SCHD Board of Directors Meeting Minutes Page 1 of 4 February 26, 2015

Southern Coos Health District Minutes

Board of Directors Meeting & Executive Session February 26, 2015

7:00 p.m. I. Call to Order

This regular meeting of the Board of Directors for Southern Coos Health District was called to order at 7:09 p.m. by Esther Williams, Board Chair.

Members Present: Esther Williams, Chair; Carol Acklin, David Allen, Bob Hundhausen, and Brian Vick, Directors. Administration: Charles Johnston, Robin Triplett, Carol Meijer, Megan Holland, MD, and Kim Russell. Additional Staff Present: Mandy Calvert, Dennis Jurgenson, Scott McEachern, and Cyndy Vollmer. Public: Linda Olsen.

II. Public Input. None.

III. Consent Agenda – Carol Acklin moved to approve the Consent Agenda. Bob Hundhausen seconded the motion. The motion passed unanimously.

IV. Staff Reports

A. CEO Report – Charles Johnston reviewed the CEO Report provided in the board packet. New Clinic & Foundation Building Update: The move into the new clinic began today and to be open for patients Monday, March 2. The parking lot asphalt is in place but must cure before striping of the standard size parking spaces can occur. The new Foundation building assembly date has been moved from March 5 to March 10 with no change to the mid-April move-in date. A new timeline is provided in the report and we are on schedule. Final inspections are tomorrow with the Fire Marshall and for our Certificate of Occupancy. Strategic Plan Goal: Charles reviewed the status of strategic plan and joint conference goals. A separate item on agenda to be covered later in meeting is the strategic goal regarding community input. The City of Bandon will be updating highway signage thanks to a grant that will include the decals we have been attempting to coordinate with Coquille Valley. Due to new laws and our new construction the Disaster Drill schedule will be moved to a later date. CPSI Update: On March 16 a team from CPSI will be on-site. Some progress has already been made with a reduction of 23 “issues” bringing our list down to 40 from 63. We hope to continue with another positive report in March. Employee Relations: Charles has been visiting with departments to share information, answer questions, and get input regarding the employee benefit program. The first of a new monthly employee potluck and birthday celebrations will be March 19 with an Irish theme. Cyndy Vollmer has distributed the first issue of a monthly employee newsletter and will include the Board of Directors beginning with the March issue. Carol Meijer shared that she scheduled 2 staff dept. meetings to cover varied shifts last month an again last week. Spirits seem high and staff is responding positively. Marketing Report: Scott McEachern continues to keep SCHHC in the news with articles regarding the new clinic, our Hospitalist, Sarah Barry, and advertising. KCBY-TV will be out to do a story after the new clinic move-in. Included with the board packet is the completed 2013-2014 Annual Report which will also be available on our website. This report will be distributed to major donors as well as used for grant seeking.

SCHD Board of Directors Meeting Minutes Page 2 of 4 February 26, 2015

WOAH Update: As previously reported, last fall we accepted proposed reimbursement pricing from WOAH but have been waiting for a contract from them since October 2014. In a meeting last night, the Lower Umpqua Hospital Board of Directors has decided to select Trillium as their new CCO. WOAH is presently in arrears to pay us $1.3M. Other counties are now able to change CCOs while we are legally bound to WOAH. We are prepared to take legislative or legal action to make a change. We have received notification that Dr. Santosa will be up for review on his Medicaid panel, indicating forward movement. The upcoming Supreme Court decision on King vs. Burwell, to rule on Federal subsidies, has the potential to affect patients whose insurance is funded by these subsidies. Our association will be advising hospitals as this unfolds.

