HERMANN — The local hospital would finish the year with a balance of about $350,000, according to Administrator Bill Hellebusch.

The Hermann Area District Hospital Board of Directors last week approved the 2024 operating budget, which takes effect Jan. 1. Bottom-line budget numbers — projected total revenues and estimated total expenses — were not readily available to the Gasconade County Republican.

However, after a telephone call to the administration asking about specific budget figures, Hellebusch told the Republican that if the budget projects hold up, the hospital could finish the year with a balance of about $350,000 — good news for a hospital that has been posting negative financial numbers for several years.

How is the administration positioning the hospital to end the year in such a positive position? Several steps are being taken to move HADH forward.

For instance, the effort to make HADH a first-choice facility for those needing therapy after medical treatment — so-called “swing-bed” patients — appears to be paying off. Swing-bed referrals have been rising in recent months and are expected to continue an upward trend. Indeed, the administration is projecting a 6-percent growth in swing-bed revenue in 2024.

More out-patient services are expected to be performed; the budget contains a 9-percent growth in out-patient revenue. In-patient revenue is estimated to increase by 1 percent. Gross patient revenue — a key marker in the budget — is expected to increase 9 percent.

On the expense side of the ledger, Hellebusch said total expenses are expected to be held to a 1-percent increase. Much of that will be in salaries, which are expected to rise about 6 percent; however, hospital officials look to reduce their purchased services — such as agency staffing — by 5 percent.

In other matters, the hospital has somewhat stalled in its efforts to take advantage of the 340B Program, which provides hospitals with a refund on drug purchases. This is one key component of making HADH more fiscally sound, hospital officials have said.

However, one crucial component of a local 340B Program is missing — a local pharmacy which fills the hospital’s orders for drugs. Administration officials have been negotiating with the local pharmacies for some time, but apparently little progress has been made.

“I think we’re at a standstill,” Hellebusch told the board last week — at least, he added, until a local pharmacy agrees to participate.

Hospital officials acknowledge that being part of the 340B Program amounts to a lot of work by the pharmacy — especially in terms of managing their inventories of drugs. That’s because a pharmacy essentially has to have two supplies, one for the 340B Program and one for regular pharmacy customers.