Franklin Co. Medical Center
PAST NOTES FROM OUR
ADMINISTRATOR’S
DESK
June 24, 2010 Thursday
FRANKLIN
COUNTY MEDICAL CENTER
Notes from Board Meeting:
Acquisition of the Foss Home:
The Board of Trustees
for the Franklin County Medical Center announces the
purchase of the home located at 82 North First East
in Preston. This is the Foss home located on the
northwest corner of the Hospital Block.
This property was
purchased for possible future use because it is
adjacent to existing Hospital property on two sides.
There are no active
plans to pursue a major Hospital or Nursing Home
expansion on the current campus. However, it is
still one of the options under consideration along
with a Partial Hospital facility on the Miller land
site and ongoing activities to improve our
financial position and ability to finance an
expansion.
Policies & Procedures:
Revisions and updates
in the following Policies and Procedures were
reviewed and approved.
1. On the Job
Injuries and Worker’s Compensation
2. Infection Control
Oversight
3. Infection Control
– Standard Precautions
4. Limited English
Proficiency Services
Constitutional Amendment:
The Board reviewed
information regarding a Constitutional Amendment
approved by the Idaho State Legislature this year to
be on the ballot this fall. The amendment would
allow Idaho’s Public Hospitals, primarily in the
rural areas of Idaho, to finance equipment,
facilities and technology as long as no tax dollars
are used to finance these investments.
Mike Andrus
Administrator
***************************************
May 20,
2010 Thursday
FRANKLIN
COUNTY MEDICAL CENTER
Notes
from the Board of Trustees Meeting:
Medicaid Payments Suspension:
On March 22, 2010 we
received a letter from Idaho Department of Health and
Welfare notifying us that Idaho Medicaid would begin
suspending payments to hospitals and nursing facilities
for the last 8-12 weeks of their fiscal year ending June
30, 2010 due to projected short falls in the state
general fund budget. Payments would resume the first
week in July 2010.
The Board discussed
establishing a Line-of-Credit with a Bank to cope with
the effects of these late payments from the State of
Idaho. The Board’s Finance Committee was asked to talk
with several banks, obtain quotes on the terms of such
an arrangement, and proceed in setting up a
Line-of-Credit with a Bank at terms they felt were most
appropriate.
Transitional Work Duty Policy:
We have not had an
employee policy regarding Light Duty work after or
during an employee illness or injury. To prevent
inconsistencies, the Policy approved by the Board
provides for assisting an employee with a work injury to
safely and productively return to their regular position
with medical limitations for a period of time not to
exceed 45 days.
Mike Andrus
Administrator
*********************************************
April 22,
2010 Thursday
FRANKLIN
COUNTY MEDICAL CENTER
Board of
Trustees Meeting
Notes from
Board Meeting:
Medicaid
Payments Suspension:
On March 22, 2010 we received
a letter from Idaho Department of Health and Welfare
notifying us that Idaho Medicaid would begin suspending
payments to hospitals and nursing facilities for the last
8-12 weeks of their fiscal year ending June 30, 2010 due to
projected short falls in the state general fund budget.
Payments would resume the first week in July 2010.
Recent information indicates
that Medicaid will hold payments to Hospitals and Nursing
Homes from May 3rd to July 1st. They
will hold all other provider payments from June 14th
to July 1st. If anticipated Medicaid
expenditures fall short of expectations, NH and Hospital
payments may not be held the full 9 weeks. Checks will
likely be released on July 7th.
The Board discussed
alternatives to coping with this anticipated cash flow
shortfall -- such as using our cash reserves or approaching
our banks for a short term line of credit.
On the
Building:
There was no new discussion in
today’s Board Meeting.
Mike Andrus
Administrator
****************************************
March 18,
2010 Thursday
FRANKLIN
COUNTY MEDICAL CENTER
Board of
Trustees Meeting
Notes from
Board Meeting:
On the Building:
In today’s meeting the Board heard
a presentation from the Architects on revisions to the cost
estimate for construction of a
Partial Hospital.
