Thank you for your overwhelming support of healthcare in Greeley County. We will continue to strive to make Greeley County Health Services a model healthcare facility that serves your needs.
Questions and Answers
What are you asking me to vote for?
Greeley County registered voters will be asked a “yes” or “no” question on the April 5 election ballot to increase the Greeley County Hospital’s mill levy. The hospital currently gets 6 mills of tax support every year. Voters are being asked to increase that from 6 to 21 mills, which is an increase of 15 mills.
The actual question is;
“Shall the Board of Supervisors of Unified Greeley County, Kansas, have the authority to levy a tax in the amount of twenty-one (21) mills for the purpose of operating, maintaining, equipping and improving the Greeley County Hospital?”
In 2011, 6 mills will be about $168,000. The Long Term Care facility receives an additional 4 mills or about $112,000 and that will remain the same.
When was the hospital mill levy last increased?
The hospital mill levy has been at 6 mills for 21 years, since 1990.
At that time, the Long Term Care facility mill levy was 2 mills, making the total for Greeley County Health Services (GCHS) 8 mills in 1990.
What percentage of the healthcare budget is funded by tax dollars?
For comparison, in 1992 the GCHS (hospital plus LTC) budget was $1.1 million and the tax money of $219,390 provided 20% of the budget.
In 2010, the GCHS budget (hospital plus LTC) was $10,000,000 and the tax money of about $356,120 provided 3.5% of the budget.
What is the tax money spent on now?
Tax money is used to pay insurance such as workman’s compensation and physician liability, purchase equipment and to help with operations such as pay bills and payroll if necessary.
The monthly payroll averages around $400,000 so right now the $280,000 of tax money doesn’t equal one month’s payroll.
How many employees does the hospital have?
Currently there are about 140 employees at Greeley County Health Services. The annual payroll is about $5,000,000.
If the mill levy increase passes, what will the money be used for?
Greeley County Health Services has an extremely high need to replace antiquated equipment still in use, much of which is ten or more years old and much of which was purchased used. Some specific items might be laboratory equipment, an updated CT scan, physical therapy and cardiac rehabilitation equipment. In addition, GCHS must complete a system-wide Information Technology (IT) conversion to meet federal regulations from the new healthcare reform.
Our employees have received little or no pay increases for the past several years. GCHS needs to catch up and keep up with our surrounding regional pay levels to remain a competitive employer. Our loyal employees need to be rewarded for their competencies. Accounts payable also needs to be caught up.
Efforts and funding need to be put into recruitment of physicians and other critical employees.
A breakeven/ profitable trend would allow GCHS to stabilize and improved operations, and begin to look forward proactively at future goals. Goals such as again being able to offer obstetrics, and increasing other services are long-term goals that must begin with stabilizing the current system.
What services does GCHS now offer that have been added in the 20 years that the mill levy has remained the same?
The following services have been added with no increase in the mill levy:
- Full-time physical therapy
- Home health services
- Improved laboratory services
- In-house CT Scan and Digital Radiology
- 140 employees (36 in 1992)
- Four physicians and three part-time mid-level providers
- Surgical services
- Specialty clinics
- Mobile services for MRI, Bone Density, Mammography
- Comprehensive health system of hospital, LTC and two rural health clinics
What is the financial impact of Greeley County Health Services in the community?
The Health Services employs 140 people, with an annual payroll of about $5,000,000.
Direct cash payments to local Greeley County vendors last year exceeded $711,000.
There is a standard community development multiplier “Rule of 7”, that says every dollar spent locally in a community goes around 7 times, or can be multiplied by 7, to see its total impact.
Are the 140 jobs, $5 million payroll, and $712,000 to local vendors only in Greeley County, or is that in the hospitals entire service area?
The $712,000 are dollars spent to vendors in Greeley County only. As you can imagine with a $10,000,000 budget, we have expenses that go to out of town vendors for items we cannot purchase in Greeley County. (For answer on payroll, see the last question.)
Are there any guidelines that dictate what part of the hospital budget that tax dollars can be spent?
