Help is on the way — Hospital board approves short-term contract in special meeting
Weston County Hospital District’s board of trustees approved a contract at a special meeting Dec. 12 in an effort to hasten transition to a new financing and accounting system and avoid extending its current contract.
The hospital is currently supported with the MEDITECH information system through a contract with Tegria, a Madison, Wisconsin-based health care consulting and technology services firm. That firm charges the hospital $32,000 a month, and officials say the hospital needs help speeding up the process of finalizing its entry into Sage computer systems, which will replace the Tegria system.
“We will save $32k in charges from Tegria after February by getting the work between the two vendors completed in January,” CEO Cathy Harshbarger told the News Letter Journal on Dec. 12. “We will have a cost of under $7,000 to build the financial reports, load the 2025 budget in Sage and all accounting forms required to meet the timeline in January and start having financial reports.”
Harshbarger said that the chart of accounts (the way the hospital breaks up all the charges it has and places them into a journal entry) is “way, way too broad” for what a usual critical access hospital has and what accountants would typically see.
“Instead of having them have to do crosswalks between all our different categories, we’re going to have ours match what is normally seen in general accounting purposes for a critical access hospital,” she said.
Tish Miller, the hospital’s chief financial officer, who has been in her position for about a month, said at the meeting that she spoke with the hospital’s auditors, who said that as long as “we have a crosswalk, they’re fine with it. She said the most cumbersome part of working in Sage is building a budget, and the hospital’s 2025 budget is based on general ledger numbers from MEDITECH (Medical Information Technology Inc).
Keith Gnagey, who was the CEO of Teton Valley Health Care in Driggs, Idaho, and is now retired, has signed on to build the hospital’s chart of accounts in Sage. The “top end” estimate for the work, which will include building the chart of accounts, the crosswalk, the financial reports and balance sheet accounts “where they need to be and doing what they’re supposed to be doing,” is about $7,000, according to Miller.
She said she worked with Gnagey on a similar project when they were both working at Teton Valley, and predicted the work should take no more than 40 hours to do, based on that experience. If she had to do it by herself, while staff are present, Miller said, it would take her twice as long. She assured the board she will not allow the contract to go over the budgeted amount, and said she actually seeks to finish under budget.
Harshbarger said she’s aware that paying consultants is “a sensitive subject” in the community currently, but she believes the hospital needs to do so in this instance.
“It’s a get out of jail project to try to have everything into Sage,” Harshbarger said.
She said that Miller could build the reports herself, like “anybody that’s a well-educated person” could, but the hospital needs to priori- tize Miller’s time to work on other challenges the operation is facing with its system, which means it makes sense to delegate this project.
“Of all the projects that we have to accomplish so we can get our audit started, our financial reports out, this is the lowest-lying fruit,” Miller said.
If she were to do the project, while juggling her other duties, she said, it would take her two weeks, or into mid-January. Instead, she will be concentrating on infrastructure, communication and interdepartmental relations, which require on-site, hands-on work.
Trustee Nathan Ballard said that considering what he knows about the state of the chart of accounts, he supports the change, as long as it’s just one time.
Harshbarger said on Dec. 17 that she has signed the contract with Gnagey. Once his work begins, it will take a week.