Northfield Hospital Board Meeting: April 2019

Opening

1. Steve O’Neill called the meeting to order at 6:30 p.m. The Agenda was approved.

The Consent Agenda was passed.   The Agenda included Minutes for the following meetings: March Board Meeting, Budget and Finance Committee, and Quality Committee. Also included were a revision to the Governance & Planning Job Description, and Medical Staff Credentialing Form Revisions.

Reports

1. Hospital Chief of Staff—Dr. Tom Holt. Holt presented the applications for Medical Staff Membership/Privileges. Applications approved.
2. CMO Report—Dr. Jeff Meland. No report.

Strategic Discussion

Board Planning Retreat Preparation—Steve Underdahl.  NH&C is at year 3 of a 3-year strategic plan.  The primary areas of focus for the retreat are: Surviving and Thriving; Social Determinants of Health, & Customer-facing Technologies. Underdahl offered Board members a series of questions to start the discussions on Friday, May3.

Presentations/Discussion/Action Items

1. Guidelines for One vs. Two-Look Purchase Approval Process—Steve Underdahl & Scottt Edin. The Guidelines were in response to a request from the Board. Purchase of items that were included in one of the annual budgets and are well understood by Board members may be approved on first presentation.  The Board will vote on items not included in a budget or related to new programs or processes after the second presentation.  Time-dependent items may be voted on at the first presentation if advantageous.
2. Faribault Lease—Jerry Ehn. The building in Faribault currently housing ENT and orthopedic services is too small.Three alternative locations in Faribault were evaluated.  One site offered multiple advantages; lower lease rate, lower remodeling costs, and room for growth.  The cost to remodel, furnish, and install imaging-equipment on the site is estimated to be $300,000.  The Board approved the lease and the funding to prepare the site.  The project will go to the Northfield City Council for approval. It is anticipated that the site will be occupied in Sept. 2019.
3. Imaging Equipment Replacement—Lisa Lang. The imaging equipment in the Northfield Orthopedic Clinic needs to be upgraded to “direct digital radiography” which will reduce radiation, improve quality, improve the patient experience, and eliminate the Medicare reimbursement penalty.Similar equipment is needed for the new orthopedic office in Faribault.  The cost for the imaging equipment and associated renovations at the Northfield Clinic was in the budget and is not to exceed $220,000.  The equipment cost for the new Faribault clinic is $110,000, and was included in the item above.  A motion to purchase the new equipment was passed based on the one-look purchasing approval process described above.
4. Anesthesia Machines Replacement—Dean Anderson. The 5 current anesthesia machines in the Northfield Hospital are 15 years old and need to be replaced.  For safety, all of the anesthesia machines in the hospital need to be identical, so all machines are being replaced at one time.  Projected cost is not to exceed $420,000. That amount is less than the amount budgeted, and includes one week of on-site training with the new machines. Again, a motion to purchase the equipment was passed under the new one-look purchasing policy.

Executive and Committee Reports

1. CEO Report—Steve Underdahl. a) Strategic—Winona Health is implementing a Patient Facing Technology system labeled “Smart Exam” that will provide an on-line diagnosis and treatment plan.The median patient input time is less than 18 minutes, and the median provider time is less than 4 minutes per patient.  The cost is $39 per visit.  Discussions continue with Stanford Medical regarding the electronic health records software.  Recent visits to Sanford-served sites by NH&C staff were favorable.  Work continues on the clinic and OB expansion projects.  b) Operations—March patient volumes were “crummy” due to weather and provider vacations. The expense-rebasing project is behind schedule, due in part to the difficulty of finding items or procedures to cut.  c) Policy—the Medicare for All movement appears to be gaining traction in spite of the fact that no one knows exactly what the term means.  It may be a plank in the Democratic Party Platform in 2020. Health care providers across MN are united in lobbying for extension of the Provider Tax since it helps fund a crucial part of the health care safety net.
2. Financial Report—Scott Edin. Inpatient days were 34% under budget and Operating Income was a negative $143,000, that was $642,000 under budget for the month and half a million dollars below budget for the quarter. First quarter financial results have been better in recent years.
3. Budget and Finance Committee Report. Committee didn’t meet.
4. Governance and Planning Committee Report.The CEO evaluation process is continuing and the results will be brought to the Board at the May Board meeting.

Roundtable

There will be a Women’s Health Fair on May 9^thshowcasing the services available at NH&C.

Meeting adjourned at 8:33 p.m.

Next meeting:  May 30, 2019