Hocking Valley Community Hospital Outpatient Rehab

Description

Hocking Valley is a non-profit organization All profit made by the hospital gets re-

invested back into the hospital It is owned by the county, but does not

receive a budget from the county Made transition to Critical Access Hospital

three years ago

Location

Hocking Valley Rehab is a free standing clinic located in Logan, Oh adjacent to the Hocking Valley Community Hospital.

It is located on state route 664, which is considered a major traffic flow area in Logan

It is also close to the prominent business area of downtown Logan

Directions to the clinic are simple

Floor Plan

Shared waiting room(as seen through the main entrance)

Secondary waiting area (once patients check in). Shared PT office space in background.

4 evaluation rooms, each w/ a sink (110 sq. ft. each) – 440 sq. ft. total

6 Curtained treatment rooms (8X10ft each) – 480 sq. ft. total

Gym w/ 10’ minimum ceilings- 2000 sq. ft.

Modality Station w/ sink – 180 sq. ft

Shared PT office space

Supply/ Storage area – 120 sq. ft.

Wound care room

Staffing

The therapy staff account for 4 FTE’s 2 PT’s who account for 1.8 FTE’s 3 PTA’s who equal 2.2 FTE’s PT’s see approximately 8-10 patients per day

averaging 2 evaluations each day PTA’s on average treat 12-14 patients per

day (2 PTA’s are full-time)

Organization

Scan picture in here

Unique benefits package

Ohio PERS– Employee Pays in 8.5% of gross salary, employer pays in

14% of employees salary Health Insurance

– Self Insured: If you receive care at the hospital, they pay 100%

Dental Plan– Covers Preventative services at 100%

Life Insurance– $5000 term life policy, Hospital pays 100%

Benefits Continued

Vision Vacation/Holiday

– For every 80 hrs worked employee gets 3.08 hours Tuition Reimbursement

– $750 for post-graduate tuition Employee Rewards and Recognition

– Honored for years of service in 5-year increments Employee Purchase Discounts

– Purchase items from pharmacy, storeroom, and nutrition services at cost

April 2005 Finances

At Hocking Valley, the expense per unit is budgeted at $20.00/unit The budgeted net revenue is $42.78/unit.

Total Patients Seen = 588 Total Units = 1934 Gross Rev/Unit = $72.61 Expense per unit = $24.30 Net Rev/Unit = $48.31

Average Units/Patient (1934/588) = 3.3 units/patient Average Gross Revenue/patient (3.3 x $72.61) = $239.69 Average Expense/patient (3.3 x $24.30) = $80.18 Average Net Revenue/patient (3.3 x $48.31) = $160.00

Estimated Gross Revenue for April ($239.69 x 588) = $140,937.72 Estimate Expenses for April ($80.18 x 588) = $47,145.84 Estimated Net Revenue for April ($160.00 x 588) = $93,791.88

2004 Finances

Commercial 23% = $307,000 BWC 22% = $296,000 Medicare 22% = $289,000 Blue Cross 11% = $140,000 Other 11% = $140,000 Medicaid 9% = $115,000 TOTAL Gross Income 98% = ~ $1,287,000

2004 Finances

The gross revenue amounts presented assumes an averaged 38% contractual adjustment which means for every $1.00 billed, $0.38 is written off as a loss.

The projected/budgeted gross revenue for 2004 was $1,331,000 and the actual was ~1,287,000. In summary the revenue and expense report for 2004 is as follows:

Gross Revenue = $1,287,000.00 Total Expenses = $504,787.43 Net Income (before taxes) = $782,212.57

Mission Statement

To be responsive to the needs of our community by…

Incorporates value statements Is not specific to purpose of HVR Not clear what the hospital represents However; is compatible with developing in

any direction (due to generalization)

Vision Statement

“We want Hocking Valley to be a facility to be a facility where it’s a good place for employees to work, physicians to practice and for patients to receive care.”

The director was able to recite clearly from memory This above statement fails to include a direction for

the future of either the hospital or clinic demonstrating complacency

The clinic should eliminate this weakness by creating a new vision statement specific to the clinic.

The changing face of Logan

The chamber of commerce expects the population to grow by approximately 1200 people in the next five years.

How will the bypass around Lancaster and the continuing withdrawal of industry from Logan effect the population and demographics?

