lee memorial health system planning board & full board … · lee memorial health system...

Lee Memorial Health System Planning Board & Full Board

of Directors’ Meetings Thursday, May 14, 2015

1:00 p.m.

BOARD OF DIRECTORS

OFFICE 239-343-1500

FAX: 239-343-1599

13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912

CAPE CORAL HOSPITAL

GULF COAST MEDICAL CENTER

HEALTHPARK MEDICAL CENTER

LEE MEMORIAL HOSPITAL

GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA

THE REHABILITATION HOSPITAL

LEE PHYSICIAN GROUP

LEE CONVENIENT CARE

BOARD OF DIRECTORS

DISTRICT ONE

Stephen R. Brown, M.D.

Therese Everly, BS, RRT

DISTRICT TWO

Donna Clarke

Nancy M. McGovern, RN, MSM

DISTRICT THREE

Sanford N. Cohen, M.D.

David Collins

DISTRICT FOUR

Diane Champion

Chris Hansen

DISTRICT FIVE

Jessica Carter

Stephanie Meyer, BSN, RN

AGENDA

PLANNING BOARD & FULL BOARD OF DIRECTORS’ MEETINGS May 14, 2015 1:00 p.m.

Gulf Coast Medical Center – Boardroom (Medical Office Building) 13685 Doctors Way, Ft. Myers, FL 33912

051415 PLANNING & FULL BOARD\AGENDA(FINAL).doc Page 1 of 2

1. CALL TO ORDER (Sanford Cohen, M.D., Board Chairman) Lee Memorial Health System Board of Directors, sitting as the Lee Memorial Health System (LMHS) Board of Directors for Gulf Coast Medical Center & Lee Memorial Hospital/HealthPark Medical Center and the Board of Directors of its subsidiary corporations, including but not limited to Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc.

2. INVOCATION & PLEDGE OF ALLEGIANCE (Rev. Mason Jackson, MDiv)

3. PUBLIC INPUT –Any Public Input is limited to three minutes and a “Request to Address the Board of Directors” card must be completed and submitted to the Board Staff prior to meeting. Individuals wishing to address the Board on a Non Agenda item must notify the Board Staff of the subject matter at least three (3) days prior to the meeting.

4. PRESIDENT’S REPORT (Jim Nathan, CEO/President)

5. CONSENT AGENDA(Approve) A. Risk Management Report

PLANNING PORTION: DONNA CLARKE, PLANNING LIAISON

6. Planning Board & Full Board of Directors Meeting minutes of 3/19/15(Approve) (Diane Champion, Board Secretary)

7. SYSTEM STRATEGIC INITIATIVES SCORECARD FY2015 (Accept) (Kevin Newingham, Chief Strategy Officer)

8. LEGISLATIVE UPDATE (Sally Jackson, System Director Government & Community Relations and Keith Arnold, Government Relations Professional)

9. CLINICAL INTEGRATION UPDATE (Anne Rose, VP Revenue Cycle/PHO)

10. SOUTH LEE UPDATE (Suzanne Bradach, System Director Special Projects)

11. CAPACITY CHALLENGE UPDATE (Scott Kashman, CAO Cape Coral Hospital)

12. OTHER ITEMS

Date of the next PLANNING BOARD MEETING August 13, 2015, 1:00 p.m. Gulf Coast Medical Center –Boardroom (Medical Office Building) 13685 Doctors Way, Fort Myers, FL 33912

LMHS SYSTEM BUSINESS – SANFORD COHEN, M.D., BOARD CHAIRMAN

BOARD OF DIRECTORS

OFFICE 239-343-1500

FAX: 239-343-1599

13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912

CAPE CORAL HOSPITAL

GULF COAST MEDICAL CENTER

HEALTHPARK MEDICAL CENTER

LEE MEMORIAL HOSPITAL

GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA

THE REHABILITATION HOSPITAL

LEE PHYSICIAN GROUP

LEE CONVENIENT CARE

BOARD OF DIRECTORS

DISTRICT ONE

Stephen R. Brown, M.D.

