Northfield Hospital Board Report: June 2019


  1. Fred Rogers called the meeting to order at 6:35 p.m. The Agenda was approved.

The Consent Agenda was passed.   The Agenda included Minutes for the May Board Meeting, Minutes of a Governance And Planning Committee Meeting, Minutes of a Community Relations Committee Meeting, and a statement of Government Data Practices Act Policy.



  1. Hospital Chief of Staff—Dr. Tom Holt. No report. Holt presented the applications for Medical Staff Membership/Privileges.  Applications approved.
  2. CMO Report—Dr. Jeff Meland. Meland reported on the results of a Physician Burnout Survey. The problem is increasing, especially among female physicians. About 48% of the survey respondents cited symptoms of burnout. This is higher then the average for MN, but lower than the average for the US.  Electronic health records (EHRs) were cited as a contributing factor, especially for older physicians.


Strategic Discussion

Deferred to the closed session to follow.


Presentations/Discussion/Action Items

  1. Nominations to the Hospital Foundation Board. Four persons were nominated to be board members of the recently formed foundation; Todd Amunrod, D.O., Alex Beeby, Lynn Clayton, and CC Linstroth.The Board approved the nominations.
  2. Birth Center and Clinic Building Projects—Jerry Ehn.The Clinic expansion will add 12 new exam rooms and move the lab to a more accessible space.  The Birth Center will add 4 delivery rooms, 3 post-partum rooms, a dedicated c-section room, and a triage room.  The cost estimates and final design are underway.  If Board and City Council approval are completed in July, construction could start in Sept.


Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) Strategic—A response from Stanford Medical regarding the EHR is expected soon.  b) Operations—the recent audit of the long-term care center (LTC Center) was very positive. The project to study hospital charges continues.  Over $15,000 in missed charges occurred in one week in one department.   Much of the problem stems from the fact that many services are “bundled” together for payment while other services are billed separately.  Service volumes continue below budget and highly variable, which presents staffing challenges.  A potential buyer has emerged for the property in Elko MN.  The sale would require City Council approval.
  2. Financial Report—Scott Edin. May was another slow month. Net Operating Income was $201K, but Net Income was negative $217K.  Again the results were bolstered by a patient shift from government (Medicare, Medicaid) to private health insurance payers.
  3. Annual Report on MN Attorney General’s Agreement on Hospitals and Debt Collections—Scott Edin. The agreement covers debt collection, charity care, and pricing of services to uninsured patients. The Hospital Board is required to annually review the agreement and monitor compliance, including the activities of any debt collection agencies used by the hospital. Charity care totaled almost $72,000 for 2018.  Wages from 46 patients were garnished for debts, realizing about $100,000. Revenue recapture (seizing of tax refunds) raised another $780K.  The audit revealed no violations of the AG’s agreement.   The rise of religious-based “cooperatives” to pay health care costs is raising new payment issues.
  4. Quality Committee Report—Charlie Mandile. A recent review of the dashboard indicators show that the quality of care has improved. A more detailed report will be presented at the July meeting.  The Committee is monitoring the use of community-based paramedics to do home visits following surgery.  The hope is that the program will reduce readmissions of Medicare patients.



A Board member suggested that NH&C explore ways in which the hospital might partner with 50 North, the senior center in Northfield, to provide more services to their 2000 members.

The Meeting adjourned at 8:02 p.m. and the Board went into closed session to discuss Strategic Planning.

Next meeting:  July 25, 2019

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