Northfield Hospital Board Meeting: April 2020

The April Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.  Not all Board members were simultaneously visible on line, so some procedures needed adjusting.  The agenda was deliberately kept short.

Opening

  1. Steve O’Neill called the meeting to order at 5:00 p.m. The Agenda and Consent Agenda were approved. The items included in the Consent Agenda did not appear on my screen.

Reports

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

Presentations/Discussions/Action Items

  1. 2019 Audit Report—Rob Schile, Clifton, Larson, Allen (CLA).Rob Schile had previously met with the Finance Committee for a detailed presentation of the Report, so the Board received a condensed report.  a) Overview and Outcome: There were no problems, no adjustments, and the facility received a clean opinion.  b) Internal Controls: a couple of issues were noted.  The issues have been discussed with the appropriate management and changes are underway.  c) Information Technology: Issues have been discussed with appropriate management and changes are underway. d) Accts. Receivable: CLA recommended that the facility implement “point of service” collections for deductions and copays given the growth of high-deductible health insurance plans and increasing problems with collections.   e) Misc. : There are new accounting and reporting requirements for the Northfield Hospital Foundation in 2020.  The facility needs to update the procedures for the access and use of purchasing cards as the number of cards in use has significantly expanded.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) Coronavirus. The emergency response activities are ongoing as there is a sustained “state of emergency”.  An emergency response control center has been created and a temporary respiratory clinic has been established in the garage.  Extra precautions are being taken in the Long Term Care Center and no visitors are allowed.  No elective surgery is being performed.  It has been challenging to follow the guidelines, as they sometimes change daily.  b) Community: The community response has been great.  The Northfield Public Schools utilized their 3-D printer to make 300 PPE masks. Carleton College donated N95 masks. Community mask makers have sewn 6000   “Lynette” masks out of surgical cloth.  St. Olaf College has offered temporary space for an alternative site. Maintenance staff has been busy building temporary barriers to protect patients and staff.  c) Financial. The expense control measures are working but NH&C is still losing about $1 million/week.  About 200 individual employees/100 FTEs have been furloughed, and administrator pay has been cut 10%.  NH&C is providing health insurance to the furloughed individuals and hopes to bring all these people back to work.  The facility has received two Federal grants, totaling about $2 million.  d) Future:  The future of health care looks different, and two groups have been organized to work on it.  One group is working on how best to reopen the services that closed.  Many time sensitive services for patients, that were postponed, are becoming critical.  More testing is necessary but there are problems.  The hospital can’t get the necessary reagents to operate their own testing program, but fortunately, the Mayo Clinic is assisting.  The hospital has adequate PPE for now, but once surgery restarts, the stock will dwindle quickly.  The second group is looking at the pandemic induced changes to the health care system.  What will the new normal look like?  NH&C has started digital visits, and the service has been well received by patients.  A proposal to provide bariatric oxygen treatment for wound care will come to the Board soon.  The implications of long-term social distancing are being considered.
  2. Financial Report—Scott Edin. The first quarter was off to a strong financial start before the bottom fell out. Gross revenue has fallen by $3.3 million, while expenses remain relatively constant.  Scott is projecting an operating loss of $12 million for 2020.  In addition, the stock market decline created a non-operating loss of $1.9 million on the hospital portfolio in March.  It is hoped that 50% of the services lost due to the shut down can be recaptured, but it is estimated that services will be down by 10% for several months.  Cash-On-Hand has declined to 236 days, but the facility is relatively well positioned to ride out the crisis.   Conversations with the holders of the hospital bonds indicate that they understand the situation and are not worried at this time.  The hospital has the financial strength and ability to survive this crisis.

 

Meeting adjourned at 6:45 pm.

Next meeting:  May 28, 2020.

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