Hospital And Nursing Home Commission

The Commission has charge of administration, operation, and maintenance of all hospitals and nursing homes, now or hereafter, owned by the City. The Commission has the power to hire a superintendent of hospitals or nursing homes and all other necessary employees, to fix and pay their compensation, to reimburse officers and employees for expenses necessarily paid or incurred in the performance of their duties, to require a bond of any officer or employee and pay the premium thereon; to effect all necessary insurance; to make repairs of the hospital or nursing home buildings and their contents; to purchase all necessary equipment, apparatus, and supplies; to receive and to accept, with the approval of the Council, on mutually agreeable terms all donations for hospital or nursing home purposes; to establish such committees as it may see fit; and to make rules relating to its own procedures and to the administration, operation, and maintenance of such hospitals. (See Section 2.36 of the City Code for additional information.)

 

Current Hospital Commission Approved Minutes

 

HOSPITAL COMMISSION MINUTES ARE POSTED ON THIS SITE AFTER FORMAL ADOPTION BY THE COMMISSION

(minutes are adopted at the next regular meeting).

 

 

 

RIVER’S EDGE HOSPITAL & CLINIC COMMISSION MEETING

River’s Edge Hospital & Clinic Conference Room

Wednesday, May 26, 2010

 

 

Present:  Gil Carlson, Chairperson; Helen White, Secretary-Treasurer; Trustees:  Brian Kuiper, Kay Moline, Margie Nelsen, and Jerry Pfeifer; Colleen Spike, CEO; Dr. Benjamin Chaska, Chief Medical Officer; Dr. Schelli McCabe, Medical Staff President; Patty Roessler, Director of Patient Care and Ancillary Services; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; Todd Prafke, City Administrator; Doug Montgomery, Eide-Bailley Consultant; Kelly Hyska and Derek Berndt, Students; and Paulette Redman, Recorder.

 

Absent:  Michelle Chalin, Vice-Chairperson.

 

The regular meeting of the Hospital Commission was called to order at 12:18 p.m. by Chairperson Gil Carlson.

 

APPROVAL OF AGENDA

 

The agenda for the May 26, 2010, meeting was reviewed.  

ACTION:  A motion was made by Jerry Pfeifer to approve the agenda as presented.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

 

APPROVAL OF MINUTES

 

The minutes of the regular Hospital Commission meeting of April 28, 2010, were reviewed.

ACTION:  A motion was made by Margie Nelsen to approve the regular Commission meeting minutes of April 28, 2010, as presented.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

MEDICAL STAFF

 

A.          Medical Staff Meeting Minutes.  The minutes of the May 11, 2010, Medical Staff meeting were reviewed.  Dr. Chaska noted the positive feedback Dr. Osborne reported regarding REHC swing bed patients.

ACTION: A motion was made by Helen White to acknowledge receipt of the Medical Staff meeting minutes of May 11, 2010.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

 

B.          Medical Staff Credentialing.  A report from the Executive/Credentials Committee was

presented for review.  A recommendation was made by the Credentials Committee to approve medical staff membership and granting of privileges to the physicians and allied health professionals listed on the report:

 

Initial Appointment to the Medical Staff:

Lori Krome, MD                           Courtesy Staff, Emergency Medicine

 

Reappointment to the Medical Staff:

              James Prokop, Psy.D.                   Courtesy Staff, AHP, Psychologist

              Gerald Berberick, OPA-C            Courtesy Staff, AHP, Orthopedic Physician Assistant

              Laurie Kersten-Ulmen, CRNA     Courtesy Staff, AHP, Anesthetist

 

Withdrawals from the staff include Dean Munnell, MD, Emergency Medicine, and

Teleradiologist Gwen Nazarian, MD.

 

 

ACTION:  A motion was made by Helen White to accept the recommendations of the Credentials Committee and grant appointment or reappointment for the practitioners listed above.  The motion was seconded by Brian Kuiper and carried with all members voting in favor.  A motion was made by Jerry Pfeifer to accept the recommendation of the Credentials Committee and grant clinical privileges to the practitioners listed above, as requested and approved by the Credentials Committee.  The motion was seconded by Brian Kuiper and carried with all members voting aye. 

 

FINANCIAL REPORT

 

The financial report for April, 2010, was presented by Doug Montgomery of the accounting firm Eide Bailley.  Mr. Montgomery is assisting the hospital with financial matters during the interim period until a new CFO is hired. 

 

Revenue over expense for the month of April resulted in a loss of $258,879, and when combined with non-operating gain showed a net loss of $247,926.  Year-to-date figures show a loss of $787,043 for a margin of -16.30%.  Trends for Revenue in Excess of Expenses were reviewed.  A statistical summary of utilization was also reviewed, showing acute patient days 0.4% under budget, swing bed days 5.7% under budget, outpatient registrations 11.8% over budget and clinic visits 8.7% below budget.  The percentage of inpatient revenue (19.71%) versus outpatient revenue (80.29%) was also reviewed, as well as a balance sheet for the month.  Mr. Montgomery noted an overall decline in volumes in 2010 compared with 2009 with a corresponding decrease in revenue. 

 

Mr. Montgomery also reported that the loss incurred on the refunding of debt done in February was recorded for the month of April, and thus is reflected in the reports.  Although a loss shows on the report, there will be an economic gain from this process, saving $1.7 million dollars over the years of the debt.

 

The Medicare Cost Report for 2009 has been completed, with a $524,000 receivable identified.  The money coming in from this receivable will apply to 2009 receivables.  The money coming back from Medicare is due to the fact that Medicare interim rates were not adjusted during 2009.  The factors of a drop in patient days, increased costs, and cost associated with the clinic building would have affected the interim rates.

 

ACTION:  Brian Kuiper made a motion to approve the April, 2010, financial report as presented, along with payment of bills, write-offs to collection and bad debt, and accounts payable review.  The motion was seconded by Helen White and carried with all members voting in favor.

 

QUALITY/SAFETY REPORT

 

A.          QHI Dashboard.

Colleen Spike presented an overview of the quality reporting available through the organization called Quality Health Indicators (QHi).  Data on measures relating to clinical quality of care, risk management, patient satisfaction, human resources and financial indicators are submitted to QHi.  Comparison reports are then returned, showing River's Edge Hospital & Clinic data compared to other participating hospitals within Minnesota and participating hospitals within a multi-state area.  The reports will be included with the Hospital Commission packets on a monthly basis.

                

ADMINISTRATIVE REPORT

 

The written report submitted by Colleen Spike was reviewed.  Ms. Spike noted the following:

 

• Interviews for the CFO position have been completed and an offer will be extended to a candidate next week.
• Dr. Troedson began work at the River’s Edge Clinic this past Monday.  He will not be seeing patients until payer credentialing has been completed.
• New Urgent Care hours will go into effect in June.  The hours will be 5 to 8 p.m. Monday through Friday, and 10 a.m. to 4 p.m. on Saturdays, Sundays and holidays.
• Planning for the clinic is LeCenter continues to move forward.
• A regional emergency preparedness exercise will be held on June 30, entitled “Operation Dry Summer.”  The facility will be setting up the Incident Command structure on that day.

 

QUALITY / EDUCATION / OPERATIONS

 

A.          Shared EHR Agreement.

Physicians at the St. Peter Clinic and Mankato Clinic now have access to the REHC electronic health record at their clinics.  Administration has worked with the hospital attorneys to draw up a document outlining each facility’s responsibilities in terms of access to the hospital system.  It will be presented to each clinic for acceptance and signature, with the ultimate goal of assuring confidentiality of patient information.  Included in the document are statements that

• Clarify that REHC is the sole owner of the EHR system along with the information in the EHR system.
• REHC will audit use and access to patient information on the system.
• Information in each medical record is to be used for treatment purposes only.

 

Passwords will be issued by REHC to personnel identified as having a need to access the system.

 

B.          Surgery Equipment Request.

The request for new equipment is in response to the addition of Dr. William Lee to the area.  Dr. Lee is a general surgeon who performs gastric lap band surgery.  He is developing a private practice and would like to see patients in the outpatient clinic and perform surgery at River’s Edge Hospital on a part-time basis.  The actual request for equipment is not yet finalized and will be brought before the Commission at the June meeting.

 

Dr. Lee is planning to be in St. Peter for four days a month beginning in July – two days every other week.  He would perform surgery the morning of the first day, see patients in consultation in the afternoon, and then follow-up and discharge the surgical patients the next day.  He would also be available during these days to perform other general surgical procedures.  Dr. Lee has asked that the hospital consider becoming a “Center of Excellence” for the performance of lap band surgeries.  A hospital task force has been established and will be meeting next week to look at the requirements for this designation. 

 

DIRECTOR’S COMMENTS

 

Todd Prafke, City Administrator:  Mr. Prafke distributed copies of the document amending the City ordinance regarding the hospital.  Changes that were made included the section on hiring, discipline and termination of the hospital CEO, as discussed at the April Commission meeting.  Additionally, wording was changed to designate the ambulance service as a department of the hospital.  The third area of change involved the financial reporting responsibilities of REHC to the City Council, amending the ordinance to reflect the reporting that is done yearly regarding the financial audit.

 

Peggy Carlson, Community Liaison: 

• A Women’s Health Forum was held on Tuesday, May 4, 2010, and had over 100 participants.
• A VIP Open House will be held for the LeCenter Clinic on July 6 from 5 to 7 p.m.  An open house for the public will be held on July 7 from 4 to 6 p.m.
• A silent auction will be held on July 22 from 7 a.m. to 4 p.m.  The funds raised from the auction will go to the hospital team participating in the Susan G. Komen 3-day cancer walk held later in the summer.
• Kelly Hyska was introduced.  She is a Minnesota State University Student working with Ms. Carlson over the summer.

 

Colleen Spike, CEO:  The financial audit is not yet complete and will be presented to the Commission at the June meeting.

 

Kay Moline, Trustee:  Ms. Moline noted a benefit fundraiser for the Arboretum being held on June 27, 2010.

 

ADJOURNMENT

 

ACTION:  A motion was made by Kay Moline to adjourn the meeting.  The motion was seconded by Margie Nelsen and carried with all members voting in favor.  The meeting was adjourned at 1:07 p.m. 

 

NEXT MEETING

 

The next regular meeting of the Hospital Commission will be Wednesday, June 30, 2010, at 12 noon.  This meeting will convene in the River’s Edge Hospital Conference Room.  The Finance Committee meeting will be held at 11:30 p.m.

