THE UNIVERSITY OF MINNESOTA HOSPITAL AND CLINIC BOARD OF GOVERNORS JULY 24, 1991 TABLE OF CONTENTS Page(s) Agenda. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Board of Governors June 26, 1991 Minutes 3 Special Presentation: Albert P. Rocchini, M.D 7 Credentials Committee Report and Recommendations 24 Major Capital Expenditure: Laser Angioplasty System 26 Fourth Quarter, 1990-91 Bad Debts 27 1991-92 Capital Budget 86 Finance Committee May 22, 1991 Minutes 91 c THE UNIVERSITY OF MINNESOTA HOSPITAL AND CLINICBOARD OF GOVERNORSJULY 24, 1991 2:30 P.M. 555 DIEHL HALL AGENDA I. Approval of the June 26, 1991 Minutes II. Chairman's Report -Ms. Kristine Johnson III. Hospital Director's Report -Mr. Robert Dickler IV. Special Presentation: Albert P. Rocchini, M.D. Approval Information Information Information c V. -Director, Pediatric Cardiology Special Presentation: MHA Trustee Conference -Ms. Margaret Matalamaki -Ms. Barbara O'Grady -Ms. Trudy Ohnsorg Information VI. Committee Reports A. Consent Items Joint Conference Committee 1. Medical Staff-Hospital Council Report Credentials Committee Recommendations Planning and Development Committee 1. Major Capital Expenditure: Laser Angioplasty System Finance Committee 1. Fourth Quarter, 1990-91 Bad Debts Approval Information Approval 1. B. Joint Conference Committee -Mr. George Heenan 1. The Joint Conference Committee Did Not Meet C. Planning and Development Committee -Mr. Robert Nickoloff 1. 1991-92 Capital Budget D. Finance Committee -Mr. Jerry Meilahn 1. Preliminary June 30, 1991 Financial Statements VII. Other Business VIII. Adjournment Approval Information 2. MINUTES BOARD OF GOVERNORS The University of Minnesota Hospital and Clinic June 26, 1991 Call To Order Ms. Kristine Johnson called the June 26, 1991 meeting of the Board of Governors to order at 2:40 p.m. in 555 Diehl Hall. Attendance Present: Not Present: David Brown, M.D. Paula Clayton, M.D. Robert Dickler Michael Dougherty George Heenan Kris Johnson David Lentz Margaret Matalamaki Robert Maxwell, M.D. Jerry Meilahn Barbara O'Grady Trudy Ohnsorg Jerry 01 son Cherie Perlmutter Leonard Bienias Phyll is Ell is Bob Erickson Nellie Johnson Robert Nickoloff Approval of Minutes The Board of Governors seconded and passed a motion to approve the minutes of the May 22, 1991 meeting as submitted. 3. Special Presentation: Anton (Tony) R. Potami Dr. David Brown introduced Mr. Tony Potami, Associate Vice President for Research and Technology Transfer. Mr. Potami presented an overview of research and inventions at the University of Minnesota. The Board thanked Mr. Potami for his presentation. Chairman's Report Ms. Johnson welcomed representatives of AFSCME. She also introduced Giles Caver, Administrative Fellow and Becky Jo Lekander, the 1991 Donna Ahlgren award recipient. Ms. Johnson confirmed the fall Board retreat will be held on September 26 &27 at Riverwood Conference Center. Ms. Johnson reported the hospital budget was presented to the Board of Regents in June and would go before the Board of Regents in July for approval. She also reported on a meeting with Regent Kuderer with favorable feedback pertaining to the Board of Governors. Consent Agenda A motion was seconded and passed to approve items on the consent agenda which consisted of: a. Committee Chairmen Appointments b. Safety Committee Report c. Cancer Center Support d. May 31, 1991 Financial Statements Director's Report Mr. Robert Dickler called on Ms. Helen Pitt to introduce Ms. Becky Jo Lekander who is a critical care nurse specialist and the 1991 recipient of the Donna Ahlgren award. Ms. Lekander thanked the Board of Governors for their recognition. Mr. Dickler reported that the Health Department had contracted with The University of Minnesota Hospital and Clinic to provide an AIDs screening clinic. Mr. Dickler reported that there was a Volunteers Recognition reception held on June 17 which Ms. Margaret Matalamaki attended as a Board of Governors representative. 4. ,Joint Conference Committee Report Mr. George Heenan called on Dr. Robert Maxwell to present the recommendations of the Credentials Committee which were endorsed by the Medical Staff Hospital Council on June 11 and the Joint Conference Committee on June 20. The recommendations of the Credentials Committee were unanimously approved as presented. Mr. Heenan indicated that the procedures used for reappraisal and reappointment which were explained in more detail at the Joint Conference Committee meeting. Dr. Maxwell recommended the names of nineteen individuals to serve as clinical chiefs for the 1991-92 fiscal year. The Board of Governors seconded and passed a motion to approve the appointments of the Clinical Chiefs as recommended. Mr. Heenan indicated that the HIV Policy was reviewed at the Joint Conference Committee meeting. The policy is being reviewed regularly and governs HIV infection of all medical personnel and medical staff. Planning and Development Committee and Finance Committee Report In Mr. Nickoloff's absence, Mr. Jerry Meilahn representing the Planning and Development and Finance Committees called on Mr. Greg Hart to report on the Lithotripsy Program. Mr. Hart presented a proposal to the Board to establish a joint program for mobile lithotripsy with the Department of Urology. A motion was seconded and passed to approve the Lithotripsy Program contingent upon successful execution of a memorandum of understanding with the Department of Urology which meets the criteria established in the proposal. Mr. Dickler presented the 1991-92 Employee Compensation Plan. The University determines final compensation increases for Hospital employees in "University-dominated classes". The University plans no salary increases for this group. The collective bargaining processes currently underway will determine compensation levels for employees represented by unions. For Hospital employees in Hospital-dominated classes there will be no overall compensation increases in accord with the University's policy. Compensation increases in accord with the University's policy. Compensation increases for some groups were recommended based on marketplace comparisons and anticipated shortages. For Hospital administrative staff no compensation increase was recommended. The Board seconded and passed a motion to approve the 1991-92 compensation plan as presented. 5. ~. Adjournment There being no further business, the June 26, 1991 business meeting of the Board of Governors was adjourned at 4:20 p.m. Respectfully submitted, ~o. Gail A. Strandemo Board of Governors Office 6. , 2/91 CURRICULUM VITAE Albert P. Rocchini, M.D. Date of Binh: Binh Place: Marital Status: Children: Social Security Number: EDUCATION December 18, 1946 Pittsburgh, PA Married. Arlene Alben James (1976) Michael Edward (1978) B.S., Chemical Engineering, University of Pittsburgh, Pittsburgh, 1968 Pennsylvania, Summa cum Laude M.D., University of Pittsburgh, Pittsburgh, Pennsylvania, Cum 1972 Laude Pediatric Intern, University of Minnesota, Minneapolis, Minnesota 1972-1973 Pediatric Resident, University of Minnesota, Minneapolis, 1973-1974 Minnesota Fellow in Pediatric Cardiology, Children's Hospital Medical Center, Boston, Massachusetts Research Fellow in Physiology, Harvard Medical School, Boston, Massachusetts CERTIFICATION 1974-1977 1975-1977 American Board of Pediatrics 1977 American Board of Pediatrics, Sub-Board of Pediatric Cardiology 1979 POSITIONS Chief of Pediatric Cardiology, Walter Reed Army Medical Center Assistant Professor, Medicine and Pediatrics. Uniformed Services, University of the Health Sciences Assistant Director of Cardiac Catheterization Laboratory, Walter Reed Army Medical Center Assistant Professor of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, The University of Michigan Medical School, Ar- Arbor, Michigan Director, Cardiac Catheterization Laboratory, Pediatric Cardiology Service, C.S. Mott Children's Hospital, The University of Michigan Medical School, Ann Arbor, Michigan 1977-1979 1977-1979 1977-1979 1979-1982 1979-1990 7. CURRICULUM VITAE 2 ALBERT P. ROCCHINI, M.D. Director, Preventive Cardiology Program, Pediatric Cardiology Service, C.S. Mott Children's Hospital, The University of Michigan Medical School, Ann Arbor, Michigan Associate Professor of Pediatrics and Communicable Diseases, C.S. Mott Children's HospitJ!. The University of Michigan Medical School, Ann Arbor, Michigan Professor of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, The University of Michigan Medical School, Ann Arbor, Michig~ Associate Director, Clinical Research Center, The University of Michigan Medical School, Ann Arbor, Michigan Rueben Bentson Professor of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota Director of the Division of Pediatric Cardiology, University of Minnesota Medical School, Minneapolis,Minnesota MILITARY SERVICE Chief of Pediatric Cardiology, Walter Reed Army Medical Center HONORS AND AWARDS 1980-1990 1982-1987 1987-1990 1988-1989 1990-present 1990-present 1977-1979 Young Investigators Award - Second place, American College of 1977 Cardiology Member and Past President of AOA Outstanding Medical School Student in Microbiology Outstanding Medical Student in Pediatrics Highest Academic Average First Two Years of Medical School Highest Academic Average in Graduating Class of Medical School 1972 Tobby Keenan Memorial Lecturer for the Maryland Heart 1988 Association PROFESSIONAL SOQETIES AND RELATED ACTIVITIES American Academy of Pediatrics American Heart Association Society of Pediatric Research Michigan Heart Association - Member of the Heart Disease in in the Young Committee Chairman, Subcommittee on Risk Factor Reduction, Heart Disease 1980-1983 1980-1983 8. '::iIBj1i 1L .,.,:.j f i UNIVERSITY OF MINNESOTA ._j. TWIN CITIES July 18, 1991 Office of the Chief of Staff The University of Minnesota Hospital and Clinic Box 707 Harvard Street at East River Parkway Minneapolis, Minnesota 55455 (612) 626-1945 TO: FROM: SUBJECT: Members of the Board of Governors Robert E. Maxwell, M.D., Chief of Staff Chairman, Medical Staff-Hospital Council Credentials Committee/Medical Staff-Hospital Council Report and Recommendations. I", .., The Medical Staff-Hospital Council on July 9 has endorsed the attached Credentials Committee Report and Recommendations. Included in this report is the reappointment of Dr. Konald Prem in Unit I for the years 1991-1993. Because the Joint Conference Committee did not meet in July this reappointment comes to the Board without a recommendation from the Joint Conference Committee. I am forwarding these recommendations to you for your review and approval on July 24. If you should have any questions, please feel free to call on me. REM/cf Attachment HEALTH SCIENCES 24. UNIVERSITY OF MINNESOTA The University ofMinnesota Hospital and Clinic July 3, 1991 TO: Medical Staff-Hospital Council FROM: Henry Buchwald, M.D. Chairman, Credentials Committee Harvard Street at East River Parkway Minneapolis. MN 55455 SUBJECT: Credentials Committee Report and Recommendations The Credentials Committee having considered the reappointment of the following physician hereby recommends reappointment to the medical staff of The University of Minnesota Hospital and Clinic for 1991-1993. DEPARTMENT OBSTETRICS AND GYNECOLOGY PREM, KONALD A. CATETORY Attending Staff 25 UTIJE UNlVERSITY OF MINNESOTA~~~~~~p CLINIC Planning & Dev. Committee Review: J u 1y 18. 199Finance Commlllee Review: July 24. 1991Board of Governors Review: J u 1y 24, 1991 MAJOR CAPITAL EXPENDITURE REPORT EQUIPMENT: CORONARY LASER ANGIOPLASTY SYSTEf·1 PURCHASE PRICE: $205, 000 DESCRIPTION: The device for purchase consists ofaXeCl eximer laser source and appropriate controlling and calibrating ~echanisms for use with fiberoptic catheters in coronary angioplasty. Eximer laser angioplasty of coronary arteries has been approved recently by the FDA for the treatment of specified types of coronary arterial stenoses. Clinical studies fro~ the United States and elsewhere have shown that eximer laser energy delivered through fiberoptic catheters can ablate atherosclerotic plaque and other tissue without significant heat generation. The most recent information suggests that exi~er laser angioplasty of long or ostial coronary lesions ~ay be safer than balloon angioplasty alone and that eximer laser assisted angioplasty of vein bypass grafts may produce a better long-term result. There are two major manufacturers of eximer laser angioplasty systems: AIS and Spectronetics. Both systems employ the same ~ype of laser source (XeCl eximer originated 308nm laser energy) and both have been used extensively in clinical studies. The AIS system has received preliminary FDA approval for general marketing and AIS systems are currently used at the Mayo Clinic and Abbott-Northwestern Hospital. It is now clear that laser angioplasty is feasible and has use in specific patients undergoing revascularization. After extensive investigation of nearly all US eximer laser clinical centers, our opinion is that the Spectronetics 1aser has certa i n advantages for our setti ng when compared to the AIS device (reliability, size, simplicity of use, cost). The Spectronetics laser system can be used currently in a limited number of centers on an investigational basis and Dr. Robert Wilson, Director of th~ Heart Cath Lab, has secured a position for Uf1HC as one of the last investigational sites. UMHC is currently doing about 450 angioplasty cases per year. It is estimated that use of the laser may be optimal for 15% - 20% of the angioplasty cases. Acquisition of a laser system is important from a competitive position if we are to offer our referring physicians and patients full range of diagnostic and therapeutic capabilities in our cardiac catheterization lab. Submitted By: _ Tille: _ 2 L>":I\TRSITY OF \II:\:\ESOT.-\ The University afMinnesota Ho.