Submitted by Ann Ness, LWV Observer
Steve Delzer, Board Chairperson, called the meeting to order.
Special Presentation
The meeting began with the 2004 Audit Report by Rob Schile of LAWCO. His company reviewed the internal accounting controls. In his opinion there are no problems. There were no audit adjustments. He says that Finance does a good job. They passed an adjustment of $20,000 on the investment valuation which he says is not significant. No difficulties were encountered and the staff was helpful. Three benchmarks were used for the evaluation of the hospital: 1) Standard & Poor’s ratings; 2) MN medians for the MN Hospital Association; and 3) LarsonAllen clients who have the same size of revenue as Northfield.
For the days which the hospital could operate with cash on hand, in 2000, it was 464 days; in 2004 it was 285 days. S&P’s for 2003 was 110 days. For the average age of the physical plant, the new hospital is considered to be a baby. For liability on the balance sheet, the debt for 2004 was 37% in 2004. The hospital is doing well and the debt is being paid down. S&P’s in 2003 was 44%. The percentage growth in net patient revenues in 2004 was 13% which Mr. Schile says is good annual growth. The profitability is two times the S&P’s ratio.
Mr. Schile explained that Critical Access Hospital Status (CAH) is beneficial for some hospitals and not for others. He said it doesn’t make sense for the Northfield Hospital. He compared the Medicare reimbursement. For the Prospective Payment System there is a fixed payment. For CAH, Medicare will pay a “reasonable cost” based on a formula. With CAH, a hospital can only operate 25 beds/day. Mr. Schile said, “The best method of operation is efficiency and that’s where you’re at.” He said that CAH is good for a lot of facilities but not for everyone.
Action Items
Approval of minutes passed with the correction of 3/3/05 that Terry Gilbertson was absent. Approval of a proposed partnership with Mayo Health System for Ob/Gyn services passed. The model which was used is one that emerged under the guidance of independent consultants from the firm of Health Care Futures and which is similar to the model utilized in creating a similar partnership with Orthopaedic & Fracture Clinic, PA for orthopedic services. One of the objectives is to develop a long-term partnership between Northfield Hospital and Cannon Valley Clinic-Mayo Health System that results in both organizations benefiting from the continued growth of Ob/Gyn services in Northfield and surrounding communities. Mayo is to provide 2 l/2 physicians and .8 FTE nurse midwife. By August 1, there will be one additional full time physician. Since in their contract, the physician is to work one night out of four and one weekend out of four, the hospital will be a little short and can contract $4000 for extra call coverage. The hospital may enter into a contractual relationship with the Cannon Valley Clinic-Mayo Health System to provide the physicians and nurse midwives necessary to provide 24/7 coverage of the hospital’s service. The hospital may acquire the furniture, equipment and supplies of the Cannon Valley Clinic’s Northfield site and will assume Cannon Valley Clinic’s current lease obligation in Northfield. The final amount of this purchase may be between $25,000-$50,000. Because of the lease assumption, this agreement must be approved by the City Council. The implementation of the partnership will be on or about June 1, 2005. There is a one year window for a decision to terminate. Mayo remains an independent contractor.The clinic will be called Women’s Health Center of Northfield Hospital. The hospital will keep the records. The first term is June 1, 2005-December 31, 2010 and after that every five years. The hospital expects to break even with the practice in 5 years. Ken Bank says it is a core service for the hospital. No primary care physicians do C sections any more. There is the potential of capturing the young market in Farmington and Lakeville. Mayo will take the agreement to their Board in April.
The present hospital has 1100 square feet where the ambulance crew quarters were to have been which would accommodate 6 exam rooms. There would be an emergency reception desk and the possible emergency C sections would be practiced in-house. The Board approved the temporary Ob/Gyn clinical space.
