KENNEWICK PUBLIC HOSPITAL DISTRICT KENNEWICK, BENTON COUNTY, WASHINGTON BOARD OF COMMISSIONERS

Transcription

1 KENNEWICK PUBLIC HOSPITAL DISTRICT KENNEWICK, BENTON COUNTY, WASHINGTON BOARD OF COMMISSIONERS Trios Mission: We are a unified team of healthcare professionals delivering quality and compassionate care to improve the health and well-being of everyone we serve. 5 p.m. Thursday, February 26, 2015 Administration Conference Room/Battelle Rooms COMMISSIONERS PRESENT: Donna Vance, Vic Johnson, Wanda Briggs, Kathy Davidson, Jim Mefford, Marvin Kinney, Richard L. Reil EXECUTIVE STAFF: Glen Marshall, Diane Sanders, Tony Sudduth, Chuck Barnes, Russ Keefer, Dr. Wassim Khawandi, Dr. Hassan Haddadin, Mary T. Schumacher GUESTS: Numerous members of the Trios Health Staff, Management and constituents of Kennewick Public Hospital District. Sara Schilling, Tri-City Herald and Annie Andrews of KEPR-TV. CALL TO ORDER: Donna Vance, Chairman, called the meeting to order in the Administration Conference Room at 5 p.m. I. EDUCATION PRESENTATION (Administration Conference Room): A. Medical Office Building Update Chuck Barnes, Executive Director for Support Services, updated the Board on the status of the Southridge medical office building construction, as well as the development of the transition plan to the building by various departments and services. The construction is on schedule and plans are underway to transition to the new building in July Transition planning is underway with Joe Kunkel, consultant. II. DISTRICT BUSINESS (Battelle Rooms): A. Approval of Consent Agenda* The materials listed under the Consent Agenda are considered routine by the Board of Commissioners, and are adopted by one motion. There will be no separate discussion of the following items: Approval of the previous month s Board minutes Approval of warrant register/revenue fund (outlined below) Approval of construction, Trios Medical Group Funds, medical dental trust, Adult Day Services funds, and other miscellaneous funds (outlined below) Acceptance of financial report Statistics 1

2 Trios Southridge Naming Opportunities KPHD Write-offs However, an item may be removed from the Consent Agenda and considered separately if the Board members desire further discussion. As of this date, the Board of Commissioners unanimously approves by a majority vote, the payment of those items included in the Consent Agenda and further described as follows: Accounts payable and payroll funds: to and and 1/9/15 to 1/23/15 in the total amounts of $3,465, and $ and $4,010, and $4,356, Construction, KGH Physician Clinics Funds, Medical/Dental Trust, Adult Day Services to in the total amounts of $ and $61, and $10, IT WAS MOVED AND SECONDED TO APPROVE THE CONSENT AGENDA AS PRESENTED. Motion carried. B. Public Comment Five people asked to address the Board. Donna Vance, President, indicated that each person speaking will be allowed 3-minutes to comment to the Board. They are not to expect that any comments will be returned by the Board, however. Kathleen Reed She indicated that she is the Payroll Coordinator for Trios Health. She indicated that we need to pull together as a team right now and make this happen. We have struggled, but we need to work as a team to get to the bottom of what the problems are. Mary LaMont retired Trios Health employee. She indicated that she has been a part of the Hospital for many years. She is very disturbed at the financial stress we are going through. It is not the first time that we have had struggles and we need to do something about it. If it means getting someone in here and someone on board before it implodes, or selling the Hospital let s do it. This town is big enough for another hospital, and we need to work towards improving it. Dr. Robert Salisbury OB/GYN at Trios Health for 14-years. Dr. Salisbury indicated that he was originally recruited by the old administration, but was glad when Glen Marshall came on board. Dr. Salisbury has worked with the Board s Planning Committee. He was in favor of building Southridge from the beginning and still feels it is a good move even though the finances have been tight. I think we can make it, I think the Board has done a good job and Glen is a good administrator and I enjoy working with him. I trust the Board and Glen to make the right decisions. Mike McWhorter Trios Health Foundation. He served on the Foundation Board for about 23-years as President and past President. He was born at Trios Health as one of the first 100 babies. He believes in the Hospital. He read a letter from the Foundation to the Board (see attached). The letter stressed unity rather than division among the Board of Commissioners as we face the financial challenges together. Stacey Struthers He attended as a taxpayer within the District. He indicated that he has no doubt that the Southridge facility was needed. He was born at the original hospital in The taxpayers said no to a tax initiative to build a new hospital, but the Board moved ahead and now we are up to our butt in alligators. He suggested that possibly the State Auditor 2