 

RIVER’S EDGE HOSPITAL & CLINIC COMMISSION MEETING

River’s Edge Hospital & Clinic Conference Room

Wednesday, April 28, 2010

 

 

Present:  Gil Carlson, Chairperson; Michelle Chalin, Vice-Chairperson; Helen White, Secretary-Treasurer; Trustees:  Brian Kuiper, Margie Nelsen, and Jerry Pfeifer; Colleen Spike, CEO; Dr. Schelli McCabe, Medical Staff President; Patty Roessler, Director of Patient Care and Ancillary Services; Kristin Schultz, Director of Quality and Infection Control, Tammie Hudspith, Director of Human Resources; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; Todd Prafke, City Administrator; Doug Montgomery, Eide-Bailley Consultant; and Paulette Redman, Recorder.

 

Absent:  Kay Moline, Trustee; Dr. Benjamin Chaska, Chief Medical Officer.

 

The regular meeting of the Hospital Commission was called to order at 12:17 p.m. by Chairperson Gil Carlson.

 

APPROVAL OF AGENDA

 

The agenda for the April 28, 2010, meeting was reviewed.  A request was made to add item VI-B – City Ordinance.

ACTION:  A motion was made by Jerry Pfeifer to approve the agenda as revised.  The motion was seconded by Michelle Chalin and carried with all members voting in favor. 

 

APPROVAL OF MINUTES

 

The minutes of the regular Hospital Commission meeting of March 31, 2010, were reviewed.

ACTION:  A motion was made by Michelle Chalin to approve the regular Commission meeting minutes of March 31, 2010, as presented.  The motion was seconded by Brian Kuiper and carried with all members voting in favor. 

 

MEDICAL STAFF

 

A.          Medical Staff Meeting Minutes.  The minutes of the April 13, 2010, Medical Staff meeting were reviewed.  Dr. McCabe noted the majority of the meeting consisted of a program presented by Dr. Andrew Reeve, neurologist.

ACTION: A motion was made by Jerry Pfeifer to acknowledge receipt of the Medical Staff meeting minutes of April 13, 2010.  The motion was seconded by Margie Nelsen and carried with all members voting in favor. 

 

B.          Medical Staff Credentialing.  A report from the Executive/Credentials Committee was

presented for review.  A recommendation was made by the Credentials Committee to approve medical staff membership and granting of privileges to the physicians and allied health professionals listed on the report:

 

              Reappointment to the Medical Staff:

              Mary Hestness, MD                      Courtesy Staff, Radiology

              Stanley Kurisko, MD                     Courtesy Staff, Radiology

              Gary Goldberg, MD                       Courtesy Staff, Urology

              Nathan Schneider, MD                  Courtesy Staff, General Surgery

              Loretta Krahn, CRNA                   Courtesy Staff, AHP, Anesthetist

              Richard Marlow, DMD                  Courtesy Staff, Oral and Maxillofacial Surgery

              Billie Jo Grieve, MD                      Courtesy Staff, General Surgery

              Gina Risty, MD                 Courtesy Staff, General Surgery

 

Withdrawals from the staff include Larry Larson, MD, OB-GYN, and Teleradiologists

Trudi Parker, MD, and Gregory Haines, DO.

 

ACTION:  A motion was made by Michelle Chalin to accept the recommendations of the Credentials Committee and grant reappointment for the practitioners listed above.  The motion was seconded by Brian Kuiper and carried with all members voting in favor.  A motion was made by Michelle Chalin to accept the recommendation of the Credentials Committee and grant clinical privileges to the practitioners listed above, as requested and approved by the Credentials Committee.  The motion was seconded by Brian Kuiper and carried with all members voting aye. 

 

FINANCIAL REPORT

 

The financial report for March, 2010, was presented by Doug Montgomery of the accounting firm Eide Bailley.  Mr. Montgomery is assisting the hospital with financial matters during the interim period until a new CFO is hired. 

 

Revenue over expense for the month of March resulted in a loss of $88,831, and when combined with non-operating gain showed a net loss of $77,772.  Year-to-date figures show a loss of $539,110 for a margin of -14.79%.  Trends for Revenue in Excess of Expenses were reviewed.  A statistical summary of utilization was also reviewed, showing acute patient days 5.6% over budget, swing bed days 2.7% over budget, outpatient registrations 10.0% over budget and clinic visits 11.9% below budget.  The percentage of inpatient revenue (22.74%) versus outpatient revenue (77.26%) was also reviewed, as well as a balance sheet for the month.  Mr. Montgomery noted an upswing in volumes in March with a resulting increase in revenue.  He also noted that the expense for employee benefits looks high for the month, in part due to some expenses that should have been paid in February.  In terms of the budget, the facility is below budget 13.4%, and down $526,000 from budget for the year to date.

 

Mr. Montgomery also reported that the balance sheet shows overstated assets and understated liabilities due to cross-over refunding, or reselling of bonds.

 

ACTION:  Brian Kuiper made a motion to approve the March, 2010, financial report as presented, along with payment of bills, write-offs to collection and bad debt, and accounts payable review.  The motion was seconded by Michelle Chalin and carried with all members voting in favor.

 

QUALITY/SAFETY REPORT

 

The minutes of the January 21, 2010, Quality Council meeting were available for review.  The meeting was primarily an organizational meeting.

ACTION:  A motion was made by Margie Nelsen to acknowledge receipt of the Quality Council meeting minutes of January 21, 2010.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

ADMINISTRATIVE REPORT

 

A.          The written report submitted by Colleen Spike was reviewed.  Ms. Spike noted the following:

• The billboard advertising colonoscopy services is up, located on Highway 22 south of St. Peter. 
• She has not yet heard from Medicare regarding the facility’s critical access status within the newly designated metropolitan statistical area.
• The River’s Edge Clinic is currently in the process of installing an electronic record.  The Clinic is serving as a beta site for the HMS software, and challenges are being encountered due to the early development stage of the software. 

 

B.          City Ordinance Change.

Todd Prafke presented a draft of a modified section of City Code that was presented to the City Council on April 16.  The purpose of the changes was to include a process whereby the City Council would play a role should there be a change in the position of Chief Executive Officer of the Hospital & Clinic.  The drafted change states “The Commission shall have power: to hire, discipline and terminate the chief administrative officer of the hospital and clinic with concurrence of the City Council.  The Commission shall have the power to hire all other necessary employees; to fix and pay their compensation including that of the chief administrative officer of the hospital and clinic.”  Mr. Prafke noted the importance of the position of CEO, and that the changed wording does not prescribe a process, but ensures that the Commission will work together with the City Council in the event that a change in CEO should occur.

ACTION:  Mr. Prafke asked that Commission members review the drafted ordinance changes and notify himself or Colleen Spike of any suggestions for changes.

 

QUALITY / EDUCATION / OPERATIONS

 

A.          Opportunity to Improve/HealthStream/Complaint Reports.

Kristin Schultz presented a report outlining data from the first quarter of 2010.  She reviewed the numbers and types of opportunities to improve and complaints that were generated during January through March, and discussed the actions taken to resolve or improve the situations.  Currently there are no outstanding issues to resolve.

 

The latest results from the HCAHPS Patient Perspective surveys were presented.  This is data that will be publically reported.  HealthStream put together a report that compares this facility to peer facilities.  Of 90 hospitals in Minnesota, River's Edge Hospital & Clinic ranks number 13 in overall patient satisfaction.  In comparing 15 hospitals in this geographic area, River’s Edge ranks second.  The three areas that have the lowest scores for River’s Edge include pain management, communication about medications, and discharge information. 

 

Ms. Schultz also reported that the facility has had no healthcare-associated infections reported in the first quarter of 2010.

 

B.          LeCenter Clinic Lease.

The proposed lease for the LeCenter Clinic was available for review.  It is a five-year lease, the first two years rent-free for River’s Edge.  At the end of two years there will be an opportunity to reassess and determine if either party chooses not to continue with the lease.  Beyond the two years, River’s Edge will begin making rent payments for the clinic facility.  Ms. Spike recommended a change be made to state that utilities for gas, electric, water and garbage be

pro-rated based on occupancy.  Each party occupying the building will be responsible for their own telephone and hazardous waste expenses.

 

The LeCenter Clinic will be staffed two days per week with a nurse practitioner, nurse and receptionist.  Dr. Jacobsen will spend one-half day in LeCenter twice a month.  Start-up costs for the Clinic were projected at $39,824.  Opening is slated for July, as it will take approximately two months to get the site credentialed with the payers.

ACTION:  A motion was made by Helen White to approve the lease and move ahead with initiating clinic operations in LeCenter.  The motion was seconded by Margie Nelsen and carried with all members voting in favor. 

 

C.          Urgent Care / Medicare Cost Report.

Colleen Spike presented a proposal for changing the hours that Urgent Care is offered in the hospital’s Emergency Department.  The change is recommended due to the method that Medicare uses in looking at the costs associated with providing emergency coverage.  Time spent by a physician as ER standby time is an allowable cost, but time spent by the physician seeing urgent care patients is not.  Thus, it is costing the hospital money to provide urgent care. 

 

The proposal is to shift some of the urgent care hours to the River’s Edge Clinic, where walk-in appointments are already being taken.  The change would be as follows:

 

              Current Urgent Care Hours in ED            Proposed Hours in ED

 

              Monday-Friday 6 a.m. to 10 p.m.              Monday-Friday 5 p.m. to 8 p.m.

              Saturday-Sunday 9 a.m. to 6 p.m.             Saturday-Sunday 9 a.m. to 5 p.m.

 

Walk-in appointments will be available at the River’s Edge Clinic Monday – Friday, 8:30 a.m. to 5 p.m.

 

D.          Personnel Changes.

Interviews for the CFO/CIO position will start in two weeks.  Gil Carlson, Helen White and Brian Kuiper have agreed to serve as part of the interview team for this position.  An internal candidate has accepted the position for Accounts Payable, and a number of applications have been received for a Senior Accountant. 

 

Dr. Peter Troedson has signed a contract and will be starting to work at the River’s Edge Clinic in June.  Sarah Davis, a nurse practitioner, has been hired to work with Dr. Bowles.  During her training time she will be completing coursework to become a rheumatology nurse practitioner.  Dr. Kvidera has left the Clinic and will be pursuing other endeavors.  Another family physician interested in the Clinic will be coming for an interview.  Recruiting for physicians with an interest in OB has been difficult thus far. 

