MORROW COUNTY HOSPITAL BOARD OF TRUSTEES REGULAR MEETING February 26, 2013

Transcription

1 Members Present: Joyce Ray, Chair Patrick Drouhard, Vice Chair Patricia Anthony Dennis Leader Jackie Weaver Brent Winand Brad Wood Absent: MORROW COUNTY HOSPITAL BOARD OF TRUSTEES REGULAR MEETING Others Present: Christopher B. Truax, President & CEO Joe Schueler, CFO CJ Miller, VP Ancillary Services Lorelei Heineman, VP Patient Care Services Matthew Hintz, MD, Medical Staff President Mark Brazitis, System VP, North Region, OhioHealth Sandie Fisher, Executive Secretary Guest Mr. Paul Hinkle, Morrow County Resident Call to Order: Ms. Ray called the meeting to order at 2:30 p.m. in Approval of Minutes Assembly Room C in the lower level of the hospital. The minutes of the regular January 22 meeting were reviewed. Ms. Weaver and seconded by Mr. Leader to approve the minutes as written. Hospital Reports Administrative Council Report Ms. Heineman reviewed the Administrative Council Report and indicated the go live of the PCMII, EDM II ORM, and CPOE modules of Meditech was successful with just a few issues to be resolved. She contributed part of the success to the hard work of ED Director, Dr. Place and Dr. Obaid, Hospitalist. Financial Performance Report Mr. Schueler reported the financial status for the month of January. Mr. Drouhard and

2 Page 2 of 10 Gross patient revenue was $895,431 under budget with inpatient revenue $165,000 under budget and outpatient under budget by $731,000 or 18%. Home Health visits were 14% under budget. ED visits were 6% under budget. Surgery Cases were 13% under budget. Radiology was $311,000 under budget. Benefits were $96,000 under budget The operating margin for the month was (12.5%) with a loss of ($261,259) Cash collections were low at $1,718,918 due to low volumes in December Mr. Truax presented the Top Three Short-term Initiatives for Improvement by division, developed by Administrative Council. Overall Hospital Overtime Management I-Vantage Benchmarking Healthcare Benefits Ancillary Services (CJ Miller) Market the MCH Pricing Position Referral Capture from Primary Care Offices Marketing of New Imaging Services to Medical Staff Financial Services (Joe Schueler) Point of Services Collections Integrate Charge Capture Analyst into Billing Processes Improve The Timeliness Of Coding And Billing Patient Care Services (Lorelei Heineman) seconded by Mr. Wood to approve the financial report as presented.

3 Page 3 of 10 Emergency Room Throughput Improvement Chargemaster Review Improving Capture of Follow-up Visits Details of each item were briefly discussed. Outcome of each initiative will be shared with the Board as they are realized. Quarterly Results Review (QRR) Mr. Truax presented the Morrow County Hospital presentation as given at the Quarterly Results Review meeting at OhioHealth. The completed Balanced Scorecard for 2012 was also included for the Board s review. Mr. Truax was asked to present this material to the Board after each QRR. Mr. Truax shared an Adjusted Income Statement to quantify the sustainability of loss. The one (1) time costs for 2012 totaled $621,000. If these extraordinary expenses had not occurred, MCH would have experienced a gain of $108,705 instead of this major loss. These expenses included: Estimated Salary Expense related to Meditech training costs. Unemployment costs related to the former ECF employees, plus PERS, WC and FICA on Meditech training. Legal Fees beyond budget related to start-up of MCHHS, physician contracts, ECF bed license sale, new specialty center leases and other compliance issues. Agency Nursing for the Emergency Department. ECF bed tax.

4 Page 4 of 10 Another item that contributed significantly to the loss in 2012 was an increase of 21% of employee benefits paid on medical claims Annual Safety Report Mr. Miller presented the 2012 Annual Safety Report. The report complied by Safety Officer, Kelley Shealy, documented the MCH Safety Program, Alerts, Security, Hazardous MaterialsInfectious Waste, Fire Safety, Medical Equipment Management, Utilities, Construction and Renovation, Emergency Management, and Life Safety areas. Medical Staff Report Dr. Hintz reported on the Medical Staff Meeting of February 5, The following credential recommendations were approved by the Medical Staff and are recommended for approval by the : Credentials Committee January 28, 2013 Appointments: Chingleput Ranganathan, MD Emergency Medical Staff Emergency Medicine Gary M. Ansel, MD Consulting Medical Staff Interpretation of Noninvasive Vascular Testing Mitchell Silver, DO Consulting Medical Staff Interpretation of Noninvasive Vascular Testing Ravi Gurujal, MD Consulting Medical Staff Cardiology Delbert Hoppes, DO Active Medical Staff Family Practice Ambulatory Care William J. Hicks, II, MD Neurology Telemedicine (Telestroke) Reappointments for the period of 3113 to : Ms. Anthony and seconded by Ms. Weaver to approve the credentials as recommended by the Medical Staff.

