Governance

Washington County Hospital

Board of Directors Meeting Minutes

Tuesday, August 25, 2009, 7:00 p.m.

Conference Rooms A and B 
 

Members Present:

Dale Blohm, Chair

Sandy Alfeldt

Greg Engele

Harry Jankowski

Bill Manier

J. W. Metcalf

Diane Nottmeyer

Rich Tomaszewski 

Member Not Present:

David Behr, excused 

Others Present:

Nancy Newby, CEO

Tammy Amizich, CNE (exited 8:56 p.m.)

Elaine Matzenbacher, CFO

Ruth Kellerman, QA Coordinator (exited 8:56 p.m.)

Kim Larkin, CIO (exited 8:56 p.m.)

Melodie Wilkey, HR Director (exited 8:56 p.m.)

Marc Zerbe, M.D. Medical Staff President (exited 9:10 p.m.)

Randy Ragan, Auditor, McGladrey & Pullen, LLP (exited 8:09 p.m.)

Richard Lynch, Auditor, McGladrey & Pullen, LLP (exited 8:09 p.m.) 
 

Called to Order: 7:02 p.m.

Adjourned:  9:40 p.m. 
 

Meeting Agenda

The agenda of the August 25, 2009, meeting of the Washington County Hospital Board of Directors was presented for review and approval.   

On a motion by Greg Engele and second by Rich Tomaszewski, the Board unanimously voted to approve the August 25, 2009, meeting agenda. 

Previous Board Meeting Minutes

Finance Committee Meetings Minutes

 

Personnel, Recruitment and Management Contract Review Committee Meeting Minutes

The following meetings minutes were presented for review and approval:

• Board meeting, July 28, 2009.
• Finance Committee meeting, July 15, 2009.
• Personnel, Recruitment and Management Contract Review Committee meeting, August 21, 2009.

 

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

Financial and Statistical Report

Elaine Matzenbacher presented the Financial and Statistical Report for July 2009.  Highlights of the report were: 

Total Patient Revenue was $2,196,120.  Total Provisions were $923,898.  Total Net Operating Revenue was $1,316,737.  Total Operating Expenses were $1,308,523.  Income from Operations was $8,214, with YTD Income $116,675.  Total Non-Operating Revenue was $42,343, with YTD Total Non-Operating Revenue of $102,622.  Income prior to Depreciation was $113,502.  Total Income was $50,557, with YTD Total Income of $219,297, as compared to a budgeted $51,273. 

Additional noted items:

• Total Patient Revenues were 5.6% ($115,842) over budget for the month of July.  All areas of revenue were over budget for the month.
• Bad debts were 32.4% over budget in July.   This continues to run significantly over budget.  Patients are not taking advantage of our charity program and that is under budget.
• Employee benefits were 62.6% over budget this month.  This was due to a quarterly adjustment from Blue Cross for our employee health insurance.  There were significant high dollar claims in the previous quarter.
• There was a positive Income from Operations of $8,214 compared to a budgeted Loss from Operations in the month of -$17,820.
• The Net Income for July was $50,557.
• The Total Current Assets of $3,235,941 plus the Total Noncurrent Cash and Investments of $1,254,272 equaled $4,471,213, which is a half million dollars better than last year’s numbers.

 

On a motion by Harry Jankowski and second by David Behr, the Board unanimously voted to approve the July 2009 Financial and Statistical Report. 

Audit Year-End Report

The results of the annual audit report for the year ending April 30, 2009, for Washington County Hospital were presented by Randy Ragan and Richard Lynch.  They are partners at McGladrey & Pullen, LLP, which are the certified public accountants engaged by WCH for the audit. 

