Past Events

Upcoming Information Sessions

Two referendums for Northfield residents will be on the ballot November 6 – a city referendum for a civic center and a school district referendum for buildings. Come to these information sessions to find out more about these ballot initiatives.

October 9, 2018 4 p.m. Community Room, Village on the Cannon – Civic Center Referendum

City Announcement

October 16, 2018 4 p.m. Community Room, Village on the Cannon – Schools Referendum

Schools Announcement

Northfield Hospital Board Meeting Sept. 2018

Opening

  1. Chair, Charlie Mandile, called the meeting to order at 6:35 p.m. The Agenda was approved.

A correction was made to the Minutes of the August Board Meeting, and then the Consent Agenda was approved.  The Consent Agenda included Minutes for the August Board Meeting, Minutes for a Community Relations Committee Meeting, Minutes for a Special Governance and Planning Committee Meeting, and the Annual Review of Quality & Performance Improvement Policy.

Reports

  1. Chief Medical Officer—Jeff Meland. There are space needs for the physicians. The applications for Medical Staff Membership/Privileges were approved.
  2. City Report—Brad Ness. The City Council met Monday and approved $300,000 for tree cleanup following the storm.Pickup will start Oct. 8. See the City website for details.  The tax levy for 2019 will increase by 7% or less.

 

Presentations/Discussions/Action Items

  1. ENT Sinus Navigation System—Jerry Ehn. (Second presentation) Ehn reviewed the details from the first presentation. The cost, $155,424 will be reduced by $75,000 as NH&C will receive credit for the rent paid on the machine thus far in 2018. Final cost: $81,424. The Board approved the purchase.
  2. Revision of Foundation Bylaws—Laura Peterson. The document brought by Peterson sparked an extensive discussion regarding the relationship between the Hospital Board, the Foundation Board, and the Foundation. The Hospital Board indicated that they wanted a closer relationship with the Foundation, and suggested several changes. Revised Bylaws will be brought to the Board at the Oct. meeting.

 

Strategic Discussion

  1. Clinic /OB Space Challenges—Jerry Ehn. The lack of space on campus is limiting growth; the funding available in the capital budget is relatively small. Top priority was given to expanding the Medical Clinic and the Birth Center. The Clinic is the source of referrals for other services. The Birth Center is viewed as a high-growth service.  The proposal is to a) construct clinic space adjacent to the north side of the existing clinic, and b) to construct birthing space adjacent to the east side of the current Birthing Center. The Administration is proposing to use “contractor design and build” project management in the hope of fitting the cost within a budget of $12 million.  Ideally, ground breaking would be in June of 2019, but that is a very tight schedule since both the City and St Olaf College need to approve the projects after the Board approves them.  Extra Board meetings may be required to meet the time schedule.
  2. Midwifery Program—Jerry Ehn. NH&C is considering a hospital-based midwife program. Patients are requesting midwife services and some potential patients are choosing other sites to give birth.  The Administration is working with physicians and staff to define the potential service.  Next steps would be to evaluate consumer demand and to prepare a financial analysis of the service.  If the service appears viable, a midwife could be added to hospital staff and service would begin in early 2019.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. Work and progress continues on a wide variety of projects:  a) NH&C continues to study the options for electronic health records (EHR).  b) A work group has been established to move “patient facing technology” forward.  c) There was a board meeting of the Accountable Care Organization. Annual visit encounters have increased from zero to about 13.5% since the ACO program began.  The target is 30%.  d) The CEO is conducting the annual individual meetings with all providers in NH&C.  e) The governance meetings between the City and NH&C are continuing.  Committee members testified to the benefits from the discussions. “Relationships take work.” f) Mental health patients warehoused at NH&C continue to be a problem as the facility can’t provide appropriate treatment and must maintain a 1:1 staffing ratio with these patients, which is very expensive.  It was estimated that 3 – 5 mental health patients appear in the Emergency Room each day. g) There are many health-related issues being raised for the November elections, including Medicare For All—a slogan in search of a policy. Unfortunately voters and politicians are as sharply divided on health issues as they are on the other issues.  With no middle ground, a change is policy is unlikely.  h) A draft of the PERA white paper is circulating and the affected hospitals are working to build a coalition.
  2. Financial Report—Scott Edin. August was a good month. Net Operating Income was $525,000, which was over twice the amount budgeted. Most service categories were higher than expected.  Income from operations is $1.8 million YTD for 2018.
  3. Budget and Finance Committee—Charlie Kyte. The committee is revising its job description to include overseeing investments and reviewing extraordinary grant requests.The threshold for review of capital spending requests will be increased for $1000 to $5000.
  4. Governance and Planning Committee—Charlie Mandile. A special meeting on the CEO Evaluation Process was held. a)Input regarding CEO performance from Board members exiting the Board will be gathered, summarized, and reported, but not used in numerical form.  b) It was proposed to pay the CEO 6 months of base salary if s/he is fired at a “Change of Control,” and the CEO would agree not to exit prior to the occurrence of the change in control.  c) It was proposed to pay the CEO’s regular salary during the 90-day waiting period for long-term disability insurance coverage to take effect.  These proposals will come to the Board for a vote at a later meeting.

