Notes for 2/7

Because of the delay, I don't know how complete I can make these notes.

1.  Announcements from closed session - Reports approved.

2.  Consent Calendar approved.

3.  ECG Monitoring system is old, outdated, and prone to glitches.  The ER had a system from the same company (Nihon Kohden) installed previously so the telemetry antennas are already available to be used.  The price is around 300k or about 6500 per month.  This is urgent and a patient safety issue.  It's another 300k that has to be paid off over time that the Hospital can't afford, but the safety issue wins out so I voted for.  Financing will be from  Bank of America on the existing 2.5 million master equipment lease (from May 2010 for the PAC, about 700k remains available).  Other systems were more expensive because they could not use the existing antennas (don't know if it's a radio frequency, lease, or proprietary protocol issue and did not ask).

4.  Stroke certification proceeds apace.  The TJC has assigned an account manager.  (The TJC charges hospitals to provide certifications so the structure of some of these things is almost like a vendor/client relationship.)

5.  Monthly statistics for January are again ahead of budget which would suggest that January financials would be favorable again (like November and December) which has brought the Hospital back from a several hundred thousand YTD loss of only 49k.  Surprisingly even a 139k positive result for December was still over 100k short of the December budget.  I knew that this fiscal year budget was optimistic, but I guess I had not thought it was so optimistic as to expect that any single month would have net income of almost a quarter million dollars (239k is the exact number).  The problem with expecting a positive January is due to a probable restructuring of IGT funds, the last month that IGT revenue will be accrued is December.  This means January has to absorb a 187k negative hit.  It's possible that there might be a slight positive given the patient census and an offsetting favorable adjustment to some long-term care reimbursement dollars, but I think it would be somewhat of a surprise if any month from now to the end of the year is positive.  There may be some future political relief in sight that might restore some of these funds, but it is not anticipated at the present time.

6.  ICU financial analysis -  Ms Stebbins answered most/all of my questions.  The preliminary financial analysis may not be 100% accurate.  The numbers seemed low to Doctors Deutsch and Yeh for the ICU charges.  They appeared to be consistent with some numbers available via a web search.  It's not clear what was included or excluded.  ICU days apparently are, on par, about the same amount of contribution as regular med/surg days although that analysis is skewed for the previous year (Kaiser cases?) The numbers for November and December were higher than historical and the 5.3 ADC was the highest for the past 5 years.  The 5.0 ADC was second or third highest in the same timeframe.  As an aside, it looks like this increase was one or two particular patients whose families wanted to continue aggressive care.  

6.  IT projects -  See the table provided in the Board material.  Quite a few ambitious projects especialy the PACS which will go live shortly.  The Hospital anticipates capturing meaningful use dollars for its IT upgrades, but I am more than a little skeptical.  Not really a criticism of this Hospital since all IT projects suffer from undue optimism, but especially healthcare IT projects.  I have seen Kaiser and UCSF software updates over two years later. The table has some old dates and some typos so it will be updated (and posted?).  I'm not sure when the update will be provided.  If not by the next Board meeting then I will ask.

7.  Updates/Events - Get your stroke screening.  The Hospital sent out postcards to most Alamedans; we got ours.  It looks like you can get a free mini-physical.  HR tenure event on 2/28.

8.  Facilities -  NPC2 Discussion is below.  Only addition to this is that I have confirmed that indeed the NPC2 requirements are applicable, but not being enforced.  That information comes straight from OSHPD.  So, although Alameda Hospital's license is valid, there is no legal reason it should remain so except forebearance on the part of OSHPD.  Also reported is that the wound care lease terms and the letter of intent terms were different in several material ways so those are being worked out.  The wound care financing will likely be through a credit line from the Bank of Alameda with the Hospital's equity commitment likely coming from the generous support of the Foundation.  It is anticipated that the package will be voted upon in March.  My tentative position is, although I believe in seeking out new revenue and offering new services where appropriate, that the capital commitment is too high and the potential contribution too speculative for me to vote in favor given, what I perceive is the looming crisis.  Until a plan is in place for addressing the question of acute care services and long-term financial viability (without the parcel tax subsidy), I do not believe I can support these type of initiatives.

9.  Community Relations Committee failed to make a quorum.  Let Stewart Chen know if you wish to serve.

 I am sure I forgot a lot.  Comments are open if someone who was there or one of the six people so far (as of 10:00 am 2/16) who watched the video wants to correct any errors or omissions.