Reports
1. Board members reported on a Minnesota Hospital Association Trustee Conference which several of them attended.  Many of the sessions dealt with the new Federal health act, and the possible implications of the act for hospitals in MN.  The details of the act aren’t known at this time, as the regulations still need to be written. The Board was concerned that NCH stay on top of the coming changes.
2.  The Board welcomed Mark Brown as the new Clinic Division Administrator.  Mark is a Mayo employee, under contract to the hospital, and he had been working at Mayo facilities in Lake City, MN.

Action Items
1. The Board voted to approve the Organizational Goals and Objectives for 2010.  There was discussion on how the goals and objectives will be communicated throughout the organization and the medical staff.  It was pointed out that the physicians are “partners” of the hospital, rather than employees.
2.  The Board approved the applications for medical staff membership.  There was a discussion of a change in process requiring a physician to have received special training to be approved for some procedures.

Discussion Item
The CEO and the CFO presented a mid-year report on the financial position of the hospital and clinics.  The recession has reduced admissions, patient days, etc. and therefore revenues.  The hospital has adjusted by trying to reduce expenses.  The hospital budgeted for a deficit of over $1 million for 2010, and it is likely to happen, but it is too early to forecast the exact deficit for the year.  I don’t recall that the financial data for the clinics was broken out, but I got the impression that the clinics are still a problem.  On the positive side, the clinics are contributing a growing number of in patients to the hospital, and the Board seemed satisfied with the progress being made.  The hospital and clinics will continue to search for ways to be more efficient.

Other
A Board member noted a problem he has encountered locally.  Medicare will pay for a short stay in a long-term care facility, if the person has been an inpatient in an acute care hospital for 3 days.  Given the financial pressure from Medicare, fewer people are being admitted, and the stays are shorter, so fewer persons on Medicare qualify to have Medicare pay for a long-term care facility.

Reports
1. Staff reported on a new delivery and fetal monitoring system.  The system records observations from both the mother and the fetus.  Information on up to four simultaneous deliveries is displayed at the nurse’s station, allowing more efficient use of nursing time.  Information on a specific patient can be accessed by the attending physician from either home or office; a feature much appreciated by physicians.  The record for each delivery is stored electronically, and requires less administrative input than the old system.  These systems are common in large hospitals, but unusual for a hospital of Northfield’s size.

2. The CFO reported on Northfield Hospital’s compliance with the Attorney General’s Agreement.  AGs around the US negotiated agreements with the hospitals in their states pertaining to discounts for patients without health insurance and the provision of uncompensated care.  An uninsured patient in MN receives a 34% discount on a hospital bill, which is the discount received by Blue Cross of MN, and then may fall in one of three categories for paying the bill. (This is my interpretation of the report.  It may not be accurate.)
a) Charity care: patient denied Medicaid coverage and family income less than 200% of federal poverty guidelines.   $259,000 of charity care provided in 2009
b) Private pay: uninsured patients who are cooperating with the hospital to pay their bill. 2009 hospital billing $6.9 million; discounts $0.9 million; collected $2.7 million or 45%.
c) Processed bills: uninsured patients whose bills received special collection efforts by the hospital or collection agencies.  As a government owned hospital, NH may seek to collect unpaid bills from tax refunds.
2009 hospital billing: $2.3 million; $406,000 collected from tax returns; $267,000 by other efforts. Collection rate 29%.

Two complaints were filed regarding the activities of the collection agencies used by Northfield Hospital.  The CFO responded that the complaints were handled in an acceptable manner by the agencies.

Action Items
1. The Board voted to require that physicians granted privileges at the hospital be required to have liability insurance of $1million/$3million.  This means that doctors without malpractice insurance should not be using the Northfield Hospital.  A small number of physicians in the US are disposing of their assets and going uninsured.

Other Items
1. The Hospital Auxiliary has met their goal of raising $100,000 for the hospital over a 3-year period.
2. Hospital system revenue continues to be slightly below projections.
3. The city and the hospital continue to have discussions regarding the financial plight of the city.  Questions: might the hospital make an annual payment-in-lieu-of- taxes to the city?  Could the city sell the hospital as a way to raise cash?

