UNIVERSITY OF VIRGINIA
BOARD OF VISITORS
MEETING OF THE
MEDICAL CENTER
OPERATING BOARD
FOR THE UNIVERSITY OF
VIRGINIA MEDICAL CENTER
November 10, 2011
UNIVERSITY OF VIRGINIA
MEDICAL CENTER OPERATING BOARD
Thursday, November 10, 2011
12:30 – 2:15 pm
Small Auditorium, Harrison Institute
Committee Members:
Vincent J. Mastracco Jr., Chair
Helen E. Dragas
W. Heywood Fralin
Andrew K. Hodson, MB.Ch.B
Patrick D. Hogan
William P. Kanto Jr., M.D.
Constance R. Kincheloe
Mark J. Kington
Ex Officio
Teresa A.
Steven T.
Dorrie K.
Robert S.
Members:
Sullivan
DeKosky, M.D.
Fontaine
Gibson, M.D.
Randolph J. Koporc
Stephen P. Long, M.D.
Edward D. Miller, M.D.
Charles W. Moorman
Jonathan B. Overdevest
The Hon. Lewis F. Payne
E. Darracott Vaughan Jr., M.D.
R. Edward Howell
John D. Simon
Michael Strine
AGENDA
PAGE
I.
II.
REPORTS BY THE VICE PRESIDENT AND CHIEF EXECUTIVE
OFFICER OF THE MEDICAL CENTER (Mr. Howell)
A.
Vice President’s Remarks
1
B.
Operations, Finance, and Write-offs, Including
Fiscal Year (FY) 2011 Audited Year-End Results
(Mr. Howell to introduce Mr. Robert H. Cofield
and Mr. Larry L. Fitzgerald; Mr. Cofield to
report on Operations; Mr. Fitzgerald to report on
Finance and Write-offs)
2
C.
Capital Projects
18
D.
Health System Development
21
EXECUTIVE SESSION
●
ACTION ITEMS - To consider proposed personnel
actions regarding the appointment, reappointment,
resignation, assignment, performance, and
credentialing of specific medical staff and health
care professionals, as provided for in Section 2.23711(A)(1) of the Code of Virginia. The meeting of
the Medical Center Operating Board is further
privileged under Section 8.01-581.17 of the Code of
Virginia.
●
Discussion of proprietary, business-related
information pertaining to the operations of the
Medical Center, where disclosure at this time would
adversely affect the competitive position of the
Medical Center, specifically:
– Strategic personnel, financial, and market and
resource considerations and efforts, including
potential strategic joint ventures and other
growth efforts, long range financial plan
assumptions, Medical Center reserves and
transfers in and out of reserves, and performance
measures and metrics;
– Confidential information and data related to the
adequacy and quality of professional services,
competency and qualifications for professional
staff privileges, and patient safety in clinical
care, for the purpose of improving patient care;
and
– Consultation with legal counsel regarding
compliance with relevant federal and state legal
requirements, licensure and accreditation
standards, and ongoing litigation; all of which
will involve proprietary business information and
evaluation of the performance of specific
personnel.
The relevant exemptions to the Virginia Freedom of
Information Act authorizing the discussion and
consultation described above are provided for in Section
2.2-3711 (A) (1), (6), (7), (8) and (22) of the Code of
Virginia. The meeting of the Medical Center Operating
Board is further privileged under Section 8.01-581.17 of
the Code of Virginia.
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 10, 2011
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
I.A.
ACTION REQUIRED:
None
Vice President’s Remarks
DISCUSSION: The Vice President and Chief Executive Officer of
the Medical Center will inform the Medical Center Operating
Board of recent events that do not require formal action.
1
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 10, 2011
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
I.B. Operations, Finance, and Write-offs,
Including Fiscal Year (FY) 2011 Audited
Year-End Results
ACTION REQUIRED:
None
BACKGROUND: The Medical Center prepares a periodic financial
report, including write-offs of bad debt and indigent care, and
reviews it with the Executive Vice President and Chief Operating
Officer of the University before submitting the report to the
Medical Center Operating Board. In addition, the Medical Center
provides an update of significant operations of the Medical
Center occurring since the last Medical Center Operating Board
meeting.
FINANCE REPORT
After two months of operations in FY 2012, the operating
margin for all business units was 5.2%, which was below the
budget of 5.3%. The operating margin for the hospital without
other entities was 3.2% against a budget of 3.7%. The operating
margins for University of Virginia Imaging and Off-Campus
Dialysis were above budget for fiscal year to date through
August, while the operating margins for the Outpatient Surgery
Center, Community Medicine, Outreach, HOPE, and the Transitional
Care Hospital were below budget.