~pita'and Clinic July 17, 1991 TO: UMHC Board of Governors FROM: Clifford P. Fearing Senior Associate Director, UMHC SUBJECT: Bad Debts - Fourth Quarter Fiscal Year 1990-91 Han'artl Street (1/ Ea.l't Ril'er parkway,. ,Hilllleapo!i.l'. MN 55.J55 ..., The total amount recommended for bad debt for Hospital and Clinic accounts receivable during the fourth quarter of 1990-91 is $1,285,078.53 represented by 2,895 accounts. Bad debt recoveries during the period amounted to $6,347.84 (38 accounts) leaving a net charge-off of $1,278,730.69. The net bad debts of $1,278,730.69 for thE .!uarter were 1.4% of gross charges. This compares to a bUdget level of bad debts of 0.90% ($753,329). This increase in the q;,.~J.rterly level of bad debts is due in part to a concerted effort by the Hospital and our collection agencies to review old accounts with no active collection effort. Also, there is one large account for $233,986.29. A statistical summary is attached along with a detailed description of losses over $2,000.00 and recoveries over $200 for each month of the fourth quarter. Total fiscal year bad debts have amounted to $2,426,085.63 represented by 6,910 accounts. Recoveries during the fiscal year amounted to $73,165.75 (172 accounts), leaving a net charge-off of $2,352,919.88. The net bad debts of $2,352,919.88 for the fiscal year were 0.67% of gross charges. This compares to a bUdgeted level of bad debts of 0.90% ($3,015,000). Along with the quarter attachments, we have also included a fiscal year statistical summary and a breakdown of bad debts by residence and admitting clinical services. CPF:slw Attachments 27. n n t' UMHC Hospital Billing Department Bad Debt Statistics: April 1991 thrOUgh June 1991 In five ranOO8 of account size -----------1 Less Than , of $100 Accounts $100 - , of $999 Accounts $1000 - , of $1999 Accounts $2000 - # uf $9,999 Ac Inpatient Bad Debt (701) Write-Offs $77.22096 148 $588.474.43 75 $665,695.39 223 Bad Debt (702) Charity Care $10.641.01 31 $67.220.86 10 $77.86187 41 Total $87.861.97 179 $655.695.29 85 $743.557.26 264 Recoveries ($3,84895) 5 $000 0 ($3,84895) 5 -- Net Total $84.013.02 179 • $655.69529 85 • $739.708.31 264 • Outpalient Bad Debt (701) Wrile-Offs $372.74926 2325 $76,273.95 20 $449,02321 2345 Bad Debl (702) Wrile-Offs $61.267.76 275 $31.230.30 II $92.49806 286 Total $434.017.02 2600 $107.504.25 31 $541 ,521.27 2631 Recoveries ($2.498.89) 33 $000 0 ($2.49889) 33 --- Net Total $431.518.13 2600 • $107.504.25 31 • $539.022.38 2631 • Total IP and OP Bad Debt Bad' Debl (701) Write-offs $449,970.22 2473 $664.748.38 95 $1.114.718.60 2568 Bad Debl (702) Charity Care $71,908.77 306 $98,45116 21 $170.35993 327 Total $521.878.99 2779 $763.199.54 116 $1.285,078.53 2895 Recoveries ($6,34784) 38 $000 0 __($6.347.84) 38 Total Net Bad Debt $515.531.15 2T19 • $763.199.54 116 • $t.178.730. 611 2895 • Dollars Budgeted $153,329.00 C:\123IRPTIBD\QTR4-9I.WK1 scv • Net lotal of accounls docs not include recoveries. UMHC Hospital Billing Department Bad Debt Statistics; April 19tU through June 1991 In two ranges of account site Under $2000 # of Accounls Over $2000 # of Accounts Toto! Total # of Amount Accounts Inpatient -'1Medicare Bad Debl (710) $1.330.86 3 $0.00 0 $1,330.86 3 Recoveries $0.00 0 $0.00 0 $000 0 Net Tolal $1,330.86 3 • $0.00 o • $1,330.86 3 • Outpatient Medicare Bad Debl (710) $2.442.29 23 $000 0 $2.442.29 23 Recoveries $000 0 $0.00 0 $000 0 -- Net Tolal $2.442.29 23 • $0.00 o • $2.442.29 23 • - To.... IP and OP Bad Debt Medicare Bad Debl (110) $3.173. IS 26 $0.00 0 $3.173.IS 26 Recoveries $0.00 0 $0.00 0 $0.00 0 Tolal Net Bad Debt $3.713. IS 26 • $0.00 o • $3.173. IS 26 • C:\123\RPT\BD\QTR4-9I.WKI sev LV ~ '-' '-' '-' n n o UMHC Patient Accounting Bad Doot Statistics: July 1990 through June 1991 In 'ive ranlleS of account siZe ]-Less Than II uf $100 - II uf $1000 - II uf $2000 - II uf II uf$100 AeeOu"'S $999 Aeeounl' $1999 Accounts $9,999 Aceounts $10,000. Aceuunls _ ~_ Tt/181Am(IUIlI 101/11# ofA",:,,-oUllh $1,091,74671 453 $110,78148 177 $1.308,534 19 6]0 _-.i!17,91355,_ J!.- $1,290,61064 630·21 • 11 6 $683,031.90 $605,60418 $87,51251 $693,11669 27 ($10,08419) 1 89 11 340,95598 $69,05309 $410,00901 106 ($3,620831 I $406,388.24 106. 46 12 58 • $67,42123 $16,330.71 $80,368.37 $83,15200 58 ($3,38J63) 2 $19,52631 181 $35,40961 88 Inpatient Bad Deb. (101) Write-Offs $4,239.01 110 Bad Dchl (102) Charily Care $2,481.44 54 Tolal $6,120.45 164 Recuverles ($30< 77~ 7 Ner To/al $6,41413 164 • I. i --~- .----------- OUlpatient Bad Debl (101) Wrile-Offs $122,33173 3425 $501.J7862 1936 $83,995.29 60 $129,24063 33 $56,51907 4 $893,465 34 5-158 Bad Debt (102) Write-Offs $11,90314 428 $105,82332 349 $31,10981 21 $52,295.11 11 $10,954.66 I $224,086 10 822 .._--- Tl~al $140,23487 3853 $601,20194 2285 $121.105 16 81 $181.53574 50 $61,473.73 5 $1.111,551 44 6280 Rcco\'cries ($2,392.49) 127 ($1,851.06) 29 ($1.166.00) 1 ($2,490.13) 1 ($41,336.52) I ($55,24220) 159 Ne. Tolal $131,84238 3853 • $599,344.88 2285 • $119,939.16 81 • $119,045.61 50 • $26,131.21 5 • $1,062,30924 6280 ~-----_.--_.._. $2,261.671.00 5911 999 6910 • 6910 172 - - ---- ------- Ind OP Bad Debt (101) Write-offs $126,51014 3535 $580,90493 2123 $151.41652 106 $410,19661 122 $662,123.25 25 $1,991.21205 (102) Charily Care $20,38458 482 $141.232.99 431 $53,44064 39 $121.34820 34 $98,467.11 7 $434.873 58 $146,95532 4011 $122.13192 2560 $204,851.16 145 $591,544.81 156 $160,59042 32 $2,426,08563 os ($2.69821) 134 ($8,385.64) 31 ($4,549.63) 3 ($6.11096) 2 ($51,42131) 2 _ ($13,165751 I Bad Debt $144.251.11 4011 • $113.15228 2560 • $200.301.53 145 • $585.433.85 156 • $109.169.11 32 • $2.352,919.88TOlalNe Dollars Budgeted TolallP Bad Deb Bad Deb To/al Recoveri • Net lotal of .'(:OUOI5 does nol include recoveries. c.ll23IRPTIBDlYTD91-Q4WK 1 klj W N UMHC Patient Accounting Bad Debt Statiatlca: July 1990 through June 1991 In five ranges of account me Less Than $100 , or Accounts $100 - $999 , or Accounts $1000 - $1999 , or Accounts $2000 - $9,999 , or Accounts $10,000 + , or Accounts -~"'-"-----1TIl'81 ToltU II of Amount AC~t)lInf~ _ Inpatient Medicare Bad Debl (110) $359.38 6 $19,29854 40 $1,11560 1 $20,173 52 47 Recoveries ($ 1,049.56) 2 ($1.049 56) 2 ------ I Net Tolal $359.38 6 • $18,248.98 40 • $1.11560 I • $000 o • $0.00 o • $19,72396 47 • ----~------- --------_. Outpatient Medicare Bad Debt (710) $4,46317 158 $11,309.19 46 $15,17236 104 Recoveries ($75.42) 5 ($7542) 5 --------------. NcI T,~al $4,38775 158 • $11,309.19 46 • $0.00 o • $000 o • $0.00 o • $15,69694 104 • ---~-_.~--- ---~-- Tutal IP and or Bad Debt MedIcare Bad Debt (710) $4,822.55 164 $30,607.73 86 $1.11560 1 $0.00 0 $0.00 0 $36,545 ij8 151 Recoveries ($7542) 5 ($1.04956) 2 $0.00 0 $0.00 0 $0.00 0 ($1,12498) 7 .__.~ • Total Net Bad Debt $4,141.13 164 • $29.558,11 86 • $1.115.60 1 • $0.00 o • $0.00 o • $35.420.90 251 • • Ncr lof.1 of accounts docs nol include recoveries. C\l13IRPTIBD\yTD91-Q4 WKI klj w w '-' v v t' t' t' UMHC Patient Accounting Bad Debt Statistics: July 1990 through June 1991 In two ranges of account sae Total # ofTotal# of # ofI Under $2000 Accounts I Over $2000 Accounts Il Amount Accounts Inpatient Bad Debt (701) Write-Offs $151.18655 343 $946.560.16 110 $1.097.746.71 453 Bad Dcht (702) Charity Care $54.22188 154 $156.56560 23 $210.787.48 177 - Total $205,40843 497 $1.103.125.76 133 $1.308.534.19 630 Recoveries ($4.21793) II ($13.70562) 2 ($17.923.55) 13 ._- Net Total $201.190.50 497 • $1.089.420.14 133 • $1.290.610.64 630 • -- Outpatient Bad Debt (701) Write-Offs $707.70564 5421 $185.759.70 37 $893.465.34 5458 Bad Debt (702) Write-Offs $160.836.33 804 $63.249.77 18 $224,086.10 822 Total $868.54197 6225 $249.009.47 55 $1.117.55144 6280 Recoveries ($11.415.55) 157 ~~,82665) 2 ($55.24220) 159 Net Tot'" $857.126.42 6225 • $205.18282 55 • $1.062.309.24 6280 • Total IP and OP Bad Debt Bad Debt (701) Write-offs Bad Debt (702) Charily Care I Total Recoveries Total Net Bad Debt Dollars Budgeted $858.892.19 5764 $215.058.21 958 $1.073.950.40 6722 ($15.633.48) 168 $1.058.316.92 6722 • $1.132.319.86 147 $219.815.37 41 $1.352.135.23 188 ($57.532.27) 4 $1.294.602.96 188 • $1.991.212.05 5911 $434.873.58 999 $2.426.085.63 6910 ($73.165.75) 172 $2,1n,91Ua 6910 • $2.261.671.00 • Net tolal of accounts does not include recoveries. C:1123IRPTIBDlYTD91-Q4.WKI k1j w ~ UMHC Patient AccQunting Bad Debt Statistics: July 1990 through June 1991 In two ranges of account size ·_----------_._._.._._------_. Under $2000 # of Accounts Over $2000 # of Accounts To,aI ArnOUDI Tolal J # of Accounts ._ -- . InpalJent Medicare Bad Debt (110) $20,773.52 47 $000 0 $20,77352 47 Recoveries ($1,04956) 2 $000 0 ($1,049.56) 2 Net Total $19,723.96 47 • $000 o • $19,723.96 47 • Outpatient Medicare Bad Debl (110) $15,772.36 204 $000 0 $15,772.36 204 Recoveries ($7542) 5 $0.00 0 ($7542) 5 ._- Net Total $15,696.94 204 • $000 o • $15,696.94 204 • Total IP and OP Bad Debt Medicare Bad Debl (110) $36,545.88 251 $000 0 $36,545.88 251 Recoveries ($1,124.98) 7 $000 0 ($1,124.98) 7 • Tolal Net Bad Debt $35,420.90 251 • $0.00 o • $35,420.90 251 • C:1123IRPTIBD\YTD91-Q4.WKI klj w VI ~ ~ '-' UMHCPatient Accounting Bad Debt Statistics: Fourth Quarter and Year"-to-Date, Fiscal Year 1991 Q By State I Fourth Y-T-D Total Quarter # of Total # ofiiState Amount Accounts Amount Accounts Alabama 0.00 0 Alaska 176.66 485.59 4 Arizona 3,597.79 22 5,305.50 34 Arkansas 1,064.48 4 1,237.47 5 California 5,208.26 21 10,045.25 53 Colorado 4,290.31 5 7,705.07 10 Connecticut 829.94 3 Delaware 0.00 0 Dist. of Colombia 0.00 0 Florida 9,075.71 12 15,091.26 23 Georgia 2,999.30 2 3,141.46 3 Hawaii 0.00 0 Idaho 0.00 0 Illinois 2,811.88 16 17,738.63 54 Indiana 9.40 1 829.85 6 Iowa 10,562.32 16 15,869.98 34 Q Kansas 443.34 8Kentucky 158.30 1 749.60 13 Louisiana 1,013.17 2 1,041.46 4 Maine 407.60 1 480.60 2 Maryland 19,322.83 1 Massachusetts 1,005.59 7 2,237.16 14 Michigan 6,877.52 20 10,816.63 37 Minnesota 821,121.26 2,490 1,597,782.76 6116 Mississippi 0.00 0 Missouri 593.96 2 2,510.54 14 Montana 19,790.41 5 24,179.94 10 Nebraska 7,550.42 2 8,255.95 5 Nevada 536.02 3 536.02 3 New Hampshire 0.00 0 New Jersey 422.17 3 New Mexico 72.83 1 1,912.77 4 New York 17,237.23 19 22,285.95 51 North Carolina 249.47 2 499.97 4 North Dakota 19,684.49 41 47,489.09 86 Ohio 881.84 3 3,887.05 13 Oklahoma 116.90 1 125.65 2 Oregon 97,076.92 40 Pennsylvania 1,473.56 9 1,649.97 15 Q Puerto Rico 97.00 1Rhode Island 100.00 1 South Carolina 203.41 3 82. C:\123\RPT\BD\ST-Q4-91.WKl scv UMHC PatientAccounting Bad Debt Statistics: Fourth Quarter.andYear'-to,-Date, Fiscal Year .1991 ...... Bystate > ! Fourth Y-T-D TotalI I Quarter # of Total # of IState Amount Accounts Amount Accounts South Dakota 25,277.44 39 56,720.53 114 Tennessee 515.90 3 921.68 7 Texas 857.93 10 17,557.54 30 Utah 0.00 0 Vermont 0.00 0 Virginia 6,610.23 6 6,632.23 7 Washington 9,356.27 6 11,557.03 14 West Virginia 51.20 1 51.20 1 Wisconsin 55,981.81 129 102,504.38 266 Wyoming 127.03 3 Out-of-Country 236,033.99 12 236,580.98 17 Total 1,273,251.45 2,915 2,355,039.38 7,138 Medicare Bad Debt'" (3,773.15) (26) (36,545.88) (251) Legal Settlements 12,614.88 3 70,881.64 12 Bad Debt Agcy Und $50 0.00 0 Bad Debt - Med NC Chgs 2,985.35 3 36,710.49 11 Grand Total 1,285,078.53 2,895 2,426,085.63 6,910 Recoveries (6,347.84) 38 (73,165.75) 172 Net Total 1,278,730.69 2,895 2,352,919.88 6,910 • NOTE: Medicare Bad Debts are included in the State Breakdown but are no longer included as a Bad Debt. C:\123\RPT\BD\ST-Q4-91.WKl seo; 83, UMHC Patient Accounting Bad Debt Statistics: Fourth Quarter andYear-to,-Oate. FiscalYear 1991 BService (, I Fourth Y-T-D Total Quarter # of Total #of :Admitting Service Amount Accounts Amount Accounts Anesthesiology 0.00 0 Clinical Research-Adult 3,209.95 4 3,412.01 6 -Child 0.00 0 Dentistry 3,110.93 3,574.02 3 Oral Surgery 0.00 0 Dermatology 200.25 340.57 2 Family Practice 1,868.82 2 -NB 801.19 I 801.19 1 -OB 2,402.64 2 2,536.34 3 -Pediatric 0.00 0 GYN 18,729.60 5 23,339.64 8 GYN-Oncology 4,011.54 4 41,097.41 27 Medicine-Blue 13,860.77 6 20,587.42 19 Gold 0.00 0 Green 1,026.86 2 15,112.30 13 Masonic (Onc) 14,937.64 19 25,841.63 45 Orange 53,189.39 19 62,371.72 35 Purple 89.70 2 Red 960.14 2 Red A 238,822.83 4 241,598.90 9 Rose A 155.80 1 21,542.95 14 Rose B 54.32 1 54.32 1 White A 22,091.83 13 48,156.94 30 White B 14,211.50 2 53,413.19 18 White C 34.60 1 543.10 4 Yellow 5,416.02 6 8,332.10 11 Neurology 22,108.84 9 32,416.45 19 Neuro-epilepsy 574.72 2 574.72 2 Neurosurgery 33,942.60 16 54,192.52 34 Newborn-General 10,101.13 5 11,920.40 9 Nuclear M,'iicine 0.00 0 Obstetrics-General 27,275.89 14 44,606.80 22 -Midwife 0.00 0 Ophthalmology 4,469.48 4 9,025.49 15 Orthopaedic Surgery 41,460.15 13 45,639.20 28 Otolaryngology 14,102.03 3 21,989.48 11 Pediatrics-General 20,428.36 21 47,156.02 51 BMT 2,770.73 1 2,770.73 1 Cardiology 846.97 4 846.97 4 Dentistry 0.00 0 Dermatology 0.00 0 (, Gastro-Intestinal 431.30 1GYN 0.00 0 Hem/Oncology 9.79 9.79 1 Immunology 0.00 0 84. C:\l23\RPT\BD\SVC-Q491.WKl klj UMHC Patient Accounting Bad DebtStatistics: Fourth Quarter.and Year-to"'Date, Fiscal Year 1991' B··.·Service Fourth Y-T-D Total Quarter # of Total #of - Admitting Service Amount Accounts Amount Accounts Infect Disease 0.00 0 Neonatology 0.00 0 Neurology 5,723.77 6,093.95 3 Neurosurgery 256.93 256.93 I Opthalmology 3,282.57 3,364.97 2 Orthopaedics 275.96 1 Otolaryngology 2,450.34 I 2,450.34 1 Pulmonary 2,671.03 2 2,995.23 3 Renal 458.43 1 Surgery Cardiovascular 4,976.46 2 4,976.46 2 Surgery Green 32,508.94 3 Surgery Purple 0.00 0 Surgery Red 0.00 0 Surg. Transplant 54.95 755.98 4 Urology 1,689.60 5 Physical Med. & Rehab. 