HomeMy WebLinkAbout20154117.tiff NCMC BOARD OF TRUSTEES
Regular Session Meeting
Monday, September 28, 2015
Attachment 1
Minutes of Regular Session of
August 31, 2015 *
* - Action Required
NCMC Board of Trustees
Regular Session Minutes
Monday, August 31, 2015
12:00 Noon
The Board of Trustees of North Colorado Medical Center met in Regular Session on Monday,
August 31, 2015, in the Richard Stenner Boardroom located at North Colorado Medical Center.
Mr. Houtchens declared a quorum and called the meeting to order at 12:00 p.m.
ATTENDANCE REPORT
NCMC Board of Trustees: Dr. Susan Carter, Catherine Davis, Brandon Houtchens, Mark
Lawley, Michael Simone, Brian Underwood,Jason Yeater, and Sean Conway(Commissioner,
non-voting member)
Banner Health: Rick Sutton (NCMC CEO) 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/Yeater) to approve the minutes from the July 27, 2015, Regular Session
meeting.
NEW BUSINESS
None.
CEO REPORT or COO REPORT
NCMC COO, Wendy Sparks, gave the following report:
. Employees - The annual employee engagement survey was completed on August 19th,
with an 80% participation rate. Once the results are received, they will begin action
planning for improvements. The Better Together campaign kickoff ended last week
where employees were encouraged to donate to United Way for the NCMC foundation.
• Patient Satisfaction- DuringJuly, NCMC hit target on three (3) of the eight (8) dimensions.
About four weeks ago, leadership decided to go back to the basics and they are already
starting to see good results for August. She noted that CMS (Center for
Medicare/Medicaid Services) now has new Five Star Rating which is available to the public
and NCMC is looking very good in comparison to other hospitals in Colorado. Following
her report, there was further discussion on the rating of"Would Recommend" compared
to the standard ratings and how to change public perception. The CMS Five Star Rating
was further explained, which now recognizes 8's, in addition to 9 and 10 rates.
Page 1 of 3 August 31,2015 NCMC Board of Trustees
• Quality - Staff is meeting Target on Care Reliability for Total Joint Care and Heart Failure,
which involves making sure the patient's medication is reconciled and that they have a
follow-up appointment scheduled with the Heart Failure Clinic before they leave the
hospital.
• Physicians - A new Neurosurgeon started on August 3rd, for a total of three on staff.
Ongoing recruitment continues for a variety of other physician positions.
• Financials- During July,the Greeley Community had a very good month with an Operating
income of$3.9 million, and Year-to-Date there is an Operating gain of$8.1 million for the
NCMC community.
Master Campus Plan - On August 17th, the 3rd Floor of Summit View was opened, which
now houses the three BMG clinics, including Internal Medical, Pediatrics and OBGYN.
VISITATION REPORTS
INTEGRATIVE THERAPY
Dr. Carter reviewed her report, dated August, 2015. A written copy of the visitation report is
attached as a part of these minutes. She stated these are positive services (i.e., acupuncture,
massage for maternal patients,therapy dogs, etc.)that are offered on a volunteer basis which
are very well received.
MEDICAL OBSERVATION DEPARTMENT
Mark Lawley reviewed his report, dated May, 2015. A written copy of the visitation report is
attached as a part of these minutes. There was discussion regarding CMS reimbursement on
Medicaid patients, and Rick Sutton explained the impacts of patients admitted to Observation
vs. In-Patient status.
LABORATORY DEPARTMENT
Mike Simone reviewed his visitation report, completed in August, 2015. A written copy of
the visitation report is attached as a part of these minutes. Ken Schultz explained NCMC Inc.
provides all of the capital and financial needs, rather than Banner; therefore, the NCMC
leadership is in a very unique and positive position to be able to address many of the
capital/equipment requests without having to compete against other Banner providers.
There was also discussion regarding the potential for future workforce needs due to tenured
Med Tech staff looking to retire. Wendy provided additional follow up at the end of the
meeting concerning in-State Medical Tech training which requires a four-year degree
available at Metro State, and the Medical Lab Tech which requires a two-year degree
available through Arapahoe Community College.
VISITATIONS FOR SEPTEMBER
Catherine Davis
Brian Underwood
NCMC, INC. REPORT
Brandon Houtchens explained the responsibility of the NCMC Inc. Board is to review stock
market options and how to satisfy obligations to employees participating in the pension plan.
