HERMANN – As the end of the years edges into sight, work is about to begin on crafting the next operating budget at Hermann Area District Hospital.

Chief Financial Officer Cindi Engemann Oct. 29 told the hospital’s board of directors that she plans to have preliminary budget figures available by its Nov. 23 session. She told the board the various departments of the hospital now are putting together their funding requests for the coming year. The hospital board traditionally gives final approval to a spending plan at its December session.

Operating on a calendar year, HADH’s new budget takes effect Jan. 1. The district is funded primarily by a property tax with additional revenue generated by payments from Medicare and Medicaid, health insurance companies and payment made directly by patients.

HADH administrators are hoping to go into the budget process on a solid financial performance in the fourth quarter, which actually began with the numbers for September.

“We had a good gross revenue month,” Engemann told the board, referring to September.

The gross revenue number was helped by an increased number of people coming into the Emergency Department. “We had a busy month,” said Chief Executive Officer and Administrator Bill Hellebusch, pointing to more than 350 visits to the Emergency Department during the month.

Other positives are a continued increase in the number of swing-bed patients. Those are patients who have undergone treatment but not yet ready to go home or who might need therapy services after treatment. HADH receives swing-bed patients from other hospitals, which bolsters the number of patients. Hellebusch reported that the swing-bed count is up 10 percent over the number at this time last year.

Business in the Radiology Department was down in September, but that should be reversed by a busy October, which is Breast Cancer Awareness Month and which saw a larger number of patients for mammographies.

Activity at the hospital’s clinics in Hermann and Montgomery City hovered around 1-percent higher than a year ago, but the administrator noted the concerning development of a sharp fall-off of the number of students returning from summer break for behavioral counseling visits.

Meanwhile, a face familiar to many Hermann-area residents has joined the HADH staff. Thuy McGarrah, who along with late husband Scott owned and operated Hermann Family Drugstore, is the hospital’s new full-time pharmacist. Hellebusch said that position has grown in importance as the need has grown for on-site pharmaceutical services.

Regarding patient volume at the two clinics, Director of Clinics Ellen Schaumberg told the board that efforts are being made to shorten the wait time for patients to see a healthcare provider. Clinical operations are down by a position, which contributes to the longer wait time for patients, as does the increase in number of new patients. She said the staff is “struggling” to get new patients scheduled on a more-timely basis.

On the staff front, HADH continues to deal with having to schedule agency nurses, which comes at a considerable cost compared to local hires. Hospital officials noted that three agency nurses were on the roster but two of those positions might be replaced soon by local hires.

As far as overall staffing, the administrator told the board there are 25 open positions, most of which are so-called “PRN” positions. That stands for “Pro Ro Nada,” which is Latin for, roughly, “as the situation dictates” meaning they are on-call, part-time positions.