Board Meeting Highlights and Minutes May 23, 2012

Highlights from the Board of Trustees Meeting 5-23-12:

Special Announcements:

Dr. Holly Payne, physician director of the Summer Student Medical Intern program gave an update and introduced this year’s interns. The program is in its 13th year and is a collaborative effort between the Teton County School District, St. John’s Foundation, Teton County Medical Society and St. John’s Medical Center. The three week program gives qualified high school juniors and seniors the opportunity to observe the real world of medicine so they can make informed career decisions with the hope that they return to Jackson to work and practice in the medical field. This year’s interns are Alexis Anderson, Juan Pablo Vazquez and Catherine Cloetta. We also heard from Natalie Meadows who was an intern in 2009 and now is in the graduate program at the University of Utah. The students are not allowed to have any other commitments during their internship including other jobs as they may have to come to the hospital at any time 24 hours a day so they are given a stipend. This program is not financially supported by the hospital or the Foundation so we want to say thank you to Dr. Emmy Knobloch for her generous donation which made this year’s program possible.

Next Terri Hayden, our volunteer coordinator, introduced one of the hospital’s volunteens - Hayden Leeds. Hayden was this year’s recipient of a $3,000 scholarship from the St. John’s Auxiliary. He started volunteering in the oncology department when he was 12 years old and is now working in that department as an employee. He has been accepted to Washington University with the goal to become an oncologist. He also recently assisted with a fundraising event that raised over $8,000 for local cancer patients. Congratulations to Hayden for his amazing accomplishments.

Education Presentation:

Nick Healey gave an update on revisions to the Public Records Act and Public Meetings Act which will become effective July 1, 2012. The purpose of these Acts is to promote transparency of government agencies. One change is that violation of these laws will no longer be considered criminal but will now be a civil violation. Other changes simplify the definitions of how information is exchanged so it is not limited to specific forms such as books, records, or sound recordings and now simply refers to the exchange of any information including electronic transfers. The process by which the public can request copies of public documents was also clarified. One major change to the public meeting laws is that electronic communications are included as part of the meeting. There were also changes to providing notice of specific types of meetings. For regularly scheduled meetings, notice can be provided in writing once a year and special meetings can now be noticed a minimum of 8 hours prior to the meeting. These documents can be viewed at http://legisweb.state.wy.us/2012/Session%20Laws.pdf.

Minutes:

The Board approved the minutes from the meeting held on April 25, 2012. Approved minutes are posted at http://www.tetonhospital.org/about/board/meetings.

New Business:

Health Fair - Julia Heemstra, Wellness Coordinator, gave a wrap up report on the 2012 Community Health Fair. She estimated that there were over 1,200 attendees, 93 health information booths, 12 free health screenings offered, 13 hospital department booths, and 5 free demonstration classes along with free food and coffee. Vickie Memmer, Director of the St. John’s Clinical Laboratory announced that they processed over 4,100 wellness blood screenings for St. John’s employees and community members. This required an incredible amount of team work between those scheduling the appointments, processing the orders and performing the testing. Julia also thanked our health fair sponsor First Interstate Bank.

2012 Community Health Needs Assessment and Implementation Strategy - Karen Connelly, Director of Marketing and Community Relations, presented the 2012 Community Health Needs Assessment (CHNA) and Implementation Strategy. She noted that St. John’s is subject to several new requirements associated with the Affordable Care Act. One of these mandates is the requirement to conduct a community health needs assessment every three years.

The approach to meeting this requirement was to stay focused on certain goals. The first was to make sure this project represented 100% compliance with the requirements. The second was to avoid duplication of community resources. The statute permits hospitals to use recent community health surveys conducted by other agencies so it was decided to use the 2011 Teton County Community Health Assessment which met the IRS parameters. Third, after conferring with members of administration, the Board and given the uncertainty around this new mandate, it was decided that this would be a baseline report for the initial CHNA and summarize current St. John’s services and programs that address the health priorities established by the Teton County survey. Lastly, the group met with our new CEO, Dr. Louis Hochheiser who requested that he have an opportunity to be present for discussion and approval of the implementation strategy. He asked Karen to emphasize that he views this report as a baseline and as a catalyst for future important community conversations about St. John’s role in community wellness.