Mr. Schultz reviewed the last page of the Second Quarter Compliance Report summarizing
Page 2 of 3 August 31,2015 NCMC Board of Trustees
the four (4) Covenants (Liquidity, Leverage, Debt Coverage - Net Income Available for Debt
Service, and Debt Coverage - Unrestricted Cash and Investments) indicating NCMC, Inc., is in
compliance with the Covenants that must be met per the Bond requirements. He also
expressed his intent to start providing these summaries on a quarterly basis.
COMMISSIONER'S REPORT
Commissioner Conway referenced Senate Bill, S.B. 82, which authorized the creation of the
Weld County Bright Futures Grant Program. Starting in 2016, High School graduates, G.E.
recipients, and honorably discharged Veterans will be eligible to receive $3,000/year for up
to four years to be used for furthering their education. He invited those present to join the
kick-off event hosted by Aims at the Cornerstone Building tomorrow morning (9/1/2015), and
stated the Trust account will be funded by voluntary contributions which are then eligible for
a 50% property tax credit, as well as an exemption on state and federal tax returns, and
potentially an Enterprise Tax Zone credit. Lastly, he stated the Commissioners have wall off
$15 million to fund the tax credits and they will be appointing a citizen board to administer
the various aspects of the program. He stated Aims and the College Promise Program are
very supportive as well.
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 [Lawley/Simone] to
adjourn the meeting at 1:17 p.m.
Respectfully submitted,
Esther Gesick
Page 3 of 3 August 31,2015 NCMC Board of Trustees
NCMC Board of Trustees /3( '‘- t-por4-
Visitation Report-Susan Carter Aug 2015
Integrative Therapy
North Colorado Medical Center offers integrative and complementary therapies that go beyond
traditional health care to help patients achieve mental, emotional and physical well-being. Integrative
therapies are used to help reduce stress, ease pain and anxiety and manage symptoms.
Programs include:
Aromatherapy Linsy Glassman,_Lenore Olson, Pre-op and PAT
North Colorado Medical Center provides aromatherapy to patients as a way to reduce pain,
stress and anxiety. This integrative therapy can also improve sleep and enhance a sense of well-
being. Essential oils are used, such as lavender as a calming agent, rosemary to decrease tension
and peppermint for cooling.The oils can be applied during a hand or foot massage or the
mixture can be placed on a cotton ball or a piece of gauze so the patient can breathe in the
soothing remedies. Anxiety, pain, N/V, decrease approx 3 pts on 10 pt scale. N=70 over 7 mos.
Massage for maternity patients- Baby Resource Line,Amy Fusco Sr Manager
Special pampering-as a special treat, our specially trained massage therapists are available to
provide 20 min massages to new mothers after delivery. Goal is all NOCO. MeaL Take-home
pending.Additionally each day between 2—4 p.m., staff turns down the lights and takes a
"Mommy Moment" and serves fresh-baked cookies to allow new parents to spend time with
their newborn without interruptions.
Therapy dogs— Dept of Volunteers, Cory Pierson, under Tiffany Hettinger
North Colorado Medical Center provides a little TLC the four-legged way through our pet
therapy program.Volunteers and their certified therapy dogs visit patients to brighten their day.
Studies have shown that pet therapy can improve emotional connections and reduce stress and
feelings of loneliness.Therapy dogs are all different types of breeds. They are specially trained
and certified through Therapy Dogs Inc. Our volunteers who work with them are compassionate
people who enjoy visiting patients.
What are the benefits of the pet therapy program at NCMC?
• The therapy dog teams provide comfort&cheer to guests, patients and staff.
• They give love, hugs, and encouragement.
• The teams help people feel better by reducing stress&anxiety.
• They help offer a distraction and help people remember their own memories from pets both
past and present.
• They help start a conversation and are a wonderful icebreaker when meeting new people.
North Colorado Medical Center invites volunteers and their certified therapy dogs to visit patients to
brighten their day. Studies have shown that pet therapy can improve emotional connections and reduce
stress and feelings of loneliness.