Therese Everly, BS, RRT

DISTRICT TWO

Donna Clarke

Nancy M. McGovern, RN, MSM

DISTRICT THREE

Sanford N. Cohen, M.D.

David Collins

DISTRICT FOUR

Diane Champion

Chris Hansen

DISTRICT FIVE

Jessica Carter

Stephanie Meyer, BSN, RN

AGENDA (Page 2 of 2)

PLANNING BOARD & FULL BOARD OF DIRECTORS’ MEETINGS May 14, 2015 1:00 p.m.

051415 PLANNING & FULL BOARD\AGENDA(FINAL).doc Page 2 of 2

13. ACUTE CARE OPERATONS REPORTS – 2nd Quarter, Fiscal Year 2015 (Approve) A. Cape Coral Hospital (Scott Kashman, Chief Administrative Officer) B. Gulf Coast Medical Center (Josh DeTillio, Chief Administrative Officer) C. HealthPark Medical Center (Donna Giannuzzi, Chief Patient Care Officer) D. Lee Memorial Hospital (Lisa Sgarlata, Chief Administrative Officer) E. Golisano Children’s Hospital of SWFL (Kathy Bridge-Liles, Chief Administrative Officer)

14. OLD BUSINESS

15. NEW BUSINESS

16. BOARD MEETING CRITIQUE

17. BOARD OF DIRECTORS REPORTS

18. Date of the next Meeting:

Thursday, May 28, 2015: 1:00pm – Quality/Safety & Full Board of Directors Gulf Coast Medical Center – Boardroom 13685 Doctors Way, Ft. Myers, FL 33912

19. ADJOURN (Sanford Cohen, M.D., Board Chairman)

BOARD OF DIRECTORS

Invocation Prayer &

Pledge of Allegiance

___________________ L E E M E M O R I A L HEALTH SYSTEM

BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS

PUBLIC INPUT – AGENDA ITEMS:

Any public input

pertaining to items on the Agenda is limited to three

minutes and a “Request to Address the Board of Directors”

card must be completed and submitted to the Board Staff

prior to meeting.

Refer to Board Policy: 10:15F: Public Addressing the Board Non-Agenda Item: Individuals wishing to address the Board on an item NOT on the Agenda, the Board office must be notified of subject matter at least three (3) days prior to the meeting to allow staff time to prepare and to insure the matter is within the jurisdiction of the Board.

___________________

L E E M E M O R I A L HEALTH SYSTEM


PRESIDENT’S REPORT

Jim Nathan CEO/President

___________________



CONSENT AGENDA (Approve)

A. Risk Management Report

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Risk Management Report to the Board of Directors

FM# 2775 Rev. 07/13

The disclosure of this document and the contents herein does not constitute a waiver of any and all protections afforded PatientSafety Work Product under the Patient Safety Quality Improvement Act of 2005 and implementing regulations.

January 2015 – March 2015

2

Risk Management Program Elements

The Risk Management Program is designed to identify, evaluate and reduce the risk of injury to the patients, personnel, visitors and to reduce the risk of loss to the health system. Risk Managers:

Review adverse incident reports, conduct investigations and analyze events in an effort to reduce risks to patients and the frequency and severity of medical malpractice claims; and

Investigate patient care complaints, provide education, and provide direction in regards to regulatory compliance.

This report includes Risk Management activities for the quarter and includes a summary of incident and safety reporting rates; impact analysis; report categories; education; claims; general activities; and goals.

3

Patient Safety Evaluation SystemPlease Note: Separate from Florida law program requirements, Risk Managers play an integral role in the health system’s Patient Safety Evaluation System, a voluntary program created by federal law. Employees are encouraged to report patient safety or quality concerns by filing a Patient Safety Report which are utilized by Risk Managers who participate in health system patient safety initiatives.