 

A plan has been set in place for a temporary reduction of staffed hours, with an overall goal of staffing to patient needs.  The changes in hours have been spread across departments and across personnel in order to minimize the effect on individual employees.  Hourly reductions, resulting in a savings of $200,000 per year, are as follows:  Imaging 74 hours, Business Services 16 hours, Registration 32 hours, OR 27 hours, Emergency Preparedness 8 hours, Administration 8 hours, OT/PT 148 hours.  These temporary cuts will be reassessed in six months, or sooner based on changes in patient volumes. 

Contracted PT and OT services to the Benedictine Living Community are also being reassessed.  Rates being charged have not increased for two years, and payments have been received on an inconsistent basis.  Consideration is being given to cutting back on the services being provided.

 

Plans are still in progress for Dr. William Lee to be establishing a private practice with a presence in St. Peter.  Dr. Lee performs lap band surgery.

 

DIRECTOR’S COMMENTS

 

Tammie Hudspith, Director of Human Resources:  Ms. Hudspith reported on a project being undertaken in conjunction with the South Central Service Cooperative.  A “High Step Academy” is being established for 11th and 12th grade students interested in health care careers.  A curriculum is being designed, and coursework would include onsite observation within the hospital and other health care facilities in the area.  Ms. Hudspith, Patty Roessler, and Colleen Spike are working with this project.

 

The hospital is also participating in a SCHIP program, working with grant money received for Brown and Nicollet Counties.  The grant is to be used to improve the health of people living within the counties.  Patty Roessler and Mary Kramer are working with this program, which is focusing on smoking cessation, improving nutrition and promoting exercise.

 

Peggy Carlson, Community Liaison: 

• A Women’s Health Forum will be held on Tuesday, May 4, 2010, from 6 to 8 p.m.
• Rasmussen College has asked permission to do some promotional filming of their students working with healthcare professionals at River’s Edge Hospital.
• Discussions are underway with the HR Department at the Regional Treatment Center to promote the River’s Edge Clinic as a Tier-2 clinic for their state health plan.
• River’s Edge Clinic is now performing DOT (Department of Transportation) examinations.  These services are being marketed directly to local businesses.  As a result of this marketing, the Clinic may also pick up some pre-employment physical business.
• The Business After Hours event for the Chamber was well received.

ADJOURNMENT

 

ACTION:  A motion was made by Helen White to adjourn the meeting.  The motion was seconded by Margie Nelsen and carried with all members voting in favor.  The meeting was adjourned at 1:35 p.m. 

 

NEXT MEETING

 

The next regular meeting of the Hospital Commission will be Wednesday, May 26, 2010, at 12 noon.  This meeting will convene in the River’s Edge Hospital Conference Room.  The Finance Committee meeting will be held at 11:30 p.m.

 

 

RIVER’S EDGE HOSPITAL & CLINIC COMMISSION MEETING

River’s Edge Hospital & Clinic Conference Room

Wednesday, March 31, 2010

 

 

Present:  Gil Carlson, Chairperson; Michelle Chalin, Vice-Chairperson; Helen White, Secretary-Treasurer; Trustees:  Brian Kuiper, Margie Nelsen, Kay Moline and Jerry Pfeifer; Colleen Spike, CEO; Patty Roessler, Director of Patient Care and Ancillary Services; Kristin Schultz, Director of Quality and Infection Control, Sheri Schmidt, Director of Business Services; Tammie Hudspith, Director of Human Resources; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; Todd Prafke, City Administrator; and Paulette Redman, Recorder.

 

Absent:  Dr. Benjamin Chaska, Chief Medical Officer; Dr. Schelli McCabe, Medical Staff President.

 

The regular meeting of the Hospital Commission was called to order at 12:22 p.m. by Chairperson Gil Carlson.

 

APPROVAL OF AGENDA

 

The agenda for the March 31, 2010, meeting was reviewed.  A request was made to add item IV-D – Policy Statement.

ACTION:  A motion was made by Jerry Pfeifer to approve the agenda as revised.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

EXECUTIVE SESSION

 

The regular meeting of the Hospital Commission was temporarily adjourned at 12:25 p.m., following which an Executive Session was convened.  The purpose of the Executive Session was for discussion of personnel issues.

 

The Executive Session was adjourned and the regular meeting of the Hospital Commission was reconvened at 12:55 p.m.

 

APPROVAL OF MINUTES

 

The minutes of the regular Hospital Commission meeting of February 24, 2010, and the workshop meeting of February 24, 2010 were reviewed.  A correction was made to the minutes to reflect the actual date of the March Commission meeting as March 31, 2010, rather than March 24, 2010.

ACTION:  A motion was made by Michelle Chalin to approve the regular Commission meeting minutes of February 24, 2010, as revised, and the workshop meeting minutes as presented.  The motion was seconded by Brian Kuiper and carried with all members voting in favor. 

 

Correction to January 27, 2010 Minutes:  A motion was made by Helen White to make a correction to the January 27, 2010 Commission meeting minutes to include a statement “The purpose of the Executive Session held was to perform the annual review for the CEO and determine a compensation package for the year.”  The motion was seconded by Michelle Chalin and carried with all members voting in favor. 

 

MEDICAL STAFF

 

A.          Medical Staff Meeting Minutes.  The minutes of the March 9, 2010, Medical Staff meeting were reviewed.  

 

ACTION: A motion was made by Michelle Chalin to acknowledge receipt of the Medical Staff meeting minutes of March 9, 2010.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

 

B.          Medical Staff Credentialing.  A report from the Executive/Credentials Committee was

presented for review.  A recommendation was made by the Credentials Committee to approve medical staff membership and granting of privileges to the physicians and allied health professionals listed on the report:

 

Reappointment to the Medical Staff:

              Theresa Dzwonkowski, ST          Courtesy Staff, AHP, Surgical Technician

 

Withdrawals from the staff include Dr. Dennis Kessler, DPM, Podiatrist, and Teleradiologists

Steven Sirr, MD, Anthony Cook, MBBS, and Geoffrey Raile, MD.

 

ACTION:  A motion was made by Jerry Pfeifer to accept the recommendation of the Credentials Committee and grant reappointment for the practitioner listed above.  The motion was seconded by Brian Kuiper and carried with all members voting in favor.  A motion was made by Helen White to accept the recommendation of the Credentials Committee and grant clinical privileges to the practitioner listed above, as requested and approved by the Credentials Committee.  The motion was seconded by Kay Moline and carried with all members voting aye. 

 

C.          Medical Advisory Panel.

              The minutes of the Medical Advisory Panel meeting of March 9, 2010, were reviewed.

ACTION:  A motion was made by Jerry Pfeifer to acknowledge receipt of the Medical Advisory Panel Meeting minutes of March 9, 2010.  The motion was seconded by Margie Nelsen and carried with all members voting in favor. 

 

FINANCIAL REPORT

 

The financial report for February, 2010, was presented by Doug Montgomery of the accounting firm Eide Bailley.  Mr. Montgomery is assisting the hospital with financial matters during the interim period until a new CFO is hired.  He noted that his first priority was to review the Medicare Cost Report, which he has completed.  His second priority is to finalize the books for February, in conjunction with the accountant. 

 

Revenue over expense for the month of February resulted in a loss of $188,087, and when combined with non-operating gain showed a net loss of $177,875.  Year-to-date figures show a loss of $548,200 for a margin of -24.05%.  Trends for Revenue in Excess of Expenses were reviewed.  A statistical summary of utilization was also reviewed, showing acute patient days 10.9% over budget, swing bed days 37% below budget, outpatient registrations 4.4% over budget and clinic visits 17.4% below budget.  The percentage of inpatient revenue versus outpatient revenue was also reviewed, as well as a balance sheet for the month.

 

ACTION:  Margie Nelsen made a motion to approve the February, 2010, financial report as presented, along with payment of bills, write-offs to collection and bad debt, and accounts payable review.  The motion was seconded by Helen White and carried with all members voting in favor.

                                                                                                                

ADMINISTRATIVE REPORT

 

The written report submitted by Colleen Spike was reviewed. 

 

QUALITY / EDUCATION / OPERATIONS

 

A.          Physician Recruitment.

The recruiting firm of Martin Fletcher will be reopening their search for physicians.  Their first search did not result in any viable candidates.  Colleen Spike has negotiated an agreement with them to reopen their search at no cost to the facility.  Thus far they have sent one resume for review.  An independent family physician has expressed interest in working at the clinic -- a physician currently working in the Cities as a hospitalist who is interested in getting back into family practice.  Ms. Spike will be following up with this physician.

 

B.          Colonoscopy Campaign.

The hospital will be initiating a marketing campaign to promote colonoscopies.  A billboard on Highway 22 between St. Peter and Mankato will be rented at a cost of $495 per month.  The billboard will highlight the importance of colonoscopy as well as promote the hospital’s use of anesthesia services to make colonoscopy procedures virtually painless.  The billboard will be leased for 12 months, with an option to change the billboard as often as the facility would like for an additional fee.

 

C.          LeCenter Clinic.

Colleen Spike presented details outlining proposed costs for starting a clinic in LeCenter.  Initial plans would be to staff the clinic two days per week, Monday and Friday, with a nurse practitioner, RN and receptionist, all currently employees of River’s Edge Clinic.  Start up costs would include $8,429 for laboratory equipment, $21,582 for IT equipment, $7,850 for supplies, and $6,402 for utilities.  There are approximately $5,000 in building maintenance costs projected, and Ms. Spike will be asking the LeCenter Economic Development Agency to provide all but $200 of the building improvements.  The hospital will pay $200 for installation of appropriate locks and security. 

 

The question has also been raised as to whether radiology services could be included.  This would necessitate purchase of an x-ray machine for $62,327, as well as supplying a CMA to run the equipment.  Ms. Spike will be discussing this issue further with the LeCenter leaders.

 

Expenses to get started total $44,463 with projected income of $73,320 without including radiology services.  By including radiology services, initial expenses would be $63,433 with income projected at $95,784. 

 

The City of LeCenter is proposing a five-year lease with the first two years being no rent and shared utilities with the chiropractor who is also using the clinic building.  Year three would see $300/month rent, year four $400/month, and year five $500/month.  Ms. Spike will be pursing a caveat with the rent agreement to allow the hospital the chance to bow out of the deal if the clinic is not making money.

 

ACTION:  A motion was made by Jerry Pfeifer to allow Colleen Spike to pursue a formal rental agreement with LeCenter.  The motion was seconded by Helen White and carried with all members voting in favor.  Ms. Spike will bring the formal rental agreement before the Commission for approval.

