Northfield Hospital Board observer Report, February 2023, submitted by David emery

The February Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.

(I joined the meeting late and missed the first couple of items on the agenda.  I started with the Q&A for the presentation immediately below.  Sorry.)


1. Nursing/Patient Care Update—Tammy Hayes, CNE.  In response to a question, Hayes answered that nurses at NH&C are not part of the MN Nurses Association and were not part of the collective bargaining unit.  However, NH&C made a series of salary adjustments and staffing changes to be competitive in the market.  The American Hospital Association reports that the staffing problems are nationwide and will persist for a while.  Hospitals are urged to be creative in the use of technology to address the problem.      

2. Wound Healing Program Update—April Miller, Director of Wound Healing.  Miller and Jerry Ehn reviewed the history of the program.  The southern Metro and Rice county were underserved since only Mayo and HCMC offered the service.  Once a need for the program was determined, NH&C partnered with Healogics, a major provider of the service. NH&C constructed a space for 2 hyperbaric oxygen chambers and 2 front desks and hired a staff, currently at 3 RNs and a PA.  The Center saw a total of 230 new patients and generated $689,000 in revenue in 2022.  Transportation for patients confined to a wheelchair is a limiting factor. The number of agencies providing transportation is declining due to inadequate reimbursement and significant regulatory requirements.  Self- referral to the Program is possible, but most patients are referred by physicians.

Executive and Committee Reports

1.  CEO Report—Steve Underdahl, CEO. a) Underdahl started by reporting on a conference for rural hospitals that he attended.  It was very evident that these hospitals share a sense of mission to their community and that they face significant challenges.  Staffing is a nationwide challenge as are finances: 55% of the hospitals lost money in 2022.  This group is grappling with the questions of who should own the hospitals? What service lines must they/should they offer? And with whom do they partner?  b) Strategic: the Strategic Plan for 2023 is drafted and will come to the Board at the March meeting. A Board retreat has been scheduled for April 7th.  c) Operations: 2023 appears to be repeating the problems of 2022 with respect to staffing and finances. The hospital’s auditor, Clifton, Larson, Allen, has been asked to generate a source of contemporaneous data.  d) Policy: There is a movement underway is St. Paul to terminate the Revenue Recapture Program which allows NH&C to claim tax refunds to cover unpaid hospital bills.  Not surprisingly, the program is very unpopular with patients, but brings in about $1million per year to NH&C. 

2.  Financial Report—Scott Edin.   Service volumes were mixed; a 8% rate increase was in effect as was a salary increase of 4 to 7  % with a minimum increase of $1.50/hour. The result was an operating loss of $1 million for January.  The percentage of patients with gov’t insurance coverage increased again, which reduces revenue since the average gov’t payer covers 23% of charges.  Not all of the financial measures are up and running on the new EHR system yet.     

3.   Community Relations Committee Report—The committee received $155,000 in grant requests.  The grant budge for 2023 is $75,000 but $10,000 is pledged for a continuing project. The allocations for the remaining $65,000 will be presented at the March Board meeting.

                        Adjourned  7:08 pm                 Next Meeting: March 31, 2023

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