Thursday, October 6, 2022

Valley Health feeling economic pinch from pandemic, inflation (October 6, 2022)

Valley Health feeling economic pinch from pandemic, inflation
By JOSETTE KEELOR The Winchester Star
Oct 6, 2022


Faced with a vastly smaller staff, rising costs and the potential of cutting ties with insurance companies in the coming years, Valley Health is considering its options for how to weather the economic impact sparked by the COVID-19 pandemic.

Valley Health is not in danger of closing, said Mark Nantz, president and CEO of the not-for-profit healthcare company that serves more than 500,000 people and operates four hospitals in Virginia and two in West Virginia as well as more than 70 medical practices and urgent care centers, outpatient rehabilitation and fitness, medical transport, long-term care and home health.

However, he said they are cautious about the financial implications for them as health systems around the country struggle with many of the same issues.

“At some point, it would be difficult for any health system to keep the doors open,” he said.

For now, no essential services are in jeopardy, he said, but if inflation and job vacancies continue and they can’t get revenues to increase, they will have to look across their 15-county region to decide where they can reduce, consolidate or discontinue services.

Instead of six places for surgery, it might have to be four, he said. Instead of 150 doctor’s offices, it might be 100.

“We’re looking at every service we provide,” Nantz said. “How can we do that at a reasonable margin?”

Nantz credits federal funding over the last 2½ years with keeping the health system afloat.

In a news release earlier this week, he said that if Valley Health hadn’t received $126 million through assistance programs such as the federal CARES Act, the Virginia Department of Medical Assistance Services and the Federal Emergency Management Agency, then it would have lost $100 million over the last 2½ years.

But all of that funding is gone now, and he’s less sure about how the health system will remain in the black in the coming months and years.

“I would say that the biggest lasting impact is the cost of staffing,” Nantz said.

As with many other areas of business operations, he said the cost of salaries has gone up 20% from pre-pandemic rates.

Furthermore, Valley Health has about 800 job vacancies, whether full- or part-time, and most of them are in Winchester and the counties of Clarke, Frederick, Page, Shenandoah and Warren.

“Right now we’re making up for that shortfall by either asking people to work overtime, finding temporary agency [professionals] or combining units and services so that we can try to do more with less,” Nantz said.

Despite being short-handed, he said Valley Health is still providing necessary procedures and that the trauma centers are functioning at the capacity they must to provide that critical level of care.

“At all times during the pandemic, we’ve maintained a safe level of care and standard of care,” he said.

But asking staff to work more hours at premium rates while bringing in agency professionals to fulfill temporary assignments at higher rates has been costing a lot more than if Valley Health simply had a full staff, he said.

As of February 2020, Valley Health was averaging about $800,000 per month in premium pay, Nantz said. Now it’s averaging $3 million a month.

“It’s across the country. Everyone is feeling the same thing,” Nantz said.

“The labor has gone up significantly, and it doesn’t appear to be going back down.”

Another major problem, he said, is that most insurance providers are reimbursing health-care facilities based on pre-pandemic rates, not today’s rates, which are much higher because of the cost of labor and also the cost of doing business during a time of inflation with higher gas prices and various other products.

Historically, a health system looks to commercial insurance to make up the difference in the shortfall of Medicaid, Nantz said.

Valley Health has been negotiating higher rates with companies like Anthem, Aetna, Cigna and United, and since each insurance company’s contract period expires at a different time, he said this process could take until the end of 2024.

“In between contract periods we don’t really have the right … to cancel,” Nantz said. “As those negotiation rates come up for renewal, we’ve been requesting and receiving increases that are higher than normal.”

Also, regardless of what happens with the insurance companies, he said that Valley Health’s financial assistance program will remain.

Still, they’ll have to see if it’s all enough.

“We’re a long way from going out of network,” he said. But it is a possibility that they’re considering.

“Most health insurance companies have had record years in the last 2½ years,” Nantz said.

That’s at least in part because many patients have been avoiding going to the doctor, some even putting off necessary care. Insurance companies are still making money, Nantz explained, but they’re not having to pay out as many reimbursements as they would have done before the pandemic.

In the meantime, he said, hospitals are dealing with runaway inflation.

If the insurance companies refuse to give a rate of increase equal to Valley Health’s costs, he said, “Then we can’t afford to do business with that company.”

