Governance

Washington County Hospital

Board of Directors Meeting Minutes

Tuesday, July 28, 2009, 7:00 p.m.

Conference Rooms A and B 

Members Present:

Dale Blohm, Chair

David Behr

Greg Engele

J. W. Metcalf

Diane Nottmeyer

Rich Tomaszewski 

 

Members Not Present: 

Sandy Alfeldt

Harry Jankowski 

Others Present:

Nancy Newby, CEO

Tammy Amizich, CNE (exited 9:03 p.m.)

Ruth Kellerman, QA Coordinator (exited 9:03 p.m.)

Kim Larkin, CIO (exited 9:03 p.m.)

Melodie Wilkey, HR Director (exited 9:03 p.m.)

Marty Skorczewski, Lab Supervisor (exited 9:03 p.m.)

Robert Davidson, M.D. (and wife and son; exited 7:10 p.m.)

Eric Trelz, Esq., Polsenelli, Shughart, P.C. (exited 8:05 p.m.) 

Others Not Present:

Elaine Matzenbacher, CFO, excused

Marc Zerbe, M.D., Medical Staff President, excused 

Called to Order: 7:05 p.m.

Adjourned:  9:24 p.m. 
 

Welcome and Introduction

• The Board welcomed Robert Davidson, M.D., who has been contracted to provide family medicine services in the Washington County Hospital Rural Health Clinic one day per week. 
• Dr. Davidson has been practicing in Pinckneyville since 1989.  Recently Dr. Davidson has begun to utilize WCH as the primary hospital for his patient admissions, although he does maintain courtesy staff privileges at Pinckneyville Community Hospital.  Dr. Davidson expressed his appreciation for a warm reception from WCH staff, the nice facility, pleasant environment and good services of WCH which he and his patients have experienced. 
• Dale Blohm then introduced WCH Board members, Administration and others in attendance.

 

Meeting Agenda

The agenda of the July 28, 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 July 28, 2009, meeting agenda. 

Board Education

Eric Trelz, Esq., Polsinelli, Shughart, P.C., presented a Board education program, “Board Do’s and Don’ts,” which focused on the following areas:

• Purpose and responsibilities.
• Fiduciary duties/consequences of breach.
• Business judgment rule.
• Access to records.
• Obligation of confidentiality.
• Oversight duties.

This Board education presentation was funded by an ICAHN grant. 

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, June 30, 2009.
• Finance Committee meetings, June 9 and 30, 2009.
• Personnel, Recruitment and Management Contract Review Committee meeting, July 7, 2009.

 

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

Financial and Statistical Report

Nancy Newby presented the Financial and Statistical Report for June 2009.  Highlights of the report were: 

Total Patient Revenue was $2,167,967.  Total Provisions were $908,471.  Total Net Operating Revenue was $1,302,043.  Total Operating Expenses were $1,202,150.  Income from Operations was $99,893, with YTD Income $108,460.  Total Non-Operating Revenue was $30,634, with YTD Total Non-Operating Revenue of $60,280.  Income prior to Depreciation was $192,786.  Total Income was $130,527, with YTD Total Income of $168,740, as compared to a budgeted $17,091. 

Additional noted items:

• Employee benefits were 9.4% over budget this month.  General Employee Benefits were over budget due to increased employee physicals (annual and new employee) written off in the month. 
• Charity Care continues to run below budget, again, because patients are not applying.
• PremierCare/Harmony Program – No revenue is coming in yet because of delayed billing cycles.  When received, the program’s revenue will be reflected under Outpatient Revenue.
• Key Statistics Report – June was a very high-volume month; historically, June has been very slow.  August stats should reflect Dr. Davidson’s productivity.
• Total Current Assets were $3,225,871 compared to last year’s $2,791,114.

 

On a motion by David Behr and second by Diane Nottmeyer, the Board unanimously voted to approve the June 2009 Financial and Statistical Report. 

Ordinances No. 142 and No. 143

In compliance with Illinois Compiled Statutes, Nancy presented for approval Ordinance No. 142, “An Ordinance making appropriations to defray all necessary expenses and liabilities of Washington County Hospital District, of Washington County, Illinois, for the fiscal year commencing May 1, 2009 and ending April 30, 2010;” 

and 

In compliance with Illinois Compiled Statutes, Nancy presented for approval Ordinance No. 143, “An Ordinance amending the levy and assessment of taxes for the fiscal year beginning May 1, 2009 and ending April 30, 2010.” 

On a motion by Greg Engele and second by Diane Nottmeyer, the Board unanimously voted to approve Ordinances No. 142 and No.143 for fiscal year 2009-2010 as presented. 