Reports
1. Staff reported on the use of a Flex-grant the hospital had received to improve and coordinate drug treatment programs in Rice County, and to establish a “Take-it-to-the-box” program for the safe disposal of unused prescription drugs.
2. Staff reported on the continuing effort to implement an electronic medical records system.  The report detailed a multi-year plan, but the Board was only asked to approve one phase, which required an immediate down payment of $15,099.  The hospital hopes to qualify for significant federal grant aid to fund this project.
3. Medical Staff: reported ongoing efforts to reduce the incidence of hospital acquired conditions (HAC).  It was reported that infection rates at NCH are lower than the state average, but that may be due to shorter length-of-stays and a higher portion of outpatient treatment than to extra precautions by the medical staff or hospital.

The results of a self-evaluation by the Board were briefly discussed.

Committee Reports
1. Public Relations: reported on the issues involved with coordinating signage with Mayo and the NCH.  How does one alert the public to the fact that there are Mayo units serving the hospital without giving the impression that NCH is a Mayo hospital?
2. Governance and Planning: an insurance claim was successfully mediated.  No details provided. The Employee Handbook was revised.
3.  Finance: Standard and Poors had reviewed the financial position of the hospital prior to issuing a new rating for the hospital bonds.  No further explanation was given.
4.  Operations: the hospital was working on establishing “medical homes” for chronically ill children to improve the coordination and quality of care.  A new triage phone system is to be operational soon.  Details were being worked out on how the staff of the Orthopedic and Fracture Clinic would relate to the Mayo staff.

Roundtable
1. Several questions were raised regarding the nurse’s strike in the Cities and how it might affect NCH.  NCH is nonunion, but its base pay for nurses is maintained at 95% of the union scale in the Cities.  Some Board members expressed support for continuing the non-union status of NCH nurses.
2. Several questions were raised regarding how the changes in the GAMC program were going to affect the hospital.  There was a concern that the continuity of care for some low-income patients would suffer, and that the hospital would likely experience an increase in uncompensated care as a result of the cuts.
3. It was reported that the City is fast-tracking the process to annex 5 acres of land for the proposed Mayo Cancer Clinic.
4.  It was reported that there had been discussions within City government regarding having NCH make a payment-in-lieu-of-taxes to help with the budget crisis facing the City.

Major increases in expenses for 2006 include:
Benefits $901,396.00
PERA 5.5% to 6%
Medical fees $2,318,998.00 (new clinics in place)
Food $26,665.00
Drugs $524,997.00
Supplies $1,155,307.00 (50% due to increase in volume)
Utilities $215,439.00
Repairs $88,382.00 (new equipment to be purchased)
Insurance $288,676.00 (professional fees are going down 1/3)
Depreciation $694,652.00
Purchased services $118,270.00 (laundry fees going up)
Other $118,270.00 (increase in clinic expense)
Taxes $114,385.00 (MN Care tax on additional revenue is 2% of cash receipts, and property tax on clinics)
Bad debt $9,415.00
MN surcharge $29,159.00 (due to increased volumes)

Decreases on interest on debt and telephone charges.
Total deductions over 2005 budget: $11,572,278.00.

Ken Bank said there were significant costs in getting the clinics underway, but there would be a positive result in years to come. The budget for 2006 is based on uncertain assumptions at this point. He emphasized the economic development benefit of creating 51 new jobs. There are about 400 FTE’s for next year with about $20 million in salaries.

The 2006 Capital Budget was approved. Some of the largest expenses include a video camera for the operating room for $96,000.00. To increase on-site parking will cost $125,000.00. The new Meditech program will cost $451,790.00. The expanded computer room will cost $340,000.00. Any amount over $50,000 must go to the Board for approval. The total Capital Budget for 2006 for the Hospital is $2,208,357.00 and for the Clinics is $9,665,000.00.

The CPA firm of LarsonAllen has agreed to audit the financial statements of the Hospital and Clinics for $20,000, a 7% increase due to the additional work with the Lonsdale Clinic. The audit proposal passed.