The total estimate now stands at
$15,211,355. The
revisions include shelling in two of the patient rooms, reducing
the number of parking spaces, reducing the area of the ground
around the new facility that would be landscaped and irrigated,
and reducing the estimate for sewer lines due to revisions by
the city engineer.
Annual Audit:
Presentation by Luke Zaracor and
Shawn Johnson from Dingus, Zarecor & Associates on the 2009
Audit report.
New Physician:
The Board approved a Medical Staff
recommendation to grant Dr.
Marc V. Farnworth, MD privileges. Dr. Farnworth is
in the Idaho State University Family Medicine Residency program
in Pocatello and will be working in our Emergency Room
occasionally. Dr Farnworth went to USU and then University of
Michigan Medical School.
MRI at FCMC:
We are ready to begin doing MRIs
at FCMC. Appointments may now be made thru the Radiology
Department. The Mobile GE 1.5T MRI Scanner will be at FCMC
every Saturday morning from 8am
– Noon beginning on March 27, 2010.
April Board
meeting was changed to Thursday, April 22,
2010 one week later.
Mike Andrus
Administrator
******************************
February
18, 2010 Thursday
FRANKLIN
COUNTY MEDICAL CENTER
Board of
Trustees Meeting
Notes from
Board Meeting:
On the
Building:
In today’s meeting the Board
reviewed three scenarios submitted from the Architects.
Option
1 is a plan for a 36.000 sq ft “Partial
Hospital” to be built on the
Miller site for about
$17,500,000.
This plan essentially included only Surgery, Labor and
Delivery, Emergency Services, Radiology, Laboratory, ten
inpatient rooms, a re-heat kitchen, a waiting area, and
limited reception and administration areas. Everything
else would remain at the in-town site.
Option
2A was a plan for a
16,900 sq ft two story
addition and remodel on the
in-town site
for about $
10,607,000. Surgery, Lab, Radiology, and PT
were included in the new two story addition. About $1.2
million was included for remodel mainly of Emergency
Services and some office space.
Option
2B is a plan for a
8,200 sq ft one story
addition plus some remodel on the
in-town site
for a total of about $ 5,523,338. The addition would include
Surgery and some support space. The remodel would
include Emergency Services and some offices for about
$444,000.
Option 2A was
eliminated from
consideration by the Board because of the cost. Some of the
non-construction and site related costs associated with
Option 1 need to be re-examined.
Mike Andrus
Administrator
***********************************************************
January 21, 2010 Thursday
FRANKLIN COUNTY MEDICAL CENTER
Board of Trustees Meeting
Notes from Board Meeting: ---- On the
Building:
The Friday, January 15, 2010 evening board
meeting at the Preston Library was very well attended. In addition to
the Board, Commissioners, Physicians and FCMC staff, there were
approximately 60 community members present. All present listened to
presentations by Board members and staff on topics including, Auditors
Nursing Home Impact Study, Privatization/Conversion, Employee
Recommendations Survey results, Nexus Architect comparison of remodeling
vs. building new, Pros and Cons of the Larry H Miller site, and Pros and
Cons of the in-town site. After the presentations, community members
were asked to speak and voice their concerns, recommendations, or
suggestions. Many good suggestions and comments were heard over the hour
and half allotted for the discussion. Suggestions and comments ranged
from doing nothing now – to having another Bond election for $31
million. Other suggestions included expanding services to curtailing
services not adequately utilized in the community. In conclusion,
Richard Westerberg, the moderator, called for a straw vote from the
group for a recommendation. Those present voted to build a smaller
version of the hospital on the Miller site.
