20
YEARS
Caring for Rural Communities of
BANNOCKBURN ROKEWOOD BEEAC MORIAC WINCHELSEA
HESSE RURAL HEALTH 8 Gosney Street, Winchelsea, Australia 3241 + 61 (03) 5267 1200 hesse@swarh.vic.gov.au www.hesseruralhealth.org.au
Hesse Rural Health 2014 Annual Report
HESSE RURAL HEALTH Twenty years ago Hesse Rural Health surfaced as a community initiative to sustain health service delivery in the rural area. Today it demonstrates with excellence how health care provided in the local community is essential to rural well being.
Leigh Community Health Ferrars Street Rokewood 3330
OUR VISION Bannockburn Primary Care 19 High Street Bannockburn 3331
Caring for Rural Communities.
OUR MISSION
Winchelsea Hospital Chelsea Lodge Hostel Hesse Lodge Nursing Home Werruna Dementia Unit 8 Gosney Street Winchelsea 3241
The continued development of an integrated health and wellbeing service to the Hesse rural community in a financially responsible and environmentally sustainable manner. Beeac Community Health Lang Street Beeac 3251
OUR GOALS To provide an integrated health service encompassing acute, aged and community based care appropriate to meeting the needs of the population within the surrounding districts of Hesse Rural Health.
Winchelsea Community Health 12 Gosney Street Winchelsea 3241
Moriac Community Health 806 Hendy Main Road Moriac 3240
Winchelsea Adult Day Activity 53 Hesse Street Winchelsea 3241
To provide high quality care for clients and residents through the maintenance of ethical and professional standards in a safe and secure environment. To promote health within the community through intiatives in health promotion, education and illness prevention.
Minister for Health: Hon David Davis MLC Auditors: Auditor General Victoria
Bankers: Bendigo Winchelsea & District Community Bank Solicitors: Birdsey Dedman Bartlett
Acute Care Breakfast Club Bus to the Hub Children at Play Community Nursing Dementia Developments Dementia Care Diabetes Education Dietetics District Nursing Exercise Groups Farm Safety Program Greet, Eat & Meet
Health Promotion HIPPY & Play Program Home Care Packages Hospital in the Home Immunisation Program Maternal & Child Health Men’s Group Men’s Shed Program Nesters Group No Fall Exercise Program Occasional Care Occupational Therapy Palliative Care
Personal Development Physiotherapy Planned Activity Groups Podiatry Post Acute Care Post Natal Care Pre-School Health Residential Aged Care Respite Urgent Care Volunteering Walking Groups Well Women’s Clinic
To access Hesse’s broad range of services contact Administration via: Phone: (03) 5267 1200 Post:
8 Gosney Street Winchelsea Vic 3241
E-mail: hesse@swarh.vic.gov.au Website: www.hesseruralhealth.org.au
Organisational Structure
6
Key Events
8
Board Games
10
Our Fairy Godmothers
11
Achieving Strategic Priorities
12
When Integrated Care Works Best
13
Breakfast at the Bus Stop
14
Ensuring Medical Sustainability
15
The Best Care Belongs at Home
16
Take a Mate
17
Health Planning for Population Growth
18
Ahead of the Pack
19
Good Foundations
20
Keeping Active at ADASS
21
Our People, Their Potential, Our Success
22
A Juggling Act
23
Wanting for Nothing
24
Healthy Lifestyles in Beeac
25
Supporters of Hesse
26
Statement of Priorities
28
Compliance
30
Performance and Data
77
Services
32
Quality Report
41
Finance Report
FINANCIAL REPORT
4
QUALITY REPORT
Organisational Report
OPERATIONAL REPORT
OP ERATION AL REPORT
2
1
Organisational Report Twenty years ago Hesse Rural Health surfaced as a community initiative to sustain health service delivery in our rural area. Today it demonstrates with excellence how health care provided in the local community is essential to rural wellbeing. It has been a year of solid achievements both financially and with service provision and we are looking forward to some significant changes, particularly the implementation of the Commonwealth Aged Care Reform. We achieved a pre-depreciation surplus which has led to an improved asset ratio. This was partly due to our aged care service being in high demand, evidenced by 98% occupancy and a strong waiting list. Such demand is undoubtedly led by the standard of building stock and the best practice care provided by our staff and management. Well done! Recognition of our increasing expertise in rural dementia care, meaningful engagement and workforce development was very apparent with requested presentations to the Department of Health (DoH) Ageing and Aged Care Seminar; the 75th VHA Annual Conference and the Alzheimer’s Disease International Conference in Puerto Rico.
Peter Birkett, CEO, and John Carr, Board President, reflect on twenty years of growth.
of further occupational therapy (OT) resources dedicated to the Werruna environment and the HACC program. Our partnership with Deakin University continues with student placements in the dementia environment, now reaching over 37 students since 2010, and a soon to commence research project investigating the role of Occupational Therapy in dementia care.
The Werruna wing continues to be of interest to other agencies both within the Barwon South West (BSW) Region and also from Boort District Health, Rochester & Elmore District Health and Alzheimer’s Australia. All are keen for shared knowledge in dementia environment design.
Students from University of Bournemouth, UK, have now been funded by their institution to further develop and promote the inclusion of rural dementia services and research into the Gateway to Rural Initiatives in Dementia (GRIID) website. In October 2013 Hesse also partnered with Alzheimer’s Australia in hosting a visit from Sue Pieters-Hawke, Co-Chair of the Federal Ministerial Advisory Committee for Dementia, to speak at a Forum that attracted over 100 people at the Winchelsea Community Hub.
Expansion of the multi-disciplinary team has occurred through the engagement
Another 2013-2014 achievement was the purchase of adjoining land to our
Winchelsea site. This was a joint effort. The Ladies Auxiliary, who continued to achieve excellent results with Op Shop sales, enabled us to seize an important opportunity for future growth and maintain the amenity of our surroundings. Thank you. The year has seen the finalisation of the ‘ACFI Project’ supported by the BSW region. The project has yielded significant results for participating agencies throughout the region, who have welcomed the assistance. We have now been provided with further funding to strengthen governance for BSW public sector residential aged care. Board governance education was enhanced with the attendance of Board and Executive Staff representatives at the Better Boards Conference. Once again this was a useful learning experience. We were disappointed to lose David Dillon who resigned from the Board
but we look forward to two new appointments in the coming year.
in July 2015 will necessitate new relationships and partnerships.
understanding of roles, expectations and outcomes was gained.
SWARH, our mandated IT provider, continues to be of concern. Although there has been a review of management and governance structures, a more cost effective and efficient service that is responsive to our organisational needs has yet to appear.
We continue to look for new ways to make Child Care a reality in Winchelsea. A joint initiative is underway with the Community Bank to fund a Project Worker who will engage with our community to progress this project.
All of these achievements and plans are brought about by the total team that support Hesse; Board, Management, Staff, Ladies Auxiliary, Volunteers, Consumer Advisory Committee, Carers Group and Community support. Together we are achieving a unique public health service, one to be quietly proud of, and we are looking forward to further achievements in our changing world of healthcare.
A major accreditation visit is looming with Australian Council on Healthcare Standards and we welcome a new Quality Manager to help us with that. During the year a review of the provision of meals was undertaken with the help of an external consultant. A better
John Carr President Peter Birkett Chief Executive
After engaging Phase One Consulting and holding a series of meetings with our communities and staff, the Board are in the process of finalising our Strategic Directions to 2018. The community meetings proved to be a valuable source of feedback and ideas. Thanks to all those who participated. Well considered by the Board in their strategic deliberations included the Commonwealth Aged Care Reform, which has necessitated new arrangements to accommodate a change in business approach. The transition of HACC funding and administration arrangements to the Commonwealth Home Support Program
QUALITY REPORT
Community Health, Allied Health and District Nursing continued to be an important health support for our total area. Attention to the way these activities are recorded has seen a lift in figures that more truly reflects the activities and contacts taking place.
FINANCIAL REPORT
We have formalised a Consumer and Community Advisory Committee for consumers to have detailed input into services and the way they are delivered.
Hon Terry Mulder MP, Member for Polwarth and Minister for Transport, and Hon Denis Napthine MP, Victorian Premier, meet with executive staff at Hesse Rural Health in May 2014.
OPERATIONAL REPORT
Our services expanded slightly with an increase of HACC funds for Occupational Therapy and Nursing in Golden Plains, and we are now a registered provider with the National Disability Insurance Agency (NDIA) to deliver a range of community nursing, assessment and wellbeing services. This will ensure local people with disabilities can be provided with the vital services they need.
3
Organisational Structure
Minister for Health Hon David Davis MLC
Board of Directors
John Carr President: Financial Resources & Audit, Medical
David Kelly Senior Vice President: Quality & Ethics
Hannah Cameron Junior Vice President: Quality & Ethics BA, LL.M
Keith Leigh Treasurer: Financial Resources & Audit Chair
Paul Benton Financial Resources & Audit DCR(R)(UK), GDMU
Chief Executive Officer Partnering for Success
Quality Ethics Finance Peter Birkett MBA, BCom, RM, RN, ACHSE, MAICD
Audit
Director of Nursing
A Sustainable Business Culture Accessible and Relevant Health Effective Service Promotion
Corporate Services Manager
Acute & Urgent Care Dementia Services Residential Aged Care Palliative Care Respite Services Janelle Hodgson RN, FACN
Andrea Dunlop MHlthSc, GDipHlthSc, BAppSc, (OT), ACHSE, MIAMA
Human Resources Business Compliance Community Liaison Project Development Consumer Participation Administration
David Dillon Financial Resources & Audit CPA
Rod Hanson Financial Resources & Audit, Medical
Donald Lang Quality & Ethics Chair
Noel Stinchcombe Financial Resources & Audit
Services Throughout the Lifespan
Community as Key
Integrating Health & Wellbeing
Primary Care Manager
QUALITY REPORT
A Skilled and Engaged Workforce
Key Personnel Helen Plant, Quality
Planned Activity Groups Allied Health Home Support Community Nursing Primary Care Health Promotion Domicilary Midwifery
Annie Coles BNurs, GDipMid, DipComServ(Childcare), GDipNurs(Fam&ChildHealth)
Jodie Hosking, Aged Care Kam Benton, Nurse Practitioner Project Jason Colville, Maintenance Maree McCallum, Environmental Suzanne Paterson, Catering Brodie Lambert, Administration Photograph: P Bassett
OPERATIONAL REPORT
Achieving Excellence and Innovation
FINANCIAL REPORT
Infrastructure, Growth and Development
5
Reflecting On 20 Years 2013 - 2014 Key Events
1994 The Journey Begins Small Rural Hospitals Task Force chaired by Dr Denis Napthine MP
Hesse sponsored ACFI Project assists public sector aged care agencies in the BSW Region to achieve significant increases in revenue.
Hesse Rural Health was formed as a public hospital under the Health Services Act 1988 following the amalgamation of Beeac & District Hospital, Leigh Comunity Health Centre and the Winchelsea & District Hospital on the 1st of November 1994 to provide acute, aged and primary care services
1995 Mission established: ‘The continued development of an integrated health and wellbeing service to the Hesse rural community in a financially responsible and environmentally sustainable manner’ Visitation by the Governor of Victoria, His Excellency Richard McGarvie Beeac Hospital becomes a Community Health Centre Birthing services ceased Residential Aged Care grows to 27 beds in Winchelsea
Photograph: S Williams
Catering Review engages residents and staff in the delivery of meal service. Registration with the National Disability Insurance Agency (NDIA) to provide selected disability services including community wellbeing, assessment and nursing services.
Foxtel entertainment into 55 aged care resident rooms.
Bullying and Harassment education undertaken by all staff following changes to Fair Work Australia legislation.
Financial assistance from Ladies Auxiliary to purchase land at the rear of the Winchelsea Campus to protect the rural vista and enable opportunities for growth.
Successful grant application under the Powerline Bushfire Safety Program for a new generator at the Winchelsea campus.
Promoting Men’s Health the ‘Blokes Night Out – Take a Mate’ initiative was jointly sponsored by the Community Bank, Hesse and local community groups.
Extensive community consultation forums conducted in Winchelsea, Beeac and Rokewood in preparation for the 2014–2018 Strategic Plan.
Additional HACC funding for nursing and occupational therapy in the Golden Plains Shire. Joint presentation with Professor David Edvardsson from LaTrobe University to the Alzheimer’s Disease International Conference 2014, ‘Gateway to
FINANCIAL REPORT
Dimensions to Care Through Meaningful Engagement: Moving Beyond Activities.’
Over 60% of staff opt in to receive SMS notifications for vacant shifts generating efficiencies in roster replacement.
QUALITY REPORT
Hesse receives $195,000 to undertake the Business of Aged Care project in 2014-2015 focussing on responsibilities of governance within public sector residential aged care.
Presentation to VHA Annual Conference 2013, ‘The
Werruna Experience – Innovative Dementia Design in a Rural Area.’ Sue Pieters-Hawke speaks about her experience with dementia to over 100 people at a forum jointly hosted by Hesse and Alzheimer’s Australia, Victoria.
OPERATIONAL REPORT
Presentation to Department of Health and Aged Care Dementia Seminar, ‘Adding New
Rural International Initiatives in Dementia (GRIID): Connecting Services Internationally.’
All aged care residents provided with opportunity for an Advanced Care Directive within three months of admission.
7
Reflecting On 20 Years Board Games: 101 Ways to 2018
1996 Day theatre surgery commences House and land acquired for community health services at Winchelsea Childless Tractors Farm Safety Program informs the development of the Victorian Farmers Federation ‘Ripper’ Program
1997 Hesse’s aged care beds increase to 33 following the construction of the Birregurra hostel wing at the Winchelsea Campus The implementation of ‘Ageing in Place’ diminishes the need for aged care placement outside the area A rural ‘hands-on’ trauma training exercise includes aeromedical, vehicle and mock disaster response
Photograph: S Williams
While, most people would view strategic planning as serious organisational business, it contains all the elements of a game; with a goal, rules, challenge and interaction. Its ultimate goal lies in the future direction of the organisation; it has rules of process and engagement; it is most certainly a challenging business for governing directors, and an effective strategic planning process requires high levels of communication and interaction around the Board table. Hesse’s Board of Directors and Executive Management team insisted upon extensive community input into their 2014-2018 Strategic Plan deliberations and development. A facilitation process with key stakeholders undertaken by Phase One Consulting set the scene in the catchment communities of Winchelsea, Rokewood and Beeac as well as with staff, executive and Board forums. These sessions generated an impressive 101 individual items of feedback from stakeholders keen to guide the health service forward.
However, the hard work was only just beginning. To ensure these 101 items were considered for inclusion into the Board’s final plan, a ‘game’ concept was applied. Teams were formed and roles randomly allocated into Chair & Timekeeper, Ideas Distributor, Priorities Agent, Group Speaker, Nourishment Officer and Scribe. Each director had a given responsibility that ensured active involvement, interaction, and lively discussion. The healthy and dynamic debate enabled clear decision-making about possibilities and priorities into the future. Guided by the Victorian Health Priorities Framework 2012-2022, the result was a comprehensive vision for the years ahead, outlined within nine strategic priorities. Hesse now looks forward to working towards the 2018 strategic vision, with a clear understanding that while governance may be serious and challenging with important responsibilities, it can also be enjoyable and sometimes just good fun.
Strategic Priorities
OPERATIONAL REPORT
QUALITY REPORT
FINANCIAL REPORT
1. Accessible and Relevant Health Services Throughout the Lifespan 2. A Sustainable Business Culture 3. Partnering for Success 4. A Skilled and Engaged Workforce 5. Achieving Excellence and Innovation 6. Integrating Health and Wellbeing 7. Effective Service Promotion 8. Community as Key 9. Infrastructure Growth and Development
9
9
Reflecting On 20 Years
1998 Minister for Aged Care Hon Rob Knowles MP officially opens the Aged and Administration Redevelopment, attended by 300 community members Staff appraisal system commenced Quality systems developed and implemented
1999 First formal Strategic Plan developed, increasing the focus on growing primary and aged care and identifying the need for specialist dementia care Cessation of birthing services Staffing numbers reach 70 people Parternship with Lorne Community Hospital for shared executive and clinical management
Photograph: S Williams
Our Fairy Godmothers How can you turn a shop full of household items into an acre of land? Without a magical wand or a Fairy Godmother, this might be just wishful thinking. But Hesse Rural Health doesn’t have one Fairy Godmother, it has a whole team of them! The Winchelsea Hospital Ladies Auxiliary is Hesse’s major fundraising partner. Over many years the Auxiliary has worked tirelessly to raise little bits of extra cash to make a difference to the lives of the health service’s residents and patients. Their donations have supported the purchase of drapes, furniture, equipment and many other items that assist in the delivery of a quality service. But this year they outdid themselves and bought their residents a whole new back yard! With the Board concerned that the available block of land to the rear of the health service may be residentially developed and limit the rural outlook so important for ageing residents, the Auxiliary agreed to provide $150,000 to enable the purchase.
The healthy bank balance that made this possible is attributable to the Auxiliary’s successful Op Shop venture. In its first three and a half years, the Shop has raised in excess of $230,000, averaging $1,250 per week through the sale of pre-used household goods, clothing, furniture, books and other items. The range is so extensive that one customer examining a porcelain wash basin, even bothered to enquire, ‘do you have another colour in stock?’ Another person asked, ‘when is the next shipment of lounge chairs coming in?’ Proof that with a first rate volunteer community workforce there is money in second-hand trade. The land has been acquired in the name of the Winchelsea Hostel and Nursing Home Society Inc, and remarkably is the first step in the objective to create a community based child care development.
Achieving Strategic Priorities
In October, with Alzheimer’s Australia (Vic Branch), Hesse hosted a community forum at the Winchelsea
CEO, Peter Birkett, said that to achieve an audience of 100 people in a day-time forum was proof that Hesse has already succeeded in raising the profile of dementia as an important health issue. His vision is to make Winchelsea and district a ‘dementia friendly’ community in line with overseas initiatives.
FINANCIAL REPORT
Person-centred models of care, based upon meaningful engagement and assisted by a generous staffing model continue to be the focus of Hesse’s strive for excellence in residential dementia services. To lead this, Director of Nursing, Janelle Hodgson has commenced a postgraduate degree in Dementia Studies at the University of Stirling in Scotland. Participation in this highly recognised course will assist
An effective partnership approach has also assisted in improving local understanding and awareness of the dementia condition. In April, Occupational Therapy students from Deakin University, Alzheimer’s Australia (Vic Branch), and Hesse jointly developed and delivered a communication workshop for family and carers of persons living with dementia. The workshop assisted in maintaining conversations, enhancing social engagement, and facilitating improved networking and peer support opportunities among carer groups.
Hub. Sue-Pieters Hawke, daughter of the late Hazel Hawke, AO, and CoChair of the Federal Ministerial Advisory Committee for Dementia reflected upon her personal journey as a carer of someone with dementia, eloquently reminding everyone of the lighter moments to be enjoyed in addition to the challenges of caring. This was Sue’s second visit to Winchelsea, after touring the Werruna unit in 2012.
QUALITY REPORT
Leadership in the area of dementia has certainly been achieved following participation in 14 state, national and international conferences between 2010 and 2014, significant local exposure and visits by agencies keen to replicate the model. Hesse has maintained the spotlight on dementia.
Hesse to continue to be at the forefront of dementia care and incorporate learnings into best practice.
OPERATIONAL REPORT
In 2008 the Hesse Board of Management established a strategic priority to be ‘…recognised by other health agencies as a leader in integrated rural health care delivery.’
