Area Metropolitan Ambulance Authority MedStar Mobile Healthcare

Area Metropolitan Ambulance Authority
MedStar Mobile Healthcare
Board of Directors Agenda
May 28, 2014
NOTICE OF
AREA METROPOLITAN AMBULANCE AUTHORITY
BOARD OF DIRECTORS MEETING
551 EAST BERRY STREET
FORT WORTH, TEXAS 76110
May 28, 2014
10:00 a.m.
I.
CALL TO ORDER
Mr. Zimmerman
II.
INTRODUCTION OF GUESTS
Mr. Zimmerman
III.
CITIZEN
PRESENTATIONS
Opportunity for citizens to address the Board of Directors
IV.
CONSENT
AGENDA
Items on the consent agenda are of a routine nature. To
expedite the flow of business, these items may be acted
upon as a group. Any board member or citizen may request
an item be removed from the consent agenda and considered
separately.
V.
NEW BUSINESS
VI.
VII.
BC - 1187
Approval of minutes for board meeting April 23, 2014
Mr. Zimmerman
Pg. 4
BC - 1188
Approval of check registers for the month of April
2014.
Mr. Zimmerman
Pg. 8
A.
Executive Director Report
• Safety Report
Mr. Hooten
Mr. Curtis
B.
Finance Report
Ms. Jordan
C.
Operations Report
Mr. Cunningham
D.
Business Office & Billing
Ms. Swagerty
E.
Human Resources
• Staffing
Ms. Jordan
F.
Clinical
Ms. Trusty
G.
Public Affairs Report
Mr. Zavadsky
H.
EPAB Monthly Report
Dr. Beeson
Miscellaneous information items from the staff or requests
Mr. Hooten
MONTHLY REPORTS
OTHER DISCUSSION
A.
from the Board for future agenda items.
VIII.
CLOSED SESSION
The AMAA Board may conduct a closed meeting concerning any subjects and
for any purposes permitted under Chapter 551 of the Texas Government Code,
including, but not limited to, the following:
(1) Consultation with its attorney pursuant to Section 551.071
(2) Deliberation regarding real property pursuant to Section 551.072
(3) Deliberation regarding prospective gift pursuant to Section 551.073
(4) Deliberation regarding personnel matters pursuant to Section 551.074
IX.
RECONVENE FROM CLOSED SESSION
BC - 1189
X.
ADJOURNMENT
Act on any item discussed on Closed Session.
Mr. Zimmerman
AMAA
BOARD COMMUNICATION
Date:
05/28/14
Reference #: BC-1187
Title:
Approval of minutes for board meeting of
April 23, 2014.
RECOMMENDATION:
It is recommended that the Board of Directors approve the minutes for the board meeting of April 23,
2014.
DISCUSSION:
N/A
FINANCING:
N/A
Submitted by: Douglas Hooten
_____Approved
Board Action: _____Denied
_____Continued until _____________
4
MINUTES
AREA METROPOLITAN AMBULANCE AUTHORITY
BOARD OF DIRECTORS MEETING
551 EAST BERRY STREET
FORT WORTH, TEXAS 76110
April 23, 2014
10:01 am
The Area Metropolitan Ambulance Authority Board of Directors met on April 23, 2014 at the
Ambulance Authority offices.
I.
CALL TO ORDER
Chairman Zim Zimmerman was not present; Dr. Rajesh Gandhi, Acting Chairman / Secretary,
called the meeting to order at 10:01 a.m. Board members present were Paul Harral, Byron
Black, Dr. Darrin D’Agostino, and Dr. Jeff Beeson.
II.
INTRODUCTION OF GUESTS
There were no guests present. Others present were Douglas Hooten, Mike D’Agostino, Susan
Swagerty, Sean Burton, Shaun Curtis, Macara Trusty, Paul Trusty, Heath Wright, Desiree
Demary, Kier Brister, Chris Cunningham, Brett Lyle, Melissa Allen, Marianne Schmidt all with
MedStar, and Dr. Veer Vithalani from EPAB; AMAA Board Attorney, Matt Goetz; Scott
Hanlan, and Mike Glynn from Fort Worth Fire Department.
III.
CITIZEN PRESENTATIONS
IV.
CONSENT AGENDA
V.
NEW BUSINESS
BC-1183
Approval of minutes for board meeting March 20, 2014.
The motion to approve the board meeting minutes under new business were made by Dr.
D’Agostino, and was seconded by Mr. Byron Black. The motion carried unanimously.
BC-1184
Approval of check registers for the month of March 2014.
The motion to approve the check register was made by Mr. Byron Black and was seconded by
Dr. D’Agostino. The motion carried unanimously.
BC-1185
Approval of Membership with North Central Texas Council of
Governments (NCTCOG)
The motion to approve membership in the NCTCOG was made by Dr. D’Agostino and second
by Mr. Byron black. The motion was carried unanimously. Vote was made to pick who from
our board would attend – Mr. Paul Harral was picked and will attend for MedStar.
5
VI. MONTHLY REPORTS
A. Executive Director Report: Mr. Hooten reported that we are moving along very well
with the construction of the building. The second floor has been poured and the two outside
decks have been poured. There is plywood on the front of the building and the curved
shape of the building is starting to show. On Friday, April 18th the transom was put in
place about the front door. We were having problems with getting steel for the structure, a
new person has been hired and things are moving along. The MedStar Community Report
2013 was handed out to each board member. Copies of this will be sent to all the Member
Cites. Mr. Hooten reviewed the MedStar Scorecard and the agenda for the board retreat
being held May 13-14 at Rough Creek Lodge.
B. Finance Report: Ms. Jordan reviewed operational results for the month of March.
For the month ended March, 2014, total revenues were $3,510,531 compared to budgeted
revenues of $3,172,838 for a positive variance of $337,693. Expenses were $2,602,165
compared to budget of $2,717,655 for a positive variance of $115,490. Net retained
earnings were $741,819 compared to budgeted earnings of $249,678 for a positive variance
of $492,141. Transports were budgeted to be 7346; actual transports billed were 7772.
This results in a gross revenue variance of approximately $729,000 and a net revenue
variance of approximately $156,000.
C. Operations Report: Mr. Cunningham reviewed section D. Our P25 radios have very
good sound. KPI’s are doing well. We are focusing on the move.
D. Business Office & Billing: Ms. Swagerty reviewed our Charity Care program for
2012. 58 applications, 27 were allowed 100% write off. The average we allow is between
30 and 40%.
E. Human Resources: Ms. Jordan reviewed the MedStar Separation Statistics for March
2014, page 36. Ms. Jordan reviewed our diversity plan – we will be updating it this year.
We plan on going out to college campuses and working with Veteran agencies to get more
African Americans for the field positions. Mr. Jordan reviewed the Lost Hours Report, our
2014 numbers are correct; we need to research the 2013 numbers.
F. Clinical: Ms. Trusty stated that we have 6 primaries in training, Saturday we will
have 7. We will be over by 10 this summer – summer is a big turnover time.
G. Public Affairs: Ms. Lyle highlighted the events over the past month in the Public
Affairs Summary.
H. EPAB Monthly Report: EPAB has been working with Ms. Jordan’s group. We have
an audit coming up soon.
VII. OTHER DISCUSSION
VIII. CLOSED SESSION
IX. ADJOURNMENT
6
There being no further business, Acting Chairman Dr. Gandhi adjourned the meeting at
10:48 a.m.
Respectfully submitted,
Dr. Rajesh Gandhi
Secretary / Acting Chairman
7
AMAA
BOARD COMMUNICATION
Date:
05/28/14
Reference #:
BC-1188
Title:
Approval of check register for the month of
April 2014.
RECOMMENDATION:
It is recommended that the Board of Directors approve the check register for payments over $5,000
for the month April 2014.
DISCUSSION:
N/A
FINANCING:
N/A
_____Approved
Submitted by: Douglas Hooten Board Action: _____Denied
_____Continued until _____________
8
MedStar - Area Metropolitan Ambulance Authority
Check History and Description Report for Checks Over $5,000
Activity From 04-01-2014 to 04-30-2014
CHECK
NUMBER
76369
CHECK
DATE
4/3/14
76370
4/3/14
76371
4/3/14
76381
4/3/14
76388
4/3/14
76390
4/3/14
76398
4/3/14
76407
4/3/14
76412
4/3/14
76418
4/3/14
1092
4/3/14
1094
4/3/14
76446
4/10/14
76448
4/10/14
76449
4/10/14
76455
4/10/14
76458
4/10/14
76478
4/10/14
76482
4/10/14
76493
4/10/14
76499
4/10/14
76517
4/16/14
76539
4/17/14
DESCRIPTION
AT&T
Telephone Base-Admin
Banc of America Leasing
Current Portion - Amb Purchase
Barker Advertising Specialty Co., Inc.
Prepaid Expense
Delta Dental Insurance Comany
Dental Ins-Admin
Fulcrum Group
Computer Hardware - IT
Group & Pension Administrators, Inc.
Health Ins-Admin
ImageTek
Computer Software - Admin
NetMotion Wireless
Prepaid Expense
ReCept Pharmacy
Medical Supplies-Logistics
Smiths Medical ASD Inc.
Medical Supplies-Logistics
Ferguson Studio
Construction in Progress
JBM Builders, Inc.
Construction in Progress
Banc of America Leasing
Current Portion - Amb Purchase
Bound Tree Medical LLC
Minor Equipment- Other-Cm Hlth
Callidus Software Inc
Prepaid Expense
Direct Energy Business
Utilities-Admin
City of Fort Worth
Prepaid Expense
Microsoft Licensing, GP
Prepaid Expense
Motorola Solutions, Inc.
Communications Equipment
ReCept Pharmacy
Medical Supplies-Logistics
Taylor Healthcare Products Inc
Medical Supplies-Logistics
US Postmaster
Postage-Admin
Konica Minolta Business Solutions
Prepaid Expense
CHECK
AMOUNT
9,663.93
56,811.44
11,240.00
15,838.31
527,102.95
41,380.32
19,664.20
9,062.50
29,233.26
5,742.77
10,000.00
194,850.00
25,128.20
12,681.39
6,709.00
5,443.96
65,088.00
22,586.64
667,951.20
21,219.12
6,418.00
5,000.00
5,003.34
9
MedStar - Area Metropolitan Ambulance Authority
Check History and Description Report for Checks Over $5,000
Activity From 04-01-2014 to 04-30-2014
CHECK
NUMBER
76548
CHECK
DATE
4/17/14
76553
4/17/14
1096
4/17/14
76691
4/28/14
76697
4/28/14
76718
4/28/14
76734
4/28/14
76737
4/28/14
76755
4/28/14
1098
4/28/14
Wire #1004415
4/11/14
Wire #1039458
4/18/14
DESCRIPTION
O'Neill
Printing Services-Public Affai
ReCept Pharmacy
Medical Supplies-Logistics
JBM Builders, Inc.
Construction in Progress
ADP, Inc.
Consultant Services-Admin
AT&T Mobility
Cell Phones-Admin
The Fulcrum Group
Computer Software - Admin
PRUDENTIAL GROUP INSURANCE
Life/AD&D Ins-Admin
ReCept Pharmacy
Medical Supplies-Logistics
ZirMed Inc
Invoice & Forms Processing-Adm
JP Morgan Chase Bank, N.A.
