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1991-09-25 Regular MeetingKODIAK ISLAND HOSPITAL ADVISORYBOARD MEE77NG SEP7EMBER 25, 1991 PRESENT: Ben Ardinger, William Brewer, Gretchen Saupe, Betty Springhill, Wayne Stevens, Ed Myers, Administrator, Keith Vorachek, Financial Services Administrator, Kate Fitzger- ald, PCA, Pam Foreman, Director of Human Resources, Cor- lene Hogg, Director of Ancillary and Patient Information Services, Stan Thompson, Director of Environmental Ser- vices. ABSENT: Gordon Gould, Jeannie Volker, Lorne White With a quorum present, the meeting was called to order at 7:20 p.m. following a dinner meeting with Commissioner of DHSS, Theodore Mala. ACCEPTANCE OF AGENDA: Moved, seconded and carried to accept the agenda. APPEARANCES AND COMMUNICATIONS None. MEETING MINUTES Moved, seconded and carried to approve the meeting minutes of September 11, 1991 as distributed. COEE REPORTS None. OLD BUSINESS A. Tymponometer Mr. Myers reported that the tymponometer will be returned to the facili- ty by Ms. Glenney on or before October 1. He asked the direction of the Board. Ms. Saupe asked if the facility would be contracting with anoth- er speech therapist and if Ms. Glenney might interested in such a con- tract. Advisory Board Meeting September 25, 1991 Page Two Mr. Myers stated that Ms. Glenney has indicated that as she has already contracted with the school system, she would not feel comfortable adding to her work load. The possibility of selling the equipment and re- turning the funds to the Auxiliary was discussed. It was the consensus of the group that staff should research alternative uses of the equip- ment. A. Business Survey Mr. Myers reviewed the results of the business survey. There was an approximate 308 return of the surveys, with one respondent having over 450 employees. The purpose of the survey was to identify services which KIH could provide to the business community. The major interest areas identified by businesses were: Drug Testing (827 employees) EAP Programs (1,165 employees) Wellness (990 employees) Mr. Myers stated that the facility would wish to limit its involvement in a drug testing program to the actual testing and certain administra- tive tasks. It would not wish to be involved with the actual operation of a business's program because of possible legal ramifications. Mr. Myers will be speaking to specifically interested groups on the various programs. B. Marketing/PR Plan Outline Ms. Foreman reviewed the plan outline. The hospital will utilize all media -- radio, print and television to market the facility and provide pubic relations information. The hospital will begin producing a news- letter which will be distributed through the mail. There was a consen- sus that as part of the new and shifting focus of marketing within the hospital, that the Hospital Corner news column will be phased out. Ms. Saupe asked whether the newsletter could be inserted into the news- paper, rather than going through the mail. Mr. Stevens pointed out that the newspaper only has a circulation of approximately 4,000, while by going through the mail, more than 7,500 homes would be reached. Motion made and seconded to accept and support proposed Marketing and PR Plan. Motion Carried. Advisory Board Meeting September 25, 1991 Page Three C. Board Meeting Evaluation Form Mr. Stevens reviewed this form which he had brought back from the board meeting in Unalaska. He proposed that the Board use the form to evalu- ate its performance and to determine if the evaluation form would be a tool worth using. It was the consensus of the Board that it would utilize the form until January 1, 1992 and determine its usefulness. ADMINISTRATOR'S REPORT Written report as attached. Mr. Myers reported that the autoclave boiler for the operating Room had broken, and it would cost $5,000 to $6,00 to replace. He said that the Borough had declined to replace the equipment, and that the Borough felt the facility should use part of the $50,000 medical equipment funds to replace the boiler. Mr. Ardinger stated that he saw the replacement of this equipment as the fiscal responsibility of the Borough. Mr. Myers stated that he had talked with the Borough regarding putting the re- placement in the contract for the new boiler, but that the need was emergent. He indicated that the facility will autoclave at the Coast Guard clinic until the new autoclave boiler is replaced. Mr. Myers reviewed the Property Appraiser's report received regarding the property of a resident of the ICF. There was much discussion re- garding the process through which the sale of the property was being made. It was suggested that the property be put up for public bid. Mr. Myers explained that the property was not owned by the facility, but that the facility had a beneficial interest in the sale of the property. He reviewed the history of the sale, explaining that based on the ap- praiser's report, that most financial institutions would decline to write a loan on the property. After extension discussion, the Board was polled and although two mem- bers expressed reservations, each member present agreed that the facili- ty should proceed with the offer as tendered. nor rec u�re& by +ks, Ado'. SO( ,3oa-rd . Mr. Mye�s briefly reviewed the situation in the ER where physicians are resigning from back-up call. He stated that he will ask the Medical Staff to meet and resolve the issue. AUDIENCE COMMENTS Stan Thompson reported that the concrete for the new floor in the Laun- dry had been poured. He stated that the facility was very appreciative to the Westmark, which had provided their facilities free of charge. Advisory Board Meeting September 25, 1991 Page Four Mr. Thompson also stated that the results of the State Fire Marshal's survey had been favorable, with no major write-ups. Kate Fitzgerald reported that Barbara Jo Ratte, OB RN, had met with Kathy Short and was working to establish a better rapport. Ms. Springhill asked Ms. Fitzgerald the status of the state survey. Mr. Myers stated that the report