Roundtable

Charley Kyte thanked Vicki  Stevens for her work with a Torch student from Northfield High School interested in a health care career.

Meeting adjourned at 9:15 p.m.

Next meeting:  Oct. 25, 2018

Northfield Hospital Board Report: August 2018

Opening

  1. Chair, Charlie Mandile, called the meeting to order at 6:35 p.m. The Agenda was approved.

The Consent Agenda was approved.  The Consent Agenda included Minutes for the July Board Meeting, Minutes for a Governance and Planning Committee Meeting, and Minutes for a Special Governance and Planning Committee Meeting.

The proposed revisions to the Foundation Bylaws were removed from the Consent Agenda and discussed by the Board.  The provisions for Foundation Board members were clarified.  The Revisions will come to the Board in Sept. for a vote.

 

Reports

  1. Hospital Chief of Staff—Randy Reister. No report, but Reister asked Board members what information they would like him to bring to them at future meetings.  The Board members didn’t offer any specifics, but asked to be kept informed of the concerns from the medical staff.  A Board member inquired about Board-staff interactions: where and when did that happen?  CEO Underdahl responded that Board involvement at scheduled staff events was appreciated, and Board members can request to visit specific departments. Concerns were voiced about the appropriate level of Board-Staff interaction; where should the line be drawn? The applications for Medical Staff Membership/Privileges were presented to the Board.  The Board approved the applications.
  2. Chief Medical Officer—Jeff Meland. The Minnesota Hospital Association is reissuing their survey of factors leading to “burnout” of medical providers. Meland cited several steps that NH&C had taken to improve conditions for MDs since last year’s survey, and hoped that last year’s good showing would be improved.

 

Presentations/Discussions/Action Items

  1. ENT Sinus Navigation System—Tammy Hayes. Hayes made the first presentation of a proposal to purchase an ENT Sinus Navigation System. NH&C is now renting the equipment each time a surgery is scheduled.  The cost last year was $81,000 for 32 surgeries.  The cost of the desired system is $155,424 plus $300 per patient for disposables.  Some of the rent currently being paid could go towards the purchase price.  The equipment has a 2-year payback period, and an anticipated technical life of 5 years.  Only one provider at NH&C is currently using the system, but the services of an ENT are essential for the hospital and sinus navigation systems are the standard of care.  This item was not included in the 2018 capital budget.  The proposal will be voted upon at the Sept. Board meeting.
  2. Nursing Patient Care Update for the LTCC—Tammy Hayes. The Center for Medicare and Medicaid mandates an annual survey of patient care in all long term care centers (LTCC) in the US.  An outside agency interviews each patient and the patient’s family. The results for all LTCCs are posted online (Nursing Homes Compare).    The LTCC at the hospital continued to earn a 5-star rating, the highest.  Hayes said that it is growing increasingly difficult to staff the LTCC with LPNs, as a higher percentage of persons entering nurses training are continuing on to earn a RN.  Also, the Mayo System has started hiring LPNs.  The Board said it would be helpful to see the survey results for NH&C in comparison to other LTCC providers in the region.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. Work and progress continues on a wide variety of projects.  a) NH&C continues to study the options for electronic health records (EHR). This has been a lengthy process, but it is imperative to “get it right”.  b) The Administration is revisiting the master plan for Obstetric services, to determine the amount it can afford to spend on improvements. c) Work continues on improving cyber security.  Medical facilities are prime targets for ransomware.  Carleton and St. Olaf Colleges have jointly hired a full-time person to work on cyber security.  The hospital IT will dialogue with the cyber expert to see if there are shared problems.  d) An assessment of customer-facing-technology is underway.  United Health Care in the Cities is pushing forward on this.  A recent study suggests that 74% of Millennials would prefer a virtual visit with an MD rather than an office visit.  e) Construction is underway on the Senior Care building.  A lot of dirt is being moved. f) NH&C is expecting to receive about $90,000 back from the Medicare Value Based Purchasing  program that punishes or rewards hospitals for providing high quality care.  g) Underdahl is working on a “white paper” regarding the funding of PERA by municipally owned hospitals.  h) The meetings of the City/Hospital Governance Team have been going well.  David Koenig volunteered his services to facilitate the process.  i) The Express Care Clinic has not been “as busy as we would like,” in part due to the closing of the street in front of the clinic, but this has provided time to solve problems prior to flu season.
  2. Financial Report—Steve Underdahl. There was a Net Operating Loss of $58,000 for July, but that was $269,000 better than budgeted. It was a relatively good month financially.  August looks to be a very good month financially.  Cash on Hand (COH) remained at 236 days.  A Board member asked if this was “too much cash?” The short answer was that there is no such thing as “too much cash,” and “COH is a metric not a bucket.” The cash actually sits in many different accounts.  A question was raised concerning a long-term capital budget. Yes, the budget exists and is voted by the Board for each budget year, but it is seldom referenced, except when purchases have not been included in the budget, as is the case for the ENT Sinus Navigation System.
  3. Strategic Discussion: Now/Near/Far Method—Steve Underdahl. Underdahl shared his thoughts on strategic planning which must simultaneously focus on 3 timelines: now, near, and far. Current problems typically receive the most attention, but it is important to understand how current plans are consistent with next year’s production and lead into future strategies.  How does one organize a management team and a board to facilitate simultaneous 3-stage planning?  Success now does not guarantee future survival of the institution, especially in a world with lengthy development cycles.  Ford Motor Company was cited as an example of a firm with a disconnect between the “now” and the “far”.  Comments were that institutions need a “safe place to dream”; small firms should plan to be “the second wave to hit the beach” if they hope to survive; the clinic strategy of NH&C some years ago was a great example of a “near” action consistent with a “far” objective.  This is material for a future strategic planning retreat.
  4. Community Relations Committee—CC Linstroth. The committee is working on a job description and calendar. The planned activities tie into many of the hospital’s strategic plans.  Candidate Tina Smith’s staff will be in Northfield on Friday, Sept. 7thto discuss affordable, accessible, health care.  Board members were urged to attend.