– Logan may become more of a tourist area– Possible increase in % of the geriatric population– How will the clinic accommodate these changes?

Patient Load

Hocking Valley Rehab is currently at max capacity in terms of patient volume.

As a result, prospective patients have gone elsewhere because they cannot be seen in a timely manner

Would it be beneficial for Hocking Valley Rehab to hire additional staff members?

Argument for hiring additional staff members

We propose that Hocking Valley Rehab hires a fulltime PTA and a PT either part-time or prn.

This could boost the number of patients seen by at least 15-20 per day

The new PT could perform approximately 25-30 new evaluations per month (currently a full time PT does ~ 50)

Would additional patients bring profit to the clinic?

Examples from April 2005– Expense per unit = $24.30– Gross Revenue per unit = $72.61– Net revenue per unit = $48.31– Average units per patient = 3.3– Average net revenue per patient = $160 (48.31 x

3.3)

Will the space/equipment accommodate any additional staff members and an increase in patient volume?

- The gym area is very large and could easily accommodate an increased pt volume. The exercise equipment is adequate at the moment but may be insufficient with a large patient influx.

- Rearranging the exercise equipment would allow for more efficient space utilization.

- The modality station is very large and under utilized. Much more equipment could be stored in the cabinets (almost half aren’t used). The modalities themselves are already in short supply at times. A wait for the e-stim unit and US machine is not uncommon. More equipment would have to be purchased to ensure treatment efficiency if patient volume were to be increased.

Will the space accommodate any additional staff members and an increase in patient volume?

- The general PT office space is not used efficiently. There are no cabinets or shelves above the counter space which could greatly reduce clutter. There are no dividers between each therapists space, so rearrangement wouldn’t be difficult. In general this area is one of the main limiting factors in hiring a new staff member.

- There are plenty of curtained treatment areas to accommodate another staff member/ patient.

Traffic Flow

There are couple of bottleneck areas that may be problematic with an increased patient volume.

The aisle between the curtained tx areas and the modality station is commonly congested.

The junction of the entrance corridor and the gym is commonly very busy.

Area directly adjacent to exercise equipment (similar ther-ex routines?)

Warm-up area (all in one side of the gym).

Safety

Three exit areas from PT dept. In case of an emergency increased pt volume may be a factor in safely evacuating the premises.

One exit is located out the front door, while the second is past the wound care area and has obstacles on the floor. The third is near the work conditioning area, although it is circuitous and getting lost is a possibility.

Continuing quality assurance

Monthly chart audits, staff evaluations, and annual staff competency quizzes

Patient satisfaction is rated at 98-100% The directors failed to mention what

specifically was included in patient satisfaction

What does the community need?

The facility provides a comprehensive rehab team including PT, OT and speech that treat a multitude of diagnoses.

They need to hire someone who offers specialized care such as manual therapy, wound care, and/or neuro

In order to get a better understanding of what the community needed, they could get request information from community leaders like the Chamber of Commerce, hold open houses to showcase their facility, or perform free screenings out in the community.

This would allow the community to be more engaged in PT services offered by the clinic.

Strengths of HVR according to the director

Mature staff– Low turnover rate– Creates pleasant working environment for the staff and

patients– Helps keep productivity high

Ability to treat all general conditions The facility

– Spacious– Able to accommodate large patient volumes while

maintaining patient satisfaction

Weaknesses as stated by the director

Lack of specialty care– No wound care or manual therapy– Underutilized wound care area/space

Not having an industrial outreach program– It would be a nice program to offer, but would be

underutilized as industries continue to leave town

Overall Impressions

Great Facility Relies heavily on referrals from local physicians

– Do not tap into other referral markets due to high volume of patients coming into the practice

Marketing– Could increase marketing to reach other referral sources as well as bring in

new patients Staffing

– Hard time meeting demands of current patient load– New PT/PTA could be added to treat patients in timely manner as well as

treating increased volume of patients Monitors

– Monitors should be put in place to watch over and make sure not losing patients secondary to untimely care

Impressions Continued

Vision – Does a great job of meeting current goals– Lack direction for the future

Should have a vision of what they want to become and how they plan to do it.

Community Needs– Should examine the needs of the community to

see how they can meet and provide for these needs