Constr Loan - Chase
American Express
MedStar business expenses
WEX Bank
Fuel/Oil
CHECK
AMOUNT
9,174.96
7,878.21
252,900.00
6,071.04
9,497.68
75,279.71
13,210.95
9,163.50
8,399.53
43,245.54
25,402.54
107,949.62
2,341,991.81
TOTAL ACCOUNTS PAYABLE
TOTAL PAYROLL EXPENSE
2,468,015.78
1,577,440.15
4,045,455.93
10
Tab A - Executive Director Report
11
A culture of
safety
MedStar Risk and Safety
12
• Unique opportunity with the development of a Just
Culture
• Focus on behavioral drift
• Must improve employee engagement
• Safety as a holistic and organizational concept
• Improved data collection for data driven improvement
Transition to a Culture of
Safety
13
120
$300,000.00
100
$250,000.00
80
$200,000.00
60
$150,000.00
Collision Count
Collision Cost
40
$100,000.00
20
$50,000.00
0
$0.00
2006
2007
2008
2009
2010
2011
2012
2013
Current Trends Collisions
14
$180,000.00
120
$160,000.00
100
$140,000.00
$120,000.00
80
$100,000.00
Count of Employee Injuries/ Exposures
60
$80,000.00
Employee Injury/ Exposure Cost
$60,000.00
40
$40,000.00
20
$20,000.00
$0.00
0
2010
2011
2012
2013
2014
Current Trends - Injuries
15
• Reduce collision count by 15% by Dec 2014
• Sustainable collision mitigation processes
• 98 collisions in 2013
• Reduce injury and exposure count by 15% by
Dec 2014
• Sustainable mitigation processes
• 106 injuries and exposures in 2013
Goals
16
• Improve data collection
• Refine collection points to enable data mining
• Update SOG’s
• SOG modification to reflect best practices and lessons
learned
• New or modified SOG’s vetted through affected teams
to build ownership
• Engage workforce
• Biggest and most effective approach
The Plan
17
• AIR Process
• Quarterly online safety briefs
• Safety committee
• “Risky Business”
• DriveCam trial
Employee engagement
18
• After incident review on all collisions or employee
injuries
• Used to develop training and system redesign
• Effective coaching tool
• Allows team member to reflect on the incident
AIR Process
19
• Brings safety training to the team member at their
convenience
• Opportunity to re-engage in safe practices
• Diverse topics sustain a conversation about safety
Quarterly online safety
brief
20
• Encourages active participation in the development of a
safe work environment
• Employee driven initiatives
• Identifies system risks/ barriers and solicits end user level
modification
• Drives SOG changes
Safety committee
21
• Monthly newsletter to promote discussion about safety
and wellness
• Topics include:
•
•
•
•
Work life balance
Safe lifting
Seasonal threats (flu, weather, etc)
Current issues
Risky Business
22
• 120 day trial of DriveCam event recorder
• Identifies risky behavior before it results in an outcome
• Recently expanded to all vehicles
DriveCam trial
23
For the good of all, directly and indirectly
involved with MedStar; our goal is to educate,
promote, and encourage the practice of safety
through Just Culture and employee engagement
by designing safe systems and reducing at risk and
reckless behavior.
MedStar
Risk and Safety
24
Tab B – Finance Report
25
AMAA/MedStar
Report to Board of Directors
Finance Report
May 28, 2014
Operational Results
For the month ended April, 2014, total revenues were $3,203,044 compared to budgeted revenues of
$3,281,416 for a negative variance of $78,372. Expenses were $2,630,524 compared to budget of
$2,689,604 for a positive variance of $59,079. Net retained earnings were $409,752 compared to
budgeted earnings of $383,300 for a positive variance of $26,452.
For the seven months ended April, 2014, total revenues were $22,697,911 compared to budgeted
revenues of $22,616,186 for a positive variance of $81,725. Expenses were $19,342,872 compared to
budget of $19,930,448 for a positive variance of $587,576. Retained earnings were $2,162,206
compared to budget of $1,235,799 for a positive variance of $926,408.
Community Health Program
As of the seven months ended April 2014, CHP has reported revenues of $867,011 compared to budget
of $707,028 for a positive variance of $159,983. Expenses are $561,044 compared to budget of
$651,173 for a positive variance of $90,128. Net Retained Earnings are $305,966 compared with budget
of $55,854 for a positive variance of $250,112.
Collections
Collections by Month of Service indicates an average 12-month collection percentage of 27.09%.
Capital Update
Attached is the final summary of the capital budget which was approved by the Board in August, 2013
along with the spending year to date April, 2014.
Key Financial Indicators
Key financial indicators are all positive as of April, 2014.
26
Area Metropolitan Ambulance Authority/MedStar
Balance Sheet as of April 30, 2014
ASSETS
Current Assets
Cash and Equivalents
Patient Accounts Receivable (net of allowance)
Inventory
Prepaid Insurance and Expemse
$
23,616,335.99
4,937,811.13
269,877.22
931,038.50
Total Current Assets
29,755,062.84
Property and Equipment
10,323,103.53
Total Assets
$
40,078,166.37
LIABILITIES AND CAPITAL
Current Liabilities
Accounts Payable
Interest Payable
Payroll Taxes and Benefits Payable
$
540,641.23
18,623.64
656,530.12
Total Current Liabilities
1,215,794.99
Long-Term Liabilities
Deferred Subscription Income
Ambulance Purchase
Construction Loan Chase
178,866.11
445,612.91
3,020,952.36
Total Long-Term Liabilities
3,645,431.38
Total Liabilities
4,861,226.37
Net Assets <Deficit>
Capital Contribution
Retained Earnings
Net Income
316,920.50
32,275,081.40
2,624,938.10
Total Net Assets <Deficit>
Total Liabilities & Net Assets <Deficit>
35,216,940.00
$
40,078,166.37
27
Area Metropolitan Ambulance Authority
Budgeted Statement of Revenues and Expenditures
For the Seven Months Ending April 30, 2014
Current Month
Actual
Current Month
Budget
Currrent Month
Variance
Year to Date
Actual
Year to Date
Budget
Year to Date
Variance
11,097,596.95
(4,288,763.66)
(3,716,274.81)
11,051,728.00
(4,595,228.80)
(3,382,094.88)
45,868.95
306,465.14
(334,179.93)
78,744,935.32
(31,966,540.90)
(25,070,359.85)
77,748,048.00
(32,293,462.60)
(23,791,947.54)
996,887.32
326,921.70
(1,278,412.31)
3,092,558.48
3,074,404.32
18,154.16
21,708,034.57
21,662,637.86
45,396.71
40,745.00
3,355.79
6,772.00
39,925.37
19,688.20
32,829.00
3,785.00
6,280.00
122,452.00
41,666.67
7,916.00
(429.21)
492.00
(82,526.63)
(21,978.47)
187,307.08
25,544.37
33,521.00
365,839.94
377,663.85
181,482.00
26,495.00
84,460.00
279,443.00
381,667.69
5,825.08
(950.63)
(50,939.00)
86,396.94
(4,003.84)
Revenues
Patient Fees-Service
Less: Contractual Allowances
Less: Provsion for Uncollectibles
Patient Fees - NET
Special Events
Subsidy
Education
Other
DISRIP
Total Revenues
$
Payroll
Benefits and Taxes
Fuel
Oxygen
Medical Supplies
Other Vehicle & Equipment
Rent & Utilities
Repairs & Maintenance Facility & Equipmnt
Postage & Shipping
Equipment Rental
Insurance
Advertising & Public Relations
Printing
Tehnical Support
Travel & Entertainment
Professional Fees
Non-Capital Equipment
Educational Expense/Training
Office Equip Maint
Bank Service Charges
Dues & Subscriptions
Computer Related Costs
Miscellaneous
Total Other Expenses
$
3,203,044.84 $
3,281,416.99
(78,372.15) $
22,697,910.81 $
22,616,185.55
81,725.26
1,583,751.85
410,730.83
113,178.15
5,716.52
131,500.14
39,507.65
36,391.46
24,726.83
13,225.70
6,399.12
8,900.35
8,127.56
10,627.73
0.00
18,711.96
110,901.83
17,795.51
4,518.38
64,664.48
17,863.73
3,139.85
144.71
0.00
1,545,577.50
493,559.00
103,605.75
4,786.00
125,189.50
37,460.33
44,766.75
17,107.67
7,780.59
6,344.17
23,382.59
11,054.25
2,558.67
0.00
11,068.08
132,574.24
13,143.00
20,252.00
81,406.58
5,875.00
1,272.25
839.92
0.00
38,174.35
(82,828.17)
9,572.40
930.52
6,310.64
2,047.32
(8,375.29)
7,619.16
5,445.11
54.95
(14,482.24)
(2,926.69)
8,069.06
0.00
7,643.88
(21,672.41)
4,652.51
(15,733.62)
(16,742.10)
11,988.73
1,867.60
(695.21)
0.00
11,776,136.32
3,200,538.26
734,377.07
35,802.30
940,724.78
302,046.98
256,399.34
128,235.91
55,597.67
42,009.73
142,327.02
43,467.49
31,591.23
0.00
77,687.84
899,058.74
147,526.68
49,783.50
381,701.16
71,384.19
20,627.83
341.08
5,506.59
11,561,826.50
3,577,613.00
725,240.25
33,502.00
876,326.50
262,552.31
244,133.25
119,753.69
54,464.13
44,409.19
163,678.13
88,879.75
20,410.69
0.00
82,471.56
979,221.68
279,260.00
177,751.00
569,846.06
41,125.00
22,103.75
5,879.44
0.00
214,309.82
(377,074.74)
9,136.82
2,300.30
64,398.28
39,494.67
12,266.09
8,482.22
1,133.54
(2,399.46)
(21,351.11)
(45,412.26)
11,180.54
0.00
(4,783.72)
(80,162.94)
(131,733.32)
(127,967.50)
(188,144.90)
30,259.19
(1,475.92)
(5,538.36)
5,506.59
2,630,524.34 $
2,689,603.84
(59,079.50) $
19,342,871.71 $
19,930,447.88
(587,576.17)
Earnings before Interest & Depreciation
572,520.50
591,813.15
(19,292.65)
3,355,039.10
2,685,737.67
669,301.43
Interest
Depreciation
9,891.90
152,876.89
21,489.00
187,024.00
(11,597.10)
(34,147.11)
61,944.41
