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Home My WebLink About20163931.tiffNCMC BOARD OF TRUSTEES Regular Session Meeting Monday, December 12, 2016 Attachment 1 Minutes of Regular Session of November 28, 2016 * * - Action Required NCMC Board of Trustees Regular Session Minutes Monday, November 28, 2016 12:00 Noon The Board of Trustees of North Colorado Medical Center met in Regular Session on Monday, November 28, 2016, 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, Mark Lawley, Michael Simone, Brian Underwood, and Jason Yeater, with Catherine Davis and Sean Conway (Commissioner, non -voting member) - Excused Banner Health: Margo Karsten (NCMC CEO), and Wendy Sparks (NCMC COO) -Excused, Tiffany Hettinger (Nursing) 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 (Yeater/Cozad) to approve the minutes from the October 31, 2016, Regular Session meeting. CEO REPORT or COO REPORT On behalf of NCMC COO, Wendy Sparks, Tiffany Hettinger gave the following report: . Employees - NCMC will be hosting the annual Holiday Buffet recognizing all of the staff, volunteers, and physicians. . Patient Satisfaction - Eight of the ten dimensions are hitting target, with Physician Communication and Nursing Communication both being very close to hitting target. The self-imposed 80% goal set by NCMC is higher than the rest of Banner, with some hitting the Gold Standard which is above the 90th percentile nationally. In response to Ken Schultz, Ms. Hettinger went into further detail regarding the 'Rate' targets, specifically Would Recommend (79.6%), RN Courtesy and Respect (90%), and Understanding Managing Health (blue stretch target). And she also addressed a question from Dr. Carter, explaining the survey addresses physicians treating in -patients, with an average of 150 patients responding to the survey on a monthly basis, and for the month of October they are hitting Stretch. . Quality - Staff continues to do well with patient Medicine Reconciliations and completion of their Advanced Directives. Page 1 of 3 November 28, 2016 NCMC Board or Trustees • Physicians- In 2017, a Pediatric Hospitalist and Ortho-trauma Surgeon will be joining the staff. • Financials - For October, the Greeley Community is behind budget by $4.8 million, or $20.5 million year-to-date, primarily due to the impact of the miscalculated provider fee and $9.6 million in project close-outs. . Master Campus Plan - The Heart Care and Wound Clinics are both open. They are managed by the Nurse practitioners who are working to keep the overall health of patients balanced and avoid comingtothe hospital, whereas their primary physicians may refer them to the hospital. COMMISSIONER'S REPORT - There was no Commissioners Report. VISITATION REPORTS INFORMATION TECHNOLOGY Brian Underwood reviewed his report, dated November 16, 2016. A written copy of the visitation report is attached as a part of these minutes. SPORTS MEDICINE Jason Yeater stated he did his visitation Tuesday, November 22, 2016, just before the Thanksgiving holiday, therefore, he will deliver his report at the December meeting. VISITATIONS FOR DECEMBER Larry Cozad Catherine Davis NCMC, INC. REPORT Dr. Carter stated the Inc. members did go to retreat; however, she has no business to report. Ken Schultz added they are looking to end the year strong in the 4th quarter. He stated it has been a tough year generating revenue due to non -cash expenses such as the State's miscalculated provider fee. NEW BUSINESS Patricia Gibson presented and reviewed the 2015 Annual Financial/Charity Update PowerPoint presentation (a copy of which is attached to these minutes as Exhibit A). • Slide 1 - Greeley Community 2015 Year -to -Date actual costs and budget, which equates to an operating margin of 5.6%. • Slide 2 - 2016 Year -to -Date is currently $22 million behind budget, or 5.8%, with $11.9 million related to the miscalculated provider fee. The total expenses are $1.4 million under budget, and the overall Operating Gain is $20.5 million behind budget. She noted trends with the provider fee, Banner Medical Group, and new processes and medical procedures and technology. • Slide 3 - Charity Care and Services