Because the hospital is developing a number of specialty medical services such as the Orthopaedic & Fracture Clinic, occupational medicine, women’s health services and possibly expanded ENT and other surgical services, Ken Bank proposed to authorize the study of development of an on-site clinic on the hospital campus. The administration recommended authorization to retain the architectural firm of Hammel, Green and Abrahamson and the construction management firm of Kraus-Anderson to assist in completing the programming phase of design for an on-site medical clinic and to provide cost estimates of various building options. The cost of these services would not exceed $6000.00. The two choices are a 2-story clinic with a maximum size of 90,000 square feet which costs more on the front end, or a single story clinic of 30,000 square feet. Either clinic will require more parking space. The Board gave its approval.
The Board approved a revision to Medical Staff Bylaws which states that “Board certification must be received within seven years of completion of residency.” The Board approved a resolution to adopt an Amendment to 457(b) Plan to bring it in line with IRS regulations. The Board approved applications for Medical Staff Membership/Privileges.
Discussion Items
Committee Assignments for 2005
Budget & Finance: Mike Allen, Terry Gilbertson, Peggy Hoffman, chairperson, and Curt Swenson.
Governance & Planning: Steve Delzer, chairperson, John Lundblad, Robert Shepley, M.D., and Curt Swenson.
Public Relations: Terry Gilbertson, John Lundblad, chairperson, Robert Shepley, M.D., and Gina Washburn.Regional Clinics Update
The regional clinic in Lonsdale will have its groundbreaking (which was postponed due to inclement weather) on Friday, April 8, at 3:00 p.m. It’s important to get bids out, although steel may have to be pulled out since there may not be enough time to wait. In Lakeville, there is a 5-7 acre site for sale offered by the owner. The City Council will have to approve buying it.The Spring Board Retreat will be May 20 & 21 from mid-afternoon the first day to noon the next.
Mary Crow gave the Safety Report Summary, Regarding hospice care, there have been no Medicare deficiencies. There was a 3-day survey reviewing 6 months of records. This was the first survey in 10 years. Seventy-four safety reports were issued in Jan/Feb. but there was no harm to patients. Ms. Crow said that “if a patient is harmed, then we drill down and down and down.” In the nursing home, the Life Safety Code requires fire protection so every quarter there is to be one fire drill per shift. Previously the emergency generator could not be tested, however, after installing the exhaust fan, the hospital is now meeting that requirement. The hospital is now clear of deficiencies.
Informational Items
The Medical Staff Report indicates that committee work will be a condition of reappointment.Northfield Hospital Emergency Medical Service Monthly Call Volume History Report for 2003, 2004, and 2005 shows 1738 calls in 2003, 1857 calls in 2004, and 304 calls in January and February of 2005.
Ken Bank announced that there would be a League of Women Voters Forum on Tuesday, April 5, on the Hospital Restructuring.
The Board meeting concluded to go into an Executive Session to discuss the Allina relationship and the CEO evaluation.
Action Items
Approval of minutes passed with the correction of 3/3/05 that Terry Gilbertson was absent. Approval of a proposed partnership with Mayo Health System for Ob/Gyn services passed. The model which was used is one that emerged under the guidance of independent consultants from the firm of Health Care Futures and which is similar to the model utilized in creating a similar partnership with Orthopaedic & Fracture Clinic, PA for orthopedic services. One of the objectives is to develop a long-term partnership between Northfield Hospital and Cannon Valley Clinic-Mayo Health System that results in both organizations benefiting from the continued growth of Ob/Gyn services in Northfield and surrounding communities. Mayo is to provide 2 l/2 physicians and .8 FTE nurse midwife. By August 1, there will be one additional full time physician. Since in their contract, the physician is to work one night out of four and one weekend out of four, the hospital will be a little short and can contract $4000 for extra call coverage. The hospital may enter into a contractual relationship with the Cannon Valley Clinic-Mayo Health System to provide the physicians and nurse midwives necessary to provide 24/7 coverage of the hospital’s service. The hospital may acquire the furniture, equipment and supplies of the Cannon Valley Clinic’s Northfield site and will assume Cannon Valley Clinic’s current lease obligation in Northfield. The final amount of this purchase may be between $25,000-$50,000. Because of the lease assumption, this agreement must be approved by the City Council. The implementation of the partnership will be on or about June 1, 2005. There is a one year window for a decision to terminate. Mayo remains an independent contractor.The clinic will be called Women’s Health Center of Northfield Hospital. The hospital will keep the records. The first term is June 1, 2005-December 31, 2010 and after that every five years. The hospital expects to break even with the practice in 5 years. Ken Bank says it is a core service for the hospital. No primary care physicians do C sections any more. There is the potential of capturing the young market in Farmington and Lakeville. Mayo will take the agreement to their Board in April.