1,130,888.24
143,696.00
1,306,243.00
(81,751.59)
(175,354.76)
409,751.71 $
383,300.15
2,162,206.45 $
1,235,798.67
926,407.78
Net Retained Earnings
5/20/2014 at 3:37 PM
$
26,451.56 $
Page: 1
28
Area Metropolitan Ambulance Authority
Budgeted Statement of Revenues and Expenditures
For the Seven Months Ending April 30, 2014
Current Month
Actual
Current Month
Budget
Currrent Month
Variance
Year to Date
Actual
Year to Date
Budget
Year to Date
Variance
4,027,247.56
(824,202.72)
4,036,930.12
(755,513.13)
(9,682.56)
(68,689.59)
29,484,657.58
(6,786,746.77)
28,400,318.46
(5,784,132.91)
1,084,339.12
(1,002,613.86)
3,203,044.84 $
3,281,416.99
(78,372.15) $
22,697,910.81 $
22,616,185.55
81,725.26
1,994,482.68
113,178.15
137,216.66
39,507.65
36,391.46
24,726.83
8,900.35
110,901.83
82,459.99
82,758.74
2,039,136.50
103,605.75
129,975.50
37,460.33
44,766.75
17,107.67
23,382.59
132,574.24
94,549.58
67,044.93
(44,653.82)
9,572.40
7,241.16
2,047.32
(8,375.29)
7,619.16
(14,482.24)
(21,672.41)
(12,089.59)
15,713.81
14,976,674.58
734,377.07
976,527.08
302,046.98
256,399.34
128,235.91
142,327.02
899,058.74
528,132.84
399,092.15
15,139,439.50
725,240.25
909,828.50
262,552.31
244,133.25
119,753.69
163,678.13
979,221.68
849,106.06
537,494.51
(162,764.92)
9,136.82
66,698.58
39,494.67
12,266.09
8,482.22
(21,351.11)
(80,162.94)
(320,973.22)
(138,402.36)
2,630,524.34 $
2,689,603.84
(59,079.50) $
19,342,871.71 $
19,930,447.88
(587,576.17)
Revenues
Patient Fees - NET
Other Revenues
Total Revenues
$
Payroll & Benefits
Fuel
Medical Supplies/Oxygen
Other Vehicle & Equipment
Rent & Utilities
Repairs & Maintenance Facility & Equipmnt
Insurance
Professional Fees
Non-Capital Equipment
Other Expenses
Total Other Expenses
$
Earnings before Interest & Depreciation
572,520.50
591,813.15
(19,292.65)
3,355,039.10
2,685,737.67
669,301.43
Interest
Depreciation
9,891.90
152,876.89
21,489.00
187,024.00
(11,597.10)
(34,147.11)
61,944.41
1,130,888.24
143,696.00
1,306,243.00
(81,751.59)
(175,354.76)
409,751.71 $
383,300.15
2,162,206.45 $
1,235,798.67
926,407.78
Net Retained Earnings
5/20/2014 at 3:37 PM
$
26,451.56 $
29
Page: 1
Area Metropolitan Ambulance Authority
Budgeted Statement of Revenues and Expenditures
For the Seven Months Ending April 30, 2014
Current Month
Actual
Current Month
Budget
Currrent Month
Variance
Year to Date
Actual
Year to Date
Budget
Year to Date
Variance
56,495.28
26,978.48
29,120.00
59,266.67
27,375.28
(32,288.19)
401,383.60
465,627.44
202,160.00
504,867.69
199,223.60
(39,240.25)
83,473.76 $
88,386.67
(4,912.91) $
867,011.04 $
707,027.69
159,983.35
102,777.38
0.00
0.00
99.00
0.00
0.00
0.00
0.00
3,800.28
26.98
77,338.17
0.00
0.00
0.00
0.00
0.00
0.00
0.00
300.00
290.00
25,439.21
0.00
0.00
99.00
0.00
0.00
0.00
0.00
3,500.28
(263.02)
548,830.30
0.00
0.00
99.00
0.00
0.00
0.00
0.00
4,704.97
7,410.09
627,282.19
0.00
0.00
0.00
0.00
0.00
0.00
0.00
3,796.00
20,095.00
(78,451.89)
0.00
0.00
99.00
0.00
0.00
0.00
0.00
908.97
(12,684.91)
106,703.64 $
77,928.17
28,775.47 $
561,044.36 $
651,173.19
(90,128.83)
(23,229.88)
10,458.50
(33,688.38)
305,966.68
55,854.50
250,112.18
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
55,854.50
250,112.18
Revenues
Patient Fees - NET
Other Revenues
Total Revenues
$
Payroll & Benefits
Fuel
Medical Supplies/Oxygen
Other Vehicle & Equipment
Rent & Utilities
Repairs & Maintenance Facility & Equipmnt
Insurance
Professional Fees
Non-Capital Equipment
Other Expenses
Total Other Expenses
$
Earnings before Interest & Depreciation
Interest
Depreciation
Net Retained Earnings
5/20/2014 at 3:38 PM
($
23,229.88) $
10,458.50
(33,688.38) $
305,966.68 $
30
Page: 1
MedStar - Collections by Charge Month
Month
Oct-11
Nov-11
Dec-11
Jan-12
Feb-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
AVG 12 Mo
Charges
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
10,566,030
10,213,990
10,798,689
10,792,415
10,362,710
10,757,281
10,609,608
10,842,741
10,507,591
11,233,951
11,231,348
10,931,864
10,821,609
10,313,485
11,256,725
12,214,103
9,889,908
10,768,038
10,783,065
11,578,684
11,228,888
11,339,070
11,382,391
11,130,297
10,880,415
10,717,275
11,637,535
11,623,880
10,445,823
11,467,405
10,798,408
Month 1
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
458,973
393,251
290,849
147,358
239,153
254,369
270,648
292,118
187,853
143,112
395,006
256,850
328,973
226,719
284,895
154,132
216,490
256,164
270,713
291,864
211,029
229,703
334,674
218,895
289,675
168,617
124,924
182,703
193,628
172,309
228,994
1.97%
Month 2
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
1,438,142
1,447,104
1,325,598
1,263,705
1,295,213
1,708,050
1,497,831
1,399,516
1,277,996
1,499,442
1,259,900
1,263,106
1,566,209
1,065,595
1,693,010
1,695,668
1,393,240
1,637,742
1,732,760
1,658,623
1,589,158
1,777,847
1,610,418
1,705,458
1,493,901
1,366,143
1,740,763
1,528,196
1,530,025
1,643,581
14.44%
Month 3
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
363,923
455,570
581,753
483,207
701,314
494,319
490,370
563,398
716,418
647,554
716,077
668,717
459,688
882,414
507,948
744,074
554,079
566,599
484,572
590,922
670,378
479,735
567,121
563,098
676,718
798,279
718,779
876,249
671,296
5.74%
Month 4
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
171,413
164,641
199,781
552,485
177,402
171,190
174,801
263,625
203,473
253,378
173,040
230,645
235,331
273,144
229,086
187,992
235,058
126,534
145,646
201,434
161,566
174,129
175,882
192,112
194,997
269,580
207,085
205,958
1.73%
Month 5
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
99,427
91,945
265,355
82,241
73,963
84,839
114,457
92,687
120,537
114,698
73,778
165,862
122,177
124,256
190,458
181,723
81,685
100,372
96,083
133,707
113,188
109,826
109,118
95,524
106,800
116,835
88,589
0.99%
Month 6
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
65,197
104,214
69,588
61,173
47,420
62,158
63,018
85,956
56,462
64,853
65,786
74,821
77,198
105,406
75,799
77,728
73,588
81,770
58,596
58,691
67,456
59,521
57,164
71,020
66,183
53,608
0.60%
Month 7
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
49,043
50,834
44,452
48,023
34,335
41,731
41,525
51,108
39,954
34,558
48,115
74,252
40,890
76,494
46,870
64,131
48,522
33,498
51,615
33,895
33,043
30,601
35,968
36,746
32,155
0.40%
Month 8
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
39,791
32,493
26,285
26,011
26,629
34,415
35,382
20,080
28,013
20,270
60,633
65,597
53,217
32,472
31,069
41,035
21,304
28,468
12,962
29,453
32,213
23,972
28,352
29,428
0.27%
Month 9
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
37,804
20,679
26,994
21,006
26,068
18,452
10,373
25,478
13,659
28,715
32,960
46,425
25,445
21,956
28,651
24,684
22,844
12,966
27,099
15,846
20,908
23,674
13,805
0.22%
Month 10
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
11,834
11,757
16,199
20,223
21,369
15,005
13,746
8,455
11,258
12,405
23,082
16,399
14,238
30,587
11,379
17,039
14,023
18,033
9,905
17,622
16,268
16,608
0.16%
Month 11
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
11,430
12,399
12,588
15,012
4,106
10,958
10,546
9,700
46,497
58,564
21,905
6,109
18,782
20,293
9,144
16,378
6,129
11,952
14,265
31,516
13,466
0.17%
Month 12
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
11,337
11,822
8,677
18,370
7,042
10,281
15,195
40,717
9,133
6,718
12,331
15,690
17,079
10,200
10,090
16,855
9,693
16,362
16,480
12,891
0.12%
Month 13
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
77,375
38,332
38,262
33,531
37,817
36,428
59,286
40,197
21,375
41,752
38,172
51,811
60,508
27,808
36,903
22,230
16,277
2,570
7,830
0.28%
Total% Collected
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
2,835,690
2,835,040
2,906,381
2,772,345
2,691,828
2,942,195
2,797,177
2,893,036
2,732,629
2,926,019
2,920,786
2,936,284
3,019,734
2,897,345
3,155,303
3,243,670
2,692,931
2,893,029
2,928,528
3,076,464
2,928,673
2,925,615
2,932,502
2,912,280
2,860,428
2,773,062
2,880,140
2,793,106
2,394,948
1,815,890
228,994
26.84%
27.76%
26.91%
25.69%
25.98%
27.35%
26.36%
26.68%
26.01%
26.05%
26.01%
26.86%
27.90%
28.09%
28.03%
26.56%
27.23%
26.87%
27.16%
26.57%
26.08%
25.80%
25.76%
26.17%
26.29%
25.87%
24.75%
24.03%
22.93%
15.84%
2.12%
27.09%
31
Summary - 12 Mo Average Rate by Member City
Blue Mound
$
Billed
222,269.50 $
Month 1
4,308.91 $
1.94%
Month 2
31,106.27 $
13.99%
Month 3
10,200.24 $
4.59%
Month 4
2,702.00 $
1.22%
Month 5
437.87 $
0.20%
Month 6
1,567.08 $
0.71%
Month 7
983.10 $
0.44%
Month 8
100.00 $
0.04%
Month 9
16.87 $
0.01%
Month 10
25.00 $
0.01%
Month 11
(4.75) $
0.00%
Month 12
14.62 $
0.01%
Burleson
$
4,703,416.82 $
275,257.39 $
5.85%
1,236,758.16 $
26.29%
397,100.38 $
8.44%
83,845.07 $
1.78%
63,707.85 $
1.35%
44,453.93 $
0.95%
23,583.89 $
0.50%
32,874.60 $
0.70%
12,735.82 $
0.27%
5,732.32 $
0.12%
6,357.59 $
0.14%
Edgecliffe Vill
$
117,417.00 $
5,034.38 $
4.29%
19,784.02 $
16.85%
7,801.77 $
6.64%
3,318.10 $
2.83%
1,266.88 $
