Annual Qualityof Care Report 2014 Our Vision: Quality - Excellence with the client A safe and healthy community where everyone feels at the centre. they are valued, supported and have the opportunity To do this we will: to participate. G embed a quality culture of continuous improvement across the organisation such that our clients’ Our Mission: experience with CGHS is characterised by the Our Mission is to provide health and community following: services that will best meet the current and future I seamless, coordinated, integrated and timely needs of our community. provision of person centred care; I capable individuals and teams working within In doing so we will focus on: structures and processes that support quality G supporting community identified need and genuine outcomes and continuous improvement; community participation; I facilities and equipment that enable the provision G placing our clients/patients and community at the of efficient, effective and sustainable service centre of our work; delivery; and I a workforce that places a very high value on G supporting individuals, groups and communities to maintain and improve their health and wellbeing excellent customer service and client/patient and minimise the negative impact of chronic disease advocacy. and injury; Caring - Support, compassion and tolerance. G integrating and co-ordinating our services within To do this we will: an interdisciplinary service delivery model; G be welcoming, caring, supportive, share knowledge G allocating and using our resources effectively freely and support learning in every setting; and efficiently; G relate to our community with tolerance and G achieving through collaboration and partnerships; compassion; G being creative, innovative and open to discovery. G assist our community to understand their rights and responsibilities and have access to genuine Our Values: complaints resolution processes; In achieving our goals and objectives we will develop G support our community to identify the need for an organisational culture that supports: and make decisions relating to the development, Social Justice - equity of outcome. delivery and evaluation of services; and G To do this we will: work within an intersectoral and collaborative framework to maximise benefits for our community; G focus on achieving equality of outcome for individuals appreciate the positive impact on organisational and and groups; community capacity that comes from diversity. G understand the impact of poverty and disadvantage on behaviour and health status; People - Respect and support. G support affirmative action for the disadvantaged In doing so we will: and marginalised amongst us; G strive to provide an environment that assists G ensure our fees policy takes into account ability to pay; our staff to: I achieve their personal goals and objectives; G support harm minimisation and targeted community I support programs; and live ethically within their personal value system; and I enthusiastically support CGHS to achieve our G be compassionate, tolerant and embrace diversity. strategic and service delivery goals and objectives. Honesty, transparency and integrity. G develop a workplace where people are enabled to: I To do this we will: be efficient and effective; I put forward ideas and participate in decision G set and model standards of behaviour consistent making; with the Victorian public sector code of conduct; I be creative and innovative; and G embrace open disclosure and provide meaningful I develop their learning and career in a manner and clear information to our stakeholders; and consistent with their strengths and interests. G support ethical leadership development at all levels G foster very high levels of staff capability and satisfaction. of the organisation. CONTENTS
Who we are 2 Report by the Chair, Board of Management 3 Chief Executive Officer’s report 4 Strategic Planning 5 New Strategic Planning Summary 6 Quality of Care Report 8 Our History 13 Governance 13 Board of Management 14 Executive Staff 14 Workforce Data 14 Overview of Services 15 Linen Services 17 Structural Framework 18 Support Groups 19 Donations 20 Fundraising 21 Our People 22 Statutory Information 25 Report of Operations 27 Statement of Priorities 29 Putting Patients First 34 Disclosure Index 35
Central Gippsland Health Service Quality of Care Report 2014 1 Who we are embedded in the ‘active service model’. To achieve these ends a number of ‘redesigning’ projects have been in progress for a number Central Gippsland Health Service (CGHS) is the major provider of of years and have recently been supported by the establishment of health and residential aged care services in the Wellington Shire. a combined patient service and centralised intake and information It serves an immediate population of around 42,000 in Central area. Gippsland, while acute specialist services reach a wider community In 2012-13, Central Gippsland Health Service released a in East Gippsland and parts of South Gippsland. comprehensive 10 year Health Plan as a consultation document. The Central Gippsland Health Service Health Plan 2012-2022 At your service represents a detailed response to Victorian Health Priorities Central Gippsland Health Service, being a sub-regional health Framework, 2012-2022, Rural and Regional Health Plan. The Plan service, works within the Victorian Health Priorities Framework describes how we will support an area-based planning approach 2012-2022 with a focus on implementing at a local and area-wide to develop a system that is responsive to people’s needs. level the priorities and actions contained in the Rural and Regional Our services Health Plan. Population served approximately 42,000 Within the Gippsland region, there is one Regional Health Service, Latrobe Regional Hospital, which is the key specialist service Emergency attendances 17,078 resource for the region and the four sub-regional health services. Inpatient services 12,400 Central Gippsland Health Service is the major provider of health Mothers delivered 460 and aged care services in the Wellington Shire. It serves an immediate population of approximately 42,000 in Central Gippsland, Community Services hours of service 95,017 and reaches a wider community in East Gippsland and parts of Non-admitted Subacute and Specialist South Gippsland in terms of more specialised services such as Outpatient Clinic Service Events 13,391 perinatal services, critical care, obstetrics and surgery. Central Gippsland Health Service is unusual being both a People sub-regional and an integrated health service, providing a broad 632 Full Time Equivalent employees range of primary, secondary and tertiary services, including a near comprehensive range of Home and Community Care (HACC) 1016 people employed, including casual, part-time and full-time services, through to adult intensive, coronary care and level 2 active employees at 30 June, 2014. neonatal care. Assets and revenue Acute services include a full time emergency department, critical G $53m in net assets G $50m in buildings care unit, neonatal critical care unit, operating theatres, day G G procedure unit, and oncology and dialysis services in addition $6m in plant and equipment $79m in revenue to general medical and surgical services and sub-acute services I Central Gippsland Health Service acknowledged staff for long including rehabilitation. service by presenting them with service badges. In 2013-2014, The Health Service has acute campuses at Sale, Maffra and Heyfield; recipients of 40 year badges were: Barbara Harper, Brenda community and home support services are provided throughout the Cahill, Wendy Kelly and Geoffrey Brown. Recipients of the 30 year Shire of Wellington (with the exception of Yarram and District) with awards were: Jennifer Lees, Robyn Dingwall, Susanna Gray, centres in Maffra, Sale, Heyfield, Rosedale and Loch Sport. Residential Peter McKenzie, Christine Mundy, Stephen Wilton, Joan Kemp, aged care services are provided at Sale, Maffra and Heyfield. Karen Luxford, Miffy Goss, Susan Baillie, Janine Jones, Anne Traill, Robyn Stone, Patricia Madeley, Robyn Blake, Susan Butcher and The current focus of the Health Service is to use its integration and Denis Robertson. Pictured (from left) at the presentation were break down the traditional program barriers and service delivery Wendy Kelly, CGHS chief executive officer Frank Evans, acting silos that have flourished. We aim to develop a highly efficient deputy director of nursing Sue Roberts, former director of system that responds to people’s needs by placing them at the nursing Bronwyn Beadle, Lois Kingston, director of medical centre of a service delivery system focused on supporting them services Sergey Bibikov, Barb Harper, Karen Luxford, Dennis to achieve their goals and aspirations, consistent with the principles Robertson, Joan Kemp, Patricia Madeley and Sue Butcher.
2 Central Gippsland Health Service Quality of Care Report 2014 REPORT BY THE CHAIR, BOARD OF MANAGEMENT
Glenn Stagg, Helene Booth, Elizabeth (Libby) Thomson, Lesley Fairhall, Louise McMahon, Tony Anderson and myself constituted the CGHS Board of Management for the 2013-2014 year. Glenn Stagg, Lesley Fairhall and my terms all expired on June 30, 2014. Glenn and Lesley have been re-appointed for further terms of three years however I did not seek re-appointment. David Willington has been appointed for a three year term and I congratulate him on his appointment and thank him, together with all the Board Members, for their preparedness to serve our community in this challenging role. You will read in this report that the health service has recorded a very small surplus in its operating budget. This is a disappointing result. The reasons for this outcome are many and varied. The Board and its CEO, Dr Frank Evans, are examining this outcome and its causes with a view to ensuring that a cash surplus is produced in the 2014-2015 financial year. Our health service needs to be able to produce cash surpluses so that it can acquire necessary equipment and refurbish its buildings. We must acknowledge the reality that funding for health from both Commonwealth and State Governments is under more pressure than we have ever seen before. The challenge to all involved in the delivery of health services is to continually find ways of doing more with less. In this regard, CGHS is well served by its innovative and committed CEO. During the year, Members of the Board, executive and staff, visiting medical officers and community attended our Planning Day in November 2013 to discuss issues that are anticipated to affect the health service for the next five years. From these discussions, the Board has adopted a strategic plan to guide its policy making over that period. I wish to thank the many people who contributed their time freely and voluntarily to the development of this most important document.
John Sullivan Board Chair
Central Gippsland Health Service Quality of Care Report 2014 3 CHIEF EXECUTIVE OFFICER’S REPORT
Our Quality of Care Report is made it clear where we are heading and the work needed to get specifically written for you - our there. We will not only retain our significant critical care and clinical community member, patient, client capability, we will continue our efforts to coordinate care for our or carer - providing information patients, clients and residents, placing them at the centre of about our performance and how our work, across every care setting. We will be unrelenting we compare to other similar health in our commitment to do this. services. I would like to acknowledge our Board for providing sound We are grateful to our community governance and clear direction for, and oversight of, the health and consumer groups for providing service and our staff who put the plans into action and hold the us with feedback on last year’s interests of our patients, clients, residents and community at heart. report and how to improve the Our thanks go to our Regional Office for its ongoing commitment content. In particular we thank and support for CGHS and all the health services within the region. them for the contribution they We work in a cooperative environment and we are grateful for the make to the health service by providing us with advice and feedback positive relationship we have with our Regional Hospital (Latrobe) on how we go about our work. and others across the region. Central Gippsland Health Service (CGHS) has a number of advisory These relationships enable us to translate the Victorian Health and consultative groups. The CGHS Community Liaison Group (CLG) Priorities Framework: Rural and Regional Health Plan into a locally is the key community and consumer advisory group for CGHS. The relevant 10 Year Health Plan and Strategic Plan for CGHS, where CLG is responsible to the CGHS Board, supporting the Board and pathways are established for patients and clients enabling them to other consumer groups such as the CGHS Chronic Disease and be at the centre of what is undoubtedly a highly complex system. Disability Network. In closing I would like to acknowledge the contribution of The Chronic Disease and Disability Network (CDDN) provides Mr John Sullivan, Board Chair to the Health Service. John retired advice to CGHS as it reviews and improves client care coordination from the Board on June 30, 2014. John has served a total of 18 years practices and systems across the acute, community and aged care over two periods on the CGHS board, the last seven as Chair. services. Network members have a chronic disease or disability He joined the then Gippsland Base Hospital Board in 1981, serving or are carers of a person with a chronic disease or disability. as its leader from 1988 until 1991 when he retired. John returned to The Rosedale Community Health Centre Advisory Committee the board on July 1, 2006 and was elected Chair the following year, is an advisory committee comprising community members serving until 2010. He took over as Chair again in 2011. One of the representing the Rosedale Community Health Centre. highlights of John’s first stint on the Board was the building of the new 102 bed hospital on its existing site, the only section of the This committee advises on the appropriateness of community original hospital retained was the operating suite. health activities and provides community feedback to the organisation. Members are aware of CGHS plans and priorities, Milestones achieved at CGHS under John Sullivan’s leadership: and contribute to these. They identify and examine the needs of G Reconfiguration and expansion of Emergency Department the Rosedale community in relation to community health programs (2007/08) and act as a forum to explore issues in the delivery of care to G Development of larger and better equipped Dialysis Unit (2007/08) Rosedale residents. G Major redevelopment of Monash University and CGHS learning The CGHS Aboriginal and Torres Strait Islander Advisory Committee services Building (2008/09) (CGHS ATSI) supports CGHS to achieve its strategic goal of: G Redevelopment of former Evelyn Wilson Nursing Home into “enhancing Aboriginal and Torres Strait Islander people’s health Community Rehabilitation Centre (officially opened Sept 2007) and wellbeing”. G Development of Strategic Plan (2008/09) CGHS also is fortunate to have a number of Health Service G Construction of new dental clinic (2008/09) Auxiliaries raising money for the benefit of patients, clients and residents. We are very grateful for the hard work undertaken G Refurbishment of McDonald Wing (2009/10) by our community representatives, auxiliary members and dedicated G Redevelopment of rehabilitation area of medical ward volunteers. CGHS and our community benefit enormously from G Construction of a specific area for centralised intake and their efforts. information (2012/13) Our Consumer Health Advocate has had another busy year helping G Redevelopment of the palliative care suite (2012/13) people to navigate our service and the wider health system to have G Development of 10 Year Population Health Plan (2013/14) their concerns heard and addressed. Alan Murray is our Consumer G Development of Strategic Plan (2014) Health Advocate in addition to being a volunteer community driver. Alan is Chair of our Community Liaison Group and Chronic Disease You can provide feedback on our annual Quality of Care Report and Disability Network, participating on many project teams to help or any matter you might like to bring to our attention via the keep consumer issues at the forefront of our thinking and our work. community feedback portal on our website. Please visit We are grateful to Alan for his tireless efforts. www.cghs.com.au and follow the prompts. This year the Board approved the CGHS Health Plan 2012-2022 and built on this work to develop a new strategic plan for the health service. You can view and comment on these plans on our website: visit: www.cghs.com.au. There is no doubt that we are operating in a very challenging Frank Evans environment. Our 10 year Health Plan and new Strategic Plan have Chief Executive Officer
4 Central Gippsland Health Service Quality of Care Report 2014 STRATEGIC PLANNING
Central Gippsland Health Service (CGHS) has adopted a service of the health service. Once again staff and VMOs were considered delivery capability planning model. The intention is to align all the key stakeholders and encouraged to participate at key times through capability dimensions of CGHS in a way that enables it to achieve the planning process. its mission: to provide health and community services that will The 2014 Strategic Plan was approved by the Board in February 2014 best meet the current and future needs of our community. and a summary plan is provided (below) for your information. All Subsequently the Central Gippsland Health Service Health Plan of the actions contained in the Strategic Plan and 10 year Health 2012 - 2022 was approved in 2013 and formed the primary vehicle Plan are being tracked through Interplan, the integrated electronic for stakeholder participation in the development of the 2014 planning system, along with actions and tasks in business plans Strategic Plan. developed by each CGHS department and service. This ensures achievement of strategic and service delivery objectives. Stakeholder consultation was extended beyond the scope of the Health Plan with a comprehensive environmental scan looking I Below, the Health Planning Cycle. beyond the service delivery and service capability requirements
Central Gippsland Health Service Quality of Care Report 2014 5 NEW STRATEGIC PLANNING SUMMARY
Key areas, goals (outcomes) and objectives
Key area 1 Accountability and governance Goal (Outcome) CGHS performs efficiently and effectively and responds strategically to changing demands Objective Develop and continuously improve transparent governance and accountability systems that are consistent with agreed values and support high performance
Key area 2 People Goal (Outcome) People are as healthy as they can be Objective Develop a system that is responsive to people's needs Goal (Outcome) People are managing their own health better Objective Improve everyone's health status and health experience Goal (Outcome) People have the best healthcare service options possible Objective Expand service capability Objective Expand workforce capability Objective Increase the systems financial sustainability and productivity
Key area 3 Business processes Goal (Outcome) People manage and use knowledge, ICT, facilities and equipment in accordance with documented practices Objective Documented practices support continuous improvement and enable business continuity
Key area 4 Knowledge Goal (Outcome) Care is appropriate and cost effective and delivered in the most appropriate, cost effective settings Objective Increase accountability and transparency Objective Develop a knowledge based culture Goal (Outcome) CGHS is highly productive and sustainable Objective Implement continuous improvement and innovation
Key area 5 Facilities and equipment Goal (Outcome) Physical facilities and equipment enable CGHS service delivery Target Infrastructure upgrades and equipment replacement or acquisitions support agreed service delivery priorities Objective Investments in infrastructure and equipment match service delivery capability priorities
Key area 6 Information and communication technologies Goal (Outcome) Information and communication technologies facilitate CGHS service delivery Objective Increased and more effective utilisation e-health and communication technology
6 Central Gippsland Health Service Quality of Care Report 2014 Fundraising for Oncology Unit expansion Central Gippsland Health Service has reached over a third of the $1 million needed to help fund the expansion of its oncology department. The planned redevelopment will extend the current area to create nine separate patient bays, allowing more privacy for patients and more room for staff and patients. Community fundraising and committed support has seen the progress total reach more than $300,000 which includes a generous donation of $150,000 from John Leslie. The expanded oncology area will greatly benefit local patients. The planned extension will increase chemotherapy treatments provided in Sale while decreasing the travel requirements for local patients. CGHS is grateful to the general public for supporting fundraising events and the general appeal. I Plans for the redevelopment of the CGHS oncology treatment area show the current area extended to the east and south of the existing area in the Waratah Wing, which is accessed from Palmerston Street. The Maternal and Child Health Unit, which shares the Waratah Wing, would remain substantially the same as its current configuration. By utilising small existing courtyards, the oncology area would more than double in size. It currently has room for five patients, with another two squeezed in when necessary.
Play a boost for Oncology Department
The Maffra Dramatic Society’s production of the stage play According to Ms Gardiner, it was her friend and colleague, Calendar Girls earlier this year raised a mammoth $37,285 for Maree Howard, who suggested the society stage the Calendar the Central Gippsland Health Service’s Oncology Department. Girls play as a major fundraiser. The society raised additional funds for CGHS by producing its “I took the idea to the society committee who, despite knowing own calendar to coincide with the event, selling all 1000 copies that we are a less than affluent theatre company, instantly agreed for $10 each while the Sunflower Club raised $575 for the to take on a production which would provide no financial gain,” Leukaemia Foundation through selling merchandise at the Ms Gardiner said. performances. “This was a moment at which I felt a great deal of pride and Overall, it was an especially satisfying result for society president, honour - to not only be a member but indeed the president Rebecca Gardiner. of a volunteer organisation, made up of a group of wonderful people, who were more than willing to take on such a massive “For a very long time now I have wanted to do something for a project.” worthy cause related to cancer and cancer sufferers, having lost my mother to the very same disease,” Ms Gardiner told After the society agreed to the idea, a fundraising committee audiences at the performances “…to be a part of a local project was formed to raise money through sponsorships and donations makes the fulfilment of this personal ambition extra special.” to cover costs as every performance was staged at the Esso BHP Billiton Wellington Entertainment Centre.
Central Gippsland Health Service Quality of Care Report 2014 7 QUALITY OF CARE REPORT
Central Gippsland Health Service is committed to quality, safety G Unplanned return to Theatre within same admission and excellence with the client/patient at the centre of care. G Deaths G Unplanned transfers to Critical Care Unit In line with the Central Gippsland Health Service Strategic Plan, G Unplanned readmissions within 28 days the Health Service reviews and improves on its existing quality G A suite of obstetric screenings including Emergency caesarean framework to ensure systems which embed a culture of continuous and perineal tears. improvement across the organisation are in place to provide our clients with a seamless and coordinated experience, providing All LAOS screening events are entered electronically into the CGHS integrated and timely provision of person centred care. LAOS system and reviewers electronically provide their review. Review of LAOS events is undertaken by a multidisciplinary clinical screening Processes are in place to seek feedback from and engagement process, and records requiring further review are tabled at Clinical with clinical and non-clinical disciplines, consumers and other key Governance and Risk Group for ongoing review and stakeholder groups. recommendations for improvements. The quality team is an integral part of Central Gippsland Health Some examples of changes to practice as a result include: Service and is central to the Clinical Governance and Risk Group, G Trauma guidelines updated and introduction of Trauma assessment which meets twice a month to identify and monitor issues relating form to patient/client/resident safety and quality of service. G Review of Clinical Photography procedure and establishment The Clinical Governance and Risk Group reports to the Quality of electronic storage system for clinical photographs to meet and Risk Committee which meets bi-monthly, has Board of legislative changes Management and consumer representation and reports directly G Improved alerts to streamline management of unwell oncology to the Board of Management. Community and consumer patients presenting to the Emergency department. participation groups work with the Health Service to enable G Revised Emergency department paediatric pain management community and consumer perspectives to be at the centre protocol of continuous improvement efforts. G Revision of burns management guidelines G Shared Care pathway with Latrobe Regional Hospital, for care Comprehensive accountability reports relating to performance of orthopaedic patients. and legislative compliance are presented to the Board on a monthly basis. Medication Management Current Accreditation Status Delivering medication safely depends on providing the right medication to the right patient in the right dose at the right time. The Australian Commission on Safety and Quality in Health Care Central Gippsland Health Service has an active program of monitoring implemented 10 new Australia wide National Safety and Quality any incidents relating to drug administration. Significant incidents are Health Service Standards. reviewed through the Clinical Governance and Risk group and the Central Gippsland Health Service (including Dental services) is Drugs and Therapeutics Committee. currently accredited against the National Safety and Quality Health Organisational incident numbers and trends are also monitored Service Standards gaining full accreditation against all 10 Nationals through the Clinical Safety Group. Standards in October 2013. All Core items were met within the Aged Care medication incidents and management is also monitored Standards and in addition there were 5 Met with Merit ratings through the Residential Aged Care Medication Advisory Group. awarded. Central Gippsland Health Service participated in the Medication Constructive feedback was received by the accreditation body, Safety Self-assessment Program for Australian Hospitals for the Australian Council on Healthcare Standards, following the survey medication management and antithrombotic therapy. visit in 2013 with a number of recommendations made to further A major improvement in medication management has been the enrich care provided. implementation of Smart pumps (Alaris Pumps). These enable Home and Community Service also received full accreditation safe and accurate delivery of Intravenous fluids and drugs. These differ against the Community Care Common Standards in October 2013. from conventional infusion pumps, as the smart pumps are equipped This service met all three Standards. They received a very positive with medication-error-prevention and data-capturing software. A drug report back from the survey with no ongoing recommendations library of intravenous drugs, their standard concentrations, dosing made. CGHS has also met the Community Care Common Standards units, and maximum and for The National Respite for Carers Program and Department of ACHS Medication Indicator minimum infusion rates is Human Services standards for the Making a Difference program. July - December 2013 programmed into the pumps and can be tailored to different Aged Care Facilities, Laurina Lodge, Wilson Lodge, Stretton Park 0.020 patient groups and medical and McDonald Wing all hold current Aged Care Accreditation.