Three Board officer positions are up for renewal, including the Chair, Vice-Chair, and Treasurer and it was proposed that the Board members now in those positions be offered as the slate of candidates to be voted on at the next Board meeting. This was unanimously approved.

A proposal for a new ultrasound system was presented due to the growth of the Women’s Health Clinic. The older unit cannot handle the current traffic. Bids have been asked for for next week. Ken Bank checked with Marin Swanson (City Attorney) and the contract can be awarded next week as long as it doesn’t exceed $300,000.00. One bid from Phillips is in, but bids from Toshiba and GE are expected. The lowest bid which meets the bid specifications will be accepted as long as it doesn’t exceed $300,000.00. This proposal passed.

The approval of Depositories and Safe Keeping Entities with the Community National Bank passed.

Donations based on a target of 2-3% of the net operating income are to be considered by the Budget & Finance Committee. Ken Bank said they must take action in the 2005 year. The amount to try to maintain would be $50,000 as they did last year. One of the Board members asked how donations are determined and Ken Bank said that historically donations are given to the United Way, the Community Action Center, the Health Community Initiative, and youth groups. The Board approved having the Budget & Finance Committee decide on the donation amount and which groups it would go to.

Applications for Medical Staff Membership/Privileges were approved. There had been no meeting by the Medical Executive Committee, but they approved by email, and the Board also approved.

David Oliver gave a regional clinics update. The Women’s Health Clinic had been averaging 200-250 clinic visits, but is now up to 400-410 per month. The Orthopedic Clinic was averaging 600 visits per month. The general surgery is still new. The Lonsdale Clinic has been in business 33 days and by 12-21-05 had 441 patient visits. There are 6 exam rooms which are expandable to 18. Some of the patients came from outside of Lonsdale (the greater Lonsdale region). 20 patients were sent to the Hospital for in-patient care. Several patients have mentioned to Dr. Glover that they are pleased to have a pharmacy across the street so he can call the prescriptions over.

Meetings are being scheduled to pursue having a Farmington Clinic. There will be 24 exam rooms and an increase of 5000 sq. ft. over the Lonsdale Clinic. Since they are taking the Lonsdale footprint of a clinic, they are happy to be able to ask the people working there if there is anything they would change.

The HealthFinders Collaborative Update gives statistics on their services through the end of October for 218 patients. The total cost to the Hospital has been $3200.00 to date.

Ken Bank reported on the Emergency Dept. physician staffing. They have come to an agreement on work scheduling. 10 shifts a month will be Full Time, in addition to any holidays or vacation days. They need the equivalent of 6 FTE’s. 3 physicians will remain. Dr. Lum will drop to half time. 5 will be half-time which gives more flexibility. Some will continue moonlighting. Most of the ED doctors have extensive family practice backgrounds. Ken Bank said, “We’re as stable as we’ve ever been.” Mary Crow said that 85% of Hospital Admissions come through the Emergency Department.

Roger Stapek gave the Administrative Report. He said that the Hospital made a $15,000 profit last month. He said they were at the beginning stages of absorbing start-up costs. He is budgeting for $100,000.00 in losses each month next year. Admissions are higher than budgeted. He expects to end 2005 fairly close to the budget.

The Hospital is having 4 houses and 3 lots appraised from the old hospital site according to City Council rules. The two houses that are rentals will give first choice to the renters to buy based on the appraised value. The Hospital is keeping the ambulance quarters and the home care quarters which are still being used. They need some attention to repairs.

Ken Bank said that with the addition of a 9th member on the Board that the Board Room would no longer be big enough for the monthly dinner which precedes the Board meeting. Members will have to let the Hospital know if they are coming for dinner so they will know which room to set up

]]> http://lwvnorthfieldmn.org/weblog/post/790/feed/ 0 http://lwvnorthfieldmn.org/weblog/post/782/ http://lwvnorthfieldmn.org/weblog/post/782/#comments Wed, 23 Nov 2005 20:09:33 +0000 Kathy Tezla http://lwvnorthfieldmn.org/?p=782 Submitted by Ann Ness, League Observer
Chair Steve Delzer called the early Board meeting to order at 4:08 p.m. instead of its usual 6:30 p.m. meeting time. He welcomed Vern Lougheed, Diector of Information Systems to the meeting. The minutes of 10/27/05 were approved.

