July 22, 2014, Board Meeting

BOARD OF DIRECTORS Public Agenda July 22, 2014

5:15 p.m. Administration Boardroom

______________________________________________________________________________ Mission Statement

Bartlett Regional Hospital provides its community with quality, patient-centered care in a sustainable manner.

____________________________________________________________________________

I. ROLL CALL 5:15 p.m.

II. PUBLIC PARTICIPATION ON NON-AGENDA ITEMS 5:20 p.m.

III. SPECIAL ORDER OF BUSINESS 5:25 p.m.

IV. APPROVAL OF MINUTES from June 17, 2014 (Pg. 3) and June 24, 2014 (Pg. 5) 5:30 p.m. ***EXECUTIVE SESSION***

V. MEDICAL STAFF REPORT (Pg. 11) 5:35 p.m.

VI. NEW BUSINESS 6:05 p.m. • CBJ Law projects for June 2014 (Pg. 13)

VII. CONSENT AGENDA

VIII. STANDING COMMITTEE REPORTS 6:10 p.m.

A. Executive Committee – Special meeting (Pg. 14)

B. Finance Committee – Alan Germany reports (Pg. 15)

C. Planning Committee – no meeting held

D. Quality Council – no meeting held

E. Bartlett Foundation – Linda Thomas reports

IX. MANAGEMENT REPORTS 6:20 p.m.

• CEO – Chuck Bill reports

X. PRESIDENT’S REPORT – Kristen Bomengen reports 6:30 p.m.

Page 1 07 22 2014 Board of Directors packet

XI. BOARD EDUCATION

XII. AUGUST BOARD CALENDAR (Pg. 47) 6:45 p.m.

XIII. BOARD COMMENTS AND QUESTIONS 6:50 p.m.

XIV. EXECUTIVE SESSION (if required)

ADJOURNMENT 7:00 p.m.


3260 Hospital Drive, Juneau, Alaska 99801 907.796.8900

www.bartletthospital.org

Special Board of Directors June 17, 2014

Minutes ROLL CALL ATTENDANCE: Kristen Bomengen, President Bob Storer, Vice President (by phone) Nancy Davis, Secretary Linda Thomas, Past President Mark Johnson Lauree Morton Mary Borthwick ABSENT: Nate Peimann, MD Alex Malter, MD STAFF ATTENDANCE: Chuck Bill, CEO Alan Germany, CFO Billy Gardner, CNO Toni Petrie, Executive Assistant CALLED TO ORDER - 12:05 p.m. PUBLIC PARTICIPATION – NONE Ms. Davis made a MOTION at 12:06 p.m., to go into executive session for the purposes of discussing matters which could have an adverse effect on the finances of the hospital. Ms. Morton seconded and it was approved without objection. The Board came out of executive session at 1:00 p.m. Ms. Thomas said after a robust discussion during executive session, the following motion will be addressed at the June Board meeting. Mr. Johnson made a MOTION to approve recommendations outlined by our Chief Executive Officer to move forward with payments to providers. Ms. Thomas seconded and it was approved without objection.


http://www.bartletthospital.org/

Ms. Borthwick made a MOTION to work on achieving a hospitalist type program through the cruise ship season for our practitioners. Mr. Johnson seconded and it was approved without objection. Ms. Thomas asked what was recommended by the hospital to the BRH Foundation at their meeting on June 16, 2014. Mr. Bill said for the pediatric funds, the kid’s entertainment carts and a pediatric climbing wall in physical therapy. For the Critical Care Unit funds, we requested 6 new beds for CCU and the trapeze equipment to support them. The Foundation said they will also continue the support for the S.A.R.T. program. They requested to have a SART Director, but Mr. Bill and Mr. Gardner see enough value in the service to handle the staff support internally. Meeting adjourned at 1:08 p.m.


3260 Hospital Drive, Juneau, Alaska 99801 907.796.8900 www.bartletthospital.org

Bartlett Regional Hospital

Board of Directors Minutes

June 24, 2014

Called to order at 5:17 p.m. Roll call Present Kristen Bomengen Nancy Davis, Secretary (by phone) Mary Borthwick Lauree Morton Mark Johnson Alex Malter, MD Absent Robert Storer, Vice President Linda Thomas, past President Nate Peimann, MD Others present Chuck Bill, CEO Mila Cosgrove, HR Director Alan Germany, CFO Billy Gardner, CNO Toni Petrie, Executive Assistant Dick Monkman, Hospital Atty. Amy Dressel, MD Carlton Heine, MD Karen Crane, CBJ Liaison Public participation – None Approval of the minutes – Ms. Morton made a MOTION to approve the minutes from the May 27, 2014, Board of Directors meeting. Mr. Johnson seconded and they were approved without objection. Ms. Morton made a MOTION to approve the minutes from the June 7, 2014, Special Board of Directors meeting. Mr. Johnson seconded and they were approved without objection. NEW BUSINESS: None CONSENT AGENDA: The Midas Plus agreement was approved at the Finance Committee and did not need to come before the Board for approval, but the details were included in the Board packet for the rest of the Board to see. STANDING COMMITTEE REPORTS: Executive Committee - Ms. Bomengen requested that each committee report be given in brief detail and if anyone had any questions or wanted to elaborate on something more, to please do so.



Finance Committee – Ms. Morton reported that the Finance Committee went into the capital budget items in more detail. We are now switching to a three year capital budget plan and asked Mr. Bill and Mr. Germany to let the committee know about things such as retention schedule and when items need to be replaced, etc. There have been several items that have not been purchased that are on the capital budget list for FY14. If they are no longer necessary or can wait until the next year(s) they will be removed from the list or moved to that year. The CERNER letter went out, but we have not heard anything from them yet. Ms. Morton asked Mr. Germany to highlight the financials (see attached) Planning Committee – Mr. Bill reported that as an organization we are going to do our board education around the Focus and Execute tool. This tool is a web based strategic planning tool that will be presented tonight. There was also a discussion about the role of the Planning Committee’s responsibilities. Quality Council – Ms. Borthwick reported that the meeting in June was a summit, but was not long as it might have been since several reports were deferred. Ms. Davis said there has been discussion that we may need to change the structure of this committee. Some parts that are in peer review are not open to the public, so abiding by the open meetings act and respecting privacy will take some fine tuning. Getting the Board’s energy around the quality and patient safety is important. Mr. Bill said he would like to see quality dashboards at the Board meetings. Dr. Malter said 4 hospitals in Alaska are getting “dinged” because they weren’t meeting the quality measure standards. He said our name was not on that list and he was wondering if it was because we are paid in a different manner, or if it’s all the hard work our Quality Department has done. Mr. Bill said it’s both. The Medical Staff and the Board do a diligent job with quality and take it very seriously. Physician Recruitment – Ms. Morton reported that the committee met and discussed psychiatric recruitment. There were two candidates that came to Juneau, but both declined. The committee thought it would be helpful to increase the psychiatry staff by one additional position to allow the new hires to do both inpatient and outpatient work. Ms. Morton made a MOTION to approve an additional psychiatrist. Ms. Davis seconded. Dr. Malter asked if administration agreed to expand that service. Mr. Bill said yes it is important because we are using a lot of locums to provide that service. Ms. Davis asked if it was for a recommendation for an additional adult inpatient and outpatient. Mr. Bill said yes. We were recruiting initially to hire one to do inpatient work. Someone expressed concern that it would be harder to recruit if they only did inpatient work. Dr. Malter said we use recruitment firms and sometimes they send people to Juneau knowing they wouldn’t take the job and wanted to know if we would we ever try and do this in-house like we did hiring the CEO. Mr. Bill said a lot depends on the specialty and resources you have to dedicate to the process. Psychiatry is a very specialized area that would be hard for the hospital to take on. The MOTION passed by a unanimous roll call vote. Bartlett Foundation – The minutes from the April meeting were reviewed.


