HomeMy WebLinkAbout20172588.tiffNCMC Board of Trustees
Regular Session Minutes
Monday, May 22, 2017
12:00 Noon
The Board of Trustees of North Colorado Medical Center met in Regular Session on Monday,
May 22, 2017, in the Richard Stenner Boardroom located at North Colorado Medical Center.
Dr. Carter declared a quorum and called the meeting to order at 12:05 p.m.
ATTENDANCE REPORT
NCMC Board of Trustees: Dr. Susan Carter, Larry Cozad, Catherine Davis, Mark Lawley,
Michael Simone, Brian Underwood, Jason Yeater, and Sean Conway (Commissioner, non-
voting member)
Banner Health: Margo Karsten (NCMC CEO) -Excused, and Wendy Sparks (NCMC COO)
Staff: Ken Schultz (Board Executive)
Recording Clerk: Esther Gesick (Weld County Clerk to the Board)
PUBLIC COMMENT
There was no public comment.
APPROVAL OF MINUTES
It was MSC (Underwood/Cozad) to approve the minutes from the March 27, 2017, Regular
Session meeting (held over from the cancelled meeting in April).
NEW BUSINESS
ANNUAL FINANCIAL/CHARITY UPDATE: Mary McCabe, NOCO Chief Financial Officer,
presented the Annual Financial Charity Update, a copy of which is attached to these Minutes.
In response to Commissioner Conway, Ms. McCabe agreed there has been a higher
percentage of Medicaid patients treated at NCMC, which is supposed to be offset by the
Hospital Provider fee. She stated it is a very complex formula, and despite various attempts
to gain an explanation, she has been unable to get an answer as to what caused the
disproportionate assessment to NCMC in comparison to its competitors. She also addressed
the pending legislation of Bill 267, which causes the funds to move from TABOR to an
Enterprise fund. The Colorado Hospital Association (CHA) is in the process of recalculating
the provider fee, and staff is hoping for a reallocation in June.
She also discussed the 2017 Budget Year -to -Date for the Greeley Community, which reflects
two primary issues causing a shift in the budget: an increase in Medicaid patients and the
Provider Fee assessment. Additionally, the new payment system implemented by the State
has not been working, which makes it difficult to tell if payments are being made and
received. In response to Mr. Lawley, Ms. McCabe estimated market share continues to go
down, which is likely a result of Orthopedic Center of the Rockies and other competitors, as
well as the impact of decreased payments by Medicaid patients.
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Page 1 of 3 May 22, 2017 NCMC Board of Trustees
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Ms. McCabe reported on the Charity Care and Services provided by NCMC. Based on the
previous discussion concerning the Provider Fee, indigent care, the complication of TABOR
and the possible assistance from Bill 267, Commissioner Conway suggested the financial
impacts are not sustainable. He proposed inviting Steven Sumner, President of the Colorado
Hospital Association (CHA), to come and explain why NCMC, which serves a higher
percentage of the Medicaid population, pays in a fund to the benefit of other providers who
have fewer clients. Mr. Schultz also expressed concern with the potential impact to the
hospital bonds. Ms. McCabe indicated Banner is working to coordinate a meeting with
Mr. Sumner in the next two weeks. Commissioner Conway proposed also inviting the
legislators.
Following the Commissioner Report listed below, Mr. Schultz returned to the topic of
defaulting on the bonds. He explained one year's worth of debt service ($18 Million) from
the hospital financial portfolio will be given to the Wells Fargo Trustee to service debt for the
next year. It could also result in a downgrading of the credit rating and an escalation of the
interest rates.
CEO REPORT or COO REPORT
NCMC COO, Wendy Sparks, gave the following report:
• Employees - Starting in July, the staff will be implementing the new system of
standardized uniforms, in which the colors will identify the various roles throughout the
hospital. She also stated the mid -year employee engagement surveys are currently under
review, and she was pleased to report positive scores in the category of Leadership
Effectiveness, considering the significant reorganization measures recently implemented.
• Patient Satisfaction - Feedback and call response comments from the patient surveys are
under review. Additionally, Banner Leadership attended the Leadership Matters
conference which resulted in a new Mission Statement: "Health care made easier so life
is better." The focus is on ensuring patients can get an appointment and visit in a timely
manner, with convenient facility locations and an emphasized focus on the consumer.
Responding to Mr. Lawley regarding a recent news article, Ms. Sparks confirmed NCMC is
still working on restructuring and there will be more changes announced in the next
several weeks. In response to Mr. Underwood, she stated the change in compensation
has not taken effect; however, it is supposed to be finalized and effective in October,
2017. She noted that many meetings have been scheduled with key physicians to provide
the latest strategy.
