Northfield Hospital Board Observer Report, March 2023, Submitted by David Emery

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

(Again, I joined a few minutes late.) The Consent Agenda included Minutes of the February Board Meeting; Minutes of a Community Relations Committee meeting; and the CEO Evaluation Policy for 2023.

The CEO, Steve Underdahl presented the Medical Staff Files.  Approved.


1. Annual Summary of Conflict of Interest Statements and Purpose—Teresa Knoedler, Legal Counsel.  Knoedler explained the purpose of the exercise and of the forms completed by Board members.  Potential conflicts of interest are self-reported on the forms and then the Board needs a routine process for managing the results.  This is a strong Board and the members are involved in the community in multiple roles, so some conflicts are inevitable.  Board members pressed Knoedler regarding legal definitions of conflict of interest, but Knoedler resisted, stressing that issues should be discussed by the Board, and each individual Board member owns their individual conflict decision.  Questions were raised concerning the role of the Mayor and a member of the City Council who sit on the Hospital Board.  Should City officials on the Board recluse themselves when an issue benefits the City but potentially harms the hospital?  Or vice versa? Could the Mayor’s power of reappointment to the Board inhibit a free discussion by some Board members?  No action was required, or taken by the Board, and the questions were left hanging.

 2.1 Annual City Orientation.  Ben Martig, City Administrator.  Martig did a quick review of the Playbook created by a joint City-Hospital Board committee to govern interactions between the two parties. 

2.2 Alternative Urban Area Review (AUAR)—Jake Reilly, Community Development Director.  (I found this confusing.) There is a 50 acre plot of land to the NW of the hospital campus that is a focus for development (light industrial?).  Excel Energy is proposing to make the site “shovel ready” by clearing some required reviews, defining the boundaries for the project, developing mitigation plans where required, etc.  The AUAR is an alternative to a “master plan” for the area.  The intent is to facilitate sustainable additions to the City’s tax base. Excel Energy offered assistance to conduct the AUAR.  The presentation was for information only.  No action required.

3. Birth Bundle Presentation—Jerry Ehn.  COO. NH&C hopes to become the preferred provider of local birthing services and the number of deliveries has been growing.    The  ”birth bundle” is a new model of value-based health care services being jointly explored by 4 parties: MN Birth Center, MN Neonatal Physicians, Wildflower Health, and NH&C.  The goal is to construct a high quality, seamless, digital network of care from conception to post delivery with the intent to improve health outcomes for baby and mother, while reducing provider burnout, and costs.  The participating parties would share in the savings and in the growth of revenues.  More to come.

Executive and Committee Reports

1.  CEO Report—Steve Underdahl, CEO.  (Given the late hour, the report was condensed.) a) Strategic: material for the April retreat will appear in the Board portal.  b) Operations:  Awful!  This is true statewide and is not sustainable.  Underdahl then recounted some of the best outcomes from the 2022 Do The Next Right Thing program where employees have gone beyond their job and responsibility to help patients in a wide variety of ways.  Great stories!  A new physician, Dr. Erickson, has been added in Surgery and Orthopedics.  c) Policy: the revenue recapture bill is still alive. The Medicaid payment formula is changing.  Underdahl will be going to DC to talk to legislators.  

2.  Finance Report—Steve Underdahl. (Scott Edin was absent.) Operating revenue was down and expenses up.  The result was a $2.2 million Operating loss in February.  In addition, investment losses for the month were almost $1 million.  Governments are now responsible for 54% of the revenue received by the hospital their payments average only 20% of charges as compared to about 50% of charges for private insurers such as Blue Cross. 

3.   Quality Committee  Report—Sarah Carlsen.  More details next month.

                        Adjourned  7:30 pm                 Next Meeting: April 28, 2023

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