10 current teams
Visits to Pediatrics, E.R., Oncology, Med-tele
Handlers counted over 12,000 visits last year
Wishes-want more teams, but it is a fairly extensive process
Can any dog become a therapy dog?Therapy dogs have wonderful temperaments, are obedient, have
the ability to learn and are well groomed.They also must readily accept strangers, sit still amidst
distractions and not react adversely to other dogs. NCMC Therapy Dogs must be at least one year old,
friendly to strangers and well-trained.
Registry with an accredited therapy dog organization (such as TDI Inc. or National Therapy Dog Registry)
is required before applying as a pet therapy volunteer at North Colorado Medical Center.Visit Therapy
Dogs Inc.for more information on , Karissa Barnes. Therapy dogs and handlers are thoroughly trained
by staff before visiting patients.
This test includes a handling portion which tests your dog's basic good manners and your handling skills,
If you and your dog pass, you move to the next step of interacting with residents or strangers on three
supervised visits.
Required for testing- proof of negative fecal exam done within the last 12 months
4,14
Visit conducted by: Mark Lawley
On Date Department
May-2015 Medical Observation
Julia Gentry, Jason Collins
Department History
The department opened in March of 2013, all nurses have a medical or surgical background. Prior to
this unit being opened all patients observation occurred throughout the hospital.
Service(s) Provided
Observation allows the medical provider to assess the condition of patient to determine if they need
admitted as an impatient or if they can be safely discharged. The observation stay is intended to be
short term; it may include diagnostic testing to further evaluate the condition of the patient. The goal
in observation if possible is to have patient discharged within 24 hours after they arrive. This is
accomplished by bringing a team of providers together such as nurses, care coordinator, social worker
and others to determine if the patient can be discharged home. If the patient needs other services
once discharged or to return safely home, these services are set up so the patient can return home.
For example follow up care or service with other providers may be criteria for discharge.
Number of staff: Revenues/Budgets if relevant
There are 51 employees in observation, 30 Seemed to be well funded, did not know revenue
Registered Nurses, 5 managers and CNAs and and budget projections.
PCAs.
Successes - •• - - — ----.
- Met all 9 dimensions for patient satisfaction
- 29% of all patients in observation were discharged in 2-18 hours in Jan, Feb and March.
- Fully staffed
- Survey results indicate employee satisfaction is high
Challenges/Obstacles
-Some physicians are reluctant to discharge within the 2-18 hour time frame; some of this reluctance is
a result of liability from the physician's perspective. For example a physician may be reluctant to
discharge a cardiac patient because of liability reasons.
Departmental Needs/Requests
Staffing and budget is good, no needs are requests.
Manager's suggestions for improvement
What would the department manage/director like NCMC, Inc. to know, if anything?
Everything is working as designed; process will be improved once attending physician is added to the
team.
Notes/Miscellaneous
None
Outpatient Observation Services
Welcome to the Outpatient Observation Unit! This area provides services tailored to
meet your medical care needs.
What does being in "observation" mean?
Observation services allow your medical provider to assess your condition and
determine if you need to be admitted as an inpatient or if you can be safely discharged
based on medical guidelines.
What is "outpatient" status?
Your medical provider may write an order for you to be placed as an outpatient/
observation patient. This is not considered a hospitalization or an admission to the
hospital.
The observation stay is intended for short-term therapy, diagnostic testing and
monitoring, to evaluate your condition. This is done in order to determine whether you
need to be admitted to the hospital as an inpatient or be discharged to go home.
Although observation is considered outpatient, you will be placed in a hospital bed and •
receive hospital services as ordered by your medical provider.
Why am I an "outpatient/observation" patient instead of an inpatient?
In some cases it is not immediately clear whether you are well enough to go home or if
hospitalization is needed until testing and evaluation is completed. Medical criteria are
used to determine what services you will need.
How long you stay in observation will depend on your condition and progress but it is
usually fewer than 24 hours.
If l am in the hospital overnight, do I get changed from outpatient/
observation" to "inpatient" status?
Your status is only changed if your condition meets "inpatient" medical criteria.
What happens if l am not admitted to the hospital as an inpatient?
