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Northfield Hospital Board Meeting - September 29, 2016

October 3, 2016 at 2:54 pm
By Dave Emery

Opening

Board Chair, James Schlichting called the meeting to order at 6:30 p.m. The Agenda was approved with a deletion of one item in the Consent Agenda. 

Spotlight Report

Patient Experience: Ann Reuter, Director of Quality for the hospital, and Stacie Rice, Quality Improvement Specialist for the clinics.  Patient experience is everything that happens to the patient from the initial conversation to paying the bills.  Ann made the point that patients may forget exactly what you did for them, but not how you made them feel.  Medicare requires all hospitals to annually survey adult inpatients and over 300 Northfield hospital inpatients were randomly surveyed in the past year.  The survey results are posted on the Hospital Compare website run by the Center for Medicare Studies (CMS).  www.medicare.gov/hospitalcompare Northfield Hospital received 4 out of 5 stars possible in the last patient survey based on national standards.  (The website only shows 3 stars.) The State of MN requires that medical clinics survey their patients and report the results every other year.  The clinics use a 50-question paper survey that goes to a random sample of patients. The clinics also use an 8-question on-line survey sent to every patient in order to get real-time feed back.   Clinic teams then work to turn the data into programs to improve patient care. 

Reports

A motion to approve the applications for Medical Staff membership was passed.

1. Chief Medical Officer—Dr. Jeff Meland.  The hospital is now three weeks into the hospitalist program and it is going well.  “So far, so good.” 

2. Family Health Clinic Medical Director—Dr. Ben Flannery. The clinics are still recruiting physicians, but hope to be fully staffed in the near future.  The Northfield clinic is running out of space and options are being considered.  The pediatric-based book/reading program is going well.  The clinic received a grant from Northfield Promise to expand the program to older children with the “Reach Out and Read Program.”  Books are provided to kids during well child visits.  The program was expanded to include children at the Healthfinders’ clinics also.  

3. City Business Update: Mayor Dana Graham.  The Mayor reported that the City staff and police did a great job in dealing with the high water.  The Mayor also offered a testimonial that he had a hip replaced at the Northfield Hospital and the procedure went well and the staff and physicians were wonderful. 

4. CFO Report—Scott Edin. August was a busy month with inpatient revenue 20% above budget for the month. Home Health services were 45% above 2015 levels.  Also, salaries and benefits declined to 53% of revenues, right on target.  Year-to-date, Net Patient Revenues are $10 million above the 2015 level YTD, and Operating Income is $2.6 million above the 2015 level.  Cash-on-hand has risen to 238 days. 

5. CEO Report—Steve Underdahl.  The Board portal should be operational soon.  Progress is being made on the strategic initiatives.  The recent launch of the hospitalist program is testimony to the level of trust that is developing between providers in this area.  The rapid changes in the health care sector are leading to larger gaps between the monthly budget figures and the actual results—the August financials are a good example.  Administration is exploring ways to improve the budgeting process.  An example of change is the opening of a Smart Choice MRI clinic in Woodbury MN with another scheduled to open in Roseville.  Smart Choice charges only $600 for an MRI including contrast agents and reading.  The Choice clinic is only open for scheduled business hours and payment is by cash or credit card.  Charge for a similar service at NH&C is $2000 - $3000.  Similarly, United Health now has 19 Urgent Health Centers open, many of them offering lab and radiology services, including primary medical care. Underdahl pointed out that stand-alone clinics siphon off the “easy patients,” those who can pay, and those who can present during regular office hours.  What does that leave for traditional medical providers?  The 2016 Award for Excellence was displayed for the Board. NH&C is in conversation with the National Rural Accountable Care Organization (ACO).  ACOs provide health services to a defined population for a set payment and are “at risk” if costs exceed the projected amount.  Progress is being made on the Ken Bank Memorial Wall.  Dedication is planned for later this year.  Training is underway to provide 24-hour respiratory therapy at the hospital beginning in Nov. The new logo for the brand “Northfield Hospital and Clinics” has been selected and it is being posted across the system.  A potential donor has asked NH&C to establish a foundation by the close of 2016 in order to make a donation, so the process is being expedited. Finally, an architect has been selected to begin work on new facilities for Obstetrics and Long Term Care, and a market analysis has been completed.         

6. Budget and Finance Committee Report: Charlie Kyte.  The committee met to review financials; discuss the 2017 budget coming to the Board in Dec.; and review the complexities of potential land transactions.

7. Quality Assurance Committee Report:  CC Lindstroth.  The committee discussed draft #11 of their project to develop a set of “dashboard indicators” of quality for tracking by the Board. CC also offered a personal testimonial on the quality of care she received at NH&C.   

Consent Agenda

The consent agenda was passed.  Items on the agenda included:  Minutes for the August Board meeting; Minutes for the August meeting of the Community Relations Committee; approval of Contracted Services; and approval of Quality and Performance Improvement Policy and Program. 

Presentations/Discussions/Action Items

1. Quality Dashboard Report—Ann Reuter.  Quality measures are now publicly reported by the CMS and the program has entered the penalty phase.  If a hospital falls below the standard, they are penalized a small percentage of their Medicare receipts; if it exceeds the standards the hospital can receive a similarly based reward.  Overall, NH&C is coming out ahead on the programs and anticipating receipt of an additional $87,000 from Medicare in 2017. 

2.  EMR Evaluation—Vern Lougheed and Emily Murphy. NH&C is anticipating a major change in its Electronic Medical Records (EMR) and commissioned Xerox to study the alternatives.  Vern and Emily discussed the final report received from Xerox.  Only 3 of the 5 major providers of EMR services were judged by Xerox to be potential service providers for NH&C: Epic via Allina, Meditech, and Athena Health. None of the 3 providers are a perfect fit for the needs of NH&C and the decision has many components.  The projected costs for the 3 providers (posted rather than negotiated prices) are as follows:

            Provider                     One Time Cost           5 year cost

            Allina                          $5.6 million                $12.2 million

            Epic/Allina                 $1.5 million                $11.1 million

            Meditech                    $3.9 million                $  9.2 million 

The next steps in the decision process are site visits from each of the 3 providers, reference checks, visits to sites similar to NH&C using each of the systems, etc. A proposal is expected to come to the Board in early 2017.

3.  Approval of Donations—Steve O’Neill. Steve asked for approval of funding for the Northfield Public School Recreation Programs: $116,000 for 2017 and $119,000 for 2018, with no stipulations.  (Previously funding was contingent on the financial performance of NH&C.)  The proposal was moved, seconded, and approved.  Steve also asked for approval of $15,500 for Northfield Public Schools to purchase wearable heart monitors for students during physical education classes.  The proposal was moved, seconded, and approved.  

The open meeting adjourned at 8:45 p.m. and the Board went into a closed session to discuss marketing activities.

Next meeting: October 27, 2016. 

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