The 2019-20 budget that Preston Sauers, director of business operations, presented June 20 to the Ellsworth County Medical Center board of directors was unique for two reasons.

First, at $346,924, the budget was in the black — not in the red — which seems to have been the case more often than not in the past few years.

Second, it was Sauers’ last budget presentation to the board. June 21 was his last day on the job after a 17-year tenure at the hospital. He plans to continue his education with the goal of earning a Master’s degree in Healthcare Administration at Wichita State University while at the same time spending a little time becoming a better musician.

“I do want to come back (to Ellsworth),” Sauers said.

Sauers said it feels great to turn in a budget that is in the black.

“I was wrong last year,” he said. “I told you we were going to lose $1 million this year. And everything in the industry pointed towards it. Everyone I talked to, everything I did — that wasn’t a number pulled out of a hat.”

Sauers said everything that has happened this past year in the health care industry has been completely opposite of what was anticipated.

“When you look at the net contribution on your financial statement on the profit and loss, year-to-date we’re at a $4,000 loss,” he said. “We were anticipating being at a $926,000 loss. This time last year we were at a $1.3 million loss. I think it is a combination of many different things that have caused that. Much of it is Mr. (Andrew) Bair (ECMC chief executive officer) and his work with collaborations and collaborating with the physicians and getting the physicians engaged.”

Sauers said while he can give the hospital board a black or red budget, the one thing he walks away from ECMC most proud of is that the hospital’s cash situation is sound, compared to when he started, and the hospital is ending the fiscal year in the black.

“There has not been a single time in my tenure that I have asked somebody to go to the county to say we need more money because we can’t make ends meet,” he said.“There has been times it has been close, but we’ve managed to keep everything going successfully in a time when many critical access hospitals are in very critical financial condition or are closing.”

Sauers described the hospital’s executive team as “incredible.”

“I don’t think you guys (the hospital board) realize how good of an executive team that you have here,” he said.“They’re innovative, they’re sharp, they know what is going on in the industry, and when they say they are going to do something they make it happen. That’s why we’re successful. That’s why we’ve done so well financially.”

Sauers said he considers himself fortunate to have worked side by side with these individuals.

He gave credit for the budget to Lynn Brock, interim chief financial officer.

“(She) was the driving force in getting this major process completed,” Sauers said.“These forecasts, calculations, and assumptions are comprehensive — and are a result of Lynn’s expertise.”

Board member Karen Pauley said she was concerned that the budget assumptions appeared to be based on hope instead of an established history.

“The budget is fine,” she said. “It’s the assumptions in the budget that worries me.”

Sauers said the projections are based on nine months of actual data that was amortized out for the year.

Pauley said Sauers explanation helped her a great deal to alleviate her concerns.

Sauers said the department heads were involved in the budget and each had to justify their figures for the budget.

“I see a bright new day at ECMC,” Sauers said.

“I think we’re going in a different direction,” board member Kenny Schepmann said.“I’d rather see us be a little bit bolder.”

Sauers said ECMC has the second lowest amount of county support of any hospital in Kansas.

“The other one though has an endowment and charitable donor,” he said.

In other business:

Bair said while he has only known Sauers for eight months, he thinks the world of him.

“He is absolutely irreplaceable,” Bair said.“Preston is a unique talent. Thank you Preston for your years of service. He has left a big footprint here.”

Board president Kenny Beneda said he was impressed with Sauers and wished him luck in his future endeavors.

Bair then thanked retiring board member Bernie Schulte for his service on the board.

He also thanked Tammy Moore, the new board member, for attending the meeting. She succeeds Schulte.

“Next month is her official start,” Bair said.

Moore worked as a respiratory therapist at ECMC from 2001-05. She has 29 years of experience in that field.

“I am so honored to be asked to join and be on the board and have an opportunity to be a voice and serve Ellsworth County,” she said.

• Bair said he is working on a new provider care model.

“Our current provider model has our physicians covering patients over in the clinic while they are on call to the emergency room,” he said. “So if they are running a full day, seeing 20-24 patients and then 14 in the emergency room that day, there’s a lot of running back and forth and I fear that we’re not providing the best of service for our community.”

Bair said the current provider compensation model is attached with how they are paid.

“I want to get to a point where when you are in the clinic, you take care of clinic patients and when you are on ER call you take care of ER call,” he said.

He would also like to see what he describes as multidisciplinary rounding.

That means every day at a certain time the providers would make their rounds and the healthcare team would go room to room and discuss whatever the situation is for that specific patient with them and their families.

“Just so we are all on the same page with what is going on with these patients,” he said. “My plan is to address the care model, and then take a look at compensation, try to layer compensation over that. We’ll take care of the patient first and then figure out how to pay the providers.”

Bair said scaling back provider compensation is not the plan.

“We want to keep them as whole as we can within reason, but we also want to incentivize them to do the right thing as far as patient care,” he added.

• The Community Health Needs Assessment was approved.

• Bair said he his getting quotes from two vendors on a new generator for the hospital. The total cost would be in the range of $250,000.

Bair said the hospital received a $115,000 grant from the Dane G. Hansen Foundation to help pay for the generator. He plans to ask for county funds to make up the difference.

The old generator will be installed in the hospital’s administration building.

The next meeting of the Ellsworth County Medical Center board of directors will be at 5:30 p.m. Wednesday, July 17, in the hospital conference room.