The October Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.
Opening & Reports
1. The Consent Agenda was approved. It contained the Minutes for the September Board Meeting; Minutes for a Quality Board Committee meeting; the Quality & Performance Improvement Policy; Annual Review of Patient Care Minimum and Professional Liability Coverage Solution; Patient Rights Policy Form; Patient Right’s Policy.
2. Hospital Chief of Staff: Dr. Meland presented the applications for Medical Staff. The Board approved the applications.
Presentations
Marketing and Communications Update—Julie Nikolai Sullivan and Betsey Spethmann. Current efforts are taking several forms. A) Focus on promoting interaction between users and staff on questions, complaints, and comments—adding the personal touch. B) Introducing new providers, especially on social media. C) Presenting new service lines such as spine, neck, and back care. Patients can self-refer for care. B) Introducing the community to the opening of the Urgent Care Center and its hours of operation. E) Alerting the community to the expansion of midwife services at the Birthing Center. The NH&C website has been accessed 165,000 times, YTD; over half of the times from a mobile device. A Board member questioned if the website displayed adequate racial and cultural diversity? The marketing team briefly described their diversity efforts. Another Board member described efforts to manage the image of NH&C on Facebook. The guidelines have been amended.
Executive and Committee Reports
1. CEO Report—Steve Underdahl, CEO. a) COVID: the community and the staff suffer from COVID fatigue. Some people in the community have strong negative reactions to any mention of vaccines and masking. The transmission rate for COVID is down but the rate of hospitalization is up. b) Strategic: The expected post-pandemic scenario has not played out as expected: the inflation rate is high; the labor market is exceedingly tight; it is difficult or impossible to transfer patients to higher or lower levels of care; hospitals and staffs are busy but margins are negative, leading to nervous workers. NH&C is searching for strategic partners to facilitate a population health initiative. The Accountable Care Organization (ACO) serving the hospital has offered to provide no-cost annual wellness physicals. (c) Electronic Health Records (EHR): The project got off to a good start, but has encountered significant “bumps” since then. The facility is “regrouping”, focusing on subroutines to improve efficiency and value, and developing the necessary workforce. d) Operations: Uncertain. The coding backlog, accompany the new EHR system, is difficult to solve due to worker shortages. This in turn, depresses revenue because bills can’t be sent. The result—busy staff, but disappointing financial results. “We are in strange times.” The MN Hospital Association reports that the employee vacancy rate is up 250% relative to pre-COVID levels; Medicare and Medicaid payments are 20 to 27% below the cost of the care provided. Skilled nursing facilities (SNFs) around the state of MN are full, and lack of staffing has forced NH&C to cap occupancy at its SNF at 30 residents instead of 40. Underdahl predicted that many nursing homes in MN will close in the coming years. Underdahl wrapped up his presentation with a question for the Board to ponder ahead of the upcoming retreat; Given that our surplus or profit margin on the services we provide is negative, we can’t make it up on volume. So how is NH&C going to survive going forward?
2. Financial Report—Scott Edin. August was pretty busy but the financials are incomplete due to coding delays. The hope is to be caught up by year-end. The EHR system was down for 3.5 days this month, further delaying results. Labor costs were $237k over the forecast due to overtime costs. The likely Operating Loss for Aug. was $1 million over the forecast loss, and given the downturn in the stock market, there aren’t financial gains on the portfolio to offset operating losses. Operating loss YTD including COVID aid grants are estimated at $7.8 million and a cash loss of $4 million when depreciation (a non-cash expense) is subtracted. Underdahl cautioned against trying to “solve the problem” before having accurate financial data from the new EHR system. The firm of CLA has been retained to test the revenue integrity of the new EHR system. Is the system capturing all of the revenue being generated by the providers within the NH&C system?
Roundtable
There will be both a Board Meeting and a Board Retreat in November.
Meeting adjourned at 7:00 p.m.
Next Meeting: Nov. 17.
