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1991-10-09 Regular MeetingKODIAK ISLAND HOSPITAL ADVISORY BOARD MEETING OCTOBER 9, 1991 PRESENT: Ben Ardinger, William Brewer, Gordon Gould, Gretchen Saupe, Betty Springhill, Wayne Stevens, Keith Vorachek, Financial Services Administrator, Kate Fitzgerald, PCA, Pam Foreman, Director of Human Resources, Corlene Hogg, Director of Ancillary and Patient Information Services, Dennis Grosulak, Radiology Department Manager, Pam Kelly, Medical Records Department Manager. Also present were Anne Kalcic, Co -President of the Auxiliary, Angie Raines and Carol Coombs, High School Students, and Jim Wilson. ABSENT: Jeannie Volker, Lorne White, Ed Myers With a quorum present, the meeting was called to order at 7:03 p.m. ACCEPTANCE OF AGENDA: Moved, seconded and carried to accept the agenda. APPEARANCES AND COMMUNICATIONS Dennis Grosulak reported that the Radiology Department has been perform- ing more mammograms in the past several months. Pam Kelly reported that the Medical Records Department is running out of storage room and a project is underway to microfilm old records. She stated that she was appreciative and supportive of the Board. Anne Kalcic requested that a new "wish list" be drawn up for presenta- tion to the Auxiliary. She asked that these be items which have not budgeted for and which would not be purchased otherwise. Ms. Springhill read a communication from Al Reiners, LHS Management Company, regarding his visit to the facility. Topics in the letter included audit/cost reporting, change of fiscal year, payment by Borough for audit performed by Price Waterhouse on 6/30/91, status of business office. He stated in his letter that the probationary status of Keith Vorachek as Finance Director would be removed in October. In his let- ter, Mr. Reiners stated that he felt the priorities of the facility were increasing cash flow and completing the Medicare cost report. He stated that he anticipated that his next visit to the facility would be in December of 1991 or January of 1992. Advisory Board Meeting October 9, 1991 Page Two MEETING NENUTFS Moved, seconded and carried to add the following sentence be added to paragraph 4 under "Administrator's Report": "No official action was taken nor required by the Board." Moved, seconded and carried approve the meeting minutes of September 2S, 1991 as corrected. CONUMTrME REPORTS Corlene Hogg reported that the Quality Assurance Committee had met this date and worked on planning Quality Assurance activities for the next twelve months. She stated that the committee will be incorporating results of the State Survey into their activities. She reviewed the Patient Care Quality Reports and answered questions regarding specific areas. The next committee meeting will be scheduled in December. Mr. Gould stated that he felt it was important that the results of the Patient Care Quality Reports be shared with the Assembly. He also stated that he felt that it was important to address the results of the Community Survey and Business Survey with the Assembly, so that members would be aware of the positive results of the surveys, noting that two members of the Assembly had voted against the new hospital as being of top priority for the Borough this year. Ms. Hogg stated that there were confidentiality issues with regard to the Patient Care Quality Reports, but that she would be willing to discuss the possibility of sharing those reports with Mr. Gould. The results of the other surveys will be sent to the Assembly. Mr. Stevens stated that the Public Relations Committee was awaiting the cost proposal by the consulting firm and that the full plan would be brought to the Board when it was received. Mr. Gould stated he felt it was important that the Assembly be made aware of the public relations and marketing endeavors of the Hospital. OLD BUSINESS A. Long Range Planning Committee Ms. Fitzgerald stated that LHS had sent the detailed Long Range Plan which had been completed some years ago. She stated that it was Mr. Myers' recommendation that this report be used as a base for a new plan. Mr. Gould said that the Long Range Plan should take into consideration what funding alternatives exist if the state does not provide funds, including bonding. Advisory Board Meeting October 9, 1991 Page three NEW BUSINESS A. Medicaid/Medicaid Survey Ms. Fitzgerald stated that the state surveyors had been in the facility for five full days. The report of written deficiencies has been re- ceived and a plan of correction has been submitted to the state. Ms. Fitzgerald stated that in general, issues of concern were infection control, quality assurance, and reporting. The most serious issue was the temperature in surgery being several degrees higher than the stan- dard states. Possible solutions are being explored by the Borough and Hospital. A summary of the survey will be provided to the Assembly for their review. Dr. Brewer asked what would happen if the facility failed to correct the deficiencies. Ms. Hogg stated that there are levels of deficiencies defined by the state, and that the facility's level of deficiency did not threaten its operation. She stated that Medicare/Medicaid reim- bursement could be cut off if deficiencies developed past a certain threshold and were not corrected. ADNEMSTRATOR'S REPORT Written report as attached. With regard to Business Office collection procedures, several board members reported adverse reactions from the public. Mr. Jim Wilson spoke of a call which a friend of his had received regarding collection on an account. He said the caller had not offered any recourse -- it was "pay bill or