Weather woes combined with new, "onerous" visibility requirements from the Federal Aviation Administration meant fewer flights for Erlanger's air medical program in 2009, a loss that contributed to lower revenues last month, hospital officials said at Erlanger's budget and finance committee meeting Monday.
"Our most acute patients are transported by aircraft, and if we have a substantial decrease in those acute patients, it has a ripple effect throughout the organization" financially, said Roger Forgey, senior vice president of operations, in a presentation to committee members on the air medical program, Life Force.
In response to an increase in air-medical accidents nationally, in January 2009 the FAA raised visibility minimums that must be met before an aircraft can lift off, such as requiring visibility of two miles instead of just one mile in nonmountainous terrain, Mr. Forgey said. For all air medical programs this significantly has increased the number of canceled flights compared to 2008, he said.
On top of that restriction, two of Life Force's new helicopters, which are equipped with instruments that allow the operator to fly in low visibility, also have been subject to more stringent weather minimums for their first six months of use, under FAA rules. That restricted period ended last month, so transports with those instrument aircraft, which can fly when other aircraft are grounded, should start increasing soon, Mr. Forgey said.
LIFE FORCE SALEIn 2008 Erlanger sold its Life Force helicopters for $12.1 million to air-medical provider Med-Trans Inc., which is responsible for updating and maintaining the aircraft and can bill patients for the transport. Erlanger retained medical control and management of the program. Erlanger would have had to spend $20 million to replace its aging fleet of helicopters otherwise.
In 2009 Life Force had to cancel 21 percent of requested transports because of weather, compared to 16 percent the year prior, he said. Mr. Forgey also noted that loss of burn victim patients, since the close of the hospital's burn unit in 2008, also has added to the decrease in trauma volumes.
That hit to trauma, which can bring in strong revenues, contributed to a loss of $1.15 million for the hospital in December, despite fairly strong admissions overall, said Britt Tabor, chief financial officer. Other concerns included delays in Medicare payments.
Patients in the adult intensive care unit were down 11 percent from December 2008, and T.C. Thompson Children's Hospital's ICU volumes were down 14 percent, compared to the prior year, he said.
Year-to-date, the hospital has lost $2.7 million, compared to a loss of $1.4 million last year. Included in last year's total is more than $3 million in state and federal assistance, which Erlanger has not yet received this fiscal year, Mr. Tabor said.
Also at the meeting, committee members gave preliminary approval for a scheduled replacement of now "obsolete" imaging technology, according to the resolution. The replacement of the hospital's 17-year-old radiographic and fluoroscopic system would cost more than $445,000 and is included in the current year's budget.