 

D.          Policy Statement.

The Medical Staff has approved a change to the Medical Staff Rules and Regulations.  The change addresses the time frame for pre-operative History and Physical Exam reports and pre-operative lab work.  Time frames are changed from 7 days to 30 days.  The change is in line with Medicare Conditions of Participation.

ACTION:  A motion was made by Michelle Chalin to approve the change to the Medical Staff Rules and Regulations as presented.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

 

DIRECTOR’S COMMENTS

 

Todd Prafke, City Administrator:  Mr. Prafke noted that Immanuel St. Joseph’s – Mayo Health System has paid their share of the medical office building costs.  A slight modification to the shared services agreement has been made, as the square footage they are using is actually different from the original plan.

 

Peggy Carlson, Community Liaison: 

• The Chamber Business After Hours event will be held in the lobby of the River’s Edge Medical Office Building on April 20.  This event will be held in conjunction with Mankato Chiropractic in celebration of the first anniversary in the building.  The event will be from 5 to 6:30 p.m.
• Dedication plaques have been ordered.
• River’s Edge Clinic is now performing DOT (Department of Transportation) examinations.  There services are being marketed directly to local businesses.
• The colonoscopy campaign is being promoted to community groups.  Rick Cauley, CRNA, will be attending service group meetings to discuss colonoscopy and colon cancer prevention.
• The hospital will be hosting a Red Cross blood drive on April 8, 2010.

 

ADJOURNMENT

 

ACTION:  A motion was made by Helen White to adjourn the meeting.  The motion was seconded by Margie Nelsen and carried with all members voting in favor.  The meeting was adjourned at 1:39 p.m. 

 

NEXT MEETING

 

The next regular meeting of the Hospital Commission will be Wednesday, April 28, 2010, at 12 noon.  This meeting will convene in the River’s Edge Hospital Conference Room.  The Finance Committee meeting will be held at 11:30 p.m.

 

 

 

RIVER’S EDGE HOSPITAL & CLINIC COMMISSION MEETING

River’s Edge Hospital & Clinic Conference Room

Wednesday, February 24, 2010

 

 

Present:  Gil Carlson, Chairperson; Helen White, Secretary-Treasurer; Trustees:  Michelle Chalin, Brian Kuiper, Margie Nelsen, Kay Moline and Jerry Pfeifer; Colleen Spike, CEO; Ken Cornish, Director of Finance; Dr. Benjamin Chaska, Chief Medical Officer; Dr. Schelli McCabe, Medical Staff President; Kristin Schultz, Director of Quality and Infection Control, Sheri Schmidt, Director of Business Services; Tammie Hudspith, Director of Human Resources; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; Todd Prafke, City Administrator; and Paulette Redman, Recorder.

 

Absent:  None.

 

The regular meeting of the Hospital Commission was called to order at 12:22 p.m. by Chairperson Gil Carlson.

 

OATH OF OFFICE

 

Gil Carlson, Commission Chairperson, administered the oath of office to the members of the Hospital Commission.

 

APPROVAL OF AGENDA

 

The agenda for the February 24, 2010, meeting was reviewed.  

ACTION:  A motion was made by Jerry Pfeifer to approve the agenda as presented.  The motion was seconded by Michelle Chalin and carried with all members voting in favor. 

 

APPROVAL OF MINUTES

 

The minutes of the regular Hospital Commission meeting of January 27, 2010, were reviewed. 

ACTION:  A motion was made by Kay Moline to approve the regular Commission meeting minutes of January 27, 2010, as presented.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

MEDICAL STAFF

 

A.          Medical Staff Meeting Minutes.  The minutes of the February 9, 2010, Medical Staff meeting were reviewed.  

ACTION: A motion was made by Kay Moline to acknowledge receipt of the Medical Staff meeting minutes of February 9, 2010.  The motion was seconded by Jerry Pfeifer and carried with all members voting in favor. 

 

B.          Medical Staff Credentialing.  A report from the Executive/Credentials Committee was

presented for review.  A recommendation was made by the Credentials Committee to approve medical staff membership and granting of privileges to the physicians and allied health professionals listed on the report:

 

Reappointment to the Medical Staff:

              Mohammed Solaiman, MD           Active Staff, Family Medicine

              Amy Kvidera, MD                        Active Staff, Family Medicine

              April Burns, CST                           Courtesy Staff, AHP, Surgical Technician

              Jill Christianson, CST                     Courtesy Staff, AHP, Surgical Technician

 

Change from Provisional to Full Membership:

              Rebecca Bailey, PA-C                  Courtesy Staff, AHP, Surgical Physician Assistant

              Ashley Brenden, PA-C                  Courtesy Staff, AHP, Surgical Physician Assistant

 

              Continuation of Provisional Status:

              Stephen Fridinger, DACBR          Courtesy Staff, Chiropractic Radiologist

 

Withdrawals from the staff include Dr. Mark Conover, DDS

 

ACTION:  A motion was made by Kay Moline to accept the recommendation of the Credentials Committee and grant reappointment or change in status for each of the practitioners listed above.  The motion was seconded by Helen White and carried with all members voting in favor.  A motion was made by Jerry Pfeifer to accept the recommendation of the Credentials Committee and grant clinical privileges to each of the practitioners listed above, as requested and approved by the Credentials Committee.  The motion was seconded by Michelle Chalin and carried with all members voting aye. 

 

FINANCIAL REPORT

 

The financial report for January, 2010, was presented.  Total Days Cash on Hand is at 270 days.  The current ratio remains strong at 5.9.  Days in Accounts Receivable is currently at 49.7 days.  Revenue over expense for the month resulted in a loss of $365,000, and when combined with non-operating gain for December showed a net loss of $353,300, for a margin on -33%. 

 

Community Care grants for January totaled $11,380.  Bad debt for the month totaled $50,430, including 38 accounts from uninsured patients with a total of $30,636 and 82 accounts from patients with balances after insurance of $19,794.  The Revenue Recapture program through the State of Minnesota has results in $193,045 recovered for the hospital during 2009.  

 

Mr. Cornish noted that the 2010 budget does include a loss for the operations of the Clinic; this was planned for as a result of a new clinic start up.  The facility is feeling the effects of the overall downturn of the economy.

 

Ken Cornish and Colleen Spike attended a recent City Council workshop where they presented information about the 2009 finances and 2010 budget. 

 

ACTION:  Brian Kuiper made a motion to approve the January, 2010, financial report as presented, along with payment of bills, write-offs to collection and bad debt, and accounts payable review.  The motion was seconded by Helen White and carried with all members voting in favor.

 

QUALITY / SAFETY

 

A.          Opportunity to Improve and Press Ganey Summary.

Kristin Schultz presented a summary of complaints and Opportunities To Improve that occurred in January.  She discussed the Opportunity to Improve (OTI) reporting process and distributed the associated policies and term definitions for review.  There were 6 complaints (2 inpatient, 4 ED/UC) received and 10 OTI reports.  Of these, 6 were attributed to technical competence/appropriateness issues, 3 to communications issues and 3 to coordination of care issues.  All but one have been resolved, and the last one is still in the process of resolution.  Appropriate actions and process changes are made based on the complaints and OTI reports received.

 HCAHPS patient satisfaction data from the 4th quarter of 2009 was presented.  The top box scores and mean trends for each indicator were reviewed.  Survey data for Emergency Department patients has been difficult to obtain due to low response rates.  The sampling rate is being adjusted and REHC managers and staff will be providing additional information to patients regarding the surveys.

 

ADMINISTRATIVE REPORT

 

The written report submitted by Colleen Spike was reviewed.  In addition, the following was noted:

• Peggy Carlson reviewed the wording and format for the dedication plaques that will be made to go onto the hospital and the medical office building near the main entrances.  The 9x12” plaques will cost $438 each and will be cast in bronze.  Colleen Spike will be asking the Foundation to cover this cost.
• The pharmacy in the Medical Office Building will be opening on Tuesday, March 2.
• The St. Peter Herald featured an article about Heidi Faul, CNP, and her upcoming trip for a medical mission to Haiti.  Janet Nordstrom, PT, is currently in Haiti working at a hospital for two weeks.
• The River’s Edge Clinic is now a provider for the Regional Treatment Center’s employee BC/BS plan.  There have been 28 of their employees that have identified REHC as their primary clinic.
• Ms. Spike reviewed utilization statistics for the past five years, showing the trends in activity throughout the facility.

 

QUALITY / EDUCATION / OPERATIONS

 

A.          SEQUEL Software Purchase.

A proposal to purchase a software package entitled SEQUEL was presented.  Sequel is a report writer that will enable increased reporting capabilities for the HMS system.  The system also provides security measures to limit access as appropriate to job functions.  The cost of the system is $13,135.00 with installation cost of $5,035.00.

ACTION:  A motion was made by Jerry Pfeifer to approve the purchase of the Sequel software package for $13,135.00 with $5,035.00 for installation.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

DIRECTOR’S COMMENTS

 

Peggy Carlson, Community Liaison: 

• A series of classes on women’s health is ongoing, the first of which was held on February 3, with 35 in attendance.  The next class will be tonight, February 24, on pre-menstrual syndrome and March 3 on menopause.  These classes are being presented by Dr. Kvidera and the Mankato Chiropractic Center, to include information about diet, exercise, acupuncture, aromatherapy and chiropractic care.  A demonstration night is being planned closer to Mother’s Day.
• A seminar on “Dealing with Asthma for Daycare Providers” was held on February 18 with 18 registered.
• REHC will be one of the sponsors for the Arthritis Walk that will be held in May.

• The Chamber Business After Hours event will be held in the lobby of the River’s Edge Medical Office Building on April 20.  This event will be held in conjunction with Mankato Chiropractic in celebration of the first anniversary in the building.  The event will be from 5 to 6:30 p.m.
• The Consumer Advisory Council will have its first meeting in March with a membership of 12 to 15 people.

 

Tammie Hudspith, Director of Human Resources:  Ms. Hudspith is looking at again participating in the Scrubs Camp for Youth to be held in Mankato during the summer.  The camp is geared for junior high youth interested in health care careers.

 

Jerry Pfeifer, Trustee:  Mr. Pfeifer thanked Administration for getting the work done on the dedication plaques.  He also suggested having a ceremony and another open house at the time the plaques are installed.