The present hospital has 1100 square feet where the ambulance crew quarters were to have been which would accommodate 6 exam rooms. There would be an emergency reception desk and the possible emergency C sections would be practiced in-house. The Board approved the temporary Ob/Gyn clinical space.
Because the hospital is developing a number of specialty medical services such as the Orthopaedic & Fracture Clinic, occupational medicine, women’s health services and possibly expanded ENT and other surgical services, Ken Bank proposed to authorize the study of development of an on-site clinic on the hospital campus. The administration recommended authorization to retain the architectural firm of Hammel, Green and Abrahamson and the construction management firm of Kraus-Anderson to assist in completing the programming phase of design for an on-site medical clinic and to provide cost estimates of various building options. The cost of these services would not exceed $6000.00. The two choices are a 2-story clinic with a maximum size of 90,000 square feet which costs more on the front end, or a single story clinic of 30,000 square feet. Either clinic will require more parking space. The Board gave its approval.
The Board approved a revision to Medical Staff Bylaws which states that “Board certification must be received within seven years of completion of residency.” The Board approved a resolution to adopt an Amendment to 457(b) Plan to bring it in line with IRS regulations. The Board approved applications for Medical Staff Membership/Privileges.
Discussion Items
Committee Assignments for 2005
Budget & Finance: Mike Allen, Terry Gilbertson, Peggy Hoffman, chairperson, and Curt Swenson.
Governance & Planning: Steve Delzer, chairperson, John Lundblad, Robert Shepley, M.D., and Curt Swenson.
Public Relations: Terry Gilbertson, John Lundblad, chairperson, Robert Shepley, M.D., and Gina Washburn.Regional Clinics Update
The regional clinic in Lonsdale will have its groundbreaking (which was postponed due to inclement weather) on Friday, April 8, at 3:00 p.m. It’s important to get bids out, although steel may have to be pulled out since there may not be enough time to wait. In Lakeville, there is a 5-7 acre site for sale offered by the owner. The City Council will have to approve buying it.The Spring Board Retreat will be May 20 & 21 from mid-afternoon the first day to noon the next.
Mary Crow gave the Safety Report Summary, Regarding hospice care, there have been no Medicare deficiencies. There was a 3-day survey reviewing 6 months of records. This was the first survey in 10 years. Seventy-four safety reports were issued in Jan/Feb. but there was no harm to patients. Ms. Crow said that “if a patient is harmed, then we drill down and down and down.” In the nursing home, the Life Safety Code requires fire protection so every quarter there is to be one fire drill per shift. Previously the emergency generator could not be tested, however, after installing the exhaust fan, the hospital is now meeting that requirement. The hospital is now clear of deficiencies.
Informational Items
The Medical Staff Report indicates that committee work will be a condition of reappointment.Northfield Hospital Emergency Medical Service Monthly Call Volume History Report for 2003, 2004, and 2005 shows 1738 calls in 2003, 1857 calls in 2004, and 304 calls in January and February of 2005.
Ken Bank announced that there would be a League of Women Voters Forum on Tuesday, April 5, on the Hospital Restructuring.
The Board meeting concluded to go into an Executive Session to discuss the Allina relationship and the CEO evaluation.