Norman Regional Hospital Authority Meeting

NORMAN REGIONAL HOSPITAL AUTHORITY Board Meeting April 27, 2020 MINUTES The Norman Regional Hospital Authority met in monthly session Monday, April 27, 2020 at 12:00p.m. via Webex and in the Norman Regional Hospital Board Room. The meeting Agenda was posted April 23, 2020 on the NRHS and City of Norman websites and at the entrance to Norman Regional Hospital. Members Present: Doug Cubberley, Chairman Members Present via Webex: Jerome (Jerry) Weber, Ph.D. Diane Chambers, MD Kevin Pipes Muhammad Anwar, MD Joan Kemmet-Greenleaf Tom Sherman Mary Womack Others Present: Richie Splitt, President & CEO John Manfredo, COO Brittni McGill, CNO Paula Price, VP Strategy & Growth Ken Hopkins, CFO Meegan Carter, VP Population Health & Wellness Aaron Boyd, MD, Chief Medical Officer Steven Sheriff, Network Infrastructure Architect Others Present Via Webex: Dr. Farhan Jawed, MD, Chief of Medical Staff Dr. Joe Voto, MD, Chief of Medical Staff-elect Jenny Anderson, Administrative Director, Quality & Performance Lisa White, Manager Performance Improvement & Medical Staff Services Larry Harden, Administrative Director, Compliance Karen Rieger, Attorney, Crowe & Dunlevy Neal Risenhoover, Supervisor, Media Services Recorder: Claudia Todd, Executive Assistant  NRHA Board Minutes 2 April 27, 2020 Agenda Item I. Meeting Called to Order Mr. Cubberley called the April 27, 2020, Norman Regional Hospital Authority meeting to order at 12:02p.m. Mr. Cubberley reviewed the rules for the Webex meeting participation. Roll call was taken by Claudia Todd. Agenda Item II. Consent Items A. May 2020 Healer of the Month – Laura Winters, RN, Manager, Intensive Care Unit B. Board/Community Update: Variety Care C. March 23, 2020 NRHA Board Meeting Minutes D. Quality & Safety Committee Update ACTION TAKEN: Dr. Weber motioned to approve Consent Items A-D. Ms. Greenleaf seconded the motion. Consent Items were approved unanimously with aye votes from Mr. Cubberley, Dr. Weber, Dr. Chambers, Dr. Anwar, Ms. Greenleaf and Mr. Sherman. Mr. Pipes joined the meeting at 12:08pm. Ms. Womack joined the meeting at 12:16pm. Agenda Item III. Approval of the March 2020 Norman Regional Health System Financial Statements Mr. Hopkins presented the March 2020 Norman Regional Health System Financial report: March 2020 Financial Performance  Gross Revenues .................................. (Budget $189,029,720)............ $157,208,204  Net Patient Revenue .............................. (Budget $41,300,422).............. $32,216,322  Total Operating Expenses ..................... (Budget $40,807,320).............. $40,373,620  Total Operating Revenues ...................... (Budget $41,723,239).............. $32,621,240  Operating Income ....................................... (Budget $915,919).............. ($7,752,379)  Non-Operating Revenues (Expenses) ..... (Budget $1,154,307)............ ($13,112,686)  Excess Revenues over Expenses ............ (Budget $2,070,226)............ ($20,865,065) Year-to-Date  Operating Income .................................... (Budget $9,179,399).............. ($3,830,369)  Non-Operating Revenues (Expenses) ..... (Budget $9,388,763).............. ($5,584,949)  Excess Revenues over Expenses .......... (Budget $18,568,162).............. ($9,415,319)  Accounts Receivable Days ............................ (Budget 43 Days).................. 49.5 Days  Days Cash on Hand…………………………………………………………….180.1 Days ACTION TAKEN: Dr. Weber motioned to approve the March 2020 NRHS Financial Statements. Dr. Anwar seconded the motion. March Financials were approved unanimously with aye votes from Mr. Cubberley, Dr. Weber,  NRHA Board Minutes 3 April 27, 2020 Mr. Pipes, Dr. Chambers, Dr. Anwar, Ms. Greenleaf, Mr. Sherman and Ms. Womack. Agenda Item IV. Medical Staff A. Dr. Jawed presented the Medical Staff report. He stated the Medical Executive Committee (MEC) met on April 8, 2020. New Business:  TigerConnect – Access was given on this secure application to nurses working in Case Management in order to aid communication with physicians during the COVID-19 pandemic.  