The Saturday morning meeting included the
Board, Commissioners, FCMC staff, a physician and community members in a
four hour discussion on the many options and alternatives. The consensus
of the Board at the conclusion was that our long term goal should still
be to build on the Miller site. An interim step to that goal may be a $5
or $6 million OR/OB project on the in-town site. Another conclusion
reached after seeing the results from the Auditor study was that keeping
the Nursing Home was necessary for the success and Mission of the
Hospital.
In today’s Board meeting the events of the weekend meeting were reviewed
and some aspects were discussed further. It was felt that a few of the
items from our weekend meeting needed further study or information.
Those items included the privatization issue, asking Nexus Architects to
provide a calculation to see what we could do for about $15 million on
the Miller site, and a calculation to estimate what we could do for
about $5 million on the in town site. Further study on these two
calculations would also be needed to evaluate Pros and Cons,
consequences, problems created in both scenarios, and other related
strategies for improving business operations and increasing cash
savings.
**************************************
December 17,
2009, Thursday
Board of
Trustees Meeting
Notes from
Board Meeting:
On the Building:
January 15 – 16, 2010 was set as a tentative date for a Special Board
Work Meeting to discuss the need for an improved Hospital physical
facility. The Agenda will include presentations by board members
reviewing pros and cons of the major options then comments and questions
from board members, physicians, and community members. The Board will
then evaluate and prioritize the information and the pros and cons to
establish a new direction. Major topics and considerations will include
the current site, the Larry H Miller site, the Nursing Home,
conversion/privatization, and financial capacity.
2010 Budget
The
Medical Center incurred an operating loss for both October and November
due largely to lower than normal inpatient and emergency room
utilization. Effective January 1, 2010 the budget for wage increases
was changed to 2 %.
Equipment:
The
board reviewed some preliminary plans to acquire Stryker Precision Knee
Navigation equipment for total knee
replacement surgery. Total cost was estimated at about
$202,226. It is proposed that this be acquired jointly and shared with
Bear Lake Memorial Hospital and Caribou Memorial Hospital. Preliminary
approval was given, details are still being negotiated.
It
was also proposed that we again arrange for visiting mobile
Model Eight Channel GE 1.5T MRI
service at Franklin County Medical Center. There is some time available
in the services being provided to other eastern Idaho Public Hospitals
thru their Public Hospital Cooperative contract. This may begin as soon
as mid-January since we already have the cement pad and hookups
necessary. This may include a Saturday visit.
******************************
November 19,
2009, Thursday
FRANKLIN
COUNTY MEDICAL CENTER
Board of
Trustees Meeting
Notes from
Board Meeting:
On the Building:
The Board re-reviewed about six of
the scenarios and plans for addition, remodeling, or new
construction that they had previously developed over the last
ten years. This included scenarios on both the current site as
well as the land donated by the Larry H Miller Family. The
costs of those reviewed ranged from about $3 million to about
$17 million.
The board briefly discussed pros
and cons of issues related to ownership and control, which site
to use, whether to take a short term or long term approach,
various costs associated with the options, and the role of the
Nursing Home. The Board identified these as key issues to
examine in preparation for establishing a new development plan.
The consensus was that developing
a new direction should first involve study of these and other
relevant key issues. We will prepare for a special work session
to be held after the first of the year. At December’s Board
Meeting we will discuss agenda items and information to gather
in preparation for that work session.
Physician
Privileges:
New Privileges were granted to Dr.
Kerry Jepson, MD Orthopedic Surgeon and Dr. Matthew Hammond MD
Ophthalmologist. Other Medical Staff privileges were granted as
part of the normally two year renewal process.
*********************
October 22, 2009,
Thursday
FRANKLIN
COUNTY MEDICAL CENTER
Board of Trustees
Meeting
Notes from Board
Meeting:
On the Building:
There was discussion on our efforts to educate the General Obligation
Bond Election to occur on November 3, 2009. The next Town Hall
meeting is tonite at 7pm at the Franklin county Extension office. We
will have almost daily presentations in our classroom next week at
noon. We have the Extension office reserved again next Thursday at
7pm for another Town Hall meeting.