05101520253035404550

Rate per 100

0 Pa

tient Days

Lee Memorial Health System

LMHS Linear (LMHS)

Reporting Rates

4

This graph shows incident and safety report rate for the system for the last 12 months. The next page shows the reporting rates for each facility

Total number of reports for the third quarter was 3091

Trend Line

Reporting Rates - continued

5

____ Indicates a Linear Trend line

6

AnalysisThis graph reflects the percentage of reports that have no impact

on the patient. The graph for the third quarter indicates that 83% (2570) of the reports received involve situations which had no impact on the patient.

Reporting “near misses” is highly encouraged to identify potential areas of improvement. This information allows us to provides data used in our quality improvement activities throughout the system.

Trend line

7

AnalysisThis graph reflects the reporting rate per 1000

patient days and the rate of patient impact for the four facilities during the quarter.

8

CategoriesThis graph shows the rate for the categories of reports from January through March 2015 at all four facilities. Rates per 1000 Patient Days are utilized to be consistent with other system reporting. The top four categories are:Treatment & Testing category includes reports of IV infiltrates, Delays and Omissions, Patient Identification Issues, Failure to Communicate, Documentation issues, etcOther category includes Complaints, Burns, Skin Breakdown, AMAs, Self-Extubation, etcPatient FallsMedication Errors70% of all reported occurrences fall within one of these four categories

During this quarter there were two reports to AHCA

Rate per 1000 Patient Days

0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00 9.00

Test & Treatment 7.73 (812)

Other 7.23 (759)

Patient Fall 3.70 (388)

Med Error 2.36 (248)

Med‐Good Catch 2.35 (247)

Lab Labeling 2.32 (244)

Surgical 1.39 (146)

NonPt Fall 0.63 (66)

Equipment 0.58 (61)

Inf/Mat/OB 0.42 (44)

Adverse Drug Rx 0.33 (35)

Transport Issues 0.19 (20)

Assault 0.18 (19)

Sedation for Proc 0.02 (2)

9

Education Activities

• Risk Management Orientation for new hires

• Safety in the Outpatient Setting

• Incident Reporting for 4 West Staff

• Fall Prevention

• Case Management EMTALA education

• Root Cause Analysis Training

• Risk Management Orientation for new hires

• Safety in the Outpatient Setting

• Incident Reporting for 4 West Staff

• Fall Prevention

• Case Management EMTALA education

• Root Cause Analysis Training

10

Liability

The October - December, 2014 quarter ended with 33 pending professional liability claims. The second fiscal quarter 2015 (January - March, 2014) ended with 34 pending claims. The quarter saw 5 claims closed and 6 claims opened. Malpractice prevention, patient safety and quality of care improvement continue to be the primary focus of the Health System’s risk managers.

05101520253035404550

FY13Q1 FY13Q2 FY13Q3 FY13Q4 FY14Q1 FY14Q2 FY14Q3 FY14Q4 FY15Q1 FY15Q2

Num

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f Cases

Number of Cases Linear (Number of Cases)

11

Risk Management ActivitiesContinued participation in system activities including:

• LMHS Policy & Procedure Committee• Individual Hospital Quality & Safety Committees• Daily Safety Check-In Calls• System Quality Safety Management Council• Participated in various Intense Analysis Teams/ Common Cause Analysis

Teams• Medication Safety Committee• Campus Specific Medication Safety Work Groups• Nursing Documentation GAP Analysis• Leadership Accountability• Heart Central Accountability Team• Quality and Conformance• LMHS Ethics Committee• CCH Grievance Committee• MD/Nursing Rounding Project• OB Hospitalist Group Meeting• CCH Retirement Committee• ED Navigation Committee

12

Risk Management Goals

• Continue to track and trend incidents, provide summary data and work closely with various departments and committees engaged in performance improvement and patient safety activities.

• Continue to work with Education and Organizational Development and management staff to assure that all employees are meeting the annual education requirement for risk management and to provide a module for the Competency activities.

• Continue to utilize pre-litigation procedures to resolve meritorious claims in a timely manner.

