- Call to Order at 5:07
- Regular and Consent Agenda
- 10/23/25 Board Minutes10/15/25 GP Minutes10/14/25 BF Minutes
- OTHER: EMTALA Policy Change Form: Some slight updates have been made to the Emergency Services Medical Treatment Labor Act Policy (EMTALA), This policy has been vetted by all medical staff committees and MEC. EMTALA Policy – DEFINITION: That hospital is bound to treat anyone who shows up at the hospital. Some very small changes to language. No real change in policy.
- Above all approved on Consent Agenda. Moved and passed.
- Reports
- Hospital Chief of Staff Report
- Medical Staff Files: No problems with the files so staff recommendations approved as presented. Passed as approved.
- Presentations/Discussions/Action items (none this month)
- Executive and Committee Reports
- CEO Report (Zander Abbot, President & CEO)
- One of Kaufman Hall Revitalize 25 Program priorities is Cash Balance. Hope to show progress in January. Hospital is seeing month-over-month improvements.
- Insurance notoriously underpays. Contracting with a firm to do a lookback to figure out how much is actually paid and will help recoup unpaid Insurance payments.
- Now adding an external billing and coding company. Need to have more timely filings to avoid denials by insurance company.
- Revenue and getting payments in the door is a high priority over the next couple of months.
- This is the reality of hospitals today is that Insurance companies underpay what is billed.
- There may be some AI tools that will help with the coding. Will likely need to be reviewed by technician. Technology is close to being ready. New coding leader working to educate clinicians on coding.
- Doctors compensated on income so motivated to code for the higher pay areas. Board would like to see more strategic coding to increase revenue.
- Engaged Workforce – (A Strategic Priority) – pulse survey sent and feedback seems pleased. More communication with leadership team. Open enrollment for insurance – employees overall pleased. Will do a total redesign of benefits in 2027.
- Service Line Growth – (A Strategic Priority) High volumes in birthing center Hospital Outpatient some nice rebounds. Clinics did well.
- Quality and Safety – (A Strategic Priority) – Positive feedback from Minnesota Department of Health in Emergency Department. Surprise visit. Did not find any issues.
- Financial Report (Andrew Soderland, Controller)
- Operating loss of $642k. Volumes were great in a lot of areas but discount rate unfavorable to budget as was bad debt and expenses. Kaufman Hall (consultant) project should help the discount rate. Workforce costs to revenue on track.
- Outpatient and inpatient visits good. Farmington as a new provider is driving Clinic Volume. Outpatient surgeries lagging. Farmington clinic should help. Volume high in ED. Record months in births. CCIC and Imaging also were slightly over expectations. OB and Ortho driving the Imaging budget. When clinic volume goes up it is a breakeven, but provides downstream business to the hospital. Births and ancillary impacts are revenue contributors. The Discount rate has the most impact on the hospital budget going negative.
- Discount rate is insurer dependent. We are driving volumes, but not getting paid for it due to Discount Rates.
- Ortho has been generally behind for the year. Would like to see more Ortho Volume.
- 4th quarter tends to have an uptick as people try to spend their HSA.
- Collections from Bad Debt should start showing up Q1 next year.
- Improvements have been made in revenue in the last year.
- Verbal Committee Reports
- Budget and Finance (Fred Rogers) – proposed to move investments to WinnTrust and got them to decrease their interest rates and fees on debt/bond refinance. Asset allocation will likely stay about the same. May consider some additional debt – favorable response from WinnTrust. Hospital trying to simplify financial relationship and build a more strategic relationship with WinnTrust.
- Governance & Planning Committee – Good meeting and talked about the retreat. Some things will be highlighted in closed session.
- Community Relations Committee – (Crystal) discussed grant requests and have some requests ready.
- Round Table/Announcements/Questions
- Minnesota Hospital Association Winter Trustee Meeting (1/8-1/9) – Board members can attend. Meeting held in Minneapolis. Hospital would like to send a delegation. Fred suggests someone attend American Hospital Association Rural Hospital meeting in February.
- 2026 NH&C Board of Directors Calendar – settled for 2026.
- Staff Appreciation Night will be December 3 – need to finalize RSVPs from Board
- ADJOURN
- There was a closed session following the open session agenda pursuant of Minn. Stat. 144.581, subd. 5, Marketing activity related to the Hospital’s competitive position with other health care providers that offer