Volunteer Auxiliary
Annual Report: Cindy Lynn Smith, President of
the auxiliary reported on the years activities and earnings and what
the earnings were used for.
*****************************
9/17/2009
Board of Trustees Meeting
Notes from Board Meeting:
On the Building:
The Board reviewed and discussed the slide show that had been developed
to communicate need for a new hospital building.
Major
points in the Slide show included:
1. 2004
Architect evaluation of the current building concluded:
“Though the
building is quite well maintained, it has significant inherent
infrastructure, flow, and site concerns that eliminate it as a good
candidate for an addition or a major remodel.”
-- Architectural Nexus
2.
A review of growth in demand for
Emergency Room, Obstetrical, and Surgical services, building limitations in those
areas, and Regulatory remodeling
restrictions.
3.
An overview of the proposed
building layout, examples
of improved operating efficiencies, and potential for additional
and expanded services.
4.
Examination of other hospital benefits to the community such as 210+ jobs, $8 million wages and benefits,
County ownership and control.
5.
Discussion of Hospital
commitment to pay as much as possible from Hospital Operations to
minimize the tax burden and the County Resident Healthcare Tax-Credit
Program where County residents could receive a credit at the
hospital for taxes they paid toward the new hospital.
6.Tax Levy estimated to be $187 on $100,000
assessed valuation. Noted that this would be on home
value in excess of the Homeowner
Exemption. This
roughly equates to about one 50 cent soda-pop per day per household.
7.Re-emphasis
on the Economic benefits and
necessity of proceeding with the project now. This includes the
Lower interest rate
available by going this route, the lower
construction costs now,
the current lower rate of inflation,
the County Resident Healthcare
Tax-Credit Program, and the benefits to the people of
Franklin County of County owned
and operated Hospital, Emergency Room, and Healthcare services.
*********************************************************
August 20, 2009
Board
of Trustees Meeting
Notes from Board
Meeting:
On the Building:
On Monday August
10, 2009 the Board of Trustees of the Franklin County Medical Center had
met with the Franklin County Commissioners. Upon our request, the
County Commissioners approved an
Ordinance calling for a Special Election to be held for the
purpose of submitting to the voters of Franklin County the proposition
of approving a General Obligation Bond for $31,000,000 to build a new
Hospital and Nursing Home.
Today in Board
meeting the FCMC Board approved a
Memorandum of Understanding that included the following
provisions. This MOU will be presented to the County
Commissioners for approval at their next meeting.
2. Estimated Hospital’s
Payment Portion: Hospital consultants have
estimated that current Hospital Revenue levels will be sufficient to
service a debt of $10 to $14 million. This will vary depending on
interest rates, potential utilization increases, and other variations in
operations. The Hospital presently has very little debt.
The annual payment on $17 million would be about $1,071,000. The tax
levy on this would be about $187 for a $100,000 home. ($17M * .11 *
$100k )
3. Free Hospital Care
for Taxes Paid: Franklin County Medical Center
will develop a process by which free care can be obtained at the
Hospital for Franklin County Residents who have paid taxes for the
Hospital Tax Levy within the three most recent years and up to $1,000.00
per year.
***************************************
July 16, 2009
Board of Trustees
Meeting
Notes from Board
Meeting:
1. New Board Member,
New Board Chairman and Vice Chairman: Thedora
Petterborg was elected Chairman of the Board and
Thane D Winward was elected
Vice-Chairman. Previous Board Chairman
Lyle Henderson had resigned
his seat on the Board to serve a Mission. Lyle had been a member of the
Board since 1987. He has served as Chairman of the Board since 2004.
The Vacancy on the Board was filled by the Franklin County Commissioners
appointment of Lance Henderson
to the Board.
2. Medical Staff:
The Board approved Medical Staff privileges for the following:
Dr.
David Paul Brizzee, DO -- Emergency Room
Dr.