1.08%
456.44 $
0.39%
12.19 $
0.01%
$
0.00%
283.36 $
0.24%
281.00 $
0.24%
Forest Hill
$
1,563,399.42 $
71,486.20 $
4.57%
187,045.13 $
11.96%
54,527.14 $
3.49%
26,129.67 $
1.67%
8,903.14 $
0.57%
12,027.47 $
0.77%
250.16 $
0.02%
5,373.92 $
0.34%
471.58 $
0.03%
Ft Worth
$
112,544,912.92 $
4,646,174.77 $
4.13%
14,958,921.64 $
13.29%
6,172,025.43 $
5.48%
2,050,674.64 $
1.82%
1,304,863.49 $
1.16%
724,576.66 $
0.64%
503,296.45 $
0.45%
358,093.36 $
0.32%
Haltom City
$
3,811,508.02 $
139,333.84 $
3.66%
516,620.22 $
13.55%
180,449.53 $
4.73%
47,257.21 $
1.24%
28,967.14 $
0.76%
27,359.69 $
0.72%
14,048.52 $
0.37%
Haslet
$
217,530.50 $
9,412.90 $
4.33%
42,620.61 $
19.59%
22,578.36 $
10.38%
5,758.79 $
2.65%
4,860.85 $
2.23%
3,112.35 $
1.43%
Lake Worth
$
1,437,228.34 $
58,600.58 $
4.08%
234,132.82 $
16.29%
81,523.72 $
5.67%
27,966.63 $
1.95%
12,917.90 $
0.90%
Lakeside
$
64,681.00 $
$
4,231.70 $
80,442.51
13,341.44 $
20.63%
4,457.55 $
6.89%
2,200.22 $
3.40%
River Oaks
$
842,271.20 $
29,629.39 $
3.52%
114,741.79 $
13.62%
45,731.14 $
5.43%
Saginaw
$
1,378,309.21 $
80,889.30 $
5.87%
212,138.92 $
15.39%
Sansom Park
$
554,926.53 $
32,329.67 $
5.83%
Westover Hills
$
21,302.02 $
Westworth Vill
$
White Settlement
$
Month 13
$
0.00%
Total
51,457.21
23.15%
7,554.43 $
0.16%
12,249.70 $
0.26%
2,202,211.13
46.82%
$
0.00%
17.58 $
0.01%
$
0.00%
38,255.72
32.58%
404.87 $
0.03%
2,187.79 $
0.14%
923.36 $
0.06%
4,807.35 $
0.31%
374,537.78
23.96%
259,463.01 $
0.23%
178,878.52 $
0.16%
149,618.99 $
0.13%
112,728.93 $
0.10%
212,469.33 $
0.19%
31,631,785.22
28.11%
7,478.13 $
0.20%
10,491.81 $
0.28%
9,752.29 $
0.26%
2,382.76 $
0.06%
3,529.16 $
0.09%
2,049.91 $
0.05%
989,720.21
25.97%
252.10 $
0.12%
166.11 $
0.08%
562.42 $
0.26%
212.24 $
0.10% $
45.00 $
0.00 $
20.00 $
0.00 $
484.50 $
0.00
90,086.23
41.41%
13,582.64 $
0.95%
5,299.76 $
0.37%
2,524.26 $
0.18%
2,846.07 $
0.20%
1,288.73 $
0.09%
870.31 $
0.06%
2,482.03 $
0.17%
3,967.01 $
0.28%
448,002.46
31.17%
25.00 $
0.04%
47.01 $
0.07%
15.48 $
0.02% $
404.99 $
0.01 $
(71.25) $
(0.00) $
40.00 $
0.00 $
831.00 $
0.01 $
7.87 $
0.00 $
-
$
25,531.01
39.47%
13,110.90 $
1.56%
5,530.85 $
0.66%
5,868.20 $
0.70%
4,474.01 $
0.53%
910.65 $
0.11%
(698.83) $
-0.08%
98.04 $
0.01%
241.94 $
0.03%
271.48 $
0.03%
300.46 $
0.04%
220,210.02
26.14%
86,666.02 $
6.29%
30,057.05 $
2.18%
16,426.42 $
1.19%
12,359.74 $
0.90%
11,677.70 $
0.85%
3,709.43 $
0.27%
2,077.09 $
0.15%
4,467.66 $
0.32%
518.12 $
0.04%
3,739.51 $
0.27%
2,687.57 $
0.19%
467,414.53
33.91%
84,272.49 $
15.19%
13,494.06 $
2.43%
2,865.22 $
0.52%
1,703.77 $
0.31%
2,698.20 $
0.49%
2,180.95 $
0.39%
511.19 $
0.09%
1,198.99 $
0.22%
116.98 $
0.02%
30.01 $
0.01%
591.40 $
0.11%
1,096.00 $
0.20%
143,088.93
25.79%
712.60 $
3.35%
1,609.17 $
7.55%
2,084.59 $
9.79%
1,159.31 $
5.44%
180.85 $
0.85%
(180.85) $
-0.85%
$
0.00%
$
0.00%
$
0.00%
$
0.00%
$
0.00%
$
0.00%
$
0.00%
5,565.67
26.13%
248,143.50 $
18,483.32 $
7.45%
36,189.06 $
14.58%
16,324.41 $
6.58%
8,199.05 $
3.30%
3,200.43 $
1.29%
671.59 $
0.27%
497.33 $
0.20%
928.74 $
0.37%
482.26 $
0.19%
469.60 $
0.19%
20.00 $
0.01%
114.42 $
0.05%
1,204.00 $
0.49%
86,784.21
34.97%
2,848,936.75 $
120,283.75 $
4.22%
406,508.52 $
14.27%
120,517.81 $
4.23%
32,446.84 $
1.14%
23,754.40 $
0.83%
14,495.41 $
0.51%
6,374.00 $
0.22%
11,779.42 $
0.41%
3,328.08 $
0.12%
2,017.23 $
0.07%
2,987.57 $
0.10%
711.33 $
0.02%
4,203.86 $
0.15%
749,408.22
26.30%
32
AMAA/Medstar - Capital Plan FY2013-2014
Item Description
FY2014 Plan
Document / Records management system
ePCR/EMR solution
Furniture/equipment - Alta Mere building
$
$
$
40,000 $
75,000 $
2,124,050 $
Replace Cardiac Monitors
IV Pump replacement (10)
Video telemedicine system
$
$
75,000 $
$
P25 compatible console replacement Includes flash)
PSIAM workstation
Visinet Browser - replace CADview
Event Log Monitoring software
$
$
$
$
Rim Clamp Tire Machine
Complete Installation of Alignment Machine w/retrofitting
current facility
Fleet software
$
4,500 $
-
$
$
36,000 $
10,609 $
-
Supervisor Vehicles
Command MCI Equipment
$
$
49,000 $
6,368 $
45,682
-
Tablet Replacements
Stonefly shelf expanded storage
ESO interface to TriTech
Biztalk Server (1 proc) - interfacing (billing)
Full replication to DR, + microwave antennas and SAN
$
$
$
$
$
67,827
46,081
30,000
10,138
50,570
$
$
$
$
$
InventoryTrac software + server+barcode system
Remount Ambulances 54 Units
SCT Ambulance + equipment
AED Location/CAD interface for CPR calls
$
$
$
$
47,904
1,212,000
260,000
45,000
$
$
$
$
511,618
67,856
-
Total Capital Request
$
5,655,571 $
1,538,609
1,425,000
12,000
15,196
13,328
FY 2014 Actual
$
$
$
$
19,664
225,837
667,951
-
-
33
Area Metropolitan Ambulance Authority/MedStar
Key Financial Indicators
April 30, 2014
Goal
Current Ratio
>1
FY 2011
FY 2012
FY2013
FY 2014
$ 10.44 $ 10.42 $ 11.77 $ 24.47
Indicates the total short term resources available to service each dollar of debt.
Ratio should be greater than 1, so that assets are available to retire debt when
due.
Debt/Equity Ratio
<2:1
.08:1
.06:1
.14:1
.10:1
Relative amount of funds provided by lenders. Today, 4% of all funds are
provided by debt. Desired ratio is dependent on agency's cash needs and risk
tolerance but should always be less than 2 to 1. Assuming a total debt addition
of $8million for the Alta Mere building, our Debt/Equity Ratio is estimated to be
.33:1.
Accounts Receivable Turnover
>3
6.08
6.53
8.26
6.27
A measure of how these resources are being managed. Indicates how long
accounts receivable are being aged prior to collection. Our goal is a turnover
rate of greater than 3 .
Return on Net Assets
6.90%
13.12%
10.42%
15.11%
11.10%
Reveals management's effectiveness in generating profits from the assets
available. Our budgeted return on net assets is 6.9%.
34
Tab C – Operations Report
35
Performance Indicators Last 12 Months
Average Daily Extended Response Times (Response Time Criteria x2)
1.5
1.3
1.0
0.8
0.5
0.3
0.0
Priority 1
May-13
0.8
Jun-13
0.4
Jul-13
0.3
Aug-13
0.5
Sep-13
0.4
Oct-13
0.5
Nov-13
0.5
Dec-13
0.5
Jan-14
0.5
Feb-14
0.4
Mar-14
0.3
Apr-14
0.3
Priority 2
1.3
0.7
0.4
0.4
0.3
0.4
0.7
1.3
0.6
0.6
0.4
0.4
Priority 3
0.9
0.8
0.3
0.5
0.7
0.4
0.9
1.0
0.7
0.5
0.2
0.2
Priority 1
Priority 2
Priority 3
36
Performance Indicators Last 12 Months
Response Time Reliability
100%
95%
90%
85%
80%
Priority 1
May-13
88.3%
Jun-13
89.6%
Jul-13
92.7%
Aug-13
90.7%
Sep-13
87.9%
Oct-13
87.1%
Nov-13
86.5%
Dec-13
84.0%
Jan-14
87.6%
Feb-14
87.9%
Mar-14
89.3%
Apr-14
88.5%
Priority 2
91.2%
91.4%
93.1%
92.8%
91.6%
92.0%
90.8%
87.8%
90.2%
90.7%
91.4%
92.0%
Priority 3
91.0%
92.5%
94.5%
92.9%
90.9%
91.9%
90.2%
88.4%
89.7%
91.2%
93.0%
92.4%
Priority 1
Priority 2
Priority 3
37
MedStar System Performance Summary
April 2014
Staffing
Authorized Shifts
Filled
In Training
FMLA / Light Duty / Other
Availability %
Paramedic
97
91
8
1
92.8%
EMT
97
93
1
1
94.8%
Unit Hour Production
Scheduled UH
Produced UH
Scheduling Efficiency
19,318
18,538
96.0%
Response Time Reliability
Overall
P1
P2
P3
P4
Average Response Time
91.6%
88.5%
92.0%
92.4%
94.2%
Average
P1
P2
P3
5:52
6:08
7:48
Extended Calls
Total
Daily Avg
8
8
7
0.3
0.4
0.2
P1 Calls > 18:00
P2 Calls > 22:00
P3 Calls > 30:00
38
Medstar Ambulance Tracking System
5/20/2014
System Response Time Reliability and Average Response Time Performance
April 01, 2014 thru April 30, 2014
Priority
1
2
3
4
Calls for
Service
2,182
3,439
3,347
1,013
9,981
Calls On Scene
2,142
3,319
3,169
996
9,626
Transport
Count
1,590
2,321
1,995
935
6,841
Patient
Contacts
2,060
3,152
2,644
950
8,806
Page 1 of 1
Current Month
On Time %
88.5%
92.0%
92.4%
94.2%
100 Response On
Time %
88.5%
92.0%
92.4%
94.2%
Avg RT
00:05:52
00:06:08
00:07:48
00:00:57
39
Medstar Ambulance Tracking System
5/20/2014
Response Time Reliability and Average Response Time Performance
By Member City
April 01, 2014 thru April 30, 2014
City
Priority
Calls for
Service
Calls On
Scene
Transport
Count
Patient
Contacts
Standard
Current Month
On Time %
100 Response On
Time %
Avg RT
Blue Mound
1
2
3
3
9
7
19
3
8
5
16
2
4
4
10
3
8
5
16
< 09:00
< 11:00
< 15:00
100.0%
88.9%
100.0%
91.0%
94.0%
96.0%
00:06:03
00:05:55
00:09:28
Burleson
1
2
3
4
53
90
59
113
315
53
86
54
112
305
38
59
39
110
246
51
85
48
110
294
< 09:00
< 11:00
< 15:00
= 00:00
84.9%
87.8%
84.7%
96.5%
84.0%
89.0%
87.0%
96.5%
00:05:50
00:05:45
00:08:43
00:00:43
Edgecliff Village
1
2
3
4
9
3
16
4
9
2
15
4
6
2
12
4
7
2
13
< 09:00
< 11:00
< 15:00
100.0%
100.0%
100.0%
100.0%
97.0%
97.0%
00:06:46
00:05:35
00:09:32
Forest Hill
1
2
3
44
43
37
124
43
41
37
121
31
30
20
81
41
40
31
112
< 09:00
< 11:00
< 15:00
95.5%
95.3%
94.6%
93.0%
93.0%
95.0%
00:06:20
00:06:36
00:08:43
Fort Worth
1
2
3
4
1,841
2,957
2,967
850
8,615
1,806
2,856
2,813
836
8,311
1,330
1,982
1,751
782
5,845
1,735
2,712
2,328
797
7,572
< 09:00
< 11:00
< 15:00
= 00:00
88.9%
92.2%
92.6%
94.1%
88.9%
92.2%
92.6%
94.1%
00:05:49
00:06:06