During the first two months of the fiscal year, inpatient
discharges were 1.2% below budget and 1.3% above the prior year.
Average length of stay was 6.02 days, which was above the budget
of 5.76 days. The longer length of stay can be partially
explained by a Medical Center case mix index of 2.01, which was
above the budget of 1.90. Observation patients, outpatient
visits (including emergency room visits), and surgeries
performed in the main hospital operating rooms were above budget
and above the prior year.
Net patient service revenue for FY 2012 through August was
3.4% below budget. Total operating expenses were 2.9% below the
$185.2 million budget. Total labor expenses (including salaries
2
and wages, fringe benefits, and contract labor) were 1.7% below
budget, and total supply cost was also 1.7% below budget. With
the exception of bad debt expense, all other expense categories
were below budget.
Total paid employees, including contracted employees, were
253 below budget.
Employee FTEs
Salary, Wage and
Benefit Cost per FTE
Contract Labor FTEs
Total FTEs
FY 2011
FY 2012
2012 Budget
5,982
6,309
6,597
$73,068
$74,642
$73,470
215
212
177
6,197
6,521
6,774
OTHER FINANCIAL ISSUES
The Patient Protection and Affordable Care Act of 2010
requires the Secretary of Health and Human Services to establish
a Value-Based Purchasing program to pay hospitals for their
actual performance on quality measures beginning in FY 2013.
The final regulation was published on May 6, 2011. We are
developing strategies to take advantage of the Value-Based
Purchasing rules.
WRITE-OFF OF BAD DEBTS AND INDIGENT CARE
Indigent care charges totaling $43.6 million for the period
July 1, 2011 through August 31, 2011, have been written off.
Recoveries during this period totaled $11.6 million.
Bad debt charges totaling $7.5 million have been written
off during FY 2012. During this same period, $3.2 million was
recovered through suits, collection agencies, and Virginia
refund set-off.
3
OPERATIONS REPORT
Clinical Operations
Patient Care Services and Nursing
The University of Virginia Health System's first
intraoperative magnetic resonance imaging scanner (IMRIS) suite
became operational on September 9. This technology provides
surgical imaging and evaluation within a fully functioning
operating room. With a 1.5 Tesla magnetic resonance imager
mounted on ceiling rails that allow it to move from its storage
bay into the operating room, a surgeon can obtain a magnetic
resonance image while maintaining the sterility of the surgical
field. The first case performed in the suite was a craniotomy,
during which the magnetic resonance image was used to assure
that the entire tumor was removed prior to closing the patient.
This procedure lowers the probability of repeat surgeries. The
second suite, which will combine magnetic resonance imaging and
X-ray angiography, will be available within four to six weeks.
In October 2012 hospitals will begin to incur financial
penalties if their readmission rates for certain identified
conditions exceed goals set by the Centers for Medicare and
Medicaid Services (CMS). The University of Virginia Medical
Center has entered into discussions with Martha Jefferson
Hospital about how the Medical Center and Martha Jefferson
Hospital can collaborate to track and share data on patients who
may get readmitted to each other's facility. Information
sharing will be important since the reported readmission rates
for a hospital include patients who get readmitted anywhere, not
just those admitted back to the same hospital. The reduction
goal has not yet been made public, but will be based on three
years of rolling data (2010-2012) and is anticipated to be at
least 10% less than the existing national level and perhaps as
high as 30%. Both the Medical Center and Martha Jefferson
Hospital currently exceed national readmission levels for
patients with congestive heart failure, one of the initial three
conditions identified by CMS.
Patient Care Services has begun to explore the development
of a remote patient monitoring center through the Office of
Telemedicine. A patient monitoring center would be utilized to
address readmissions for the same diagnosis for which penalties
may be applied by CMS and private payers beginning in 2012. The
Medical Center anticipates the development of partnerships and
contracts with other health systems. The model of a patient
4
monitoring center in chronic disease management has been well
established in certain care coordination models, including the
Department of Veterans Affairs. Funding is being sought from
the Virginia Tobacco Indemnification and Revitalization
Commission. The University of Virginia Center for Telehealth
recently received an award from Health Resources and Services
Administration to create a Mid Atlantic Telehealth Resource
Center. Remote patient monitoring is one of the core elements
of that proposal.