7,814.56 3 7,814.56 3 J)~vchiatry-Adult 67,819.14 22 134,886.11 50 '~hild 6,144.01 4 RaolO,ugy 0.00 0 Surgery-Blue 3,917.32 1 159,683.16 34 Cardiovascular 4,683.77 6 20,571.41 14 Purple 31,785.14 11 38,236.55 21 Red 6,472.67 7 11,109.85 23 White 10,371.03 9 15,928.76 20 Therapeutic Radiology 0.00 0 Urology 16,500.94 12 29,961.00 26 Unknown 1,749.15 2 1,991.23 3 Outpatient 528,363.33 2,648 1,025,731.67 6,461 Total 1,273,251.45 2,915 2,355,039.38 7,138 Medicare Bad Debt· (3,773.15) (26) (36,545.88) (251) Legal Settlements 12,614.88 3 70,881.64 12 Bad Debt Agcy Und $50 0.00 0 Bad Debt - Med NC Chgs 2,985.35 3 36,710.49 11 Grand Total 1,285,078.53 2,895 2,426,085.63 6,910 Recoveries (6,347.84) 38 (73,165.75) 172 Net Total 1,278,730.69 2,895 2,352,919.88 6,910 • NOTE: Medicare Bad Debts are included in the Service Breakdown but are no longer included as a Bad Debt. C:\l23\RPT\BD\SVC-Q491.WKl klj 85. UNIVERSITY OF .l'v1INNESOTA The University ofMinnesota Hospital and Clinic July 18, 1991 TO: Members of the Board of Governors FROM: Greg Hart Senior Associate Director RE: 1991-1992 Capital Budget Harvard Street at East River Parkway Minneapolis. MN 55455 . , Enclosed please find the proposed 1991-92 capital budget. Our operating budgets assumed cash flow for equipment and remodeling of $8,511,000. As the attached summary indicates, we are recommending an equipment and remodeling budget next year of $8,511,000. Of this amount, $6,818,850 is for equipment purchases. The remainder is for equipment installation and remodeling. A departmental breakdown of the equipment budget and the capital remodeling budget are attached. We are requesting Committee and Board approval for the recommended total $8,511,000 capital budget at the July meetings. We will be reporting actual capital expenditures compared to budget on a quarterly basis during the fiscal year, consistent with Board policy. Major capital expenditures and special capital projects will be brought forward individually at later dates. This material will be reviewed by the Clinical Chiefs Capital Budget Advisory Committee on July 23rd. We will be happy to answer any questions you may have on July 24. /gs attachments 15-Jul-91 199111992 CAPITAL BUDGET IEQUIPMENT I BUDGET Equipment Requests Contingency TOTAL EQUIPMENT lffiMODELINGI Projects under $5000 Projects over $5000 TOTAL REMODELING ICAPITALBUDGETTOTAL I Total Equipment Total Remodeling TOTAL SUM92 $6,649,401.00 $169,449.00 $6,818,850.00 $402,000.00 $1,290,150.00 $1,692,150.00 $6,818.850.00 $1,692.150.00 $8,511,000.00 87 . THE UNlVERSITY OF MINNESOTA HOSPITAL AND CLINIC (, CAPITAL EQUIPMENT BUDGET FOR FISCAL YEAR 91/92 DEPARTMENT Ambulatory Care Biomedical Engineering Cardio-Respiratory Services Central Sterile Processing Chaplaincy Closed Circuit TV Communication Center Diagnostic Radiology Environmental Services Facilities Office Finance Healthcare Network Hospital Administration Hospital Attorney Human Resources Infection Control Information Services Laboratories Maintenance & Operations Materials Services Medical Records Neurology Lab Nursing Services Nutrition Services Operating Room Patient Transport Pharmacy Planning & Marketing Protection Services Quality Assurance Rehabilitation Center Therapeutic Radiology IGrand Total BUDGET $338,010.00 $18,175.00 $660,000.00 $401,250.00 $4,400.00 $45,000.00 $23,250.00 $1,715,475.00 $72,000.00 $14,400.00 $104,757.00 $19,500.00 $5,000.00 $7,000.00 $26,910.00 $1,765.00 $661,300.00 $1,139,494.00 $124,350.00 $90,300.00 $297,780.00 $64,000.00 $194,870.00 $22,250.00 $441,640.00 $6,000.00 $18,200.00 $5,175.00 $21,400.00 $5,535.00 $47,595.00 $52,620.00 $6,649,401.00 I 88. THE.UNIVERSITYOF MINNESOTA HOSPITAL AND ••·CLINIC CAPITAL REMODELING BUDGET FORFISCAt Y'EAR.91/92 DIRECTOR DEPARTMENT PROJECT DESCRIPTION PROJECT COST Fearing Admissions Paint & carpet 2-100 PWB $13,700.00 Wells Ambulatory Care Remodel ENT/Psychology clinic $60,500.00 Wells Ambulatory Care Remodel Neurology clinic $135,000.00 Dees Diagnostic Radiology· Install radio. fluoroscopic equip. $31,400.00 Dees Diagnostic Radiology· Install tomographic equipment $31,400.00 Koenig Facilities Office General interior improvements $70,000.00 Koenig Facilities Office Equipment installation $61,000.00 Wells Family Practice Clinic Remodel Family Practice Clinic $100,000.00 Hart Laboratdries Remodel PWB bloodbank area $7,700.00 Koenig Maintenance & Operations Return air from lab court $54,500.00 Koenig Maintenance & Operations Access panels to service WAN doors $7,350.00 lCnig Maintenance & Operations Replace hot water heater $28,750.00 l\.oenig Maintenance & Operations Bypass for J cooling tower $33,500.00 Koenig Maintenance & Operations Lab court electrical stabilization $144,500.00 Koenig Maintenance & Operations Replace S I steam preheat coil $17,250.00 Koenig Maintenance & Operations Energy efficient lamps & ballasts $16,300.00 Koenig Maintenance & Operations Replace steam absorption chiller $100,000.00 Koenig Maintenance & Operations Mayo elevator upgrade for controls $103,500.00 Pitt Nursing Services Remodel PCU 3C $5,000.00 Pitt Nursing Services Remodel Dialysis $125,600.00 Pitt Nursing Services Remodel PCU 68 $75,000.00 Pitt Nursing Services Remodel C245 Mayo $14,500.00 Pitt Nursing Services Remodel space for lounge on SA $7,300.00 Wells Protection Services Upgrade CCTV security system $10,000.00 Wells Protection Services Re-key Mayo building $10,500.00 Wells Protection Services Remodel rooms C138 & C139 Mayo $14,900.00 Wells Protection Services Construct smoking shelter $11,000.00 IGRAND TOTAL $1,290,150.00 , ComRem2 15-Jul-91 n n ('t UNIVERSITY OF MINNESOTA HOSPITAL AND CLINIC ANNUAL CAPITAL REQUIREMENTS 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 Tot.l APPROVED PROJECTS ____ ••••. ________________ .a .... ____ . ___ •••• ________ ••• _. ________________ •__________ •••• _______ •••• _______ .... _______ .. _..... _. ____ •_______ Surgic.l P.thology ....••••..••..••.•..••••.. 813,623 222,864 7,750 0 0 0 0 0 0 0 0 1,044,237 Oer,""tology CI inic ••.••.....•.•••••••••••••• 655,064 151,774 2,180 0 0 0 0 0 0 0 0 809,018 MRI • II •••.•...••••.••••••••••••••••••••••• 2,737,125 888,903 0 0 0 0 0 0 0 0 0 3,626,628 CUHCC •••.••••.•••..•.....•••.••.•••••••••••• 346,000 52,006 1,951,994 0 0 0 0 0 0 0 0 2,350,000 Masonic III ••...........•.•.•••••••••••••••• 533,277 1,068,213 75,100 0 0 0 0 0 0 0 0 1,676,590 CT Sc.nner ••.•.•••...••..•••••••.•••••.••••• 0 0 1,210,000 0 0 0 0 0 0 0 0 1,210,000 C"""",,ter Upgr.de ••••.••..••••••.••••••.••••. 0 324,000 0 0 0 0 0 0 0 0 0 324,000 Neuror.diology Upgr.de ........•..••••.•••••. 0 0 1,900,000 0 0 0 0 0 0 0 0 1,900,000 He.rt C.th ••••.•••.••••..•.••...•..•••.••.•• 0 0 3,100,000 0 0 0 0 0 0 0 0 3,100,000 CV Radiology •..•••...•••.•.••..••••.•..••..• 0 0 800,000 0 0 0 0 0 0 0 0 800,000 Linear Accelerator ....•.•••.....••..•.•.•... 0 0 0 2,168,000 0 0 0 0 0 0 0 2,168,000 Other Miscell.neous C.pi t.l. ................ 115,234 33,963 0 0 0 0 0 0 0 0 0 149,197 .......... _... --- ........ -._ .... -- .......................................................................... _........... _..... -_ .................................................. -- .......................... _...... - - - - .... - ...... --_ .... _- Approved Projects SubtotaL ....••..••..• 5,200,923 2,741,723 9,047,024 2,168,000 0 0 0 0 0 0 0 19,157,670 ANIICIPATEO PROJECTS Repl.ce CT Sc.nners ........••............... 0 0 0 1,210,000 0 1,206,000 0 0 0 0 0 2,416,000 Repl.ce Linear Accel .••...•.•••••••••••••••• 0 0 0 0 1,583,000 520,000 1,583,000 0 0 0 0 3,686,000 Repl.ce MRI·I. .••••••••••••••••••••••••••••• 0 0 0 1,500,000 1,500,000 0 0 0 0 0 0 3,000,000 Co"""ter Upgr.de•••••••••••••••••••••••••••• 0 0 1,054,000 3,753,000 1,877,000 2,498,000 1,506,000 1,016,000 7,200,000 3,000,000 2,500,000 24,404,000 Neuror.diology Upgr.de •••••••••••••••••••••• 0 0 0 2,300,000 0 0 0 0 0 0 0 2,300,000 Ant lclp.ted New Technology/Progr.m Oevelopnent 0 0 0 3,600,000 1,500,000 1,500,000 1,500,000 1,500,000 1,500,000 1,500,000 1,500,000 14,100,000 Heart C.th •••••.••••.••••••••••••••••••••••• 0 0 0 1,500,000 0 • 0 0 0 0 0 0 1,500,000 BMI/ICU Reconfigur.tion .•..••••••••••••••••• 0 0 300,000 400,000 0 0 0 0 0 0 0 700,000 Pr.ctice Acquisition ••••.••••••••••••••••••• 0 0 0 6,300,000 600,000 600,000 600,000 600,000 600,000 600,000 600,000 10,500,000 ------.--.- •••••• _._.- •••••••••• - ••••••••••••• -•••••••••• - ••••••• - --- •••• - •• - -- •••••••• - •••••••••• - 1+ •••••••• - •• -••••••• - - •• -•••.••• Anticipated Projects Slobtoul •••...•.•.• 0 0 1,354,000 20,563,000 7,060,000 6,324,000 5,189,000 3,116,000 9,300,000 5,100,000 4,600,000 62,606,000 ANNUAL EQUIPMENT AND REMOOELING PROJECTS Actu.l/Ant icipated Expendi tures •••••••..•••• 4,231,883 3,221,708 7,000,000 8,511,000 8,200,000 8,800,000 9,400,000 10,000,000 10,600,000 11,200,000 11,800,000 92,964,591 Net Equipment Roll forw.rd •••••••..•••••.•••• 2,397,525 2,692,203 6,224,875 0 0 0 0 0 0 0 0 11,314,603 ----_ .... _-- -.. _------- _..... _------ .............. -_ ......... _- _...... _----- -------_._. _.. _.~ ..... ~~~~.~.. ~~- .. ~ ................. ~. -_ .... ~ ..... Amu.l Equip .nd Remod Subtotal .••.••.•• 6,629,408 5,913,911 13,224,875 8,511,000 8,200,000 8,800,000 9,400,000 10,000,000 10,600,000 11,200,000 11,800,000 104,279,194 ANNUAL PRINCIPAL & LEASE PAYMENTS Fixed Rate Bond Principal P.yments .••••.•.•. 2,815,000 2,215,000 2,345,000 2,490,000 2,650,000 2,830,000 3,015,000 3,230,000 3,455,000 3,705,000 3,975,000 32,725,000 VROB Princip.l P.yments ••.•••••••••••••••••• 0 0 0 0 0 0 0 1,681,000 1,681,000 1,681,000 1,681,000 6,724,000 Existing Cspit.l le.se P.yments ............. 1,011,783 828,785 927,628 989,222 813,089 787.675 763,713 253,781 0 0 0 6,375,676 _............. -~ .... __ .. _..................................................... _.............. _... _... - ..... _.. _...- .... _-_ .............. -... -..-.-- ...... -... __ .... _..- .. -........... ---- Annu.l Principal P.yments Subtot.I. ••••• 3,826,783 3,043,785 3,272,628 3,479,222 3,463,089 3,617,675 3, n8, 713 5,164,781 5,136,000 5,386,000 5,656,000 45,824,676 Slobtot.I ••••••••.•••.••••••••••••••••••• 15,657,114 11,699,419 26,898,527 34,721,222 18,723,089 18,741.675 18,367,713 18,280,781 25,036,000 21,686,000 22,056,000 231,867,540 Renew.1 Project Ph.se II •••••••••••••••••••• 0 299,509 3,206,087 13,299,846 15,241,662 5,812,405 0 0 0 0 0 37,919,509 Amu.l C.pi t.l Requi rement Tot.I. ••••••• 15,657,114 11,998,928 30,104,614 48,021,068 33,964,751 24,614,080 18,367,713 18,280,781 25,036,000 21,686,000 22,056,000 269,787,049 =:1•••••:1:1••==••:1.=.:.=.==••••••:1.:.==••=••• 11:•••==••: •••=1::.:11=•••,;;.:•• ::1••==::1•• ::1•• :11.::.==•••••••&.:1=:1••••••&•••:=.&&•••••S:===:1:&==&a================== '-0 0 THE UNIVERSITY OF MINNESOTA HOSPITAL AND CLINIC BOARD OF GOVERNORS FINANCE COMMITTEE June 26, 1991 MINUTES ATTENDANCE: Present: Staff: CALL TO ORDER: Edward Ciriacy, M.D. Robert Dickler Cl ifford Feari ng Leo Furcht, M.D. David Lentz Margaret Matalamaki Jerry Meilahn Vic Vikmanis Gil es Caver Greg Hart Teri Holberg Nels Larson Shannon Lorbiecki Hel en Pitt Sharon Weiss The Finance Committee was called to order by Mr. ~erry Meilahn on June 26, 1991 at 12:30 P.M. APPROVAL OF THE MINUTES: The Board of Governors Finance Committee seconded and passed a motion to approve the minutes of the May 22, 1991 meeting as written. JULY 1, 1990 THROUGH MAY 31, 1991 FINANCIALS: Mr. Fearing reported to the Finance Committee the month of May inpatient admissions totaled 1,474, which was 9 above bUdget; average length of stay was 8.0 days; patient days totaled 12,010, which were 734 days above budget. The May average daily census was 400, which was above the budgeted level of 379. Clinic visits for the month of May were reported to be 1.7% over budget. The Hospital's year-to-date Statement of Operations showed revenues over expenses by $12,316,666 a favorable variance of $12,724,298. Gross patient revenue was 4.9% above budget and operating expenditures through May were ...~ reported to be 1.1% above budget. ~ 91. As of May 31, the balance of accounts receivable totaled $95,966,356 and represented 94.8 days of revenue outstanding. Mr. Fearing introduced Giles Caver, who will be replacing Shannon Lorbiecki as Adminstrative Fellow, and Sharon Weiss, who will replace Teri Holberg as the Finance Committee's Recording Secretary. LITHOTRIPSY PROGRAM: Mr. Greg Hart presented to the Committee, for endorsement, a proposal to establish a mobile lithotripsy program. This proposal was presented to the Committee for information at the May 22, 1991 meeting. The lithotripsy program will be organized as an internal University venture between the Hospital and the Department of Urology, both equally sharing risks and re rds, including equal sharing of the financial risks. A management commit~ee will be created, with equal representation, to make policy decisions. The vendor, Medstone, has agreed to charge $800 per case. A minimum of 450 cases, or $360,000 is guaranteed by the University to the vendor. Mr. Hart reported a letter has been received from Dr. Fraley, Chair of the Department of Urology, indicating his concurrence with the proposed approach to the program. A formal internal memorandum of agreement is being developed and will be signed by the Hospital and the Department of Urology before an external contract with Medstone is finalized. This proposal has been reviewed and endorsed by the Medical School Dean's office, the Vice President for Health Sciences, and the Clinical Chiefs' Capital Budget Advisory Committee. Mr. Hart stated the key issue discussed at the Capital Budget Advisory Committee was the organizational and financial concept of the shared risk/reward and shared financing between the Hospital and the department. The Finance Committee seconded and passed a motion to endorse the proposal establish a mobile lithotripsy program. A motion was made that the Board request the Medical for Health Science, and Clinical Chiefs work with the institutional policy for these types joint projects. seconded and passed the motion. RED WING: School, Vice President Hospital to develop an The Finance Committee Mr. Fearing reported to the Committee, for information, an agreement of acquisition of the Interstate Medical Center by UMHC at a cost of $9,100,000. The agreement is subject to approval of each organization's respective Boards. Mr. Fearing reported UMHC will purchase the IMC land and buildings at the Red Wing, MN and Elsworth, WI facilities at a price of approximately $4,000,000, 92. which will be leased back to a new non-profit corporation. The remalnlng $5,100,000, which will be paid out over eight years, will be directed towards the purchase of the goodwill and ongoing business value of the clinic. Mr. Fearing stated the University will be the sole member of this new corporation. The operation of this corporation will be controlled by a Board of Directors consisting of three members chosen by the Clinic, and three by the University. A Physician's Committee, whose members will be chosen from among the IMC physicians, would be set up for the day to day management of the clinic. The Physician's Committee will not engage in any non-budgeted capital expenditure of more than $50,000 without specific approval of the Board of Directors, and the budget itself. It is anticipated that the Red Wing proposal will be brought before the Board of Governors for approval in September or October, 1991, and then brought before the Board of Regents the first part of 1992. CANCER CENTER SUPPORT: Mr. Robert Dickler presented to the Committee for endorsement, a proposal that UMHC pledge $1,000,000, to be paid over a seven year time period, to the Cancer Center for facility development. The proposal had been presented to the Committee for information at the May 22, 1991 meeting. The Finance Committee seconded and passed a motion to endorse the Hospital committing $1,000,000, over seven years, to the Cancer Center. ~ COMPENSATION PLAN: Mr. Dickler presented to the Committee, for endorsement, the 1991-92 Employee Compensation Plan. Mr. Dickler stated the Board of Governors has delegated authority over 60% of the Hospital employees. Of the remaining 40%, 10% consists of University- dominated classes, whose compensation plan is determined by the University, and 30% are employees represented by a union, whose compensation levels will be determined by the collective bargaining process. For the Hospital-dominated classes it was recommended compensation increases be given to staff in professional/technical job families including radiologic technologists, medical technologists, social work, nursing, pharmacy, cardio- respiratory services, and rehabilitation. These adjustments may vary based upon marketplace and shortage conditions. General staff nurses would receive a 7% increase, while the rest would receive approximately 4% increase. It is estimated 21 of the 143 Hospital-dominated classes would receive increases based upon this criteria. Compensation increases for 38 classes will be determined after further analysis. It was recommended no adjustments be made for the remaining classifications. 