After another month of heavy losses, and only four months remaining in the fiscal year it is highly likely Booneville Community Hospital will have a substantial loss.

Stuart Lisko, the chief financial officer at BCH, told the city council last week it is unlikely the hospital can turn a profit, even after booking a cost report estimate at the end of the year. That figure is money the hospital expects to see in the form of a reimbursement from Medicaid and or Medicare.

With fewer outpatient services and a census drop of 0.6 patients per day, in February the hospital had an operational loss of $87,000 and an overall loss of $144,000, Lisko said. The larger figure includes the monthly payment required for the bonds sold to construct the hospital.

"It’s still not where it needs to be to show a profit each month," said Lisko.

The year to date figures showed an operational loss of $364,000 and an overall loss of $818,000, Lisko said.

Booneville Mayor Jerry Wilkins asked Lisko if he could foresee an end of the losses.

"I don’t see the hospital being able to turn a profit this fiscal year," said Lisko. "Even with a cost report receivable we’ll be posting when auditors come to do the audit — probably somewhere in the neighborhood of $400,000 to $500,000 — I just don’t see it in the next few months being able to get back to break even."

At the highest end of the estimate the hospital is still $318,000 in the hole, before any losses — or gains — are realized in March through June.

"We certainly need additional providers here in the community to provide services," said Lisko. "(Chief executive officer) Dave (Hill) is actively recruiting physicians to come to the area but without those services we are not generating enough revenue to sustain a profit.

"It’s tough recruiting out there nowadays. Everybody is going after the same physicians. There’s a shortage nationwide of family physicians."

As he has said in previous meetings, Lisko said an average daily census of 8 to 9 is necessary for the hospital to break even. In February, he said, the census was 5.8. January was the best recent month at 6.4 per day, he added.

Lisko also reminded the council of the process of bad debt removal and an unrealistic receivable rate assumed and reflected in balance statements prior to his arrival at the hospital.

Of the current loss at least $200,000 of the operational loss is from bad debt, so without the recalculation and with the receivable from the cost report, there could have been an operational gain.

Even in that scenario, the interest associated with the bonds — about $90,000 per month — which Lisko also re-situated on balance sheets as a nonoperational expense, would cause an overall loss.

Hospital board chairman James Fields also told the council that over the last several months the hospital has also attempted to trim the work force through attrition and that a flex program is in position now that reduces the number of hours.

Fields also said there is a good prospect for a nurse practitioner to come aboard but two other possibilities for physicians have fallen through.

"We’re working. We’re not just sitting on our hands out there," said Fields.