Northfield Hospital Board Report Nov. 2017

Opening

Chair, Charlie Mandile, called the meeting to order at 6:30 p.m. The Agenda was approved.

The Consent Agenda was approved. The Consent Agenda included Minutes for the October Board Meeting; Minutes for a Governance and Planning Committee meeting; Revision to the Emergency Medicine Privilege Request Form; Medical Staff Polices; and Compliance Policies.

Reports

1. Hospital Chief of Staff. The applications for Medical Staff Membership/Privileges were approved.
2. Chief Medical Officer—Jeff Meland. Recruiting medical providers is becoming increasingly difficult, but providers appear to be interested in working with NH&C.
3. NH&C Report—Ben Flannery. The remodeling and expansion of the Northfield facility is underway. NH&C has hired a neo-natal/pediatric practitioner who is upgrading the care provided in the system.
4. Allina Medical Clinic Report—Keith Olson. The clinic is adding a physician assistant in March. Allina is working with ICSI on the opioid crisis and is willing to share the results. Allina is also working on reducing readmissions at District One Hospital and would share the results.

 Presentations/Discussions/Action Items

1. Hospice Quality—Tammy Hayes. The problems that led to lower satisfaction and quality ratings in the hospice program for 2016 have been resolved. Patient satisfaction is over 90% on 2017 surveys and the HIS quality-of-care measures were 100% achieved in 2017. CEO Underdahl praised Tammy Hayes’ work on this project.
2. Nurse Call/Code Blue System—Tammy Hayes. The internal communication system/nurse call system/Code Blue System is at the end of its useful life. The proposal is to replace the current system with the Responder 5 system at a cost of $515,035. The Responder 5 system offers many more communication options for both patients and staff and will reduce the noise level in patient rooms. The Responder 5 system is already deployed in the recently remodeled sections of the hospital. Given the need to connect to the Responder 5 system already in place, this is a no-bid purchase.   The Board will vote at the Dec. meeting.
3. Foundation Board Nominations—Charlie Mandile. Charlie asked for 3 Hospital Board members to serve on the Board of the new hospital foundation. The new Board’s task in 2018 will be to organize and establish procedures for the foundation. Four additional foundation Board members, including 2 community members, will be added in 2019. It is likely that the hospital will provide $5,000-$10,000 of initial funding to launch the foundation and establish financial ties.
4. December Board Retreat—Charlie Mandile. The Board has hired Heather Durenburger to facilitate the retreat and she has talked individually with all Board members. An agenda for the retreat was shared along with a reading for the retreat, “Three Phases of a Board’s Evolution.” In response to a question, Charlie stated his hope that a document describing board procedures and expectations would emerge from the Retreat. Any such document would require periodic/annual updates.
5. EHR (Electronic Health Records) Update—Steve Underdahl. NH&C is exploring the potential for partnering with Olmstead Medical Center (OMC) in Rochester to share an EPIC electronic medical records system. This would be an expensive project, perhaps $20 million over 10 years for NH&C, but it would allow NH&C to be with the same software vendor as the Mayo and Allina systems. Northfield and OMC would run the standard/non-customized system, unlike Mayo and Allina, but the standard system can be continuously upgraded, a plus. Work is going forward on three fronts: establishing a financial model for the arrangement, drafting contractual/legal documents, and exploring EPIC compatibility with the operation of NH&C. Teams from NH&C are currently working with OMC and EPIC personnel to determine compatibility. A decision on the OMC/EPIC option is expected early in 2018.

Executive and Committee Reports

1. CEO Report—Steve Underdahl. a) The City Council and the Hospital Board held a joint work session on Tuesday evening 11/28/17 to discuss the proposed Senior Services project. Steve reported NH&C is working to support the City staff as they consider the project. b) NH&C has contracted with a firm to help with “enterprise risk management,” i.e., how can we best deal with the multitude of threats in our environment? The contract will provide software and consulting time. c) NH&C’s participation in an ACO (Accountable Care Organization) will go live in January. The purpose of participation is to gain experience with what many perceive as the evolving Medicare payment system featuring financial rewards and penalties depending on how the hospital delivers care. There are no financial penalties in the system for 2018. d) Strategic partnerships with HCMC and OMC are being explored. e) The Medicare Low-Volume Program that ended in October will reduce NH&C revenues by $300,000 in 2017 and by $1 million in 2018. f) The self-funded employee health insurance program operated by NH&C will not run a surplus in 2017. It was commented that recent studies show that individuals with high- deducible health insurance coverage behave similar to persons who are uninsured. The uninsured avoid using the health care system until they turn up in the emergency room. g) A cultural sea change is underway, and NH&C is reviewing policies and procedures with respect to sexual harassment.
2. Financial Report—Scott Edin. October was busy but the proportion of payments by Medicare and Medicaid was higher than budgeted, so the discount was higher than budgeted. The Net Operating Income was positive but almost $300,000 under budget.
3. Community Relations Committee—Steve O’Neill. The committee received community requests for donations totaling $125,000. The budget is $70,000. The committee will bring a list of awards to the Dec. meeting. Should the budgeted amount be increased for 2018?

Roundtable

The Budget and Finance Committee received and reviewed proposals from 10 investment firms. The Committee will interview 3 – 4 firms and will recommend an investment adviser at the December Board meeting. Recent changes in state law now allow NH&C to invest in a wider variety of financial instruments.

Meeting adjourned at 8:25 p.m.

Next meeting: December 21, 2017