HomeMy WebLinkAbout20171094.tiffNCMC Board of Trustees
Regular Session Minutes
Monday, March 27, 2017
12:00 Noon
The Board of Trustees of North Colorado Medical Center met in Regular Session on Monday,
March 27, 2017, in the Richard Stenner Boardroom located at North Colorado Medical Center.
Jason Yeater, Vice -President, declared a quorum and called the meeting to order at 12:05 p.m.
ATTENDANCE REPORT
NCMC Board of Trustees: Larry Cozad, Catherine Davis, Mark Lawley, Michael Simone, Brian
Underwood, Jason Yeater, and Sean Conway (Commissioner, non -voting member), with
Dr. Susan Carter being excused
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 (Simone/Underwood) to approve the minutes from the February 27, 2017,
Regular Session meeting.
CEO REPORT or COO REPORT
NCMC COO, Wendy Sparks, gave the following report:
• Employees — March 17, 2017, was a heavy day with 19 positions (NOCO Directors and
Sr. Manager FTE positions) which were released as part of a staff reduction caused by
economic pressures and the Colorado Provider Fee. She stated they are working on
continually improving efficiency and ensuring it does not impact any positions that deal
directly with patients, therefore, she does not foresee any negative impacts on quality
care. Ms. Sparks also discussed the matrix, which is evaluated monthly, to monitor
budgeted productivity, volume and in -patients.
• Patient Satisfaction — No report.
• Quality — No report.
• Physicians — No report.
• Financials — Ms. Sparks stated the Colorado Provider Fee continues to be problematic.
She explained there has been no change in the payer mix of Medicare and Medicaid
patients, therefore, they budgeted for a positive $8 million to match last year; however,
there was an unanticipated additional $1.8 million to be paid in February resulting in an
overall negative $10 million unexpected hit to the budget despite a high census and 100%
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March 27, 2017 NCMC Board of Trustees
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2017-1094
productivity. Ken Schultz commented NCMC is getting $0.83 back per dollar from the
State; however, the competitors are getting 100 percent or more despite their higher
percentage of paying and insured population. He noted Margo Karsten is conversing with
HealthOne, which is also getting hit hard, concerning the flaws of the fee versus the
perception that it was presented as a tax through the legislature. Commissioner Conway
stated there needs to be some transparency to explain the apparent inconsistencies.
Mr. Schultz further commented the inconsistency impacts the bottom line of the
participating hospitals which could impact NCMC's bond. Following further discussion,
responding to Catherine Davis, Ms. Sparks confirmed Banner does have lobbyists,
attorneys and representatives attempting to address this through the legislature.
. Master Campus Plan — No report.
COMMISSIONER'S REPORT
Commissioner Conway reported the Board of Commissioners was pleased to recognize NCMC
as being ranked as one of the Top 50 Best Hospitals for a 3rd consecutive year (1% of 4,500
hospitals nationwide make the list), and they are very proud of the benefits the hospital
provides to the citizens of the County. He stated CR 49 should be done by December, 2017,
and the project is ahead of schedule as a result of early warm weather. The Planning
Environmental Linkage (PEL) Study on Highway 34, from 1-25 to Kersey, is contracted among
all eight entities, in the amount of $2.1 Million. He also reviewed the contributions being
made by local jurisdictions toward various transportation improvements throughout
northern Colorado. In response to Mr. Simone, Commissioner Conway stated the County
budgeted $150 million for the CR 49 project, including $25 million for the bridges on the
Parkway over the Poudre and Platte Rivers, repairs after the flood, soil mitigation, etc. He
stated it is the largest construction project in the history of the County, which was made
possible by unprecedented oil and gas productivity and fiscally sound budget practices. He
noted the project remains on schedule and under budget, and he gave credit to the
contracted work of IHC.
VISITATION REPORTS
BEHAVIORAL HEALTH
Mark Lawley reviewed his report, held over from February. A written copy of the visitation
report is attached as a part of these minutes. In response to questions, Mr. Lawley indicated
the positions are staffed in the ER and they treat patients on the 3rd floor unit. Further
discussion implied they are continually busy and they refer patients to other facilities when
appropriate. Larry Cozad commented on the difficulties presented in his work at the Weld
County jail and stated they are not equipped to provide the level of behavioral service need
by certain inmates, when often their behavior is not law enforcement driven, and they have
limited in -patient facilities available.
NOCO TRAUMA SERVICES DEPARTMENT
Larry Cozad reviewed his report, dated March 20, 2017. A written copy of the visitation report
is attached as a part of these minutes.
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March 27, 2017 NCMC Board of Trustees
NOTE: Due to time constraints, the group agreed that the scheduled report of Brian
Underwood be held over for the April meeting.
VISITATIONS FOR APRIL
Brian Underwood (held over from March)
Michael Simone
Jason Yeater (to be postponed until May)
NCMC, INc. REPORT- Mr. Schultz indicated he had no new information to report.
NEW BUSINESS - None.
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/Lawley] to
adjourn the meeting at 1:05 p.m.
Respectfully submitted,
Esther Gesick
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March 27, 2017 NCMC Board of Trustees
Visit conducted by: Mark lawley
Andrea Wilson Program Coordinator
Department
Behavioral Health
Department History
Started in the 1990's. At one point the hospital had trained physicians to treat patients at the hospital.
Today there are no trained psychiatrist in the hospital to provide these services. The services are
provided by trained behavioral health professionals. All of these professionals are licensed therapists.