The Medical Center’s patient progression initiative
continues to move forward. Inpatient flow initiatives focus on
care coordination and the commencement of daily
multidisciplinary rounds, case management model design and
implementation recommendations, bed/transfer center, and
implementation of a new patient placement matrix. Work also
commenced in perioperative flow, with efforts focused on
automating operating room scheduling and processes to ensure
pre-assessment testing is completed prior to the day of surgery.
Efforts have also begun with Emergency Department flow and
triage.
Clinical Ancillary Services
Medical Laboratories
The Medical Laboratories performed the laboratory testing
to support Prostate Cancer Screening Day. On September 17, 199
gentlemen were screened by the Department of Urology and had
prostate specific antigen testing performed by the Medical
Laboratories. According to the urologists, at least five
patients will require follow-up care.
Pharmacy Services
The University of Virginia HOPE pharmacy at Pantops became
operational. The pharmacy successfully passed the Board of
Pharmacy licensing inspection and received a Drug Enforcement
Agency registration. The HOPE pharmacy is able to purchase its
medication through the Medical Center’s 340B purchasing program,
which will result in significant savings for the organization.
Radiology Services
Radiology Services purchased new imaging technology to be
installed at Kluge Children’s Rehabilitation Center to provide
enhanced and lower dose imaging for pediatric patients needing
5
scoliosis evaluations. When the University of Virginia
Children’s Hospital vacates the Kluge facility, the new imaging
equipment will be relocated to the Battle Building for greater
utilization by our pediatric population.
New cardiac software was also installed on the Positron
Emission Tomography/Computerized Tomography scanner located at
the Emily Couric Clinical Cancer Center to enhance the care of
cardiac patients.
Therapy Services
The Sleep Disorders Center opened a satellite lab at 154
Hansen Road on Pantops. The Sleep Center at Pantops offers four
patient rooms in a newly staffed and redesigned lab. With the
new lab and the eight-room lab at 1222 Jefferson Park Avenue, a
total of 12 beds are available for sleep studies. The Sleep
Center expansion was undertaken to offer more flexibility to our
patients and to keep the wait time for a sleep study appointment
to a minimum.
University of Virginia WorkMed participated in the
University’s Hoo’s Well program by providing biometric health
screenings. All Academic Division and Medical Center employees
and their spouses who are currently covered by the University’s
health plan were eligible to participate. Screenings were
conducted September 12 – October 8, and over 3,000 individuals
signed up to participate. WorkMed was also awarded a contract
to provide on-site occupational health physician services and
occupational health nurse services to employees of General
Electric Intelligent Platforms headquartered in Charlottesville.
The company has 3,500 employees worldwide, with 500 employees
located in Charlottesville.
Culpeper Regional Hospital
Renovation work started on Culpeper Regional Hospital’s
Emergency Department and Admitting Entrance. Temporary
entrances were created to facilitate the renovation work. The
renovation is anticipated to be complete by the beginning of
2012. It will create a more aesthetically pleasing entrance and
improve work flow for the hospital’s admitting and registration
functions.
6
The Hospital completed a Request for Proposal process for
construction management at risk for the Emergency Department
expansion project. Gilbane Building Company was chosen to help
the Hospital complete the project.
Human Resources
Leadership Development
The Uteam Leadership Academy began a New Leader On-Boarding
program in October. This is a conscientious effort to train
leaders who are new to the Medical Center and/or new to managing
people and departments. The New Leader On-Boarding program has
two major components: 1) New Leader Coaching - assignment of a
coach to help new leaders navigate their first few months in
their new role; and 2) New Leader Orientation - a six-month
series of sessions taught by senior leadership (which supports
our Leaders as Teachers philosophy) and designed to help new
leaders better understand our organization, behavioral
expectations, and tools for success.
The Uteam Leadership Education Retreat was held September
29 at the Boar’s Head Inn Pavilion with over 200 Medical Center
leaders in attendance. The retreat theme was “Living Our
Values, Every Patient, Every Day.” Eli Pagonis from the Baptist
Leadership Group shared their journey to customer service
excellence. Attendees received tips and tools to use in their
areas to improve patient satisfaction and service.
Electronic Performance Appraisals
New electronic performance evaluations were rolled out for
all staff in September 2011. The evaluations, called EPerformance, are similar to those introduced for management in
July. The performance appraisal will bring a higher level of
consistency and ease to the performance management process.
Managers and employees will be able to better track performance,
set goals, gather input, and document developmental needs based
on the new electronic process. The electronic performance
evaluation process for management was successfully completed in
September.