00:07:42
00:01:00
Haltom City
1
2
3
4
88
94
92
14
288
85
88
86
13
272
68
73
61
11
213
81
85
75
11
252
< 09:00
< 11:00
< 15:00
= 00:00
81.8%
89.4%
90.2%
85.7%
84.0%
89.0%
91.0%
NA
00:06:17
00:07:22
00:09:42
00:01:59
Haslet
1
2
3
1
3
1
5
1
3
1
5
0
1
1
2
1
3
1
5
< 09:00
< 11:00
< 15:00
100.0%
66.7%
100.0%
64.0%
83.0%
NA
00:07:21
00:10:38
00:00:17
Lakeside
1
2
3
2
2
4
8
2
2
4
8
2
2
3
7
2
2
3
7
< 09:00
< 11:00
< 15:00
0.0%
100.0%
75.0%
NA
NA
NA
00:09:48
00:09:31
00:14:39
Lake Worth
1
2
3
4
28
41
23
6
98
28
39
22
6
95
20
23
15
5
63
27
34
21
5
87
< 09:00
< 11:00
< 15:00
= 00:00
85.7%
92.7%
91.3%
100.0%
84.0%
87.0%
88.0%
NA
00:05:41
00:05:24
00:07:00
00:00:00
River Oaks
1
2
3
4
16
26
22
2
66
16
26
21
2
65
12
19
12
2
45
16
23
20
2
61
< 09:00
< 11:00
< 15:00
= 00:00
93.8%
92.3%
95.5%
100.0%
81.0%
95.0%
81.0%
NA
00:06:05
00:06:56
00:08:46
00:00:00
Saginaw
1
2
3
36
53
41
130
35
50
37
122
30
34
24
88
35
46
30
111
< 09:00
< 11:00
< 15:00
80.6%
90.6%
92.7%
77.0%
92.0%
94.0%
00:07:10
00:06:42
00:08:28
Sansom Park
1
2
3
9
27
20
9
26
18
7
22
13
9
26
16
< 09:00
< 11:00
< 15:00
88.9%
88.9%
100.0%
82.0%
90.0%
95.0%
00:05:56
00:06:25
00:05:09
Page 1 of 2
40
Medstar Ambulance Tracking System
5/20/2014
Response Time Reliability and Average Response Time Performance
By Member City
April 01, 2014 thru April 30, 2014
City
Priority
4
Calls for Calls On Transport
Patient
Service
Scene
Count
Contacts
3
3
3
3
59
56
45
54
Standard
= 00:00
Current Month 100 Response On
On Time %
Time %
100.0%
NA
Avg RT
00:00:00
Westover Hills
2
3
1
1
2
1
1
2
1
1
2
1
1
2
< 11:00
< 15:00
100.0%
100.0%
NA
NA
00:04:51
00:09:37
White Settlement
1
2
3
4
53
78
59
25
215
53
78
58
24
213
43
59
39
22
163
52
74
53
22
201
< 09:00
< 11:00
< 15:00
= 00:00
90.6%
89.7%
91.5%
88.0%
92.0%
89.0%
94.0%
NA
00:05:23
00:05:35
00:07:35
00:00:21
Westworth Village
1
2
3
4
6
11
21
4
6
10
20
3
6
10
19
3
6
10
19
< 09:00
< 11:00
< 15:00
100.0%
100.0%
72.7%
91.0%
91.0%
91.0%
00:07:04
00:06:42
00:11:19
9,981
9,626
6,841
8,806
Grand Total
Page 2 of 2
41
Tab D – Business Office & Billing
42
Area Metropolitan Ambulance Authority
551 E. Berry Street
Fort Worth, Texas 76110-4329
(817) 923-3700
(817) 632-0537(fax)
www.medstar911.org
May 28, 2014
Susan Swagerty, Business Office and Billing
•
Update on the 40% Prompt Pay Mailings YTD
•
Update on our Collection Rate currently at 27.34% and how we will strive for our goal of 27.5%
43
Tab E – Human Resources
44
MedStar Mobile Healthcare Turnover
Fiscal Year 2013-2014
October
November
December
January
February
March
April
May
June
July
August
September
Projected
20.00%
18.00%
16.00%
14.00%
12.00%
10.00%
8.00%
6.00%
4.00%
2.00%
0.00%
Cumulative Year to Date
2013-2014
2012-2013
2011-2012
0.27%
0.27%
2.91%
1.33%
1.65%
4.10%
2.39%
2.76%
6.16%
2.39%
4.11%
7.36%
4.50%
4.91%
7.93%
5.63%
5.43%
8.79%
7.25%
7.34%
10.20%
9.22%
11.62%
10.86%
13.32%
13.27%
13.85%
16.02%
16.13%
16.02%
17.26%
7.71%
2013-2014
2012-2013
2011-2012
45
MedStar Mobile Health Care Separation Statistics - April 2014
Current Month
Invol
Total
4
1
0
0
4
1
Vol
Full Time Separations
Part Time Separations
Total Separations
Total Turnover %
Full Time Part Time
1.45%
0.00%
Year to Date
Invol
Total
20
6
1
1
21
7
Vol
5
0
5
Total
1.27%
Full Time Part Time
7.25%
2.00%
EE End of
Period
25
345
1
50
26
395
Total
6.58%
Separations by Department
Full time
Vol
Admin/Billing Office
Clinical
Communications Center
Compliance
Deployment
Current Month
Invol
Total
1
1
Vol
Directors - Exec, Ops, Admin, HR
Field - All Others
Field Supervisors
Fleet
Human Resources
Information Technology
Logistics
Primary (L4, L4T, L5 and L6)
1
1
2
2
1
1
Public Affairs/Business Development
Risk and Safety
Secondary (L1, L2, and L3)
Special Events
Total
4
Part Time
Current Month
Invol
Total
Vol
1
5
Year to Date
EE End of
Invol
Total
Period
1
1
2
32
4
2
2
27
2
3
4
9
1
1
8
1
1
2
8
1
3
5
4
4
32
3
3
6
100
2
2
7
7
102
1
1
2
20
Vol
6
25
Year to Date
Invol
Total
345
EE End of
Period
1
Admin/Billing Office
Clinical
Communications Center
Compliance
Deployment
3
0
Directors - Exec, Ops, Admin, HR
Field - All Others
Field Supervisors
Fleet
Human Resources
Information Technology
Logistics
Primary (L4, L4T, L5 and L6)
0
1
1
0
1
0
19
Public Affairs/Business Development
Risk and Safety
Secondary (L1, L2, and L3)
12
15
Special Events
Total
0
0
0
1
1
1
50
46
Tab F - Clinical
47
Tab G – Public Affairs Report
48
Client
6511
EMS System Report
April 2014
Number of Your Patients in this Report:
133
Monthly Score
92.44
0
49
Monthly Report
Dispatch Analysis
This analysis details the section results that concern dispatch operations. The analysis contains the mean scores for each survey question. The first
column shows the company score, the second column details the total Database score and the third column is the variance +/-.
Your
Score
Total
DB
Variance
Helpfulness of the person you called for ambulance service
93.75
92.63
1.12
Concern shown by the person you called for ambulance service
Extent to which you were told what to do until the ambulance arrived
92.14
92.79
92.38
90.53
-0.23
2.26
94.00
93.50
Helpfulness of the person you called for ambulance
service
93.00
Concern shown by the person you called for ambulance
service
92.50
Extent to which you were told what to do until the
ambulance arrived
92.00
Overall Section Score
91.50
Benchmark Section Score
91.00
90.50
Dispatcher
1
50
Monthly Report
Ambulance Analysis
This analysis details the section results that concern ambulance operations. The analysis contains the mean scores for each survey question. The first
column shows the company score, the second column details the total Database score and the third column is the variance +/-.
Your Score
Total DB Variance
Extent to which the ambulance arrived in a timely manner
Cleanliness of the ambulance
93.60
93.70
91.56
93.45
2.04
0.25
Comfort of the ride
87.72
86.61
1.10
Skill of the person driving the ambulance
94.21
93.32
0.89
95.00
94.00
93.00
92.00
Extent to which the ambulance arrived in a timely manner
91.00
Cleanliness of the ambulance
90.00
Comfort of the ride
89.00
Skill of the person driving the ambulance
88.00
Overall Section Score
Benchmark Section Score
87.00
86.00
85.00
84.00
Ambulance
2
51
Monthly Report
Medic Analysis
This analysis details the section results that concern the medics’ performance. The analysis contains the mean scores for each survey question. The
first column shows the company score, the second column details the total Database score and the third column is the variance +/-.
Your Score
Total DB Variance
Care shown by the medics who arrived with the ambulance
Degree to which the medics took your problem seriously
93.87
94.21
93.56
93.45
0.30
0.77
Degree to which the medics listened to you and/or your family
93.71
92.93
0.78
Skill of the medics
Extent to which the medics kept you informed about your treatment
94.14
92.50
93.55
91.71
0.59
0.79
Extent to which medics included you in the treatment decisions (if applicable)
91.67
91.21
0.45
Degree to which the medics relieved your pain or discomfort
Medics' concern for your privacy
89.08
94.23
89.47
92.40
-0.39
1.83
Extent to which medics cared for you as a person
93.14
93.39
-0.26
95.00
Care shown by the medics who arrived with the
ambulance
94.00
Degree to which the medics took your problem seriously
93.00
Degree to which the medics listened to you and/or your
family
92.00
Skill of the medics
91.00
Extent to which the medics kept you informed about your
treatment
90.00
Extent to which medics included you in the treatment
decisions (if applicable)
89.00
Degree to which the medics relieved your pain or
discomfort
Medics' concern for your privacy
88.00
Extent to which medics cared for you as a person
87.00
Overall Section Score
86.00
Benchmark Section Score
Medics
3
52
Monthly Report
Office Staff Analysis
This analysis details the section results that concern office operations. The analysis contains the mean scores for each survey question. The first
column shows the company score, the second column details the total Database score and the third column is the variance +/-.
Your Score
Professionalism of the staff in our billing office
Willingness of the staff in our billing office to address your needs
Total DB Variance
90.34
88.58
87.53
87.53
2.81
1.04
90.50
90.00
89.50
Professionalism of the staff in our billing office
89.00
Willingness of the staff in our billing office to address your
needs
88.50
Overall Section Score
88.00
Benchmark Section Score
87.50
87.00
86.50
Billing Office
4
53
Monthly Report
Overall Assessment Analysis
This analysis details the section results that concern the overall assessment of operations. The analysis contains the mean scores for each survey
question. The first column shows the company score, the second column details the total Database score and the third column is the variance +/-.
