STATE OF GEORGIA

 

COUNTY OF HENRY

 

The Henry County Board of Commissioners held a Called Public Meeting at 6:30 p.m. on Monday, May 4, 2009, in Conference Room B, County Administration Building, 140 Henry Parkway, McDonough, Georgia. Notice of this meeting was posted in the entrance foyer of the County Administration Building. The Daily Herald was notified of this meeting. Those present were:

            Board of Commissioners

                        Elizabeth “BJ” Mathis, Chairman,

Warren E. Holder, District I Commissioner

Rick Jeffares, District II Commissioner

            Randy Stamey, District III Commissioner

Johnny B. Basler, District V Commissioner

                        Not present was:

Reid A. Bowman, Vice-Chairman, District IV Commissioner

Also attending were Shay Mathis, County Clerk; LaTonya Nix-Wiley, County Attorney; Rob Magnaghi, County Manager; Phyllis Shrader, Deputy County Manager; and others.

            Henry Medical Center

            Marcia Taylor, Chairman

            Charlie Scott, Hospital CEO and Operating Board

Dr. Joseph Blissit, Chairman of the Hospital Authority

            Joyce Rodgers, Hospital Authority and the Operating Board

            Steve Kay, Hospital Authority and Operating Board

            Dr. Gayla Sylvain, Hospital Authority

            Dr. Gopal Rao, Operating Board

            Mike Lyle, Hospital Authority

            Jeff Mills, Hospital Authority and Operating Board

            Terry Wilk, Vice President and Chief Information Officer

            Claude Carruth, Vice President and CFO

            Jeff Cooper, Vice President of Operations

            Lynette Ball, Chief Nurse

            Rod Meadows, Council to the Hospital Authority and the Operating Board

            Dr. Jorge Spinolo, Chief of Staff at Henry Medical Center

            Ellen Ethridge, Board Secretary

(NOTE: Audio of this meeting is available with the County Clerk in the Board of Commissioners’ Office and will be retained for a period no less than twelve (12) months from the date of this meeting.) 

            Chairman Mathis called the meeting to order and called for acceptance of the agenda with an amendment to add the “Nomination of three members to the Hospital Authority”.  Commissioner Basler made the motion to approve the amended agenda; Commissioner Jeffares seconded.  The motion carried 4-0-0. 

            Commissioner Jeffares made the motion to nominate Bill Tush, Herman Cane and David Williams to the Hospital Authority; Commissioner Basler seconded.  The motion carried 4-0-0.

            The meeting was turned over to Marcia Taylor, Chairman of the Operating Board of Henry Medical Center and she called the meeting to order for the Operating Board.

            Dr. Joseph Blissit, Chairman of the Hospital Authority of Henry County called the meeting to order for the Hospital Authority.

            The Hospital Authority and the Operating Board made a presentation to the Board of Commissioners about what’s going on at Henry Medical and some of the challenges they are facing during these economic times.  

            Rod Meadows, Council for the Hospital Authority and the Operating Board made a presentation regarding the Board structure. 

            In 1995 Henry Medical Center became the last hospital in Metro Atlanta to reorganize pursuant to a court case that was decided ten years early to create a hospital system.  Henry Health System, Inc. (Parent Holding Corporation) was created as the parent Board for the hospital organization.  The Henry Medical Center, Inc. (Operating Corporation) runs the hospital on a day-to-day basis.  The Henry Medical Center Foundation is utilized to raise money and friends.  Henry Health Ventures, Inc. (Venture Corporation) and Henry Development Ventures (Property Ventures) are both corporations established in 1995 do to certain things that are anticipated to happen in the future. These corporations while they exist are inactive.  The current members of the Hospital Authority are Joseph Blissit, M.D., Steve Kay, Michael Lyle, Jeff Mills, Joyce Rodgers, Gerald Taylor and Gayla Sylvain, M.D. 