Whatever happens, though, Valley Health will “continue being the safety net for 15 counties," he said.

“Valley Health is strong; we’ve been here for a long time,” he said. “It’s important that the community know that we didn’t come through this without a mark.”

But, he’s proud of how they’ve responded throughout the pandemic.

“We’re gonna be here,” he said. “It’s not over for us yet.”

Monday, August 1, 2022

Valley Health investing $50M to upgrade electronic medical record system (August 1, 2022)

Valley Health investing $50M to upgrade electronic medical record system
By MATT WELCH The Winchester Star
Aug 1, 2022 


WINCHESTER — “This is one small step for technology and one giant leap for health and wellness in our community,” Valley Health President and CEO Mark Nantz said on Monday about Project Elevate — a 16-month process that Valley Health is undergoing to implement its own more robust version of the electronic medical record system, Epic, which it has used since 2014.

“This is a pretty major endeavor for us,” Nantz said during the announcement in the Winchester Medical Center Conference Center. “It’s a big lift. Most of you who were here back in 2012 and 2014, it was a lot of work then and it’ll be a lot of work now. But it’ll be our own.”

Project Elevate is slated for completion by November 2023.

Over the past eight years, Valley Health hospitals, outpatient clinics and affiliated providers have used Epic to document medical care, order tests and procedures, and communicate with patients and medical professionals. The service has been made available through a partnership with Inova Health System.

The partnership helped Valley Health streamline the initial implementation process while curbing expenses, Valley Health officials said. Project Elevate, however, will allow Valley Health to transition to its own upgraded electronic medical record system, which will be managed exclusively by Valley Health. Valley Health will continue to partner with Inova during the transition as well as the Huntzinger Management Group.

In April, Valley Health’s Board of Trustees approved $50 million to fund Project Elevate. About $17 million will be spent on outside labor and expertise.

Project Elevate aims to give Valley Health more flexibility and independence, improve responsiveness and add three new modules currently not on Epic such as laboratory, cardiology and home health.

“This is a future where we’re shooting for technology being better used to take care of our patients, to communicate with one another, to communicate with our clinicians,” Nantz said.

Valley Health has 8,640 active Epic users and 99,562 MyChart users, which is Epic’s patient portal. Additionally, 1,006 physicians and advanced practice clinicians with Valley Health use Epic.

Nancy Ripari, Huntzinger Management Group’s interim chief information officer, explained that five new applications will be implemented as part of Project Elevate: Cupid will be for invasive and non-invasive cardiology; Beaker will replace ALab; Dorothy will replace McKesson Home Health; OnBase will replace OneContent for patient documents, and Optimization will be for targeted improvements to key functions.

Beaker and Cupid are expected to launch in July 2023, followed by Optimization in September and Dorothy in October. Everything associated with Project Elevate is slated to go live on Nov. 4, 2023.

Monday, January 17, 2022

Winchester Medical Center's solar energy system nears completion (January 17, 2022)

Winchester Medical Center's solar energy system nears completion
By Josette Keelor The Winchester Star
Jan 17, 2022




A nearly two-year-long solar panel project on Winchester Medical Center’s campus is expected to be finished next month.

Once finished, it will be one of the largest solar power systems at any Virginia hospital, said Mark Baker, vice president of facilities management and safety for WMC’s parent company, Valley Health.

The solar project should save an estimated $3.25 million in electric utility bills over the next 30 years, The Winchester Star reported in January 2020.


“There are three pieces to the project, two of which are already complete,” Baker said recently.

The first two sections — a roof-mounted system on Valley Health’s diagnostic center and another system on the roof of the cancer center — were both completed last year, he said.

The first one has a capacity of 289.4 kilowatts and the second one 125.8 kilowatts, a Valley Health news release from early 2020 says. Combined with the final section (1.3 megawatts), the total grid of 4,635 solar panels will provide 1.7 megawatts of clean energy.

The final section, a ground-mounted system on the northwest side of the campus, should be completed in February, Baker said, depending on any issues outside of Valley Health’s control.

“We’re up against some weather challenges and parts availability because of COVID,” Baker said.

Though the solar panel grid can stand up to the weather, he said that enough snow will prevent the panels from generating solar power until it's cleared away.