3 should review the District s finances. He suggested that Hospital leadership develop the Auburn campus into a rehab facility such as was done in Spokane. Donna Vance, President, indicated that we have 7 Commissioners here and each one has a lot of experience. Every one of the Board members is devoted to the purpose of the Hospital District. Each one of us may have a different view at times and that is healthy. She indicated further that every Commissioner at this table is doing the very best job for the health care in the community. She thanked all of the Commissioners for their hard work and dedication, and thanked the community for their continued support. The President then congratulated Glen Marshall, CEO, for being awarded the Kennewick Man of the Year award this week, and introduced Renee Pepiot Norman who was crowned Kennewick s Woman of the Year. The award is based on service to the community. C. Construction Projects/Expansion Updates Chuck Barnes reported that the construction of the medical office building at Southridge is on track and will open in the summer of The remodel of the former emergency room space at Auburn as an urgent care is complete. That space will be used for family practice, pediatrics, and medical residency practice care. D. Membership/Liaison Reports: 1. Tri-Cities Cancer Center Donna Vance reported that the Board did not meet this month. 2. Trios Medical Group Physician Operating Committee Marv Kinney reported that: Tammy Barnes presented a quality report to the Committee. Brad Gould, Executive Director for Trios Medical Group, has joined Trios. The POC made and passed a motion to ask the CFO to integrate the Information Technology team under one accountable officer and efforts are underway to do so. Dr. Khawandi discussed with the Committee wait times for clinic patients. More discussion will follow at next month s meeting. 3. Trios Foundation Kathy Davidson reported that the Foundation has a lot of talented professionals working with them and volunteering their time for the betterment of our community. Their annual breakfast was held this month, and was very successful. They awarded 4 scholarships out of 41 applicants. The annual Golf Tournament will be held on June 19 th at Canyon Lakes in Kennewick. Development of The Grateful Patient program is underway. The Board will hear more about that project in May at their education session. 3

4 4. Adult Day Services Richard L. Reil reported that the service continues to thrive and do well. Their client base has increased to the highest level in 3-years. They have plans to expand their services and undergo some remodeling projects this year. III. HOSPITAL BUSINESS: A. Executive Report 1. CEO - Glen Marshall a. Departmental Annual Reports None b. General Update The CEO reported that: Management has successfully recruited a Surgical Services Director, Patrick Morgan, that will join us in March. University of Washington representatives will meet with members of the Board and the Medical Staff on Monday, March 2 nd to discuss areas of joint collaboration. The event starts at 4 p.m. at The Country Gentleman. Trios Health was surveyed by the Joint Commission in 2014, and we recently received word from them that we are fully accredited with no conditions. Diane Sanders, CNO, resigned effective April 3 rd. She has accepted a chief nursing officer position at a hospital in India. We wish Diane well in her new endeavors! At the Foundation breakfast, they gave some special awards. One was for Outstanding Physician and was received by Dr. Steven Kincaid, general surgeon. Caring Heart Awards were awarded to Leah Carter and Joan Stewart. Jodi Pilot was awarded the Outstanding Employee Award, and the annual Jim Mokler Award was given to Chuck Barnes, Executive Director for Support Services. Rick Reil indicated that after the last Board meeting an was sent to the staff and Trios providers indicating that a Board member had questioned the Hospital s financial and business operations. Mr. Reil asked if that alluded to his questioning of the finances, and Mr. Marshall said it did. He then asked if Mr. Marshall felt it was Mr. Reil s job as a commissioner to question the finances, and he said yes he did. B. Medical Staff Report 1. Hassan Haddadin, MD, Medical Staff President Dr. Haddadin reported that the Committee received a presentation on the implementation of the ICD10 project by a representative of Beacon Partners. IV. NEW BUSINESS: A. Committee Reports/Recommendations 1. Planning a. Meeting Report 4