• Monitor the 3M/Softmed Risk Management System• Continue development of specialized training materials.• Continue to collaborate with others in the Health System with regard to

patient safety initiatives and make recommendations based on trends.• Evaluation and implementation of a Patient Safety Reporting System

with emphasis on compatibility with patient record and standardized PSO reporting (common formatting)

BOARD CHAIRMAN TO PLANNING LIAISON:

PLANNING BOARD OF DIRECTORS

MEETING Thursday, May 14, 2015

1:00pm

PLANNING LIAISON: Donna Clarke, Board Member

LEE MEMORIAL HEALTH SYSTEM

PLANNING BOARD & FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, March 19, 2015

LOCATION: Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom, 13685 Doctors Way, Fort Myers, FL 33912 MEMBERS PRESENT: Sanford N. Cohen, M.D., Board Chairman; Chris Hansen, Board Vice Chairman; David Collins, Board Treasurer; Diane Champion, Board Secretary; Donna Clarke, Board Member; Nancy McGovern, RN, MSM, Board Member; Steven Brown, M.D., Board Member; Therese Everly, Board Member; Jessica Carter Peer, Board

Member; Stephanie Meyer, BSN, RN, Board Member

NOTE: Documents referred to in these minutes are on file by reference to this meeting date in the Office of the Board of Directors and on the Board of Directors website at www.leememorial.org/boardofdirectors, for public inspection.

SUBJECT DISCUSSION ACTION FOLLOW-UP

MEETING CALLED TO ORDER

The LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD & FULL BOARD OF DIRECTORS MEETINGS

were CALLED TO ORDER at 1:01 p.m. by Sanford Cohen, M.D., Board Chairman.

INVOCATION AND

PLEDGE OF ALLEGIANCE

Reverend Cynthia Brasher gave the Invocation, followed by the Pledge of Allegiance.

PUBLIC INPUT None at this time.

RECOGNITIONS

Bob Johns spoke about recently gaining federal approval for the FQHC-Look Alike for Lee Community. He introduced Linda Brown Lenz, VP of the Lee Community Health Board and Cedric Hall, Lee Community Health Board Chairperson. Chris Lee presented Lisa Sgarlata and Donna Giannuzzi with the Healthgrades-Top 50 Nations Best Hospital Awards for Lee Memorial Hospital and HealthPark Medical Center. A brief video was shown.

PRESIDENT’S REPORT Jim Nathan presented the President’s report.

LEASE-MEDICAL

OFFICE SPACE FOR PEDIATRIC ALLERGY

Kris Fay asked for approval of the Medical Office Space for Pediatric Allergy lease. A motion was made by David Collins to (1) approve the proposed lease for 1,938 square feet located at 3410 Tamiami Trail, Suite 1, Port Charlotte, FL at $16.00/sq. ft., initial lease term of 1 year with a thirty (30) day notice of termination, and (2) authorize the health system President or Board Chairman to execute the lease. The motion was seconded by Chris Hansen and it carried with no opposition.

CONSENT AGENDA Dr. Cohen asked for approval of the Consent Agenda consisting of the following:

A. Workshop Minutes of 3/5/15 B. Lease Approval- Park Windsor Warehouse space C. Extension of 2011 Bank of America Term Loan

Therese pulled item B for further discussion.

A motion was made by Donna Clarke to approve the Consent Agenda consisting of: A. Workshop Minutes of 3/5/15 C. Extension of 2011 Bank of America Term Loan The motion was seconded by Jessica Carter Peer and it carried with no opposition. A motion was made by Therese Everly to approve item B of the

LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD & FULL BOARD OF DIRECTORS MEETING MINUTES

Thursday, March 19, 2015 Page 2 of 3


Consent Agenda. The motion was seconded by Jessica Carter Peer and carried with no opposition.

CHAIRMAN TO PLANNING LIAISON

The gavel was turned over to PLANNING Liaison, Donna Clarke, to CONVENE the Planning portion of the meeting at 2:03 p.m.

