The Box Butte General Hospital (BBGH) Board of Trustees signed an interlocal agreement with Box Butte County for legal blood draw procedures during the regular monthly meeting held Monday, October 29. The agreement will be presented to the County Commissioners for approval at their next board meeting.

The agreement was drawn up in response to BBGH no longer wishing employees who conduct legal blood draws to be subpoenaed and testify in court, in that it causes an undue burden financially and a burden on staff scheduling.

The agreement, once signed by both parties, provides for procedures, policy and payment for times when a contract qualified person is required to come to the hospital to draw blood. Any qualified person hired by the County shall participate in training provided by the hospital Laboratory regarding proper procedures required by BBGH for blood draws in a medically accepted manner as per the hospital’s standard operating procedure. BBGH will provide the training to the qualified contract person at no cost to the county. The qualified contract person will have liability insurance. The county will be responsible for compensating the individual when called to respond to a blood draw. The hospital will not receive compensation. Once signed by the County, the agreement will take effect as of November 15, 2012.

The agenda for the evening included the following items:

— The board recognized PBX Operator/Customer Service Representative Anne Stirewalt as the October Employee of the Month. Also recognized was Dr. Mark Chu as Provider of Choice for the Third Quarter. Leslie Romick, LPN and Sally Bryner, RN, were recognized for being awarded scholarships of $2,500 each from the Nebraska Rural Radio Foundation. New employees introduced included Dede DeVeny, Customer Service Liaison; Tiffany Shellabarger and Mattie Sadd, Nursing Assistants; Tracey Abell, Admissions Assistant; and Vickie McCune, Environmental Services.

— After unanimously approving the consent calendar, the board heard the monthly Quality Management and Safety report from Special Services Director Mary Mockerman. She provided the month’s Nebraska Patient Safety Coalition patient care accident report, which focused on a diabetes patient not receiving insulin “per protocol.” Ms. Mockerman said BBGH protocol developed by Chief of Staff Dr. Tim Narjes, as well as having designated RNs for diabetes care, mitigates having a similar case occurring here. West Nile cases are winding down, There were two deaths reported in Nebraska from this year’s outbreak. Nebraska influenza surveillance commenced September 30. There is no influenza activity in Nebraska or locally, however there has been a spike of gastroenteritis cases in the community and BBGH employees.

— Controller Lori Mazanec reported results for the first quarter of the fiscal year (July through September). The results show an increase in net assets of $35,000. Total patient revenue of $10,400,000 fell $346,000 short of projections, with all services excluding outpatient services finishing behind the hospital’s target for the quarter. Quarterly inpatient revenues were 12 percent less than expected and $12,000 less than a year ago. On the other hand, outpatient revenue was on target for the quarter, exceeding last year’s figure by $500,000. Operating expenses were $331,000 under budget. July through September operating income was $5,700, 95% lower than predicted. Non-operating sources over the same time period increased net assets to $35,000, behind the budgeted $147,000. The trustees unanimously accepted the financial report.

— Chief Financial Officer Tracy Jatczak presented a USDA Letter of Conditions for the hospital addition/renovation project. The 10 page pro foma letter lists several conditions required by the USDA in regard to the $23,000,000 loan awarded BBGH. The conditions include the loan being repaid over 40 years at 3.5 percent per annum; the establishment of a reserve account for the first 10 years; how the loan is secured; insurance and bonding requirements, as well as other conditions. Ms. Jatczak requested a motion to approve the hospital’s Letter of Intent to Meet Conditions. The trustees so moved and unanimously approved the Letter of Intent to Meet Conditions.

— The annual election of officers for the Board of Trustees was held. By unanimous consent, the board approved keeping the current slate of officers for the coming year, with David Briggs Chairman and Ted Bohlen Secretary Treasurer.

— CEO Dan Griess provided a couple of reports, including a brief report about the hospital Wellness Program receiving the prestigious “Well Workplace Gold Award” from the Wellness Council of America (WELCOA), as recently reported in local media. He gave special kudos to Wellness Coordinator Dan Newhoff and the Wellness Committee. The Wellness Program at BBGH has 174 employees participating.

— Mr. Griess also gave a presentation on the hospital’s most recent performance with the Hospital Consumer Assessment Healthcare Providers and Systems (HCAHPS) survey. After providing an overview of how to interpret the July-September HCAHPS survey, he said, “What’s really incredible is that in four of the eight domains, we ranked in the 90th percentile of the 1703 hospitals reporting in that period.” The HCAHPS survey helps the hospital identify areas of improvement as well. As healthcare reform moves closer to a value-based model to replace the current volume based funding model, HCAHPS performance will account for 30 percent of funding while performance in core measures will account for 70 percent of funding. Mr. Griess said Critical Access Hospitals such as BBGH are not currently included in that model due to low patient volumes skewing survey results, but that inclusion will eventually occur.

— There were no Chief of Staff or Governance Focus reports given.

After all credentialing requests were unanimously approved, the board moved to go into executive session at 7:43 p.m. to discuss physician recruitment. The board reconvened in open session at 8:37 p.m. and adjourned with no action taken.

The next board meeting will be held November 26 at 7:00 p.m. in the BBGH Alliance Room. As always, the public is invited to attend.