Board of Trustees Meeting

CRAWFORD COUNTY MEMORIAL HOSPITAL Denison, Iowa

Hospital Meeting Rooms C-D

100 Medical Parkway

June 28, 2021

5:30 p.m.

Iowa Code Section 21.4 requires that each Board of Trustee meeting shall be held at a place reasonably accessible to the public and at a time

reasonably convenient to the public, unless for good cause such a place or time is impossible or impracticable. Given the Governor's prohibition on

gatherings of ten or more persons during the COVID19 outbreak and further given Section Nine of the Governor’s March 19, 2020 proclamation

suspending the regulatory provisions of Iowa Code §§ 21.8, 26.12, and 414.12, or any other statute imposing a requirement to hold a public meeting

or hearing, the Board of Trustee has determined that a meeting at a physical place is impossible or impracticable and all Board of Trustee meetings

for the time being will be conducted electronically with the public allowed to attend per the instructions on this agenda. Meeting minutes will

continue to be provided per the Board’s normal course of business. Public Participants may listen to the conversation:

Call in Number +1-415-655-0001

Meeting number 1772 54 4699

I. CALL TO ORDER

II. APPROVAL OF PREVIOUS MONTH’S MINUTES

III. COMMITTEE REPORTSA. Mission Committee

B. Quality Committee

C. Finance Committee Payables

i. Write-offs, Recoveries & Recommendations/Action

IV. NEW BUSINESS

A. COVID Update

B. Board Vacancies / Recommendation / Action

a. LaVerne Ambrose Resignation

b. Appoint new board member

c. Committee assignments for new board member

V. CEO REPORT

VI. EXECUTIVE SESSION PURSUANT TO IOWA CODE

Section 21.5 (1)(a) Credentialing:

Open Session – Possible Action

VII. EXECUTIVE SESSION PURSUANT TO IOWA CODESection 21.5 (1)(i) To evaluate the professional competency of an individual whose appointment, hiring,

performance, or discharge is being considered when necessary to prevent needless and irreparable

injury to that individual’s reputation and that individual requests a closed session. - Open Session –

Possible Action

VIII. ADJOURNMENT

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Crawford County Memorial Hospital Board of Trustees May 24, 2021

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A meeting of the Board of Trustees of Crawford County Memorial Hospital was held on Monday, May 24, 2021 via WebEx due to the Governor’s prohibition on gatherings of ten or more persons during the COVID 19 outbreak and further given Section Nine of the Governor’s March 19, 2020 proclamation suspending the regulatory provisions of Iowa Code §§ 21.8, 26.12, and 414.12, or any other statute imposing a requirement to hold a public meeting or hearing, the Board of Trustee has determined that a meeting at a physical place is impossible or impracticable and all Board of Trustee meetings for the time being will be conducted electronically with the public allowed to attend per the instructions on this agenda. Meeting minutes will continue to be provided per the Board’s normal course of business. Present in the WebEx were Thomas Gustafson, Greg Kehl, Jay Mendlik, Sid Leise, David Reisz, Erin Muck, (CEO), Rachel Melby (CFO), Doug Hollander (CNO), Terry Welker (Executive HR Director), Heather Rasmussen, (Executive Director, Care Integration), and Wendy Frank (Recorder). In addition, Rich Knowles, and Dan Mundt (Denison Bulletin & Review). Absent was LaVerne Ambrose and Amy Schultz.

The meeting was called to order at 5:31 pm. APPROVAL OF PREVIOUS MONTH’S MINUTES A motion was made by Gustafson, second by Reisz, to approve the April 26, 2021, minutes as presented. Motion carried unanimously. PUBLIC INPUT

The board heard comments from Rich Knowles. Mr. Knowles’ comments were cut short due to a violation in board policy “Board of Trustee Public Access Policy 105.00”. Section 3 a. iii. Any patient who has received care at CCMH may address the Board of Trustees regarding her or his own care. However,

it is unacceptable for an individual who is not the patient to talk about a patient’s care unless the patient has provided

written consent to the Board of Trustees permitting the speaker to talk about the patient’s care.

Mr. Knowles started to comment about a patient’s care at CCMH without written consent to do so. He was muted from further comments. Erin Muck explained the violation to the policy and Mr. Knowles hung up the phone shortly thereafter. COMMITTEE REVIEW / ACTION Mission Committee. 1. There were no recommendations from the Mission committee. Quality Committee. 1. Recommend a COVID-19 updated be presented at the Board Meeting. 2. Recommend Board action regarding Medical Staff Accountable Care Committee recommendations for approval of

Medical Staff privilege(s) and appointment/reappointment applications. Finance Committee. Listed the following recommendations. 1. $88,395.61 in write-offs and $56,792.20 in recoveries for approval. 2. Total Accounts Payable of $2,666,325.71 for payment.

A motion was made by Kehl, second by Leise, to approve write offs in the amount of $88,395.61 as assets of the hospital but still subject to collection, recoveries in the amount of $56,792.20 and total payables in the amount of $2,666,325.71. Motion carried unanimously.

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Crawford County Memorial Hospital Board of Trustees May 24, 2021

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OLD BUSINESS COVID-19 Update Heather gave a brief COVID-19 update. CCMH’s two-week positivity rate is down to 2.3%. Crawford County’s two-week positivity rate is 2.8%. Crawford County is currently at 51% vaccinated and to obtain heard immunity we need to be up to 70%. If you have questions, please contact CCMH or Crawford County Public Health. To make an appointment for a COVID vaccination, please call 712-265-2700. NEW BUSINESS FY2022 Operating / Capital Budget Recommendations / Action A motion was made by Gustafson, second by Leise to adopt and approve as presented the FY2022 Operating Budget and FY2022 Capital Budget. Total amount for the Capital Budget for purchase $1,315,360 with $980,360 to be purchased with cash and $335,000 to be purchased with a capital lease. Board Resolution Approving Asset Purchase Agreement Recommendation / Action A motion was made by Kehl, second by Reisz to approve the Board Resolution as presented authorizing the CEO and CFO to act on behalf of Crawford County Memorial Hospital and to approve the Asset Purchase Agreement as presented. Motion carried unanimously. CEO REPORT

Caregiver Hero Nominations Congratulations to Debbie Ahart-Muhlbauer (Greeter) on being chosen to represent Crawford County Memorial Hospital as a Caregiver Hero at the Reimagining Healthcare Engagement virtual summit on Tuesday, June 8! The top 5 nominees were entered into a popular vote survey sent to all CCMH staff; Debbie received the highest number of votes from her peers.

The board would like to recognize Debbie with a certificate of accomplishment to be presented at a later date. Erin gave a brief update from the Medical Staff meeting held on May 11, 2021.