COMMISSIONER'S REPORT
Commissioner Conway stated on June 5, 2017, the Commissioners will transfer
operation/promotion of the Bright Futures Program to an independent board under the
Upstate Economic Development Board, and the County will continue to administer the
finances. He commented numerous students are aware of the benefits of the program;
however, a recent survey indicated that only about 30% of County residents were actually
aware, and upon explanation, indicated support. He stated it can be sustainable with proper
marketing and public participation. Lastly, he reported construction of County Road 49 is
scheduled to be complete by the end of October, 2017, pending weather conditions. He also
Page 2 of 3
May 22, 2017 NCMC Board of Trustees
commented that the Planning and Environmental Linkages (PEL) application and study is on
schedule.
VISITATION REPORTS
NORTH COLORADO MEDICAL EVAC PRE -HOSPITAL SERVICES (AIR MEDICAL
TRANSPORTATION SERVICE:
Brian Underwood reviewed his report, dated March 13, 2017. A written copy of the visitation
report is attached as a part of these minutes.
HOSPITALITY HOUSE:
Larry Cozad reviewed his report, dated May 12, 2017. A written copy of the visitation report
is attached as a part of these minutes.
VISITATIONS FOR JUNE
Catherine Davis
Jason Yeater
OTHER BUSINESS
In response to Ms. Gesick, it was MSC (Underwood/Davis) to bypass the April visitations,
which were inadvertently missed due to the meeting cancellation.
NCMC, INC. REPORT
Dr. Carter mentioned the NCMC Inc. Board attended the Governance Institute conference in
Scottsdale, Arizona, where they received a lot of exiting and stimulating information about
the future of healthcare.
Ken stated, in conjunction with the County's regulation of the Trustee meetings, he began
forwarding the NCMC Inc. quarterly financial reports and annual letters to be included in the
Commissioners' public record. (Copies of those letters were also electronically provided to
the Trustees for informational purposes.) The Certificate of the Sublessee letter, dated
April 28, 2017, is required as part of the terms of the Lease, and it explains that, since 1995,
NCMC has not carried malpractice insurance, rather, they are self -insured. He also
referenced the Annual Support Letter regarding the issue of support to the community on
behalf of the Trustees to comply with tax requirements.
PLANNING SESSION
No discussion was held on scheduling a future planning session.
ADJOURN
There being no further business to come before the Board, it was MSC [Simone/Davis] to
adjourn the meeting at 1:05 p.m.
Respectfully submitted,
Esther Gesick
Page 3 of 3
May 22, 2017 NCMC Board of Trustees
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NCMC Department Interviewed — North Colorado Med Evac Pre -Hospital Services (Air Medical
Transportation Service) Director - Pamela Howes Date of Interview: March 13, 2017
Department provides air -medical transportation services within Northern Colorado.
Three helicopters positioned at three locations — Greeley (NCMC), Akron (airport hangar) and Boulder
(Boulder Community Hospital). The helicopters, pilots and mechanics are provided by Med Trans
Helicopters — Emergency Air Ambulance Service. Hospital partners include North Colorado Medical
Center, Boulder Community Hospital, Denver Health and Children's Hospital Colorado.
Med Trans Corporation bills third party payers for the patient helicopter ambulance services provided.
Med Trans also pays a portion of health care staffing salaries for staff who serve at Boulder and Akron
locations. Banner/NCMC employs the medical/dispatch staff involved in working at locations of NCMC,
BCH and Akron (airport hangar). NCMC/Banner does not pay for the costs of operating and maintaining
the air medical helicopters.
Medical helicopters normally operate with one pilot, a critical care flight nurse, and a flight paramedic.
The crew can only transport one patient. Approximately 70% of patient flights are intra-hospital
transfers, 30% are scene emergencies. Average flight volumes are around 50 - 60 per month.
Staffing: overall about 50 employees (including full-time, part-time and per diem). Staffing includes
critical care nurses, paramedics and dispatch/communication staff. This is not a difficult department for
recruiting — may see 10 applicants per opening. Staff are experienced and work hard to retain key skills
necessary in the pre-hosptal/intra-hospital environment (drug interventions, labs, arterial lines, chest
tubes, intubation, et.al.)
Pam became the department director about a year ago. She has three direct reports — Chief Flight
Nurse, Chief Flight Medic, and dispatch supervisor — all new to their current positon after Pam assumed
the department leadership in the spring of 2016. Pam is very pleased with her staff and has experienced
good engagement scores — 49% actively engaged in 2016 compared to 20% in 2015. The leadership
experience dimension result for 2016 was above the industry 90th%tile.
Pam reports to Marilyn Fein (Banner NOCO COO).
