% and our Patient Cash Receipts have increased $1,103,600 or 428. In summary, the financial performance of the Hospital has significantly improved over the last twelve months. Respectfully, Dale Wagner, Assistant Administrator for 'Fiscal Affairs j i WOW n"wl FLOW MEMORIAL HOSPITAL G OS T RECEIVABLES 2,000,000 1,9000000 i 1,800,000 ' 1000,000 1,600,000 l,5oo,ooo 1,4oo,ooo 1,300,000 1,200,000 i 1,I0o,oo0 r, 1,000,000 9060000 800,000 7000 666 F 6oo,ooo 500,000 i 400,000 300,000 200,000 100,000 0 MA; OSM1577,7- MAY 31.1gZa MAY 31,1917-, MAY 11 .1978- t I I; s lnw.rv.... . u:..p ~ N n (.p1i {a(!lirvS,N!.r: ✓,Q'q4 \}f 1 h i ~ 'yrr4bC.w... K4N1Rti.b!NSe+i'e'U,VeSiuk~e~taeNl~'+iHxl rlY~~gi:SbU. AYW'Y9M r stvxry f I'LOW MEMORIAL HOSPITAL GROSS PATIENT REVENUE TOTAL EXPENSES PATIENT CASH RECEIPTS $5,000,000 4,800,000 4, 601,000 4,400,000 _ if 4,200,000 4,000,000 318000000 _ , 3,600,000 i ,400,000 31200,000 f 3,000,000 r 2,800,000 i 2,600,000 ' i 2,4oo,ooo r 2,200,000 2,000,000 1 i ,8oo,oo0 € i 1,6oo,ooo 1,400,000 j 1,200,000 1,000,000 I 800,000 600,000 400,000 ' i 200,000 $ 0 } Y.T.D. 5/31/77 5731/78 Y,T,D. 5/77 5/78 Y.T.D. 5/77 5/78 F. 2 C7 C1 "I O Z -I d b mv Z n r a h 31 M ~ a b-O n ocx m o~'orr'n~ ~az o on a z m n I ~N O o n r o ~ ce o -1 m - z x ~w a , ~z at N W4 oj n N (A 3 G! fkn M n 1A M. o", N Ct7 O n ~p4 'I i " C N r0 ~N t~0 D Al GJ N a M W < W CA I c " - y I w O' P4 %A 1W 1q w ,coo C, O a vi v1 Wn N V ni OD W - ~ rya 1 V n a = <n 44 +n in M .n in v. e N W W` V1 r I'S !r (p y 'I7 7~ W..r U7WW W V W lD N ~ b ~ ~n ~n {n ~n v1 an an ~ M -i . ]Wvj-01 V00W NW OO OOV co Nf~~110 V~1~ ~q "I' 111 14 W 0' N 1D OD V Un 11 U1 ~K1' 1 ry1 4/1 Vf N to N4A W N VN1 W'WW N w 14'1f Nw DI Ib ~H l0 00 l0 NOOVW~ ~ WNW WW o t .y. 4A 4A1 to iA N N b r 1 01 W WOiTV 1.!14'1 1~D lC OdaWO Wy V'•y p r1 P '.w~~yy'tid^rPr~r w.w.-...... ,...,.,..r _.........,~...;....Mww.a.piyAYaMlW+ru S+aaes,a.✓.Mau.,.~.~NM i 171 p~cfmr Q pp r Q~. 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VI t~ W CO N V} fh N ,I~ %.w I W 1~. z :f p VCf V'° VCf V OUZO Vp Vd Vw~ .j 4,j Jl7 VJO Mx j . , ~ MM 111 ro, i CLO, i N r • N O0 wVY.1... vi ~4d.1't'!tA w ° I - , ,JAL.. uw, I Ems' °vi vii 4r3 n ~n` W 1 + ki) • CM .I v N o. ~.f M, vi t CA CJ J- W 0 W V 0 L* l•1 C1 x v, ca i~ n ° a v, d a n to m H i I ` p r~ Sy T+ W ri S» n b Tr b 461 ' r ...+..~...a..-. rsr,..et~ww+5 r4~M r.N:~n19K+1/.K+AaNr%H:UWf}6iM1il~.~W4W\'lkcMtYii.wrN.••••, ELL 1 r~ r I f AQ MINI alulo i 8T BUSINESS MINUTES oafs March 22, 1978 Pala 1 i - The activities of tha ;,ast month have been varied, and I will elaborate on the significant ones. Hospital occupancy has been holding at a steady level, except for the past week, I feel that our decline in census was due to the schools' spring breaks, The surgery schedule for this week is good, and l feel that this is a good indication. The 3D Unit has been experiencing a good census, the balance of the furniture has been ordered, and within the next month we should have the unit in excellent condition. Cash receipts r are good, and we hope to make continued improvement in this area, We have completed some items, maintenance-wise. The work on the boilers has been completed] the exhaust duct from the dishwasher has been replaoedr the auxiliary generator bought during the renovation program has now been properly installed and is functioning properly] a small renovation program in the pharmacy is underway and will be completed soon. This will allow them better arrangement f ' and will make room for the admixture program, The Lifepak 9 unit for the .tmergenoy Boom that was authorized in December hap been purchased. I recently attended a meeting in Dallas regarding the communicatiod system that has been authorized through NCTCOG4 The original system was for a VHF system, but the Feds have changed the program, and they wanted our permission to change w to a UHT' system which is supposed to be superior. A new engineering study will have to be made, but there is not to be any change in costs to us. A follow-up meeting is to be held next wok, I I visited with Mr, rhris Harturgo the City Manager, yesterday, Discussions were related to the anticipated change in the emergency ambulance service, initial I discusstona are taking place among several groups, and I indicated that we wanted to actively be apart of any discussions regarding the emergency ambulance service, We also briefl discussed the possibility of a shared computer service, The amount of the o Y Cfty's involvement toward the operation of plow was also discussed, We plan W b keep our lines of communication open, Mrs. Helen Mena, Assistant Administrator for Nursing Service, began her - duties Monday and is.in the process of evaluating Nursing Service by observation, as well as meetings.with supervisors and head nurses, Respectfully submitted, e; k Lt c Lenard 1~.` Watson, FACHA Administrator i 00~ LEWsgm APR 24 197$ ' CITY OF DENTO N MANAMIS o7,-c [ } F ..w... s ....J.v,t.ws.w a.1.cA.nN~n.a:a....a a..u„lrur a4:'Y~'Ur aPtii' tJ fin "Wi ROOM t _ OUR X18 b n t PAR t ~1., "'I 7b Ji C3 ID IC rymOry y 09 N fD ¢ n ~G M t Vi y T 1 M H iA M4 M f n p~ ~{p~ ..pWp. 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Also present were Mr. Wallace Duvall, Dr. R. J. Lee, I Dr, S. T. Love, Mrs, Gloria Madewell, Mr. Leonard Watson, and Mr. Dale Wagner. Two representatives from the firm of Touche Ross and Company, Mr, Don-Wagner and Mr. Rill Fowler, were also present. ' The minutc4 of the January 24, 1978 meeting were approved as presented. Mr. Wagner reviewed the Monthly Financial Report and the financial statements. The average, daily census for January was 89. 1, and the current ratio was 2, 81 to 1, ' A surplus of $15, 000 revenue over expenses had been achieved. Mr. Wagner was asked to report on the status of accounts payable, and he noted that due to an increased j r' cash flow, the aging of payables has decreased. Items such as medical and surgical supplies are being carried about 60 days, while other payabies are being paid on a c current basis, The Charity Charge-Off Lt.st In the amount of $42, 374, 77 and the Bad Debt Charge-Off List in the amount of $82, 044.24 were reviewed. Dr. Finlay asked why, an employee's name, appearod on the Bad Debt Charge-Off List,'and Mr. Wagner stated that the name had been overlooked until earlier this week, The employee has since been contacted and arrangements made for payroll deductions for the account I balance. There was some concern expressed over the increasing number,of bad f debt accounts which is expected to reach $500, 000 for this fiscal year. :Mrs Wagner explained.that attempts are made to call all persons with inpatient accounts on.the ( Bad Debt List. Some other solutions to this problem ware discussed, Dr. Lee added that some doctors might delay, if possible, the, admission of,a patient with an I outstanding bill until the bill has been paid. Dr. Finlay moved that the Charity Charge-Off List andthe Bad Debt Charge-off List be approved; this was seconded by Mr, Hilz and passed by voice vote, br. Finlay moved that the Finance Committee ieport be approvedi this was seconded by Mr. Hilz and passed by voice vote,;, Mr. Don Wagner and Mr. Bill Fowler reviewed the tentative audit report and Woes explained that it represented a "clean opinion. " Following a recommendation of the Finance Committee, the allowance for bad debts was increased to 130 to reflect more accurately the actual increase in the amount of bad debts, The audit report was amended to reflect this changes The recommendatiorslisted in the audit were reviewed and discussed. The finalized audit will be sent to the City and County and the Board of Directors. Dr. Vinlay moved that the tentative audit be approvedl this was seconded by Mr. Moore and passed by voice vote. 'The Joint Conference Committee Report was given by, Mrs Watson. He announced that a Director of Nursing, Mrs. Helen Mona, had been employed. He had had a discussion with some Board members of the Denton Area Crisis Center ' concerning their desire to remain at Flow Memorial Hospital and will talk with Dr. Oiiver and fir, Taboada to get their comments regarding this. Mrs Watson had I also talked with Dr. Lowe regarding a new contract for anesthesia services. The { communications equipment, to be purchased ona shared basis,by Flow and a grant from the Department of Health, education, and Welfare through the North Central i Texas Council of Governments, is scheduled to be Installed at Plow sometime this summer, Dr. PlnlAy moved that the Joint Conference Committee Report be approved= this was seconded by Mr, `Moore and passed by voice votes Fnrueu.l uaa ~ `!9"~+Y'I*N Ys Ala... CI ItA Wr IIUMII /I W15AYV5 r 1 i 4- hop..: BOARD OF DIRECTORS ~r BUSINESS MINUTES Do* Febru 23, 1978 Mr, Watson explained that,Dr. Love had given him just prior to the Board ( } Meeting a proposal for a new contract, and this proposal was discussed. This new proposal included Increases in the monthly guaranteed salary which Dr, hove explained is necessary to offset his expenses for increased liability insurance coverage; Mr. Watson asked Dr. Love if he would agree to continuing the present contract for I one more month so that he could further study the possibilities. Dr, Love agreed to this provided that, if the Increase is approved, it be retroactive to March I— !f Mr. Watson agreed to this. The Utilization Review Committee's Report was reviewed by Mr. Watson. One k hundred six Medicare and 18 Medicaid admissions had been reviewed and justified, as,well as 40 Medicare and 3 Medicaid extensions of stay. Mr. Shelton moved that the Utilization Review Report be approved; this was seconded by Mr. Hilz and passed by voice vote, Me. Watson read the Administrator's Report and commented on some of his activities since arriving at Flow Memorial Hospital on February 8, 4 ~ 1 Y He also anted 'I that the Neuro-diagnostic /Behavioral Medicine Unit had opened cn February 7 aad Is maintaining a cansua of 8-10 patients per day. Mr. Moore moved that the Adminis- trator's Report be approved; this was seconded by Mr. Shelton and passed by voice vote. Dr. Lee present 'ed'three applications for a ` ppcintment to the Active Medical. Staff from Jo-Allene Horne, M .D. for privileges in anesthesiology; Mary B, Smith, { M. D, for privileges In general medicine and pediatrics; and,Mickey Wayne Via, M. D, 1 ( ,t for privileges in aneethesiblogy' He explained that the applications had heen,approved by the Credentials Committee and the Executive Committee of the Medical S044 Dr, Led stated that all physicians are being requested to complete all dglitiqubnt, charts priot. to the survey by the Joint Comrrtission bn Accreditation cf Naepitala In April, Mr Shelton moved that the Medical Staff Report, including the three applica- t tions to the Medical. Staff, be approved; this was seconded by Mr. Hilz and passed by voice vote. ~r A request to pay the moving expenses, totalling $1, 2001 for Mrs Ray Thomson, the newly hired Administrator/Coordinator for the Neuro-diagnostio/Rehavioral- Medicine 11ntt was diseu$eed and considered. No decisibn was made, however, 'Aftei Mrs Thomson arrives'on March 1; if he requests the moving Upenses, then Mr,' Wats can determine whether or not to reimburse him and for what amount. k The By-Laws of the Board of Directors of glow Memorial Hospital were reviewed, There wbre no changes recommended. f Mr, Watson announced that'he has designated the Assistant administrator for Nursing Service and the Assistant Administrator for Fiscal Affairs to ac(In his behalf r whenever he is absent from the building, { The Spring Seminar of the Texas A'sdociation of Hospital C,bverning Boards to be held In McAllen on March S and 4'wad discussed, Mr, Moore "commented that he had E found these seminars to be extremely educational and helpful to 'him. Mr, Moore and Mr. Shelton agreed to attend the seminar on behalf of the Board, i „Iw r,eia { NNF~ e 4"1!