MANAGEMENT REPORTS: CEO report – Mr. Bill said he has leased a house and will be leaving town Saturday to move his stuff to Juneau. Mr. Gardner and Mr. Germany will be the go to people while he is away, but he will be checking emails regularly. Mr. Bill said he and Dr. Heine attended an ASHNHA conference in Anchorage that included a Horty Springer training session. He was able to attend a dinner with ASHNHA’s Executive Committee the night before the conference. The training addressed the credentialing process and proposed identifying applications that are incomplete so that the word denial is not used. A denial is reportable while an incomplete application is not. There was also discussion on how to set the different categories for the Medical Staff. Conflict resolution was also a big part of the training. They touched on the on call issues, pointing out that it is not uncommon. 73% of the hospitals in the country pay for physician call. HR Director – Ms. Cosgrove handed out the results of our 2014 Employee Culture Survey. She said there are two basic types seen commonly. This one addresses employee engagement. There was a summary of what was included in the survey and then the survey results themselves that were reviewed. The focus of the questions were;

• Teamwork

• Morale

• Information flow

• Employee involvement

• Supervision

• Meetings

• Customer service

• Quality of care

We had a good return rate of 80.3%. The overall culture score was 3.57% out of a possible 5, which is good performance based on the amount of turnover we have had from a leadership standpoint. This survey creates a baseline for the organization. The documents were sent out electronically to all employees. Each director got individual reports for their departments and they will work with their teams. MEDICAL STAFF REPORT – Dr. Dressel said there is still a lot of discussion amongst the Medical Staff on the pay for call and they appreciate Mr. Bill working with the physicians. Ms. Davis made a MOTION to go into executive session at 6:08 p.m., to discuss matters which are confidential by law. Dr. Malter seconded and it was approved. Out of executive session at 6:28 p.m. No action was taken. Ms. Borthwick made a MOTION to approve the credentialing report. Mr. Johnson seconded. Ms. Davis said she reviewed each credentialing file that is on the report. The credentialing report was approved without objection.


Dr. Heine gave an update on a meeting he had with the single specialty physicians concerning call. He said it’s difficult because we don’t know when we will need them. They worked on a plan to help provide the best services to the community. Rather than having them being listed on call for specific days, they would be available by phone whenever they are needed and if they are available they would be willing to come in. We would keep track of when the individuals would be contacted by the Emergency Department. That seemed to be well received by most of them and the Medical Staff. CFO report – Mr. Germany said we are wrapping up the Medicare Audit from FY11. We will have our exit conference later this week. They met with Max Mertz and the auditors to work on the starting the financial audit. This will be more of a stand-alone audit. Mr. Germany announced that Martha Palicka has been appointed as the permanent IT Director. Mr. Germany recognized Mike Dumont, who has been our interim Revenue Cycle Director and is leaving us this week. He has brought a lot to the table mentoring the PAS, PFS and HIM Departments. Due to his leadership, we were able to promote two employees as Directors of PFS and HIM. Ms. Cosgrove reported that we have been involved in recruiting for a CFO. The pool of candidates has been reduced to three people that will be coming to Juneau for an onsite interview July 24th and 25th. Dr. Malter asked what kind of ideas would he pass on to the Board to change the way the next years go to improve our A/R days. Mr. Germany has done a thorough line by line review. Once we get some stability, it will improve. PRESIDENTS REPORT: Ms. Bomengen said her trip to the Ukraine went well. We are still trying to get our consent agenda inline. She is interested in feedback on how to approach portions of the consent agenda. We will be looking at ways to make our meetings more effective and more efficient. Dr. Malter said he thinks that sometimes there are substantive issues that people might be afraid to raise if they are on consent agenda and to be judicious when placing certain items on the consent agenda. Ms. Crane said at the Assembly level they let the public make recommendations on what can be removed from the consent agenda. BOARD EDUCATION: Mr. Bill introduced David Sandberg from Focus and Execute (over the phone) for an online presentation of the tool Focus and Execute. Mr. Bill said he would like the Foraker Group and David Sandberg at the strategic planning on October 18th, then on the following Monday for Mr. Sandberg to meet with our Directors and go over the tool. Mr. Bill has used this tool through three different cycles at other hospitals.


The July calendar was reviewed. There will be a special Executive Committee on June 27, 2014. There will not be an Executive Committee held in July. BOARD COMMENTS: Ms. Davis said she has a new medical issue and will be traveling and is not sure when she will be in town for meetings. Ms. Borthwick made a MOTION to extend the meeting until 9:00 p.m. Ms. Morton seconded and it was approved. Ms. Borthwick made a MOTION to go into executive session at 7:54 p.m., to discuss matters which could adversely affect the finances of the hospital. Ms. Davis seconded and it was approved without objection. Out of executive session at 8:30 p.m. no action was taken. Mr. Monkman said a colleague of his will be here Thursday and Friday to talk about HIPAA and Compliance to staff and members in the community that are in healthcare. Adjourned at 8:32 p.m.