Mary Crow presented the Emergency Management Plan which had no substantive changes and was easily approved.

Ken Bank brought forward a proposal for the construction of a new computer room with redundant cooling and power. He said that it had been “quite a summer.” The present computer room cannot sustain the

current system. There is not enough space and there needs to be additional cooling in case, as has happened, the cooling is shut down. Roger Stapek said that when the present building was built, the Hospital didn’t know what was going to be needed. Vern Lougheed wasn’t yet hired. They were designing for needs of 2002 versus where they are today with the addition of Meditech. The old system had no environmental processes. Meditech required air conditioning. Then Vern went over the highlights. He said the major issues were 3 outages in the last year. The last was due to the cooling system failing and the temperature rose to 100 degrees which affected the computer. No data was available to staff while the computer was down. It wasn’t a design flaw in Meditech. Vern said the Hospital has 250 PCs now, but by 2006, there will be 406. The growth of computers has exploded. He asked, “What is the acceptable level of downtime?” The answer was two hours for scheduled maintenance. There are 4 simple fixes: cooling; power source; space (a huge issue

]]> http://lwvnorthfieldmn.org/weblog/post/782/feed/ 0 http://lwvnorthfieldmn.org/weblog/post/758/ http://lwvnorthfieldmn.org/weblog/post/758/#comments Tue, 30 Aug 2005 23:00:03 +0000 Kathy Tezla http://lwvnorthfieldmn.org/?p=758 Submitted by Ann Ness, League Observer

Here is a timeline of interest to those of you following the Hospital Restructuring Proposal (handed out at the City Council/Hospital Board work session 8-25-05):
August 25 Council suggests that Hospital Board make a recommendation
September 12 Council acts on resolution to ask for recommendation
September 29 Hospital Board develops and approves a recommendation,
including suggested schedule for implementation
October 10 Council receives recommendation and decides next steps
October 17 Council receives and acts on suggested process and schedule for decision (if applicable)

August 25, 2005 Meeting:
The Hospital Board had an unusually early meeting so that the Hospital Board could meet in a work group session with the City Council at 7:00 p.m. Board Chair Steve Delzer called the meeting to order at 4:40 p.m. Minutes of the 7/28/05 Board Meeting were approved. Application for Medical Staff Memberships were approved and four resignations were accepted. Board members had received a copy of the Hospital Bylaws at the last meeting to review. There were no recommendations for revisions. The Board members had also received the 3rd Quarter Summary of Strategic & Organizational Objectives at the last meeting. No issues were raised so no action was needed.

David Oliver reported that the Women’s Health Staff had been moved to the Hospital and opened for business on August 8. (A tour was planned for after the meeting.) He said the new space was confined but was working well. The staff was happy to be on site. With respect to the Lonsdale Clinic, the roof is on, the precast stone is on, and the cultured stone similar to the Hospital’s, is on. The first layer of stucco is on and the third layer is on one side of the building. The building looks like it should. He will nail down the possession date. The door frames have been delayed one week. The roof trusses adjustments took some extra time. Dr. Jose Fulco will be starting in October. He has been in practice for 13 years. David Raniero in general surgery with Allina will also be working there.

Ken Bank related the Farmington situation with the “drama and trauma of a trout stream.” In the process of doing due diligence, it was discovered that at the back edge of the property, there is a trout stream, which even though completely dry, is still a trout stream in the eyes of the DNR. Also, a ditch is now a “tributary” or wetland. This discovery may require an environmental assessment which may take too many months to be feasible. As a result, the Hospital is now looking at other sites in Lakeville. Ken says that the Hospital Board needs to know by the next meeting where we are.

Roger Stapek reported that there were 155 more admissions in July. There is a positive cash flow.

Ken reported on two resignations. The Emergency Director is leaving to join a private clinic in the Twin Cities on October 15. The Director of Human Resources will retire October 2.

