Governance

Washington County Hospital
Board of Directors Meeting Minutes
Tuesday, September 27, 2011, 7:00 p.m.
Conference Rooms A and B

Members Present:
Dale Blohm, Chair
David Behr via phone
Jim Cange Greg Engele
Audrey Finke
Victor Lopez
Bill Manier
J. W. Metcalf
Diane Nottmeyer

Others Present:
Nancy Newby, CEO
Alanna Barker, HR Director (exited 8:15 p.m.)
Ruth Kellerman, QA Coordinator (exited 8:15 p.m.)
Kim Larkin, CIO (exited 8:15 p.m.)
Elaine Matzenbacher, CFO

Other Not Present:
Tammy Amizich, CNE, excused
Alfonso Urdaneta, M.D., Medical Staff President, excused

Called to Order:         7:10 p.m.
Adjourned:                 9:07 p.m.

Meeting Agenda
The agenda of the September 27, 2011, meeting of the Washington County Hospital Board of Directors was presented for review and approval. 

The following amendments were made:

• Addition:   IV. E. HR Director
• Addition:   VI. E. Corporate Letter

On a motion by Audrey Finke and second by Diane Nottmeyer, the Board unanimously voted to approve the September 27, 2011, meeting agenda with the aforementioned amendments.

Board of Directors 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 of Directors, August 23, 2011.
• Finance Committee, August 11 and 23, 2011.
• Personnel, Recruitment and Management Contract Review Committee, August 23, 2011.

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

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

Total Patient Revenue was $1,978,202.  Total Provisions were $793,415.  Total Net Operating Revenue was $1,288,178.  Total Operating Expenses were $1,296,431.  Income/(Loss) from Operations was ($8,253), with YTD Income/(Loss) ($245,913).  Total Non-Operating Revenue was $50,382, with YTD Total Non-Operating Revenue of $180,138.  Total Income/(Loss) was $42,129 as compared to a budgeted ($826).

Additional noted items:

• Total Patient Revenues were 6.9% ($146,203) under budget for the month of August.   Outpatient and Swing volumes were down.
• Contractual Adjustments were 10.5% under budget.  Charity care was $15,890 for August.
• Other Operating Revenue was over budget by $73,635 in the month as we are now receiving the Medicaid “double” assessment payments.  We also received the “catch up” payment from Medicaid for cost-based reimbursement.  This accounted for another $34,500 in assessment money as most of this was accrued in earlier months.
• Salaries were 6.5% under budget in August.  Supervisors continue giving “low census” days to staff to control salaries, as well as controlling overtime. 
• Employee benefits were 21.8% over budget as our regular Blue Cross monthly pre-funding is over our budgeted amount.
• Supplies and Other Expenses were 11.3% over budget in the month.   This was due to “start-up” supplies for our new lab analyzer.

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

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

• Reviewed in detail progress of Stage 1 Core Criteria and Stage 1 Menu Set Criteria.
• WCH has met all Stage 1 criteria by the September 30, 2011, deadline. 
• Kim will submit the official CMS attestation next week, and Elaine will file expenses for reimbursement.  Reimbursement is expected six to eight weeks after submission, and this will replenish WCH funds.
• WCH must continue to meet Stage 1 criteria.  With each additional stage, additional criteria will need to be met and maintained.  Failure to maintain may result in penalties of decreased percentage of reimbursement.
• WCH is one of the first two Illinois critical access hospitals to successfully complete MU Stage 1.  Being in the early run of MU allows participants an additional year to meet Stage 2.
• Nancy stated that this project has been a massive undertaking for the whole organization and all involved are to be commended.
• Kim will provide a MU report to news reporters.

Omnitech Update
Kim Larkin provided the following update:

• Omnitech is the lab system software.
• Omnitech sent one of their HL7 implementation team members to Washington County Hospital (at their own expense) from September 6-16.
• His purpose was to review the workflow between Omnitech and NextGen and create a document that would encompass all of the functionality that we need between the two systems.  He was successful in creating that document and Omnitech and WCH agreed with the contents. 
• NextGen has reviewed this document as well and agreed to the concepts outlined. 
• The next step is for Omnitech to create the specifications document, and we are asking for that document by month end. NextGen will need to agree to the specifications, and once that happens the timelines may be identified.

Joint Conference Committee Meeting
The Joint Conference Committee will meet on Thursday, October 20, 2011, at 7:00 p.m. in the boardroom.

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.
• 19-20 teams have registered.
• Four tournament ($1,000) sponsors have registered.
• Two prize ($500) sponsors have registered.
• Two teams are sponsoring dinner and one team is sponsoring lunch.
• 22 Tee signs have been sponsored.
• Lunch starts at 11:30 a.m. with 12:00 noon shot gun start. 
• There will be a basket raffle, 50/50 and attendance prizes.