93. ,The recommended increases would be effective July 1, 1991. In situations where a community contract increase goes into effect later than July 1, the UMHC increases would be timed to that later date. It was further recommended that the Hospital Administrative Staff classification not receive a compensation increase for 1991-92. The Finance Committee seconded and passed a motion to endorse the 1991-92 Employee Compensation Plan. There being no further discussion, the June 26, 1991 meeting was adjourned at 2:00 P.M. Respectfully submitted, ;;"', ;k lie) Teri Holberg Recording Secretary 94. l511 UNIVERSITY OF MINNESOTATWIN CITIES The University of Minnesota Hospital and ClinicHarvard Street at East River RoadMinneapolis, Minnesota 55455 JUly 24, 1991 . TO: FROM: SUBJECT: Board of Governors Clifford P. Fearing Report of Operations for the Period July 1, 1990 through June 30, 1991 The Hospital's operations for the month of June reflect both inpatient admissions and outpatient clinic visits activity below budget; inpatient days are over budget. Both ancillary revenue and routine revenue are above bUdgeted levels for the month. INPATIENT CENSUS: For the month of June, inpatient admissions totaled 1,441 which was 7 below budgeted admissions of 1,448. Our overall average length of stay for the month was 8.0 days. Patient days for June totaled 11,833 and were 988 days above budget. The ~ areas in which admissions were less than budget were in Gynecology, .~ Urology, Pediatrics, and Physical Medicine and Rehabilitation. These were somewhat offset by increases in Medicine, Neurosurgery, Neurology, and otolaryngology. To recap our year-to-date inpatient census: 1989-90 1990-91 1990-91 % Actual BUdget Actual Variance Var Admissions 18,331 17,350 18,161 811 4.7 Patient Days 147,484 137,800 145,665 7,865 5.7 Avg Length of stay 8.0 8.0 8.0 0.0 0.0 Avg Daily Census 404.1 377.5 399.1 21.6 5.7 Percent Occupancy 69.6 65.1 69.3 4.2 6.5 OUTPATIENT CENSUS: Clinic visits for the month of June totaled 22,889 which was 452, or 1.9%, less than budgeted visits of 23,341. Visits were below budget in Radiation Therapy, Dermatology, OB/GYN, Surgery, orthopedics, Child Psych, and Psychology. These were only partly offset by increases in Medicine, Endoscopy, Family practice, and the Emergency Room. Community University Health Care Center (CUHCC) visits for the month of June totaled 4,587 which was 355, or 8.4%, above budgeted visits of 4,232, while Home Health visits of 1,092 for the month were 170, or 18.4%, above bUdgeted visits of 922. HEALTH SCIENCES REPORT OF OPERATIONS June 1991 PAGE 2 To recap our year-to-date outpatient census: Clinic Visits CUHCC Visits HHA Visits 1989-90 Actual 270,756 53,062 11,255 1990-91 BUdget 263,000 53,112 11,222 1990-91 Actual 277,036 50,009 11,489 Variance 14,036 (3,103) 267 % Var 5.3 (5.8) 2.4 FINANCIAL OPERATIONS: The Hospital's statement of Operations shows revenues over expenses by $12,086,819 a favorable variance of $11,988,819. Patient care charges through June totaled $350,978,116, which was 4.8% over bUdget. Routine revenue was 4.4% above budget and reflects our favorable inpatient census variance. Ancillary revenue was $11,761,177 above budget (4.9%) and primarily reflected the favorable variance in both inpatient and outpatient census. Inpatient ancillary revenue averaged $9,770 per admission compared to the budgeted average of $9,810 per admission. outpatient revenue per clinic visit averaged $265 compared to the budgeted average of $262. Operating expenditures through June totaled $293,931,156 and were $3,613,156 (1.2%) above budgeted levels of $290,318,000. The overall unfavorable variance is primarily due to increased demand for patient services, which is reflected in higher personnel costs and patient care supplies (blood and medical supplies and services). Insurance expense was also adjusted in June to reflect a $454,000 anticipated loss related to open claims from 1985-86 that could conceivably pay more than the policy aggregate limits under an excess liability policy written by Evanston Insurance Company. ACCOUNTS RECEIVABLE: The balance in patient accounts receivable as of June 30, 1991, totaled $95,679,101 and represented 94.9 days of revenue outstanding. The overall increase in our patient receivables in June of 0.1 day occurred with several transplant contracts, including Blue Cross/Blue Shield, Group Health, United Health Care and Med Centers. CONCLUSION: The Hospital's overall operating position is positive and above bUdgeted levels for 1990-91 fiscal year. The June financial statements presented today are preliminary in that the University and the Hospital have not completed the year- end closing process. Even though these are preliminary statements, we do not anticipate any material changes to them as a result of the closing process. Financial statements reflecting the final close will be presented at the octob~r meeting of the Board. PRELL'1INARY UNIVERSITY OF MINNESOTA HOSPITAL & CLINIC EXECUTIVE SUMMARY OF FINANCIAL ACTIVITY FOR THE PERIOD JULy 1. 1990 TO JUNE 30.1991 Variance 1990-91 1990-91 Over/-Under Variance Budgeted Actual Budget % Patient Care Charges $335.005·090 $350.978.116 $15.973.116 4.8% Deductions from Charges 80,483.000 84,654,002 4,171,002 5.2% Other Operating Revenue 25,982.000 27,401,690 1,419,690 5.5% Total Operating Revenue 280,504.000 293.725,804 13,221,804 4.7% Total Expenditures 290,318,000 293,931.156 3,613.156 1.2% Net Operating Revenue (9.814,000) (205.352) 9,608,648 97.9% Non-Operating Revenue and Expenses 9,912.000 12.292.171 2,380,171 24.0% JRevenue Over/Under Expense $98,000 $12,086,819 $11,988,819 Variance 1990-91 1990-91 Over/-Under Variance Budgeted Actual Budget % Admissions 17.350 18,161 811 4.7% Patient Days 137,800 145,665 7,865 5.7% Average Daily Census 3n.5 399.1 21.6 5.7% Average Length of Stay 8.0 8.0 0.0 0.0% Percentage Occupancy 65.1 69.3 4.2 6.5OAJ Outpatient Clinic Visits 263,000 2n,036 14,036 5.3% J UNIVERSITY OF MINNESOTA The University ofMinnesota HospitaJ and Clinic RESOULUTION Harvard Street at East River Parkway Minneapolis. MN 55455 . IT IS HEREBY RESOLVED, that on July 24, 1991 the Board of Governors of the University of Minnesota Hospital and Clinic shall convene in closed session pursuant to Minnesota Statutes § 471.705, Subd. Ha) (1990) to discuss a personnel matter. THE UNIVERSITY OF MINNESOTA HOSPITAL AND CLINIC BOARD OF GOVERNORS SEPTEMBER 26, 1991 TABLE OF CONTENTS Page(s) Agenda. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Board of Governors July 24, 1991 Minutes 2 Joint Conference Committee August 14, 1991 Minutes 5 Joint Conference Committee September 11, 1991 Minutes 8 Credentials Committee Report and Recommendations 11 Committee Chairman Appointment 18 Major Capital Expenditure Report: Outpatient Laboratory Remodel i ng. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 Major Capital Expenditure Report: Replacement of Disk System for UNISYS A15 and A9 Computers 21 Interstate Medical Center Proposal 23 THE UNIVERSITY OF MINNESOTA HOSPITAL AND CLINIC BOARD OF GOVERNORS SEPTEMBER 26, 1991 3:00 P.M. RIVERWOOD CONFERENCE CENTER AGENDA I. Approval of the July 24, 1991 Minutes Approval II. Consent Items 1. Medical Staff-Hospital Council Report Credentials Committee Recommendations 2. Appointment of Medical Staff-Hospital Council Committee Chairman 3. Major Capital Expenditure Report: Outpatient Laboratory Remodeling 4. Major Capital Expenditure Report: Replacement of Disk System for UNISYS A15 and A9 Computers III. Committee Reports A. Finance Committee Mr. J.E. Meilahn 1. August 31, 1991 Financial Statements B. Planning and Development Committee Mr. Robert Nickoloff 1. Interstate Medical Center Proposal IV. Other Business V. Adjournment Approval Approval Information Information Information Information 1. MINUTES BOARD OF GOVERNORS The University of Minnesota Hospital and Clinic July 24, 1991 Call To Order In Chairman Johnson's absence, Mr. David Lentz called the July 24, 1991 meeting of the Board of Governors to order at 2:45 p.m. in 555 Diehl Hall. Attendance Present: Not Present: David Brown, M.D. Paula Clayton, M.D. Robert Dickler Michael Dougherty Phyllis Ellis Bob Erickson George Heenan David Lentz Margaret Matalamaki Robert Maxwell, M.D. Jerry Meilahn Barbara O'Grady Trudy Ohnsorg Jerry Olson Cherie Perlmutter Leonard Bienias Kris Johnson Nell ie Johnson Robert Nickoloff Approval of Minutes The Board of Governors seconded and passed a motion to approve the minutes of the June 26, 1991 meeting as submitted. 2. Chairman's Report Mr. Lentz welcomed representatives of AFSCME. Mr. Lentz reported that the Regents Nominating Committee has been appointed. Mr. Lentz presented Paula Clayton, M.D., who has completed her term as Chair of the Council of Chiefs of Clinical Services, with a plaque to thank her for service to the Board. Special Presentation: Albert P. Rocchini, M.D. Mr. Robert Dickler introduced Dr. Albert Rocchini, Director, Pediatric Cardiology. Dr. Rocchini presented an overview of the strengths and weaknesses of the Pediatric Cardiology division. The Board thanked Dr. Rocchini for his presentation. Director's Report Mr. Robert Dickler reported that the Board of Regents approved the Board of Governors 1991-92 operating budget. Mr. Dickler commented that The University of Minnesota Hospital and Clinic HIV policy for health professionals is a very aggressive policy but is being reviewed in light of guidelines released by the Centers for Disease Control. Mr. Dickler reported that labor negotiations are in process. He will keep the Board advised as this process evolves. Consent Agenda A motion was seconded and passed to approve items on the consent agenda which consisted of: a. Credentials Committee Recommendations b. Major Capital Expenditure: Laser Angioplasty System c. Fourth Quarter, 1990-91 Bad Debts Special Presentation: MHA Trustee Conference Ms. Margaret Matalamaki, Ms. Barbara O'Grady and Ms. Trudy Ohnsorg reported on the Minnesota Hospital Association Trustee Conference they attended at Cragun's in Brainerd July 12-14, 1991. 3. Planning and Development Committee and Finance Committee Report In Mr. Nickoloff's absence, Mr. Jerry Meilahn representing the Planning and Development and Finance Committees called on Mr. Cliff Fearing to give the monthly financial report. Mr. Fearing reported that the Hospitals's Statement of Operations for the period July 1, 1990 through June 30, 1991 shows revenues over expenses by $12,086,819, a favorable variance of $11,988,819. Patient care charges through June totaled $350,978,116, which was 4.8% over budget. Mr. Fearing reported inpatient admissions for June totaled 1,441 which was 7 below budgeted admissions of 1,448. Overall average length of stay for the month was 8.0 days. Outpatient clinic visits for the month of June totaled 22,889 which was 452, or 1.9%, less than budgeted visits of 23,341. Mr. Fearing presented the 1991-1992 Capital Budget to the Board. A $8,511,000 equipment and remodeling budget is recommended for next year. Of this amount, $6,818,850 is for equipment purchases. The remainder is for equipment installation and remodeling. Actual capital expenditures compared to budget will be reported to the Board on a quarterly basis during the fiscal year, consistent with Board policy. A motion was seconded and passed to approve the 1991-1992 Capital Budget. Adjournment There being no further business, the July 24, 1991 business meeting of the Board of Governors was adjourned at 3:50 p.m. A closed executive session of the Board of Governors was called at 3:55 p.m. to discuss a personnel matter. Respectfully submitted, ~a. Gail A. Strandemo Board of Governors Office 4. MINUTES Joint Conference Committee Board of Governors August 14, 1991 Attendance: CALL TO ORDER Present: Absent: Staff: Guest: Amos Deinard, M.D. Robert Dickler Phyll is Ell is George Heenan Barbara O'Grady Richard Price, M.D. Debbie Day, M.D. Robert Maxwell, M.D. Gerald Olson Keith Dunder Greg Hart Sally Huntington Carol Letourneau Shannon Lorbiecki Helen Pitt Frank Rhame, M.D. Chairman Heenan called the meeting to order at 4:42 p.m. APPROVAL OF MEETING MINUTES The minutes of the June 12, 1991 meeting were approved as submitted. HIV AND HEPATITIS B IN HEALTHCARE WORKERS Dr. Frank Rhame provided an update on the Hospital's policy concerning Human Immunodeficiency Virus (HIV) infection in healthcare workers. Revisions in the Hospital's policies for preventing transmission of HIV and Hepatitis B (HBV) virus to patients will be proposed in response to recommendations recently published by the Centers for Disease Control (CDC). The guidelines provide recommendations for dealing with healthcare workers who are HIV positive or Hepatitis B carriers but do not provide specific gUidance for 5. determining which procedures are "exposure-prone" for HIV or HBV. These determines will be made by the clinical departments who may work with their respective medical organizations. A survey will be conducted of medical staff, residents, nursing staff and medical students to ascertain current opinion about testing of healthcare workers for HIV and Hepatitis B. The categories and number of healthcare workers affected by a policy change will be dependent upon which procedures are classified as exposure-prone. This item will be brought back to the Committee with a more definitive recommendation. QUALITY ASSURANCE PLAN Mr. Greg Hart presented a draft of the Quality Assurance Steering Committee work group report. Following a successful JCAHO survey of the Hospital's QA program in 1990, the work group was formed to make recommendations for establishing future directions for the Quality Assurance program. Ms. Sally Huntington discussed the background work done by the group on outcomes measurement and continuous quality improvement. Ms. Carol Letourneau presented an overview of the Hospital's current quality assurance program. Significant progress has been made over the last couple of years in creating forums on all services and special/intensive care units for quality assurance .