Coffey County hospital reports improved collections, eyes surgical and behavioral health growth

Hospital administrator Stacy gave commissioners a quarterly update on finances and service plans, telling the board the recently announced federal Rural Health Transformation Fund totals $10,000,000,000 over five years and that 50% of that allocation will be distributed equally among states while the rest will be awarded based on state applications and data points. "It's not to support operations or capital expense," Stacy said, noting CMS guidance limits direct payments to hospitals and steers funding toward programmatic investments that support rural health broadly.

Stacy and finance staff reported progress on collections and cash management. "In the first nine months of this year, we've collected about $1,600,000 more than we did in the first six months of 2024," a finance presenter said, and month-by-month cash figures were reviewed. The hospital reported roughly four days cash on hand in October (versus a target of about 30 days) and described a year-to-date position within several thousand dollars of budget when one-time grants and a county contribution were taken into account. Staff also said they have reduced salary-related costs through attrition and are monitoring rising supply and pharmaceutical costs tied to 340B and ingredient-price pressure.

On services, Stacy said the hospital is prioritizing surgical services, behavioral-health integration and growth of swing-bed capacity after the closure of labor-and-delivery services freed space for new uses. "We're working on developing some swing bed suites ... and then also a therapy room for our swing bed patients," Stacy said. The hospital confirmed it currently has a surgeon under contract through January and expects another surgeon to begin under a lease model that pays salary only for days the surgeon provides services, a change intended to limit fixed overhead.

Commissioners asked for details on payer mix and reimbursement. Finance staff provided an approximate breakdown (self-pay ~3%; Blue Cross ~20%; commercial ~14%; Medicaid ~7%; Medicare ~~40%; Medicare Advantage ~12%) and explained collection benchmarks and contract variations across payers. Hospital staff said national comparisons are difficult because charges and contracts vary, and they described efforts to improve billing consistency, add mailed statements and phone outreach and to roll out an online patient portal for payments and payment-plan setup.

Next steps: the hospital plans a February board retreat that will include strategic planning and asked commissioners to attend if possible. The board did not take formal action on hospital items during the meeting.