Governance

Washington County Hospital
Board of Directors Meeting Minutes
Tuesday, August 23, 2011, 7:00 p.m.
Conference Rooms A and B

Members Present:
Dale Blohm, Chair
Greg Engele
Audrey Finke
Victor Lopez
Bill Manier
J. W. Metcalf
Diane Nottmeyer

Members Not Present:
David Behr, excused
Jim Cange, excused

Others Present:
Nancy Newby, CEO
Tammy Amizich, CNE (exited 7:59 p.m.)
Chris Bening, HR (exited 7:59 p.m.)
Ruth Kellerman, QA Coordinator (exited 7:59 p.m.)
Kim Larkin, CIO (exited 8:55 p.m.)
Elaine Matzenbacher, CFO
Mark Dallas, KEB Auditor (exited 7:30 p.m.)

Other Not Present:
Alfonso Urdaneta, M.D., Medical Staff President, absent

Called to Order:         7:10 p.m.
Adjourned:                 9:01 p.m.

Meeting Agenda
The agenda of the August 23, 2011, meeting of the Washington County Hospital Board of Directors was presented for review and approval. 

The following amendment was made:

• Addition:   VI. H. Contract - Motion

On a motion by Greg Engele and second by Audrey Finke, the Board unanimously voted to approve the August 23, 2011, meeting agenda with the aforementioned amendment.

Board of Directors Meeting Minutes
Finance Committee Meetings Minutes
The following meetings minutes were presented for review and approval:

• Board of Directors, July 26, 2011.
• Finance Committee, July 14, 2011.

On a motion by Victor Lopez and second by J. W. Metcalf, the Board unanimously voted to approve the aforementioned meetings minutes.

Financial and Statistical Report
Elaine Matzenbacher, CFO, presented the Financial and Statistical Report for July 2011.  Highlights of the report were:

Total Patient Revenue was $1,663,528.  Total Provisions were $762,987.  Total Net Operating Revenue was $970,537.  Total Operating Expenses were $1,109,024.  Income/(Loss) from Operations was ($84,942), with YTD Income/(Loss) ($107,829).  Total Non-Operating Revenue was $29,847, with YTD Total Non-Operating Revenue of $53,545.  Total Income/(Loss) was ($18,306) as compared to a budgeted $67,382.

Additional noted items:

• Total Patient Revenues were 21.7% ($460,877) under budget.   Both outpatient and swing volumes were below budget.
• Contractual Adjustments were 13.9% under budget.  Charity care was $6,843 for July.
• Other Operating Revenue was over budget ($31,193) in the month as we are now receiving the Medicaid “double” assessment payments.  This will continue through December and then stop.
• Salaries were 8.5% under budget in July.  Supervisors continue giving “low census” days to staff to control salaries, as well as controlling overtime.  We continue to hold open positions as possible.
• Employee benefits were 38.7% under budget this month as our health insurance claims for July were below our prefunding by $26,000, and we received stop loss credits (from previous high months) on our July MCHC bill.
• Supplies and Other Expenses were 33% under budget in the month.   This reflects Supervisors’ attention to supply ordering, reducing inventories and controlling expenses.
• Total Operating Expenses were 15.3% under budget in July.
• Non-Operating Income was $19,075 over budget as we received some disaster grant money during this month.

On a motion by Diane Nottmeyer and a second by Bill Manier, the Board unanimously voted to approve the July 2011 Financial and Statistical Report.

Meaningful Use Update
Kim Larkin, CIO, presented the following (copy on file):

• Reviewed in detail progress of Stage 1 Core Criteria.
• Compliance has improved since a month ago, and areas are projected to meet compliance within the next month. 
• Reviewed in detail progress of Stage 1 Menu Set Criteria.

Year-End Audit Report
The results of the annual audit report (copy on file) for the year ending April 30, 2011, for Washington County Hospital were presented by Mark Dallas, KEB, which are the certified public accountants engaged by WCH for the audit. 

• Mr. Dallas stated that his firm gave WCH an “unqualified opinion” which is the highest opinion an accounting firm can give to a client. 
• The Board was presented copies of the Financial Report prepared by KEB. 
• Mr. Dallas reviewed the audit process as well as the auditors’ comments in the report. 
• WCH funds are down related to investment in the EHR; however, this should improve when WCH meets Meaningful Use compliance and reimbursement is received.

Quarterly Status Report
Nancy reviewed in detail the second Quarterly Status Report (copy on file). 

