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WINNSBORO – The Fairfield Memorial Hospital Board of Trustees is looking for multiple ways to deal with the hospital’s declining revenues and empty beds, but its financial picture improves.

During the Finance and Audit Committee meeting Tuesday evening, Board members heard from the hospital’s consultants, Brent and Doug Rollins, of Receivable Solutions (RSI), which has been assisting FMH in improving its collection of money owed by patients and insurance companies. FMH trustees and management also learned ways to avoid payment denials from Medicare and insurance companies and how to attract more patients to the inpatient floor with swing beds.

It was explained that under Medicare rules, small rural hospitals can participate in the swing bed program, meaning that a bed can be used for either an acute care patient or a post-acute patient who has been discharged from a hospital stay of at least three days but who still requires skilled nursing care. For example, a patient, after undergoing heart surgery at a Columbia hospital, could be transferred to a Fairfield Memorial swing bed if they needed additional skilled care.

Putting patients into swing beds provides an important source of revenue for the inpatient side of FMH, because the rate the hospital receives is more than its normal charges.

However, during the Finance and Audit Committee meeting held before the full Board meeting, Chief Financial Officer Timothy Mitchell expressed his concern about the drop of revenues from the swing beds for the current period compared to the previous year.

“Our swing bed program has been decimated,” he said.

“The problem is not in the outpatient business, it is in our swing bed business,” hospital CEO Suzanne Doscher added.

Statistics reviewed by the Board showed that the average daily patient census for March 2017 was .52 (i.e., on some days there were no patients in the hospital) compared to 2.65 in March 2016. However, ER admissions and other outpatient admissions were up in March 2017 compared to the same month a year ago.
During the full Board meeting, Darlene Hines, Chief Operating Officer, described steps the hospital is taking to try to fill its swing beds, including an outreach initiative to identify Fairfield county residents receiving acute care services in other medical centers who could be transferred into a swing bed for continued recuperation.

The consultants cautioned that “denied claims” is another area where the hospital could lose money. Claims for payment of services can be denied by insurance companies and government payers such as Medicare and Medicaid when the hospital does not meet conditions necessary for payment, even if it provided the services.

The two biggest reasons for denial of claims, Mitchell said, are failure to obtain proper pre-authorization for a procedure or a hospital stay, and billing for a service deemed not medically “necessary”.

Board member Randy Bright wanted to know why the hospital was making these kinds of errors and asked where the gap is in terms of hospital procedures and staff training.

“Do we have the right training in place?” Bright asked.

Rollins said that insurance companies are always changing the rules on what must be pre-authorized, but noted that the hospital has more work to do and needs to do a better job in training staff to follow appropriate policies and procedures in order to avoid claim denials.

On the down side, Mitchell said that patient revenues continue to decline and are down more than $950,000 from the previous year. FMH also took a hit in March because its CAT scan machine was down for repairs. The hospital’s imaging service line is one of its primary revenue generators. However, the Board was assured by staff that the scanner is now 100% operational.

Although March was a bad month for patient revenues, Mitchell said, the hospital’s year to date financial report for March 2017 looked hopeful compared to the same period last year. Year to date earnings (before depreciation and taxes) was about $308,000 compared to a negative $847,471 in 2016. Mitchell said that in April the hospital earned enough money to meet its budget, and that it also had a significant inflow of cash due to increased collections through the South Carolina Department of Revenue G.E.A.R. program and tax refund set-off.

Finally, Mitchell said the hospital continues to cut its operating costs, which have decreased by more than $683,000 since last year.

BLYTHEWOOD – The Blythewood Planning Commission recommended that Town Council not adopt a zoning ordinance that would have deleted the R-5, R-8 and R-12 zoning districts from the Town’s zoning map and leave hundreds of parcels of land to be rezoned. Instead, Commissioners recommended downzoning 30 selected parcels from either R-5 or R-12 zoning districts to D-1, with the exception of 150.19 acres of The Abney Hills Estate after representatives of the builder in that development objected.

