board of directors agenda packet - palomar health · 10/06/2013 · bruce g. krider, m.a. jeffrey...

BOARD OF DIRECTORS AGENDA PACKET

June 10, 2013

The mission of Palomar Health is to heal, comfort and promote health

in the communities we serve.

BOARD OF DIRECTORS

T.E. Kleiter, Chairman

Stephen P. Yerxa, Vice Chairman

Linda C. Greer, R.N., Secretary

Jerry Kaufman, P.T.M.A., Treasurer

Bruce G. Krider, M.A.

Jeffrey D. Griffith, E.M.T.-P.

Aeron D. Wickes, M.D.

Michael H. Covert, F.A.C.H.E., President and C.E.O.

Regular meetings of the Board of Directors are usually held on the second Monday of each month at 6:30 p.m., unless indicated otherwise.

For an agenda, locations or further information call (760) 740-6375, or visit our website at www.pph.org

MISSION STATEMENT

The Mission of Palomar Health is to: Heal, Comfort, Promote Health in the Communities we Serve

VISION STATEMENT

Palomar Health will be the health system of choice for patients, physicians and employees, recognized nationally for the

highest quality of clinical care and access to comprehensive services

CORE VALUES

Patient’s Well-Being

We passionately give and support heartfelt care that encourages patient comfort and safety

Professionalism

Each of us takes pride in teamwork, self-discipline, our skills and trustworthiness

Highest Quality

We are each accountable for providing the safest, most effective and innovative care

Affiliated Entities

*Palomar Medical Center * Palomar Continuing Care Center * Arch Health Partners*

*Palomar Pomerado Health Foundation * Palomar Pomerado Home Care * Pomerado Hospital* *Palomar Health Development, Inc.* North San Diego County Health Facilities Financing Authority*

*San Marcos Ambulatory Care Center * Villa Pomerado Palomar Pomerado Health Concern * Palomar Pomerado Health Source*

Time Page

I. CALL TO ORDER 2

II. OPENING CEREMONY 5

A. Pledge of Allegiance

III. PUBLIC COMMENTS 5

(5 mins allowed per speaker with cumulative total of 15 mins per group - for

further details and policy see Request for Public Comment notices available

in meeting room.)

IV. MINUTES * 5 1

A. First Closed Session Meeting - May 13, 2013

B. Second Closed Session Meeting -May 13, 2013

C. Third Closed Session Meeting - May 13, 2013

D. Regular Board Meeting - May 13, 2013

V. APPROVAL OF AGENDA to accept the Consent Items as listed * 10

A. 1Approval of Revolving, Patient Refund & Payroll Fund Disbursements – April 2013

1. Accounts Payable Invoices

2. Net Payroll

Total

B. 1Ratification of Paid Bills

C. 1

Summary of Executed Budgeted Routine Physician Agreements - Finance Committee

D. 1

April 2013 and YTD FY2013 Financial Report - Finance Committee

E. 1Arch Health Partners Request for Equity Transfer - Finance Committee

VI. PRESENTATIONS 10A. Bloomberg TV "BRINK" documentary - Palomar Medical Center, Hospital of the Future

VII. REPORTS 12

A. Medical Staffs

*1. Palomar Medical Center - Richard C. Engel, M.D. 5

A. Credentialing and Reappointments

B. Revisions to PMC Pediatric Clinical Privileges

C. Revsions to PMC/POM Emergency Medicine Physician Assistants

Core Privileges

Leonel Sanchez, Media Relations Manager

PALOMAR HEALTH

BOARD OF DIRECTORS REGULAR MEETING AGENDA

Monday, June 10, 2013 Palomar Health Start Time: 6:30 p.m. Downtown Campus Graybill Auditorium 555 E. Valley Parkway Escondido, CA 92025

Mission and Vision

“The mission of Palomar Health is to heal, comfort and

promote health in the communities we serve.”

“The vision of Palomar Health is to be the health system of choice for patients,

physicians and employees, recognized nationally for the highest quality

of clinical care and access to comprehensive services.”