•11 t: 7 , BOARD Of DIRECTORS BUSINESS MINUTES DN. e 23 . ! 978 Dr, Finlay suggested that the two advisory committees, the { Committee and the Medical Advisor members be prepared to makes y Committee, be activated and t financial Advisory ~ meeting. ~e added that the Board ~ould a$ for these committees at the next Board 5 more community involvement. , ppoint other committees, also, to get ax . a i IRespecttutl submitted Gray Shelton F• Secretary d r, t e, )rat t~.;' t$ kkaa add ti Sir+btety kP~'~'Qtkf9litil~ rig: n r ADMINISTRATOR'S REPORT i, BUSINESS MINUTES 06140 ]February 23, 1978 toes I My first two weeks in Denton and at Flow have been busy and enjoyable. My plan for the first few weeks is to listen and observe what was taking plaoe--to determine the strong points and the weak points and to begin Initiating programs and changes that would improve upon the weak points. The interest and reception i ` of the Medical Staff has been excellent= the hospital department directors and other i hospital personnel have been interested and cooperative, Our emphasis with them a f has been that Flow Memorial Hospital is going to be the number one hospital in i t Denton and Denton County. We will accomplish this. { I There have been some definitive situations and challonges that we have had <3. to respond to--such as; SAy~ ! 1, The Director of Pharmacy, Duffy James, has resigned. Mr, Paul Carpenter has been appointed to assume these duties, 'x = I 2, A Director of Nurses has been employed. 3. Had discussions with Dr. Love regarding an anesthesia agreement. 4 ' f 4, 3BO the Department of Behavioral and Neuro-dlagnostio Medicine has been opened. 5, . Have reviewed the report of the last J'CAH survey, Will be devoting time and effort in determining which of these deficiencies have been corrected and the E ones to be worked on, E 8, Have been reviewing the budget and the Business Office operations. 7. Have also reviewed contracts and agreements that we have with vendors. 8, Have discussed with Rance Cotton the problems In Maintenance as it relates to equipment that needs replacing or an effective preventative maintenance program, 94 Have made special efforts to meet all of the physicians, !a. 10, Had a discussion with the people In the Crisis Center, ,"'N 11, I would be remis if 1 did not express my appreciation to you for allowing ' ' Mr, Duvall to spend a few days with me, He was very thorough in bringing to my , { attention 'special agreements and situations that would be helpful to me during the 1 first few weeks of my administration, ,r, <I Respectfully submitted, "I",f LeonardWa son c",+, Administrator p LEW sgm f Y ~j ~r'~~i ~}:W.va.1 .L.,.•_. . ,n L r,......uans... ~xa:, ..k a..en.emroyAp.pµ Yeitp'+NA iathlY } G1t.::Ji!flrn.pi+k,Nld4Ni6 Kc,O,l~iP 11 r ~F } H1tOM FLOW MEMORIAL HOSPITAL Monthly Financial Report t February 28, 1978 ~ s We achieved an average daily census of 91.7 for February, 1978, and year to date, an average daily census of 81.3. The schedule shown below shows our total patient days for the current fiscal year, compared to our budget forecast. Nursing Unit Actual Buffet Variance ° t 2'A 1,304 10186 118 { 2MC 41841 3 3-8 -AA 30409 30909 (6 0 1,782 168 0 NO 3 681 ff>, I.C.U. ► ? Total Adult t 1 Nursery 15242 X1,7 67 10 a Total ~bT Pediatrics, Unit 2-A, has achieved a 67.6 percent occupancy; the favorable variance is due to an overflow of medical patients from 2-0, The medical unit, 2-C, has had a high patient load for the past several months; it has achieved a 84,4 percent occupancy level. The surgery unit, 3-A, has r! ' not achieved its projected budget occupancy level; it has a 12,8 percent unfavorable variances when compared to budget; however,'it has achieved a 22.1 percent tncrpdase over the rfor fiscal year. The obstetrical unit, 0.8,0 is utili$ing only 47, percent of its available beds, ¢ The Nauro4sychfatric,Unit opened on February 7y 1978, and had a total of 212 patient days In Fobruary, 19.78; this was an aderage' of 9,6 patients Aft l per day. There were twenty-five admissions to the unit; ten Isere 5e1f- Pay, six were Commercial tnaurance, five ware Blue Cross, Wee Were Mediaafd, and one was Medicare. The average length of stay, for those, E patients discharged in February, was 9.4 days, Gross Revenue for February was $24,000, estimated revenue deductions were $6,2& providing a net revenue amount of $18,1300. Direct expenses were $7,9tl0, resulting in a direct surplus of $10,900. February's Hospital operations produced a four, thousand dollar surplus on $576,000 worth of gross revenue. Revenue deductions were 17.9 percent }E, percent revenue, and ekpanses,exceaded our net revenue by 6.1 schedule indicates the percent allocation of our year to date revenue and expense. rat, t`. r fin! 1 I , >..~u eisa~yp,i i. .r<W, wv art lba.N,ekx r a:n, , t r~ h.y iv 'y~h., qy .f ~t t Classification Amount Percent Gross Revenue. Daily Care $ 1,082,000 36 % Medical 107109000 56 % } Non-14edical 55,000 2 % Appropriations 1510000 5 % Non-Operating 19 000 1 % Total Gross Revenue TTIVI,Q Revenue Deductions. Charity $ 144,000 5 % Contractural pgg'p00 9 % Bad Debt % Total Revenue Deductions T_f Expenses 29423,000 81 % Result 39 000 l % Total 01~;~6{l I This schedule provides some insight for methods of improving the total j result, If we reduced our extension of credit to patients, by five t percent, we would reduce our gross revenue by $140,000, our revenue deductions by $140,000, our direct variable expenses by $24,000, and i increase our result by $24,000 (62 percent), , 1978. The Balance Sheet remained essentially unchanged from January 3' Account Receivables show an increase of $27,OOQ9 and the reserve increased $8,000. Our reserve for our patients receivables was 17,9 percent of r E our total receivables' Cash, and inventories both showed slight increases. Total. Current Assets increased $429000. Current liabilities increased E slightly from 47.0 to 49,4 days of expense, A decrease in Medicare cash, receipts contributed significantly to the increase in current liabilities. Projections for March, 1978, indicate total cash,receipts of $680,0009 which will cover three payroll disbursements and also reduce pa ables by $25,000. A potential reduction in expenses and inventories will provide 4 additional assistance in the reduction of our payables. A review of. our cash activity for the past five months shows we have collected`$217s000 / ' in excess of our expenses (exclusive of depreciation), If this level, of activity was sustained for the next five months, we would then have our., payables in a current position (thirty days of expense), In order to accelerate this result, essentially four procedures will need to be l accomplished: 1) increase cash collections; 2) reduce expenses; 3) reduce inventory; 4) accelerate the payment schedule for appropriations from tho'City and County, E ` Respectfully, 1 Dale Wagner Assistant Administrator for Fiscal Affairs y `i r i • .<.).Wt ti11ti r.tnl.dV it P-•n<FaGlx-:V~Pfi//.Yr!?,Fifi.r.+tr M.ityVrK'AL!'ygy ;J,6eg ~141.9f em.•~ . S A t Y i ' a Al a a ~ e ~ ~ n•cyaaoo~ c ao~ an~L" ~ ~ pp rt a a (4 i i a• 0 V) a r1. 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Y ~ ~ 9 W V /O to 3' ~7 ~ i V :1 4 fyb Vf tL (p M P} .+r u u -4. ~p y i Oj 0+0 i N I i a.:a Oro' ell Y V.~ V _ Y`A.~ ~ r ~ r`y .7 ~ ~ r`j `J ~ r"'1 r~ •yi `1 ~ i ~b xf VV VYe c~ Y V Y Y Y ~t a7s --1~ Na k kC .t .1 b y W e,► y t*1~}. yp 'fop ,1, pi kw z 1 '1 ~ N'rC H ' lil fit' IA ~ 41 ~C N ~C ~ y~... N ~C N N ~C 'NC ~1A 11 ~ C~ [r ry t~ •,j i t y G ~~f r to 7tl > V V 0 v V 4 V ivv V V V V(~ ~1.yI ~7 V tut 'G1 V V v V VO W~ V C . VO.. O~ ~P• k ir-m cwy ~ ' ~ U'1 aA 4A A U5 O IV 44. yy . ; f, r, 1 _ II 000 pp Y Lt~Jk~~ { .+J 144 a N ~C of fah, r• $ n ~ ~ ~ ~ ~ ~ ~ ~ ~ $ ~ ~~3 / s :to r,hi~lb+lr 4,.),1 Mail 14 d.i?gIY, r<rAiC5.R1:C~0...~n?1.=a4 a. +.l:e.rdr'±.~, f 1~1 A Y 1 1 {aCttY F'L6w tdVIORIAL HOSPITAL MONTHLY STATISTICAL REPORT '--JANUARY, 1978 .4 U This This Mo. This Yr. Last Yr. e Patients remaining last report: 107 Month Last Yr. To-Da t e To bate Al Admitted: w 3 Adult. 307 273 1,056 970 Pediatxic 99 57 327 180 0batatriaal 80 94 346 385 Sub Total 4T6 424 10729 10535y Newborn.... 70 74 308 326 Total 556 498 20037 10861 Medicare (Included in Adult)...:.,..... 106 82 .388 309 Medicaid,(Xnaluded in all Categories).. 23 18 79 62 f T al Patients treated: 663 ? i~chakged: Ad 1't...,....~ 287 258 1,036 957 Ps iatric.........,....~..,....... 91 56 315 175 Obatetrical........ 90 92 352 384 4 Sub Total 468 406 1,703 10516 Newborn....., 85. 73 313 23 V~ Total 553 479 2,0ib ),839 is Medicare (included In Adu1t),.......... 107 88 380 308 Medicaid (Included' in all categories).. 23 17 74 62 Total Patients remainings 110 tAdult..........:........ .2,097 1,6/2 70568 66355 Pedia.ttic 327 248 1,121.: Obaxetrical 311 M 87 1$'" 1.235- Sub Sub Total 2 *261 Newborn 376 256 1,247 18461 .183, TOTAL -_Y.. ~ X111 2;463: 11,125' 90444 4 Medicare (Included in Adult)........... 10134 813 36853 2,$51 Medicaid (Tnaluded in 41 categories).. 153 78 434 255 Average Length of Stay Adult.................. 7.3 6.4 7.3 6.6 Pediatric 3.5 4.4 3.15 3.8 Obstetrical 3.4 3.1 3.3 3.2 - - Total .6 5.1 5.5_ 5.1 1 Medicare (Included in 10,5 9.2 10.1 9.2 1 Medicaid (Included in,all categories)... 6.6 4.5 ; 5,8 4.1 i . xnGYYf*.n.J rsw.ew»...r?m.~ . ....-.u e:. ' t=` .udfi"..9,d,a+iv VA xiL,iQ<d.1k%Yy'ali{IS+q+NAt:~kl~~P:4,r Z91SiiP~'IMiPdrJ~A'}7.!(k1tz']'~SA'., I ANN r7. JAfSUARYs 1978 MONTHLY STATISTICAL REPORT Page 2 P This Thin Mo. This Yr. Last Yr. Census Patient Uayst Month Last Yr. To-bate To Date Adult 2;41 1,993 a Pediatric,,,... 343 244 10167 661 Obstotrical 287 280J:__; ~1.~,139 1 237 Sub Total 2" 7_. ,2 Newborn 397 245 1,297 10182 Total 3,'1682,56 2 110025 9,444 Medicare (Included in Adult)........... 1 122 765 3,822 •2,750 Medicaid (Included in all categories).. 148 78 .444 20 Average Daily Census: Adu1C 69 58 60 52 Pediatric., li 8 9 5 3 Obstetrical 9 9 9 10 Sub Total 89 75 79 67 Newborn,.:.•:, 13 8 10 10 Tonal 102 _ .83 .90 .."'77: j Medicare (Included in Adult),.....,,.,. 36 25 31 J Medicaid (Included in all categories),, 5 2 22 4 g j Percentage of Occupancy: Adult....... , .7,4. Pods. 872 732 762 66% Pediatric..,.........}4.78% 37% 642 362 Obstetrical ......z5.Olds 362 36% 362 40X 118 Bads Sub Total 2 Ne wbo rn . .2b 4MAfg0~` 50X 312 389 357 82 144 Bads & Businat*Total 71% 582 62% 53X.` , Medicare (Included in Adult)„78,4844., 43% 322 39%- 28X'. Medicaid (Included in all categorise),, 32 12 3x 1k (144 Haft & Bassinets) AW*ths Over 48 hours: Adult 14 9 42 25 PeaiAatr~c 0 0 1 0 Obstetrical...,.. 6.:. 0 0 0 0 Sub Total Newborn 0 0 0 0 Total I4 9 43 23; ` Medicare (InGludqd in Adult)......,. 13 6 38 21 ~ ` Medicaid (Included in all categories) 1 1 2 1 ~ s Under 48 hours: Adu1C..........~ 2 1 6 7 Pediatric........ 0 0 l 0 0 0 0 0 Sub Total '2 1 7 7 Newborn 4 _ 2 0 , Total 3 7 10 Nadicare (Included in Adult)....... 2 1 6 6 Medicaid (Includodin all categories) 0 0 0 0 } Autopsies: 1 0 2 2 ' Not Autopsy 6,3X 02 4% 3.72 d , 1i r. R,; X'...,.:r...v .•Y ".:.yHA Y1r M1..4. • (yiy, h ..~.v a ...r {t;tfb,f. ¢4.i.A...1 a ..ik..u...n .c N.{(.1kla1rAe1~~1 ,.TM" a*a.S,.ti.~fex~F,Ytuaahn?rz~~rcidM.btr«a+,1~3<<~+'rt:, , e -1 17, ' - .YUUIttA.l JLHLLJ,ILL}W 11Gt'Vt(1 JAWARY, 1918 tugs i This This Mo. Thio Yr. Laet'r, Month Last Yr. To Date To bate xntonsive Cara Unit: (Figures of this category ara included in other eatcgoriga)y Patients Admitted.:...,...,............. 40 Patients Discharged 25 158 152 Patients Expired 36 29 142 131 4 2 12 Zg i Census Daya 129 141 539 ,t Average Daily Census , 4 439 4 4 3 Average Length of Stay,,,,,,,.., 4.1 Percentage of Oac4 anc 44% 2,9 3 2,7 ,f p y 9,.Eeda:.. 44% 44 4X 43X Medicate; (included in above totals) Admissions... 18 16 83 79 Discharges 17 22 73 63 f gxpiredp.. 4 1 11 13 Census Lays 0.., 75 86 .318, 232 Medicaidt (Included is above totals) Adtsission4 i , 0 3 5 Discharges... 1 0 3 3 . ! Expired 0 0 0 1 Census Days 4 0 11 16 Operationst O.R.~---'-Ma3ort 42. Major 64 54 267 285 Minor: ,,.iw- Minor --12k _ 127 37 481 W »--Majori 21 Total 190 181 Minoru 804 766 Cardiopulmonaryt Respiratory Therapy Treatmentss xu4Patianttst.. v. Total 3,383 ~719 10,1 3' 30251 8lectrocardiogrmus t In»Patietitst......, ...v• ° 293 887 Out-Pgtients 29 7 Total 292 322 16111: 961~ 0 X80 16 6 31 F110 0 i 0 Rchooardiograq. 24 0 101 Laboratory Takta: zn-Patiantat 80851 34,095 137 Total 12, 72 748 47,9 9 Phyaicsl Therapy TreAtmentat TA-Patiantal...........'....... 1 193 I296 Out~Patients;' 282 j 4,821 4,752 { 246 2,423 928. ~s+ Total 1,475 10542 6,244 5,680 4 Dietary: (Meals Sorvad).,,..,,,...Cafeteria 4,969 313 ft 14,543 12 883 Patient 89301 ' 5 885 ` other 2,122 1,943 10,014 27451 # Total 15,32 12,219 073 TAundry Lbm:... 43,407 41,094 156,844 1670420 ; Per Patient bays 13.7 16.0 14.2 1767 . asnl,r'eU 8': l9 L,Y't'G°Jn,.' 'Ta}.~ftiA~r1iY~~6~1r+M!.~.~"s~~hYp~itr;~~~ q 0 4 I :~NUARY, Z97$ - - - NONT11LY STATISTICAL REPORT Paso 4~' This This Mo. This Yr. Month Last Yr, To - Last Yr, Date TaCe Department of Dleclicnl Imaging (.Radiology) Examinationst, Xn--Pationto:......... .1...... 764 83 Out-pationts:...........f.... 780 4679 483 Total 1154.__ g I`---Ml 2 y *358 4,425 Mammograms. : f Yg Nuclear Madicloot 64 Zntpatt (htC-Patientientgt.......,........ Total 36' Sonogzatat♦ s Yn- 5 3 Pabientot VYt-patient:at Total 25 Q9GnQY Roots Dept: Ceti 922 717 30556 3,13S I I ~a Ir, i I j r F JY~ '(('MJJ `~'t'81n 44',ut•4rY~a,.RIFN:1j~&[~~~q: r'W/d km.5~a' UAW d~ 1 E' oar a tl+O~ cnv c~v 06 CPU V yYN'=ro mc, ro a~ Amy tie ~ cy ~ ro ~ a ~ I j v J..„ Er lb Y Mr O w 4A a w a ~ s ..4 lob, too w v~ alpr VO V VCS V ' g w ko 1~i rt "R Lh to w N w W ,p N W rv W d p Ill r.l ~ Q d1 _ CA p 6 S to ~ Iti'1 ~ i tU. rxtidr~s~k~tuar~isl.•:r++„x~gidy.~i~+{~. SlTyasl~j`~ i. 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L~' IV ~ ~ Y (QT~~ Y r~ 2D a r 6~t7Y .~~~~y v~~p> ~ (7 ~ VA1 O P~'fD N n ~ s 0 CA t r i f I C IV 4A l i r ~ ~ ~ $ 8 8 tp r) t e b MR)l y..~.!y1 w,.n~.n.~.r ,i.. 'f~r!n hatw.f! Y' xai.4'.. -04 v•fo( n~'r tS<{.<s i»azrAv.tv.4 t[X@Y GX($t{!. 1.+OARD OF DIRECTORS MEETING BUSINESS MINUTES Dal* Jahuat 24 1970 _ rJy. 1 s Vie Flow Memorial Hospital Board of Directors met at 4;00 p.m. on Tuesday* January 24, 1973 with Mr. A. E. Wyatt, Chairman, presiding. Other Board members present were Dr. A. INI. Finlay, Mr, George lfllz, Mr, Brad Moore, Mr, Bob Nichols, M and Mr. Gray Shelton. Also present were Dr. J. K. Dowling, Mr. Wallace Duvall, f~ l Mrs. Gloria Madewell, Dr. J. H. Oliver, and Mr. Dale Wagner. Mr. ' Wyatt explained that the icy road conditions on Thursday, January 19 had caused the Board Meeting to be postponed until today, f The minutes of the regular Board Meeting of December 15, 1977 and the Called Meeting of January 5, 1978 were approved as presented, ! ! Mr, Duvall reviewed the minutes of the Joint Conference Committee Meeting. As a result of the increased number of respirators and ventilators In the Nursery; the present airy compressor is being replaced with a new compressor purchased by a local sorority. He discussed the progress toward the opening of the Neuro -diagnostic and i Behavioral Medicine Unit, and some revenue and expense projections submitted by M Me. Wagner and Dr, Oliver were examined and compared. In order for the unit to ! reach the "break even point, " a daily census of 11s. 8 patients will need to be maintained I It was the consensus of the Board members that the staff as proposed by Dry Oliver would be, appropriate, including the position of Administrator/Coordinator of the Unit. Mr. Wyatt asked Mr, Wagner to carefully monitor the revenue and expenses of the unit 1 and to,report any undue losses. It was also agreed that some publicity would be T i appropriate after the unit Is opened, Mr. Shelton moved that the Joint Conference I Committee Deport be approved] this was seconded by Dr. ;Finlay and passed by voice ! vote, Mr, Duvall presented the Administrator►e Report and fu rther'discussed the ` preparations, and modifications being made for the opening of the Neuro-diagnostic and t Behavioral edicine Unit. He announced that the Joint Commission on Accreditation of Hospitals will survey the hospital about the first of April, and he invited the Board s Tambora to attend the Summation Conference which will be held at the conclusion of the survey, Mr. Hllz moved that the Administrator's Report be approvedi this was seconded by Dr. Finlay and passed by voice vote, 1, t The Utilization. Review Report was reviewed and approved. There were no pro- ~ blems with the Medicare and Medicaid admissions and lengths of stay. Mr. Duvall reviewed the Foundation Report and briefly outlined the status of the " Forester interest note'whioh has not been received, Mr. Hllz moved that the Pounda- ` tion Report be acceptedi this was seconded by Dr. Finlay and passed by voice vote, Mrs Hilz reviewed the minutes of the Finance Committee Meetings' He added that t the hospitalts auditors will be asked to attend a meeting of the Lard of Directors in order to fully Explain the audit report, The average daily census for the month of December was reported as 74, S patients, and the financial statements showed an excess i j of revenue over expenses of $10 000 for the month of December and a year-to-date y surplus of $38, 000. The Bad Debt Charge-Off List in the amount of $te, 0480 78'and y the Charity Charge-Off r,lst hi the amount of $31, 078, 77 were approved as presented, h 1 a , ~;r ; ~'Hi'~tt~,'Yrkm- dw.• -,c vc~yYr ~da9-haNEI. , ~ 4nP i {h •r!:'r ,.r.Y rn?r,~ rY it . i'.'lf.~ A ' t3~ttq Y61sro117 ••a' 619 Rli 141 00ARD OF DIRECTORS MEETING rim; J BUSINESS MINUTES aAa Jairuar 24 1078 ! The Finance Committee had reviewed the collection experience of the various agents 1: over the past four years and proposed the following policy for bad debt actions; i; 1) Accounts with a balance over $200 which exhibit the potential of being imminently collectible will be turned over to the firm of L, A. Nelson;: ' the remaining accounts will be turned over to Chilton, inc., a collection agen y 2) Accounts with a balance of under $200 which exhibit the potential of being imminently collectible will be processed through small claims judgments through the hospital's collection personnel] the remaining accounts will be turned over to Chilton, Inc. This proposed new policy was discussed and then approved. Dr. Finlay moved that th s Finance Committee Report be approved, this was seconded by Mr, Hilz and passed by voice vote, [ Dr. Dowling, who had attended in Dr. Tweet's absence, presented the Report from the Medical Staff and reviewed the minutes of the Medical Staff's Executive Committee Meeting. He presented an application to the Active Medical Staff from Marcel 1. Horowitz, M. D, for privileges in urology. He pointed out that Dr. Horowitz at the present time holds a "temporary" license to practice medicine which expires in.rl+lay, 1978. Dr. Finlay moved that Dr. Horowitz be approved for temporary appointment ' to the Active Medical Staff until his permanent license is received, and upon the ! receipt of the permanent license, the temporary status would automatically be changed ! to regular status, This motion was