MORROW COUNTY HOSPITAL BOARD OF TRUSTEES REGULAR MEETING April 23, 2013

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MORROW COUNTY HOSPITAL BOARD OF TRUSTEES REGULAR MEETING Members Present: Patrick Drouhard, Chair Joyce Ray, Vice Chair Carolyn Beal Dennis Leader Brent Winand Brad Wood Absent: Patricia Anthony, Secretary Others Present: Christopher 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 Justin Rubbio, OhioHealth Sandie Fisher, Executive Secretary Call to Order: Mr. Drouhard called the meeting to order at 6 p.m. in Assembly Room C in the lower level of the hospital and welcomed Justin Rubbio from OhioHealth who is shadowing Mr. Truax today. Approval of Minutes The minutes of the regular March 23 meeting were reviewed. Ms. Ray and seconded by Mr. Winand to approve the minutes as written. Hospital Reports Medical Staff Report Dr. Hintz reported on the April 2, 2013 meeting of the Medical Executive Committee. The following Ongoing Professional Practice Evaluations and credential recommendations were approved by the Medical Executive Committee and are referred to the Board for approval. Mr. Winand and seconded by Mr. Leader to approve the Credentials as presented. Credentials Committee February 25, 2013: Ongoing Professional Practice Evaluations Approved: AllergyImmunology- Practitioner 156 Anesthesia Practitioners 709, 715, 725, 726, 733

Page 2 of 9 Dermatology Practitioner 200 Emergency Medicine Practitioners 939, 942, 945, 946, 947, 952, 997 Family Practice and Internal Medicine Practitioners 003, 007, 036, 038, 046, 045. Gastroenterology - Practitioner 192 General Surgery Practitioners 159, 225, 238, 239, 246 Gynecology Practitioners 233, 182 Neurology Practitioner 032 Ophthalmology Practitioner 009 Orthopedics Practitioner 230, 243 Otolaryngology Practitioner 131 Practitioners with no patient contact for 24 months focused professional practice evaluations will need to be initiated should they utilize privileges: Anesthesia Practitioners 186, 702, 717, 719, 722 Emergency Medicine Practitioners 948, 955 Gynecology Practitioner 234 Practitioners with no patient contact for 12 months focused professional practice evaluations will need to be initiated should they utilize privileges: Anesthesia Practitioners 186, 702, 717, 719, 722, 723, 24 Credentials Committee March 25, 2013 Appointment: Hafiz Ayub, MD Emergency Medical Staff Emergency Medicine Reappointment: Mohiuddin Ghazi, MD Active Medical Staff Internal Medicine Zachary Place, MD Emergency Medical Staff Emergency Medicine

Page 3 of 9 James Bazzoli, MD Courtesy Medical Staff Gynecology Aleskey Prok, MD Courtesy Medical Staff Pain Management Mary Beth Breckenridge, MD Consulting Medical Staff Cardiology Satish Joshi, MD Consulting Medical Staff Anesthesia Jesse Blake Kellum, MD Consulting Medical Staff Neurology wpolysomnography Dr. Hintz reported the Medical Staff recommended the The following certification requirements to request Emergency Medicine privileges: Advanced Cardiac Life Support (ACLS). Pediatric Advanced Life Support (PALS). If Board certified in a specialty other than Emergency Medicine, must show evidence of Advanced Trauma Life Support (ATLS) or documentation of evidence of pursuit of ATLS certification within 6 months of review of appointment or reappointment application by the Credentials Committee. Credentials Committee MARCH 25, 2013: Ongoing Professional Practice Evaluations Approved: Pulmonology Practitioners 122 and 698 Podiatry Practitioners 102 and 240 Pain Medicine Practitioners 190, 193 and 226 Practitioners with no patient contact for 24 months focused professional practice evaluations will need to be initiated should they utilize privileges: Pain Management Practitioner 227

Page 4 of 9 Voluntary Withdrawal David Kasserman, MD Active Medical Staff General Surgery Daryl Sander, MD Courtesy Medical Staff Stereotactic Breast Biopsy Richard Doerfler, MD Radiology-Teleradiology Administrative Council Report Some of the main items Mr. Truax shared as he reviewed the Administrative Council Report include: Dr. Hintz will be joining Morrow County Hospital Health Services effective July 1. The Ohio Department of Health has approved the sale of eight (8) of the extended care bed licenses. After a 30 day waiting period the bed license sale will close after May 10. The remaining 30 bed licenses are expected to close before the end of August. The 90-day collection of data for meaningful use on the Meditech System will begin May 1. Once the data is collected and the criteria are met, a request for reimbursement from CMS for our investment will be submitted. This is to cover hardware, build and implementation costs associated with Meditech (estimated to be $1.8 million). The reimbursement of funds will be used to reduce the bank loan obtained to purchase the system. An impressive seventy-percent of our physicians completed the Physician Perception Survey. Results will be shared with the Board in June or July. The timeframe for the Employee Opinion Survey will begin tomorrow.