Lori Novich-Welter, MD -- Physiatrist
Joshua
Torman, CRNA
3.On the Building:
Bond Council:
The Board reviewed a letter and an Election and
Financing Timeline from Mike Stoddard of Hawley Troxell, Attorneys. A
General Obligation Bond can only be issued pursuant to 2/3’s approval of
the electorate. To get the issue on the ballot the County Commissioners
adopt an Ordinance/Resolution for the Bond Election. Representatives of
the Hospital Board will seek a time to meet with the County
Commissioners to request this.
Community Education:
The Board reviewed a letter from Greg Gunter of Rave Communications in
Pocatello proposing to help educate the public on the upcoming Bond
Election. Mr. Gunter will be invited to come to our next Board Meeting
to make a presentation.
New Portable X-ray
Machine: Jim Hansen, Radiology Manager
recommended to the Board that we purchase a new portable X-ray machine.
We purchased the current one used 15 years ago. Jim presented three
bids. He recommended the lowest bid from Turnkey Medical for $41,000.
The Board approved the purchase.
***********************
June 18, 2009
Board of Trustees
Meeting
Notes from Board
Meeting:
1. Auditor RFPs:
Paul reviewed with the Board responses received to replace our Auditor,
Don Hagen who had recently retired. Five requests were sent for
proposals to do our Annual Audit and for the annual Medicare and
Medicaid Cost Reports. Three responses were received. Of the three
received one was for the Audit only while the other two were for both.
The two responses to do both the Audit and Cost Reports were from
Dingus, Zarecor & Associates PLLC, and Eide Bailey, LLP. Both are
highly respected firms among Idaho hospitals. Discussion and
consideration was given to cost and experience in Idaho and with Idaho
Medicare Critical Access Hospitals and Nursing Homes. Consideration was
also given to the need for assistance with evaluating financing options
for the proposed new hospital and analysis of the impact on our Cost
Reports. The Board asked the Finance Committee to check some references
and then make the selection.
2. On the Building:
The Board reviewed a preliminary
draft timeline of tasks to be completed before the November
election. Some discussion ensued on the practicality of sufficiently
educating the public, meeting legal deadlines and requirements, and
defining the scope of the project in the time available. Consensus was
to continue working towards the election at this time. A preliminary
analysis from bond council for the Idaho Health Facilities Authority was
also reviewed. This gave the Board some idea of what a
tax levy might be -- given a
preliminary set of assumptions.
A comparison of Project scenarios was also
reviewed. A draft Project Plan
will be developed with a basic Hospital including 16 inpatient beds,
five emergency bays, two operating rooms, and two Labor and Delivery
Rooms. The Nursing Home and a Physicians Clinic will also be included
initially as options. This would total approximately 68,000 square feet
for the Hospital, Nursing Home, and Clinic combined. Based upon
project comparisons to date, we currently estimate cost to be
approximately $25 million. These will be reviewed with the architects
to more accurately project costs for each.
Over the next month
we will meet with architects to more accurately estimate the project
scope and costs, begin developing Community Education Plan schedule and
content, draft language and begin circulating petitions to be signed by
community to allow the question to be put on the November ballot, and
begin communication with the State of Idaho and Medicare on the hospital
relocation process requirements.
**********************
June 4, 2009
Board of Trustees --
Special Meeting
Notes from Board
Meeting:
This special meeting was held to discuss
next steps to be taken toward obtaining financing and funding for a new
replacement hospital.
The board discussed the recent WIPFLI
Square footage and Cost Estimates Reports. This report built on the
February Market and Utilization Study and provided calculated
recommendations for the size and scope of a new hospital building.
As a result of news of the potential
availability of a new federal loan program that would subsidize the
interest on certain loans and the impact this would have on our debt
capacity, revised numbers were reviewed for a 47,440 square foot
facility with a resulting cost estimate of $20,143,789.
The 2004 study by Architectural Nexus was
also provided and reviewed. This report outlined the condition of the
current building and its potential for a major remodel.
