Northfield Hospital Board Meeting: July 2020

The July 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.

 Opening

  1. 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 June Board Meeting, Minutes for a Quality Committee Meeting, Minutes for a Budget Committee Meeting, the Annual Review of Government Data Practices Act Policy, plus revisions to the Clinical Privileges Forms.

 

Reports

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

 

Presentations/Discussions/Action Items

  1. Annual Compliance Update—Teresa Knoedler, JD Freidmann Firm. NH&C retained outside counsel earlier in the year. Knoedler reviewed the regulations, Compliance Plan, Policies, and Code of Conduct.   Scott Edin, CFO, has been appointed Compliance Officer for NH&C.  The COVID crisis has resulted in a relaxation of reporting requirements and some regulations.  No problems were cited in the report.
  2. Sale of Faribault Property—Jerry Ehn, NH&C acquired commercial property in Faribault, some time ago, for clinic space at a cost of $170,000..  The space proved to be inadequate and a larger building was purchased to house a primary care and orthopedic care clinics.  NH&C has received a bid of $185,000 for the property and the Board voted to accept the purchase agreement.  The agreement is being reviewed and will be sent to the Northfield City Council for final approval.
  3. Medicare for All Discussion—Steve Underdahl.  A local chapter of Medicare for All has met with hospital administrators to seek support for the plan.  The administration expressed support for the goals of the group, but was hesitant to publicly support the MFA proposal.  The plan would require a massive reengineering of the health care sector at a time when the sector is under stress from the Corona virus.  Also, if NH&C had been paid Medicare rates for all of their services in FY 2019, it would have reduced Gross Revenue by $50 million.

 

Strategic Discussion

New Planning Cycle—Steve Underdahl.  The 2020 planning cycle is being restarted.  Underdahl reviewed the historical and current challenges facing NH&C.  Current challenges include the movement toward patient centered care, cost shifting, the reliance on inpatient care to subsidize other care, and the rise of giant health care organizations, such as United Health, which perceive themselves as “health care” and providers such as NH&C as “the shop.”  Rural health care is changing and Gov. Walz is promoting a plan “Aging on the Farm”.  Board meetings from now until the Planning Retreat in Oct. will spend time on exploring the state of health care in the US.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) Coronavirus review. Thus far there have been 791 Covid cases in Faribault and 132 in Northfield. Most cases have occurred in persons living in a private residence (68.5%),  22% of the cases have been in the prison, and less than 1% have been in long term care facilities.  Testing is still limited to persons who meet medical criteria, e.g. symptomatic, exposed, scheduled for surgery, etc. rather than  “just worried”.  b) Hyperbolic Chamber.  Contract negotiations are continuing.  NH&C has secured geographic exclusivity with the company.  c) The Birth Center is on time and on budget.  This isn’t news, but the CEO said he rarely gets a chance to report these conditions for a building project.  d) Supply Chain.  Significant progress has been made. Two-Bin Implementation was completed in all departments and 19 of the departments are fully automated.  e) A new “rolling” budgeting process is underway. f) A sale is pending on the property owned by NH&C in New Market MN.  g) The administrative salary reduction program, implemented a few months ago, was ended 7/18/20.  h) NH&C has received more CARES Act funding.  The money just shows up and the staff is trying to stay current on the regulations and COVID policy.  Steve O’Neill reported that St. Olaf College will be resuming in-person classes on Aug. 20.  Everyone will be tested for COVID upon arrival and then 15 days later.
  2. Financial Report—Scott Edin. (My Comment: the disruption of typical service patterns, the receipt of CARES Act grants, and significant Non Operating Income events makes it difficult to put current financial conditions in perspective.) Hospice and Home Health services were above budget for June, but most other services were still below budget. Net Operating Income was negative for June: -$102,000. Net Income was positive, +$548k, due to a significant non-operating income gain.
  3. Quality Dashboard Report—Steve O’Neill.The patient experience ratings were high: 87% of respondents rated their experience a 9 or 10 out of 10. CMS (The Center for Medicare Studies) will likely impose a small penalty for excess hospital readmissions, but will reward the facility under the Value-Based Purchasing program.

 

Adjourned:  6:50 p.m.

Next meeting:  Aug. 27, 2020.

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