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Crawford County Memorial Hospital Board of Trustees May 24, 2021

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EXECUTIVE SESSION PURSUANT TO IOWA CODE Section 21.5(1)(a) Credentialing The Board went into Closed Session at 6:51 pm with a motion made by Leise, second by Reisz. Motion carried unanimously. Members of the board present during the closed session were Thomas Gustafson, Greg Kehl, Jay Mendlik, Sid Leise, David Reisz, Erin Muck, (CEO), Rachel Melby (CFO), Doug Hollander (CNO), and Wendy Frank (Recorder). The Board returned to Open Session at 6:56 p.m. motion by Reisz, second by Gustafson. Motion carried unanimously. A motion was made by Kehl, second by Leise, to approve the recommendations from the Medical Staff for the following Medical Staff appointment and reappointments. Motion carried unanimously. New Appointments Heidi J. Bradley, ARNP Sara Luft, ARNP Stacie L. Ranniger, MD, RACEP Kerry J. Cromer, ARNP Reappointments Leslie A. Eiland, MD Padmaja Akkireddy, MD Erin Linde, MD ADJOURNMENT A motion was made by Leise, seconded by Kehl, that the meeting be adjourned at 7:02 p.m. Motion carried unanimously.

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Crawford County Memorial Hospital

Mission Committee

June 17, 2021 4:30 PM

A meeting of the Mission Committee of the Board of Trustees was held on Thursday, June 17, 2021. Present on

site were Erin Muck, Heather Rasmussen, Doug Hollander, Amy Schultz, Jay Mendlik, and Brandi Mefferd

(recorder). Present via phone conference was Tom Gustafson.

The meeting was called to order at 4:36 p.m.

QUALITY CARE AND SERVICES

COVID-19 Update: Heather gave a brief COVID-19 update.

Quality Taskforce: Doug briefed the committee on a recently developed Quality Taskforce, which

will focus on improving CCMH quality rating.

ACO Update: A population health nurse has been hired and started. CCMH will be expanding

Chronic Cares Management (CCM) to include uncontrolled hypertension along with diabetes.

PATIENT EXPERIENCE

5-Star Update: Erin shared updates on the 5-Star program.

CareSay: Physical Therapy will be the next department rolling out CareSay.

Press Ganey: Current scores reviewed by Doug.

PEOPLE

Provider Recruitment: New CRNA begins in July. We continue to recruit for a fulltime ER

provider. Sara Luft has started seeing patients.

Facilities Management Recruitment: Interviews are underway for John McMullen’s replacement as

Director of Facilities Management.

GROWTH

Master Facility Plan: Interviews were conducted with several different companies; proposals have

been received and will be reviewed by executive staff.

FINANCE

SHIIP Grant Opportunity: $100k grant opportunity for each rural health clinic to be used for

testing and mitigation of COVID-19. We are investigating possible uses for UV lighting for

ambulances, HVAC upgrades, plasma bars, etc.

COMMUNITY

Golf Outing: HFCC Golf Outing is scheduled for July 16. Sponsorship forms were mailed directly to

surrounded businesses and can be found on the CCMH website.

EMS Update: Recruitment has been successful, and new hires have been onboarded. Doug has met

with several area volunteer groups to discuss mutual aid.

The meeting adjourned at 5:49 p.m.

Marketing, pricing strategies, and proprietary information where public disclosure of such information

would harm the hospital’s competitive position are protected under Iowa Code 21.5 (1)(l)

Committee Recommendations/Actions:

None

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Crawford County Memorial Hospital QUALITY COMMITTEE OF THE BOARD OF TRUSTEES June 22, 2021, Meeting Minutes

A meeting of the Quality Committee of the Board of Trustees was held on Tuesday, June 22, 2021. Present were Jay Mendlik, David Reisz, Erin Muck (CEO), Doug Hollander (CNO), Heather Rasmussen (Executive Director: Care Integration), Wendy Frank (recorder). Jay Mendlik called the meeting to order at 4:35 p.m. Greg Kehl and Michael Luft, DO were absent.

Statistics:

The statistics for the month of May were down, however, May is typically a slower month. We will continue our statistical comparison of 2021 to 2019 (pre-pandemic) to get a better sense of how volumes compare to normal business. Hospital procedures were down 3.09% compared to May of 2019, Surgical Procedures were only down by 2%. Admits from the ER was down by almost 30%. Total Medical Clinic Visits were down by almost 40% and that resulted in lab and radiology to also be down. Physical Therapy was up by slightly by 3.71%. Medical Staff Credentialing The Committee members reviewed the recommendation from the Medical Staff Accountable Care Committee for clinical privilege approvals of the submitted applications for new and re-appointments. The committee recommends (approval) action at the Board of Trustees. Projects / Standard Reports: A. Standard Peer Review / Protected Reports – Peer review records are privileged and confidential. Quality Improvement activities are protected from discovery under Iowa Code 147.135. 1. Monthly

a. Press Ganey - Doug reviewed the Press Ganey reports with the committee. b. ED Quality Slides - Doug also reviewed the ED Stats for the month of May. c. Med Safety Quality Slides – The Med Safety Quality Slides for May were reviewed. d. Medical Staff Meeting - The committee was updated from the minutes of the medical staff meeting held on June 8th.

2. 5 Star Journey Review

The SEA’s have started their Year II training sessions this week for all staff. Training is going very well.

3. COVID-19 Update The 7-day positivity rate at 0%. The 14-day positivity rate is at 0.9%. Crawford County continues to be at 51% vaccinated. CCMH is at 87% vaccinated. The Test Iowa sites will be closed by July 16th. Iowa has been alerted that the Delta variant has been found in the state.

Committee Recommendations/Actions 1. Recommend Board action regarding Medical Staff Accountable Care Committee recommendations for

approval of Medical Staff privilege(s) and appointment/reappointment applications.

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New Business / Old Business: Quality Taskforce The goal of the Quality Taskforce is to raise our quality star rating. The 4 areas of focus will be 1) 30-day re-admission rates; 2) C-section rates; 3) ER through put times; 4) Surgical site infections. The taskforce will start collecting data July 1st and this committee will see the reports in August. ACO – Population Health Nurse CCMH was able to fill the open position with a nurse from the acquisition of Dr. Luft’s practice. She has adapted to the position very well and we are on target with our annual wellness visits. We are looking at the automated reminder system. Currently it only reminds patients if they have an appointment. We are looking into to see if the system will send patients a reminder text or call when it is time for their yearly wellness check. EMS Update Staffing issues continue to improve as we have made progress on the hiring of paramedics, EMTs and a driver. We were at 70 percent of second call uncovered. We have reduced uncovered shifts to 20-25%. CCMH has met with area voluntary EMS groups and addressed concerns. Peer review records are privileged and confidential. Quality Improvement activities are protected from discovery under Iowa Code 147.135. Adjournment Wendy Frank, recorder. 5:53 pm

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CRAWFORD COUNTY MEMORIAL HOSPITAL FINANCE COMMITTEE MEETING

JUNE 24, 2021 4:30 P.M.