11
Reflecting On 20 Years When Integrated Care Works Best
2000 Commonwealth approval for an additional 12 aged care beds Ballarat and Deakin University nursing students receive clinical placement opportunity Cessation of theatre services Aged Care Accreditation achieved Workcover funds farm safety ‘Childless Tractors’ Program
2001 District Nursing services provided into Bannockburn Winchelsea Masonic Hall acquired Hesse’s ‘Culture of Continuous Improvement’ recognised by the Australian Council of Healthcare Standards (ACHS)
Photograph: S Williams
Eileen was distraught when Fred’s chest infection developed into a pneumonia that almost didn’t return him home from an admission to Barwon Health’s McKellar Centre. Faced with the prospect of moving Fred to permanent residential care, Eileen in desperation called Hesse Rural Health. The Primary Care team suggested her involvement in a care planning meeting, and helped her convince the Transitional Care Coordinator at the regional health service to allow Fred a trial at home with district nursing and physiotherapy support. Hesse’s community nursing team visited daily to monitor his respiratory condition, a personal care worker assisted with showering and dressing and the physiotherapist visited twice a week to assist with improving Fred’s mobility and strength. This coordinated involvement allowed Fred and Eileen many more months at home together, before Fred’s health deteriorated again resulting in an admission to Hesse’s
acute unit. Fred then agreed to a period of respite care to give Eileen a break but the couple were still unprepared to accept this move as permanent. The multi-disciplinary team comprising the occupational therapist, physiotherapist, aged care manager and district nursing team explored every avenue to get Fred and Eileen safely back home together again. With her own health failing, Eileen was not strong enough anymore to provide the care that Fred needed and she finally accepted his move to permanent residential care. However she was content with the knowledge that everything possible had been tried. It was important to her that nobody gave up on them and she was extremely grateful.
Fred and Eileen’s story demonstrates the benefits of a small rural integrated service combining true coordinated and person focussed care.
The Rokewood Breakfast Club provides a forum to connect the children with older generations within the community, before heading off to school. Now in its tenth year the program was the brain child of a small committee of seven local students, three volunteers, including Heather and Noelene, and a Coordinator from Hesse Rural Health. Since its inception the Rokewood Breakfast Club has served over 2,200
The Bus Driver starts his route early on program days and brings the kids to the Rokewood Community Health Centre where the barbeques are burning, the pancakes sizzling and fruit aplenty waiting. Supported initially by both a one-off grant from the Department of Victorian Communities and local donations, Hesse’s flexible funding model keeps the program alive with a very small annual $2,500 investment.
Noelene and Heather have been astounded by what the program has offered the small community of Rokewood and say it has been very rewarding to be a part of. ‘It is now such an important event on the monthly calendar. In smaller towns there is often little focus on the younger people, but this keeps them considered, connected, communicating... and fed!’
QUALITY REPORT
breakfasts to students, parents and community members, including the Bus Driver. While many schools run breakfast programs, this one is unique in that the meeting point is at the Bus Stop, before the kids travel to their respective schools for the day.
OPERATIONAL REPORT
While most people understand the benefits of a healthy breakfast, two special people in Rokewood can see its value for connecting a whole community. As Hesse Rural Health volunteers, Heather and Noelene have been serving up breakfasts and packed lunches to the secondary school students living around Rokewood once a month for the last nine years.
FINANCIAL REPORT
Breakfast at The Bus Stop
13
Reflecting On 20 Years
2002 Revenue exceeds $3 million A refurbishment program commences at the Beeac and Leigh Community Health Centres Donations received from 490 households Hesse Lodge expansion lifts overall aged care beds to 45
2003 Hesse Lodge opened by Hon Stewart McArthur MP Invitation to present to State Parliamentary Committee on Farm Safety Visited by State Minister for Health Hon Bronwyn Pike MP and Federal Minister for Ageing the Hon Julie Bishop MP Professor Joseph Levi from the University of York, Canada, lectures staff and Board on health and wellness ‘Broadway at the Mansion’ fundraising event at historic Barwon Park attracts 700 people
Photograph: S Williams
Ensuring Medical Sustainability Ensuring local general medical care remains available within the catchment has long remained a key objective of the Board at Hesse Rural Health. The continued availability of General Practitioners (GPs) is vital to support the local community, hospital and aged care service, one which is predicted to grow. In 2010, after three and a half years of directly managing the Winchelsea Medical Centre, Hesse entered into a business arrangement with partner Health Financial, a specialist in the operational management of general practices in rural areas. The joint venture established the Winchelsea Medical Clinic (WMC) Pty Ltd as a separate company, with Hesse Rural Health and Health Financial each owning 50% share holdings. This strategic business initiative has proved to be successful both operationally and financially. The WMC Pty Ltd broke even in its first year and has generated surpluses in
subsequent years with another healthy profit in 2013-2014. This will assist with other service development and growth opportunities within the rural area. The WMC Pty Ltd remains busy with five part-time GPs and services offered in Winchelsea, Beeac and within the purpose built Moriac Community Health Centre. Sessional allied health services including podiatry, osteopathy, massage and chiropractic are all complementary to, not competing with, the public nursing and allied health services offered by Hesse. The only problem is that the leased Willis Street premises is now bursting at the seams. Ideally a purpose-designed Primary Care Hub on the Gosney Street site would facilitate further integration between public and private health and medical services. The success of the joint venture may now just enable that to become a possibility.
When earlier this year Tom was ready for a new form of administering the Factor VIII treatment his parents Rebecca and Peter were excited. Intravenous transfusion meant he would no longer have to rely on a central venous port access, which held higher risks of infection and possible
However, Rebecca understood the issue for Tom was simply that all this cajoling took place in a clinical hospital environment. The family were willing to pay privately for a home nursing professional, yet nobody was prepared to take on this assignment involving a child with such a rare disorder. The local GP eventually considered a referral to Hesse Rural Health’s
community nursing team. Rebecca says District Nurse Denise was a ‘Godsend.’ She went to Melbourne with the family and met the specialists to learn what was expected. Mostly Denise focussed on gaining Tom’s trust. After only a small number of visits, in the comfort of his own home and with the assistance of Ella, Tom was prepared to allow the venepuncture. In a few short months Rebecca and Peter are managing the venepuncture with only an occasional visit from Denise. Peter says, ‘it is like being able to walk on the moon.’ For Tom, he can now enjoy the normal life of an eight year old boy.
QUALITY REPORT
Tom was three days old when he was diagnosed with haemophilia, a rare genetic disorder that means that his blood is missing an important clotting factor, and has required regular blood transfusions. Under the specialist care of the Royal Children’s Hospital (RCH) the family have travelled up to 9,000km per year to access treatment.
dislodgement as Tom grew. The problem was that there was no way Tom was having a bar of any needles. Despite all efforts from the RCH staff and his parents he remained adamant. The experts suggested counselling, play therapists and even hypnosis to overcome what they identified as Tom’s fear of needles.
OPERATIONAL REPORT
Tom is a lively eight year old from Bannockburn who has an older sister Ella, a pet turtle and barracks for the Tigers.
FINANCIAL REPORT
The Best Care Belongs at Home
15
Reflecting On 20 Years
2004 Commonwealth approves 10 dementia specific aged residential beds Maternity service consultations increase to 130 The Nester Program commences at Beeac
2005 Philanthropic trusts and foundations embrace the dementia project: Helen Macpherson Smith, Ian Rollo Currie Estate, ANZ Charitable, Percy Baxter Charitable, William Angliss, R.E. Ross, Bell Charitable, Tattersalls George Adams Childless Tractors’ health promotion initiative features in the Australian Farm Journal Harp Therapy program funded by Ladies Auxiliary Staff present at three national conferences Neighbouring Main Street milk bar and land purchased
Take a Mate There is no doubt that getting blokes to access preventative health services is a hard gig. Addressing these barriers, remains a focus for Hesse’s health promotion program. Males are more likely to die prematurely than females from preventable conditions and they possess higher levels of risk factors for cancers, diabetes mellitus, circulatory disorders, suicide, accidents and injury. For men in rural areas the news is even worse with limited access to health services, information and support, more physically demanding and isolated work, and stoic attitudes to their own health. However, not so in Winchelsea it would seem. In October over 100 local men turned out to the Blokes Night Out – Take a Mate evening to see what all this fuss was about. Hosted by Hesse and partnered by sponsors Corangamite Financial Services (Winchelsea Community Bank), Working With Winchelsea Group, Lions Club of Winchelsea and the Geelong Football Club, these Winchelsea and district men
faced some hard core truths about their health prospects and had important decisions to make. Over a two course meal the male-only audience was treated to some live theatre with well known actor and author Alan Hopgood and his cast presenting the play ‘Six Degrees of Diabetes’ . The story was set in a pub with three journalists discussing diabetes, the ‘epidemic of the 21st century.’ The play was an opportunity for men to think about and act upon their own health issues. Complemented by real life examples of health trajectories, individual accounts of personal lives and Q & A sessions, the presentations resonated with warmth, humour and honesty. And if these 100 men pass the word to five friends each, then the health prospects for men living in the Winchelsea district will be looking good.
Health Planning for Population Growth
For now though the sheep and the alpacas are the beneficiaries, as they have been eyeing off the land on the other side of the fence for some time now.
FINANCIAL REPORT
To enable the purchase, the Winchelsea Hospital Ladies Auxiliary generously donated funding. Sitting alongside the current public reserve, the new parcel of land additionally protects the vista for the residents living within the Werruna dementia environment. CEO, Peter Birkett, says ‘having urban development
blocking this outlook would have destroyed the open space and freedom which is crucial to resident wellbeing. It was on these well researched concepts that the development was based.’
QUALITY REPORT
Board President John Carr says, ‘that despite some mixed feelings within the community about the level of these population predictions, it is incumbent upon the Board to make some future provisions.’ When two vacant Hesse
Street blocks adjacent and to the north of the health service became available, the Board were aware that an urgent decision must be made. If these blocks were sub-divided for residential living, it would limit any future chance of expansion from this site. So the decision was made to purchase both.
OPERATIONAL REPORT
Along with the 2013 announcement for Winchelsea’s long awaited connection to natural gas and the State Government commitment to the Princes Highway duplication through to Colac, regional lobby group G21 has forecast a potential growth in Winchelsea’s population from 1,400 to 10,000 by 2050. Understandably, such increases will impact considerably on the demand for local health and aged care services, and the Hesse Board of Management have been giving much thought to the issue.
17
Reflecting On 20 Years
2006 Initial plans developed for an intergenerational childcare facility Commonwealth funded water harvesting project Annual Report mailed to 2,600 homes within the community Staffing levels exceed 100 Adult Day and Activity Program delivers 3,458 occasions of service
2007 The Winchelsea Community Bank branch of the Bendigo Bank generously support the dementia unit development Winchelsea Medical Centre acquired to sustain local GP services Construction commences on a rural 10 bed dementia environment Primary Care team deliver 16,138 occasions of service Women’s Health initative across the catchment attracts 50 attendees in Beeac
Ahead of the Pack The Living Longer Living Better Commonwealth aged care reforms which came into effect on 1st July 2014 are deigned to keep people living in their homes longer and shift the emphasis to a user pays system. While the changes provide greater choice and demand improved levels of consumer information, they also introduce market competition and sustainability challenges for smaller residential facilities. However, Hesse has positioned itself to successfully navigate this new era. Predicting increased business and financial complexity when the reforms were announced in 2012, Hesse resourced the training of key personnel. Most significantly, this was by supporting an Administration employee to undertake an undergraduate degree in Accounting at Deakin University. CEO Peter Birkett says, ‘It was obvious that we needed to take a smarter approach to the business aspects of residential care and it made sense that
we developed our own knowledge in the process, rather than outsourcing.’ The Board were also eager to understand the impact and received education sessions to make their first important decision required of the aged care reforms, to set their maximum room price. While the features of Hesse’s facilities keep them ahead of the pack, the Board looked to their own organisational mission, ‘Caring For Rural Communities,’ in their deliberations to ensure that accommodation remained affordable and accessible for the local community. Drawing upon their past achievements within public sector aged care, Hesse has now received Department of Health funding to host a region-wide project commencing later in 2014. The Business of Aged Care project focusses on the responsibilities of governance within rural public sector aged care to ensure sustainability into the future.
Good Foundations
Outcomes of the project have included the establishment of a BSW Regional Leadership ACFI Group to network and share information and resources, and
Remarkably, over the life of the two year project there have been reported individual agency gains of up to 29%. While Miranda says she cannot take credit for the agencies’ work, she would like to think that the increased focus on the importance and appropriate use of the tool provided by the Project has provided the impetus for change. In an era of change and uncertainty, the ACFI Project has laid the foundations for the continued sustainability of our rural BSW public sector residential aged care agencies.
FINANCIAL REPORT
The success of the project lay in the ‘ground-up’ process used to embed new skills within the care staff. ACFI is a tool that requires a whole of organisation approach if it is to be implemented and managed successfully. Miranda suggests, ‘While agencies may be lured by the financial appeal of specialist consultancies, this short term approach won’t result in quality care and sustainable change.’
a collaboration with the Loddon Mallee Region of the Department of Health who commenced their own version of the Project.
QUALITY REPORT
Project Officer Miranda Gretgrix provided on-site information, resources, education and support to key agency personnel responsible for managing the ACFI data collection, documentation and claims processes. She says, ‘Pleasingly each participating agency has made improvements at some level in their approach to the ACFI, whether that be through their resident assessments, care documentation, data collection,
claiming and review processes or their resourcing of the coordination role. When some or all of these changes were made, aged care revenue would increase accordingly.’
OPERATIONAL REPORT
Improving awareness of the importance of managing the Aged Care Funding Instrument (ACFI) and sharing successful strategies was the key aim of the BSW regional ‘ACFI Project.’ Hosted by Hesse Rural Health, in association with the Barwon South West (BSW) region of the Department of Health, eight public sector residential aged care agencies participated in the two year project which was completed in June.
19
Reflecting On 20 Years Keeping Active at ADASS
2008 Leading Australian musical theatre performers reunite to raise funds for Broadway at the Mansion The 2008-2013 Strategic Plan commits to developing international best practice Sustainable Farm Families Project commences across the catchment
2009 The Werruna dementia environment accepts its first resident Hesse’s aged care beds reach 55 Murdeduke Open Garden fundraising initiative attracts 2,000 people from across Victoria Visit by the State Minister for Health, Hon Daniel Andrews MP
It is well understood that social interaction contributes to health and wellbeing. However, as we age opportunities for social connections often diminish. Families grow, children leave, retirement approaches and spouses sadly pass. Adult Day Programs have long provided an answer to socialisation needs, but these days offer so much more than a regular day out. Primary Care Manager Annie Coles explains that the programs are required to follow an Active Service Model (ASM). The program must meet the holistic needs of clients, be person focussed, incorporate principles of choice and decision making and facilitate independence, all within a social setting. New clients have their needs identified and an individualised care plan developed. Annie says that ‘an individualised care plan ensures strategies are in place to meet clients’ needs, and wherever possible build upon clients’ existing capacities.’ The more detailed the plan, the more clients can benefit from the program.
The Winchelsea and Beeac Planned Activity Programs are funded jointly by the Victorian and Commonwealth governments under the Home and Community Care (HACC) Program. A recent review revealed that 17 of the 54 registered clients currently have a plan in place, so this will be an area of focus over the next few months. Winchelsea ADASS Coordinator Wayne Reid says it is challenging to apply principles of choice and individual focus when working in a group setting, but the activity workers are highly skilled. They know when to assist, how to involve quieter members of the group, and when to just listen or facilitate active discussion. He says today’s programs offer so much more than the Day Centres of the past when participants had to fundraise to keep the program running. The ADASS Program turns 25 years old in August and clients are looking forward to a big birthday bash.
Our People, Their Potential, Our Success
Other workforce recruitment strategies outlined within Hesse’s Human Resource Plan have included undergraduate Bachelor of Nursing and Allied Health students working in personal care roles, and casual
With the success of specialist dementia and aged care programs, Hesse’s reputation has developed as an aged care employer of choice. The prospective employee database has provided the source for 15 new staff within the last two years, minimising recruitment costs. Providing the means to do what we do well, in the business of healthcare our greatest potential lies in the skills of our people.
FINANCIAL REPORT
With nationwide workforce nursing shortages compounded by the tyranny of distance in rural areas, recruitment
Recruitment challenges are also overcome if there is an active pool of applicants available. As a host employer in the LASA and Monash University Aged Care Graduate Nurse Program over the last three years, recruitment into Hesse’s junior Division 1 nursing roles has been a valuable outcome.
summer holiday employment for Deakin University occupational therapy students to extend established programs post-clinical placement.
QUALITY REPORT
Sue and Deborah have worked at Hesse as Personal Care Workers for fourteen and five years respectively. While they enjoyed their roles caring for residents within Hesse’s aged care facilities they also felt they had more to offer. Fully supported by Hesse they are both now undertaking a Diploma of Nursing traineeship with The Gordon. This means they are able to continue working while they study, an opportunity for which they are both grateful.
difficulties are a common experience. However this traineeship allows Hesse to offer capable and dedicated employees a growth and development opportunity which maximises workforce productivity and sustainability.
OPERATIONAL REPORT
‘Opportunities for career progression’ is not a term you would expect to associate with a small organisation of only 130 people. However, Hesse Rural Health has effected a number of career pathway opportunities of which larger corporate employers would be envious.
21
Reflecting On 20 Years A Juggling Act
2010 Rokewood Men’s shed project sponsored by Geelong Community Foundation Werruna dementia initiative presented to a London audience State government funds repair structural and fire hazards within hospital roof space www.hesseruralhealth.org.au website launched
2011 Partnership with Winchelsea Bendigo Bank builds Moriac Medical and Community Health Centre Hesse shortlisted for National and State aged care building and organisational awards Ladies Auxiliary open the ‘Opportunity Shop’ International visit from researchers with the University of Umea, Sweden
What do a counsellor, technician, clairvoyant, air traffic controller, child care worker and a juggler have in common? They are the skills possessed by the wonderful reception team at Hesse Rural Health as they meet the various needs of our customers, and all with a smile. Multitasking is their specialty. From welcoming visitors, coordinating multiple incoming calls, keeping an eye out for a lost resident, fixing the photocopier, lending a friendly ear to a staff grumble, watching waiting children after school and monitoring the two-way radio to ensure our rural community team are safe from bushfire; these are just some of the simultaneous tasks undertaken by our Reception team. From visitors to staff, residents, family members, contractors, volunteers and even the Premier who recently wandered in, the Reception team provide a calm, warm and welcoming greeting to all.
It seems no problem is too hard; like the day that a young boy came in upset because the chain had come off his bike. After a call to our maintenance team, in pure Tour de France style, he was back on his way. They also have some entertaining tales to tell; like the day that 750 beer glasses arrived instead of the 20 expected. With the stacked boxes blocking the reception window, our rural hospital had more beer glasses than the nearby pub. Hesse regularly receives positive feedback about our bright and cheery reception team who play a vital role in keeping the organisational wheels in motion. A resident wandering away from the desk was recently heard to mutter under his breath, ‘their blood is worth bottling.’ And that’s what we think too.
Wanting for Nothing
A staunchly independent woman who lived alone, her daughters were extremely worried when her physical health deteriorated. She had a series of falls, was experiencing pain, lost interest in food and became increasingly isolated. However, Betty remained adamant she did not require any help.
The change in Betty was noticeable immediately. With regular meals, dietetics and physiotherapy intervention, friendly and caring staff, and social support she began to gain weight, strength and became increasingly mobile. She was able to have videoconferencing appointments with her Rheumatologist, avoiding the need to go out for appointments, something she had always disliked. Betty now spends her days watching her beloved Cats and other sports on Foxtel, visiting fellow community residents and making the occasional trip to the pokies.