COVID-19 – Open discussion was held covering COVID-19 details and testing. Dr. Jawed shared current case numbers as provided by the state department of health. Department Reports: Reports were provided by Emergency Medicine, GMEC, OB/GYN, Pediatric Hospitalist, Pharmacy & Therapeutics, Physician Advisory, Radiology, Residency, Surgery and Medical Staff. Administrative Reports: Ms. McGill provided an update from the Emerging Infectious Disease Team (EID) and other clinical departments. Ms. Carter announced the Cleveland County Health Department would be hosting COVID- 19 drive-thru testing on specific dates at Griffin Memorial Park. Ms. Price expressed thanks to the Foundation and their efforts to obtain Personal Protective Equipment (PPE) donations from throughout the community. Mr. Manfredo reported that physician-led discussions are ongoing to plan for resuming elective surgeries. Mr. Splitt thanked healers for their dedication and collaboration during this challenging time. Agenda Item V. Finance Committee A. Report from the April 20, 2020 Finance Committee Mr. Sherman reported committee discussions focused mainly on the financial impact of COVID-19 – especially NRHS’s decision to proactively postpose elective surgeries starting March 16,2020. Mr. Hopkins provided an update on the Corona Aid, Relief and Economic Security Act (CARES Act): o The first wave of Provider Relief Funds were received by NRHS and was proportionate to NRHS’s share of Medicare fee-for-service reimbursements in 2019. o Accelerated and Advanced Payments Program – During this public health emergency, CMS expanded their existing program to a broader group of Medicare providers. These expedited payment are being offered in order to accelerate cash flow to the impacted health care providers. NRHS applied for this program and awaits final approval/denial. o Telehealth flexibility, utilization and payment was also provided.  NRHA Board Minutes 4 April 27, 2020 Mr. Hopkins reported a Line of Credit initiated through a local banking institution to ensure liquidity. B. Mr. Manfredo presented for approval capital items totaling $4,707,339 – a. Mobile Digital Radiographic Unit: $120,000 b. Journey Clinic - Phase 2 Construction: $1,759,950 c. HIT Project: Upgrade OCC Technology to NRHS Standards: $303,533 d. API Healthcare System: $158,325 e. Defibrillator & AED Standardization/Optimization Project: $1,675,379 f. HIT Project/Windows Upgrade & COVID-19: $73,250 g. COVID In-House Testing Equipment: $80,190 h. Lab RNA Extraction Equipment: $68,277 i. Single-Chamber Washer/Disinfector: $468,436 ACTION TAKEN: Dr. Weber made a motion to approve the Capital Equipment Request, cost $4,707,339 as recommended by the Finance Committee. Ms. Greenleaf seconded and the motion was approved unanimously with votes from Mr. Cubberley, Dr. Weber, Mr. Pipes, Dr. Anwar and Dr. Chambers, Ms. Greenleaf, Mr. Sherman and Ms. Womack. Agenda Item VI. Old Business None Agenda Item VII. New Business A. Crisis Standard of Care Mr. Larry Harden, Administrative Director, Risk Management, reported the recent opportunity to work with Oklahoma State Department of Health (OSDH) and representatives from Oklahoma City metro health systems to develop guidelines for the Crisis Standards of Care. The group reviewed current guidelines and made recommendations to address potential circumstances whereby resources become scarce during crisis conditions. The revised Crisis Standard of Care was approved by the OSDH and is now available to guide hospitals and providers throughout the state. B. Proposed Revisions to the 2020 Infection Prevention Plan Policy ACTION TAKEN: Dr. Weber made a motion to approve the Proposed Revisions to the 2020 Infection Prevention Plan Policy. Ms. Greenleaf seconded and the motion was approved unanimously with votes from Mr. Cubberley, Dr. Weber, Mr. Pipes, Dr. Anwar and Dr. Chambers, Ms. Greenleaf, Mr. Sherman and Ms. Womack. Agenda Item VIII. Administrative Report  NRHA Board Minutes 5 April 27, 2020 Mr. Manfredo provided an Inspire Health update for the Free Standing Emergency Department. Representatives of NRHS presented the site master plan to the Planning Commission. This was the first of several scheduled meetings to receive feedback and comments from residents in the immediate area of the proposed development. During the Commission’s Zoom meeting, community members asked questions and provided feedback about the site. Those comments and questions will be taken into account before the next Planning meeting. Mr. Splitt provided further details on the COVID-19 CARES Act. $50 billion of the Provider Relief Fund is allocated for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers’ net patient revenue. The initial $30 billion was distributed between April 10 and April 17. NRHS received that relief payment. Distribution of the remaining $20 billion started Friday, April 24. Payments will go out weekly, on a rolling basis, as information is validated. All recipients will be required to submit documents sufficient to ensure that these funds were used for healthcare-related expenses or lost revenue attributable to coronavirus. Norman Mayor Brea Clark announced the initiative to “Reboot