            The Hospital Authority is a statutory governmental authority that was established in 1973 and meets quarterly.  This was the Authority that ran the hospital when it opened in 1979 to 1995.  There are seven members on the Authority.  The Hospital Authority has statutory powers and responsibilities that still exist even though the hospital on a day to day basis is operated by the Operating Board.  The Hospital Authority can issue bonds and exercise powers of a private corporation.

            The Hospital Authority serves as a conduit for Henry Medical Center with the Board of Commissioners.  On an annual basis the Authority participates in strategic planning, considers and adopts with the Operating Board the annual budget, ensures there is an annual financial audit, responsible for the contract with the County for indigent care, and approve changes in the CEO. 

            The Henry Health System, Inc. (Parent Holding Corporation) is the parent holding corporation for the remaining portion of the hospital system.  The members of the Henry Health System, Inc. are Hans M. Broder, Jr., Charles Scott, Deborah Haynes, M.D., Dave Huelsbeck, K. Matthew, M.D., Jeff Mills (also a member of the Authority), Kay Pippin, Joyce Rodgers (also a member of the Authority), and Gerald Taylor (also a member of the Authority).  

            The Henry Medical Center, Inc. (Operating Corporation) members are Marcia G. Taylor, Steve Kay (also a member of the Authority), Joseph Blissit, M.D. (also a member of the Authority), Hans M. Broder, Jr., Jeff Mills (also a member of the Authority), Gopal C. Rao, M.D., Joyce Rodgers (also a member of the Authority), Charles F. Scott, and Sheryl Simpson-Jones, M.D.  The Operating Board is a not-for-profit corporation that was activated in 1995 and meets monthly.  The reason for the reorganization is it allowed the hospital to do things that could not be done under the Hospital Authority Law as it existed at that time.  There responsibilities and powers, under the lease, is they assume certain statutory duties of the Authority under the lease and bond covenants.  They assume the staturoty, regulatory and credentialing duties to operate Henry Medical Center under a lease.  They also have the powers of a corporation.  Under Hospital Law the Operating Board serves as the Governing Board; they make the final decisions about the operation of the hospital.  They are responsible for the over all quality of care of medical treatments. 

            Henry Medical Center is in the process of opening a comprehensive cancer program.  The only way to do this was to enter into a joint agreement with some physicians.  Henry HealthVest Inc. and Henry RadiationVest, Inc. was created under Henry Medical Center, Inc. to enter into a joint venture with a physician group, Henry Radiation Oncology Partners, LLC and together the radiation oncology center can open.  For the first time there will be a radiation oncology center in Henry County. 

            Charlie Scott, CEO of the Hospital gave a presentation on the mission statement, vision and pillars of excellence for the hospital. The mission statement is “The Mission of Henry Medical Center, Inc. is to maintain and strengthen its leadership position in the operation of a patient-oriented institution for the delivery of quality, cost-effective healthcare, and to promote an atmosphere of wellness and preventive medicine to the community it serves.”  The vision is “Henry Medical Center will be widely regarded as the premier hospital on the Southside of Atlanta and will be the hospital of choice by the residents of Henry County based on quality of care and excellence of service.”

            Pillars of excellence represent broad categories of activity, of strategy, of initiatives that are all vitally important to the success of the hospital.  The strategic plan is based upon the five pillars: Growth, Service, Quality, Employees, and Finances.  Growth refers to initiatives designed to develop new services, and expand existing services to grow the business.  Service refers primarily to customer satisfaction both patients and physicians.  Quality encompasses a number of quality initiatives and quality outcomes.  Employees pillar encompass actions designed to make the hospital a good work place to try and enhance the quality of life for the employees.  Finances refer to having sound financial footing.  The message that is conveyed to the community is that the hospital provides leading edge technology, first class care and it’s close to home.

            There are several major initiatives that were the focus this past year. They are growth, finance, quality and service. 