 

Roundtable

Northwest Area Process Advisory Committee—Fred Rogers.  City Mayor, Pownell appointed the committee to study land use and zoning in the area near the hospital.  Pownell’s objective was to foster new growth in Northfield and to increase the tax base, i.e. promote commercial and industrial development.  This is a problem as currently the workforce available in the area is not sufficient to support another large employer, and there is a lack of affordable housing for workers earning factory/retail wages.  The Committee recommended that the City start with a small plot (80 acres) and see if the landowners and neighbors are supportive of the effort.

Meeting adjourned at 9:20 p.m.

Next meeting:  Sept. 27, 2018

Homeless in Northfield September 13

homelesshands

 

Thursday, September 13 7pm                                                                                                    Viking Theater, Buntrock Commons, St. Olaf College, Northfield

The League has been working on a study on Homelessness in Rice County. We will be gathering to learn more about that at our Fall Kick Off Meeting.

Join us to learn more about this issue, and for a panel discussion with representatives from the Northfield Union of Youth, Isaiah, Rice County, and others.

Books and Brews August 30

booksbrews
August 30, 2018 7 – 8:30pm  Imminent Brewery , Northfield, MN

Please bring a good book or recent title to share (or come to learn of others) and bring a friend!

This is our first annual Books and Brews New Member Gathering. The Roseville League has had lots of fun with this event and we thought we could learn from our fellow League while drinking our own local brews both alcoholic and not.

We will be holding tables so if you know you can make it, let us know and also how many you will be. You can still just show up, but if you know in advance, it would be helpful know for our planning.

Letter Writing July 21 9am-noon

Join us at The Hideaway Saturday, July 21anytime between 9 am and noon for this month’s League letter writing get together. Our focus is the upcoming decision about the addition of a citizenship question to the 2020 US Census. The League has a formal statement opposing the addition of a citizenship question and the public comment period ends August 7th. We’ll provide paper, pens, stamps, background information and sample letters -you just need to show up, have a drink, and write! Drop by whether you can stay for 15 minutes or two hours and bring a friend.

This year, our local League plans to do a series of letter writing events to provide education for members, action opportunities, and a chance to get together with other League members.

Information from the MN League of Women Voters:
Earlier this year, Secretary of Commerce Wilbur Ross announced that he had directed the Census Bureau to add a question about citizenship status to the 2020 Census. The Department of Commerce is accepting public comments until August 7th on the use of a citizenship question in the U.S. Census. We need as many people as possible to respond with comments to oppose this decision. This will demonstrate there is a strong public voice that opposes this decision.

