Cookeville Regional board approves 2020-2021 audit

COOKEVILLE — The 2020-2021 audit for Cookeville Regional Medical Center (CRMC) shows that despite COVID-19 being a challenge in many areas, the financial health of the hospital is in good standing. In 2021, the audit shows that Cookeville Regional reported a net income of $9,554,777 and $4,380,554 in 2020 and a net loss of $5,842,948 in 2019. The Medical Center used the net income to reinvest in a variety of equipment and services to better serve our patients. 

“Even though COVID took over a lot of operational and clinical aspects of the hospital, we took the initiative to invest in new equipment and assets,” said Paul Korth, CEO. “Those investments include the purchase of the da Vinci Xi surgical system, the replacement of the nurse call system, new patient beds and the purchase of the remaining shares of the Upper Cumberland Physicians Surgery Center, which is now known as the Surgery Center on Whitney.”

The hospital previously owned 52% interest in the joint venture with Upper Cumberland Physicians Surgery Center and purchased the remaining shares for approximately $1.8 million in order to expand the capacity for surgeries and special procedures. 

“The hospital has typically demonstrated an increase in net assets,” Cookeville Regional management states in the audit. “The increase in net assets is attributable to the increase in volumes and severity of the patients treated during the year.” Operating expenses increased by $31,620,525 (9.5%) in 2021 compared to 2020 which increased by $5,884,588 (2%) compared to 2019. Different areas of the hospital saw growth in 2021 compared to 2020, all attributed to the pandemic. The length of patient stay increased by 9%, surgical cases increased by 6%, cath lab volume increased 20% and the severity of illness for the patients increased 4%. The increase in cath lab and surgery cases can be attributed to the backlog of cases awaiting procedures that had been delayed due to the suspension of elective cases.

Due to the increased volume, net patient service revenue increased 7% in 2021 versus 3% in 2020. Just like 2020, the hospital incurred substantial increases in expenses related to personal protective equipment and other COVID related supplies and pharmaceuticals. COVID expenses exceeded $16.5 million in the last fiscal year.

Employee salary and benefit costs increased 8% in 2021 due to the need for additional personnel. The hospital also spent in excess of $5.8 million in 2021 when compared to 2020 in clinical employee salaries, bonuses to cover extra shifts and retention of personnel. Cookeville Regional is one of a few facilities in the region to provide monoclonal antibodies to patients to help prevent admission into the hospital. As a service to the community, the hospital did not bill patients for this service but accepted insurance payments only. The hospital also provides care for patients who have little or no health insurance or other means of repayment. The level of services provided to these patients in 2021 and 2020 was $4,751,812 and $5,467,253, respectively. Because there is no expectation of repayment, charity care is not reported as patient service revenue.

A lot of federal funding with regards to COVID assistance also came in during these last two years. The hospital spent approximately $20 million in Department of Health and Human Services Provider Relief stimulus money from the CARES Act to cover for lost revenue and additional COVID related expenses to care for COVID patients.  

Due to patients delaying care, the level of care needed is much higher, contributing to higher medical costs. The pandemic also emphasized the use of non-traditional venues for providing healthcare such as virtual care visits, remote patient monitoring and hospital-at-home models. These venues present challenges with coordinating care in an era that is attempting to move toward an integrated healthcare system.

“Navigating the COVID pandemic continued with patients needing a higher level of care. Cookeville Regional Medical Center continues to innovate and collaborate with all parties, looking toward the future, in order to continue to build healthier communities,” said Board of Trustees Chairman Kevin Carter. 

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