CONSENT AGENDA Donna Clarke asked for approval of the Consent Agenda which consisted of: A. Planning Board & Full Board of Directors meeting minutes of 1/15/15 B. System Strategic Initiatives Scorecard FY 2015 C. Revision to Strategic Plan

A motion was made by Dr. Cohen to approve the Consent Agenda consisting of: A. Planning Board & Full Board of Directors meeting minutes of 1/15/15 B. System Strategic Initiatives Scorecard FY 2015 C. Revision to Strategic Plan The motion was seconded by David Collins and it carried with no opposition.

CAPACITY

CHALLENGES AND RECOMMENDATIONS

Josh DeTillio and Dave Kistel presented Capacity Challenges and Recommendations for approval. Discussion ensued.

A motion was made by Chris Hansen to approve $7,289,781.00 for the design, construction, furniture, equipment, and information technology to implement and operationalize patient care beds at Lee Memorial Hospital and observation beds at Gulf Coast Medical Center and HealthPark Medical Center as presented. Then motion was seconded by Dr. Cohen and it carried with no opposition.

ARCHITECT AND CONSTRUCTION

MANAGER SELECTION

Dave Kistel presented and requested approval for the Architect and Construction Manager Selection.

A motion was made by Dr. Cohen to approve to proceed with selection of an Architectural Led Design team, Construction Manager at Risk, and Building Commissioning Authority per Board Policy, for the 275 bed expansion of Gulf Coast Medical Center. The motion was seconded by Nancy McGovern and it carried with no opposition.

.

MEDICAL STAFF DEVELOPMENT

Kevin Newingham presented the Medical Staff Development plan.

OTHER ITEMS

None at this time.

NEXT PLANNING

MEETING The next Lee Memorial Health System Planning Board Meeting is:

Thursday, May 14, 2015, 1:00 p.m. Gulf Coast Medical Center, Medical Office, Boardroom

13685 Doctors Way, Fort Myers, FL 33912

The Lee Memorial Health System Planning portion of the Meeting was ADJOURNED at 3:36 p.m. by PLANNING LIAISON, Donna Clarke. The

gavel was turned back to Sanford Cohen, M.D., Board Chairman, At 3:36 p.m. to RECONVENE

the LMHS Full Board portion of the meeting.

MEDICAL STAFF

RECOMMENDATIONS Dr. Cohen requested a motion to approve the following Medical Staff Recommendations of March 18, 2015:

A. Lee Memorial Hospital B. Cape Coral Hospital C. Gulf Coast Medical Center D. HealthPark Medical Center

E. Golisano Children’s Hospital of SWFL

A motion was made by Nancy McGovern to approve the Medical Staff Recommendations of March 18, 2015:

A. Lee Memorial Hospital B. Cape Coral Hospital C. Gulf Coast Medical Center D. HealthPark Medical Center E. Golisano Children’s Hospital of SW FL

The motion was seconded by Steve Brown and it carried with no

LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD & FULL BOARD OF DIRECTORS MEETING MINUTES

Thursday, March 19, 2015 Page 3 of 3


opposition.

OLD BUSINESS None at this time.

NEW BUSINESS None at this time.

BOARD MEETING CRITIQUE

All were in agreement that it was a good meeting with great information and dialogue.

BOARD OF

DIRECTORS REPORTS

Jessica Carter Peer announced the opening of the new Rehabilitation and Wellness Center. Nancy McGovern stated she will speak at the Long Service Awards ceremony this weekend in Dr. Cohen’s absence. Dr. Cohen stated they have closed the loop with the Medical Staff on the issue of the recent Surgeon General visit. Donna Clarke stated the System Scorecard will now be presented at every other Planning meeting. Therese Everly reminded everyone of the upcoming Home Health Open House. Steve Brown stated he attended the recent Sanibel Cares sponsor party where sponsors being honored pledged a total of $2 million to Golisano Children’s Hospital.

