Northfield Hospital Board Meeting: October 2021

The October Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.  The Board Chair, Fred Rogers, started the meeting with the reports since there wasn’t a quorum of Board members at 5:00 p.m. and there were technical difficulties.      

Presentation/Discussion/Action Items

1. Marketing and Communications—Betsy Spethmann and Julie Nikolai-Sullivan. The pair reported on their efforts to inform the community of new services at NH&C, and to connect with potential patients in the time of COVID 19.  Campaigns included publicity for the COVID vaccines program; morale boosting for the staff; publicizing new services such as the Birth Center Expansion, opening of the new Wound Healing Center, the start of the Farmington Walk-In Clinic from 7:00 to 8:30 a.m., and the expansion of eCare.  A quorum being present, the Board then returned to the printed agenda.

Opening & Reports    

1. Items on the Consent Agenda included: a) Minutes for the Sept. Board Meeting and Minutes for a Quality Board Committee Meeting.  b) a review of the Hospital Bylaws, and c) approval of the Northfield Urgent Care Building lease terms.  Passed. 

2. Chief of Staff Report:  Dr. Monty Seper.  Applications for Medical Staff privileges and membership were approved.  

Presentation/Discussion/Action Items

2.  NH&C 2026 (Healthcare Inflection Point)—Matt Anderson, ATREDE Consulting.

(Background for upcoming Board Retreat)  Anderson’s theme was to suggest questions that Board members might consider when looking ahead 5 years.  He suggested that health care is at an “inflection point” now, due to COVID, rising costs, the anachronistic fee-for-service payment system, etc.  The future will likely be different. COVID has reframed thinking about the provision of health care services.  Pre COVID it was widely thought that a) there was excess capacity in hospitals and nursing homes; b) the focus of health care services was the individual; and c) the demand for procedures was driven by clinical need.  Post COVID there is a growing awareness that a) communities may need/want some excess capacity in the health care system; b) population health is a critical concern; and c) workers may no longer view the health care sector as a preferred employer.  If health care is viewed as a “market good”rather than a “public function”, these changes present challenges.  Who is going to fund the “excess” system capacity?  How will communities pay for population health programs using fee-for-service?  From where will the next generation of health care workers come?    

Anderson also cited a list of changes occurring in the health care sector.

a) The rise of large for-profit insurers such as United Health that are aggressively seeking market share, will lead to tougher negotiations with providers and new products.  United Health has a plan that will reduce copays and coinsurance if the customer will access the health care system via telemedicine first—i.e. a new gatekeeper.  

b) The laws pushing providers to publish payment rates will likely narrow the range of fees locally and nationwide, and lead to tougher negotiations between insurers and providers. (If curious, go online to Turquoise Health, and check out prices at Northfield Hospital and Clinics.)  

c) New players are entering the sector.  Amazon Care is expanding to 20 markets.  
Walmart just purchased Epic Systems, a major provider of electronic health record (EHR) software.  Over 50% of patients in the US have their health records on Epic. 

d) Health care workers are experiencing burnout at a high rate.  Some large hospitals are experiencing 90% worker turnover in 5 years  

e) While telemedicine is expanding, younger people are more suspicious of technology than those over 55 years of age.  Will this eventually limit the use of technology?

The Nov. Board meeting will feature another “big picture” presentation.  

3. Faribault Clinic Proposal—Scott Edin.  The proposal is to purchase the building in Faribault that NH&C has been leasing since 2020.  The current lease contains a buyout option with a set price and credit for 25% of the rent paid.  The price now would be $775,000. An inspection by NH&C employees indicates that the building is currently in good shape.  A motion was made to authorize the purchase: passed.  The motion now goes to the Northfield City Council for their approval.  The hope is to close on the purchase by 12/31/2021.

Executive and Committee Reports

1. CEO Report—Steve Underdahl.  a) COVID: the saga continues. The COVID population in the hospital goes up and down.  Occasionally there are no COVID patients.  Several employees have left due to the vaccine mandate. Work force issues are a daily challenge. The Kenyon Clinic opened on 10/18/2021. The financial picture is improving.

2.  Financial Report—Scott Edin.  Patient volume was “robust” in Sept.; up 35%.  The fall surge of procedures is happening again this year and pushing NH&C toward a breakeven fiscal year.  The YTD deficit as of the end of Sept. was only negative $311,000.  Expenses are up 10% from 2020.  Capital expenditures were $582,000 YTD, with another $1.2 million committed. About $1.7 million of the 2021capital budget is uncommitted at this time.   

3. Quality Dashboard—Sarah Carlson. The Quality Committee continues its work in an environment made more difficult by COVID, staffing challenges, changes in regulations, etc. 

Announcements

Next meeting:  Nov. 18, 2021  

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