Digital Mammography Capital Campaign Update

• The Digital Mammography Capital Campaign Kick-off event on Saturday, July 30, grossed $11,000 and netted $9,000.  Two additional $1,000 donations were received from Karen Droeste of Almart and an anonymous donor.  Thanks was expressed to the Board, WCH staff and the community for their response to the event.  Feedback has been very positive.
• Upcoming campaign events:
• Trivia Night - Saturday, September 3, 7:00 p.m. at Southside, $10 cover charge
• Fall Festival – Friday-Saturday, September 23-24
• Quarter Auction and Vendor Fair – Sunday, October 16, 12:00 p.m. at Nashville Community Center with lunch at noon, $10 cover charge (includes lunch), with speaker Dr. Patricia Whitworth at 12:30 p.m. and auction/vendor fair at 1:30 p.m.
• Color Me Pink T-shirts will be sold at all events

Tax-Exemption Decision

• Not-for-profit hospitals are in jeopardy of losing their tax exempt status.  The Department of Revenue (DOR) recently refused to grant tax-exempt status to three hospitals citing lack of charity care as the basis for their decision.  However, there are no established criteria for charity care.  Legal action has been taken by the three hospitals.  IHA expects this to be the first of many denials.
• Taxing Illinois hospitals would create more economic hardships and make survival even more difficult in these financially challenging times.
• In response, IHA has asked members to participate in a letter writing campaign.
• DOR wants more tax revenue and is expected to eventually pursue property and sales tax from not-for-profit hospitals, also.

ICAHN Manual Request
ICAHN reply cards were distributed to Board members which requested suggestions for topics for  ICAHN’s Annual Board Manual publication.

WCH Golf Tournament
Elaine provided the following WCH Golf Tournament report:

• Date/time/location:  Friday, September 30, at 12:00 p.m. at the Nashville Community Golf Course.
• A kick-off meeting was held August 15.
• Flyer/registration forms were distributed at the Board meeting and will be mailed to prospective golfers. 
• Donations will go toward the digital mammography equipment fund.
• The lunch and dinner meal will remain the same as last year—brown bag lunch and pizza dinner.

Annual WCH Picnic

• Annual WCH Picnic will be Sunday, October 9, 1:00-4:00 p.m. at the Nashville Community Park.
• Board members and families were invited to attend.

Community Comments/Questions and Answers

• In response to reporters’ questions, Nancy provided clarification related to the audit report.
• Board members expressed their thanks to the media for their positive articles and announcements about the digital mammography capital campaign.

Closed Meeting
At 7:59 p.m. on a motion by Victor Lopez and second by Bill Manier, the Board took a roll call vote to enter closed session under Open Meetings Public Act 88-621 Sections 2(C)(1)(11)(17)(21).  Blohm AYE, Engele AYE, Finke AYE, Lopez AYE, Manier AYE, Metcalf AYE, Nottmeyer AYE.  Motion carried.

At 8:58 p.m. on a motion by Greg Engele and second by Audrey Finke, the Board took a roll call vote to leave closed session and re-enter open session.  Blohm AYE, Engele AYE, Finke AYE, Lopez AYE, Manier AYE, Metcalf AYE, Nottmeyer AYE.  Motion carried.

Board of Directors Closed Meeting Minutes
Medical Staff Meeting Minutes

QA/CQI Meetings Minutes
The following meetings minutes were presented for review and approval:

• Board of Directors closed, July 26, 2011.
• Medical Staff, June 8, 2011.
• QA/CQI, May 19 and June 23, 2011.

On a motion by Greg Engele and second by Victor Lopez, the Board unanimously voted to approve the aforementioned meetings minutes.

Medical Staff Credentials and Privileges
Allied Health Professional Staff Reappointment
Board members reviewed the applications, the supporting documentation, the Medical Executive Committee’s recommendations, and information received during the credentialing and privileging processes.  Based on this review, it was the Board’s opinion that the following applicants have met the requirements for Medical Staff appointment and clinical privileges as recommended. 

On a motion by Greg Engele and second by J. W. Metcalf, the Board unanimously voted to approve the following appointments and clinical privileges:

• Nishant Pillai, D.O.  – Provisional staff, emergency services.
• Debra Carson, D.O. – Provisional staff, gyn services.

and

Board members reviewed the Medical Executive Committee’s recommendations and information received during the biennial reappointment process.  Based on this review, it was the Board’s opinion that the remaining applicant has met the requirements for Allied Health Professionals Staff reappointment and clinical privileges as recommended. 

Approve the biennial reappointment of WCH Allied Health Professionals Staff member, David Rakey, CRNA, as presented.

Contract
On a motion by Victor Lopez and second by Bill Manier, the Board unanimously voted to:

Enter into an agreement with Clear Wave (fiber with 20mb) for primary Internet connection at a cost of $300/month and change Charter to backup service (a reduction from $1,045/month for 1.5 mb with ATT and ICN).

Adjournment
On a motion by Audrey Finke and second by J. W. Metcalf, the Board unanimously voted to adjourn the meeting at 9:01 p.m.

Respectfully submitted,

James Cange, Secretary

WCH Board

Administrative Team

Nancy Newby, Chief Executive Officer

Tammy Amizich, Chief Nurse Executive
Kim Larkin, Chief Information Officer
Elaine Matzenbacher, Chief Financial Officer

Alanna Barker, Human Resources Coordinator
Ruth Kellerman, Quality Coordinator

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