0.02 conditions. The J H F McDonald Wing at Maffra underwent its accreditation 0.015 I This graph shows that Central survey in July 2013 and met all 44 standards. Gippsland Health Service had How does Central Gippsland Health Service no significant medication 0.010 monitor issues? incidents, and compares well when benchmarked through Limited Adverse Occurrence Screening (LAOS) the Australian Council 0.005 on Healthcare Standard The Limited Adverse Occurrence Screening process has been Indicators. in place at Central Gippsland Health Service since April 2005. 0 The occurrences screened include: G Peers Medical Emergency Team calls CGHS 0 G Cardiac Arrest
8 Central Gippsland Health Service Quality of Care Report 2014 Prevention of Pressure Ulcers Safe use of blood and blood products Pressure Ulcers result from damage to the skin when patients Central Gippsland Health Service employs a Transfusion Trainer are unable to move freely in bed. Nurse who monitors use of blood and blood products and reports through to the Blood Transfusion Group. Any serious There are six levels of severity and recognising the subtle changes adverse reactions to blood or blood products are reported in the skin before it breaks down has a major influence on reducing through the Serious Transfusion Incident reporting system. the occurrence of pressure ulcers. There have been no serious adverse reactions reported. CGHS Regular audits of pressure injury management are conducted and also participates in the 2013 Blood Matters survey which audited results are discussed by the Clinical Safety Group. Risk assessment acute transfusion reaction knowledge and management. The results and strategies to prevent and manage any pressure injuries are of this audit have shown that CGHS benchmarked well with other discussed with clients as part of the pressure injury management health services. Improvement areas identified were the need for strategy further education to improve staff knowledge and awareness of acute transfusion reactions and access to additional resources for Central Gippsland Health Service submits Pressure Ulcer Clinical staff to improve their acute transfusion management skills. Indicators six monthly to the Australian Council on Health Care Standards. A system to monitor blood wastage has been implemented as part of our requirement to meet the National Safety and Quality Health ACHS Pressure Area Indicator Service Standards - Standard 7 Blood and Blood products. July - December 2013 At left is a graph of the Significant Adverse Transfusion 0.08 Events July - December 2013 incidence of significant adverse transfusion events 0.08 0.08 0.5 relating to a blood transfusion 0.06 benchmarked through the Australian Council on 0.4 0.48 0.04 Healthcare Standard Indicators I Central Gippsland Health 0.3 0.02 I This graph shows Central Service has not had any Gippsland Health Service episodes of significant comparison with peer 0.2 transfusion reactions. 0 hospitals. Peers CGHS 0.1 Falls Monitoring
0 0 Central Gippsland Health Service continues to identify those patients who are at increased risk of falls in the hospital setting, as well as in Peers CGHS their home environment.
Falls risk assessment tools and falls minimisation plans are developed The graphs below show benchmarked results for July - December and continuous improvements implemented in acute, community 2013. There also continues to be above benchmark results for these services and aged care. Completion of assessments and two indicators graphed below. implementation of plans continue to be audited. The Clinical Safety Group meets regularly and continues to monitor Transfusion Episodes RBC Transfusions data related to falls, especially incidents reported. where informed patient where haemoglobin level consent was not documented is 100g/l or more Falls minimisation education strategies include development of a falls July - December 2013 July - December 2013 information sheet for staff. Monitoring of falls is also included as part of the Productive Ward Project 2.5 2.5 The result of benchmarking ACHS Falls Indicator 2.0 2.0 July - December 2013 through submission of Falls Clinical Indicators to the
0.38 Australian Council on Health 1.99 1.5 1.5 1.86 Care Standards is presented 0.38
at left and shows the Health 1.5 0.37 Service remains below 1.0 1.0 the peer benchmark. 0.36 0.5 0.5
0.35 0 0 0 0.35 Peers Peers CGHS 0.34 CGHS Peers CGHS
Central Gippsland Health Service Quality of Care Report 2014 9 Incident Reporting Pressure Areas Falls Rate Central Gippsland Health Service promotes a robust incident % Rate % Rate reporting system. 1.0 15 Staff are encouraged to report both clinical and non-clinical incidents, through the Incident reporting system. Regular 1.05 0.8 12 14.7 monitoring and management of incidents takes place within the Quality Department in conjunction with relevant managers 11 and governance groups. Significant reported incidents are tabled at 0.6 9 the fortnightly meeting of the Clinical Governance and Risk Group, with specified reporting to the Quality and Risk Committee. 0.63 0.4 6 Occupational Health and Safety Incidents are monitored by the HR Consultant - Occupational Rehabilitation and Injury Management and the Health, Wellbeing and Safety Officer in conjunction with relevant 0.2 3 managers. Central Gippsland Health Service is part of the Department of 0 0 Health Incident Monitoring system Victorian Hospitals Incident State State CGHS Management System (VHIMS). CGHS Reporting of incident information to the Department of Health, with the people involved de-identified, occurs monthly. This reporting helps enable state-wide trending of incident types Fractures as a result of a fall Restraint and frequency, which shall be provided to health services by % Rate % Rate the Department of Health. 0.30 2.5 Public Sector Residential Aged Care Quality Indicators
Central Gippsland Health Service submits Aged Care Quality 0.25 0.27 2.0 Indicators for its public sector residential Aged Care facilities, 0.26 Wilson Lodge and JHF McDonald Wing. 0.20 1.5
Benchmarked results show that the Health Service is below 1.66 the state average in all indicators. 0.15 1.0 I The graphs at right show results for Central Gippsland Health Service aged care, from 1 October 2013 to 31 March 2014. 0.10 0.5 Hand hygiene 0.67
In 2013, all clinical areas were audited for compliance with 0 0 the 5 Moments of Hand Hygiene over the 12 month period. State State Compliance for 2013 at Central Gippsland Health Service was 78.7% CGHS CGHS which was calculated from 1354 observed hand hygiene moments. This is slightly above the Hand Hygiene Australia aggregate for 2013 of 78% and well above the national requirement of 70%. Multiple medication use Unplanned weight loss Wards nominated for National Data Submission for the last % Rate % Rate 12 months have been the Critical Care Unit, the Level 3 Nursery in Women and Children’s Unit and the Emergency Department. 10 2.5 Critical Care is a compulsory inclusion for auditing of hand hygiene due to the high acuity level of patients. 8 2.0 For collection of national data at least 100 moments must be 8.75 observed and recorded from each nominated area in the audit 6 1.5 period. A result of 80.85% compliance was achieved for these 1.56 areas and has been reported through to Hand Hygiene Australia as a requirement of the National Hand Hygiene Initiative. National 4 1.0 data collated for this period saw a compliance rate of 79.2%
The hand hygiene stations located at the entrance to our three 3.73 2 0.5 0.77 major campuses continue to be well utilised by all who enter our Health Service and have done much to promote the importance of hand hygiene in the organisation. 0 0 State State CGHS CGHS
10 Central Gippsland Health Service Quality of Care Report 2014 Thrombolysis Implementation Plan for Stroke The Community Liaison Group meets on a monthly basis with the (TIPS) Project CGHS Executive Team. Among many achievements over the past year, members have played a key role in supporting the health The Thrombolysis Implementation Plan for Stroke (TIPS) Project service in preparation to undertake the process of being evaluates the effectiveness of a strategy to increase the adoption accredited as a Communication Accessible Organisation. of best evidence practice. The group regularly provides its comments on written information It is a cluster randomised controlled trial in acute stroke care. that has been developed for distribution to clients and patients. Stroke is the second leading cause of death and the leading cause Throughout the year, members of this group have supported of long-term adult disability in Australia. It is proven that thrombolysis consumer feedback by facilitating patient satisfaction surveys to therapy is a powerful and cost effective treatment in stroke care. capture the views of our patients in ‘real time’ in order for us to However in Australia, less than one-quarter of patients who could respond to comments in a timely manner. benefit from thrombolysis receive it. An evidence practice gap As a result of conducting the surveys, a number of improvements currently exists in thrombolysis for ischaemic stroke; however have been implemented on the wards. Members of the Community there is little evidence about how to most effectively reduce this. Liaison Group are also participating on a CGHS Car Park committee The project began in 2010 and is a five year project. The Principal which has been established this year. The aim of this committee is Investigator is Dr Krishna Mandaleson, and the team is led by Jenny to support CGHS to provide sufficient parking for all patients and Dennett, Nurse Unit Manager (NUM), Critical Care Unit (CCU) with visitors taking into consideration the needs of people who require trial coordinator Anne Van Berkel. Twenty hospitals are participating, minimal distance and ease of access to our facilities due to mobility and CGHS was randomised to the intervention arm of the study. limitations. CGHS has been provided with onsite expert-led training for relevant The Consumer and Carer Chronic Disease and Disability staff to develop a minimum skill base to implement the intervention. Network continues to meet monthly with a prime focus on the This project will rigorously evaluate a methodology to improve care coordination framework. The support and advice this group implementation of complex interventions by addressing the brings to the direct service delivery has been invaluable and it implementation of acute stroke therapy (thrombolysis), a major continues to assist in improving direct care to clients. public health issue in Australia. The lessons gleaned from this The network provides membership to the organisation’s Care evaluation will be relevant to many other aspects of health care Coordination Project Steering Group and a sub-group - the Home delivery in terms of increasing evidence-based practice. If successful, and Community Care (HACC) Workforce Redesign Project - as well this study will have immediately delivered improved implementation as the Quality and Risk Committee, which is a subcommittee of the of stroke thrombolysis across 10 major hospitals. Board of Management. The findings will provide a platform for national roll-out of The Rosedale Community Health Centre Advisory Committee a thrombolysis implementation plan across Australia. meets on a bi-monthly basis and provides one of the links between CGHS has been provided with up to date and evidence based this community and the Health Service. Chaired by Tom Wallace, educational material on thrombolysis for all members of the the committee has supported the development of the CGHS Health multidisciplinary team and the site champions to use and distribute Plan, as well as advocating on behalf of its community on a variety to relevant staff. of issues. A web-based stroke training module has been provided for medical This year, the health service has re-established the Central and nursing staff. Two selected nurse champions, Kate Roberts, Gippsland Health Service Aboriginal and Torres Strait Islander NUM Emergency Department and Sue Dobson, Associate NUM Advisory Committee. This committee will support and assist Emergency Department, have completed NETSMART, an intensive the health service to undertake the work needed to achieve web-based education package for advanced stroke management. the strategies contained in the Aboriginal Health Plan. Potentially CT scan imagery can be exported to smartphones of A member of each consumer group participated and contributed physicians on call after hours to speed up thrombolysis. valuable input in the Strategic Planning day held earlier in the year. Bi-monthly teleconferencing with implementation sites allows CGHS also has many less formal, but equally important links to collation of data and assists with benchmarking. other community based groups. CGHS acknowledges the tremendous work and dedication from all community and Consumer, carer and community participation consumer groups, whether formal or informal. Consumer, Carer and Community participation, through a number More information about these consumer groups can be found on of key consumer groups and the Consumer Advocate, assists the health service website under the banner About Us/Our People. Central Gippsland Health Service to continually improve and provide the services that best meet the needs of the community. Carers recognition This is important from the perspective of consumers of health and CGHS has continued this year to support the knowledge and community services, and from the wider community. All consumer capacity of all Community Carers by providing a number of networks are chaired and vice chaired by community members. nationally accredited units of training. The Consumer Advocate, Alan Murray, continues to play an active This year 18 Community Carers successfully completed all required and important role in advocating for patients and clients. The results units of learning and obtained their Statements of Attainment of a recent evaluation of this position have reinforced the benefits which were presented to them at this year’s Graduation Ceremony. of having an independent advocate to liaise between the community and the health service. These units of learning are expanding the skills and knowledge of Community Carers, and will enable them to provide a range of services during the one visit.
Central Gippsland Health Service Quality of Care Report 2014 11 HACC Workforce Redesign Project - Reablement Model Instead of the traditional model of doing things for the person, such as helping them get up and dressed, Community Carers, with the This year, as part of the HACC (Home and Community Care) guidance and support of clinicians, actively assist people in doing Workforce Redesign Project, Central Gippsland Health Service things for themselves. This means staff are more likely to stand back has undertaken a pilot titled “Reablement”. This pilot has involved and give encouragement, or show the person a new way of doing patients who live independently but have had a recent admission something, such as using a perching stool for support while they to hospital. wash themselves rather than being washed by the Community The Reablement Model supports people who are either frail, Carer. This takes longer than traditional home care support, recovering from an illness/injury or have a disability. The aim which is why visiting times tend to be longer. of Reablement is to help people regain their ability to perform Staff focus on assessments to measure how the person is improving usual daily activities like cooking meals or maintaining their home. as time goes on in order to record progress and plan their ongoing This can support people to stay independent and remain living support. in their own home. This is achieved through people relearning how to do things for themselves rather than the customary home care Finally, staff may introduce equipment or modifications to the approach of doing things for people. person’s home. The equipment and modifications might be temporary, to help Reablement, or permanent, to help keep Reablement is usually offered as a short term (normally up to six the person safe and independent at home. weeks), intensive service for people who have just come out of hospital or who have recently experienced a significant illness or Governance and Community Accountability injury, to help them regain their abilities and confidence as soon as possible. Reablement support may be extended slightly if cutting Consultation took place over the past year with the Community the service off at that point is likely to reverse or limit the progress Liaison Group, seeking its input into the Quality of Care Report. made. Additionally, because Reablement is an intensive service, it The Governance Accountability Framework is continuously is likely staff may visit more frequently and stay for longer than the modified and improved to ensure that key performance traditional home care service. indicators adequately report the performance of CGHS Participants in the pilot meet with a Care Coordinator to discuss across the governance domains. the goals they would like to achieve to regain their independence. This framework enables accountability and transparency on Clinicians (a multidisciplinary team) from appropriate services, for a number of fronts, including to various funding bodies, local example physiotherapist, occupational therapists, etc, then visit and government and more importantly, the community. assess the person’s existing abilities and needs with their agreed goals central to their planning. Over the next few days or weeks, The framework responsibilities have been assigned to the the person is supported to regain physical function, relearn skills various committees within the organisation’s Quality Structure, or if necessary learn different ways of doing daily activities such as ultimately reporting to the Board of Management. meal preparation, cleaning and dressing. I The CGHS Community Rehabilitation Centre.
12 Central Gippsland Health Service Quality of Care Report 2014 OUR HISTORY
A hospital is the heart of a community, playing an important role The former Evelyn Wilson Nursing Home was redeveloped into in the lives of many of our citizens. the Community Rehabilitation Centre in 2007 while the Monash University and CGHS Learning Services Building opened in The Central Gippsland Health Service (CGHS) and its predecessor, 2008/2009. the Gippsland Base Hospital, together with various other smaller service entities, have provided health care to citizens of what is The new Dental Clinic was built in 2008/2009, the McDonald now the Wellington Shire for almost 150 years. wing refurbished in 2009/2010 and more recently there was a redevelopment of the rehabilitation area in the medical ward. CGHS is now the major provider of health and residential aged care services in the Shire with more than 70 acute beds: 180 high and low The next major infrastructure project for CGHS will be the care residential aged care beds as well as 15 independent living units. expansion of its Oncology Unit, estimated to cost $1 million. Through a series of amalgamations, the Gippsland Base Hospital, Today’s CGHS Board and staff continue to uphold the service Maffra and District Hospital, the JHF McDonald Wing Nursing and spirit of those early pioneers who worked so hard to Home and Evelyn Wilson Nursing Home became CGHS in 1999. establish a hospital in the 1860s. The Heyfield Hospital, Stretton Park and Laurina Lodge Hostel became associated with CGHS by management agreement. Governance CGHS provides management and corporate services to the two Central Gippsland Health Service is a Body Corporate listed in not-for-profit private facilities, Stretton Park Hostel Inc and Heyfield the Victorian Health Services Act 1988 and operates under the Hospital Inc. provisions of this Act. The current hospital was built on the existing site in 1990. The only The Minister responsible for the administration of the Victorian section of the original hospital retained was the operating suite. Health Services Act during the reporting period was Since then, it has undergone significant upgrades including the The Hon. David Davis. reconfiguration and expansion of the Emergency Department in The registered office of Central Gippsland Health Service is 2007/08 and the development of a larger and better equipped 155 Guthridge Parade, Sale, 3850. Telephone (03) 5143 8319. Dialysis Unit in 2007/08. I Gippsland Base Hospital staff in 1913.
Central Gippsland Health Service Quality of Care Report 2014 13 BOARD OF MANAGEMENT
John Sullivan, Glenn Stagg, Vice Chair: Helene Booth: Board Chair: Accountant, Director Accountant, partner of Lawyer, former Chair of DMG Financial, Booth Cartledge Sellings of the Gippsland Base former Board member (BCS) Accountants in Sale Hospital Board and of the Gippsland Base and member of the CGHS member of the CGHS Hospital and Chair of Audit Committee. Credentials & the CGHS Quality & Appointments Committee. Risk Committee.
Lesley Fairhall: Louise McMahon: Tony Anderson: Finance Manager at the Manager of Rosedale Rabobank Branch Manager, Wellington Shire Council Pharmacy, Pharmacist former Manager, Sales and and former Resource at Latrobe Regional Marketing - Agribusiness - Officer at the Department Hospital and former National Australia Bank of Defence. secretary of Traralgon and member of the CGHS Arts Council. Audit Committee.
Libby Thomson: Executive Staff Long term Division 1 nurse, As at 30 June 2014 former staff member of Chief Executive Officer: Dr Frank Evans Maffra and Sale Hospitals Director Medical Services: Dr Sergey Bibikov and member of the CGHS Director of Nursing: Ms Denise McInnes Quality & Risk Committee. Libby is also involved in the Director Community Services: Ms Mandy Pusmucans agricultural sector through Director of Affiliated Health Service: Mr Wayne Sullivan involvement in the family Solicitors: Ms Lucy Hunter, Latrobe Regional Hospital, Legal Counsel farm. Banker: National Australia Bank Limited
Workforce data: Central Gippsland Health Service labor category details for the period YTD 2013 -14
Labour Category June Current Month EFT June YTD EFT 2013 2014 2013 2014
Administration & Clerical 90 83 84 82
Ancilliary Support Services 37 49 39 43
Hospital Medical Officers 25 26 24 26
Hotel & Allied Services 153 158 155 154
Medical Officers 20 18 19 19
Medical Support Services 46 45 45 45
Nursing Services 265 267 261 265
Total 635 645 626 635
Central Gippsland Health Service 635 645 626 635
Heyfield 41 40 42 41
Stretton Park 26 25 25 25
Total EFT for the Whole Network 702 710 693 700
14 Central Gippsland Health Service Quality of Care Report 2014 OVERVIEW OF SERVICES
Acute Care
Clinical Visiting Specialist Services Support Services - Acute Outpatient Services Cardiology General Surgery Infection Control Continence Critical Care Genetics Wound Management Podiatry Day Procedure Oncology Professional Development Cystic Fibrosis Dialysis Ophthalmology Pharmacy Audiology Emergency Paediatric Surgery Environmental Antenatal Rehabilitation Paediatric Endocrinology Care Coordination Stomal Therapy Hospital in the Home Paediatric Rehabilitation Clinical Trials Obstetrics and Gynaecology Colorectal Surgery Paediatrics Ear, Nose and Throat Oncology Dermatology General Medicine Gastroenterology General Surgery Urology Operating Theatres Orthopaedics Pre Admission Renal IVF Vascular Surgery
Aged Care Services
Residential Care Respite Care Independent Living Units Maffra - McDonald Wing Heyfield - Laurina Lodge Maffra - Stretton Park Sale - Wilson Lodge Nursing Maffra - Stretton Park Hostel Home Heyfield - Laurina Lodge Maffra - Stretton Park
Community Services
Allied Health to both Home Support and Partnerships Community Support Groups the Acute and Service Co-ordination Wellington Primary Care Childbirth Education Classes Community Settings Personal Care Partnership Parkinson’s Support Group Physiotherapy Respite Care Wellington Shire Carers’ Support Groups Occupational Therapy Delivered Meals Gippsland Regional Palliative New Mothers’ Group Exercise Physiology Property Maintenance Care Consortium Co-located Visiting Services Podiatry and foot care Planned Activity Groups Gippsland Sustainable Health Services Community Mental Health Dietetics Community Transport Gippsland Health Services Family Court Counselling Speech Therapy Care Coordination Partnership Family Mediation Social Health Carer Respite Gippsland Closing the Gap Primary Mental Health Koori Liaison Centralised Information Gippsland Regional Cancer and Intake Disability Services Community Health Services Community Health Nursing Home Nursing Respiratory Educator District Nursing Diabetes Educator Palliative Care Maternal and Child Health Continence Nurse Volunteer Program (CAVA) Consultancy Community Dental Program Health Promotion
Central Gippsland Health Service Quality of Care Report 2014 15 Support Services Human Resources
Finance Payroll Occupational Health & Safety Financial and Management Payroll Risk Management Reporting Salary Packaging WorkSafe/Return to Work Accounts Payable Accounts Receivable Fleet Management
Support Services
Engineering Supply Services Food Services and Catering Building Maintenance Supply & Development Accommodation Management
Information Services
Medical Records Information Technology Library Education Freedom of Information/ Privacy
Administration
Strategic Planning Business Units Fundraising Medical Imaging Quality Management Linen Service Consulting Suites
16 Central Gippsland Health Service Quality of Care Report 2014 LINEN SERVICE
Linen service investment for the future $2.4m in revenue. The new equipment has created the opportunity for the service to increase its business by 50 percent.
Central Gippsland Health Service has invested $1.3 million The Sale service has been long overdue for an upgrade to modern in installing state-of-the-art equipment for its Linen Service. equipment such as a batch washer and associated machinery (drying, ironing and folding machinery). The investment will secure the service’s position as a high quality, high achieving linen provider for the next 20 plus years as well as As well as the environmental efficiencies, the continuous batch the 40 employment positions. washer (CBW) significantly reduces manual handling and improves quality control. A computer monitors loads from the conveyor belt, The equipment, from German company, Kannegeisser, was installed through the entire washing and drying process. in mid-December and has still not reached its full capacity. The three gas-fired dryers work in conjunction with the CBW Not only does the equipment increase production, but significantly and are also extremely efficient with regards to utilities as well improves environmental efficiency by cutting electricity, water and as extending the useful life of linen. steam use. The gas-fired ironer has the ability to double the previous ironing Water use has reduced from 25 litres of water per kilo of linen production and the new towel folding machine is not only more to eight litres. This water saving alone is the majority of saving efficient but has improved occupational health and safety features. that will fund the purchase of new equipment. The new continuous batch washer is processing 1200 sheets per day, The linen service has been operated by CGHS since the 1950s 3000 towels and between 600 and 700 blankets as well as many and has 137 clients across multiple service models including health, smaller items. The ironing machine does 600 blankets an hour hospitality and other private industries. and 1000 sheets an hour. In a climate where this type of service has been privately I outsourced by most hospitals, it is a credit to staff that it has General Manager Support Services Jon Millar and Linen Service remained competitive for so long, now generating in excess of Manager Robert Stewart are pictured with the continuous batch washer, part of new Linen Service equipment, installed earlier this year.
Central Gippsland Health Service Quality of Care Report 2014 17 STRUCTURAL FRAMEWORK Medical Imaging Manager Service Medical Imaging Support Services ICT and Food Supply Services Services Services General Manager General Sale Linen Engineering Maintenence Environmental Director Affiliated Park Stretton Heyfield Hospital Health Services Incorporated Incorporated Finance and Payroll Switch Finance Reception General Manager General Chief Executive and Fleet and Learning Safety Library Human Services Services Learning Resource General Manager General Health and Occupational Intake Management Management Workforce Capability Workforce and Care Coordination Director Care Services Public Dental and Nursing Support Services Allied Palliative Health Health of Community Support Community Services Home and Community Community Partnerships Director of Nursing HITH Units Suite Acute Lodge Maffra Wilson District Theatre Hospital Inpatient Pharmacy (inc. CSSD) Emergency Department Services Services Operations and Hospital Clinical Patient and Client Patient Specialist Nursing (inc. Pre-admission and General Intake) CGHS Health Rooms Consulting Information Management Quality General Manager General Medical Admin, Medical Admin, Risk and Special Projects Medical Services Medical Specialists Visiting Medical Officers Hospital Medical Officers Director of Director I I I
18 Central Gippsland Health Service Quality of Care Report 2014 SUPPORT GROUPS
New curtains for Surgical Ward
The Friends of Central Gippsland Health Service purchased new curtains for the Sale hospital’s surgical ward. Friends group treasurer, Athol Jones and other members presented $5000 for the curtains. Donations which went towards the curtains included funds from Carols by Candlelight, the Lions Club sausage sizzle, the Christmas wrapping fundraiser at the Gippsland Centre Sale, the Friday Crafters at the Gippsland Centre Sale and Ritchies IGA Community Chest. The Friends’ Easter raffle also raised $1700.