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Credentials Committee Hospital Privileges for Medical Staff Executive Consideration

Tuesday, July 22, 2014 5:15 p.m. – Robert F. Valliant Center Boardroom REAPPOINTMENTS TO THE MEDICAL STAFF: Name Category Privileges In 1. Beatrice M. Brooks, MD Active Emergency Medicine Dr. Beatrice M. Brooks graduated from the Oregon Health Sciences University School of Medicine in Portland, OR in 2003. Dr. Brooks is an emergency medicine physician for BRH Emergency Department. 2. John T. Connolly, Jr., MD Locum Tenens Anesthesiology Dr. John T. Connolly Jr. graduated from the Baylor College of Medicine in Houston, TX in 1981. Dr. Connolly is an anesthesiologist for the BRH Operating Department. 3. Deborah L. Lessmeier, MD Active Family Medicine Dr. Deborah L. Lessmeier graduated from the University of Wisconsin-Madison in 1987. Dr. Lessmeier is a family practice physician for Family Practice Physicians. 4. Kristi Linsenmayer, DDS Consulting Pediatric Dentistry and Dentistry

Under Anesthesia Dr. Kristi A. Linsenmayer graduated from the University of Washington in 1993. Dr Linsenmayer is a pediatric dentist in private practice in Ketchikan and contracts with SEARHC - Dental. 5. David Miller, MD Active General Surgery, Gynecologic, Lap

Cholecystectomy, Appendectomy, Sentinel Node Biopsy for Cancer, C-Section, Endoscopy, Bronchoscopy, Colonoscopy, EGD, Esophagoscopy and Dilation, Other Major Peripheral Vascular Arterial and Venous Reconstructions, Pancreatectomy, Parathyoidectomy, PEG, Sclerothapy, Administer Fluoroscopy, Transoral Fundoplication, Bronchoscopy, and Lap Hysterectomy

Dr. David A. Miller graduated from the Kansas University Medical Center School of Medicine in Kansas City, MO in 1989. Dr. Miller is a general surgeon for AK Minimally Invasive Surgery Center. 6. Sze K. Pang, MD Locum Tenens Family Medicine Dr. Sze K. Pang graduated from the Tulane University School of Medicine in 2007. Dr. Pang is a family medicine physician for CompHealth – Family Medicine.


CHANGE OF STATUS: 1. Robert Schults, MD – (Active to Locums (Reoccurring)

LOCUM TENENS: 1. William Carroll, MD – (LocumTenens.com/BRH MHU; Psychiatry, Child/Adolescent

Psychiatry, and Chemical Dependency Detox) 2. Clifford Crafton, MD – (LocumTenens.com/BRH MHU; Psychiatry, Child/Adolescent

Psychiatry, and Chemical Dependency Detox) 3. Alberta Laktonen, MD – (Family Practice Physicians; Family Medicine w/OB)

REQUEST TO WITHDRAWAL: 1. Daniel Hambleton, MD – (Active – SEARHC; Family Medicine w/OB) 2. Guy Ross, MD - (Consulting – vRrad; Teleradiology)

TELERADIOLOGY: 1. Mary Jane Betterman, MD – (Consulting – vRad; Teleradiology) 2. Marc Paul, MD - (Consulting – vRad; Teleradiology)

MEDICAL RESIDENT: 1. Jamie Tribo, MD – (Cox Family Medical Residency Program and SEARHC – Cedar; Family

Medicine w/OB)

Y:\Medical Staff\BOD\2014\2014 07 22 BOD Summary.doc





Executive Committee June 27, 2014

Minutes CALL TO ORDER 12:03 p.m. ATTENDANCE: Kristen Bomengen, Linda Thomas, Bob Storer (by phone), Mary Borthwick, Mark Johnson, Kendri Cesar (Sonosky/Chambers, esq.), Dick Monkman, Sonosky/Chambers, esq, Chuck Bill, CEO, Billy Gardner, CNO Ms. Thomas made a MOTION to go into executive session to receive legal advice. Mr. Storer seconded and it was approved. Out of exec at 12:33 p.m. No action was taken. Orthopedic agreement – Ms. Thomas made a MOTION to approve the Orthopedic On-Call agreement, subject to final minor edits by legal. Mr. Storer seconded and it was approved by a roll call vote. Ms. Thomas said she thinks this will really help us allowing people to get more services in Juneau and improve patient care. Ms. Bomengen thanked everyone that worked so diligently to get this moving forward in a timely manner. On-call Personal Services agreement - Ms. Thomas made a MOTION to approve the On-Call agreement subject to final minor edits by legal. Mr. Storer seconded and it was approved by a roll call vote. Ms. Borthwick asked where we were with the CFO candidates. Mr. Bill said we have done the Skype interviews and they will bring three candidates onsite on July 24th and 25th. Ms. Thomas asked who was involved in the interview process. Mr. Bill said he was, Mr. Germany and Mila Cosgrove. Once they are onsite, there will be different teams put together to do interviews. Adjourned at 12:40 p.m.





Finance Committee June 19, 2014

Minutes

Attendance: Lauree Morton, Alex Malter, MD,

Absent: Linda Thomas

Also in attendance: Chuck Bill, CEO, Billy Gardner, CNO, Alan Germany, Interim CFO, Toni Petrie, Executive Assistant, Marise Knock, Controller, Bethany Rogers, Quality Risk Director, Martha Palicka, IT Director, Mila Cosgrove, HR Director, Mike Dumont, Interim Revenue Cycle Director

Ms. Morton called the meeting to order at 5:19 p.m.

Mr. Germany recognized the staff in attendance and announced that Martha Palicka has accepted the permanent IT Director position. Ms. Morton made an amendment to the agenda to move the Midas Plus contract to the top of the agenda. Midas Plus - Ms. Rogers said this contract is replacing a module that we used to use with Press Ganey that conducts ongoing professional practice evaluations (OPPE) of credentialed providers; however Press Ganey discontinued this module in January.

Rationale:

Regulatory imperative to conduct ongoing Professional Practice Evaluation (OPPE) of credentialed providers (The Joint Commission)

Previous OPPE vendor (Press Ganey Clinical Performer) discontinued product Jan. 31, 2014

Vendor Choice: MIDAS+ Statit

Customizable Recommended by Medical Staff Quality Improvement Committee (MSQIC) after

review of two vendors Recommended by Quality Director after review of four vendors Lowest pricing model of four vendors reviewed

Pricing: (see attachments) MIDAS+ Statit OPPE Product: $10,000 (annual) On-site system set up and training (1 MIDAS+ staff, 2 days): $ 2,500 (one-time) BRH Microsoft Server: $ 2,500 (one-time)


