1991-12-11 Regular MeetingKODIAK ISLAND HOSPITAL
ADVISORY BOARD MEETING
DECEMBER 11, 1991
PRESENT: Ben Ardinger, William Brewer, Gordon Gould, Gretchen
Saupe, Betty Springhill, Wayne Stevens, Jeannie Volker,
Lorne White, Ed Myers, Administrator, Corlene Hogg, Di-
rector of Ancillary and Patient Information Services,
Kate Fitzgerald, Patient Care Administrator, Tim Hocum,
Staff Accountant, Joe Smith, LHS Management Co.
With a quorum present, the meeting was called to order at 7:05 p.m.
ACCEPTANCE OF AGENDA:
Moved, seconded and carried to accept the agenda.
APPEARANCES AND COMMUNICATIONS
Ryan Mackie, a student at Kodiak High School, and Tracy Powell, also
from KHS, were welcomed as visitors to the meeting.
Ms. Springhill shared a card from Mrs. Myers thanking the board for
their kindness during her illness.
MEETING M [NUI'ES
Moved, seconded and carried to approve the meeting minutes of November
13, 1991.
COM[MT1 TEE REPORTS
Gretchen Saupe reported that the Quality Assurance Committee had met and
reviewed the recommendations of the recent Risk Management Surveys. Of
57 recommendations, 22 have been implemented, and several are in pro-
cess. One major area of concern was in OB and intubation for newborns.
It was noted that this will be a large capital issue and might require
that a Risk Manager Nurse be hired.
Mr. Myers reported that the Finance Committee had met and reviewed the
Financial Variance Report for October. The facility experienced an
overall increase of $29,000. Mr. Myers noted that the hospital had
increased revenues, while the Care Center had experienced another de-
crease.
Advisory Board Meeting
December 11, 1991
Page Two
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Ms. Springhill asked about the status of Dr. Tschersich's contract. Mr.
Myers advised that discussions are continuing and he is working to
finalize the agreement.
Mr. Myers stated that Dr. Johnson had proposed that the hospital support
his Doctor's Corner column by paying for one column per month.
With regard to the Care Center Bus, Mr. Myers stated that he has estab-
lished a policy and procedure for its use. Mr. Gould stated that there
has been some concern voiced about spending hospital funds for the bus,
if it is available only for use by the Care Center. He stated that
there have been some complaints received by the Borough. Mr. Myers will
discuss the use of the vehicle with Anne Kalcic, Administrator of Ms.
Fuller's estate, and advise Mr. Gould.
NEW BUSINESS
A. Medical Staff By -Laws Change
Gordon Gould moved and Gretchen Saupe seconded the motion to amend
Article zil, Section 1, of the Medical Staff Bylaws as follows:
,,...without limiting the foregoing, the term "Allied Health Person-
nel" includes:
counseling or clinical psychologists, psychiatric social
workers, nurse practitioners, nurse anesthetists, physicians'
assistants, optometrists, and alcohol counselors."
Motion Carried.
Gordon Gould moved and Gretchen Saupe seconded the motion to add to
Article III, Section 3, a subsection "G" as follows:
"Each family practitioner or family physician on the Medical Staff
shall serve as backup for the emergency room physician on a rota-
tion basis. This means they shall be on call for emergency assis-
tance when necessary and shall be responsible for admission of
unassigned patients. Exemptions from backup responsibility may be
obtained by majority agreement of other involved physicians."
Motion Carried.
Advisory Board Meeting
December 11, 1991
Page Three
B. Mon-Reneval of EYcess Liability
Mr. Myers reported that the facility's excess liability insurance carri-
er, Reliance, has notified us of their intent to non -renew the policy.
The broker has asked for a 30-day extension. The broker will be meeting
with Reliance on December 18th and if renewal is forthcoming, a very
large rate increase is likely. If required to obtain insurance through
another carrier, the facility will also note a large increase in premi-
um. Mr. Myers stated that Reliance's action is based in part on their
concern about the low limits of liability insurance carried by the
medical staff and the history of claims. If Reliance does agree to
renew, it is possible that they may come back with requirements for
corrective action. Mr. Gould noted that the management contract states
that LHS shall provide excess liability insurance with approved levels.
The current policy is $3 million per occurrence, $6 million yearly
aggregate. Mr. Myers stated that the carrier has also notified Soldotna
of its intent to non -renew.
Joe Smith stated that LHS has resurfaced its proposal to conduct a
survey for the medical staff with regard to liability insurance. He
noted that the excess liability carrier may require higher limits of
medical staff liability insurance if it agrees to renew.
C. Board Education
Mr. Myers asked if the Board would be amenable to having one business
meeting per month and one education meeting per month. It was the
consensus of the Board that it was agreeable to this. Mr. Myers stated
that he would draw up a list of educational subjects for the Board's
review.
