Fallon County waives $153,009 Medicare-related claim; hospital renovation change orders approved

Fallon County commissioners voted to waive the county's $153,009.25 claim arising from a Medicare cost-report settlement, after hospital finance staff explained the accounting mechanics behind related-party costs and interim rate adjustments.

Hospital finance said the Medicare payable without related-party costs is $360,567; with related-party costs included the settlement rose to $514,592, creating a net difference of $153,009.25. Staff explained those related-party items are book entries (administrative cost allocations) that increase the hospital’s reported costs and therefore alter the Medicare settlement calculation. Commissioners voted to forgo collecting that difference to avoid imposing the additional burden on hospital operations.

Separately, project managers presented renovation change orders (doors, flooring, elevator lift and related electrical/surge-protection recommendations). Commissioners approved change orders (not-to-exceed $55,664.22 before credits were applied) and discussed elevator maintenance options and surge protection for new electronic lift equipment; staff will solicit maintenance bids and consider alternatives if tariff or availability issues arise for Canadian-sourced equipment.

Formal actions: The cost-report waiver and the construction change orders were both approved by voice votes. Claims and payroll were also approved later in the meeting (claims $225,537.59; payroll and withholdings $745,793.21).

What next: Hospital administrators will notify the county auditor of the commission’s decision on the cost-report payable, and project managers will continue ordering equipment and evaluating alternatives for the elevator lift and surge protection.