Greeneville Community Hospital Opposition to HealthStar Imaging – CN1912-056 June 23, 2020
MRI Locations in HealthStar Imaging Proposed Service Area Proposed HealthStar MRI • CT • Hawkins Ultrasound • X-ray • Mammography • Bone Density • Greene Hamblen GCH East MRI (2) – Open and Closed • CT • Ultrasound • X-ray • Mammography • Cocke GCH West Bone Density • MRI • Ballad CT • HealthStar Ultrasound • X-ray • Other Providers 2
Net Revenue Impact for Key Service Lines April-May % Diff Two Month Revenue Impact Discharges -20% (1,007,920) OP Surgery -39% (600,496) OP Emergency -35% (834,768) OP Imaging -39% (1,232,985) Total ($3,676,169) As a result of covid-19 there has been a significant reduction in volumes in key service lines. The volume reductions that have occurred over the past two months have ranged between 20-40% below the prior four month average run-rate. Further, as a result of reduced volumes, the facility has produced significantly less revenue during this time period.
Unemployment Rates for Greene County Unemployment rates have increased sharply over the past 60 days from a 4.3% to 17.1% in Greene County. The percentage point increase year-over-year has increased 13.4%. The Greene County unemployment rate is 2.4% higher than 17.1% the state rate for the month of April. Source: https://www.tn.gov/workforce/tennessee-economic-data-/labor-force-statistics/unemployment-rates.html
Charity Care and Bad Debt $16 Contra Revenue Charity Millions This graph details the allowances and Bad Debt $15.2 Million for bad debt and charity care for Total $14 Charity FY19 and FY20 YTD May Annualized. $12 7.6 The annualized combined total for $10 $10.3 Million bad debt and charity for FY20 is Total expected to be $15,184,217 which 4.8 $8 is 48% greater than the prior year. $6 There is a year-over-year increase in the total self-pay payor mix of $4 7.6 0.71% which is a large portion of 5.5 the additional bad debt and charity $2 allowances. $0 FY 2019 FY 2020 YTD May Annualized
Greene County Consolidated Financial Performance Impact of COVID-19 FY 2019 FY 2020 FY 2020 Feb Annualized May Annualized Total Operating Revenue 111,946,012 109,361,444 100,229,633 Total Operating Expenses 122,488,291 110,781,303 106,479,642 Net Operating Income (10,542,279) (1,419,859) (6,250,009) Before Support Allocation
Greene County Consolidated Financial Performance Impact of COVID-19 FY 2019 FY 2020 FY 2020 Feb Annualized May Annualized Total Operating Revenue 111,946,012 109,361,444 100,229,633 Total Operating Expenses 122,488,291 110,781,303 106,479,642 Net Operating Income (10,542,279) (1,419,859) (6,250,009) Before Support Allocation Impact of $2.9 Million Net Income Loss to (4,319,859) (9,150,009) HealthStar* Note: Impact of Net Income Loss to HealthStar calculated assuming 75% of the net income projected in year 1 of the HealthStar project would come from imaging studies that would have otherwise been performed at Greeneville Community Hospital
Proposed Project Charity Care Comparison $300,000 Total Project MRI $240,596 $250,000 $200,000 $150,000 $100,000 $77,133 $50,890 $50,000 $18,129 $0 HealthStar Greeneville Community Hospital 8 Source: Each project’s respective CON Application
Proposed Project Payor Mix Comparison HealthStar Greeneville Community Hospital Medicare/Medicare Medicare/Medicare Managed Care Managed Care 52% 52% Self Pay 1% TennCare Self Pay TennCare/ /Medicaid 10% Medicaid Commercial/Other 9% 13% Commercial/ Managed Care Other 38% Managed Care 25% 9
Service Area MRI Utilization Average MRI Scans per Unit - 2018 3,500 3,000 HSDA Standard - 2,880 2,500 2,000 Current Average - 1,589 1,500 Current average 1,000 is 59% of the Need Standard 500 0 Newport MC GCHE GCHW HealthStar Hamblen Morristown-Hamblen Lakeway RH Hawkins Co. MH Series 1 HSDA Standard Current Average Source: HSDA Medical Equipment Registry Note: Hawkins County Memorial Hospital average based off of service 2 days per week 10
Proposed Service Area Population From page 22 of HealthStar CON Application: Population by County 140,000 120,000 Population 100,000 66,217 Overstated 80,000 60,000 40,000 69,382 64,906 56,622 20,000 35,303 0 Greene Cocke Hamblen Hawkins Source: https://www.tn.gov/content/tn/health/health-program-areas/statistics/health- 11 data/population.html
MRI Locations in HealthStar Imaging Proposed Service Area Proposed HealthStar MRI • CT • Hawkins Ultrasound • X-ray • Mammography • Bone Density • Greene Hamblen GCH East MRI (2) – Open and Closed • CT • Ultrasound • X-ray • Mammography • Cocke GCH West Bone Density • MRI • Ballad CT • HealthStar Ultrasound • X-ray • Other Providers 12
Greeneville Community Hospital ODC CN2001-001 June 23, 2020
MRI Locations in GCH ODC Proposed Service Area Greene Hamblen GCH East MRI (2) – Open and Closed • CT • Ultrasound • X-ray • Mammography • Cocke GCH West Bone Density • MRI • Ballad CT • HealthStar Ultrasound • X-ray • Other Providers 14
Service Area MRI Utilization Average MRI Scans per Unit - 2018 3,500 3,000 HSDA Standard - 2,880 2,500 2,000 Current Average - 1,589 1,500 Current average 1,000 is 59% of the Need Standard 500 0 Newport MC GCHE GCHW HealthStar Hamblen Morristown-Hamblen Lakeway RH Hawkins Co. MH Series 1 HSDA Standard Current Average Source: HSDA Medical Equipment Registry Note: Hawkins County Memorial Hospital average based off of service 2 days per week 15
Greene County Consolidated Financial Performance Impact of COVID-19 FY 2019 FY 2020 FY 2020 Feb Annualized May Annualized Total Operating Revenue 111,946,012 109,361,444 100,229,633 Total Operating Expenses 122,488,291 110,781,303 106,479,642 Net Operating Income (10,542,279) (1,419,859) (6,250,009) Before Support Allocation Impact of $2.9 Million Net Income Loss to (4,319,859) (9,150,009) HealthStar* Note: Impact of Net Income Loss to HealthStar calculated assuming 75% of the net income projected in year 1 of the HealthStar project would come from imaging studies that would have otherwise been performed at Greeneville Community Hospital
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