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1991-03-27 Regular MeetingOJ KODIAK ISLAND HOSPITAL ADVISORY BOARD MEETING MARCH 27, 1991 PRESENT: Ben Ardinger, Gordon Gould, Dr. William Brewer, Betty Springhill, Wayne Stevens, Jeannie Volker, Jan Blanton, Inter- im Administrator, Keith Vorachek, Finance Manager. Also present were Drs. Bringgold and Mickleson. ABSENT: Gil Bane, Gretchen Saupe, Lorne White The meeting was called to order at 7:00 P.M. ACCEPTANCE OF AGENDA: Moved and seconded to accept the agenda. Motion Carried. APPEARANCES AND COMMUNICATIONS Chairperson Springhill shared a letter from Joe Smith in which he stated that he was pleased to announce that Edmon Myers had accepted the position as Administrator. He also requested that a speaker phone be placed in the Conference Room so that when necessary, he could participate in the Board meetings. The Recording Secretary was asked to make the necessary arrange- ments for installation. In his letter, Joe Smith requested that an all -hands employee meeting be called for April 15 to meet with Mr. Myers. The Board members are invited to attend that meeting. Ms. Springhill reported that House Bill. 159 (facility funding) had passed to the Finance Committee and that there was a teleconference regarding this issue scheduled for April 4 at the Legislative Information Office. Dr. Bringgold spoke of his concern regarding the issue of medical malpractice and asked if a system such as the hospital's self-insured trust could be devised for the medical staff. An explanation of how the hospital came to be self-insured was provided. Dr. Bringgold stated that he would like the hospital to communicate its concern for the number of ungrounded suits being filed against the medical staff. After discussion, Wayne Stevens suggested establishing several joint work sessions of the Borough, Board, Medical Staff, LHS management, and legal counsel to discuss what medical malpractice coverage presently is, ways to remedy the number of nuisance suits filed, and how the medical staff and hospital might support tort reforms. It was determined that a Joint Confer- ence Committee meeting comprised of the above groups would be scheduled after Mr. Myers' arrival. Advisory Board Meeting March 27, 1991 Page'Two Jan Blanton shared a letter he had received from Fred Zharoff in which Sena- tor Zharoff reiterated his support for the new facility. 1 01 DON1► U I I►Ili 11—_ Mr. Ardinger requested that the meeting minutes of March 13, 1991 be amended to reflect that he felt that an Ears, Nose and Throat Specialist needed to "perform surgeries in Kodiak" rather than "hold clinic". Jeannie Volker moved that the minutes of March 13, 1991 be approved as amended. Ben Ardinger seconded the motion. Motion Carried. • I I ILM M ' • � _ Finance Committee: Keith Vorachek reviewed the February financial state- ments. Although total revenue was under 12 1/2% of the budget estimate, expenses for the hospital were decreased by 14 1/2%, resulting in a $1,600 net loss for the month. The Care Center experienced a 6% revenue increase over budget, resulting in a $19,000 net gain for the month of February. Mr. Ardinger pointed out that uncollected revenues and unrecoverable accounts receivables, including those incurred by indigent patients, are included as part of the financial statement and that these figures affect the bottom line loss figure. He stated that if these figures were excluded, that the facili- ty would not show a loss. He stated that he felt the Borough should be aware of these unrecoverable and uncollected accounts receivables and take them into consideration when reviewing the financial statements. Mr. Vorachek reported that the March financials, although not as good as those of February, appeared to be positive. The C/T Scan is on line and generating revenue. He reported that the facility has gone back into the budget process in order to align with the Borough's fiscal year. It was suggested that a statement regarding the length of time it could take for Medicare to reimburse the hospital be placed on patient billing notices to alleviate patient concerns that their medical care had not been paid for. It was also suggested that Medicare patients be requested to send the busi- ness office a copy of the notice sent to them by Medicare that the facility had been reimbursed for their care in order that such a notation could be made in the file. OLD A. RIH 2000 The Board will meet with Nancy McMurtry on April 5, 1991 at 6:00 p.m. in Room 129 of the Benny Benson Building of Kodiak College. Advisory Board Meeting March 27, 1991 Page Three B. surgeon Recruitment Mr. Blanton reported that a letter of agreement has been signed by Dr. Mason and that pending reference checks, Dr. Mason had been tentatively granted staff privileges. He stated that Dr. Bob Johnson had offered office space in his clinic for Dr. Mason. Mr. Blanton reported that he had consulted with the medical staff, and with one exception, that the medical staff felt that this would be an appropriately neutral location for Dr. Mason's office. C. Facility Mission Statement Wayne Stevens moved that the following mission statement be adopted by Kodiak Island Hospital & Care Center: "The mission of Kodiak Island Borough Hospital and Care Center is to provide quality, affordable inpatient, outpatient and long term health care services to all persons who seek them." Jeannie Volker seconded the motion. Motion Carried. D. Emergency Room Report Dr. Lynn Mickleson, E.R. Medical Director, reviewed changes in the E.R. billing structure which will be implemented. He compared the present