Capital Request – Omnicell Medication Cabinet

• Our existing Med-Dispense medication cabinet is over 15 years old, experiencing frequent shut-downs requiring frequent service and is no longer able to be upgraded nor can we even obtain parts for replacement.  Also, a new cabinet is needed in order to maintain compliance with The Joint Commission which does not allow nurses to enter the pharmacy after hours, and that may be our only option if the Med-Dispense totally expires. 
• To address this need, about a year ago WCH purchased a medication cabinet from MDG.  This, vendor declared Chapter 7 Bankruptcy on August 16.  Legal counsel has been sought to recoup WCH’s down payment.  At this time, there is no way of estimating how much may be recouped or the expected timeframe.
• Administration has been exploring other vendor options.  Of the original four medication cabinet bids, Omnicell was the preferred choice by the pharmacy, IT and nursing; however, WCH agreed to purchase MDG because it was nearly $100,000 less expensive.
• With MDG’s bankruptcy, Omnicell has reached out to the clients affected, including WCH, and offered the identical cabinet previously quoted at $204,439 for $114,000–roughly $90,000 less than last year.  Our pharmacy system, Ascend, has already done their part of the interface to MDG, but they have agreed not to charge us to change it to Omnicell.  
• Omnicell cannot deliver until March or April 2012.
• Lease and purchase options were presented and discussed at length.  To utilize available funds from the IDPH Hospital Capital Investment Program Construction Grant, the cabinet would need to be purchased—not leased.

On a motion by Diane Nottmeyer and second by Bill Manier, the Board voted to purchase the Omnicell medication cabinet at a cost of $125,761.26 (covers product, support services, shipping and handling) using the IDPH Hospital Capital Investment Program Construction Grant.  The motion carried.  Victor Lopez and J. W. Metcalf opposed.  David Behr abstained.

Capital Request – Bariatric Bed
WCH received a $5,000 ICAHN Capital Improvement Grant and requested that funds be used to purchase a “gently” used bariatric bed (original price: $19,000).  This bed has a weight capacity of 1,000 pounds and can convert to a sitting position for ease of moving patients from laying to sitting to upright positions.

On a motion by Victor Lopez and second by Greg Engele, the Board unanimously voted to purchase the bariatric bed using the ICAHN Capital Improvement Grant of $5,000.

CEO Evaluation
Dale Blohm reminded Board members to turn in their completed CEO evaluations to him this evening or as soon as possible.

Human Resources Director
Nancy introduced, and all welcomed, new Human Resources Director Alanna Barker.  Alanna is originally from Edwardsville, Illinois.  She received a Bachelor of Science degree from Western University and a Masters degree in HR from SIU-E.  Her most recent experience includes three years as HR director at a critical access hospital in Kansas.

Community Questions and Answers
In response to reporters’ questions, Administrative staff members provided clarification related to the new HR Director, Financials Report, Meaningful Use and the golf tournament.

Quarter Auction Fundraiser for Digital Mammography Capital Campaign

• The Quarter Auction will be Sunday, October 16, at noon at the Nashville Community Center.
• Tickets are $10 (covers lunch), and Patricia Whitworth, M.D., of Clinical Radiologists, S.C., of Springfield, Illinois, will speak regarding breast cancer. 
• Auction begins at 1:30 p.m. and will coincide with a vendor fair with over 25 participants.

Closed Meeting
At 8:15 p.m. on a motion by J. W. Metcalf and second by Audrey Finke, the Board took a roll call vote to enter closed session under Open Meetings Public Act 88-621 Sections 2(C)(11)(17)(21).  Behr AYE, Blohm AYE, Cange AYE, Engele AYE, Finke AYE, Lopez AYE, Manier AYE, Metcalf AYE, Nottmeyer AYE.  Motion carried.

At 9:04 p.m. on a motion by J. W. Metcalf and second by Audrey Finke, the Board took a roll call vote to leave closed session and re-enter open session.  Behr AYE, Blohm AYE, Cange AYE, Engele AYE, Finke AYE, Lopez AYE, Manier AYE, Metcalf AYE, Nottmeyer AYE.  Motion carried.

Board of Directors Closed Meeting Minutes
The following meeting minutes were presented for review and approval:

• Board of Directors closed, August 23, 2011.

On a motion by Audrey Finke and second by J. W. Metcalf, the Board unanimously voted to approve the aforementioned meeting minutes.

Mid-Level Provider Recruitment
On a motion by Bill Manier and second by Jim Cange, the Board unanimously voted to pursue recruitment of a mid-level provider for staffing needs in the Rural Health Clinic.

Adjournment
On a motion by David Behr and second by Bill Manier, the Board unanimously voted to adjourn the meeting at 9:07 p.m.

Respectfully submitted,

James Cange, Secretary
Board of Directors
Washington County Hospital

WCH Board

Administrative Team

Nancy Newby, Chief Executive Officer

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

Christine Bening, Human Resources Coordinator
Ruth Kellerman, Quality Coordinator

>  2011 board meeting dates
>  Board of Directors agenda & minutes