Although Winneshiek Medical Center's September profit was only $10,973, that's significantly better than this time last year.

Last September resulted in a net loss of $106,320 for the Medical Center.

At Wednesday's meeting of the WMC Board of Trustees, Chief Financial Officer Lynn Luloff explained this September came in under projections, which she attributed to a continuing decline in inpatient proceeds.

"We had 93 less acute patient days this quarter compared to the first quarter of fiscal year 2013," said Luloff.

"Nationally, census is down and has been declining. The future holds a continual decline in patient care being provided in an inpatient status," said Luloff.

On the bright side, Luloff said that trend is not necessarily true for skilled care, which many patients utilize while recovering from surgical procedures.

"Care and treatment may move from an acute care setting to a skilled setting, slowing continuity of care. Studies show treatments received under this level of care can limit readmissions," said Luloff.

WMC experienced a 42 percent increase in skilled patient days in the first quarter of this fiscal year, compared with last year.

Year to date, the Medical Center has a net gain of $238,497.

Annual audit

Following an unqualified (clean) opinion issued on WMC's financial statements, Gwen Moser of Eide Bailly, the accounting firm conducting the annual audit, presented her report to the Board.

She said the auditing firm had "no concerns with the results."

In a management discussion and analysis which accompanied the financial statements, WMC indicated a $1,001,247 profit for fiscal year 2013, which ran July 1, 2012, to June 30 of this year.

"Stronger financial performance was gained by experiencing an 8.4 percent increase in total operating revenues while minimizing expense growth to 4.9 percent," said the document.

Luloff noted a number of positive gains with regard to WMC's strategic plan.

She explained during fiscal year 2013 the Medical Center's health outcomes were either maintained or improved and overall patient satisfaction scores increased.

In regard to workforce satisfaction, the Medical Center performance an extensive review of pay ranges and made adjustments to ensure market competitiveness.

There was growth in volumes in many patient care areas due to the Medical Center's success in recruiting six new physicians and three new associate providers and establishing gynecology as a new specialty.

In addition, the Medical Center purchased capital equipment of over $1.2 million, installed new state-of-the-art digital mammography system and increased cash balances by $2.7 million.

Luloff said WMC exists within a competitive environment with other local and regional healthcare providers offering many duplicate services, such as MRI tests, CT scans and outpatient surgeries.

"Fewer cases mean decreased revenues," she said, citing the example that for every CT scan or MRI test not performed at WMC, there is a minimum of $1,000 in net revenue lost," she said.

She added those services help maintain less profitable services available at the Medical Center, such as a 24/7 physician-staffed emergency room and ambulance services.

"The environment is not only competitive, but ever changing, due to healthcare reform and unknown regulatory changes," she said.