 

Benjamin Chaska, MD, Chief Medical Officer:  Dr. Chaska announced that Dr. Graeme Browne, a physician in the ED, has been appointed to the American Board of Physician Specialists for Emergency Medicine.  Dr. Alpana Singh, also an ED physician, has passed her Family Medicine boards.  Dr. Chaska also reported that the Institute for Healthcare Improvement (IHI) has asked the him to author a paper about the facility’s experience with improvement initiatives, and he will be working on this project.

 

ADJOURNMENT

 

ACTION:  A motion was made by Helen White to adjourn the meeting.  The motion was seconded by Kay Moline and carried with all members voting in favor.  The meeting was adjourned at 1:06 p.m. 

 

NEXT MEETING

 

The next regular meeting of the Hospital Commission will be Wednesday, March 24, 2010, at 12 noon.  This meeting will convene in the River’s Edge Hospital Conference Room.  The Finance Committee meeting will be held at 11:30 p.m.

 

 

RIVER’S EDGE HOSPITAL & CLINIC COMMISSION MEETING

River’s Edge Hospital & Clinic Conference Room

Wednesday, January 27, 2010

 

 

Present:  Gil Carlson, Chairperson; Helen White, Secretary-Treasurer; Trustees:  Michelle Chalin, Brian Kuiper, Kay Moline and Jerry Pfeifer; Colleen Spike, CEO; Ken Cornish, Director of Finance; Dr. Benjamin Chaska, Chief Medical Officer; Dr. Schelli McCabe, Medical Staff President; Kristin Schultz, Director of Quality and Infection Control, Sheri Schmidt, Director of Business Services; Patty Roessler, Director of Nursing and Ancillary Services; Tammie Hudspith, Director of Human Resources; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; Todd Prafke, City Administrator; and Paulette Redman, Recorder.

 

Absent:  Margie Nelsen, Trustee.

 

The regular meeting of the Hospital Commission was called to order at 12:20 p.m. by Chairperson Gil Carlson.

 

Chairperson Gil Carlson turned the meeting over to Colleen Spike, CEO.

 

COMMISSION MEMBERSHIP

 

Colleen Spike announced that Margie Nelsen has been appointed by the City of St. Peter as a new Commission member.  She is currently traveling out of the country and unable to attend this meeting.  Jerry Pfeifer has been reappointed as the City Council representative on the Commission.  The oath of office will be administered at the February meeting.

 

ELECTION OF OFFICERS

Commission members were presented with ballots to nominate members for the offices of Chairperson, Vice-Chairperson, and Secretary-Treasurer.  The ballots were completed and votes tallied.  Commission members nominated for office:  Chairperson – Gil Carlson, receiving 6 votes; Vice-Chairperson – Three-way tie; Secretary-Treasurer – Helen White, receiving 5 votes. 

ACTION:  A motion was made by Kay Moline to approve the nomination for Chairperson and Secretary-Treasurer as voted upon by the Commission members.  The motion was seconded by Michelle Chalin and carried with all voting in favor.

 

Colleen Spike turned the meeting over to Chairperson Gil Carlson.

 

ACTION:  Mr. Carlson opened the floor for nominations for Vice-Chairperson.  Brian Kuiper was nominated; Mr. Kuiper declined the nomination.  Michelle Chalin was nominated; Ms. Chalin accepted the nomination.  Kay Moline was nominated; Ms. Moline declined the nomination.  Kay Moline made a motion that nominations cease.  The motion was seconded and carried.  A motion was made by Jerry Pfeifer to approve the nomination of Michelle Chalin as the vice-chairperson.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

 

APPOINTMENT OF COMMITTEE MEMBERS

 

Committee appointments were made as follows:

              Finance Committee:  Brian Kuiper and Helen White.

              ACTION:  A motion was made by Jerry Pfeifer to appoint Brian Kuiper and Helen White as

members of the Commission Finance Committee.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

Quality Council:  Michelle Chalin and Helen White.

ACTION:  A motion was made by Kay Moline to appoint Michelle Chalin and Helen White to the Quality Council.  The motion was seconded by Jerry Pfeifer and carried with all members voting in favor. 

River’s Edge Hospital & Clinic Advisory Group:  This is a new committee with membership to include representatives from surrounding communities for purposes of discussion on meeting the health care needs of the communities being served by River's Edge Hospital & Clinic. 

ACTION:  A motion was made by Jerry Pfeifer to appoint Kay Moline and Helen White to the Advisory Group.  The motion was seconded by Michelle Chalin and carried with all members voting in favor. 

 

APPROVAL OF AGENDA

 

The agenda for the January 27, 2010, meeting was reviewed.  

ACTION:  A motion was made by Kay Moline to approve the agenda as presented.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

APPROVAL OF MINUTES

The minutes of the regular Hospital Commission meeting of December 16, 2009, and the Strategic Planning meeting of December 16, 2009, were reviewed. 

ACTION:  A motion was made by Brian Kuiper to approve the regular Commission meeting minutes and Strategic Planning meeting minutes of December 16, 2009, as presented.  The motion was seconded by Jerry Pfeifer and carried with all members voting in favor. 

 

MEDICAL STAFF

A.          Medical Staff Meeting Minutes.  The minutes of the January 12, 2010, Medical Staff meeting were reviewed.  

ACTION: A motion was made by Kay Moline to acknowledge receipt of the Medical Staff meeting minutes of January 12, 2010.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

B.          Medical Staff Credentialing.  A report from the Executive/Credentials Committee was

presented for review.  A recommendation was made by the Credentials Committee to approve medical staff membership and granting of privileges to the physicians and allied health professionals listed on the report:

 

Reappointment to the Medical Staff:

              Timothy Deaconson, MD             Courtesy Staff, General Surgery

              Todd Christianson, OPA-C          Courtesy Staff, AHP, Orthopedic Physician Assistant

              Mark Mahoney, DC                      Active Staff, Chiropractic

              Teresa Marshall, DC                     Active Staff, Chiropractic

              Susan Klenk, MD                          Active Staff, Family Medicine

              Teleradiologists:

                           Norman Arslanlar, DO                            Geoffrey Bodeau, MD                             Brent Bullis, MD

                                    Nerraj Chepuri, MD                                 Anthony Cook, MBBS                            Benjamin Crandall, DO

                                    Charles Donovan, MD                            Mark Doyscher, MD                               Kevin Edelman, M

                                    Eduardo Ehrenwald, MD, PhD              Christopher Engeler, MD                        Nazih Farah, MD

                                    Stephen Fry, MD                                     Frederick Gramith, MD                            Gregory Haines, DO

                                    Douglass Hassell, MD                            Stephen Hite, MD                                   Thomas Ibach, MD

                                    Radha Inampudi, MD                              Subbarao Inampudi, MBBS                   Steven Jensen, MD

                                    Jon Kane, MD                                           Eul Kang, MD                                          Timothy Koelz, MD

                                    J. Denise Krivach, MD                            Richard Levey, MD                                 Thomas Matson, MD

                                    Jason Mehling, MD                                 Karla Myhra-Bloom, MD                        James Mylrea, MD

                                    Gwen Nazarian, MD                                 John Nobrega, MD                                  Frederick Olson, MD

                                    Mark Oswood, MD                                  Robin Parker, MD                                    John Perl, MD

                                    Jeffrey Peterson, MD                              Michael Plunkett, MD                             Robert Pollock, MD

                                    Kenneth Priemesberger, MD                 Geoffrey Raile, MD                                  Anne Reddy, MD

                                    Paul Rust, MD                                          Lisa Schneider, MD                                 Clark Schumacher, MD

                                    Scott Sidney, MD                                    Steven Sirr, MD                                        John Steely, MD

                                    Christopher Tillotson, MD                     David Tubman, MD                                 Sara Beth Veldman, MD

                                    Robert Yost, MD

                  Additional Teleradiology Privileges:                    Daniel Beggs, MD                                    Stephen Fridinger, DACBR

                                    Mary Hestness, MD                               Mareve Kayfes, MD                                Stanley Kurisko, MD

                                   David Mills, MD                                      Patrick O’Brien, MD                                                    

                                   Martin Schularick, MD                            Matthew Stone, MD

 

Change from Provisional to Full Membership:

               John Jacobsen, MD                       Active Staff, Allergy

              Bret Cardwell, MD                        Courtesy Staff, General Surgery

              Julie Buettner, DC                         Active Staff, Chiropractic

 

Withdrawals from the staff include Paul Mittelstadt, MD, Emergency Medicine, Brian

Lambrect, Surgical Technician, and Burrel Deaton, MD, moving to Honorary Staff following

retirement.

 

ACTION:  A motion was made by Jerry Pfeifer to accept the recommendation of the Credentials Committee and grant reappointment or change in status for each of the practitioners listed above.  The motion was seconded by Kay Moline and carried with all members voting in favor.  A motion was made by Brian Kuiper to accept the recommendation of the Credentials Committee and grant clinical privileges to each of the practitioners listed above, as requested and approved by the Credentials Committee.  The motion was seconded by Jerry Pfeifer and carried with all members voting aye. 

FINANCIAL REPORT

The financial report for December, 2009, was presented.  Total Days Cash on Hand is at 257 days.  The current ratio remains strong at 6.2.  Days in Accounts Receivable is currently at 44 days.  Revenue over expense for the month resulted in a loss of $222,500, and when combined with non-operating gain for December showed a net loss of $189,667, for a margin on -15.5%.  Year-to-date there is a net loss of $757,744, for a margin of -4.67%.

 

Community Care grants for December totaled $13,283.  Bad debt for the month totaled $76,371, including 43 accounts from uninsured patients with a total of $39,358 and 99 accounts from patients with balances after insurance of $37,013.  The Revenue Recapture program through the State of Minnesota has results in $193,045 recovered for the hospital.  The compares with $148,000 recovered in 2008 and $124,000 recovered in 2007.

Mr. Cornish reported that the City of St. Peter is looking into refinancing the hospital debt.  Standard & Poors has rated the bonds as A+ stable.  The bonds will go out to bid this afternoon or tomorrow morning, and it is expected that a lowering of the interest rate would result in savings of $80,000 per year over the life of the bonds.

 

The budget process for the State of Minnesota has resulted in the elimination of the program for General Assistance Medical Care, or GAMC.  Eliminating this program results in an estimated loss in revenue of $65,000 for River's Edge Hospital & Clinic.  The Minnesota Hospital Association has developed a compromise plan.  If accepted, this plan would result in a loss of $160,000 for River’s Edge, but would be providing equity across the state and additional funding for the state’s safety net hospitals, such as Hennepin County and Regions, each of which stand to lose in excess of $20 million with the elimination of GAMC.