• Mr. Ragan 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 three reports prepared by McGladrey & Pullen, LLP:  (1) The Financial Report, (2) The Report to the Board of Directors and (3) The Financial and Compliance Report. 
• Mr. Ragan reviewed the audit process as well as the auditors’ comments in the reports.
• He indicated that the recommendations McGladrey made in the previous year were implemented by WCH. 
• Mr. Lynch reviewed the financial analyses in the report.
• They both noted that WCH has again made significant financial improvements over the previous year and trends were headed in the right direction.
• Harry questioned whether the Board could receive reports in advance, perhaps e-mailed.  Elaine stated that because of the tight timeline for completion, it would be highly unlikely to be able to meet this request—it’s a challenge to get it done by the Board meeting.

 

WCH Website Update

In response to the Board’s request, Kim Larkin provided a WCH website counter update as follows:

• Unique Visitors Monthly Average:  In 2006/319; 2007/502; 2008/688; 2009/726.
• Pages Monthly Average:  In 2006/6,607; 2007/6,768; 2008/6,130; 2009/3,747.
• Number of Visits Monthly Average:  In 2006/1,344 (although appears to be highest, the timeframe was only from May-December; employees were also encouraged to access/utilize the new website); 2007/1,155; 2008/1,135; 2009/1,144.
• Hits Monthly Average:  In 2006/39,983; 2007/45,297; 2008/53,465; 2009/25,310.
• Most common pages visited in 2009, high to low:  Home Page; HR Available Positions; About Us; Contact Us; Medical Staff—Active; Auxiliary; Governance; Services.
• Annual expenses:  1) Hosting = $100/year.  Designer = $180/month based on three hours of service time/month.

 

In the future, a WCH Website Report will be given on an annual basis. 

Personnel, Recruitment and Management Contract Review Committee Report

Chair J. W. Metcalf gave the following report:

• Committee met August 21, 2009.
• Details of the meeting will be reviewed and discussed in closed session.

 

D&O (Directors & Officers) Insurance Coverage

In response to the Board’s request, Elaine Matzenbacher reported that WCH’s D&O insurance coverage is $1 million per occurrence.

 

Expense Management Policy

In response to the Board’s request, Nancy Newby reviewed WCH’s Expense Management policy. 

• All capital expenditure requests should include at least two bids/quotes.  The only exceptions to this rule are if the item is under a Premier sole source, committed contract or a preferred vendor as part of a system (i.e., IT interfaces).
• A policy revision was made that the Capitalization Limit was increased from $1,000 to $5,000, which the Finance Committee approved and recommended for approval by the full Board.

 

On a motion by Greg Engele and second by Harry Jankowski, the Board unanimously voted to approve the revised Expense Management policy as presented. 

Disaster Drill Report

Ruth Kellerman, disaster coordinator, gave the following report regarding the August 5, 2009, IHA Region 5 disaster drill in which WCH participated:

• Incident simulation:  Earthquake in the New Madrid Fault resulting in Washington County area loss of electricity and WCH structural damage.  All WCH staff and patients were evacuated.
• Area participants:  Community Disaster Coordinator brought his command bus; ambulance service; health department; police department; boy scouts and parents and leaders as disaster victims; five girls (community members) were brought to WCH ER resulting from a vehicle accident.
• The Board noted that the fire department—a county-supported entity—did not participate.
• Most participating hospitals conducted their exercise as a paper drill.
• WCH took the drill very seriously and went through actual processes of the exercise.
• Several issues were identified and will be addressed.

 

Additional noted items:

• The following week WCH hosted a two-day decontamination training session with a total of 26 attendees from WCH, Salem and Du Quoin hospitals.
• WCH is preparing for H1N1.  WCH has completed a survey to obtain vaccines and additional supplies which are projected to be available in late October. 

 

WCH Medical Staff Bylaws Review

Nancy reported the following:

• The only significant change is that the Rules and Regulations have been incorporated into the Bylaws.
• An additional revision is that the Active staff member’s primary office must be within a 20-mile radius of WCH—changed from a 15-mile radius (which will accommodate a new Active staff member).

 

On a motion by Rich Tomaszewski and second by Diane Nottmeyer, the Board voted to approve the revised WCH Medical Staff Bylaws as presented.  Motion carried.  Harry Jankowski abstained. 