1 To be forwarded under separate cover later this week

*2. Pomerado Hospital - Roger Acheatel, M.D. 5

A. Credentialing and Reappointments

B. Administrative

1 Chairman of the Palomar Health Foundation - John Forst 5 Verbal Report

2 Chairman of the Board - Ted Kleiter 5 Verbal Report

3 President and CEO - Michael Covert, FACHE 5 Verbal Report

VIII. INFORMATION ITEMS

IX. COMMITTEE REPORTS 10 38

A. Governance / Audit and Compliance Committee

B. Human Resources Committee

C. Community Relations Committee

D. Strategic / Facilities and Grounds Committee (no meeting in May)

E. Quality Review Committee

F. 1Finance Committee

G. Other Committee Chair Comments on Committee Highlights

X. BOARD MEMBER COMMENTS/AGENDA ITEMS FOR NEXT 5

MONTH

XI. ADJOURNMENT

1 To be forwarded under separate cover later this week

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BOARD OF DIRECTORS

Closed Session

Pomerado Hospital 15615 Pomerado Rd. Poway, CA 92064

Monday, May 13, 2013

AGENDA ITEM DISCUSSION CONCLUSIONS/ACTION FOLLOW-UP

RESPONSIBLE PARTY

CALL TO ORDER 5:34 P.M.

ESTABLISHMENT OF QUORUM

Present: Directors Kleiter, Krider, Yerxa, Kaufman, Greer, Wickes and Griffith.

NOTICE OF MEETING

Notice of Meeting was mailed consistent with legal requirements. Pursuant to California Government Code §54954.5(h) 20 Report Involving Trade Secrets.

PUBLIC COMMENTS

There were no public comments.

ADJOURNMENT TO CLOSED SESSION

Pursuant to California Government Code §54954.5(h) 20 Report Involving Trade Secrets. Discussion will concern proposed new facility.

Chairman Kleiter adjourned the meeting to closed session.

CLOSED SESSION

OPEN SESSION RESUMES

MOTION: by Chairman Kleiter to resume open session.

ACTION RESULTING FROM CLOSED SESSION DISCUSSION, IF ANY

MOTION: by Director Kaufman, 2nd

by Director Greer and carried to approve the project as described. All in favor. None opposed.

FINAL ADJOURNMENT

Chairman Kleiter adjourned the meeting at 6:04 P.M.

SIGNATURES

Board Secretary

Board Assistant

__________________________________ Linda C. Greer, R.N.

___________________________________ Debbie Hollick

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BOARD OF DIRECTORS

Closed Session



AGENDA ITEM DISCUSSION CONCLUSIONS/ACTION FOLLOW-UP RESPONSIBLE

PARTY




NOTICE OF MEETING

Notice of Meeting was mailed consistent with legal requirements. Pursuant to California Government Code Subdivision (a) of Section 54956.9 Conference with Legal Counsel – Existing Litigation Quarterly Claims/Risk Management Report 2 Conference with Legal Counsel – Existing Litigation Quarterly Claims/Risk Management Rep

PUBLIC COMMENTS



Pursuant to California Government Code Subdivision (a) of Section 54956.9 Conference with Legal Counsel – Existing Litigation


CLOSED SESSION




There was no action resulting from the closed session.

FINAL ADJOURNMENT


SIGNATURES Board Secretary Board Assistant

__________________________________ Linda C. Greer, R.N. ___________________________________ Debbie Hollick

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BOARD OF DIRECTORS

Closed Session




RESPONSIBLE PARTY




NOTICE OF MEETING

Notice of Meeting was mailed consistent with legal requirements. Pursuant to California Government Code §54954.5(h) Report Involving Trade Secrets.

PUBLIC COMMENTS



Pursuant to California Government Code §54954.5(h) Report Involving Trade Secrets. Discussion will concern proposed new service.


CLOSED SESSION




MOTION: by Director Krider, 2nd

by Director Wickes and carried to approve the proposed Cerner contract for Information Technology software and services. All in favor. None opposed.

FINAL ADJOURNMENT


SIGNATURES Board Secretary Board Assistant


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BOARD OF DIRECTORS REGULAR BOARD MEETING

Pomerado Hospital 15615 Pomerado Rd.

Poway, CA 92064



RESPONSIBLE PARTY

CALL TO ORDER 6:33 P.M. Quorum comprised of Directors Kleiter, Krider, Yerxa, Wickes, Griffith, Kaufman and Greer.

OPENING CEREMONY The Pledge of Allegiance was recited in unison.