She looks forward to the delivery of the daily newspaper and keeping up with local events in the Winchelsea Star. Her family say they have never seen her so sociable and that it is the first time in years they have heard her laugh. As for Betty herself, she is Hesse’s biggest supporter and won’t hear a negative word about the place. She was recently overheard to tell another resident, ‘Here at Hesse we want for nothing.’
A very special and well loved resident in Olive achieved an important milestone in 2013, turning 100 years.
OPERATIONAL REPORT
QUALITY REPORT
After a series of admissions to hospital she accepted the need for care, but was not having a bar of suggestions that it be anywhere other than Hesse Rural Health. Her mother, brother and sister had all been residents there, and both her daughters work at the service.
FINANCIAL REPORT
Many people live with the hope that they will never need to access residential aged care. This was indeed the case for Betty who has lived in Winchelsea all her life. She admired the care offered by the hospital and aged care facilities but never imagined herself living there. It was a place for others.
23
Reflecting On 20 Years
2012 Hesse is ‘highly commended’ in the Premier’s Health Service of the Year Award Werruna features as the Australian case study in an international publication on the design of outdoor spaces for dementia GRIID International collaboration commences to create a global repository for access to rural dementia initiatives
2013 Dr Jane Melton, NHS UK, presents on Social Inclusion and Client Centred Practice Hesse and Alzheimers Australia (Vic) host Sue Pieters-Hawke, CoChair of the Federal Ministerial Advisory Committee for Dementia Research commences with Deakin and LaTrobe Universities Revenue exceeds $9.5 million
Healthy Lifestyles in Beeac In Australia and throughout the rest of the world, the prevalence of many chronic diseases is increasing. In the 2007-2008 National Health Survey nearly all people aged 65 years and over reported having at least one longterm condition, with 80% having three or more long-term conditions. Lifestyle factors, such as smoking, poor diet and limited exercise increase the risks. Keeping chronic disease at bay was the focus of a Healthy Lifestyles seminar, held over two days in September at Beeac Community Health Centre. Ten local community members attended the first day of the Seminar ‘Understanding Diabetes and Healthy Eating Habits’ to hear Hesse’s Diabetes Educator, Raelene Alexander, discuss the importance of a good diet to prevent Type II Diabetes. Maintaining physical health and wellbeing was the focus of the second day with tips from guest Exercise Physiologist Kim Carty on remaining active. Thirteen day two participants learned the importance of incorporating physical exercise into daily routines to limit the onset of osteoporosis,
cardiovascular disease, arthritis, diabetes, obesity and other chronic health conditions. Community Health Nurse, Karen O’Loughlin, was responsible for coordinating and promoting the event and said that it was so successful that it has led to increased use of the gymnasium within the Beeac facility and interest in continued facilitated exercise programs. Karen says, ‘these types of events are important to get the community together as they provide motivation for sharing personal health goals.’ As a result of the program, the Corio Bay Sports Medicine Clinic continued to attend the Beeac Community Health Centre on a weekly basis between October and May to provide ongoing group sessions. Participants were provided with an individualised plan outlining a range of exercises tailored to their personal health needs. The cost of the program was subsidised by Medicare.
Supporters of Hesse Hesse enjoys continued support from the community in the way of financial donations or other contributions such as gifts, bequests or valuable input of personal volunteer time. Financial donations totalled $19,004 for the financial year. Our 35 registered program volunteers are more than just an extra pair of hands. They provide our clients and residents with additional personalised attention and social support enabling us to deliver programs and services to the highest standards. They are also fabulous community ambassadors for the service.
J Johns
•
Winchelsea Community Bank
•
Winchelsea Girl Guides
•
J & M Kelly
•
D & J Lang •
D Morris MP
•
D Burns
•
B Moules
•
L Murfitt
•
N & C Mawson
M Guy Hon MP
•
J Hosking
•
R Russell
•
J Earl
•
J Welsh
•
E & J O’Donohue
•
Victoria Edgar Jewellery
•
Barwon Hotel
•
Victorian Racing Club
•
Inverleigh Golf Club
•
A Callea
•
Winchelsea Ladies Aux
•
N & P Hunter
•
M Gregory
•
Winchelsea Lions Club
•
Werribee Secondary College
•
Colac Otway Shire
•
J & P Taylor
•
Inverleigh Senior Citizens
•
Winchelsea Neighbourhood Watch
•
Winchelsea Repertory Society
•
D Watson
•
W Lovell MP
•
Barwon Copiers
•
P Walsh MLA
•
Bell Charitable Trust
•
Winchelsea Men’s Shed
QUALITY REPORT
•
•
OPERATIONAL REPORT
Thank you to all Hesse’s supporters in 2013-2014.
FINANCIAL REPORT
Member for Corangamite, Sarah Henderson MP, presents Hesse Board President, CEO and residents with a new Australian Flag.
25
Statement of Priorities
The Statement of Priorities is a key document of accountability between the Department of Health and Hesse Rural Health as a small rural public health service. This agreement identifies how Hesse has contributed to the achievement of the government’s seven key priorities in 2013-2014 through the following actions, deliverables and outcomes.
Priority Developing a system that is responsive to people’s needs
Action Mandatory: Implement formal advance care planning structures and processes that provide patients with opportunities to develop, review and have their expressed preferences for future treatment and care enacted. Standard: Configure and distribute services to address the health needs of the local population.
Improving every Victorian’s health status and experiences
Mandatory: Improve thirty-day unplanned readmission rates.
Standard: Collaborate with key partners such as Medicare Locals, community health services and other providers to support local implementation of the Victorian Health and Wellbeing Plan 2011–2015. Expanding service, workforce and system capacity
Standard: Build workforce capability and sustainability by supporting formal and informal clinical education and training for staff and health students, in particular inter-professional learning
Deliverable
Outcome
Ensure that 90% of all patients and residents are provided with the opportunity to have their advanced treatment and care needs documented and enacted.
Achieved An opportunity is offered to 100% of residents to participate in advanced care planning within three months of admission. The uptake has been 47%.
Ensure a minimum of ten RNs and ENs have received training in the Respecting Patient Choices program.
Achieved Fourteen nursing personnel have participated in the Respecting Patient Choices program.
Complete organisational community consultation commenced in 2013.
Achieved Extensive stakeholder consultations undertaken in three locations across the Hesse catchment generated 101 community suggestions for health service delivery.
Undertake organisational Strategic Plan development in late 2013 incorporating needs in line with the local population health profile, sub-regional service provision, and as expressed by the Hesse catchment communities.
Achieved Development of the 2014-2018 Hesse Rural Health Strategic Plan focussing on nine Priority Action Areas.
Review handover, clinical communication and documentation practices and schedule a weekly ‘whole of service’ clinical handover/review meeting that better integrates clinical needs and risk issues for clients, patients and residents across residential, urgent care, community nursing, and CACPs programs.
Achieved A weekly organisation wide clinical handover was implemented which incorporates primary care, acute and residential services.
Continue to work with partnership organisations such as Barwon Medicare Local, Department of Health and Bass Community Health in the implementation of Hesse’s rural health and aged care Nurse Practitioner Model.
In Progress A rural nurse practitioner model is being developed with assistance received from Barwon Health, Northeast Health Wangaratta and Bass Coast Community Health, and is due to be completed by December 2014.
Participate in the Clinical Placement Network Program (Nursing & Allied Health) and make placement opportunities available via ViCPlace initiative to students undertaking training in a Bachelor of Nursing, Diploma of Nursing, Physiotherapy, Occupational Therapy and Dietetics from 2014.
Achieved Nursing clinical placement opportunities were undertaken within the limitations of ViCPlace.
Host four professional education sessions conducted by external specialists and multidisciplinary representatives to enhance inter-professional learning and role understanding.
Achieved Session topics were: Dementia, Population Health, Workplace Communication & Men’s Health.
There were three unplanned readmissions during the year.
Mandatory: Reduce variation in health service administrative costs. Standard: Identify opportunities for efficiency and better value service delivery
Implementing continuous improvements and innovation
Standard: Support change and innovation in practice where it is proven to deliver more effective and efficient health care.
Increasing accountability & transparency
Mandatory: N/A Standard: Prepare for the National Safety and Quality Health Service Standards, as applicable. Prepare for, and respond to changes in policy and regulation, for example, with regard to proposed amendments to Aged Care legislation.
Improving utilisation of e-health and communications technology.
Standard: Maximise the use of health ICT infrastructure.
Outcome
Review of administrative employee roles and functions In Progress to be conducted to achieve improved workflow and Administrative role review commences. efficiencies and absorb reduction in administrative budget. Increase monitoring, measurement and reporting of ICT utilisation and cost effectiveness in the delivery of services in a small rural health service context.
In Progress ICT expenditure has risen to four percent of operating budget with no parallel gains in return on investment.
Identify two Registered Nurses to participate in the Dept. of Health Rural and Isolated Practice Endorsed Registered Nurse (RIPERN) Program commencing in 2013 to improve nursing responsiveness and treatment provided within a small rural health urgent care context.
Achieved Two Registered Nurses participated in RIPERN training.
Develop a consumer participation policy and implement formal consumer advisory committee structures that meet the needs of a small rural health service and is in line with National Health Standards.
Achieved Consumer Participation Policy and Consumer and Community Advisory Committee Terms of Reference were developed.
Ensure key executive and administrative personnel participate in relevant external education sessions which assist to identify and implement new business models required to meet the Commonwealth Living Longer Living Better Reform.
Achieved Extensive education was undertaken by senior executive, administration and Board of Management.
In partnership with our rural ICT alliance, improve the system requirements and increased electronic telecommunication band width to facilitate VMO and GP access to and use of electronic patient records.
Achieved Increased electronic band width was achieved with copper cable connectivity replaced by a microwave link on site.
FINANCIAL REPORT
Increasing the system’s financial sustainability and productivity
Deliverable
QUALITY REPORT
Action
OPERATIONAL REPORT
Priority
27
Compliance
H
esse Rural Health Service (Hesse) has a statutory obligation to report legislative compliance status on a range of matters. Board Functions The Directors contribute to the governance of Hesse collectively through attendance at meetings. Individual contribution occurs through participation in, or chairmanship of, the various committees of the Board. The Board has established a number of sub-committees which are also attended by members of the Hesse management team. The President is an ex-officio of each committee. Payment of Board Members In accordance with the Health Services Act 1988, Board Members of rural hospitals are not eligible for payment or sitting fees, but may be reimbursed for expenses incurred as a member of the Board. Pecuniary Interest Board Members must declare a pecuniary interest in agenda items of Board meetings, where applicable, and retire from the meeting until discussions on the subject are terminated or voting has concluded. No issues of pecuniary interest were noted. Conflict of Interest Members declare a conflict of interest in matters listed for discussion at Board meetings and leave the meeting when the item is under discussion. They do not participate in proceedings or voting. No issues of conflict of interest arose. Education Governance education is available to Board members through external sources. Corporate Risk Management The Board has policies and procedures in place to ensure that it is compliant with the requirements of Risk Management.
28
Clinical Risk Management All staff are qualified to undertake their roles. Professional persons are checked each year to ensure they meet the standards of the Australian Health Practitioner Regulation Agency (AHPRA) or other recognised bodies. Hesse is part of a sub-regional approach to medical credentialing with access to clinical advice through Colac Area Health. Hesse participates in a variety of quality systems ensuring clinical care is subject to continuous review. Fees All Fees charged by the service are in accordance with the Hospitals and Charities (Fees) Regulations 1986 and otherwise determined by the Department of Health and as directed by the Commonwealth Department of Health & Ageing. Comments and Complaints Consumer comments are valued as a guide to the quality of care delivered. Comments and suggestions enable us to gauge the need for improvement as well as reaffirm our worth to the community. Comments and suggestions are welcomed and should be directed to the Chief Executive Officer. The Health Service Commissioner can be contacted on (03) 8601 5200 or Toll Free 1800 136 066 to assist with unresolved complaints. Formal complaints were one. Financial Management Act 1994 The requirements as listed under the Direction for the Minister for Finance Part 9.1.3 (iv) are available for scrutiny by the Minister, Members of Parliament or consumers on request to the Chief Executive Officer. Freedom of Information Act 1982 Four requests for information were received during the year. The Service operates within the guidelines defined within the Freedom of Information Act 1982 and its subsequent amendments.
For access to medical records there is a mandatory application fee of $26.50 that must accompany the written charges for searching, photocopying and postage. Consumers wishing to access information should make a written request to the Chief Executive Officer, Hesse Rural Health Service, 8 Gosney Street, Winchelsea, Vic 3241. Privacy Hesse complies with legislation relating to confidentiality and privacy including the Health Services Act 1988, Health Records Act 2001, Australian Privacy Act 1988 and Privacy Amendment Act 2012. Policies ensure that personal health information remains confidential and secure and is accessible under FOI guidelines. Buildings and Maintenance Hesse Rural Health Service complies with the Building Act 1993, which encompasses the Building Code of Australia, under the guidelines for publicly owned buildings in all redevelopment and maintenance issues and issued by the Minister for Finance in 1994. Publications and Information This Annual Report is distributed widely and is available upon request at Hesse Rural Health Service. A range of brochures and information pamphlets are freely available for consumers and carers. Occupational Health & Safety Act 2004 Policies and procedures provide guidance for safety in the workplace. Designated workgroups have been established and representatives are elected. No major work accidents were reported during the year. Employment and Conduct Principles Hesse is committed to the principles of merit and equity in the workplace with respect to employment, promotion and opportunity.
Victorian Industry Participation Policy Hesse is required to report the application of the Victorian Industry Participation Policy against any tenders greater than $1 Million. During 2013-14 no tenders were let or completed with a value greater than $1 Million. Reporting Compliance Index This Report is prepared in accordance with the Financial Management Act 1994 and the directions of the Minister for Finance, Part 9, for open disclosure about our Service, our people and our financial management. Competitive Neutrality All competitive neutrality requirements were met in accordance with Government
costing policies for public hospitals. Consultancies In 2013-2014 Hesse engaged four consultancies where the total fees payable to each consultant were less than $10,000, with a total expenditure of $25,840 for the year. Protective Disclosures Act 2012 Hesse has in place appropriate procedures for disclosures in accordance with the Protected Disclosures Act 2012. No protected disclosures were made within the Act in 2013-2014. Carers Recognition Act 2012 The Carers Recognition Act 2012 recognises, promotes and values the role of people in care relationships. Hesse understands the different needs of persons in care relationships and
that care relationships bring benefits to the patients, their carers and to the community. Hesse takes all practicable measures to ensure that its employees, agents and carers have an awareness and understanding of the care relationship principles and this is reflected in our commitment to a model of patient and family centred care and to involving carers in the development and delivery of our services. Environmental Hesse is committed to minimising environmental impacts and has in place effective systems including water harvesting, paper waste recycling and reducing energy consumption through reporting and monitoring.
RESPONSIBLE BODIES DECLARATION In accordance with the Financial Management Act 1994, I am pleased to present the Report of Operations for Hesse Rural Health Service for the year ending 30 June 2014. John Carr, President
FINANCIAL REPORT
An employee Code of Conduct guides responsible behaviour in the workplace. Employees have been correctly classified in workforce data collections.
John Carr, President
26 August 2014
ATTESTATION FOR COMPLIANCE WITH THE MINISTERIAL STANDING DIRECTION 4.5.5.1 - INSURANCE I, John Carr, certify that Hesse Rural Health Service has complied with Ministerial Direction 4.5.5.1 - Insurance. John Carr, President
26 August 2014
ATTESTATION ON COMPLIANCE WITH AUSTRALIAN / NEW ZEALAND RISK MANAGEMENT STANDARD I, John Carr, certify that Hesse Rural Health Service has risk management processes in place consistent with the Australian/New Zealand Risk Management Standard, and an internal control system in place that enables the executives to understand, manage and satisfactorily control risk exposures. The audit committee verifies this assurance and that the risk profile of the Hesse Rural Health Service has been critically reviewed within the last 12 months. John Carr, President
26 August 2014
OPERATIONAL REPORT
ATTESTATION ON DATA INTEGRITY I, John Carr, certify that Hesse Rural Health Service has put in place appropriate internal controls and processes to ensure that reported data reasonably reflects actual performance. Hesse Rural Health Service has critically reviewed these controls and processes during the year.
QUALITY REPORT
26 August 2014
29
Performance and Data TABLE 1: FINANCIAL SUMMARY (Refer to consolidated Financial Statements for details.)
2014
2013
2012
2011
2010
Total Expenses
10,106,138
9,805,155
8,902,974
7,842,599
7,677,823
Total Revenue
9,773,155
9,539,908
8,845,720
7,323,706
7,285,532
Operating Surplus (deficit)
1,261,580
(265,247)
(57,254)
(518,893)
(392,291)
Retained Earnings (accumulated losses)
2,585,877
2,918,860
3,184,107
3,241,361
3,760,254
16,796,166
14,756,484
14,981,155
15,834,386
15,209,130
6,128,907
5,350,805
5,310,229
6,106,206
4,962,057
Net Assets
10,667,259
9,405,679
9,670,926
9,728,180
10,247,073
Total Equity
10,667,259
9,405,679
9,670,926
9,728,180
10,247,073
Total Assets Total Liabilities
6m 6000000 6000000
Figure 1: Revenue
5m 5000000 5000000
Actuals
Target
Before Capital & Specific Items
$146,601
($4,509)
$1,261,580
($665,009)
Comprehensive Result
Residential Aged Care contributes 53% of revenue
4m 4000000 4000000
Net Operating Result
Cash Management
3m 3000000 3000000
Actuals
Target
Creditors
15
< 60 days
Debtors
4
< 60 days
2m 2000000 2000000
Figure 2: IT Costs
1m 1000000 1000000 0m 00
Ad
Mandated IT costs continue to occupy 4% of the health service budget
Pri
Ho
ma ry sid & e Co Healt ntia ted m h l Pa tien Aged muni t yC ts Ca re are
mit
Re
me
TABLE 2: WORKFORCE STATISTICS June Current Month
2014
2013
2014
2013
31.30
29.40
31.22
Medical Support
0.00
0.00
Administration
9.12
Hotel & Allied
34.10
Nursing
Ancillary (Allied) TOTAL
June Year to Date
2012
2011
2010
27.09
24.70
23.17
24.23
0.00
0.00
0.00
0.00
1.00
8.05
9.50
9.35
9.82
9.73
8.21
33.70
34.49
32.72
28.96
28.19
23.09
0.85
0.84
0.84
0.88
1.31
1.48
1.54
75.36
71.99
76.06
70.04
64.79
62.57
58.07
Figure 3: Staff
Pe
rso
Nu nal
rsin
Alli
Ca
re (
26)
g (5
ed
6)
He
En
viro
alth
nm
Ad
(6)
ent
min
Act
al (
istr
19)
ivit
ies
(9) n (1 1)
atio
Hesse Rural Health employs a total of 127 staff
TABLE 3: ADMITTED PATIENTS SEPARATIONS Acute Non-Acute Same Day
2014
2013
2012
2011
2010
59
56
43
40
49
3
3
2
2
1
2
3
1
2
4
64
62
46
44
54
114
113
81
64
45
Acute
822
796
496
457
315
Non-Acute
303
207
253
358
205
Same Day
2
3
1
2
4
1,127
1,006
750
817
524
2014
2013
2012
2011
2010
175
216
167
201
248
22,337
19,567
17,090
16,691
17,183
2014
2013
2012
2011
2010
19,513
19,417
19,287
19,401
17,633
41
56
50
38
50
Total Hospital Separations WEIS
Emergency Medical Treatment HACC (District Nursing, Allied Health, PAG)
TABLE 5: AGED CARE Bed Days (Consolidated) Separations (Consildated)
Figure 4: Barriers to Healthcare
Waiting List
Of barriers to healthcare cited in a recent survey undertaken in the catchment, distance presented a problem to 20% of respondents.