seconded by Mr. Hilz and passed by voice vote. Mr, Wyatt announced that the Board of Direbtors would go into a closed session { to disoussipersonnel matters, and all nonmembers were excused at 5;00 p. m.: The g Board of Directors reconvened in open session at 8;40 p, m. Mr. Shelton announced the Search Committee recommendation--viz, that Mrs Leonard Watson be offered'the position of Administrator of Plow Memorial hospital at the salary of $30, 000 per years This recommendation wag discussed, Mrs Shelton moved that this recommendation be approved by the board of Directors. The motion was seconded and approved by a unanimous voice vote, Dr. Finlay moved that Mr. Duvall be authorized to remain as Administrator at the full rate of pay until Mr. Watson assumes his duties, This motion was seconded by Mr, Nichols and passed by voice vote. Dr. Finlay moved that Mrs Duvall iegotiate with Dr. Love the present Aneethesi agreement on a month-to-month basis until a new agreement can be further studied. This was seconded by Mr, hilz and passed by voice vote. Mr. Wyatt asked Mr. Duval to inform the Board members if Dr. Love declines this move. ,f 't'here was a discussion of the desirability of employing an Administ: ator/ Coordinator for the Neuro-diagnostic and Behavioral Medicine Unit--specifically, Mr. Ray Thonnsom Dr. Finlay asked Dr. r. Olivor the unit could open all prior to { Mr. `Phomson's arrival, and Dr, responded that right It woul be since Mrs Thomson would arrive soon. Drs Oliver added that he feels that Flow Memorial hospital will have a good psychiatric unit, as It is presently configured, and one that will pay for itself. Dr, Finlay moved that Mr, Thomson be contacted and offered the 1 -1 '7- ~Z_77111111Z 1 1(t 7iY2ISIl i4'ff~yifR ~t'Itlht,l~fk,.q.~,F~flf~~;~RY?+~~+J~l~l ~[f~~ItY}!ar'1!.[b4~1',~~kA.l i N.wYYY r wanv .33OARD OF DIREC'T'ORS MEETING ~L DUSiN&SS 6s MINUTES GHQ Pig, t1 a job as Administrator/ C'oordinator of the Neuro-diagnostic and Behavioral Medicine Unit, This motion was seconded by Mr. Moore and passed by voice vote. a The meeting was adjourned at 7105 p.m. Rex9pectfully submitted, j Gray Shelton Secretary r i + ! gm If f ~ llli y AIL 1 ]ry 11 1 / €,~~1 eM1.:.. . i.....,.yr,, .........i:.;w:Jlr.x>r 1MJ~.[JN xe J/'~"~.SI"~'SC.'G1G@J~ ~ ,~!!h`Cgi{#G ti~~~re~^-"-r_-rsr. t Yu.4t%.k'.Yh^ak'w41 sA rk?W~':i,~tiryC~y;'~~f~1~1fUlr''~i~f~A7{+~ r,~i1~Q ~RYJ`,',; S, ' y }'O. } F'00 ADMINISTRATOR'S RE, Polt'i' ` BUSINESS MINUTES aele Januat'y 19 , 1978 p,q, 1 Subsequent to the last Board meetings a great deal of time and effort has beau devoted to discussions and preparations of the Neuro« a Unit. I have met with Dr, Oliver, Dr, Taboada, and Dr, Leeie/i3ehavloral Medlcfn than met with Dr, Oliver and Dr. Taboada jointly and individually on one occan on thergoccason We have proceeded on the basis of an understanding of the staff required and the physical requiraments. All of the v iIWOWs have been securred, and the electronic looking devices on the doors and the key control on the elevator have been installed, and other miner adjustments have been accomplished. Some additional furniture has also been acquired. We havo not arrived at any acceptable manner of placing the nursing station In the corridor because of the fire code. Hopefully, installation i ' of a mirror to en:,ble visual observation of the entire corridor will suffice, have employed the desired nursing personnel, with the exception of the nurse c on the 3-11 shift, We are also pursuing the employment of an exceptionally well qualified person with a Masters Degree in Social Work to coordinate the unit, i ' Upon opening the unit, hopefully within another week, we will try to have f i appropriate publicity , arranged. Mr, Wyatt has suggested that perhaps the involve- ment of Mayor hlughes and Judge Trammell as well as others would be appropriate, and we will pursue this, ? f As you know, our census has been very high since the Christmas holidays, The high census does not appear to be due to anyone factor. Although there have i been some upper respiratory problems, it does nat'secm to be epidemic proprotions i This means that we have a variety of patients from a large number of doctors, l As mentioned in the Joint Conference Committee's minute;, we are devoting i 7 t our attention to preprtratlons for the Joint Commission on the Accreditation of P, 110spital's survey, We should be batter prepared for this survey than we have been for the prevlou.~ surveys, The renovation project that we completed last year I' enabled us to comply with all of the fire safety codes so we should have no difficulty. i Also, we know whflt is expected in the other areas, so it is a matter of documenting i that we are In compliance with the JCAH standards, the survey team so the An Invitation is usually • extended to the Board members to attend the Summation Conference conducted by t you will have a good understanding of their survey and any recommendations that they might make, Respectfully submitted, I l Wallace L. Duvall Administrator WLDigm f ,y'elF:'MA~r rn Xaly'c1'',~,YSA 1~I'fc4'.rlil{'their?~7y.h~tdlCU`alTkti~i~'r[u~'P~kSYNr.h,p r, 9iy$1A2 1VL4tIVltl _.•+Iw. FLOW MEMORIAL HOSPITAL Monthly Financial Report t January ,21, 1978 January, 1978, achieved an average daily census of 89,1, which was the highest month since March, 1976, We had a high level of patient utilization, as compared to our prior years however, we achieved only a 53,5% utilization of our licensed bed capacity, and only 76,66 utilization of our staffed bed capacity. During January, 1978, we generated $653,000 in Gross Patient Revenue, This was $132,600, 25,5'8, in excess of our prior year- to-date average. The source of this Gross Revenue, as classified by the primary payor, was Medicare - 34.68, Medicaid - 4.5%, Blue Cross - 14,3%, Commercial Insurance - 27,5%, and Self-Pay - 19,18. The schedule shown below shows the profit or loss for January, 1977, and January, 1978, on a ~ f par patient day basis. 't 7anuarw v 1977 Januar 1978 3 Gross Patient Revenue $ 196.44 $ 236,15 Non-Medical Revenue 3,48 4.35 20.0% Total Gross Revenue 199~,9Z 0 50 20.3% z j Revenue Deductions 28.25 '59) 1 20.38 Net Revenue $ 1 1y (7 .67) (5 103.5% ; 18 .91 6.58 Nursing Expense 68,67 67,73 G Professional 9xpende 53,02 61.21 (1.46) General Expanse 39.95 13.% 39,41 ((4.5%) Admin, & #isoal l:xpenae 20.86 19,92 (4,54) Depreciation 9.56 7,61 Total Expense 191. 8 (20.43) . 190.9 (0.48) Gain or Loss $ (19.99) $ ('1,97) Non-operating Revenue 23.90 13.40 Total chain or Loss' 3.,-..991 9 5.43 38.94 The significant increase in gross rovenua reflects our rate inoreaees and an increased intensity of services provided to our pstisitto, The increase In revenue deductions is due to our increased provision for non-collectible account and our adjustment to our alluwance percentage during the last part of fiscal year 1977, The expenses show a deoreage, t due to the increase in patient days, which has the affect of spreading the expenses over a larger patient base. The total gain increase is due E to the mix of increased revenue and decrease in expense per patient day. Year to date, we have generated some $600,000 of gross raven ' of our pr-toe year's gross revenue ds of January 31, 1077. This ;increase was due to a $302,000 voluma varianoe, and a $198,000 intensity/rate g t variance. Revenue Deductions were 20.1% of gross patient revenue through f January 31, 1978, compared to 15.0% through January 310 1977. Nat t revenue has increased $340,000 (22.8%) over the prior year amount, our } expenses have increased $268000 (16,28 over the prior year period, through January 31, 1977, Major components of our expenses ere detailed below. . r a .i.,:: i nx ,i' ,:a., . b :~t, i~t>Ada,;}s;J~,,r•Y~M~`4v%;•bur.6An~i~l~..Mrt~v r a Y.T.D. Y.!'.D. Division 01-31~7d r O1-f1-77 Increase pwrce_ ht me Nursing ~Ij Salaries $ 493,500 S Other 955,800 $ 37,700 180,500 163,200 17 300 8.39 674,000 619,000 55,000 10.64 8.9% Professional Salaries $ 102,300 $ 117,300 $ (15-o0o) Other 492,700 _ 299 700 f12.9;1 $5 9 p0Q S 417 pp $ l191 78 000 64.4 f $ 412.74• i GenexaZ Salaries $ 150,000 $ 154,900 Other 202,000 197 600 $ (4,Q00) a,8; $ 3 p .C.»r. X1_r 400 5.71 $ 346000 $ 70000 2.0; Admin. 6 piaoal f ` Salaries $ 960600 $ 94,000 $ 2,600 f Other 122 400 97 000 { 25 400 2.8; 219,000 $ 19 0 $ 2 00 26.24 ~ 14.6; i I Depreciation $ 851000 $ 851000 $ ~0» ' ,0» } Total 4 Salaries $ 842,400 f Other $ 821,500 $ 20,900 3; 29082.600 838 $00 247 100 21 ~Teta1 1 9 ~8 29.69 16 Thelarie Nurffsing 9ervi0ee Division has utilized some $7,000 in expenses for se and supply costa for the'kauro-payehiatric Unit. They have increased their staffing, which accounts for a salary expanse increase i of appr0xi4M tely $22,000, The Professional Services Division's increase. 3 was due to a $28,000 volume variance in the laboratory and the pharmacy. The change in the Cardiopulmonary Departmani. accounts for Oil 060 of the expense inoreaser the increase in xevanue for this department Woo $149,000. Primary increases within the Administration and FieoAl Aervioes Division ware, interest expense of $19,000 and unemployment insurance of ' a $3,000. ' Patient cash receipts in 4anuary 1978) were $460,000, a;1 increase i { ;187,000 {51.9;) over dor.uary, 1977. We received $90,701 from 'thepCity s and County for the quarterly payment. We disbursed $178,600 for salaries, ! $10jO00 for the quarterly s.1,C,A. payment, and $317,000 in non-salary ry expeng&s- Our cash receipts have exceeded our expense& (exclusive of 1. depe4oiati.on) by $167,040 for the first four months of this fiscal year., The Balance Sheet reflejts a Current Ratio of 2.81 to Y.O. Accounts ~ ' P=4ivOle has remained stable for the past five months, droas Patient Rmvonue has increased 30,86 for the five month period ended January 31, 1978, as compared to the five month period ended August 31, 1971, our Accounts Pecul,vable allowance increased $20,000 over the prior month, # 8~y,} u G..i ei.G. < I C;.id C;fkrh l At, 40 !7, Gres+'Ar2 r"h!xL+;r~;A~r:~#~ 'i U and represents 14.78 of our total patient receivables. Our Accounts Payable amount of $332,000 represents 77,0 days of trade payable oxpennes, And our Contract Foes Payable amount of $208,000 represents 53,5 days of r contracted expense. j i The 7anuazy 310 19781 Financial Statements rofloct the trend this year # of improvement in all areas o; finan-ial performance. Operationally, the high level of revenue ha= j' produced the favorable surplus, even with the increase in revenue,deduacions, and expenses, The balance sheet continues to improve due to the igprease in cash receipts, r 1 ~ 1 j Respectively submitted,. ~ J Dale Wagner, s~( sistant Administrator for Fiscal Affairs j ~ t I ti ~ c f~ ~ I i 3 i I i i :<i,ysd.4}hF'lf411A4 J v~,a,,;o~w~<I•v.:arza~, .r. 