~ discussions. ~ Mr. Hart summarized the short-term and long-term goals recommended by the group. Possibly the most important goal is to develop quality assurance programs which are clinically relevant and integrated with clinical research programs. The long-term goals are also very important in setting future direction. The report will be presented to the Council of Chiefs of Clinical Services and the Medical Staff Hospital Council and then it will be brought back before the Committee. SEARCH FOR SENIOR ASSOCIATE DIRECTOR, DIRECTOR OF MEDICAL AFFAIRS Mr. Robert Dick1er informed the Committee that the search committee for a Senior Associate Director and Director of Medical Affairs has completed its work and forwarded a list of finalists to Mr. Dick1er. He will be meeting with each of the candidates over the next couple of weeks. CLINICAL CHIEFS REPORT Dr. Richard Price reported that Dr. Roby Thompson will begin his term as Chair of the Council of Chiefs of Clinical Services in September. The clinical chiefs have discussed University and Hospital budget issues, the Vice .~ President for Health Sciences position, and labor negotiations. ~ 6. cMEDICAL STAFF HOSPITAL COUNCIL REPORT Due to the late hour, this item was deferred to the next meeting. ADJOURNMENT The committee meeting was adjourned at 6:32 p.m. Respectfully submitted, .- . _.J-C,-o,- vt, ~ 1"t:'H .,~C (:;LL-~k~~'L Shannon Lorbiecki Assistant Director 7. MINUTES Joint Conference Committee Board of Governors September 11, 1991 Attendance: CALL TO ORDE~ Present: Absent: Staff: Debbie Day, M.D. Amos Deinard, M.D. Phyllis Ellis George Heenan Robert Maxwell, M.D. Barbara O'Grady Richard Price, M.D. Robert Dickler Gerald Olson Giles Caver Keith Dunder Greg Hart Shannon Lorbiecki Helen Pitt Chairman Hee n called the meeting to order at 4:38 p.m. APPROVAL OF MEETING MINUTES The minutes of the August 14, 1991 meeting were approved as submitted. HIV AND HEPATITIS B IN HEALTHCARE WORKERS Dr. Robert Maxwell provided an update regarding internal discussion of the Hospital's policy concerning Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV). The medical staff is considering either reaffirming or amending the Hospital's policies and procedures in this arena. Dr. Maxwell also said that Dr. Frank Rhame had presided over a "balanced" discussion regarding HIV/HBV policy at August's Semi-Annual Medical and Dental Staff meeting. Although no definitive conclusions or recommendations were reached, some members of the medical staff expressed concern regarding national discussion of mandatory ~9sting and expressed the need for strict measures to ensure confidential Mr. George Heenan then advised Maxwell to consider how the Hospital might maintain its leadership in the area of HIV/HBV policy. Mr. Heenan also suggested that the Hospital should either reaffirm or amend its policy soon, as this would better assure internal unity in the midst of continuing external ..,. debate. ~ 8. cThis item will be brought back to the Joint Conference Committee with a more definitive recommendation. APPOINTMENT OF MEDICAL STAFF-HOSPITAL COUNCIL COMMITTEE CHAIRMEN Dr. Maxwell presented the recommendations of the Medical Staff-Hospital Council that Dr. Stevan Zimmer become chairman of the Emergency Department Committee and that Dr. Roberto Heros become chairman of the Operating Room Committee. Both appointments are for one year terms. The Joint Conference Committee endorsed the recommendations of the Medical Staff-Hospital Council. MEDICAL STAFF-HOSPITAL COUNCIL CREDENTIALS COMMITTEE REPORT AND RECOMMENDATIONS Dr. Maxwell presented the Credentials Committee recommendations. The recommendations concerned extension of provisional status and clinical privileges, addition and/or deletion of clinical privileges, regular appointment, and resignations. The Joint Conference Committee endorsed the recommendations of the Medical Staff-Hospital Council. QUALITY ASSURANCE PLAN Dr. Maxwell informed the Committee that the report of the Quality Assurance Steering Committee was being circulated. The report had been presented to the Medical Staff-Hospital Council. It is expected that the report will be presented to the Clinical Chiefs on September 24. The report will be returned to the Joint Conference Committee in October. CLINICAL CHIEFS REPORT Dr. Richard Price presented the Clinical Chiefs Report. Dr. Price informed the Committee that Dr. Roby Thompson has been elected chair of the Clinical Chiefs. Dr. Price also informed the Committee the chiefs are enthusiastic about the appointment of Dr. Robert Anderson to be the Vice President of Health Sciences. Dr. Anderson is Chief of Pathology at the University of New Mexico and is nationally recognized for his expertise in research, education, and patient care. 9. ADJOURNMENT There being no further business, the Committee meeting was adjourned. ;gx"c;:,tted, Gil es Caver Administrative Fellow 10 t..5.···-*'!·.·]ii;·~·,. t-0< ~: UNIVERSITY OF MINNESOTA TWIN CITIES Office of the Chief of Staff The University of Minnesota Hospital and Clinic Box 707 Harvard Street at East River Parkway Minneapolis, Minnesota 55455 (612) 626·1945 September 12, 1991 TO: FROM: SUBJECT: Members of the Board of Governors Robert E. Maxwell, M.D., Chief of Staff Chairman, Medical Staff-Hospital Council Credentials Committee/Medical Staff-Hospital Council Report and Recommendations. The Medical Staff-Hospital Council on September 10 and the Joint Conference Committee on September 11 have endorsed the attached Credentials Committee Report and Recommendations. I am forwarding these recommendations to you for your review and approval on September 26. If you should have any questions, please feel free to call on me. REM/cf Attachment HEALTH SCIENCES 11. I~ i UNIVERSITY OF MINNESOTA ~ ~ I ! TWIN CITIES August 26, 1991 The University of Minnesota Hospital and Clinic Harvard Street at East River Parkway Minneapolis, Minnesota 55455 TO: FROM: SUBJECT: Medical Staff-Hospital Council Henry Buchwald, M.D. Chairman, Credentials Committee Credentials Committee Report and Recommendations The Credentials Committee after examining all pertinent information provided to them concerning the professional competence and other necessary qualifications, hereby recommends the approval of provisional status and clinical privileges to the following applicants to the Medical Staff of The University of Minnesota Hospital and Clinic. Department c; Anesthesiology Mark W. Stuckey Department of Dermatology Mary E. Meighan Ell en B. Rest Department of Family Practice and Community Health David C. Current Laboratory Medicine and Pathology Pascual Abenoza Department of Medicine Srinivas K. Janardan Susan E. Kline Gregory L. Miller Robert D. Winston Department of Orthopedic Matthew D. Putnam Category Attending Staff Category J Attending Staff Attending Staff Clinical Staff. Attending Staff Attending Staff-ER Attending Staff-ER Attending Staff-ER Attending Staff-ER Clinical Staff nEALTH SCIENCES 1 MS-HC August 26, 1991 Page 2 Provisional status and clinical privileges continued: , Department of Pediatrics Catherine M. Bendel Elsa N. Keeler Jane M. Laco Mark G. Roback Homer D. Venters John E. Wagner Department of Radiology Steven J. Burbidge Janine L. Carson Martin R. Crain Helmut C. Diefenthal Kevin D. Gustafson Kenneth P. Korte Jon F. Snider James W. Walsh Department of Surgery Michael D. Caldwell Terrence P. Horrigan Edward W. Humphrey Therapeutic Radiology Maureen C. Holasek Department of Urology Jon L. Pryor Category Attending Staff Attending Staff Attending Staff Attending Staff Clinical Staff Attending Staff Attending Staff Attending Staff Attending Staff Attending Staff Clinical Staff Clinical Staff Attending Staff Attending Staff Category Attending Staff Clinical Staff Clinical Staff Attending Staff Attending Staff The following medical staff have submitted applications and supporting documentation requesting change in staff category or addition and/or deletion of clinical privileges. The Committee has reviewed and considered their requests and hereby recommends approval. , Department of Medicine Ti mothy D. Henry Department of Hospital Dentistry Christopher Blixrud Present Category Attending Staff Category Attending Staff Recommended Category Clinical Staff Add: removal of teeth both surgical and non-surgical 13. MS-HC August 26, 1991 Page 3 Addition/deletion of clinical privie1ges continued: Department of Medicine John A. Hitt Attending Staff Add: arterial puncture; arthrocentesis; bone marrow aspiration; lumbar puncture; paracentesis; thoracentesis, aspiration only Delete: ER privileges Jeffrey S. Miller Attending Staff Add: arterial puncture; bone marrow aspiration; cancer chemotherapy by protocol; CNS chemotherapy; lumbar puncture; bone marrow transplantation; needle biopsy of: bone marrow, tumor; paracentesis; small intestine intubation; thoracentesis, aspiration only, aspiration and chemotherapy Laura Stahnke Attending Staff Add: biopsy ulcerated tumors; co10noscopy, with biopsy/polypectomy, control of hemorrhage cautery; esophago-gastro-duodenoscopy, with biopsy/polypectomy, treatment of bleeding lesion cautery, with balloon dilatation; endoscopic retrograde co1angiopancreatography; endoscopic retrograde sphincterotomy, with Stent placement, stricture dilatation; esophageal tamponade with Senstaken tube; esophagoscopy, biopsy and cytology; esophagoscopy with injection, Sclerosis of varices, Stent placement; gastric lavage and cytology; needle biopsy of: liver; paracentesis; sigmoidoscopy and biopsy; small intestinal biopsy with Crosby capsule and Shiner tube; small intestine intubation Delete: ER privileges Department of Neurology Jacqueline T. Bernard Attending Staff Add: Botulinum injection of neck muscles for torticollis Department of Neurosurgery Stephen J. Haines Attending Staf Add: central nervous system endoscopy Robert E. Maxwell Add: stereotactic radiosurgery Attending Staff 14 MS-HC August 26, 1991 Page 4 Addition/deletion of clinical privileges continued: Department of Ophthalmology Jonathan D. Wirtschafter Categroy Attending Staff Joint Appointment Neurology Add: Neurology: spinal tap; muscle biopsy; nerve biopsy; injection therapy of nerves, muscles and joints; caloric testing; visual field perimetry; electroretinography; Department of Pediatrics Robert A. Ulstrom Delete: all clinical privileges Department of Surgery Henry Buchwald Category Emeritus Staff Attending Staff Add: laparoscopy; laproscopic cholecystectomy; laproscopic biopsy The following medical staff are completing their provisional status and are eligible for regular appointments as members of the Medical Staff of The University of Minnesota Hospital and Clinic. The Committee has reviewed recommendations concerning their appointment and hereby recommends approval. Department of Laboratory Medicine and Pathology Howard Clark Department of Medicine Category Attending Staff Date Eligible June 19, 1991 Pablo Denes Joan M. Fox Ralph J. Katsman Nigel S. Key Jane C. Pederson Georgia L. Wiesner Department of Obstetrics and Gynecology Clinical Staff Apri 1 24, 1991 Attending Staff April 24, 1991 Attending Staff-ER April 24, 1991 Attending Staff Apri 1 24, 1991 Attending Staff-ER Apri 1 24, 1991 Attending Staff-ER Apri 1 24, 1991 c Deborah A. Thorp Department of Orthopedics Timothy A. Garvey Clinical Staff Attending Staff June 19, 1991 June 19, 1991 15. MS-HC August 26, 1991 Page 5 Regular medical staff appointments continued: Department of Psychiatry Sheila M. Specker Department of Radiology Lenore I. Everson David E. Fi nl ay William J. Ford Arthur E. Stillman Department of Surgery Edgar A. Pi neda Department of Therapeutic Radiology Karthryn E. Dusenbery Kathryn E. Farniok Attending Staff Attending Staff Attending Staff Clinical Staff Attending Staff Attending Staff Attending Staff Attending Staff June 19, 1991 June 19, 1991 April 24, 1991 June 19, 1991 June 19, 1991 June 19, 1991 June 19, 1991 June 19, 1991 The Committee recommends acceptance of the resignations of Medical Staff appointments from the following physicians. Department of Laboratory Medicine and Pathology Evan George James M. Greenberg Department of Medicine Edward C. Clark Robert J. Helgren Teresa C. McCarthy Department of Neurology Michael J. Glantz Department of Orthopedics Serena S. Hu Department of Pediatrics David M. Steinhorn Robin H. Steinhorn Category Attending Staff Attending Staff Category Attending Staff Attending Staff Attending Staff Attending Staff Category Attending Staff Attending Staff Attending Staff Joint Appointment Pediatrics 16 MS-HC August 26, 1991 Page 6 Resignations from the medical staff continued: Department of Radiology Richard N. Aizpuru Sandra J. Althaus David M. Drees Bertrand L. Gallet Kathleen A. Goossens Keith M. Horton Timothy M. Skopec HB/cf Attending Staff Attending Staff Attending Staff Attending Staff Attending Staff Attending Staff Attending Staff 17. 