Northfield Hospital Board Meeting, Aug. 2020

The August Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.

 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 July Board Meeting and Minutes for a Governance and Planning Committee Meeting.

 

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.

 

Strategic Discussion

State of the State—Dr. Rahul Koranne, CEO, MN Hospital Association.  Koranne began by describing his path from New Deli to MN, to leading the MHA.  He complimented NH&C on the quality of their website and on their innovative system for checking and reporting employee temperature readings each day.  Koranne also complimented Steve Underdahl for the quality of his work with the MHA.  Board Members introduced themselves to Koranne and posed questions they hoped he would answer during the session.  Koranne started with COVID, saying that health leaders in MN were in immediate discussion with state policy makers at the start of the pandemic and the State appropriated $200 million to deal with the crisis.  The decision to suspend elective surgeries in the state made medical facilities more available at the peak of the first wave, but left many patients in pain and uncertainty.   We probably don’t want to repeat this strategy.  Koranne predicted that waves of COVID will continue to sweep through the state’s population for a while.

The confusion over reporting of COVID may continue for a while.  Science needs good data if it is to make progress, and the important point in the data battle is to insure that the data remains good and is accessible, regardless of who is in charge and where it is stored.  Koranne said he didn’t know why Washington was trying to prescribe a different data collection practice in the midst of a pandemic.

Today’s successful health care providers are more than just hospitals; they are health care systems, such as NH&C.  The next few years are likely to be financially challenging to providers, and you must innovate to survive.  Medicaid is facing a massive funding shortfall in the near future.  Successful innovations will be ones that create standardized treatment across a wide range of payers, and where the payers share the financial gains from innovation with the providers.  This will require a major change in approach by payers and providers.  Providers need to be paid for creating health not just providing services to the sick. The industry needs to address the structural racism laid bare by COVID, and it needs to do it soon, before the moment passes.  The responses, by health care providers to COVID have launched a wave of innovations, such as telemedicine, and there are more to come.  The aged have needs that should be addressed.  NH&C must keep up the innovations through collaborations such as the Rural Transformation Council and leveraging its municipal ownership.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) Coronavirus review. Thus far there have been 2663 negative tests at NH&C, and 91 positive tests. b) Our customer facing technology continues to improve and become more user-friendly.  We hope to have e-scheduling operational next quarter.  c) Apple Health Records and/or Google are predicted to disrupt current electronic health records (EHR) technology.  We are rethinking our acquisition of new EHR services.  The Sanford Health avenue to an EPIC EHR system is off the table.  Our current EHR provider, Meditech, has made improvements that will meet our needs at a fraction of the cost of a new EHR system, and allow us to wait to see what comes from Apple or Google.  A formal proposal will come to the Board at a future meeting.  d) Work continues on the same-day scheduling of orthopedic services.  e) July service volumes were significantly higher than June, and the financial results reflect the improvement. The numbers for August are down a bit.   f) The building projects are on time and on budget.  The sales of the properties are moving forward.  g) We continue meeting with the Medicare For All group as they address inequalities in the health care system.  h) Our Accountable Care Organization (ACO) saved Medicare $3.5 million last year, but as Dr. Koranne noted, under current contracts, the savings all go to the payer.  Still, we need to participate to gain experience with ACOs.
  2. Financial Report—Scott Edin. July volumes were up in many areas with some being above budget. Inpatient days, outpatient visits, and emergency department visits were still below budget.  Net Operating Income was $118,000 over budget.  Two major items impacting the July financial results were non operating revenues: the addition of $2.87 million from the CARES act and $850,000 of portfolio gain.  No further CARES grants are expected in 2020.  Due to the $10.8 million in grants and $3 million of portfolio gains thus far in 2020 at NH&C, the cumulative Net Income for the year stands at $5.7 million.  While the number is very reassuring, Edin pointed out that in order to break even for the year, services would need to operate at 80% of the pre-COVID budget for the remainder of the year.  Edin’s forecast was for a “break even” year. The government accounting office, (GASB), is asking for a change in how hospitals in MN account for grants.  NH&C plans to wait for clarification.
  3. Community Relations Committee Report—CC Linstroth.Linstroth reported on a project to increase access to community health information and a project by Age Friendly Northfield to create a tutorial/checklist that older people could use when preparing for a telemedicine visit.  Dr. Koranne requested a copy.

 

Adjourned:  7:10 p.m.

Next meeting:  Sept.  24, 2020.

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