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BROOKINGS HOSPITAL AND BROOKVIEW MANOR
BOARD OF TRUSTEES MEETING
September 25, 2003
The Board of Trustees of the Brookings Hospital and Brookview Manor met on
September 25, 2003, at 7:00 p.m. in Hospital Conference Rooms A-B-C.
Present were: Michelle Robbins; Dianna Evers; Ardelle Lundeen; Rob Jones;
Roberta Olson; Chuck Blazey; Eric Rasmussen; John Ramsay; Tim Reed, ex-officio;
Dave Johnson, Administrator; and Pam Emmett, Executive Secretary. Larry Fjeldos
was also present.
The meeting was called to order at 7:10 p.m. by President Rob Jones.
Consent Agenda: The following items from the consent agenda were approved:
Charge-Off/Write Off Accounts; Bid for Colonoscope: authorized advertisement
for bid for a new colonoscope with an estimated cost of $21,000 as budgeted;
Purchase of New Copier: authorized purchase of a Canon IR6000 copier for
approximately $16,400; Credentialing: approved Dr. Park to move from
provisional to full active medical staff; Statistical Report; Statistical
Graphs. M/S/P.
Larry Fjeldos spoke to the Board and thanked them for serving in that
capacity. He stated that as we move more towards a healthcare campus, even
though we are not currently providing assisted living, he believes and is
concerned that eventually we will have no choice but to do so regardless of
our original intentions. Larry provided the Board with general information
on the assisted living industry.
Financial Report: Dave Johnson stated he had reviewed the figures on the
financial reports for Brookings Hospital, Brookview Manor, and Home
Health/Hospice Agency for August 2003, and after reviewing these figures
with the Board, Board members approved Dave Johnson’s recommendation for
approval of the financial report for August, 31, 2003. M/S/P
Minutes: Minutes from the August 28, 2003, meeting were reviewed and discussed.
Board members felt the minutes from last month should reflect that the
financial report was discussed along with Board member job descriptions and
the Board Bylaws. There were questions raised regarding approving a
financial report where the totals did not balance when the numbers were
totaled. It was noted by Board that the reason the totals did not balance
was the financial report sent to Board was a shortened version. While it is
the Board’s fiduciary responsibility to approve the financial report, it was
felt that a full financial report was not needed every month. Board members
receive a full financial report in January and July. Board members felt
that our auditors were approving our numbers and thus they were comfortable
approving the financial report. Last month’s minutes were approved as
amended. M/S/P.
Accounts Payable: Board members reviewed the accounts payable and there was a
question as to why one of the vendors is listed as “travel.” It was noted
that most travel was grouped together and put under travel instead of
listing each individual name. It was felt that this should be changed to
“staff travel.” There was also a question of a payment to Eric Rasmussen
which was noted to be paid for legal fees for land we had recently purchased
on Yorkshire Drive.
Physician Recruiting Expenses: Board members raised the question of how long
physicians were required to stay in Brookings if they received a signing
bonus. Board members also asked for and were presented a summary of how
much has been paid out for doctor recruiting in the past five years. It was
noted that the relationship between the hospital and clinic is very
important and each entity needs the other to survive. Board members
reviewed a memo from the Brookings Medical Clinic asking for cost sharing in
moving and interview expenses for $9,554.97. M/S/P.
Committee Reports:
Joint Conference (Medical Affairs): Ardelle Lundeen stated the Joint
Conference/Medical Affairs Committee had not met but the bylaws are in the
process of being revised.
Strategic Planning: Michelle Robbins stated the Strategic Planning Committee
had met on September 11 and the minutes were included in the packet. Naming
of congregate housing was discussed. There was a suggestion that the naming
of congregate housing should be tabled until next month and listed on the
agenda as an action coming out of committee so this would be public
information. Board members explained the need to move forward with naming
of congregate housing so we could begin advertising. Board members reviewed
names submitted by staff and chose Brookhaven Estates to keep with
continuity of the “Brook” theme as in Brookings Hospital and Brookview
Manor. M/S/P.
It was noted that a letter was received from a representative of the
Brookings Chapter of the National Association of the Mentally Ill (NAMI).
The letter requested Brookings Hospital and Brookview Manor consider housing
for the severe and persistent mentally ill (SPMI) people in our community.