had been received this date and that one major concern of the surveyors was the high temperature in the OR. Keith Vorachek reviewed financial statements for the previous month. Mr. Myers stated that there had been a press release regarding the collections policy of the hospital explaining to the public why the facility was pursuing collections more vigorously. Scott Allen, acting business office manager, has been doing a great deal of training in the business office, stressing that collectors be polite and businesslike, but firm. i•' 1 • 1 1 � Dr. Brewer stated that he felt very positive about the increased well- ness emphasis of the hospital. He said he had many materials which he would be glad to share with the hospital. Pam Foreman said that the facility will be participating in the Coast Guard's Wellness Day on November 16. Mr. Ardinger stated that, in his opinion, through the years, the Borough has developed the attitude that all facility maintenance bills should be sent to the Hospital. He stated that in order to help the hospital's bottom line, that he recommended that the bill for the autoclave boiler and other building maintenance bills be sent back to the Borough for payment. Ms. Saupe said she is excited about the wellness push. She asked if the hospital was still having prenatal classes. Ms. Fitzgerald stated that it is. Ms. Springhill asked about the status of the contract with the radiolo- gist. Mr. Myers reported that the radiologist will be meeting with the Financial Services Administrator to review financial issues before going to contract. EXECUTIVE SESSION Moved, seconded and =arried to recess to Executive Session to discuss litigation issues at 9:05 p.m. Advisory Board Meeting September 25, 1991 Page Five Moved, seconded and carried to reconvene to regular session at 9:25 p.m. Moved, seconded and carried to adjourn at 9:26 p.m. Recorded by Debra Raper. ADMINISTRATOR'S REPORT TO RIH/CC ADVISORY BOARD 10/4/91 BIISINESS SURVEY TO BIISINESS i INDUSTRY COUNCIL: On October 3, I provided a general briefing of the business survey recently con- ducted by the hospital, along with some general discussion of a business alliance or "partnering" concept. The presentation went quite well, in my opinion, and it was very clear that there was a tremendous amount of interest in health care issues. I intend to propose that quarterly, the Council include some aspect of communi- ty health care issues on its agenda. BIISINESS OFFICE COLLECTIONS: As you know, we are trying to clean up a real problem in the Business Office and to get our cash flow in order and to establish a survivable cash flow policy. From time to time, I hear some complaints from a very few people concerning these collections activities. Primarily, the complaints revolve around what time people are being called, being called twice, or having never received a bill, or they claim that the caller was less than polite. I have continually stressed to our Business Office that the people who making calls shall be polite, courteous and professional in their approach. In many cases, there is a reaction because the hospital has called regarding a past due balance and people aren't used to being questioned regarding the bill. Unfortunately, the hospital is seen often as a "soft touch" and bills tend to linger. This is more than amply demonstrated by the fact that we are carrying more than $1.2 million of excess accounts. In some cases, the complaints are legitimate and I have addressed those with the individuals who have taken the time to contact me. In every case, so far, I have been able to reach an agreeable understanding of the hospital's problem. Considering the number of calls which are being made and the amount of activity, the complaints are few and most people are understanding. I will continue to stress our policy and whenever possible, to avoid the problems which result in complaints. However, if we don't under- take this activity, we will not be able to reach a positive cash flow and the hospital can be expected to continue its cash flow deterioration. MEDICAID - VOLUNTARY CONTRIBUTIONS: As you may know, the state recently considered whether or not to solicit voluntary contribu- tions from hospitals to the state to add to Medicaid funds, as other states already do. What this results in is matching federal funds. The theory is the state receives more Medicaid funds and is able to increase payments to hospitals and increase the number of eligible recipients. This has been fraught with problems and most recently, HCFA has issued rules that this practice will no longer be acceptable and although it is being debated in Congress, it is my opinion that those states which have adopted such plans may find themselves in serious problems upon the withdrawal of federal funds. I was opposed to Alaska entering into such a scheme and I am glad to report that the Hospital Associated has decided against exploring a system of voluntary contributions. UNASSIGNED PATIENTS IN ER: The Bylaws Committee of the Medical Staff has met to adopt new wording for my proposed change to the bylaws to handle unassigned patients which require admission through the Emergency Room. If the Medical Staff as a whole can agree upon this wording, perhaps we will be able to resolve this issue. We currently have an adequate number of physicians taking unassigned patients; however, I believe that it is essential that we formalize the procedure and process. SURGEON VISIT: Dr. Mason entertained a visiting surgeon who may be interested in joining his practice. He is from the San Francisco area. I met with him briefly and will provide more information if a sincere interest develops. KODIAK ISLAND BOROUGH MEETING, OCT. 3: I am sure that all of you are aware of the statements made by Kenny Kimmel at the October 3 Borough meeting. I have attached a copy of a letter which I have forwarded to Jerome, outlining a few issues and stating that our staff would be at the next regular Borough meeting to formally address those concerns and issues.