Northfield Hospital Board Report: August 2019

Opening

1. Steve O’Neill called the meeting to order at 6:30 p.m. The Agenda and Consent Agenda were approved. The Consent Agenda included Minutes for the July Board Meeting, Minutes of a Governance And Planning Committee Meeting, Minutes of a Budget and Finance Committee Meeting, and a revision of the Medical Staff Bylaws.

Reports

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

Strategic Discussion

Deferred to the closed session to follow.

Presentations/Discussion/Action Items

1. Home Care and Hospice Annual Quality Update—Tammy Hayes.Hayes presented 7 measures of patient satisfaction for the home care services provided through NH&C.  Five of the measures were above the national average and four of the five were at 100 percent. Two of the measures were below the national average: “talk about medications”and “talk about pain”. There were 8 measures of patient satisfaction for hospice care, based on patient family satisfaction.  The measures for NH&C were all about at the national average, with some being slightly above and some being slightly below.

Executive and Committee Reports

1. CEO Report—Steve Underdahl. a) Strategic—negotiations with Stanford Medical regarding EHRs continue, now focusing on nuts and bolts issues such as supply chain purchasing. NH&C is in a “creative tension”phase for patient facing technology.  b) Building—bids have been received on construction of the Clinic addition and Birth Center expansion.  The bids were close to target and construction is scheduled to start in Sept.  A groundbreaking ceremony will be held on Sept. 12, at 12:30 p.m.  Construction will start next week on remodeling the Faribault Clinic.   c) Operations—Version 5.1 of the proposed revision to the PERA law is circulating.  The Board for the Northfield Hospital Foundation held its first meeting.  The paperwork for the IRS has been completed.                                                                                                                                                                                                                                           There will be a “changing station”is the Urgent Care Center during Defeat of Jesse James Days in Northfield.  This worked well last year, bringing many new people in contact with the NH&C.

2. Financial Report—Scott Edin. July was a good month. Net Income was $572K, over $500K above budget for the month.  The results were bolstered by a patient shift from government (Medicare, Medicaid) to more generous private health insurance payers, and careful management of staffing and expenses.  An extensive discussion of the downward trend in patient numbers followed. Dr. Meland commented that the patient mix in the ER has changed in recent years.  The proportion of very sick persons has increased while the proportion of patients needing local services has declined. The very sick are typically transferred to tertiary hospitals in the region ASAP and don’t receive local care.  There was speculation that a) high deductible insurance plans and b) plan “shaming”keep people from utilizing the ER, or c) skipping the local ER and going immediately to a tertiary medical center. The high deductible plans may discourage people from receiving medical care until they are very sick and can’t delay any longer.  The point was made that NH&C had 24/7 staffing by specialists in the ER, something uncommon in hospitals of their size.  Does the community realize the services that are available?

A question was raised concerning recent efforts by Minnesota Blue Cross/Blue Shield to channel patients to certain facilities for endoscopic procedures (not NH&C). The process chosen by BC/BS appears to put the onus on the providers to inform the patients of the restrictions, rather than on BC/BS.  Several voices expressed dissatisfaction with the process and intent of the BC/BS plan. An opinion was expressed that other insurers were likely to follow BC/BS, but it was hoped that they would do it in a more thoughtful manner.

3. Community Relations Committee Report—CC Linstroth.The Committee met with members of the Northfield Rescue Squad to learn about their project to purchase a new rescue vehicle.  The Committee will bring a report and possibly a request to the next Board meeting.

The regular Meeting adjourned and the Board went into closed session to discuss Strategic Planning.

Next meeting:  Sept. 26, 2019