NEXT REGULAR

MEETING The next LEE MEMORIAL HEALTH SYSTEM QUALITY/SAFETY BOARD

& FULL BOARD MEETING will be held on April 9, 2015, 1:00 p.m. in the Gulf Coast Medical Center, Medical Office Building, Boardroom

13685 Doctors Way, Fort Myers, FL 33912

ADJOURNMENT The LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD

& FULL BOARD OF DIRECTORS MEETINGS ADJOURNED at 4:01 p.m.

by Sanford Cohen, M.D., Board Chairman.

Minutes were recorded by Katie Fournier, Board Assistant/Board of Directors Office

________________________________________ Diane Champion Date approved

Board Secretary


UPDATE REPORT TO THE BOARD (No Action Required)

DATE: May 14, 2015 NAME OF SERVICE LINE/ENTITY UPDATE: LMHS FY2015 Strategic Scorecard Update PERSON RESPONSIBLE & TITLE: Kevin Newingham, Chief Strategy Officer KEY ACCOMPLISHMENTS na GOALS (MET) na

GOALS (UNMET)

FINANCIAL STATUS (including cash flow statement, projected cash flow, balance sheet and income statement) na PROBLEMS/ISSUES na ANTICIPATED NEEDS na SUMMARY/COMMENTS LMHS FY2015 Strategic Scorecard is updated with the most recent performance. This UPDATE supports the following Strategic Initiative(s): All

BOD/Forms/Board UPDATE Report to the Board Form – Updated 052113cs

Keep form to one page, EMAIL to: [email protected] by Noon eight (8) days PRIOR to presenting.

System Strategic Initiatives

FY 2015 ScorecardAs of May 6, 2015

Strategic Initiative

Key Performance

Indicator

Meets

2015

Exceeds

2015

Desired

Direction

Current

Status Tracking

Reporting

Period

Service, Safety,

Quality

Patient Experience (Systemwide rollup of

"Overall Rate…" top box)

74.7% 77.2%higher is

better67.4% Below Goal

2Q

FY 2015

Serious Safety Event

Rate(per 10,000 adjusted patient

days)

0.06 0.05lower is

better0.04

Exceeds

Goal

Mar 2015

12 mos avg

Clinical

Integration30-day Readmissions(LMHS data)

12.25% 11.75%lower is

better13.22% Below Goal FYTD Feb

Length of Stay

Improvement4.35 4.30

lower is

better4.56 Below Goal FYTD Mar

Aligned Multi-

specialty Group

Year over year

freestanding net

outpatient revenue

growth (2014 vs 2015)

5.0% 7.5%higher is

better12.3%

Exceeds

GoalFYTD Mar

Increase the LPG

Primary Care Patient

Base (new patients)

5,000 7,000higher is

better4,340

In progress

(on track)

June 2014

- Dec 2014

Caring PeopleEmployee

Engagement73.4 73.7

higher is

betterTBD

Annual Study

starts July 2015

Financial Viability Operating Margin % 3.2% >3.6%higher is

better8.4%

Exceeds

GoalFYTD Mar

Labor as a % of net

operating revenue46.4% <46.0%

lower is

better43.9%

Exceeds

GoalFYTD Mar

Page 1 of 3

FY 2015 System Scorecard - Trending History

64%

66%

68%

70%

72%

74%

76%

78%

Q4 FY14 Q1 FY15 Q2 FY15 Q3 FY15 Q4 FY15

Patient Experience (higher is better)

Meets Goal

Historical data not available

0.00

0.02

0.04

0.06

0.08

0.10

0.12

Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15

Serious Safety Event Rate (lower is better)

12-mos rolling average

4.0

4.2

4.4

4.6

4.8


Length of Stay (lower is better)

Monthly FYTD 15 10%

11%

12%

13%

14%

15%

Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15

30-day Readmissions (lower is better)

Monthly FYTD 15

0%

2%

4%

6%

8%

10%

12%


Operating Margin (higher is better)