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A meeting of the Finance Committee of the Board of Trustees was held on Thursday, June 24, 2021 in the hospital’s Administrative Conference Room. Present were Jay Mendlik, Greg Kehl, Sid Leise, Rachel Melby (CFO), Erin Muck, (CEO), and Wendy Frank (recorder). The meeting was called to order by Jay Mendlik at 4:53 pm.

Committee Recommendations: 1. $61,109.93 in write-offs and $56,823.64 in recoveries for approval. 2. Total Accounts Payable of $2,000,117.58 for approval of payment.

Approval of Minutes

The May minutes were reviewed and approved.

CFO Report The CFO Report was reviewed.

Statistical, Income and Cash Flow Report

Total hospital procedures in May were down 3% compared to May of 2019. In addition, total medical clinic visits were down almost 40%, which impacted Radiology with a decrease of 15.62% and Lab with a slight decrease of .22%. However, although admissions were down, total patient days were up by 4 days. It is also encouraging to see that total surgeries were only down by 2 for the month compared to 2019. This is noteworthy and promising, as we only have a partial year of service from the new orthopedic group, which didn’t get up and running until late fall.

The most significant event in May was the SBA forgiveness of our PPP loan. Last April, at the start of the pandemic, we applied for and received a Payment Protection Program (PPP) SBA Guaranteed Loan in the amount of $3,095,100 to cover 2 ½ months of salary and benefit expense. Last month, we were finally notified that the loan was fully forgiven, which created a significant profit for the month. Although, the cash was received last April, the loan had been recorded on our Balance Sheet as a short-term liability until we received official notice from the SBA of the amount forgiven. In May, that liability was written off and recorded as non-operating revenue. With the loan forgiveness, the profit for May was $3,007,940. In addition, total cash balances increased by $15,493 for the month to a total of $20,411,683 and days cash on hand for May are 226 days. Please note that with the purchase of Denison Family Health Center on June 1st, we expect a sizable decrease in cash next month with days cash on hand anticipated to decrease to approximately 200 days. However, that is still above our target of 180 days cash.

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CRAWFORD COUNTY MEMORIAL HOSPITAL FINANCE COMMITTEE MEETING

JUNE 24, 2021 4:30 P.M.

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Balance Sheet The Balance Sheet as of 05/31/21 reflects Total Assets of $49,978,610.

Write-offs/Recoveries

The Finance Committee reviewed and recommends approval of $61,109.93 in write-offs and $56,823.64 in recoveries to the Board for approval. YTD Recovery Rate of 25.59%

Accounts Payable

The committee reviewed and recommends total Accounts Payable of $2,000,117.58 to the Board for approval. This amount includes $1,370,839.76 in salaries.

Accounts Receivable Patient Accounts Receivable as of May 31, 2021, totaled $8,342,504 which is an increase of $217,354 from last month.

Capital Budget Update FY2021 Capital Budget Recap Total amount requested in FY2021 was $2,262,191. Recommended Budget was $1,106,196. Deferred was $299,995 and $791,000 was placed on contingent. The actual amount spent was $2,150,535. This amount included the practice acquisition at $1,275,000 and $195,531 for the Sterilizer Construction Project that was approved in FY2020 and rolled over into FY2021. The remainder of Capital spent for FY 2021 was $680,004.

New Business

Insurance Renewal – deferred to next month Wellmark Contract Wellmark Blue Cross Blue Shield of Iowa (Wellmark) has started selling a Medicare Advantage product. Wellmark approached CCMH to be added as an “in network” provider for the new product. CCMH is pleased to partner with Wellmark and be an “in network” provider to patients who sign up for this new plan offering.

Adjourn - The meeting was adjourned at 5:45 pm. Wendy Frank, Recorder

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Comparative Statistical Report May 2021

Month to Date Fiscal Year to Date Month to Date

FY 2021 FY 2020 Variance FY 2021 FY 2020 Variance FY2021 FY2019 Variance

Total Admissions 53 49 8.16% 622 690 -9.86% 53 59 -10.17%

Acute/OB 42 40 5.00% 500 529 -5.48% 42 48 -12.50%

Skilled 3 2 50.00% 29 46 -36.96% 3 0 100.00%

ICF 0 0 0.00% 7 10 -30.00% 0 2 -100.00%

Respite 0 0 0.00% 1 0 100.00% 0 0 0.00%

Newborns 8 7 14.29% 85 105 -19.05% 8 9 -11.11%

Observation Admissions 22 10 125.90% 148 166 -10.82% 22 20 10.21%

Total Adjusted Admits 75 59 27.62% 770 856 -10.04% 75 79 -5.03%

Total Patient Days* 214 193 10.88% 2,418 2,537 -4.69% 214 210 1.90%

Acute/OB 123 139 -11.51% 1,611 1,565 2.94% 123 123 0.00%

Nursery 11 13 -15.38% 138 204 -32.35% 11 18 -38.89%

Skilled 16 9 77.78% 157 258 -39.15% 16 6 166.67%

ICF 0 0 0.00% 24 27 -11.11% 0 9 -100.00%

Respite 0 0 0.00% 3 0 100.00% 0 0 0.00%

Observation 64 32 100.00% 485 483 0.41% 64 54 18.52%*Includes Observation

Average LOS (Acute/OB) 2.92 3.30 -11.46% 3.28 2.91 12.60% 2.92 2.72 7.54%

Hospital Procedures

Inpatient 992 1,203 -17.54% 12,684 13,639 -7.00% 992 1,081 -8.23%

Outpatient 10,231 7,737 32.23% 115,394 106,531 8.32% 10,231 10,500 -2.56%

Total 11,223 8,940 25.54% 128,078 120,170 6.58% 11,223 11,581 -3.09%

Surgical Procedures 98 9 988.89% 1029 967 6.41% 98 100 -2.00%

Anesthesia Procedures 99 26 280.77% 1053 998 5.51% 99 95 4.21%

ER Visits 438 319 37.30% 3,838 4,301 -10.76% 438 450 -2.67%

Admits from ER 47 48 -2.08% 479 576 -16.84% 47 67 -29.85%

Scheduled Outpatient Visits 63 59 6.78% 1,079 1,225 -11.92% 63 135 -53.33%

Ambulance Trips 135 128 5.47% 1,222 1,324 -7.70% 135 128 5.47%

Xray Procedures 686 541 26.80% 7,068 7,576 -6.71% 686 771 -11.02%

Mammography Procedures 72 33 118.18% 1096 1041 5.28% 72 91 -20.88%

Flouro Procedures 10 1 900.00% 106 67 58.21% 10 4 150.00%

Ultrasound Dept Procedures 169 140 20.71% 2112 2313 -8.69% 169 237 -28.69%

Echo Procedures 34 20 70.00% 349 313 11.50% 34 53 -35.85%

CT Dept Procedures 186 169 10.06% 1987 2112 -5.92% 186 211 -11.85%

MRI Dept Procedures 49 30 63.33% 633 601 5.32% 49 62 -20.97%

Nuc Med Procedures 4 4 100.00% 81 93 -12.90% 4 5 -20.00%

Total Radiology Procedures 1,210 938 29.00% 13,432 14,116 -4.85% 1,210 1,434 -15.62%