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OO ~7 -•I P ~ ~ C V V ~ '~1 ~ V O wf' J O ~ o S7 I k ~I v t1114 r v w • fi S O w ~ O N D O $ $ 5 $ (HG 1 1.a y~ ,p ,app `}N"!V~N! dip Nfn~P W+~I W}N.i ~ cn pol W* .4 ka e co .j : 1 wpppp n. w ~ N N A 6 . s y to v w ',~t+14~}`A4•~.. .r.. ..e.rv.a i.f. ...a•,vtJ~,: ,~s'+ttis~'r~Y++Yh*~{/r+-mfM.lv~~'il h~yJ'~'~9~kf`~,P~q+7E~~~~W'~'~^z4Sw't~~~~, ',p~S~'.'i~~~~n5?'..GTeS 1 {r1 (I t, FLOW M E M 0 R I A L HOSPITAL BOARD OF DIRECTORS MEETING THURSDAY, DECEMBER 149 1978 ; 7:00 p.m. LIBRARY AGENDA 4 j a .1. Review and Approve Minutes of Previous Meeting t II. Review and Approve Committee Reports A, finance Committee--Mr. Hilz 8. Utilization Review Committee--Mr. Watson E j 111. Adminittrator's Report--Mr. Watson { r IV. Medical Staff Report--Dr, Lee a' } V., Old Business VI, New Business A, progress Report on Remodeling 8. Report on Group Health Insurance Proposals C. Review Agreement With Dr, Kagal For Pulmonary Services D. bi ;toss Emergency Room Physician Coverage E. Ot'e,• Business VII, Adjournment r ; t F~ r ti 1978 0/ry o~ ny MAMAG~'N N ' s Off1CE 1 ` 1~~~~1wn•m~~~'Pl~•^`~' .t>a/.RN1'ILNL.W+W~.Yhf4PwrYY.weNwsrN-+nm ••••aw.»cVY.+.n.Y-ri. u.orw. t«. sCl7Ap' ' r,Kk Y 6 i 1 IS l I r y FLOW MEMORIAL HOSPITAL BOARD OF DIRECTORS MEETINGpw ; THURSDAY, NOVEMBER 16, 1078 7:00 p.m. Library NOV 1,j 1976 f + } AGENDA CITY OFDENTON WOWS OFFICE f I. Review and Approve Minutes of previous Meeting F' 11. Review and Approve Committee Reports ' A. Finance Committees-Mr. Hilz B. Foundation Board--Mr. Nichols' s C. Utilization Review Committee--Mr. Watson III. Administratn"'s Report,-Mr. Watson , IV. Medical Staffs Report A. Approve Re-appointments to the Medical Staff V. Old Business VI. New Business 'A. Consider Salary Plan 8. Discuss Newspaper'Ad C, Progress Report on Monitoring Equipment D, Discuss Group Health Coverage r j E• Other Business ; VII.' Adjournment t 1 + a I • 1 .:•,~i[Fi~',~Y+^4WbM0~~1H14RRl~ll•w°114~4*~'.'AIi11~.'~~~~ho' Y~N%:411: Y. to/ nT.•~l~L'a.ti4'.N:YAIIA./tr1{H.rN+W+:F+'i~{If.'i,b.Mr~k~l'R.hii/YSN1•••••,,... `....,41iV{'x Ai{o l,}lf WYVJrv . ""Owl k f BOARD OF DIRECTORS MEETING THURSDAY, OCTOBER 19, 1978 7:00 p.m, Library I AGENDA 1. Review and Approve Minutes of Previous Meeting II. Election of Officers .ti A. Appointment'of Finance Committee ' ITT. Committee Reports A. Finance Committee--Me. Hilz 4 E B. Utilization Review Committee--Mr, Watson J IV. Administrator's Report-Mr. Watson I ! V. Mid Ical'Staff Report-.Dr. Lee A. Presentation- of Recommendations for Re-appolntments to the Medical Staff (to be voted on in November) r ( B. Amendment to Medical Staff Rules and Regulations t, E C. Appointment of New Physicians f of 1. Anil T. Be11ale0 M.O., Courtesy Staff Emergency. Room 2. Dinesh P. Kaga1, M,D „ Active Staff, Internal medicine I, and pulmonary medicine VI. Old Business y VI1. New Business A. Discuss Salery Plan p' , B. Update of RT Contract C. Review Pathollogy Contract r{ D. Status Report on Nuclear Medicine Camera E. Employee and Volunteer Awards Events F. Status of Department Modifications 1. Business Office 2, Emergency Room 3. 2 A . { A. 2 6 4 VIII, Adjournment I e ' A~W AAIY Y.u..... 1~'~4V$154f:`t1+~r~7C~iVi1.V~i:+,`.}A7C5}i,l#i '.~1s.. `;,-:•:•i`5Y'/,Ni tk~t3~1'SY~;W,,'>v~,.S~i rYVYAM~'ff d'2~!A.3'S:Nt. J^N SNi~+.Ul~`'Y~ k.li , ' a ■ rPo r, ~ i awwtsa . P' t } iek FLOW MEMORIAL HOSPITAL BOARD OF DIRECTORS MEETING 7 THURSDAY, SEPTEMBER 21; 1979 7.00 p.m, LIBRARY AGENDA 3 I, Review and Approve Minutes of Previous Meeting 1 ~ fs' I1, Revfew and Approve Committee Reports A. Finance Committeeiii H112 a ` B, Foundation Board»-Mra Moore I C. Utilization Review Committee»»Mr. Watson r ' Administrator's Report.-Mr. Watson f 1r 'I}a Report From Medical StaffIi Lee i V Old Business is V1. New Business r, I A. Discuss CI WCounty Financing Ba Adopt Personnel Policies C. Consideration of Computer Proposals Da Report on Governin Board Meeting-»Mr. Ea Report on Texas Health Facilities ComirfissMoore Mr, ion,Seminare~ton I Mra Wyatt, Mr. Watson ; F. Other Business I V1I. Adjournment f; na, ~ }4 t F V • ~1."+r6~r' f{r~76~r~1~A~!~'E+'fiPS~l\`WYS~t'~.vt5!}1'IMity sr.a::+'.4kyfa tvuilkl kynn. AUw~4s^r.ryl. `•t~.'..VMr1..a i.r:-r,.i1 wW1NalcYa?! A N I J se I` FLOW MEMORIAL HOSPITAL {F' BOARD OF DIRECTORS MERTING AUGUST 34, 1878 7:00 p. m. LIBRARY AGENDA K 1. Review and Approve Minutes of previous Meeting II, Review and Approve Committee Reports ;t A. Finance Committee, Mr, Hltz 5 13. Utllizatian Review Committee, Mr, Watson III, Administratorls Report, Mr. Watson IV. Medical Staff Report, Dr. Lee V. Old Business A. Report on Status of Computer selection y ' B. Report on 5tatun of Nuclear Medicine Equipment C. Report on Auditor's Engagement Letter . F VI. New Business r A. Discuss Board Members' Terms of Office B. Discuss Possible Security Program C. Other Business t VII. Adjournment 'K . I~ IX. Executive Session for Personnel Matters 1 3 7 l , yy, QR4S~~ltiY{.~}Rk~A~{flk.~§li~yir?:kll/"xAr i.ivafbtiv.+.sr. 1 7 ~p1pW...♦: R J 1 1 • ray 1 I Ik(I ~ l w 4S ` BOARD Or, DIRECTOlt1; MPi ETINGr a PLOW MEMORIAL HOSPITAL ~r JULY 201 1978 7:00 p. m. j AGENDA ' to Review and Approve Minutes of Previous Meeting YL Approve Appointments for Finance Advisory Committee ; 1114 Aeview and Approve Committee Reports Finance Committee-Mr, Hilz p B. E'oundation Board--Mr. Hilt C IV. Administrator's Report--Mr. Watson. r; V. Medical Staff Report--Dr, Dowling A' Appr'ove Applications to Medical :Staff 13 Recommend Suspension of physic.'ans VI4 Old Business VII. New Business A. Report on Texas Association of Hospital Governing Boards Seminar B. Discussion of Replacement of Nuclear'Medicine Squipm'ent VIII. Adjournment r, Y%. Executive Session to Discuss Personnel Matter " t I. ,1l i r ' try ~MiRh~'~'M,~kk~M1lAkYt'r>VAiAb1'Ii,rn;.`txwki34~+Meti.:, ..rtia4eair v..w:;4r.+.n 1 'vnti,rsnu.nr;._:a•ia. H;Jtidrv+,ti•E.s.9.+r..aAWB .i.tYr7laYiF/~Wl.,:W1tw. yi1 . Ob • I r xe er.r %f z}fir;; 1 iA7N 1 nlFLOW ML04O IAL HOSPITAL I30AIRD aF DIRECTORS AGENDA a MAY 18, 1978 7.00 p, rn, Library I. Minutes of Previous Meeting z f IZ. Committee Reports A, Finance Committee t I3. koundution Board ~ Mr. Hilx Mr.' Nichols TII. Administrator's Report Mr. Watson IV. M;;dical Staff Report _ Dr. Lae ! V. Old Business r t VI, New Business •E y A. Medica.llll►uxsfn j B. iltilkation Review Committee ilRepoBrt port CJ Report on Ambulance Service D. Flans for 213 j Presenthtion of pathology Contract AMhk Discussion ofgionalServicem Iarneraeter Contract Report on Roe dJ eno I H. Discussion of Blood Bank g Y Modical Services' system - ~ ~y~r 4 f • 4 Y,µ, Adjournment { 1` G} . n 1 ' (~reP4.v\V1S'Rnl4~SFl+at~.a mi+ dMNaf'x..P~ni ea4JUS 1biA)02u4^~ P r r-k~ AGENDA ( BOARD OP DIRECTORS FLOW MEMORIAL HOSPITAL FEBRUARY 23, 1$78 7:00 p.m. LIBRARY AGENDA It Minutes of Previous Meeting i it, Committee Reports M A. 1♦'ktfanoe Committee Mr. Ililz B/ Joint Conference Committee Mr. Watson C Util zatiort.Review Committee Mr. Watson f ' f YIL Administrator's Report Mm Watoon IV. Medical' Staff Report Dr. Lee V. Old Business V1. New Business V1I: ' Adjournment o f F~.C 2 'CITY Qf DENIj Qy : 1 AQ~'c~ OPmE A I i 1 /..HII. ~YG4«1•{'4:i. Ir.Y I.:..p Af u'; !.IYA AtiM1J•.. . ..VU. h Liw IN,,1lNr: YY~y~~lA~liA Nle't~'S~ri~~PSA~#SIdW._c •~I'i )F Wn,y/ I ~Ili!'r~~Re,l'!IYAI`NtW nt~l~t. la.'I I' t,, r a y RRR Vt1A91t 1 , i F 4 AGENDA JAN J. ! ..,rd BOARD OT UIRUC,'7 ORS PLOW MEMORIAL HOSPITAL CITY Or r JN R MANAGER J OFACE JANUArtY 1 J, 1978 s 7;00 P. m, LIBRARY f r: AOE ND A i i I. Minutes of 1'revioun Meeting ! II, C'OMMIttee Reports A. p'inKnce Corrtmittee Mr, Hilra B. Joint Conference Committee - Mr. Duvall C. Foundatinn Board of Dircotors a r s on Review C ommitt Mr, Duvall E ' JII, Adminlstxator'c+ Report Mr. Duvall ,r IV. Medical staff Report ` Dr. Lee a V. Old Businoss VI. New lusiaess c a ` VII, Adfournmont 5 f r ~~~~}~YIfdFWVa+WVIk.R.+ras•'wtwN.._. ..r...H ia..i.a w,.a.r.u .nv...rt'.uMn.w,f<... oSy N~¢~G'Al%ga~Sk'ra'?~F.a'H wNaa.~„, BLOW MEMORIAL HOSPYVA1, \t, 130ARD 0I- I7IREC'rOIIS AGENDA DECEMBER 15, 1977 7.00 p. m., Library 1. Milrutes of Previous Meeting it. Committec Reports A.' Pinance Committee - Mr. Hilr. 13, Joint Conference - Mr. Duvall III, Administrators Report - Mr. Duvall IV. Medical Staff Report Dr. Love , A. Re-appointment of Medical Staffs (Active & Courtesy) 13. Re-appointment of Dental Staff i V, Old Business VI. New Business A. Utilization Review Report Mr, lluvall 13. Other New Business , VII. Adjournment Y i f r y:.,nk rreyY,kf}:'A'ANY,:DS`9+kNltiibl~'y~t~y'~:1~~1x"~r.ew.. 'ierA, e ~ .r i; u AGENDA )BOARD OF DIRECTORS FLOW MEMORIAL HOSPITAL ~ NOVEM13ER 17, 1979 r 7:00 P. M. y U 1. Minutes of Previous Meeting 11. Committee Reports f A. Financial Report _ Mr. George Hilz B. Foundation Board Mr. George Hilz C, Utilization Review - Mr. Wallace Duvall III. Administratorts Report Mr. Wallace Duvall IV. Medical Staff Report Dr, Stewart Love V. Old Business . Vl+ New Duainess V9. Adjournment r ,F 04 ~U r NOV 12197 CITY OF kANAO OFTON lot. x AWh)rV1.Sbt4fYMknyp+.re r. •.w -uNY~ •a 'F AGENDA 130A RD 0F' DIll I;CTp~$ FLOW MEMORIAL HOSPITAL 4 tl j OCTOBER 20, 1977 ~ I 7:30 p. zn, I. Minutes [I, Committee Reports A. !finance Committee {f+?'~~~~~ P~ H. Joint Conference committee 0~T 171977 IIi. Administratorts Report r 1V., Medical Staff Report jcIIY Old Business t i Vi. New 1usiness + A. utilization 7toview Report I ; T3. Legislative Report C. )election of Officers Vll. Adjournment Y ~t. Nr v#V.FIYMYa.4MNrr ! / ~ lW,-a FI(1,1:• 1 14 t: r i; AGENDA, BOARD OF DIRECTORS FLOW MEMORIAL HOSPITAL, SEPTEMBER 20, 1977 7;30 p.m. 1. Minutes II, Committee Reports A. F0 atice Committee i Mr, Testa 1 133, Joint Conference Committee Mr. Duvall i C Foundation Board Mr. Hilx Ill. Administrator's Report - Mt. Duvall IV. Medical Staff Report - Dr. Love 3 V. Old Business VI. New Business A. UtiltUtion Review Report - Mr.' Duvall 4 ; B. Legislative Report - Dr. Holladay VII. Adjournment ' Ys sEP i s !r CITY OF DENTON MARMER's PRE Y!