Northfield Hospital January Board Meeting Report

The January Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.  The incoming Board Chair, Fred Rogers, called the meeting to order shortly after 5:00 p.m.   

Opening

1. The Agenda was modified to include a closed session. Then the Consent Agenda was approved.  The Consent Agenda included Minutes from the December Board Meeting, Minutes from a Governance and Planning Committee Meeting, Minutes from a Governance and Planning Committee Meeting, Minutes from a Quality Committee Meeting, Revisions of Clinical Privilege forms, and a summary of the December Closed Session.  The closed session reviewed a report on the 2020 performance of the CEO,  Steve Underdahl, which found that he had performed, “exceptionally well.”

Reports

(My internet connection failed, and I missed part of the above report and the report of the Hospital Chief of Staff.)

Presentation/Discussion/Action Items

1. City/Hospital Governance Committee Playbook: Steve Underdahl and Ben Martig. Communication between the Hospital Board, City Council, and City Officials has occasionally been strained in past years.  Mayor Pownell sought to remedy this several months ago, and a joint committee was formed to study the problem and provide guidance.  After many meetings and considerable work the committee has produced a set of guidelines or “playbook” detailing processes and procedures to facilitate communication and decision-making.  (Comment: I presume the Playbook will be accessible on either the hospital or city website once it has been approved.) The book identifies shared values, goals, processes for informal discussions, changes of ownership, purchases or disposal of property, donations from NH&C to City programs, etc.  Extensive discussion followed.  Martig said that the document in its current state was meant as a starting point and it would be revised as the parties gained experience with it.  Board members expressed concern with some wording, and felt it important that both the Board and the City Council voted on the same document.  Board members were given a deadline for any proposed editing; the City Council will discuss the document at a Work session on Feb. 9 and perhaps recommend changes.  The Board will vote to approve the resulting document at the Feb. Board Meeting, and the City Council will vote to approve it shortly after that.     

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 4.6%, and on a typical day the hospital is now serving only 1 to 3 COVID patients.  All employees of NH&C, as well as many other health care providers in the Northfield area, have received the first dose of the COVID 19 vaccine.  Second doses are being administered.  Rules and procedures on delivering and applying vaccine are evolving.  Administering the vaccine requires planning and a significant commitment of resources, but the supply of vaccine is uncertain.  Currently, NH&C is in a pool with other “small” providers that will be awarded vaccine shipments on the basis of a lottery, rather than having a regularly scheduled vaccine delivery date.  This allocation plan is not ideal, and will hopefully change soon. Underdahl expressed concern that the polarized public opinion dominating current policy in many areas is going to limit acceptance of the COVID vaccine.  When questioned concerning mandatory vaccination for NH&C employees, Underdahl reminded the group that the current vaccines only have “emergency” FDA approval and therefore employers cannot mandate acceptance.   b) Operations: The new Wound Care Center is about ready to open;, and the Birthing Center is in the final stages of construction.   c) Electronic Health Records: planning is underway for the new system.   Actual work on the new system will begin in March and the new system is planned to go live in Jan. of 2022.  d) Other: Underdahl expects the COVID crisis to dominate hospital utilization for the first half of 2021.  The financial results for 2020 would have been disastrous without the grants from the Federal and state governments.     

2. Financial Report—Scott Edin.  Patient visits continued to run substantially below budget projections. Net Operating Revenue for the month of December was $2 million below budget.  NH&C received a COVID related grant of $147k, and had investment income of $883K for the month.  Edin reviewed the impact of COVID on the financial results for 2020: COVID expenses were $3.6 million, CARES and state grants totaled about $11 million?? COVID related expenses are expected to continue into 2021, so $2.4 million of grant funds received in 2020 were shifted forward into 2021.   The result was a Net Income of $2.5 million in 2020.  These results are unaudited and do not include any PERA charges.  (Comment: The influx of COVID-19 related grants, from the Federal and state and governments turned the large operating loss incurred by NH&C in FY2020 into a significant surplus.  The shifting of grant funds into 2021, results in a large reported loss for Dec. 2020, and a large reduction in the FY2020 reported surplus.) A review of the Capital Budget and Capital Expenditures in 2020 showed that of the $3.5 million budgeted for capital items in 2020, $1.1 million remains unspent and uncommitted.  

3.  Governance and Planning Committee Report—Fred Rogers.  The Committee nominated new Board officers for 2021:  Fred  Rogers—Chair; Sarah Carlsen—Vice Chair; Treasurer—Scott Edin; Secretary—Bobbie Jenkins .  

4. Quality Board Dashboard Report—Charlie Mandile.  Volume in the joint Accountable Care Organization is growing.  There is some fluctuation in the quality measures, but overall the trend is good.  The risk sharing agreement negotiated with Blue Cross will likely cost NH&C about $53,000 for 2020, as the facility did not meet all of its targets.

Announcements

The meeting stopped for a break about 7:05 p.m. and was followed by a closed session. 

Next meeting:  Feb. 25, 2021  

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