Ken commented on recent power outages and failures of the cooling system. He reports that the Hospital is out of space in the server room. They are looking at back-up feeds. At the present location there is only one electrical feed. There is no second transformer source at present. Also there is no outside lighting or signage when power goes out. The Hospital is having electricians price out additions. A booster station for water is needed in order to serve any additional facilities. He is working with Heidi Hamilton at the City. No additional booster station is expected before next spring.

The Hospital Board concluded its short meeting at 5:17 p.m. and then went into Executive Session to review 2006 Strategic Objectives. Following that, there was a tour of the Women’s Health Center. The Registration desk for the Women’s Health Center is right around the corner from the general reception desk, in the Atrium where there is a fireplace. There are two people at that desk and there is room for medical records. The staff now escorts patients to the Women’s Health Center. There will eventually be a sub-waiting area right outside the Women’s Health Center location. An LPN and Certified Medical Assistant help with labs. They will be adding an LPN to supervise. There are six exam rooms. There have been as many as 45 visits a day. Thirty visits is average but it is moving up to 40. Rice County Family Planning has made an agreement for services.

The Hospital Board met at 7 p.m. with the City Council for a work session. Mayor Lee Lansing facilitated. The purpose of the meeting was for the Restructuring Committee to present to the Council and the Hospital Board information that they have been gathering. There was no public input. Comment cards were handed out if any of the public wanted to leave a message. The focus of the evening was on the 501 (c) (3) model. The mayor said that other options pale in complexity to this model so that most time would be spent on it.

As identified in the Timeline above, the Council will request that the Hospital Board come forward with a recommendation after its next meeting in September.

]]> http://lwvnorthfieldmn.org/weblog/post/758/feed/ 0 http://lwvnorthfieldmn.org/weblog/post/751/ http://lwvnorthfieldmn.org/weblog/post/751/#comments Tue, 09 Aug 2005 18:39:22 +0000 Kathy Tezla http://lwvnorthfieldmn.org/?p=751 Submitted by Ann Ness, League of Women Voters Observer

Board Chair Steve Delzer called the monthly Board meeting to order at 6:45 p.m. with a presentation by the Hospital Auxiliary President Ellen Cox. Through its proceeds from the annual Book Fair, the Auxiliary donated more than $28,000 to cover important equipment needs, including a community notification phone system to aid in summoning staff in times of mass casualty disasters.

The community notification system will be purchased from a Bloomington firm at a cost of $21,950.00. Besides its notification features, it also has the ability to help with data gathering for strategic planning and performance assessment as well as patient compliance with discharge instructions. The rest of the funds donated by the Auxiliary will purchase a dual chamber infusion pump for the Hospital’s chemotherapy program ($2,700) and a new lift for the Long Term Care Center ($3,995). Ken Bank noted that the gift of the community notification system is a really “big deal” and a “big enhancement for the Emergency Response Rate.”

Next, Mary Crow gave a Meditech implementation update. Mary said she wanted to give the Board a sense of the enormity of the work involved in computerizing everything. She said she is very proud of the staff. When attending the eHealth Summit, she learned that the Northfield Hospital was the only hospital who had come this far. In the first year, the business (registration and billing) implementation had to happen before the clinic. They went from paper to computer. Northfield Hospital teams traveled to Boston for an intense training. Team members took all paper systems and started to work to a computer outline. This included all converting all paper forms to computer which was a big process. Then began application training. Most modules required 3 days of training and some, more. They put in test patient records to do a parallel run. They developed training materials. The big day was when they went live. This process occurred from the fourth quarter of 2003 to the first and second quarter of 2004. Gary Anderson, Pharmacist, in particular has done a lot of work because pharmacy affects all areas. The nursing staf did 8 hours of training. In August 2004, long-term care went live. In September 2004, the Emergency Room module was added. The physicians writing orders online said it slowed them down at first but now like the system. There are nearly 1000 procedures related to the Operating Room. In May 2005 the Patient Care System was added. The nursing staff had 12 more hours of training. There are continued improvements worked on a monthly basis at first; now application changes are made on a weekly basis every Wednesday. There are benefits to having an electronic record.

The Board Meeting Minutes of 6-30-05 were approved. The 2006-2008 Strategic Plan was approved with an amendment by Curt Swenson of the words “independent from any health care system.” The Applications for Medical Staff Membership/Privileges were approved.

