Governance

Washington County Hospital

Board of Directors Meeting Minutes

Tuesday, March 24, 2009

7:00 p.m., Conference Rooms A and B 
 

Members Present:

Dale Blohm, Chair

David Behr

Greg Engele

Harry Jankowski

J. W. Metcalf

Diane Nottmeyer

Rich Tomaszewski 

Members Not Present: 

Jim Cange, excused 

Others Present:

Nancy Newby, CEO

Kim Larkin, CIO, (exited 7:55 p.m.)

Ruth Kellerman, Quality Coordinator (exited 7:55 p.m.)

Elaine Matzenbacher, CFO

Melodie Wilkey, HR Director (exit 7:55 p.m.)

Marc Zerbe, M.D., Medical Staff President 

Others Not Present:

Tammy Amizich, CNE, excused 

Called to Order: 7:02 p.m.

Adjourned:  8:09 p.m. 

Moment of Silence

A moment of silence was held at the beginning of the Board meeting in memory of the passing of Ken Harre, former Board member, and the passing of the mother of Board member Jim Cange. 

Meeting Agenda Additions/Corrections

The agenda of the March 24, 2009, meeting of the Washington County Hospital Board of Directors was presented for review and approval.   

The following amendments were made:

• Amend: IV.  D.  Capital Equipment to include two additional equipment requests – Nancy Newby
• Add: IV.  G. Questions to the CEO – Harry Jankowski

 

On a motion by Diane Nottmeyer and second by Greg Engele, the Board unanimously voted to approve the March 24, 2009, meeting agenda with the aforementioned amendments.

 

Previous Board Meeting Minutes

Finance Committee Meetings Minutes

Personnel, Recruitment and Management Contract Review

Committee Meeting Minutes

Nominating Committee Meeting Minutes

 

Joint Conference Committee Meeting Minutes

The following meetings minutes were presented for review and approval:

• Board meeting, February 24, 2009.
• Finance Committee meetings, February 11 and 24, 2009.
• Personnel, Recruitment and Management Contract Review Committee meeting, February 24, 2009.
• Nominating Committee meeting, March 17, 2009.
• Joint Conference Committee meeting, March 17, 2009.

 

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

Financial and Statistical Report

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

Total Patient Revenue was $1,946,226.  Total Provisions were $815,846.  Total Net Operating Revenue was $1,185,445.  Total Operating Expenses were $1,183,327.  Income from Operations was $2,118, with YTD Income ($647,206).  Total Non-Operating Revenue was $37,237, with an YTD Total Non-Operating Revenue of $677,519.  Income prior to Depreciation was $107,311.  Total Income was $39,355 with an YTD Total Income of $30,313 as compared to a budgeted $111,610. 

Additional noted items:

• WCH received its Hospital Assessment check of $241,000.  Money was immediately put back into WCH reserves, some in CDs and more into WCH bond and reserve account to make our bond payment May 1, 2009.  This replenishes WCH reserves to last year’s level.  Additionally, money has been set aside for the HVAC payment.  Future Hospital Assessment payments will be on a monthly basis.
• Other Operating Revenue was 44.2% over budget because WCH received some additional Medicaid and Medicare incentive payments.
• Employee benefits were 15.7% under budget.  Again in February, WCH had some credits for group health insurance which were applied to the payment in the month.
• Bad debts were 197% over budget.  All large balances were checked and many patients were sent Financial Assistance Applications, but these were not returned.  WCH is meeting its obligations by sending the forms to patients with a follow-up call to remind them to return the forms.  If they don’t comply, then they are turned over to collections and taken off our A/R.  Nancy reported on the recent Illinois Legislators and Hospital CEO’s round table which focused on these two topics.  While the State mandates hospitals to meet minimum percentage of charity care in their budget, this cannot be done if patients don’t apply.  CEO’s urged legislators to consider hospital’s bad debts along with charity care.

 

On a motion by Harry Jankowski and second by Greg Engele, the Board unanimously voted to approve the February 2009 Financial and Statistical Report. 

Nominating Committee Report

Committee Chair Diane Nottmeyer gave the following report:

• A Slate of Board Officers was developed and will be presented for approval at the April Board meeting:
• Chair – Dale Blohm
• 1st Vice Chair – J. W. Metcalf
• 2nd Vice Chair – Greg Engele
• Treasurer – Harry Jankowski
• Secretary – Rich Tomaszewski
• A form will be distributed to Board members to complete regarding their preferences for Committee assignments.  Dale Blohm will use this information to compose Committees which will be presented at the April Board meeting.
  

Joint Conference Committee Report

Chair Dale Blohm gave the following report of topics discussed:

• Development/Expansion of Physician Practices
• Explore potential options with another area physician.
• Continue collaborative relationship with a local physician.
• Need to revisit medical office building (MOB)--a new MOB would promote physicians’ practices and allow growth.
• Physician Recruitment--current trends:
• Sparse number of Family Practice graduates available.
• New graduates all want positions with hospitalists.
• Over 50% of all current medical students in Illinois are female.
• Very difficult to recruit to rural area.
• WCH plans to reach out to three known area residents in residencies to explore opportunities.

 

Gero-Psych Update

Nancy gave the following report:

• “Harmony” will be the name of WCH’s gero-psych program.
• Renovation work is being completed.  Furniture is to be delivered the first of April.
• Marketing brochures are being published and should be available in the next week.
• Hired:  Program director - Julie Smirl; therapist - Kathy Seibert; van driver – Virginia Benz; still interviewing for nurse.  Mark Napier, M.D., has agreed to be the medical director with Mark Freeman, M.D., as back-up.
• A van has been purchased and the lift is being installed.
• Chargemaster and Medicare billing numbers have been set up.
• Two patients have already been scheduled for the second week of April.
• Date of an open house will be announced.
• Board members will tour the area during the April Board meeting.

