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Northfield Hospital Board Meeting - March 30, 2017

April 1, 2017 at 7:42 pm
By Dave Emery

Opening

1. Board Vice Chair, Virginia Kaczmarek,  called the meeting to order at 6:30 p.m. The Agenda was approved.

 The Consent Agenda was approved, with an addition to the February Minutes.  The Consent Agenda included Minutes for the February Board Meeting; Minutes for a Community Relations Committee meeting; revisions to the Emergency Medicine Core Privileges, Health Awards Recommendation for 2017; and Medical Staff policies. 

Reports

1. Hospital Chief of Staff—Dr. Reister. Reister asked for approval of the applications for Medical Staff membership and privileges.  Motion approved.

2. Chief Medical Officer—Dr. Meland.  Meland reported that Minneapolis Heart Institute is now affiliated with NH&C.  Referrals will be made to the Institute and specialists from the Institute may start seeing patients in Northfield.

3. Family Health Clinic—Dr. Flannery. Three new associate providers have been added to the Clinic network; one in Farmington, one in Lakeville, and one in Northfield.

4. Allina Clinic—Dr. Olson.  Allina is recruiting a new family medical provider to offset a pending retirement.  The Clinic has purchased a parcel of land adjacent to the clinic for potential expansion. 

5. City Business—Brad Ness. The city’s strategic planning process will begin next week. Northfield has joined the MN League of Cities in opposing preemptive regulations imposed by the State of MN, e.g. banning local minimum wage laws.  A roundabout will likely be installed at the intersection of Highway 246 and Jefferson Ave. in 2021.  Brad remarked that he was skeptical about the roundabout, but was convinced when he saw the accident data for roundabouts relative to stoplights and 4-way stops. 

6.  Strategic Planning—Matt Anderson.  Anderson continued laying the groundwork for Board discussion at their Strategic Retreat on April 28th.  The strengths and weaknesses of the hospital (public ownership, independent, affiliations, particular market, etc.) were assessed.  Looking ahead, Anderson suggested the Retreat focus on three very different scenarios post ACA, and work through the implications of each for NH&C: a free market system, global budgeting, and an IT driven health care system.  What would NH&C need to do to thrive in each of these environments?  Anderson commented that his initial presentation was going to have NH&C focus on the changes presented by the repeal of the Affordable Care Act (ACA) and the implementation of the Republican Health Plan.  That presentation was scrapped last Friday afternoon when the House of Representatives didn’t vote.  Anderson predicted that the health care environment is going to change.  Marketing by the for-profit providers is going to become more widespread and aggressive; payment rates are going to be reduced; mental health and substance abuse are becoming epidemic and the health care sector must respond.     

Presentations/Discussions/Action Items

1. Quality Dashboard Report—Ann Reuter.  Reuter reminded the Board of 3 goals set by the Dept. of Health and Human Services in DC: better care, affordable care, and healthier people.  Medicare reimbursement is increasingly being tied to these goals through financial penalties and rewards.  Currently, Medicare is addressing three problems: hospital acquired conditions, unscheduled readmissions to the hospital, and sub optimal quality of care.  When NH&C performance falls below the benchmark set by Medicare, it faces financial penalties. When performance exceeds the benchmark, NH&C receives a financial reward.  The rewards have exceeded the penalties in recent years.  Reuter said NH&C does very well in 3 areas: patient safety, infection prevention, and patient ratings of their hospital experience.  

2. Ambulance Replacement—Joe Johnson.  The useful life of an ambulance is about 180,000 miles, and there is a 6-month lag between orders and delivery of a vehicle.  One ambulance needs to be replaced now.   The Emergency Medical techs have been working with Allina on redesigning the interior of ambulances to make them safer for patients and med techs.  They are excited about the progress and eager to see their efforts in action.  The lowest bid received for a new ambulance with the redesigned interior was $203,000; below the amount projected in the 2017 capital budget.  The Board will vote on the proposal at the April meeting.

3. Foundation Update—Laura Peterson.  Peterson presented the Board with several possible structures for a foundation including:

a) Establishing a 501 (c) (3) organization tightly tied to the hospital and controlled by the hospital Board.

b) Establishing a 501 (c) (3) organization with greater autonomy

c) Affiliation with an existing community foundation such as Northfield Shares, where the community foundation would manage the investment decisions and could provide administrative services.  A number of options are available on who controls the funds in the foundation.

Discussion followed. Northfield hospital is the only hospital in the state without a foundation.  The Board asked the administration to bring a specific recommendation to a future Board meeting for action.  

 4. PERA Committee—Virginia Kaczmarek.  A work team is being formed to address the problem and work is underway.  The audit firm, Clifton, Larson, Allen has been asked to arrange a meeting with PERA to discuss pension and accounting options.  The team will report back to the Finance Committee.

 

Executive and Committee Reports

1. CEO Report—Steve Underdahl. The notebooks for the upcoming Retreat will get to Board members ahead of the retreat.  The Do The Next Right Thing (DTNRT) banquet was held at St. Olaf College and was a success.  Staff members brought their families and people stayed to socialize after the event. The Rebranding initiative continues.  The discussion on a new Electronic Health Records system will continue at the Retreat.  The hospital has been very busy the past few months and staff are stretched thin.  Administration is working on a “nurse pool system” where some nurses would move between units as needed on a daily basis.  The Orthopedic and Fracture Clinic is short on exam/treatment rooms, and some remodeling is planned to create 3 more rooms.  The estimated cost is $200,000.   Nine solar garden proposals have been received and are being evaluation.  The costs and revenues are very similar in all the proposals. The Hospital Auxiliary Book Fair will be held April 20 – 25th.  Board members were urged to visit it.    

2. Financial Report—Scott Edin.  Business was great in February, and most services were over budget in both volume and dollars.  Rehab services were significantly below budget again and require some attention.  Net Income is about $700,000 over budget year-to-date.  Work continues on updating the electronic health records.  Site visits have been completed.  Contract negotiations could begin in May, and a final recommendation to the Board could come in June. 

3. Budget and Finance—Charley Kyte. The all-employee bonus program tied the bonuses to a) improvement in patient satisfaction, b) quality of care, and c) financial stability.  All goals were met in 2016, and the Board wanted to recognize the efforts of the staff.  The Committee recommended a bonus of 2% of annual salary, paid with a separate check.  Passed by the Board.  The Committee recommended that $383,500 be allocated for the Management Incentive Pool.  Managers can earn a bonus of 3 – 5% of salary, based on individual performance.  Passed by the Board.  It was noted that actual payouts may be less than the amounts allocated since not everyone will receive the maximum bonus. 

4. Quality Committee—Dr. Michelle Muench. The patient experience ratings at all clinics are up.  Birth center ratings are down, possibly due to staffing problems. Over 150 patients were treated via telemedicine thus far this year.  The electronic Intensive Care Unit at the Red Wing hospital is up and running.  Patients have requested faster access to test results on the MyHealth site.  The issue is under discussion.  Physicians are reluctant to make the results available before being reviewed and interpreted by a physician. 

5. Legislative Work Group—Steve Underdahl.  The group is getting organized and making plans.  They would like to introduce themselves to local legislators when they are not trying to lobby or seek funding.  

Roundtable

Some EMT staff participated in de-escalation training.  De-escalation is a hot topic among people who deal with the public in crisis situations.  More training is anticipated. 

The meeting adjourned at 9:30 p.m.

Next meeting:  April 27, 2017

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