#~h4k,V~.IYUd>nY•c-;'kiNl.ki.+a.:ela 4+a .U...,.s. ,..r ....,...w a. =4Yyt ryiLyil~ YIP1Rr.c~a7iNi1W9Fn_.,w... 'K S>; gg x- 1 ,i AGENDA I30ARD OF DIRECTORS FLOW MEMORIAL HOSPITAL AUCIUS'r 18, 1977 j 7:30 p. M. 1 ~ 1. Minutes I I ~ ?I,. Committee Reports A. Finance Committee - Mr. Testa B. Joint Conference Committee Mr, Duvall III. Adminlstratorls Report - Mr. Duvall IV. Medical Staff Report - Dr. Love V. Old Business VI. New Business ` . A. Utilization Review Report ~ Mr. Duvall B. Legislative Report - Dr. Holladay p' VII. Adjournment ' x i i 1 • ~'j,(xEti7:Uiif.r1~FN''k'ts.i14.iV+4..w~araacu «n. ..........o .rv+.4r.? a.. m:~-:r • .xa.y%;c. Px"ririiiMYP .59'2?i3Ffi 7k~N'ir A. •I:.y: 7 i i I ti AGENDA BOARD OF DIRECTORS FLOW MEMORIAL HOSPITAL APRIL 21, 1977 ii E I. Minutes II. Committee Reports - A. Finance Committee Mr. Testa H. Joint Conference Committee - Mr. Duvall E III, Administrator's Report - Mr. Duvall IV. Medical Staff Report - Dr, Love V, Old Business r' V1. New Business A. Utilization Review Report Mr, Duvall H. Legislative Report - Dr. Holladay VIL Adjournment 4 i d AvH 18 1977 CITY OF DEN 'ON • r MANAGER'S OFFICE F' z %tOfN1'M+4~6t1:k6;bAaaaraA.,s',cu.4N..,a+„aai.. . *a .z~lklrerv.•v.•~,. ,.,ets..,.g,CUZa+P'a1afk'Fd~?sllts.'~.y.%:»-'. _.vr,,,,. k+ S r'!t E AGENDA ' 130ARD Of DIRECTORS FLOW MEMORIAL. HOSPITAL E i MARCH 24, 1077 I. Minuted j Committee Reports i A. Finance Committee - Mr. Testa B. Joint Conference Committee Mr. Duvall ( C. Foundation Board III. Administrator's Report Mr, Duvall IV. Medical Staff Report Love k V. Old Business . VI. Now Business LJ A. Utilization Review Report - Mr. Duvall B, Legislative Report - Dr. Holladay VII. Adjournment 5 l~fn; r r M~II r 2 ~ r~~~ . city ~~'R,5° ofir~N wrq i+avf19A7#MW14}Mtriy'J4^ry:ra...,kre+,.4.•aWYr: vr-.a,..I c... _..w~ns.r,:. a . iW}x':l 1•ini .1 \...1: rY9+Y Y,NI*AI(1S Y'ln Y.+ry.,!iiF~WC4a1Si~.'vfy{f~lt>Y{\ti:!d'AiSvW'.: r rYrR'. r 4 I 7YL1. r.. , r TOUCHE RQSS & CQ. 2001 BRYAN 70WER, SUITE 2000 oA~~~s,rexAS rs2o1 ' December 29, 1976 1 1 1 I ~ ~ Board of Oirectora E j t+low Memorial Hospital ~ k Denton, Texas ~ ~ we have examined the balance sheet of Fiaw MemorieY Hospital, ~ apolitical subdiviaicn of the State of Texas, as of September 30, 19'76 end 1975, and the related statements of revenues and expenses "1 and changes in fund belanaea, and changes in Cinanoial position Ecr wJ the years then ended. Our examination wee made in accordance with generally aocepted auditing standards, and aocordingly included such testa of the accounting reoords and auah other auditing proaedureg ~ r as we aonaidered neoeasary in the ciroumetanoes. Yn our opinion, the aforementioned Efnan~ial statements a present fairly the finanoial position of Fiow Memoria}. Hospi~el at September 30 1976 and 19'5, and the results of its operations and the ohainges in its finanoial position for the years then ended, in aonfurmity with generally acoepted eocounting .principles applied on a consistent basis. Y Certified public .Accountants 1 (L• } 0. u '3 ~ySMPruxaf. w....,....... r.......... .v„ a,..; ir...~ d..r .esn}eea1:7 .n'lyjtiFf: ~!k+:!1 ~,(.r +.~rd sXaf~~, ~ ~+fu F?~~Y1; ,L.i~'4YMi$1~jAf~.:.. ,,Y~ , ~ A C F.. maw "M Foe mm F~ PM MGM M~ 1 "104 W" mum MM59 mmm a 1 w.,:; ~ O p~p1~ F+ T. !Y t•1 ~ A ~ G trot CC (p~f~ C O~0 p .7H G~Ar ID ro ~H0 RO M r~ py M O~ ~q +~ti+• N0<00 m j A M H BMO% OfMfDD CON w~ ~~z~I ayro D oA 1WD Crt~ !M 09 O,y O WC! 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H H co N I! % W to O H W 00 q q H is KD N W0co-j H N Go W co 0W1 HO d+ tD W N fppf 4A -W C N rD W W ~ q N W ON pi W to O A VI VI H d~i J N I O ` ` O A UI ~j 111 W ~p Ch ` `w V v v p ~O H W Ul N FN' W -4 0 OD 00 O W Ln t) O HH i " - rat i .b,W1 a H ci fd w c I R ~ P ~p f7 n ro H ro pEp ctrl y ~4LLW M fy, H roM MnywH Q i7 o (0 rt 0 PIN C4 rt f Y y ro a to Ci N G, ~ 0, z In fD O ~ V~ Q Tff N pj t~A V! frt p { P (D rt o rHn a ° ~c~ (D H. H I. a~ ro writ d n w v cwt " ' ~ i' rl ~ P-h lot C { IW a Di' w to OM Kok ' ~ W n ,.ti <n 1`. ~ 1-+ H 1~ ~ ~ pa y ! tv W W W 00 b In w (a Iay ! V ~ Ut W N 00 N H CO W ei 0 v a I In b N 4o W Gn b If v v 00 N W O C75, V LO 0 In N W V M VI Co V In 0 ap ~ N ~ N t] ►r f4 %0 N 00 F` W b O~ N %0 O V V fh tHYJ W v W O W F M 00 O V 000 W W 00 v t7 1 i iA 1 1-+ I 1 I 1 I 1 f I 1 I f I ! I I I V Y yy W MN \w( ib& 00 4 00 1 00 Ill Q ~ t W W p w „ look f~ W 1-l W Y y W N O W N Vwb+ O F WW~CWW W F ~O In N f+ b! W 00, N In O+ ~G W V {JI W tp Ch N VI ~C 00 In N F-~ y Q~ b l1t t0 M, Op w V+ LA 00 N N tD C~ aaW++ l••l v ~ b v OD w ~D Ot1 ~O ~O V oo ~O w N ~ E 1: i W W W WILD y Q1 1 I 1 1 I ! 1 1 I 11 I I f f 1 V d ww ~ •cn II I I, I 1 I 1.. 1 1 _...I. I 1.. j ,,I ' _ S.'......J,', J 1.. Q 4 . I,, C R W ~ HHH ~ ~ N W 41 W W W Co NP~ 01` to f-! Y Y F2 00 W CWi l~ii O Hc114 o Uri N N00WwV O O O H Ili 0 O00 00W~ O I; 00 N W O% V W Y Vi H W V In Vn 00 V In 00 Co n1 o+ 'o N N N 00 W O Oh 1-'~ ~0 O V V O\ O to 0 V1 o W VI 00 v ~ O V 00 VI fi H W 00 H kp Y V N W W W W N£00W. O N d W N co ~ QS H co V~ Q W W W W W %0 cn V Y 0 l' W N 000 O LA t O H ON N LA a% 00 W W ~0 ~n 0\ N 4t 50 In 0o N N 10 rn tD ON H u ~ O ~ ~ 00 W ~D 00 ~O V co 10 W N ~ II I i ( j. i i 1 1 X19. ~ '....r.a ...J ~ _,J I:. N'~ l.e....~~ I I Iw.~.: ~w..l ~.w....: t..,r...: t....r~ -,~t,Y; 1 1 Iv: i MONO ti TOUCHE 8083 Co. FLOW MEMORIAL HOSPITAL STATEMENT OF CHANGES YN FINANCIAL POSITYON UNRESTRICTED FUND Year ended Se to be 30 SOURCE OF Ff1'ND;r Hospital operations: Operating loss Depreciation $(385,703) $(3200561) - 2-~:S-10 2, 033 } Funds used by Hospital operations w {]65,193} (116,628) ~ Nonoperating revenues 1 I - 3-- 3~'?83 ~3~08,9 54` Funds Provided by Hospital opera. tions and nonoperating revenues 164,990 192,326 Increase in notes payable, less current maturities Transfers from Restricted Fund 58►459 58035 4~9 -~~w APPLICATION OF FUNDS: 2700440 260,402 ~J Additions, to property, plant and equipment - 169,385 ' INCREASE IN WORKING CAPITAL _J 1`"`~'S5 ~ 101 055 158 3 v~ CHANGES IN WORKING CAPITAL COMPONENTSs Increase (decrease) in current aesetsI ` Cash Receivables $ 109,152 $ 62,532 Inventories 17o,466 1210612 Prepaid expenses 75,278 ( 2,527) Due from plant Renovation Fund 13,844 ( 4,606) 20 ) 31 6 195,187 208,307 increase (decrease) in current liabilities Accfutlts payable r Accrued expenses 34 171 Ile Current maturities of notes payable 26.559 ----10, _ _4_,! 2 __99,960 INCREASE IN WORKING CAPITAL 1 1 055 15 347 Sea notes to financial statements, L .lr 1 TOUCHE 8098 & c0. FLOW MEMORIAL HOSPITAL NOTES TO FINANCIAL STATEMENTS YEARS ENDED SEPTEMBER 30,t 1976 AND 1975 A. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIESa i 1, General In 1971 the City of Denton, Texas and the County of Denton, Texan by mutual resolution reorganized Flow Memorial Hospital to E operate under the authority of Texas Civil Statute Article i No. 4494(i)-l as a joint city-county hospital board, without taxing I powers, and to be designated as Denton County-City of Denton, Texas Hospital Board. ' The Board is composed of seven memberel four appointed by the Commissioners Court of Denton County, and three appointed by the I City Council of the City of Denton. # 2, inventories Inventories, consisting primarily of pharmaceuticals and ; supplies, are stated at the lower of cost, approximating the first in, first-out method, or market. 3. Third-Party Rate Adiustments Revenues Which totaled $1,446400 and ,$1477,000 for the years ended September 30, 1976 and 19751 respectively were received i from Federal and state governments under provisions of Public Law 89-97, Title XVIII and Title XIX, known as Medicare and Medicaid. The 1976 revenue is subject to audit and retroaotive adjustment by third-party payors. Inasmuch as these adjustments are subject to final settlement, any difference between the amounts accrued and the amounts settled is recorded in operations in the year of settlement. 40 Lang, Buildings and Xauipment A Land, buildings and equipment are recorded at cost, or, in the case of property donated to the Hospital, at the fair market value at the date of the donation. Depreciation is calculated using the straight-line method over estimated useful lives as foll.owss ii Land improvements 5 - 15 years j buildings 15 - 35 ears Parniture and equipment 3 - 27 years U k . lk.n.rtiwb.a.nwauw: v. nw .....4.Ja..:q.„J-.:.. , i A 1 T000HE 8093 & CO, Y££. E r FLOC MEMORIAL HOSPITAL NOTES TO FINANCIAL STATEMENTS SCONTINUWD YEARS ENDED SEPTEMBER 301 1976 AND 1975 A. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTrNUED)r 5. Contributions N1 Contributions which have been restricted as to their use by the donor are credited directly to fund balance of the Restricted J Funds. At the time the funds are expended for the purpose specified by the donor, the related fund balance is transferred to the Unrestricted Funds. Contributions which are not designated for a specific purpose by the donor are recorded as nonoperating revenues j in the Unrestricted Fund. The Hospital does not record the fair value of contributed services received since no objective basis is available to measure the value of such services. , f 6. Pension Plan The Hospital sponsors a money purchase pension plan covering all employees over twenty-five years of age with at least one year's continuous service. Plan participants are required to contribute two percent of base salaries and the Hospital five percent. The Hospital's policy is to fund the five percent contribution i currently, reduced by any nonvested participant forfeitures. The total pension costs included in operating expenses are $36,114 (1976) and $31,665 (1975). 79 2no9me.Taxes The Hospital is exempt from Federal income taxes as a politi- cal subdivision of the State of Texas under Section 115 of the internal Revenue Code of 19546 B. LAND, BUILUINaS AND BOUIPMENTi Land, buildings and equipment consist of the followings September 30 Land and improvements $ 1320586 $ 132,586 Buildings 1,9191584 11919,584 Furniture and equipment 2,684,760 20,532,t542 2~ 542 4,7360930 41584,712 Less accumulated depreciation 2,355,223 2,151,880 2 381,707 2,432.832 i~l 14 i TOUCHB ROSS & CO. FLOW MEMORIAL HOSPITAL NOTES TO FINANCIAL STATEMENTS (CONTINUED) j.; YEARS ENDED SEPTEMBER 30. 