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‘Hero Pay’ among topics for GSHA board discussion

By Staff | Aug 29, 2020

New hires and new ideas for boosting employee morale were among topics for discussion by the Good Samaritan Hospital Association at its regular August meeting on Monday, Aug. 24.

Citing an increased count of COVID-19 cases in Pierce County and ever-changing directives from government health officials to combat the outbreak, Heart of America Medical Center CEO Erik Christenson noted employee morale has sunk in recent months at the hospital, clinic and long-term care facilities. Christenson proposed a one-time payment of $500 for full-time employees and $250 for part-time employees at Heart of America Medical Center, Heart of America Johnson Clinic and Haaland Estates.

Called “Hero Pay,” the bonuses would go to 243 full-time and 13 part-time employees.

“The total cost if we were to do that would be $124,750,” Christenson told the board. HAMC Chief Financial Officer Melissa Shepard said the payments would come from federal CARES Act funds the hospital received to combat the pandemic.

The board voted to approve the payments. No date has been set for the disbursement.

“We’re looking at things like popcorn day. We stopped doing things like that because of COVID. I think we’re going to do that again,” Christenson said, “We’re looking at other ideas, like a corn feed. We’re looking at ways to improve employee morale and keep the staff engaged and everybody working toward the same goals.”

Christenson reported success in CEO Circles, a program where employees air their concerns freely. Christenson said a “more formal” CEO forum, where employees can talk with him in a large group, would take place at the end of September.

Shepard presented an audit report for review by the board. She also reported monthly financial information, which put the hospital’s cash at 44.92 days and accounts receivable at 24.3 days. “Average payment period is 24.3 so that’s how quickly we’re paying our accounts payable. Accounts payable is current. No outstanding liability,” she said.

“Revenues were higher this month than what we had budgeted for so we had a little bit more, which was great. Expenses were slightly over though. With non-operating income, we did have operating income. Net income has covered net losses over the last couple of periods,” she added.

“The tax return is in final review. It will be finalized this month and submitted. That will be for the hospital foundation as well. We just finalized the Medicare cost report. We just started the Medicaid cost report,” Shepard said.

“Basic care cost reports have already been filed,” she added.

The board heard of two new administrative hires at the hospital. Sarah Radomski began work Aug. 17 as HAMC’s new human resources manager and Meredith Childress was hired as the new hospital compliance officer Aug. 27.

Christenson told the board the Human Resources Department had begun work on a new employee handbook, and documents to comply with Medicare transparency requirements would be put on the hospital’s website.

The board heard information about changes in workflow at HAMC’s Johnson Clinic.

Christenson said the changes were “due to COVID Dustin (Hager) has adjusted to one day instead of half a day in the clinic due to the volume. As we get into cold and cough season I think we’ll see probably increased volumes in the COVID clinic again. You should know that this provides stress on the doctors and nurses. You have to gown up, basically complete PPE, face mask, all the different things to protect themselves and their patients from COVID. So, it’s a lot of work. It’s an added stress on the staff.”

The board heard an update on the development of the hospital’s strategic plan, which will be presented at a public meeting in November.

Dustin Hager presented a study on outmigration, which he said meant seeking medical care from providers outside of a patient’s local clinic. Hager said he used data from Blue Cross/Blue Shield health insurance studies.

“The number of BCBS patients seeking care elsewhere were low, but the dollar amounts were high,” Hager reported. In Pierce County, according to (Blue Cross/Blue Shield) data, we had 695 patients receiving care here on a regular basis. They claim the total number of Blue Cross Blue Shield members in Pierce County is 1,776, thus there are 630 unattributed members, meaning 630 Blue Cross Blue Shield members in Pierce County in the last two years have not spent substantial health care dollars in any one (health care provider) they could be attributed to.”

“When we talk about opportunities, that is one of our biggest opportunities, trying to capture those 630 people that are not spending health care dollars anyplace else and trying to get them to spend their health care dollars here.”

Hager also presented information on opportunities to reach patients in McHenry, Bottineau and Benson Counties.

“When we talk about inpatient care, we capture the majority of our market when we talk about Blue Cross Blue Shield patients,” Hager said.

Hager reported market share for HAMC is lost with orthopedic surgery, cardiothoracic surgery and “things we will not be able to do here.”

Hager pointed out that orthopedic patients come to HAMC for physical therapy, however, some patients receive therapy services outside of HAMC.

“The biggest general medicine category that people are going out for are infusions chemotherapy, biologics,” Hager noted, identifying infusion patients as a group HAMC providers could serve.

“There are not a lot of claims going out for general medicine appointments,” he added.

In other business, the board reviewed credentialing requests from Real Radiology, a subcontractor of Trinity Health, whose services HAMC uses for radiology reports.

The board reviewed information on a large group of Real Radiology providers.

Board member Craig Zachmeier pointed to a number of civil actions against some of the providers on the list.

“Radiology is one of the higher areas in litigation so it’s not surprising to see, but ultimately, they were given approval by the medical staff (at Trinity),” Hager explained, adding, “After hours, if we do a c/t scan and send it to Minot, and Minot sends it to the Real Radiology group, they’re essentially reading for us, so they have to be credentialed as part of that billing process. We’re not able to bill because the reading would be done by an uncredentialed provider, and uncredentialed providers don’t belong to the group, so we can’t bill for services under that agreement.”

The board approved the credentialing request, with Zachmeier voting no.

The board also discussed purchasing the HAMC Johnson Clinic. “As far as I understand, it’s in the hands of the city,” Christenson said. “I was informed that city legal needs to review city some of the city ordinances what would pertain to us to obtain that property.”

Christenson added “From my understanding, going back through thousands of pages of documents and hearing all kinds of different information from all kinds of different people, the original understanding they felt was a lease to own, at least that’s what I was informed by the previous board president who called me to tell me that was the intent. Nobody can find that documentation if that was the case.”

“Dustin (Hager) alluded as he read through the lease, it’s in perpetuity. So it just goes on. I’m not sure about the idea we would have to purchase the property or if we would just lease it. If the JDA wished to do that, but there’s some concern if the JDA can own the property and continue to lease it to the hospital. I don’t know,” Christenson noted.

“So, there are all these questions in place and basically, the question comes, how do we purchase it if we want to purchase it, and what do we pay for it and what does the JDA want to charge for it?” Christenson asked.

“So, we’re still in the hands of legal. They need to create an ordinance that would allow us to do so,” Christenson added.

Zachmeier said public property “has to go for public auction. It’s considered public property and that’s a government entity, so hypothetically, it has to go to a public bid or public auction, so (Rugby city officials) are trying to look up some laws and see if anyone needs to pass a public ordinance and how they proceed. They’re working on it.”

Board member Janelle Engstrom pointed out that the clinic and hospital building were more than 50 years old, and the buildings might eventually be replaced. “Do we want to buy it if the plan is to eventually build something else?” She asked.

“That’s a very good point,” Christenson answered.

In other business, the board approved financials and minutes from its July meetings. The board also discussed a proposal from the North Dakota Hospital Association to create a partially self-funded employee insurance plan. “At this point, it’s a fact-finding process,” Christenson told the board.

The board also approved finalizing the financial audit report presented by Shepard. Zachmeier voted no, telling the board he didn’t see the report.

Dr. Steven Schoenburg announced his resignation from the board. The board discussed filling the vacancy with another health care provider.

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