BRH Symantec Backup / Antivirus Client: $ 300 (one-time) Initial Year: $15,800 Subsequent Years: $10,000 Term: 3 years Notes: The contract has been reviewed and approved by CBJ Legal and approved by the Board Finance Committee Dr. Malter asked if we had to go through a vendor, or if we could do this type of monitoring in-house. Ms. Rogers said we don’t have to use a vendor, but the FTE burden would be higher than the cost of this software. This vendor was a good fit for the size of our hospital. Mr. Germany recommends the Finance Committee approve this contract. Dr. Malter made a MOTION to approve this contract. Ms. Morton seconded and it was approved. Due to the dollar amount, this does not need to go to the full board for final approval, but Ms. Morton asked that Ms. Rogers provide a summary in the Board packet. OLD BUSINESS: Mr. Germany acknowledged Marise Knock for her work during the budget process and provided her a letter signed by Mr. Germany and Ms. Morton that will go in her personnel file. Capital Budget follow-up – Mr. Germany went over the FY15-17 Capital Budget summary. (See attached) Ms. Morton asked if there was a retention schedule for some of these items and said that it would be helpful to know when discussing the Board’s strategic plan. Ms. Morton asked if this is the first time we have done the three year outlook on Capital Budget items. Mr. Germany said he hasn’t seen a three year plan at BRH, but it is required by the Joint Commission. May Financials were reviewed – Mr. Germany reported. (See attached) Mr. Germany said the Cerner recovery funds letter has gone out. We don’t know at this time if or when we will get any funds back. Mr. Germany recognized Mr. Dumont for his hard work since he has been here as the Interim Revenue Cycle Director. Mr. Germany said Mr. Dumont’s been working a lot with the PFS Director, HIM Director and the PAS Director and they are all working very well together to bring down our A/R days.


Other revenue cycle updates – Mr. Germany said we have been making a lot of progress with bringing in the cash thanks to Mr. Dumont. We had a meeting with SEARHC that went well. There have been improvements with their payments to BRH since then. A/R days are about 90-91 currently. Supply Chain/GPO discussion – Mr. Germany said he had to do a lot of reviewing of minutes and such to get up to speed on what the issues were with having two GPO’s. The hospital signed an agreement with VHA Novation then later signed one with Amerinet. It’s a bit unusual to have two GPO’s, but sometimes one GPO cannot provide everything that the other one can. He’s been working with our Materials Management Director on this. Audit – Mr. Germany said we got a proposal for the stand alone audit. He said it’s approximately $25,000. The Medicare audit is ongoing. There are some challenges, on behalf of the pension payments. The money is reserved on the balance sheet just in case. Ms. Morton said the capital budget for this year still shows several things that have not been purchased. Of these items that are not purchased by the end of the year, is there a plan of deciding what’s going to be put in FY15. Mr. Germany said they are working on these items that may cross over from year to year. There are number of items that in looking back, we don’t really need. Some of the items wouldn’t be capitalized, such as painting and re-carpeting. Ms. Morton would like to see a list of when things should be replaced. She said there has been concern with some board members not having the detailed list of items that have not yet been purchased. APPROVAL OF THE MINUTES: Dr. Malter made a MOTION to approve the minutes. Ms. Morton seconded and they were approved. Meeting adjourned at 6:25 p.m.


June 2014 Financial Results


Bartlett Regional Hospital June 2014 Financial Operating Summary

Excess of revenues over expenses for the month of June 2014 was a negative $1.28 million which was $1.86 million worse than the budget of $578,000. The reason for this significant loss in June was primarily due to a $2.0 million write-off related to prior year Cerner fees (as Bartlett has decided to implement Meditech instead). The hospital’s June performance brings the fiscal year actual to $5.07 million which exceeds the budget of $3.33 million by $1.74 million or 52%. Hospital volume saw an average of 26.7 patients per day in June. Rainforest Recovery Center’s average daily census in June was 13.4 patients. Of the hospital census, the Mental Health Unit census averaged 9.3, a slight increase over May. Surgical cases totaled 267 in June, 38 cases lower than May. It appears that part of the reason surgical volume was lower in June related to vacation time/physicians away from the hospital. Emergency Department volume was strong in June at a total visit count of 1,400 or 46.7 average visits per day, the highest since last July. Total operating revenue was $7.3 million in June, $162,000 less than budget. For the fiscal year, total operating revenue was $86.82 million, $3.29 million over budget. This included the impact of the unbudgeted electronic medical record incentive funds received in December 2013 of $898,000. Higher than budgeted total revenue for the year also includes the impact of a reduced bad debt level than originally budgeted. Bad debt was $1.69 million lower than budget for the year. Total expenses were over budget for the month by $2.1 million and includes the impact of the $2.0 million Cerner write-off. For the fiscal

year, total expenses were $1.9 million over budget. Excluding the Cerner write-off, expenses for the month and total year were in line with budget.

Expense variance detail for the month of June includes: Salaries/Wages/Benefits: $8,251 over budget, a variance of less than 0.2% The Cerner write-off directly impacted Supply Expense in the amount of $2.42 million, specifically Computer Software which rolls

up into the Supply Expense category. Prior to FY14, $400,000 in Cerner fees had been previously written off to Software Maintenance. Reversing that caused Repairs & Maintenance to show negative $191,000 for the month.

Interest expense: $61,000 over budget as the FY14 interest expense related to the Bond Defeasance was not known in time for inclusion in the budget

Other expense: $42,000 over budget due to physician clinic lease income (reduction in expense) not meeting budgeted expectations

Operating cash was $25.0 million as of June 30, 2014 and Days Cash on Hand was 168. From an overall cash receipts and disbursements standpoint, for FY14 in total, cash was managed well, with receipts exceeding disbursements by $7.8 million. Receipts totaled $88.6 million versus disbursements of $80.8 million. June Net A/R Days was 90 and includes the impact of a slow-down from the state Medicaid program which is causing Medicaid Days in A/R to be 21 days higher than normal.








Actual Prior Year Budget Actual Prior Year BudgetInpatient:Patient DaysPatient Days ‐ Med/Surg 301 425 373 3,352 4,107 4,167Patient Days ‐ Critical Care Unit 78 67 90 733 990 963Avg. Daily Census ‐ Acute 12.63 16.40 15.43 11.19 13.96 14.05Patient Days ‐ Obstetrics 72 89 102 960 973 1,200Patient Days ‐ Nursery 70 69 65 820 796 750Births 27 30 32 381 379 370Patient Days ‐ Mental Health Unit 280 215 255 2,707 3,017 3,193Avg. Daily Census ‐ MHU 9.33 7.17 8.50 7.42 8.27 8.75

Inpatient: AdmissionsMed/Surg 60 72 85 763 899 936Critical Care Unit 26 33 56 378 474 624Obstetrics 27 33 43 395 408 500Nursery 27 30 35 381 379 478Mental Health Unit 41 41 33 384 371 416Surgery:Inpatient Surgery Cases 43 62 65 596 708 717Same Day Surgery Cases 224 174 234 2,545 2,601 2,636Total Surgery Cases 267 236 299 3,141 3,309 3,353Total Surgery Minutes 15,327 15,240 20,034 205,939 222,096 230,280