I Pictured right, the Friends of CGHS inspected the new surgical ward curtains they helped purchase. They are pictured with surgical nurses Emmy Lina (left) and Jessica Tonkin.
Support for families Friends of Central Gippsland Health Service
Parents with young children face all kinds of challenges from finding Once again we had a very successful year with the businesses and time to take a break to keeping appointments. members of the community supporting our fundraising efforts. It is these kinds of issues that the Maternal and Child Health Service We are very grateful for donations from Richies IGA, Leckies Store, at Central Gippsland Health Service (CGHS) has addressed with an the Lions Club of Sale, Wellington Craft Ladies, Sale City Band from innovative volunteer program it introduced earlier this year. the Carols Night, Gippsland Centre Sale, the Sale Greyhound Racing Club’s Bingo Night and others. Maternal and child health nurses identified a need for such a service after talking with mothers of young children. These donations have been used to purchase equipment for the hospital. The Wellington program involves a volunteer committing to two hours a week for eight weeks with a family. After the initial training, I would like to express a special thankyou to members of the there are additional monthly training /support sessions. executive team and administration staff at the Central Gippsland Health Service for their assistance. A mother may require help with shopping, getting to appointments, attending community activities or need an extra hand with the A special thankyou goes to our committee members for their time children and may benefit from some guidance with organising and assistance throughout the year and finally, I would like to pay a household. tribute to the public for their ongoing generosity and support of CGHS services. The training covers things such as communication, listening skills, promoting learning through play and music, breastfeeding, infant Elva Doolan-Jones and toddler nutrition, normal development, understanding President behaviour, safety, mild illnesses, emotional wellbeing and general life skills. Maffra Hospital Auxiliary I Pictured below is one of the many happy participants taking part in regular activities at the Maternal and Child Health As president of Maffra Hospital Auxiliary, I am pleased to say that we Service at CGHS. have had another successful year with the help of a very dedicated group of members. We have been happy to welcome four new members to the group which is great. Once again we ran a rewarding High Tea event on Oaks Day, Christmas and Easter raffles, a morning coffee and a sausage sizzle. This allowed us to give funds to Maffra Hospital for whiteboards which are used for the clients in McDonald Wing. Physiotherapy equipment is also being purchased with our funds. There are quotes being sourced for further funds to be used later in the year. This is my last year as president so I would like to thank my hard working members for their support throughout my time as president and look forward to being able to help the next president and committee as we continue to fund projects that help our friends at Maffra Hospital. Jill Cameron Maffra Auxiliary President.
Central Gippsland Health Service Quality of Care Report 2014 19 DONATIONS
Esso donation to Emergency Department “It gives Esso and BHP Billiton great pleasure to be able to continue our long term support of local community organisations like CGHS which we have been contributing to for more than 30 years,” Esso Australia Resources Pty Ltd and BHP Billiton Petroleum (Bass Mr Olson said. Strait) Pty Ltd saw the benefits of their recent donation to Central Gippsland Health Service (CGHS) at a recent visit. Among the visitors to the hospital was Longford Plants manager, Monte Olson, who was thrilled to see the benefit of his company’s The company donated $10,000 to the Emergency Department last donation. year for the purchase of vital equipment, bringing its total financial support since 1982 to over a quarter of a million dollars. “This is an example of how local industry can genuinely help the people of Gippsland through the provision of additional health The equipment includes a dust extraction plaster saw which greatly care equipment.” improves the speed and safety associated with plaster removal. Two Phillips End Tidal Carbon Dioxide Monitors were also purchased and are used for ventilated patients, providing vital information on Individual support the patient’s respiratory function. Central Gippsland Health Service gratefully acknowledges the In addition to the Emergency Department donation, the company support of individuals, families and organisations who gave also supported the CGHS 2013 Spring Ball, raising funds for the donations of cash or equipment during the past year. redevelopment of the CGHS Oncology Department. Because of issues which may arise due to the Privacy Act, I Pictured below, CGHS Emergency Department senior medical CGHS has chosen not to list personal names in this report. officer Dr John Hambly (second from left) demonstrates the dust Total contributions received 2013/2014: extraction plaster saw to (from left) Longford Plants manager Monte Olso, CGHS chief executive Dr Frank Evans and G Capital Donations: $320,920 Occupational and Evironmental physician with Esso, G General Donations: $22,118 Dr Nathan Pastor. G Clyne Estate: $118,839
20 Central Gippsland Health Service Quality of Care Report 2014 FUNDRAISING
“Hollywood” night a hit
Around 280 people walked the “Hollywood” red carpet at the annual Central Gippsland Health Service Ball and raised more than $23,000 for the Sale hospital’s oncology redevelopment. The theme for the night was “Hollywood” and many guests came dressed for the part with awards going to the best dressed women and men. Guests included National Party MHR for Gippsland, Darren Chester. Held at the Gippsland Regional Sports Complex, guests danced the night away to the music of Soul Tanas and Ricky Wood. Master of Ceremonies was Sale councillor Darren McCubbin while fellow councillor and local real estate agent Leo O’Brien conducted the “live” auction. Organisers of the event thanked guests for supporting the night with a special thanks to the sponsors for their generous donations of cash and auction goods. Plans for this year’s ball are already underway with the theme “Bond 007”.
I Pictured at left, guests enjoy the annual CGHS ball.
Shaping up for Bikeathon
Local bike riders are getting into shape for this year's annual bikeathon to raise funds for Central Gippsland Health Service. Funds from the 21st annual event late last year have been used by CGHS to purchase an Apnoea Monitor for the Women’s and Children’s Unit and a dialysis chair for the Dialysis Unit at the Sale hospital. The last bike relay raised $15,000 and attracted 21 teams of riders, most of whom completed the trip from Sale to Lake Tyers and return. The team from Southern Rural Water at Maffra raised the largest amount of $2000. Riders stay at the Lake Tyers Caravan and Camping Park with the entry fee cost of $85 for adults and $55 for students. Staff from the hospital kitchen organise meals for the participants. This year's event is on the weekend of November 8 and 9. For more details contact either Shirley Mowat on 0488 045 484, Edward Pickering on 5143 2230 or Colin McQuillen on 0400 174 700.
I Pictured at right is Southern Rural Water bikeathon team member Colin McQuillen being congratulated by CGHS CEO Frank Evans on a marathon effort in last year’s event.
Central Gippsland Health Service Quality of Care Report 2014 21 OUR PEOPLE
Senior Management Team Emergency Medicine Ophthalmologist as at 30 June 2014 Senior Medical Officers Mr A Amini Dr J Hambly Orthopaedic Surgeons Chief Executive Officer: Dr Frank Evans Dr A Richards Mr P Rehfisch Dr S Williams Director of Nursing: Ms Denise McInnes Otorhinolaryngologists (ENT) Dr F Sundermann Director Community Services: Mr S Chan Forensic Medical Officer (Affiliated) Ms Mandy Pusmucans Mr B Cook Dr R Hides Mr PJ Guiney Director of Medical Services: Gastroenterologist Dr Sergey Bibikov Paediatricians Dr M Ryan Dr A Erasmus (until February 2014) Director of Affiliated Health Services General Practitioners Dr. O Welgemoed (Heyfield Hospital and Stretton Park Dr Y Ahmad Dr M Pillay (until June 2014) Hostel): Mr Wayne Sullivan Dr S Anderson Paediatric Endocrinologist (Consulting) General Manager, Finance: Dr M T Baker Dr J Brown Mr Daryl Cooper Dr F Begum Paediatric Peer Reviewer General Manager, Support Services: Dr JM Bergin Dr J Tam Mr Jon Millar Dr A Burk Paediatric Rehabilitation Physician General Manager Medical Services: Dr P Dandy A/Prof H Rawicki Ms Lisa Neuchew Dr RJ Hides Dr G Ivanoff Paediatric Surgeons Dr Y Jiang Mr C Kimber Senior Medical and Dr B Johnston Mr N McMullin (retired December 2013) Dental Staff 2013-2014 Dr RH Melville Mr P Ferguson Dr DA Monash Palliative Care Practitioners Anaesthetist Consultant Dr D Mudunna Dr A Burke Dr A Dell Dr IC Nicolson Dr J Fischer Dr R Knoesen Dr C O’Kane Dr H Gregory Anaesthetist Peer Reviewer Dr R Nandha Dr Scott King Dr R Dawson Dr G Pathania Dr B McDonald Dr A Roberts Anaesthetists GP Pathologists Dr K Seach Dr N Atherstone Dr A Haddad Dr K Sirimanne Dr N Fuessel Dr P Jayasurya Dr H Stanley Dr J Lancaster Dr M Peiris Dr P Stevens Dr R Nandha Dr S Rorke Dr F Sundermann Dr C O’Kane Dr LA Waters Physicians Dr A Wong Dr AJ Watt Dr H Connor Cardiologist Dr AJ Wright Dr V Das Dr A Wilson Dr K Mandaleson General Practitioners Consultant Cardiologist (Interventional) Dr M Van der Heiden Dr A Hughes Dr S Palmer Dr RW Ziffer IVF/Gynaecology Dentists Radiologists Dr G Weston Dr JJ Gibson Dr T Kulatunge Dr C Law Nephrologist Dr K Stribley Prof D Power Dr R Malouf Surgeons General Dr V Roberts Dr B Pedrotti Mr A Aitken (until June 2014) Dr T Ranten Nuclear Medicine Physician Mr A Sarkar Dr J Roberts Dr Y Jenkin Mr P Strauss Dr Y Stevens Obstetricians & Gynaecologists Mr S Syed Dermatologists Dr B Aali Surgeon Honorary Dr C Baker Dr R Guirguis Mr I McN Miller Dr D Gin Dr RJ McKimm (retired August 2013) Surgeon (Locum) Dr J Horton Dr A Sarkar Mr I Farmer (RIP March 2014) Dr A Mar Obstetricians GP Surgeon Upper GI Dr R L Nixon Dr C O’Kane Mr S Banting Dr D Orchard Dr AJ Wright Surgeon Vascular (Consulting) Director Medical Services Obstetricians (Locums) Mr N Roberts Dr S Bibikov (until June 2014) Dr T Chong Surgeon Colorectal (Consulting) Echo Cardiologist Dr S Alemu Assoc/Prof John Mackay Dr J Gutman Oncologist (Medical) Dr S Joshi Urologists Assoc Prof M Frydenberg Oncologist (Radiation) Mr P McCahy Dr A Kuyumcian
22 Central Gippsland Health Service Quality of Care Report 2014 Acute Services Affiliated Health Services Workforce Capability Director Critical Care and Director Affiliated Health Services and Learning Emergency Services: Dr Howard Connor (Heyfield Hospital & Stretton Park): General Manager: Denise McInnes Deputy Director of Emergency Services: Wayne Sullivan (until March 2014). Suzanne Askew Dr John Hambly Heyfield Hospital Clinical Care Manager: commenced as Acting Manager, Learning Services in March 2014. Head of Anaesthetics: Dr Arthur Dell Belinda Cornwall Librarian: Helen Ried Director of Aged Care: Dr Krishna Mandaleson Stretton Park Hostel and Human Resources Manager: Hannah Atkins Director of Pharmacy: Mamdouh George Independent Living Units Deputy Director of Nursing and Quality Stretton Park Nurse Unit Manager: Improvement Manager: Dianne Matcott Vino and Sally Weatherly Business Units Hospital Co-ordinators: Wendy Harwood, Business Units General Manager: Therese Smyth, Judy Niziolek, Janny Steed, Residential Aged Care Jon Millar Michael Hams, Sue Shadbolt, Medical Imaging Practice Manager: Dianne Matcott, Caroline Rossetti, Wilson Lodge Nursing Home Simon Waixel Jo Bennett, Jennifer Dennett, Gary McMillan, Nursing Unit Manager: Melissa Hogan Sue Roberts, Tim Coles, Tanya Stiles, Sale Central Linen Service Manager: Tracy McConnell-Henry, Anne Woollard Robert Stewart Community Services Surgical Services Manager Home Nursing & Support Services: Kylie Clarke Nursing Unit Manager, Surgical: Allied Health Managers: Gary McMillan Alethea Leendertz, John Heath (until July Nursing Unit Manager, 2013), Keren Fuhrmeister, Kathy Cook Perioperative Services: David Curtin Community Health and Partnerships Manager: Ruth Churchill Obstetric/Paediatric Unit Nursing Unit Manager, Obstetrics and Support Services Paediatrics: Moira Tulloch (until April 2014). General Manager, Finance: Daryl Cooper Therese Smyth commenced as Acting Nurse Unit Manager in May 2014. General Manager Support Services: Jon Millar Engineering Services Supervisor: Medical Services David Martin Nursing Unit Manager, Critical Care, Environmental Services Manager: Dialysis, Cardiology, Oncology: Geoff Brown Jenny Dennett Food Services Manager: David Askew Nursing Unit Manager, Medical: Health Information Manager: Sue Roberts Heather Rowell Nursing Unit Manager, Emergency: Hospital Medical Officer Kate Roberts (HMO) Manager: Hannah Atkins Payroll Manager: Raquel King Clinical Support Services Supply Manager: Matt McQuillen Infection Control Officers: Cathy Mowat and Andrea Page Wound/Stomal Therapy: Ann Payne
Maffra Campus Health Service Manager: Sonya Hanratty Nursing Unit Manager: Matt Gray
Central Gippsland Health Service Quality of Care Report 2014 23 Productive challenge for hospital Each ward has its own ‘Know How You’re Doing’ boards which map information such as patient experiences, efficiency of care and staff wellbeing. These things are discussed at ward meetings and then at Central Gippsland Health Service staff embraced “The Productive fortnightly meetings of the unit managers. Ward” project in 2013, aimed at seeing staff spend more time with patients and improving “direct care” time with patients by identifying The WOWing of wards and implementing a colour coding system areas where any wasted time can be avoided. for storage have been a great success. Something as simple as making better use of space or ensuring equipment is placed in the The initiative was introduced in medical, surgical, women’s and same spot, so it can be easily accessed by everyone, saved valuable children’s wards and Maffra Hospital’s acute and aged care wards. time as shown in medical ward statistics. Initially, staff chose their own vision for their respective wards. For The Activity Follows have shown just how many times a day a staff example, the medical ward’s vision is “We aspire to deliver a well member may be interrupted. At the start of this project, the Activity organised, calm, safe and caring environment”. Above the vision Follows showed that a nurse would be interrupted up to 136 times are photographs of all staff. per shift. The majority of interruptions revolved around general staff The “Tool Kit”, which contains structured modules, was followed enquiries. A staff in/out board reduced general staff enquiries from with all wards participating in the “knowing how we are doing”, 17 times per hour to nil. “Patient status at a glance” and “well organised ward (WOW)” After a few more changes, a tour post audit showed that modules. interruptions had been decreased, staff learning to work smarter, Medical ward extended to complete the “medication” module and not harder. will work on the admissions and discharges and meals module next. CGHS plans to sustain the Productive Ward by having staff with a Maffra hospital extended to commence the “meals” module. Productive Ward portfolio and tabling it in all unit meetings. Areas “Activity Follows” were undertaken at the start of the project where that have been “Wowed” have audit checklists and photos of how day shift staff were filmed while they worked. Analysis of activity the room or area should look to help new staff in the areas. Staff on most wards was completed with initial “direct care” time with plan to continue working on modules in each ward area to increase patients between 30 and 40 percent. Through a change of ward direct care time even further. processes and procedures, medical ward were measured again CGHS is also well underway with the productive operating theatre six months later to show an increase in direct care time from program as well. A well organised theatre is the first step with 37 percent to 49 percent. WOWing of storage areas, and eliminating excess equipment I Pictured below, CGHS registered nurse Rachel Hawkes with and wasted time walking to gather equipment. The team briefing patient Kevin Jackman. Rachel’s nursing unit is taking part in and scheduling modules are currently taking place. Suggestions are The Productive Care project which will see staff spend more already flowing. time with patients.
24 Central Gippsland Health Service Quality of Care Report 2014 STATUTORY INFORMATION
Statutory compliance Reporting requirements Central Gippsland Health Service is a public hospital listed in The information requirements listed in the Financial Management Schedule 1 to the Health Services Act 1988 (the Act). Central Act 1994 (the Act), the Standing directions of the Minister for Gippsland Health Service is an incorporated body and is regulated Finance under the Act (Section 4 Financial Management Reporting); by the Act. The Victorian Minister for Health during 2013/2014 was and Financial Reporting Directions have been prepared and are The Hon. David Davis. available to the relevant Minister, Members of Parliament and the public on request.
Objectives, functions, powers and duties of Central Gippsland Health Service
The principal objective of Central Gippsland Health Service is to provide public hospital services in accordance with the Australian Health Care Agreement (Medicare) principles. In addition to these, Consultancies engaged during 2013/2014 Central Gippsland Health Service has set other objectives which During 2013/2014 there have been nil contracts commenced or encompass the shared vision, core values and strategic directions completed under the Victorian Industry Participation Policy Act 2003. of the organisation. Details of consultancies: In 2013-14, there were two (2) consultancies where the total fees payable to the consultants were $10,000 or greater. The total expenditure incurred during 2013-14 in relation to these consultancies is $55,752 (excl. GST). Details of individual consultancies can be viewed at www.cghs.com.au In 2013-14, there were three (3) consultancies where the total fees payable to the consultants were less than $10,000. The total expenditure incurred during 2013-14 in relation to these consultancies is $4,311 (excl. GST).
Details of individual consultancies (valued at $10,000 or greater):
Total approved Expenditure Future project fee 2013-14 expenditure Start End (excl GST) (excl GST) (excl GST) Consultant Purpose of consultancy Date Date ($’000) ($’000) ($’000)
Clark Philips Pty Ltd To advise on the detail required to apply for Home Care Packages Mar -14 Jul - 14 18 16 2 Health-e Workforce To provide advice on Solutions Pty reducing overall salary and wages costs through better rostering Jan - 14 Jul - 14 40 40 0
Victorian Industry Participation Policy Competitive Neutrality (VIPP) Act 2003 Central Gippsland Health Service supports the Victorian Government’s policy statements as outlined in Competitive During 2013-14 the Central Gippsland Hospital did not enter into Neutrality; a statement of Victorian Government policy. Competitive any contracts under the criteria specified in the Victorian Industry Neutrality is seen as a complementary mechanism to the ongoing Participation Policy (VIPP) Act 2003. quest to increase operating efficiencies by way of benchmarking and embracing better work practices. Statement of occupational health and safety matters Building Act 1993 Compliance Central Gippsland Health Service complies with the Standards for The Health Service employs a Health Wellbeing and Safety Officer Publicly Owned Buildings (the guideline). Central Gippsland Health and during 2013/14 health and safety representatives have attended Service controls nine (9) properties, six (6) residential care and various training programs. three (3) non-residential care. Central Gippsland Health Service has begun a comprehensive review of all of it forms and procedures. This is being done under the guidance of an internal committee.
Central Gippsland Health Service Quality of Care Report 2014 25 Non residential Residential Privacy
Loch Sport CHC 1 Central Gippsland Health Service has embraced the privacy legislation and is committed to ensuring that consumer and Community Care 1 staff rights to privacy are upheld at all times. The organisation has proper processes and policies in place to ensure compliance with Community Rehab Centre 1 privacy legislation and to provide information to staff and consumers regarding privacy rights and responsibilities. Heyfield Hospital 1 All Central Gippsland Health Service consumers have the right Laurina Lodge 1 to have personal information stored in a secure location and to be assured that only that information that is necessary to ensure Maffra Hospital 1 high quality health care is to be collected. Central Gippsland Health Service has implemented a privacy complaints procedure that can Stretton Park 1 be accessed by both staff and consumers that monitors and Sale Acute 1 enforces privacy issues.
Wilson Lodge 1 Additional Information All new work and redevelopment of existing properties is carried In compliance with the requirements of FRD 22D Standard out to conform to the 2006 Building Regulations and the provisions Disclosures in the Report of Operations, details in respect of the of the Building Act 1993. The local authority or a building surveyor items listed below have been retained by Central Gippsland Health issues either a Certificate of Final Inspection or an Occupancy Service and are available to the relevant Ministers, Members of Permit for all new works or upgrades to existing facilities. Parliament and the public on request (subject to the freedom of information requirements, if applicable): Five yearly fire risk audits are conducted, with the next audit scheduled in 2018. (a) A statement of pecuniary interest has been completed; Central Gippsland Health Service installs and maintains fire safety (b) Details of shares held by senior officers as nominee or equipment in accordance with building regulations and regularly held beneficially; conducts audits. The upgrading of fire prevention equipment in (c) Details of publications produced by the Department about the buildings is also undertaken as part of any general upgrade of activities of the Health Service and where they can be obtained; properties where necessary and is identified in maintenance inspections. (d) Details of changes in prices, fees, charges, rates and levies charged by the Health Service; Central Gippsland Health Service requires building practitioners engaged on building works to be registered and to maintain (e) Details of any major external reviews carried out on the registration throughout the course of the building works. Health Service; (f) Details of major research and development activities undertaken by the Health Service that are not otherwise covered either in National Competition Policy the Report of Operations or in a document that contains the Central Gippsland Health Service complied with all government financial statements and Report of Operations; policies regarding competitive neutrality with respect to all tender (g) Details of overseas visits undertaken including a summary applications. of the objectives and outcomes of each visit; (h) Details of major promotional, public relations and marketing Freedom of Information activities undertaken by the Health Service to develop community awareness of the Health Service and its services; A total of 74 requests under the Freedom of Information Act were processed during the 2013/2014 financial year. (i) Details of assessments and measures undertaken to improve the occupational health and safety of employees; Requests for documents in the possession of Central Gippsland Health Service are directed to the Freedom of Information Manager (j) General statement on industrial relations within the Health and all requests are processed in accordance with the Freedom of Service and details of time lost through industrial accidents Information Act 1982. and disputes, which is not otherwise detailed in the Report of Operations; A fee is levied for this service based on the time involved in retrieving and copying the requested documents. Central (k) A list of major committees sponsored by the Health Service, Gippsland Health Service nominated officers under the Freedom the purposes of each committee and the extent to which those of Information Act are: purposes have been achieved; Principal Officer: (l) Details of all consultancies and contractors including Dr Frank Evans, Chief Executive Officer consultants/contractors engaged, services provided, and expenditure committed for each engagement. Freedom of Information Manager: Ms Heather Rowell, Health Information Administrator
26 Central Gippsland Health Service Quality of Care Report 2014 REPORT OF OPERATIONS
Key Performance Indicators Responsible Bodies Declaration Service Level as at 30 June 2014 Central Gippsland Health Service provides services throughout In accordance with the Financial Management Act 1994, I am pleased the Wellington Shire. The population of the total area served is to present the Report of Operations for Central Gippsland Health approximately 42,000. Service for the year ending 30 June 2014. ACTIVITY DATA Admitted Services
SEPARATIONS John Sullivan Board Chair Same Day 7,261 Sale Victoria Multi Day 4,951 30 August 2014 Sub- Acute 188 Total Separations 12,400 Summary of Operational THEATRE SERVICES and Budgetary Objectives Emergency Surgery 361 The service recorded a net profit from continuing operations before Elective Surgery 3,767 capital and specific items of $15K (2012/13 $506K profit). After taking Total Surgical Occasions 4,130 into account capital and specific items the net result was a loss of Total WIES 7,210.09 $5,223K (2012/13 $2,760K loss) Bed Days 32,428 The Health Service budgeted for a net surplus before capital and Emergency Department Attendances 17,078 specific items of $250K and a Net Result loss for the year of $5,416K. Mothers Delivered 460 Summary of factors that have COMMUNITY SERVICES affected the Operations for the Year Hours delivered by Community Services 95,017 The results of the service during the reporting period have been Meals Delivered 14,482 affected by the following factors: Hours delivered to externally funded - WIES was 5.64% below target which resulted in reduction of community, aged care package clients 11,586 income and payback to the Department of Health of $1.3 million. Palliative Care Contacts 2,565 - Management revaluation of Land & Building was carried out Non-admitted Subacute and Specialist resulting in an upwards revaluation of $2,5 million. Full revaluation Outpatient Clinic Service Events 13,391 of Land & Building is scheduled for June 30th 2014.
