Northfield Hospital Board Meeting May 2022

The May Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.  The Board Chair, Fred Rogers, called the meeting to order at 5:10 p.m. 

Opening & Reports    

The Consent Agenda was approved.  The Agenda included: Minutes from the April Board meeting and Minutes from a Governance and Planning Committee meeting.

2. Hospital Chief of Staff Report—Dr. Monty Seper.  The medical staff requests for privileges were approved.   COVID is again causing difficulties with staffing, scheduling surgeries, and transferring patients to other facilities. 

Executive and Committee Reports

1. CEO Report—Steve Underdahl.  a) COVID: the pandemic isn’t over, but many of the patients testing positive are hospitalized “with COVID” rather than “because of COVID”.  The problems cited by Dr. Seper are real and may get worse.  The combination of inflation, which is driving up wages, and staff shortages is creating financial problems for NH&C.  b) Strategic: while NH&C is still dealing with COVID on a daily basis, it is planning for a transition back to a world without COVID.  The CEO is making an effort to reconnect with the staff on an informal basis.  The Electronic Health Records (EHR) project is on track to go live in late June or early July.  Health care may be facing a workforce crisis as attitudes turn unfavorable.  NH&C is considering ways to meet its future staffing needs.  c) Operations: “Crummy”.  The operations are clinically demanding but financially challenging.  Thus far in 2022, staffing costs have increased by $1.7 million; medical supplies and drug costs have increased by $0.5 million.  The portion of patients on Medicare or Medicaid has increased which has reduced revenue by $0.8 million, since government pays the lowest amount per procedure.  Hospitals are unable to transfer patients, especially mental health patients, in a timely manner which increases the need for nursing staff, increases costs, and increases the length of stays without an increase in revenue.  Medicare reimburses providers based on DRGs (Diagnosis Related Groups).  There is a fixed $ payment for each DRG, and that stays the same whether the patient is in the hospital for 2 days or 5 days. As a city-owned hospital, NH&C is required to belong to the Public Employees Retirement (Agreement?) PERA.  PERA was designed to serve a very stable workforce, and makes it more difficult for public hospitals to recruit  and retain employees.  The fact that there aren’t many city-owned hospitals make it unlikely that the legislature will consider changes to the PERA plan.  The Finance Committee is studying how to best meet the anticipated cash needs of the facility.   d) Policy: hospitals are communicating with policy makers that a hospital is the bedrock of community health care—available to all, 365 days a year.  Health care institutions may need inflation protection.  The DEI (Diversity, Equity, Inclusion) program at NH&C is currently focused on hiring and retention.  A Board member urged the facility to broaden its thinking to get more ideas into consideration.         

2.  Finance Report—Scott Edin. It was another challenging month, financially.  The major revenue categories were below forecast: operating expenses were about on forecast. Operating Income YTD is minus $2.46 million, including positive COVID grants.  The COVID grant offsets will run out soon (June?)   Investment losses for April were $2.6 million, but are not included in the financial data on operations.  The changeover to a new EHR system will likely result in a collection delay of about 30 days, 

3.  Community Relations Committee Report—CC Linstroth.  The 2022 Book Fair conducted by the Hospital Auxiliary had record sales of $80,000.  The Board and Administration thanked the Auxiliary.  The Hospital Foundation is receiving gifts from a variety of sources.   


Next meeting:  June 23, 2022  

The Northfield Hospital Foundation needs community members 

There are openings on the Hospital Board for 2 new members who live within the City limits of Northfield. 

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