Northfield Hospital Board Meeting: August 2021

The August Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.  The Board Chair, Fred Rogers, called the meeting to order at 5:05.   

Opening & Reports    

Items on the Consent Agenda included: a) Minutes for the July Board Meeting, Minutes for a Community Relations Committee Meeting, Minutes for a Budget and Finance Committee meeting, Minutes for a Governance and planning Committee Meeting, and b) approval of the Trauma Team Activation Policy.  

Chief of Staff Report:  Dr. Monty Seper.  No report.  Applications for Medical Staff privileges and membership were approved.  

Presentation/Discussion/Action Items

1. Home Care and Hospice Quality: Tammy Hayes.  The Board is required to annually review a series of quality measures for the care provided.  Quality measures for Home Care were comparable to the measures for the State of MN and at the national level, but below the desired target levels.  The quality measures for Hospice care were similar to those for Home Care.  The Hospice measures for “Grief Support” were above the state and national averages.   

2.  Capital Request: Radiology systems for Northfield, Lakeville, and Kenyon Clinics.  The radiology systems in Northfield and Lakeville are obsolete and need to be replaced.  Currently, Medicare is imposing a financial penalty on these clinics for the use of outdated technology.  The radiology system for Kenyon will go into the new clinic to be opened in Oct. 2021.  The cost for replacing the systems in Northfield and Lakeville ($360,000) was included in the Capital Budget for 2021, but the cost of the Kenyon system was not.  Bids for the 3 systems were grouped together so that the technology and operation would be consistent across the sites and to achieve a larger discount.  The best bid for the 3 systems was $430,000.  A question was raised as to why the other two radiology systems within NH&C weren’t included in the bidding as they too feature old technology.  The response was that replacing a system requires significant time to tear out the old system and replace it. During that time X-ray procedures must be shifted to other facilities so the process is disruptive and coordination is required.  Three systems seemed like a manageable level of disruption, but the staff will investigate the possible savings from bidding all 5 radiology systems simultaneously.  A motion to allow purchase of the 3 systems was passed. 

Executive and Committee Reports

1. CEO Report—Steve Underdahl.  a) COVID: the saga continues.  The hospital is now experiencing a steady stream of COVID patients, including younger people and children.  The ER is very busy. About 80% of the hospital staff is now vaccinated, and NH&C has mandated that all employees must be vaccinated for COVID by Oct. and for influenza by Nov.  It is expected that the policy will result in some turnover of staff: 3 persons have already resigned and more are expected.  Staffing is difficult, but so far elective surgery is continuing.  There is concern for staff morale, as COVID fatigue sets in and some employees view the current wave of infections as due to “bad choices” by the patients.   NH&C is on record as strongly supporting masking requirements for public schools.  

NH&C are expecting that booster shots for COVID will be recommended.  Currently, the plan is to channel booster shots through the clinics and not hold mass shot clinics at the hospital.  The thinking is that COVID shots are widely available now through a variety of settings and that the demand will be spaced out—6 months after the last vaccine date.   

b) Strategic: The Northfield City Council approved the lease on the Kenyon Clinic building c) Operations: patient volume continues to build.   CEO Underdahl proposed that the theme for the 2021 virtual retreat be a vision exercise: What will health care look like in 2026?  What will be different?  What will be the same?  How will the changes affect payments?

2. Financial Report—Scott Edin.  July inpatient service levels were above the forecast: outpatient services were slightly below the forecast: clinic service levels were above the forecast.  Net Income from operations were minus $151,000; Investment gains for July were $337,000.  Year to date (YTD) Operating Income incorporating the COVID related grants from 2020 is minus $764,000, but this includes a $600,000 payment on the installation of the new electronic health records system.  The “payer mix” at NH&C has been unfavorable recently with 54.6% of payments coming from government sources paying 27% of charges.  By contrast, only 19% of payments came from Blue Cross Blue Shield, but the Blues pay 60% of charges.  

3. Quality Dashboard Report—Sarah Carlsen.  The data was included in Board packets.  The Medicare based performance incentives resulted in a bonus of $47,000 to NH&Cs.   

Other

1.  Community Relations Committee—CC Lindstroth.  The Committee reviewed the PR work of the hospital and were impressed with the breadth of community activities incorporating NH&C.  

2. Northfield Hospital-City Committee—Rhonda Pownell.  Much of the work this year has been to understand the roles and processes of the committee.    

AnnouncementsNext meeting:  Sept.  30, 2021  

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