Summary of Operational and Budgetary Objectives Nil Summary of Financial Results
2013/14 2012/13 2011/12 2010/11 2009/10 2008/09 2007/08 2006/07 2005/06
Total Expenses 84,191 81,478 77,769 75,298 74,239 65,605 60,482 56,818 54,320
Total Revenue 78,968 78,718 75,339 70,408 70,028 65,161 59,286 57,732 55,752
Operating Surplus/(Deficit) (5,223) (2,760) (2,430) (4,890) (4,211) (444) (1,196) 914 1,432
Accumulated Surplus (Deficit) (25,536) (20,019) (17,183) (14,796) (9,956) (5,745) (5,301) (4,105) (5,019)
Total Assets 7,1547 7,2535 7,0317 7,0305 7,3416 7,7797 6,3660 6,4487 6,2998
Total Liabilities 18,461 16,744 16,836 14,394 13,082 13,252 12,579 12,682 12,107
Net Assets 53,086 55,791 53,481 55,911 60,334 64,545 51,081 51,805 50,891
Total Equity 53,086 55,791 53,481 55,911 60,334 64,545 51,081 51,805 50,891
Central Gippsland Health Service Quality of Care Report 2014 27 Revenue Indicators Attestation on Data Integrity
Average Collection Days I, Frank Evans certify that the Central Gippsland Health Service has put in place appropriate internal controls and processes to 2013/14 2012/13 ensure that reported data reasonably reflects actual performance. The Central Gippsland Health Service has critically reviewed these Private Inpatients 46 46 controls and processes during the year.
Victorian Workcover Inpatients - -
Other Compensable Inpatients - - Dr Frank Evans Nursing Home 8 6 Accountable Officer Sale Victoria Community Services 30 53 30 August 2014
Environmental Performance Attestation on Compliance with Australian/ Central Gippsland Health Service has continued to improve its environmental impact in the following areas. New Zealand Risk Management Standard
G Development of an organisation wide environmental management I, Frank Evans certify that the Central Gippsland Health Service plan in line with the resource smart guidelines with some key has risk management processes in place consistent with the objectives including: Australian/New Zealand Risk Management Standard and an internal control system is in place that enables the executives I Creation of an environmental management committee to understand, manage and satisfactorily control risk exposures. (green team) to develop strategies to reduce our environmental The Audit committee verifies this assurance and that the risk impact across multiple services within the organization, i.e. profile of the Central Gippsland Health Service has been critically supply chain, utility costs, etc. reviewed within the last 12 months. I Setting of an environmental framework including the measurement and benchmarking utilities, waste management, healthy commuting and procurement.
G Implementation of new state-of-the-art efficient industrial laundry Dr Frank Evans equipment providing a water reduction from 25 litres of water Accountable Officer per kilogram washed to just eight litres per kilo. Sale Victoria 30 August 2014 G Redirection of captured rain water to main hospital acute building toilet flushing tanks. Attestation on Insurance I, Frank Evans certify that the Central Gippsland Health Service has complied with Ministerial Direction 4.5.5.1 - Insurance.
Dr Frank Evans Accountable Officer Sale Victoria Patient Debtors Outstanding 30 August 2014 as at 30 June 2013
Under 30 30-60 61-90 Over 90 Total Total Days Days Days Days 30/06/14 30/06/13 ($’000) ($’000) ($’000) ($’000) ($’000) ($’000)
Private Inpatients 116 34 5 - 155 128 Victorian Workcover Inpatients ------Nursing Home 51 - - - 51 26 Community Services 7665289135 Total 243 40 10 2 295 289
28 Central Gippsland Health Service Quality of Care Report 2014 STATEMENT OF PRIORITIES
Part A:
Priority Action Outcome
Developing a system that is responsive G Implement formal advance care planning G Advanced care planning procedures have to people’s needs. structures and processes that provide been developed and are being patients with opportunities to develop implemented. review and have their expressed preferences for future treatment and care enacted. G Contribute to area based planning G Incorporated into the Strengthening initiatives that consider health care our Region Initiative. across the care continuum.
G Configure and distribute services to G All recommendations from the CGHS address the health needs of the local 2012-2022 Health Plan have been population. incorporated into relevant CGHS service plans and their implementation is being tracked through Interplan (Integrated Planning System).
G In partnership with other local G Significant progress has been made providers apply existing service capability through the Strengthening Our Region frameworks to maximise the use of Initiative. available resources across the catchment.
Improving every Victorian’s health status G Improve thirty-day unplanned G Regular Care Coordination Evaluation and experiences. readmission rates. will include identification of patient readmission trends.
G Collaborate with key partners such G CGHS senior executive were involved as Medicare Locals, community health in the development of the Wellington services and other providers to support Shire Council Health and Wellbeing Plan. local implementation of the Victorian Health and Wellbeing Plan 2011–2015.
G Identify service users who are G We are working with the ATSI Liaison marginalised or vulnerable to poor Group to identify and implement health, and develop interventions that strategies to reduce the percentage of improve their outcomes relative to other Aboriginal people leaving the Emergency groups, for example, Aboriginal people, Department at their own risk or people affected by mental illness, people prior to treatment. at risk of elder abuse, refugees and asylum seekers.
G Improve health literacy and support G Health literacy program is in development informed choice by responding to the in conjunction with CGHS Community health information needs of service users. Liaison Group and CGHS Chronic Disease and Disability Network. Some components are already being delivered.
Expanding service, workforce and system G Optimise workforce productivity through G Completed HACC Workforce Redesign capacity. identification and implementation Project with a focus on targeted capability of workforce models that enhance development for our Home and individual and team capacity and Community Care workforce to enable support flexibility. these workers to: I provide a range of health promotion, health support and therapy for people in their homes; I have available to them a number of pathways to career development including pathways to vocational qualifications in allied health and nursing, thereby providing further pathways to higher VET and university studies.
Central Gippsland Health Service Quality of Care Report 2014 29 Priority Action Outcome
G Increased the utilisation of our allied health assistant workforce in the community care settings.
G Implement the Credentialing and Scope G ‘Partnering for Performance’ framework of Practice policy and ‘Partnering for currently being integrated into CGHS Performance’ framework for senior Capability Development Program clinicians. (Integrated, online Performance Evaluation System (PES).
G Develop and implement a workforce G CGHS workforce immunisation policy immunisation policy that builds capacity updated and aligned with national and aligns with national guidelines, guidelines and includes employment including reference to employment screening and staff immunisations screening and staff immunisation assessment. assessment.
G Contribute to the provision of additional G Fourth dental chair operational. dental services to achieve targets, milestones and objectives of the National Partnership on Treating More Public Dental Patients.
Increasing the system’s financial G Reduce variation in health service G Benchmarking health service corporate sustainability and productivity. administrative costs. and administrative costs is now part of regular performance reporting.
G Significant progress has been made with regard to the Productive Ward and Productive Theatre Projects.
G Identify opportunities for efficiency G Participating in implementation of and better value service delivery. system improvements, partnerships and collaboration within the region through the Strengthening our Region Initiative.
Implementing continuous improvements G Develop and implement improvement G Improvements from centralised intake and and innovation. strategies that optimise access, patient the establishment of care coordination flow, system coordination and the quality across all care settings have been and safety of hospital services. embedded through documented procedures and processes.
G Develop and implement strategies that G Code Green: Emergency Department, support service innovation and co-design. Escalation response procedure developed and implemented.
G Support change and innovation in G Theatre productivity improved by over practice where it is proven to deliver 10 percent. more effective and efficient health care. G Outputs from the “Embedding Continuous Improvement Project” include: I Continuous improvement whiteboards being used in all departments I CGHS has progressed 4 “redesigning” or CQI/lean projects in 2013/14 I Established position of Knowledge and Performance Improvement Manager
30 Central Gippsland Health Service Quality of Care Report 2014 Priority Action Outcome
Increasing accountability and transparency. G Prepare for the National Safety and G Action plans have been developed and Quality Health Service Standards, as are being implemented to maintain applicable. National Safety and Quality Health Service Standards Accreditation.
G Increase transparency and accountability G Fully implemented integrated planning in reporting of accurate and relevant system including score card reporting information about the organisation’s of a comprehensive accountability (KPI) performance. framework.
G With the support of Government, G VHA Board Evaluation and Development develop Board capability to ensure Program piloted with Stretton Park and all Board members are well equipped Heyfield Hospital Boards of Management. to effectively discharge their responsibilities and deliver against the outcomes articulated in the VHPF.
Improving utilisation of e-health G Maximise the use of health ICT G iPM Community Module is fully and communications technology. infrastructure. implemented across all community services and campuses.
G Replaced local ICT infrastructure with access to Gippsland Health Alliance infrastructure and have thereby increased our capability and reduced operating costs and risk.
G Trial, implement and evaluate strategies G Completed trial of telehealth link from the that use e-health as an enabler of better critical care unit to specialist metropolitan patient care. units and extension to other clinical units within CGHS.
G Work with partners to better connect G Providing electronic delivery of patient service providers and deliver appropriate discharge information and service delivery and timely services to rural and regional plans to GP and specialist medical Victorians. practices.
Central Gippsland Health Service Quality of Care Report 2014 31 Part B: Performance Priorities
Financial Performance
Key Performance Indicator Target Actual
Operating result
Annual operating result ($m) $0.25m $0.013m
WIES (1) activity performance
Percentage of WIES (public & private) performance to target 100% 94%
Cash management
Creditors < 60 days 17
Debtors < 60 days 24
(1) Weighted Inlier Equivalent Separations
Access Performance
Key Performance Indicator Target Actual
Emergency care
Percentage of ambulance transfers within 40 minutes 90% 94%
NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (July – December 2013) 75% 77%
NEAT - Percentage of emergency presentations to physically leave the emergency department for admission to hospital, be referred to another hospital for treatment, or be discharged within four hours (January - June 2014) 81% 79%
Number of patients with a length of stay in the emergency department greater than 24 hours 03
Percentage of Triage Category 1 emergency patients seen immediately 100% 100%
Percentage of Triage Category 1 to 5 emergency patients seen within clinically recommended times 80% 77%
32 Central Gippsland Health Service Quality of Care Report 2014 Service Performance
Key Performance Indicator Target Actual
Quality and safety
Health service accreditation Full compliance Achieved
Residential aged care accreditation Full compliance Achieved
Cleaning standards Full compliance Achieved
Cleaning standards (AQL-A) 90 97
Cleaning standards (AQL-B) 85 96
Cleaning standards (AQL-C) 85 95
Submission of data to VICNISS (2) Full compliance Achieved
Hospital associated infection surveillance No outliers Achieved
Health Care Worker immunisation - influenza 75% 65%
Hand Hygiene (rate) 70% 83%
SAB rate per occupied bed days <2/10,000 0
Victorian Patient Satisfaction Monitor (OCI) (3) (January to June 2013) 73% Achieved
Consumer Participation Indicator (4) (January to June 2013) 75% Achieved
Victorian Hospital Experience Measurement Instrument (5) (January to June 2014) Full compliance Result unavailable
People Matter Survey Full compliance Partially achieved
Maternity
Percentage of women with prearranged postnatal home care 100% 100%
(2) VICNISS is the Victorian Hospital Acquired Infection Surveillance System (3) The target for the Victorian Patient Satisfaction Monitor is the Overall Care Index (OCI) which comprises six categories (4) The Consumer Participation Indicator is a category of the Victorian Patient Satisfaction Monitor (5) The Victorian Health Experience Measurement Instrument (VHEMI) will succeed the VPSM as the instrument for measuring patient experience.
Central Gippsland Health Service Quality of Care Report 2014 33 PUTTING PATIENTS FIRST
Medical service between “good” and “very good” and for the final statement, the expands highest response was “very good” followed by “excellent”. Individual comments made by patients were given to each ward Medical services in Rosedale have surveyed - Women’s and Children’s, Surgical and Medical - to follow expanded, thanks to a partnership up. between Central Gippsland Health Service and Ramahyuck District Small things make a big difference Aboriginal Corporation in Sale. A small effort can often make all the difference to a hospital patient. CGHS initially auspiced four GP morning sessions a week from the This is evidenced at the Central Gippsland Health Service whose Rosedale Multi-Purpose Centre. three main hospital wards – Medical, Surgical and Women’s and Dr Ann Hughes, pictured left, Children’s – have taken action on all comments and complaints is the GP, with CGHS providing raised in a patient satisfaction survey where possible. a nurse and receptionist. Some issues raised by a number of patients including feeling the However after negotiations between the two organisations, ward routine and procedures were not adequately explained on Ramahyuck provided a doctor to run two afternoon sessions admission. As a result, there has been increased education and per week with Dr Hughes continuing to run the four morning expectation placed on staff to explain them. sessions on Monday, Tuesday, Wednesday and Thursday. The location and size of bedside cupboards was also an issue. The expansion of GP services had been a goal of CGHS Now new bedside cupboards have been purchased in some areas, for some time as part of its extensive community programs. providing more space, and have been located next to the beds. A similar arrangement to Rosedale operates in Loch Sport. Noise at night has been addressed with staff while doors have been adjusted to prevent “banging”. Making a stay in hospital stress free All regularly used equipment, such as showers and soap containers, are checked and replaced when not working. When staff are alerted A hospital stay can be stressful however Central Gippsland Health to problem, the engineering staff are contacted immediately. Service wants to make it as comfortable as possible for patients. Earphones for televisions have also been provided for patients on This led to CGHS instigating its own satisfaction survey in addition request. to the bi-annual Victorian Patient Satisfaction Monitor (VPSM) in an effort to improve time taken to analyse patient comments and response. New kitchenette CGHS Community Network Support Officer, Jude Deedman, said the most important aspect of the survey was that patients knew A new kitchenette at Maffra Hospital was built with aged care when they made a suggestion, it would be acted upon. Their residents making a valuable contribution to its design. participation was also confidential. The new kitchenette is used for a number of purposes in the aged The CGHS survey asked similar questions of patients to the VPSM. care ward. Members of the CGHS Community Liaison Group, independent The previous kitchenette comprised a sink, tap, small fridge and and not members of CGHS staff, conducted the survey. drawers. The new one, pictured below, built by a local cabinet The survey was also linked with CGHS’ Productive Ward initiative maker, consists of two portable modules on wheels. It can attach which is about “changing the culture” of CGHS. Its overall aim is to to the existing facility or be used as stand-alone options. improve “direct care” time with patients by identifying areas where The modules are table height with wheelchair access on both sides. any wasted time can be avoided. They have a dual purpose. They can be used by occupational The five statements on which patients were asked to respond were: therapy staff to teach residents kitchen skills or for additional 1 You were treated with dignity and respect by staff; bench space. 2 You were given the opportunity to participate in decisions regarding your care; 3 Hospital routine and procedures (eg meal times, visiting hours, doctors’ visits) were explained to you; 4 The restfulness of the hospital (peace and quiet); and 5 Adequate information was given to you during your stay. The highest response to the first statement was “very good”, followed by “excellent”. The highest response to the second was “good”, followed by “very good”. The highest response to the third was “poor”. The fourth statement saw the highest response a tie
34 Central Gippsland Health Service Quality of Care Report 2014 DISCLOSURE INDEX
The annual report of the Central Gippsland Health Service is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the Department’s compliance with statutory disclosure requirements.
Legislation Requirement Page Reference
Ministerial Directions
Report of Operations
Charter and purpose
FRD 22C Manner of establishment and the relevant Ministers 13-14
FRD 22C Objectives, functions, powers and duties 25
FRD 22C Nature and range of services provided 15
Management and structure
FRD 22C Organisational structure 18
Financial and other information
FRD 10 Disclosure index 35-36
FRD 11 Disclosure of ex-gratia payments 81
FRD 15B Executive officer disclosures 81
FRD 21A Responsible person and executive officer disclosures 81
FRD 22C Application and operation of Freedom of Information Act 1982 26
FRD 22C Compliance with building and maintenance provisions of Building Act 1993 25
FRD 22C Details of consultancies over $10,000 25
FRD 22C Details of consultancies under $10,000 25
FRD 22C Major changes or factors affecting performance 27
FRD 22C Occupational health and safety 25
FRD 22C Operational and budgetary objectives and performance against objectives 27
FRD 22C Significant changes in financial position during the year 27
FRD 22C Statement of availability of other information 26
FRD 22C Statement on National Competition Policy 26
FRD 22C Subsequent events 81
FRD 22C Summary of the financial results for the year 27
FRD 22C Workforce Data Disclosures including a statement on the application of employment and conduct principles 14
FRD 25 Victorian Industry Participation Policy disclosures 25
SD 4.2(j) Sign-off requirements 27
SD 3.4.13 Attestation on Data Integrity 28
SD 4.5.5 Attestation on Compliance with Australian/New Zealand Risk Management Standard 28
Central Gippsland Health Service Quality of Care Report 2014 35 Legislation Requirement Page Reference
Financial Statements
Financial statements required under Part 7 of the FMA
SD 4.2(a) Statement of changes in equity 42
SD 4.2(b) Operating statement 40
SD 4.2(b) Balance sheet 41
SD 4.2(b) Cash flow statement 43
Other requirements under Standing Directions 4.2
SD 4.2(a) Compliance with Australian accounting standards and other authoritative pronouncements 46
SD 4.2(c) Accountable officer’s declaration 37
SD 4.2(c) Compliance with Ministerial Directions 46
SD 4.2(d) Rounding of amounts 47
Legislation
Freedom of Information Act 1982 26
Victorian Industry Participation Policy Act 2003 25
Building Act 1993 25
Financial Management Act 1994 27
36 Central Gippsland Health Service Quality of Care Report 2014 37 38 39 CENTRAL GIPPSLAND HEALTH SERVICE
COMPREHENSIVE OPERATING STATEMENT FOR THE YEAR ENDED 30 JUNE 2014
Note 2014 2013 $'000 $'000
Revenue from Operating Activities 2 77,667 75,886 Revenue from Non-operating Activities 2 456 474 Employee Expenses 3 (56,133) (54,783) Non Salary Labour Costs 3 (2,249) (1,807) Supplies and Consumables 3 (9,152) (9,033) Other Expenses From Continuing Operations 3 (10,574) (10,231)
Net Result Before Capital & Specific Items 15 506
Capital Purpose Income 2 845 2,358 Depreciation 4 (6,083) (5,624) NET RESULT FOR THE YEAR (5,223) (2,760)
Other Comprehensive Income - - Net fair value revaluation on Non Financial Assets 11 2,518 5,070 COMPREHENSIVE RESULT FOR THE YEAR (2,705) 2,310
This statement should be read in conjunction with the accompanying notes.
40 CENTRAL GIPPSLAND HEALTH SERVICE
BALANCE SHEET AS AT 30 JUNE 2014
Note 2014 2013 $'000 $'000
ASSETS
Current Assets Cash and Cash Equivalents 5 3,695 4,570 Receivables 6 1,685 1,847 Investments and other Financial Assets 7 3,739 2,372 Inventories 8 246 282 Other Assets 9 137 148 Total Current Assets 9,502 9,219
Non-Current Assets Other Assets 9 33 60 Receivables 6 1,238 1,162 Property, Plant & Equipment 11 60,774 62,094 Total Non-Current Assets 62,045 63,316 TOTAL ASSETS 71,547 72,535
LIABILITIES
Current Liabilities Payables 12 3,667 1,893 Provisions 13 11,862 11,134 Other Liabilities 14 1,071 1,955 Total Current Liabilities 16,600 14,982
Non-Current Liabilities Provisions 13 1,861 1,762 Total Non-Current Liabilities 1,861 1,762 TOTAL LIABILITIES 18,461 16,744 NET ASSETS 53,086 55,791
EQUITY Property, Plant & Equipment Revaluation Surplus 15a 43,825 41,307 Restricted Specific Purpose Surplus 15a 543 249 Contributed Capital 15b 34,254 34,254 Accumulated Deficits 15c (25,536) (20,019) TOTAL EQUITY 53,086 55,791 Commitments for Expenditure 18 Contingent Liabilities & Contingent Assets 19
This statement should be read in conjunction with the accompanying notes.
41 CENTRAL GIPPSLAND HEALTH SERVICE
STATEMENT OF CHANGES IN EQUITY FOR THE YEAR ENDED 30 JUNE 2014
Property, Plant Restricted Contributions by Accumulated Total & Equipment Specific Owners Surpluses/ Revaluation Purpose (Deficits) Surplus Surplus
Note $'000 $'000 $'000 $'000 $'000 Balance at 1 July 2012 36,237 173 34,254 (17,183) 53,481 Net result for the year - - - (2,760) (2,760) Other comprehensive income for the year 15a 5,070 - - - 5,070 Transfer to accumulated deficit 15a,c - 76 - (76) -
Balance at 30 June 2013 41,307 249 34,254 (20,019) 55,791
Net result for the year - - - (5,223) (5,223) Other comprehensive income for the year 15a 2,518 - - - 2,518 Transfer to accumulated deficit 15a,c - 294 - (294) -
Balance at 30 June 2014 43,825 543 34,254 (25,536) 53,086 This Statement should be read in conjunction with the accompanying notes.
42 CENTRAL GIPPSLAND HEALTH SERVICE
CASH FLOW STATEMENT FOR THE YEAR ENDED 30 JUNE 2014
Note 2014 2013 $'000 $'000
CASH FLOWS FROM OPERATING ACTIVITIES
Operating Grants from Government 63,935 61,023 Patient and Resident Fees Received 4,575 4,489 Private Practice Fees Received 4,457 4,204 Donations and Bequests Received 141 146 GST Received from / (paid to) ATO 92 (72) Interest Received 345 360 Other Receipts 6,063 5,576 Employee Expenses Paid (55,337) (54,984) Fee for Service Medical Officers (2,218) (1,807) Payments for Supplies and Consumables (8,896) (9,138) Other Payments (10,584) (10,265)
Cash Generated from / (used in) Operations 2,573 (468)
Capital Grants from Government 541 2,240 Capital Donations and Bequests Received 321 105
NET CASH INFLOW FROM OPERATING ACTIVITIES 16 3,435 1,877
CASH FLOWS FROM INVESTING ACTIVITIES Purchase of Investments (1,371) (348) Payments for Non-Financial Assets (2,284) (2,710) Proceeds from Sale of Non-Financial Assets 23 60
NET CASH OUTFLOW FROM INVESTING ACTIVITIES (3,632) (2,998)
NET DECREASE IN CASH HELD (197) (1,121)
CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIOD 2,929 4,050
CASH AND CASH EQUIVALENTS AT END OF PERIOD 5 2,732 2,929
This Statement should be read in conjunction with the accompanying notes.