After discussion, it was recommended a letter declining this invitation be
drafted by Dave Johnson and this letter would be reviewed by the full Board
for approval. A draft of the letter written by Dave Johnson was reviewed by
the Board and there was consensus that the letter could be sent.
Strategic planning issues were discussed and these items were listed in the
strategic planning minutes. The mayor had previously mentioned meeting
quarterly. It was noted that we have a City Council member attending each
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of our meetings and maybe we could meet twice a year. Minutes from the
joint meeting were discussed and it was questioned if there were minutes
taken. It was noted that they had been published in the Brookings Register
recently. The minutes did state, in error, that the Brookings
Hospital/Brookview Manor had approved the building of 75 congregate housing
units, when the actual figure at this time is 25. It was suggested to Tim
Reed that those minutes be corrected to reflect that.
Finance & Personnel: Roberta noted the Finance and Personnel Committee had
met on September 3 and budget issues were discussed. It was noted that the
administrator needs direction for a profit margin. Committee members
recommended the Board adopt a 4% profit on net operating income with
expenses to be controlled dependent upon the volume and utilization of
services. It was noted that the salaries were not yet available from the
SDAHO survey, thus making it more difficult to finalize budget numbers.
Board members felt the total budget should be brought to the November Board
meeting for final approval. M/S/P.
September 25, 2003
Page 4
Emergency Room: A memo from Pat Waligoske, Administrator of the Brookings
Medical Clinic was reviewed. It was noted that PA’s covering the emergency
room were working 24-hour shifts. A question was raised on how one can
account for unexpected costs. The intent of the clinic is to cover expenses
and not overcharge. The hospital is willing to pay the clinic but doesn’t
wish to overpay. It was noted that the contract should be written with this
stated intent. Both parties have the right to renegotiate the contract.
Board members gave Dave Johnson the authority to finalize an agreement that
is acceptable with the Brookings Medical Clinic within the $125,000 already
approved. M/S/P. Dr. Ramsay abstained.
Physician Recruitment: Dianna Evers raised a question on physician recruitment
and the Stark Law and where there is a safe harbor. It was noted that Dave
Johnson had verbally confirmed with attorney Matt Michels that physician
recruiting expenses don’t violate anti-trust laws when paid directly to the
practitioner. Dianna raised further questions as to what our role is in the
community and if this arrangement should be clarified with OIG to cover us
against anti-trust. Several Board members noted that Dave Johnson serves as
the administrator and that they were comfortable with this issue since Dave
had obtained legal counsel.
A memo from Pat Waligoske was reviewed regarding tuition assistance for
Rebecca VandeKop, M.D. who had completed a two week rotation at Brookings.
A Board member questioned if there was a precedence of paying off school
loans as part of recruiting and was not in favor of assisting in paying off
school loans. Board members questioned if it would be worth the investment
to get another female OB/GYN in the clinic, but it was noted that the clinic
wants a general medicine physician, not one who wants to practice
obstetrics. It was felt that Dr. VandeKop was a good candidate for our
medical staff. Board members voted to split the $25,000 in tuition
assistance over three years with the Brookings Medical Clinic, approve the
$10,000 signing bonus and half the moving expense. M/S/P. Dianna Evers
voted no and Dr. Ramsay abstained.
New Business: It was noted that monthly Board minutes and agendas have been
sent through inter-office mail to Mike Williams at city hall.
Three board members attended the SDAHO Board of Trustees session in Sioux
Falls earlier in the day. A handout of that presentation was distributed to
all members for their review.
Reading and Information: Board members received for information and reading, a
thank you from Roberta Olson, Dean of College of Nursing; U.S. Nuclear
Regulatory Commission Survey Results; and Sole Community Provider Status for
Brookings Hospital.
Comments: Tim Reed questioned who approves medical staff credentialing. It was
noted that credentialing goes to the appropriate service committee,
Executive Committee, and to the Board of Trustees for final approval. It
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was noted that the Board of Trustees is a volunteer Board appointed by the
City Council and the Brookings County Commission. Roberta Olson stated that
the Board of Trustees is educated in nursing, economics, health education,
etc. and feels they are well informed to carry out their duties.
The meeting was adjourned at 9:50 p.m.
____________________________
Michelle Robbins, Secretary