David Oliver gave a regional clinics update. He noted that the Hospital is just coming out of building a new building and is now working on a new clinic building. There is now a roof on the clinic. He anticipates opening in early October. The building still reflects the steel delay. They have completed hiring 5 staff (3 are transfers and 2 are internal hires). Training and orientation will begin about September 12. Dr. Griff Kelley, the second doctor, has moved to Northfield. He joins Dr. Greig Glover. Go to www.lonsdaleclinic.org for a look at the clinic.

The Women’s Health Center at 710 Division is moving next Thursday or Friday and opening at the Hospital site on August 8. Dr. Melanie Dixon will be added on August 1. There are 3 obstetricians.

David spent two hours working with architects and developers for both the Lonsdale clinic and the Lakeville/Farmington clinic site. They hope to get into the ground in Lakeville by October 5.

Hospital By-Laws were handed out, but because there were no changes no action was needed. The By-Laws are renewed every one or two years.

Roger Stapek gave his administrative report. He said the Hospital made $64,000 last month. The in-patient care was over budget; the out-patient was lagging. The nursing home was right on budget. There is a positive cash flow of $604,000. Surgery is below projections. Lab tests are up. A Medicare settlement for 2002 of $239,810 was received. June and July are normally the slowest months of the year. With respect to selling the Hospital’s houses from its old site, they may not close until 2006.

Scott Davis asked about benefiting by using government pricing. Ken says that the Hospital is part of another buying group. With respect to Design/Build versus a competitive bidding process, the Hospital is required to do the latter.

A tour of the new Women’s Health Center was postponed from this meeting to the August meeting because it is not fully cleaned and furnished yet.

The meeting adjourned at the early hour of 7:40 p.m.

]]> http://lwvnorthfieldmn.org/weblog/post/751/feed/ 0 http://lwvnorthfieldmn.org/weblog/post/744/ http://lwvnorthfieldmn.org/weblog/post/744/#comments Fri, 15 Jul 2005 19:11:11 +0000 Kathy Tezla http://lwvnorthfieldmn.org/?p=744 Submitted by Ann Ness, League Observer

As a matter of interest, the Hospital Board Governance & Planning Committee met on June 8 at 7:00 a.m., and the minutes indicate that Steve Delzer, John Lundblad and Ken Bank brought the other attendees (Bob Shepley, M.D., Curt Swenson, Lee Lansing, Mayor, and David Oliver) “up-to-date on the status of restructuring study

discussions. The governance documents have been put into final draft form and the focus of attention is now on trying to finalize drafts of the landlord’s agreement and the sublease between the City and the new not-for-profit. A consultant is also working diligently to put together a comprehensive summary of all information related to the Restructuring Study. This will form the basis for education and discussion among the Board of Directors, the Northfield City Council and the public.

An interesting development that has occurred during the course of the Restructuring Study is legislation that makes Hennepin County Medical Center a ‘public subsidiary’ of Hennepin County. Through this legislation, HCMC is granted many of the same benefits enjoyed by not-for-profit organizations while retaining many benefits of public organizations. Because of this, the information summary that is being created is structured to compare minimal organizational change with creation of a community-owned, not-for-profit organization or creation of a public subsidiary model.”

Board Chairperson Steve Delzer called the monthly Board meeting to order at 6:45 p.m.

Gary Anderson, Director of Pharmacy and Chief Pharmacist, along with Mary Crowe, gave a presentation on Omnicell, an automated medication dispensing system for the Emergency Department, Medical-Surgical/CCU Units and Birth Center. The system ties patient information from the hospital’s new Meditech business system and enterprise medical record to an advanced medication software program to automatically dispense right drugs in right doses to the right patients. It was necessary to have Meditech up and running before such an automated system could be used. A lot of work was done by the Patient Subcommittee regarding common errors.

The machine would function like an ATM with each patient being given an account. The machine would dispense the appropriate medications to the nurse for each patient based on their individual medication profile. Site visits to see the Omnicell program were made to Hutchinson Hospital which has 58 beds and to the Hennepin County Medical Center which has 336 beds, the largest account in MN. Everything the nurse or pharmacist enters into the computer is recorded.