            Steve Kay, Chairperson of the Business Development Committee committed regarding the growth initiative.  The growth strategy is key for continuing to be able to competitively create opportunities for the patients in the community.  Examples of growth strategies are the nursing home (Laurel Park), the McDonough Clinic, the North Tower, the Wound Healing Clinic, and Physician Recruitment. 

            Mr. Scott stated there are two major services.  One is the Radiation Therapy Center.  It will be a freestanding outpatient radiation therapy center located on the Henry Medical Center campus.  There will be top of the line, state of the art radiation equipment.  The ground breaking is expected to be in June, 2009 with the projected opening in May, 2010.  This center will be set up as a 50/50 joint venture between a subsidiary of Henry Medical Center and Henry Radiation Oncology Partners.  There are also plans to expand the cardiovascular services to include the addition of coronary angioplasty. 

            Jeff Mills, the Chairperson for the Finance Committee commented regarding the finances.  The primary function of the Finance Committee is to review the current financial operations of the hospital and make recommendations to the Operating Board. 

            Claude Carruth, the hospital Chief Financial Officer presented the following economic indicators:

·         Employees                                 1,500

·         Inpatient Admissions              12,000

·         Surgeries                                   9,000

·         Births                                        2,400

·         ER Visits                                 62,000

·         Revenue                                  $140 million

·         Payroll                                     $  70 million

·         Operating Costs                      $400,000 per day

Mr. Carruth stated there was a study published by the Georgia Hospital Association that was done by the US Department of Commerce, the Bureau of Economic Analysis that seeks to quantify for hospitals around the country, the economic impact of individual hospitals on their local and state economy.  A couple of indicators from the current report regarding Henry Medical Center:

·         Total Output / Income Generated                   $328 million

·         Household Earnings Generated                      $135 million

·         Georgia Full Time Jobs Created                           3,000

Mr. Carruth stated hospitals have been thought of as recession proof, but that is not the case.  A study that was recently released by the American Hospital Association surveyed approximately 1,100 acute care hospitals around the country on a number of economic issues to try and understand what the impacts are on their organizations and how they are responding or reacting to those impacts. 

·         Uninsured and Medicaid populations increasing

·         Patients are deferring inpatient and elective services

·         Community need for subsidized services increasing

·         Hospital responses to the economic crisis:

§  50% have reduced staff

§  80% have cut administrative costs

§  20% have reduced services to their communities

§  80% have cut capital spending

§  80% have seen an increase in physicians seeking assistance

Below are the affects of the economic crisis at Henry Medical Center:

·         Volume generally flat except ER

·         Patients are deferring treatments / surgeries

·         Uninsured population up 12.5%

·         Capital access diminished

·         Investment income subsidy non-existent

·         Henry Medical Center responses:

o   Hold open positions

o   Delay capital expenditures

o   Administrative cost reductions

o   Contract renegotiations

o   Supply cost reduction initiatives

Below are the 2009 financial results through March 31, 2009:

                                                                        FY 2009                      FY 2008

Patient revenue                                               $ 97,881                      $  93,999

Other operating revenue                                      5,817                            5,555

                        Total operating revenue          103,698                          99,554

Operating expenses:

Labor and related                                            52,558                            51,365

Supplies and other                                          42,494                            40,174

Capital related                                                  13,757                            13,602

                        Total operating expenses         108,809                         105,141

Operating loss                                                  (5,111)                             (5,587)

Investment income:

Realized                                                                539                              1,448

Unrealized                                                         (3,220)                                (23)

Net (loss)                                                         $ (7,792)                      $   (4,162)

            Commissioner Holder asked regarding indigent care, what portion does the one mil tax that is received from the county pay.  Mr. Carruth stated it pays approximately 60% of the total indigent population.  Not all of those indigents are Henry County residents, there are indigents from other counties and states.  The hospital is on track to collect $6.2 million of nine months in the tax subsidy from Henry County.  The total indigent projection is a little more than $10 million for the current year. 