MISSION AND VISION STATEMENTS The Palomar Health mission and vision

statements are as follows: The mission of Palomar Health is to heal, comfort and promote health in the communities we serve. The vision of Palomar Health is to be the health system of choice for patients, physicians and employees, recognized nationally for the highest quality of clinical care and access to comprehensive services.

NOTICE OF MEETING Notice of Meeting was mailed consistent with legal requirements

PUBLIC COMMENTS Erik Olson Fernandez and Patty Hirst spoke about caregivers and nurses.

APPROVAL OF MINUTES

Closed Session Board Meeting April 8, 2013

MOTION: by Director Kaufman, 2nd

by Director Greer and carried to approve the Closed Session and Regular Board Meeting minutes of April 8, 2013 as submitted.

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AGENDA ITEM DISCUSSION CONCLUSIONS/ACTION FOLLOW-UP RESPONSIBLE PARTY

Regular Board Meeting April 8, 2013

All in favor. None opposed.

APPROVAL OF AGENDA

(to accept the Consent Items as listed)

A. Approval of Revolving, Patient Refund & Payroll Fund Disbursements– March 2013 Accounts Payable Invoices $ 34,273,150.00 Net Payroll $ 21,184,082.00 Total $ 55,457,232.00 B. Ratification of Paid Bills C. Budgeted Routine Physician Agreements Board Summary Report D. March 2013 & YTD FY2014 Financial Report E. CEP – Final Hospitalist Agreement - Finance Committee F. Resolution No. 05.13.13(02)-01 – Morgan Stanley – Authorized Persons & Enabling Resolutions for Municipalities and Certain Other Unincorporated Entities G. Banking and Treasury Services RFP H. Annual Financial Audit Policy - 21808 – Governance / Audit & Compliance Committee I. Board Self-Evaluation Policy - 21782 - Governance / Audit & Compliance Committee J. Confidentiality Statement Policy - 21799 – Governance / Audit & Compliance Committee

K. Establishing Board Meeting Dates Policy – 21793 - Governance / Audit & Compliance Committee L. Gifts & Donations Policy - 21776 – Governance / Audit & Compliance Committee M. Board Community Relations Committee Description Governance / Audit & Compliance Committee N. Board Governance / Audit & Compliance Committee Description Governance / Audit & Compliance Committee O. Board Finance Committee Description Governance / Audit & Compliance Committee P. Board Human Resources Committee


by Director Kaufman and carried to approve the Consent Items as submitted. All in favor. None opposed.

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Description Governance / Audit & Compliance Committee Q. Board Quality Review Committee Description Governance / Audit & Compliance Committee R. Board Strategic & Facilities Planning Committee Description Governance / Audit & Compliance Committee S. Board Handbook Table of Contents Governance / Audit & Compliance Committee T. Palomar Medical Center Medical Staff Bylaws June 2011 Governance / Audit & Compliance Committee U. Pomerado Medical Staff Bylaws June 2011 Governance / Audit & Compliance Committee

PRESENTATIONS There were no presentations.

REPORTS Medical Staff Palomar Medical Center

Credentialing and Reappointments Richard Engel, M.D., Chief of Staff, Palomar Medical Center, presented requests for approval of Credentialing and Reappointment Recommendations.


by Director Yerxa and carried to approve the Palomar Medical Center Medical Staff Executive Committee Credentialing and Reappointments recommendations for the Palomar Medical Center Staff as presented. All in favor. None opposed.

Pomerado Medical Center

Credentialing and Reappointments Roger Acheatel, M.D., Chief of Staff for Pomerado Hospital, presented requests for approval of Credentialing and Reappointments Recommendations.


by Director Yerxa and carried to approve the Pomerado Hospital Medical Staff‘s Executive Committee Credentialing and Reappointments recommendations for the Pomerado Medical Staff as presented. All in favor. None opposed.