RAC Audits

Nancy presented a detailed overview regarding RAC (Recovery Audit Contractor):

• The Medicare Prescription Drug, Improvement and Modernization Act of 2003 was delayed for review.  However, it is slated to begin in August 2009 and be completely implemented by 2010.
• The mission of the RAC program is to reduce Medicare improper payments through efficient detection and collection of overpayments, identification of underpayments and the implementation of actions which will prevent future improper payments.
• Recommended WCH strategies are:
• Assess all current processes and identify issues or areas of potential risk.
• Educate all staff involved in charting, coding and billing.
• Conduct defense audits to find billing errors and provide mandatory education to prevent future errors.
• Work to improve documentation, coding and billing practices.
• Establish concurrent auditing processes to eliminate billing errors.
• Continue to follow websites for updates on RAC program.

 

Capital Equipment:  LIS (Lab Information System)

Marty Skorczewski, Kim Larkin and Nancy Newby provided the following information:

• Historical background:  LIS software has been on our Capital Equipment List for the past three years.    The need to replace the current lab system continues to escalate.
• WCH has been trying to access funding for this project from the SIU School of Medicine’s Rural Downstate Initiative Project for nearly two years.  Although SIU has approved WCH’s project, at this point in time, SIU does not have funds from the State for any of these grant projects.
• Current LIS purchased in 2000 only stores data with no means to retrieve it.  All QA (quality assurance) reports and QC (quality control) review activities must be done manually.  These processes are tedious, time consuming and increase possibility for data error.
• New LIS software would:
• Interface with EHR, Order Entry, and Microbiology.
• Enable immediate on-line access to records; reduce multiple records printing and eliminate overtime for after-hour calls to medical records staff to provide records.
• Automatically populate forms with data.
• Data could be manipulated for reporting needs.
• Document and track fax transmissions to physicians.
• Address five JCAH O issues of compliance.

 

Discussion ensued:

• This is a quality of care issue. 
• Software would enable lab to retrieve clinical date, track outcome and improve point of care.
• It would be difficult to quantify savings of time, manpower, improved efficiency; no ROI.
• It was recommended to stay with same vendor--Sphere/Omnitech. 
• The grand total for LIS software, hardware and related equipment, training (two employees) is $138,600, less PHIN Grant funds of $13,200, for a final total of $125, 400.  Additionally, there would be an annual support fee of $22, 158 which includes upgrades.

 

On a motion by David Behr and second by Rich Tomaszewski, the Board unanimously voted to approve the purchase of LIS software, hardware and related equipment, training (two employees) at a cost of $138,600 from Sphere/Omnitech. 

Sensory Room Open House

• A Sensory Room Open House is scheduled Thursday, August 13, 2009, 6:00-8:00 p.m. at the Nashville Middle School. 
• Memorials for Traci Storey, who was pursuing a career in autism-related healthcare, funded this
• project, which has been a collaborative effort between WCH and the school.  The community has been invited via an invitation published in the local newspaper.  Board members will receive an e-mail reminder of this event.

 

Personnel, Recruitment and Management Contract Review Committee Report

Chair J. W. Metcalf gave the following report:

• Robert Davidson, M.D., family medicine, contracted with WCH to provide family medicine services one day per week (currently ten hours on Mondays) in the Rural Health Clinic.
• WCH contracted with Clay County Hospital for pharmacist relief coverage.

 

Community Comments/Questions and Answers

There were no comments/questions from the news reporter. 

Closed Meeting

At 9:03 p.m. on a motion by Greg Engele and second by Rich Tomaszewski, the Board took a roll call vote to enter closed session under Open Meetings Public Act 88-621 Sections 2(C)(21).  Behr AYE, Blohm AYE, Engele AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried. 

At 9:09 p.m. on a motion by David Behr and second by Diane Nottmeyer, the Board took a roll call vote to leave closed session and re-enter open session.  Behr AYE, Blohm AYE, Engele AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried. 

Board Closed Meeting Minutes

 

Personnel, Recruitment and Management Contract Review Committee Closed Meeting Minutes

The following meeting minutes were presented for review and approval:

• Board closed minutes, June 30, 2009.
• Personnel, Recruitment and Management Contract Review Committee closed minutes, July 7, 2009.

 

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

Requests for Agenda Items for Next Board Meeting

• Update on WCH Webpage Counter – requested by J. W. Metcalf
• D&O Coverage – requested by J. W. Metcalf
• Capital Purchases—Bid Requirements – requested by Rich Tomaszewski

 

Meeting Evaluation

Meeting evaluation forms were distributed for Board members to complete and return. 

Adjournment 

On a motion by Greg Engele and second by J. W. Metcalf, the Board unanimously voted to adjourn the meeting at 9:24 p.m.

 

Respectfully submitted,

 

Richard Tomaszewski, Secretary, Board of Directors