HOULTON, Maine — The Houlton Rotary Club welcomed Tom Moakler and Cynthia Thompson of Houlton Regional Hospital at the group’s Monday, March 13 meeting. Moakler is the CEO at the hospital, while Thompson is the chief financial officer.
Both were the guests of Rotarian Marguerite Lawler.
Moakler has been the CEO of the hospital for 20 years. He hails from New Jersey, where he earned his undergraduate degree at Villanova and went on to George Washington University for his advanced degree in hospital management. He has over 40 years of experience in this field.
Thompson, a native of The County, majored in accounting in college and became a certified public accountant, working in this field for eight years. She lives in Houlton with her husband and two children.
Thompson used a slide show to educate the group on the state of financial affairs at HRH considering current regulations and challenges. Houlton is a critical access hospital and is under federal designation to keep medical care in the area. The lines of business include the emergency room, Positive Steps, Aroostook County Surgical Association and Special Clinics. HRH employs 350 people at a cost just over $17 million.
An upcoming recognition dinner will honor 11 employees who have served HRH between 30 and 50 years. The hospital offers the Houlton Family Practice, the Sigrid Tompkins Health Center, Houlton Internal Medicine, Houlton Pediatrics, Houlton OB/Gyn, Cardio Pulmonary Rehab Services and Podiatry and Urology. Fifty professionals staff these areas of expertise.
Currently the hospital is allowed only 25 patient beds with exceptions for women in labor or inclement weather. This is in proportion to a shortage in the nursing staff. The actual limit at this time is 18 beds due to this shortage. The hospital also has seven students through NMCC in the nursing program at the Education Center. Staff hope these students will stay on to work at the hospital in Houlton.
For the critical access hospital, Medicare’s allowable cost is set at 99 percent, while Medicaid is set at 109 percent. Bad debts are not covered. As a 501(C)(3), the IRS requires community benefits for unfunded payers. The challenging financial picture comparing 2011, 2013 and 2016 show the last profit in 2011 at $19,251; a loss of $3,446,065 million for 2013; and $618,424 for 2016.
Bad debt for 2011 totaled $3,020,524, while for 2013 that number was $3,612,895 and for 2016 it was $4,813,486 dollars. There is a challenge in the payer mix as Medicare has grown and Medicaid has declined. The could be caused by the high deductible health plans.
People with $5,000 deductibles do not have the funds to cover the cost. Many families gamble with not having any health care coverage. Both lead to bad debt. There is no Medicaid expansion in Maine and Maine has cut Medicaid rosters.
The hospital has added jobs to track the different payment criteria and programs. Overpayments from Medicaid helped to fund the years in 2013, 2014 and 2015, but 2016 had no overpayments. HRH must pay back those overpayments and works with Katahdin Trust to do so with a credit line account and weekly payments at $22,527.
Spending cuts are in effect as there is no extra money. The Health Services Foundation has helped to fund new equipment. Other initiatives have been to cut back on administration from seven to four full-time people and one half-time person. The skilled nursing unit closed and the rights were sold to Madigan Estates. Personnel was cut in many departments. The physical plant converted from just oil heat to propane heat in an effort to save funds.
HRH is part of the Maine Rural Health Collective including HRH, Northern Maine Medical Center, Cary Medical Center, St Joseph’s Hospital, Mount Desert Island Hospital and Millinocket Regional Hospital. By working together these hospitals are able to stay open as one third of rural hospitals are in danger of closing nationally. Thompson mentioned that the Community Health plan benefited HRH but the Medicaid Expansion hurt HRH.
On a positive note, Thompson and Moakler mentioned that starting pay for nurses is at $23 per hour and goes up to $37 per hour to give yearly salaries up to $50,000 for nurses.
Other guests present were Caribou Rotarian John Kavin and his mother, Natalie Kavin.
Special announcements including sharing Bingo on Facebook and the next Bingo committee meeting will be Thursday, March 23.