This document is being present today so the Board has time to review and ask questions and can approve the implementation strategy by the June 30, 2012 deadline. Mike Tennican stated that there will be several meeting opportunities to discuss this document with members of administration as well as other health care agencies to get ready for approving the implementation strategy by June 30th.

Report from County Commission:

Paul Vogelheim, County Commissioner and Hospital Liaison, opened his report by congratulating the Board members on the process and new appointment of the new CEO. He went on to note that the county is facing a very challenging time with their budget process. They still have a hiring freeze and are trying to be protective of the agencies that provide much needed community services. They have commitments for the next two years of SPET for different allocations and projects such as the county transfer station could push this out further. They are also subject to the changes in the public meeting laws and will have to make some changes to how they approach some of their more informal workshop meetings so they are in compliance with the new regulations. They have sent out a Request for Proposal regarding their medical insurance plan to look at different structure models but will remain self-insured with a health savings account plan. They are also looking at different options for the ambulance program and appreciate the hospital’s continued support of this important service.

Board Committee and Medical Staff Reports and Action Items:

JCC Report – Mike Tennican stated that he gave a brief update of the expansion project and noted simply that the other board committees were working on their items. There was also a preliminary discussion on how to approach certain issues discussed in the JCC committee.

Approval of Credentialing and Policy Items – Dr. John Payne presented the credentialing recommendations that were approved at the May MEC and JCC meetings and included in the MEC report to the Board dated May 8, 2012. Dr. Payne also presented revisions to policy R30 – Practitioners’ Credentials Files – Contents and Retention of Information and policy R12 – Confidentiality of Medical Staff Records. Both of these policies were approved in the MEC and JCC May Meetings. The Board approved all recommended credentialing items and policy revisions. Dr. Payne had no further Chief of Staff Report.

Finance Committee – Joe Albright said that the committee met Tuesday including Dr. Hochheiser and two members from the Foundation, Jim Eden and Chuck Fleischman. They reviewed a presentation for providing employee housing to various non-profits and were offered an opportunity to participate. The committee asked administration to come up with a recommendation as to whether the hospital should proceed with this opportunity and present their findings at a future committee meeting. The main discussion centered on the budget for the upcoming fiscal year. They will have to approve this by the July meeting. Individual Board members were asked to discuss their ideas and questions directly with John Kren prior to the next committee meeting. Mr. Tennican asked for clarification of when we have to approve the budget as in the past this has been done in June. Mr. Albright stated we actually have through July and that as Dr. Hochheiser assumes his new role of CEO on June 18th, the finance committee wants to give him plenty of time to come on board and be comfortable with all aspects of the budget.

Facilities Committee - Jim Johnston gave an update on the expansion project noting that they are on track for getting a guaranteed maximum price (GMP) on the project by the beginning of July. They have started receiving bids for portions of the project and are reviewing them. The State’s third party reviewer has checked the structural design plans and gave no comments to make changes. A pre-bid meeting was open to all contractors interested in submitted proposals. They are expecting to resume construction on July 9th. They will also have the GPM on the central energy plan project.

Mr. Albright stated the Board will either have to have a special meeting to review and approve the GMP or authorize the Facilities Committee to review and approve the GMP prior to resuming construction. After a brief discussion it was decided the Board will announce a special public board meeting for the sole purpose to review and approve of the GMP for both the expansion project and the central energy plant project on Thursday, July 5th at 4:00 pm.

Organization Committee – Zach Hall presented a draft version of an information sheet for perspective board members. It covers what it means to be a Trustee, to serve on a Board committee, what areas of expertise are helpful for participation on the Board, and the roles and responsibilities of the Board regarding administration and medical quality. There is also an extensive time commitment for being a Board member. Mr. Albright noted that in light of new revisions to public meeting and records acts we may need to make some changes to this document so we are in compliance. The Board approved the document noting that the appropriate language will be added to comply with any applicable revisions of the public meeting and records acts. Once finalized, the documents will be located on the hospital public website.