The Med Evac department has been working for accreditation with CAAMS (nationally recognized air
ambulance certification). The accreditation process took a significant amount of time and effort to
complete (summer and fall of 2016). The process of preparing for this certification has helped to bring
the team together. Formal survey results are still pending but verbal comments provided by the
inspection team were perceived as being very favorable.
Capital: majority of capital needs are funded through annual golf tournament which raises about
$50k/year.
NCMC's air ambulance program is a major connection with Eastern Colorado hospitals (Yuma, Haxtun,
Holyoke, Benkelman, Julesburg (in addition to Banner hospitals in Brush, Sterling and Ogallala). The
flight staff provide in -services and support to rural hospital staff and EDs as a form of marketing,
improving hospital relationships and supporting rural efforts to maintain emergency skills.
dozad
NCMC Trustee Report
Department History: Hospitality House is located on the north side of the hospital at 1910 15th
Street and was started in the current space in 1996. Current Manager is Leslie Gann-Exner.
Leslie has been with Banner 15 years. Leslie also manages the gift shop.
Name of contact: (Mary) Lou Jones — Coordinator of the Hospitality House. Lou has been with
Banner 16 years.
Duties include cleaning and servicing rooms when guest depart (no daily cleaning
service during stay)
Cleaning common areas
Guest reservations and check-in/registration
Tracking finances and managing guest registration fees
Coordinating with Plant Services for maintenance and repairs
Services Provided: Hospitality House is "Your home away from home "designed to serve out-
of-town family members of Banner patients. It also serves those out-of-town patients that are
receiving extended outpatient treatments such as oncology and burn patients.
- 20 Rooms total, 14,000 sq/ft, 4 common areas on 3 floors
- 1St floor has 5 rooms, 2"d floor has 6 rooms, and 3n° floor has 9 rooms
- Rooms w/2 single beds or 1 queen bed and private bath = $20/night
- Rooms w/2 queen beds and private bath = $25/night
- Rooms w/1 queen, 2 twins beds, and a private bath = $25/night
- Apartments include 2 singles beds, sofa, loveseat. Private bath, and efficiency kitchen =
$30/night
Guest rooms include a microwave oven, refrigerator, coffee pot and cable TV_ Guests also
have use of on -site laundry facilities, as well as the large common kitchen and living area.
Guests must reside outside the Greeley/Evans area and rooms are used only by current
patients and family members/care takers of patients. Guests have access to the NCMC
cafeteria and are provided with a badge to receive meal discounts. 27 States were represented
by guests in 2016. This is the only facility of its kind in the Banner system.
Number of Staff: full-time and part-time and what fields:
1.3 FTE's.
- 1 full time staff 8:30-4:45 Monday through Friday
- 1 part time from Noon to 3:45 on Saturday and Sunday.
- Hospital security helps with registration of after hour arrivals.
Revenues:
- In 1996 they served 2,100 guests. The average stay was 3.2 days/guest
- In 2016 they served 6.081 guests. The average stay was 1.4 days/guest
- 2017 through April they have served 1,842 guests
- The current pricing has been in place for 10 years
- $62,567 income for 2016
- $5,135 in charity received for 2016
- $67,702 total income for 2016
- Additionally $1,356 tips left by guests. Tips and grants are given to the NCMC
Foundation.
Banner covers the cost for staff salaries and maintenance of the Hospitality House. The NCMC
Foundation helps with the purchase of items such as comforters, washers/dryers, curtains, and
decorations, microwaves, and refrigerators. The Foundation also recently paid to remodel the
common kitchen/living area.
Successes:
Lower length of stay @ 1.4 days/guest = more availability = higher annual revenue. More
patients/guest are served per year. This speaks toward the overall patient care provided by
NCMC as a whole.
Challenqes/Obstacles:
Higher room turnover rate and increase number of guests served creates more room cleaning
and turn -around duties. It becomes increasingly difficult to get the rooms cleaned and prepared
for the next guest for a single staff person on top of all other duties for that person.
The building has'no elevator This creates a challenge for guests with disabilities and/or
mobility limitations.
The decor and furniture in the rooms is becoming dated and well used. Upgrades and updates
are needed to the room's decor and furnishings
Departmental Needs/Requests:
Increased staff or help from housekeeping to get the rooms turned around as guests depart.
Funds to keep the facility upgraded and updated.
Conclusion: This is a fantastic asset to NCMC, Banner Health and the Greeley community.
Lou is a very upbeat and outgoing person and she does a great job. I have personally been In
the situation where long-term care of a family member was required and there was nothing like
this available. I believe that continued support and funding of the Hospitality House is a must.
This is just one more fantastic service provided by NCMC and Banner Health for Northern
Colorado!
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