Secretary Ross disregarded the advice and recommendations of Census officials, including six former Census Bureau directors from Republican and Democratic administrations, who stated in aJanuary 26th letter to the Secretary, “We strongly believe that adding an untested question on citizenship status at this late point in the decennial planning process would put the accuracy of the enumeration and success of the census in all communities at grave risk.

For more on the 2020 Census, you can watch our video from the presentation at the High School this spring: https://www.youtube.com/watch?v=pvSP1PWjZ9Q

Northfield Hospital Board Report June 2018

Headlines:

  1. Groundbreaking for new senior care facility anticipated in mid July.
  2. Charity Care by NH&C totaled $135,297 in 2017.
  3. Revenue recapture (seizing tax refunds) totaled $717,895 for 2017.
  4. Supply chain remodeling cost estimated at $392,000.

 

Opening

  1. Chair, Charlie Mandile, called the meeting to order at 6:35 p.m. The Agenda was approved.

The Consent Agenda was approved.  The Consent Agenda included Minutes for the May Board Meeting, Minutes for a Community Relations Committee Meeting,  Minutes for a Special Budget and Finance Committee Meeting, Minutes for a Special Governance and Planning Committee Meeting, Entrance and Parking Easement, Government Data Practices Act Policy, Compliance and Ethics Program Policy, Temporary Privileges Policy, Disaster Privileging Policy.

 

Reports

  1. Hospital Chief of Staff—Randy Reister. No report.  The applications for Medical Staff Membership/Privileges were presented to the Board.  The Board approved the applications.

 

 Presentations/Discussions/Action Items

  1. Supply Chain Remodel—First Look—Scott Edin. The hospital is implementing a 2-bin supply system that will reduce the inventory held in departments, and store inventory remotely in a central location.The system has been implemented in the ER Department and Obstetrics, but space limitations have constrained implementation in the Operating Room.  The proposal is to move all inventory into the basement of the new Endoscopy Center, which will require enclosing a loading dock and constructing a caged storage area.  The estimated cost is $392,000.  Extensive discussion followed regarding the cost of the project, possible savings, and the sense that the proposed project is a “third best” option that leaves many problems unsolved.  The administration was urged to rethink the project once more, and bring a recommendation to the Board at the July meeting.
  2. Compliance 101—Part 2—Laura Peterson, Compliance Officer. The presentation continued Board education on their responsibilities to oversee the fiscal practices of the hospital with regard to Medicare and Medicaid. Violations are violations regardless of the intent of the Board and prosecution may be both criminal and civil. Peterson identified several areas of high risk.  The Board was asked to consider how the institution and the Board are structured to oversee compliance issues, the Code of Conduct, the reporting system, and internal controls.  Peterson said that in her judgment, the Compliance Officer had the authority, autonomy, and resources to conduct a robust compliance program.  It was noted that the Compliance Officer reports directly to the Board rather than the CEO.  The roles of Legal Counsel and Compliance Officer are combined at NH&C (Laura Peterson), which could create a conflict of interest, but outside legal counsel is retained whenever a compliance complaint is received.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) work and progress continues on a wide variety of projects.  There are data transmission problems to Caravan with the Accountable Care Organization; the rules governing the appointment of Board members to the Foundation will be revised; a new strategy for market surveys is being explored; a new productivity-benchmarking program is being implemented.  b) Price transparency was the primary topic at a recent American Hospital Association regional meeting.  Health care providers in MN appear to be much further advanced with this trend, due to the high percentage of high-deductible insurance polices in the state.  When they have the chance, patients are price shopping for health care in MN. Underdahl reported that in his experience, “People aren’t much interested in the actual cost of health care; they care about what the health care costs them.”  c) Underdahl interpreted the appointment of Atul Gawande to be CEO of the new Amazon-driven health care coalition to portend major changes/disruptions in the delivery of health care.
  2. Financial Report—Scott Edin. May was a good month. Net Operating Revenues for March were $337K over budget, and Deductions were under budget. The result was a Net Operating Income of $230K.  Income from operations is above budget for the year thus far, but June has been a slow month.
  3. Annual Report of MN Attorney General’s Agreement on Hospitals & Debt Collections—Scott Edin. The Board reviewed their compliance with the agreement between the MN AG and hospitals in MN regarding the prices charged uninsured patients, charity care, and collection practices. The hospital judged itself to be in compliance with the agreement. NH&C sent 78 accounts/18 patients to its outside collection agency in 2017, resulting in $57,697 collected. Prior collection actions executed in 2017 resulted in $67,201 of wages garnished by the collection agency.  Internally, NH&C collected $717,895 from revenue recapture (seizing tax refunds); and $348,701 from collection actions, for an average collection ratio of 1/3.  (It was noted that patients do not like it when their tax refunds are seized.)  The hospital’s procedure is to first attempt to assist patients in finding payment sources and to work with patients on a payment schedule before sending the accounts to collection. The CFO and CEO review all accounts sent to collection. No complaints were received by NH&C in 2017 against the collection agencies.  Charity Care in 2017 totaled $135,297.
  4. Quality Committee—Charlie Mandile. The Committee is continuing to study opioid prescribing practices.
  5. Governance and Planning Committee—Charlie Mandile. Work on a CEO evaluation policy is almost complete. The policy follows the process used in 2017 that seeks input from all groups affected by the hospital.  The policy won’t specify the use of an outside consultant, as has been done in recent years, but will recommend the practice.  The outside consultant adds credibility to the survey results and provides a wider window on the CEO market in MN.  The Committee will bring the policy proposal to the Board in July for a vote.