The results of the discussion were to work
toward a Public Bond election in early November 2009.
In preparation for this we would hold
Public Meetings in September and October 2009.
We may go to the Public Meetings with
information on a couple of scenarios. Factors that would be considered
in the two scenarios would include sizes, costs, whether to include a
new Nursing Home, how much could we borrow, how much should we Bond
for, etc.
A draft timeline and plan for this will be
reviewed at the next Board Meeting on June 18, 2009.
*************************
May 21, 2009
NOTES FROM BOARD
MEETING:
1. Audit and Cost
Report. Requests have been sent out to five firms
to perform our annual financial Audit and prepare our Medicare and
Medicaid Cost Reports. Our current Auditor, Don Hagen, is retiring.
We hope to have received enough proposals by our regular June Board
meeting to make a selection for the coming year.
2. Nursing Home
Sprinkler System. Federal Law has mandated that
all Skilled Nursing Facilities are required to be fully protected with
fire sprinklers by August 2013. The facility is currently partially
sprinkled. The Board today reviewed a proposal from Architectural Nexus
to identify the most feasible direction to bring our facility into the
mandated compliance. The cost of the proposed study is $9,250. The
estimated cost of the project is $300,000. No action was taken on the
proposal at this time pending the outcome of other decisions related to
the future of the current building.
3. On the Building:
The Board reviewed Phase 2 of the
WIPFLI study. This study built on the February Market and
Utilization Study to provide calculated recommendations of the square
footage size of the new Hospital, number and nature of the bed
requirements, space calculations, and preliminary cost estimates. The
study recommends 12-17 Medical/Surgical beds, 3
Labor/Delivery/Postpartum beds, 5 emergency department bays, at least 1
Operating Room, and one additional Procedure room. Department level
square footage comparisons were provided by WIPFLI, the architect, and
other actual or planned Critical Access Hospitals. A Detailed Capital
Cost Estimate was also included.
A
special Board meeting was set for June 4, 2009 at noon to
continue review of the WIPFLI study, review the cost of maintaining the
current facility, discuss the scale and size for our new facility, and
the ramifications for financing the project.
************************
April 16, 2009
Notes from Board Meeting:
1.Medical Staff privileges were granted to
Ryan Wheatley our new CRNA. He recently moved to Preston and
began working at FCMC.
2.On the Building: Discussed a
recent meeting with Architectural Nexus regarding potential
financing for a new building. Nexus has indicated they have a working
relationship with a company that may be interested in financing the
project. We will follow up with another meeting to get more
information. While we are waiting for results of the second phase of
the Wipfli study, we will also request some additional
information on other potential financing alternatives including the
Idaho Health Facilities Authority, and options that we may need to
evaluated due to the impact of the Frazier vs. the City of Boise
-- Idaho Supreme Court ruling. Board Members were
asked to come to meeting next month prepared to discuss their
perceptions of what our next steps should be in arriving at a financing
strategy and a timeline. John Kezele, CRNA also made a
presentation on surgical volumes and potential volumes with a new and
larger Operating Room and facilities.
3.Smoking Assessment Policy was
approved. Federal Regulations require that a Nursing Home Resident’s
Care Plan reflect information that is needed to provide for safe smoking
if allowed. Current Policy does not allow for smoking in our facility.
State Law prohibits smoking within 20 feet of the facility. In harmony
with these, smoking areas will be designated beyond the 20 feet limit
and signage will be posted noting the designated smoking areas. This
policy provides for the form and procedure to evaluate a patient’s
ability to comprehend and comply with smoking policy and state law,
their need for supervision as they smoke, and what other safety measures
may be needed. Residents will be given the opportunity to participate
in the assessment and agree to needed safety measures.
4.Physical Therapy space requirements
were discussed. The pros and cons of an on-campus versus off-campus
Physical Therapy department were discussed. It would be a way to free
up some on-campus space for other uses if they were to move off-campus.
