Northfield Hospital Board Report: Feb 2019


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

The Consent Agenda was passed; it included Minutes for the January Board Meeting.

Board Officers for 2019 were nominated and elected.

Chair: Steve O’Neill

Vice Chair: Fred Rogers

Recording Secretary: Bobbi Jenkins

The meeting was then turned over to Steve O’Neill, the new Chair.  CEO Steve Underdahl thanked Charlie Mandile for his service as Board Chair.  Sarah Carlson was welcomed as a new Board member. Committee assignments for 2019 were announced.



  1. Hospital Chief of Staff—Dr. Tom Holt. The medical staff is investigating the possibility of joining a physician-teaching program, noting that physicians who train at NH&C are more likely to return and practice in the community.
  2. Chief Medical Officer—Dr. Jeff Meland. The Medical Staff has granted voting privileges to the CMO. A new surgeon has joined the medical staff.


Strategic Discussion

  1. Environmental Scanning Part 1. Matt Anderson, Senior VP, MHA. Anderson presented an overview of the US. health care sector and how it may impact NH&C in the future.  The overview is in preparation for a strategic retreat later in the year, and was mostly negative.  There are many challenges on the horizon.  The percentage of people with employer-provided health insurance is declining while public coverage is rising.  Payments to providers from public coverage are at or below cost. Consolidation among insurers gives them increased bargaining power when negotiating with providers to set payments. Independent surgical centers compete with hospitals for services that are likely to provide a profit margin. Medicare reimbursement is increasingly requiring providers to share the financial risks via bundled payments and accountable care organizations (ACOs).   The movement for “price transparency” has started and will become more focused.
  2. Enterprise Risk Management Update. Laura Peterson. Peterson reviewed the progress made thus far at NH&C, and set out a timeline for the next series of tasks to spread ERM throughout the organization.


Presentations/Discussion/Action Items

Ambulance Replacement–First Look.  Jerry Ehn. Ehn presented the case for replacement of Ambulance 315; one of 5 in the fleet.  No. 315 has 240,000 miles on it. Industry data suggests that 175,000 miles is a typical end-of-life for an ambulance.  The proposal is to purchase a Crestline Icon Type 3 on a Freightliner Chassis at a cost of $230,000.  New ambulances are safer and less expensive to operate.  There is a 6-month lag between order and delivery.  No. 315 will be kept as a backup once the new ambulance arrives. The Board will vote on the proposal at the March meeting.


Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) The orthopedic practice in Faribault is being reorganized to promote team medicine. b) The proposal for expanding the clinic and the OB suite was presented to the City Council. c) A contract for electronic health records was received from Sanford Medical and is being reviewed.  d) The exploration of patient-facing-technology continues with investigation of eVisit and Smart Exam.  New hospitals were added to the accountable care organization to which NH&C is affiliated.  e) Work continues on the new Senior Living Facility, and the building will soon be closed to the weather.  f) A pamphlet listing the services provided at NH&C has been prepared: Do We Do That Here?  The pamphlet is available from the hospital.  g) Underdahl thanked the employees for their efforts to get to work in spite of the winter storms so that the hospital could remain fully staffed at all times.  h) The new price transparency requirements are proving very complicated and frustrating to consumers.  i) Underdahl will serve on the Policy Advisory Committee for the MHA, hoping to provide more input from rural hospitals in MN.
  2. Financial Report—Scott Edin. January was a month when a Net Operating Loss was good news: the loss of $42k was only 20% of the budgeted loss. January is typically a slow month since insurance deductibles and copays start over in January. The improvement was largely due to a decline in payments from public programs (Medicare, Medicaid) and an increase in payments from commercial insurers (BCBS)
  3. Board Quality Dashboard Report—Charlie Mandile.The Patient Family Advisory Committee is up and running.  The Community Paramedics program has been well received.  Hospital ratings can be found on the www at   .
  4. Community Relations Committee—CC Linstroth.The Committee has been working on recommendations for the $75,000 in community grant funds.  Requests totaled $104,000.
  5. Governance and Planning Committee—Charlie Mandile.The Committee plans to again use a consultant when reviewing the CEO’s annual performance and compensation.
  6. Budget and Finance Committee—Scott Edin. There will be no “gain sharing”/(All Employee Bonus) for employees based on 2018 financial results, since the margin on Net Revenue was less than 3% in 2018.  Funding for the Management Incentive Plan will be reduced by 30% due to the financial results.  MIP payments are based on attainment of organizational and personal goals by senior management.  A motion to accept the bonus recommendations from the Budget and Finance Committee was passed.  b) A motion to raise the threshold for public bidding on NH&C projects from $150,000 to $175,000, consistent with MN Statutes, was passed.



Special Report

City of Northfield Orientation and Strategic Plan/Work Plan—Mayor Rhonda Pownell & Ben Martig.  Pownell and Martig presented a municipal perspective on factors that influence the Board’s ability to make consistent, reasoned decisions that support the city’s strategic vision.  The presentation covered a wide variety of topics including the City Charter, City Codes, Key Documents, Guiding Documents, City/Hospital Governance Committee, the Comprehensive Plan, Advisory Committee, etc.


Meeting adjourned at 9:20 p.m.


Next meeting:  Mar. 21, 2019.


Closed Session

The Board went into a closed session immediately following the open meeting.

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