Valley Health won’t be storing any solar energy, so they’ll use whatever power they have as they generate it, he said.


Most of the energy will be generated from March to October, Baker said, and the rest of the year, Valley Health will supplement with the energy it buys from Shenandoah Valley Electric Cooperative, which he said has been fantastic to work with.

“They are our primary source,” he said.

He expects the solar panels to provide about 20 to 25% of electrical power to the campus, Baker said.

“It certainly provides an element of resilience which might not currently exist, meaning we can generate our own power,” he said.

“It gives us some independence if you will.”

The solar panel grid is also expected to result in about $80,000 a year in energy cost savings, The Star reported in early 2020.

Staunton-based company Secure Futures Solar agreed not to charge Valley Health for the installation of the grid, Valley Health Public Relations Manager Carol Weare said in January 2020. Instead, Secure Futures Solar planned to cover all costs to get the system up and running and will start billing Valley Health for services once the system begins operation and starts producing power.

Aside from sustainability and reliability, using solar energy helps Valley Health keep its costs down so it can provide more cost-effective health care, Baker said.

“Ultimately it benefits the environment and the patient.”

Saturday, July 24, 2021

Local practices merge with Valley Health (July 24, 2021)

Local practices merge with Valley Health
Star staff report
July 24, 2021




WINCHESTER — Multiple medical practices have merged with Valley Health in recent weeks.

According to a Valley Health news release, Winchester Surgical Clinic on South Stewart Street and the ACCESS (Acute Care Emergency Surgery Service) Clinic at Winchester Medical Center merged in June and now operate under a the name Valley Health Surgical Partners in Medical Office Building II in Suite 310 at 190 Campus Boulevard on the WMC campus.

Additionally, Valley Health Pulmonary Specialists and Valley Health Winchester Pulmonary and Internal Medicine have merged to create Valley Health Pulmonary and Sleep Specialists, a second release said. The practice is located on the second floor of Medical Office Building II.

Winchester Surgical Clinic has served the region since 1956, providing expertise in gastrointestinal surgery, including hepatobiliary, colorectal, gallbladder and other advanced laparoscopic and robotic surgeries, hernia repair, breast disease and cancer, endoscopy, thyroid, parathyroid and adrenal conditions, dialysis access, wound care and trauma. The practice joined Valley Health in 2010.

According to the news release, trauma and acute care surgery is a 24/7 hospital-based emergency service whose providers treat and manage the follow-up care of patients coming into the WMC Emergency Department. Winchester Medical Center is a state-designated Level II Trauma Center, offering subspecialists and services to meet the complex needs of injured patients from the larger region. In 2020, WMC cared for 1,672 trauma patients.

Valley Health Surgical Partners includes 11 physicians and five advanced practice clinicians:


- General Surgery: Charles Hyre, MD; Victoria Lyness, MD; Fadi Makari, MD; Valerie Plant, MD; Jorge Posadas, MD.

- Endocrine Surgery: Victoria Lyness, MD.

- Trauma and Acute Surgery: Loretta Boyd, MD; Jeffrey Carter, MD; Terral Goode, MD; Alexander Johnston, MD; Matthew Mayuiers, MD; Paul Ulich, MD.

- Advanced Practice Clinicians: Cara Bland, NP; Jennifer Rohrbaugh, NP; Jessica Sites, PA; Laura Stade, PA; Heather Wallace, NP.

The pulmonary practice will serve as a central hub for pulmonary care and sleep medicine for patients in the Northern Shenandoah Valley. Providers will continue to see patients at Valley Health satellite clinics in Front Royal, Luray, Romney, W.Va., and Spring Mills, W.Va, according to the news release.

The board certified physicians, advanced practice clinicians and other staff at Valley Health Pulmonary and Sleep Specialists offer comprehensive services — including advanced interventional diagnostic and therapeutic procedures — for individuals with a wide range of lung conditions and sleep disorders, as well as other chronic health issues and wellness services. the release added.

Valley Health Pulmonary and Sleep Specialists has nine physicians and three advanced practice clinicians:

- Pulmonary Medicine: T. Glen Bouder MD, FCCP; Daniel Hynes, MD; Christian A. LaFalce MD, FCCP; David LeCronier, DO; Jeffrey Lessar, MD; Thomas M. Murphy, MD; John Price, DO; G. Keith Wolfe, MD; Allyson Rinker, NP.