Respiratory Tx Procedures 357 261 36.78% 3,149 3,729 -15.55% 357 420 -15.00%

EEG Procedures 0 0 0.00% 0 0 0.00% 0 0 0.00%

EKG Procedures 226 148 52.70% 2055 1925 6.75% 226 213 6.10%

Sleep Studies 10 2 400.00% 53 137 -61.31% 10 5 100.00%

Lab Procedures 6,683 6,476 3.20% 81,056 73,953 9.60% 6,683 6,698 -0.22%

Physical Tx Procedures 1,734 586 195.90% 18,443 15,894 16.04% 1,734 1,672 3.71%

Speech Procedures 34 0 100.00% 145 266 -45.49% 34 22 54.55%

OT Procedures 139 72 93.06% 1494 1374 8.73% 139 216 -35.65%

Cardiac Rehab Procedures 120 44 172.73% 1175 1079 8.90% 120 110 9.09%

Pulmonary Rehab Procedures 12 0 100.00% 77 206 -62.62% 12 11 9.09%

Specialty Clinic Visits 672 207 224.64% 6,220 5,833 6.63% 672 748 -10.16%

Total Medical Clinic Visits 1,790 1,738 2.99% 22,708 28,657 -20.76% 1,790 2,968 -39.69%

Crawford County Memorial Hospital

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Gray lines are YTD. All %'s are based on net revenue

except for the variance column and gross revenue.

PATIENT SERVICE REVENUES

INPATIENT SERVICES 551,473 12.7% 719,499 13.3% (168,025) -23.4% 614,331 18.2%

7,758,279 15.2% 7,513,855 13.3% 244,425 3.3% 7,369,277 14.0%

OUTPATIENT SERVICES 3,742,804 86.4% 4,642,151 86.0% (899,347) -19.4% 2,754,098 81.5%

43,108,732 84.3% 48,478,827 86.0% (5,370,095) -11.1% 44,819,730 85.2%

SWING BED SERVICES 39,438 0.9% 38,609 0.7% 829 2.1% 11,841 0.4%295,249 0.6% 403,202 0.7% (107,953) -26.8% 387,347 0.7%

TOTAL GROSS PATIENT REVENUE 4,333,716 100.0% 5,400,259 100.0% (1,066,543) -19.7% 3,380,271 100.0%

51,162,260 100.0% 56,395,884 100.0% (5,233,623) -9.3% 52,576,353 100.0%

DEDUCTIONS FROM REVENUE

MEDICARE ADJUSTMENTS (911,265) -21.0% (1,021,368) -18.9% 110,102 -10.8% (553,830) -16.4%

(10,145,578) -19.8% (10,666,327) -18.9% 520,750 -4.9% (9,786,248) -18.6%

TITLE XIX ADJUSTMENTS (116,777) -2.7% (382,330) -7.1% 265,553 -69.5% (154,189) -4.6%

(1,802,411) -3.5% (3,992,743) -7.1% 2,190,332 -54.9% (3,755,349) -7.1%

BLUE CROSS ADJUSTMENTS (539,861) -12.5% (791,970) -14.7% 252,109 -31.8% (449,590) -13.3%

(6,692,010) -13.1% (8,270,682) -14.7% 1,578,672 -19.1% (7,531,311) -14.3%

OTHER ADJUSTMENTS (135,381) -3.1% (148,377) -2.7% 12,996 -8.8% (160,420) -4.7%

(1,306,280) -2.6% (1,549,526) -2.7% 243,246 -15.7% (1,724,644) -3.3%

PROVISION FOR UNCOLLECTIBLE (45,244) -1.0% (163,518) -3.0% 118,274 -72.3% 18,113 0.5%

(1,444,874) -2.8% (1,707,645) -3.0% 262,771 -15.4% (1,538,993) -2.9%

CHARITY CARE (17,282) -0.4% (20,680) -0.4% 3,398 -16.4% (45,550) -1.3%(148,888) -0.3% (215,965) -0.4% 67,077 -31.1% (224,741) -0.4%

TOTAL DEDUCTIONS FROM REVENUE (1,765,811) -40.7% (2,528,242) -46.8% 762,431 -30.2% (1,345,467) -39.8%(21,540,040) -42.1% (26,402,888) -46.8% 4,862,848 -18.4% (24,561,287) -46.7%

NET PATIENT REVENUE 2,567,905 59.3% 2,872,017 53.2% (304,112) -10.6% 2,034,804 60.2%

(as % of Gross Patient Revenue) 29,622,220 57.9% 29,992,996 53.2% (370,776) -1.2% 28,015,067 53.3%

NET PATIENT REVENUE 2,567,905 94.8% 2,872,017 94.1% (304,112) -10.6% 2,034,804 33.3%

(as % of Total Operating Revenue) 29,622,220 93.6% 29,992,996 93.8% (370,776) -1.2% 28,015,067 80.6%

OTHER REVENUE

COVID STIMULUS PYMTS - 0.0% - 0.0% - #DIV/0! 3,978,401 97.8%

58,592 2.9% - 0.0% 58,592 #DIV/0! 4,639,796 68.8%

DIETARY/MEALS INCOME 4,085 0.2% 7,842 0.3% (3,757) -47.9% 5,665 0.1%

70,138 0.2% 86,258 0.3% (16,120) -18.7% 87,674 0.3%

OTHER INCOME 138,060 5.1% 173,283 5.7% (35,223) -20.3% 83,078 1.4%1,891,376 6.0% 1,906,117 6.0% (14,741) -0.8% 2,016,972 5.8%

TOTAL OTHER REVENUE 142,145 5.2% 181,125 5.9% (38,980) -21.5% 4,067,145 66.7%2,020,106 6.4% 1,992,375 6.2% 27,731 1.4% 6,744,442 19.4%