The company will hold training seminars for nurses. The pharmacist will enter prescriptions through Meditech. There is a back-up system and keys to get into the system if the computer breaks down. The system can generate reports and customize reports. Currently there are 2 nurses who physically count out narcotics. The machine spits out one dose at a time. Now each patient has a drawer. A nurse might be looking through 15 different medications. The machine uses a Bio I.D., i.e, a fingerprint. $431.00 a month is the ongoing maintenance cost. The hospital will train a maintenance person.

A bid process was conducted and bids were received from Pyxis and Omnicell. Omnicell cost the least at $202,417.00. There will be additional costs of approximately $15,000 to interface Meditech with the system. Staff were pleased with both systems’ ease of use and did not strongly prefer one system over another. A motion to approve the purchase of Omnicell was taken and passed unanimously.

Roger Stapek presented a Voluntary Agreement on Billing and Collection which resulted from negotiations between the Minnesota Hospital Association and Minnesota Attorney General Mike Hatch. The agreement was announced in May of 2005. Thus far, at least five of the state’s major healthcare systems, along with several independent hospitals, have voluntarily agreed to abide by these billing and collection practices. Seventy-five per cent or more of total Minnesota hospital admissions are now covered by these agreements. The 19-page agreement will remain in effect for two years. Mr. Stapek plans to add an additional $28,000 for this plan to his budget for write-offs. The charity budget was $102,000 this year. Ken Bank stated that this agreement doesn’t deal with the underlying problem of uninsured patients. In response to critics who wondered why the Hospital had not yet signed the Agreement, Mr. Bank stated that this was the first Board meeting since the Hospital received the Agreement. The Board unanimously approved the Agreement.

The Board approved the Hospital Quality and Performance Improvement Framework. This framework provides a guideline for a planned, systematic, organizational approach for process design and performance measurement, assessment, and improvement activities that are collaborative and interdisciplinary. The Quality and Performance Improvement process is reviewed annually to determine its effectiveness.

The Revised Professional Reference Questionnaire was approved. The question about applicant health status was changed to “Are you aware of any alcohol impairment?”

A list of applicants for Medical Staff Membership/Privileges was approved.

David Oliver gave a regional clinic update. As of June 21, the Lonsdale Clinic was waiting for steel. Late last week it arrived and is now up. There has been a two week delay in the project. However, there has also been a positive improvement in the weather and delivery of supplies. Staff are being hired for 5 open positions: 2 staff, 2 nurses, and a radiologist. They have been overwhelmed by interest in these positions and are excited by the quality.

The Women’s Clinic at 710 Division Street has the additional services of Occupational Medicine with Dr. Thomas Oas. The Clinic had a site visit by Blue Plus for managed care credentiality. It was approved for participation. The temporary clinic space at the Hospital will be ready August 1. It is undergoing drywalling this week. Dr. Melanie Dixon will be joining. A tour is scheduled for the next meeting.

On the Lakeville site, a site agreement has been approved by the Planning Commission and the City Council for 6.89 acres. Frauenshuh (the developer) has had a headstart on due diligence. The Hospital may have construction documents by the end of the summer. The Hospital requested right of first refusal on the rest of the acreage (up to a total of 10 acres). Lakeville has been very cooperative.

The Administrative Report indicated that $99,000 was made last month; $314,000 to date. Extra money has been required for demolition of the old hospital site. In-patient volume is higher, related to Medicare. Out-patient admissions lag behind last year. Roger Stapek reported the lowest accounts receivable in 25 years.

Ken Bank reported that the draft information from the Planning Retreat will be brought to the Board for approval. July 28 will be the next meeting.

The meeting was adjourned at 8:13 p.m.