43 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Table of Contents
Note Page
1 Summary of Significant Accounting Policies 45-48 2 Revenue 59 2a Analysis of Revenue by Source 60-61 2b Patient and Resident Fees 62 2c Net Gain/(Loss) on Disposal of Non Financial Assets 62 2d Assets Received Free of Charge 62 3 Expenses 63 3a Analysis of Expenses by Source 64-65 3b Analysis of Expenses by Internal & Restricted Specific Purpose Funds Supported by Hospital & Community Initiatives 66 4 Depreciation 66 5 Cash and Cash Equivalents 67 6 Receivables 67 7 Investments and Other Financial Assets 68 8 Inventories 68 9 Other Assets 68 10 Jointly Controlled Operations and Assets 69 11 Property, Plant and Equipment 70-74 12 Payables 75 13 Provisions 75-76 14 Other Liabilities 76 15 Equity 76 16 Reconciliation of Net Result for the Year to Net Cash Inflow 77 from Operating Activities 17 Financial Instruments 78-81 18 Commitments for Expenditure 82 19 Contingent Liabilities & Contingent Assets 82 20 Segment Reporting 83 21a Responsible Person Disclosures 84 21b Executive Officers Disclosures 84 22 Events Occurring after Balance Sheet Date 84 23 Economic Dependence 84
44 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies These annual financial statements represent the audited general purpose financial statements for Central Gippsland Health Service for the period ending 30 June 2014. The purpose of the report is to provide users with information about Central Gippsland Health Services’ stewardship of resources entrusted to it. ( a ) Statement of Compliance These financial statements are general purpose financial statements which have been prepared in accordance with the Financial Management Act 1994 and applicable AASs, which include interpretations issued by the Australian Accounting Standards Board (AASB). They are presented in a manner consistent with the requirements of AASB 101 Presentation of Financial Statements. The financial statements also comply with relevant Financial Reporting Directions (FRDs) issued by the Department of Treasury and Finance, and relevant Standing Directions (SDs) authorised by the Minister for Finance. Central Gippsland Health Service is a not-for profit entity and therefore applies the additional Aus paragraphs applicable to “not-for- profit” Health Services under the AASs. The annual financial statements were authorised for issue by the Board of Central Gippsland Health Service on 19 August 2014. ( b ) Basis of Accounting Preparation and Measurement Accounting policies are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substance of the underlying transactions or other events is reported. The accounting policies set out below have been applied in preparing the financial statements for the year ended 30 June 2014, and the comparative information presented in these financial statements for the year ended 30 June 2013.
The going concern basis was used to prepare the financial statements. These financial statements are presented in Australian dollars, the functional and presentation currency of Central Gippsland Health Service. The Health Service is developing a long-term strategic plan to meet the needs of the community in the most cost efficient manner without compromising services. The Department of Health provided a financial commitment to the Health Service that they will provide adequate cash flow support should it be required to enable the Health Service to meet its current and future obligations as and when they fall due up to September 2015. The financial statements, except for cash flow information, have been prepared using the accrual basis of accounting. Under the accrual basis, items are recognised as assets, liabilities, equity, income or expenses when they satisfy the definitions and recognition criteria for those items, that is they are recognised in the reporting period to which they relate, regardless of when cash is received or paid. The financial statements are prepared in accordance with the historical cost convention, except for: • non-current physical assets, which subsequent to acquisition, are measured at a revalued amount being their fair value at the date of the revaluation less any subsequent accumulated depreciation and impairment subsequent losses. Revaluations are made and are re- assessed with sufficient regularity to ensure that the carrying amounts do not materially differ from their fair values; • the fair value of assets other than land is generally based on their depreciated replacement value. Judgements, estimates and assumptions are required to be made about carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on professional judgements derived from historical experience and various other factors that are believed to be reasonable under the circumstances. Actual results may differ from these estimates. Revisions to accounting estimates are recognised in the period in which the estimate is revised and also in future periods that are affected by the revision. Judgements and assumptions made by management in the application of AASs that have significant effects on the financial statements and estimates relate to: • the fair value of land, buildings, infrastructure, plant and equipment (refer to Note 1(k)); • superannuation expense (refer to note 1(h); and • actuarial assumptions for employee benefit provisions based on likely tenure of existing staff, patterns of leave claims, future salary movements and future discount rates (refer to Note 1(l)).
Consistent with AASB 13 Fair Value Measurment , Central Gippsland Health Service determines the policies and procedures for both recurring fair value measurements such as property, plant and equipment, investment properties and financial instruments, and for non- recurring fair value measurements auch as non-financial physical assets held for sale, in accordance with the requirements od AASB 13 and the relevant FRD's. All assets and liabilities for which fair value is measured or disclosed in the financial statements are categorised within the fair value hierarchy, described as follows, based on the lowest level input that is significant to the fair value measurement as a whole: • Level 1 - Quoted (unadjusted) market proices in active markets for identical assets or liabilities • Level 2 - Valuation techniques for which the lowest level input that is significant to the fair value measurementis directly or indirectly observable • Level 3 - Valuation techniques for which the lowest level input that is significant to the fair value measurement is unobservable. For the purpose of fair value disclosures, Central Gippsland Health Service has determined classes of assets and liabilities on the basis of the nature, characteristics and risks of the asset or liability and the level of the fair value hierarchy as explained above. In addition, Central Gippsland Health Service determines whether transfers have occurred between levels in the hierarchy by re- assessing categorisation (based on lowest level input that is significant to the fair value measurement as a whole) at the end of each reporting period. The Valuer-General Victoria (VGV) is Central Gippsland Health Service's independent valuation agency Central Gippsland Health Service, in conjunction with VGV monitors the changes in the fair value of each asset and liability through relevant data sources to determine whether revaluation is required.
45 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) ( c ) Reporting Entity The financial report includes all the controlled activities of the Central Gippsland Health Service. The principle address is: 155 Guthridge Parade Sale Victoria 3850
A description of the nature of Central Gippsland Health Service's operations and its principal activities is included in the report of operations, which does not form part of these financial statements.
Objectives and funding Central Gippsland Health Service's overall objective is to provide health and community services that will best meet the current and future needs of our community, as well as improve the quality of life to Victorians.
Central Gippsland Health Service is predominantly funded by accrual based grant funding for the provision of outputs.
( d ) Principles of Consolidation Intersegment Transactions Transactions between segments within the Central Gippsland Health Service have been eliminated to reflect the extent of the Central Gippsland Health Service's operations as a group. Jointly controlled Assets or Operations Interests in jointly controlled assets or operations are not consolidated by Central Gippsland Health Service, but are accounted for in accordance with the policy outlined in Note 1(k) Financial Assets. ( e ) Scope and Presentation of Financial Statements Fund Accounting The Central Gippsland Health Service operates on a fund accounting basis and maintains three funds: Operating, Specific Purpose and Capital Funds. The Central Gippsland Health Service's Capital and Specific Purpose Funds include unspent capital donations and receipts from fund-raising activities conducted solely in respect of these funds.
Services Supported By Health Services Agreement and Services Supported By Hospital and Community Initiatives Activities classified as Services Supported by Health Services Agreement (HSA) are substantially funded by the Department of Health and include Residential Aged Care Services (RACS) and are also funded from other sources such as the Commonwealth, patients and residents, while Services Supported by Hospital and Community Initiatives (H&CI) are funded by the Health Services own activities or local initiatives and/or the Commonwealth. Residential Aged Care Services The JHF McDonald Wing Nursing Home and Wilson Lodge Nursing Home are an integral part of Central Gippsland Health Service and share its resources. They are substantially funded from Commonwealth bed-day subsidies. Wilson Lodge has been segregated based on actual revenue earned and expenditure incurred. While JHF McDonald Wing and the Maffra Hospital are contained within the one facility, revenues and expenditure are allocated directly to the respective facilities where possible. Those revenues and expenses that cannot be allocated directly to one of the relevant areas of service are allocated on the basis of floor space used by each facility. Comprehensive Operating Statement
The comprehensive operating statement includes the subtotal entitled ‘net result before capital & specific items’ to enhance the understanding of the financial performance of Central Gippsland Health Service. This subtotal reports the result excluding items such as capital grants, assets received or provided free of charge, depreciation, expenditure using capital purpose income and items of an unusual nature and amount such as specific income and expenses. The exclusion of these items is made to enhance matching of income and expenses so as to facilitate the comparability and consistency of results between years and Victorian Public Health Services. The ‘net result before capital & specific items’ is used by the management of Central Gippsland Health Service, the Department of Health and the Victorian Government to measure the ongoing operating performance of Health Services. Capital and specific items, which are excluded from this subtotal, comprise: • Capital purpose income, which comprises all tied grants, donations and bequests received for the purpose of acquiring non- current assets, such as capital works, plant and equipment or intangible assets. It also includes donations of plant and equipment (refer Note 1 (g)). Consequently the recognition of revenue as capital purpose income is based on the intention of the provider of the revenue at the time the revenue is provided.
Specific income/expense, comprises the following items, where material: - Voluntary departure packages - Voluntary changes in accounting policies (which are not required by an accounting standard or other authoritative pronouncement of the Australian Accounting Standards Board) • Depreciation and Amortisation, as described in Note 1 (h). • Assets provided or received free of charge (refer to Notes 1 (g) and (h)); and • Expenditure using capital purpose income, comprises expenditure which either falls below the asset capitalisation threshold or doesn’t meet asset recognition criteria and therefore does not result in the recognition of an asset in the balance sheet, where funding for that expenditure is from capital purpose income.
46 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) Balance Sheet
Assets and liabilities are categorised either as current or non-current (non-current being those assets or liabilities expected to be recovered/settled more than 12 months after reporting period), are disclosed in the notes where relevant.
Statement of Changes in Equity The statement of changes in equity presents reconciliations of each non-owner and owner changes in equity from opening balance at the beginning of the reporting period to the closing balance at the end of the reporting period. It also shows separately changes due to amounts recognised in the comprehensive result and amounts recognised in other comprehensive income. Cash Flow Statement Cash flows are classified according to whether or not they arise from operating activities, investing activities, or financing activities. This classification is consistent with requirements under AASB 107 Statement of Cash Flows.
For the cash flow statement presentation purposes, cash and cash equivalents includes bank overdrafts, which are included as current borrowings in the balance sheet. Rounding of Amounts All amounts shown in the financial statements are expressed to the nearest $1,000 unless otherwise stated. Minor discrepancies in tables between totals and sum of components are due to rounding. ( f ) Change in accounting policies AASB 13 Fair Value Measurement AASB 13 establishes a single source of guidance for all fair value measurements. AASB 13 does not change when a health service is required to use fair value, but rather provides guidance on how to measure fair value under Australian Accounting Standards when fair value is required or permitted. The health service has considered the specific requirements relating to highest and best use, valuation premise, and principal (or most advantageous) market. The methods, assumptions, processes and procedures for determining fair value were revised and adjusted where applicable. In light of AASB 13, the health service has reviewed the fair value principles as well as its current valuation methodologies in assessing the fair value, and the assessment has not materially changed the fair values recognised. AASB 13 has predominantly impacted the disclosures of the health service. It requires specific disclosures about fair value measurements and disclosures of fair values, some of which replace existing disclosure requirements in other standards, including AASB 7 Financial Instruments: Disclosures. The disclosure requirements of AASB 13 apply prospectively and need not to be provided for comparative periods, before initial application. Consequently, comparatives of these disclosures have not been provided for 2012-13, except for financial instruments, of which the fair value disclosures under AASB 7 Financial Instruments Disclosures . AASB 119 Employee Benefits In 2031-14, the health service has applied AASB 119 Employee Benefits (Sept 2011, as amended) , and related consequential amendments for the first time. The revised AASB 119 changes the accounting for defined benefit plans and termination benefits. The most significant change relates to the accounting for changes in defined benefit obligation and plan assets. As the current account policy is for the Department of Treasury and Finance to recognise and disclose the State's defined benefit liabilities in its financial statements, changes in defined benefit obligations and plan assets will have limited impact on the health service. The revised standard also changes the definition of short-term employee benefits. These were previously benefits that were expected to be settled within 12 months after the end of the reporting period in which the employees render the related service, however, short- term employee benefits are now defined as benefits expected to be settled wholly within 12 months after the end of the reporting period in which in which employees render the related service. As a result, accrued annual leave balances which were previously classified as short-term employee benefits no longer meet this definition and are now classified as long-term employee benefits. This has resulted in a change of measurement for the annual leave provision from an undiscounted to discounted basis. This change of measurement has not resulted in a material change to accrued annual leave therefore no changes was required.
47 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued)
( g ) Income from transactions Income is recognised in accordance with AASB 118 Revenue and is recognised as to the extent that it is probable that the economic benefits will flow to Central Gippsland Health Service and the income can be reliably measured at fair value. Unearned income at reporting date is reported as income received in advance. Amounts disclosed as revenue are, where applicable, net of returns, allowances, duties and taxes. Government Grants and other Transfers of Income (other than contributions by owners) In accordance with AASB 1004 Contributions , government grants and other transfers of income (other than contributions by owners) are recognised as income when the Health Service gains control of the underlying assets irrespective of whether conditions are imposed on the Health Service's use of the contributions. Contributions are deferred as income in advance when Central Gippsland Health Service has a present obligation to repay them and the present obligation can be reliably measured.
Indirect Contributions from the Department of Health – Insurance is recognised as revenue following advice from the Department of Health. – Long Service Leave (LSL) – Revenue is recognised upon finalisation of movements in LSL liability in line with the arrangements set out in the Metropolitan Health and Aged Care Services Division Hospital Circular 05/2013 (update for 2012-13). Patient and Resident Fees Patient fees are recognised as revenue at the time invoices are raised. Private Practice Fees Private practice fees are recognised as revenue at the time invoices are raised. Donations and Other Bequests Donations and bequests are recognised as revenue when received. If donations are for a special purpose, they may be appropriated to a surplus, such as the restricted specific purpose surplus.
Interest Revenue Interest revenue is recognised on a time proportionate basis that takes into account the effective yield of the financial asset, which allocates interest over the relevent period. Fair value of assets and services received free of charge or for nominal consideration Resources received free of charge or for nominal consideration are recognised at their fair value when the transferee obtains control over them, irrespective of whether restrictions or conditions are imposed over the use of the contributions, unless received from another Health Service or agency as a consequence of a restructuring of administrative arrangements. In the latter case, such transfer will be recognised at carrying value. Contributions in the form of services are only recognised when a fair value can be reliably determined and the service would have been purchased if not received as a donation. Other Income Other income includes non-property rental, dividends, forgiveness of liabilities, and bad debt reversals.
48 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued)
( h ) Expense Recognition
Expenses are recognised as they are incurred and reported in the financial year to which they relate.
Cost of Goods Sold
Costs of goods sold are recognised when the sale of an item occurs by transferring the cost or value of the item/s from inventories.
Employee Expenses Employee expenses include: - Wages and Salaries; - Annual Leave; - Sick Leave; - Long Service Leave; and - Superannuation expenses which are reported differently depending upon whether employees are members of defined benefit or defined contribution plans. Defined Contribution Superannuation Plans In relation to defined contribution (i.e. accumulation) superannuation plans, the associated expense is simply the employer contributions that are paid or payable in respect of employees who are members of these plans during the reporting period. Contributions to defined contribution superannuation plans are expensed when incurred. Defined Benefit Superannuation Plans The amount charged to the comprehensive operating statement in respect of defined benefit superannuation plans represents the contributions made by the Central Gippsland Health Service to the superannuation plans in respect of the services of current Health Service staff during the reporting period. Superannuation contributions are made to the plans based on the relevant rules of each plan, and are based upon actuarial advice. Employees of the Central Gippsland Health Service are entitled to receive superannuation benefits and the Central Gippsland Health Service contributes to both the defined benefit and defined contribution plans. The defined benefit plan provides benefits based on years of service and final average salary.
The name and details of the major employee superannuation funds and contributions made by the Health Service are as follows:
Fund Contributions paid or payable for the year. 2014 2013 $'000 $'000 Defined benefit plans: Health Super 202 232 Defined Contribution Plan Health Super 4,082 3,911 Other 218 188 Total 4,502 4,331
Central Gippsland Health Service does not recognise any unfunded defined benefit liability in respect of the superannuation plan because Central Gippsland Health Service has no legal or constructive obligation to pay future benefits relating to its employees; its only obligation is to pay superannuation contributions as they fall due. The Department of Treasury and Finance administers and discloses the State’s defined benefit liabilities in its financial report.
Depreciation
All infrastructure assets, buildings, plant and equipment and other non-financial physical assets that have finite useful lives are depreciated (i.e. excludes land assets held for sale, and investment properties). Depreciation begins when the asset is available for use, which is when it is in the location and condition necessary for it to be capable of operating in a manner intended by management. Intangible produced assets with finite lives are depreciated as an expense from transactions on a systematic basis over the asset’s useful life. Depreciation is generally calculated on a straight line basis, at a rate that allocates the asset value, less any estimated residual value over its estimated useful life. Estimates of the remaining useful lives and depreciation method for all assets are reviewed at least annually, and adjustments made where appropriate. This depreciation charge is not funded by the Department of Health. Assets with a cost in excess of $1000 are capitalised and depreciation has been provided on depreciable assets so as to allocate their cost or valuation over their estimated useful lives.
49 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) The following table indicates the expected useful lives of non current assets on which the depreciation charges are based.
2014 2013 Buildings - Structure Shell Building Fabric 1 - 50 years 1 - 40 years Buildings - Site Engineering and Central Plant 1 - 36 years 1 - 36 years Buildings - Fit Out 1 - 20 years 1 - 20 years Buildings - Trunk Reticulated Building Systems 1 - 22 years 1 - 22 years Plant & Equipment 5 - 20 years 5 - 20 years Furniture & Fittings 5 -20 years 5 -20 years Leased Assets 5 - 10 years 5 - 10 years Computers & Communication 3 - 5 years 3 - 5 years Linen 1 - 5 years 1 - 5 years Please note: the estimated useful lives, residual values and depreciation method are reviewed at the end of each annual reporting period, and adjustments made where appropriate. As part of the Buildings valuation, building values were componentised and each component assessed for its useful life which is represented above.
Other operating expenses Other operating expenses generally represent the day-to-day running costs incurred in normal operations and include:
Supplies and consumables Supplies and services costs which are recognised as an expense in the reporting period in which they are incurred. The carrying amounts of any inventories held for distribution are expensed when distributed.
Bad and doubtful debts Refer to Note 1 (j) Impairment of financial assets.
Fair value of assets, services and resources provided free of charge or for nominal consideration Contributions of resources provided free of charge or for nominal consideration are recognised at their fair value when the transferee obtains control over them, irrespective of whether restrictions or conditions are imposed over the use of the contributions, unless received from another agency as a consequence of a restructuring of administrative arrangements. In the latter case, such a transfer will be recognised at its carrying value. Contributions in the form of services are only recognised when a fair value can be reliably determined and the services would have been purchased if not donated.
( i ) Other comprehensive income Other comprehensive income measures the change in volume or value of assets or liabilities that do not result from transactions.
Net gain/(loss) on non-financial assets Net gain/(loss) on non-financial assets and liabilities includes realised and unrealised gains and losses as follows:
Revaluation gains/(losses) of non-financial physical assets Refer to Note 1(k) Revaluations of non-financial physical assets. Net gain/(loss) on financial instruments Net gain/(loss) on financial instruments includes: - realised and unrealised gains and losses from revaluations of financial instruments at fair value; - impairment and reversal of impairment for financial instruments at amortised cost (refer to Note 1 (j)); and - disposals of financial assets and derecognition of financial liabilities
Revaluations of financial instrument at fair value Refer to Note 1 (j) Financial instruments.
50 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) Share of net profits/(losses) of associates and joint entities, excluding dividends. Refer to Note 1 (d) Basis of consolidation. Other gains/(losses) from other comprehensive income Other gains/(losses) include: - the revaluation of the present value of the long service leave liability due to changes in the bond interest rates; and - transfer of amounts from the reserves to accumulated surplus or net result due to disposal or derecognition or reclassification.
( j ) Financial Instruments Financial Instruments arise out of contractual agreements that give rise to a financial asset of one entity and a financial liability or equity instrument of another entity. Due to the nature of the Central Gippsland Health Service's activities, certain financial assets and financial liabilities arise under statute rather than contract. Such financial assets and financial liabilities do not meet the definition of financial instruments in AASB 132 Financial Instruments: Presentation. For example, statutory receivables arising from taxes, fines and penalties do not meet the definition of financial instruments as they do not arise under contract. Where relevant, for note disclosure purposes, a distinction is made between those financial assets and financial liabilities that meet the definition of financial instruments in accordance with AASB 132 and those that do not. Loans & Receivables Loans and receivables are financial instrument assets with fixed and determinable payments that are not quoted on an active market. These assets are initially recognised at fair value plus any directly attributable transaction costs. Subsequent to initial measurement, loans and receivables are measured at amortised cost using the effective interest method, less any impairment. Loans and receivables category includes cash and deposits (refer to Note 1(k)), term deposits with maturity greater than three months, trade receivables, loans and other receivables, but not statutory receivables.
Financial liabilities at amortised cost Financial instrument liabilities are initially recognised on the date they are originated. They are initially measured at fair value plus any directly attributable transaction costs. Subsequent to initial recognition, these financial instruments are measured at amortised cost with any difference between the initial recognised amount and the redemption value being recognised in profit and loss over the period of the interest-bearing liability, using the effective interest rate method. Financial instrument liabilities measured at amortised cost include all of the Health Service’s contractual payables, deposits held and advances received, and interest-bearing arrangements other than those designated at fair value through profit or loss. ( k ) Assets Cash & Cash Equivalents Cash and cash equivalents recognised on the balance sheet comprise cash on hand and cash at bank, deposits at call and highly liquid investments with an original maturity of three months or less, which are held for the purpose of meeting short term cash commitments rather than for investment purposes, which are readily convertible to known amounts of cash and are subject to insignificant risk of changes in value. For cash flow statement presentation purposes, cash and cash equivalents include bank overdrafts, which are included as liabilities on the balance sheet.
Receivables Receivables consist of: - Statutory receivables, which include predominantly amounts owing from the Victorian Government and GST input tax credits recoverable; and - Contractual receivables, which include mainly debtors in relation to goods and services, loans to third parties, accrued investment income, and finance lease receivables. Receivables that are contractual are classified as financial instruments and categorised as loans and receivables. Statutory receivables are not classified as financial instruments as they do not arise from a contract. Trade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition. Receivables are recognised initially at fair value and subsequently measured at amortised cost, using the effective interest method, less any accumulated impairment. Collectability of debts is reviewed on an ongoing basis, and debts which are known to be uncollectible are written off. A provision for doubtful debts is recognised when there is objective evidence that the debts may not be collected and bad debts are written off when identified.