Outpatient:Total Outpatient Visits (Hospital)Emergency Department Visits 1,400 1,365 1,340 14,384 14,795 14,500 Cardiac Rehab Visits 25 26 39 452 356 400 Lab Tests 7,528 8,072 9,586 89,686 93,563 107,000 Radiology Procedures 2,207 2,168 2,539 25,119 26,404 27,610 Sleep Studies 18 21 25 209 258 300

Rain Forest Recovery:Patient Days ‐ RRC 403 454 338 4,668 4,621 4,476 Avg. Daily Census ‐ RRC 13.43 15.13 11.28 12.79 12.66 12.26Outpatient visits 326 371 N/A 3,847 5,808 N/A

Physician Clinics:Specialty Clinic Visits 764 475 635 6,717 7,289 7,200

Other Operating Indicators:Dietary Meals Served 17,931 19,629 19,890 234,226 242,320 242,000 Laundry Pounds (Per 100) 321.79 310.57 316.67 3,559.01 3,799.78 3,800.00

Financial Indicators:Revenue Per Adjusted Patient Day 5,843.92 6,449.18 5,657.07 6,407.80 5,750.76 5,596.23Contractual Allowance % 29.84% 27.17% 26.90% 25.34% 27.42% 27.14%Bad Debt & Charity Care % 7.87% 5.58% 9.17% 8.49% 8.17% 9.25%Wages as a % of Net Revenue 35.93% 34.70% 34.71% 35.66% 36.91% 35.59%Staff Hours Per Adjusted Patient Day 37.61 43.14 37.48 44.77 38.26 38.34Overtime/Premium % of Productive 4.50% 6.05% 3.50% 4.98% 5.24% 3.50%Days Cash on Hand 168 153 120 168 153 120Days in Net Receivables 90 76 55 90 76 55

Facility Utilization:CURRENT MONTH YEAR TO DATE

Bartlett Regional HospitalDashboard Report for June 2014




Cash Summary for June 2014 Increase/(Decrease) in Cash

Current Month Year-To-Date

CASH RECEIPTS 6,599,021$ 88,561,422$

CASH DISBURSEMENTS:Payroll (Net Pay) 1,793,412$ 22,803,749$ Accounts Payable 4,280,968$ 44,844,592$ Other 129,195$ 11,772,573$ Bond/Lease Payment -$ 1,378,021$

Total Cash Disbursements 6,203,576$ 80,798,935$ NET CHANGE IN CASH 395,445$ 7,762,487$

BEGINNING BALANCE 24,534,480$ 17,167,437$

NET CHANGE IN CASH 395,445 7,762,487ENDING BALANCE - OPERATING CASH 24,929,924$ 24,929,924$

Board Designated FundsCapital Reserve Fund 8,741,530$ BRH CAMHU 2,500,000$ Insurance Deductible Fund 125,764$ Contributions 9,772$ New Bond Debt Service Reserve 1,686,975$ BRH Deposits 65,521$

13,129,562$ 38,059,486$

CBJ Appropriated FundsCIP 484,920$

CAMHU 5,000,000 5,484,920$

TOTAL CASH 43,544,406$


ProposedDescription of Item Department Budget Purchased Unused

Mental Health Acoustics NEW FAC 240,000$ -$ 240,000$

Condo-Housing for Locums, recruits, etc. FAC 230,000$ -$ 230,000$

Monitors Patient MP5 15 ea OR 197,688$ -$ 197,688$

Switch & UPS for Medical Arts Building IS 150,000$ 128,000$ 22,000$

Vitros 4600 Chemistry analyzer LAB 125,000$ 88,000$ 37,000$

Sterrad Gas Sterilizer NX - Vpro Max OR 115,000$ 164,709$ (49,709)$

Cisco Wireless and Network Control Hardware & software refresh IS 61,318$ 26,253$ 35,065$

Vehicle for Locums FAC 50,000$ 41,792$ 8,208$

Boiler Room Ventilation upgrades FAC 50,000$ -$ 50,000$

Co2 Hysteroinsufflator OR 44,500$ -$ 44,500$

Anesthesia Ventilator OR3 OR 40,861$ 67,174$ (26,313)$

Anesthesia Ventilator OB OR 40,861$ -$ 40,861$

Hospital Lobby Flooring FAC 40,000$ -$ 40,000$

ASU 15 Heating Upgrades NEW FAC 40,000$ -$ 40,000$

ASU 15 Duct Repairs FAC 40,000$ -$ 40,000$

Colonoscope Pediatric NBI OR 33,115$ -$ 33,115$

Tele monitoring system ED 32,033$ 32,033$ -$

Fax Server Upgrade IS 31,975$ 50,000$ (18,025)$

Bartlett Regional HospitalCapital Budget FY14

As of June 2014




As of June 2014

API Upgrade IS 31,850$ -$ 31,850$

Cafeteria Flooring FAC 30,000$ -$ 30,000$

Anesthesia Monitor MP70 OB OR 27,273$ 33,020$ (5,747)$

SDC Lobby Flooring FAC 15,000$ -$ 15,000$

Fluid Management System OR 13,000$ 87,123$ (74,123)$

Cisco Switchboard Console-Communications IS 12,400$ -$ 12,400$

3 ea CO2 monitoring modules ED 9,000$ 10,964$ (1,964)$

Cautery/Ligasure Valley Lab OR 8,000$ -$ 8,000$

TV's - Flatscreen (13) OR 7,723$ 7,380$ 343$

Dr Lounge Flooring FAC 7,500$ -$ 7,500$

Capintec Dose Calculator CRC-25R w/chamber NUC MED 6,842$ 3,770$ 3,072$

Portable slit lamp ED 5,000$ -$ 5,000$

Budget Total 1,735,939$ 740,218$ 995,722$

Unbudgeted Items: Department Proposed

Unbudgeted PurchasedPurchased Not Budgted

McKesson PACS Architecture IS $ 164,224 48,668$ 115,556$

NetApp Capacity Storage/PACS Archive Migration IS $ 67,280 41,950$ 25,330$

OB Tracevue OB 56,070$ -$ 56,070$




As of June 2014

T-System Upgrade IS 44,000$ 44,000$ -$

Olympus OTV Camera or Laparoscopic and Arthoscopic Procedures OR 27,664$ 27,671$ (7)$