TOTAL OPERATING REVENUE 2,710,050 100.0% 3,053,142 100.0% (343,092) -11.2% 6,101,949 100.0%

31,642,326 100.0% 31,985,371 100.0% (343,045) -1.1% 34,759,509 100.0%

OPERATING EXPENSES

SALARIES 1,403,915 51.8% 1,681,421 55.1% (277,505) -16.5% 1,444,815 23.7%

15,821,320 50.0% 17,683,530 55.3% (1,862,210) -10.5% 17,058,127 49.1%

BENEFITS 463,440 17.1% 582,714 19.1% (119,274) -20.5% 448,739 7.4%

5,325,514 16.8% 6,128,414 19.2% (802,900) -13.1% 5,470,842 15.7%

PROFESSIONAL FEES 123,916 4.6% 87,917 2.9% 35,999 40.9% 26,769 0.4%

1,397,349 4.4% 967,083 3.0% 430,265 44.5% 1,517,676 4.4%

SUPPLIES & EXPENSES 571,694 21.1% 635,899 20.8% (64,206) -10.1% 426,913 7.0%

6,684,031 21.1% 6,994,893 21.9% (310,862) -4.4% 6,068,582 17.5%

OCCUPANCY 116,560 4.3% 105,133 3.4% 11,427 10.9% 109,120 1.8%

1,092,739 3.5% 1,156,462 3.6% (63,722) -5.5% 1,216,891 3.5%

DEPRECIATION 212,000 7.8% 234,417 7.7% (22,417) -9.6% 214,000 3.5%2,292,000 7.2% 2,578,583 8.1% (286,583) -11.1% 2,354,000 6.8%

TOTAL OPERATING EXPENSE 2,891,525 106.7% 3,327,501 109.0% (435,975) -13.1% 2,670,356 43.8%

32,612,953 103.1% 35,508,965 111.0% (2,896,012) -8.2% 33,686,117 96.9%

NET OPERATING INCOME (LOSS) (181,475) -6.7% (274,359) -9.0% 92,883 -33.9% 3,431,593 56.2%

(970,627) -3.1% (3,523,594) -11.0% 2,552,967 -72.5% 1,073,392 3.1%

NONOPERATING REV/EXP

TAXES 165,896 6.1% 165,896 5.4% - 0.0% 140,896 2.3%

1,824,861 5.8% 1,824,861 5.7% - 0.0% 1,549,857 4.5%

GENERAL CONTRIBUTIONS 5 0.0% - 0.0% 5 0.0% 5 0.0%

1,058 0.0% 5,000 0.0% (3,942) 0.0% 520 0.0%

SBA LOAN FORGIVENESS 3,095,100 2177.4% 3,095,100 1708.8% - 0.0% - 0.0%

3,095,100 153.2% 3,095,100 155.3% - 0.0% - 0.0%

INTEREST INCOME 2,893 0.1% 8,750 0.3% (5,857) -66.9% 12,964 0.2%

58,681 0.2% 96,250 0.3% (37,569) -39.0% 171,287 0.5%

INTEREST EXPENSE (74,478) -2.7% (89,251) -32.2% 14,773 -16.6% (84,017) -1.4%(906,255) -2.9% (981,761) -3.1% 75,506 -7.7% (951,029) 0.2%

TOTAL NONOPERATING INCOME (LOSS) 3,189,416 117.7% 3,180,495 104.2% 8,920 0.3% 69,848 1.1%

4,073,445 12.9% 4,039,450 12.6% 33,996 0.8% 770,635 2.2%

NET INCOME (LOSS) 3,007,940 111.0% 2,906,137 95.2% 101,804 3.5% 3,501,441 57.4% Year to Date 3,102,818 9.8% 515,856 1.6% 2,586,963 501.5% 1,844,026 5.3%

ACTUAL BUDGET VARIANCE ACTUAL

CRAWFORD COUNTY MEMORIAL HOSPITAL

OPERATING/INCOME STATEMENT

FOR THE MONTH ENDING MAY 31, 2021

CURRENT MONTH CURRENT MONTH CURRENT MONTH PRIOR YEAR

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THIS MONTH YTD

CASH FLOWS FROM OPERATING ACTIVITIES

CASH RECEIVED FROM PATIENTS AND THIRD -PARTY PAYORS 2,112,174 29,776,364

CASH PAID TO SUPPLIERS FOR GOODS AND SERVICES (813,692) (12,169,170)

CASH PAID TO EMPLOYEES FOR SERVICES (1,385,040) (17,618,595)

OTHER OPERATING REVENUE RECEIVED 142,145 2,020,106

NET CASH PROVIDED BY OPERATING ACTIVITIES 55,587 2,008,705

CASH FLOWS FROM NONCAPITAL FINANCING ACTIVITIES

COUNTY TAXES 154,460 2,034,009

CASH FLOW FROM CAPITAL AND RELATED FINANCING ACTIVITIES

PROCEEDS FROM ISSUANCE OF LONG-TERM DEBT - (693,921)

PRINCIPAL PAYMENTS ON LONG-TERM DEBT (56,230) (808,836)

INTEREST PAID ON LONG-TERM DEBT (47,403) (761,221)

ACQUISITION OF PROPERTY AND EQUIPMENT (93,450) (736,341)

NET CASH FROM (USED IN) CAPITAL AND RELATED FINANCING ACTIVITIES (197,082) (3,000,318)

CASH FLOW FROM INVESTING ACTIVITIES

INTEREST RECEIVED 2,528 69,876

PROCEEDS FROM MATURITIES OF CERTIFICATES OF DEPOSIT - -

PURCHASE OF CERTIFICATE OF DEPOSIT - -

PROCEEDS OF MATURITIES OF U.S. GOVERNMENT AGENCY SECURITIES - -

PURCHASE OF GOVERNMENT AGENCY SECURITIES - -

NET CASH PROVIDED BY INVESTING ACTIVITIES 2,528 69,876

NET INCREASE (DECREASE) IN CASH 15,493 1,112,272

CASH

BEGINNING 20,396,190 19,299,412

ENDING 20,411,683 20,411,683

DAYS CASH ON HAND 226

Desirable Actual

OPERATING INDICATORS: DEC JAN FEB MAR APR MAY Target Trend Trend

Total Margin: -15.68% 0.66% 2.59% 4.48% 0.41% 50.35% 2.00% Increasing Increasing

Total Margin ytd: -0.89% -0.67% -0.27% 0.30% 0.31% 8.47% 2.00% Increasing Increasing

Debt Service Coverage Ratio: 2.31 2.24 2.37 2.66 2.81 2.57 1.60 Increasing Increasing

Days Revenue in Patient A/R: 57 62 59 54 53 55 50 Decreasing Decreasing

Days Cash on Hand: 210 198 203 218 224 226 180 Increasing Increasing

CRAWFORD COUNTY MEMORIAL HOSPITAL

STATEMENT OF CASH FLOWS

FOR THE MONTH ENDING MAY 31, 2021

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ASSETS

CURRENT ASSETS

Total Cash 13,449,542 26.91% 13,534,757 27.09% (85,215) -0.63% 12,263,694 25.07%

Patient Receivables 8,342,553 16.69% 8,125,200 16.26% 217,354 2.68% 7,630,970 15.60%

Allowance for Uncollectibles (753,000) -1.51% (722,000) -1.45% (31,000) 4.29% (910,000) -1.86%

