Board Meeting - November 13, 2006
The regular meeting of the Board of Commissioners of Whidbey Island Public Hospital District was called to order at 6:00 p.m. by Board President, Roger Case, M.D. Present were Commissioner Saugen, Commissioner Case, Commissioner Zaveruha, Commissioner Schoenknecht and Commissioner Miller. Chief Executive Officer, Scott Rhine, Chief Financial Officer, Doug Bishop, Chief Information Officer, Tom Tomasino, Chief Nurse Executive for Home and Community Services, Judy Moore, Chief Nurse Executive for Acute Care Services, Jacque Scott, Chief of Staff, Dr. Terry Lee, Dale Roundy, Esq., Trish Rose, Arlene Johnson and Laura Renninger were also present.
President Case asked if there were any points of order to discuss, of which there were none.
Minute Approval
Minutes from the October 10, 2006 regular Board meeting were approved as presented in a motion by Commissioner Schoenknecht, seconded by Commissioner Miller. Motion carried.
Educational Presentation – Patient Care Follow-Up/Laura Renninger, RN
Scott Rhine, CEO introduced Laura Renninger, RN who works here at the hospital and has been working on a patient call back program that was restarted last April with grant funds that were received. Laura recently reported to the hospital Quality Committee about the work she has been doing on this program. Laura makes calls two days per week and identifies an accurate list of medications with patients, which helps prevent errors. Laura has contacted 90 patients since last April, with 14% of the phone calls resulting in referrals to a physician. This program has been well received by the public.
Quality and Patient Safety
Scott Rhine, CEO reported that some of the quality and patient safety projects being worked on include improving hand hygiene, medication reconciliation, and the rapid response team. Mr. Rhine will ask that representatives for these projects come to future Board meetings to present education.
Mr. Rhine talked about new regulations for hazardous waste removal to make sure that liquid waste is disposed of properly. A committee has been formed to work on this, and an agreement with another company in addition to Stericycle will be looked into.
Medical Staff Report
Dr. Terry Lee, Chief of Staff presented the following medical staff appointments and reappointments for approval:
Sidney D. Sparks, M.D. – Active Staff Reappointment
Commissioner Schoenknecht made a motion, seconded by Commissioner Saugen to approve the Active Staff Reappointment as presented. Motion carried.
Michael K. Koerner, M.D. – Courtesy Staff Reappointment
David A. Kantorowitz, M.D. – Courtesy Staff Reappointment
Josephine C. Zuzarte, M.D. – Courtesy Staff Reappointment
Richard W. Satre, M.D. – Courtesy Staff Reappointment
Vikas Vij, M.D. – Courtesy Staff Reappointment
Commissioner Saugen made a motion, seconded by Commissioner Schoenknecht to approve the Courtesy Staff Reappointments as presented. Motion carried.
Thomas P. McAnally, M.D. – Affiliate Active Staff Appointment
Commissioner Saugen made a motion, seconded by Commissioner Schoenknecht to approve the Affiliate Active Staff Appointment as presented. Motion carried.
Peter D. Sutcliffe, M.D. – Courtesy Staff Appointment
Commission Saugen made a motion, seconded by Commissioner Schoenknecht to approve the Courtesy Staff appointment as presented. Motion carried.
Colum Tinley, CRNA – Allied Health Professional
Gretchen M. Alsip-Vollbrecht, ARNP – Allied Health Professional
Commissioner Saugen made a motion, seconded by Commissioner Schoenknecht to approve the Allied Health Professional appointments as presented. Motion carried.
Dr. Lee announced the resignation of Kent Smillie, M.D. orthopedic surgeon effective October 1, 2006.
The following were reported under change of status: John Eggers, M.D., OB/GYN leave of absence as of October 20, 2006 and K. Byron Skubi, M.D., orthopedic surgeon to honorary staff as of
October 15, 2006.
Dr. Lee presented changes to the privilege request form for family practice. After review, Commissioner Saugen made a motion, seconded by Commissioner Miller to approve these changes as presented. Motion carried.
Individual Items: (Discussion and/or Action)
- Approval of District Legal Budget – Doug Bishop, CFO stated that preparation of a legal budget is an annual event and must be filed by November 30, 2006. The two main purposes of this are that it is state mandated to have a minimum budget submitted, and to set the collection legal limits on levies. Doug noted that the hospital prepares separate operating and capital budgets for the hospital each year as well.
EMS Levy – Due to the construction projects that were outlines in the community presentation, the EMS quarters in Coupeville, and the new ambulance bay at Bayview it is recommended that the full 50 cents of the EMS levy money be collected in 2007. Doug stated that it is important to have enough reserve money, which will earn interest. The numbers could change slightly, however the district could save taxpayers approximately $500,00 in 2008 and $367,314 in 2009 if we can reduce the amount of taxes collected in these years to $0.43 per $1,000 of assessed value. These concepts have been discussed by the Finance Committee, and will continue to be reviewed. The Board would like "talking points" prepared, and Commissioner Miller wants demographic statistics so Board members feel they can provide the community correct information when asked. Doug stated that the regular levy is ongoing at a 1% increase plus new construction. We could ask for 6%, but will ask for 1%. After review and discussion Commissioner Saugen made a motion, seconded by Commissioner Schoenknecht to approve Resolution #271 authorizing an increase in the regular property tax levy in the amount of 1% to be collected in the 2007 tax year. Motion carried.