Administrative

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Palomar Health Foundation John Forst, Palomar Health Foundation, Board Chair Chairman Forst reported that in April 2013, the Foundation received $268,113 in cash, new pledges and pledge payments. Year-to-date $2,972,804 in cash, new pledges and pledge payments have been received. The Medical Staff Campaign has received $3,838,978 million toward the $5 million goal in cash and pledges as of April 30, 2013, including gifts made in response to the physician alumni reunion event which took place last month. The Chapel Campaign has received $283,854 in cash. A firm has been contracted to begin the design process for the chapel project. A visioning session has been planned for Tuesday, May 21, at which point the Chapel Committee will present their vision for the chapel to the Architects. The Employee Campaign has received $2,827,113 million in cash and pledges as of April 30, 2013. During the month of April, $61,700 in new employee gifts were received during rounds conducted by Employee Campaign members lead by Sonia Lopez. In the past twelve weeks since the Corporate Partners in Health Annual Giving and Sponsorship program launched, 16 corporations and organizations have pledged their support at various sponsorship levels, generating $164,104 in sponsorships. Letters and follow-up phone calls have been made to 1,305 households since the program launched in April. The program

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has generated $23,925 in new gifts and pledges nearing the $25,000 matching gift made by Kevin Harkenrider, Foundation Board member. The program will continue through the spring and summer months with letters and phone calls planned for a total of 10,000 households. The next issue of the Foundation newsletter will be sent to nearly 20,000 households later this week. The newsletter features articles on the Physician Alumni Reunion, and a cover article on Penny and Harold Dokmo for their generous gift in support of the chapel project at the new hospital. Mr. Dokmo is a member of the Foundation board and a Rancho Bernardo business owner. A series of oral history sessions filmed by Dr. Ralph Ocampo have been hosted at the Palomar Health Foundation. The series features panels of retired and former Palomar Health-affiliated physicians who share their historical account of Palomar Health’s past. The next Oral History Project session is scheduled this Wednesday, May 15, and will feature Palomar Health Board Chairman, Ted Kleiter, as the featured speaker.

Chairman of the Board Ted Kleiter Chairman Kleiter reported that he and Chief

Financial Officer Robert Hemker attended the recent HealthPro annual meeting (HealthPro being the proprietary arm of BETA). He also went on to congratulate Mr. Hemker for being elected chair of the HealthPro Board.

President and CEO Michael Covert Mr. Covert reported that talks are continuing

with Loma Linda re: partnering to establish

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a common insurance product. He also noted that there are great opportunities for Palomar Health to build a presence in Riverside county. Mr. Covert stated that, due to issues such as lower reimbursement rates, Medicare sequestration, patient satisfaction scores and lower census levels, the organization has been compelled to look for ways to right-size itself and deal with these challenges. Therefore, several staffing positions will be reduced and 84 employees (or approximately 2% of the workforce) will be laid off. The organization is looking to make reductions in all expenses, not just labor. Mr. Covert also noted that coming to an agreement with the union that is amenable to all parties will be vital to the growth of the organization and its employees. Mr. Covert reported that the Board Strategic & Facilities Planning committee has approved the 2013 - 2017 Strategic Plan as presented; the plan will be shared with all physicians and staff as it has implications for the organization and its growth as a whole. Mr. Covert stated that changes need to be made to the way that we price our services. Unfortunately much of Palomar Health’s pricing has been built over the years utilizing CMS/Medicare chargemaster. He included that he would like to have discussion, perhaps at the Board Finance level, on how to best address this and to challenge ourselves to come up with a new way to create a realistic charging methodology for services rendered. Chairman Kleiter noted that that he appreciates the work that will be done to

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help clarify the chargemaster issues, noting that the system needs major improvements as it currently varies from one hospital to anther and from one state to another. On behalf of the Board of Directors, Mr. Covert presented Dr. Paul Neustein with an award for his service in 2012 as Chief of Staff-elect at Pomerado Hospital.

COMMITTEE CHAIR COMMENTS Governance / Audit and Compliance

Director Greer commented on the State Legislatives Bills report that was presented at the last Governance Audit and Compliance committee meeting. She noted that, if approved, AB 900 will have a significant impact to the organization. AB 900 involves cuts that will reduce the Medi-Cal reimbursement to Palomar Health’s DP/SNFs by 30% and 37%. The state will also seek to recuperate the higher reimbursements dating back to June 1, 2011, resulting in an effective rate reduction of 50%.

Human Resources Director Krider reported that the Human Resources committee did not convene in April, opting to utilize that time for orienting Director Aeron Wickes to their departmental structure, processes and programs.