15 p~ Ii UNIVERSITY OF MINNESOTA ... fl·. TWIN CITIES September 12, 1991 Office of the Chief of Staff The University of Minnesota Hospital and Clinic Box 707 Harvard Street at East River Parkway Minneapolis, Minnesota 55455 (612) 626-1945 TO: FROM: SUBJECT: Board of Governors Robert E. Maxwell, M.D., Chief of Staff Chairman, Medical Staff-Hospital Council Appointment of Medical Staff-Hospital Council Committee Chairman The Medical Staff-Hospital Council on September 10 and the Joint Conference Committee on September 11 have endorsed the appointments of Stevan D. Zimmer, M.D. as chairman of the Emergency Department Committee ..J... and Roberto Heros, M.D. as chairman of the Operating Room Committee for . 1991/1992, and are forwarding these recommendations to you for your approval. The Bylaws of the Medical and Dental Staff, Article VI, Part A, Section 1, (s), sets forth the requirement that the appointment of all Medical Staff-Hospital Council committee chairmen be made by the Board of Governors after receiving recommendations from the Medical Staff- Hospital Council. Thank you. REM/cf H!:ALTH SCIENCES 18 IPlanning & Dev. Committee Review: _ Finance Committee Review: _ Board of Governors Review: _ MAJOR CAPITAL EXPENDITURE REPORT EQUIPMENT: Outpatient Laboratory Remodel ing PURCHASE PRICE: $21 6,033 DESCRIPTION: The UMHC outpatient laboratory service was one of the first in the country designed to accommodate only outpatients with on-site testing for common tests. Its goal has been and continues to be a minimum waiting time and rapid reportingofresults to the clinics. Although growth was anticipated when the building opened in 1979, more recent demands have exceeded the capacity to provide the best possible service. The marked rise in test volume and processing has created a need for expansion and remodeling. The need for remodeling and expansion results from the continued shift of patient care to the outpatient setting. The total volume of outpatient tests has increased more than expected, rising from 10% of inpatient tests when the lab opened to 36% of inpatient tests in 1990/91. For the year ending June 1991 there were 825,389 outpatient tests, compared to 275,000 in 1984. About 90% of test specimens for all of these outpatient tests are processed through the outpatient laboratory for on-site testing or for distribution to other ut1HC laboratories. Continued increase in total outpatient testing creates a need for additional processing space, to improve turn- around time, decrease patient waiting, and relieve staff congestion. Increases in on-site testing result not only from the rising number of patient visits but also the introduction of new procedures such as EKG tests, tests on small infants, and blood drawing from indwelling lines. The principle objectives in remodeling are: 1. Expand the blood drawing area to accommodate more patients at one time, and decrease waiting times. 2. Expand and rearrange the working space to alleviate overcrowding of technical staff. The following changes in the laboratory are planned: 1. In the blood drawing area--an increased number of stations, better patient flow, better handicapped facilities, semi-private stations, private areas for infants and small children. To accomplish this, spa,..e-e' has been expanded 4~ feet into the waiting area. /1 / /~ f\. / Submitted By: _ Title: _ / I 'XI Approved 1lV.. '-' , Title: Senior Assoc i ate Di rector 19. 2. In the reception area--a larger window to easily accommodate two patients and two staff members at one time. 3. In the laboratory area--expand the specimen processing space, rearrange the lab testing area to r~duce crowding resulting from a staff increase from 13 to 22.6 FTEs, move microscope work away from a vibrating wall (due to the escalators), meet new code requirements involving doorways, install emergency power sources to offset black-out periods. In planning the remodeling, careful consideration has been given to the use of available adjacent space to minimize effect on other outpatient activities. Part of a rear corridor between current laboratory spaces and also a rear sparingly-used storage area will be converted to lab space. Current space is 3,212 square feet. Proposed additional space totals 665 square feet. The design for remodeling will enable the Outpatient Laboratory to further improve service to the patients of UMHC now and for some time in the future. Total project cost is estimated at $216,033. This amount was originally included in the capital budget for 1990-91. 20. UTIlEUNNERSl1YOFMINNF~A o ~2~~~~ CLINIC Planning & Dev. Committee Review: _ Finance Committee Review: _ Board of Governors Review: _ MAJOR CAPITAL EXPENDITURE REPORT EQUIPMENT: Replacement of Disk System for UNISYS A15 and A9 Computers $500,000 PURCHASE PRICE: DESCRIPTION: A significant increase in the maintenance contract cost for the disk data storage system for UMHC's UNISYS A9 and A15 mainframe computers caused the Information Service Department's staff to analyze various alternatives. Their findings indicate that over a 5 year period the least expensive alternative is acquisition of a new, state-of-the-art disk system. As displayed below, this is due to reduced operating costs, because of lower power consumption and reduced air conditioning requirements, coupled with significantly lower maintenance costs. PROJECTED 5 YEAR COSTS Acqui sit ion Maintenance Electrical Energy System Operation Air Conditioning TOTALS CURRENT SYSTEM $ 0 578,000 160,000 46,000 $784,000 PROPOSED NEW SYSTEM $500,000 117,000 37,000 13,000 , $667,000 PROPOSED OVER/(UNDER) CURRENT $500,000 (461,000) (123,000) (33,000) ($117,000) Sale of the existing disk system will increase the projected cost saVings somewhat. The amount is difficult to project as it varies significantly depending upon market demand at the time the sale is formally advertised. In addition to the direct savings, the decreased air conditioning requirements will help alleviate the current deficit of air conditioning capacity in the main computer room and help to avoid the expense of increasing capacity. The current deficit was highlighted as a significant concern by a disaster recovery consultant last year. Maintenance of adequate computer support has become an increasing concern as the failure rate of components of the existing disk system have begun to increase with age. The simplified design of new disk systems makes them lessCf- f_a_i_l_ur_e_p_ro_n_e_-_-_a_m_a_j_or_r_e_a_so_n_f_o_r_t_h_e_s_ig_n_i_f_i7c:t..n-r-~t=-t~~1+~"",?e",,~_m~:--=--i-n-t-e-na-n_c-e-co_s-t_s_.-t Submitted By: Al Dees Approved B : .:;;>""'(~:......t:.J.-lo..-.J(=--)_..:.1v _.~_~~.:!- _ Associate Director '--'::7 -"Title: Title: _ 21. Replacement of the disk system is included in the hospital's long range ... ~ capital budget for the 1991/92 and 1992/93 fiscal years. An interest free, ~ two installment payment plan, 50% upon delivery and 50% on July 1, 1992, to correspond with the budget will be a condition in the bid request. 22 TO: FROM: UNIVERSITY OF MINNESOTA The University ofMinnesota Hospital and Clinic September 17, 1991 Board of Governors Robert Dickler~ Hospital Director SUBJECT: Acquisition of Red Wing Medical Center Harvard Street at East River Parkway Minneapolis, MN 55455 I am writing to you at this time to request that you approve UMHC acqulrlng the Interstate Medical Center (IMC) physician practice in Red Wing, Minnesota. It is our intent to make this presentation to you for information during the retreat on September 26 and 27, 1991. We will seek your endorsement of this proposal at the October Board of Governors meeting. Should you approve this proposal, we will request the Board of Regents approval during November and December. While the actual acquisition documents are still being developed, the expected future structure of IMC will be a new nonprofit corporation. The price for the acquisition is $9,074,600 subject to adjustment for any issues discovered during the due diligence process. We request that you review the attached proposal so we can answer any of your questions at the retreat, or as usual you may call either Mr. Fearing or myself at 626-0966 or 626-5003 if you have questions or concerns. RD:sw Attachment 23. PROPOSAL UNIVERSITY OF MINNESOTA HOSPITAL AND CLINIC ACQUISITION OF INTERSTATE MEDICAL CENTER RED WING, MINNESOTA (Much of the following are excerpts from the Bylaws and Articles of Incorporation of the New Corporation.) Existing Physician Practice Description: Interstate Medical Center (IMC) is a multiple specialty clinic of twenty-eight physicians, and related staff, which operates primarily out of a facility in Red Wing, Minnesota. IMC also owns a clinic building in Elsworth, Wisconsin, and has satellite office space in Zumbrota, Minnesota. IMC is the only major clinic in Red Wing and is the major physician provider in this geographic area. IMC is a healthy and viable clinic with a patient volume of apprOXimately 150,000 patient encounters per year. It's yearly gross revenues are approximately $14 mi 11 ion, and it has demonstrated a cons i stentpattern of growth over the 1ast several years. The Red Wing facility consists of two buildings, containing a total of approximately 42,000 gross square feet, and parking space for 205 cars. The main clinic building is twenty years old and consists of two floors of about 16,000 gross square feet each. The therapy bUilding, which is about five years old, also houses storage. The Elsworth facility was constructed in 1984, and comprises approximately 3,000 gross square feet. New Corporation: The name of the new corporation will continue to be Interstate Medical Center. We are proposing, with concurrence of our legal counsel, that the new organization be established as a non-profit organization and seek tax exempt status from the Internal Revenue Service. It is our belief that this type of organizational structure best fits the mission of the University and the new organization. Mission of New Corporation: The mission of the corporation will be to engage in, and assist and contribute to, the support of charitable, scientific, and educational activities and projects, within the meaning of Section 501(c)(3) of the Internal Revenue Code. In support of the mission, the main activities of the corporation shall include: A. To operate a multi-specialty medical clinic providing health care .~ services and promoting health in Red Wing, Minnesota and the surrounding ~ areas. c B. To operate programs for medical education including medical residencyand continuing medical education, as well as community health education and specialty outreach programs. C. To engage in clinical research and scientific investigation related to health and medicine. D. To do any and all other acts and things, and to exercise any and all other rights and powers which may be necessary, advisable, desirable or expedient in the accomplishment of any of the foregoing purposes. Corporate Authority: The corporation shall have authority to do any and all acts and things and carry on and conduct all other activities as may be necessary, advisable, desirable or expedient to accomplish its purposes, to the full extent permitted by the laws of the State of Minnesota. All activities of the corporation shall be carried on, and all of its funds shall be used and applied exclusively for, the purposes for which this corporation was organized. No part of the net earnings of the corporation shall inure to the benefit of any member, officer, director or any other individual (except that reasonable compensat ion may be paid for servi ces rendered to or for the corporation in furtherance of one or more of its purposes, and except that individuals may benefit from grants, and similar payments or contributions made for the purposes for which this corporation was organized, in furtherance of the purposes of the corporation). No substantial part of the activities of the corporation shall be the carrying on for propaganda or otherwi se attempting to infl uence 1egi sl at ion, and the corporation shall not participate or intervene in any pol itical campaign on behalf of any candidate for public office, by publishing or distributing statements or otherwise. The corporation shall not carryon any other activities not permi tted to be carri ed on by a corporat ion exempt from federal income tax under Sect ion 501(c)(3) of the Internal Revenue Code. The corporation shall not afford pecuniary gain or profit, incidentally or otherwise, to its members or its employees. This corporation will be formed under Chapter 317A of Minnesota Statutes. Governance: Sole Member - The sole member of the corporation shall be the Regents of the University of Minnesota, a corporation established and operating in accordance with Minnesota Statutes, Section 158. The rights and obligations of the sole member shall be fulfilled by the University of Minnesota Hospital and Clinic, by and through its Board of Governors and management. 