Cook County News Herald

Fluctuating numbers make hospital budgeting a guessing game




Budgeting is very difficult at North Shore Hospital and Care Center. As of the July 19 hospital board meeting, the facility had seen 1,000 swing bed patient days in the first half of the year while only 314 had been budgeted. That is good news, although the facility continues to operate in a deficit.

Medicare reimburses rural hospitals for swing bed care, which can provides services to a hospital patient not ready to go home but not needing to be in a nursing home.

Hospital Controller Yvonne Gennrich said they try to be conservative in their estimation of how much of which services might be utilized in the next year. Swing bed usage has varied widely from year to year. Predictions like this not only make budgeting hard, but they make setting the levy difficult as well, she said.

Sandra Barkley, vice-president of St. Luke’s, North Shore Hospital’s administrative partner, said this variability is happening at other hospitals as well.

Head Nurse Bridget Sobieck said that recent openings in the care center would clear out some of the swing beds. The hospital has been getting a lot of people who won’t be able to return home but do not want to go into the nursing home, she said.

“If we had a crystal ball,” said Hospital Administrator Kimber Wraalstad, “it would make budgeting so much easier.”

Board member Justin Mueller wondered why more people don’t use the hospital’s home health care program. Administrator Wraalstad said many people could use these services but don’t quality for funding because they are not completely homebound. If they could use these services, she said, they could postpone their entrance into the nursing home.

Controller Gennrich said the home health program is busier this year than last. Last year at this time, the department had made 948 home visits by the end of June, and this year, it had made 1,028, an 8.4 percent increase.

Board member Tom Spence recommended increasing their advertising so more people would know the breadth of services the hospital provides, including many procedures ordered when people make visits to their doctors.

In other hospital news:

The hospital is purchasing the Masonic Lodge building just northeast of the hospital on the west side of the Old Gunflint Trail. Administrator Wraalstad said they are sometimes short on meeting spaces and could use it for that.

Administrator Wraalstad expected the care center to be cited for six deficiencies after an annual inspection the week of July 9. She said they were not related to the quality of care patients are receiving. For example, one regarded a form turning down a flu vaccine that had not been renewed after it expired, another regarded a dispensing date that had not been written on a medication bottle, and another regarded the fact that the facility has no family council in place, something families have not been interested in pursuing. The care center is required to submit a corrective plan to the state.

“I think the care center employees should be commended for a good survey,” said board member Kay Olsen. Wraalstad said the housekeeping, dietary, and maintenance departments should also be commended.

Two board member terms are coming up for re-election: Kay Olsen’s term (the Maple Hill/ Gunflint Trail district) and Justin Mueller’s term (the east Grand Marais district). The filing period for those interested in running for these positions is July 31 through August 14.

Justin Mueller said that at a recent health care conference he attended, he learned of new trends in the field. They include enhancing the physical environment to include artwork and gardens, posting a brief biography and photo of a patient on his or her door to use as a conversation starter, incorporating things like pets, music, and massage into therapy, inviting nursing home patients to participate on committees that address things like music and gardens, creating events to get hospital boards and staff together, providing fitness centers for employees, and “green” (environmentally friendly) initiatives.



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