The June 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
- Steve O’Neill called the meeting to order at 5:00 p.m. The Agenda and Consent Agenda were approved. The Consent Agenda included Minutes for the May Board Meeting and a meeting of the Community Relations Committee, plus revisions to the Medical Staff Privilege Forms and the Medical Staff Manual.
Reports
- Hospital Chief of Staff—Dr. Tom Holt. No business came from the Medical Staff, but Holt reported that the staff was developing procedures for water births. Dr. Holt presented the applications for Medical Staff Membership/Privileges. Applications approved.
Presentations/Discussions/Action Items
- New Planning Cycle—Steve Underdahl. The 2020 planning cycle was disrupted by the Covid outbreak. Planning activities will begin again in August with a final plan done in Dec. Underdahl argued that this was an opportune time to coordinate the planning cycle with the budget cycle, which runs on the calendar year. The Board seemed supportive of the change.
- Hyperbaric Oxygen Wound Program Business Plan—Scott Edin.This was the second presentation for the new service line. Edin reviewed the material from the May meeting that forecast about 300 new patients each year; gross profits rising from $96k the first year to $539k in the fourth year; and construction costs of $700k. The proposal was to hire a specialty firm, Healogics, to provide the service, training, support, and electronic record keeping. The plan is to have the service available in Feb. 2021. Experience at other sites suggests that 60% of the patients served will be local and that the Covid pandemic would not significantly affect patient volume. It was suggested that the program director would need to reach out to physicians in the service area.
Executive and Committee Reports
- CEO Report—Steve Underdahl. a) Coronavirus. The Express Care and Urgent Care Clinics are the only NH&C facilities still closed. The concern is that these facilities would serve as unplanned portals for Covid to enter the care system. In-person visits to NH&C facilities have increased dramatically. Virtual visits have dropped to about 50% of their peak. Surgical volumes have returned to 70 – 80% of normal. The Covid trend is favorable in MN and people are urged to be logical and vigilant. b) Long term Care. Visiting guidelines are being updated. In the interim, families are being very creative on ways to connect with their loved ones. c) Racial justice. About 1/3 of the Covid cases in Rice County are Hispanic, and 1/3 are African American/black. The City is working on a Race Equality Action Plan that will be widely shared in an attempt to reduce the significant racial health disparities statewide. The Plan will be incorporated into the NH&C planning cycle. NH&C is participating with the MN Hospital Association in a program to promote diversity in the workplace. d) Building projects. The projects are on time and on budget. Work continues to refine Covid screening processes to be faster and more accurate. The IT department has been in the forefront of this process. e) Staffing. The furloughs, salary reductions, and incentive compensation programs implemented a few months ago will be re-evaluated in July. f) Finance. The remaining $6.4 million of grants was added to operating revenue in May, so the NH&C’s financial picture currently looks much better than it really is.
- Financial Report—Scott Edin. A few services were busy, but most services were 25% to 74% below budgeted levels. Operating income for April was $4.1 million due to the incorporation of the $6.4 million in grants. Non-operating income (portfolio gains) was positive $$785k, resulting in a Net Income of $4.9 million.
- Annual Report on Attorney General’s Agreement—Scott Edin. The MN Attorney General’s Office has an agreement with hospitals in the state regarding billing and collection practices. The Agreement mandates a self-pay discount and a written policy on Charity Care. Charity care is available for patients with incomes up to 2 times the poverty level guideline. The Board must review their practices annually and certify compliance. The Board certified that NH&C and their collection partners were in compliance. Edin noted that as a municipal hospital NH&C is eligible for the state Revenue Recapture program that seizes individual state tax refunds to pay delinquent hospital bills. NH&C recaptured $876k in 2019. Edin noted that recapture generates complaints from persons who had other uses planned for their tax refund.
- Reimbursement Resolution—Fred Rogers.The Budget and Finance Committee brought a resolution that would allow NH&C to issue bonds to pay for some expenses, such as construction projects, after the fact, if the need arose.
Meeting adjourned at 7:00 pm.
Next meeting: July 30, 2020.