You will be discharged home with a follow up plan or transferred to another health
care facility that will continue to care for you
Banner Health'
Sri( Rapes
Laboratory Department Visit
Mike Simone
VBe ui,r:�itt rls:le,•y: a=',):>i }:t;+ Luis,.,:#;icn to 1',: clapultirreltk, as in other d rtm'tnts, has led to an
ov haul of o ..;;Affil:.i. 1 :'r)lO)i5 r;ti•in is1 fey r?; )net and is an alternative to many of
the cocrr,r:, t-:tl :a:fz F;cx ; ,s{}11Z1Ve. ; ;vat n €I�?fr i'.ftir;es. l l{-dic31t gives doctors consistency in lab
testis h,+l -'`t:r_= ..,,rt`s- iL with!, X1 1 c{,#sFJ the ho pii �l. ? st testing is done in the hospital
(NCMC—the largest, f ant t,':ti 1 it;3r -i I :a fr Lrdi'f ,t 11 >sp€Jtic
billing—which agiears to, ro:surt i 21. :t(ir:r r :"rl iurS ll :li 'r. ; ;::: W ,Flirt:';i., i S`,i �,t! 4a�:, sitr r 9 p with
Mayo Clinic for 111E:morr,: ... !<<,:Lrl. F ,y
tti�l�., i��. f:�. e;11 � ? ,r;fc�a1
cytological pathology $`:v7icc li<;[s_'} iii_'j a i,S;4u` cork }' i C"•!4,'f'`:::is Fs:l�l C!} KI12:T
Public I leaitit I) pai{went. t c; tjat c.t r l-ic,ii o•n l_3bs 1 r Uic�3d in increased turnaround time and
decrnasad costs. ilcai.L)':4l so does Ter iler:cer h)spitds in other states.
The roic,robiol%gy n I toxir;c-i sy iab',s row!ty_;-iiiad tit Mee i?!;t the lab tech at NCMC can consult with
pathologists on the interns:t when c:;;a riir a-y
The lab at NCMC is higl}-vdainc-fr),I Ci:t;:c fau1i[iIr ':n I Si.,.a E iricie ise in volume of about 45%.
There has been about a thrceio i in re e in f,g1—time
Chhe hospital lab bar'ad lab (i'-IL.,Cn) Coi accts b'Jh I Icr]ien. i c-sh ae owned by Bartrer. Horizon zeroes out
their profit each r'oc.ic fur;(is .,e%•:}i i?l_;r.;;J nmonij :be Cifrei(7. ,t hospitals that are involved in testing.
The r ed lr.il r oc: , . r dd. ',1c.'t U<_4;.N 3 it _t tl;:y ~ave r1 .t cr surp_issed expectations for increased
History fat �.}r�; .��:i Mitt I iahoy is fi,e Noon I)`' .; r, v. goo ' f..t:ctr��; gin" �:� C c r I �c.�cat( r l at)!,_; I ic:15 a trained
medical laborafo y° scienliist. I Ia began I c, .•c.er in 'rig's and spent about I-«91i of li: c..arecr in leadership.
Services r''io)? ;: F Lners r.fr li r Tr (;clI rode I CaorEllcry -:i'.!`'( () €'Urn-lent cortscklateci
Iaboratc:r y mode]v ithIn the Northern Colorado region and perform the majority of tests on site at either
North Colorado;; ,;s:;.zl Center er t,;c,1<;,c; "tlet`ic:l C€ntwr, The COO is Julie Klein but 1 get the sense Matt
supervis s j);-3t r rff;{
A provider order is not requited for services that arc p;ov r c;to the coo irnorris at ID-g of Ion direct access
testing (e.g. Lab Health Parry i, Woliness I fairs, �;`'`c c::: S,.i�inp. sc:rcn1;tieg rrr 1111f gams)"
• NCMC and MoKcr: I �;.rcL r,tc�r-r- ft:t: (:/- (�:r,;. :r c{f;= +. ., _ws' I'i.:.r;',%[ri+;;)).ILr i: CLIA arrd FDA
accredited laboratory.
Services Provided by Banner Northern Colorado Laboratories:
• Hematology
• Chemistry
• Transfusion services
• Microbiology
• Point of Care Testing and Toxicology.-(for example, blood sugar at the bedside)
• Phlebotomy
8tarl, 17fe e r c about t)staff rnenrters at NCMC—which are almost equally distributed among
technical, supped and spiais:iii era procurement staff. Four anatomic and clinical board-certified pathologists
lead the I bo; Io.y tr:f'if eppfr*'riiinately /0 employees.
Revcnri .i/Budg'afs„If Relevant: The budget is about $60 million and they do make a profit. Matt pointed
out that 70% of clinical decision-making is based on lab data.
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