51 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) Investments and Other Financial Assets Investments are recognised and derecognised on trade date where purchase or sale of an investment is under a contract whose terms require delivery of the investment within the timeframe established by the market concerned, and are initially measured at fair value, net of transaction costs. Investments are classified in the following categories: - Financial assets at fair value through profit and loss; - Loans and receivables; - Held to maturity; and - Available-for-sale financial assets. The Central Gippsland Health Service classifies its other financial assets between current and non-current assets based on the purpose for which the assets were acquired. Management determines the classification of its other financial assets at initial recognition. The Central Gippsland Health Service assesses at each balance sheet date whether a financial asset or group of financial assets is impaired. All financial assets, except those measured at fair value through profit or loss are subject to annual review for impairment. Inventories Inventories include goods and other property held either for sale, consumption or for distribution at no or nominal cost in the ordinary course of business operations. It includes land held for sale and excludes depreciable assets. Inventories held for distribution are measured at cost and adjusted for any loss of service potential. All other inventories, including land held for sale, are measured at the lower of cost and net realisable value. Inventories acquired for no cost or nominal considerations are measured at current replacement cost at the date of acquisition. The bases used in assessing loss of service potential for inventories held for distribution include current replacement cost and technical or functional obsolescence. Technical obsolescence occurs when an item still functions for some or all of the tasks it was originally acquired to do, but no longer matches existing technologies. Functional obsolescence occurs when an item no longer functions the way it did when it was first acquired. Cost for all other inventory is measured on the basis of weighted average cost. Inventories acquired for no cost or nominal considerations are measured at current replacement cost at the date of acquisition. Property Plant and Equipment
All non-current physical assets are measured initially at cost and subsequently revalued at fair value less accumulated depreciation and impairment. Where an asset is acquired for no or nominal cost, the cost is its fair value at the date of acquisition. More details about the valuation techniques and inputs used in determining the fair value of non-financial physical assets are discussed in Note 11 Property, plant and equipment. Crown Land is measured at fair value with regard to the property’s highest and best use after due consideration is made for any legal or constructive restrictions imposed on the asset, public announcements or commitments made in relation to the intended use of the asset. Theoretical opportunities that may be available in relation to the asset(s) are not taken into account until it is virtually certain that any restrictions will no longer apply. Therefore unless otherwise disclosed, the current use of these non financial assets will be their highest and best use.
Land and Buildings are recognised initially at cost and subsequently measured at fair value less accumulated depreciation and impairment.
Plant, Equipment and Vehicles are recognised initially at cost and subsequently measured at fair value less accumulated depreciation and impairment. Depreciated historical cost is generally a reasonable proxy for fair value because of the short lives of the assets concerned.
Revaluations of Non-Current Physical Assets
Non-current physical assets are measured at fair value and are revalued in accordance with FRD 103E Non-current physical assets. This revaluation process normally occurs at least every five years, based upon the asset’s Government Purpose Classification, but may occur more frequently if fair value assessments indicate material changes in values. Independent valuers are used to conduct these scheduled revaluations and any interim revaluations are determined in accordance with the requirements of the FRDs. Revaluation increments or decrements arise from differences between an asset’s carrying value and fair value. Revaluation increments are recognised in ‘other comprehensive income’ and are credited directly to the asset revaluation surplus, except that, to the extent that an increment reverses a revaluation decrement in respect of that same class of asset previously recognised as an expense in net result, the increment is recognised as income in the net result. Revaluation decrements are recognised in ‘other comprehensive income’ to the extent that a credit balance exists in the asset revaluation surplus in respect of the same class of property, plant and equipment. Revaluation increases and revaluation decreases relating to individual assets within an asset class are offset against one another within that class but are not offset in respect of assets in different classes. Revaluation surplus is not transferred to accumulated funds on derecognition of the relevant asset. In accordance with FRD 103E, Central Gippsland Health Service’s non-current physical assets were assessed to determine whether revaluation of the non-current physical assets was required.
52 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued)
Prepayments Other non-financial assets include prepayments which represent payments in advance of receipt of goods or services or that part of expenditure made in one accounting period covering a term extending beyond that period.
Disposal of Non-Financial Assets Any gain or loss on the sale of non-financial assets is recognised in the comprehensive operating statement. Refer to note 1(i) – ‘comprehensive income’.
Impairment of Non-Financial Assets Apart from intangible assets with indefinite useful lives, all other non-financial assets are assessed annually for indications of impairment, except for: • inventories; • financial assets
If there is an indication of impairment the assets concerned are tested as to whether their carrying value exceeds their possible recoverable amounts. Where an assets carrying value exceeds its recoverable amount, the difference is written off as an expense except to the extent that the write-down can be debited to an asset revaluation surplus amount applicable to that same class of asset. If there is an indication that there has been a change in the estimate of an asset's recoverable amount since the last impairment loss was recognised, the carrying amount shall be increased to its recoverable amount. This reversal of the impairment loss occurs only to the extent that the asset's carrying amount does not exceed the carrying amount that would have been determined, net of depreciation or amortisation, if no impairment loss had been recognised in prior years. It is deemed that, in the event of the loss or destruction of an asset, the future economic benefits arising from the use of the asset will be replaced unless a specific decision to the contrary has been made. The recoverable amount for most assets is measured at the higher of depreciated replacement cost and fair value less costs to sell. Recoverable amount for assets held primarily to generate net cash inflows is measured at the higher of the present value of future cash flows expected to be obtained from the asset and fair value less costs to sell. Investments in Jointly Controlled Assets and Operations In respect of any interest in jointly controlled assets, Central Gippsland Health Service recognises in the financial statements: • its share of jointly controlled assets; • any liabilities incurred; • its share of liabilities incurred jointly by the joint venture; • any income earned from the selling or using of its share of the output from the joint venture; and
• any expenses incurred in relation to being an investor in the joint venture.
For jointly controlled operations Central Gippsland Health Service recognises: • the assets that it controls; • the liabilities that it incurs; • expenses that it incurs; and • the share of income that it earns from selling outputs of the joint venture
Derecognition of Financial Assets
Financial assets (or, where applicable, a part of a financial asset or part of a group of similar financial assets) is derecognised when : • the rights to receive cashflows from the asset have expired; or • Central Gippsland Health Service retains the right to receive cash flows from the asset, but has assumed an obligation to pay them in full without material delay to a third party under a 'pass through' arrangement; or • the Health Service has transferred its rights to receive cash flows from the asset and either: (a) has transferred substantially all the risks and rewards of the asset; or (b) has neither transferred nor retained substantially all the risks and rewards of the asset, but has transferred control of the asset. Where Central Gippsland Health Service has neither transferred nor retained substantially all the risks and rewards or transferred control, the asset is recognised to the extent of the Health Service's continuing involvement in the asset.
53 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) Impairment of Financial Assets At the end of each reporting period Central Gippsland Health Service assesses whether there is objective evidence that a financial asset or group of financial assets is impaired. All financial instrument assets, except those measured at fair value through profit or loss, are subject to annual review for impairment. Receivables are assessed for bad and doubtful debts on a regular basis. Bad debts considered as written off and allowances for doubtful receivables are expensed. The amount of the allowance is the difference between the financial assets carrying amount and the present value of estimated future cash flows, discounted at the effective interest rate.
Where the fair value of an investment in an equity instrument at balance date has reduced by 20 per cent or more than its cost price or where its fair value has been less than its cost price for a period of 12 or more months, the financial instrument is treated as impaired. In assessing impairment of statutory (non-contractual) financial assets, which are not financial instruments, professional judgement is applied in assessing materiality using estimates, averages and other computational methods in accordance with AASB 136 Impairment of Assets .
Net Gain/(Loss) on Financial Instruments Net Gain/(loss) on financial instruments includes: - realised and unrealised gains and losses from revaluations of financial instruments that are designated at fair value through profit or loss or held-for-trading; - impairment and reversal of impairment for financial instruments at amortised cost; and - disposals of financial assets.
( l ) Liabilities Payables Payables consist of: • contractual payables which consist predominantly of accounts payable representing liabilities for goods and services provided to Central Gippsland Health Service prior to the end of the financial year that are unpaid, and arise when Central Gippsland Health Service becomes obliged to make future payments in respect of the purchase of those goods and services. The normal credit terms for accounts payable are usually Nett 30 days. • statutory payables, such as goods and services tax and fringe benefits tax payables. Contractual payables are initially recognised at fair value, and the subsequently carried at amortised cost. Statutory payables are recognised and measured similarly to contractual payables, but are not classified as financial instruments and not included in the category of financial liabilities at amortised cost, because they do not arise from a contract.
Provisions Provisions are recognised when Central Gippsland Health Service has a present obligation, the future sacrifice of economic benefits is probable, and the amount of the provision can be measured reliably. The amount recognised as a provision is the best estimate of the consideration required to settle the present obligation at reporting date, taking into account the risks and uncertainties surrounding the obligation. Where a provision is measured using the cash flows estimated to settle the present obligation, its carrying amount is the present value of those cash flows, using a discount rate that reflects the time value of money and risks specific to the provision. When some or all of the economic benefits required to settle a provision are expected to be received from a third party, the receivable is recognised as an asset if it is virtually certain that recovery will be received and the amount of the receivable can be measured reliably.
Employee Benefits This provision arises for benefits accruing to employees in respect of wages and salaries, annual leave and long service leave for services rendered to the reporting date. Wages and Salaries, Annual Leave, Sick Leave and Accrued Days Off
Liabilities for wages and salaries, including non-monetary benefits, annual leave, accumulating sick leave and accrued days off are all recognised in the provision for employee benefits as 'current liabilities', because the health service does not have an unconditional right to defer settlements of these liabilities. Depending on the expectation of the timing of settlement, liabilities for wages and salaries, annual leave and sick leave are measured at:
• Undiscounted value - if Central Gippsland Health Service expects to wholly settle within 12 months; or
• Present value - if Central Gippsland Health Service does not expect to wholly settle within 12 months.
54 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) Long Service Leave Liability for LSL is recognised in the provision for employee benefits. Unconditional LSL is disclosed in the notes to the financial statements as a current liability, even where Central Gippsland Health Service does not expect to settle the liability with 12 months because it will not have the unconditional right to defer the settlement of the entitlement should an employee take leave within 12 months. The components of this current LSL liability are measured at: • Undiscounted value - if Central Gippsland Health Service expects to wholly settle within 12 months; and
• Present value - if the Central Gippsland Health Service does not expect to wholly settle within 12 months. Conditional LSL is disclosed as a non-current liability. There is an unconditionasl right to defer the settlement of the entitlement until the employee has completed the requisite years of service. This non-current LSL liability is measured at present value. Any gain or loss following revaluation of the present value of non-current LSL liability is recognised as a transaction in the operating statement.
Termination Benefits Termination benefits are payable when employment is terminated before the normal retirement date or when an employee decides to accept an offer of benefits in exchange for the termination of employment. Central Gippsland Health Service recognises termination benefits when it is demonstrably committed to either terminating the employment of current employees according to a detailed formal plan without possibility of withdrawal or providing termination benefits as a result of an offer made to encourage voluntary redundancy. Benefits falling due more than 12 months after the end of the reporting period are discounted to present value. On-Costs Provisions for on-costs, such as payroll tax, workers compensation and superannuation are recognised together with provision for employee benefits. Superannuation Liabilities Central Gippsland Health Service does not recognise any unfunded defined benefit liability in respect of the superannuation plans because Central Gippsland Health Service has no legal or constructive obligation to pay future benefits relating to its employees; its only obligation is to pay superannuation contributions as they fall due.
( m ) Leases A lease is a right to use an asset for an agreed period of time in exchange for payment. Leases are classified at their inception as either operating or finance leases based on the economic substance of the agreement so as to reflect the risks and rewards incidental to ownership.
Leases of property, plant and equipment are classified as finance leases whenever the terms of the lease transfer substantially all the risks and rewards of ownership to the lessee. All other leases are classified as operating leases. Finance leases Central Gippsland Health Service does not hold any finance lease arrangements with other parties. Operating Leases Rental income from an operating lease is recognised on a straight-line basis over the term of the relevant lease. Operating lease payments, including any contingent rentals, are recognised as an expense in the Comprehensive Operating Statement on a straight line basis over the lease term, except where another systematic basis is more representative of the time pattern of the benefits derived from the use of the leased asset. The leased asset is not recognised in the Balance Sheet. Lease Incentives
All incentives for the agreement of a new or renewed operating lease are recognised as an integral part of the net consideration agreed for the use of the leased asset, irrespective of the incentives nature or form or the timing of payments. In the event that the lease incentives are received by the lessee to enter into operating leases, such incentives are recognised as a liability. The aggregate benefits of incentives are recognised as a reduction of rental expense on a straight-line basis, except where another systematic basis is more representative of the time pattern in which economic benefits from the leased asset are diminished. Leasehold Improvements The cost of leasehold improvements are capitalised as an asset and depreciated over the remaining term of the lease or the estimated useful life of the improvements, whichever is the shorter.
55 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued)
( n ) Equity Contributed Capital Consistent with Australian Accounting Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities and FRD 119 Contributions by Owners , appropriations for additions to the net asset base have been designated as contributed capital. Other transfers that are in the nature of contributions or distributions that have been designated as contributed capital are also treated as contributed capital. Property, Plant & Equipment Revaluation Surplus The asset revaluation surplus is used to record increments and decrements on the revaluation of non-current physical assets. Restricted Specific Purpose Surplus A specific restricted purpose reserve is established where Central Gippsland Health Service has possession or title to the funds but has no discretion to amend or vary the restriction and/or condition underlying the fund received. The Health Service has funds which are retained specifically for future capital works on the Health Service's Residential Aged Care facilities.
( o ) Commitments Commitments for future expenditure include operating and capital commitments arising from contracts. These commitments are disclosed by way of a note (refer to note 18) at their nominal value and are inclusive of the GST payable. In addition, where it is considered appropriate and provides additional relevant information to users, the net present values of significant individual projects are stated. These future expenditures cease to be disclosed as commitments once the related liabilities are recognised on the balance sheet.
( p ) Contingent assets and contingent liabilities Contingent assets and contingent liabilities are not recognised in the balance sheet, but are disclosed by way of note and, if quantifiable, are measured at nominal value. Contingent assets and contingent liabilities are presented inclusive of GST receivable or payable respectively. ( q ) Goods & Services Tax Income, expenses and assets are recognised net of the amount of associated GST, unless the GST incurred is not recoverable from the taxation authority. In this case it is recognised as part of the cost of acquisition of the asset or as part of the expense. Receivables and payables are stated inclusive of the amount of GST receivable or payable. The net amount of GST recoverable from, or payable to, the taxation authority is included with other receivables or payables in the balance sheet. Cash flows are presented on a gross basis. The GST components of cash flows arising from investing or financing activities which are recoverable from, or payable to the taxation authority, are presented as operating cash flow. Commitments for expenditure and contingent assets and liabilities are presented on a gross basis.
( r ) Events after the Reporting Period Assets, liabilities, income or expenses arise from past transactions or other past events. Adjustments are made to amounts recognised in the financial statements for events which occur after the reporting period and before the date the financial statements are authorised for issue, where those events provide information about conditions which existed in the reporting period. Note disclosure is made about events between the end of the reporting period and the date the financial statements are authorised for issue where the events relate to conditions which arose after the end of the reporting period and which may have a material impact on the results of subsequent reporting periods.
56 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) ( s ) AASs issued that are not yet effective Certain new Australian accounting standards have been published that are not mandatory for the 30 June 2014 reporting period. DTF assesses the impact of all these new standards and advises Central Gippsland Health Service of their applicability and early adoption where applicable. As at 30 June 2014, the following standards and interpretations had been issued by the AASB but were not yet effective. They become effective for the first financial statements for reporting periods commencing after the stated operative dates as detailed in the table below. Central Gippsland Health Service has not and does not intend to adopt these standards early.
Impact on Health Applicable for reporting Service's Annual Standard/ Interpretation Summary periods beginning on Statements AASB 9 Financial instruments This standard simplifies 1 Jan 2017 The preliminary requirements for the assessment has classification and measurement identified that the of financial assets resulting from financial impact of Phase 1 of the IASB’s project to available for sale (AFS) replace IAS 39 Financial assets will now be Instruments: Recognition and reported through other Measurement (AASB 139 comprehensive income Financial Instruments: (OCI) and no longer Recognition and Measurement). recycled to the profit and loss. While the preliminary assessment has not identified any material impact arising from AASB 9, it will continue to be monitored and assessed. AASB 11 Joint Arrangements This Standard deals with the 1 Jan 2014 Based on current concept of joint control, and assessment, entities sets out a new principles-based already apply the equity approach for determining the method when type of joint arrangement that accounting for joint exists and the corresponding ventures. It is accounting treatment. The new anticipated that there categories of joint arrangements would be no material under AASB 11 are more impact. Ongoing work is aligned to the actual rights and being done to monitor obligations of the parties to the and assess the impact arrangement. of this standard. AASB 12 Disclosure of Interests in Other This Standard requires 1 Jan 2014 The new standard is Entities disclosure of information that likely to require enables users of financial additional disclosures statements to evaluate the and ongoing work is nature of, and risks associated being done to with, interests in other entities determine the extent of and the effects of those additional disclosure interests on the financial required. statements. This Standard replaces the disclosure requirements in AASB 127 Separate Financial Statements and AASB 131 Interests in Joint Ventures.
AASB 127 Separate Financial Statements This revised Standard 1 Jan 2014 Current assessment prescribes the accounting and indicates that there is disclosure requirements for limited impact on investments in subsidiaries, Victorian Public Sector joint ventures and associates entities. Ongoing work when an entity prepares is being done to monitor separate financial statements. and assess the impact of this standard. AASB 128 Investments in Associates and This revised Standard sets out 1 Jan 2014 Current assessment Joint Ventures the requirements for the indicates that there is application of the equity method limited impact on when accounting for Victorian Public Sector investments in associates and entities. Ongoing work joint ventures. is being done to monitor and assess the impact of this standard.
57 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 1: Summary of Significant Accounting Policies (continued) ( t ) Category Groups Central Gippsland Health Service has used the following category groups for reporting purposes for the current and previous financial years. Admitted Patient Services (Admitted Patients) comprises all recurrent health revenue/expenditure on admitted patient services, where services are delivered in public hospitals, or free standing day hospital facilities, or alcohol and drug treatment units or hospitals specialising in dental services, hearing and ophthalmic aids. Outpatient Services (Outpatients) comprises all recurrent health revenue/expenditure on public hospital type outpatient services, where services are delivered in public hospital outpatient clinics, or free standing day hospital facilities, or rehabilitation facilities, or alcohol and drug treatment units, or outpatient clinics specialising in ophthalmic aids or palliative care. Emergency Department Services (EDS) comprises all recurrent health revenue/expenditure on emergency department services that are available free of charge to public patients. Aged Care comprises revenue/expenditure from Home and Community Care (HACC) programs, Allied Health, Aged Care Assessment and Support services. Primary Health comprises revenue/expenditure for Community Health Services including health promotion and counselling, physiotherapy, speech therapy, podiatry and occupational therapy. Off Campus, Ambulatory Services (Ambulatory) comprises all recurrent health revenue/expenditure on public hospital type services including palliative care facilities and rehabilitation facilities, as well as services provided under the following agreements: Services that are provided or received by hospitals (or area health services) but are delivered/received outside a hospital campus, services which have moved from a hospital to a community setting since June 1998, services which fall within the agreed scope of inclusions under the new system, which have been delivered within hospitals i.e. in rural/remote areas. Residential Aged Care including Mental Health (RAC incl. Mental Health) referred to in the past as psychogeriatric residential services, comprises those Commonwealth-licensed residential aged care services in receipt of supplementary funding from DH under the mental health program. It excludes all other residential services funded under the mental health program, such as mental health- funded community care units (CCUs) and secure extended care units (SECs).
Other Services excluded from Australian Health Care Agreement (AHCA) (Other) comprises revenue/expenditure for services not separately classified above, including: Public health services including Laboratory testing, Blood Borne Viruses / Sexually Transmitted Infections clinical services, Koori liaison officers, immunisation and screening services, Drugs services including drug withdrawal, counselling and the needle and syringe program, Dental Health services including general and specialist dental care, school dental services and clinical education, Disability services including aids and equipment and flexible support packages to people with a disability, Community Care programs including sexual assault support, early parenting services, parenting assessment and skills development, and various support services. Health and Community Initiatives also falls in this category group.
58 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 2: Revenue HSA HSA H&CI H&CI Total Total 2014 2013 2014 2013 2014 2013 $'000 $'000 $'000 $'000 $'000 $'000 Revenue from Operating Activities Government Grants Department of Health 9,309 25,386 - - 9,309 25,386 Victorian Health Funding Pool 44,859 25,960 44,859 25,960 Dental Health Services Victoria 1,071 721 - - 1,071 721 State Government - Other Other 1,243 1,221 - - 1,243 1,221 Commonwealth Government Residential Aged Care Subsidy 3,984 3,905 - - 3,984 3,905 Victorian Local Hospital Networks - 638 - - - 638 Other 1,812 1,953 - - 1,812 1,953 Total Government Grants 62,278 59,784 - - 62,278 59,784 Indirect Contributions by Department of Health Insurance 82 1,166 - - 82 1,166 Long Service Leave 77 306 - - 77 306 Total Indirect Contributions by Department of Health 159 1,472 - - 159 1,472 Patient and Resident Fees Patient and Resident Fees - (refer note 2b) 2,557 2,713 - - 2,557 2,713 Residential Aged Care (refer note 2b) 1,757 1,575 - - 1,757 1,575 Total Patient and Resident Fees 4,314 4,288 - - 4,314 4,288 Business Units & Specific Purpose Funds Diagnostic Imaging - - 4,692 4,427 4,692 4,427 Linen Service - - 2,082 2,029 2,082 2,029 Other - - 644 704 644 704 Total Business Units & Specific Purpose Funds - - 7,418 7,160 7,418 7,160 Donations & Bequests 141 146 - - 141 146 Other Revenue from Operating Activities 3,357 3,036 - - 3,357 3,036
Sub-Total Revenue from Operating Activities 70,249 68,726 7,418 7,160 77,667 75,886 Revenue from Non-Operating Activities Interest - - 345 360 345 360 Other Revenue from Non-Operating Activities - - 111 114 111 114 - Sub-Total Revenue from Non-Operating Activities - - 456 474 456 474 Revenue from Capital Purpose Income State Government Capital Grants - - 541 2,224 541 2,224 Commonwealth Funded Capital Grants - - - 5 - 5 Capital Donations - - 321 106 321 106 Assets Received free of Charge (refer note 2d) - - - 9 - 9 Net Gain/(Loss) from Sale of Non Current Assets - (refer note 2c) - - (17) 14 (17) 14
Sub-Total Revenue from Capital Purpose Income - - 845 2,358 845 2,358 Total Revenue (refer note 2a) 70,249 68,726 8,719 9,992 78,968 78,718 Indirect contributions by Department of Health Department of Health makes certain payments on behalf of the Health Service. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.