 

ACTION:  Kay Moline made a motion to approve the December, 2009, financial report as presented, along with payment of bills, write-offs to collection and bad debt, and accounts payable review.  The motion was seconded by Brian Kuiper and carried with all members voting in favor.

 

QUALITY / SAFETY

 

A.          Quality Council Meeting.

              The minutes of the November 19, 2009, meeting were available for review.

ACTION:  A motion was made by Michelle Chalin at acknowledge receipt of the Quality Council meeting minutes of November 19, 2009.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

B.          Patient Safety Committee Meeting.

The minutes of the January 19, 2010, Patient Safety Committee meeting were available for review.  Dr. Chaska noted that River’s Edge will again be designated as a Mentor Hospital for the IHI.  The Patient Safety Committee has reviewed the IHI’s new Improvement Map program and has determined priorities for working on various measures.  A number of the measures have been instituted over the past years, and the hospital is performing at benchmark on many of them.

ACTION:  A motion was made by Jerry Pfeifer to acknowledge receipt of the Patient Safety Committee meeting minutes from January 19, 2010.  The motion was seconded by Brian Kuiper and carried with all members voting in favor. 

 

ADMINISTRATIVE REPORT

 

The written report submitted by Colleen Spike was reviewed.  In addition, the following was noted:

• Each of the Commissioners received a packet of forms to review and sign.  The signed forms may be turned in to Colleen Spike.
• The new digital mammography equipment is up and running in the Imaging Department.
• The pharmacy space in the Medical Office Building should be completed by the first week in March.
• The hospital and clinic staff sponsored a potluck lunch last week and raised $1,079 for Haitian relief following the recent earthquake in that country.
• Michelle Chalin has recently attended a “New Trustee Boot Camp,” as well as attending the Minnesota Hospital Association conference along with Colleen Spike.

Ms. Spike questioned whether the commissioners would be willing to have an informal planning session prior to February’s commission meeting.  The purpose of the session would be to discuss directions the hospital and clinic may wish to look at for future planning, specifically in light of the financial challenges being faced.  Ms. Spike reported that ISJ-Mayo/St. Peter Clinic will be starting to do scope procedures in their clinic beginning in April, which will result in a revenue decrease of over $500,000 for the hospital.  In view of this, the hospital will be looking at a marketing strategy in an effort to keep cases here.  Ms. Spike also stated she had received a telephone call from LeCenter – the City has asked that she have a discussion with their leaders to discuss the health care needs of their city.

ACTION:  Informal planning session to be held at 11 a.m. on Wednesday, February 24, 2010.

 

QUALITY / EDUCATION / OPERATIONS

 

A.          BHS Senior Housing Entrance Turnaround.

The most recent revision of the BHS senior housing plan had taken up some space that had been designated as potential hospital expansion space.  Colleen Spike had requested that BHS look at this again and revise the plan.  A revised plan was presented and was less beneficial to the hospital, as it required that traffic exiting the senior housing parking lot would travel through the hospital employee parking lot to return to the street.  This was not acceptable to Administration.  BHS has returned to the first plan presented, with some alterations to utilize a smaller piece of the hospital expansion property.

 

B.          Minnesota Statewide Quality Reporting.

Colleen Spike reported on the legislation that has been passed requiring hospitals and clinics to report patient care data to the state for quality comparison and pay for performance programs.  River’s Edge Clinic will be reporting data related to optimal diabetes care, optimal vascular care, care for patients with depression, and health information technology use.  Beginning in 2011, the clinic will also be required to report patient race, ethnicity and language data.  The hospital will be reporting on quality measures for both inpatient and outpatient care.  For inpatients this includes topics relating to acute myocardial infarction congestive heart failure, pneumonia and surgical care.  Mortality measures, patient safety issues and complications of care will also be monitored.  Outpatient data will include topics of acute myocardial infarction, chest pain and outpatient surgical measures, as well as looking at patient experience through the HCAHPs patient satisfaction data.

 

C.          Minnesota Stroke Registry.

River's Edge Hospital & Clinic has been named as one of three hospitals to receive a grant to be a part of the Minnesota Rural Health Stroke Pilot project.  The aim of the project is to improve quality of care for stroke patients.  The project will being in February, 2010, and will end in January 2011.  Hospitals included are River’s Edge, Kanabec Hospital in Mora, and Abbott Northwestern Hospital.

 

D.          River’s Edge Ambulance Update.

Ms. Spike reported that there have been no further indications of unionizing activity following a change in leadership within the ambulance service.  Management for the ambulance service is contracted through Gold Cross.

DIRECTOR’S COMMENTS

 

Sheri Schmidt, Director of Business Services:  Monitoring results for the documentation policy were presented.  Ms. Schmidt noted an improvement in the timeliness of record completion since the policy was put into place.

 

Peggy Carlson, Community Liaison:  Classes coming up include:

• A series of classes on women’s health, the first of which will be February 3, discussing perimenopausal issues, followed by February 24 on pre-menstrual syndrome and March 3 on menopause.  These classes are being presented by Dr. Kvidera and the Mankato Chiropractic Center, to include information about diet, exercise, acupuncture, aromatherapy and chiropractic care.
• Heidi Faul, CFNP, will be presenting a class entitled “Living a Stress-Reduced Life”.  The class is geared toward young mothers and will be held February 9 at Creative Play Place.
• On February 18, in collaboration with the American Lung Association, a seminar will be presented on “Dealing with Asthma for Daycare Providers.”

Additionally, several groups of high school students have been hosted for health care career exploration.

 

Todd Prafke, City Administrator:  Mr. Prafke reported that he just received word that the hospital bonds had been refinanced, with a resulting savings to the hospital of $1.13 million over the life of the bonds.

 

Colleen Spike, CEO:  Ms. Spike reported that Dr. Teresa Marshall of Mankato Chiropractic has been reappointed to the Chiropractic Board of Examiners.

 

EXECUTIVE SESSION

 

The regular meeting of the Hospital Commission was temporarily adjourned at 1:15 p.m., following which an Executive Session was convened.

 

The Executive Session was adjourned and the regular meeting of the Hospital Commission was reconvened at 1:28 p.m.

 

CEO SALARY

 

ACTION:  A motion was made by Jerry Pfeifer to increase the CEO salary by 3% for the year 2010, plus associated benefits.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

ADJOURNMENT

ACTION:  A motion was made by Jerry Pfeifer to adjourn the meeting.  The motion was seconded by Kay Moline and carried with all members voting in favor.  The meeting was adjourned at 1:40 p.m. 

NEXT MEETING

The next regular meeting of the Hospital Commission will be Wednesday, February 24, 2010, at 12 noon.  This meeting will convene in the River’s Edge Hospital Conference Room.  The Finance Committee meeting will be held at 10:30 p.m.  An informal planning session with the Commission will take place from 11 a.m. until 12 noon.

 

RIVER’S EDGE HOSPITAL & CLINIC COMMISSION MEETING

River’s Edge Hospital & Clinic Conference Room

Wednesday, December 16, 2009

 

 

Present:  Gil Carlson, Chairperson; Bonnie Hunt, Vice Chairperson; Helen White, Secretary-Treasurer; Trustees:  Michelle Chalin, Brian Kuiper, Kay Moline and Jerry Pfeifer; Colleen Spike, CEO; Ken Cornish, Director of Finance; Dr. Benjamin Chaska, Chief Medical Officer; Kristin Schultz, Director of Quality and Infection Control, Sheri Schmidt, Director of Business Services; Tammie Hudspith, Director of Human Resources; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; Todd Prafke, City Administrator; and Paulette Redman, Recorder.

 

Absent:  Dr. Schelli McCabe, Medical Staff President.

 

The regular meeting of the Hospital Commission was called to order at 4:01 p.m. by Chairperson Gil Carlson.

 

APPROVAL OF AGENDA

 

The agenda for the December 16, 2009, meeting was reviewed.  

ACTION:  A motion was made by Helen White to approve the agenda as presented.  The motion was seconded by Michelle Chalin and carried with all members voting in favor. 

 

APPROVAL OF MINUTES

The minutes of the regular Hospital Commission meeting of November 18, 2009, were reviewed. 

ACTION:  A motion was made by Kay Moline to approve the regular Commission meeting minutes of November 18, 2009, as presented.  The motion was seconded by Bonnie Hunt and carried with all members voting in favor. 

 

MEDICAL STAFF

A.          Medical Staff Minutes / Medical Advisory Panel Minutes.  The minutes of the December 8, 2009, Medical Staff and Medical Advisory Panel meetings were reviewed.  Dr. Chaska noted the patient safety initiative the Medical Staff will be working on for 2010 is the “Clean Your Hands” initiative.

ACTION: A motion was made by Brian Kuiper to acknowledge receipt of the Medical Staff meeting minutes of December 8, 2009.  The motion was seconded by Helen White and carried with all members voting in favor.  A motion was made by Brian Kuiper to acknowledge receipt of the Medical Advisory Panel meeting minutes of December 8, 2009.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

 

B.          Medical Staff Credentialing.  A report from the Executive/Credentials Committee was

presented for review.  A recommendation was made by the Credentials Committee to approve medical staff membership and granting of privileges to the physicians and allied health professionals listed on the report:

 

Reappointment to Medical Staff

David Mills, MD                            Courtesy Staff, Radiology

Lynn Gustafson, DPM                   Courtesy Staff, Podiatry

Paula Prybylla, DC                        Active Staff, Chiropractic / Acupuncture

Jennifer Miller, DDS                      Courtesy Staff, Dentist

 

ACTION:  A motion was made by Jerry Pfeifer to accept the recommendation of the Credentials Committee and grant reappointment for each of the practitioners listed above.  The motion was seconded by Bonnie Hunt and carried with all members voting in favor.  A motion was made by Jerry Pfeifer to accept the recommendation of the Credentials Committee and grant clinical privileges to each of the practitioners listed above, as requested and approved by the Credentials Committee.  The motion was seconded by Bonnie Hunt and carried with all members voting aye. 

 

FINANCIAL REPORT

A.          Financial Report.

The financial report for November, 2009, was presented.  Revenue over expense for the month resulted in a gain of $81,297, and when combined with non-operating gain for November showed a gain of $93,451.  Year-to-date there is a net loss of $545,643.  Mr. Cornish noted that reductions from revenue were recalculated based on the new Medicare rates that went into effect in October.

 

Community Care grants for November totaled $16,508.  Bad debt for the month totaled $74,030, including 35 accounts from uninsured patients and 86 accounts from patients with balances after insurance.