B. CFO Report – January had a small drop in volume but YTD we are head of 2014. An analysis of Swing Bed days shows that other hospitals are also trending downward in volume. Lab and Radiology volumes are up due to referrals from Drs. Holland and Santosa. January had a positive bottom line for the month of $42,216 and YTD -229,000. Net revenue was above budget by 16.1% and YTD 7.4%. Expenses were above budget by 14.7% and YTD 9.6%, with several one-time costs in January including the 403B contribution, SDAO Worker’s Comp insurance, new clinic fixtures, Bandon Concrete, and Hospital Association annual dues. Thank you to the Foundation for the donations for Lippencott and the camera for the Outpatient Clinic. January 2015 Net Revenue outperformed 2014 by 17.1% with expenses 16.3% higher due to additional staff and building projects. Total Net Operating Revenue is 14.9% above last year. Days Cash on Hand dropped to 69.0, due in part to the WOAH payments over 90-days old totaling $1.3M. They are to be caught-up with us by end-of-month, so far WOAH has paid $17,000. Other hospitals covered by WOAH are Bay Area, Coquille Valley, and Curry General and are having similar experiences. January Days in A/R is up at 95.4, but this has dropped to 88.4 as of February 18. Payroll is up due to Dr. Antola’s arrival in January, for which we are reimbursed by EmCare, and use of our own staff rather than registry use. Overtime was down also due to less registry nurse usage. State pool: State Pool reserve balance is $2.3M with $5,500 paid to board specified fund. C. Medical Staff Report

Dr. Holland submitting the following recommendations:

6 month Provisional Staff Privileges Carla Antola-Lardizabal, MD—Emergency Medicine

2 year Courtesy Privileges Randall Steffens, MD—Emergency Medicine Timothy Turnbull, MD—Emergency Medicine Roma Sprung, MD—Emergency Medicine

Dwain Watkins, CRNA Active Staff Privileges

Enrique Montana, MD—General Surgery 60 day temporary Privileges

James E. Sharp,OD—Optometry

Brian Vick moved to accept Medical Staff recommendations as presented. Carol Acklin seconded. With no further discussion, motion passed unanimously.

SCHD Board of Directors Meeting Minutes Page 3 of 4 February 26, 2015

V. Old Business A. Annual Report – A brief review of the completed Annual Report for fiscal year

ending 2014 as included with the Board Packet produced positive feedback. Distribution will be to major Foundation donors and will be used as tool for prospective donors. The report will also be available to the public via the SCHHC website.

B. Strategic Plan-Public Input – This item is on the agenda for the purpose of

selecting a method to obtain public input for completion of the Strategic Plan goal due in April. A suggestion was made to solicit an invitation to submit ideas in conjunction with a written survey. Discussion concurred that open forums are typically less productive. The invitation and survey can be included in the City of Bandon utility bills that go out to district residents. The City must be notified in advance to secure a mailing date. An ad can be placed to notify residents of the survey that will also posted on the SCHHC website. Board Members are to email suggested questions to Charles to add to next Board Meeting for review, in addition to a review past surveys.

. VI. New Business A. Benchmark Reports –

1. Peer Comparisons – All comparative hospitals are showing lower numbers in Swing Bed. Swing Bed service has local competition with other care centers in the area. Coquille Valley has not been reporting in the last year, possibly due to their new software system, therefore are not included as comparative hospital. Blue Mountain Hospital is in Eastern Oregon. Outreach with face-to-face marketing with physician offices and patient discharge coordinator at Bay Area are suggested to help increase Swing Bed usage. SCHHC shows very low tax income compared to the other hospitals which is not likely to change.

2. HCAHPS – Charles Johnston reviewed the HCAHPS report noting that it is for the reporting period of January 1, 2013 through December 31, 2013. Also of note is that every other hospital has enough responses to have a semi-accurate record. We have “footnote 6” that fewer than 100 patients completed the survey in the entire year, which questions the statistic validity. We are comparable until the last question, “Would you recommend our hospital.” The report shows us down even with our good results on the other questions. Heather Edwards has put together another report with additional detail under January 1, 2014 to December 31, 2014. A 12-week grace period for reporting has not yet closed, so this may change, but we show that 70.2 would recommend our hospital. The last 3 months of 2014 show that in the month of October there were 7 responses, in November there were only 4 responses. In November 1 says probably no, 2 said probably yes, and 1 said definitely yes. The positive reporting totals are taken from the “definitely yes” results. The probably yes or no are not used. In 2014 there were only 84 respondents making us under 100 on everything, in addition to basing our concerns on these statistics. We do see we are generally improving. We are required to subscribe to this service for national reporting. Carol Acklin pointed out that in surveys it has been found that surveyed participants routinely do not check or circle the top mark, the second of which is “probably yes” which is not reported, meaning that the 84 respondents