Your Score
Total DB Variance
How well did our staff work together to care for you
Extent to which our staff eased your entry into the medical facility
93.27
93.28
92.57
92.75
0.70
0.53
Appropriateness of Emergency Medical Transportation treatment
94.13
92.56
1.57
Extent to which the services received were worth the fees charged
Overall rating of the care provided by our Emergency Medical Transportation service
85.61
93.16
86.08
92.70
-0.47
0.46
Likelihood of recommending this ambulance service to others
91.28
92.08
-0.80
96.00
How well did our staff work together to care for you
94.00
92.00
Extent to which our staff eased your entry into the
medical facility
90.00
Appropriateness of Emergency Medical Transportation
treatment
88.00
Extent to which the services received were worth the
fees charged
Overall rating of the care provided by our Emergency
Medical Transportation service
86.00
Likelihood of recommending this ambulance service to
others
84.00
Overall Section Score
82.00
Benchmark Section Score
80.00
Overall Assessment
5
54
Monthly Report
Question Analysis
This section lists a synopsis of the information about your individual questions and overall scores for this monthly reporting period. Again the first
column shows the company score, the second column details the total Database score and the third column is the variance +/-.
Your Score
Total DB Variance
Helpfulness of the person you called for ambulance service
93.75
92.63
1.12
Concern shown by the person you called for ambulance service
92.14
92.38
-0.23
Extent to which you were told what to do until the ambulance arrived
92.79
90.53
2.26
Extent to which the ambulance arrived in a timely manner
93.60
91.56
2.04
Cleanliness of the ambulance
Comfort of the ride
93.70
87.72
93.45
86.61
0.25
1.10
Skill of the person driving the ambulance
94.21
93.32
0.89
Care shown by the medics who arrived with the ambulance
Degree to which the medics took your problem seriously
93.87
94.21
93.56
93.45
0.30
0.77
Degree to which the medics listened to you and/or your family
93.71
92.93
0.78
Skill of the medics
Extent to which the medics kept you informed about your treatment
94.14
92.50
93.55
91.71
0.59
0.79
Extent to which medics included you in the treatment decisions (if applicable)
91.67
91.21
0.45
Degree to which the medics relieved your pain or discomfort
Medics' concern for your privacy
89.08
94.23
89.47
92.40
-0.39
1.83
Extent to which medics cared for you as a person
93.14
93.39
-0.26
Professionalism of the staff in our billing office
Willingness of the staff in our billing office to address your needs
90.34
88.58
87.53
87.53
2.81
1.04
How well did our staff work together to care for you
Extent to which our staff eased your entry into the medical facility
93.27
93.28
92.57
92.75
0.70
0.53
Appropriateness of Emergency Medical Transportation treatment
94.13
92.56
1.57
Extent to which the services received were worth the fees charged
Overall rating of the care provided by our Emergency Medical Transportation service
85.61
93.16
86.08
92.70
-0.47
0.46
Likelihood of recommending this ambulance service to others
91.28
92.08
-0.80
Overall Survey Rating
92.44
91.74
0.69
6
55
Monthly Report
Company Comparisons
The following chart gives a comparison of the mean score for each question as scored by comparable companies. Your company is highlighted. There
is also a green-shaded highlight of the highest score for each question. This will show how you compare to similar companies.
National
DB
Y
AA
Medstar
EMS
AD
AE
Total Score
91.74
93.40
90.69
92.44
89.71
90.52
Helpfulness of the person you called for ambulance service
Concern shown by the person you called for ambulance
service
Extent to which you were told what to do until the
ambulance arrived
Extent to which the ambulance arrived in a timely manner
Cleanliness of the ambulance
Comfort of the ride
Skill of the person driving the ambulance
Care shown by the medics who arrived with the
ambulance
Degree to which the medics took your problem seriously
Degree to which the medics listened to you and/or your
family
Skill of the medics
Extent to which the medics kept you informed about your
treatment
Extent to which medics included you in the treatment
decisions
Degree to which the medics relieved your pain or
discomfort
Medics' concern for your privacy
Extent to which medics cared for you as a person
Professionalism of the staff in our billing office
Willingness of the staff in our billing office to address your
needs
How well did our staff work together to care for you
Extent to which our staff eased your entry into the medical
facility
Appropriateness of Emergency Medical Transportation
treatment
Extent to which the services received were worth the fees
charged
Overall rating of the care provided by our Emergency
Medical service
Likelihood of recommending this ambulance service to
others
92.63
94.22
92.58
93.75
91.82
92.38
94.57
91.59
92.14
90.53
91.56
93.45
86.61
93.32
91.38
93.60
93.75
88.46
94.49
90.18
89.62
91.82
83.05
90.76
93.56
93.45
96.30
94.64
92.93
93.55
Number of Surveys for the period
Large Services (>100 Responses per quarter)
AG
AH
AI
AJ
AK
AL
89.80
82.80
92.28
90.35
89.77
88.28
91.53
91.13
86.96
89.82
89.66
87.89
84.64
91.59
90.63
92.39
84.78
90.84
89.09
87.89
83.33
92.79
93.60
93.70
87.72
94.21
87.75
90.17
91.26
86.18
90.46
86.56
88.51
91.27
91.02
92.58
91.48
89.23
91.42
80.22
90.31
80.95
77.68
83.93
76.96
86.15
84.80
89.80
93.58
84.49
94.52
83.06
87.85
92.86
85.33
91.67
84.12
90.20
92.31
86.06
91.51
83.87
86.78
91.83
85.33
88.04
92.72
91.95
93.87
94.21
91.46
91.60
92.03
91.80
91.80
91.39
88.04
86.36
94.32
95.00
93.28
93.66
94.39
91.33
88.98
90.24
93.42
96.23
91.96
93.30
93.71
94.14
91.74
90.52
91.80
91.54
92.37
92.11
85.23
85.23
95.77
95.77
94.53
93.18
90.82
92.35
90.50
90.65
91.71
91.92
92.06
92.50
89.43
90.45
90.87
83.82
92.86
89.92
88.10
86.95
91.21
92.91
91.57
91.67
87.37
90.56
93.29
80.56
93.37
88.73
89.84
85.84
89.47
92.40
93.39
87.53
92.72
92.33
95.24
91.30
90.46
90.89
91.29
86.27
89.08
94.23
93.14
90.34
86.99
89.83
91.24
85.96
90.84
93.06
92.92
85.71
88.04
90.63
91.53
82.24
80.88
86.11
90.91
81.82
91.96
94.35
94.92
90.31
86.81
93.33
93.36
84.46
87.50
91.86
92.78
87.04
87.22
89.15
91.69
88.10
87.53
92.57
91.30
93.57
88.57
91.36
88.58
93.27
87.07
89.68
85.26
90.53
82.43
91.82
77.78
83.33
87.91
92.05
85.16
91.67
87.54
90.43
89.29
90.02
92.75
94.30
91.41
93.28
90.23
91.53
92.24
85.53
94.32
92.13
92.02
90.33
92.56
92.58
91.67
94.13
89.68
92.92
93.98
77.68
93.10
90.00
90.12
89.91
86.08
88.79
85.43
85.61
85.47
84.13
84.06
59.69
89.56
86.98
80.41
84.20
92.70
94.96
91.75
93.16
89.57
90.53
90.00
81.30
94.14
92.21
90.76
89.75
92.08
95.10
91.43
91.28
91.06
90.48
87.50
82.95
91.92
91.25
89.36
87.80
5952
124
137
133
137
80
73
30
78
76
60
57
Large Service Ranking - 32 Companies
3
23
9
29
24
27
34
10
25
28
33
Overall National Rank
6
29
12
35
30
33
43
14
31
34
41
7
56
Monthly Report
Monthly Breakdown
Below are the monthly responses that have been received for your service. It details the individual score for each question as well as the overall
company score for that month.
Jul-13
Aug13
Sep13
Oct13
Nov13
Dec-13
Jan14
Feb14
Mar14
Apr14
Helpfulness of the person you called for ambulance service
Concern shown by the person you called for ambulance service
Extent to which you were told what to do until the ambulance
arrived
Extent to which the ambulance arrived in a timely manner
Cleanliness of the ambulance
Comfort of the ride
Skill of the person driving the ambulance
Care shown by the medics who arrived with the ambulance
Degree to which the medics took your problem seriously
Degree to which the medics listened to you and/or your family
Skill of the medics
Extent to which the medics kept you informed about your treatment
Extent to which medics included you in the treatment decisions (if
applicable)
Degree to which the medics relieved your pain or discomfort
Medics' concern for your privacy
Extent to which medics cared for you as a person
Professionalism of the staff in our billing office
Willingness of the staff in our billing office to address your needs
How well did our staff work together to care for you
Extent to which our staff eased your entry into the medical facility
Appropriateness of Emergency Medical Transportation treatment
Extent to which the services received were worth the fees charged
Overall rating of the care provided by our Emergency Medical
Transportation service
Likelihood of recommending this ambulance service to others
89.92
89.58
93.87
91.35
81.25
84.38
90.73
92.02
95.00
92.86
91.52
92.41
94.55
93.46
100.00
100.00
93.52
94.05
93.75
92.14
90.42
92.74
94.40
89.49
90.45
91.39
91.80
92.21
92.08
91.53
92.79
90.18
89.17
87.76
92.94
91.35
90.33
91.86
92.35
90.10
82.14
90.63
87.50
75.00
84.38
75.25
68.14
68.88
84.38
68.00
91.33
94.30
94.23
88.73
94.81
95.45
94.55
94.44
95.00
91.83
90.38
92.11
94.44
88.89
93.06
89.76
92.25
92.25
90.69
89.06
91.98
93.15
93.44
87.10
92.62
89.95
90.97
89.95
93.75
89.81
90.45
90.89
93.94
89.51
90.25
91.81
90.64
91.44
92.08
92.37
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
100.00
87.50
91.51
94.92
95.87
87.85
94.74
94.96
94.71
94.87
96.46
93.69
92.79
93.60
93.70
87.72
94.21
93.87
94.21
93.71
94.14
92.50
90.28
90.64
90.95
92.50
85.26
87.18
91.39
91.38
90.74
84.18
90.34
90.10
92.22
93.23
82.29
87.04
89.29
88.85
89.13
84.83
62.83
71.43
81.38
75.14
75.00
75.00
68.00
60.86
71.00
57.43
93.48
88.27
94.44
95.45
89.19
88.57
93.98
94.00
96.57
93.37
89.58
85.71
91.67
92.25
89.58
89.58
92.65
88.24
90.63
81.73
89.91
92.00
90.47
90.21
82.61
84.41
89.15
90.02
89.58
86.19
90.47
89.67
90.59
90.76
85.81
86.11
91.68
93.05
92.48
87.78
100.00
87.50
100.00
100.00
100.00
100.00
100.00
100.00
100.00
87.50
90.85
89.46
93.93
94.47
91.09
90.96
94.74
93.22
93.23
87.40
91.67
89.08
94.23
93.14
90.34
88.58
93.27
93.28
94.13
85.61
91.67
92.08
90.45
90.98
68.00
64.43
95.19
95.19
92.19
92.19
90.31
90.60
91.95
91.25
93.75
98.10
92.64
92.71
93.16
91.28
Medstar EMS Overall Survey Rating
90.78
90.33
74.66
93.30
90.79
90.37
91.18
98.10
93.14
92.44
Crew Sub-Score
91.50
90.68
73.77
93.65
90.93
90.65
91.36
97.84
93.56
92.82
65
57
8
59
19
65
74
4
127
133
Responses
8
57
Monthly Report
Monthly Breakdown Graphic
Below are the monthly scores for your service. It details the overall score for each month as well as the overall benchmark score for that month.