            Dr. Joseph Blissit commented regarding the quality pillar.  Dr. Blissit stated that the quality of care is vital to any hospital.  One of the promises made at the opening of the hospital in 1979 was that the hospital was dedicated to providing the highest quality of medical care that is available at any hospital.  This is just as true today. 

            Terry Wilk, Vice President and Chief Information Officer made a presentation regarding the quality pillar.  Henry Medical Center is on a journey for an electronic health record.  This is essential to enable an organization to provide the highest quality of care.  An electronic health record is an integration of a number of different types of data, text, images, video and voice across inpatient and outpatient settings.  The Federal Government support electronic health record technology to promote information sharing, while ensuring privacy and security.  Some of the recent accomplishments are radiology imaging, pharmacy, lab/blood bank/pathology, surgery, materials management, accounts payable and general ledger.  Some the upcoming milestones are:

·         Clinical Data Repository (July)

·         Clinician “Portal” (July)

·         Medical Records Document Imaging

·         Medication Safety / Bar Coding

·         Clinician Documentation

·         Computerized Physician Order Entry

·         Clinical Decision Support

·         Physician Office “Integration”

In summary, Henry Medical Center is on a quest to build Electronic Health Records so that they can improve access to information, redesign work processes, provide high quality and safe care, improve clinical outcomes, increase customer satisfaction and conform to government initiatives.

Joyce Rodgers, Hospital Authority and Operating Board commented regarding the service pillar.  One of the top goals is quality service for the people of Henry County.  There have been concerns of the wait time in the Emergency Room.  With one of the top priorities being quality care for patients thereby increase patient satisfaction, an endeavor was initiated in the ED by a consultant group to assess the situation. 

Lynette Ball, Chief Nurse stated that a firm was engaged that specialized only in emergency services process improvement. The goals of the project were to:

·         Improve quality of care for all emergency department patients

·         Decrease walk out rates by 20%

·         Reduce arrival to bed times by 20%

·         Improve length of stay for all emergency department patients, with a 20% reduction in LOS for discharged patients

·         Improve patient satisfaction by a 10 percentile improvement within our hospital peer group

·         Provide mentoring, education and support for the emergency department staff and leadership team

There have been quite a few operational improvements such as:

·         Rapid triage process – 98% accuracy

·         Immediate bedding – 100% when there are open beds

·         Bedside Registration 

·         Standing orders revised and implemented – 90% utilization 

·         Mentor leadership team to create a model for sustainable process improvement

·         Team Care patient care delivery model implemented 2/09

·         Standardization of all patient care rooms

·         Spectra-link phones assigned to all ED staff

·         Mobile Care Phlebotomy implemented 2/09

·         A culture of accountability

            There has been a reduction of time by 45% for the arrival to triage since the process improvements were implemented in December.  The best practice is seven minutes and Henry Medical is at nine and a half minutes and over the next couple of months we should be closer to the seven minutes.  The goal for door to bed was to decrease the time by 20% and so far it has been decreased by 26%.  There should be a continued reduction in the length of stay for patients.  The average length of staff for ED discharged patients (those patients that come for treatment and are discharged) time has decreased.  The goal is to have people in and out of the emergency room within four hours.  There are patients that walk in and register and leave before they are treated.  This is a critical element for patients, it they feel they need to be seen then the hospital needs to see them.  The number of patients that leave without treatment has been reduced from 7.52% to 2.82%.  The last objective is customer satisfaction.  The goal is to improve the customer satisfaction.  There has been an increase of customer satisfaction and the score is expected to continue to rise until the hospital is in the top percentile group for their peer group and hospitals.

             Mr. Scott gave closing remarks and stated this was the end of the presentation.

            Commissioner Stamey made the motion to adjourn the meeting; Commissioner Jeffares seconded.  The motion carried 4-0-0. (Commissioner Holder left the meeting early)

                                   

                                                                        Elizabeth “BJ” Mathis, Chairman

 

            Shay Mathis, County Clerk