HGH Interim CEO Karen Cole shared highlights from the March financial statements.
Patient days were over budget month-to-date by 9.2%, although year-to-date numbers remain under budget by 6.5%. Surgical cases, however, were over budget both for the month by 33.9% and for the year by 12.1%. Emergency Room visits were over budget month-to-date by 0.3% and year-to-date by 1.8%. Rural Health Clinic visits were also over budget month-to-date by 18.7% and year-to-date by 3.7%. The hospital continues to struggle with clinic visits due to a lack of providers. For the month, Rural Health Clinic visits were down 17% for the month, and 17.8% for the year.
CEO Cole said operating income for the month saw a positive variance of 191.2%; for the year, the hospital is still operating in the negative, but still saw a positive variance. Net income for the month was $704,060 against a budget of $76,638. For the year, net income is $3.1 million against a budget of $746,684, for a positive variance of 818.7%.
The board approved the Consent Agenda, including the board meeting minutes for March 26, 2019; March 30, 2019; and April 9, 2019. The board also approved medical staff appointments, reappointments, provisional and temporary privileges for 10 care providers.
Business Items-Other Reports
1. Hospital Administration-EMS / proposal to procure security services for hospital, outbuildings and grounds / EMS Director - EMS Chief Sean Burke presented a request for security guard services at the hospital. Sean said HGH has a large campus with various points of entry. Unfortunately, national trends indicate that workplace violence, especially in the healthcare setting, is on the rise. Last year, HGH had 399 calls for service with the Winnemucca Police Department, including multiple unauthorized intrusions inside the HGH facility. In one instance, a local provider was threatened with a firearm in his office. Under Sean's direction, the HGH Security Work Group developed several potential options to employ armed security guards. Allied Universal, the company that has been providing contract security services at HGH since January, was the only vendor to provide a quote for around-the-clock security guard services. The HGH Security Work Group also looked into HGH hiring its own guards, but the cost for 6 full-time staff equivalents, plus benefits, training and liability insurance, was prohibitive. Sean recommended the board choose Allied Universal to provide security guard services. Board Chairman JoAnn Casalez said she has been supportive of security services at the hospital since she came on the board. She said Sean's presentation provided good information and answered her questions. She also appreciated staff sharing how much safer they feel with a security presence at the hospital. Trustee Bill Hammargren said he would like to see quarterly data moving forward, especially regarding how many calls to the Winnemucca Police Department now originate from the hospital as compared to pre-security times. He said he would also like to see staff surveyed after six months regarding the security services. Trustee Gene Hunt said he would like reports to differentiate between calls that occur after action by a security guard versus calls without security's involvement. Sean said he believes there will be a dramatic dip in the number of calls to the police department. The motion to contract with Allied Universal for one year at a cost of $302,000 passed unanimously.
2. Hospital Administration-OR/ proposal to purchase scopes for operating room /OR Director - HGH Operating Room Director Janet Sturtz requested two new scopes for the OR: a colonoscope that allows direct visual examination of the large intestine and rectum, and a gastroscope that allow direct visual examination of the inside of the upper gastrointestinal tract (esophagus, stomach and duodenum). Janet said the gatroscope is a slimmer design, which can be used on pediatric patients. Both offer brighter, more powerful imaging, providing twice the viewable distance as compared to earlier scope models. Janet had budgeted $120,000 for the new equipment, but was able to take advantage of several offers through her sales rep. Trustees unanimously approved the two new scopes and a processor for a total price of $87,595.25.
3. Hospital Administration-Pharmacy/ bids-proposals for pharmacy-physical therapy remodel project / award of contract for pharmacy-physical therapy remodel project / Owners Rep-CTA - HGH Owners Representative Mike Sheppard presented the sole bid from Sletten Construction of $2.795 million for the Pharmacy-Physical Therapy remodel. Approximately $1.5 million was budgeted for the project. Part of the extra cost results from a $900,000 HVAC project, which trustees agreed should be completed while construction crews are on site. Because the numbers were higher than expected, Mike said there are three options: reject the bid; award the bid and then immediately begin the change order process in an attempt to bring costs down; or, table the item and do a comprehensive review to determine if there are areas for potential cost savings, which includes having Pharmacy Director Dave Simsek review the project and explain why each of the various components are needed. Board trustees agreed to table this item until the May board meeting and ask Dave Simsek to review the project.
4. Hospital Administration-Clinic/ terms and conditions of employment agreement with C. Robert Westling, M.D. / Administration - HGH Legal Counsel Kent Maher advised that negotiations between the hospital district and Dr. Robert Westling continue and there is no contract yet to approve. He directed trustees to authorize staff to sign the contract, once it is complete, and bring it to the board at the May meeting for their ratification. The motion passed unanimously.
5. Hospital Administration/ request for approval of QAPI Plan policy / Administration-Quality Control - Quality Services Director Lisa Andre requested approval of a Quality Assurance and Performance Improvement (QAPI) Plan policy. Lisa said a QAPI plan is a data driven and proactive approach to quality improvement. All members of an organization, including residents, are involved in continuously identifying opportunities for improvement.
Trustee Bill Hammargren responded to Dr. Brad Granath who, during public comment at the beginning of the meeting, thanked the board for his 14 years at HGH as a private practice physician and said his goodbyes before he moves to Washington State to take a position there. Trustee Hammargren said he was lucky to be a board member when Dr. Granath and his wife, Robin, chose to come to Winnemucca. He said Dr. Granath will be missed as he plans to leave the community by June 1.
Trustee Jennifer Hood "seconded" that Dr. Granath has done an "amazing job as a doctor and a community member."
Board Chairman JoAnn Casalez also thanked Dr. Granath. Further, she thanked HGH staff for all they have done to bring about positive change at the hospital.