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1989-10-18 Regular MeetingI ADVISORY BOARD REGULAR MEETING OCTOBER 18, 1989 I. CALL TO ORDER: 7:05 PM PRESENT: Wilton White, Gretchen Saupe, Lonnie White, Dr. Bob Johnson, Bill Hogan, and Betty Springhill; absent -Ben Ardinger; also present: Don Wee, Margaret French, and Kate Fitzgerald; guest -Dr. Rene' Alvarez. II. ACCEPTANCE OF AGENDA: Added to Old Business: A. Smoking Issue; B. Hospital Funding. Dr. Alvarez will address his letter under IV. Appearances & Communications. Agenda accepted as modified. III. MINUTES OF PREVIOUS MEETINGS: A. Special Meeting, 9/27/89; unanimously accepted. B. Finance Meeting, 9/28/89; unanimously accepted. C. Regular Meeting, 9/20/89; unanimously accepted. D. Joint Conference; 9/18/89; Stands approved. E. QA Minutes, 10/13/89; Stands approved. QA Committee Chairperson Gretchen Saupe announced the Committee will be meeting regularly bi-monthly the Thursday before the Board Meeting. Chairman White stated the meeting was being recorded. IV. COMMUNICATIONS & APPEARANCES A. Dr. Rene' Alvarez & Letter to the Board: Chairman White addressed Dr. irez and members receipt of his letter at the meeting. Dr. Alvarez read letter which addressed his concern regarding anesthesia coverage. Various points were addressed in a lengthy round table discussion between Dr. Alvarez and each board member. 8:10 Dr. Alvarez left. 8:15 - 8:20 break Don gave review to the initial situation and reporting process it went through. More discussion occurred on anesthesia situation and coverage. Don will receive a proposal for the anesthetist, this will be brought to the Board. 8:40 Dr. Bob excused; asked the anesthetist issue be resolved as soon as possible. V. NEW BUSINESS A. Financial/Stats, August, 1989: Don went over financial stating another net loss experienced in August of $176,417.00. Now we are $50,000 under the cash flow we expected. Some measures have been taken: business office staff has cut hours; not filling slot in respiratory care; nursing is on productivity system; hope to put other departments on productivity system. Re/management fee: Chairman White doesn't understand about the management company saying they offer more services and not seeing we have assumed more costs, and the fact the fee has not been reduced. Why are our expenses so high and we are running a deficit while our revenue is up if we haven't assumed more costs? Don responded re/expenses :affecting us the most: m=lpractice, legal fees, health insurance, increases In wages, training new Ff, contractual deductions, recruitment. Stated the #1 priority is dying revenue picture of departments that don't have charge system set up. dvisory Board, 10/18/89 2 Don shared graphs on patient days, admissions, length of stay with the Board. The present trend is shorter hospital stays, more outpatients. Room rates discussed. Don stated med staff agreed our rates were too low. Don's recommendation on hospital loss: Reduction of expenses and increase of revenue, especially if we're going to support the services being discussed (home health, CT, ER doctor). September --looking at a big loss because of low revenue. Betty requested joint Board/KIB work session. Discussed for later part of November. Lonnie will set up. Don will advise Finance Committee when budget .is ready. Lonnie said to be prepared to state basis to KIB for wanting subsidy. VI. OLD BUSINESS A. Smoking Policy: Gretchen urged Board support for non-smoking facility policy, stating state epidemiologist (Dr. Marvin Bailey) who recently visited to speak on AIDS was appalled at our allowance of this knowing dangers of 2nd hand smoke. Gretchen encouraged use of small locker room if smoking is allowed. MOTION #1: GRETCHEN MOTIONED TO REMOVE SMOKEATER 8 PUT ITIN SPECIAL ROOM DESIGNATED FOR SMOKING AREA AND NOT ALLOW SMOKING IN THE CAFETERIA. SECONDED BY BETTY. DISCUSSION ON THIS. YES: Gretchen, Lonnie, Betty NO: Bill, Wilton MOTIONED DEFEATED; LACKED REQUIRED MAJORITY. ,40TION #2: GRETCHEN MOTIONED FOR MANAGEMENT TO INVESTIGATE THE USE OF SPECIAL ROOM FOR SMOKING AREA WITH ESTIMATED COST OF MOVING THE SMOKEATER. SECONDED BY BETTY. YES: Gretchen, Lonnie, Bill, Betty, Wilton. NO: None opposed. MOTION PASSED UNANIMOUSLY B. Hospital Construction Fund: Lonnie White again encourage Board to consider moving reserve fund to KIB at the recommendation of Sterling Gallegar (and assembly) and identify it for new hospital. It will show state the readiness for project. He also said be prepared to discuss this with assembly. After discussion on restricting the fund to hospital or/& hospital equipment, and having access to a portion of it, the Board generally agreed with the idea. VIII. ADMINISTRATOR REPORT A. CT SCANNER. Don reported he and Dr. Tschersich went to Anchorage to visit GE CT Scanner at Diagnostic Imaging Center; will look at Toshiba & Picker before end of year. Toshiba has the potential of fee "per slice." Discussion on present new GE Xray equipment and the frequent "down" time due to malfunctions. Because of this track record, GE is less desired. Discussion on leasing. Margaret stated there appears to be a higher payback from Medicare if it's leased and not owned. Security contract for night guard has been cancelled, effective 10/31, due to finances, have two male nurses on night shift, and do have Sage ecurity, and due to turnover problems. HAA has filed joint suit against Medicaid re/setting Medicaid Upper limits. 9visory Board, 10/18/89 g IX. BOARD COMMENTS Gretchen: In spite of negative issues, some good things are going on in hospital. Have good report from State. Lonnie: KIB has put hospital 14 million dollar project as #1 priority and plans meeting with City to jointly do same. Bill: No comment. Betty: Home health program going? Still recruiting. Neseth/nothing new. Solarium/no update. Litigation/ no update. Carpet/Bid due in 10/20. Xray billing/was negotiated. Wilton:. Can Board members individually address dept heads with questions and visa versa. Don expressed his feeling they go through him because he was concerned about Board being involved in day to day operations. Board should go through administrator as a courtesy --this is normal protocol. Discussion on each department head coming to meeting and giving lo" presentation. Board concurred with this idea. a ded by Beth Stohl-Reiland retchen Saupe, Secretary