Cost Distance Other
Long Term Condition No Condition Disability Short Term Condition
Figure 5: Health Conditions In a recent survey undertaken within the catchment 11% of respondents were living with a disability
QUALITY REPORT
TABLE 4: NON-ADMITTED PATIENTS
OPERATIONAL REPORT
Total Hospital Patient Days
FINANCIAL REPORT
PATIENT BED DAYS
31
QUALITY REPORT
33
Clinical Governance
33
Partnering with Consumers
34
Information Management
35
Preventing Falls
35
Medication Safety
35
Safe Use of Blood Products
36
Clinical Handover
36
Provision of Care
37
Preventing and Controlling Infections
37
Preventing and Managing Pressure Injuries
37
Patient Identification
38
Workforce Management
38
Service Delivery: Measuring Patient Satisfaction
39
Corporate Systems and Safety
39
Responding to Clinical Deterioration
40
Please tell Us
1
Operations Report
41
Finance Report
Clinical Governance: Quality in Focus In this 20th year as an amalgamated health service, as the Chair of the Quality Improvement and Ethics Committee, it is with great pleasure that I introduce Hesseâ&#x20AC;&#x2122;s 2014 Quality of Care Report.
Later this year Hesse will undergo
an organisation wide survey by the Australian Council on Health Care Standards (ACHS) using the EQuIP National program, incorporating the new National Safety and Quality Health Service (NSQHS) Standards. We are confident that our systems based quality approach undertaken as core business will ensure our achievements are well regarded during this accreditation exercise. Donald Lang Chair of Quality & Ethics Committee
Partnering with Consumers Hesse has long held a commitment to the local community in the design and delivery of our health service. Long standing informal community advisory roles have been undertaken by the Winchelsea Hospital Ladies Auxiliary, Volunteers, the Resident and Carers Group and the Board of Management. These committees have worked
tirelessly to support the operations of the health service and fulfilled multiple aims including fundraising, volunteering, strategic development, evaluation and consultation, especially during the design of our dementia specific environment. As a result of the introduction of the National Safety and Quality Health
Service (NSQHS) Standards, Hesse must now undertake a more formalised approach to consumer and community participation and has developed a comprehensive Consumer and Community Participation Policy. The standards demand input at the micro as well as macro level of health service planning and design.
QUALITY REPORT
In 2014 Hesse has developed a new Quality Framework which outlines an organisation wide approach to ensure clinical and corporate quality systems are implemented, supported and
reviewed. The ultimate purpose of this Framework is to ensure our consumers and the broader community receive a health service that is safe, of the highest quality, based on best practice evidence, informed by consumers themselves and built upon effective and open systems of communication and decision making. This Quality Framework is overarching across the organisation and enables everyone to understand their contribution to quality.
OPERATIONAL REPORT
As Board Directors, public health care governance can indeed be a complicated business with accountabilities to multiple levels of government, to the business itself as well as to serve the interests of our local communities. However, when a quality and consumer focus is firmly retained at the centre of our vision, effective stewardship is simplified. For our incoming Directors an understanding of clinical governance is fundamental to their role and as such participation in the Quality Improvement and Ethics Sub-Committee of the Board of Management is an excellent starting point to understand the centrality of Quality in all that we do.
FINANCIAL REPORT
Hesse stands proud of its commitment to quality care and service provision. Quality is the backbone of the health service and embedded in all that we do.
33
Partnering with Consumers: Continued A dedicated Community and Consumer Advisory Committee has been formed. The Committee reports to the Quality Improvement and Ethics
Sub-Committee of the Board of Management. In recognition of our strong community consultative history, the Committee comprises representation
from each of the groups mentioned. We hope that the formalisation of the concepts of consumer participation does not serve to diminish the spontaneity that is so often the essence of equitable and excellent community relations in rural areas. In May 2014 our local communities and stakeholders were invited to participate in Hesseâ&#x20AC;&#x2122;s 2014-2018 organisational strategic planning process undertaken by Phase One Consulting. The outcome of these consultations held within the Beeac, Winchelsea and Rokewood communities was 101 individual pieces of feedback in the forms of suggestions, encouragement and compliments. It was an impressive list of items for the Board to consider for steering the organisation into the future.
Information Management Information and data management systems in healthcare are almost as critical as the patient care itself. Collecting, recording, retrieving and analysing information and acting upon it is necessary in any knowledge based environment like Hesse. This enables a planned and comprehensive approach to the management and governance of health care. Extensive data is collected on a range of clinical, corporate, workforce, and environmental issues. Of particular focus this year has been the refinement of clinical data captured to enable resident care review in the application of the Aged Care Funding Instrument (ACFI). Other initiatives have been the increases in electronic band width with the SWARH installation of a microwave
link preliminary to the support of telehealth and electronic patient records. Electronic file management
Table 6: Service Performance
in office based systems has also been streamlined.
KPI - Quality & Safety
Target
2014 Actuals
Health Service Accreditation
Full compliance
Achieved
Residential Aged Care Accreditation
Full compliance
Achieved
Cleaning Standards (Overall)
Full compliance
Achieved
Cleaning Standards (AQL-A)
90 %
Not Applicable
Cleaning Standards (AQL-B)
85 %
99 %
Cleaning Standards (AQL-C)
85 %
100 %
Submission of Data to VICNISS
Full compliance
Achieved
Hospital Acquired Infection Surveillance
No Outliers
Achieved
Health Care Worker Immunisation - Influenza
60 %
46 %
SAB Rate per Occupied Bed Days
<2/10,000
0
Hand Hygiene Program Rate
70 %
90 %
Victorian Patient Satisfaction Monitor: (OCI)
73
Not Applicable
Consumer Participation Indicator
75
Not Applicable
Vic Hospital Experience Measurement Inst.
Full Compliance
Full Compliance
People Matter Survey
Full Compliance
Full Compliance
Preventing Falls alert staff via pager when movement is detected. These devices are individually programmed to ensure a balance is achieved between encouraging independent exercise and active monitoring for residents at risk.
Figure 6: Fall Locations Wound Infection
Other Off Site Grounds 1% 3% 5%
Bathroom 13%
Medication Safety Medication safety continues to be a dedicated area of focus for our clinical care team, and for good reasons. With over 13,000 individual doses of medication dispensed within the inpatient and residential facility each month alone, accuracy is vital. There are
many points in the medication system where errors can occur from ordering, to packaging, dispensing and in the recording process. Whilst recorded errors did increase in 2014 to 74, up from 59 in 2014, omission of signature was the most significant cause but increased auditing has led to improved awareness and reporting. No medication errors have resulted in significant harm.
Figure 7: Medications
A further area of focus has been in the use of anti-psychotic medication for psychological and behavioural symptoms of dementia. Clinical best practice prefers the use of appropriate person centred and environmental strategies wherever possible. Hesse advocates for statewide benchmarking opportunities in this area. In addition to six monthly comprehensive GP medication reviews, an internal project has been developed led by the Nurse Practitioner Candidate and Aged Care Manager. The project will create a flow chart and assessment guideline to ensure all non-pharmacological interventions are explored before antipsychotic use is considered.
Safe Use of Blood Products Greater risks are often associated with procedures that occur infrequently. Hesse participates in the Blood Matters Program and undertakes
audits to ensure staff are clear about the procedures and are aware of the clinical guidelines. Of the 64 acute admissions throughout the year, three
blood transfusions were undertaken with appropriate consent and without adverse reaction.
FINANCIAL REPORT
Lounge 18%
QUALITY REPORT
As the majority of falls continue to occur in the bedroom, Hesse has emphasised the use of floor sensor mats and other motion sensors which
Bedroom 60%
The falls risk assessment tool has also been reviewed with clearer links to care planning, and a physiotherapy led exercise program has assisted in maintaining ability and strength for aged and hospital residents.
OPERATIONAL REPORT
Falls are common in older people, and can occur in any setting, such as at home, in the community, in hospital or in residential aged care. Hesse uses a multi-faceted approach to dealing with falls. Key elements of this include prevention through education and exercise, monitoring through individual risk assessments, incident trending, and the use of equipment.
35
Clinical Handover Hesse uses the ISBAR mnemonic (Identify, Situation, Background, Assessment and Recommendation) to ensure the safe transfer of patient information in clinical handover in primary care, acute and residential settings. This provides a structured means of communication that ensures important information is conveyed between clinicians. This process has also been adopted for all communication with medical practitioners, external referrals and during clinical triage.
I S B A R
During 2014 the service replaced multiple handovers with one facility wide handover at each change of shift, ensuring registered nurses were able to carry out their responsibilities with adequate information. In a move toward
effective service integration, a weekly organisation wide clinical handover has also improved communication between
primary care nursing, acute, urgent care and residential care settings.
Provision of Care Nutritional needs of inpatients, residents and community members in receipt of delivered meals are of paramount importance to Hesse Rural Health. In 2013, a Food Services Strategy was developed with significant focus on an external Catering Review. This provided a systematic and comprehensive evaluation of the catering program. Residents, family and staff provided feedback to identify where processes
could be improved. The outcomes included a menu review with greater provision for patient choice, increased satisfaction with meal quality and temperature, improved communication and feedback systems, improved workflow and resident interaction with the Chef. Hesse wishes to acknowledge the assistance of Mary Whelan Consulting in this process.
Table 7: Care Provision Provision of Care KPIâ&#x20AC;&#x2122;s Rate of unexpected acute readmission within 30 days
Achievement 5%
Opportunity to participate in advanced care planning within 3 months of admission
100%
Residents with advanced care plans in place
47%
Resident Care Plans reviewed within 12 months
100%
Preventing and Controlling Infections
303030 20 2020
101010 00
Oth Wo er Ski und Urin n In Ch I ary n f est e f e ctio Tra ctio Infe ns ct I ns ctio nfe ns ctio ns
rates reached 90%, an increase of 11% from 2013.
In healthcare settings, RTIRTI hand hygiene is the single most important method to prevent infections. For all staff hand hygiene is an annual mandatory education requirement and nursing staff also revise aseptic technique annually. Observational hand hygiene compliance
There were no reported hospital acquired infections. A dedicated focus of the infection control program during the year was the introduction of effective anti-microbial stewardship through the monitoring of infections and antibiotic prescribing habits.
Reporting of infections occurs across all clinical areas. Recorded infections within residential aged care and acute inpatient services (See Figure 8) increased by 53 from the previous year. Significant to this is the introduction of new surveillance tools that assist in the accurate identification of infections.
Preventing and Managing Pressure Injuries Pressure injuries can develop in anyone with reduced mobility and people confined to a bed or chair are particularly vulnerable. Such skin damage is difficult to treat and can lead to serious complications. Hesseâ&#x20AC;&#x2122;s nurses are highly attuned to the need to assist bed-bound or movement
restricted patients to regularly change position, provide good hygiene and skin care, and a healthy diet. Prompt referrals made to the dietitian and physiotherapist contribute to robust prevention strategies for people deemed at risk. In 2014 additional pressure relieving air mattresses have been purchased.
Graded by severity, Hesse reported five instances of the least serious Stage 1 pressure injuries demonstrated by early skin discolouration, one instance of a Stage 2 injury showing some skin loss and only two Stage 3 injuries. These figures are significantly below the recorded state average.
Patient Identification The NSQHS Standards place increasing emphasis on ensuring correct patient identity when providing treatment and care in acute hospital facilities. This requires clinical staff to check patients by name, date of birth and unit record
number to avoid error. Audits have been conducted with 100% accuracy. Although not mandatory within aged residential care, Hesse has extended these procedures to include resident photographs within the clinical file, so
visual matching can occur. In the case of clinical deterioration new photographs are taken. Activities staff also use this procedure for outings to ensure all residents are accounted for.
FINANCIAL REPORT
40 4040
The objective of Hesseâ&#x20AC;&#x2122;s infection Other program is to prevention and Other control promote a safe and healthy environment by preventing transmission of infectious WoundInfection Infection agents betweenWound patients/residents, healthcare workers and visitors. A dedicated Infection Control Nurse Chest Chest coordinates education, monitoring and compliance, environmental cleaning, benchmarking and UTIUTIan influenza vaccination program.
QUALITY REPORT
Figure 8: Infections
OPERATIONAL REPORT
50 5050
37
Workforce Management A comprehensive professional development and education policy outlines Hesse’s annual mandatory training program for all employees and is tailored for each workgroup. A new format was trialled with staff electing to participate in one of three dedicated training days. Smart Lift, Open Disclosure, Elder Abuse and Bullying and Harassment education were among the programs conducted. Employees were highly satisfied with the format which included ample opportunities for social interaction, a CEO address to update on organisational service development initiatives and lucky door prizes. Completion of the program will occur later in 2014 with Fire and Evacuation, Basic Life Support and Aseptic Technique programs.
Hesse has committed to providing additional significant training and development opportunities with staff attending sessions on 117 different topics. Staff perception of values and principles are measured via participation
in the Victorian Public Sector People Matter Survey. At 35%, Hesse was above the average response rate with a 13% improvement on 2013. High satisfaction levels were noted across all domains.
Service Delivery: Measuring Patient Satisfaction The consumer is the ultimate judge of the effectiveness of service delivery in health care and as such their feedback is essential to evaluate care provision. The Department of Health supported Victorian Patient Services Monitor (VPSM) has been one method of evaluating the satisfaction of Hesse consumers following an inpatient stay. Whilst the number of hospital separations during the year (64) was low, feedback was very positive. A revised Victorian Hospital Experience Survey (VHES) has now commenced ‘Thank you for the professional care and support of mum. It was comforting to all our family that she was being cared for in her own community by people who knew and respected her.’ - Family Member
which will focus on the experience of patients rather than satisfaction and is in line with international practice. The level of satisfaction from Hesse primary care client surveys was exceptional in terms of consumer involvement in care, clear explanations about treatment, care coordination and respectful and professional conduct. When responding to the question ‘what did you like most about the service?’ One response says it all,‘That it exists’.
‘Thank you for caring for our Aunty. Everyone we encountered was wonderful. It was terrific to visit a facility where we were always welcome, no matter what time of day. All staff were friendly and kind, from the nursing and care staff to the kitchen, cleaners and reception. Thank you.’ - Family Member
‘We were very impressed with the staff, meals and care during my husband’s hospital stay. He was not looking forward to his respite stay but Hesse changed his view into a positive one.’ - Spouse
‘There is an excellent level of care being provided to the residents of this facility. As an outsider observing I am very impressed with the gentle and kind and caring ways of the staff and the impressive range of activities for the residents.’ - Visitor
‘The district nurses were all very friendly putting both my husband and myself at ease. We could not fault the care given and many, many thanks for getting to the root of the trouble … thank you girls.’ - District Nursing Client
Corporate Systems and Safety Resources and Audit Committee, Quality and Ethics Committee and Whole of Board in order to manage risk interdependencies.
Figure 9: Aged Care Occupancy
60
60 60
5050 50 40 4040
FINANCIAL REPORT
30 3030 20 2020 10 1010 000
201 1
201
2
201
3
201
4
Responding to Clinical Deterioration An important aspect of clinical nursing care is to be alert for signs that a patient might be in a deteriorating health state. A quality improvement this year has been the piloting of a revised frequent observation chart in both the acute and residential areas. This has improved monitoring for deterioration and allows trends to be identified earlier. Case reviews are also undertaken following a patient death to evaluate if clinical care received prior was escalated in response to deterioration. Training and education is key to recognising and responding to
deterioration. Nine nurses have received dedicated training in Advanced Life Support in addition to Hesseâ&#x20AC;&#x2122;s mandatory annual Basic Life Support Education for all nursing and personal care workers. Two acute nurses have also commenced the Rural and Isolated Practice Endorsed Registered Nurse Program (RIPERN). The program provides registered nurses with a Scheduled Medicines Endorsement placed on their registration by the Australian Health Practitioner Regulations Agency (AHPRA). The endorsement allows
nurses within the urgent care setting to prescribe a limited range of medicines where there is no or reduced access to GPs, nurse practitioners, paramedics or pharmacists. This is an important initiative within the urgent care service. In addition, Kam Benton RN is scheduled to complete her Nurse Practitioner Program at the University of Melbourne later this year. This will allow Hesse to extend a rural integrated health service in parts of our catchment under-serviced by GPs and greatly improve access to care.
QUALITY REPORT
All staff are provided with education to understand their role in identifying and reporting risk issues. The RiskMan electronic management system captures risk at the clinical and workplace level, in partnership with an active Occupational Health and Safety (OHS) Committee with an established OHS Action Plan. Hesseâ&#x20AC;&#x2122;s Risk Framework and Risk Register was extensively reviewed and externally audited in 2014. It operates within a context of governance mandate, identification, implementation, monitoring and continuous improvement. Risks are rated in line with the Australian Standard for Risk
Management AS NZS ISO 31000:2009 and are managed at strategic, financial and operational levels. Governance oversight is provided by the Finance,
OPERATIONAL REPORT
Risks affecting organisations can have consequences in terms of economic performance and professional reputation, as well as environmental, safety and societal outcomes. Hesse believes the management of risk is an act of balance. Appropriate controls and monitoring of risk need to be in place to ensure the safety and ongoing sustainability of the organisation and the clients it serves.
39
Please Tell Us We hope that you found the Quality of Care Report relevant and informative. We would be pleased to hear your feedback and suggestions regarding the report or the services of Hesse Rural Health. You may direct your responses to: The Chief Executive Officer Hesse Rural Health 8 Gosney Street Winchelsea Victoria 3241 or submit them via our website: www.hesseruralhealth.org.au
Hesse staff receive an organisational update from CEO, Peter Birkett.
Our Reception team are waiting to hear from you.
Members of the Winchelsea CFA participate in an evacuation exercise.
Three new all wheel drive vehicles were fitted out for Community Nursing across the catchment.
Hesseâ&#x20AC;&#x2122;s residents enjoying their favourite music hits on iPads generously donated by our community.
Visitors from Boort District Health seeking our knowledge in designing a world class dementia environment.
