“Hell, that’s not the hospital’s fault,” Dr. Cantor said.
“CMV doesn’t care about such technicalities,” Beaton said. “Consequently, we’ve been forced to bill the patients directly and they are understandably upset. Most have refused to pay, telling us to go to CMV.”
“Health care is becoming a nightmare,” Sherwood said.
“Tell that to your representative in Washington,” Beaton said.
“Let’s not digress,” Traynor said.
Beaton looked back at her notes, then continued: “Quality indicators for April were within normal expectations. Incident reports were actually fewer than in March and no new malpractice actions have been initiated.”
“Will wonders never cease,” Dr. Cantor commented.
“Other disturbing news for April involved union agitation,” Beaton continued. “It was reported to us that both dietary and housekeeping have been targeted. Needless to say, unionization would significantly add to our financial problems.”
“It’s one crisis after another,” Sherwood said.
“Two areas of under-utilization,” Beaton continued, “are the neonatal intensive care unit and the linear accelerator. During April, I discussed this situation with CMV since our fixed costs for maintaining these units are so high. I emphasized it had been they who demanded these services. CMV promised me that they would look into ferrying patients from areas without these facilities to Bartlet and reimbursing us accordingly.”
“That reminds me,” Traynor said. As chairman, he felt he had the right to interrupt. “What is the status of the old cobalt-60 machine that the linear accelerator replaced? Have there been any inquiries from the state licensing division or the nuclear regulatory commission?”
“Not a word,” Beaton answered. “We informed them the machine is in the process of being sold to a government hospital in Paraguay and that we are waiting for the funds.”
“I don’t want to get involved in any bureaucratic snafu with that machine,” Traynor warned.
Beaton nodded and turned to the last page of her notes. “And finally, I’m afraid I have some additional bad news. Last night just before midnight there was another attempted assault in the parking lot.”
“What?” Traynor cried. “Why wasn’t I informed about this?”
“I didn’t hear about it until this morning,” Beaton explained. “I tried to call you as soon as I heard, but you weren’t in. I left a message for you to call back but you never did.”
“I was in Montpelier all day,” Traynor explained. He shook his head in dismay. “Damn, this has to stop. It’s a PR nightmare. I hate to imagine what CMV thinks.”
“We need that garage,” Beaton said.
“The garage has to wait until we can float a bond issue,” Traynor said. “I want that lighting done quickly, understand?”
“I’ve already talked to Werner Van Slyke,” Beaton said. “And he’s already gotten back to me that he’s been in touch with the electrical contractor. I’ll follow up on it so that it’s done ASAP.”
Traynor sat down heavily and blew through pursed lips. “It’s almost mind-boggling what running a hospital today entails. Why did I get myself into this?” He picked up the current meeting’s agenda, glanced at it, then called Richard Arnsworth, the treasurer, to give his report.
Arnsworth got to his feet. He was a bespectacled, precise, accountant type whose voice was so soft everyone had to strain to hear him. He started by referring everyone to the balance sheet each had received in his information packet that morning.
“What’s immediately obvious,” Arnsworth said, “is that the monthly expenses still significantly outstrip the monthly capitation payments from CMV. In fact, the gap has expanded relative to the increase in admissions and lengths of stay. We’re also losing money on all Medicare patients not enrolled in CMV as well as all indigents who are not enrolled in any plan. The percentage of paying patients or those with standard indemnity insurance is so tiny we cannot cost-shift enough to cover our losses.
“As a result of this continued loss, the hospital’s cash position has deteriorated. Consequently, I recommend switching from one hundred and eighty days investing to thirty days.”
“It’s already been taken care of,” Sherwood announced.
When Arnsworth took his seat, Traynor asked for a motion to approve the treasurer’s report. It was immediately seconded and carried with no opposition. Traynor then turned to Dr. Cantor to give the medical staff report.