Allowance for Contractuals (1,830,000) -3.66% (1,800,000) -3.60% (30,000) 1.67% (1,560,000) -3.19%

Net Accounts Receivable 5,759,553 11.52% 5,603,200 11.22% 156,354 2.79% 5,160,970 10.55%

Other Receivables

Est. Third Party Settlement - 0.00% - 0.00% - 0.00% - 0.00%

Taxes Receivable (13,530) -0.03% 140,930 0.28% (154,460) -109.6% 28,677 0.06%

Other 1,229,152 2.46% 878,098 1.76% 351,055 39.98% 673,102 1.38%

Inventory 785,360 1.57% 795,965 1.59% (10,605) -1.33% 759,430 1.55%

Prepaid Expenses & Other 519,877 1.04% 686,042 1.37% (166,165) -24.22% 470,733 0.96%

TOTAL CURRENT ASSETS 21,729,955 43.48% 21,638,991 43.31% 90,963 0.42% 19,356,606 39.56%

ASSETS LIMITED AS TO USE

Investments

Cash & CD's 6,104,389 12.21% 6,102,746 12.21% 1,643 0.03% 6,040,788 12.35%

Bond/Project Funds 857,754 1.72% 758,688 1.52% 99,065 13.06% 1,456,093 2.98%

Interest Receivable 7,520 0.02% 7,155 0.01% 365 5.10% 33,005 0.07%

TOTAL ASSETS LIMITED AS TO USE 6,969,662 13.95% 6,868,589 13.75% 101,073 1.47% 7,529,886 15.39%

PROPERTY & EQUIPMENT, NET

Land 314,500 0.63% 314,500 0.63% - 0.00% 329,500 0.67%

Land held for Future Dev 120,400 0.24% 120,400 0.24% - 0.00% 120,400 0.25%

Land Improvements 2,511,827 5.03% 2,511,827 5.03% - 0.00% 2,511,827 5.13%

Building 8,499,661 17.01% 8,499,661 17.01% - 0.00% 8,307,960 16.98%

Fixed Equipment 17,671,815 35.36% 17,671,815 35.37% - 0.00% 17,671,815 36.12%

Major Moveable Equipment 17,458,770 34.93% 17,421,777 34.87% 36,993 0.21% 16,992,410 34.73%

Leased Equipment 1,640,977 3.28% 1,640,977 3.28% - 0.00% 1,458,912 2.98%

Allowance for Depreciation (31,786,104) -63.60% (31,574,104) -63.20% (212,000) 0.67% (29,480,898) -60.26%

TOTAL PROPERTY & EQUIP, NET 16,431,845 32.88% 16,606,853 33.24% (175,007) -1.05% 17,911,926 36.61%

DEFERRED OUTFLOWS OF RESOURCES

Pension Related Deferred Outflows 3,809,086 7.62% 3,809,086 7.62% - 0.00% 4,126,448 8.43%

Deferred Loss on Refunding 1,038,063 2.08% 1,038,063 2.08% - 0.00% - 0.00%

TOTAL DEFERRED OUTFLOWS 4,847,149 9.70% 4,847,149 9.70% - 0.00% 4,126,448 8.43%

TOTAL ASSETS 49,978,610 100.00% 49,961,581 100.00% 17,029 0.03% 48,924,866 100.00%

LIABILITIES & NET ASSETS

CURRENT LIABILITIES

Accounts Payable 421,726 0.84% 455,176 0.91% (33,450) -7.35% 251,184 0.51%

Accrued Payroll & Payroll Taxes 2,559,561 5.12% 2,395,173 4.79% 164,388 6.86% 2,021,529 4.13%

Accrued Health Ins & Flex 1,642,246 3.29% 1,526,258 3.05% 115,987 7.60% 980,841 2.00%

Deferred Pro Tax Receivable 165,896 0.33% 331,793 0.66% (165,896) -50.00% 140,896 0.29%

Due to Third Parties - Other 5,701 0.01% 3,387 0.01% 2,314 68.33% (3,493) -0.01%

Lease Payable - Short Term - 0.00% 3,095,100 6.19% (3,095,100) 0.00% 3,095,100 6.33%

Est. Third Party Settlements 312,797 0.63% 312,797 0.63% - 0.00% 150,000 0.31%

TOTAL CURRENT LIABILITIES 5,107,927 10.22% 8,119,684 16.25% (3,011,757) -37.09% 6,636,057 13.56%

OTHER LIABILITIES

Lease Payable - Long Term 545,359 1.09% 557,377 1.12% (12,018) -2.16% 647,156 1.32%

Bonds Payable - Long Term 21,692,636 43.40% 21,736,848 43.51% (44,212) -0.20% 22,143,800 45.25%

Interest Payable 205,816 0.41% 178,741 0.36% 27,076 15.15% 263,458 0.54%

Net Pension Liability 12,685,222 25.38% 12,635,222 25.29% 50,000 0.40% 12,760,847 26.08%

TOTAL LONG-TERM LIABILITIES 35,129,033 70.29% 35,108,187 70.27% 20,846 0.06% 35,815,260 73.19%

TOTAL LIABILITIES 40,236,960 80.51% 43,227,872 86.52% (2,990,911) -6.92% 42,451,317 86.75%

DEFERRED INFLOWS OF RESOURCES

Pension Related Deferred Inflows 1,817,664 3.64% 1,817,664 3.64% - 0.00% 770,475 1.57%

OPEB Related Deferred Inflows 5,953 0.01% 5,953 0.01% - 0.00% 7,306 0.01%

TOTAL DEFERRED INFLOWS 1,823,617 3.65% 1,823,617 3.65% - 0.00% 777,781 1.59%

NET ASSETS

General Fund 4,815,215 9.63% 4,815,215 9.64% - 0.00% 3,859,742 7.89%

Net Revenue (Loss) 3,102,818 6.21% 94,878 0.19% 3,007,940 3170.33% 1,844,026 3.77%

