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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 OLD 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. �.CF-�}�;-a 27 -1/.K ICLAND e"—_,, CIE' .K'S O ; icE