Community Comments/Questions and Answers

• Clarification was given regarding the WCH Website Report.
• Nancy reported that the WCH Board is at full membership again:  The Washington County Board appointed Sandy Alfeldt in July and Bill Manier was appointed in August.  Bill will be scheduled for new Board member orientation and will attend the September WCH Board meeting.

 

Closed Meeting

At 8:56 p.m. on a motion by J. W. Metcalf and second by David Behr, the Board took a roll call vote to enter closed session under Open Meetings Public Act 88-621 Sections 2(C)(1)(17)(21).  Behr AYE, Blohm AYE, Engele AYE, Jankowski AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried. 

At 9:29 p.m. on a motion by David Behr and second by Rich Tomaszewski, the Board took a roll call vote to leave closed session and re-enter open session.  Behr AYE, Blohm AYE, Engele AYE, Jankowski AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried. 

Board Closed Meeting Minutes

Personnel, Recruitment and Management Contract Review Committee Closed Meeting Minutes

Medical Staff Meeting Minutes

 

QA/CQI Meetings Minutes

The following meetings minutes were presented for review and approval:

• Board closed minutes, July 28, 2009.
• Personnel, Recruitment and Management Contract Review Committee closed minutes, August 21, 2009.
• Medical Staff minutes, June 3, 2009.
• QA/CQI minutes, May 21 and June 18, 2009.

 

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

Medical Staff Credentials and/or Privileges

On a motion by Harry Jankowski and second by Greg Engele, the Board unanimously voted that credentials and/or privileges be approved/granted as follows:

• Gaspar Fernandez, M.D. -- credentials were approved and Provisional Medical Staff privileges were granted specific to teleradiology services.
• Jeffery Morrill, D.O. -- credentials were approved and Provisional Medical Staff privileges were granted specific to teleradiology services.
• Schlepphorst, D.O. -- credentials were approved and Provisional Medical Staff privileges were granted specific to teleradiology services.
• Lisa Reis, M.D. -- credentials were approved and Provisional Medical Staff privileges were granted specific to cardiology services.
• Robert Davidson, M.D., family medicine –change of status from Provisional to Active.

 

Biennial Medical Staff Reappointment

On a motion by Harry Jankowski and second by J. W. Metcalf, Board unanimously voted to approve the Medical Staff biennial reappointment of Robert Davidson, M.D., Active staff, family medicine services. 

On a motion by Rich Tomaszewski and second by J. W. Metcalf, the Board unanimously voted to approve the Medical Staff biennial reappointment of Salvador Chavez, M.D., Courtesy staff, emergency services, with review of a recent incident. 

Physician Employment Agreements

On a motion by J. W. Metcalf and second by Greg Engele, the Board unanimously voted to extend Dr. Siddiqui an employment agreement as modified:  three-year term; 3% annual salary increase; no rollover of unused vacation time. 

On a motion by J. W. Metcalf and second by Diane Nottmeyer, the Board voted to extend Dr. Urdaneta an employment agreement as modified:  three-year term; 2% annual salary increase; add one week of vacation time.  Motion carried.  Harry Jankowski abstained.   

The Personnel, Recruitment and Management Contract Review Committee will meet on Thursday, September 3, 2009, at 6:30 p.m.  

Requests for Agenda Items for Next Board Meeting

No requests were made. 

Meeting Evaluation

Meeting evaluation forms were completed and returned. 

Impairment in the Workplace Inservice

• An “Impairment in the Workplace” staff education program will be presented during the week of August 31, and it is mandatory that employees attend. 
• The education program is in response to a recent incident. 
• A point of focus will be that an impaired employee poses safety risks to patients and employees and that staff are required to report such behavior.
• Nancy will e-mail this slide presentation to Board members.

 

Adjournment

On a motion by Harry Jankowski and second by Greg Engele, the Board unanimously voted to adjourn the meeting at 9: 40 p.m. 

Respectfully submitted, 

Richard Tomaszewski, Secretary, Board of Directors

Washington County Hospital