 

Vitek Analyzer:  Capital Lease

Two Additional Capital Items

1. Lab analyzer - As discussed by the Finance Committee, since WCH now has replenished its reserves, and the original lease offer is $6,500 more expensive, the Committee recommended to the Board to purchase the Vitek analyzer for the lab.  Current equipment is antiquated and requires several processes to be done manually which delays time-sensitive results.

 

On a motion by Rich Tomaszewski and second by David Behr, the Board unanimously voted to approve the purchase of a Vitek analyzer for the lab at a cost of $54,340. 

2. Physical therapy mobile storage cabinet – This is a patient safety need as patients could become entangle in loose equipment resulting in injuries which could be prevented.  The cabinet is special to PT equipment storage with adjustable shelving, hangers and is mobile.  J. W. questioned whether staff could make a cabinet, and Nancy responded that they probably could.

 

On a motion by Greg Engele and second by Diane Nottmeyer, the Board voted to approve the purchase of a Kangoo mobile equipment cabinet for physical therapy at a cost of $1,322.82. 

The motion passed with an opposing vote from J. W. Metcalf. 

3. Dietary three-basin sink – A three-basin sink is needed to meet State compliance requirements.

 

On a motion by Harry Jankowski and second by David Behr, the Board unanimously voted to approve the purchase of a three-basin stainless steel sink at a cost of $1,570. 

IDPH Bed Survey

Nancy provided the following information:

• IDPH is requiring all Illinois hospitals to submit an accurate bed count by the end of 2009, with validation by an architect-signed blueprint showing all actual beds.
• Her recommendation is that the five LTC beds on West Wing be converted back to acute med-surg/swing beds resulting in 22 beds actually ready for occupancy.  The total number of LTC beds on East Wing would be 28 which have sufficiently accommodated the LTC census for the past three years.  WCH will then submit an accurate, certified blueprint to the State reflecting 50 beds which is actually the current number of beds available.

 

On a motion by Harry Jankowski and second by Diane Nottmeyer, the Board unanimously voted to approve the reduction of WCH total bed count from 58 to 50—28 LTC beds and 22 acute med-surg/swing beds. 

WCH Medical Staff Rules and Regulations

Historical background:  During the October 2008 JCAHO site visit, the surveyors wanted Medical Staff processes/procedures compiled into one resource; subsequently, Medical Staff Rules and Regulations were developed.  At the February Board meeting, members received a copy of the WCH Medical Staff Rules and Regulations for review. The Medical Staff has reviewed, revised and recommended these for Board approval. 

On a motion by David Behr and second by Rich Tomaszewski, the Board unanimously voted to approve the WCH Medical Staff Rules and Regulations as presented. 

Nancy stated that these will be incorporated into the WCH Medical Staff Bylaws. 

Questions for CEO

After reading “Nancy’s Notes” in the employee newsletter, Harry inquired about the following topics:  

• Sick leave policy – Nancy provided clarification:
• A maximum of 906 hours may be accumulated.
• At the time of resignation/termination, benefits are not paid out—“use or lose.”

 

• Smoking policy –
• Harry suggested a designated smoking area on campus.  This would eliminate poor PR of employees standing across the street smoking.  Nancy reported that a homeowner has given staff permission to smoke in her yard.
• Nancy said that WCH promotes a healthy community which is reflected in this policy and applies to staff, patients and visitors.
• Diane expressed her opposition to smoking on campus and support of the hospital’s policy.
• Elaine conveyed that some patients are offended by the stench of smoke on their care giver.

 

Harry Jankowski made a motion that the Buildings and Grounds Committee be allowed to research a designated smoking area on campus for employees, patients and visitors; however, it died for lack of a second. 

Community Comments/Questions and Answers

Clarification was given regarding the Board’s Slate of Officers, the gero-psych program and capital equipment purchases. 

Closed Meeting

At 7:55 p.m. on a motion by J. W. Metcalf and second by Greg Engele, the Board took a roll call vote to enter closed session under Open Meetings Public Act 88-621 Sections 2(C)(21).  Blohm AYE, Behr AYE, Engele AYE, Jankowski AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried. 

At 8:05 p.m. on a motion by J. W. Metcalf and second by David Behr, the Board took a roll call vote to leave closed session and re-enter open session.  Blohm AYE, Behr AYE, Engele AYE, Jankowski AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried. 

Board Closed Meeting Minutes

The following meetings minutes were presented for review and approval:

• Board closed minutes, February 24, 2009.

 

On a motion by Diane Nottmeyer and second by Rich Tomaszewski, the Board unanimously voted to approve the aforementioned meeting minutes. 

Budget Presentation at Finance Committee Meeting

• FY2009-10 Budget will be presented at the Finance Committee meeting on Wednesday, April 8, 2009, at 6:30 p.m. in conference rooms A and B. 
• The full Board was invited to attend.

 

Memorials

• In response to Diane’s inquiry, Nancy stated that memorials are used for hospital/patient care needs unless otherwise specified by the family of the deceased. 
• In response to J. W.’s inquiry, Nancy said that a memorial plaque will presented to Ken Harre’s family, probably in a few months.  According to the family’s wishes, the plaque may be displayed at WCH or they may keep it

Adjournment

On a motion by Harry Jankowski and second by Greg Engele, the Board unanimously voted to adjourn the meeting at 8:09 p.m. 

Respectfully submitted,

J. W. Metcalf, Secretary, Board of Directors