59 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 2a: Analysis of Revenue by Source Admitted Outpatients EDS Ambulatory RAC Aged Primary Other Total Patients Care Health 2014 2014 2014 2014 2014 2014 2014 2014 2014 2014 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 Revenue from Services Supported by Health Services Agreement
Government Grants 36,232 4,272 4,059 4,566 6,225 3,844 1,521 1,559 62,278 Indirect Contributions by Department of Health 107 13 11 13 15 - - - 159 Patient and Resident Fees - (refer note 2b) 1,158 358 117 11 1,757 810 13 90 4,314 Donations & Bequests (non capital) 104 13 11 13 - - - - 141 Other Revenue from Operating Activities 1,728 202 160 884 11 210 98 64 3,357
Sub-Total Revenue from Services Supported by Health Services Agreement 39,329 4,858 4,358 5,487 8,008 4,864 1,632 1,713 70,249
Revenue from Services Supported by Hospital and Community Initiatives
Business Units & Specific Purpose Funds ------7,418 7,418 Other ------456 456 Capital Purpose Income (refer Note 2) ------845 845
Sub-Total Revenue from Services Supported by Hospital and Community Initiatives ------8,719 8,719
Total Revenue 39,329 4,858 4,358 5,487 8,008 4,864 1,632 10,432 78,968
Indirect contributions by Health Department of Health makes certain payments on behalf of the Service in respect of insurance and long service leave. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.
60 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 2a: Analysis of Revenue by Source Admitted Outpatients EDS Ambulatory RAC Aged Primary Other Total Patients Care Health 2013 2013 2013 2013 2013 2013 2013 2013 2013 2013 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 Revenue from Services Supported by Health Services Agreement
Government Grants 35,615 4,119 3,869 3,666 6,107 3,735 1,479 1,194 59,784 Indirect Contributions by Department of Health 1,361 35 30 30 16 - - - 1,472 Patient and Resident Fees - (refer note 2b) 1,283 345 102 10 1,575 866 17 90 4,288 Donations & Bequests (non capital) 109 13 12 12 - - - - 146 Other Revenue from Operating Activities 1,465 176 173 843 39 234 73 33 3,036
Sub-Total Revenue from Services Supported by Health Services Agreement 39,833 4,688 4,186 4,561 7,737 4,835 1,569 1,317 68,726
Revenue from Services Supported by Hospital and Community Initiatives
Business Units & Specific Purpose Funds ------7,160 7,160 Other ------474 474 Capital Purpose Income (refer Note 2) ------2,358 2,358
Sub-Total Revenue from Services Supported by Hospital and Community Initiatives ------9,992 9,992
Total Revenue 39,833 4,688 4,186 4,561 7,737 4,835 1,569 11,309 78,718
Indirect contributions by Department of Health Department of Health makes certain payments on behalf of the Service in respect of insurance and long service leave. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.
61 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 2b: Patient and Resident Fees
2014 2013 $'000 $'000 Patient and Resident Fees Raised Recurrent: Acute Care - Inpatients 840 966 - Outpatients 767 774
Residential Aged Care - Nursing Home Patient Fees 1,757 1,575
Community Health 950 973
Total Patient and Resident Fees 4,314 4,288
The Service charges hospital fees in accordance with the Department of Human Services directives.
Note 2c: Net Gain/(Loss) on Disposal of Non-Financial Assets 2014 2013 $'000 $'000
Proceeds from Disposal of Non-Current Assets Plant and Equipment - Medical Equipment 7 12 - Transport 16 47 - Other Equipment - 1 Total Proceeds from Disposal of Non-Current Assets 23 60
Less: Written Down Value of Non-Current Assets Sold Buildings - 20 Plant and Equipment - Medical Equipment 6 20 - Transport 34 6 - Computers & Communications - - Total Written Down Value of Non-Current Assets Sold 40 46
Net Gain/(Loss) on Disposal of Non-Current Assets (17) 14
Note 2d: Assets Received Free of Charge 2014 2013 $'000 $'000 During the reporting period, the fair value of assets received free of charge, was as follows
Plant and Equipment - 9 Total Assets Received Free of Charge - 9
Assets were purchased and donated to the Health Service by members of the public for use by the Loch Sport Community Centre and Learning Services..
62 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 3: Expenses HSA HSA H&CI H&CI Total Total 2014 2013 2014 2013 2014 2013 $'000 $'000 $'000 $'000 $'000 $'000 Expenses from Operating Activities Employee Benefits - Salaries & Wages 46,014 44,887 3,549 3,292 49,563 48,179 WorkCover 675 586 49 47 724 633 Departure Packages 87 110 37 - 124 110 Long Service Leave 1,121 1,374 99 133 1,220 1,507 Superannuation 4,178 4,040 324 314 4,502 4,354 Total Employee Benefits 52,075 50,997 4,058 3,786 56,133 54,783
Non Salary Labour Costs - Fee for Service Medical Officers 1,880 1,461 - - 1,880 1,461 External Contract Staff 338 308 31 38 369 346 Total Non Salary Labour Costs 2,218 1,769 31 38 2,249 1,807
Supplies & Consumables Drug supplies 1,822 1,869 327 359 2,149 2,228 S100 Drugs 520 638 - - 520 638 Medical & Surgical Supplies 2,873 2,582 159 162 3,032 2,744 Pathology Supplies 761 780 6 13 767 793 Radiology Supplies 1,333 1,354 395 312 1,728 1,666 Food Supplies 832 841 124 123 956 964 Total Supplies & Consumables 8,141 8,064 1,011 969 9,152 9,033
Other Expenses from Continuing Operations Domestic Services & Supplies 401 405 183 174 584 579 Fuel, Light, Power and Water 1,106 1,058 242 259 1,348 1,317 Insurance Costs funded by Department of Health 1,483 1,166 - - 1,483 1,166 Motor Vehicle Expenses 203 202 81 84 284 286 Repairs and Maintenance 297 352 7 38 304 390 Maintenance Contracts 221 268 203 269 424 537 Patient Transport 1,194 1,189 - 1 1,194 1,190 Bad & Doubtful Debts 53 - 20 8 73 8 Lease Expenses 198 201 444 436 642 637 Other Administrative Expenses 3,932 3,837 231 224 4,163 4,061 Audit fees -VAGO - Audit of Financial Statements - - 37 36 37 36 -Other Audit Fees - - 38 24 38 24 Total Other Expenses from Continuing Operations 9,088 8,678 1,486 1,553 10,574 10,231 Depreciation - (refer note 4) 5,736 5,368 347 256 6,083 5,624 Total 5,736 5,368 347 256 6,083 5,624
Total Expenses 77,258 74,876 6,933 6,602 84,191 81,478
63 CENTRAL GIPPSLAND HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 3a: Analysis of Expenses by Source Admitted Outpatients EDS Ambulatory RAC Aged Primary Other Total Patients Care Health 2014 2014 2014 2014 2014 2014 2014 2014 2014 2014 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000
Services Supported by Health Services Agreement Employee Benefits 31,799 799 4,836 1,344 6,458 4,579 1,110 1,150 52,075 Non Salary Labour Costs 2,152 5 47 11 - 1 - 2 2,218 Supplies & Consumables 5,182 28 1,550 231 624 - 76 450 8,141 Other Expenses from Continuing Operations 6,615 93 1,097 295 553 201 63 171 9,088 Depreciation (refer Note 4) 5,736 ------5,736
Sub-Total Expenses from Services Supported by Health Services Agreement 51,484 925 7,530 1,881 7,635 4,781 1,249 1,773 77,258
Services Supported by Hospital and Community Initiatives - Employee Benefits ------4,089 4,089 Supplies & Consumables ------1,011 1,011 Other Expenses from Continuing Operations ------1,486 1,486 Depreciation (refer Note 4) ------347 347
Sub-Total Expenses from Services Supported by Hospital & Community Initiatives ------6,933 6,933
Total Expenses 51,484 925 7,530 1,881 7,635 4,781 1,249 8,706 84,191
64 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 3a: Analysis of Expenses by Source (continued) Admitted Outpatients EDS Ambulatory RAC Aged Primary Other Total Patients Care Health 2013 2013 2013 2013 2013 2013 2013 2013 2013 2013 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000
Services Supported by Health Services Agreement Employee Benefits 31,567 849 4,672 1,119 6,375 4,251 1,153 1,011 50,997 Non Salary Labour Costs 1,713 5 40 9 1 1 - - 1,769 Supplies & Consumables 5,114 31 1,572 213 652 200 73 209 8,064 Other Expenses from Continuing Operations 6,085 109 1,155 289 569 229 70 172 8,678 Depreciation (refer Note 4) 5,368 ------5,368 Sub-Total Expenses from Services Supported by Health Services Agreement 49,847 994 7,439 1,630 7,597 4,681 1,296 1,392 74,876
Services Supported by Hospital and Community Initiatives - Employee Benefits ------3,824 3,824 Supplies & Consumables ------969 969 Other Expenses from Continuing Operations ------1,553 1,553 Depreciation & (refer Note 4) ------256 256
Sub-Total Expenses from Services Supported by Hospital & Community Initiatives ------6,602 6,602
Total Expenses 49,847 994 7,439 1,630 7,597 4,681 1,296 7,994 81,478
65 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 3b Analysis of Expenses by Internal & Restricted Specific Purpose Funds Supported by Hospital and Community Initiatives 2014 2013 $'000 $'000 Diagnostic Imaging 3,815 3,635 Linen Service 2,582 2,160 Cardiology 132 133 Regional Stores 391 438 Other 13 236 TOTAL 6,933 6,602
Note 4: Depreciation.
Depreciation Buildings 4,912 4,429 Plant & Equipment: -Plant 73 33 -Transport 124 103 -Major Medical 540 600 -Computers and Communications 54 41 -Other Equipment 110 125 Furniture & Fittings 67 100 Linen 203 193 Total Depreciation 6,083 5,624
66 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 5: Cash Assets & Cash Equivalents
For the purpose of the Cash Flow Statement, cash includes cash on hand and in banks, and short-term deposits which are readily convertible to cash on hand, and are subject to an insignificant risk of change in value, net of outstanding bank overdrafts. 2014 2013 $'000 $'000
Cash on Hand 34 34 Cash at Bank 1,119 1,105 Deposits at call 2,425 474 Short Term Deposits 117 2,957 Sub Total 3,695 4,570 less Trust Funds Gippsland Palliative Care Consortium (963) (1,641) Total Cash as per Cash Flow Statement 2,732 2,929
The Health Service has a bank overdraft facility of $0. (2013:$0)
Included in the cash assets are the following amounts:
(i) $963,240 (2013:$1,640,735) held on behalf of the Gippsland Palliative Care Consortium (refer Note 14)
Note 6: Receivables 2014 2013 $'000 $'000 Current Contractual Inter Hospital Debtors 509 364 Trade Debtors 439 591 Patient Fees 347 314 Diagnostic Imaging Debtors 131 164 Accrued Revenue - Other 211 153 Less Allowance for Doubtful Debts Patient Fees 52 25 Trade Debtors 3 4 Diagnostic Imaging Debtors 22 25 1,560 1,532 Statutory GST Receivable 125 216 Accrued Revenue - Department of Health - 99 125 315 Total Current Receivables 1,685 1,847 Non Current Statutory Department of Health - Long Service Leave 1,238 1,162 Total Non-Current Receivables 1,238 1,162
Total Receivables 2,923 3,009
(a) Movement in the Allowance for doubtful debts Balance at beginning of year 54 91 Amounts written off during the year (50) (45) Increase/(decrease) in allowance recognised in net result 73 8 Balance at end of year 77 54
(b) Ageing analysis of receivables Please refer to note 17(b) for the ageing analysis of receivables
(c) Nature and extent of risk arising from receivables Please refer to note 17(b) for the nature and extent of risk arising from receivables
67 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 7: Investments and Other Financial Assets 2014 2013 Current $'000 $'000
Cash at Bank 18 22 Short Term Deposits 3,721 2,350 Total 3,739 2,372 Represented by Current Patient Monies held in Trust 18 22 Short Term Deposits 3,721 2,350 Total 3,739 2,372
(b) Ageing analysis of other financial assets Please refer to note 17(b) for the aging analysis of investments and other financial assets
(c) Nature and extent of risk arising from other financial assets Please refer to note 17(b) for the nature and extent of risk arising from investments and other financial assets
Note 8: Inventories 2014 2013 $'000 $'000
Pharmaceuticals At Cost 152 169 Other Consumables At Cost 94 113 Total Inventories 246 282
Note 9: Other Assets 2014 2013
Current $'000 $'000 Prepayments 84 93 Other - Gippsland Health Alliance (Refer Note 10) 53 55 Total Other Current Assets 137 148
Non Current Prepayments 33 60 Total Other Non Current Assets 33 60 Total Other Assets 170 208
68 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2013
Note 10 : Jointly Controlled Operations and Assets
Ownership Interest 2014 2013 Country of Name of Entity Principal Activity Incorporation % % Gippsland Health Alliance Information Technology Australia 13.3 13.8
The Central Gippsland Health Service interest in assets employed in the above jointly controlled operations and assets is detailed below. The amounts are included in the financial statements and consolidated financial statement under their respective asset categories:
2014 2013 $'000 $'000 Current Assets Cash and Cash Equivalents 593 591 Receivables 94 259 Other Current Assets 53 55 Total Current Assets 740 905 Non-Current Assets Property, Plant and Equipment 16 16 Total Non-Current Assets 16 16 Share of Total Assets 756 921
Current Liabilities Other Current Liabilities 194 395 Total Current Liabilities 194 395 Share of Total Liabilities 194 395 Net Assets 562 526
Reconciliation of jointly controlled assets: Share of funds at beginning of the reporting period 526 558 Contributions made in current reporting period 889 961 Share of current year Surplus/(Deficit) (853) (993) Share of funds at end of reporting period 562 526
Operating Revenue GHA Revenue 383 248 Total Operating Revenue 383 248 Operating Expenses GHA Expenses 1,235 1,240 Total Operating Expenses 1,235 1,240 Capital Expenditure Depreciation 1 1 Total Expenditure 1,236 1,241 Net Result (853) (993)
69 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 11: Property, Plant & Equipment
(a) Gross carrying amount and accumulated depreciation 2014 2013 $'000 $'000 Land Crown Land at Fair Value 2,360 3,577 Freehold Land at Fair Value 1,635 555 Total Land 3,995 4,132 Buildings Buildings Under Construction at Cost 10 20 Buildings at Fair Value 49,998 52,174 Less Accumulated Depreciation - - Leasehold Improvements at Fair value - - Less Accumulated Depreciation - -
Total Buildings 50,008 52,194
Plant and Equipment -Plant at Fair Value 2,271 922 Plant Under Construction at Cost - - Less Accumulated Depreciation (452) (380)
-Transport at Fair Value 1,256 1,233 Less Accumulated Depreciation (896) (778) -Major Medical at Fair Value 7,459 7,216 Less Accumulated Depreciation (4,128) (3,682)
-Computers & Communications at Fair Value 664 607 Less Accumulated Depreciation (538) (484)
-Other Equipment at Fair Value 2,044 1,903 Less Accumulated Depreciation (1,415) (1,305) Total Plant and Equipment 6,265 5,252
Furniture & Fittings at Fair Value 1,208 1,135 Less Accumulated Depreciation (1,002) (935) Total Furniture and Fittings 206 200 Other at Fair Value Linen 612 605 Less Accumulated Depreciation (312) (289) Total Other 300 316
Total Property, Plant & Equipment 60,774 62,094
Land and buildings carried at valuation An independent valuation was performed by the Valuer-General Victoria to determine the fair value of the land and buildings. The valuation, which conforms to Australian Valuation Standards, was determined by reference to the amounts for which assets could be exchanged between knowledgeable willing parties in an arm's length transaction. The valuation was based on independent assessments. The effective date of this valuation was 30 June 2014. The Health Service assessed its other non current physical assets in accordance with FRD103E and ascertained that no formal revaluation was required.
70 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 11: Property, Plant & Equipment (continued)
Reconciliations of the carrying amounts of each class of asset at the beginning and end of the previous and current financial year are set out below.
Land Buildings Plant & Furniture Linen Total Equipment & Fittings $'000 $'000 $'000 $'000 $'000 $'000
Balance as at 1 July 2012 4,132 50,419 4,864 283 287 59,985 Additions - 1,154 1,317 17 222 2,710 Disposals - (20) (27) - - (47) Depreciation (refer Note 4) - (4,429) (902) (100) (193) (5,624) Revaluation - 5,070 - - - 5,070
Balance as at 1 July 2013 4,132 52,194 5,252 200 316 62,094 Additions - 71 1,954 73 187 2,285 Disposals - - (40) - - (40) Depreciation (refer Note 4) - (4,912) (901) (67) (203) (6,083) Revaluation (137) 2,655 - - - 2,518 Balance as at 30 June 2014 3,995 50,008 6,265 206 300 60,774
71 Note 11: Property, Plant & Equipment (continued)
(b) Fair Value measurement hierarchy for assets as at 30 June 2014.
Carrying Amount as at 30 June 2014 Level 1 Level 2 Level 3 Land at fair value Non-specialised 1,635 - 1,635 Specialised land - - 155 Guthridge Pd, Sale 2,132 - - 2,132 - 48 Kent St, Maffra 228 - - 228 Total Land at fair value 3,995 - 1,635 2,360
Buildings at fair value Non-specialised buildings 920 - 920 - Specialised buildings - - 155 Guthridge Pd, Sale 47,102 - 47,102 - 48 Kent St, Maffra 1,787 - 1,787 - Loch Sport 189 - 189 Total of buildings at fair value 49,998 - 920 49,078
Plant and equipment at fair value Plant and equipment at fair value - Vehicles (ii) 360 - - 360 - Plant and equipment 2,780 - - 2,780 Total of plant, equipment and vehicles at fair value 3,140 - - 3,140
Medical equipment at fair value Medical equipment at fair value 3,331 - - 3,331
Total medical equipment at fair value 3,331 - - 3,331 Linen at fair value Linen at fair value 300 - - 300
Total linen at fair value 300 - - 300
Assets under construction at fair value Assets under construction at fair value 10 - 10 -
Total assets under construction at fair value 10 - 10 -
Total Assets at fair value 60,774 - 2,565 58,209
(i) Classified in accordance with fair value hierarchy, see Note 1. (ii) Vehicles are categorised to level 3 assets if the depreciated replacement cost is used in estimating the fair value.
There have been no transfers between levels this period.
Non-specialised land and non- specialised buildings. Non-specialised land and non-specialised buildings are valued using the market approach. Under this valuation method, the assets are compared to recent comparable sales or sales of comparable assets which are considered to have nominal or no added improvement value. For non-specialised land and non-specialised buildings an independent valuation was performed by independent valuers, Opteon Victoria Specialised Pty Ltd to determine the fair value using the market approach.
Valuation of the assets was determined by analysing comparable sales and allowing for share, size, topography, location and other relevant factors specific to the asset being valued. An appropriate rate per square metre has been applied to the subject asset. The effective date of the valuation is 30 June 2014. To the extent that non-specialised land and non-specialised buildings do not contain significant, unobservable adjustments, these assets are classified as Level 2 under the market approach.
72 Note 11: Property, Plant & Equipment (continued)
Specialised land and specialised buildings
The market approach is also used for specialised land and specialised buildings although is adjusted for the community service obligation (CSO), to reflect the specialised nature of the assets being valued. Specialised assets contain significant, unobservable adjustments; therefore these assets are classified as Level 3 under the market based direct comparison approach. The CSO adjustment is a reflection of the valuer's assessment of the impact of restrictions associated with an asset to the extent that is also equally applicable to market participants. This approach is in light of the highest and best use consideration required for fair value measurement, and takes into account the use of the asset that is physically possible, legally permissible and financially feasible. For the health service, the depreciated replacement cost method is used for the majority of specialised buildings, adjusting for the associated depreciation. As depreciation adjustments are considered as significant and unobservable inputs in nature, specialised buildings are classified as Level 3 for fair value measurements.
An independent valuation of the Health Service's specialised land and specialised buildings was performed by the Valuer-General Victoria. The valuation was performed using the market approach adjusted for CSO. The effective date of the valuation is 30 June 2014.
Vehicles
The health service acquires new vehicles and at times disposes of them before completion of their economic life. The process of acquisition, use and disposal in the market is managed by the Health Service who set relevant depreciation rates during use to reflect the consumption of the vehicles. As a result, the fair value of vehicles does not differ materially from the carrying value (depreciated cost)
Plant and equipment. Plant and equipment is held at carrying value (depreciated cost). When plant and equipment is specialised in use, such that it is rarely sold other than as part of a going concern, the depreciated replacement cost is used to estimate fair value. Unless there is market evidence that current replacement costs are significantly different from the original acquisition cost, it is considered unlikely that depreciated replacement cost will be materially different from the existing carrying value.
There were no changes in valuation techniques throughout the period to 30 June 2014.
For all assets measured at fair value, the current use is considered the highest and best use.
(c) Reconciliation of Level 3 fair value
Plant & Medical Assets under Land Building Equipment equipment Linen construction
Opening Balance 3,577 51,195 1,918 3,534 316 20 Purchases (sales) - 81 1,617 243 187 (10) Transfers in (Out) of Level 3 ------
Gains or Losses recognised in net result - Depreciation - (4,689) (397) (446) (203) - Subtotal 3,577 46,587 3,138 3,331 300 10
Items recognised in other comprehensive income - Revaluation (1,217) 2,491 - - - -
Subtotal (1,217) 2,491 - - - - Closing Balance 2,360 49,078 3,138 3,331 300 10
(i) Classified in accordance with the fair value hierarchy, see Note 1.
There have been no transfers between levels during the period.
73 Note 11: Property, Plant & Equipment (continued)
Sensitivity of fair value Significant Range measurement to changes unobservable (weighted in significant unobservable Valuation Technique inputs average) inputs Specialised land A significant increase or - 155 Guthridge Parade, Sale Community decrease in the CSO - 18 Kent St, Maffra Market approach Service 20% adjustment would result in a Obligation (CSO) significantly lower (higher) adjustment (20%)(i) fair value. Specialised buildings A significant increase or decrease in direct cost per square metre adjustment Depreciated Direct cost per $1000-$1500/m2 would result in higher or - 155 Guthridge Pd, Sale replacement cost square metre. ($1300) lower fair value. - 48 Kent St, Maffra A significant increase or decrease in the estimated Useful life of useful life of the asset would specialised result in significantly higher - Loch Sport buildings 1-50 years or lower valuation. Plant and equipment at fair value
A significant increase or decrease in cost per unit Depreciated $9,000-$10,000 would result in higher or - Plant and equipment replacement cost Cost per unit ($9,500) lower fair value.
A significant increase or decrease in the estimated useful life of the asset would 5-10 years (7 result in a significantly higher Useful life of PPE years) or lower valuation. Vehicles at fair value - Vehicles A significant increase or decrease in cost per unit Depreciated $9,000-$10,000 would result in higher or replacement cost Cost per unit ($9,500) lower fair value.
A significant increase or decrease in the estimated useful life of the asset would Useful life of 3-5 years (3 result in a significantly higher vehicles years) or lower valuation. Medical equipment at fair value - Medical equipment Increase (decrease) in gross replacement cost would Depreciated $6,000-$7,000 result in a significantly higher replacement cost Cost per unit ($6,500) (lower) fair value.
