Pago Pago, AMERICAN SAMOA — LBJ Medical Center collected just over $30.14 million in “operating revenue” in the first 6 months of fiscal year 2019, compared to expenditures of over $37.76 million for the same period, according to LBJ’s second quarter performance report for FY 2019 submitted to the governor and the Fono.

LBJ’s summary of financial data on year-to-date, shows that $11.98 million was collected during the first quarter — for the period of Oct. 1 - Dec. 31, 2018 — while just over $18.16 was collected in the second quarter: Jan. 1 - Mar. 31, 2019

During both quarters, LBJ didn’t receive any subsidy from ASG in which the hospital had budgeted $2 million in the first 6 months of FY 2019.

According to the law, a 2% wage tax is paid by all wage earners in the territory, with 50% of all proceeds collected earmarked for LBJ operations and the other 50% for the LBJ off-island medical referral program.

The ASG Treasury collects the wage tax, which is submitted to LBJ, whose CEO, Faumuina John Faumuina told last year’s budget committee that whatever subsidy LBJ receives from ASG is used as matching funds for Medicaid and Medicare — which are the major funding sources for LBJ. (See Samoa News Sept. 2, 2018 edition for details)

In past budget hearings, there are always questions from lawmakers on whether Treasury pays over to LBJ all of the revenues collected from the 2% wage tax, with ASG officials saying that they can only pay revenue to LBJ from what is collected.

Lawmakers have also questioned why ASG doesn’t submit in a timely manner, the subsidy due to the hospital. ASG officials have testified that they have to look at pressing government expenditures first, especially payroll, before paying out subsidies to ASG entities that get annual subsidies. 

The 2nd quarter performance report shows that the highest revenue collection for LBJ was from Medicaid, with $5.53 million in the first quarter and $6.21 million in the second quarter. LBJ also received part of its Interior Department subsidy of over $1.49 million in the first quarter and $5.04 million in the second quarter.

Other revenue cash-flow for LBJ came from Medicare, local collections at the hospital, and LBJ’s share from revenues collected by ASG through excise tax and terminal fees.

According to the financial summary, LBJ disbursed over $37.76 million in “operating expenses” during the first 6 months of FY 2019, with the highest expenditure totaling over $17.89 million for salaries, wages an fringe benefits — $4.86 million in the first quarter and $13.02 million in the second quarter. 

There was no explanation as to why there’s a big difference in the amounts between the two quarters.

The second highest expenditure during the first six months is $11.95 million for “pharmaceutical, medical and general supply” with over  $3.97 million in the first quarter and $7.98 in the 2nd quarter.

For Off Island Medical Care, the LBJ appears to have tapped into its other financial resources, paying a total of $644,203 for the first 6 months of FY 2019.

According to the report, LBJ’s management team strives to continually assess, monitor and improve hospital/clinical areas as required by the US Center for Medicaid and Medicare (CMS) standards of practice for patient quality care.

“As a CMS qualified health care facility, we are certified for Medicare/Medicaid financial assistance in meeting a large part of our health care provider cost,” it says.