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RHG Services

Crisis Management Services

  • Preparation of unaudited monthly financial statements and assistance in arranging for financial audits.

  • Assistance with the preparation of annual strategic and financial plans.

  • Assistance with general accounting, revenue cycle, reimbursement and cost reporting services, supply chain activities and contracting services, information technology services, and human resources management.

  • Assistance with the maintenance and retention of patient records and other records.

  • Assistance with the implementation and maintenance of programs for quality assurance and quality control, regulatory compliance and risk management.

  • Assistance with the recruitment of physicians and other healthcare professionals and the development of amicable working relationships with the Medical Staff, regulatory authorities, vendors, and the local community.

  • Assistance with the filing and prosecution of legal actions or other proceedings and the defense of legal actions and proceedings, except for legal actions between the Parties.

  • Assistance in complying with applicable law related to the safety of persons or property with respect to operations and in arranging for routine maintenance and safety inspections of facilities and equipment.

  • Assistance with the coordination of the planning, development and implementation of long-term and short-term capital projects.

Executive & Operational Leadership

  • Interim and crisis hospital executive leadership, including provision of an onsite Chief Executive Officer (CEO).

  • Designation of Turnaround Managers and Co-Managers, often on-site, to coordinate operations and report to the hospital board.

Financial Management

  • Revenue cycle management (billing, coding, A/R, A/P).

  • Financial reporting (e.g., cash flow, income statements, operating reports).

  • Preparation and maintenance of financial statements (not audits).

  • Cash management and bank relations.

  • Ensuring compliance with debt covenants and reporting to bond trustees or lenders (when applicable).

Human Resources

  • Staffing structure assessments.

  • Pay scale, call pay, and policy development.

  • Recruitment and retention strategy input.

  • Reduction of excess or misaligned FTEs.

Legal, Risk & Compliance Oversight

  • Contract review, negotiation, and vendor management (limited to transactional support).

  • Oversight and management of risk management programs (e.g., insurance, compliance).

  • Establishment and administration of a compliance program, including policy development and staff education.

  • Oversight of legal disputes related to hospital operations (excluding actual legal representation).

Information and Records Management

  • Oversight and evaluation of Health Information Management (HIM) functions and coding efficiency.

  • Review of hospital data systems and tracking processes for reimbursement optimization.

Staffing and Departmental Efficiency Assessments

  • Evaluation and recommendations to optimize:

    • Surgery department utilization

    • Emergency department staffing and hospitalist coverage

    • Radiology and laboratory services

    • Nursing operations and census-based flex staffing

    • Pharmacy staffing

    • Dietary services efficiency

    • Primary care clinic operations

Strategic Planning & Advisory

  • Development of strategic and operational improvement plans.

  • Review and guidance on merger or partnership discussions.

  • Market competition analysis and surgical volume improvement recommendations.

  • Participation in board meetings as non-voting advisory observers.

Board & Stakeholder Engagement

  • Regular reporting to the hospital board (monthly or more frequently).

  • Coordination with bondholders, trustees, and lenders on financial status and operations (where applicable).

  • Communication with stakeholders during transitions or operational crises.

Operational & Financial Assessment and Consulting

  • Conduct operational and financial assessments to identify performance drivers and inefficiencies.

  • Evaluate departments, service lines, staffing levels, productivity, payor relationships, and vendor contracts.

  • Assess facilities layout, supply chain efficiency, revenue cycle (denials, bad debt, collections), and cost structure.

  • Deliverables include:

    • A written Plan of Recommendations.

    • A 5-year financial proforma modeling cost-saving and revenue-generating strategies.

    • Identification of recurring vs. one-time opportunities with estimated costs and implementation timelines.

    • In-person presentation of findings and recommendations to the hospital board.

Rural Emergency Hospital (REH) Conversion

  • Assessment of REH eligibility based on CMS guidelines, financial viability, community healthcare needs, and alternative scenarios.

  • Guidance through federal and state regulatory requirements, including the preparation and submission of necessary CMS applications, notifications, and licensure changes.

  • Development of a detailed REH transition roadmap, including changes to inpatient services, reconfiguration of staffing models, and continuity planning for outpatient and emergency services.

  • Creation of financial proformas projecting the short- and long-term implications of REH status, including new reimbursement structures and operational cost changes.

  • Assistance in educating hospital boards, medical staff, community leaders, and the public about the REH model, its benefits, and implications for local healthcare access.

  • Ongoing advisory services to ensure compliance, optimize performance under the REH payment model, and develop outpatient strategies aligned with community needs.

Acquisition and Investment Option

Where appropriate, RHG can bring capital to local communities and purchase the assets of the hospital while still keeping the local feel and touch.  RHG is in the business of investing in small-to-medium sized rural hospitals that are operationally distressed. Its investment goal is to maximize total return on capital by seeking capital appreciation and current income through the acquisition of a diversified portfolio of distressed rural hospital investments located primarily in the less populated and more remote areas in the Central United States where rural hospitals are usually the sole provider of emergency, acute care inpatient and outpatient clinic services to their communities.

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In pursuing its investment strategy, RHG will focus its investment activities toward the acquisition of medium "tweener" hospitals and Critical Access Hospitals.  The investment transactions can be structured as either a long-term lease or a sale and purchase of assets, where RHG takes ownership of the physical assets and permanent control over governance and operations.

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