 

ACTION:  Helen White made a motion to approve the November, 2009, financial report as presented, along with payment of bills, write-offs to collection and bad debt, and accounts payable review.  The motion was seconded by Brian Kuiper and carried with all members voting in favor.

 

B.          2010 Budget:

The proposed budget for 2010 was reviewed.  Ken Cornish noted the projected utilization for the coming year to be similar to 2009 – inpatient days are expected to be steady with an average daily census of 5, and outpatient utilization is expected to show steady growth of 9.9%, with the increase mainly coming from the clinic.  Revenue projections include an average 2.12% rate increase, with some charges seeing no increase, and some, including room rates, seeing an increase of 4%.  Deductions from revenue are increased by 8.6% over 2009.  Net inpatient revenue is projected to increase 17% over current levels, outpatient revenue increase 5.5%, and clinic revenue to double from 2009 levels.  Net patient services revenue is projected to increase 21% over current levels.

 

Salaries and benefits make up the largest percentage of expense.  Total salary expense is expected to increase 20%, including a 2% increase in employee wages and additional FTEs needed.  Total benefits costs will remain steady on an individual basis, but overall a 14% increase is projected due to an increase in employees.  The cost of professional services will increase 14.2%.  Leases and rental expense will increase 152% due to the leasing of the clinic space and the leasing of new mammography equipment.  Three areas of focus for cutting expenses are professional development, minor equipment and overtime.

 

A net loss from operations of $719,699 is projected.  Including nonoperating gains, revenue over expense is projected at a loss of $435,858, for a -2.51% margin.  This compares to overall projected loss of $435,858, or a -5.73% margin for 2009 thus far.

 

ACTION:  A motion was made by Brian Kuiper to approve the 2010 hospital and clinic budget as presented.  The motion was seconded by Kay Moline and carried with all members voting in favor. 

 

QUALITY / SAFETY

 

A.          Patient Safety Committee.

The minutes of the December 1, 2009, Patient Safety Committee meeting were available for review.  Dr. Chaska noted that the IHI (Institute for Healthcare Improvement) campaigns for Save 100,000 Lives and 5 Million Lives have been completed.  Their new improvement campaign is an “Improvement Map.”  There are 72 different initiatives included in the Improvement Map, and facilities can choose the initiatives they wish to focus on.  River’s Edge already has a number of the measures in place and will be looking at additional measures to work on.  Dr. Chaska summarized the results of the various initiatives that have been worked on over the past year, noting the successes and improvements seen, including, but not limited to, 0 nosocomial infections in 2009, a decrease in the use of catheters with no associated infections identified, implementation of a Surgical Safety Checklist, continued high utilization of the medication reconciliation process, improvement in administration of aspirin for chest pain patients and implementation of quality/safety measures in the clinic.

ACTION:  A motion was made by Jerry Pfeifer to acknowledge receipt of the Patient Safety Committee meeting minutes from December 1, 2009.  The motion was seconded by Bonnie Hunt and carried with all members voting in favor. 

 

ADMINISTRATIVE REPORT

The written report submitted by Colleen Spike was reviewed.  In addition, the following was noted:

• An additional 200 doses of H1N1 vaccine were received and distributed within two days.
• The hospital has received Level 4 Trauma designation from the State of Minnesota.
• The Nash Finch agreement for lease of the pharmacy space in the Medical Office Building has been completed.  It was presented to and approved by the City Council on Monday and is now pending agreement by Nash Finch.  A pharmacist has been hired to work in the pharmacy.  Colleen Spike will be talking with them regarding time frames for completion of the project.

QUALITY / EDUCATION / OPERATIONS

 

A.          Mission Statement.

The proposed revision of the Mission and Vision Statement has been reviewed by DNV and suggestions were made to modify it.  The proposed Mission and Vision Statement now reads:

“River’s Edge Hospital & Clinic provides quality health services that value all dimensions of health including mind, body and spirit.  Our goal is to improve the health of all individuals we serve through continuous, measurable improvement in patient satisfaction, clinical quality, and operational effectiveness.”

ACTION:  A motion was made by Bonnie Hunt to approve the Mission and Vision Statement as presented.  The motion was seconded by Michelle Chalin and carried with all members voting in favor. 

 

B.          Website / Agenda & Meeting Minutes.

The City of St. Peter has asked that the Hospital Commission agendas and meeting minutes (following approval) be posted on the hospital website.  A link would then be established on the City website for access to these documents.  Proposed start date for posting is March, 2010.  Peggy Carlson will be working on implementation of this project.

 

C.          Physician Recruitment Lunch.

A female family practice physician currently practicing in South Dakota will be on site on December 29, 2009, to interview and see the hospital and clinic.  A luncheon will be provided and Commission members are invited to attend.  A packet of information about the community of St. Peter has been sent to her.

ACTION:  Commission members wishing to attend the luncheon should notify Colleen Spike.

 

D.          Benedictine Health System Senior Housing Plan.

The most recent revision of the BHS senior housing plan had taken up some space that had been designated as potential hospital expansion space.  Colleen Spike reported that she had rejected this plan, and BHS has subsequently revised it, although the revision plans have not yet been available to view.  The agreement with BHS does state they are required to obtain a building permit from the City by the end of the year.

 

Todd Prafke updated the Commission on the other senior housing project, “Bristle Cone,” that has been proposed for St. Peter.  A request has been submitted to sell the purchase agreement with Ecumen to private owners who currently have a number of facilities in the Dakotas.  There will need to be approval from the City Council before this can be done.

 

E.           Clinic Proforma.

Colleen Spike reviewed the River’s Edge Clinic proforma that had been completed in 2007.  The proforma projected a loss in 2010 of $642,529.  This compares to the actual proposed budget for 2010 of a projected loss of $645,000.  The losses currently seen in 2009 and projected for 2010 were anticipated when the proforma was first completed.

 

F.           Trustee Conference.

              Information regarding two upcoming conferences for hospital trustees was distributed.

              ACTION:  Commission members wishing to attend either of the conferences should notify

              Colleen Spike.

 

DIRECTOR’S COMMENTS

 

Tammie Hudspith, Director of Human Resources:  Ms. Hudspith distributed annual evaluation forms for the Commission members to complete and turn in to either herself or Gil Carlson.

 

Peggy Carlson, Community Liaison:  REHC partnered with the American Lung Association and offered a COPD class for healthcare providers on December 16.  A “Living on Less” expo was held at the Community Center on December 1 – REHC was represented with a booth.  The next American Red Cross blood drive will be held January 14 and 15, 2010.  The hospital will be hosting approximately 40 students from the St. Peter Public Schools for a career exploration experience on January 13, 2010.  Packets made up for new patients and physicians were available for review.

 

Todd Prafke, City Administrator:  Mr. Prafke congratulated the Commission and the Administration on a successful year,

 

Kay Moline, Commission Member:  Ms. Moline thanked the Commission and Administration for the efficiency of the meetings and Commission processes.

 

Bonnie Hunt, Commission Member:  Ms. Hunt noted that the five years of her first term are up and thanked the City, Commission and hospital for the opportunity to serve.

 

Benjamin Chaska, Chief Medical Officer:  Dr. Chaska noted that the plenary sessions from the recent IHI conference are available online for viewing.  He particularly recommended the presentation by Dr. Berwick discussing how to make health care affordable.

 

ADJOURNMENT

 

ACTION:  A motion was made by Kay Moline to adjourn the meeting.  The motion was seconded by Helen White and carried with all members voting in favor.  The meeting was adjourned at 4:53 p.m. 

 

 

 

Strategic Planning Meeting

River’s Edge Hospital Conference Room

Wednesday, December 16, 2009

 

Present:  Gil Carlson, Chairperson; Bonnie Hunt, Vice-Chairperson; Helen White, Secretary; Trustees:  Michelle Chalin, Brian Kuiper, Kay Moline, and Jerry Pfeifer; Colleen Spike, CEO; Ken Cornish, Director of Finance; Dr. Benjamin Chaska, Medical Director; Amy Kvidera, MD, Julie Buettner, DC, Andrew Lundquist, DPM, Heidi Faul, CNP; Kristin Schultz, Director of Quality and Infection Control; Tammie Hudspith, Director of Human Resources; Sheri Schmidt, Director of Business Services; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; and Paulette Redman, Recorder.

 

Absent:  Todd Prafke, City Administrator.

 

The meeting was called to order at 6:05 p.m. by Chairperson Gil Carlson.

COMMISSION MEMBER CORE COMPETENCIES

 

River's Edge Hospital & Clinic will be participating in a program by the American Hospital Association called “Competency Based Governance.”  Colleen Spike presented an outline of the core competencies the AHA has identified for Commission members, covering four categories of knowledge and skills in health care delivery and performance, personal capabilities, knowledge and skills in business and finances, and knowledge and skills in human resources.  Administration will be working with the Commission over the coming year to develop the competencies.  One tool that will be used is participation in a new quality program called QHi.  QHi provides a database for submission and benchmarking of quality data.  Reports are then available to compare your facility with similar facilities also participating in the program.  A statistical “dashboard” will be available to display key measures regarding quality, safety, customer satisfaction, financial and employee performance.

 

STRATEGIC GOALS FOR 2010

 

The Strategy Map for the coming year was laid out during the November Commission meeting.  As a means of moving through the map, a number of goals have been set for the 2010.  The primary objective for the year is to work toward compliance with ISO 9001 standards accreditation by the DNV. The three overall facility goals are:

• Achieve 50% of the ISO 9001 implementation by July 31, 2010.
• Respond to 100% of ISO Pre-Assessment Audit nonconformities from DNV by December 31, 2010.
• Remain 100% compliant with Medicare Conditions of Participation and other regulatory bodies.

 

A major initiative for ISO 9001 will be control of records, which will involve establishing a numbering system for policies and procedures, organizing and centralizing all policies and forms on the G drive.  Emphasis is also placed on how things are done – procedures need to be done the same way 100% of the time, regardless of shift or day of the week.

 

Departmental goals have also been delegated to each department.  The Directors have established one or two goals per department.  Each department will formulate an action plan and determine how to measure the outcomes.  Departments can also choose to set additional goals.

 

 

A question was raised about goals set for documentation in relation to the documentation policy that was established by the Hospital Commission.  Concern was expressed regarding difficulties in meeting the policy at the 100% compliance level, thus resulting in reportable variances.  Dr. Chaska noted the patient safety issues affected by this policy, but that a task force is being established to discuss compliance issues, measures and guidelines in regard to this policy.

