CEO Update 1/10/19

(Tony gives a regular ,usually weekly, update to the SHS staff.  Excerpts of which are below…)

We are still in the process of completing the December statements but it appears we will stay on track with our positive financial performance when looking at normalized results.  The reason I say normalized is we will have to do a bit of year-end clean up to recognize an issue that has recently come to our attention for the years 2014 -2016 and amounts due back to the state Medicaid program. This entry will be made in December and will skew our results for that month and put us in a negative bottom line position.  More to come on that as we finalize December.


I asked Rick Shrader, our CFO,  to give a brief financial update:

Good Morning!

 As many of you are aware, we have been working with our leaders to address our forbearance covenants with our financing as well as working to improve our  efforts with Revenue Cycle Operations.  We have had strong financial progress the last 5 months.  We are reporting October 2018 operating results, as we have not reported our operating results to our SHS Board for November 2018 and we are in the process of closing December 2018 for year end. 

 For October, our Net Revenues were $4.97MM, our Non-operating Revenues were $205K and Operating Expenses were $5.03MM, yielding Revenue over expenses of $143K.  We would have had a stronger month, but Health insurance claims incurred on the hospital were $313k in excess of budget.  As a self-insured entity, this occurs from time to time.  Our IP days totaled 279, our ALOS was 2.92.  We had 3,838 total clinic visits for October 2018 and we performed 194 surgeries.  Our Ed visits totaled 981.  At Southwest, we appreciate everyone’s efforts and I look forward to reporting November 2018 and December 2018 in the next few weeks.  Thanks to all of our Southwest team! 

What I can share about December 2018 is our Days Cash on Hand was 34 days!  We have exceeded our covenant goal by 4.0 days!  Thanks to all for your continued hard work!


I want to give a big thank you to the Trauma Committee and all those involved for all the hard work that they have been doing to prepare for the upcoming Trauma review in February.  This Committee, chaired by Dr. Kamper and coordinated by Vernie Page, have devoted an tremendous amount of time and effort in getting the organization ready for this review.  We anticipate this to be a learning experience and expect to learn we have opportunities but they have put us in a very good position to be successful with this program.  Thanks to all of you for your efforts.


Last summer when the new facilities were finished was not the right time to throw a party to celebrate our new facilities as we worked through a challenging time.  2019 is a new year and a fresh start for SHS.  As such, we will be hosting an “Open House” for our community in the new lobby.  Stay tuned for more information in the coming weeks.

So welcome to 2019, this promises to be a very exciting year for the organization.  I have complete confidence that you/we will continue to move this organization forward and continue the success we have seen in 2018.  

Thanks as always for all you have done and continue to do.



Just Culture at SHS


After an on-site review and implementation of the Just Culture philosophy and concept with David Marx and John Westphal of Outcome Engenuity in the fall of 2018,  SHS has embraced and is implementing facility-wide a “Just Culture” philosophy including education and training to leadership and staff.

“A just culture balances the need for an open and honest reporting environment with the end of a quality learning environment and culture. While the organization has a duty and responsibility to employees (and ultimately to patients), all employees are held responsible for the quality of their choices. Just culture requires a change in focus from errors and outcomes to system design and management of the behavioral choices of all employees.” – Marx D. Patient Safety and the Just Culture: A Primer for Health Care Executives. New York, NY: Trustees of Columbia University;; 2001.

A fair and just culture improves patient safety by empowering employees to proactively monitor the workplace and participate in safety efforts in the work environment. Improving patient safety reduces risk by its focus on managing human behavior (or helping others to manage their own behavior) and redesigning systems. In a just culture, employees are not only accountable for their actions and choices, but they are also accountable to each other.  A just culture fosters innovation and cross-departmental communication.

In a just culture, both the organization and its people are held accountable while focusing on risk, systems design, human behavior, and patient safety.