Stryker System 6 Set OR 24,273$ 24,273$ -$

Fire Smoke and Damper Installation FAC 22,458$ 34,332$ (11,874)$

Olympus Scopes OR 21,562$ 21,562$ -$

Fusion Upgrade Project (Hardware/Licensing) IS $ 19,614 19,162$ 452$

Exhaust System in the Medical Gas Room FAC 13,957$ 13,957$ -$

4.0 Cannulated Screw Set OR 13,615$ 13,616$ (1)$

Mayfield - Spine Head Rest OR 13,562$ 12,714$ 848$

EKG EKG 11,432$ 11,432$ -$

Cardiac Rehab Remodel REHAB 11,000$ 11,000$ -$

Blanket Fluid Warmer ED 8,852$ 8,582$ 270$

Urine Analyzer LAB 6,500$ 6,500$ -$ Grand Total 2,262,002$ 1,079,638$ 1,182,365$


Monthly Operations "Dashboard" June 30th, 2014

15.50

17.50

19.50

21.50

23.50

25.50

27.50

29.50

31.50

Average Daily Census - BRH

budget 2012 2013 2014

4.00

6.00

8.00

10.00

12.00

14.00

16.00

Average Daily Census - RRC

budget 2012 2013 2014



3,000,0004,000,0005,000,0006,000,0007,000,0008,000,0009,000,00010,000,00011,000,00012,000,00013,000,00014,000,00015,000,00016,000,00017,000,00018,000,00019,000,00020,000,00021,000,00022,000,00023,000,00024,000,00025,000,00026,000,00027,000,000Operating Cash

budget 2012 2013 2014

(20.00)

(15.00)

(10.00)

(5.00)

-

5.00

10.00

15.00

20.00

25.00Net Margin %

budget 2012 2013 2014



25.00

30.00

35.00

40.00

45.00

50.00Salaries & Wages as a % of Net Revenue

budget 2012 2013 2014

40 45 50 55 60 65 70 75 80 85 90 95

100Net AR Days

budget 2012 2013 2014



390.00

405.00

420.00

435.00

450.00

465.00

FTEs

budget 2012 2013 2014

-

1.00

2.00

3.00

4.00

5.00

6.00

7.00

Overtime Premium Percentage

budget 2012 2013 2014



20.00 22.50 25.00 27.50 30.00 32.50 35.00 37.50 40.00 42.50 45.00 47.50 50.00 52.50 55.00 57.50 60.00

Staff Hours per Adjusted Patient Day

budget 2012 2013 2014

15.00

20.00

25.00

30.00

35.00

40.00Total Revenue Deduction as % of Patient Revenue

budget 2012 2013 2014





Bartlett Regional HospitalCapital Budget 2014/2015 FYDepartment: Respiratory Therapy 6170

Estimated Number Total AttachedDescription of Item Priority Cost of Units Cost Brief Summary of the Necessity for the Item ROI (Y or N)

Respironics‐‐Bipap Auto biflex 1 $3,564 3 $3,564 Currently patients are brining their own cpap units into the Nhospital with them when they are admitted. This is an Infection Control and risk management problem; in addition,non‐compliance, ineffective equipment, illness progressionmay have surpassed the theraputic pressure setting, or more may be contributing to their illness. RT will be able to adjust these units and generate a printout report of the pt'sadaptation to therapy. They will not be an infection controlor risk management issue and maintained in the hospital.

Carefusion‐‐PFT* upgrade 2 $5,441 1 $5,441 Software for this (existing) unit is based on XP operating N*Pulmonary Function Testing system, which will no longer be supported. We need to

upgrade OS to a level that can be supported. In addition, there are multiple 'glitches' that occur in the processing ofthe data during the testing; this causes rework and lowersproductivity and quality.

Covidien‐‐840 model ventilator upgrades 3 $61,009 3 $61,009 Software upgrades to existing ventilators to improve N New quote INCLUDES a new ventilator plus upgrades$54,984 $54,984 efficiency and increase capability to function with neonates.

We currently have two neonate compatible vents; recentlyone was out of service, leaving us with only one vent if weneeded it for a newborn. All three vents will be capable of treating neonates, pediatrics, and adults.

Covidien‐‐new 840 ventilator 3 $23,310 1 $23,310 We need to replace our Covidien 7200 ventilator (end of N Don't need this as it is included in above quote.life)

Philips‐‐V‐60 bipap units 2 $24,000 2 $24,000 Our bipap Vision units are end of life; need replacements. NThe Vision units are still working and we will keep them in service as long as they run, but will have the new units to fall back on when these fail.

Total $117,324


2

thickness, and the ability to go to a lower floor level for getting in and out, thus reducing risk for falls. That is the particular model we are now requesting 2 of the Progressa beds. Over the most recent months we have seen the real advantage of having a trapeze or “patient helper” at the head of bed (HOB) to increase mobility of the patient, and assist us in their movement. While in the past this has not be a product of critical care because of its inability to be removed to reach the HOB in an emergency, this is now available. We hope to add this attachment to as many beds as possible to improve patient self‐care and mobility. We would like to have this attachment starting now on any new beds. They are approximately $700 a piece and will be additional to the base cost of the bed. They are sold separately from a different company than Hill‐Rom. Please give your consideration to the urgent need of being able to fully supply the CCU with appropriate beds. Thanks, Rhio Rhio Imboden Harper RN CCRN RN‐BC Clinical Assistant Manager, CCU Bartlett Regional Hospital [email protected] 907‐796‐8980


1

Anita L Moffitt

From: Rose LawhorneSent: Thursday, July 17, 2014 11:48 AMTo: Toni R Petrie; Anita L Moffitt; Alan W. GermanySubject: CCU bed justification/requestAttachments: HRCPRO_12576266.pdf

I have provided the quote for two Hill‐Rom beds with added trapezes. Below is Rhio Harper’s justification. The Hill‐Rom rep will be unable to provide final shipping costs for at least a couple more days. See attached for the original quote for 6 beds with shipping included. # ITEM UNIT PRICE TOTAL 2 Progressa Beds PRO‐885 (see attached for specs) $ 41,620.74 $ 83,241.482 Trapezes 700.00 1400.00 Estimated shipping 1100.00 Total cost $ 85,741.48

Thank you for your consideration. Rose Lawhorne, RN, CEN, CPEN Director of ED, CCU, Cardiopulmonary Rehab & Physical Rehab Services Bartlett Regional Hospital Phone (907)796‐8310 Fax (907)796‐8444 From: Rhio I. Harper Sent: Thursday, July 17, 2014 11:19 AM To: Toni R Petrie; Rose Lawhorne Subject: RE: CCU Bed info request for tonight's finance meeting My justification for needing new beds in CCU is related to the aging out of the bed and the repairs needed for them. All are requiring servicing to the tune of few thousand dollars a month in service cost. This last week 4 out of 9 beds were out of service. This reduces our ability to accommodate patients and could impact revenue if the beds are not replaced. We are now waiting for special parts to arrive from a different repair service, as Hill‐Rom, the manufacturer, is on back order for some time. 2 beds are 20 years old 3 beds are 11 years old 3 beds are 7 years old 1 bed is 3 years old We have found the new series Hill‐Rom critical care bed “the Progressa” to be ideal for us. While it offers high levels of care for our most sick, it now incorporates better mobility features for better early movement of the patient. We have recently been using the added percussion module on out patient with good pulmonary improvement. While this bed meets the weight standard for our obese patients (equal to our bariatric bed), it has the advantage of smaller mattress


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Attn:BARTLETT REGIONAL HOSPITAL3260 HOSPITAL DRATTN: ACCOUNT PAYABLEJUNEAU AK 99801

Customer #: 624444

PROGRESSA

PROPOSAL #:Proposal Date:Expiration Date:

sP 7257626606123120t40812312014

ql/ .