5 Page 5 of 10 Eric Hansen, MD Emergency Medical Staff Emergency Medicine John Nduaguba, MD Emergency Medical Staff Emergency Medicine Eric Hansen, MD Active Medical Staff Family Practice Ambulatory Care Eric Hansen, MD- Active Medical Staff Family Practice (as Hospitalist) Vinod Koduri, MD Active Medical Staff Anesthesia William K. Lee, MD Active Medical Staff General Practice Emad Mousa, MD Courtesy Medical Staff Gynecology except for the Special Privilege request of Interstim Therapy (Meditronic) Peter Sanford, MD Active Medical Staff - Orthopedics Focused Professional Practice Evaluation Haritha Mikkilineni, MD Emergency Medicine Initial Privileges Documentation to meet the requirements of the Focused Professional Practice Evaluation was submitted and reviewed. The Credentials Committee concluded that Dr. Mikkilineni satisfactorily met the requirements of Focused Professional Practice Evaluation. Voluntary Withdrawals Roberto Concepcion, MD Courtesy Medical Staff Urology, voluntarily chose to not return his reappointment application. Dr. Concepcion also sent a letter stating he would like to withdraw his clinical privileges. His medical staff membership and clinical privileges expire February 28, 2013.

6 Page 6 of 10 David Fitkin, MD Courtesy Medical Staff Urology, sent a letter stating he would like to withdraw his clinical privileges. His medical staff membership and clinical privileges expire February 28, Other Business: Board Self-Assessment Results for 2012 Mr. Truax presented the results from the 2012 Board Self- Assessment. Each section was compared to the 2011 results and indicated areas that have improved and some areas that still need attention. The end results were also compared to results from 2008 forward.. Prospective Board Member Interviews Mr. Truax shared an interview committee of Mr. Truax, Mr. Drouhard and Mr. Leader interviewed five (5) candidates for the Board seat vacated by Bonnie Fisher: o Olen Jackson o Don Plotts o Karen Wagenhals o Carolyn Beal o Brenda Harden A recommendation from the Committee was presented to the County Commissioners. The final decision is to be made by the Commissioners and the County Judges. Determination of Brain Death Policy Ms. Heineman presented Policy RI-102, Determination of Brain Death. Ms. Heineman stated the likelihood of using this policy is extremely low because at this time, MCH does not keep ventilated patients and that is a requirement to consider this policy. This policy was reviewed to determine if MCH has the ability should a vented patient be kept. The form that is attached to the policy will be deleted as the information on the form will be in Meditech. Mr. Leader and seconded by Mr. Winand to approve the policy as written.

7 Page 7 of 10 Nominating Committee Ms. Ray appointed Ms. Weaver, Mr. Leader and Ms. Anthony to the nominating committee which will meet following this afternoon s meeting. OhioHealth Mr. Brazitis distributed an article written by OhioHealth President & CEO Dave Blom. The article was published in the Columbus Dispatch in support of the expansion of Medicaid. There are one and one-half million uninsured in the state. Board members were asked to contact their congressmen in support. Mr. Truax also has additional information he will send to Board members on the subject. The Joint Commission Mr. Miller indicated that as a result of The Joint Commission (TJC) survey last November, findings required 45 day and 60 day evidence of corrections to be submitted. Mr. Miller submitted the last set to TJC on January 30, Last Friday night at 9 p.m. he received an that the evidence of correction he sent was not approved. The deadline for submission was Tuesday. The issues were in the Life Safety category. Mr. Miller, Kelley Shealy, Safety Officer and Mike Gale, Security Officer, began working with the engineer at TJC to determine what they needed to do to ensure approval. Additional information will be submitted after conversations with the engineer. Our status currently is Accredited with follow-up survey. If the engineer is satisfied with our submission, that status could change.

8 Page 8 of 10 Ohio Department of Health (ODH) Survey for the Center for Medicare and Medicaid Services (CMS) Mr. Miller reported ODH performed a two (2) day complaint survey on behalf of CMS. The survey resulted in three (3) verbal findings: Some orders were not date and time stamped. Receiving physician on a transferred patient was not documented. Medical History and physical documentation lacked completed medical screening information. This could have been a whole hospital survey but the majority of time was spent reviewing charts and asking questions. The main focus was a complaint that was made to MCH several months ago and was addressed. The case was reviewed by The Peer Review Committee and the family of the patient was upset because we would not share the peer review information with them as it is protected under state law. The family then filed complaints with The Joint Commission and Ohio KeyPro. Both of those entities reviewed the documentation and agreed with MCH. Filing a complaint with CMS is the last agency they can complain to. It was noted the physician involved is no longer practicing at MCH. It was also noted that attorneys from Bricker & Eckler have been consulted from the beginning of this issue and have made the responses on behalf of MCH to the family. The attorneys also advised that peer review documentation and client attorney privilege does not exist when CMS is involved. They can review whatever they wish. The surveyors also reviewed thirty of our ED patient charts.

9 Page 9 of 10 Recess for Executive Session At this time, MCH is awaiting the findings of their final written report. Ms. Anthony and seconded by Mr. Drouhard to recess for Executive Session at 3:50 p.m. to discuss Performance Improvement Council Minutes and under Pending or Imminent Litigation, The Annual Risk Report. Dr. Hintz and Mr. Brazitis were excused. unanimously by roll call vote. Executive Session Approvals Performance Improvement Council Minutes A motion was made at 4:11 p.m. by Ms. Weaver and seconded by Ms. Anthony to adjourn Executive Session and return to regular session. Mr. Drouhard and seconded by Mr. Leader to approve the Performance Improvement minutes as presented. Annual Risk Report 2012 It was noted the Annual Risk Report was given to the Board of Trustees in Executive Session.

10 Page 10 of 10 As Ms. Weaver s term ends March 4, Ms. Ray presented her with a gift from the Board in gratitude for years of service. Adjournment: Minutes submitted by: There being no further business, Ms. Ray adjourned the meeting at 4:15 p.m. Minutes approved by: Patricia Anthony Secretary Joyce Ray Chair