1976 AND 1975 ~.1 C. NCIES PAYABLE t Notes payable at September 300 1976 and 19750 consist princi- pally of notes payable to banks for the purchase of equipment. The notes bear interest at rates of from 58 - 68 per annum► and are collateralized by equipment with a depreciated cost of approximately E $153,000. Scheduled' payments on the notes, including interest, are f as follows: $48,900 - 1977; $41,000 - 1978; $41,000 - 1979; $31,000 - 1960; $17,000 1981. D. FLOW MEMORIAL HOSPITAL FOUNDATION, INC., During the yoars ended September 30, 1976 and 1975, Flow Memorial Hospital Foundation, Inc., a tax-exempt not-for-profit organization, contributed $24,725 and $34,638, respectively, to the Hospital which are inoluded in`nonoperdting revenue, and $46,991 and $4,985, respectively, which are restricted as to usP and are M credited to the Restricted Fund balance. 1J E. PLANT RENOVATION FUND: During 1975 the floepital began a project to expand and improve its existing building and medioal facilities. As of September 30, 1976, this project had been subst4ntia]1y completed. Financing of the project was accomplished by a $07,410 grant from the Texas Board of Health Resources under the Federal Hill-Burton Program (Department of Health, Education and Welfare), and the issue of $370,000 in Denton County - City of Denton# Texas Hospital Board Revenue Bonds, At September 30, 1976, approximately $32,000 was still available to the Hospital under the grant, and all of the bonds were issued and outstanding, i The bonds consist of: Series 1975, 6,98$, due July 1, 2000 $ 2900004 Series 1975-A, 78 - 7.25%, due duly 1, 1994 _280,000 5 0 0 Repayment provisions of the bonds are as followar Series 1975 - The bond agreement calls for scheduled principal payments aggregating $60,000 during the period July 1, 1979 through July 1, 1986, in amounts ranging from $5,000 to $10,000 eaoh year, The remainder of the bonds become callable for redemption beginning duly It ~ 19871 and are subject to mandatory redemption each July 1 thereafter in amounts ranging from $10,000 to $25,600, !a TYi :a.:i! Vd v. :NY-45'a (Ipri ~~~,y ti Mai h ` X14 rauaHE Ross 6 co FLOW MEMORIAL HOSPITAL NOTES TO FINANCIAL STATEMENTS CONTINUED YEARS ENDED SEPTEMBER 30 1976 AND 1975 I~ ! E. PLANT RENOVATION FUND (CONTINUED)t Series 1975-A - The first $120,000 is } installments on July 1, 1981 and 1982, andybears interest at 78 per annum. The balance is due at the rate of $20,660 per year, beginning in 1987, and bears interest at 7.258 per annum. The related bond agreements contain various restrictive covenants including limitations on additional long-term debt In addit:ion$ the bondholders have a lien on all net revenues of the Hospital. i Interest on the bonds of $35017 has been capitalized during the period of construction. F. UNRESTRICTED FUND SALANCEt The sources of the unrestricted fund balance are detailed as followst Se tember 30 Operations awl County of Denton $(1,05701) $(,1,6960071) City of Denton 1,696,87871 10693$166 Flow Estate Bequest 393,166 393,166 Federal Grants 1240,461 ll7,871 t071 Pledges and Gifts ,7170871 1,717 278,956 265 3a7 0 i89 Q` 3r28t713 713 s, 'wAl}ulYlwge M'h✓/INM'A4'..i.HluYrv+. r.tiYro -.Ia........ >YI"o J'w.ry'YIj6M r,vs,:xYb fui•M+.'(( t t,Il.. i • • i X11 L11 lX M"i A sonar 1 x U TUuclre Ross & Q. January 13, 1976 Board of Directors Flow Memorial Hospital Denton, Texas Gentlemen: I! in connection with our examination of the financial state- ments of Flow Memorial Hospital for the year ended September 300 1977, we have reviewed the Hospital's accounting procedures and system of internal control. The purpose of such evaluation is to establish a basis for reliance on recorded transactions in defier- mining the nature, timing and extent of other auditing procedures that are necessary for us to formulate an opinion on the financial statements of Flow Memorial Hospital taken as a whole and, there fore, would not necessarily disclose all weaknesses in the system k which may exist. The objective of internal accounting control is to provide reasonable, but not absolute, assurance as to the safeguarding of assets against loss from unauthorized use or disposition, and the reliability of financial records for preparing financial statements and maintaining accountability for assets, The concept of reason- f able assurance recognizes that the cost of a system of internal accounting control should not exceed the benefits derived and also recognizes that the evaluation of these factors necessarily requires estimates and judgments by management. The problems and weaknesses noted in our review of the Hospital's accounting procedures and aystem of internal control were not of such magnitude that they would significantly affect the fair presentation of the financial statements taken as a whole. t However, we noted during our review certain areas where improvement could be made. We trust these comments and recommendations as not forth in the attachment will be of assistance to you, and we would be pleased ' to discuss any of them further or to assist in their i0plementa tion. Yours very truly, Certified Public Accountants a 2001 BRYAN TOWER • SUITE 2400 • DALLAS, TEXAS 76201- (214) 741.3663 y* L ry Y , J td4 . N 4 e ' &)SS & t~ FLOW MEMORIAL HOSPITAL INTERNAL CONTROL COMMENTS AND RECOMMENDATIONS YEAR ENDED SEPTEMBER 30 1977 Accounts receivable . dross patient receivables increased approxim (760) between atel September 30, Y $700,Qoo During' this same period 1476 and September 30► 1977, x deteriorated , the aging of accounts receivables days, and aeaounrsnmore arhan 214 of total receivables. u150adaysgoidcinoreasedogrom 17% to i We are aware that the Hospital has recently hired manager► and attempts are being made to reduce the level collection receivables by increasing the collection rates stand that theca has been an increase in self- We also unde f r- f cases admitted by the tiospitai, pay e charity We recommend that the Board closely monitor the vel o J receivables, the related allowance, and the write off of ` uncolleatible accounts in order to be constantly aware of the Success of collection efforts and the yy ualit of the - ables in general, and to ensure that unaolleotiblo accountseare being promptly written off, j We further recommend that the Hospital develop a formal R with regard to the ubtf accounts, Such a calculation of the allowance for doubtfuay l ~ > age of reaeivabiesbeiregerved g~paenify that a certain pesent- the aging of receivables and the mix `ofrre eivableseb based on ta# payor, The percentages used in the aaloulation Should ybeybased ~r on the Hospital's write-off experience, Comouter Service Bureau } Under present arrangements for computer Un data F dependent upon its service bureau forr uninterrupted pdat 4f Processing, The Hospital also depends upon the Service bureau for the accuracy of programs and changes thereto, for the security and confidentiality of Hospital data files► and to . Some extent► for backup copies of important master files transaction listings, and As a normal part of our audit procedures, we requested but did I not receive a review of the bureau's internal independent auditors, in accordance with the Amer! an institute 1 of Certified Public Accountants'A+,tdit Guide, Aud tS of Serv ae~ Center-pr ~r: aluaed Records, i i n i t r F : 1 i 1 , 1"dw Ross & Co. We believe that the Hospital should request the service bureau to provide a third-party review, made in accordance with the audit guide. This review should encompass, but not necessarily be limited to, the following questions: Does the service bureau have an adequate disaster contin- gency plan? Does the service bureau have adequate formal plans, which have been tested in simulation situations, for alternate processing in the event of temporary equipment failure? ` - Does tho service bureau have adequate segregation of duties betwe.an programmers and operators? - Does the service bureau maintain offsite copies of major roaster files, source programs, program documentation and operating procedures documentation? 11 Does the service bureau have adequate security to prevent unauthorized access to the Hospital's programs and data files? The answers to these and other questions could disclose E weaknesses in the service bureau's controls which should be i i compensated for by controls within the hospital, or which would E require a revision of the service bureau's system4 Bank deposits 3 `i Hospital receipts are deposited at the bank daily by an employee, We recommend that the feasibility of an Armored car i pickup; of cash be investigated since such a service would reduce the opportunity for robbery and eliminate the risk of harm to a hospital courier in a robbery situation. i tfi Ix,i} 5, 1 r. Il i 1 arl~ i "U i`e~v'^t' rM1~ .tt { '1,. t. 7 r~. e„ t_r r ^I+. r4 `~i iic., 4 I ti e f k ~jy~ it. . _ •4t,,,it, i' s.e'^dh y., r 4 a' f 7t l F , C rrCCll +otm Ross G9. December 27, 1977 ! ark . Board of Directors Flow Memorial Hospital Denton, Texas r¢.~ We have examir.4d the balance sheets of plow Memorial ' Hospital, a political subdivision of the State of Texas, as a September 30, 1977 and 1976, and the related statements of revenues and expenses and changes in fund balances and changes in financiai position for the years then ended, our exami accordance with nations wars made generally accepted auditing standar"ds and, , i accordingly, included such tests of the accounting record ybid such other auditing procedures is we considered necessary,,, %n the y~ airaumstanaes. in our opinion, the financial statements referred to above present fairly the financial position of Flow Memorial Hospital at 'I September 30, 1977 and 1976, and the rebult6 of n, r the changes in its financial its operations and Conformity with generally a0rsep ed accounting principles applied on A ! 1 . r Certified Public Accountants Rat ' ' , r ~7 6 F i X r IJ4~' 2001 BRYAN TOWER - SUITE 2400. DALLAS, TEXAS 76201- (214) 741.3663 ' r `I iNA~}Qt~j(~IV 6Y{kaPa'.CdW n.ry..,.,.:.. e,_„. ( ! .-ekI ~i t7. SAM VOW S F ; F m i5.. N b" iA n~Hp N yy rr ~ ro r~ro a x~~ . 1 H l€f py b~ M FL b M p%. pNp tD 118 g l~ya~fif & g w v, 00 P. 5 ; C> 1) z Q 1.4 ~ n ° - H Ogg ,.~~a : ro is gr ~NNOViN 4; r M~ ro 10 pp~€€ ~ ~ ~i ~ f+• M n 0 ~ rh 1.