Employee Engagement
The Medical Center Management Team met with staff in
September to review Employee Engagement Survey results and
create action plans to improve employee engagement in specific
7
departments and work areas. The overall engagement score for
the Medical Center was 68.27%, just under the healthcare average
of 71%. The new engagement survey is designed to regularly
survey and review improvements in our employees’ engagement as
it relates to their job, their manager, senior leadership, and
the Medical Center. The new survey was well received by
employees and managers with over 81% of employees responding.
Compensation
The Medical Center rolled out its new compensation program
for staff and management, effective October 2, 2011. The new
program is designed to support the mission, vision, and values
of the organization by providing compensation that is
transparent, performance-based, market-driven, and fair. All
employees will be affected by the new salary structure that
includes a new minimum wage of $10.65/hour and salary ranges
that better reflect the market. This new program will help us
retain and recruit the best people to fulfill our mission of
providing excellent service to our patients and our community.
The new compensation program is the result of months of
extensive work, during which we gathered internal input and
benchmarked the Medical Center’s current practices against local
and national competitors.
As a result of the program, 77% of our staff received a
market adjustment to better reflect the pay within our market.
The investment in our employees totals over $5 million annually.
Managers were trained on the principles and basic components of
the new compensation program prior to announcing it to staff.
All staff members received a personalized pay statement from
their managers noting any changes to their pay and their new pay
range.
Quality and Performance Improvement
Accreditations and Survey
In preparation for an upcoming survey by The Joint
Commission, a two-day, unannounced “mock survey” was conducted
by a contracted administrator. The survey focused on the
Environment of Care, Emergency Management, Leadership, and Human
Resources. The survey included an extensive “walk around” of
the environment and was successful in assisting staff in
understanding new Joint Commission and CMS requirements. The
surveyor left recommendations for actions to support a
8
successful survey. We have invited the surveyor to return in
October to continue work with the staff.
The Medical Center completed a survey by the Virginia
Department of Behavioral Health and Development Services on
September 15. The visit was a routine annual unannounced survey
of our inpatient psychiatric services. During the visit, the
surveyor toured the unit, spoke to staff, and reviewed our
policies and procedures. Once the surveyor completes her
report, we will file corrective actions for the anticipated
minor findings.
Quality and Patient Safety Initiatives
A fourth Quality and Patient Safety Grand Rounds, “Medical
Decision Making,” was presented by Dr. Jeffrey Young. Over 100
medical center staff and students attended the presentation,
which focused on the education process in medicine, safety,
lessons learned from other high risk occupations, and the role
of medical simulation.
Medical Center senior leaders and managers are
participating in a new program of structured rounds in patient
care areas. The rounds are named “Fridays Before Five” to link
with Charlottesville tradition. The program brings all Medical
Center leaders together each Friday for an overview of key
quality and patient safety topics followed by visits to patient
care areas to interview staff about the topic of the day. The
objectives of the program are to engage all managers and staff
in a regularly scheduled effort focused on quality, patient
safety, and environmental safety. In addition, each visit
assists staff to become more comfortable with and knowledgeable
about patient safety and the processes that support our
continued maintenance of the clinical environment.
The Medical Center has introduced Schwartz Center Rounds®.
The rounds focus on the human dimension of medicine by providing
a forum for staff to discuss the social and emotional issues
that often arise during the course of a day or an event.
Environment of Care
Nutrition Services
The University of Virginia Health System received the
Institutional Leader Award from the Local Food Hub and the
Virginia Department of Agriculture and Consumer Services. The
9
award honors an institution that has made a commitment to local
agriculture through their menu planning and food service
offerings.
The Medical Center’s Food and Nutrition Services team
received the Bronze Level “Compass in our Community” award for
their outstanding community service over the past year.
Compass, the parent company of Morrison Management Specialists,
made only five community services awards in North America. The
local team received $2,000 for their favorite charities.
Patient & Guest Services
The Language Services Department is training 29 Madison
House student interpreter volunteers who will provide a variety
of interpreter services for patients at the Medical Center.
This year over 400 undergraduates, mostly pre-med, have signed
up at Madison House for the Medical Services program and will
volunteer at the Medical Center in one of 21 different areas.
Liz Courain, Manager of Volunteer Services, was awarded the
credential, “Certified Administrator of Volunteer Services
(CAVS)”, a national credential that distinguishes an individual
as being among the elite in the field of volunteer management in
healthcare. The CAVS credential is sponsored by the Association
for Healthcare Volunteer Resource Professionals, a professional
membership group of the American Hospital Association.