- Internal Medicine: S. Preston Childress, MD; Sarah Chrisman, FNP-C; Anne Weiss, MSN, RN, FNP-C.

Wednesday, December 12, 2018

Valley Health laying off 20 employees (Dec. 12, 2018)

Valley Health laying off 20 employees
By JOSH JANNEY The Winchester Star
Dec 12, 2018



WINCHESTER — Faced with financial challenges, Valley Health plans to lay off 20 employees.

Valley Health President and CEO Mark Merrill sent an internal memo last week to the regional health system’s approximately 6,000 employees informing them of the situation. The memo, which was sent to The Star anonymously, says Valley Health is “experiencing financial headwinds” in the current fiscal year that have resulted in an operating loss of $4.2 million through November. In October, Valley Health identified the need to improve financial performance by $18 million on an annual basis.

“These headwinds, though prevalent throughout the health care industry, are affecting Valley Health more significantly than many peers,” Merrill wrote in the Dec. 3 memo, which had the subject line “Valley Health Financial Improvement Plan.”

Valley Health, a nonprofit organization, is parent company of Winchester Medical Center and five other regional hospitals.

In a statement to The Star on Tuesday, Valley Health said it remains “financially strong” but is being adversely impacted by rising costs and several “unfavorable revenue trends,” including flat and/or declining volumes, an increase in charity care and bad debt expense, rising costs for labor and supplies and external factors such as delayed Medicaid expansion in Virginia.

Merrill noted that Valley Health reported favorable financial results for fiscal years 2014-17. But in 2017 expense growth outpaced revenue growth for the first time in five years. “This trend has continued into 2018 with revenue growth of 1.8 percent while expenses have increased 6.3 percent,” he said in the memo.

Valley Health said in its statement that these trends are prevalent across the industry, as payment constraints and expense growth are challenging hospitals and health systems nationally.

According to IRS Form 990 filings, Valley Health had revenues of $986,757,666 and expenditures of $927,685,312 in 2016. In 2017, revenues were $1,035,467,293 and expenditures $989,125,698.

As part of a financial improvement plan, Valley Health leaders did a systematic review of operating costs, staffing patterns, revenue opportunities and efficiency improvements, which resulted in “difficult decisions to adjust the number of positions or hours worked for a combination of 20 full-time, part-time, and per diem positions in a variety of roles throughout the organization,” Tuesday’s statement said. “Valley Health is working with the individuals affected by these decisions during a transition period between now and February, when the changes will be completed. Valley Health anticipates that a majority of individuals affected will find opportunities in other roles within the organization.”

The affected workers have been notified.

Valley Health did not say what jobs are being eliminated or their salaries, but three are at Winchester Medical Center in administrative and support roles, according to a hospital spokesperson.

“Each of our team members are important to Valley Health’s success, but regrettably, we have to make tough decisions to remain sustainable,” Merrill said in his memo. “These decisions are not easy, but they are crucial. Our community expects us to keep costs down while still providing great care and service.”

Valley Health will continue to look at ways to use less expensive products that still provide quality patient care, Merrill’s memo said, as well as seek ways to work more efficiently with fewer employees and routinely seek ways to reduce costs.

While the base compensation for Valley Health’s 16 highest-paid employees increased from 2016 to 2017, there has been a decrease in other reportable compensation and benefits.

According to IRS Form 990 filings, the top 16 employees received a combined $8,944,911 in 2016. In 2017, that number dipped to $8,122,124. Merrill was compensated with $2.3 million in 2016 and $1.7 million in 2017.

The Valley Health Board of Trustees has a plan in place that places a portion of each executive’s compensation “at risk” based upon attaining certain quality, safety, service and operating performance targets, according to a hospital spokesperson. The differences in compensation from 2016 to 2017 “represent different performance levels of the leaders in attaining goals set for the plan year.”

In 2013, Valley Health laid off 17 employees, reduced the hours of eight workers and eliminated about 100 vacant positions. In 2014, it laid off 33 employees.

Merrill noted in his memo that Valley Health experienced similar challenges five years ago but was able to reverse them and achieve financial improvement.