Report from the Foundation:

Foundation Chair, Jim Eden gave an update on Foundation activities. He stated that the Foundation continues to run better than last year in terms of ongoing giving and they now have a new group of officers for this year. They have goals to extent the activities of the Foundation and have been working closely with members of the hospital board and administration to continue moving forward with achieving these goals. The Foundation also works on grant applications. He said that they look forward to working with administration on the CHNA so we can meet the goals and strategies implemented.

Foundation President, Liz Finegan thanked Mr. Eden for taking the chairmanship again of the Foundation. She said they currently have an unusual opportunity for a grant through General Electric who approached the Susan G. Komen Foundation of Wyoming as we are one of the most underserved places for providing mammogram services. She has been working with Dondi Weeks, Director of Oncology, Michelle Kren, Director of Radiology and Kerry Carr, FNP-C on this project. They are going to ask for approximately $100,000 to provide services to our patients. The idea is to enrich community breast health education and hope to have the information available in both English and Spanish. The funds from this grant can also help them grow the navigation and survivorship programs.

Liz also reminded everyone that the St. John’s Auxiliary Spring Fling is this Saturday, May 26th and there are a few tickets left so come join in the fun at this special fundraising event.

Reports/Updates from Administration:

Mr. Kren, CFO and Acting CEO, gave a brief review of the April monthly financial report. He stated that across the board we are running 20-30% greater than we expected. We once again had an increase in patient volumes and were able to hold down our expenses. We currently have a total increase in net assets of $3,083,101 over budget. We do have to be very careful as we continue to move through uncertain times but we are moving forward in a very strong way. We are not bumping the expenses to accommodate the increased volumes. Scott Gibson said that there has been some criticism of the need for our expansion project and asked if there were continuing indicators showing that the needs are there. Mr. Kren said that as an example our OB unit was completely full today and that we have to be prepared to accommodate the needs of peak demand and not just the needs of low volume days in the slow seasons and all trends are continuing to move up. Projects of this size and scope are designed to meet the needs of up to 10 years from now. Last Mr. Kren noted that we have started a significant customer service initiative and are now staffing our front desk full time and implementing a full service education for employees.

Mr. Trauner, COO, announced that he, along with John Kren and Marty Trott, MD, did a site visit to the University of Utah to explore options and review the existing collaborations with visiting specialists. They also met with members of the Huntsman Cancer Institute on how to further develop the oncology program. We want to keep more patients here when appropriate and avoid the high cost and risk of a transport.

Dr. Payne said that on a parallel note the Moran Eye center is also looking to develop a satellite project here and are working with Dr. Ramsay.

Mr. Trauner continued saying he attended the American Hospital Association conference and most of the discussions centered on physician alignment and the trends towards closer alignment, employment contracts and how this is accelerating. Balance sheet growth was also a big topic with the consensus that liquidity is the key. You need to build reserves as we don’t know what will happen with reimbursements and physician contracts, etc. Growth strategies were the third big issue. You need to look at growing the market share, ambulatory facilities and do all you can to bring in more patients and provide more services.

Ms. Geatz, Director of Risk Management gave a patient safety update report saying that the response rate for the Patient Safety Survey came in at 55% and now they are in the process of collecting the data and reviewing the results. A final report should be ready to present to the Board in July.

Ms. Connelly reported that as per the communications plan for this year we did complete a Directory of Services which includes a physician directory and was distributed at the health fair. This directory will also be distributed to patients and visitors at the hospital and the physician clinics.

These are the highlights. Final approved minutes of the board meetings and monthly financial reports are available on the public website. Please mark your calendars for the next regular monthly meeting of the Board of Trustees which will be Thursday, June 28, 2012 with public session at 4:00 pm in the boardroom.

Thank you –

Sherry Wieters
Marketing Coordinator/Executive Assistant
(307) 739-7501
swieters@tetonhospital.org

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