TOTAL NET ASSETS 7,918,033 15.84% 4,910,093 9.83% 3,007,940 61.26% 5,703,768 11.66%

TOTAL LIABILITIES & NET ASSETS 49,978,610 100.00% 49,961,581 100.00% 17,029 0.03% 48,932,866 100.00%

Month Month Net Change Month

CRAWFORD COUNTY MEMORIAL HOSPITAL

BALANCE SHEET

AS OF: 5/31/2021

Current Prior 1-Month 1 Year Ago

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Alcon Laboratories, Inc. - Supplies $7,137.92 Martin Bros. Dist. Co., Inc. - Supplies $3,395.04Ameritex Services - Fees $3,769.92 Masimo Corporation - Supplies $982.98Anderson Erickson Dairy - Supplies $446.51 Microsurgical Technology - Supplies $799.00Arthrex - Supplies $7,906.00 Mindray DS USA, Inc. - Supplies $1,010.64Bayer Healthcare - Supplies $1,114.68 MSDS Online, Inc. - Fees $3,049.00Bio-Rad Laboratories - Supplies $598.62 Neighbors Business Review - Advertising $129.50Bomgaars - Supplies $64.32 O'Reilly Auto Parts - Supplies $29.18Bound Tree Medical LLC - Supplies $69.47 Observer - Advertising $428.83CareFusion - Supplies $2,318.48 Ohio Medical - Supplies $257.00Carroll Broadcasting Co. - Advertising $336.00 Onmedia - Fees $491.00Civco Medical Solutions - Supplies $182.00 Ossur Americas - Supplies $492.92Compression Dynamics, LLC - Supplies $135.57 Pfizer, Inc. - Supplies $53.02Continental Fire - Fees $787.00 Pipeline Health Holdings - Supplies $3,576.93Control Masters - Fees $1,166.00 Platinum Code - Fees $141.68Convergeone, Inc. - Supplies $4,950.00 Plumbing & Heating Whsl - Supplies $94.02Counsel - Fees $1,288.92 PPP Web Design - Fees $160.00CPSI - Fees $39,462.58 Precision Dynamics Corp. - Supplies $806.44Custom Motorcycle - Fees $40.00 Prenger Furniture, Inc. - Supplies $139.99Denison Newspaper, Inc. - Advertising $4,144.75 Professional Medical Mgmt. - Supplies $6,853.00Echo Group, Inc. - Supplies $500.83 Qiagen, Inc. - Supplies $1,182.66Fareway Stores - Supplies $557.76 Rogers Pest Control, LLC - Fees $415.00Farmer Bros. Co. - Supplies $1,013.42 Secure Shred Solutions - Fees $228.00Federal Express Corp. - Fees $22.61 Sharn Anesthesia, Inc. - Supplies $693.95Genzyme Corporation - Supplies $972.98 Sherwin Williams - Supplies $44.99Grainger - Supplies $395.18 Smart Shopper - Advertising $1,104.00GRP & Associates, Inc. - Supplies $600.91 Smiths Medical - Supplies $161.74H&R Accounts, Inc. - Fees $4,566.47 Standard Textile Co., Inc. - Supplies $54.96Healthcare Compliance Test - Fees $380.00 Steris Corporation - Supplies $100.29Home Depot Pro - Supplies $368.54 Stone Printing - Supplies $73.55ICP Medical, LLC - Supplies $661.52 Stryker Endoscopy - Supplies $6,184.50ID Apparel LLC - Supplies $655.50 Stryker Medical - Supplies $10,122.62IDEXX Distribution, Inc. - Supplies $1,033.51 Stryker Orthopedics - Supplies $7,969.60Industrial Bearing Supply - Supplies $60.77 Stryker Sales Corp. - Supplies $1,188.70J & J Health Care Systems - Supplies $20,936.40 Suture Express, Inc. - Supplies $1,392.25Jerico Services, Inc. - Supplies $423.60 Tri-Anim Health Services - Supplies $126.82JP Gasway Co. - Supplies $1,180.00 Universal Publications - Advertising $150.00Karl Storz Endoscopy - Supplies $230.50 Van Meter, Inc. - Supplies $65.67Lifeserve Blood Center - Supplies $1,640.00 Virence Health Technologies - Fees $25,382.80Manilla Times - Advertising $438.20 Volkert Pro Exhaust - Fees $45.28Mapleton Press - Advertising $435.40 Welch Allyn, Inc. - Supplies $225.67Marco, Inc. - Fees $6,693.42 Win - Fees $1,500.00Marks Plumbing Parts - Supplies $228.88 Zimmer US, Inc. - Supplies $3,725.53