Page 5 of 9 Financial Performance Report Mr. Schueler reported the financial status for the month of March: Gross patient revenue was $827,526 under budget. Inpatient revenue was $319,000 or 43% under budget. Inpatient days were 42% under budget. Swing beds days were 35% under budget. Outpatient revenue was $509,000 under budget. Employee benefits were under budget by $126,000. Net Days in Accounts Receivable increased from 64.7 to 67.7 days. Days Cash On Hand increased from 46.4 to 51.9. The net gain for the month is $121,539. The year-to-date loss is ($329,377). The operating margin for the month is 4.9% and for the year-to-date, (5.0%). Mr. Wood and seconded by Ms. Beal to approve the Financial Report as presented. Finance Committee Minutes April 17, 2013 Mr. Schueler reported on the Finance Committee meeting of April 17. The Committee discussed the employee benefit plan. Currently Administration is waiting to hear from the County Commissioners Association and OhioHealth to see if MCH would be eligible for either of those plans and what the costs would be. Morrow County ranks 49 out of 88 counties for health risks behaviors. In addition, MCH s claims experience does not work in our favor. Ms. Ray and seconded by Mr. Leader to approve the minutes as presented.

Page 6 of 9 The Committee also discussed Rural Health Clinic (RHC) designation. RHC status for the primary care offices would increase reimbursement. Practice Manager, Barry Myers is working with Plante & Moran to understand the impact for each location. Each location must be applied for and surveyed individually. The Neal Avenue office will not be eligible until Dr. Hoppes begins practice in May and a nurse practitioner is hired and seeing patients 50% of the available clinic time to meet essential criteria. The appropriate MCHHS offices could obtain RHC status by the end of this year. Other Business: Balanced Scorecard Mr. Miller presented the first quarter Balanced Scorecard results. The new format of the report contains additional information. Customer Service scores reflected improvement in all areas over last year. MCH also chose to report additional core measures under Quality of Care: VTE = Venous thromboembolism STK = Stroke IMM = Immunizations Committee Assignments Mr. Drouhard discussed the committee assignments. It was agreed that current assignments will be maintained for 2013. Mr. Winand was appointed to the Ethics Advisory Committee. Board members were asked to contact Mr. Drouhard with any changes they would like.

Page 7 of 9 Bylaws Review of Bylaws, Code of Organization, Mission Vision Cardinal value. The following changes were discussed: Article 1.2 Amended so the ability to use e-mail as a means of notification and conference calling to also be utilized as necessary for special meetings. 4.3.3 Strategic Planning Committee to meet at least annually. 4.3.4 Performance Improvement Council to meet quarterly rather than six (6) times per year. 4.3.6 Information Systems Steering Committee to meet quarterly. It was also discussed that Board packets can be e-mailed instead of sent US mail, prior to the Board meetings with the printed packet presented at the meeting. Morrow County Hospital Foundation Mr. Leader discussed the potential of philanthropic endeavors for the MCH Foundation and suggested the possibility of a paid part-time administrator. The Group discussed the proposal and will hold an MCH Foundation meeting in May to further discuss. Guard Care The Morrow County Health Department, the Ohio Department of Health in collaboration with the Ohio National Guard is planning Guard Care which is a program of free health care usually held for one (1) or two (2) weekends. Morrow County has been selected for 2013. Fifty National Guard clinicians will be on-site providing medical screenings and tests to the public. The former ECF space will be utilized. MCH is committing to providing lab Mr. Leader and seconded by Mr. Winand to amend the bylaws as discussed to be adopted at the May Meeting.

Page 8 of 9 tests and mammography slots. The cafeteria will be open to the public. The Guard will provide the advertising and the event will be on a Saturday and Sunday in August. OhioHealth Mr. Brazitis indicated OhioHealth is contacted on a regular basis by other healthcare facilities with interest in entering into a relationship with OhioHealth System. OhioHealth does not search out other facilities. Ethics Advisory Committee Ms. Heineman reported on the Ethics Advisory Committee of March 18. Chairman of the Committee is Chaplin Dave Matos. Chaplin Matos is head of the MCH Chaplin group and is a Chaplin for Hospice of Morrow County. Ms. Heineman reviewed the minutes of the meeting: Dr. Frank presented a case review for the group. Mr. Gene Gompf introduced a new state form for the authorization to dispose of bodily remains. As the Durable Power of Attorney for Healthcare ends upon death, this form is for a person to appoint who they would like to make their final arrangements upon death. Their wishes regarding these arrangements can also be listed on the form. OhioHealth Corporate Director of EthicsFaith Group, Missions & Ministry, Corey Perry provided an overview of the Ohio DNR law on March 14 at two presentations. The audience included physicians, hospice, and hospital and physician office staff. Ms. Ray and seconded by Mr. Leader to approve the minutes as presented. The minutes were approved

Page 9 of 9 South Campus Mr. Truax reported a proforma of the exact return will be presented to the Board in June. Studies show only 10% of residents south of State Route 95 seek healthcare at Morrow County Hospital. Forty percent of commercially insured residents north of State Route 95 seek healthcare at MCH. It is essential that MCH have a presence in the southern part of the county. Mr. Miller gave a presentation to the Board on the project and indicated RHC status is necessary in order to provide ancillary services at that location. The name selected is Morrow County Hospital at the Cardinal Center. Invitations will be going out soon for the May 22 groundbreaking. Board Member Candidates Mr. Truax indicated three (3) excellent candidate interviews have been held. One additional candidate will be interviewed next week. Adjournment Minutes submitted by: Minutes approved by: Being no further business, the meeting was adjourned at 7:30 p.m. Dennis Leader Acting Secretary Patrick Drouhard Chair