audit (includes actual cost, unpaid cost of Medicaid, education, community health services). She explained most of the costs are remaining Page 2 of 3 November 28, 2016 NCMC Board of Trustees relatively flat, with the exception of a shift from charity care to Medicaid, with about $3 million increased overall above the prior year. Slide 4 - Write -Off Trending Amounts for basic and enhanced charity, the Colorado Indigent Care Program (CICP), and bad debt are continuing to decline because the program was expanded but the hospital gets very little money from Medicaid and it does not typically cover the cost of doing the service. In response to Mr. Simone, Ms. Gibson explained the various other assistance programs. She also gave further explanation concerning staff's efforts to complete a line -by-line review of the balance sheets and the discovery of the State's miscalculation of the Provider Fee which had to be corrected. OTHER BUSINESS There was no other business 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/Yeater] to adjourn the meeting at 12:55 p.m. Respectfully submitted, Esther Gesick Page 3 of 3 November 28, 2016 NCMC Board of Trustees Undwivood November 16, 2016 Brian Underwood NCMC Board of Trustees Report — Information Technology Department Contact — Steve Rains, IT Senior System Director Steve is a 27 year Banner employee. Reports to Lori Mathews (VP IT Customer Relations (Phoenix)) who reports to Ryan Smith (Banner CIO) Other leads in IT department housed at NCMC include Jade Engel (server team) and Dave Roberts (Network Planning Integration, Data Center). Services Provided It is difficult to clearly articulate the totality of Steve's responsibilities. He has responsibility for Customer Relations (internal and external) as it relates to IT service - matching IT systems capabilities' with the needs of the end users; navigating customers through the Banner IT network to get at the information they need. And he manages this responsibility throughout Banner's Western Region. He works to stay in touch with each facility throughout the Region to understand the various issues and needs. He works within the System to prioritize needs and get them appropriately addressed —either through his team or other connections within Banner. His long tenure with Banner is a major benefit to his position because he knows both Corporate and Regional personnel - its leaders and the nuances of the various facilities throughout the Western Region. Maintaining strong personal relationships with leaders (and physicians) throughout each hospital, the Region and the Corporate office is paramount to his success. He feels he has appropriate in-house staff to replace his position at some point in time — realizing that it would take someone from the "inside" to be effective in doing the work of this position. Examples of recent/current projects with which he is involved include: Supporting system integration to provide data for 1500 billing/global billing (NCMC project) Collating data from various systems to meet end -user requirements (such CMS "meaningful use" reporting requirements) Supporting clinicians who use computerized templates for patient care (customization of areas that can be customized will ensuring system integrity for the need to collect and manage data). Ensuring information is entered in a manner that facilities accurate data analysis Entering incomplete data sets can lead to improper interpretation of data. - Facilitating consistent cell phone service throughout NCMC (much more complicated and involved than most people understand) CORHIO — Colorado Health Information. Coordination for the flow information of health systems throughout Colorado (i.e. Banner, UCH, Centura, Health One, et. al) - Improving Banner patient's IT interface through "My Banner." DATA Center Toured the state of the art data center on the third floor of NCMC. To ensure secure and consistent operation at all times, the data center incorporates duplicate power sources from Xcel (power comes from separate transformer systems — east and west side of Greeley), it is connected to both of NCMC's emergency generators, has duplicate cable links from