Increase (decrease) in useful Useful life of life would result in a medical 10-15 years significantly higher (lower) equipment (12 years) fair value. Assets under construction at fair value - Assets under construction A significant increase or decrease in direct cost per unit adjustment would result Depreciated in a significantly higher or replacement cost Cost per unit $500-$600 ($550) lower fair value. CSO adjustments of 20% were applied to reduce the market approach value for the Health Service specialised land, with the weighted average 20% (i) reduction applied.
74 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 12: Payables 2014 2013 $'000 $'000 Current Contractual Trade Creditors 1,492 1,302 Accrued Expenses 773 591 Department of Health 1,402 - TOTAL 3,667 1,893 (a) Ageing analysis of payables Please refer to note 17(c) for the aging analysis of payables (b) Nature and extent of risk arising from payables Please refer to note 17(c) for the nature and extent of risk arising from payables
Note 13: Provisions 2014 2013 $'000 $'000 Current Provisions Employee Benefits ( Note 13 (a)) ) Annual Leave (Note 13(a)) - unconditional and expected to be settled within 12 months (ii) 3,856 3,723 - unconditional and expected to be settled after 12 months (ii) - - Long service leave (Note 13(a)) - unconditional and expected to be settled within 12 months (ii) 600 603 - unconditional and expected to be settled after 12 months (ii) 5,258 4,656 Employee Termination Benefits - unconditional and expected to be settled within 12 months (ii) - - - unconditional and expected to be settled after 12 months (ii) - - Other - Accrued Days Off 141 121 - Salary and Wages 932 1,036 Provisions related to employee benefit on-costs - unconditional and expected to be settled within 12 months (ii) 417 353 - unconditional and expected to be settled after 12 months (ii) 658 642
Total Current Provisions 11,862 11,134 Non-Current Provisions Employee Benefits (i) 1,682 1,598 Provisions related to employee benefits on-costs 179 164 Total Non-Current Provisions 1,861 1,762 Total Employee Provisions 13,723 12,896 (a) Employee Benefits and Related On-Costs 2014 2013 Current Employee Benefits and related on-costs $'000 $'000 Unconditional LSL Entitlement 6,065 5,840 Annual Leave Entitlement 4,502 4,124 Accrued Wages and Salaries 1,138 1,036 Accrued Days Off 157 134 Non-Current Employee Benefits and related on-costs Conditional long service leave entitlements (iii) 1,861 1,762 Total Non-Current Employee Benefits and related on-costs 13,723 12,896 ( i ) Employee benefits consist of annual leave and long service leave accrued by employees. On-costs such as payroll tax and worker's compensation insurance are not employee benefits and are reflected as a separate provision. (ii) The amounts disclosed are at present values.
75 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 13: Provisions (continued)
(b) Movements in provisions 2014 2013 Movement in Long Service Leave: $'000 $'000 Balance 1 July 7,602 7,104 Provision made during the year - Revaluations (368) 148 - Expense recognising Employee Service 1,589 1,359 Settlement made during the year (897) (1,009) Balance 30 June 7,926 7,602 2014 2013 $'000 $'000 The following assumptions were adopted in measuring present value: Wage Inflation Rate 4.44% 4.50% On-Cost Factor 11.0% 11.0% Note 14: Other Liabilities 2014 2013 $'000 $'000 Current Trust Funds -Monies held on behalf of Patients at 30 June 18 22 -Monies held on behalf of Gippsland Palliative Care Consortium 963 1,641 Other - Gippsland Health Alliance (refer Note 10) 90 292 Total Current 1,071 1,955 Total Monies Held in Trust Represented by the following assets Cash Assets (refer note 5) 963 1,641 Other Financial Assets (refer note 7) 18 22 Total 981 1,663 Note 15: Equity 2014 2013 $'000 $'000 (a) Surpluses Property, Plant & Equipment Revaluation Surplus Land Balance at the beginning of the reporting period 3,073 3,073 Revaluation Increments (137) - Balance at the end of the reporting period 2,936 3,073 Buildings Balance at the beginning of the reporting period 38,234 33,164 Revaluation Increments 2,655 5,070 Balance at the end of the reporting period 40,889 38,234 Balance Property, Plant & Equipment Revaluation Surplus at the end of the reporting period 43,825 41,307 Restricted Specific Purpose Surplus Balance at the beginning of the reporting period 249 173 Transfer from reserve - - Transfer to reserve 294 76 Balance at the end of the reporting period 543 249 Total Surpluses 44,368 41,556 (b) Contributed Capital Balance at the beginning of the reporting period 34,254 34,254 Capital contribution received from Victorian Government - - Balance at the end of the reporting period 34,254 34,254 (c) Accumulated Deficit Balance at the beginning of the reporting period (20,019) (17,183) Net Result for the Year (5,223) (2,760) Transfer from Restricted Specific Purpose Reserve - - Transfer to Restricted Specific Purpose Reserve (294) (76) Balance at the end of the reporting period (25,536) (20,019) Total Equity at end of financial year 53,086 55,791
76 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 16: Reconciliation of Net Result for the Year to Net Cash Inflow/(Outflow) from Operating Activities 2014 2013 $'000 $'000
Net Result for the Year (5,223) (2,760) Depreciation 6,083 5,624 Provision for Doubtful Debts 73 8 Net Loss from sale of Plant & Equipment 17 (14) Assets Written Off - - Change in Operating Assets & Liabilities Increase/(Decrease) in Payables 1,875 (439) Increase/(Decrease) in Other Liabilities (203) 118 Increase/(Decrease) in Employee Benefits 826 (201) Decrease/(Increase) in Other Assets 37 (24) Decrease/(Increase) in Inventories 36 75 Decrease/(Increase) in Receivables (86) (510) Net Cash Flows from Operating Activities 3,435 1,877
77 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 17: Financial Instruments (a) Financial Risk Management Objectives and Policies Central Gippsland Health Service's principal financial instruments comprise of: - Cash Assets - Term Deposits - Receivables (excluding statutory Receivables) - Payables (excluding statutory payables)
Details of the significant accounting policies and methods adopted, including the criteria for recognition, the basis of measurement and the basis on which income and expenses are recognised, with respect to each class of financial asset, financial liability and equity instrument are disclosed in note 1 to the financial statements.
The Health Service's main financial risks include credit risk, liquidity risk, interest rate risk, foreign currency risk and equity price risk. The Health Service manages these financial risks in accordance with its financial risk management policy.
The Health Service uses different methods to measure and manage the different risks to which it is exposed. Primary responsibility for the identification and management of financial risks rests with the financial risk management committee of the Health Service. The main purpose in holding financial instruments is to prudentially manage Central Gippsland Health Service financial risks within the government policy parameters. Categorisation of financial instruments
Carrying Carrying Amount Amount 2014 2013 $'000 $'000 Financial Assets Cash and cash equivalents 3,695 4,570 Loans and Receivables 1,560 1,532 Loans & Receivables - Other Financial assets 3,739 2,372 Total Financial Assets 8,994 8,474 Financial Liabilities Payables at amortised cost 2,265 1,893 Other Financial liabilities at amortised cost 1,071 1,955 Total Financial Liabilities 3,336 3,848
Net holding gain/(loss) on financial instruments by category
Carrying Carrying Amount Amount 2014 2013 $'000 $'000 Financial Assets Cash and cash equivalents 345 360 Loans and Receivables - - Loans & Receivables - Other Financial assets - - Total Financial Assets 345 360
Financial Liabilities Payables at amortised cost - - Other Financial liabilities at amortised cost - -
Total Financial Liabilities - -
78 CENTRAL GIPPSLAND HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 17: Financial instruments (continued) (b) Credit Risk Credit risk arises from the contractual financial assets of the Health Service, which comprise cash and deposits, non-statutory receivables and available for sale contractual financial assets. The Health Service's exposure to credit risk arises from the potential default of a counter party on their contractual obligations resulting in financial loss to the Health Service. Credit risk is measured at fair value and is monitored on a regular basis. Credit risk associated with the Health Service's contractual financial assets is minimal because the main debtor is the Victorian Government. For debtors other than the Government, it is the Health Service's policy to only deal with entities with high credit ratings of a minimum Triple-B rating to obtain sufficient collateral or credit enhancements, where appropriate.
In addition, the Health Service does not engage in hedging for its contractual financial assets and mainly obtains contractual financial assets that are on fixed interest, except for cash assets, which are mainly cash at bank. As with the policy for debtors, the Health Service's policy is to only deal with banks with high credit ratings.
Provision of impairment for contractual financial assets is recognised when there is objective evidence that the Health Service will not be able to collect a receivable. Objective evidence includes financial difficulties of the debtor, default payments, debts which are more than 60 days overdue, and changes in debtor credit ratings. Credit quality of contractual financial assets that are neither past due nor impaired
Financial Government Government Other Total institutions agencies agencies (min BBB (AAA credit (AAA credit (BBB credit credit rating) rating) rating) rating)
2014 $'000 $'000 $'000 $'000 $'000 Financial Assets Cash and Cash Equivalents 3,695 - - - 3,695 Receivables - Trade Debtors ------Other Receivables (i) - 211 - 910 1,121 Other Financial Assets - Term Deposit 3,739 - - - 3,739
Total Financial Assets 7,434 211 - 910 8,555
2013 Financial Assets Cash and Cash Equivalents 4,570 - - - 4,570 Receivables - Trade Debtors - - - 591 591 - Other Receivables - 153 - 788 941 Other Financial Assets - Term Deposit 2,372 - - - 2,372 - Shares in Other Entities - - - - -
Total Financial Assets 6,942 153 - 1,379 8,474
(i) The total amounts disclosed here exclude statutory amounts (e.g. amounts owing from Victorian Government and GST input tax credit recoverable).
Ageing analysis of financial assets as at 30 June Past Due But Not Impaired
Not Past Due Less Impaired Carrying and Not than 1 3 Months Over 5 Financial Amount Impaired Month 1-3 Months - 1 Year 1-5 Years Years Assets 2014 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 Financial Assets Cash & Cash Equivalents at variable interest rates 3,695 3,695 ------Receivables 1,560 1,305 84 127 44 - - - Other Financial Assets 3,739 3,739 ------Total Financial Assets 8,994 8,739 84 127 44 - - - 2013 Financial Assets Cash & Cash Equivalents 4,570 4,570 ------Receivables 1,532 1,402 71 38 21 - - - Other Financial Assets 2,372 2,372 ------Total Financial Assets 8,474 8,344 71 38 21 - - - (i) Ageing analysis of financial assets must exclude the types of statutory financial assets (i.e. GST input tax credit) There are no material financial assets which are individually determined to be impaired. Currently Central Gippsland Health Service does not hold any collateral as security nor credit enhancements relating to any of its financial assets. There are no financial assets that have had their terms renegotiated so as to prevent them from being past due or impaired, and they are stated at the carrying amounts as indicated. The ageing analysis table above discloses the ageing only of contractual financial assets that are past due but not impaired.
79 CENTRAL GIPPSLAND HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 17: Financial instruments (continued)
(c) Liquidity Risk Liquidity risk is the risk that the Health Service would be unable to meet its financial obligations as and when they fall due. The Health Service's maximum exposure to liquidity risk is the carrying amounts of financial liabilities as disclosed in the face of the balance sheet. The following table discloses the contractual maturity analysis for the Central Gippsland Health Service's financial liabilities. For interest rates applicable to each class of liability refer to individual notes to the financial statements. Maturity analysis of financial liabilities as at 30 June Maturity Dates Less Impaired Carrying Contractual than 1 3 Months Over 5 Financial Amount Cash Flow Month 1-3 Months - 1 Year 1-5 Years Years Assets 2014 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 Payables Trade Creditors and accruals 3,667 3,667 3,667 - - - - - Other Liabilities 1,071 1,071 1,071 - - - - - Total Financial Liabilities 4,738 4,738 4,738 - - - - - 2013 Payables Trade Creditors and accruals 1,893 1,893 1,893 - - - - - Other Liabilities 1,955 1,955 1,955 - - - - - Total Financial Liabilities 3,848 3,848 3,848 - - - - -
(d) Market Risk The Central Gippsland Health Service exposures to market risk are primarily through interest rate risk with only insignificant exposure to foreign currency and other price risk. Currency Risk The Central Gippsland Health Service is exposed to insignificant foreign currency risk through its payables relating to purchases of supplies and consumables from overseas. This is because of a limited amount of purchases denominated in foreign currencies and a short timeframe between commitment and settlement. Interest Rate Risk Exposure to interest rate risk might arise primarily through the Central Gippsland Health Service's interest bearing liabilities. Minimisation of risk is achieved by mainly undertaking fixed rate or non-interest bearing financial instruments. For financial liabilities, the health service mainly undertake financial liabilities with relatively even maturity profiles.
Interest rate exposure of financial assets and liabilities as at 30 June Weighed Interest Rate Exposure Average Effective Fixed Variable Non Interest Carrying Interest Interest Interest Rate Amount Rate rate Bearing 2014 % $'000 $'000 $'000 $'000 Financial Assets Cash & Cash Equivalents 2.54% 3,695 117 3,578 - Receivables - 1,560 - - 1,560 Other Financial Assets 3.77% 3,739 3,739 - - Total Financial Assets 8,994 3,856 3,578 1,560 Payables Trade Creditors and accruals - 2,265 - - 2,265 Other Liabilities - 1,071 - - 1,071 Total Financial Liabilities - 3,336 - - 3,336 2013 Financial Assets Cash & Cash Equivalents 3.18% 4,570 2,957 1,613 - Receivables - 1,532 - - 1,532 Other Financial Assets 4.34% 2,372 2,372 - - Total Financial Assets 8,474 5,329 1,613 1,532 Payables Trade Creditors and accruals - 1,893 - - 1,893 Other Liabilities - 1,955 - - 1,955 Total Financial Liabilities 3,848 - - 3,848
80 CENTRAL GIPPSLAND HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 17: Financial instruments (continued) Sensitivity Disclosure Analysis
Taking into account past performance, future expectations, economic forecasts, and management's knowledge and experience of the financial markets, the Central Gippsland Health Service believes the following movements are 'reasonably possible' over the next 12 months (Base rates are sourced from National Australia Bank): - A parallel shift of +1% and -1% in market interest rates (AUD) from year-end rates of 4%; The following table discloses the impact on net operating result and equity for each category of financial instrument held by the Health Service at year end as presented to key management personnel, if changes in the relevant risk occur.
Interest Rate Risk Other Price Risk -1% -1% -1% -1% Carrying Amount Profit Equity Profit Equity Profit Equity Profit Equity 2014 $'000 $'000 $'000 $'000 $'000 $'000 $'000 Financial Assets Cash & Cash Equivalents at variable interest rate 3,578 (36) (36) 36 36 - - - - Cash & Cash Equivalents at fixed interest rate 117 ------Receivables 1,560 ------Other Financial Assets 3,739 ------Financial Liabilities Trade Creditors and accruals 2,265 ------Other Liabilities 1,071 ------Interest Rate Risk Other Price Risk -1% -1% -1% -1% Carrying Amount Profit Equity Profit Equity Profit Equity Profit Equity 2013 $'000 $'000 $'000 $'000 $'000 $'000 $'000 Financial Assets Cash & Cash Equivalents at variable interest rate 1,613 (16) (16) 16 16 - - - - Cash & Cash Equivalents at fixed interest rate 2,957 ------Receivables 1,532 ------Other Financial Assets 2,372 ------Financial Liabilities Trade Creditors and accruals 1,893 ------Other Liabilities 1,955 ------
(e) Fair Value The fair values and net fair values of financial instrument assets and liabilities are determined as follows: - Level 1 - the fair value of financial instrument assets and liabilities with standard terms and conditions and traded in active liquid markets are determined with reference to quoted market price; and - Level 2 - the fair value is determined using inputs other than quoted prices that are observable for the financial asset or liability, either directly or indirectly; and - Level 3 - the fair value is determined in accordance with generally accepted pricing models based on discounted cash flow analysis using unobservable market inputs. The Health Service considers that the carrying amount of financial instrument assets and liabilities recorded in the financial statements to be a fair approximation of their fair values, because of the short term nature of the financial instruments and the expectation that they will be paid in full.
81 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 18: Commitments for Expenditure 2014 2013 Capital Expenditure Commitments $'000 $'000 Maffra Kitchen Upgrade 13 - Air Concentrator 4 - Electric Lift Recline Chair 3 - Oxygen Concentrator - 3 Urisys Analyser - 2 Dental Digital Imaging System - 16 Cardiograph - 5 External Awning - 8 Patient Furniture - 45 Ceiling track & Hoists - 59 Total Capital Commitments 20 138
Not later than one year 20 138 Total 20 138
Operating Leases Non-Cancellable Not later than one year 487 406 Later than one year but not later than 5 years 996 341 - TOTAL 1,483 747
All amounts shown in commitments note are nominal amounts inclusive of GST
Note 19: Contingent Liabilities & Contingent Assets Recallable Capital Grant During 2012-13 Department of Health provided the Central Gippsland Health Service with a recallable capital grant of $1,200,000 to fund the replacement of Sale Linen Service equipment. This grant is reacallable at the Departments discretion and $200,000 was recalled in 2013-14. At this point in time, there is no obligation to repay the balance of the recallable grant.
82 CENTRAL GIPPSLAND HEALTH SERVICE
CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 20: Segment Reporting Hospital RACS Linen Service Community Health Eliminations Total 2014 2013 2014 2013 2014 2013 2014 2013 2014 2013 2014 2013 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 $'000 REVENUE External Segment Revenue 60,324 60,871 8,008 7,737 2,082 2,029 8,209 7,721 - - 78,623 78,358 Intersegment Revenue 1,318 1,326 - - 488 452 - - (1,806) (1,778) - - Total Revenue 61,642 62,197 8,008 7,737 2,570 2,481 8,209 7,721 (1,806) (1,778) 78,623 78,358 EXPENSES External Segment Expense 66,171 64,352 7,635 7,597 2,582 2,160 7,803 7,369 - - 84,191 81,478 Intersegment Expenses - 1,778 ------(1,778) - - Total Expenses 66,171 66,130 7,635 7,597 2,582 2,160 7,803 7,369 - (1,778) 84,191 81,478 Net Result from ordinary activities (4,529) (3,933) 373 140 (12) 321 406 352 (1,806) - (5,568) (3,120) Interest Income 345 360 ------345 360 Net Result for the year (4,184) (3,573) 373 140 (12) 321 406 352 (1,806) - (5,223) (2,760) OTHER INFORMATION Segment Assets 56,697 58,412 8,912 9,038 1,989 1,081 3,949 4,004 - - 71,547 72,535 Intersegment Assets ------Total Assets 56,697 58,412 8,912 9,038 1,989 1,081 3,949 4,004 - - 71,547 72,535 Segment Liabilities 15,080 13,677 1,328 1,205 625 567 1,428 1,295 - - 18,461 16,744 Intersegment Liabilities ------Total Liabilities 15,080 13,677 1,328 1,205 625 567 1,428 1,295 - - 18,461 16,744 Investments Accounted for using the Equity Method ------Acquisition of property, plant and equipment 513 2,016 149 159 1,585 532 38 3 - - 2,285 2,710 Depreciation 4,535 4,241 582 520 347 252 619 611 - - 6,083 5,624 The major products/services from which the above segments derive revenue are: Business Segments Services Hospital Patient Services Residential Aged care Services (RACS) Aged Care Services Linen Service Laundry & Linen Services Community Health Community Services provided to the General Public Normal commercial rates apply for charges from the Linen Service to other segments of the Service. Geographical Segment Central Gippsland Health Service operates predominantly in East Gippsland, Victoria. More than 90% of revenue, net surplus from ordinary activities and segment assets relate to operations in East Gippsland, Victoria.
83 CENTRAL GIPPSLAND HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Note 21a: Responsible Person Disclosures In accordance with the Ministerial Directions issued by the Minister for Finance under the Financial Management Act 1994, the following disclosures are made regarding responsible persons for the reporting period. Responsible Ministers The Honourable David Davis, MLC, Minister for Health and Ageing 1-Jul-13 30-Jun-14 The Honourable Mary Wooldridge, MLA, Minister for Mental Health 1-Jul-13 30-Jun-14
Governing Board John Sullivan 1-Jul-13 30-Jun-14 Glenn Stagg 1-Jul-13 30-Jun-14 Helene Booth 1-Jul-13 30-Jun-14 Louise McMahon 1-Jul-13 30-Jun-14 Lesley Fairhall 1-Jul-13 30-Jun-14 Elizabeth Thomson 1-Jul-13 30-Jun-14 Tony Anderson 1-Jul-13 30-Jun-14
Accountable Officer Frank Evans (Chief Executive Officer) 1-Jul-13 30-Jun-14
Remuneration of Responsible Persons
The number of Responsible Persons are shown in their relevant income bands;
Total Remuneration 2014 2013 No. No. $0 7 7 $230,000 to $239,999 1 $240,000 to $249,999 1 Total 8 8 Total Remuneration for Responsible Persons $243,917 $239,328
Amounts relating to Responsible Ministers are reported in the financial statements of the Department of Premier and Cabinet Other Transactions of Responsible Persons and their Related Parties Any transactions with responsible persons and related parties are under normal commercial terms and conditions no more favourable than to other parties.
Note 21b: Executive Officers Disclosures The number of Executive Officers other than the Ministers and Accountable Officers, and their total remuneration during the reporting period are shown in the table below in their relevant income bands. The base remuneration of executive officers is shown in the third and fourth columns. Base remuneration is exclusive of bonus payments, long service leave payments redundancy payments and retirement benefits. Total Remuneration Base Remuneration 2014 2013 2014 2013 No. No. No. No. $110,000 to $119,999 1 1 $130,000 to $139,999 1 1 1 1 $140,000 to $149,999 1 1 $160,000 to $169,999 1 0 1 $170,000 to $179,999 1 1 $180,000 to $189,999 1 1 1 1 Total Number of Employees 5 3 5 3 Total Annualised Employee Equivalent (AEE) (i) 4.8 2.8 4.8 2.8 $749,066 $483,987 $749,066 $483,987
(i) Annualised employee equivalent is based on working 38 ordinary hours per week over the reporting period.
Note 22: Events Occurring after Balance Sheet Date No events have occurred subsequent to balance date.
Note 23: Economic Dependence
The Central Gippsland Health Service is wholly dependent on the continued financial support of the State Government and in particular, the Department of Health. The Department of Health has provided confirmation that it will continue to provide the Central Gippsland Health Service adequate cash flows support to meet its current and future obligations as and when they fall due for a period up to September 2014.
84 SALE: Acute Care Services: 155 Guthridge Parade Sale VIC 3850 Telephone: 03 5143 8600 Facsimile: 03 5143 8633 Community Services: Telephone: 03 5143 8800 Facsimile: 03 5143 8889 Wilson Lodge Nursing Home: Telephone: 03 5143 8540 Facsimile: 03 5143 8542
MAFFRA: 48 Kent Street Maffra VIC 3860 Telephone: 03 5147 0100 Facsimile: 03 5147 0152
HEYFIELD: 14 Licola Road Heyfield VIC 3858 Telephone: 03 5139 7979 Facsimile: 03 5139 7922
All Correspondence: Chief Executive Officer Central Gippsland Health Service 155 Guthridge Parade Sale VIC 3850 Telephone: 03 5143 8319 Facsimile: 03 5143 8633 Email: [email protected] www.cghs.com.au