Northfield Hospital Board Meeting: Oct. 2019


  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 September Board Meeting, Minutes of a Community Relations Committee Meeting, Minutes for a Quality Committee Meeting, Minutes for a Governance and Planning Committee Meeting, Revisions to the Disaster Privileging Policy, and the Annual Review of Contracted Services.



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


Strategic Discussion

Deferred to the closed session to follow.


Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) EHR—negotiations with Stanford Medical regarding EHRs continue and a variety of options are being investigated.  b) Buildings—parking space is being expanded.  A ribbon cutting ceremony was held to open the Faribault Clinic.  The perspective of the Patient Facing Technology project has been expanded to include EHR agnostic technology, given the delays being encountered with a new EHR system.  c) Social Determinants of Health—the search continues for cost effective strategies applicable for a facility the size of NH&C that would incorporate the facility’s strategic partners in the community.  NH&C wants to do something that “would move the needle” on the health of the community.  d) The Board of the hospital foundation discussed programs to promote contributions at its second meeting.   e) Operations—Oct was a “super crummy month” financially.   Patient volume was down, expenses were difficult to control, and the payer mix was unfavorable.  Several reasons for the declining patient volumes were suggested, but the issue remains open.  The fear is that months like Oct. will be “the new normal.”  The Express Care Clinic is “hitting its stride” with respect to volume, perhaps driven by the efforts of health care insurers to steer patients to low cost care.  f) The annual NH&C planning process will begin again in Dec. Board members gained a variety of insights into the current strategic environment at a recent Monova Conference that featured Walmart’s strategies to remake health care in the US. Walmart is exploring the provision of primary health care services in or at its stores.  A variety of integrated services might be available on site with no appointment required, low prices, and cash-only, no insurance accepted.  If successful, the program would continue the erosion of profitable services from traditional health care providers, such as hospitals.  Where does this trend end?
  2. Financial Report—Scott Edin. Inpatient services were significantly under budget for the month of Sept.  Net Operating Revenues were $677K under budget resulting in a Net Operating Loss of $411K for the month.  Thus far in 2019, cumulative Income from Operations is a loss of $433,000.  Net Income remains positive for the year due to over $3.9 million of Non-operating Income thus far.
  3. Quality Committee Report—Charlie Mandile. Mandile very briefly reviewed the quality benchmarks for Q3/2019 that included the hospital, the clinics, and the Accountable Care Organization (ACO). The benchmarks seem to show some gains and some slippage, but I found it difficult to interpret the benchmarks.  Sorry!  The ACO is currently trying to find predictors of potential high service users in their population.
  4. Governance and Planning Committee—Steve O’Neill. The Committee discussed the philosophy behind the CEO evaluation model currently in use by NH&C, and the use of data on compensation for CEOs in comparable markets and facilities. The issues of deferred compensation and retention were also discussed. No recommendations were forthcoming at this time.

A letter from the Board Chair to Mayor Pownell, urging reappointment of 3 Board members with expiring terms, was on the original agenda, but it was removed without explanation.


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

Next meeting:  Nov. 21, 2019

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