Northfield Hospital Board Meeting: October 2020

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

Opening

1. The Agenda and Consent Agenda were approved.  The Consent Agenda included Minutes from the September Board Meeting; Minutes from a Budget and Finance Committee Meeting; Minutes from a Quality Committee Meeting; and the Annual Review of Contracted Services.    

Reports

1. Hospital Chief of Staff Report—Tom Holt.  The hospital physicians are feeling the pressure of a busy season, and encountering some pushback when trying to transfer very sick patients to tertiary hospital settings.  The next 60 to 90 days could prove a challenge to the hospital staff if the Covid 19 cases keep rising.  On the positive side, the facility has a set of well vetted plans for dealing with Covid, and the supply line for PPE is much more robust now due to the emergence of domestic suppliers.    

Presentation/Discussion/Action Items

Home Care and Hospice Annual Quality Update—Tammy Hayes.  a) Long Term Care Facility: the facility underwent a variety of evaluations.  The LTC F received 5 of  5 stars in all but one category of the Nursing Home Compare Ratings.  The Quality of Life Survey for Oct 2019 ranked the facility in the 90th percentile in about half of the categories.  The Family Satisfaction Survey ranked the facility above the state average in all categories.  Infection rates and falls were up slightly in 2019 but still very good.  A recent health inspection revealed 3 deficiencies related to recent regulatory changes, but that is better than state and national averages.  b) Home Care: The Home Compare Star Ratings were below the state and national averages. The Patient Satisfaction Survey show satisfaction above the state and national averages.  The Quality of Care was about average.  There is a serious problem in hiring and retaining staff during the pandemic.  c) Hospice: Patient Satisfaction, and Grief Support rankings are above the national average, and Quality of Care is above the national average in a majority of categories.   Again, there is a problem with an unstable labor force.    

Executive and Committee Reports

1. CEO Report—Steve Underdahl.  a) Covid: the wave is moving in the wrong direction both locally and nationally.  NH&C has administered 5945 Covid tests and 3.72% of them have been positive.  Again, the unrelenting pressure on staff is a concern. b) LTC: New visitation rules go into effect in LTC facilities for persons designated as “essential care givers”.  c) Electronic Health Records: the project is moving forward more swiftly now.  A formal presentation will be coming to the Nov. Board Meeting. d) Foundation: the Foundation Board has been meeting to refine goals and processes.  e) Underdahl is reaching out to local employers to explore mutual interests, as suggested by the consultant at the Oct. Board Meeting.   f) Operations: the hospital is busier but the utilization is very uneven which creates staffing challenges. The new Birthing Center is open and receiving positive reviews.  There seem to be a stream of credible cyber security threats, but so far no serious breaches to the system.  

2. Financial Report—Scott Edin.  Service volume is increasing but the changes are very uneven.  Net Operating Revenue for Sept. was $253k under budget; the Net Operating Loss for Sept. was $43k, and there was an investment loss of $476k. No further CARES Act grants were received.  Net Income was negative for Sept.; a loss of $519k.  The cumulative Net Income for the first 3 quarters of 2020, including CARES grants is $5,802k.   The delay of committing to a new EHR system means that a major portion of the 2020 Capital Budget remains unspent. 

3. Committee Reports

a) Governance and Planning Committee—Steve O’Neill.  The CMS survey of the LTC facility found a problem, as reported above, in that staff were still using cloth masks instead of N95 masks.  The facility had been saving the N95 masks for hospital use.  The problem has been corrected.  The Administration feels that the litigation against the hospital reported in the local paper is without merit. 

b) Governance and Planning Committee—Steve O’Neill.  A new set of Board officers is needed for 2021.  Please share your ideas and information with the Committee.   

c) Quality Dashboard Report—Charlie Mandile.  The data is contained in the Board packet, online.  The Center for Medicare Studies (CMS) is shifting to quality based reimbursement.   There are now 700 lives participating in the Accountable Care Organization (ACO).  The trends for the group are improving.

Announcements

The annual Strategic Planning Retreat is being held tomorrow, Friday Oct, 30.  

Adjourned:  6:05 p.m. 

Next meeting:  Nov. 19, 2020.

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