5 Vic Johnson updated the Board on the business of the meeting to include the Committee s work with the results of the Planning Committee s October strategic planning retreat. b. Committee Member Appointment* Wanda Briggs, Chairman of the Committee, has asked Steve Simmons, Owner/Operator of The Country Gentleman restaurant to serve on the Board s Planning Committee. He has consented to do so and Ms. Briggs asked for the Board s approval to appoint Mr. Simmons. IT WAS MOVED AND SECONDED TO APPOINT STEVE SIMMONS TO THE BOARD S PLANNING COMMITTEE. Motion carried. c. Committee Charter Amendments* There were two minor amendments suggested to the Charter and the Committee recommends its approval to the Board. IT WAS MOVED AND SECONDED TO APPROVE THE AMENDED PLANNING COMMITTEE CHARTER AS SUBMITTED. Motion carried. 2. Finance & Audit a. January Financials The CEO indicated that he was very encouraged to see the numbers of those who attended the meeting this evening. It shows him how many people are committed to Trios Health and its financial success. He wanted to assure everyone that the Board and the Executive Team are working hard towards insuring the Hospital s continued success. He made the following points: In July 2014 we moved to the new building at Southridge. Since moving there, we have treated record numbers of patients. On several occasions, most of the 74 beds have been full, and we believe that will continue. Overflow plans for patient volume have been developed and are being utilized. This summer the medical office building or Care Center at Southridge will open and we know that will bring similar growth. Many health care organizations including some locally have responded to the health care market and made hard decisions to improve their financials. We chose to wait until Southridge opened and was operating to see what the affect would be on our operations. We have made some changes, but need to do more. The Hospital has experienced tremendous medical oncology growth under our three medical oncologists, and Management knows that service will continue to grow. Management has implemented the 340B prescription drug program and that should be fully implemented by the end of March. This will provide significant improvement to our finances. Work continues with the medical staff on improvement of clinical documentation. Management believes they have made improvement, but there is more to be done. 5

6 Plans are underway to renegotiate our managed care contracts and that will help improve the bottom line. Management has contracted with American Health Solutions to implement a productivity plan for staffing. Some savings have been realized through attrition. The plan is to elevate our performance to the 75 th percentile. Some departments are already there, and some are not. AHS s representatives will be on site soon to work with managers. Plans are also underway to better manage the use of agency staffing and premium pay. Plans are underway to sell non-core assets, but we have hit some stumbling blocks with those sales. We know that they will eventually sell, but it has taken more time than anticipated. We expect $8 million as the result of those sales. Management has worked to adjust our current operations plan and it is now ready for implementation. Management plans to move ahead tomorrow to cut $3 million from operations through realignment of the Hospital s organizational structure, elimination of approximately 40 staff positions and reduction of non-essential service contracts. Recognizing how difficult this is for our staff members, Management is committed to making the transition as easy as possible for our employees and their families. They are also committed to not affecting clinical positions at this time due to the high patient volume that we continue to experience. Management is contracting with Navigant to review our revenue cycle. Their review will include the areas of registration, billing, and collections and make recommendations to help improve net revenue using best practices. Plans are also underway to contract with Accretive Health to manage our observation patients vs inpatients. The plans outlined above will allow us to meet the 2015 Operating Budget approved by the Board, and not only survive, but thrive in this health care environment. Now is the time for the Trios Health team to work as a team and stay together. The CFO reported that consolidated net loss was $1,082,776. Patient volume occurred in record numbers, but expenses rose. Days cash on hand totaled 2.5 at the end January. Management plans to meet the budget approved by the Board and with the changes outlined above, the CFO feels the cash position and our relationship with our vendors should improve. Discussion followed with points noted below by Board members: The Hospital realized a record month in volume, but the revenue is not there. We had a budget variance of $360,000. The plan outlined above is necessary to improve net revenue. None of the concerns noted are a personal attack on anyone, but it is the Board s job to ask the right questions and make sure that everything possible is being done to insure that the Hospital s finances are healthy. Concern was noted that the turnaround plans above will take too much time to realize swift improvement. It was indicated that Management recognizes that and they are looking into short term financing to help in the interim. It was asked if Trios Health has ever missed a payroll or a lease payment, and it was indicated that we have not. The CFO indicated that his first priority is payroll, and his second priority is the lease payment at Southridge. Concern was expressed that accounts payable in January was $16 million and has now jumped to $19 million. We have a list of 80 creditors that have 6