Overall Monthly Scores
120.00
100.00
80.00
60.00
40.00
20.00
0.00
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Medstar EMS Overall Survey Rating
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
Overall Benchmark Rating
9
58
Public Affairs Summary
May 2014
1115 Waiver Project:
• Significant increase in referrals last 30-45 days
o Thanks to JPS resource identification
• Still working through the Obs Admit program
• 9-1-1 Nurse Triage referrals behind due to RN staffing and call setting eligibility
o New nurses started taking calls week of 5/12
o Now includes 12 hours/day, 6 days a week
o Working through the eligibility with team and Nurse Triage Steering committee
• THR referrals scaled back while revised process developed
• Beginning the discussion with JPS for next fiscal year
Mobile Integrated Healthcare Book:
• Post reviewer edits done for Ch.’s 1-5 in process
o Added testimonials from patients, partners, other stakeholders
• Second set of reviews expected shortly
• Already discussing additional books and materials with publisher
• Pre-release marketing by Jones & Bartlett started
o $89/book
Mobile Healthcare Program Updates:
• North Texas Specialty Physicians
o Still pending expansion
• VITAS Hospice
o Agreement reached for a per enrolled patient/per month economic model
o They have asked for a possible expansion for CHF patients
• USMD/Medical Clinics of North Texas
o Further discussions on Call Center services
• Klarus Home Health
o Significant referral increase past month
• National Association of EMTs MIH Video
o National education video to be shot at MedStar June 18 & 18
o Interviews with patients, providers, JPS, Klarus, Vitas
o Medical Director from Wake County EMS System (another MIH site) will be here as well for taping
National Commission on Quality Assurance:
• Accreditation team working on accreditation for our CHF program
Paid Speaking Engagements:
• Recent:
Event
Memphis FD/Hospital CEO Briefing
Michigan EMS Expo
IAED Navigator Conference
IAFC Annual Conf. (MIH Workshop)
California Fire Chiefs
Date
Apr. 2014
Apr. 2014
Apr. 2014
May 2014
May 2014
Location
Memphis, TN
Detroit, MI
Orlando, FL
Arlington, VA
Palm Springs, CA
Attendees
~50
~1,000
~2,000
~2,000
~500
59
•
Upcoming:
Event
New England EMS MIH Summit
Ohio Ambulance Association
Firehouse World Expo – East
Pinnacle EMS Conference
Intern. Round Table on Comm. Para.
EMS World Expo
American Ambulance Assoc. Annual Conf.
Date
May 2014
June 2014
July 2014
July 2014
Sept 2014
Nov. 2014
Nov. 2014
Location
Uncasville, CT
Columbus, OH
Baltimore, MD
Scottsdale, AZ
Reno, NV
Nashville, TN
Las Vegas, NV
Attendees
~1,000
~100
~1,000
~500
~100
~2,000
~500
Texas EMS Alliance, Inc.:
• 55 membership applications received
• Educational conference held April 25th
• David & Brian Werfel, Novitas representative and State Texas EMS Director speakers
o 5 sponsors with more pending
Site Visits:
• Up to 112 agencies/communities from 40 states, 6 countries
• Hosted 25 visitors from Werfel & Associates meeting on 4/25
• Upcoming Visitors:
o 6/10 –
Mid-Georgia Ambulance (Macon, GA)
Elgin Ambulance (Elgin, IL)
Mercy Flights (Medford, OR)
Impulse Ambulance (N. Hollywood, CA)
Lifeline Medical Transport (Ventura, CA)
o 6/17 –
National Health Transport (Miami, FL)
Member City Updates:
Annual MedStar Updates being scheduled and conducted
o Done –
Burleson
Saginaw
Edgecliff Village
Haslet
o Scheduled –
Fort Worth
6/3 @ 3pm
Westworth Village
7/10 @ 7pm
60
Paid Consulting:
• $54,000 booked revenue FYTD
o $47,000 ahead of plan
• Contracts executed and in place with:
o Acadian Ambulance (LA)
o American Medical Response (National)
o Dekalb Ambulance (AL)
o East Baton Rouge Parish EMS (LA)
o GEM ambulance (NJ)
o Harris County Emergency Corp (TX)
o MedEx Ambulance – (IL)
o Medstar Ambulance/Henry Ford Health System (MI)
o Nature Coast EMS (FL)
o PRN Ambulance (CA)
o Priority Ambulance (CA)
o Puckett EMS (GA)
o Richmond Ambulance (GA)
•
Contract proposals requested from and sent to:
o New Britain EMS (CT)
o Montgomery County Hospital District (TX)
o Leon County EMS (FL)
o ETMC (TX)
o LifeNet EMS (TX)
o Kaiser Permanente (CA)
o Lifeguard Ambulance
MedStar Citizen’s Academy:
• New program to be held 6 Wednesdays, 6p – 9p
• June 4th – July 9th
Media:
•
•
•
•
•
JEMS “In-Action” photo
Doug Hooten interview with Austin Statesman on ambulance costs
EMS Insider Cover Story on MIH Payer Perspective (Part 1 of 4 feature stories next 4 months)
EMS World Column on Value-Based Purchasing (pre-release June 2014)
MIH Patient focus article in JEMS – July ‘14
o Written by a MedStar MIH Patient
61
Business Development Activity:
• New Facilities opening
o Baylor Emergency Medical Center – Burleson
o HCA Burleson
o Southeast Community Health Center (FQHC)
•
Events:
o Golf Tournament- May 27th at The Golf Club at Fossil Creek- shotgun start at 8am; taking Sponsors and
registering teams- benefits The MedStar Foundation and Project Access
o EMS Week Activities - schedule to attached
o Nurses’ Week- largest appreciation event thus far- expanded appreciation gifts from just main hospital
ERs to ERs, ICUs, LTACs, and Nursing homes- approximately 30 facilities
o TMA Foundation Gala May 2nd
•
ED Coordination Meetings
o Have added a new coordination meeting that we host to discuss common community challenges and
concerns- ED Meeting- hosted second meeting last Friday; will hold them quarterly
•
Wellness Committee
o Continue to host Education sessions with Dietician each month, currently surveying employees for
feedback on how to get them more engaged in health and wellness to adapt event offerings
AMAA Board Invitational Events:
• MedStar Golf Tournament May 27th
• FWCC Briefing June 3rd at 3p
• Citizen’s Academy Kickoff June 4th @ 6p
• NAEMT Video 6/19 all day
62
Even with insurance, that EMS bill could cause sticker shock
http://www.statesman.com/news/news/local/even-with-insurance-that-ems-bill-could-cause-stic/nfYZZ/
April 13-- Sandy Bayne was two months pregnant and at an Austin pharmacy last fall when her nose suddenly began to
bleed profusely. EMS providers in Williamson and Hays counties do it the same way-- as do many municipal EMS
agencies nationally. While the federal government forbids ambulance companies from balance billing patients covered
by government payers...
By Mary Ann Roser, Austin American-Statesman
McClatchy-Tribune Information Services
April 13--Sandy Bayne was two months pregnant and at an Austin pharmacy last fall when her nose suddenly began to
bleed profusely. She called her physician father, and when the bleeding wouldn't stop, she took his advice to call 911.
By industry standards, her $867 ambulance bill was not especially steep. But Bayne, who is covered by Blue Cross Blue
Shield of Texas and worked as a health care lawyer for 11 years, was amazed to discover she was on the hook for the
entire amount.
Even the savviest consumers are often unaware that they might have to shoulder a large share of their ambulance bill.
Austin-Travis County Emergency Medical Services is the exclusive emergency ambulance provider in the county.
Whatever portion of the bill is not covered by private insurance, the patient is asked to pay. EMS providers in Williamson
and Hays counties do it the same way -- as do many municipal EMS agencies nationally.
In Tarrant County, the same ambulance ride would have cost Bayne nearly $1,500.
"When you call 911, you get no say in who shows up," said Stacey Pogue, a senior policy analyst with the Austin-based
Center for Public Policy Priorities. "That scenario is exactly why you need protection in an emergency. You have a 100
percent chance in Austin of getting an out-of-network ambulance ride. I think that would be somewhat shocking to a
consumer.
'Caught in the middle'
Insurance payments vary widely based on individual policies and the amount of service a patient receives on the ride to
the hospital.
Austin-Travis County EMS, which transports more than 75,000 patients a year to local hospitals, will send a bill to private
insurers on behalf of their covered patients. But unlike going to a hospital or a doctor in your health plan's network -and likely being responsible for a smaller share of the overall bill -- EMS does not have contracts with private insurers
such as Blue Cross.
Further, Austin-Travis County EMS does not negotiate payment amounts with consumers, even though some people will
never be able to pay their bills, making them uncollectible. The county's base rate is $815, plus $12.50 per mile. EMS
officials said they will place consumers needing help on a payment plan, with some paying as little as a few dollars a
month -- for years.
Negotiated rates for medical care generally entitle private insurance companies to a substantial cut in cost. But EMS
providers have no incentive to negotiate discounted rates with insurers, said Douglas Hooten, president of the Texas
EMS Alliance and of the Coalition of Advanced Emergency Medical Systems. That's especially true when there are no
other 911 competitors in a community.
The money to cover the service "has got to come from somewhere," he said.
63
Newly insured people under the Affordable Care Act represent a whole new group of people poised to confront balance
billing for ambulance services, Pogue and others said.
"I think people who have insurance very comfortably think, 'Because I have insurance, I will be covered,'" said Bayne,
who has since paid her bill in full.
So that consumers don't get "caught in the middle," EMS providers and insurance companies should get together and
negotiate a fair cost for ambulance service, said Kevin Lucia, a senior research fellow at the Center on Health Insurance
Reforms at Georgetown University.
"Balance billing is really an issue between the provider and the insurer, and the consumer is used as a pawn," Lucia said.
"Consumers go to hospitals that are in network and they don't expect to be balance billed. The person having an
emergency is not in the position of asking whether the doctor or ambulance is in network."
Even if an emergency patient were to ask about the cost of an ambulance ride before getting in, Travis County EMS
personnel are not likely to have answers. They don't have insurance information nor are they in any position to discuss
costs, EMS Chief of Staff James Shamard said.
"We're dealing with folks at one of the worst times in their lives," he said. "It's about taking care of patients."
People with insurance are advised to find out before they need an ambulance how much of the cost is covered. They are
likely to face far steeper charges once they get to the hospital. Emergency care is among the costliest of medical
services.
Paying for the rest
Austin-Travis EMS collects about $20 million in ambulance fee revenue a year -- about a third of the $59.9 million
budgeted for the service. Most of the rest comes from the city and county.
At the same time, however, Travis County taxpayers who need an ambulance help pay again for EMS. They also
subsidize the emergency ambulance costs of out-of-town visitors who call 911.
If not for that taxpayer money, Austin-Travis County EMS bills would likely be much higher. MedStar Mobile Healthcare,
which is the exclusive 911 provider in Fort Worth covering 15 Tarrant County cities, doesn't get any taxpayer support,
and its fees start at $1,485, said Hooten, MedStar's executive director.
Austin-Travis County EMS said the costs to taxpayers would rise further if it had contracts with insurers.
"Private insurance has a vested interest in increasing the company profit line regardless of the impact on the cost of
readiness," having the service available, 24/7, officials said in a statement. "If the city entered into contracts with private
insurance companies, the cost of use would shift to the general taxpayers by increasing the cost of readiness."
Like MedStar, Austin-Travis EMS has a program designed to reduce the number of unnecessary EMS transports -- and
uncollectible bills -- by sending paramedics to help fit callers into social and other services when an ambulance is not
warranted.