Century Link, et. al. It's a totally modern facility in every way. The high-level of security surrounding the Data Center is managed through Phoenix — anyone entering the space must log -in through Banner Security in AZ —code and visual identification are required with security in Phoenix before the door is unlocked. The room also has a fire suppression system that will smother any fire without damaging electrical systems or electronic components — and without displacing the oxygen in the room. A unique ventilation system provides cooling to server components without requiring the entire room to be chilled. Challenges/Obstacles Like many departments that interface with Corporate services, a major challenge is coordinating the competing priorities within Banner Health — i.e. working to ensure that unique needs of individual facilities are appropriately addressed. The integration of U of Arizona hospitals (Tuscon) into Banner is growth that is equivalent to the size of the entire Western Region. Therefore, as Banner grows; these challenges continue to grow. As an example, Steve mentioned that NCMC cardiologists recently incorporated a new heart valve replacement technology that required a unanticipated change at the System level. While the task was accomplished, it was very challenging to get this recognized as a system priority. The competition for services and patients within the Western Region is different than what Banner experiences in AZ. Steve did point out that the physical IT infrastructure of individual facilities throughout the Western Region have been developed in such a way that most individual facilities (including NCMC) could theoretically transition away from Banner. This comment is not intended to reflect a change of direction for Banner Health but does acknowledge unique relationships that exist within the Western Region such as the management agreement between NCMC and Banner Health. Banner Health" North Colorado Medical Center Trustee's Update November 2O16 ($ in thousands) Patricia Gibson Greeley Community December 31, 2015 YEAR - TO - DATE ACTUAL BUDGET VAR % VAR Total Patient Revenue 1,116,296 1,111,879 4,417 0.4% - Deductions and Bad Debt 671,167 690,138 (18,971) -2.7% TOTAL NET REVENUE 445,129 421,741 23,388 5.5% EXPENSE: Salaries & Contract Labor 189,417 194,861 (5,444) -2.8% Supplies 54,771 54,287 484 0.9% All Other Expenses 175,682 149,198 26,484 17.8% TOTAL EXPENSES 419,870 398,346 21,524 5.4% OPERATING GAIN (LOSS) 25,259 23,395 1,864 8.0% Deduction Percentage 60.1% 62.1% Banner Health' ($ in thousands) Greeley Community October 31, 2016 YEAR - TO - DATE ACTUAL BUDGET VAR % VAR Total Patient Revenue 977,368 995,373 (18,005) -1.8% - Deductions and Bad Debt 617,812 613,807 4,006 0.7% TOTAL NET REVENUE 359,556 381,566 EXPENSE: Salaries & Contract Labor 167,313 Supplies 49,708 All Other Expenses 126,188 TOTAL EXPENSES 343,210 OPERATING GAIN (LOSS) 169,195 48,801 126,703 344,699 (22,010) -5.8% (1,882) -1.1% 908 1.9% (516) -0.4% (1,489) -0.4% 16,346 36,867 (20,521) -55.7% Deduction Percentage 63.2% "Banner Health' 61.7% Charity Care and Services - NCMC Traditional chanty cart, al cast Unpaid cost of pubtic ptogratrL, N'ledicaid and other indigent care plo?tam Health pit fe5,sionaledi atioa. Coiit12itiat q Beall ;ei v ce; Sub; idized 13ealtg cervices ('oltJ' utiali., and in -kid donations C'onuntinity building acri -dies Rewards activitie, Total cost ofcc.wniuruty benefit Unpaid Cost of It.ledicare Total coat ofconsusiuiity beueftt and unpaid cost of Medicare #Banner Health' Per -enrage of Total 201+ E sense llli i�t. rt. a,jds 5 5,263 38.=9' 3.606 1.114 3.2-11 208 115 178 Pel'ceotage of Total 2014 E ens 1.3% $ 8,779 2.2% 9.1 0.9 0.3 0.8 34,240 4,839 767 1,531 8.8 1.2 0.2 0.4 742 0.2 140 150 52,022 12.4 24.403 5.8 51.188 13.0 21,829 5.6 $ _ 76,430 • 18.2% $ 73,017r 18.6% NCMC Community Write Off Trending 80,000,300 Ta,ao0,000 60,000,003 50,000,003 40,030,000 34,000,000 20,010,000 10,000,000 Charity w 2013 70,926,012 w 2014 30,141,539 2015 18,541,425 i5eptyTDhnrtJi6Zed 22,633,757 Banner Health' CICP 43,798,854 11,150,229 4,337,023 4,360,133 Bad Debt 32,644,564 23,205,841 14,628,257 13,431,953 Hello