P:roduct Information

4 PROGRESSAPRO-855 Chair Egress Frame Design

OPTIONS :StaylnPlace Patient Migration Management System

(PMMS)PPM,3 Level Advanced Bed ExitRotation ModuleAdvanced MicroClimate MgmtPoint of Care Touch ScreensEnglish Language LabelsVoltage: 120Progressa Power Plug NEMA5-15P (US)Accessory OutletCaregiver Pendant YesCLRT PulmonaryCaregiver Foot Controls5th WheelSteeringIn Bed-ScaleStraight Power CordNurse Call, Universal WNavicare ReadyPermanent IV Pole Left SideO2 Tank Holder Module

********xxxx***** ******* *** ***

OPTIONS INCLUDED IN ABOVEBase Package 36900,00Sidecom........ 623,205th Wheel..... 649.44Permanent IV Pole left side... 168.10

PRO-885 Chair Egress Frame DesignOPTIONS :

StaylnPlace Patient Migration Management System(PMMS)

PPM, 3 Level Advanced Bed ExitPercussion & VibrationRotation ModuleAdvanced MicroClimate MgmtPoint of Care Touch ScreensEnglish Language LabelsVoltage; 120Progressa Power Plug NEMA5-15P (US)

For Questions / Correspondence Please Contact:Hill-Rom Customer Service @ 800-,+45-3730Fax: 812-934-8189Architectural Prod ucts Fax: 872-93L-2264Email : [email protected]

Your Account Rep.: JACK KOWALMobile Phone #: +! 907 350 9354Email : jack.kowal@hil l-rom.com

Unit Price Extended Price

$38,340.74 $153,362.96

4I,620.74 83,24t.48

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Attn:BARTLETT REGIONAL HOSPTTAL3260 HOSPITAL DRATTN: ACCOUNT PAYABLEJUNEAU AK 99801

Customer #: 624444

Qty Product Information

Accessory OutletC:regiver Pendant YesFull PulmonaryCaregiver Foot Controls5th WheelSteeringIn Bed-ScaleStraight Power CordNurse Call, Universal WNavicare ReadyPermanent IV Pole Left Side02 Tank Holder Module

x x** *******xx****** * **** *** ***

OPTIONS INCLUDED IN ABOVEBase Package 40180,00Sidecom,,,..... 623.205th Wheel..,,. 649.44Permanent IV Pole left side,,. 168.10

FREIGHTCHARGE FREIGHT

For Questions / Correspondence Please Contact:Hill-Rom Customer Service @ 800-445-3730Fax: 812-934-8189Architectural Products Fax:. Bt2-93I-2264Email : [email protected]

Your Account Rep.: JACK KOWALMobile Phone #: +t 907 350 9354Email : jack. kowal @hill-rom.com

Unit Price Extended Price

PROPOSAL #:Proposal Date:Expiration Date:

sP 1257626606123120t40812312074

Thank you for your interest in Hill-Rom products

2,563.98TotalOrder(USD)

2,563.98239,168.42

1p69 S&tr r8CI{.de.,16. Cast 8at€sui&*lt{.4@6:9167 800.445.3730 ttlrw&tlill:rooUCorD


