Valley Board of Trustees MINUTES September 18, 2017

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1 MISSION STATEMENT: Valley Medical Center, the District s Healthcare System, is committed to providing access to safe, quality healthcare for the public. The District Healthcare System is integrated with UW Medicine and collaborates to ensure comprehensive, high quality, safe, compassionate, cost-effective healthcare is provided. Valley Board of Trustees MINUTES Board Members Present Bernie Dochnahl, Barbara Drennen, Peter Evans, Gary Kohlwes (Chair), Mike Miller, Lawton Montgomery, Vicki Orrico, Julia Patterson Board Members Absent Paul Joos, MD, Chris Monson, MD, Donna Russell, Tammy Sleeter, MD Others Present Katina Ashlock, Bonnie Bizzell, Theresa Braungardt, Tammy Coleman, Jeri Craine, Cara Estep, Jeannine Grinnell, Kim Herner, MD, Gayle Jago, Amber Kaiser, Paul Larson, Kim McClung, Wayne Manuel, Matt Mulder, MD, Hiroshi Nakano, Jamie Nephew, Jamie Park, MD, Tony Pedroza, MD, Elizabeth Perry, Rich Roodman, David Smith, Debbie Standard, Todd Thomas, Bob Thompson, MD Recorder Kathryn Holland 1. CALL TO ORDER Gary Kohlwes called the meeting to order at 1:35 p.m. 2. VOICE OF THE PATIENT Dr. Jamie Park shared an emotional story from the mother of a patient under his care that unfortunately passed away. 3. CONSENT AGENDA AND ACTION ITEMS MOTION: Mike Miller moved to approve the consent agenda and Bernie Dochnahl seconded the motion. The items moved for adoption were: Minutes of August 21, 2017 Financial Vouchers/Warrants/Pay Apps Surplus Property Resolution No. 070 The motion carried 8-0.

2 Page 2 4. EDUCATION Honoring Choices Pacific Northwest: Kim McClung, Vice President of the Clinic Network, along with Jamie Nephew, Clinic Manager Valley Family Medicine, provided a report on the National and State-wide initiative in partnership with Washington State Hospital Association and the Washington State Medical Association to achieve 95% participation with Valley s patient population to honor patients endof-life choices through one-on-one discussions, education, personal conversation and ultimately the recording of an Advance Care Plan in EPIC. Jamie Nephew discussed 2017 Time Line and the challenge of discussing this topic with patients with the goal of expanding the population of patients with advanced directives and having the directives in the patients charts. Palliative Care/Inpatient Hospice: Elizabeth Perry, Director of Palliative Care, provided a report regarding Palliative Care and Hospice through the Care Continuum. Valley s role in assisting in the various stages of hospice were presented, from advanced care planning in healthy adults, to diagnosis of a serious illness and palliative care, to the terminal phase and hospice care, and ultimately to death and bereavement support. 5. COMMITTEE REPORTS Finance, Facilities & Audit Committee Mike Miller reviewed materials from the FF&A Committee meeting highlighting Valley s profit year-to-date, our active cost containment efforts, revenue, and mixed volumes, with a more favorable payer mix with Medicare at 34% for the month. Self pay was discussed at length with 2.6% vs 1.5% self pay; 131 days cash on hand and accounts receivable as of June 30 was 44 days, the lowest to date and 46 for July. Call for Bid: MOB Shell/Core, ASF TI, North Road Realignment and Traffic Signal Todd Thomas requested authorization to advertise for a call for bids for the Medical Office Building which will provide approximately 161,400 square feet of additional medical office space in a new five story building. The general scope of the project includes construction of the shell and core, tenant improvements for a new Ambulatory Surgery Facility, realignment of the VMC campus north road, and installation of a traffic signal and other associated improvements on Talbot Road, in addition to a skybridge connection to the expanded north parking garage and a tunnel connection to the main hospital. The estimated total cost of the project is $70,816,674 which includes $44,098,893 from Healthcare Realty Trust for construction of the Shell and Core as well as their share of the site work. The project cost estimates will include construction, contingencies, equipment, furniture and fees to complete the project for occupancy. This project is forecast to be funded through FY18 and FY19 capital budgets. MOTION: Gary Kohlwes moved to approve the Call for Bid for the MOB Shell/Core, ASF TI, North Road Realignment and Traffic Signal. Vicki Orrico seconded the motion. Motion carried 8-0.

