The Regional Medical Center's president and CEO says he’s confident the new Bamberg-Barnwell Emergency Medical Center will not be a financial drain on the hospital.
"The numbers have been out there saying we are going to lose millions of dollars on the free-standing” emergency department, RMC President and CEO Charles Williams said Tuesday.
"I am unwilling to accept that,” he said.
"What we are trying to do here at the main shop as we build that facility is we are trying to make some modifications and changes so that we can efficiently operate not only the medical center but also our outlying centers and open the free-standing ED and break even," Williams continued.
Williams spoke Tuesday following the hospital board's approval of a $225 million budget for the upcoming fiscal year.
RMC Chief Financial Officer Liza Porterfield said the emergency center was initially projected to lose $1 million to $2 million annually based on very conservative volumes.
"We believe volumes will exceed expectations," she said.
According to RMC’s 2019 budget, the hospital projects about 6,000 patients will visit the center in 2019.
But Porterfield says officials don’t yet know how the center will perform once it opens in December.
"We don't know," she said. "We believe things will be better than we originally projected. Those projections are a worst-case scenario."
The center will employ approximately 51.
Bamberg County has been without an emergency room since 2012, when the county hospital was closed. Southern Palmetto Hospital, formerly Barnwell County Hospital, announced its closure in January 2016.
RMC has taken steps to be more efficient, such as closing the Denmark primary care center and the hospital’s retail pharmacy, Williams said. Both services, which were unprofitable, were deemed expendable since there are other local providers.
The Bamberg urgent care center will close once the new emergency department is up and running.
"We have to ask ourselves who are we and to who," Williams said. "You can't be all to all people, but you want to ensure the core service, that acute care service that this community so much needs, that we retain that."
Williams described RMC’s budget for the upcoming year as “conservative,” based on realistic revenues and expenses.
"Let's not over inflate," Williams said. "Let us be realistic based on the economy and based on operations. What is the reasonable number and we want to make that number work."
Other budget highlights include:
• The hospital budget projects $225.3 million in revenue and $223.3 million in expenses. The gross revenue does not include a rate increase. The fiscal year runs from Oct. 1 through Sept. 30.
The hospital projects its primary care practices will see a loss of about $1.7 million. The hospital's seven primary care practices typically lose money each year.
The combined system is expected to end the 2019 fiscal year with a positive margin of about $211,000.
• The hospital has budgeted for about 1,316 employees. The hospital is planning on reducing its number of contract employees, which typically cost more.
• The budget includes a 2.5 percent employee pay increase beginning Jan. 1 with an impact of about $1.2 million on the hospital's budget.
• The hospital has budgeted about $7.5 million in capital projects in 2019. This year, the capital budget was $10.3 million although only about $5.5 million is projected to be spent.
• The hospital plans to spend about $276,000 in physician recruitment for nine providers in the specialties of medical oncology, vascular surgery, orthopedics, cardiology, neurology and gastrology.
Trustee Melvin Seabrooks was the sole trustee who oppose the budget's approval. Seabrooks declined comment on his reasons for opposing it.
There was very little public discussion of the budget. Trustees held a special called meeting Monday to discuss budget, which was done entirely in closed session.
In related matters, year-to-date the hospital is about $212,000 in the black.
RMC Finance Committee Chairman Kenneth Rickenbaker praised the administration for helping turn around the hospital's finances. At the end of February, RMC was running a $4.6 million deficit for the budget year.
"They are still working every day to try to continue so hopefully we can end up in the black. We are moving in the right direction,” he said.
The entire system is $1.3 million in the red for the year so far.
In other matters:
• Trustees approved entering into a contract with Texas-based Vanguard Resources. The company will provide management services for the hospital's facilities. Seabrooks and trustee Betty Henderson opposed the motion.
While details of the contract are not finalized, the contract will run between three and five years and cost the hospital about $1.3 million annually, at an estimated savings of about $700,000 a year, Williams said. Currently, system maintenance has been handled internally.
"We hope to enhance the services we provide from an engineering standpoint," Williams said. "The building that you practice in is the most important thing that you have. You want to make sure you have highly skilled professionals that will basically be the captains of the ship to ensure things are running on time."
In addition to the flat contract fee, Williams said there will also be expenses that arise as part of maintaining a hospital.
"We want to be efficient," he said. "We want to be accurate and we want to look at all costs."
• Trustees approved a microtome for the hospital's laboratory department for $20,847. The instrument is used to prepare tissue for a pathology review.
• The board recognized former board member Matt Stokes for his service on the board from March 2014 to January 2018.
Stokes left the board when he was appointed Orangeburg County treasurer earlier this year.