OBSERVER REPORT: NORTHFIELD HOSPITAL AND CLINICS, 6.25.25

1. Executive Summary

1. Call to Order

1. Regular and Consent Agenda
   1. 5/22/25 Board Minutes
   1. 5/14/25 Governance and Planning Minutes
   1. 5/20/25 Community Relations Committee Minutes
   1. OTHER
      1. SBAR:  Chiller Replacement
      1. Emergency Services Readiness Policy

PASSES UNANIMOUSLY

1. Reports
   1. Hospital Chief of Staff Report (Jennifer Fischer, MD Chief of Staff) 

No Issues with any staff.  Files needed approval.  Approval Given.  No discussion.

• CRNA Privilege Form/SBAR (Jennifer Fischer, MD Chief of Staff)

Pain management clinic and procedures done by CRNA.  One CRNA will complete all education and credential committee added this to his form.  Approval Given.

• Presentations/Discussions/Action items
  • Nursing Update (Lisa Bauer, CNE Presents)

Birth Center–  Anticipating 700 deliveries this year.  Midwifery group continues to increase.  Midwifery is a recently added service.  As volume increases, outpatient service is also increasing for follow-up or pre-delivery issues.  Newborns transferred to higher level of care (2,3 and 4 levels of care is low).  Neonatal nurses add much to services.  Continuous evaluation of staffing happening.  The building could incorporate a Level 2 care (designed as such) but need the birth numbers up slightly to justify the staffing needs.  Allina Family Practice doctors are licensed to deliver at Hospital.  Financially this is beneficial.  Their numbers are declining slightly.  People from surrounding areas are coming to see the Northfield facilities and taking tours to see where they might deliver.  Increasing interest.

Emergency Department– volumes shared year over year.  Will beat last year’s volume.  Hospital Auxiliary has donated 12 carts to make the rooms safer and more efficient.  Approximate $30,000 donation.

• Mid-Year Strategic Planning Priorities Update (Zander Abbot, President & CEO)

Priorities approved at April meeting. Now have data from Q1.

Financial Performance and Quality and Safety  (Clinic) – Labeled At Risk with priorities. Hospital, clinic and ED Physicians is 99%.   Wound is a work in process.  Undergoing some program re-design.    A consultant has identified some opportunities for improvement.  We are early in the year.

Engaged Workforce and Service Line Growth –  On Track with priorities. 

Overall President/CEO pleased with progress.

• Executive and Committee Reports
  • CEO Report (Zander Abbot, President & CEO)
• Excited about new COO – Josh Salzman – starting August 4^th. 
• 0 reportable Quality and Safety Events
• Northfield will no longer receive a STAR rating due to the fact that the volume is too low to qualify based on the new CMS Rating requirements.  Our volume did not go down, CMS changed the standard.  Many small hospitals no longer qualify for a star rating.
• Internal communication re: ICE activity.  Generated Community discussion. There have been no ICE incidents yet.
• Adult undocumented individuals have been removed from MN Medicaid coverage.  Undocumented Immigrants will likely use the ER rather than primary care.  Also skipping primary care will cost and use ER –  expensive.  Hospital will continue to try to monetize what this change means to the Hospital.
• Proposed Medicaid cuts by Congress would result in a $50.4 billion.  reduction in federal Medicaid spending on rural hospitals over 10 years.  Senate is still negotiating.  Then goes back to the House of Representatives.  If passed as is today, Northfield will likely see $1-$3 million in revenue loss.    If other hospitals shut down services in our area, Northfield might see bigger numbers. 
• Nursing Homes also at risk with Medicaid cuts.  The potential closing of nursing homes will impact the hospital in that there will be no place to discharge patients for the next level of care.
• Board wants to make a public statement to the Community in addition to elected officials on how patients will be affected by these cuts.
• Discussion as to whether Board should lobby Congressional delegation directly on this issue.    Some concern over spending Political Capital on this issue.  There is no precedent for this action.   Decision to share facts but not attack public officials on their policy positions.  A letter will be sent.  President/CEO will draft the letter on the effects of Medicaid Cuts on the hospital with editorial review from Mr. Rogers and Mr. Estenson. 

• Financial Report (Eric Guth, CF0)

Revenue Surplus in May.  Partially due to a catch-up in billing.

YTD Operations improvement over previous years.

• Verbal Quality Report (Katie Lane)

Patient Experience Committee putting Care into Caring Initiative

Patient Grievances lower in 2025

Billing is biggest grievance

• Round Table/Announcements/Questions

BREAK

Closed session held pursuant of MN State St. 144.581, subd. 5 : Marketing activity related to Hospital’s competitive position with other health care providers that offer similar services.