 

Roundtable

The Senior Services building project will likely break ground in mid July.  The City Council approved the last required agreement earlier in the month.  A ground- breaking ceremony will be announced.

Meeting adjourned at 9:10 p.m.

Next meeting:  July 26, 2018

Northfield Hospital Board Report: May 2018

Opening

  1. Chair, Charlie Mandile, called the meeting to order at 6:30 p.m. The Agenda was approved.

The Consent Agenda was approved.  The Consent Agenda included Minutes for the April Board Meeting and Minutes for a Governance and Planning Committee Meeting.

Reports

  1. Hospital Chief of Staff—Jeff Meland for Randy Reister. The applications for Medical Staff Membership/Privileges were presented to the Board. The Board approved the applications.
  2. Chief Medical Officer—Jeff Meland. Dr. Fulco has been working with the hospital to form a high-risk breast cancer registry and support group. The addition of 3 new hospitalists to the staff appears to be encouraging the retention of higher acuity patients at NH&C.
  3. NH&C Report—Dr. Ben Flannery. The Express Care Clinic in downtown Northfield is up and running. Three new associate providers have been added to the staff.  The feedback from patients has been positive.

 

Presentations/Discussions/Action Items

  1. Approval of City/Hospital Governance Committee—Rhonda Pownell and Charlie Mandile. This item was brought back to the Board after some editing. The motion would establish a temporary committee composed of 3 City Council members and 3 NH&C Board members. The charge to the committee is to explore best practices for working together and building a stronger relationship.  The committee will bring recommendations within 6 months, and then could be disbanded.  Motion passed.
  2. Patient Care Update: Include Always—Tammy Hayes. This is a Minnesota Hospital Association campaign to establish a functioning Patient and Family Advisory Council in every hospital to provide a new perspective on care and a shift in the culture of hospitals.  The Council is up and running at NH&C, but they hope to add additional members to broaden the perspective.

 

Executive and Committee Reports

  1. CEO Report—Steve Underdahl. a) The Open House for the Express Care Clinic was well attended.  The Clinic will be open weekends starting June 9th.  b) The initial data from the ACO (Accountable Care Organization) indicates that there are significant differences between current medical practices at NH&C, and the goals of the ACO.  An example is the “annual wellness visit” recommended by Medicare and the ACO, but not currently promoted by NH&C. There is work to be done in order to meet the goals of the ACO.  c) staff is continuing to study the electronic health record problem. d) the long term care facility at NH&C again received a 5-star rating. This is the 7thyear in a row that the facility has been so recognized.  d) planning for the ambulatory surgical center continues.  e) the cost rebasing effort continues; another $1 million needs to be cut.  f) the Omnibus Supplemental Spending Bill vetoed by Gov. Dayton contained financing to counter the opioid epidemic.  g) a health price transparency bill did pass and the clinics will now be required to post prices for their 25 most frequently billed services. h) The MN Health Records Act did not pass so providers in MN will continue to be held to higher privacy standards for patient records than providers in other states. This can complicate interstate sharing of medical records.  i) a revision to the Workers’ Compensation program will reduce the revenue NH&C receives from Workers’ Comp.
  2. Financial Report—Scott Edin.  Net Operating Revenues for March were $222K over budget, and Deductions, Bad Debt, and Operating Expenses were under budget. The result was a Net Operating Income of $421K.  Income from operations is well above budget for the year thus far.  It was noted that even years (2014, 2016, etc.) seem to generate much better financial results than the odd years.  Maybe 2018 will continue this pattern?

 

Roundtable

A Board member inquired as to whether the art work displayed in the hospital related to the clientele; can patients see themselves in the art?

Meeting adjourned at 8:50 p.m.    Closed Session began.

Next meeting:  June 28, 2018