2 25. Notwithstanding anything to the contrary herein, the sole member shall reserve ~ and retain certain powers to manage the affairs of the corporation. No action may be taken by the corporation inconsistent with the mission of the corporation, nor shall any amendment to such corporate purposes occur, without the specific written approval of the sole member. In addition, the sole member shall be notified of any proposal for the Corporation to enter into a provider agreement with any third party payor, and the Corporation shall not enter into any such provider agreement without the approval of the sole member; provided, that the sole member may only withhold such approval if the terms of the proposed agreement materially confl ict with the mission or corporate purposes of the University of Minnesota Hospital and Clinic. The Corporation's annual budget shall be formulated for the purpose of maintaining first-rate medical clinic, education and research programs. All revenues generated by the Corporation shall be devoted to the maintenance of its programs and other corporate operat ions. The annual operat i ng and capi ta1 budgets shall be formulated by the Board of Directors or its designee and shall be approved in writing by the Board of Directors not later than the end of the first month of the new fiscal year to which the budget applies. Subsequent to such approval, the annual budget shall be submitted for approval to the sole member and shall be subject to the written approval of such member. The prior written consent of the sole member shall also be required for: A. Any merger, consolidation, or substantial transfer of the property of the corporation to any other entity; or B. Any mod ifi cat i on or amendment of the corporate capital or operating budget in excess of $50,000 or in excess in the aggregate of 10% of the budget; or C. Any act ion that mi ght, in the reasonable judgement of the member,jeopardize the non-profit status of the corporation. The University of Minnesota Hospital and Clinic shall not be removed as a member of the Board. In addition, the sole member of the corporation shall have the sole vote on or in respect of any matter on which members of the corporation have the right to vote under law, the Articles of Incorporation or Corporation Bylaws. The sole member may not voluntarily or involuntarily transfer or assign its membership or any right arising therefrom, except to another entity controlled by the University of Minnesota and acceptable to the majority of the Board of Directors of the corporation. Consent of the Board of Directors shall not be unreasonably withheld. In the event of liquidation, dissolution or winding up of the corporation, whether voluntary or involuntary or by operation of law, the remaining property and assets of the corporation, after provision has been made for the payment of debts, obligations and liabilities of the corporation in accordance with M.S.A. 317A.701 et seq., shall be distributed to the University of Minnesota. Finally, no amendment to the Articles of Incorporation may be made which has ~ material impact on the powers reserved to the sole member. 3 26 Board of Directors - The management of the corporation shall be vested ina Board of Di rectors, subject to the reservation of certain powers for the sole member. The number of directors shall be fixed by the Bylaws of the corporation, and may be altered by amending the Bylaws. The first Board of Directors shall consist of two classes of directors. Three directors shall be the "University Directors". The Board of Governors of the University of Minnesota Hospital and Clinic shall appoint the University Directors based on recommendation of the Hospital Director. The remaining three directors shall be the "Physician Directors". The physicians shall appoint the Physician Directors by election of the entire physician group. The term of office of the members of the first Board of Directors shall be for the periods of 1, 2, or 3 years for University and Physician Directors. Each such director shall hold office until the end of the term of his or her office or until his or her successor has been elected and qualified. Except as provided otherwise in the Articles of Incorporation of the corporation, the business and affairs of the corporation shall be managed by or under the direction of the Board of Directors. Each director, except members of the first Board of Directors, whose terms of office are specified in the Articles of Incorporation of the corporation, shall serve for a three year term and until his or her successor is elected and qual ified. Any director may resign at any time by giving written notice to the Secretary. Such resignation shall take effect without acceptance upon receipt of the notice, unless a later date is specified in the notice. Vacancies in the Board of Directors shall be filled by a new appointment or election, as the case may be, as set forth in the Bylaws. A person so elected to fill a vacancy shall serve as a director for the remainder of the term whose vacancy has been filled, and until his or her successor has been elected and qua1ifi ed. Any Physician Director may be removed at any time by a majority vote of the physicians eligible to vote for a Physician Director. Any University Director may be removed at any time by the University. Any Physician Director shall be removed as a director of the corporation should he or she cease employment with the corporation. In such circumstances, either the presiding officer of the Board or the corporation's President shall provide immediate written notice of such removal, which removal shall be effective upon the earlier or either (i) the date the notice is received; or (ii) the date the director to be removed ceases employment with the corporation. 4 27. A majority of the directors currently holding office shall constitute a quorum ~ for the transaction of business, except under no circumstances shall a quorum be deemed to exist if fewer than two Physician Directors and two University Directors are present. In the absence of a quorum, a majority of the directors present may adjourn a meet i ng from time to time until a quorum i present, provided, that notice of a meeting's adjournment by less than a quorum of directors shall be provided to the absent directors. Except as otherwise required by law or the Bylaws, the acts of a majority of the directors present at a duly held meeting shall be the acts of the Board of Directors; provided, that if fewer than six directors are present at a meeting, a unanimous action by the directors shall be required for the Board of Directors to act. If the Board is unable to reach a decision on an issue because of a deadlock and such deadlock cont inues for a peri od of 90 days then med i at i on shall be mandatory upon the written request of any Director. If such deadlock is not resolved by mediation, the Directors may agree to submit the issue to binding arbitration by a mutually agreeable arbitrator. If a deadlock is not resolved by mediation and is not submitted to bi ndi ng arbitration, any Di rector may ask a court of competent jurisdiction to resolve the issues. Bylaw Amendments. The power to adopt, amend, or repeal the Bylaws is vested in the Board of Directors, provided, that no amendment shall be made to the Bylaws which has a material impact on the reservation of powers to the sole member. Any amendment to the Articles of Incorporation or Bylaw changes must be approved by 3/4 of the members of the Board of Directors. Board Meetings: The Board of Directors shall hold an annual meeting for the purpose of electing officers and transacting any other business coming before it. The Board may hold such other meetings as it may from time to time determine. The meetings shall be held at any place within or without the State of Minnesota that the Board may designate. Absent such designation, Board meetings shall be held at the registered office of the corporation. The President or any director may call a special Board meeting. An action required or permitted to be taken at a Board meeting may be taken by written action signed by all of the directors. Directors shall receive no compensation, but may be reimbursed for reasonable expenses as shall be determined from time to time by resolution of the Board of Directors. Nothing herein shall be construed to preclude any director from serving this corporation in any other capacity and receiving proper compensation therefor. At either the annual meeting or a special meeting, the Board of Directors shall consider the annual budget for the corporation. At l~ast ten days prior to such meeting all directors shall be provided with the proposed annual budget, as approved by the Physician's Committee. Such meetings shall occur at least 30 days prior to the commencement of the fiscal year of the corporation for which the budget is proposed. Simultaneous with the delivery of the proposed budget to the directors, such budget shall also be delivered to the member. 5 28, The following matters shall require specific approval by the Board of Directors: A. Non-budgeted capital expenditures of more than $50,000; B. The merger or consol idation of the corporation with, or transfer of more than 25% of the assets of the corporation to, any entity; C. The incurring or guaranteeing by the corporation of indebtedness in excess of $50,000 in aggregate during any fiscal year, as defined in generally accepted accounting principles to include notes, bonds, debentures, capital leases and otherwise, except purchase money indebtedness incurred in connection with the purchase or construction of a capital asset included in the budget and except indebtedness incurred by the corporation's drawi ng down on any 1i ne of credi t approved by the Board of Directors; D. The purchasing or acquiring by the corporation of stock or other securities or evidences of indebtedness, or the making of loans or advances to, or any investment in, any corporation, partnership or other entity, except for the regular investment of funds (in accordance with the corporation's investment policies) including, without limitation, clinic revenues and employee benefit plan funds, and except for investments in joint ventures in the amount of $25,000 or less. E. The adoption or termination of any lease for space or equipment with annual costs in excess of $50,000. F. The Board shall be informed of, but need not approve, termination of the employment of any physician. G. Grants or gifts in excess of $5,000. Officers: The corporation shall have at least two natural persons exercising the functions of the office of President and Treasurer. The Board of Directors may elect or appoint such other officers or agents as it deems necessary, each of who shall have the powers, rights, duties and responsibilities set forth in these Bylaws unless otherwise determined by the Board. Any of the offices or functions of those offices may be held by the same person. Officers shall receive no compensation, but may be reimbursed for reasonable expenses as determined from time to time by resolution of the Board. At the annual meeting of the Board of Directors, the Board shall elect officers, who shall hold office until their successors are elected and qualified; provided, however, that any officer may be removed with or without cause by the affirmative vote of the directors in accordance with the Bylaws (without prejudice, however, to any contract rights of such officer). Any officer may resign at any time by giving written notice to the corporation. The resignation is effective without acceptance when notice is given to the corporation, unless a later date is specified in the notice. 6 If a vacancy in any office of the corporation occurs for any reason, such vacancy may, or in the case of a vacancy in the office of President or Treasurer shall, be filled for the unexpired part of the term by the Board of Directors. President. Unless provided otherwise by a resolution adopted by the Board of Directors, the President shall (a) be the chief executive officer of the corporation, and have general active management of the business of the corporation; (b) preside at all meetings of the Board and of the members; (c) see that all orders and resolutions of the Board are carried into effect; (d) sign and deliver in the name of the corporation any deeds, mortgages, bonds, contracts or other instruments pertaining to the business of the corporation, except in cases in which the authority to sign and deliver is required by law to be exercised by another person or is expressly delegated by the Articles, the Bylaws or the Board to some other officer or agent of the corporation; (e) maintain records of and certify proceedings of the Board and Members; and (f) perform such other duties as may from time to time be prescribed by the Board. Treasurer. Unless provided otherwise by a resolution adopted by the Board of Directors, the Treasurer shall (a) keep accurate financial records for the corporation; (b) deposit all monies, drafts and checks in the name of and to the credit of the corporation in such banks and depositories as the Board of Directors shall designate from time to time; (c) endorse for deposit all notes, checks and drafts received by the corporation as ordered by the Board, making proper vouchers therefor; (d) disburse corporate funds and issue checks and drafts in the name of the corporation, as ordered by the Board; (e) render to the President and the Board of Directors, whenever requested, an account of all of his or her transactions as Treasurer and of the financial condition of the corporation; and (f) perform such other duties as may be prescribed by the Board of Directors or the President from time to time. Secretary. The Secretary shall, unless otherwise determined by the Board, be secretary of and attend all meetings of members and Board of Di rectors, and record the proceedings of such meetings in the minute book of the corporation and, whenever necessary, certify such proceedings. The Secretary shall give proper notice of meetings to members and directors and shall perform such other duties as may be prescribed by the Board of Directors or the President from time to time. Vice President. Each Vice President shall have such powers and shall perform such duties as may be specified in the Bylaws or prescribed by the Board of Directors. In the event of absence or disability of the President, the Board of Directors may designate a Vie President or Vice Presidents to succeed to the power and duties of the President. Other Officers. Any other officers appointed by the Board of Directors shall perform such duties and be responsible for such functions as the Board of Directors may prescribe. Delegation. Unless prohibited by a resolution by the Board of Directors, an officer elected or appointed by the Board may delegate in writing some or all of the duties and powers of his or her office to other persons. 