Northfield Hospital Board Meeting: January 2022

The January 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 meeting opened with an introduction of 4 new members of the Board: Michael Hemesath, Robert Morrison, Rhonda Pownell, and Jami Reister.  

2.   The Consent Agenda was approved.  Items on the Consent Agenda included: a) Minutes for the Dec. Board Meeting; Minutes for a Quality Board Committee Meeting; and b) approval of Board Committee Membership and Officers (not included in my packet.)        

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

Presentation/Discussion/Action Items

1. 2021 Year in Review—Steve Underdahl  (Underdahl thought that the review could be helpful for incoming Board members.) The year started with COVID and a vaccine initiative by NH&C to protect the community as part of its responsibility as a community hospital.  25,000 doses of vaccine were administered at the hospital to residents and nonresidents of Northfield and another 7000 doses of vaccine were given to other clinics in the area.  As the year progressed and COVID receded, services were reopened and the practice was grown with the addition of a new Wound Healing Center, a Birthing Center, a clinic in Kenyon MN, and a soon to be opened Urgent Care Clinic in Northfield.  The Delta COVID wave had an outsized effect on communities and community hospitals, such as NH&C, which had been less affected by the initial COVID wave. Patient volumes and revenues increased.  The Omicron wave brought new challenges as it became very difficult to transfer patient to hospital providing higher levels of care, and staff outages increased.  NH&C begin work on a  “defend in place” plan to care for patients that needed a higher care level but couldn’t be transferred due to a lack of open beds.  “What do we do when forced to care for a very sick patient?”  Looking forward, Underdahl cited the new Electronic Health Record system coming on line in summer of 2022, and the worry that health care was going to find it more difficult to recruit staff in the future because of COVID.   2021 ended with a small financial margin, and hopes for a better 2022. 

2. Capital Request: Ambulance Replacement—Jerry Ehn.  Ehn reviewed the ambulance replacement plan: replace one of the 5 ambulances in the fleet each year after 225,000 to 250,000 miles.  The plan wasn’t going to work in 2022 and 2023 because the current fleet was becoming unreliable, repair parts were difficult to find, and the wait time for delivery of new vehicles was increasing.  Ehn proposed buying 3 new ambulances in 2022 and 2023 similar to the ambulance recently purchased by the Northfield Fire Dept. The cost for the 3 would be $1,023, 600. The purchase now would result in a volume discount and avoid further price increases on the vehicles. The Capital Budgets for 2022 and 2023 included a line item for 1 ambulance each year, and the increased spending would mean less money for other capital items.  After discussion, a motion to approve the proposal was passed.            

Executive and Committee Reports

1. CEO Report—Steve Underdahl.  a) COVID: COVID is keeping the hospital busy, but patient volume this week is down 40% compared to last week.  NH&C has re-imposed visiting restrictions. b) Strategic: the new EHR system is on schedule to go live this summer.  The Ehospitalist program is going well and the use of specialist video consultation is likely to expand.  The Workforce Succession Plan is moving forward.  c) Operations: things have been “crazy busy”.  Some surgeries were postponed.  NH&C is still facing staffing challenges. The Kenyon clinic is making good progress. Cyber attacks are increasing in frequency and sophistication, and it is a challenge to stay ahead of them.  d) Outreach: Underdahl has recently met with Congress woman Angie Craig and Speaker of the MN House, Melissa Hortman. Underdahl also wrote an Op Ed piece and did radio interviews.  e) Planning: the “2026 Visioning Session” will be held remotely in Feb.  

2. Financial Report—Scott Edin.  Patient volume continues to increase in many areas and in some cases surpassed 2019 levels.  NH&C received $3.4 million is grants for 2021, one million of which was pushed forward into 2022.  Including grant income, the Operating Income for 2021 was $595,000.     

Edin’s Rolling Forecast for 2022 projected little or no growth for most services (>2%); prices/charges increasing by 4%; merit raises for staff of 2%; and Net Operating Income about zero for 2022. The Capital Budget for 2022 was set at $3.5 million. 

3.  Board Quality Committee Dashboard Summary—Sarah Carlsen. The Committee included a few pages of quality measures in the Board packet.  The quality measures tend to show a slight decrease in Q3 of 2021, likely due to COVID and to staffing problems. Several of the performance measures used by the Center for Medicare Studies to reward or penalize hospitals are not being calculated for 2021.    


Next meeting:  Feb.  24, 2022 

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