SPARTA COMMUNITY HOSPITAL DISTRICT BOARD MEETING MINUTES Date: November 17, 2015 Members Present: Dennis Ernsting, Claudia Kerens, Kay Hapke, Gary Stephens, Kevin Wilson, Alene Holloway and Lynette Jalivay Members Absent: Chris Haury and Nathan Lee Others Present: Joann Emge, Paul Mueller, Ruth Holloway, Dale Worthington and Angela Oathout Meeting called to order at 7:00 p.m. by Mr. Ernsting. Item Discussion Action, Resolution, or Follow-up Approval of Minutes Board Report Financials Mr. Ernsting presented Board minutes from October 20, 2015 for review. Dale Worthington, Materials Management and Plant Operations Director presented the Annual facility report to the board of directors. Dale shared the numerous facility enhancements that had been completed over the last year as well those in progress and pending. Mr. Stephens shared the treasurer s report for the month of October. Paul Mueller shared the financial report for the month of October. Cash and Investments Cash decreased $309,394 or 4% in comparison to September. Day s cash on hand decreased to 109. We measure favorably to the performance indicator established at 90 days. Accounts Receivable Total system gross accounts receivable increased $970,474. Total system Days in A/R (excluding claims reimbursed by the State of Illinois) increased from 65 in September to 66 in October. Our performance indicator is 62 days. Hospital patient gross accounts receivable increased $967,562. Hospital Days in A/R (including IL State) increased from 85 in September to 93 in October. Hospital Medicaid gross receivables are $5,635,668 Ms. Kerens made a motion to approve minutes, Ms. Holloway seconded. Motion Ms. Kerens made a motion to approve the Treasurer s Report as presented and file subject to audit. Ms. Hapke seconded, motion 1
Hospital gross receivables from State of Illinois self-funded insurance plans for its employees and retirees is $1,275,186 of the hospital gross A/R, 43% is greater than 90 days old from discharge, with 48% and 69% of Medicaid and the State of Illinois self-funded insurance plan greater than 90 days, respectively. Clinic gross accounts receivable increased $23,646 or 2%. Clinic gross A/R is 2.0 times current clinic revenue. We measure favorably to the performance indicator of 2 time s current revenue. Account Payable Accounts payable decreased $74,869. Current month has 13 days non-salary expense in A/P, September had 14. We measure favorably to the performance indicator of 30 days. Income Statement Revenues Inpatient revenues decreased $49,670 or 20% compared to June. Outpatient revenues increased $321,609 or 11%. Emergency service revenues increased by $116,186 or 8%. Swing bed revenues increased by $9,357. Physician office revenue increased by $14,146 or 3%. Total system gross revenues increased $411,628 or 8%. System net revenues decreased $38,740 or 2%. Gross revenue per calendar day is $179,427 vs. $184,719 budgeted. Allowance of revenues is 51% vs. 49% budgeted. Total system gross revenues, year-to-date are $164,029 or 3% below budget. Expenses Salary and fringe benefit expenses decreased $161,568. Our performance indicator is 50.5% of net Patient revenues; salary and fringe benefit expense is 51% for July. Bad debts, we measured favorably (3.2%) to the performance indicator of 5% of gross patient revenues. Total expense per calendar day is $76,399 vs. $84,097 budgeted. Expenses year-to-date are $238,630 or 9% under budget. 2
Physician s Report CEO Report Paul shared the current collection process that Trubridge is following Dr. Salarda was not present The board members complimented Joann for receiving the Presidential Award from ICAHN. Expenditures: 1. Truck Replacement Snow Removal Cost $19,500 2. IT Equipment Proposal Access Points wireless network o Cost $8,189.58 Cisco Switches and UPS replacements o Cost $23,133.78 IT Connectivity with (USAC discount), 3 yr. commitment Increase from 5megabytes to 100 megabytes o Cost $25,620.00 annually (With USAC Funding) One time connection fee for five(5) outlying sites o Cost $8750.00 (With USAC Funding) 4. Mandy s Cleaning Service Contract: $4988.00 annually NTC $2880.00 annually PCP offices 3. Midwest Emergency Dept. Service (MEDS) Fee Annual increase not to exceed 3.5% beginning in 2016 4. GPO Group Purchasing Organization. Dale Worthington is currently researching other options, more to come as information is obtained. 5. ICT/IPT Dividends and premiums Available at December meeting CEO Report Cont d. 6. Future Expenses Ultrasound Equipment 3
