Northfield Hospital Board Meeting: December 2020

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


1. The Agenda was modified to include a closed session. Then the Consent Agenda was approved.  The Consent Agenda included Minutes from the November Board Meeting,  Minutes from a Governance and Planning Committee Meeting, Minutes from two Community Relations Committee Meetings, Ratification of Medical Staff Officers, and Revision of Complaint & Grievance Process Policy. 


1. Hospital Chief of Staff Report—Tom Holt.  Holt commended the staff and institution for pulling together and pulling through during a tough year.  This was Holt’s last meeting as Hospital Chief of Staff.  The Board thanked Dr. Holt for his service and made a virtual presentation of a plaque.

2. Budget and Finance Committee Report—Fred Rogers.  The Committee had met to discuss the two budgets to be presented later in this meeting, and approved both.  

Presentation/Discussion/Action Items

1.  Approval of Operating and Capital Budgets—Scott Edin.  Edin urged the Board to put 2020 behind them and refer back to 2019 as they thought about the budgets for 2021.  The rollout of the vaccines will take a while, but the hope is that hospital operations will be back to “normal” by the start of Q3.  Patient loads for most departments were projected to increase modestly in the 2021 Operating Budget.  The exception was outpatient surgery that was projected to increase by 68%, due to changes in Medicare and Medicaid regulations.  Several orthopedic surgical procedures that had been paid as inpatient procedures will switch to outpatient procedures.  The budget proposed a 3% merit increase for staff at NH&C and a 3% increase in charges for hospital and clinic services.  The proposed increases could change if medical inflation were to increase.  The Operating Budget for 2021 is a “rolling budget” that will be revised each quarter to reflect the latest financial information.   

A Capital Budget of $4.8 million was proposed: $1.3 million for Strategic objectives and $3.5 million for Operations.    

2.  Electronic Health Records (EHR)—Vern Lougheed.  Lougheed’s presentation followed his extensive presentation on electronic health records (EHRs) at the November Board meeting. Lougheed recommended that NH&C consider the Expanse Maas Electronic Health Records system from Meditech.  This would be a monthly subscription service hosted by the Google Data Center and features advanced technology.  There is a one-time capital cost of $1.3 million and a annual cost of $1.9 million for the system. The 5-year cost of the new system is projected to be $11.6 million.  The new system does not require  a long-term contract: Google Data Center provides most of the system cyber security: and it is relatively easy to add outside software to the package.  The proposed timeline would be to start system implementation in April 2021 and go live in January of 2022.  

The Board voted to pass the recommendation, and thanked Vern and his staff for literally years of work on this project.    

Executive and Committee Reports

1. CEO Report—Steve Underdahl.  a) COVID: The 7-day moving average infection rate for hospital administered tests has declined to 5.25%.   On a given day, 25 to 50% of patients are in for COVID related problems and 3 to 6% of the staff are out do to COVID.  Covering the staff outages has proven to be expensive.  The U of MN has loaned NH&C an ultra-cold freezer to store the Pfizer vaccine and staff vaccinations are expected to start next week. Vaccinating will be staggered in each department so that an entire department would not be absent due to a vaccine problem.  b) Operations: the Wound Healing project is on schedule.  The ecare team is working on how to deliver asynchronous visits.  c) Staffing: In place of an in-house event to honor the staff, employees were treated to a “pizza at your house” event where the hospital picked up the cost, and sent each employee a thank you note from the Hospital Board.  d) Strategic: This is the final year of the current ACO (accountable care organization) agreement.  NH&C will move into a larger ACO pool for 2021 in an attempt to reduce the variance of the results and allow for more accurate monitoring.   The 3-year plan is taking shape, following a recent Board retreat.  Underdahl spoke to a recent state legislative meeting that included the Governor.  e) Other: Underdahl and the Board thanked Steve O’Neill for his 9 years of service on the Hospital Board, including 2 years as chair.  O’Neill in turn thanked Bobbi Jenkins for making his job much easier.     

2. Financial Report—Scott Edin.  Only two departments experienced patient visits that exceeded the budget: all others were below budget.  This is a good predictor of the financial results for November.  However, the Non Operating Revenue due to investment gains were +$2.3 million for Nov.  The result is a YTD surplus for NH&C of $5.67 million, due to the $10 million plus of CARES grants earlier in the year.  Without the CARES grants, YTD results would be a loss of $1.86 million.  

The Board was concerned with how best to communicate the financial results for 2020 because the COVID related expenses will continue on into 2021, but the grants will not.  The financial results for the first half of 2021 will likely appear very negative while the financial results YTD for 2020 appear very positive.  Edin was not aware of any accounting adjustments that would allow a restatement of the results.  

3.  Community Relations Committee—CC Linstroth.  The Committee received 13 grant requests from non-profits in the service area totaling $120,000.  In addition NH&C is committed to a multiyear $10,000 donation to NAFRS to help pay for a new truck.  It was noted that NH&C gives about $100,000 per year to HealthFinders and the City via donations and in-kind contributions.  The Committee earmarked a $1500 donation to Age Friendly Northfield.  The Board passed the Committee’s grant recommendations.  


The meeting stopped for a break about 6:50 p.m. and was followed by a closed session. 

Next meeting:  Jan. 28, 2021

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