VAGO Report
45
Declaration
46
Comprehensive Operating Statement
47
Balance Sheet
48
Statement of Changes in Equity
49
Cash Flow Statement
50
Note 1: Statement of Significant Accounting Policies
62
Note 2: Revenue
63
Note 2a: Analysis of Revenue by Source
63
Note 2b: Patient and Resident Fees
63
Note 2c: Net Gain/(Loss) on Disposal of Non-Current Assets
64
Note 3: Expenses
65
Note 3a: Analysis of Expenses by Source
65
Note 4: Depreciation
65
Note 5: Cash and Cash Equivalents
66
Note 6: Receivables
66
Note 7: Investments and Other Financial Assets
66
Note 8: Investments Accounted for Using the Equity Method
67
Note 9: Property, Plant & Equipment
69
Note 10: Payables
70
Note 11: Provisions
70
Note 12: Other Liabilities
70
Note 13: Equity and Reserves
71
Note 14: Reconciliation of Net Result for the Year to Net Cash Inflow from Operating Activities
71
Note 15: Financial Instruments
74
Note 16: Commitments for Expenditure
74
Note 17: Contingent Assets & Contingent Liabilities
74
Note 18: Operating Segments
75
Note 19: Jointly Controlled Operations and Assets
75
Note 20a: Responsible Person Disclosures
76
Note 20b: Executive Officer Disclosures
76
Note 21: Remuneration of Auditors
76
Note 22: Controlled Entities
76
Note 23: Events Occuring After the Balance Sheet Date
1
Operations Report
32
Quality Report
FINANCIAL REPORT
43
QUALITY REPORT
Disclosure Index
OPERATIONAL REPORT
FINANCIAL REPORT
42
41
HESSE RURAL HEALTH DISCLOSURE INDEX
MINISTERIAL DIRECTIONS Report of Operations - FRD Guidance Charter and Purpose
LEGISLATION
FRD 22D FRD 22D FRD 22D FRD 22D
REQUIREMENT
Manner of Establishment and the Relevant Ministers Objectives, Functions, Powers and Duties Nature and Range of Services Provided Management and Structure Organisational Structure
PAGE
Inside Cover, 4 & 6 Inside Cover, 2 & 9 Inside Back Cover 4
FINANCIAL AND OTHER INFORMATION LEGISLATION
FRD 10 FRD 11A FRD 12A FRD 21B FRD 22D FRD 22D FRD 22D FRD 22D FRD 22D FRD 22D FRD 22D FRD 22D FRD 24C FRD 22D FRD 22D FRD 22D FRD 22D FRD 22D FRD 22D
FRD 25B FRD 29 SD 4.2(g) SD 4.2(j) SD 3.4.13 SD 4.5.5.1 SD 4.5.5
REQUIREMENT
Disclosure Index Disclosure of Ex-Gratia Expenses Disclosure of Major Contracts Responsible Person and Executive Officer Disclosures Application and Operation of Protected Disclosure 2012 Compliance With Building and Maintenance Provisions of Building Act 1993 Details of Consultancies Over $10,000 Details of Consultancies Under $10,000 Employment and Conduct Principles Major Changes or Factors Affecting Performance Occupational Health & Safety Operational and Budgetary Objectives and Performance Against Objectives Reporting of Office-Based Environmental Impacts Significant Changes in Financial Position During the Year Statement of Availability of Other Information Statement on National Competition Policy Subsequent Events Summary of the Financial Results for the Year Workforce Data Disclosures Including a Statement on the Application of Employment & Conduct Principles Victorian Industry Participation Policy Disclosures Workforce Data Disclosures Specific Information Requirements Sign-off Requirements Attestation on Data Integrity Attestation on Data Insurance Attestation on Compliance with Australia / New Zealand Risk Management Standard
PAGE
42 na na 76 29 28 na 29 28 2&3 28 2 & 30 29 2 & 30 28 29 na 30 28 & 30 29 30 6 29 29 29 29
FINANCIAL STATEMENTS Financial Statements Required Under Part 7 of the FMA
LEGISLATION
SD 4.2(a) SD 4.2(b) SD 4.2(b) SD 4.2(b) SD 4.2(a) SD 4.2(c) SD 4.2(c) SD 4.2(d)
REQUIREMENT
Statement of Changes in Equity Comprehensive Operating Statement Balance Sheet Cash Flow Statement Other Requirements Under Standing Directions 4.2 Compliance with Australian Acounting Standards & Other Authoritative Pronouncements Accountable Officerâ&#x20AC;&#x2122;s Declaration Compliance with Ministerial Directions Rounding of Amounts
PAGE
48 46 47 49 50 45 50 52
LEGISLATION LEGISLATION
Freedom of Information Act 1982 Protected Disclosure Act 2012 Carers Recognition Act 2012 Victorian Industry Participation Policy Act 2003 Building Act 1993 Financial Management Act 1994
PAGE
28 29 29 29 28 28
OPERATIONAL REPORT
QUALITY REPORT
FINANCIAL REPORT
INDEPENDENT AUDIT REPORT
HESSE RURAL HEALTH
43
HESSE RURAL HEALTH
INDEPENDENT AUDIT REPORT: CONTINUED
HESSE RURAL HEALTH
OPERATIONAL REPORT
QUALITY REPORT
FINANCIAL REPORT
BOARD MEMBER’S, ACCOUNTABLE OFFICER’S AND CHIEF FINANCE & ACCOUNTING OFFICER’S DECLARATION
45
HESSE RURAL HEALTH
COMPREHENSIVE OPERATING STATEMENT FOR THE FINANCIAL HESSE RURAL HEALTH SERVICE YEAR ENDED 30 JUNE 2014 COMPREHENSIVE OPERATING STATEMENT FOR THE FINANCIAL YEAR ENDED 30 JUNE 2014
Note
Revenue from operating activities Revenue from non-operating activities Employee expenses Non salary labour costs Supplies & consumables Other expenses Share of net result of associates and joint ventures accounted for using the Equity Method
Parent Entity 2014 $
Other comprehensive income Changes in physical asset revaluation surplus Total other comprehensive income
Consolidated Consolidated 2014 2013 $ $
2 2 3 3 3 3
6,962,367 111,364 (4,337,570) (118,023) (209,625) (2,198,751)
7,209,401 109,213 (4,832,309) (176,859) (186,634) (2,042,072)
9,406,786 163,823 (6,437,569) (139,341) (364,029) (2,481,742)
9,315,915 148,951 (6,006,102) (238,772) (353,818) (2,509,767)
8
(1,327)
(1,979)
(1,327)
(1,979)
Net result before capital & specific items Capital purpose income Depreciation and amortisation NET RESULT FOR THE YEAR
Parent Entity 2013 $
208,435 2 4
53,825 (551,241) (288,981)
13
277,476
COMPREHENSIVE RESULT
(11,505)
This statement should be read in conjunction with the accompanying notes
Page 2
78,761 52,500 (564,479) (433,218)
(433,218)
146,601
354,428
203,873 (683,457) (332,983)
77,021 (696,696) (265,247)
1,594,563 1,261,580
(265,247)
HESSE RURAL HEALTH
HESSE RURALAS HEALTH BALANCE SHEET AT 30SERVICE JUNE 2014 BALANCE SHEET AS AT 30 JUNE 2014 Consolidated Consolidated 2014 2013 $ $
138,946 138,343 615,999 37,857
(847,241) 180,386 1,159,870 11,113
874,941 152,883 1,815,999 37,857
697,760 174,164 1,159,870 11,113
931,145
504,128
2,881,680
2,042,907
246,312 1,040 8,631,202
242,799 2,367 8,617,350
246,312 1,040 13,667,134
242,799 2,367 12,468,411
Total Non-Current Assets
8,878,554
8,862,516
13,914,486
12,713,577
Total Assets
9,809,699
9,366,644
16,796,166
14,756,484
460,202 1,374,282 1,076,038
276,286 1,494,371 719,783
482,488 1,795,002 3,531,026
284,286 1,667,212 3,113,394
2,910,522
2,490,440
5,808,516
5,064,892
320,391
285,913
320,391
285,913
320,391 3,230,913 6,578,786
285,913 2,776,353 6,590,291
320,391 6,128,907 10,667,259
285,913 5,350,805 9,405,679
1,649,543 3,527,113 1,402,130
1,372,067 3,527,113 1,691,111
3,566,766 4,514,616 2,585,877
1,972,203 4,514,616 2,918,860
6,578,786
6,590,291
10,667,259
9,405,679
Total Current Assets Non-Current Assets Receivables Investments accounted for using the equity method Property, plant & equipment
LIABILITIES Current Liabilities Payables Provisions Other current liabilities
6 8 9
10 11 12
Total Current Liabilities Non-Current Liabilities Provisions
11
Total Non-Current Liabilities Total Liabilities Net Assets EQUITY Property, plant & equipment revaluation surplus Contributed capital Accumulated surpluses
13a 13b 13c
Total Equity Contingent assets and contingent liabilities Commitments
17 16
This statement should be read in conjunction with the accompanying notes.
Page 3
FINANCIAL REPORT
5 6 7
Parent Entity 2013 $
QUALITY REPORT
ASSETS Current Assets Cash and cash equivalents Receivables Investments and other financial assets Other assets
Parent Entity 2014 $
OPERATIONAL REPORT
Note
47
HESSE RURAL HEALTH
HESSE RURAL SERVICE STATEMENT OF CHANGES IN EQUITY FOR THEHEALTH FINANCIAL YEAR ENDED 30 JUNE 2014 STATEMENT OF CHANGES IN EQUITY FOR THE FINANCIAL YEAR ENDED 30 JUNE 2014
Note Consolidated Balance at 1 July 2012
Property, Plant & Equipment Revaluation Surplus $
Contributions by Owners $
Accumulated Surpluses $
1,972,203
4,514,616
3,184,107
Net Result for the year Balance at 30 June 2013
13
Net Result for the year Other Comprehensive Income for the year Balance at 30 June 2014
1,972,203 1,594,563
13
Note Parent Balance at 1 July 2012
Property, Plant & Equipment Revaluation Surplus $
Contributions by Owners $
Accumulated Surpluses $
1,372,067
3,527,113
2,124,329
1,372,067 277,476
13
1,649,543
This statement should be read in conjunction with the accompanying notes.
Page 4
(332,983) 2,585,877
Net Result for the year Other Comprehensive Income for the year Balance at 30 June 2014
-
2,918,860
4,514,616
13
4,514,616
(265,247)
3,566,766
Net Result for the year Balance at 30 June 2013
-
3,527,113 3,527,113
(433,218) 1,691,111 (288,981) 1,402,130
Total $ 9,670,926 (265,247) 9,405,679 (332,983) 1,594,563 10,667,259
Total $ 7,023,509 (433,218) 6,590,291 (288,981) 277,476 6,578,786
HESSE RURAL HEALTH
HESSE HEALTH SERVICE CASH FLOW STATEMENT FORRURAL THE FINANCIAL YEAR ENDED 30 JUNE 2014 CASH FLOW STATEMENT FOR THE FINANCIAL YEAR ENDED 30 JUNE 2014
Note
Parent Entity 2014 $
Parent Entity 2013 $
Consolidated Consolidated 2014 2013 $ $
CASH FLOWS FROM OPERATING ACTIVITIES 5,283,926 559,016 1,603 126,481 109,280 1,270,218 7,350,524 (4,423,181) (140,736) (246,897) (2,369,905) (7,180,719) 169,805
Capital Grants from Government Capital Donations and Bequests Received NET CASH FLOW FROM OPERATING ACTIVITIES
14
CASH FLOWS FROM INVESTING ACTIVITIES Payments for non-financial assets Proceeds from sale of non-financial assets Proceeds from sale of investments NET CASH FLOW FROM/(USED IN) INVESTING ACTIVITIES
CASH AND CASH EQUIVALENTS AT BEGINNING OF FINANCIAL YEAR CASH AND CASH EQUIVALENTS AT END OF FINANCIAL YEAR
5
6,911,815 1,231,513 1,603 154,780 162,872 1,542,404 10,004,987 (6,275,301) (140,736) (401,301) (2,688,227) (9,505,565) 499,422
6,752,367 1,255,086 988 154,780 149,148 1,415,909 9,728,278 (5,896,816) (240,167) (355,694) (2,652,555) (9,145,232) 583,046
32,423 167,401
52,500 24,521
32,423 167,401
52,500 24,521
369,629
335,379
699,246
660,067
(304,568) 21,000 (258,407) (541,975)
(228,904) (343,172) (572,076)
(304,568) 21,000 880,216 596,648
NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS HELD
5,265,456 622,676 988 108,011 108,277 1,390,522 7,495,930 (4,729,717) (240,167) (188,510) (2,079,178) (7,237,572) 258,358
(186,792) (833,468) (1,020,260)
966,277
(684,881)
157,271
87,991
(891,214)
(206,333)
653,787
565,796
75,063
(891,214)
811,058
653,787
FINANCIAL REPORT
Operating grants from government Patient and resident fees received Donations and bequests received GST received from/(paid to) ATO Interest received Other receipts Total receipts Employee expenses paid Non salary labour costs Payments for supplies & consumables Other payments Total payments Cash Generated from Operations
Page 5
OPERATIONAL REPORT
QUALITY REPORT
This statement should be read in conjunction with the accompanying notes.
49
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
HESSE RURAL HEALTH 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES These annual financial statements represent the audited general purpose financial statements for Hesse Rural Health Service for the period ending 30 June 2014. The purpose of the report is to provide users with information about the Health Services' stewardship of resources entrusted to it. (a)
Statement of Compliance These financial statements are general purpose financial statements which have been prepared on in accordance with the Financial Management Act 1994 and applicable Australian Accounting Standards (AASs), which include interpretations issued by the Australian Accounting Standards Board (AASB). They are presented in a manner consistent with the requirements of AASB101 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. The Health Service is a not-for profit entity and therefore applies the additional Aus paragraphs applicable to “not-for-profit” Health Services under the AAS's. The annual financial statements were authorised for issue by the Board of the Hesse Rural Health Service on August 26th, 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 the Health Service. 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 subsequent impairment 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 the 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)) superannuration expense (refer to Note 1(h)) 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 Measurement, Hesse Rural 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 such as non-financial physical assets held for sale, in accordance with the requirements of AASB 13 and the relevant FRDs. 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 prices 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 measurement is directly or indirectly observable • Level 3 – Valuation techniques for which the lowest level input that is significant to the fair value measurement is unobservable.
Page 7
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
HESSE RURAL HEALTH 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)
NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED For the purpose of fair value disclosures, Hesse Rural 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, Hesse Rural Health Service determines whether transfers have occurred between levels in the hierarchy by re-assessing categorisation (based on the 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 Hesse Rural Health Service's independent valuation agency. Hesse Rural 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. (c)
Reporting Entity The financial statements include all the controlled activities of Hesse Rural Health Service. Its principal address is: 8 Gosney Road WINCHELSEA VIC 3241 Objectives and funding Hesse Rural Health Service's overall objective is to improve the quality of life to Victorians.
Bodies consolidated into Hesse Rural Health Service reporting entity include the Winchelsea Hostel and Nursing Home Society Inc. Intersegment Transactions Transactions between segments within the Hesse Rural Health Service have been eliminated to reflect the extent of Hesse Rural Health Serviceâ&#x20AC;&#x2122;s operations as a group. Associates and joint ventures Associates and joint ventures are accounted for in accordance with the policy outlined in Note 1(k) Financial Assets. Jointly Controlled Assets Interests in jointly controlled assets or operations are not consolidated by Hesse Rural 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 Hesse Rural Health Service operates on a fund accounting basis and maintains three funds: Operating, Specific Purpose and Capital Funds. 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 The activities classified as Services Supported by Health Services Agreement (HSA) are substantially funded by the Department of Health and includes 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 Service's own activities or local initiatives and/or the Commonwealth. Residential Aged Care Service The Hesse Rural Health Service Nursing Home operations are an integral part of the Hesse Rural Health Service and shares its resources. An apportionment of land and buildings has been made based on floor space. The results of the two operations have been segregated based on actual revenue earned and expenditure incurred by each operation in note 2b to the financial statements. The Hesse Rural Health Service Nursing Home has a separate Committee of Management and is substantially funded from Commonwealth bed-day subsidies. 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 the Hesse Rural Health Service. This subtotal reports the result excluding such items as capital grants, assets received or provided free of charge, depreciation, and items of unusual nature and amount such as specific revenues 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 the Health Service, the Department of Health and the Victorian Government to measure the ongoing performance of Health Services. Page 8
QUALITY REPORT
Principles Of Consolidation In accordance with AASB 127 Consolidated and Separate Financial Statements , the consolidated financial statements of Hesse Rural Health Service incorporates the assets, liabilities of all entities controlled by Hesse Rural Health Service as at 30 June 2014, and their income and expenses for that part of the reporting period in which control existed. Control exists when Hesse Rural Health Service has the power to govern the financial and operating policies of an entity so as to obtain benefits from its activities. In assessing control, potential voting rights that presently are exercisable are taken into account. The consolidated financial statements include the audited financial statements of the controlled entities listed in Note 22.
OPERATIONAL REPORT
(d)
FINANCIAL REPORT
Hesse Rural Health Service is predominantly funded by accrual based grant funding for the provision of outputs.
51
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS 30 JUNE 2014 NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014
NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED (e)
Scope and Presentation of Financial Statements (cont'd) Capital and specific items, which are excluded from this sub-total, 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 or plant and equipment. It also includes donations of plant and equipment. 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 - Non-Current asset revaluation increments/decrements • impairment of financial and non-financial assets including all impairment losses (and reversal of previous impairment losses) which have been recognised in accordance with Note 1 (i) and (k) • depreciation and amortisation, as described in note 1 (h) • assets provided or received free of charge (refer to Note 1 (g) and (h)) • 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. 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 that 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 . Rounding All amounts shown in the financial statements are expressed to the nearest dollar 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 are required under AASB 7 Financial Instruments Disclosures. AASB 119 Employee Benefits In 2013-14, the health service has applied AASB 119 Employee Benefits (Sep 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 accounting 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, shortterm employee benefits are now defined as benefits expected to be settled wholly within 12 months after the end of the reporting period in which the 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. The change in classification has not materially altered the measurement of the annual leave provision.
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) 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 the Hesse Rural 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 and 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 the 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. Donations and Bequests Donations and bequests are recognised as revenue when received. If donations are for a special purpose, they may be appropriated to a reserve, such as the specific restricted purpose surplus.
Sale of investments The gain/loss on the sale of investments is recognised when the investment is realised. 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 services would have been purchased if not received as a donation.
FINANCIAL REPORT
Interest Revenue Interest revenue is recognised on a time proportionate basis that takes in account the effective yield of the financial asset, which allocates interest over the relevant period.
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 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.
OPERATIONAL REPORT
(h) Expense Recognition Expenses are recognised as they are incurred and reported in the financial year to which they relate.
QUALITY REPORT
Other income Other income includes non-property rental, dividends, forgiveness of liabilities, and bad debt reversals.
53
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED (h)
Expense Recognition (continued) 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, residual value 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 $1,000 are capitalised and depreciation has been provided on depreciable assets so as to allocate their cost or valuation over their estimated useful lives. 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 Up to 60 years Up to 60 years - Site Engineering Services and Central Plant Up to 30 years Up to 30 years Central Plant - Fit Out Up to 30 years Up to 30 years - Trunk Reticulated Building Systems Up to 40 years Up to 40 years Plant & Equipment Up to 15 years Up to 15 years Medical Equipment Up to 15 years Up to 15 years Computers & Communications Up to 15 years Up to 15 years Furniture & Fittings Up to 15 years Up to 15 years Motor Vehicles Up to 7 years Up to 7 years Leasehold Improvements Up to 10 years Up to 10 years As part of the Buildings valuation, building values were separated into components 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 (i) 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-current physical assets
Refer to Note 1(k) Revaluations of non-current physical assets . Net gain/ (loss) on disposal of non-financial assets
Any gain or loss on the disposal of non-financial assets is recognised at the date of disposal and is the difference between the proceeds and the carrying value of the asset at the time. 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: a. the revaluation of the present value of the long service leave liability due to changes in the bond interest rates; and b. transfer of amounts from the reserves to accumulated surplus or net result due to disposal or derecognition or reclassification.
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED (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 Hesse Rural Health Serviceâ&#x20AC;&#x2122;s activities, certain financial assets and financial liabilities arise under statute rather than a 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. The following refers to financial instruments unless otherwise stated. Categories of non-derivative financial instruments Loans and 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 Serviceâ&#x20AC;&#x2122;s contractual payables, deposits held and advances received, and interest-bearing arrangements other than those designated at fair value through profit or loss.
Cash and 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 the cash flow statement presentation purposes, cash and cash equivalents includes bank overdrafts, which are included as current borrowings in the balance sheet. Receivables
FINANCIAL REPORT
Assets
- Contractual receivables, which includes 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 recognised and measured similarly to contractual receivables (except for impairment), but are not classified as financial instruments because they do not arise from a contract. Receivables are recognised initially at fair value and subsequently measured at amortised cost, using the effective interest rate method, less any accumulated impairment. Trade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition. 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.
QUALITY REPORT
Receivables consist of: - Statutory receivables, which includes predominantly amounts owing from the Victorian Government and Goods and Services Tax (GST) input tax credits recoverable; and
Investment 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: - Loans and receivables The Hesse Rural 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 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 and loss are subject to annual review for impairment.