Quality Review Director Greer wished to express to everyone that the Board has the ear of the employees and the community regarding the quality of care provided to our patients. She shared that she regularly hears many good things from patients and their families, but allowed that we all need to continuously strive to improve. She stated that she is fully aware of what goes on in the front lines of patient care, noting that the organization is currently focusing efforts on the patient flow process, from admission to post-discharge. She reiterated that the Board is proud of the work and effort put forth by all Palomar staff.

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Strategic & Facilities Planning

The April 2013 Board Strategic & Facilities Planning Committee meeting summary was accepted as written.

Finance The April 2013 Board Finance Committee meeting summary was accepted as written.

Community Relations Marketing / Public Relations Specialist Bobette Brown provided a Community Relations Committee Health Care Communicators update, noting that Palomar Health has once again been lauded with many honors by this long-standing organization. Such honors include the prestigious Best in Show Award for Media Relations for the opening of the new Palomar Health Medical Center. This auspicious recognition was compounded by the fact that the winner must receive a perfect score!

Additional Comments

Director Krider asked everyone to keep the current issues facing the organization in perspective, and to know that the Board and administration are fully invested in ensuring that the compensation offered to Palomar Health employees is in line with the market survey rates for facilities in the area. He also requested that the issues not be taken out of context. Director Greer questioned whether the upcoming Board Budget Workshop meeting packet would be published in advance of the meeting, to which an affirmative response was given.

ADJOURNMENT 7:17 P.M. SIGNATURES

Board Secretary

Board Assistant


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ME M O R AN D U M

TO: Debbie Hollick, Executive Assistant to the Board FROM: Tammy Chung, Assistant to the Board Community Relations Committee DATE: May 22, 2013 RE: Board Community Relations Committee – May 8, 2013 Meeting Summary INFORMATION ITEMS: Leonel Sanchez reported on Palomar Health in the news including media monitoring and analytics 2012/2013. Samples of FREE media:

• U-T San Diego – Headline: “Palomar moves patients to new hospital” – UT San Diego 8/19/2012 (A-1) • Bloomberg Television • ENR.com – Engineering News-Record • NCT, 8/20/2012 Headline: Open for Business Photo: Palomar Health nurse caring for the Rev. Harry

Kuehl, one of first patients at PMC • Health Care Design Magazine • HealthLeaders Magazine • ModernHealthcare.com

Leonel mentioned that Palomar Health appeared in the news 1,706 times since 1/15/12 with a total ad value of $1.4 million in free media, including print circulation of 26.7 million and total unique online visitors of 640 million. This information was derived from a PR media-monitoring tool called Vocus, which tracks media and prepares reports. Vocus is also able to gauge tone of story. The majority of Palomar Health’s coverage was neutral to positive. The top outlets by news article listing since January 2012:

1. UT San Diego/NC Times: 221 2. San Diego Daily Transcript: 111 3. Pomerado News: 108 4. California Patch: 49 5. KGTV: 40 6. Ramona Sentinel: 35 7. Individual.com (aggregator): 31 8. KFMB: 29 9. KUSI: 24 10. KSWB: 24

The media seems to be most interested in technology, expansion of services and newness. Palomar Health was featured in articles across the nation including The Boston Globe, Health Care Design Magazine, HealthLeaders Magazine and ModernHealthcare.com. Leonel shared a clip from the Bloomberg TV’s print time program BRINK that featured PMC on May 6, 2013. Bloomberg Television reaches 310 million households

Cameron Curry, Executive Director of The Classical Academy, provided an overview of the Classical Academy organization, founded in 1999 by a group of dedicated parents and community members. There are elementary schools in Escondido and Oceanside with a Learning Center in Vista. The Classical Academies collaborated with ViaSat, Genentech, Northrop Grumman and California State University San Marcos to provide the 3rd Annual Super STEM Saturday on March 16, 2013. This interactive event focused on science, technology, engineering and math. They are making plans for their 2014 STEM Saturday event and invited Palomar Health to be a partner. The 2014 event will be March 15, 2014.

