Case Study #2 Red Bear River Valley Hospital is one of the small, scattered villages located in rural northern Utah and about 40 miles from the Big Swift, the closest town and commercial center. The only transportation linkages to Red Bear River Valley is rural county and state highways. These routes are closed or not easily utilized between 7-10 days a year. Red Bear River Valley Hospital offers a basic emergency room and 16 inpatient beds in a 44.000 square-foot facility. An adjoining medical clinic, Red Bear River Clinic, provide an additional 20,000 square-feet of space. The Bear River Clinic provides for basic outpatient care. The hospital is supported by 10 physicians. Attached are the following data for Bear River Valley Hospital: Population StatisticsStatement of Revenues and Expenses for the last three yearsTop eight DRG DischargesPatient Days by PayerBest and Worst percentages for Performance against CMS Core Measure Based on the data given, consider the following: Describe the current financial and functional outlook for the facility.Describe the two most imminent issues facing the facility.Describe the areas of strengths and weakness impacting the long-term future of the facility.Describe the potential impact on the community if Bear River Valley Hospital is closed.Describe the ways that the facility might modify the delivery of health care to improve the long-term future.Describe how the facility might utilized new technology to improve the delivery of healthcare to the community. POPULATION STATISTICS Bear Valley Total Population White Black Other 2014 1,965 1,942 14 9 2019 1,935 1,924 6 5 Ages and Gender Under 5 5-14 15-24 25-44 45-64 65-74 75+ Male 60 140 133 292 210 68 55 Female 54 146 139 294 226 75 73 Insurance Coverage (%) No Coverage Employer Provided Self-Employment Medicaid Medicare 14.1 6.0 40.8 9 31 Household Income Less than $25,000 41% $25,000- $49,000 30% $50,000- $74,999 15% $75,000 or more 12% Revenues Patient Services Revenue 2018 2019 Inpatient Net of Allowances 52,240,653 53,286,192 Outpatient Net of Allowances 22,742,147 22,147,554 Total 74,982,800 75,433,746 Expenses 2018 2019 Salaries and Wages 30,275,410 31,952,632 Fringe Benefits 8,225,293 8,925,471 Supplies 20,513,755 21,539,851 Professional Fees 12,541 13,887 Interest 575,774 524,899 Depreciation 2,000,124 2,220,521 Amortization 851,440 855,108 Other 10,143,221 8,152,147 Total 72,597,528 74,184,516 NET INCOME FROM OPERATIONS 2018 2019 Net Income 2,385,272 1,249,230 Top 8 DRG Discharges 2018 2019 Normal Newborns* 31 28 Vaginal Delivery, no complications 25 24 Medical Back Problems 125 141 Chest Pains 126 178 Coronary Atherosclerosis 150 161 Simple Pneumonia 27 21 Digestive Disorders 19 12 Cesarean Section 5 4 Totals (excluding births) 477 541 *counted as births, not discharges. Patient Days by Payer Payer Medicare Medicaid Other Total Days 26.9 14.2 58.9 CMS Core Measures Category CMS Core Measure Benchmark Bear River Timely and Effective Heart Attack Care Average number of minutes before outpatients with chest pain or possible heart attack got an ECG 7 minutes 9 minutes Timely Surgical Care Percentage of surgery patient whose preventive antibiotics were stopped at the right time 98% 95% Timely Emergency Dept Care Average time patients who came to the emergency department with broken bones had to wait to getting pain medication 54 minutes 44 minutes Blood Clot Prevention Percentage of patients who go treatment to prevent blood clots on the day of or the day after hospital admission or surgery 93% 94%