Mississippi State Auditor Stacey Pickering has released an in-depth study of Mississippi’s publicly owned, rural hospitals’ financial health.
Public finances and the efficiency and effectiveness of rural hospitals are areas frequently studied by the State Auditor Office.
North Sunflower Medical Center received a rating of 5.44, which is above the National Financial Average for rural hospitals.
"We value cleanliness and customer service, patient satisfaction and employee satisfaction. When you put all of those together you get a successful hospital," said North Sunflower Medical Center Executive Director Billy Marlow.
"When you provide good customer service, patients come and when they come, you prosper from it. We don’t put finances above patient care. We are one of the more successful hospitals in the county," he added.
"We are in the top 40 of the cleanest hospitals in the nation out of 5,500 hospitals. We pride ourselves on taking really good care of the patients and they get what they need," continued Marlow.
Marlow said North Sunflower Medical Center is a county owned hospital and whenever the hospital generates money, it is able to put money back into the community and various services.
The numbers generated by the Financial Service Institute did not have a minimum or maximum but it was based on simplified medians taken form the population of all United State hospitals; the theoretical national median FSI score is zero.
A hospital with a final FSI score over three is considered to be in excellent financial health; one whose FSI is between zero and three is in good financial health; one with FSI between negative two and zero is in fair condition financially and one whose FSI is below negative two is in poor shape financially.
The lower the score, the more reason there is to investigate more closely.
The report identifies three areas of financial well-being: those ranking above the national average for financial strength; those below the national average but not on the verge of failing; and those in need of immediate financial attention.
"We created a state based index so that way we could compare and contrast the national average with the state average. We found out that most things were pretty similar with both indexes," said Kittredge.
"Out of the 25 hospitals that we looked at, 15 were above the national average. There were four that were in what we call bad shape – they had significant financial concerns," he added.
Kittredge said the study only examines current financial well-being and is was not intended to predict future financial strength of weakness.
OSA's work was designed to rate the hospital's financial performance on a broad set of relevant measures.
"The results should help focus attention toward hospitals in the population with the most financial need," he added.
The four hospitals whose finances are of most concern: Montfort Jones Memorial Hospital, Kosciusko, Attala County; Natchez Regional Medical Center in Adams County, Tallahatchie County General Hospital in Charleston, and Tippah County General Hospital in Ripley.
These hospital were had an FSI score below negative two.
According to Communications Director for the Office of the State Auditor Brett Kittredge the Office of the State Auditor wanted to conduct an "honest" assessment of financial records from the past four years.
"There is so much changing with healthcare and some of these hospitals are county owned. We just did this study to basically get an idea as to where rural hospitals are financially. The study was conducted to get this information out there to county governments, hospitals, state legislatures and just all policymakers and administrators," said Kittredge.
The study was conducted over a four span, 2009-2012.
Kittredge said the hospitals that were involved in the study had been defined as rural according to standards outlined by the United States Department of Agriculture as a rural hospital.
According to USDA Rural hospitals face great pressures as government payments decline due to their small size, modest assets and financial reserves, and higher percentage of Medicare patients since rural populations are typically older than average urban populations.
Rural hospitals provide essential health care services to nearly 54 million people, including 9 million Medicare beneficiaries.
Contributing to Medicare payment challenges is a host of significant pressures – largely beyond hospitals’ control.
Medicare margins are the lowest for rural hospitals, with the smallest hospitals having the lowest margins.
A sustained workforce shortage and rising health care liability premiums continue to drive costs higher.
In addition, access to capital is poor as the average age of hospital facilities and the demand for expensive new information systems climb.
USDA estimates, 55 percent of Mississippi's population lives in rural areas.
The study combined two different methods of assessing hospital financial health.
Both used profitability, liquidity and capital structure as measurements.
Two other areas used were age of facilities and solvency.