Austin-Travis County EMS collects about 35 cents on the dollar for its emergency calls, mostly because of uncollectible
bills.
"Like all of health care, there is a lot of cost-shifting," Hooten said. "Our bills would be about $400 if everyone paid. The
way it is, those that can pay, pay. And they also pay for the ones who can't."
64
65
Local ambulance companies join effort to transform EMS system
Several ambulance companies in the state, including local providers South Shore Hospital EMS and Fallon Ambulance of
Quincy, are trying to transform the state's EMS system by proposing pilot programs that, if approved by the state's
Department of Public Health…
By Patrick Ronan
The Patriot Ledger
May 12, 2014
http://www.patriotledger.com/article/20140512/News/140519422
QUINCY – If you get treated by a paramedic today, you’ll get in an ambulance and be sent to an emergency room.
There’s no getting around it unless you refuse to be transported – it’s the law.
But several ambulance companies in the state, including local service providers South Shore Hospital EMS and Fallon
Ambulance of Quincy, are trying to transform this practice by proposing plans that would allow paramedics to start
treating patients at their homes with no automatic trip to the ER.
Proponents of the new practice, which needs approval from the state Department of Public Health, say reducing the
number of unnecessary trips to the hospital would lower inflated health care costs and improve patient care.
“It really changes the complete dynamic of the emergency medical services mind set, which has been: you call 911, we
pick you up and we bring you to the hospital,” said Dr. Jason Tracy, chairman of emergency medicine at South Shore
Hospital in Weymouth. “This really challenges that thinking.”
Although it hasn’t debuted in Massachusetts, this practice of paramedics giving at-home care in lieu of transportation,
also being called community paramedicine or mobile integrated health care, has gained popularity in other states. Many
in the industry say MedStar Mobile Healthcare of Fort Worth, Texas, is the trailblazer, providing a successful model that
other ambulance companies have adopted.
Proponents of mobile integrated health care say it particularly benefits patients who make frequent trips to the
emergency room, like those with pulmonary disease who are prone to shortness of breath and elderly people
susceptible to falls. Superfluous trips to the hospital crowd waiting rooms while raising health care costs for providers
and patients alike, experts say.
66
67
68
Tab H – EPAB Monthly Report
69
Emergency Physician Advisory Board
Annual Operating Budget
For The Month Ended 4-30-14
Current Month
Revenues
Quality Assurance Fees
Permit Fees
Transfer from Fund Balance
Development & Research Program
Med Dir 1115A
Gross Revenues
Expenditures
Development Expenses - Salaries
Salaries - Medical Director
Salaries - Associate Medical Director
Salaries - Development
Salaries - Office Support
Contract Employee
Worker's Compensation Insurance
FICA/FUTA/SUI
Health & Disability Ins
Health & Disability Ins-Med Dir
Matching ICMA
Auto Allowance
Total Development Salaries
Development Expenses - Operating
Dev & Research-Education
Grant Research & Writing
Research/Audit Expenses
Legal Services
Audit Services
Medical Director Search
Phone - Office
Cellular Phone
Pagers
Printing
Office Supplies
Promotional
Postage
Bank Charges
Payroll Services
Uniforms
Subscriptions & Memberships
Publications
Texts
Committee Work and Team Supplies
Computer Hardware
Computer Software
Computer Maintenance
Vehicle Insurance
Vehicle Costs
Repairs & Maintenance/Contingency
Online Web Services / Hosting
Office Equipment Leasing
Office Furniture & Equipment
Meeting Room Rental
Professional Development
Office Services
Travel-Medical Director
Travel-Staff
Fuel
Dues-Medical Director
Dues-Assistant to Medical Director
Insurance-Malpractice
Total Development Operating
Total Development Expenses
Research Expenses - Salaries
Salaries - Research
Research-Contract Employee
FICA/FUTA/SUI
Health & Disability Ins
Matching ICMA
Total Research Salaries
Actual
Budget
65,190.49
0.00
0.00
0.00
0.00
62,516.17
166.67
22,002.25
12,333.33
3,987.92
65,190.49
Year To Date
Variance
Pos (Neg)
Variance
Pos (Neg)
Actual
Budget
2,674.32
(166.67)
(22,002.25)
(12,333.33)
(3,987.92)
510,029.94
150.00
0.00
68,508.00
0.00
437,613.17
1,166.67
154,015.75
86,333.33
59,818.75
72,416.77
(1,016.67)
(154,015.75)
(17,825.33)
(59,818.75)
101,006.33
(35,815.84)
578,687.94
738,947.67
(160,259.73)
16,666.67
5,833.33
16,061.54
3,846.16
216.75
0.00
1,583.42
148.94
3,750.00
1,095.59
0.00
16,666.67
5,833.33
14,166.67
4,583.33
3,333.33
166.67
1,333.33
4,264.50
4,125.00
1,137.92
0.00
(0.00)
0.00
(1,894.87)
737.17
3,116.58
166.67
(250.09)
4,115.56
375.00
42.33
0.00
116,666.69
40,833.31
104,081.91
31,346.20
2,894.25
782.53
10,807.71
8,212.72
32,887.50
7,688.19
0.00
116,666.67
40,833.33
98,076.92
31,730.77
23,076.92
1,166.67
1,846.15
29,851.50
28,875.00
7,877.88
0.00
(0.02)
0.02
(6,004.99)
384.57
20,182.67
384.14
(8,961.56)
21,638.78
(4,012.50)
189.69
0.00
49,202.40
55,610.75
6,408.35
356,201.01
380,001.82
23,800.81
0.00
0.00
0.00
0.00
0.00
395.00
866.06
371.56
0.00
0.00
183.58
0.00
0.00
0.00
64.95
280.17
0.00
0.00
0.00
613.96
0.00
0.00
0.00
0.00
0.00
0.00
88.75
861.74
0.00
125.00
0.00
60.00
0.00
432.11
0.00
0.00
0.00
0.00
0.00
0.00
0.00
625.00
0.00
0.00
333.33
391.67
0.00
41.67
150.00
0.00
41.67
83.33
0.00
166.67
41.67
41.67
0.00
833.33
0.00
0.00
0.00
333.33
416.67
83.33
608.33
666.67
0.00
100.00
125.00
0.00
625.00
416.67
333.33
416.67
41.67
2,083.33
0.00
0.00
0.00
625.00
0.00
(395.00)
(532.73)
20.11
0.00
41.67
(33.58)
0.00
41.67
83.33
(64.95)
(113.50)
41.67
41.67
0.00
219.37
0.00
0.00
0.00
333.33
416.67
83.33
519.58
(195.07)
0.00
(25.00)
125.00
(60.00)
625.00
(15.44)
333.33
416.67
41.67
2,083.33
0.00
0.00
78.00
0.00
0.00
395.00
2,590.82
2,716.10
0.00
0.00
1,473.72
0.00
256.43
512.18
64.95
458.75
160.00
0.00
0.00
3,908.01
2,739.41
257.30
0.00
1,490.00
2,419.37
766.49
7,169.64
3,619.82
0.00
293.50
498.36
60.00
3,464.25
2,396.43
52.55
1,238.00
375.00
10,380.62
0.00
0.00
0.00
4,375.00
0.00
0.00
2,333.33
2,741.67
0.00
291.67
1,050.00
0.00
291.67
583.33
0.00
1,166.67
291.67
291.67
0.00
5,833.33
0.00
0.00
0.00
2,333.33
2,916.67
583.33
4,258.33
4,666.67
0.00
700.00
875.00
0.00
4,375.00
2,916.67
5,000.00
2,916.67
291.67
14,583.33
0.00
0.00
(78.00)
4,375.00
0.00
(395.00)
(257.49)
25.57
0.00
291.67
(423.72)
0.00
35.24
71.15
(64.95)
707.92
131.67
291.67
0.00
1,925.32
(2,739.41)
(257.30)
0.00
843.33
497.30
(183.16)
(2,911.31)
1,046.85
0.00
406.50
376.64
(60.00)
910.75
520.24
4,947.45
1,678.67
(83.33)
4,202.71
4,342.88
9,000.00
4,657.12
49,834.70
65,666.67
15,831.97
53,545.28
64,610.75
11,065.47
406,035.71
445,668.49
39,632.78
4,228.90
221.00
310.57
14.98
0.00
8,333.33
1,250.00
616.67
2,058.33
291.67
4,104.43
1,029.00
306.10
2,043.35
291.67
39,070.67
4,058.75
3,360.11
394.02
0.00
57,692.31
1,730.77
4,269.23
14,408.33
2,019.23
18,621.64
(2,327.98)
909.12
14,014.31
2,019.23
4,775.45
12,550.00
7,774.55
46,883.55
80,119.87
33,236.32
Research Expenses - Operating
70
Emergency Physician Advisory Board
Annual Operating Budget
For The Month Ended 4-30-14
Current Month
Printing
Bank Charges
Fuel Cost
Office Supplies
Uniforms
Postage
Cellular Phone
Professional Development
Payroll Services
Legal Services
Office Furniture & Equipment
Online Web Services/ Hosting
Vehicle Cost
Travel
Vehicle Insurance
Work Comp- Insurance
Computer Hardware
Computer Software
Pagers
Committee Work and Team Supplies
Total Research Operating
Total Research Expenses
Capital Outlay:
Computer System Upgrades
Office Equipment
Medical Training Equipment
Vehicle
Total Capital Outlay
Total Expenditures
Ending Balance
Year To Date
Actual
0.00
0.00
0.00
125.76
381.93
0.00
23.08
0.00
154.95
0.00
0.00
78.75
0.00
754.00
0.00
0.00
0.00
0.00
0.00
302.28
Budget
41.67
41.67
166.67
41.67
83.33
83.33
75.00
41.67
275.00
0.00
0.00
0.00
83.33
0.00
125.00
166.67
0.00
0.00
0.00
83.33
Variance
Pos (Neg)
41.67
41.67
166.67
(84.09)
(298.60)
83.33
51.92
41.67
120.05
0.00
0.00
(78.75)
83.33
(754.00)
125.00
166.67
0.00
0.00
0.00
(218.95)
Variance
Pos (Neg)
291.67
291.67
944.43
(191.19)
87.78
583.33
39.95
291.67
480.85
(180.00)
0.00
(78.75)
583.33
(754.00)
1,130.00
(282.53)
0.00
(489.95)
0.00
281.05
1,820.75
1,308.33
(512.42)
6,596.20
13,858.33
7,262.13
54,012.58
90,278.21
36,265.63
0.00
0.00
0.00
0.00
6,273.58
12,275.75
0.00
0.00
6,273.58
12,275.75
0.00
0.00
0.00
399.00
0.00
0.00
43,915.08
85,930.25
0.00
0.00
43,915.08
85,531.25
0.00
0.00
0.00
18,549.33
18,549.33
399.00
129,845.33
129,446.33
60,141.48
97,018.42
36,876.94
460,447.29
535,946.69
75,499.40
5,049.01
3,987.92
1,061.09
118,240.65
203,000.97
84,760.32
Actual
0.00
0.00
222.24
482.86
1,162.22
0.00
485.05
0.00
1,444.15
180.00
0.00
78.75
0.00
754.00
745.00
782.53
0.00
489.95
0.00
302.28
Budget
291.67
291.67
1,166.67
291.67
1,250.00
583.33
525.00
291.67
1,925.00
0.00
0.00
0.00
583.33
0.00
1,875.00
500.00
0.00
0.00
0.00
583.33
7,129.03
10,158.33
3,029.30
71