OPERATIONAL REPORT
(k)
Inventories
The value of supplies held at balance date is not considered to be material. The cost of supplies is charged to operating expenses when incurred.
55
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED
NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) (k)
Assets (cont'd) 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. Assets transferred as part of a merger/machinery of government are transferred at their carrying amount. More details about the valuation techniques and inputs used in determining the fair value of non-financial physical assets are discussed in Note 9 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 physical restrictions imposed on the asset, public announcements or commitments made in relation to the intended use of the land. 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 physical assets will be their highest and best uses. 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 FRD103E 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 in equity 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 are normally not transferred to accumulated funds on derecognition of the relevant asset. In accordance with FRD 103E the Hesse Rural Health Service's non-current physical assets were assessed to determine whether revaluation of the non-current physical assets was required. As movements were assessed to be less than 10% no revaluation was required in the current year. 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
All other non-finanical assets are tested annually for indications of impairment except for: • financial assets; • investment property that is measured at fair value; and • non-current physical assets held for sale. If there is an indication of impairment, the assets concerned are tested as to whether their carrying value exceeds their possible recoverable amount. Where an asset’s 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 reversal 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.
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) Assets (cont'd) Investments accounted for using the equity method
Associates are those entities over which Hesse Rural Health Service exercises significant influence, but not control. Investments in associates are accounted for using the equity method of accounting. Under the equity method for accounting, the health service's share of the post-acquisition profits or losses of associates is recognised in the net result, and its share of postacquisition changes in revaluation surpluses and any other reserves, are recognised in both the comprehensive operating statement and the statement of changes in equity. The cumulative post acquisition movements are adjusted against the cost of the investment. Joint ventures are contractual arrangements between the health service and one or more other parties to undertake an economic activity that is subject to joint control. Joint control only exists when the strategic financial and operating decisions relating to the activity require the unanimous consent of the parties sharing control (the venturers). Interests in jointly controlled entities are accounted for in the financial statements using the equity method, as applied to investments in associates. Investments in jointly controlled assets and operations
For jointly controlled operations, the 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
A financial asset (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 cash flows from the asset have expired; or • the 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 the 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.
FINANCIAL REPORT
In respect of any interest in jointly controlled assets, the Hesse Rural Health Service recognises in the financial statements: - its share of jointly controlled assets; - any liabilities that it had 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.
At the end of each reporting period the Hesse Rural Health Service assesses whether there is objective evidence that a financial asset or group of financial asset 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. Bad debt written off by mutual consent and the allowance for doubtful debts are classified as ‘other comprehensive income’ in the net result. The amount of the allowance is the difference between the financial asset’s 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. Revaluations of financial instruments at fair value
The revaluation gain/(loss) on financial instruments at fair value excludes dividends or interest earned on financial assets.
QUALITY REPORT
Impairment of financial assets
OPERATIONAL REPORT
(k)
57
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)
NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED (l)
Liabilities Payables
Payables consist of: • contractual payables which consist predominantly of accounts payable representing liabilities for goods and services provided to the Health Service prior to the end of the financial year that are unpaid, and arise when the health service becomes obliged to make future payments in respect of the purchase of those goods and services. The normal credit terms are usually Nett 30 days. • statutory payables, such as goods and services tax and fringe benefits tax payables. Contractual payables are classified as financial instruments and are initially recognised at fair value, and then 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 the 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 liability 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 cashflows 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, and accumulating sick leave 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 the health service expects to wholly settle within 12 months; or • Present value – if the health service does not expect to wholly settle within 12 months. Long Service Leave
Liability for long service leave (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 the health service does not expect to settle the liability within 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 the health service expects to wholly settle within 12 months; and • Present value – if the health service does not expect to wholly settle within 12 months. Conditional LSL is disclosed as a non-current liability. There is an unconditional 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 followed revaluation of the present value of non-current LSL liability is recognised as a transaction, except to the extent that a gain or loss arises due to changes in bond interest rates for which it is then recognised as an other economic flow. 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. The 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
Employee benefit on-costs, such as payroll tax, workers compensation and superannuation are recognised together with provisions for employee benefits. Superannuation Liabilities
The Hesse Rural Health Service does not recognise any unfunded defined benefit liability in respect of the superannuation plans because the 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.
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: STATEMENT OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)
NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED (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. Operating Leases Entity as lessee
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. 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. (n) Equity Contributed Capital
Consistent with Australian Accounting Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities and FRD 119A 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 to or distributions by owners that have been designated as contributed capital are also treated as contributed capital.
(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 and 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, the GST payable 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 an operating cash flow. Commitments for expenditure and contingent assets and liabilities are presented on a gross basis.
QUALITY REPORT
Commitments for future expenditure include operating and capital commitments arising from contracts. These commitments are disclosed by way of a note (refer to note 16) 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.
OPERATIONAL REPORT
(o) Commitments
FINANCIAL REPORT
Property, Plant & Equipment Revaluation Surplus
The asset revaluation reserve is used to record increments and decrements on the revaluation of non-current physical assets.
59
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: STATEMENT OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED (r)
AASs issued that are not yet effective Certain new accounting standards have been published that are not mandatory for 30 June 2014 reporting period. DTF assesses the impact of all these new standards and advises the Health Service of their applicability and early adoption where applicable. As at 30 June 2014, the following standards and interpretations had been issued by 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. Hesse Rural Health Service has not and does not intend to adopt these standards early. Standard / Interpretation
AASB 9 Financial instruments
This standard simplifies requirements for the classification and measurement of financial assets resulting from Phase 1 of the IASB’s project to replace IAS 39 Financial Instruments: Recognition and Measurement (AASB 139 Financial Instruments: Recognition and Measurement ).
Applicable Impact on public sector entity financial statements for annual reporting periods beginning on
01-Jan-17
The preliminary assessment has identified that the financial impact of available for sale (AFS) assets will now be reported through other comprehensive income (OCI) and no longer 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.
This Standard forms the basis for determining which entities should be consolidated into an entity’s financial statements. AASB 10 defines ‘control’ as requiring exposure or rights to variable returns and the ability to affect those returns through power over an investee, which may broaden the concept of control for public sector entities. The AASB has issued an Australian Implementation Guidance for Not-for-Profit Entities – Control and Structured Entities that explains and illustrates how the principles in the Standard apply from the perspective of not-for-profit entities in the private and public sectors.
1 Jan 2014 For the public sector, AASB 10 builds on the control (not-for-profit guidance that existed in AASB 127 and Interpretation entities) 112 and is not expected to change which entities need to be consolidated.
AASB 11 Joint Arrangements
This Standard deals with the concept of joint control, and sets out a new principles-based approach for determining the type of joint arrangement that exists and the corresponding accounting treatment. The new categories of joint arrangements under AASB 11 are more aligned to the actual rights and obligations of the parties to the arrangement.
1 Jan 2014 Based on current assessment, entities already apply the (not-for-profit equity method when accounting for joint ventures. It is anticipated that there would be no material impact. entities) Ongoing work is being done to monitor and assess the impact of this standard.
AASB 12 Disclosure of Interests in Other Entities
This Standard requires disclosure of information that enables users of financial statements to evaluate the nature of, and risks associated with, interests in other entities and the effects of those interests on the financial statements. This Standard replaces the disclosure requirements in AASB 127 Separate Financial Statements and AASB 131 Interests in Joint Ventures.
1 Jan 2014 The new standard is likely to require additional (not-for-profit disclosures and ongoing work is being done to entities determine the extent of additional disclosure required.
AASB 127 Separate Financial Statements
This revised Standard prescribes the accounting and disclosure requirements for investments in subsidiaries, joint ventures and associates when an entity prepares separate financial statements.
1 Jan 2014 Current assessment indicates that there is limited (not-for-profit impact on Victorian Public Sector entities. Ongoing entities work is being done to monitor and assess the impact of this standard.
AASB 128 Investments in Associates and Joint Ventures
This revised Standard sets out the requirements for the application of the equity method when accounting for investments in associates and joint ventures.
1 Jan 2014 Current assessment indicates that there is limited (not-for-profit impact on Victorian Public Sector entities. Ongoing entities work is being done to monitor and assess the impact of this standard.
AASB 10 Consolidated Financial Statements
(s)
Summary
Ongoing work is being done to monitor and assess the impact of this standard.
Category Groups The Hesse Rural 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. Aged Care comprises revenue/expenditure form 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.
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 30 JUNE 2014 NOTE 1: STATEMENT OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)
NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: CONTINUED Category Groups (continued) 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
QUALITY REPORT
FINANCIAL REPORT
separately classified above, including: Public health services including Laboratory testing, Blood Borne Viruses / Sexually Transmitted Infections clinical services, Kooris 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.
OPERATIONAL REPORT
(s)
61
4,049 17,353 53,825
Net Gain/(Loss) on Disposal of Non-Current Assets (refer note 2c) Donations & Bequests Total Capital Purpose Income
7,307,114
52,500
52,500
HESSE RURAL HEALTH
(1,327) 83,673
-
-
(1,979) 62,021
-
-
64,000 64,000
-
-
-
-
-
-
-
H&CI 2013 $
-
-
-
-
-
Parent
85,000 85,000
H&CI 2014 $
(1,327) 7,126,229
4,049 17,353 53,825
32,423
111,364 111,364
66,194 495,239 561,433 1,603 1,179,850 178,954 6,962,367
9,099 3,514 12,613
11,763 5,027,914
1,385,738
3,630,413
Total 2014 $
(1,979) 7,369,135
52,500
52,500
109,213 109,213
39,149 577,025 616,174 988 1,225,859 207,852 7,209,401
1,127 43,484 44,611
25,990 40,914 5,113,917
1,274,670
3,772,343
Total 2013 $
9,689,482
4,049 167,401 203,873
32,423
78,823 78,823
66,194 1,189,631 1,255,825 1,603 1,179,850 301,092 9,406,786
9,099 3,514 12,613
11,763 6,655,803
3,013,627
3,630,413
HSA 2014 $
2014
9,477,887
24,521 77,021
52,500
84,951 84,951
39,149 1,195,762 1,234,911 988 1,225,859 208,718 9,315,915
1,127 43,484 44,611
25,990 40,914 6,600,828
2,761,581
3,772,343
HSA 2013 $
(1,327) 83,673
-
-
85,000 85,000
-
-
-
-
-
-
-
-
-
-
(1,979) 62,021
-
-
64,000 64,000
Consolidated H&CI H&CI 2014 2013 $ $
(1,327) 9,773,155
4,049 167,401 203,873
32,423
163,823 163,823
66,194 1,189,631 1,255,825 1,603 1,179,850 301,092 9,406,786
9,099 3,514 12,613
11,763 6,655,803
3,013,627
3,630,413
Total 2014 $
Page 19
This note relates to revenues above the net result line only, and does not reconcile to comprehensive income.
Indirect contributions by Department of Health; The 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.
7,042,556
32,423
Capital Purpose Income - Targeted Capital Works and Equipment
Share of net result of Joint Ventures Accounted for using the Equity Method (refer note 8) Total Revenue (refer to note 2a)
26,364 26,364
Revenue from Non-Operating Activities Interest & Dividends Total Revenue from Non-Operating Activities 45,213 45,213
39,149 577,025 616,174 988 1,225,859 207,852 7,209,401
25,990 40,914 5,113,917
11,763 5,027,914
66,194 495,239 561,433 1,603 1,179,850 178,954 6,962,367
1,274,670
1,385,738
1,127 43,484 44,611
3,772,343
3,630,413
9,099 3,514 12,613
HSA 2013 $
HSA 2014 $
Indirect Contributions by Department of Health - Insurance - Long Service Leave Total Indirect Contributions by Department of Health Patient and Resident Fees - Patient and Resident Fees (refer note 2b) - Residential Aged Care (refer note 2b) Total Patient and Resident Fees Donations & Bequests SWARH revenue from jointly controlled assets Other Revenue from Operating Activities Total Revenue from Operating Activities
Revenue from Operating Activities Government Grants - Department of Health - Commonwealth Government Residential Aged Care Subsidy Commonwealth Grant - Health Network Funding Adjustment Other Total Government Grants
NOTE NOTE2:2: REVENUE REVENUE
NOTES TO
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS THEFOR FINANCIAL STATEMENTS: 30 JUNE THE YEAR ENDED 30 JUNE 2014
(1,979) 9,539,908
24,521 77,021
52,500
148,951 148,951
39,149 1,195,762 1,234,911 988 1,225,859 208,718 9,315,915
1,127 43,484 44,611
25,990 40,914 6,600,828
2,761,581
3,772,343
Total 2013 $
HESSE RURAL HEALTH HESSE RURAL HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 FOR THE YEAR ENDED 30 JUNE 2014
1,597,833 12,613 66,194 603 1,179,850 (60,771) 21,819 31,402
2,849,543
Revenue from Services Supported by Health Services Agreement Government Grants Indirect Contributions by Department of Health Patient and Resident Fees (refer note 2b) Donations & Bequests (non capital) SWARH revenue from jointly controlled assets Other Revenue from Operating Activities Interest Capital Purpose Income (refer Note 2) Share of net result of Joint Ventures Accounted for using the Equity Model (refer note 8) Total Revenue from Services Supported by Health Services Agreement
Aged Care 2014 $
3,709,632 1,189,631 84,922 57,004 160,048
-
Revenue from Services Supported by Hospital and Community Initiatives Other Total Revenue from Services Supported by Hospital and Community Initiatives Total Revenue
RAC 2014 $
5,201,237
853,555 199,032 12,423 1,065,010
Primary Health 2014 $
Other 2014 $
494,783 1,000 77,909 573,692
Total 2014 $ -
(1,327) (1,327)
6,655,803 12,613 1,255,825 1,603 1,179,850 301,092 78,823 203,873 (1,327) 9,688,155
-
-
-
-
85,000
85,000
-
-
-
-
85,000
85,000
83,673
9,773,155
2,849,543 Admitted Patients 2013 $ 1,934,455 44,611 39,149 988 1,225,859 93,478 22,308 10,000
5,201,237
RAC 2013 $
3,370,848
Aged Care 2013 $
3,290,285 1,195,762 898 62,643 67,021
-
1,065,010
4,616,609
822,117 71,278 893,395
573,692 Primary Health 2013 $ 553,971 43,064 597,035
Other 2013 $
Total 2013 $ -
(1,979) (1,979)
6,600,828 44,611 1,234,911 988 1,225,859 208,718 84,951 77,021 (1,979) 9,475,908
Revenue from Services Supported by Hospital and Community Initiatives Other
-
-
-
-
64,000
64,000
Total Revenue from Services Supported by Hospital and Community Initiatives
-
-
-
-
64,000
64,000
62,021
9,539,908
Total Revenue
3,370,848
4,616,609
893,395
597,035
Parent Entity Parent Entity ConsolidatedConsolidated 2014 2013 2014 2013 $ $ $ $ 66,194 39,149 66,194 39,149
NOTE 2b: PATIENT AND RESIDENT FEES Note 2b: Patient And Resident Fees Acute - Inpatients Residential Aged Care - Generic - Residential Accommodation Payments Total Patient and Resident Fees
425,409 69,830 561,433
553,521 23,504 616,174
1,099,421 90,210 1,255,825
1,124,226 71,536 1,234,911
Note 2c: Gain/(Loss) on Disposal Non-Current NOTE 2c:NetNET GAIN(LOSS) FROMofDISPOSAL OFAssets ASSETS Proceeds from Disposals of Non-Current Assets Motor Vehicles Total Proceeds from Disposal of Assets
21,000 21,000
-
21,000 21,000
-
Less: Written-Down Value of Assets Sold Motor Vehicles Total Written-Down Value of Assets Sold
16,951 16,951
-
16,951 16,951
-
4,049
-
4,049
-
Net gains/(losses) on disposal Page 20
FINANCIAL REPORT
Revenue from Services Supported by Health Services Agreement Government Grants Indirect Contributions by Department of Health Patient and Resident Fees (refer note 2b) Donations & Bequests (non capital) SWARH revenue from jointly controlled assets Other Revenue from Operating Activities Interest Capital Purpose Income (refer note 2) Share of net result of Joint Ventures Accounted for using the Equity Model (refer note 8) Total Revenue from Services Supported by Health Services Agreement
Admitted Patients 2014 $
QUALITY REPORT
(based on the consolidated view of note 2)
OPERATIONAL REPORT
NOTE 2a: ANALYSIS OFREVENUE REVENUEBYBYSOURCE SOURCE NOTE 2a: ANALYSIS OF
63
7,802,353
-
-
-
-
-
-
-
-
-
-
-
-
-
-
PARENT H&CI H&CI 2014 2013 $ $ Total 2014 $
7,415,210
551,241
16,500 7,925 2,198,751
107,609 149,056 9,100 114,575 57,674 34,991 353 1,177,466 523,502
12,371 77,365 119,889 209,625
92,739 25,284 118,023
3,836,078 42,992 104,320 354,180 4,337,570
Page 21
This note relates to revenues above the net result line only, and does not reconcile to comprehensive income.