May Check Run $204,943.89

TO BE PAID THIS MONTH - May 2021

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Abbott Laboratories - Supplies $483.85 Landauer, Inc. - Fees $471.00Airgas USA, LLC - Supplies $3,349.63 Language Line Services - Fees $714.12American Cancer Society - Sponsorship $1,000.00 Debra Legore - Expenses $144.00Avel eCare, LLC - Fees $7,001.94 Macro Helix, LLC - Fees $10,547.14Baxalta US Inc. - Supplies $9,240.00 Main St Cakes & Gifts - Fees $216.00Beckman Coulter, Inc. - Fees $1,745.73 Manilla Times - Advertising $305.38Bio-Rad Laboratories - Supplies $1,063.94 Macro, Inc. - Fees $4,496.50Black Hills Energy - Utilities $354.29 McKesson Medical Surgical - Supplies $2,902.77Natalie Bohlmann - Expenses $31.00 Coleen McLaughlin - Expenses $31.00Boston Scientific Corp. - Supplies $331.12 Medi-Dose, Inc. - Supplies $458.88Bracco Diagnostics, Inc. - Supplies $674.29 Medical Solutions, LLC - Fees $58,051.50Brown's Medical Imaging - Fees $11,981.25 Medivators, Inc. - Supplies $350.00Cable Channel 13 - Fees $250.00 Medline Industries, Inc. - Supplies $2,148.98Campbell, Smith & Assoc. - Fees $800.00 Network Services Company - Supplies $1,232.61Caravan Health - Fees $5,000.00 New York Life - Premiums $5,086.97Cardinal Health - Supplies $26,907.07 Nuclear Sonics - Fees $3,414.00Carroll Control System - Fees $493.79 NW Iowa Yes Center - Fees $2,590.75CCMH Auxiliary - Fees $35.00 Erin Olson - Expenses $144.00CDW Government, Inc. - Supplies $46.28 Omnicell, Inc. - Fees $1,605.00CenturyLink - Telephone $864.89 Ortho Clinical Diagnostic - Supplies $360.00Chamber & Development - Sponsorship $1,250.00 Owens & Minor - Supplies $11,147.76Change Healthcare - Fees $5,114.74 Oxen Technology - Fees $10.00CHI Health - Fees $1,636.50 Pentax Medical - Supplies $190.00CMS Communication, Inc. - Supplies $47.67 Petty Cash - Fees $100.00Cobblestone Inn - Fees $1,091.00 Pfizer, Inc. - Supplies $327.50CompHealth - Fees $36,204.42 Pharmacy Onesource - Supplies $474.27Compression Dynamicss, LLC - Supplies $277.69 Physicians Lab Services - Fees $14,784.00Craw. Co. Abstract Co. - Fees $180.00 Pipeline Health Holdings - Fees $1,745.85Crawford County Home Health - Fees $39.06 Platinum Code - Supplies $390.94Crystal Clear of SW Iowa - Supplies $100.00 Phyllis Poggensee - Expenses $31.03Database Solutions, Inc. - Fees $3,920.00 Practical Sleep Services - Fees $5,000.00Dearborn National - Premiums $20,150.71 Precision Dynamics Corp. - Supplies $44.72Julie Dekker Flint - Expenses $100.00 Priority Healthcare Dist. - Supplies $4,674.10Denison Municipal Utilities - Utilities $17,369.68 QuVa Pharma, Inc. - Supplies $1,199.08Denison Rotary Club - Fees $200.00 R & S Waste Disposal - Fees $1,290.10Dish - Fees $591.66 Dr. Elizabeth Ranniger - Expenses $144.00Do It Best Hardware - Supplies $11.99 Reimer, Lohman & Reitz - Fees $500.00Dorsey & Whitney - Fees $903.65 Rolling Hills Community Services - Fees $4,785.00Electronic Engineering Co. - Fees $64.80 Lisa Sample - Expenses $40.32EPS, Inc. - Supplies $48.31 Scopifi - Fees $162.68Eventide Lutheran Home - Fees $76.50 Shared Medical Services - Fees $1,075.00Fareway Stores - Supplies $66.27 Siemens Healthcare Diagnostic - Fees $3,256.80FFF Enterprises - Supplies $299.20 Dr. Eric Simons - Expenses $40.00First National Bank Omaha - Expenses $3,542.73 Shirlene Simon - Expenses $13.44Rochelle Frain - Expenses $4.49 Smart Shopper - Advertising $39.00Frazier Contracting Corp. - Supplies $30.75 St. Anthony Regional Hospital - Fees $2,940.00Frontier Telephone Co. - Telephone $106.30 Staples Advantage - Supplies $964.31Grainger - Supplies $62.94 State Hygienic Laboratory - Fees $610.00Greatamerica Financial SE - Fees $1,303.00 Steris Corporation - Supplies $344.71Jamie Gross - Expenses $72.02 Stryker Rental Services - fees $511.30Growmark FS - Fuel $1,165.07 T.A. Penke & Associates - Fees $32.00Health Enterprises - Fees $3,611.71 Thoroughcare, Inc. - Fees $895.00Healthcare Compliance Test - Fees $1,900.00 Tri-Anim Health Services - Supplies $32.34IA Assn for Rural Health - Fees $300.00 Tri-State Specialists - Fees $4,500.00IA Dept of Public Health - Fees $105.00 Turnkey Pharmacy Solutions - Fees $850.00ICU Medical, Inc. - Supplies $5,765.16 UnityPoint Health - Fees $810.00Intrado Interactive Services - Fees $340.16 US Foods - Supplies $6,417.79J & J Health Care Systems - Fees $2,662.77 Van Meter, Inc. - Supplies $70.71Jackson Physician Search - Fees $10,067.21 Verizon Wireless - Telephone $472.00Lori Johannsen - Expenses $215.00 Vision Service Plan - Premium $3,647.74Joint Restoration Foundation - Supplies $2,355.00 West Bend Mutual Ins. Co. - Premiums $10,128.50KFMC Health Improvement - Fees $725.85 Western Iowa Networks - Telephone $1,680.32Jill Kierscht - Expenses $1,291.51 Kelly Weiman - Expenses $134.96KPNINJA - Fees $1,800.00 Patient Refunds $6,738.80

Manual Check & ACH Total $387,341.26

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DEPRECIATION FUND:Omnicell, Inc. - Med Cabinet $36,992.67

Depreciation Total $36,992.67

Salaries $1,370,839.76

GRAND TOTAL $2,000,117.58

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Crawford County Memorial Hospital FY 2021

Writeoffs May-21 Year to Date

Hospital 51,793.64$ 1,191,032.35$

CCMH Medical Clinic 9,316.29$ 141,302.30$

TOTAL 61,109.93$ 1,332,334.65$

Recoveries May-21 Year to Date

Avadyne Health 21,352.57$ 259,721.32$

In-house Recoveries 35,471.07$ 79,299.24$

General Service Bureau -$ 405.50$

Hawkeye -$ 980.08$

Returned Accounts -$ 560.90$

Small Claims -$ 10.00$

TOTAL 56,823.64$ 340,977.04$

YTD Recovery Rate 25.59%

Accounts Payable

Monthly Check Run 204,943.89$

Manual Check Run 387,341.26$

Depreciation Fund Checks 36,992.67$

Salaries 1,370,839.76$

Grand Total 2,000,117.58$

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Iowa Code 347.10

347.10 Vacancies. Vacancies in the board of trustees may, until the next general election, be filled by appointment by the remaining members of the board of trustees or, if fewer than four trustees remain on the board, by the board of supervisors for the period until the vacancies are filled by election. If any board member is absent for four consecutive regular board meetings, without prior excuse, the member's position shall be declared vacant and filled as set out in this section.

Board of Trustee By-Laws

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CEO Report

June 25, 2021

Good Day,

Customer service education by this year’s SEA’s is underway and has been well received. This will be

completed in the middle of July. The Caregiver Engagement Survey has also been sent out to staff and

the results will be collected by July 2. OASIS teams continue with their projects and are making

progress. We should have a report for the Mission Committee next month.

Continued comparison to pre-COVID volumes show a decrease in 3% when compared to May of 2019.

Clinic visits continue to lag from pre-COVID numbers which can be attributed to lower radiology

numbers. On a positive note, surgeries are showing positive signs of a comeback. There were only 2

less surgeries this May than May of 2019. The orthopedic program has contributed to this

improvement. There were 28 orthopedic surgeries this May, compared to 9 in May of 2019.

Our Paycheck Protection Program (PPP) loan was finally forgiven in May, which you will note on the

income statement as Nonoperating Revenue. Gross revenue was $1 million less than budget. Expenses

were under budget by $435,000. Without the PPP loan income, we would have seen a net loss of about

$87,000 for the month, however we remain $2.3 million better than budget year-to-date. This

improvement from budgeted projections was partially due to contractual adjustments, but more

importantly, expenses are under budget by $2.8 million year-to-date.

Total cash balances ended at $20,411,683, a $15,493 increase from last month. Please note that with

the purchase of Dr. Luft’s practice, cash balances will go down in June. May days of cash on hand ended

at 226.

Heather will present the most recent COVID statistics at the meeting. We will have some new changes

starting July 1 regarding our visitor policies since our positivity rate is at or near zero.

LaVerne Ambrose has submitted his resignation from the board after 16 years. We thank him for his

service to CCMH and our community. He has been through many positive changes throughout the

years. A new member will need to be appointed on Monday to his open position as per Iowa Code

347.10.

We are in the process of receiving proposals and conducting interviews to select a vendor to complete

our 10-year master facility plan. The entire planning process should take 3-6 months. Once this process

is completed, it will be presented to the board for review before FY23 budget in case there is a need to

address any immediate concerns.

I look forward to seeing you Monday evening. Please let Wendy know if you cannot attend.

Kind Regards,

Erin

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