billing sheet with the proposed billing sheet, explaining how various E.R. procedures, nursing services, drugs and equipment used would be billed. A comparison of the existing and proposed billing structures was shown. Dr. Brewer asked what portion of E.R. charges were uncol- lectible because of bad debt. Dr. Mickleson stated that approximately 30% of E.R. charges were unrecoverable as bad debt. NEW Mr. Ardinger stated his concern regarding the amount of payment made to E.R. physicians. Mr. Blanton stated that a proposal comprised of five possible E.R. physician scenarios had been sent to LHS for review. This will be an item of discussion at the next board meeting. Dr. Bringgold stated that the physicians have been discussing various options regard- ing this situation as well. He cautioned against the hospital competing with the clinics for primary patient care services. Mr. Stevens stated that he felt progress had been made to reestablish cooperation between the Medical Staff, Board and Borough and that these issues should be discussed with all parties pertinent to the action present. Moved and seconded to postpone regular meeting of Hospital Advisory Board scheduled for April 10, 1991 to April 15, 1991 in order that Edmon Myers and Joe Smith be able to attend. Motion Carried. ADNDNISTRATOR'S REPORT As attached. Advisory Board Meeting March 27, 1991 Page Four AUDIENCE COMMENTS None Ben Ardinger asked that at the ComFish event in 1992, that the Hospital have information or a video on hypothermia. The proceeds of the Pillar Mountain Golf Tournament will go toward the purchase of hypothermia equipment. There was a general discussion of the hospital's participation in COmFish. Wayne Stevens stated that if the facility wished to make a commitment to participate in the 1992 ComFish event, that the Chamber would ensure that the hospital would be placed in an area which could be expanded to include a first aid station. Jeannie Volker moved and Ben Ardinger seconded that the Hospital participate in the 1992 ComFish event and provide a first aid sta- tion as well as a hospital booth to be staffed by the Advisory Board, staff and Auxiliary. Motion Carried. Wayne Stevens stated that he had been contacted by the local newspaper re- garding the status of surgeon recruitment. He stated that he felt who the spokesperson for the Hospital Advisory Board is needed to be clarified. It was the consensus of the Board that the Chairperson of the Advisory Board should serve as spokesperson for the Board, and that the Administrator should serve as spokesperson for the Hospital. Mr. Stevens noted that the newspaper felt there were some areas concerning the hospital which needed to be addressed. Jan Blanton, Betty Springhill and Wayne Stevens will meet with Andy Hall of the Daily Mirror on March 28 at 3:00 p.m. to address these issues. Dr. Brewer asked what his status on the Advisory Board was. He was informed that he has full voting privileges on the Board. A question regarding the facility's policy on employee alcohol/drug use was raised. Administration was asked to research this question and present the facility's policy to the Board at the next meeting. 1 • l: ►lu 1 ►Y Meeting adjourned at 9:30 p.m. Recorded by Debra Raper. Cktwecc__ Jeanrl a Volker, Secretary/Treasurer ADDIINMURATOR'S REPORT MARCH 27, 1991 SURGEON INTERVIEWS: Dr. Roger Mason visited the facility and island March 7 & 8. He was favorably impressed with the island as a place to live and work. He feels he could be satisfied professionally. In a conversation, he indicated to me that he would need relocation expenses, malpractice coverage expenses, office management and billing, personnel expense coverage, and would be flexible concerning a minimum income guarantee. UNION NEGOTIATIONS: The negotiator for the hospital, Joe Smith, and the Union negotiation team reached an accord which will be presented to Union members for ratification on Friday, March 15th. The negotiations were completed without the presence of Mr. Baird, saving the facility a large attorney fee. LITIGATION: At present, the Hospital has been named in two suits as defendants. One of them is an extremely long standing suit. We also have been notified of an intent to file "suit" against the Hospital and a CRNA. HOSPITAL VAN: We called the company Monday and they said the van would be finished in a week and would arrive in Oregon four (4) days thereafter. The company has arranged for for shipment to Kodiak. KAVA: I am presently in negotiations with KANA to contract for Laboratory and X-ray services at a reduced rate in return for receiving all of their outpatient diagnostic services. This will also forestall additional diagnostic equipment acquisition by KANA. KCA: We have made an offer to support KCA's needs for a "non-medical" detoxification room in the Hospital. They would pay us for an empty room to be available and we, in turn, would not bill them for one day of the fust five days of service. Their patient would be required to test for alcohol and drugs prior to delivery of service. KIH would also be an additionally named insured on the KCA Liability Insurance policy. Any guard services required for these patients would be a "pass through" cost. ADMINISTRATOR INTERVIEWS: All three administrator candidates met with the hospital and medical staffs prior to their evening meeting. Mrs. Anne Kalcic arranged an excellent tour of island facilities for the candidates' wives and then co -hosted a Hospital Auxiliary Tea. After deliberation, the Advisory Board recommended that an offer be extended to Mr. Myers. To date, no response has been received.