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Janet Klitzner provided an overview of the Health Care Communicators of San Diego County. The HCC was established in 1977 and serves as a valuable networking resource for the region’s health care marketing and communications professionals. They host programming/networking meetings on a monthly basis with their largest evening being the HCC Finest Awards, which started in 1993. This year’s event received 121 entries from 14 different health-care organizations. Palomar Health submitted 14 entries. The entries were judged by Orange County health care marketing professionals in four categories: goal, planning, creativity and results. Palomar Health has earned over 20 awards from 2004 – 2012 including “Best in Show for the Prop BB Campaign in 2004. Bobette Brown has served on the Board for the past two years as the Finest Chair and now serves as President. Palomar Health earned the following awards:

Ad Campaign -- GOLD – Opening of the New PMC

Media Relations -- Gold – Opening of the New PMC

Logo Creation/Brand Identity -- Gold – Palomar Health Logo

Single-Day Event -- Gold – The New PMC Community Celebration

Invitation--Gold – The New PMC Community Celebration Invitation

Internal/External Magazine -- Silver – The HealthSource Magazine

Special Publication -- Silver – The New PMC Community Celebration Program

Brochure -- Silver – Excitement is Building Brochure Series

Off the Wall -- Silver – Employee Passport (No Gold Award)

BEST IN SHOW -- Opening of the New PMC -- Media Relations (Must receive a PERFECT score)

Elly Garner provided a Government Affairs update:

AB 900 – Reverse Cuts to Distinct-Part Skilled-Nursing Facilities Passed Assembly Health unanimously Was heard in the Assembly Appropriations Committee on 5/8/2013

Elly also provided an overview of the Scope of Practice Bills: • SB 491 – Nurse Practitioners

– Changes the Nurse Practice Act; would remove requirement that medical acts performed by a nurse practitioner need standardized procedure or consultation with a physician or surgeon

• SB 492 – Optometrists – Allows optometrists to perform certain health-related services, including preventing, diagnosing,

and treating any disease, condition, or disorder of the visual system, the human eye, and adjacent and related structures, prescribing appropriate drugs, and administering immunizations

• SB 493 – Pharmacists – Authorizes a pharmacist to administer drugs and biological products that have been ordered by a

prescriber; would expand other functions pharmacists are authorized to perform ACTION ITEMS:

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ME M O R AN D U M

TO: Debbie Hollick, Executive Assistant to the Board

FROM: Sherry McClendon, Assistant to the Board Quality Committee

DATE: May 21, 2013

RE: Board Quality Review Committee – May 20, 2013 Meeting Summary

INFORMATION ITEMS:

Nursing Division Update: Lorie Shoemaker, Chief Nursing Officer provided an overview of the Nursing Division key accomplishments to include: Stabilization of key processes at PMC, Nursing/Medical Director Dyads, Community Care Transition Program and Patient Flow. Lorie also shared the focus for the immediate future to include: shift huddles, incident debrief, service excellence bundle, falls bundle and accountability metrics and audits.

Joe Parker, Care Transitions Nurse Leader also presented on the Alert Management Taskforce Performance Improvement Project which reduced overall alerts by 71.6%.

Skilled Nursing Facility Update: Steve Gold, Chief Officer Post Acute Services and staff provided an overview to include Infection Control Norovirus outbreaks, California Department of Public Health (CDPH) survey outcomes to include 8 minor deficiencies at Villa Pomerado and 4 minor deficiencies at PCCC. Deficiencies are under the National average of 9.4 and California average of 12.4.

Laura Weber, Nurse Practitioner presented on the Re-Admission Performance Improvement Project. Findings found 70% of readmitted patients at PCCC returned to the hospital within 10 days, discharge diagnoses for re-admission did not show trends, and re-admits most frequent on Thursday at PCCC and Friday at Villa POM.

Hospitality Performance Improvement Update: David Tam, M.D., Chief Administrative Office, POM provided an update on Hospitality Services for Palomar Hospital. Aramark’s contract will end on June 30, 2013 and Palomar Hospital will be creating a new Hospitality Division.

Quality / Patient Safety Plan: Opal Reinbold, Chief Quality Officer provided an update on the Quality / Patient Safety Plan to include the kick-off of working with Truven to improve reporting capabilities, Dr. Neustein has stepped in as MD Champion for Infection Control, Executive Health Resource (EHR) will be starting on July 1, 2013 to assist with the appropriate level of care, and the Patient Flow pilot was kicked off on May 1, 2013.

ACTION ITEMS:

No Action Items

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board of directors agenda packet - palomar health · 10/06/2013 · bruce g. krider, m.a. jeffrey...

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