501a Shell Game at Glen Rose Medical Center -Doctor Salaries (Sep 2016)
24 September 2016 at 2:50:21 PM
I went to record the budget meeting on Sep 20 2016 and have a real issue with some of the ways the budget is presented. Overall, it appears to me that the budget is not a tied down and bow-tie wrapped entity but that certain elements, including the rent, can be shown in various ways or under different accounts. There were a number of items that appeared one way or were not broken out in detail, this is one of them. Readers know I have long felt that the 501a allowed for abuses of money accountability, including, as I have long talked about, a slush fund situation with the contracts. The 501a or Glen Rose Healthcare Inc exists as a one-off way to employ doctors, but the doctors salaries, etc are included in.... the Somervell County Hospital District budget. As Ray Reynolds said in September 2014, the 501a exists to provide shortfall (OSA) money to doctors. If that is the only purpose or, let's say, the sole purpose, and since the doctors salaries are paid by the hospital district, etc, (here's from 2015) then the next logical conclusion would be, does it matter how or where the 501a financial information appears within the Somervell County Hospital District budget? Here's what Ray Reynolds said at the meeting. For some reason, when it comes to 501a, he calls the money *allocations* as if that makes the money different.
Reynolds: Certainly we provide services to the 501a, we provide accounting services, we do their payroll, and maybe I do some things too but that is an allocation .. how do you want to handle it? If you're really wanting the, I guess, the 501a to only absorb direct expenses, fine, we'll move it back to the hospital but it's not going to change the consolidated bottom line at all, just moving from one to the other. Our thoughts have been we would treat the 501a as if they were an independent practice and allocate expenses out to them. It really doesn't matter to us... we want to improve the look, I mean, there's $137.000 right there that we can move back and that'll get us closer to the ... What's the philosophy behind employing physicians and the deal is you employ physicians so they generate hospital revenue and we've gone back and looked at all of our employed positions and we got their gross and their net revenue ... the big number is the 3.791 million, revenue generated by our employed physicians last year and that's a pretty big number ... somewhat equivalent to cash because we have all the discounts and allowances ... the real hard question is are you willing to accept a 353,000 loss knowing what you know .. Our position is that is a significant improvement over 2016 annualized, both of that came out of physicians compenstations, we recognize that but also a fair amount of that is coming from increased revenue that we've budgeted for the positions.
What about those *allocations* which seems to be the word Ray Reynolds uses for putting money in one part of the budget versus another. (THEY ARE ALL PART OF THE BUDGET THAT THE SOMERVELL COUNTY HOSPITAL DISTRICT IS APPROVING)
Reynolds We talked a little about allocations. There is $135,000 of allocations from the hospital to the 501a, primarily me and Becky and Ladonna for services that we provide. The other is the rent
(I didn't put the full discussion on rent but it's an example of money being put in one way or another and very fluidly shown)
Putting a fine point on this. WHO IS paying for the doctor salaries. Somervell County taxpayers are. From Somervell County Hospital District. Period. Heck, hospitals in Texas now CAN directly employ physicians, don't have to use a 501a. Reynolds has said before the 501a just there to give out extra money beyond the salaries, (which are pretty hefty for some doctors) do taxpayers here still agree with that?