Monthly FYTD 15

0

2,000

4,000

6,000

8,000

Q4 FY14 Q1 FY15 Q2 FY15 Q3 FY15

New Primary Care Patients (higher is better)

Quarterly Cumulative

Quarterly

-10%

0%

10%

20%

30%


Increase in Freestanding OP Net Rev. (higher is better)

Monthly FYTD 15

35%

40%

45%

50%


Labor as a % of Revenue (lower is better)

Monthly FYTD 15

Page 2 of 3

System Strategic InitiativesFY 2015 Scorecard

DefinitionsStrategic

Initiative

Key Performance

Indicator

Exceeds

2015

Initiative Indicator/Measure Period Definition

Service, Safety

& Quality

Patient Experience 4Q

FY 2015

Systemwide rollup of "Overall Rate..." top box score (9 & 10)

across all survey types throughout the system.

Serious Safety Event Rate (per 10,000 adjusted patient days)

FY 2015

Average

Number of Serious Safety Events, per 10,000 adjusted patient

days. Data is based on a 12-month rolling average. Adjusted

patient days includes impact of outpatient stays.

Clinical

Integration

Length of Stay Improvement FY 2015

Average

Average Length of Stay for inpatient adults, excluding the

Rehab hospital. It is calculated by taking the number of

discharges for the fiscal year divided by the number of patient

days associated with those discharges.

30-day Readmissions(LMHS data)

3Q

FYTD 2015

LMHS internal all cause 30-day readmissions from acute care

to acute care within the health system (all payers). Total

acute care readmissions within 30 days divided by total acute

care discharges.

Aligned

Multispecialty

Group

Year over year freestanding net

outpatient revenue growth (2014 vs 2015)

FY 2015

Average

Annual percentage increase in net revenues generated in

freestanding outpatient centers. Compare growth between

FY 2014 and FY 2015.

Increase the LPG Primary Care

Patient Base (new patients)

July 2014

thru

June 2015

Grow primary care base of patients measured by unique

patients seen within last two years.

Caring People Employee Engagement Index FY 2015

Annual

Study

There are three questions included in the index:

*I am comfortable discussing issues or problems with leaders

in my department

*I have input in making decisions that affect my job.

*Work processes are designed in a way that allows me to do

my work effectively.

Calculate the mean score for each question, and then

calculate the average of the three scores. Goal is based on

Annual Study.

Financial

Viability

Operating Margin FY 2015

Average

Operating Margin percent is calculated by dividing the

system's gain from operations by total operating revenues.

This is reported in the monthly consolidated financial

statements on page A-8 and A-9 along with comparatives.

Labor as a % of net operating

revenueFY 2015

Average

Amount spent on salaries compared to net operating revenue.

Page 3 of 3

System Strategic Initiatives

FY 2015 System Scorecard Update

©Copyright Lee Memorial Health System • All rights reserved

Kevin Newingham

May 14, 2015

Service, Safety, & Quality


Key Performance Indicator

Meets 2015

Exceeds 2015

Desired Direction

Current Status Tracking

Reporting Period

Service, Safety, Quality

Patient Experience (Systemwide rollup of "Overall Rate…" top box)

74.7% 77.2%higher is better

67.4%Below Goal

2QFY 2015

Serious Safety Event Rate(per 10,000 adjusted patient days)

0.06 0.05lower is better

0.04Exceeds Goal

Mar 201512 mos avg

Clinical Integration



Meets 2015

Exceeds 2015

Desired Direction


Reporting Period

Clinical Integration

30‐day Readmissions(LMHS data)

12.25% 11.75%lower is better

13.22%Below Goal

FYTD Feb

Length of Stay Improvement

4.35 4.30lower is better

4.56Below Goal

FYTD Mar

Aligned Multispecialty Group



Meets 2015

Exceeds 2015

Desired Direction


Reporting Period

Aligned Multi‐specialty Group

Year over year freestanding net outpatient revenue growth (2014 vs 2015)

5.0% 7.5%higher is better

12.3%Exceeds Goal

FYTD Mar

Increase the LPG Primary Care Patient Base (new patients)

