The November 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 p.m.
Opening & Reports
1. The Consent Agenda was approved. Items on the Consent Agenda included: a) Minutes for the Oct. Board Meeting; Minutes for a Governance and Planning Committee Meeting; and Minutes for a Budget and Finance Committee Meeting, and b) Revisions to the Medical Staff Manual, and c) Annual Review of Contracted Services.
2. Chief of Staff Report: Dr. Monty Seper. Applications for Medical Staff privileges and membership were approved
Presentation/Discussion/Action Items
1. State of the Health Care Union: 2021—David Willis, Consultant, Health Advisory Board. (Background for upcoming Board Retreat) Willis argued that the state of uncertainty facing the health care sector is as great as it has been in the 27 years he has been consulting. He compared the current situation in health care to the Yalta Conference in 1945, near the end of WWII. The participants (including, Roosevelt, Stalin, and Churchill) knew that the world was not going back to the world of the 1930s, and what they decided would shape world events for the next couple of decades.
Willis claimed that the US was in Phase 3 of the pandemic: the PeriPandemic. The Pandemic has had several major impacts. 1) There is workforce burnout and trauma leading to labor shortages and high turnover. 2) There are widening gaps in the financial stability of hospitals: the large multihospital systems are doing better financially than smaller, less integrated hospitals. 3) The care site has been shifting to lower acuity sites such as televisits, hospital@home, more outpatient services, and less geriatric care. 4) The “cost shifting” movement has about run its course, without having had much effect, and will likely be replaced by more “steerage” such as networks, gatekeepers, etc. Willis cited 6 areas likely to see major changes: price transparency, value based payments, physician alignment, virtual care, home based care, and health equity. Willis said he wasn’t going to try to predict what would come out of Washington DC given the current state of politics and the high level of uncertainty.
Willis urged the Board to consider, “What do you want to be at the next stage” in health care? Are you willing to accept change? Do you want to shape the industry or be shaped by it? How do you use size and scale to your advantage? Are you willing to compete at every level? And if so, will you play to win?
Executive and Committee Reports
1. CEO Report—Steve Underdahl. a) Honors: NH&C recognized staff who excelled in the “Do The Next Right Thing”program with a reception, including a video on “Lynnette Masks”. When it appeared that the facility was going to run short of surgical masks, Lynnette took it upon herself to organize local production of PPE. The hospital received a grade of “A” from Leapfrog, an organization that monitors hospital quality in the US. b) COVID: COVID has made its way to rural America and rural hospitals are busy. c) Operations: the Kenyon clinic is doing well. The Northfield City Council approved the lease on the Urgent Care Center. Staffing continues to be a struggle, especially as volume increases. d) Policy: Steve Underdahl took part in a meeting with Health and Human Services Secretary, Xavier Becerra, that was arranged by Angie Craig.
2. Financial Report—Scott Edin. Patient volume continues to increase in most service areas. Net Operating Income showed a surplus of $310,000 in Oct., including a COVID related grant of $81,000. The investment gain for Oct. exceeded $1 million. As a result, considering all sources, NH&C has reached “Break even” for 2021.
3. Community Relations Committee Report—CC Linstroth. The committee received fund requests totaling $116,500 from various groups in the service area. The committee reviewed the requests and forwarded a request to the Finance Committee for $84,000. The Board will vote on the requests at the January 2022 meeting.
Announcements
Next meeting: Dec. 15, 2021