D. Medical Staff appointments
Moved and seconded to acknowledge the recommendation of the Medical
Staff to grant courtesy privileges to Dr. Michael James. Motion Car-
ried.
Moved and seconded to acknowledge the recommendation of the Medical
Staff to grant active privileges to Dr. Blaine Rinehart. Motion Car-
ried.
ADMINISTRATOR'S REPORT
As written.
Mr. Myers noted that legal fees pertaining to Mr. Dickson will be paid
by LHHS.
Advisory Board Meeting
December 11, 1991
Page Four
Mr. Myers stated that after being picked up by sanitation workers, a
container of medical waste burst, raising concern on the part of land-
fill workers that this waste might be infectious, although the facility
follows CDC regulations. Mr. Myers stated that he has met with the
landfill supervisor and will be meeting with Mr. Camardella of the
Borough. He stated that he felt that the best solution would be an
incinerator owned by the Borough at the landfill which would charge user
fees.
With regard to the Finance Director position, Mr. Myers stated that he
expects to receive applications by the first of the year and interviews
might begin by February 1.
Mr. Myers stated that letters have been sent, news articles written and
published, and radio spots aired asking for participants on the Strate-
gic Planning Committee. He said that he felt the committee would be in
place by the latter part of January.
The Americans with Disabilities Act will have major financial impact on
the facility if it is forced to meet all of the requirements of the Act.
Mr. Myers stated that a facility audit will be performed, noting those
areas which will require correction.
Mr. Stevens stated that upcoming legislation will be introduced by
Senator Brown which would provide 50% matching funds to public
facilities required to meet ADA standards. He recommended that the
Board support that legislation.
Mr. Myers stated that 1992 Medicaid rates for the ICF have been estab-
lished at $269.13 per day. He stated that there are vacant beds in the
facility and that staff is exploring alternative uses. He noted that
the Care Center has incurred losses during the last several months
because of low census. Mr. Stevens asked if there were a way through
the marketing plan to make the community aware of the available beds.
Mr. Myers will have staff ensure that organizations, such as KANA, are
aware of available facilities.
AUDIENCE COMMENTS
None.
BOARD CONEVIENTS
Mr. Ardinger asked if the Borough should be responsible for the pays nt
of the $6,500 Errors and Omissions insurance premium of the Advisory
Board. Mr. Gould said that he felt the Borough should be responsible
for this premium and would address this issue with the Borough. Mr.
Advisory Board Meeting
December 11, 1991
Page Five
Myers stated that he would also speak with Mayor Selby regarding this
issue.
Mr. Stevens stated that he met with Ron Garzini in Anchorage and dis-
cussed the upcoming legislative climate. He said he felt that if any
money was forthcoming for a new facility, that this would be the year.
He noted that in an independent survey performed by the Institute of
Educational Research on health care needs, it was concluded that Kodiak
was in need of a new health care facility. He stated that he had also
spoken with Sinclair Wilt of Dutch Harbor and that Mr. Wilt was positive
about the possibility of affiliation with Kodiak and LHS.
Mr. Gould stated that he would meet with LHS and Administration with
regard to concerns he had about bylaws and credentialing. He asked that
staff ensure that packet information sent to Board members be the most
current available. He wished a Merry Christmas to all and voiced his
appreciation to the staff for a good job.
Mr. White noted that this was his last meeting as an Advisory Board
member. Ms. Springhill voiced appreciation to Mr. White on behalf of
the Board for his years of service and expressed regret that he would
not again be serving on the Board.
Ms. Saupe noted that the lack of an infant ventilator was a concern in
the Risk Management survey. She felt staff needed to work more closely
with medical staff on this issue since it is a standard of care.
Ms. Volker stated that it was good to be back after her extended ab-
sence.
Ms. Springhill asked if the facility performed AIDS testing. Mr. Myers
stated that we draw blood, but that it was sent to an outside lab for
testing. Ms. Springhill asked about the status of new surgical equip-
ment. Mr. Myers stated that new choly equipment was on order and that
purchase of a reconditioned surgical table had been approved by the
Borough. He noted that selection of the table has been completed.
Mr. Myers stated that a review of charge audits is being conducted. He
stated that on a national average, facilities lose lot of charges on
lost stickers and he said it was realistic to assume that we are losing
at least 10% of charges due to lost stickers.
Mr. Myers stated that in November, collections were $822,000, the high-
est he had seen thus far.
Advisory Board Meeting
December 11, 1991
Page six
Not called.
• 1 � 1: ►lu 1 ►
Moved, seconded and carried to adjourn at 9:20 p.m. Recorded by Debra
Raper.
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