it's going to collection." He stated that he felt there needed to be a middle ground -- that the facility should work with people who could not make full payment. Mr. Stevens said that he felt it was unfortunate that the hospital was in the current situation of having to get firm in its collection poli- cies -- that it seemed the pendulum had swung from a laissez faire attitude to one perceived by the community to be wholly made up of rigid requirements. He stated that he understood that the facility was work- ing to get back to a middle ground, with a responsible collection atti- tude. Ms. Kalcic brought up several points regarding legalities in collection. Mr. Vorachek will check on these issues. Mr. Gould stated that he has only received positive comments and that they had been based on the articles in the newspaper. Advisory Board Meeting October 9, 1991 Page Four Dr. Brewer addressed the issue of unassigned patients in the Emergency Room. He stated that the Medical Staff is working to change its Bylaws to address this issue which is not covered in policies or procedures. He said the proposed Bylaw change would require each physician who served as back-up to the E.R. physicians to accept unassigned patients. There was a discussion of surgeons, surgeries and surgical equipment, particularly that required for laparoscopic cholecystectomy. Requests for proposals for new equipment have been sent out. Dr. Brewer stated that KANA is getting colposcopy equipment which he would be willing to share with the hospital. Ms. Kalcic stated that as trustee of the Fuller Residual Trust, that once the legal matters have been completed, that she will get with the administrator to work to identify items such as these. AUDIENCE CON MWNTS Keith Vorachek stated that his department is continuing to work on the budget proposals. In a recent survey of hospital rates, this hospital's rates were second lowest in the state (Homer was lowest), and the rates for the Intensive Care Unit were the lowest. He stated that the general financial picture showed improvement in collections and that he hoped to have the A/R days down to 90 by the end of December. He stated that he had talked with Jim Brenner of NBA, and it appeared that an agreement regarding recourse notes would be reached in the next week. There was some discussion regarding the selection criteria which would be used for recourse notes. Mr. Wilson stated that the public relations program of the hospital should emphasize that people don't have to leave the island to receive good medical care. He was positive about the idea of recourse notes. Ms. Kalcic presented several ideas on collections including: * File liens against Fisherman's Funds within five days - get I.D. card from fisherman; * Call within 72 hours on V.A. admissions to insure payment; * Pursue liability insurance on car accidents; * Use negotiated settlements for fishermen. BOARD CONIMENTS Ms. Springhill stated that she felt that having an Advisory Board member attend each Assembly meeting was beneficial. The recording secretary was asked to prepare a calendar of the assembly meetings so that an Advisory Board member could be assigned to attend. All Advisory Board members were encouraged to attend the Assembly meeting of October 17. Advisory Board Meeting October 9, 1991 Page Five Mr. Gould stated that the agenda should have included the proposed changes to the ordinance amending KIB Code 8.04.030 Hospital and Health Facilities Advisory Board Powers and Duties. After discussion, it was the consensus of the Board that discussion of this item would be post- poned until the Administrator's return. Mr. Gould reiterated his desire that the Assembly be furnished with the results of the various surveys and instruments used in quality assurance. Mr. Stevens said that he had talked with Joe Smith recently regarding the possibility of LHS managing the Dutch Harbor clinic. The Board for the Dutch Harbor clinic meets two weeks from this date to make a deci- sion. Mr. Stevens that LHS will submit a proposal to manage the Bristol Bay health facility in response to a Request for Proposals. Mr. Ardinger asked if it would be possible to get some of the positive comments made by patients published in the newspaper. He asked what follow-up was made to negative comments. Ms. Fitzgerald stated that she calls on all negative comments and that the results of that follow-up call goes back to the Quality Assurance Committee. Dr. Brewer stated that he felt the Board had chosen well when it select- ed Ed Myers as Administrator. He said he felt that Mr. Myers was doing many positive things, such as identifying and promoting specialties. Ms. Saupe stated that she has been impressed with the inservices such as TB and Smoking Cessation being offered by the hospital. She commended the staff. She also said that she was grateful to the Auxiliary for their involvement and support. Ms. Springhill asked about the status of the radiologist's contract. Mr. Vorachek stated that it is still being negotiated. Ms. Springhill stated that she had asked the public for patience regarding the accounts receivable push. Ms. Springhill asked about the status of the autoclave boiler. Ms. Fitzgerald stated that the boiler has been replaced. Ms. Springhill asked about the status of the sale of the Neseth house. Mr. Vorachek stated that the sale had been completed and the funds, when released, would be applied to Mrs. Neseth's bill. EXECUTIVE SESSION Not Called. ADJOURNMENT Moved, seconded and carried to adjourn at 9:50 p.m. Recorded by Debra Raper. I a%/f/11 I I I i I I I I I I I I I _ JtE/ 9F6/ ,U-, "41 W6/ /db/ 0/6/ EL6/ M