Quality Joann shared the accomplishments of the hospital and recognition for being in the top 100 Critical Access Hospitals, receiving a 5-star rating from CMS and being recognized for being a top quality performing. Service: Patient Satisfaction Surveys implemented November 1, 2015 in the following departments: Physician Clinics Emergency Dept. Ambulatory Surgery Out patient Specialty Services: Oncology clinic to begin December 1, 2015 Dr. Dhillon has started to provide services here Joann shared the monthly newsletter from Dr. Vandover highlighting emergency department activities. SCH will be involved in a community outreach program. Barb Brown, Registered Dietician will be working with the Randolph County Health Department to provide diabetic education to the community. People: Veterans Day: The hospital recognized employees for their past military service. Coding Supervisor: Julie Lackey assumed the coding manager role. Town Hall Meetings: Joann conducted Town Hall meetings to enhance communicate throughout the hospital and to share any changes or activities the staff could expect to see in the future. SCH held a Right to Brag week to recognize the staff for a job well done. Employee Appreciation Party will be held on Saturday, 4
January 16, 2016 at the Lion s Club in Sparta. Executive Session Paul Mueller left the meeting at 7:35 p.m. Ms. Hapke made a motion to go into Executive Session at 7:35 p.m. for the purpose of discussing Litigation and Employee matters, Mr. Stephens seconded. Motion Regular Session Ms. Kerens moved to return to Regular Session at 8:15 p.m. Ms. Holloway Minutes Committee Reports Executive Session minutes from October 20, 2015 were reviewed in executive session. Quality Council: Mr. Holloway shared the highlights from the Quality Council meeting. Support Services- 20 projects are in progress, 6 have been completed. 92% of work orders were completed by end of the month. HCAHPS top box score for cleanliness of room was 91%. Dietary patient satisfaction was 92%. seconded. Motion Mr. Ernsting made a motion approving Executive Session minutes from October 20, 2015. Ms. Holloway seconded. Motion Health Information Management- Transcription Turn Around Time and Scanned Image Audits ranged 97-100%. Continuum of Care Documents will be sent by direct messaging to non-staff physicians. Templates have been created in CPSI for the team care documentation. ED- Average length of stay- 105 min. Time to be seen by provider 15 min. 15/16 Chest pain EKG s were completed within 10 minutes. ED transfer rate was 5.7%; Physician s effort to explain information was75%. Sepsis screening compliance was 84%. Case management will be working with complex ED patients to develop care plans. Education was provided on high blood pressure best practice guidelines. PQRS measures documentation triggers have been added to T-system. 5
Med/Surg Medication errors reaching patient- 8. No restraints were used in September. 100% of wound risk assessments and interventions were completed. Readmissions for September were 2 (8% readmission rate). Swingbed program will be redesigned and marketed to increase utilization. Pharmacy No insulin errors reaching the patient. No IV pump errors. Final revisions were made on the insulin management policy. Surgery Call back contact rate reached 79%. Overall satisfaction rate was 100%. Specialty clinic staff members are being retrained on medical clearance process. Infection control- No employee exposures. Hospital Acquired Infection rate for 2015 is 0.25%. Infection control and safety surveillance surveys will be combined. Safety- Three patient/visitor falls in September. Sheriff will meet with administration in November to plan Active Shooter Drill. Rehab Services- Rehab EMR has been implemented. New Business Expenditures Grievance log 12 complaints were received during September. Complaints were investigated and addressed with patients. Finance Committee: Mr. Stephens shared the highlights from the finance Committee. Approval of Capital Expenditures: Truck Replacement with blade and spreader Cost $19,500 Mr. Stephens made the motion to approve the Truck with Blade and Spreader for a cost 6
Adjournment 2. IT Equipment Proposal Access Points wireless network o Cost $8,189.58 Cisco Switches and UPS replacements o Cost $23,133.78 3. IT Connectivity with (USAC discount), 3 yr. commitment Increase from 5megabytes to 100 megabytes o Cost $25,620.00 per year One time connection fee for five(5) outlying sites o Cost $8750.00 4. Midwest Emergency Dept. Service (MEDS) Fee Annual CPI increase not to exceed 3.5% beginning in 2016. 5. Mandy s Cleaning Service - NTC - $4988/month Primary Care offices- $2880.00/ month 6. Approval of the annual facility Report. Credentialing Applications: Mr. Wilson presented the medical staff applications for appointment/reappointment. of $19,500.Ms. Kerens seconded, motion Mr. Stephens made the motion to approve the IT equipment access points for a cost of; $8,189.58 and the Cisco Switches for a cost of $23,133.78. Mr. Stephens made a motion to approve the IT connectivity agreement for a period of three years at a cost of $25,620. And the one time implementation fee of $8750.00 Ms. Kerens seconded motion A motion was made by Mr. Stephens to approve the 3.5% increase in MEDS contract. Ms. Kerens seconded, motion Mr Stephens made a motion to negotiate contract cleaning contract for outlying clinic sites. Ms. Kerens seconded. Motion carried Mr. Ernsting made a motion to approve the annual facility report. Mr. Wilson seconded, motion Mr. Wilson made a motion to approve the applications. Ms. Holloway seconded, motion A motion was made by Ms. Kerens to adjourn at 8:30 p.m. Ms. Holloway seconded. Motion Dennis Ernsting, Chairman Kevin Wilson, Secretary 7