Norman”. Norman Regional is working closely with the mayor and City of Norman to assist in determining what this (re-opening) process will look like. Following the directive issued by the Governor’s office to allow elective surgeries to resume April 24, Norman Regional has begun the safe and gradual transition of resuming the elective surgery process. Mr. Splitt shared graphs and data used by the Governor’s office to assist in determining measures to re-open the state under his plan, Open Up and Recover Safely (OURS). NRHS will act in accordance with orders from the Governor and Mayor. Ms. Carter provided an update on Virtual Visits. When Physician offices closed in early March, Norman Regional began to ramp up virtual clinic visits in order to preserve necessary patient care and to remain connected to our patients. As a result, we experienced a significant jump in virtual visits. Bryce Ell, former Administrative Fellow, accepted the position of TeleHeath Manager. Mr. Ell will work to expand existing Telehealth programs and to pursue new programmatic offerings that better connect patients to providers. During this public health emergency, telehealth has been a very effective tool used to aid COVID-a9 screening as well as extending important care to our patients. COVID-19 antibody testing will soon be made available to our healers. Mayor Clark would like to make COVID-19 tests more readily available to the entire Norman community, and NRHS is working hard to fulfill that request. Agenda Item IX. Proposed Executive Session A. Proposed Vote to Convene an Executive Session Pursuant to 25 Okla. Stat. Section 307 B.4. to Discuss with Legal Counsel Pending Internal Peer Review/Credentialing Investigation Regarding the Medical Staff Members/Applicants Listed Below; ACTION TAKEN: Dr. Weber made a motion to adjourn into Executive Session. Mr. Pipes seconded and the motion was approved unanimously with NRHA Board Minutes 6 April 27, 2020 aye votes from Mr. Cubberley, Dr. Weber, Mr. Pipes, Dr. Chambers and Dr. Anwar, Ms. Greenleaf, Mr. Sherman and Ms. Womack. B. Medical Staff Recommendations Regarding the Medical Staff Members/ Applicants as Listed in XIII.B 1-2 Below. 1. Recommend New Provisional Medical Staff Appointments a. Kendral Knight, MD – Active Staff – Medicine b. Michelle Spehr, APRN-CNP – Allied Health – Pediatrics c. Dylan Shockley, APRN-CNP – Allied Health – Medicine 2. Recommend Medical Staff Reappointments: a. Julie Rygaard, MD – Active Staff – Anesthesia b. John Cherry, DO – Active Staff – OB/GYN c. Betty Harmon, MD – Active Staff – Pediatrics d. Daphne Lashbrook, MD – Active Staff – OB/GYN e. Kevin McKeown, MD – Active Staff – Anesthesia f. Todd Gleaves, MD – Active Staff – Anesthesia g. Kiran Prabhu, MD – Consulting Staff – Medicine h. Nicole Jarvis, MD – Associate Staff – OB/GYN i. Christi Pendergraft, MD – Associate Staff – Medicine j. Cheryl Montgomery, RNFA – Allied Health Staff – Surgery k. Lauren Hill, PA-C – Allied Health Staff – Surgery l. John Chace, MD – Ortho Central m. Jordan Hobbs, PA-C – Ortho Central C. Request to Adjourn Out of Any Such Executive Session and Return to Regular Session ACTION TAKEN: Dr. Weber made a motion to adjourn out of Executive Session and return to regular session. Ms. Greenleaf seconded, and the motion was approved unanimous aye votes from Mr. Cubberley, Dr. Weber, Dr. Chambers, Mr. Pipes and Dr. Anwar, Ms. Greenleaf, Mr. Sherman and Ms. Womack. Mr. Cubberley noted the Board returned to regular session. There were no decisions or votes taken except to return to regular session and any information shared during the Executive Session is privileged and needs to remain in Executive Session. D. Proposed Vote to Approve or Disapprove the Medical Executive Committee Recommendations Regarding Credentialing of the Referenced Medical Staff Members as Listed in XII B 1-2. ACTION TAKEN: Dr. Weber motioned to approve credentialing items as recommended by Medical Executive Committee and Credentials Committee of all referenced Medical Staff members listed in XII B 1-2. Ms. Womack seconded, and the motion was approved with unanimous aye votes from Mr. Cubberley, Mr. Weber, Dr.  NRHA Board Minutes 7 April 27, 2020 Chambers, Mr. Pipes and Dr. Anwar, Ms. Greenleaf, Mr. Sherman and Ms. Womack. Agenda Item X. Board Open Discussion None. Agenda Item XI. Adjournment ACTION TAKEN: Mr. Sherman made a motion to adjourn the meeting at 1:03p.m. Ms. Greenleaf seconded, and the motion passed unanimously with aye votes from Mr. Cubberley, Dr. Weber, Mr. Pipes, Dr. Chambers and Dr. Anwar, Ms. Greenleaf, Mr. Sherman and Ms. Womack. Respectfully Submitted, Tom Sherman, Vice-Chair/Secretary