7,415,210
551,241
Depreciation & Amortisation (refer note 4)
Total Expenses
14,968 7,100 2,042,072
16,500 7,925 2,198,751 564,479
95,913 143,384 13,523 124,283 83,777 23,923 2,075 1,015,980 517,146
14,585 47,688 124,361 186,634
107,609 149,056 9,100 114,575 57,674 34,991 353 1,177,466 523,502
12,371 77,365 119,889 209,625
Supplies & Consumables Drug Supplies Medical, Surgical Supplies & Prosthesis Food Supplies Total Supplies & Consumables
80,661 96,198 176,859
4,238,651 46,005 162,316 385,337 4,832,309
HSA 2013 $
Other Expenses Domestic Services & Supplies Fuel, Light, Power and Water Insurance costs funded by Dept of Health Motor Vehicle Expenses Repairs and Maintenance Maintenance Contracts Patient Transport SWARH other expenses Other Administrative Expenses Audit Fees - VAGO - Audit of financial statements - Other Total Other Expenses
92,739 25,284 118,023
3,836,078 42,992 104,320 354,180 4,337,570
HSA 2014 $
Non Salary Labour Costs Fee for Service Medical Officers Agency Costs - Nursing Total Non Salary Labour Costs
Employee Expenses Salaries and Wages Workcover Premium Long Service Leave Superannuation Total Employee Expenses
NOTE EXPENSES Note 3:3: Expenses
7,802,353
564,479
14,968 7,100 2,042,072
95,913 143,384 13,523 124,283 83,777 23,923 2,075 1,015,980 517,146
14,585 47,688 124,361 186,634
80,661 96,198 176,859
4,238,651 46,005 162,316 385,337 4,832,309
Total 2013 $
10,106,138
683,457
25,000 7,925 2,481,742
168,073 209,604 9,100 140,482 116,838 34,991 353 1,177,466 591,910
12,480 90,941 260,608 364,029
92,739 46,602 139,341
5,684,080 66,899 153,859 532,731 6,437,569
HSA 2014 $
FOR THE YEAR ENDED 30 JUNE 2014 NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014
HESSE RURAL HEALTH SERVICE HESSE RURAL HEALTH NOTES TO THE FINANCIAL STATEMENTS
9,805,155
696,696
25,961 7,100 2,509,767
165,812 197,181 13,523 132,023 108,506 32,099 2,075 1,015,980 809,507
14,585 73,607 265,626 353,818
80,661 158,111 238,772
5,279,353 61,027 180,696 485,026 6,006,102
HSA 2013 $
-
-
-
-
-
-
-
-
-
-
-
-
-
-
CONSOLIDATED H&CI H&CI 2014 2013 $ $
10,106,138
683,457
25,000 7,925 2,481,742
168,073 209,604 9,100 140,482 116,838 34,991 353 1,177,466 591,910
12,480 90,941 260,608 364,029
92,739 46,602 139,341
5,684,080 66,899 153,859 532,731 6,437,569
Total 2014 $
9,805,155
696,696
25,961 7,100 2,509,767
165,812 197,181 13,523 132,023 108,506 32,099 2,075 1,015,980 809,507
14,585 73,607 265,626 353,818
80,661 158,111 238,772
5,279,353 61,027 180,696 485,026 6,006,102
Total 2013 $
HESSE RURAL HEALTH HESSE RURAL HEALTH SERVICE
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
Total Expenses
1,137,132 98,968 93,242 1,754,210 551,241 3,634,793
Admitted Patients 2013 $ Services Supported by Health Services Agreement Employee Benefits Non Salary Labour Costs Supplies & Consumables Other Expenses from Continuing Operations Depreciation & Amortisation (refer note 4) Total Expenses from Services Supported by Health Services Total Expenses from Services Supported by Hospital and Community Initiatives Total Expenses
3,879,457 40,373 266,617 474,331 132,216 4,792,994
3,634,793
2,080,387 118,791 48,788 1,533,004 564,479 4,345,449 4,345,449
NOTE 4:4: DEPRECIATION NOTE DEPRECIATION
Buildings Plant & Equipment Medical Equipment Total Depreciation
Aged Care 2014 $
RAC 2014 $
752,489 949 52,453 805,891
4,792,994
Primary Health 2014 $
805,891 Aged Care 2013 $
RAC 2013 $ 2,734,924 119,981 296,823 809,996 132,217 4,093,941 4,093,941
668,491 3,221 200,748 872,460
535,628
Parent Entity
2014 $ 415,838 117,233 18,170 551,241
830,137
Parent Entity
2013 $ 415,747 128,948 19,784 564,479
6,437,569 139,341 364,029 2,481,742 683,457 10,106,138
-
872,460
678,422 4,911 146,804 830,137
Total 2014 $ -
-
Primary Health 2013 $
512,369 3,296 19,963 535,628
Other 2014 $
-
Other 2013 $
10,106,138
Total 2013 $ -
Consolidated
2014 $ 520,598 144,689 18,170 683,457
6,006,102 238,772 353,818 2,509,767 696,696 9,805,155 9,805,155
Consolidated
2013 $ 520,507 156,405 19,784 696,696
NOTE CASH AND CASH EQUIVALENTS NOTE 5:5: CASH AND CASH EQUIVALENTS For the purposes 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 insignificant risk of change in value, net of outstanding overdrafts. Cash on Hand Cash at Bank Total Cash and Cash Equivalents Represented by: Cash for Health Service Operations (as per Cash Flow Statement) Cash for Monies Held in Trust - Deposits at Call Total Cash and Cash Equivalents
Parent Entity
2014 $ (621) 139,567 138,946
Parent Entity
Consolidated
FINANCIAL REPORT
Services Supported by Health Services Agreement Employee Expenses Non Salary Labour Costs Supplies & Consumables Other Expenses from Continuing Operations Depreciation & Amortisation (refer note 4) Total Expenses from Services Supported by Health Services Agreement Total Expenses from Services Supported by Hospital and Community Initiatives
Admitted Patients 2014 $
Consolidated
2013 $ (135) (847,106) (847,241)
2014 $ (621) 875,562 874,941
2013 $ (135) 697,895 697,760
75,063
(891,214)
811,058
653,787
63,883 138,946
43,973 (847,241)
63,883 874,941
43,973 697,760
QUALITY REPORT
(based on the consolidated view of Note 3)
OPERATIONAL REPORT
NOTE ANALYSIS OF EXPENSES Note 3a:3a: Analysis of Expenses by Source BY SOURCE
65
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 6:6: RECEIVABLES NOTE RECEIVABLES CURRENT Contractual Patient Fees Trade Debtors Accrued Investment Income
Parent Entity
Parent Entity
Consolidated
Consolidated
2014 $
2013 $
2014 $
2013 $
32,611 73,331 3,968 109,910
7,329 121,767 3,017 132,113
47,151 73,331 3,968 124,450
22,839 100,035 3,017 125,891
TOTAL CURRENT RECEIVABLES
28,433 28,433 138,343
48,273 48,273 180,386
28,433 28,433 152,883
48,273 48,273 174,164
NON-CURRENT Statutory Long Service Leave - Department of Health TOTAL NON-CURRENT RECEIVABLES TOTAL RECEIVABLES
246,312 246,312 384,655
242,799 242,799 423,185
246,312 246,312 399,195
242,799 242,799 416,963
Statutory GST Receivable
(a) Ageing of Receivables Please refer to note 15 (c) for the ageing analysis of receivables (b) Nature and extent of risk arising from Receivables Please refer to note 15 (c) for the nature and extent of credit risk arising from receivables NOTE 7:7: INVESTMENTS AND OTHER FINANCIAL ASSETS ASSETS NOTE INVESTMENTS AND OTHER FINANCIAL Current Loans and receivables Term Deposit Aust. Dollar Term Deposits > 3 months TOTAL INVESTMENTS AND OTHER FINANCIAL ASSETS Represented by: Health Service Investments
Operating Fund
2014 $
2013 $
Parent Entity
2014 $
Consolidated
2013 $
2014 $
2013 $
1,815,999 1,815,999
1,159,870 1,159,870
615,999 615,999
1,159,870 1,159,870
1,815,999 1,815,999
1,159,870 1,159,870
1,815,999 1,815,999
1,159,870 1,159,870
615,999 615,999
1,159,870 1,159,870
1,815,999 1,815,999
1,159,870 1,159,870
(a) Ageing of Other Financial Assets Please refer to note 15 (c) for the ageing analysis of Other Financial Assets (b) Nature and extent of risk arising from other financial assets Please refer to note 15 (c) for the nature and extent of credit risk arising from Other Financial Assets NOTE 8:8: INVESTMENTS ACCOUNTED FOR USING THE EQUITYTHE METHOD NOTE INVESTMENTS ACCOUNTED FOR USING EQUITY METHOD Investments in Associates Total
Name of Entity
Principal Activity
Associates Winchelsea Medical Clinic Pty Ltd
Medical Clinic
Country of Incorporation Australia
Parent Entity
2014 $ 1,040 1,040
Current Assets Total Assets Current Liabilities Non-Current Liabilities Total Liabilities Net Assets Share of Associates Net Assets Total Income Net Result Share of Associates' Result after Income Tax Dividends received from Associates
2013 $ 2,367 2,367
Ownership Interest 2014 2013 % % 50.00% Parent Entity
Summarised Financial Information of Associates
Parent Entity
50.00% Parent Entity
2014 $ 270,792 270,792
2013 $ 285,991 285,991
265,368 3,344 268,712 2,080 1,040 1,593,279 (2,653) (1,327) -
Consolidated
2014 $ 1,040 1,040
Consolidated
2013 $ 2,367 2,367
Published Fair Value 2014 2013 $ $ 1,040 Consolidated
2,367 Consolidated
277,915 3,343 281,258 4,733 2,367
2014 $ 270,792 270,792 265,368 3,344 268,712 2,080 1,040
2013 $ 285,991 285,991 277,915 3,343 281,258 4,733 2,367
1,558,810 (3,937) (1,979) -
1,593,279 (2,653) (1,327) -
1,558,810 (3,937) (1,979) -
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 (a) Gross carrying amount and accumulated depreciation
Parent Entity
Parent Entity
Consolidated
Consolidated
2014 $
2013 $
2014 $
2013 $
Land Land at fair value Total Land
1,629,500 1,629,500
1,177,000 1,177,000
1,629,500 1,629,500
1,177,000 1,177,000
Buildings Buildings at Fair Value Less: Accumulated Depreciation Total Buildings
6,535,500 6,535,500
8,495,294 1,639,399 6,855,895
11,443,500 11,443,500
12,610,294 2,058,726 10,551,568
Plant and Equipment Plant and Equipment at fair value Less: Accumulated Depreciation Total Plant and Equipment
2,192,476 1,765,983 426,493
2,197,340 1,664,465 532,875
2,611,821 2,057,396 554,425
2,616,685 1,928,422 688,263
Medical Equipment Medical Equipment at fair value Less: Accumulated Depreciation Total Medical Equipment
318,102 278,393 39,709
311,803 260,223 51,580
318,102 278,393 39,709
311,803 260,223 51,580
8,617,350
13,667,134
12,468,411
TOTAL
8,631,202
(b) Reconciliations of the carrying amounts of each class of asset
Balance at 1 July 2012 Additions Disposals Depreciation Expense (Note 4) Balance at 1 July 2013
Land $ 1,177,000 1,177,000
Plant & Buildings Equipment $ $ 11,037,204 677,680 34,871 166,988 (520,507) (156,405) 10,551,568 688,263
Additions Disposals Revaluation Increments/(Decrements) Depreciation Expense (Note 4) Balance at 30 June 2014
265,500 187,000 1,629,500
4,967 1,407,563 (520,598) 11,443,500
27,802 (16,951) (144,689) 554,425
Medical Total Equipment Consolidated $ $ 44,319 12,936,203 27,045 228,904 (19,784) (696,696) 51,580 12,468,411 6,299 (18,170) 39,709
304,568 (16,951) 1,594,563 (683,457) 13,667,134
Land and buildings carried at valuation
FINANCIAL REPORT
NOTE 9: PROPERTY, PLANT & EQUIPMENT NOTE 9: PROPERTY, PLANT AND EQUIPMENT
Land at fair value Specialised land Total of land at fair value Buildings at fair value Specialised buildings Total of buildings at fair value Plant and equipment at fair value Plant equipment and vehicles at fair value - Vehicles - Plant and equipment Total of plant, equipment and vehicles at fair value Medical equipment at fair value - Medical equipment Total medical equipment at fair value
Note (i) Classified in accordance with the fair value hierarchy, see Note 1 There have been no transfers between levels during the period.
Carrying amount Fair value measurement at end of reporting period as at 30 June using: 2014 Level 1 (i) Level 2 (i) Level 3 (i)
1,629,500 1,629,500
-
-
1,629,500 1,629,500
11,443,500 11,443,500
-
-
11,443,500 11,443,500
67,628 486,797 554,425
-
39,709 39,709 13,667,134
67,628 486,797 554,425
-
-
39,709 39,709
-
-
594,134
-
-
13,073,000
OPERATIONAL REPORT
( c) Fair value measurement hierarchy of assets as at 30 June 2014
QUALITY REPORT
An Independent valuation of the Health Service's land and buildings 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 the valuation is 30 June 2014.
67
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 9: PROPERTY, PLANT & EQUIPMENT (CONTINUED) NOTE 9: PROPERTY, PLANT AND EQUIPMENT: CONTINUED ( c) Fair value measurement hierarchy of assets as at 30 June 2014 (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 asset 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 permissable and financially feasible. As adjustments of CSO are considered as significant unobservable inputs, specialised land would be classified as Level 3 assets. For the Health Services, 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 Hesse Rural Health Services' 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 Hesse Rural 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 Hesse Rural 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 the 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 to be the highest and best use. (d) Reconciliation of Level 3 fair value 2014 Land
Opening Balance Purchases (sales) Transfers in (out) of Level 3 Gains or losses recognised in net result - Depreciation - Impairment loss Subtotal Items recognised in other comprehensive income - Revaluation Subtotal Closing Balance Unrealised gains/(losses) on non-financial assets
There have been no transfers between levels during the period.
Plant and equipment
Buildings
1,177,000 265,500 1,442,500
Medical equipment
Assets under construction
10,551,568 4,967 (520,598) 10,035,937
-
-
-
187,000 187,000
1,407,563 1,407,563
-
-
-
-
-
-
-
-
1,629,500
11,443,500
-
-
-
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 9: PROPERTY, PLANT & EQUIPMENT (CONTINUED) NOTE 9: PROPERTY, PLANT AND EQUIPMENT: CONTINUED (e) Description of significant unobservable inputs to Level 3 valuations:
Valuation technique
Significant unobservable inputs (i)
Range (weighted average)
Sensitivity of fair value measurement to changes in significant unobservable inputs
Specialised land Market approach
A significant increase or decrease in Community the CSO adjustment would result in Service Obligation 50 - 70% (60%) a significantly lower (higher) fair (CSO) adjustment (ii) value
Specialised buildings
Hospital Complex and Nursing Home
Community Health Centres
Depreciated Direct cost per replacement cost square metre Useful life of specialised buildings
$1,000 $1,500/m2 ($1,300)
A significant increase or decrease in direct cost per square meter adjustment would result in a significantly higher or lower fair value
30 - 60 years (45 years)
A significant increase or decrease in the estimated useful life of the asset would result in a significantly higher or lower valuation.
$9,000 $10,000 ($9,500)
A significant increase or decrease in cost per unit would result in a significantly higher or lower fair value
Plant and equipment at fair value Depreciated replacement cost Cost per unit
5-10 years (7 Useful life of PPE years)
A significant increase or decrease in the estimated useful life of the asset would result in a significantly higher or lower valuation.
3-5 years (3 years)
A significant increase or decrease in the estimated useful life of the asset would result in a significantly higher or lower valuation.
Medical equipment at fair value
NOTE 10:PAYABLES PAYABLES NOTE 10: Current Payables Contractual Trade Creditors Accrued Expenses Commonwealth subsidies Statutory Department of Health Total Current TOTAL PAYABLES (a) Maturity analysis of payables Please refer to note 15d for the ageing analysis of payables (b) Nature and extent of risk arising from payables Please refer to note 15d for the nature and extent of risks arising from payables
Depreciated replacement cost Cost per unit
Increase (decrease) in gross replacement cost would result in a $6,000 $7,000 ($6,500) significantly higher (lower) fair value
Useful life of medical equipment
Increase (decrease) in useful life 10-15 years (12 would result in a significantly higher (lower) fair value years)
Parent Entity
Parent Entity
Consolidated
Consolidated
2014 $
2013 $
2014 $
2013 $
140,266 42,079 21,846 204,191
144,100 37,513 181,613
140,266 50,079 36,132 226,477
144,100 45,513 189,613
256,011 460,202 460,202
94,673 276,286 276,286
256,011 482,488 482,488
94,673 284,286 284,286
QUALITY REPORT
Useful life of vehicles
OPERATIONAL REPORT
Depreciated replacement cost Cost per unit
$9,000$50,000 per unit ($25,000 per A significant increase or decrease in unit) cost per unit would result in a significantly higher or lower fair value
FINANCIAL REPORT
Vehicles
69
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 11:PROVISIONS PROVISIONS NOTE 11: Current Provisions Employee Benefits * Annual Leave -Unconditional and expected to be settled wholly within 12 months (nominal value) -Unconditional and expected to be settled wholly after 12 months (present value) Long Service Leave -Unconditional and expected to be settled wholly within 12 months (nominal value) -Unconditional and expected to be settled wholly after 12 months (present value) Accrued Wages -Unconditional and expected to be settled wholly within 12 months (nominal value) Accrued Days Off -Unconditional and expected to be settled wholly within 12 months (nominal value) Total Current Provisions Non-Current Provisions Employee Benefits * Total Non-Current Provisions Total Provisions (a) Employee Benefits and Related On-Costs Current Employee Benefits and related on-costs Unconditional Long Service Leave Entitlements Accrued Wages and Salaries Annual Leave Accrued Days Off Non-Current Employee Benefits and related on-costs Conditional Long Service Leave Entitlements (present value) Total Employee Benefits and Related On-Costs
Parent Entity
Parent Entity
Consolidated
Consolidated
2014 $
2013 $
2014 $
2013 $
441,744 182,717
506,478 148,089
562,581 232,699
562,881 164,581
112,828 440,906
109,321 481,335
112,828 571,307
109,321 552,783
187,507
240,568
307,007
269,066
8,580
8,580
8,580
8,580
1,374,282
1,494,371
1,795,002
1,667,212
320,391 320,391
285,913 285,913
320,391 320,391
285,913 285,913
1,694,673
1,780,284
2,115,393
1,953,125
553,734 187,507 624,461 8,580
590,656 240,568 654,567 8,580
684,135 307,007 795,280 8,580
662,104 269,066 727,462 8,580
320,391 1,694,673
285,913 1,780,284
320,391 2,115,393
285,913 1,953,125
* Provisions for employee benefits consist of amounts for annual leave and long service leave accrued by employees, not including on-costs. (b) Movements in Provisions: Movements in Long Service Leave: Balance at start of year Provision made during the year - Revaluations - Expense recognising Employee Service Settlement made during the year Balance at end of year
876,569
832,242
948,017
886,723
1,770 112,245 (116,459) 874,125
1,770 159,016 (116,459) 876,569
1,770 171,198 (116,459) 1,004,526
1,770 175,983 (116,459) 948,017
NOTE 12:OTHER OTHER LIABILITIES NOTE 12: LIABILITIES Current Monies Held in Trust Resident Monies held in Trust Refundable Entrance Fees Total Oher Liabilities
63,883 1,012,155 1,076,038
43,973 675,810 719,783
63,883 3,467,143 3,531,026
43,973 3,069,421 3,113,394
Total Monies Held in Trust Represented by the following assets: Cash and Cash Equivalents (refer to Note 5) Land and Buildings TOTAL
63,883 1,012,155 1,076,038
43,973 675,810 719,783
63,883 3,467,143 3,531,026
43,973 3,069,421 3,113,394
NOTE 13:EQUITY EQUITY AND RESERVES NOTE 13: AND RESERVES Parent Entity
(a) Surpluses Property, Plant & Equipment Revaluation Surplus Balance at the beginning of the reporting period Revaluation Increments/(Decrements) - Land - Buildings Balance at the end of the reporting period Represented by: - Land - Buildings
Parent Entity
Consolidated
Consolidated
2014 $ 1,372,067
2013 $ 1,372,067
2014 $ 1,972,203
2013 $ 1,972,203
187,000 90,476 1,649,543
1,372,067
187,000 1,407,563 3,566,766
1,972,203
947,565 701,978 1,649,543
760,565 611,502 1,372,067
947,565 2,619,201 3,566,766
760,565 1,211,638 1,972,203
(b) Contributed Capital Balance at the beginning of the reporting period Balance at the end of the reporting period
3,527,113 3,527,113
3,527,113 3,527,113
4,514,616 4,514,616
4,514,616 4,514,616
(c) Accumulated Surpluses/(Deficits) Retained Surplus at the beginning of the reporting period Net Surplus/(Deficit) for the year Balance at the end of the reporting period Total Equity at end of financial year
1,691,111 (288,981) 1,402,130 6,578,786
2,124,329 (433,218) 1,691,111 6,590,291
2,918,860 (332,983) 2,585,877 10,667,259
3,184,107 (265,247) 2,918,860 9,405,679
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 14: OF NET FOR THEFOR YEAR TO NET CASH FROM NOTE 14:RECONCILIATION RECONCILIATION OFRESULT NET RESULT THE YEAR TOINFLOW NET CASH OPERATING ACTIVITIES INFLOW FROM OPERATING ACTIVITIES Net Result for the Year
Parent Entity
Parent Entity
Consolidated
Consolidated
2014 $ (288,981)
2013 $ (433,218)
2014 $ (332,983)
2013 $ (265,247)
551,241 -
564,479 -
683,457 -
696,696 -
Non-Cash Movements Depreciation Revaluation Decrement re buildings Movements included in investing and financing activities Net (gain)/loss from disposal of non financial physical assets Movements in assets and liabilities: Change in Operating Assets & Liabilities Increase/(Decrease) in Payables Increase/(Decrease) in Employee Entitlements (Increase)/Decrease in Receivables (Increase)/Decrease in Other Assets (Increase)/Decrease in Prepayments
183,916 (85,611) 38,530 1,327 (26,744)
105,533 102,592 (10,637) (2,022) 8,652
198,202 162,268 17,768 1,327 (26,744)
108,533 109,286 4,169 (2,022) 8,652
Net Cash Inflow From Operating Activities
369,629
335,379
699,246
660,067
(4,049)
-
(4,049)
-
NOTE 15: INSTRUMENTS NOTE 15:FINANCIAL FINANCIAL INSTRUMENTS
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, in respect of 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 and interest rate 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 the Health Service's financial risks within the government policy parameters. (b) Categorisation of Financial Instruments
FINANCIAL REPORT
(a) Financial Risk Management Objectives and Policies The Health Service's principal financial instruments comprise of: - Cash Assets - Term Deposits - Receivables (excluding statutory receivables) - Payables (excluding statutory payables) - Accommodation Bonds
(c) 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 as listed in the table below. 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 deal where possible with entities with high credit ratings. Trade and Other receivables that are not either past due nor impaired are considered to be of high credit quality. 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. The maximum exposure to credit risk is the carrying amount, net of any provisions for impairment of those assets, as disclosed in the balance sheet and notes to the financial statements. The health service does not have any material credit risk exposure to any single receivable or group of receivables under financial instruments entered into by the entity.