]]> http://lwvnorthfieldmn.org/weblog/post/744/feed/ 0 http://lwvnorthfieldmn.org/weblog/post/733/ http://lwvnorthfieldmn.org/weblog/post/733/#comments Wed, 18 May 2005 22:59:03 +0000 Kathy Tezla http://lwvnorthfieldmn.org/?p=733 Submitted by Ann Ness, LWV Observer

A special meeting of the Northfield Hospital Board was called for the purpose of approving bids for the Lonsdale Clinic. As long as the Board was meeting, a couple of other items were added. A quorum of five members was present. Board Chairperson Steve Delzer called the meeting to order just after 5:00 p.m.

The Board considered a proposal to recommend awarding the remaining contracts to the lowest qualified bidders for construction of the new clinic in Lonsdale, MN. Award of these contracts will result in a construction cost of $2,170,058.00 which is approximately 13% over budget. There were no bids for masonry. The Hospital is talking to Kraus-Anderson for a possible masonry contractor. They think the final construction cost will be reduced to between 5% and 10% over budget. The Board approved awarding bids so they will go next to the City Council for confirmation at Monday night’s meeting. While they would like to have the masonry finished before the opening, masonry is particularly affected by weather so it may not be possible. The clinic could open without it.

Ken Bank introduced a proposal for assistance to the HealthFinders Collaborative. HealthFinders Collaborative is an emerging group representing local churches, health and social service providers, clinicians and hospitals, residents and businesses in the Northfield and Faribault area. The purpose of the Collaborative is to organize community resources to address issues of access to health care for uninsured persons in the hospital service areas of Northfield and Faribault. HealthFinders has secured a location at which it will offer clinic services. The clinic will be staffed by volunteer physicians, nurses and others. HealthFinders has asked that Northfield Hospital and District One Hospital of Faribault agree to provide inpatient and outpatient hospital services to clinic patients. These services would be provided at no charge to the patient
or to HealthFinders. The initial agreement would commence on June 1, 2005 and continue for a three-month trial run.

In the discussion that followed a question was asked about whether the patients would have pre-scheduled appointments

]]> http://lwvnorthfieldmn.org/weblog/post/733/feed/ 0 http://lwvnorthfieldmn.org/weblog/post/729/ http://lwvnorthfieldmn.org/weblog/post/729/#comments Fri, 06 May 2005 16:03:56 +0000 Kathy Tezla http://lwvnorthfieldmn.org/?p=729 Submitted by Ann Ness, LWV Observer.

As a follow-up to the Meeting Minutes of 3-31-05, it should be noted that following a short break the Board went into Executive Session for the purpose of discussing the Allina Relationship and the CEO Evaluation. The LWV Observer was not present for the Executive Session nor for the following open session, so this information is from the Northfield Hospital Meeting Minutes Record. Following the Executive Session, the Board went back into an open session to discuss the outcome of the CEO evaluation. A motion was made to make the following wage adjustments: 1) Merit increase 5%;
2) Technical adjustment 10% (based on Comparative Market Data 4-01-05); and
3) Management Bonus 18% of 2004 Base Salary.

Steve Delzer, Board Chairperson, called the meeting to order at 6:48 p.m.

Dr. Lawler was present for the approval of applications for medical staff membership/privileges but had to leave early so they were approved first. It was noted that #2935 is still in residency. With respect to the Medical Staff Report, they are working on core privileges. Someone who recently went through the change will speak at their meeting.

Special Presentation
A special presentation of a video sponsored by the Institute for Healthcare Improvement called the “100,000 Lives Campaign Video” was shown. The speaker compared the proposed campaign to a political campaign and he quoted a saying, “Some is not a number. Soon is not a time.” The speaker said that the tasks are specific and will either be done or not done. There is a discipline of deadlines. The goal is to save 100,000 lives by June 14, 2006 by 9:00 a.m. by making six changes in 1600-2000 hospitals across the country. He said how to do this is to make lifechanging improvements by taking things we know work and making them our national standard. The old way was to use components; the new way to is to use composites or “bundles” to prevent avoidable deaths. The 6 changes are as follows:
1) Rapid Response Teams to decrease “failure to rescue.” In Australia it was discovered that by using Rapid Response Teams for a Code Red when it appeared that a patient was having difficulty, there was a 27% decline in mortality rates. 2) Reliable care of heart attacks. The idea is to bundle strategies together using all the things that can be done. 3) Ventilator bundle

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