Service(s) Provided
Behavioral health specialist assess and interact with mental health patients in the hospital. They are
trained to determine if there are concerns that need additional treatment from care providers outside
the hospital. They work with patients to assist them with mental health issues while in the hospital if
necessary. They are also trained in de-escalation techniques. If treatment is needed beyond a patients
stay at the hospital they work with outside providers such as Front Range Behavioral Health to get the
patient care. If they know a patient is under the care of a professional from the outside they may
notify them if necessary.
Number of staff: 13
NCMC 2 people 24 hours a day
McKee 1 person 24 hours a day
Fort Collins 1 person 40 hours a week
Revenues/Budgets if relevant
Unknown
Successes
The behavioral health professional works with nurse and physician's to help them understand what
they might encounter with mental health patients. They also provide basic techniques to nurses and
physicians, to assist them in dealing with difficult patients while receiving medical care. They work
with patients in the burn unit and cardiac rehab to help them with the issues associated with major
medical procedures are the psychological impacts of life changing events. Sometimes, the behavioral
health people are a sounding board for nurses and other staff who have had to deal with a tough
medical or trauma situation in the hospital.
Challenges/Obstacles
Not having a psychiatrist on staff. Sometimes patients need meds or the patient need treatment that
exceeds the skill level of the behavioral health professional.
Departmental Needs/Requests
The behavioral health professionals would like staff training, it sounds like most training they have to
get on their own.
Manager's suggestions for improvement
None
What would the department manage/director like NCMC, Inc. to know, if anything?
Overall, they find their jobs very rewarding and they enjoy working for NCMC.
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NCMC Trustee Report
NOCO Trauma Services Department
Interview Date: March 20, 2017
Submitted March 27, 2017
Trustee: Larry Cozad
Name of contact: Toni Moses MS, RN, BSN, CNML, CEN
History of contact: Toni has been a nurse for 30 years. 6 years as a trauma/emergency/flight
nurse and 18 years with Banner.
Services Provided: NCMC is one of two Level II Trauma Centers in northern Colorado. Some of
the criteria to be a level II trauma center include:
24 -hour immediate coverage by general surgeons, as well as coverage by the
specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine,
radiology and critical care.
Provides trauma prevention and continuing education programs for staff.
Incorporates a comprehensive quality assessment program.
To maintain this status NCMC submits to a very intensive verification process by the State of
Colorado and American College of Surgeons every 3 years. The verification team assesses
commitment, readiness, resources, policies, patient care, performance improvement, and other
relevant features of the program.
Other Services and Responsibilities:
Data tracking: This department tracks and monitors every injured patient (minor or major injury)
that comes through NCMC from the time and point of initial injury to the release and after care
of the patient. The data collected is uploaded into a state data base within 60 -days. Toni's
team strives to upload the data concurrent with patient care so that the data is more relevant.
Internal Training and Skill Assessment: Work with all provider levels within the hospital to
ensure the training, skill levels, procedures and patient care are up to date meeting the needs of
the patients.
Outreach: Toni's team works with other lower level hospitals and providers in the region to
assist with training and skill assessments. These facilities feed patients to NCMC for high level
care and are a significant source of new patients for NCMC.
The Trauma Services Department organizes and the annual Northern Colorado Emergency and
Trauma Care Symposium every year at The Ranch in Loveland. This is a 1 day event that
brings approximately 300 providers from around the area for lectures and pertinent skills
sessions and offers continuing educations credits to attendees. 35-40 vendors also participate.
Community Training and Injury Prevention: The Trauma Services Department offers programs
to schools and the community in injury prevention and education. One current program is the
W8 to Text program. They have window decals, bumper sticker and yard signs that can be
place at school entrances and exits. They attend health fairs, children festivals and other event
to teach injury prevention.
Number of Staff: full-time and part-time and what fields: 6 FTE's including Toni. (Actually 2 of
Toni's staff are considered .8)
Revenues/Budgets If Relevant: Toni didn't mention any specific numbers. She said the
symposium is basically cost neutral as registration fees and vendor fees cover the cost. She
also mentioned that the Foundation is helping them with funds from the annual golf tournament.
A couple of their budgetary needs are funds for injury prevention and for promotions.
Successes: Toni says she has a very efficient staff. Each member is cross trained to a certain
degree with all other staff responsibilities so that when one person is absent the others can
keep up with the work load. They meet twice a week to ensure everyone is on the same page.
Toni said she was proud of the high standard of care that exists at both NCMC and McKee.
Maintaining that high standard of care can be challenging when you have the responsibility but
not necessarily the authority. She also mentioned their success with the Concussion Prevention
outreach program.
Toni mentioned the relationships she has built not only within the Banner system but also
regionally and state wide. She attends statewide meetings with governing bodies to review and
update current regulations and laws.
Challenges/Obstacles:
- Interpreting the new ACS guide book, much of which is vague and subjective.
Adequate staffing to maintain the quality and efficiency within the department.
Staying up to date on the latest care practices and educating the providers on the latest
practices.
Working to get the NCMC burn program recognized and certified.
Changes to the current health care funding.
Legalized marijuana
- Getting some physicians on board
Departmental Needs/Requests: Funding for educational materials for the outreach program.
What Would The Department Manager/Director Like NCMC Trustees To Know: Toni wanted to
thank the administration for their support of the Trauma Services Department and for the
commitment to keep NCMC a level II trauma center. She believes that level II status brings
patients to NCMC that would otherwise have to go elsewhere. As part of that, working with the
lower level hospitals and providers creates referrals that might otherwise go to a different
hospital. Toni believes this all helps keep NCMC competitive in the current market environment.
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