Arts Committee
An exhibition of photographs by Kevin Blackburn and Mark
Miller entitled “Life Through a Lens” was held in the University
Hospital Lobby from September 2 – November 4, 2011.
Awards and Recognition
The University of Virginia Health System was awarded the
following 2011 Aster Awards for excellence in Medical Marketing:
Level
Best of Show
Gold Award
Gold Award
Gold Award
Gold Award
Gold Award
Gold Award
Silver Award
Category
Title
Total Advertising Campaign
Service Line Advertising
Poster/Display
Internal Publication
Photo/Illustration
Brochure
Newsletter
Special Events
10
EMR Campaign
Spine Center Ads
Cancer Clinical Trials Poster
Beyond Measure
Clinical Trials Photography
Community Relations Report
Epic Communicator
Cancer Center Opening
Silver Award
Bronze
Bronze
Service Line Advertising
TV/Video Advertising
Service Line Advertising
Children’s Hospital Ads
Link TV Thanksgiving Edition
Surgery Campaign
The University of Virginia Electronic Medical Record (EMR)
Campaign was featured on the cover of Marketing Healthcare
Today, Volume 9, Issue 3, 2011. The Emily Couric Clinical
Cancer Center was the subject of an article in the September
2011 issue of Healthcare Design.
Community Outreach
Over 400 employees from the Medical Center, School of
Medicine, School of Nursing, and University Physicians Group
volunteered for the United Way Laurence E. Richardson Day of
Caring on September 21, 2011. Health System volunteers
comprised 40 teams and provided services ranging from cleaning
and washing animals at the SPCA, playing bingo with the elderly
at the Senior Center, and painting murals at local elementary
schools. An “in-house” Day of Caring project was held at the
Medical Center on September 23 for those individuals who were
not able to participate on September 21. A food and toiletries
drive was undertaken to benefit families who stay at the
University of Virginia Hospitality House. Over 100 pounds of
food and toiletries were collected.
11
University of Virginia Medical Center
Income Statement
(Dollars in Millions)
Most Recent Three Fiscal Years
Description
Net patient revenue
Aug-10
Aug-11
Aug-12
Budget/Target
Aug-12
$166.5
$168.8
$184.0
$190.4
4.8
4.4
5.6
5.1
$171.3
$173.2
$189.6
$195.5
152.0
154.9
166.8
171.0
Depreciation
8.7
9.4
11.8
11.9
Interest expense
1.0
1.4
1.2
2.3
$161.7
$165.7
$179.8
$185.2
$9.6
$7.5
$9.8
$10.3
Other revenue
Total operating revenue
Operating expenses
Total operating expenses
Operating income (loss)
Non-operating income (loss)
$8.7
$9.5
$4.3
$1.2
Net income (loss)
$18.3
$17.0
$14.1
$11.5
Principal payment
$2.9
$3.5
$3.5
$3.5
12
University of Virginia Medical Center
Balance Sheet
(Dollars in Millions)
Most Recent Three Fiscal Years
Description
Aug-10
Aug-11
Aug-12
Assets
Operating cash and investments
$110.3
$155.5
$97.7
Patient accounts receivables
53.7
90.6
110.2
Property, plant and equipment
479.6
579.0
673.4
Depreciation reserve and other investments
306.4
255.3
205.9
Endowment Funds
257.1
341.8
410.0
Other assets
154.0
174.6
229.5
$1,361.1
$1,596.8
$1,726.7
Current portion long-term debt
$20.2
$20.0
$24.5
Accounts payable & other liab
88.5
119.6
113.8
Long-term debt
277.0
331.2
315.8
Accrued leave and other LT liab
117.5
156.3
143.4
$503.2
$627.1
$597.5
$857.9
$969.7
$1,129.2
$1,361.1
$1,596.8
$1,726.7
Total Assets
Liabilities
Total Liabilities
Fund Balance
Total Liabilities & Fund Balance
13
University of Virginia Medical Center
Financial Ratios
Most Recent Three Fiscal Years
Description
Aug-10
Operating margin (%)
Aug-11
Aug-12
Budget/Target
Aug-12
5.6%
4.3%
5.2%
5.3%
Total margin (%)
10.2%
9.3%
7.3%
5.8%
Current ratio (x)
1.5
1.8
1.5
2.4