“To mitigate the financial impact of these factors — and others — it will be critical that ALL members of the Valley Health team adopt a new fiscally conscious mindset,” Merrill told Valley Health employees in his memo.

Wednesday, October 29, 2014

2011 and 2014 Winchester 10U Cal Ripken World Series Final reports

The City of Winchester lost approx $32,000 in 2011 and $31,000 in 2014 when the City hosted the 10U Cal Ripken World Series.

To learn more, click on the following links:

2011 Final Report

2014 Final Report


Click here to view a side by side comparison between the 2011 and 2014 World Series events for expenses and revenue.

2014 vs. 2011 World Series Side by Side comparison

Wednesday, November 13, 2013

Perplexed by VHS's president/CEO quote on The Affordable Care Act

I wonder what research and information Valley Health System’s Mark Merrill based his quote on “The Affordable Care Act” back on July 23, 2012 in the Winchester Star?

The Winchester Star ran a story that Virginia's medicaid expansion was unlikely as the commonwealth was considering opting out of a key provision of the Affordable Care Act: expansion of Medicaid, the government-run insurance plan.

“It’s really disappointing if the Commonwealth doesn’t participate,” said Mark Merrill, president and CEO of Valley Health System, which operates Winchester Medical Center and five other hospitals in the region.

“The Affordable Care Act is better for all involved: patients, pharmaceuticals, physicians, and especially the uninsured.”

READ MORE HERE ... http://www.winchesterstar.com/article/va_medicaid_expansion_unlikely

Wednesday, December 12, 2012

re: Economic Research Institute

ERI Economic Research Institute is constantly updating this Form 990 Library as new images are provided by the IRS.


Valley Health System:
http://www.eri-nonprofit-salaries.com/index.cfm?FuseAction=NPO.Summary&EIN=540505979&Cobrandid=0


Shenandoah University:
http://www.eri-nonprofit-salaries.com/index.cfm?FuseAction=NPO.Form990&EIN=540525605&Year=2012

Shenandoah University Salaries for FY-6/30 2006-2011

Continuing to build on The Winchester Star's database of local salaries, below is Shenandoah University as they are ranked in the Top 5 of local employers in the City of Winchester for the 2nd Qtr of 2009.  Also included are the top 5 highest paid contractors that Shenandoah University has secured for their services rendered over recent years.

SU Top Salaries and Top Contractors (comparison from 2006-2009)

Salaries, other compensation, employee benefits had a noticeable increase from 2008.
$41,186,110 ... FY-6/30/2010

$40,783,692 ... FY-6/30/2009

$34,901,609 ... FY-6/30/2008

$34,821,188 ...
FY-6/30/2007

$32,490,932 ...
FY-6/30/2006
These figures are the total sum of Compensation of the current officers, directors, trustees and key employees;  Other Salaries and wages; Pension plan contributions (include section 401(k) and section 403(b) employer contributions); Other employee benefits and Payroll taxes.

Related public documents:

SU IRS990 2012

SU IRS990 2011

SU IRS990 2010

SU IRS990 2009

SU IRS990 2008

SU IRS990 2007

SU IRS990 2006

Tuesday, December 4, 2012

re: 60 minutes ... Hospitals: The cost of admission


60 minutes exposed what a "for-profit" hospital system is doing .. but makes one wonder are "not-for-profit" hospitals doing the same?

https://youtu.be/iEXkKV3kbb8


Hospitals: The cost of admission
December 2, 2012 4:42 PM

Steve Kroft investigates allegations from doctors that the hospital chain they worked for pressured them to admit patients regardless of their medical needs.




Steve Kroft updates a story 60 Minutes first broadcast a year ago called "The Cost of Admission." The report investigated allegations from doctors that the hospital chain they worked for pressured them to admit patients regardless of their medical needs.  
Update on "The Cost of Admission"

 




Wednesday, June 27, 2012

VHS A NONPROFIT IN NEED?

With so many people enduring these difficult economic times since 2008, is Valley Health System a nonprofit that is in much need?

Please keep other nonprofits that are truly struggling in mind when you decide to give financially and to volunteer your time. Several that come to mind would be Boys and Girls Club, C-CAP, United Way, and SAAA. They could use your financial support as well as volunteer time.

Why might you ask? Were you aware that the Winchester Medical Center has tallied a 10-year profit total of $418.6 million from 2000-2010. And, also, that VHS investment and other securities had a market value of $459.2 million at the end of 2010?