However, additional costs for rent, supplies, personnel, and
inefficiencies with care to Nursing Home, Hospital, and Clinic patients
would result. The Board requested further study.
********************
March 19, 2009
Here
are some highlights from our Board meeting yesterday:
1.
Don Hagen, CPA presented the Audit Report for 2008. Some of
the highlights of 2008 include:
2. Dr Charles M. Clair, MD, a resident from Pocatello, was
granted provisional privileges to cover in our Emergency Room.
3. ON THE BUILDING:
A
proposal from WIPFLI was reviewed for the next phase in our
Financial Feasibility Study.
This
phase is estimated to take 2-4 weeks. Objectives include:
1.
Translating
future clinical volume estimates into key room counts
2.
Finalizing
scope of key clinical and non-clinical support departments
3.
Translate
key room counts and support departments into space requirements.
4.
Compare
estimated square footage needs to other Critical Access Hospital
Benchmarks.
5.
Develop
detailed project cost estimates based on square footage required.
WIPFLI
is also still working on another proposal for an Operational Assessment
to:
1.
Evaluate key processes for efficiency and potential cost savings.
2.
Review Medicare and Medicaid reimbursement, coding, and
chargemaster functions.
3.
Evaluate Nursing Home profitability and its impact on the
Hospital’s financial position.
****************************
February 19, 2009
Here is a synopsis of some items from our Board Meeting
today:
1. Trish Checketts, Fund Development Coordinator and Foundation
Executive Director, presented a summary report on the status of our
Electronic Medical Record (EMR) project. We have grant funds available
for the next phase, the addition of the Laboratory module. That module
will cost about $146,000. Beyond that, Trish presented a two year plan to
finish the project. This will include the final hospital Nursing module
and modules for Home Care, Nursing Home, Physical therapy, and Central
Supply bar coding. The total cost for the two year plan is about
$472,595. Grant funds have been secured for some of this but not all.
Currently we are applying for a grant/loan combination thru the USDA and
RBEG programs. Our plan is to proceed with the Laboratory module
installation and continue to secure grant funding to finish the project
over the next two years.
2. Bryan Shuman, Lab Manager, made a presentation and
recommendation for the selection of a Vendor for the Lab Module.
Bryan had investigated a
number of products and had narrowed it down to two. Bryan recommended we
go with the Orchard Harvest vendor. Cost is approximately $146, 000. The
board approved this recommendation.
3. Policies & Procedures:
Three Policies were reviewed and approved. A Nursing Home Admission
Policy, Workers Compensation Policy , and a Leave of Absence Policy. The
Nursing Home Admission Policy is a new policy to help facilitate Nursing
Home Admissions after hours and outline what is required by regulation for
an admission. The Leave of Absence Policy included some revisions
required by new regulations. The Workers Policy was a combination and
replacement of two previous policies and to harmonize it with the changes
to the Leave of Absence Policy.
4. On the new Building: The Board reviewed a summary of
a progress report from Wipfli, the Financial Feasibility Consultants. The
following preliminary points were made.
a.
The credit crunch has affected hospitals access to affordable capital.
Rates for 30 year tax-exempt bonds for even highly rated entities are
approximately 7%. Even other federal programs may be nearly 8%. This
has impacted the amount of debt that FCMC could afford.
b.
national increases in patient bad debts at hospitals will also be a major
risk factor in affordability.
c.
While waiting for markets to stabilize and rates to come down, FCMC could
do several things:
1.
Conduct an Operational Assessment to evaluate key processes for
efficiency and potential cost savings.
2. Review Medicare and
Medicaid reimbursement structures and evaluate coding and chargemaster
functions.
3. Evaluate Nursing Home
profitability and its impact on the Hospital’s financial position.
Most of these items were in the original scope for the
Financial Feasibility Study. We will be working with Wipfli on these
focus items as we proceed with the study.