170.3
183.3
163.3
190.0
Gross accounts receivable (days)
47.2
43.7
48.3
45.0
Annual debt service coverage (x)
7.2
5.7
5.8
5.2
31.6%
34.5%
30.5%
31.8%
6.0%
6.5%
7.2%
7.7%
Days cash on hand (days)
Debt-to-capitalization (%)
Capital expense (%)
University of Virginia Medical Center
Operating Statistics
Most Recent Three Fiscal Years
Description
Acute Discharges
Patient days
SS/PP Patients
Average length of stay
Clinic visits
ER visits
Medicare case mix index
FTE's (including contract labor)
Aug-10
Aug-11
Aug-12
Budget/Target
Aug-12
4,684
4,696
4,758
4,817
28,653
28,624
28,215
27,762
1,449
1,553
1,711
1,503
6.28
6.10
6.02
5.76
110,234
114,873
118,091
118,435
10,127
9,789
10,404
9,825
1.96
2.04
2.17
2.04
6,176
6,197
6,521
6,774
14
University of Virginia Medical Center
SUMMARY OF OPERATING STATISTICS AND FINANCIAL PERFORMANCE MEASURES
Fiscal Year to Date w ith Com parative Figures for Prior Year to Date - August FY12
OPERATING STATISTICAL MEASURES - August FY 2012
DISCHARGES and CASE MIX - Year to Date
Actual
Budget
OTHER INSTITUTIONAL MEASURES - Year to Date
% Variance Prior Year
DISCHARGES:
Adult
Pediatrics
Psychiatric
Transitional Care
Subtotal Acute
4,019
522
192
25
4,758
4,038
516
231
32
4,817
(0.5%)
1.2%
(16.9%)
(21.9%)
(1.2%)
3,962
485
249
4,696
Short Stay/Post Procedure
1,711
1,503
13.8%
1,553
Total Discharges
6,469
6,320
2.4%
6,249
Adjusted Discharges
8,598
8,624
(0.3%)
8,410
CASE MIX INDEX:
All Acute Inpatients
Medicare Inpatients
2.01
2.17
1.90
2.04
5.8%
6.4%
1.85
2.04
Actual
Budget
% Variance
Prior Year
ACUTE INPATIENTS:
Inpatient Days
Average Length of Stay
Average Daily Census
Births
28,215
6.02
455
305
27,762
5.76
448
285
1.6%
(4.5%)
1.6%
7.0%
28,624
6.10
462
281
OUTPATIENTS:
Clinic Visits
Average Daily Visits
Emergency Room Visits
118,091
2,988
10,404
118,435
2,878
9,825
(0.3%)
3.8%
5.9%
114,873
2,899
9,789
3,436
1,331
4,767
3,312
1,442
4,754
3.7%
(7.7%)
0.3%
3,233
1,427
4,660
SURGICAL CASES
Main Operating Room (IP and OP)
UVA Outpatient Surgery Center
Total
15
OPERATING FINANCIAL MEASURES - August FY 2012
REVENUES and EXPENSES - Year to Date
($s in thousands)
NET REVENUES:
Net Patient Service Revenue
Other Operating Revenue
Total
Actual
$
EXPENSES:
Salaries, Wages & Contract Labor
Supplies
Contracts & Purchased Services
Bad Debts
Depreciation
Interest Expense
Total
$
Operating Income
$
Operating Margin %
Non-Operating Revenue
$
Net Income
$
184,004
5,559
189,563
Budget
$
190,452
5,073
195,525
81,531
40,893
37,383
7,039
11,765
1,207
179,818
9,745
5.2%
4,305
$
$
82,941
41,606
40,330
6,138
11,940
2,291
185,246
10,279
5.3%
1,195
14,050
$
11,474
$
$
OTHER INSTITUTIONAL MEASURES - Year to Date
% Variance Prior Year
(3.4%)
168,774
9.6%
4,398
(3.0%) $ 173,172
1.7%
76,044
1.7%
36,940
7.3%
36,080
(14.7%)
5,796
1.5%
9,444
47.3%
1,376
2.9% $ 165,680
(5.2%) $
7,492
4.3%
260.3% $
9,523
22.5%
$
17,015
($s in thousands)
NET REVENUE BY PAYOR:
Medicare
Medicaid
Commercial Insurance
Anthem
Southern Health
Other
Total Paying Patient Revenue
OTHER:
Collection % of Gross Billings
Days of Revenue in Receivables (Gross)
Cost per CMI Adjusted Discharge
Total F.T.E.'s (including Contract Labor)
F.T.E.'s Per CMI Adjusted Discharge
Actual
54,282
11,921
37,051
33,205
5,745
41,800
$ 184,004
Budget
$
$
65,178
15,318
24,690
35,295
10,687
39,284
$ 190,452
$
35.72%
48.3
9,980 $
6,521
23.35
35.34%
45.0
10,946
6,774
25.67
% Variance
Prior Year
(16.7%) $
(22.2%)
50.1%
(5.9%)
(46.2%)
6.4%
(3.4%) $
1.1%
(7.3%)
8.8% $
3.7%
9.0%
57,759
13,574
21,880
31,277
9,471
34,813
168,774
35.80%
43.7
10,282
6,197
24.71
University of Virginia Medical Center
SUMMARY OF OPERATING STATISTICS AND FINANCIAL PERFORMANCE MEASURES