7 placed Trios Health on credit hold. The CFO applauded the Accounting Department and Accounts Payable for their continued hard work to balance payments to vendors. Our vendors have been flexible and worked with us. Our major priority is the vendors who provide medical supplies. It was indicated that $900,000 of accounts payable is over 360-days old. However, it was indicated that that figure includes McKesson payments and that is in error as their amount needs to move to a lease line item. That will be done as soon as possible. Management distributed a newsletter entitled, The Lead to Management and it indicated that at the end of January there would be a $1.8 million EBIDA. However, at the end of January EBIDA was -$105,000. The CFO stated that a very unusual change in payor mix resulted in a much lower net revenue than expected resulting in a lower than projected EBIDA. The plan is to contract with Navigant to review and improve the Hospital s revenue cycle. It was asked if the plan to reduce staff was shared and coordinated with managers since it will affect some of their employees. It was indicated that the Plan was developed with the Executive Team, and meetings will be held tomorrow with those affected. It was indicated that the Board approved the use of a turnaround consultant back in July However, in August the motion was reintroduced and voted down. The Executive Team then hired American Healthcare Solutions (AHS), a productivity consultant. The Board was assured at that time that they would receive a report from AHS, but have not seen it to date. It was indicated that accounts receivable has been growing and is about $5 million over last year. As mentioned above, that is an area that Navigant will review. It was indicated that the money to be collected is influenced by coding. Trios Health contracted with a new coding company this year. A decision was made to terminate our former agreement as the CFO found that they were overcharging the Hospital for services rendered. As a result of that change, we should save $900,000 this year, and that has not yet been factored into the 2015 Operating Budget. b. Committee Member Appointment* The Committee recommends the appointment of Mike McWhorter of Payne West Insurance to serve as a community representative to the Board s Finance and Audit Committee. Mr. McWhorter served in this capacity previously, and has consented to rejoin the Committee. IT WAS MOVED AND SECONDED TO APPROVE THE APPOINTMENT OF MIKE MCWHORTER TO SERVE ON THE BOARD S FINANCE AND AUDIT COMMITTEE. Motion carried. The President commented how important these community members are to the Board s committee structure and expressed thanks to all of those in the community who serve the Board in this capacity. c. Resolution # Appoint Auditor for District* Management submits to the Board for approval Resolution # to remove Brandon Allen as Auditor and add Martha Herrera as the Controller/Auditor for the District. 7

8 IT WAS MOVED AND SECONDED TO ADOPT RESOLUTION # TO REMOVE BRANDON ALLEN AS AUDITOR OF THE DISTRICT AND APPOINT MARTHA HERRERA, AUDITOR FOR THE DISTRICT AS OUTLINED ABOVE. Motion carried. d. Resolution # Banking & Wire Transfer Authority* The purpose of Resolution # is to adopt commercial master signature cards for bank accounts and authorize authority for wire transfers, adding Martha Herrera, Controller/Auditor to the authority. IT WAS MOVED AND SECONDED TO ADOPT RESOLUTION # AND ADD MARTHA HERRERA, CONTROLLER/AUDITOR TO THE BANKING AND WIRE TRANSFER AUTHORITY. Motion carried. 3. Executive/Governance There was no meeting in February. 4. Joint Conference a. Infection Prevention & Control Plan 2015* The updated Plan is recommended to the Board by the Medical Executive and Joint Conference committees. This approval is an annual item considered through the appropriate Medical Staff Committees and the Joint Conference Committee for subsequent approval by the Board of Commissioners. It was indicated that amendments to the Plan were minimal. IT WAS MOVED AND SECONDED TO APPROVE THE INFECTION PREVENTION & CONTROL PLAN FOR Motion carried. V. EXECUTIVE SESSION (RCW and RCW and 2): Per RCWs and and 2, the regular meeting was adjourned to Executive Session for the purpose of reviewing the following: Dashboard Indicator/Clinical Scorecard Report Patient Flow Dashboard Medical Staff Privileges The Session will take about 20-minutes, and when the Session opens, action will be taken on the Medical Staff privileges. A short recess was taken at 7:15 p.m. The meeting closed to Executive Session at 7:30 p.m. OPEN FOR ACTION: The Session opened for action at 7:55 p.m. and two members of the public returned to the meeting. IT WAS MOVED AND SECONDED TO APPROVE THE MEDICAL STAFF PRIVILEGES AS RECOMMENDED BY THE MEDICAL EXECUTIVE AND JOINT CONFERENCE COMMITTEES. Motion carried. 8

9 VI. BOARD MEETINGS/EVENTS/EDUCATION: A. Next Board Meeting Thursday, March 26 5 p.m. in the Administration Conference Room and 6 p.m. in the Battelle Rooms ADJOURNMENT: There being no further business, the meeting adjourned at 7:56 p.m. Respectfully submitted, Mary T. Schumacher Recorder Donna Vance, Chairman Wanda Briggs, Secretary 9