Commissioner Saugen made a motion, seconded by Commissioner Miller to approve the legal budget as presented. Motion carried.
- Capital Equipment Lease Resolution #270 – A tax exempt capital lease for $1.5 million from Citicorp was presented for approval. This will be a five year lease at 4.27% interest with a monthly payment of $27,800. Funds will be put in an escrow account that will earn 5% interest, which will go toward payments. After review and discussion, Commissioner Saugen made a motion, seconded by Commissioner Miller to approve Resolution #270 as presented. Motion carried. (See attached listing of equipment).
- Board and Leadership Meeting Dates for 2007 - Commissioner Schoenknecht made a motion, seconded by Commissioner Saugern to approve the following Board meeting dates for 2007: January 8, February 12, March 12, April 9, May 14, June 11, July 9, August 13, September 10, September 28 & 29 (tentative dates for Leaders Conference), October 9 (a Tuesday due to Monday Columbus Day holiday), November 12, and December 10. All Board meetings, with the exception of the Leaders Conference, will be held at 6:00 p.m. in the hospital conference rooms. The media will be notified of these meeting dates.
Staff and Status Reports by Administration
Administrator’s Report – The Board had no questions regarding Mr. Rhine’s written Administrator’s report. Mr. Rhine announced that after further discussion, Jacque Scott would take a six month leave of absence and come back as the Director of Nursing with an office in the nursing area upstairs. Mr. Rhine noted that other changes are still being made and would be announced soon.
Financial Report – Doug Bishop, CFO reported that cash was low in September. The debt owed to Medicare has been paid in full. AR days were 61 in September. Revenue was over budget by $178,000, contractuals under budget by $71,00, operating expenses were over budget and the bottom line for September is a positive $206,000.
Year to date revenue is under budget by $1.5 million, contractuals are over budget by $1.2 million, operating expenses are under budget by $1.4 million and the bottom line year to date is a positive $505,000.
Graphs for statistics were reviewed with concerns about the high amount of bad debt, and the high number of Champus claims this year.
Doug reported that the CPA auditors from Moss Adams have completed two days of interim work, which went well.
The State auditors will be here for three weeks the beginning of December. Among other things, they will review all Board minutes for 2004/2005.
The operating budget is being prepared, and should be ready to present to the Board in the December meeting.
Operations Reports
Tom Tomasino reported that there have been four patients diverted since becoming a critical access hospital. Average inpatient census is sixteen, although was slightly higher in September. Length of stay has remained about the same. It was noted that the bottom line has remained positive due to the critical access program, while the bottom line year to date is currently a positive $500,00, it would be a negative $600,000 if we were not critical access.
The next 100-day objectives were presented for review. Mr. Rhine noted that there is some community concern that the hospital’s hospice program is not Medicare certified, and assured the Board that Administration is looking at this.
Mr. Rhine asked that the Board please email or call him with any questions on the 100-day objectives as presented.
Administration asked the Board if there were other things that should be tracked on the Dashboard report? It was discussed that the Dashboard report would be kept the same for the remainder of 2006, and changes would be looked at for 2007 i.e. looking at reasons for diverts other than census. It also was mentioned that the hospital should get feedback from patients that have been diverted.
Board Items
Suggestions for changes to the Board meeting discussion and report format came from the Building Committee. The Board likes new information and presentations. Mr. Rhine asked that the Board please submit subjects they want presented at Board meetings. Some upcoming topics include a report by Randy White, Diagnostic Imaging manager on new digital mammography equipment, a report on charity care and bad debts by Beth Stout, Business Services director, and Commissioner Schoenknecht asked for a report on the Ethics Committee work.
Commissioner Case asked about video conferencing capabilities as a future technology for Board members to "attend" Board meetings while away. It was noted that a high speed connection would be needed to use this technology. There was a question whether a Board member needed to be present to vote? Attorney Dale Roundy stated that if a Board member could hear the discussion, they could vote.
Commissioner Zaveruha apologized to the Board and Administration for coming late to Board meetings, and gave assurance that he is trying to remedy circumstances causing this.
Commissioner Saugen reported that a community member had recently inquired why there was not more publicity about the recent donation by Mr. and Mrs. Sebo for new digital mammography equipment? It was noted that the hospital was honoring the Sebos’ wishes by keeping publicity for the donation low key.
Public Questions or Comments
There were none
Consent Agenda Items:
- After review and discussion, Commissioner Saugen made a motion, seconded by Commissioner Schoenknecht to approve the write offs as presented in the amount of $286,230.39. Motion carried.
- Vouchers audited and certified by the auditing officer as required by RCW 40.24.080, and those expense reimbursement claims certified as required by RCW 42.24.090, have been recorded on a listing which has been made available to the Board. Commissioner Miller made a motion, seconded by Commissioner Schoenknecht to approve vouchers #380632 and #380651 in the total amount of $14,165.44. Motion carried. Commissioner Zaveruha abstained from the review, discussion, vote and written approval of these vouchers due to a potential conflict of interest.
Vouchers audited and certified by the auditing officer as required by RCW 40.24.080, and those expense reimbursement claims certified as required by RCW 42.24.090, have been recorded on a listing which has been made available to the Board. Commissioner Miller made a motion, seconded by Commissioner Saugen to approve vouchers #380564 to #381397, excluding #380632 and #380651, in the total amount of $4,242,689.38. Motion carried with all commissioners voting.
There being no further business or public comments, the meeting was adjourned at 7:47 p.m.