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Northfield Hospital Board Meeting - January 24, 2013

January 27, 2013 at 10:38 am
By Dave Emery

 Action Items

  1. The Board approved the minutes of the December Board meeting.
  2. The Board approved the applications for medical staff privileges, and welcomed Dr. Gerard O’Halloran as the new Chair of the Medical Executive Committee. 
  3. The Board approved a new application form for Pediatric Core privileges.
  4. The Board approved the purchased of Omnicell units for Post Anesthesia Care and for Same Day Surgery.  The Omnicell units will improve the security and administration of controlled substances.    
  5. The Board approved new officers for 2013: Gina Franklin will continue as Board Chair and Charlie Kyte will be Vice-chair.

Special Presentations

Andy Yurek and Vern Lougheed reported on hospital and clinic security procedures.  The hospital has adopted an “integrated” approach that combines all security concerns, electronic and physical, on a single committee.  Part of the rational for integration is that failure at any one site can compromise security in other sites.   The hospital has continued to upgrade both electronic and physical security systems over the past year.

It was reported that the staffs of the hospital and the long-term care unit achieved a high rate of flu vaccination.  There have been no cases of flu reported in the long-term care unit thus far this season in spite of the increase in flu cases among the general population.

Discussion Items

1.  CEO Mary Crow reported on 2012 year-end service volumes.  Inpatient admissions continued to decline; outpatient services continued to grow.   The total of inpatient and outpatient continues to grow.  Births, ER visits, and EMS services all increased in 2012; surgery and imaging services decreased.   Services delivered at the 5 clinics (Elko, Lonsdale, Northfield, Lakeville, and Farmington) showed mixed results: some increases and some decreases. 

The clinic figures prompted considerable discussion.  Board members wanted to know why there were decreases in patient services and what was being done to reverse the trend.  The response was that doctors attract patients, and physician turnover at the clinics has resulted in fewer visits this year.  Plans to reduce physician turnover include more recruiting of physicians by current clinic physicians and less reliance on Mayo Clinic recruiting; promoting better integration of clinic physicians into the Northfield Hospital system; and establishing an effective system for communication between clinic physicians and the larger system.  

One Board member expressed his appreciation for the insight and courage of earlier Board members who adopted the clinic strategy. 

2. Board members reported on what they had learned at a recent 2-day MHA Trustee Conference.  (All of the Board members were in attendance.)

  • City hospitals are at a disadvantage due to the open meeting law.  Should NCH be exploring a 501 C-3 status?
  • Board members should be communicating with their state and national legislators on health related issues.
  • Addiction to controlled substances is a national epidemic.
  • The aging of the Baby Boomers is going to increase the need for home health care and long-term care.
  • NCH should participate in a community health needs assessment.   

Informational Items

1. The Governance and Planning Committee reported that they were in communication with the City on various issues.

  • The Council did not approve of the documentation necessary to complete the $107,000 NCH donation to fund the 2012 Community Ed and Rec Program.
  • The City Council and the Hospital are exploring ways to promote communication between them.  Should a Council member be appointed to the Board’s Governance and Planning Committee?
  • How far does the City Charter allow the Hospital to go in its support of the City budget?
  • Board members expressed the hope that the issues could be quickly resolved to the satisfaction of both parties.

2. The Budget and Finance Committee minutes show that $5000 was approved to fund outside legal counsel, and that CEO Mary Crow was in conversation with Friends of Way Park. 

3. CFO Report:  The Hospital and clinics had a strong fourth quarter. Revenues and Net Income for December were above budget.  The improvements allowed the hospital to slightly exceed its Net Income target for the year.

4. CEO Report: The process for recruiting a new CEO is going more slowly than expected.   The recruiting firm found in their visit that Northfield City Hospital is more complex than indicated by its size, and that City ownership adds a degree of complexity in the minds of candidates.  The current plan is to have on-site interviews in April and a decision sometime in May.

Comments

  • January 29 2013 at 7:50 pm
    kiffi summa

    David: to quote one of your bulleted points: "City hospitals are at a disadvantage due to the open meeting law. Should NCH be exploring a 501 C-3 status?" This issue seems to come up about every 5-8 years; first: the Hospital IS owned by the City and the City's business MUST be done in the open... I say it is a 'given'. Period. Secondly: The last time the 501C-3 issue was explored, there was a large, very well-attended forum put on by the LWV... I believe Eve Webster moderated that discussion ... and I thought that issue had been put to rest. What has changed? Can you give a few more indications of the tenor of the Board's discussion?

  • January 31 2013 at 10:23 am
    Dave Emery

    The 501 C-3 comment was an outgrowth of one session at the MHA Trustee Conference. A Board member had attended the session, and was merely reporting the content from the session. The Board didn't discuss the report. There are law firms that profit from the legal work and consultation that accompany conversion to 501 C-3 status, so they constantly stir the pot at hospital conventions. Naturally they focus on the disadvantages of city ownership rather than the advantages. A discussion at a Council-Task-Force meeting last summer suggests that a couple of the Board members may be more focused on the disadvantages than on the advantages of City ownership. Most hospitals are private not-for-profits rather than publicly owned, but they were founded by a not-for-profit organization such as a church or civic organization. The founding organization has a financial stake in the hospital and a history of supporting and governing the hospital. Neither of those things occur when a city-owned hospital is spun off as a 501 C-3. Some group of people (a board) gets control of a multimillion dollar facility to which they haven't made a significant financial contribution and there isn't an institutional framework or history to guide their decisions. This makes me nervous about converting to a 501 C 3.

  • January 31 2013 at 11:59 am
    kiffi summa

    excellent reply, David... Thank you. The success of the clinic operations would bely the complaint that the OML inhibits the NCH's development. The simple fact of the matter is that the original 'framers' of the structure of this city owned entity did, IMO, a great job in setting up that structure. They made sure that the 'city' could not raid the Hospital for cash, and that the finances of both were held to be totally separate' That's one reason why I find the Council's desire for fiscal support from the Hospital to be questionable in establishing any repetitive, or long term relationship of that sort. Thanks again...

  • January 31 2013 at 10:44 pm
    Jane McWilliams

    David - is there a relationship between these two - " $5000 was approved to fund outside legal counsel, and that CEO Mary Crow was in conversation with Friends of Way Park?" Is the board contemplating donating/selling the old ambulance facility to the city at the behest of the Friends of Way Park and they've hired an attorney to facilitate the transaction? I've heard that the Friends would like to acquire that property for parking. Is that true?

  • February 1 2013 at 3:34 pm
    Dave Emery

    Sorry, I should not have put the two items in the same sentence. The minutes of the Finance Committee meeting did not specify the issue to be studied by outside legal counsel. I gathered from the other discussion at the Board meeting that the topic would be the legal basis for hospital contributions to the City, but I don't know that for a fact. The Chair said she expected to have a legal opinion by the February meeting. The minutes from the Finance Committee simply mentioned that Mary Crow was in conversation with Friends of Way Park. There was no indication of a position by the Finance Committee or the Board regarding a request from park group. Typically, the discussion would start in the Finance Committee and they would bring a recommendation to the Board. I haven't heard any mention of the topic at a Board meeting.

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