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YTRSVIS &ru* CSN**?ICINS

Prices:Pr icesonHi| | -Rom,sproposa|aresubject tochange,un|esstheproposa|statesthatpr ic ingisrmthroughaferthee)pirat iondate, thepr iceinef fectat thet imeoftheprovides a tax-e)Gmpt certificate (resale certificate) to Hill-Rom with respect to such taxes. Applicable ta)€s will be calculated and billed at lime of in\/oicing.cance| |at ion:Thiscontraclwhensignedisanagreementofperformancebybothpart ies. |ntheeventei therpartyrequestsaterminat ionPaymentTerms: |n\ ,o icesarepayab|enet th i r ty(30)daysfromdateof inVoice.Un|esswai \€dbyHi |FRominwri t ing 'the lesser of (i) one and one half percent ('l 'll2%) per month or (ii) the maximum rate allowed by law. Customer agrees to pay Hill-Rom for any and all costs and e)penses (includingwithout | imi tat ionreasonab|eat torneys' fees) incurredbyHi | | -Romtoco| |ectanyamountsowedtoi t ,enforceanyof i tsr ightsorseekanyof i lsremediescustomerhasdirectedthat thechargeshereunderbebi | |edtoanotherpersonororganizat ion,andpayment isnotmadebysuchpersondate,customersha| |st i | | remain| iab|ehereunder 'customerisadvisedthat thecustomermaybeob| igatedtoi tsco3tsc|a imedorchargesmadetofedera|(e.g 'Medicare)orstate(e.g.Medicaid)hea| thcareprogramsrequir ingmay not reflect the net cost to the Customer. Customer shall make written request to Hill-Rom in the event Customer requires additional information in order to meet applicablereporting or disclosure obligations.|nsta| |at ion:Un|essotherwiseagreedinwri t ing,customersha| |performanyinstainstructions and information to assist with the installation and/or first operation of the products.L imi tedWarranty:Forspeci fcwarranty informat iononHi| | -Romproductsandparts,p|easeseeowner 'smanualorreviewmanua|son| ineatourwebsi te,w.h| |From.com.THEFOREGOING WARRANTY CONSTITUTES THE SOLE WARRANTY MADE BY HILL-ROM AND IS IN LIEU OF ALL OTHER REPRESENTATIONS OR WARRANTIES EXPRESS ORIMPLIED OR STATUTORY, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, AND ALLOTHER REMEDIES. IN NO CASE SHALL HILL-ROM BE LIABLE TO CUSTOMER OR ANY THIRD PARTY FOR INDIRECT, SPECIAL, CONSEQUENTIAL OR INCIDENTALDAMAGES OR DELAYS. NO EMPLOYEE OR REPRESENTATIVE OF HILL-ROM IS AUTHORIZED TO CHANGE THIS WARRANTY IN ANY WAY OR GRANT ANY OTHERWARRANTY.Product|nterface:customersha||beresponsib|eforensuringtocustomer.ssatiproductsproper|y inter faceoroperatewithHi | | .Romproducts.Hi | | -Romsha| |notbe| iab|etocustomeroranytthird party equipment and accessories with Hill-Rom products.Limitation of Liability: Hill-Rom shallfrom any such cause shall extend shipment date correspondingly. lN NO EVENT SHALL HILL-ROM BE LIABLE FOR SPECIAL, INDIRECT, INCIDENTAL, OR CONSEQUENTIALDAMAGES, EVEN lF lT HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. THIS CONTRACT lS BETWEEN CUSTOMER AND HILL-ROM. Customer must makec|aimsforshortagesorerrorswi th inareasonab|et imeaferreceiptof theproducts.Hi |FRomreserVesther ight tospeciflcations and are warranted as new.Secur i ty lnterest ,Defau| tandlnsurance:Hi | | -Romsha| | reta inasecur i ty interestde| iver toHi | | .Romanyaddi t iona|documentsrequiredbyHi | | -Romtoprotect iconf iscat ion, thefu| |amountunpaidsha| | immediate|ybecomedueandpayab|eat theopt ionof theHi | | -Romando' theproductswherever|ocatedwithoutcourtorderandcanrese| |orreta inaccordingtothe|awsofthestateWhereproductsare|ocated.Theproductssha| |nbecons|deredafxturei fathchedtoanyrea| ty.customersha| |assumea| | |ossre|at ingfromdamagetotheproductsoccurr ingafer theproducts|eaveinsurancethereforeata| | t imesunt i | thepurchasepr icesha| |havebeenfu| |ypaid.Hi |Romwith a statement from such insurer limiting cancellation or changes to said policy within ten (10) days after wriften notice of same to Hill-Rom.specifications:specificationsanddrawingsandanyotherinformationsha||orusedformanufactureofanyproducts. lnaccordancewithHi | | -Rom'sestab| ishedpo| icyofconstant improment 'without notice.Merger: These terms and conditions supersede any inconsistent agreements and understandings, oral or written, between the parties, including any terms and conditions in anydocumentat ionsubmit tedbycustomertoHi | | -Rom,un|essagreedtoinwr i t ingbyanauthor izedrepresentat iofHany further purchase orders, Hill-Rom will have no obligation to accept or otherwise honor any such purchase order.Acceptance:Thiscontract iSsubject toHi | | .Rom.sappro\ ,a|ofcustomer 'scredi t .Wri t tennot jcesha| |begi \€ntocustomerwith indeemed' is theso|ediscret ionof theHi | | -Rom,tobeunsat isfactor .Thiscontractofpurchaseandsa|ebetweenthecustomerandHi| | -Romre|at ingtoeshall be subject to and shall include the terms and conditions hereof.Choice of Law: This contract shall be governed by, and construed in accordance with, the laws of the State of Indiana.Deliver and Shipment Date of deli\€r shall be determined by mutual written agreement of the parties. No deli\€r date set forth in a Purchase Order shall be binding on Hill-Romun|essHi | | -Rome>rp| ic i t |yagreestosuchde| i \ ,erdateinawri t ingsignedbyanauthor izedrepresentat jofHCustomer,wi tha| |costsof t ransportat ionandre|atedinsurancebeingtheresponsibi l i tyofHi | | -Romwiththeeept |onshipmentstopointsouts idethecont i9uousU.s ' ,or( i i i )specia|de| i \ ,erand/orai rshipmentsrequestedbycustomer.Un|essoeMisesignedbyanauthor izedrepresentat iveofHi | | -Rom,Hi | | -Romwi| |prepayandaddtotheinvoiceforre imbursementbycustomeranyandde| iverofserv iceparts,shipmentstopointsouGidethecont iguousU.s ' ,andanyspecia|de| iverand/orai rshipmentsrequestedbycustomer.TermsforshippingtoAlasandHawaii shall be F.O.B. port of embarkment, prepaid and add from port of embarkment to destination.ReturnGoodsPo| icy:shou|dHi | l -Romshipproducts inerror ,Hi | | -Romshal |arrangeandpayforreturnshipmentof theproductswi thoutapp|y ingacustomernot i fesHi |FRomoftheerrorwi th inth i r ty(30)daysofshipment;and( i i ) theHi | | -Romoftheerrorwi th inth i r ty(30)daysofshipment,customermayreturntheproducts in,asshipped,,condi t ionatcustomer 'scostande}pense;howeraof net price will be applied. Notwithstanding tcustomized products or special orders only if and on the terms negotiated and agreed by the parties on a case by case basis.orderCance| |at ionPo| icy:Customermayon|ycance|apurchaseorder i fCustomerprovideswri t tenn|cetoH|| | -Romand if Customer cancels an order, Customer agrees to pay Hill-Rom a cancellation fee of 15% of the net price for the cancelled products. No purchase orders may be cancelled afterfourteen(14)dayspr ior totheschedu|edshipmentdate.Notwi thstandingtheaboVe,cance| |at ionswi | |benotbeacceptedonarchi tectura|produc'communications products, and any customized products or special orders, e)cept if mutually agreed on terms acceptable by both parties on a case by case basisDe| iverchange/Refusa|Po| icy:customermayrequest toreschedu|easchedu|edde| iverdatetoa|aterdatebyprod|ngH||FRomwtotheschedu|edde| iverdate. | fcustomerrequestsatanyt imetoreschedu|ethede| iverdatetoanewdatethat ismorethanthi (3date,customeragreestopayHi |FRomareschedu| ingfeeof15o/oof thenetpr icefor theaf fectedproducts ' l fcustomerrefuwith a written request to reschedule at least fourteen (14) days in advance, Customer agrees to pay Hill-Rom a rescheduling fee of 1 5% of lhe net price for the afected products.

Ordering: All Purchase Orders may be placed by mail, telephone or facsimile at the following:Hill-Rom Company, Inc.Aftn: Customer Service1 069 State Route 46 EastBatesville, Indiana 47006Phone: 800/445-3730Fax: 812/934-8189

Hill-Rom CompanyAttn: Customer Service

1705 Tech Avenue. Unit 3Mississauga, Ontario L4W 0A2Phone: E00-267-2337

Telefax: 905-206-0561


August 2014 Sunday Monday Tuesday Wednesday Thursday Friday Saturday

1 2

3 4 5

6

7

N-Compliance Committee BR

8 9

10 11 N-BRH Foundation BR

12

7:00-Credentials Committee BR

13

N-Quality Council BR

14

N-Planning Committee BR

15 16

17 18 19

20 21

5:15-Finance Committee BR

22 23

24 25

26

5:15-Board of Directors BR

27 28 29 30

31


Documents

July 22, 2014, Board Meeting