+ F,, ~Fs P ri tb rh ~OJ V rr~~ v► V 0 ar' AN w Nn ..N d' biro ro caw ro r' J w W Ir + ` +d t,~;; ~ I 11 f 1'r w W tp W 1~1 N G O W ( dbh p }1 i ry mod w P U1 45 i(7t y ~ ~ W w N 'Nl M rt ~ Nr ~ ad ~ w ow i,1n, app,, W 00 a W N cn W w we a, I OeNd W rv V Cn COdaiOwiW x, ~ n r' ~l titw QQ q CS Fy r} ft d €D R et ti ro r. N ro~~wr~ ~ ~i "d , r7 ~p Jdr r I~f~lLL~ It Aro ~`~€9tlWU . N SfS .w a `VWV` ;Vk1YM~ F.. Mr ..n•.nr. et y r 44 1, }g ~r € k3~9xF.^{A{~'~i' A'~•r~.~v~a'a PSn:?. x1218 ~..."R§yt~~F~~3~F'i~,8~~i~` NA~7Md~9'~! I~ r r Om . E ttt ~ N N N ,y rt~• , I ~ w i r u+ f+ e I I I! 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M W 4 t M "C 9 Ar n f N rT ' 4 A f r W W r Y-tf W v Owi l}!1 I 00 J w J ppN)~ a, O J 0 'D W J OD C~ I,;I I V1 O } N J O Nw A J OVNObONO pip O Vwl VJI N J ~O yy}} 001 Wp * • ♦ • •W r ♦ OVi I i.:s ~ rP {~iIW CO W Ob~Oi.CA A J N W V ` r} W J !n W W A W m W Op U1 P W 41 N r I . ~ ~s;, N W w M~ t 1 ! I ! I I I 1 I. I I 1 I l I J I I ~ W}W I I I I I I I I I I I 1~ I I I V b ' o to W WW } WWW } w ah 13 d~ m A I ~ W N ~ N N40O~DJ } W C.~p Gy ~n pwp ~ o W o, ~ popo ~ w ~a ~ ~m1 N w C~ r s44~' r ` FJ"' ta~f OwD ~A yW~ O n w ~0 0 V V ^ p yet (0 N. E r aly W W UI OD V A OJOD LA A. F' W Op il' ~;F ) W I ~ O~♦ I I I! I... I I I I{ 11 I I I I ~q ` Imo., W W N fIJ O~ ?6; i , M I ~ I~ I I fI I. I I I I II I f I I I ~ I r' a a ~ ~ I W WWN } } lA ~ V dV0 N A ~ w J HUE .c. W O ♦ • ♦ ♦ • • % app .I yI O VI. UI N 1~j N N I O W to v N C , } lWr y~ 6~.~7 OD Ob ; N.. N i.- v V oWO VWi W N V+ W w W eo w m UI O 1/I S pup I w w N OWD N W W OW (~yy • a • W 4Ni pyO~~~ MOOD tr~ppD,Op JW 0, C Op IOd W iA p0 W N I V}I O w L" pWp w rA D•4 pQp 111 W b ; t W I l«'~ll 1' p... a z a 4z&1.x,1 FLOW MEMORIAL HOSPITAL ,~3s STATEMENT OF CHANGER TN FINANCIAL POSITION y; UNRESTRICTED FUND 5_ eptember 3p ~ 1976 SOURCE OF FUNDSt Hospital operationst ' Operating lose 466,292) $(385,703) 260, 701 220.510 Funds used by Hospital operations 205.581) (165,193) Nonoperating revenues 'I 378 gig 33! 0_i83 Funds provided by Hospital ` Operations and nonoperating revenue +I 173,35 vA~ 164,990 Increase in Ion term debt, less current maturities 557,258 58t459 ` Transfers from Restricted Fund _452,247 46x991 v 1,182,842 270,440. APPLICATION OF FUNDS: Additions to property, plant and t. equipment (net) 112_ 0~9 518 f 169,385 INCREASE (DECREASE) IN WORKING CAPITAL ''"t 26 676) 101 0 5 CHANGES IN WORKING CAPITAL COMPONE"NTSt Increase (decrease) in current assetst Cash $ ( 268, 026) $ 1090152 ik Receivables 637,168 "~~>>s Inventories 17,466 30,451) 75 Prepaid expanses and other assets ( 1 397) ( 1278 a Due from Plant Renovation Fund 24.3843,544 a 312,910 195,197 Increase (decrease) in current liabilitiest Accounts payable 368t271 t Accrued expenses 34,171 > Current maturities of long- ( 27,816) 33,402 , term debt ( 869 ) 2„6.559 "339,.586 94,132 1 INCREASE (DECREASE) IN WORKINGS CAPITAL t+° 2) 1 1 0 See notes to financial statements, . y I.W . 'TiM 1Y GAiW /.Ny`A i1.l dib yhF.!rYiN 44 rL ♦ :4• W~.4 JG4.4.y:6 V:u. a.w..piL lwVtiosw .V.M e. weti L~< uer, i n. :kepi.. 1 y L ~1 w rl A a, µ . FLOW Mt'MORTAL HOSPITAL NOTES TO STATEMENTS Irk,, YEARS ENDED SEPTEMBER 30 1977 AND 1976 rp A' SUMMARY of SIGNIFICANT ACCOUNTING POLICIES, 1• General , Texas by y utu the City of Denton# Texas and the County of Denton mutual resolution reorganized Flow Memorial I~ospital to Operate under the No. 9494(i)-1 authority Of Texas Civil Statute Article k powers, and toabes adesignapoint citedty-ascount owers, Board. Y hospital board, without taxing P Ht&l bentori County-City of Denton, Texas I•r The Board is composed of seven memberet four appointed Commissfgnerl a Court of Denton Count by the r City council of the city of Denton, y' and three.appointed by the 2 j' . Inv---Vemt~ Les Ynventoriera r consisting primarily of pplies, are atat.ad at the lower of cast, approximating and in, first out method, or market, the first. 3. Third-Part R ~ • ~ ate Ad ustments rk Revenues which totaled I~ years ended September 30, 1977 andl1g76'000 and 9'1,446,000 for from S~ederal and state ► respectivel the Law 89-970 Title XVITT and ernmen Tftlets XXX under Y► were race Medicaid, provisions of Public The 1977 revenue is sub epto to sown as Medicare and qtr adjustment by third-party payors, audit and retroactive f; su Ject to Inasmuch as these adjustments are final ► e s~>; accrued and the amounts settledny difference between the Year of settlement. Is recorded in operations iamo n uthe 4. hang Bufldin s and ui me 1i Land, buildings nt and e the case of p quipment, are recorded at cost, or, in rk Y. eoperty donated to the 'Hospital, at the fair market r! value at the date of the donation. <r ~ over Depreciation Is ,l f estimated calculated using the strai ht- useful lives as followst g line method Land IMproveMente n r Buildinggs 5 ~ 15 years r,!~.. Purniture and equipment 15 35 years V" ~s°.3 w 27 years a .~4 ,r t~ i i 11• Lt{ ~:j~JS~($N.'NlMibl rJ..k lM.N}:, u. w,rr,:..-. ' Pr + ; s 1. s r L . FLOW M ir~ EMORIAL HOSPITAL s NOTES TO FINANCIAL STATEMENTS CONTINUED YEARS ENDED SEPTEMBER 30 ~ 1977 AND 1976 G, A' SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES ~ (CONTINUED) r 5. Contributions 1 the donor Contributions which have been restricted as to their us Funds are credited directly to At the time the funds are expended for a by fund ba7anee of the Restricted by the donor, the related fund balance is the purpose specified Unrestricted Funds. Contributions which are not delign 4nsferred to the specific purpose b in the Unrestricted Fund. g ed for a y the donor are reworded as nnnaperating revenues value of contributed services receiHospivedt4l since does . ` available to measure the valuehe ob3ebtivd the fair no n of such services. a basis is Pension Plan F The Hospital sponsors a t 4,11 employees over twe continuous service Pia-five years ofua Base wi pension , an covering p a an th at least one year'a two percent Of base -sale partici Hospital's it, to are required to Contribute rently, pod by by no fund the five Hospital five percent, The s costa any nnvested percent contribution gur- 536,114 participant forfeitures. $361, n costs included in operating expenses are (1976). $34,579 (19The 77) and ~ 7• Income Taxes The Hospital f pol Internal Revenue exempt from Federal income taxes In ternal subdivision of the State of T Fee under t as a Code of j ~t 1954, Section 115 of`the irk ? B, LAND, BUILDINGS AND EQUIPMENTt ~ C.and, buildings and equipment consist of the follawingi s s r. September 30 Land and improvements T7~ Buildings $ 132,586 Furniture and rk`r' fit' equipment 2,823,767 $ 132,586 1,919t584 X Z'9-- 7__5,667 2 6__ . 8~.. 4.76.0 Less accumulated depreciation a Y '4' 5033p020 4, 736 930 __24.60 -.t 52 2 rl,, , ' 3 330 524 $.2 38.t_ r,. ' ) MAR gTY~"!111~h!]y~.a -1j1(~(r 1 ~ f. yt,. lit 1 1 "i _ Y L AI q y y 1 r i 1 4 FLOW MEMORIAL HOSPITAL A 1+ NOTES T'0 FINANCIAL STATEMENTS CONTINUED ~d YEARS ENDED SEPTEMBER 30 1477 ANA 1476 t C. LONG-TERM DEBTS Long-term debt consists oPs 1977 1976 Bondes t' Series 1975, due July 1, 2000 $ 290,000 Series 197 1984 due - 280,000 14 1 i 570,000 t l Eguipment notes, 5.61 144,252 15"~J 963 714,252 159,963 Less current maturities 40.500 41,369 9~''a: 673 752 116 494 Cf 714 During 1975 the Hospital began - r` improve its existing building and medical a project to expand and facilities, 10 Financing of ti. the Projects was accomplished by d $407,4 grant of Health Resources under the Federal .-BUrtonhprTexas (Department of Health, Education and welfare) Wid the issue of $570400 in Denton County - City of Denton, Texas Hospital Board Revenue Bonds, The project was completed during 1977 and the assets and related liabilities of the fund were transferred_ to the +Y J,`+1 unrestricted fund. At September 30, 1977, all of the grant money had been received and all of the bonds were issued and outstanding, Repayment provisions of the bonds are as follows, r Series .1975 - The bond agreement calls for scheduled oipal payments Aggregating $60,000 during the periodJuly It 19'79 through July 1, 1996, in amounts ranging from $5,000 to $10,000 each year, The remainder of the bonds become callable for redemption beginning July 1, 1987, ` and are subject to mandatory redemption each July 1 41 thereafter in amounts rangingg from $10,,000 to $25,000, The bonds bear interest at 6.98$ per annum. Series 1978»A ' The first $'120,000 is payable in equal rr<: .inatallmenrs on July It 1981 and 1982, and bears interest at 78 per annum. $20o000 per The balance is duo at the rate of year, beginning in 1987, and bears interest nt 7.25% per annum. i+t A? i,x.'n,NewMNxm,.wr,e.new..• ,.,n y y''r is I ' 1pAe n+ ? E'{{,,µ~ ..t~~!!;;j!< Fyn , r s i 1 S. ~ 7btecheNa~s&C`n FLOW MEMORIAL HOSPITAL NOTES TO ~'TNANCTAL STATEMENTS (CONTINUED} YEARS ENDED SEPTEMBE~t 30 1977 AND 1976 +Y C. LONG-9'ERM DEBT (CONTINUED) t The related bond agreements contain various restrictive cove- nants including limitations on additional long-term debt. In addition, the bondholders have a lien on all revenues of the i Hospital. Included in land, buildings and equipment is $56,998 in interest on the bonds Capitalized during the period of renovation and. aonstruation. Of that amount, $21,681 was capitalized during j fiscal 1977 and $35,317 during fiscal 1976. Equipment notes payable are collateralized b' e u a depreciated cost of a y q ipment with Scheduled approximately $165,p04 at September 36, 1977. *Schedul payments on the notes► including interesto are as s, $49,487 - 19781 $460652 - 19791 $37,566 - 1980 1981} $3,322 W 1982, t $23,251 0. UNRESTRICTED FUND BALANCRt a14 ` ~y The sources of the unrestricted fund balance are detailed as follows tr, Se tember 3~ l Operations O County perations of Denton $(10128,252) $(1,057,141) City of Denton 106960871 1,696,871 s rr, M kf Flow estate Bequest 3930166 393,166 Federal Grants 240,461 240,461 Pledges and lifts 2eL26,261 1,717,871 3-____7 .540 278,956 a, $ 3. 7 3, 270 184 8. FLOW MEMORIAL HOSPITAL FOUNDATION, INC.t `r a for Flow Memorial Hospital Foundation, Ina., a tax-exempt notes profit organization, contributed to the Hospital $35,323 In and $24,'725 in 1976, which contributions have been included in non? }f{ operating revenue. Additional contributions of $28,584 in 1977 and $46,491 in 1976 were reatriated for the were added to the purchase of equipment and Equipment Fund balance. fk~E~ cr 4. q r ; t kS'a. W~ d; +r{ - r ."`S,AV e:L l + rc , , y~,yi ,r i.'k x 4 rti IQ14.Y. 66 M$»roe waar N f i IF= ly 1) { I t i C) F i I t 'A, 0 s r t i. r { 1k° .ti7 1 `yk Le r , . VA, 4 ! r