The general guideline from the state statute K.S.A. 19-4606 permits the Board of Supervisors of Unified Greeley County to annually levy a tax for the purpose of operating, maintaining, equipping and improving the Greeley County Hospital. Tax dollars are kept in a separate board account. This money cannot be spent without the board’s approval and two or more board signatures for authorization. Part of this money is spent every year on physicians’ liability insurance and workman’s comp. insurance. One of the requirements for the hospital board is that adequate insurance is provided on the physicians, so that is what part of the money goes for. In a best case scenario, the balance of the board funds not used to pay insurance is used to purchase equipment or otherwise enhance the facility, but sometimes funds have to be used to meet payroll, if necessary, in less favorable economic times, when hospital census is low, etc. Keep in mind that $280,000 of tax money is not even one full month’s payroll. Once in a great while, board funds have been used to pay an outstanding account payable.
Currently, how much of the hospitals budget is made up of tax dollars and how much of the budget is made up of revenue generated from the hospital and/or other sources?
The current hospital budget is $10,000,000 and the current tax dollars are $280,000 which is 2.8%. We do get some additional funds from resources such as grants which provided $220,000 in 2010 and will be about $180,000 in 2011 (with some grants still pending.) We currently have a staffing agreement with Hamilton County which totals $360,000 annually. This is a straight contractual arrangement which means we do not “bill” the patients for our time down there — the Hamilton County Hospital pays Greeley County Health Services this amount directly. Our providers are simply paid for their time in the hospital and clinics. There is also revenue generated from each clinic in Tribune and Sharon Springs, the long term care and departments such as physical therapy and home health. However, when we say “the hospital”, we mean Greeley County Health Services which includes the entire system.
Are the satellite clinics under GCHS funded through mill levies in those counties? If not how are they funded and are Greeley county taxpayers helping fund the clinics in the other counties with their tax dollars?
The clinic in Syracuse is owned and operated by Hamilton County Hospital. The clinic is Sharon Springs is owned and operated by Greeley County Health Services. The building in Sharon Springs was constructed by the Greeley-Wallace County Healthcare Foundation and the building costs and equipment were purchased through grants and local donations at no cost to the Greeley County Hospital.
The clinic in Sharon Springs accounts for almost a full third of all clinic visits. When patients are seen in Sharon Springs, they are billed and the money is returned, to Greeley County Health Services (GCHS). The Sharon Springs clinic operates at a breakeven and that breakeven does not include the financial impact of the patients who travel to the GCHS for hospitalization or other tests which is 28.9% of the total GCHS or other testing such as labs which are drawn in Sharon Springs but performed in GCHS. We do our best to allocate expenses (such as salaries) to each profit center or location and at Dr. Moser’s direction years ago, we have worked hard to view ourselves as an entire system.
Are the salaries of the staff that circulate through the satellite clinics being paid from different funding sources when they are at the satellite clinics, or are the entire salaries of the staff that circulate through the satellite offices being paid from funds generated from the mill levy in Greeley county?
Staff in Syracuse are paid for through the Hamilton County Hospital. Staff in Sharon Springs are paid out of the Wallace County Clinic profit center. As an example, GCHS allocates a percentage of each physician’s time to each clinic, where it becomes part of their expenses. The staff who primarily stay in that clinic full time are also allocated there, although on any given day a staff member can be working partially or exclusively on something that benefits one clinic or another – or the entire system. For example, currently, all of the clinic billing is done in Sharon Springs. Those ladies’ salaries are allocated entirely to the Sharon Springs profit center and yet some of their work is systemwide as well. We do work to allocate time equitably.
The history of the clinic is Sharon Springs is a long story which has created a hand-in-hand benefit to both of our communities. A number of years ago, we put together a joint county group to investigate the standards across the state and we found that in every other Kansas county without a hospital, a satellite clinic was operated at the expense of a regional hospital. This serves a number of purposes but one of the most important financial reasons is to funnel patients back to the parent hospital. We found that in 2010 the vast majority of Wallace County residents were hospitalized in Tribune with only a handful seeking care at the two other hospitals within 30 miles of Sharon Springs. This is an important revenue stream for GCHS.