7 30 ~ Physicians' Committee: The Board of Directors shall establish a Physicians' Committee which shall have and exerci se the authority of the Board in the day-to-day management of the business of the corporation, including, without limitation, the following matters: A. Determination of physician work schedules, call coverage schedules, vacation and leave schedules, staffing, and all issues of a similar nature relating directly to the performance of work and services by physicians employed at the corporation. B. Determination of compensation for professional employees, including salaries, bonuses, insurance and other welfare benefits, retirement and other similar benefit plans, and all other aspects of compensation for professional employees of the corporation. In establishing compensation for professional employees of the corporation, the Physicians' Committee shall refer to salary ranges of similarly situated practitioners in comparable clinics which shall be prepared by the corporation's outside accountants. Compensation for professional employees of the clinic shall be competitive with comparable group practices, so as to permit the corporation to retain its professional staff, but shall not exceed a reasonable level of compensation. In accordance with the purposes of the corporation as set forth in its Articles of Incorporation, the compensation system shall not be used as a device to distribute the net profits of the corporation to its professional employees. No action shall be taken by the Physicians' Committee as to compensation that might reasonably be anticipated to jeopardize the tax-exempt status of the Corporation. Compensation and benefit programs must be fully reflected and approved in the annual budget. C. All other matters respect i ng the management and operat ion of the corporation except those powers retained by the sole member and except as the Board of Directors may otherwise determine by specific resolution adopted by such Board. The Physicians' Committee shall be composed of the three Physician Directors servi ng as members of the Board of Di rectors and three or more addi tiona1 physicians practicing medicine as employees of Interstate Medical Center. The Physicians' Committee may, from time to time, appoint such other committees as it may deem proper, and may prescribe the functions and membership of such other committees. The Physicians' Committee shall at all times be subject to the control and direction of the Board. The degree of local control over the governance and management of the Corporation is intended to maintain the local influence over the medical practice of the Red Wing area and reduce the operating inefficiencies and increased costs that would be associated with direct University control. The separate corporation also allows the University to be isolated for malpractice actions, retirement and other liabilities of the physicians and employees of IMC. The fiscal year of the corporation shall be established by the Board of Directors. 8 31 The corporation shall indemnify such persons, for such expenses and liabilities, in such manner, under such circumstances, and to such extent, as permitted by Minnesota Statutes. The corporation shall not enter into contracts or transactions between the corporation or a related corporation and a director or member of the Physicians' Committee of the corporation or between the corporation and an organization in which a director or member of the Physicians' Committee of the corporation is a director, officer or legal representative or has a material financial interest, except in accord with the provisions of Minnesota Statutes. Purchase Price: The purchase price of IMC that has been agreed to is an aggregate $9,074,600 subject to change due to new property or equipment acquisitions or any errors or omissions or other issues affecting the purchase price discovered during the due diligence process. Of this amount, $3,596,600 is directed toward the real property and other assets. Rea1 estate and equi pment appra i sa1s have been received which support the $3,596,000 purchase price. UMHC will loan the new corporat ion the funds to purchase these assets from exi st i ng IMC. The new corporat ion wi 11 in turn repay UMHC for the real estate and other assets. $5,478,000 is directed toward the purchase of the goodwill and ongoing business value of the clinic, and will be paid out over the course of eight years. The reasonableness of this component of the price was confirmed by an independent accounting firm. All of these parameters have been reviewed by external consulting and legal firms experienced in the legal and financial issues related to the acquisition of a pract ice. These efforts have indi cated that the aggregate purchase pri ce proposed is within the fair market value of the practice and that the structure and purposes of the acquisition are consistent with the current understanding and interpretations of relevant laws and regulations. Other: The University of Minnesota Hospital and Clinic has - throughout it's history - served as a statewide and regional resource. The types of relationships which UMHC and the University have developed with outstate communities has continually evolved over this period of time to both reflect and initiate changes in health care delivery. The acquisition of IMC provides a significant opportunity for the University and UMHC to geographically expand the base of medical operations, and provide greater opportun it i es for educat ion, research, and serv ice to the Greater Mi nnesota community and the Red Wing region. By this acquisition, UMHC will gain a secure relationship with a viable out-state provider. We expect to very quickly expand the residency program in Pediatrics to place residents in Red Wing, and as other departments develop relationships with IMC, further residency arrangements will be instituted. We expect that the relationship with the Rural Physician Apprenticeship Program (RPAP) will be reinforced and potentially expanded. The IMC patient population will be incorporated into appropriate research activity, allowing the expansion of research protocols. We also envision that this re1at i onsh ip wi 11 permi t the potent i a1 development of protocols and models ...) 9 32. related to rural health care and expansion of community education and continuing medical education involving a geographic region where this opportunity has not previously existed. These types· of changes will, of necessity, take place over a number of years and require the existence of a secure relationship to foster their development. The Board structure of three physicians and three University directors was negotiated in concert with the sole member retained powers. We believe that the sole member retained powers are adequate to assure that the corporation is acting in the best interest of the University, and at the same time a three to three Board membership provides equal opportunity for maintaining a joint interest in the new corporation's programmatic financial viability. The purchase of IMC has been discussed with local business leaders and the local Hospital Board. State legislators from the area have been briefed on this issue and we have had numerous discussions with our clinical leadership and faculty. To our knowledge, there is no vocal opposition to this acquisition. As an investment, the final negotiated price will allow UMHC to provide a return on investment of approximately our historical rate of return on the short term investment portfolio. It will also provide us with education and research opportunities that would not be available should we not proceed. We hope this proposal provides you the basis for understanding the presentation we will provide during the retreat. As always, should you have any questions or concerns, please contact me or Mr. Fearing at 626-5003 or 626-0966 respectively. 10 L~j*] :~~~~~ITYOF MINNESOTA September 25, 1991 The University of Minnesota Hospital and Clinic Harvard Street at East River Road Minneapolis, Minnesota 55455 TO: FROM: SUBJECT: Board of Governors Finance Committee Clifford P. Fearing Report of Operations for the Period July 1, 1991 through August 31, 1991 The Hospital's operations for the month of August reflect inpatient admissions and days, and outpatient clinic visit activity below bUdget. Similarly, both ancillary revenue and routine revenue are below budgeted levels. INPATIENT CENSUS: For the month of August, inpatient admissions totaled 1,552 which was 130 below budgeted admissions of 1,682. Our overall average length of stay for the month was 7 .1 days., Patient days for August totaled 12,056 and were 1,287 days below ~ budget. The areas in which admissions were most significantly below budget were Medicine, Gynecology, Pediatrics, Adult Psych, and Ophthalmology. OUTPATIENT CENSUS: outpatient encounters (including CUHCC and Home Health) for the month of August totaled 27,897 which was 4,107, or 12.8%, less than budgeted visits of 32,004. Encounters were below bUdget in virtually all clinical areas with the most significant decreases in Radiation Therapy, OB/GYN, Medicine, Adult Psych, Surgery, Orthopedics, Pediatrics, and Dermatology. Family Practice and Home Health visits were over budgeted levels for August. Although we are continuing to monitor our decline in census, the cause for the current lower trend is not known. However, for some of the clinical areas, a decline in census was the result of medical staff vacations. To recap our census: Monthly Data YID Data CXJ/91 91/92 91/92 % CXJ/91 91/92 91/92 % ~ Budget Actual Variance Var Actual Budget Actual Variance Y!! 1,671 1,682 1,552 (130) (7.7) Admissions 3,302 3,282 3,192 (90) (2.7) 13,088 13,343 12,056 (1,287) (9.7) Patient Days 25,TI5 26,282 24,720 (1,562) (5.9) 7.5 7.9 7.1 (0.8) (10.1) Avg Length of Stay 7.8 8.0 7.6 (0.4) (5.0) J422.2 430.4 388.9 (41.5) (9.6) Avg Daily Census 415.7 423.9 398.7 (25.2) (5.9) 73.6 74.7 68.3 (6.4) (8.6) Percent Occupancy 72.4 73.6 70.0 (3.6) (4.9) 30,806 32,004 27,897 (4,107) (12.8) Outpt Encounters 59,137 60,860 57,986 (2,874) (4.7) HEALTH SCIENCES REPORT OF OPERATIONS Auqust 1991 PAGE 2 FINANCIAL OPERATIONS: The Hospital's statement of Operations shows revenues over expenses by $632,000, an unfavorable variance of $2,353,000. Patient care charges through August totaled $63,037,000, which was 5.6% under budget. Routine revenue was $1,775,000 (9.2%) below budget and ancillary revenue was $1,974,000 (4.2%) below budget and reflects our unfavorable inpatient census variance. Deductions from charges totaled $16,660,000, which was $189,000 (1.1%) over budgeted deductions of $16,471,000. Billing adjustments and discounts related to contracted services with other providers and commercial payers were over budget. The variance was caused by timing differences in settlement dates, budget versus actual. The moderate variance in the government contractual adjustments was partly caused by an increase in the average charge per case and an increase in Medicare volume, resulting in increased charges written off. This was offset by lower write-offs in Minnesota Medical Assistance because of low patient charge utilization. HMO/PPO discounts have a favorable variance as a result of receiving a better than anticipated reimbursement rate for the Aware contract. Operating expenditures through August totaled $51,728,000 and were $1,948,000 (3.6%) below budgeted levels of $53,676,000. The overall favorable variance is primarily due to lower patient related costs (medical supplies and services and blood) and anticipated expenses not yet incurred. ACCOUNTS RECEIVABLE: The balance in patient accounts receivable as of August 31, 1991, totaled $97,732,000 and represented 94.2 days of revenue outstanding. The overall increase in our patient receivables in August of 1.0 day was reflected in increases in Commercial Insurance, Minnesota Medical Assistance, and BCBSM Organ Transplant contracts. CONCLUSION: The Hospital's overall operating position is positive through August. Our ongoing efforts are aimed at reducing costs and increasing productivity while still maintaining a high quality of patient care. Variance 1991-92 1991-92 Over/(Under) Variance Budgeted Actual Budget % Gross Patient Revenue $66,786,000 $63,037,000 ($3,749,000) -5.6% Deductions From Revenue 16,471,000 16,660,000 189,000 1.1°.41 Net Patient Service Revenue 50,315,000 46,377,000 (3,938,000) -7.8°.41 Other Operating Revenue Appropriation & Support 2,230,000 2,171,000 (59,000) -2.6% Other Revenue 2,020,000 1,933,000 (87,000) -4.3% Total Other Revenue 4,250,000 4,104,000 (146,000) -3.4°.41 Total Revenue From Operations 54,565,000 50,481,000 (4,084,000) -7.5% Operating Expenses: Salaries 21,119,000 20,952,000 (167,000) -0.8°.41 Fringe Benefits 5,162,000 5,041,000 (121,000) -2.3°.41 Contract Compensation 3,330,000 3,361,000 31,000 0.9°.41 Supplies And Services 12,559.000 11,831,000 (728,000) -5.8°.41 Utilities And Maintenance 1,987,000 1,986,000 (1,000) -0.1°.41 General Supplies & Expense 3,634,000 2,811,000 (823,000) -22.6°.41 Insurance 334,000 334,000 0 Depreciation & Amortization 3,094,000 2,969,000 (125,000) -4.0°.41 Interest 1,927,000 1,913,000 (14,000) -0.7°.41 JProvision For Uncollectibles 530,000 530,000 0Total Operating Expenses 53,676,000 51,728,000 (1 ,948,000) -3.6°.41 Net Revenue From Operations 889,000 (1,247,000) (2,136,000) Nonoperating Gains: Investment Income 2,095,000 1,878.000 (217,000) -10.4% Revenue And Gains In Excess Of Expense $2,984,000 $631,000 ($2,353,000) Variance 1991-92 1991-92 Over/(Under) Variance Budgeted Actual Budget 0.41 Admissions 3,282 3,192 (90) -2.7°.41 Patient Days 26,282 24,720 (1,562) -5.9°.41 Average Length Of Stay 8.0 7.6 (0.4) -5.0°.41 Average Daily Census 423.9 398.7 (25.2) -5.9°.41 Percentage OCcupancy 73.6 70.0 (3.6) -4.9°.41 Outpatient Encounters 60,860 57,986 (2,874) -4.7°.41 J