Fiscal Year to Date w ith Com parative Figures for Prior Year to Date - August 31, 2011
Assumptions - Operating Statistical Measures
Discharges and Case Mix Assum ptions
Discharges include all admissions except normal new borns
Pediatric cases are those discharged from 7 West, 7 Central, NICU, PICU and KCRC
Psychiatric cases are those discharged from 5 East or Rucker 3
All other cases are reported as Adult
Short Stay Admissions include both short stay and post procedure patients
Case Mix Index for All Acute Inpatients is All Payor Case Mix Index from Stat Report
Other Institutional Measures Assum ptions
Patient Days, ALOS and ADC figures include all patients except normal new borns
Surgical Cases are the number of patients/cases, regardless of the number of procedures performed on that patient
16
Assumptions - Operating Financial Measures
Revenues and Expenses Assum ptions:
Medicaid out of state is included in Medicaid
Medicaid HMOs are included in Medicaid
Physician portion of DSH is included in Other
Non-recurring revenue is included
Other Institutional Measures Assum ptions
Collection % of Gross Billings includes appropriations
Days of Revenue in Receivables (Gross) is the BOV definition
Cost per CMI Adjusted Discharge uses All Payor CMI to adjust, and excludes bad debt
MEDICAL CENTER
ACCOUNTS COMMITTEE REPORT
(Includes All Business Units)
(Dollars in Thousands)
Year to Date
August
2011-12
INDIGENT CARE (IC)
Net Charge Write-Off
30,786
Percentage of Net Write-Offs to Revenue
5.98%
Annual Activity
2010-11
2009-10
195,645
172,917
6.89%
6.60%
Total Reimbursable Indigent Care Cost
11,637
73,954
53,095
State and Federal Funding
11,162
70,936
52,053
Total Indigent Care Cost Funding As a Percent
of Total Indigent Care Cost
96%
Unfunded Indigent Cost
474.79
96%
98%
3,017.31
1,042.00
Annual Activity
August
2011-12
BAD DEBT
Net Charge Write-Offs
7,039
Percentage of Net Write-Offs to Revenue
1.37%
2010-11
25,838
0.91%
2009-10
30,948
1.18%
Note:
Provisions for bad debt write-offs and indigent care write-offs are recorded for financial statement purposes based on the
overall collectibility of the patient accounts receivable. These provisions differ from the actual write-offs of
bad debts and indigent care which occur at the time an individual account is written off.
17
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 10, 2011
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
I.C.
ACTION REQUIRED:
None
Capital Projects
BACKGROUND: The Medical Center is constantly improving and
renovating its facilities. A status report of these capital
projects will be provided at each Medical Center Operating Board
meeting.
DISCUSSION: The current Medical Center capital projects report
is set forth in the following table:
18
The University of Virginia Medical Center
Capital Projects Report
November 2011
Budget
Funding
Source
BOV
Approval
Date
Projected
Completion
Date
$14.3 M
Bonds
Feb 2008
2011
$117 M
Bonds and
Outside
Fundraising
N/A
2014
$7.6M
Bonds
Feb 2008
2011
University Hospital:
$21.2 M
Bonds
Feb 2008
2013
Renovate Radiology
Department. Phased
construction underway
(52,000
GSF)
Bonds and
Health System
Operating
Revenue
Sept 2005
Scope
1.
Construction Completion
*University Hospital:
Add two Operating Rooms and
Magnetic Resonance Imaging
Room (with equipment).
Interior fit-out is complete.
Magnet was delivered on April
30, 2011. First patient was
seen in September 2011.
2.
(2,330 GSF)
Under Construction
Barry and Bill Battle
Building:
The Groundbreaking Ceremony
was held on June 9, 2011.
Site excavation is complete.
Installation of the drilled
pier foundation system is
nearing completion.