OPERATIONAL REPORT
Note Financial Assets Cash and Cash Equivalents 5 874,941 697,760 Loans and Receivables 6 124,450 125,891 Other Financial Assets 7 Loans and receivables 1,815,999 1,159,870 Total Financial Assets 2,815,390 1,983,521 Financial Liabilities At Amortised Cost 10,12 3,757,503 3,374,412 Total Financial Liabilities 3,757,503 3,374,412 No net holding gain or loss was made in respect of any of the above categories of financial instruments with the exception of interest revenue which is disclosed in note 2.
QUALITY REPORT
Carrying Amount 2014 2013 $ $
71
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 15: INSTRUMENTS (Continued) NOTE 15:FINANCIAL FINANCIAL INSTRUMENTS: CONTINUED Ageing analysis of financial assets as at 30 June
2014 Financial Assets Cash and Cash Equivalents Receivables - Trade Debtors - Other Receivables Other Financial Assets - Term Deposit Total Financial Assets 2013 Financial Assets Cash and Cash Equivalents Receivables - Trade Debtors - Other Receivables Other Financial Assets - Term Deposit Total Financial Assets
Consolidated Carrying Amount $
Not Past Due And Not Impaired $
Less than 1 Month $
Past Due But Not Impaired 1-3 3 Months 1-5 Months 1 Year Years $
$
Over 5 Years
$
Impaired Financial Assets $
$
874,941
874,941
-
-
-
-
-
-
73,331 51,119 1,815,999 2,815,390
73,331 20,993 1,815,999 2,785,264
14,512 14,512
4,526 4,526
11,088 11,088
-
-
-
$
$
$
$
$
$
$
$
697,760
697,760
-
-
-
-
-
-
100,035 25,856 1,159,870 1,983,521
100,035 13,113 1,159,870 1,970,778
-
5,906 5,906
5,904 5,904
933 933
-
-
There are no material financial assets which are individually determined to be impaired. The 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. (d) 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 Serviceâ&#x20AC;&#x2122;s maximum exposure to liquidity risk is the carrying amounts of financial liabilities as disclosed in the face of the balance sheet. The Health Service manages its liquidity risk by monitoring forecast cash flows and ensuring that liquid assets are available. The following table discloses the contractual maturity analysis for the 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
2014 Payables Accommodation Bonds Total Financial Liabilities 2013 Payables Accommodation Bonds Total Financial Liabilities
Consolidated Carrying Contractual Amount Cash Flows $ $ 226,477 226,477 3,531,026 3,531,026 3,757,503 3,757,503
261,018 3,113,394 3,374,412
261,018 3,113,394 3,374,412
Less than 1 Month $ 226,477 226,477
261,018 261,018
Maturity Dates 3 Months 1 Year $ 3,531,026 3,531,026 -
1-3 Months $
3,113,394 3,113,394
1-5 Years $
-
Over 5 Years $ -
-
-
-
(e) Market Risk The Health Service's exposures to market risk are primarily through interest rate risk with only insignificant exposure to foreign currency and other price risks. Objectives, policies and processes used to manage each of these risks are disclosed below. Currency Risk The Health Service has no exposure to foreign currency risk. Interest Rate Risk Exposure to interest rate risk might arise primarily through the Health Service's interest bearing assets and liabilities. The Health Service currently has no interest bearing liabilities and is unlikely to have any into the future as interest bearing liabilities can only be entered into with the approval of the Department of Treasury and Finance. Cash flow interest rate risk is the risk that the future cash flows of a financial instrument will fluctuate because of changes in market interest rates. The Health Service has minimal exposure to cash flow interest rate risks through its cash and term deposits that are at a floating rate. The Health Service manages this risk by mainly undertaking fixed rate or non-interest bearing financial instruments with relatively even maturity profiles, with only insignificant amounts of financial instruments at floating rate. Management has concluded for cash at bank and bank overdraft, as financial assets that can be left at floating rate without necessarily exposing the Health Service to significant bad risk, management monitors movement in interest rates on a daily basis.
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 15:FINANCIAL FINANCIAL INSTRUMENTS: CONTINUED NOTE 15: INSTRUMENTS (Continued) Interest Rate Exposure of Financial Assets and Liabilities as at 30 June Interest Rate Exposure Fixed Variable Non Interest Interest Interest Rate Rate Bearing $ $ $
2.50
874,941
-
875,562
(621)
0.00 0.00 3.65
73,331 51,119 1,815,999 2,815,390
1,815,999 1,815,999
875,562
73,331 51,119 123,829
0.00 0.00
226,477 3,531,026 3,757,503
-
-
226,477 3,531,026 3,757,503
2.50
697,760
-
697,895
0.00 0.00 4.10
100,035 25,856 1,159,870 1,983,521
1,159,870 1,159,870
697,895
100,035 25,856 125,756
0.00 0.00
261,018 3,113,394 3,374,412
-
-
261,018 3,113,394 3,374,412
Other Price Risk The Health Service is exposed to insignificant other price risk Sensitivity Disclosure Analysis Taking into account past performance, future expectations, economic forecasts, and management's knowledge and experience of the financial markets, the Health Service believes the following movements are 'reasonably possible' over the next 12 months (Base rates are sourced from the Reserve Bank of Australia) - A parallel shift of +1% and -1% in market interest rates (AUD) from year-end rates of 6%; - A parallel shift of +1% and -1% in inflation rate from year-end rates of 2% .
The following table discloses the impact on net operating result and equity for each category of variable rate financial instruments held by the Health Service at year end as presented to key management personnel, if changes in the relevant interest rate risk occur Interest Rate Risk Carrying -1% +1% Amount Profit Equity Profit Equity 2014 $ $ $ $ $ Financial Assets Cash and Cash Equivalents (i) 875,562 (8,756) (8,756) 8,756 8,756 Receivables - Trade Debtors 73,331 - Other Receivables 51,119 Other Financial Assets 1,815,999 (18,160) (18,160) 18,160 18,160 Total Financial Assets 2,816,011 (26,916) (26,916) 26,916 26,916 Financial Liabilities Payables 226,477 Accommodation Bonds 3,531,026 Total Financial Liabilities 3,757,503 2013 Financial Assets Cash and Cash Equivalents 697,895 (6,979) (6,979) 6,979 Receivables - Trade Debtors 100,035 - Other Receivables 25,856 Other Financial Assets 1,159,870 (11,599) (11,599) 11,599 Total Financial Assets 1,983,656 (18,578) (18,578) 18,578 Financial Liabilities Payables 261,018 Accommodation Bonds 3,113,394 Total Financial Liabilities 3,374,412 (i) eg. Sensitivity of cash and cash equivalents to a 1+% movement in interest rates; ($875,562* 0.07) - ($875,562*0.06) = $8756. Similar for a -1% movement in interest rate, impact = -$8750.
FINANCIAL REPORT
(135)
QUALITY REPORT
Consolidated Carrying Amount $
6,979 11,599 18,578 -
OPERATIONAL REPORT
2014 Financial Assets Cash and Cash Equivalents Receivables - Trade Debtors - Other Receivables Other Financial Assets - Term Deposit Total Financial Assets Financial Liabilities Payables Accommodation Bonds Total Financial Liabilities 2013 Financial Assets Cash and Cash Equivalents Receivables - Trade Debtors - Other Receivables Other Financial Assets Total Financial Assets Financial Liabilities Payables Accommodation Bonds Total Financial Liabilities
Weighted Average Interest Rates %
73
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 15: INSTRUMENTS (Continued) NOTE 15:FINANCIAL FINANCIAL INSTRUMENTS: CONTINUED (f) 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 with standard terms and conditions and traded in active liquid markets are determined with reference to quoted market prices;
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 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.
NOTE 16:COMMITMENTS COMMITMENTS FOR EXPENDITURE NOTE 16: FOR EXPENDITURE Capital Expenditure Commitments There are no commitments for capital expenditure for the Hesse Rural Health Service. Operating Leases Operating leases relate to motor vehicles used for primarily for district nursing services provided by the Health Service with the lease terms of three to five years, photocopiers with lease terms of 5 years, and rental of a property for the delivery of community health services in Moriac with lease term of 5 years. Parent Entity
Non-cancellable operating lease payables
2014 $ 50,061 89,975 140,036
Not longer than one year Longer than one year but not longer than five years Total lease commitments
Parent Entity
2013 $ 68,114 134,977 203,090
Consolidated
2014 $ 50,061 89,975 140,036
Consolidated
2013 $ 68,114 134,977 203,090
NOTE 17: CONTINGENT ASSETS & CONTINGENT LIABILITIES NOTE 17: CONTINGENT ASSETS & CONTINGENT LIABILITIES Hesse Rural Health Service has provided a financial guarantee of $100,00 in relation to payroll services.
NOTE 18: OPERATING SEGMENTS NOTE 18: OPERATING SEGMENTS RACS
Hospital 2014 $ REVENUE External Segment Revenue Total Revenue EXPENSES External Segment expense Total Expenses Net Result from Ordinary Activities Interest Income Share of net result of Joint Ventures using the Equity Method Net Result for the year OTHER INFORMATION Segment Assets Total Assets Segment Liabilities Total Liabilities Investment in Associates and Joint Venture Partnership Acquisition of Property Plant & Equipment Depreciation
2013 $
2014 $
Community Health 2014 2013 $ $
2013 $
Consolidated 2014 2013 $ $
2,829,051 2,829,051
3,350,519 3,350,519
5,144,233 5,144,233
4,553,966 4,553,966
1,722,375 1,722,375
1,552,451 1,552,451
9,695,659 9,695,659
9,456,936 9,456,936
3,634,793 3,634,793 (805,742)
4,345,449 4,345,449 (994,930)
4,792,994 4,792,994 351,239
4,093,941 4,093,941 460,025
1,678,351 1,678,351 44,024
1,365,765 1,365,765 186,686
10,106,138 10,106,138 (410,479)
9,805,155 9,805,155 (348,219)
57,004
62,643
-
-
78,823
84,951
21,819
22,308
(1,327)
(1,979)
-
-
-
-
(1,327)
(1,979)
(785,250)
(974,601)
408,243
522,668
44,024
186,686
(332,983)
(265,247)
5,191,099 5,191,099
3,886,331 3,886,331
10,566,957 10,566,957
10,173,652 10,173,652
1,038,110 1,038,110
696,501 696,501
16,796,166 16,796,166
14,756,484 14,756,484
1,444,471 1,444,471
1,302,418 1,302,418
4,284,468 4,284,468
3,676,959 3,676,959
399,968 399,968
371,428 371,428
6,128,907 6,128,907
5,350,805 5,350,805
1,040 190,997 551,241
2,367 190,997 564,479
94,625 132,216
486,753 132,217
18,946 -
18,946 -
1,040 304,568 683,457
2,367 696,696 696,696
The major products/services from which the above segments derive revenue are: Business Segments Services Hospital Acute Care RACS Residential Aged Care - both high and low level care Community Health Primary Health and HACC services including district nursing. GEOGRAPHICAL SEGMENT The Hesse Rural Health Service operates predominantly in Winchelsea, Victoria. More than 90% of revenue, net surplus from ordinary activities and segment assets relate to operations in Winchelsea, Victoria.
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 19: CONTROLLED OPERATIONS AND ASSETS NOTE 19:JOINTLY JOINTLY CONTROLLED OPERATIONS AND ASSETS
Ownership Interest
Interest in Jointly Controlled Entities
Principal Activity
South West Alliance of Rural Health (SWARH)
Information Technology
2014 % 3.79%
2013 % 3.79%
The 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 under their respective asset categories: 2014 2013 Current Assets $ $ Cash and Cash Equivalents 69,471 39,797 Receivables 38,475 77,492 Other Assets 11,812 11,113 Total Current Assets 119,758 128,402 Non-Current Assets Property, Plant & Equipment 11,029 12,681 Total Assets 130,787 141,083
1,179,850 1,179,850
1,225,859 1,225,859
Expenses Employee Benefits Maintenance Contract and IT Support Operating Lease Costs Other Expenses from Ordinary Activities Depreciation Total Expenses Net Result
195,885 349,115 125,475 506,991 2,141 1,179,607 243
215,910 275,716 153,016 587,248 950 1,232,840 (6,981)
a) Responsible Persons Period From Responsible Minister The Honourable David Davis, MLC, The Honourable Mary Wooldridge, MLA,
Minister for Health and Ageing Minister for Mental Health
To
01/07/2013 01/07/2013
30/06/2014 30/06/2014
Governing Board J. Carr H. Cameron N. Stinchcombe K. Leigh P. Benton D. Kelly D. Lang R. Hanson D. Dillon
01/07/2013 01/07/2013 01/07/2013 01/07/2013 01/07/2013 01/07/2013 01/07/2013 01/07/2013 01/07/2013
30/06/2014 30/06/2014 30/06/2014 30/06/2014 30/06/2014 30/06/2014 30/06/2014 30/06/2014 23/07/2013
Accountable Officers P. Birkett
01/07/2013
30/06/2014
b) Remuneration of Responsible Persons The number of Responsible persons are shown in their relevant income bands; $0 - $9,999 $150,000 - $159,999 $210,000 - $210,999 Total Remuneration received or due and receivable by Responsible Persons from the reporting entity amounted to:
Parent 2014 $
2013 $ 10 1 11
210,362
11 1 12 159,335
Consolidated 2014 2013 $ $ 10 11 1 1 11 12 210,362
159,335
c) Other Transactions of Responsible Persons and their Related Entities The chief financial officer, Stephen Wight, is a director of Davidsons Accountants and Business Consultants, which provided accounting and consulting services to Hesse Rural Health Service on normal commercial terms and conditions. Total payments made to Davidsons Accountants and Business Consultants in the financial year were $85,080 (2013 $87,301).
OPERATIONAL REPORT
NOTE 20a:RESPONSIBLE RESPONSIBLE PERSONS DISCLOSURES NOTE 20a: PERSONS DISCLOSURES
QUALITY REPORT
FINANCIAL REPORT
The Health Service interest in revenues and expenses resulting from jointly controlled operations and assets is detailed below: Revenues Revenue from Operating Activities Total Revenue
75
HESSE RURAL HEALTH
HESSE RURAL HEALTH SERVICE NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2014
NOTES TO THE FINANCIAL STATEMENTS: 30 JUNE 2014 NOTE 20b:EXECUTIVE EXECUTIVE OFFICER DISCLOSURES NOTE 20b: OFFICER DISCLOSURES The numbers of executive officers, other than Ministers and Accountable Officers, and their total remuneration during the reporting period are shown in the first two columns 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. Parent
$130,000 - $139,999 Total annualised employee equivalents (AEE) (i)
Total Remuneration
Consolidated Total Remuneration Base Remuneration 2014 2013 2014 2013 No. No. No. No.
Base Remuneration 2014 2013 No. No.
Total Remuneration 2014 2013 No. No. 1
2
1
1
1
2
1
1
1 134,084
2 201,664
1 134,084
1 123,783
1 134,084
2 201,664
1 134,084
1 123,783
2014 $ 32,925 32,925
2013 $ 25,961 25,961
(i) Annualised employee equivalent is based on paid working hours of 38 ordinary hours per week over the 52 weeks for a reporting period.
NOTE 21:REMUNERATION REMUNERATION OF AUDITORS NOTE 21: OF AUDITORS Victorian Auditor-General's Office Audit or review of financial statement
NOTE 22:CONTROLLED CONTROLLED ENTITIES NOTE 22: ENTITIES Name of Entity Winchelsea Hostel and Nursing Home Society
Country of Incorporation Australia
Equity Holding 100%
Control is established due to both entities having common Board of Management
NOTE 23:EVENTS EVENTS OCCURRING THE BALANCE SHEET DATE NOTE 23: OCCURRING AFTERAFTER THE BALANCE SHEET DATE There are no events occurring since the balance date to the date of this report that would have a material effect on the operations of the Health Service.
HESSE RURAL HEALTH Twenty years ago Hesse Rural Health surfaced as a community initiative to sustain health service delivery in the rural area. Today it demonstrates with excellence how health care provided in the local community is essential to rural well being.
Leigh Community Health Ferrars Street Rokewood 3330
OUR VISION Bannockburn Primary Care 19 High Street Bannockburn 3331
Caring for Rural Communities.
OUR MISSION
Winchelsea Hospital Chelsea Lodge Hostel Hesse Lodge Nursing Home Werruna Dementia Unit 8 Gosney Street Winchelsea 3241
The continued development of an integrated health and wellbeing service to the Hesse rural community in a financially responsible and environmentally sustainable manner. Beeac Community Health Lang Street Beeac 3251
OUR GOALS To provide an integrated health service encompassing acute, aged and community based care appropriate to meeting the needs of the population within the surrounding districts of Hesse Rural Health.
Winchelsea Community Health 12 Gosney Street Winchelsea 3241
Moriac Community Health 806 Hendy Main Road Moriac 3240
Winchelsea Adult Day Activity 53 Hesse Street Winchelsea 3241
To provide high quality care for clients and residents through the maintenance of ethical and professional standards in a safe and secure environment. To promote health within the community through intiatives in health promotion, education and illness prevention.
Minister for Health: Hon David Davis MLC Auditors: Auditor General Victoria
Bankers: Bendigo Winchelsea & District Community Bank Solicitors: Birdsey Dedman Bartlett
Acute Care Breakfast Club Bus to the Hub Children at Play Community Nursing Dementia Developments Dementia Care Diabetes Education Dietetics District Nursing Exercise Groups Farm Safety Program Greet, Eat & Meet
Health Promotion HIPPY & Play Program Home Care Packages Hospital in the Home Immunisation Program Maternal & Child Health Men’s Group Men’s Shed Program Nesters Group No Fall Exercise Program Occasional Care Occupational Therapy Palliative Care
Personal Development Physiotherapy Planned Activity Groups Podiatry Post Acute Care Post Natal Care Pre-School Health Residential Aged Care Respite Urgent Care Volunteering Walking Groups Well Women’s Clinic
To access Hesse’s broad range of services contact Administration via: Phone: (03) 5267 1200 Post:
8 Gosney Street Winchelsea Vic 3241
E-mail: hesse@swarh.vic.gov.au Website: www.hesseruralhealth.org.au
20
YEARS
Caring for Rural Communities of
BANNOCKBURN ROKEWOOD BEEAC MORIAC WINCHELSEA
HESSE RURAL HEALTH 8 Gosney Street, Winchelsea, Australia 3241 + 61 (03) 5267 1200 hesse@swarh.vic.gov.au www.hesseruralhealth.org.au
Hesse Rural Health 2014 Annual Report