“We’re suggesting an alternative that will leave the text alone, leave those districts in place and keep the development rights in tact for those projects that are already developed on top of those districts but downzone select parcels that have either the R5, R8, or R12 zoning,” Planning Consultant Micheal Criss told the Commission. Chairman Bryan Franklin compared the alternative recommendation to using a “scalpel” approach instead of the “sledgehammer” approach.

Representatives from Essex Homes, the owners of the Abney Hills Estate, attorney Steven Harvey and planner Frank Berry were in attendance to argue that the Abney Hills Estate would be negatively affected if it were downzoned.

“Changing this zoning on us in mid-stream is going to have a big impact not just on us as the landowners but also on our residents in the neighborhood. They will see increased association dues due to the lost number of lots that could have potentially been there,” Berry said.

“It was a plan there and we looked at that plan and made the numbers work. We in this industry have to rely upon you doing what you say you’re going to do, it’s the only way we have for projecting our needs in the future and investing our dollars in areas. There has to be a level of certainty there and that’s really all I wanted to say,” Harvey added.

Builder Mike Shelley began developing Abney Hills in 2008. After his death, the property was transferred back to the bank, and the bank in turn sold lots to Hurricane Homes. When looking to offload the property to a developer the bank reached out to Essex Homes in 2013.

Franklin saw downzoning the Abney Hills Estate as an undue burden on homeowners in the neighborhood who could potentially see their homeowner’s association dues increase by as much as three times, due to smaller lot sizes.

“The issue I have is the existing homeowners, like in Oakhurst. So, if you live in Abney Hills Phase 1 right now, and you’re paying a regime fee or homeowner’s association dues, based on so much per year or per month, all of a sudden that’s going to triple in cost,” Franklin said.

Commissioner Cynthia Shull disagreed with that assessment. While acknowledging that she would be out-voted, Shull pointed out that the developers “have had four years to do something.” Shull leaned towards rezoning all 31 parcels of land listed by the Commission including the 150.19 acres of the Abney Hills Estate.

Commissioner Donald Brock worried that changing the zoning rights to Abney Hills Estate would not only be in bad taste, but could open the Commission up to potential legal ramifications.

“It seems to me that rocking the boat on that particular development would be a little bit of a bad taste. Probably would get us in a little bit of legal trouble, and I don’t really feel like fighting a lawsuit from a volunteer Commission position. So I’m for exempting your property from the downzoning with the understanding that you will build in good faith,” Brock said.

Criss said neighborhoods such as Oakhurst and Cambridge Point, that are in the R-8 zoned districts were excluded from the list of the 31 locations to be downzoned, because they have already been constructed or have gotten approval to begin the process.

“We’re not proposing that the zoning be changed, downzoned to a lower density, because they’re either already built like Oakhurst, like Dawson’s Creek and Dawson Pond or they’ve been through the approval process like Cambridge Point so don’t pull that zoning rug out from under them,” Criss said.

In, addition R-12 zoned parcels that did have at least 20,000 square feet were left off of the list because downzoning them to a D-1 zoning classification would create a non-conforming lot or structure. Non-conforming lots can lead to a number of headaches, particularly in the private sector, including issues with titles, financing, insurance and marketability.

Of the 30 lots listed, excluding Abney Hills, only two R-5 zoned lots were included. (what were the rest?) This led Donald Brock to propose that the two current R-5 zoned parcels be rezoned, and then remove just the R-5 classification.

Criss said this was possible with a new ordinance, but pointed out that removing the R-5 zoning from the text would remove an important tool in limiting commercial development from encroaching into the Town Center.

“R5 is the only residential district that allows multi-family, maybe you don’t want multi-family but suppose at some point in the future the commission and/or the council decides that we have enough apartments there already in the Town Center District,” Criss said. “We got a good project just outside but we don’t want to allow a lot of commercial encroachment too far beyond the town center, that R5 is a surgical district, it says ok you can do the multi-family but you can’t do all kinds of commercial on it.”

The motion to recommend downsizing the selected 30 parcels to D-1, from either their R-5 or R-12 designation with the exception of the Abney Hills Estate, passed. Donald Brock abstained from voting and Cynthia Shull voted to downsize all 31 parcels.