3 Page 3 Call for Bid: North Substation Update Todd Thomas requested authorization to advertise for a call for bids for the North Substation. This project is located on the Valley campus and will provide a necessary upgrade to the campus electrical system to support the expanded north parking garage and new medical office building. The general scope of the project includes the removal and replacement of existing switchgear equipment in the north substation that does not meet current electrical codes and is undersized for the loads required to service the new parking garage and medical office building. The estimated total cost of this project is $1,539,954 including construction, contingencies, equipment and fees to complete the project. This project has been funded through the FY18 capital budget. MOTION: Mike Miller moved to approve the Call for Bid for the North Substation Update. Peter Evans seconded the motion. Motion carried 8-0. Call for Bid: VPCN Connector Todd Thomas requested authorization to advertise a call for bids for the VPCN Connector. The project will be located on the Valley campus and will provide an enclosed on-grade connection between the expanded north parking garage and the Valley Professional Center North (VPCN) building. The general scope of the project will involve the construction of the enclosure, new MEP utilities and associated modification to surrounding site elements including sidewalks, ramps and stairs. The total project area is approximately 575 square feet and estimated total cost is $565,450 including construction, contingencies, equipment, and fees to complete the project for occupancy. This project has been funded through the FY18 capital budget. MOTION: Mike Miller moved to approve the Call for Bid for the VPCN Connector. Bernie Dochnahl seconded the motion. Motion carried 8-0. Long Range Financial Plan Update Jeannine Grinnell provided a brief update of the Long Range Financial Plan previously recommended by the FF&A Committee at their September FF&A Committee meeting. MOTION: Mike Miller moved to accept the Long Term Financial Plan and recommended approval by the Board. Vicki Orrico seconded the motion. Motion carried 8-0. Joint Conference Committee Bernie Dochnahl reported on the September JCC meeting. Credentials were approved without exception. Dr. Park provided a brief overview of the Quality Improvement Dashboard for the new fiscal year and directed attention to quality measures for pressure ulcers, and the committee received an education summary on pressure injuries. The Medical Executive Committee approved the 2016 Bylaws revisions. These changes were previously approved at Medical Executive Committee but signatures were inadvertently left out of the documents. Per request from our delegated insurance plans they required signed copies. MOTION: Peter Evans moved to approve MEC Bylaws and Policies & Procedures as revised and approved by the MEC in Vicki Orrico seconded the motion. Motion carried 8-0.

4 Page 4 6. INFORMATION REPORTS UW Medicine Update Rich Roodman commented on the high quality of work from the previous presentations earlier in the meeting regarding Valley s Palliative Care and In-Patient Hospice Program and that these programs do not exist at all hospitals because of the financial commitment by a sponsoring hospital. Rich Roodman provided an update that UW Medicine has a budget for FY18 that is essentially break even and that long range financial planning is ongoing. They are preparing for a 3-year time line and hope to acquire capital from the University of Washington. The rest of the System is working on a similar expense management program as VMC. One month into the fiscal year, they are pleased with the financial results. Annual Institution Report from the Valley Family Medicine Residency Dr. Pedroza provided a comprehensive report on the Valley Family Medicine Residency program as an annual requirement. As part of the UW Medicine program, Valley s residency program graduated their 200 th resident in The program began with 4 residents per year, and has expanded to 8 residents per year for a total of 24. The curriculum is known throughout the WWAMI FMRN network for our Clinic First curricular model, which prioritizes continuity of patient care between residents and their panel of patients. Graduates are trained in a variety of environments, including prenatal and obstetrics. Administrative Update Rich Roodman reviewed highlights from the September Operational Update, directing attention to the Community outreach and Growth areas. He described pending field trips to clinic networks to seek out best practices in a variety of areas. The future benefits to the community of the ongoing Proliance joint venture discussion were described as well. Hiroshi Nakano reported that Valley continues on Track 1 towards beginning the Medicare Shared Savings Program (MSSP), that we committed to three years if accepted by the government, including the fact that the Valley Board of Trustees is listed as the Board for the Valley MSSP program. There was considerable explanation and conversation on this matter. 7. OLD/NEW BUSINESS Chair of the Board Gary Kohlwes reminded the Board of the proposed meeting times for the October FF&A Committee and Board of Trustees meetings. The recommendation was made going forward to begin the FF&A Committee at 12:00 p.m. followed by the Board of Trustees meeting beginning at 1:30 p.m. This change would take affect going forward in November and include the Board of Trustee meeting in October beginning at 12:00 p.m. October 16. MOTION: Peter Evans moved that the aforementioned ongoing change of times be accepted.

5 Page 5 Bernie Dochnahl seconded. Motion carried ADJOURNMENT The meeting adjourned at 3:26 p.m. Respectfully submitted, Kathryn Holland Executive Assistant to the CEO and Board of Trustees Valley Medical Center All reports and presentations reviewed by this committee were in draft format, unless otherwise noted in these minutes.

MOUNT VIEW CARE CENTER COMMITTEE (MVCC)

MOUNT VIEW CARE CENTER COMMITTEE (MVCC) AGENDA Date & Time of Meeting: Monday, May 7, 2018 at 5:30 PM Meeting Location: Board Room, North Central Health Care, Wausau, WI Mount View Care Center Committee