Valley Health officials keep publicly promoting the bad debt and charity care that they provide, which is great, but is that not part of the mission of a “not-for-profit” facility, to serve the needy and uninsured? Wonder how come VHS officials never promote their profitability?

The following information was cited from a mid-2000s Not-For-Profit Hospital Class Action Litigation from the state of Illinios.

“Not-for-profit hospitals (NFPs) have operated free from federal and state taxes because they have promised the government that they would operate as a charity provider of health care for the uninsured and that they would not engage in business ‘directly or indirectly, for the benefit of private interests.’ In reality, some NFPs do just the opposite:

Charging their uninsured patients significantly more than those who have insurance, Medicare, or Medicaid.

 Pursuing the poor or uninsured relentlessly by aggressive and humiliating collection techniques.

 Rampantly violating federal and state prohibition against profiteering by ‘private interests,’ through either ‘connected’ board members and/or physicians whose for-profit businesses are formed and subsidized by the ‘tax-free’ organization.

“Certain NFPs, and their subsidiaries who employ the same business model, have amassed and hoarded billions of dollars in cash and marketable securities that otherwise would have been available to provide charity care to those who were contemplated by the tax exemption. Moreover, enormous property and revenues have been isolated from taxation, the effect of which has bestowed upon the NFPs greater liquidity than that possessed by most state and local governments.

“Lawsuits have been filed against NFPs asking the court simply to require the defendants to honor their obligation to provide charity care to those who need it, and to cease the cronyism to favored board members or physicians whose businesses are being unlawfully subsidized by the perverse business practices summarized above.


There is no doubt that VHS has positive impact on the regional area, but are Winchester residents feeling the effect of it not being a better neighbor in paying its real-estate taxes to the City of Winchester?

Just one example: How much more will Winchester residents’ water rates keep increasing?


The community benefit report shows that VHS’s annual community benefit for 2010 was $96.7 million, but that community covers 18 regional counties serving approximate 1.1 million individuals. The 2010 census tells us that approximately 26,000 individuals live in Winchester and 78,000 in Frederick County. Winchester and Frederick County represents approximately 9.5 percent of the regional population served by VHS.

To close, why should residents of Winchester continue to bear the lost of tax base from VHS’ campus while they make millions and millions locally while reinvesting into other regional counties and even out of state? Is this fair to the residents of Winchester?

Saturday, November 19, 2011

re: Valley Health 'recalibration' to hit workers across network (NVDaily)


By Alex Bridges -- abridges@nvdaily.com

WINCHESTER -- Valley Health's efforts to "recalibrate" positions will hit salaries across the hospital network, officials said Friday.

The initiative means many workers could see their "shift differential" pay cut but, as two administrators explained, the system plans to compensate those affected employees with bonuses or other means "to make them whole."

The initiative began roughly a year ago after Elizabeth Savage-Tracy took over as Valley Health's vice president of human resources. As the new person in charge of the department, Savage-Tracy recalled taking a look the "total rewards program" to make sure it was fair, competitive and sustainable.

Total rewards includes all benefits, such as health insurance, welfare, retirement plans, as well as compensation -- base and premium pay. Premium pay includes shift differentials and career-ladder pay. Total rewards also includes "access management" -- vacation, holiday pay and other benefits.

To read the entire story, follow this link: http://www.nvdaily.com/news/2011/11/valley-health-recalibration-to-hit-workers-across-network.php

Friday, November 18, 2011

re: Some VHS workers to get raises; others could see pay cuts (NVDaily)


By Alex Bridges -- abridges@nvdaily.com


http://www.nvdaily.com/news/2011/11/valley-health-to-realign-positions.php

WINCHESTER -- Some Valley Health staff face pay cuts or may get increases as the hospital system equalizes positions among its thousands of workers.
Employees learned this week salaries may rise or fall as a result of an effort to align job titles and descriptions among the thousands of staff across the system.


Details of the initiative -- specifically who the changes affect and by how much -- were not available Thursday. More details on the effort would be available today, said Carol Weare, public relations manager for Valley Health.



Read the reamainder of the story on NVDaily:
http://www.nvdaily.com/news/2011/11/valley-health-to-realign-positions.php