JENKINSVILLE – The question of how much water customers are being billed each month by the Jenkinsville Water Company is again under the microscope.

According to water reports delivered at the company’s regular monthly Board meeting on Monday evening by JWC’s water operator James Green, the company billed its 400+ customers for 2,829,285 gallons of water in March and 3,221,260 gallons in April – a 2 million gallon per month drop from what the company billed those same customers in January (5,307,070 gallons) and February (5,106,022). Prior to January, records show total monthly customer billings averaging in the 3 million range, just as they did in March and April.

“Something doesn’t match up here” customer Dee Melton told the JWC Board members. “You billed more than 5 million gallons of water in January and again in February, and then dropped back to about 3 million gallons in (each of) March and April. Those numbers shouldn’t fluctuate that much.” Melton said. “Is there a reason for this?”

“The plant shut down?” Board member Julie Brendell offered with a shrug of her shoulders.

“The readings come from water sales out of the office here,” Greg Ginyard, President of the JWC Board, said. “The amount of water that’s produced, the amount of water we purchase from Mid-County Water, Ms. Hollins does the amount of water we bill and that’s where those numbers come from,” Ginyard said.

“And we had a computer glitch,” Board member Preston Peach added, interrupting Ginyard, “and we had some double billings go out. But we caught it and changed that. I’m not sure,” Peach said.

“Does the Board approve these water reports?” Melton asked.

“We have to see them before we show them to the public,” Ginyard said.

“Is that an approval process?” Melton asked.

Several Board members mumble but give no answer.

“My question is why is there a 3 million gallon difference (in customer billing) between the January and February reports and the March and April reports?” Milton asked.

“Put that in writing and we’ll give you all that information,” Peach said.

“Mr. Melton, we can’t say how much water you used this month or how much anyone else used this month,” Ginyard said. “You don’t use the same exact amount of water every month. All we can go by when the guys read (the meter) and they bring it in the office and put it in the computer and it’s billed out by the number of gallons that were used, there’s no way we can say you may have had a leak. Things happen to change the meter reading.”

“My question is specifically about the amount of water billed to customers. Why was it 2 million gallons more per month in January and in February than it is in March and in April,” Melton repeated.

“We’ll get back to you at the next meeting,” Peach told Melton. “There are other reasons for the numbers being different. There are several reasons together that cause this.”

Questions about the monthly water report from those who attend the board meetings are an ongoing point of contention between the customers and the Board. There is frequent criticism from those in attendance that Green gives his report at the beginning of the meetings, then leaves without taking questions.

Earlier in the Monday evening meeting, following Green’s water report, Melton again asked if he could ask Green about the report.

“No Sir, not at this time,” Ginyard said as Green left the room.

“We’re going to move on,” Ginyard said. “Next we have open discussion for customers and visitors.”
But when customer and water company member Bertha Goins asked, “How did you arrive at the amount of increase (in water bills) for residents and commercial users?” more than a minute of silence ensued as Ginyard sat silent, looking down at the table.

When urged by others in the audience to answer Goins’ question, Ginyard spoke up.

“What we the Board had said was, any questions that anyone has, bring any questions to the office and we’ll answer them at that time. We would use up a lot of time and get into a back and forth, so I was instructed by board members that we would not be doing that (answering questions) at meetings.”

“Then, why should we even come to the meetings?” customer John Hones said, speaking up from the audience.
“To see what’s going on,” Ginyard said.

“These people here are not unruly. They are very polite and respectful. Gee whiz, courtesy calls for a simple answer,” Jones said.

Ginyard called for the next speaker.

Following an executive session that lasted more than an hour to address agenda items “contractual (new well), personnel and legal matters (Broad River Campground lawsuit),” the Board reviewed the company’s monthly financial statement. When The Voice asked for a copy of the statement, Ginyard refused, saying the Board had not yet approved it.

Following the meeting and approval of the financial statement, The Voice again asked for the statement.

“No, Ginyard said. “I will have to check with our attorney to see if we can give out financial reports…it’s not public information.”

JWC Board meetings are held the first Monday of each month at the company’s office at the intersection of Hwy 215 and Hwy 213 in Jenkinsville.