 

ACTION:  A motion was made by Kay Moline to approve the initiatives and goals for River’s Edge Hospital & Clinic for 2010 as outlined.  The motion was seconded by Jerry Pfeifer and carried with all members voting in favor. 

ADJOURNMENT

 

The Strategic Planning Meeting was adjourned by general consensus at 6:35 p.m.

 

 

RIVER’S EDGE HOSPITAL & CLINIC COMMISSION MEETING

River’s Edge Hospital & Clinic Conference Room

Wednesday, November 18, 2009

 

 

Present:  Gil Carlson, Chairperson; Bonnie Hunt, Vice Chairperson; Helen White, Secretary-Treasurer; Trustees:  Michelle Chalin, Brian Kuiper, Kay Moline and Jerry Pfeifer; Colleen Spike, CEO; Ken Cornish, Director of Finance; Dr. Benjamin Chaska, Chief Medical Officer; Patty Roessler, Director of Patient Care and Ancillary Services; Kristin Schultz, Director of Quality and Infection Control, Sheri Schmidt, Director of Business Services; Tammie Hudspith, Director of Human Resources; Tom Wilcox, Director of Environmental Services; Peggy Carlson, Community Liaison; Todd Prafke, City Administrator; and Paulette Redman, Recorder.

 

Absent:  Dr. Schelli McCabe, Medical Staff President.

 

The regular meeting of the Hospital Commission was called to order at 12:26 p.m. by Chairperson Gil Carlson.

 

APPROVAL OF AGENDA

 

The agenda for the November 18, 2009, meeting was reviewed.  

ACTION:  A motion was made by Helen White to approve the agenda as presented.  The motion was seconded by Bonnie Hunt and carried with all members voting in favor. 

 

APPROVAL OF MINUTES

 

The minutes of the regular Hospital Commission meeting of October 21, 2009, were reviewed. 

ACTION:  A motion was made by Kay Moline to approve the regular Commission meeting minutes of October 21, 2009, as presented.  The motion was seconded by Michelle Chalin and carried with all members voting in favor. 

 

MEDICAL STAFF

 

A.          Medical Staff Minutes.  The minutes of the November 10, 2009, Medical Staff meeting were reviewed.  Dr. Chaska noted that Dr. Amy Kvidera has recently passed her board certification for Holistic and Integrative Medicine.  Dr. Carolyn Bowles has been certified by this board since 2008.

ACTION: A motion was made by Jerry Pfeifer to acknowledge receipt of the Medical Staff meeting minutes of November 10, 2009.  The motion was seconded by Brian Kuiper and carried with all members voting in favor.

 

B.          Medical Staff Credentialing.  A report from the Executive/Credentials Committee was

presented for review.  A recommendation was made by the Credentials Committee to approve medical staff membership and granting of privileges to the physicians and allied health professionals listed on the report:

 

Initial Appointment to the Medical Staff

Heidi R. Faul, CNP-FNP             Active Staff, AHP, Family Nurse Practitioner

Jennifer L. Donkin, RD/LD          Courtesy Staff, AHP, Dietitian

 

Reappointment to Medical Staff

Matthew R. Stone, MD                Courtesy Staff, Radiology

Andrew Lundquist, DPM              Active Staff, Podiatry

James Nack, DPM                       Courtesy Staff, Podiatry

Kevin Sirmons, MD                      Courtesy Staff, Emergency Medicine

Voluntary Withdrawal of Medical Staff Membership

Scott Stevens, MD -- Courtesy, Orthopedics

 

ACTION:  A motion was made by Bonnie Hunt to accept the recommendation of the Credentials Committee and grant the appointment or reappointment for each of the practitioners listed above.  The motion was seconded by Helen White and carried with all members voting in favor.  A motion was made by Helen White to accept the recommendation of the Credentials Committee and grant clinical privileges to each of the practitioners listed above, as requested and approved by the Credentials Committee.  The motion was seconded by Kay Moline and carried with all members voting aye. 

 

FINANCIAL REPORT

 

The financial report for October, 2009, was presented along with key financial indicators.  Operating days cash on hand dropped to 91.4 days.  Total days cash on hand is at 247.9 days.  The current ratio is 6.3.  Industry standard is 2.0.  Days in accounts receivable for the hospital increased to 50 days.  The Minnesota average for rural hospitals would be 60 to 65 days.  Revenue over expense for the month resulted in a gain of $61,700, and when combined with non-operating loss for October showed a gain of $60,988.  Year-to-date there is a net loss of $639,096, a -4.72% margin.  Mr. Cornish reported that the Medicare payment of $250,000 is reflected in lower discounts.

 

Community Care grants for October totaled $18,198, covering 13 accounts.  Bad debt for the month totaled $73,178, including $40,797 from uninsured patients and $32,381 from patients with balances after insurance.

 

ACTION:  Brian Kuiper made a motion to approve the October, 2009, financial report as presented, along with payment of bills, write-offs to collection and bad debt, and accounts payable review.  The motion was seconded by Helen White and carried with all members voting in favor.

 

QUALITY / EDUCATION / OPERATIONS

 

The written report submitted by Colleen Spike was reviewed.  Ms. Spike stated that the community seems to be on the down side of the influenza wave, although health experts are predicting additional waves to come.  Work on the details of Flu Center operation is continuing. 

 

Nash Finch is reviewing the final details of the contract for the pharmacy space in the Medical Office Building.  They have hired a pharmacist to work in this pharmacy.

 

The statewide Adverse Events report will be distributed in December or January.  Ms. Spike reminded Commission members that the hospital did report an adverse event (pressure ulcer) occurring in January of 2009.  A prepared statement will be available should media outlets call to ask questions about the event.

 

QUALITY / EDUCATION / OPERATIONS

 

A.          Benefits 2010.

Tammie Hudspith presented a summary of the benefits that will be offered to employees for 2010.  She reported that benefits will essentially stay the same and there will be no increase to health insurance premiums.  A benefit fair has been held for employees featuring 10 of the benefit providers.  Benefit forums have also been held.  Of the 180 staff employees of the facility, 120 are benefit-eligible.  Of the 120, 89% participate in the health insurance and 94% participate in the dental insurance plans.  There has been a 10% increase in the number of employees participating in the health insurance program.

ACTION:  A motion was made by Kay Moline to approve the 2010 employee benefits as presented, with no changes from 2009.  The motion was seconded by Helen White and carried with all members voting in favor. 

 

B.          River's Edge Hospital & Clinic Mission Statement.

The initial review and survey by the DNV surveyors resulted in a suggestion to revise and add to the facility’s mission and vision statement.  Administration and the team of Directors have met and drafted a combined mission/vision statement, to read as follows:

              “River's Edge Hospital & Clinic provides quality health services that value all dimensions of health including mind, body and spirit.  Our goal is to create continuous, measureable improvement in the health of all individuals within the communities we serve.”

              ACTION:  A motion was made by Jerry Pfeifer to approve the statement as presented.  The

motion was seconded by Bonnie Hunt and carried with all members voting in favor. 

 

C.          2010 Strategy Map.

Colleen Spike presented the 2010 Strategy Map that will be further defined, along with the Balanced Scorecard, during the upcoming Strategic Planning meeting in December.  The four major categories of the map are:

 

              1.           Patients, Physicians and Community Partnerships.

                            --Improve Community Health Outcomes.

                            --Grow Physician Support.

                            --Increase Patient Satisfaction.

                            --Grow Community Confidence.

                            --Recapture Market Share.

              2.           Learning, Implementation and Growth.

                            --Leadership Development.

                            --Staff Development.

                            --Empowering Culture.

              3.           Internal Processes/Quality.

                            --Recognized Leader in Innovation and Quality Improvement.

                            --Safety/Risk Management.

                            --HIT Implementation.

                            --Clinical Process Improvement/Innovation.

                            --Business Process Improvement/Innovation.

                            --Operational Process Improvement/Innovation.

              4.           Finance.

                            --Maximize Operating Efficiency.

                            --Grow Revenues from Existing and New Markets.

                            --Minimize Financial Instability During Growth.

                            --Ensure Adequate Margin to Fund Mission.

 

Each of the categories and subcategories contains multiple goals to be achieved during 2010. 

 

D.          Strategic Planning Meeting – December.

The Strategic Planning meeting is set for December 16, 2009.  The Commission Finance Committee will meet at 3:30 p.m., followed by the Commission meeting from 4:00 to 5:15 p.m.  Dinner will be served, followed by the Strategic Planning meeting from 6 to 7 p.m.

 

DIRECTOR’S COMMENTS

 

Sheri Schmidt, Director of Business Services:  Ms. Schmidt thanked the Commission for their support of the documentation policy, noting that benefits are already being seen.

 

Peggy Carlson, Community Liaison:  The Halloween Fun Run had 738 finishers, compared with 535 in 2008.  Heidi Faul will be presenting a class on “Stress-Reduced Life.”  A class for health care providers on the topic of COPD will be presented on December 16, 2009, at 12 p.m. in the Hospital Conference Room.  River’s Edge is partnering with the Recreational Department and Community Education to provide a program entitled “Living on Less.”

 

Todd Prafke, City Administrator:  The project manager from the Benedictine Health Services has made some changes to the Assisted Living facility that will be attached to the nursing home.  The project seems to be on track for obtaining a building permit by the end of the year.

 

Michelle Chalin, Commission Member:  Ms. Chalin invited members of the Commission to attend the ribbon cutting for the Forensic Nursing Home located on the State Hospital campus.  The ceremony will be held on Thursday, November 19, 2009, at 10:30 a.m.

 

Benjamin Chaska, Chief Medical Officer:  Dr. Chaska thanked the staff of the hospital and the Commission members for providing the support and resources to enable the facility to continue to provide quality care in St. Peter.

 

Jerry Pfeifer, Commission Member:  Mr. Pfeifer noted that he serves on the Hospital Commission as the representative of the City Council, and serves at the discretion of the Mayor.  City Council appointments will be made for 2010, and Mr. Pfeifer does not know at this point if he will be returning to the Hospital Commission.  He thanked the Commission and staff for the opportunity to work with them.

 

ADJOURNMENT

 

Colleen Spike noted that she will be on vacation over the next week.  In her absence, Patty Roessler will be on administrative call and Kristin Schultz will be handling any ILI-related issues.

ACTION:  A motion was made by Kay Moline to adjourn the meeting.  The motion was seconded by Bonnie Hunt and carried with all members voting in favor.  The meeting was adjourned at 1:20 p.m.