FERRIDAY, La. &045; During an audit presentation by CPA Bob Miller on Tuesday, the Riverland Medical Center board discussed proactive solutions to increase revenue and patient volume.

Miller reported the hospital had a net loss of $284,304 for the fiscal year 2002, but $386,839 of that figure is depreciation and amortization for the building, land and equipment and is not cash flow. Thus, the hospital’s financial statement does reflect a positive cash flow.

Miller said that where the hospital does lose money is in uncompensated costs &045; which accounts for patients who are not insured or have no intention of paying the hospital back.

The Rural Hospital Preservation Act was established to reimburse uncompensated costs to public, rural hospitals with 60 beds or less. The federal government pays 70 percent and the legislature pays 30 percent of the state costs.

Vernon Stevens, administrator and board member of the hospital, said the time period of reimbursement is always a year behind. If the hospital accrues more uncompensated costs this year, the reimbursement will not be received until the following year.

The board discussed several avenues to increase volume and revenue if the hospital team works together.

One of those options is discharge planning &045; the shifting of care to another mode or using more aggressive treatment.

For example, the shifting of care to a swing bed will help keep the hospital from taking a loss on Medicare patients. Medicare is for adults 65 and older and is diagnostic related grouping, or DRG. Medicare pays the hospital a set amount for those patients depending on the diagnosis.

The Medicare costs may only cover three days in the hospital but if the patient stays 10 days the hospital takes a loss.

The swing bed can prevent those additional costs by having a doctor discharge a patient from the hospital and readmit to the swing bed. The swing bed will bring in $200 per day.

Only patients who qualify for skilled nursing will be eligible for the swing bed.

The board said it will be sending staff members to a seminar to learn more about the swing bed process.

The hospital will also be hiring two doctors and an internist to increase patient volume.

One of the doctors being hired will work full-time for the hospitalist program. The hospitalist doctor sees patients who do not have a regular doctor, which keeps the hospital’s physicians from being on call 24 hours a day and therefore saves money.

Stevens said it costs about $1,000 per day to have the hospitalist program and 18 to 20 admissions per month pays for the costs.

Miller recommended the hospital look at programs that can stand to be cut.

Stevens said the hospital cut the cardiac rehabilitation center last year because Medicare did not pay for it and it was not in great demand. Stevens also said there are some programs that will absolutely not be cut because of the high demand they command. One of these is the baby delivery unit. &uot;Others may have more money in the bank but we’re the only one that delivers babies,&uot; said Stevens of other rural hospitals in Concordia Parish.

As to the hospital’s finances, the outlook for the future will be worked on through proactive measures and a team effort.

&uot;We are a strong rural hospital,&uot; said Stevens.