University Hospital:
Add elevators. The new
elevators are in place. They
are not in use awaiting
completion of the new
elevator lobbies as a part of
the Hospital Bed Expansion
project.
University Hospital Bed
Expansion:
$80.2 M
Project to increase inpatient
bed capacity in University
Hospital by adding 72
private, ICU-level rooms.
Finishes and casework
installation is on-going.
19
June 2007
2011
Budget
Funding
Source
BOV
Approval
Date
Projected
Completion
Date
*University Hospital:
$15.6 M
Bonds
Feb 2008
2011
Renovate Heart Center
invasive procedure areas –
design complete for several
phases. Construction is
complete for the first phase
with occupancy in August
2010. Phase 2 was completed
at the end of October 2010.
To facilitate more efficient
patient flow, Phase 3 was
broken into 3a and 3b. Phase
3a was completed in May 2011
and Phase 3b is scheduled for
completion in November 2011.
(21,600
GSF)
$36.5M
Bonds & Other
June 2010
2013
$6.7M
Bonds
Nov. 2010
2012
Scope
*Health System Precinct:
Realignment of Lee St. and
construction of new chiller
plant. Realignment necessary
to create site for subsequent
construction of chiller
plant. New chiller plant to
replace capacity in North
Chiller Plant that has
outlived useful life.
*University Hospital:
Relocation of helipad to roof
of University Hospital.
Helipad relocation is
required prior to
construction of East Chiller
Plant.
*Project modifies original HEP project
20
UNIVERSITY OF VIRGINIA
BOARD OF VISITORS AGENDA ITEM SUMMARY
BOARD MEETING:
November 10, 2011
COMMITTEE:
Medical Center Operating Board
AGENDA ITEM:
I.D.
ACTION REQUIRED:
None
Health System Development
BACKGROUND: Health System Development will provide reports of
recent activity to the Medical Center Operating Board from time
to time.
DISCUSSION:
SIGNIFICANT GIFTS
July 1, 2011 – August 31, 2011
A $4.5 million proposal was accepted by Altria for the
establishment of the Virginia Center for Translational and
Regulatory Sciences, completing a $25M commitment the company
made to the University in 2007.
The Cystic Fibrosis Program at the University of Virginia
Children’s Hospital received a realized bequest of $184,811.
A donor committed $135,000 in support of Biomedical Ethics and
Humanities.
A University alumna and her husband pledged $125,000 in support
of a scholarship fund in the Center for Global Health.
The 27th Annual Klöckner Pentaplast Walk for Kids generated
$110,483 in support of the University of Virginia Children’s
Hospital.
The family of a School of Nursing alumna made a $100,000
commitment in her honor to create a named endowment at the
School of Nursing which will provide scholarship support for
graduate students.
Other gifts and pledges received include:


A $57,000 gift to the Mahadevan Mytonic Muscular Dystrophy
Research Fund.
A $54,531 realized bequest in support of a medical
scholarship.
21




A $50,000 bequest for the School of Medicine.
A $50,000 bequest for the School of Nursing.
A $50,000 gift for the Teen Health Education Program in
support of adolescent advocacy and outreach.
Two memorial commitments of $25,000 each in support of the
Battle Building.
OTHER DEVELOPMENT INITIATIVES
In FY 2012, the Children’s Hospital development staff
launched the “Champions of UVA Children's Hospital,” a new
leadership annual giving program.
Two Children’s Miracle Network events were held in August,
raising more than $30,000 for the Children’s Hospital.
In August, Dean Fontaine and Health System development
staff met with the Helen Fuld Health Trust to discuss a future
opportunity for support in the range of $600,000.
In July and August, the Health System Development
Communications team produced the summer edition of Pulse Online,
which was e-mailed to approximately 37,000 individuals, and
produced a Volunteer Exchange e-mail blast that was sent to
approximately 300 University of Virginia Health System
volunteers.
Development staff made 221 face-to-face visits with donors
and prospects as of August 31, 2011.
CAMPAIGN PROGRESS THROUGH AUGUST 31, 2011
Through the end of August, the Health System campaign total
is $560,428,958. This represents 112% of the $500 million
campaign goal achieved. The following table shows the FY 2012
totals for new commitments as of August 31, including gifts and
pledges, as compared with this same period in FY 2011.
FY 12 through 8/31/11
New Gifts
New Pledges
Total New Commitments
(excludes pledge payments on
previously booked pledges)
22
FY 11 through 8/31/10
$1,336,009
$8,239,490
$54,168
$18,805
$1,390,178
$8,258,295