5,000 7,000higher is better

4,340In progress (on track)

June 2014 ‐ Dec 2014

Caring People



Meets 2015

Exceeds 2015

Desired Direction


Reporting Period

Caring PeopleEmployee Engagement

73.4 73.7higher is better

TBDAnnual Study starts July 2015

Financial Viability



Meets 2015

Exceeds 2015

Desired Direction


Reporting Period

Financial Viability Operating Margin % 3.2% >3.6%higher is better

8.4%Exceeds Goal

FYTD Mar

Labor as a % of net operating revenue

46.4% <46.0%lower is better

43.9%Exceeds Goal

FYTD Mar

___________________



LEGISLATIVE UPDATE

Verbal Report

(Sally Jackson, System Director Government & Community Relations and Keith Arnold, Government

Relations Professional)

Clinical Integration UpdateAnne Rose

VP Revenue Cycle/PHO

Joby Kolsun D.O.Medical Director

May 14, 2015

LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM

Background

• During 2013, Lee Memorial Health System (LMHS) requested the Lee Physician Hospital Organization (LPHO) create a Clinical Integration Program (CI Program) in order to prepare for the shift from volume‐based payments to value‐based payments.

• The Lee Employee Health Plan (LEHP) agreed to be the initial payer in the CI Program.

LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM Background (continued)• Clinical Integration Program means the adoption of

active and ongoing clinical initiatives that are designed to improve quality, increase efficiency, and control costs.

• The Clinical Integration Program will initially be available to Lee Health Plan members and will support improving the coordination of care.

• The LEHP will share savings with the LPHO that are a result of the CI Program initiatives.

• Over 600 physicians enrolled in the initial cycle of CI Program (2014).

• Today, over 800 physicians are in the CI Program.


CI Program VisionTo develop advanced care management capabilities across the PHO network that will:• Improve the coordination and quality of care provided to

the community, thereby lowering costs and improving the health status of the community.

• Position the provider community for continued success and stability as health care transitions to value‐based payment models.

LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM Operating Committee, 2015Elected by PhysiciansH. Lee Adkins, Fort Myers Family MedicineJon Burdzy, D.O., Physicians Primary CareRamiah Krishnan, M.D., Ramiah Krishnan, M.D.David MacKoul, M.D., MacKoul PediatricsStephen Zellner, M.D., Internal Medicine Associates Julio Conrado, M.D., (CHAIR), Specialists in HealthcareDaniel Dosoretz, M.D., 21st Century OncologyValerie Dyke, M.D., The Colorectal InstituteThomas Kowalsky, M.D., Associates in General & Vascular SurgerySanford N. Cohen, M.D., Invited Member, LMHS Board

Appointed by Health SystemLarry Antonucci, M.D., COOAvra Bowers, M.D., (VICE‐CHAIR), System Medical Director Primary Care ServicesNelayda Fonte, D.O., Trauma SurgeonBen Spence, CFOMarilyn Kole, M.D., System Medical Director Specialty Care ServicesScott Nygaard, M.D., CMO Physician Services


2014 LEHP Results• In collaboration with the Lee Health Plan, we closed

over 7,000 care gaps that were identified in the reports related to diabetes, asthma, and cancer screenings.

• As a result of closing care gaps, we met 100% of the quality measures established by the Lee Health Plan.

• Through our shared savings arrangement with the Lee Health Plan we received $381,815 to distribute to our participating physicians.


2015 Initiatives• Distributed 1st quarter Closing Care Gaps report package

in April/May

• Implementing Process Improvement Programs that have been adopted by the Operating Committee

• Expanding our payer base through additional shared savings contracts; commercial payer expansion scheduled for July 1, 2015; Medicare expansion targeted for January 1, 2016.


2015 Initiatives• Quality Programs

Care Gaps

• Process Improvement ProgramsEnhanced Primary Care, Care Transitions, Generic Drugs, Complex Care, Specialty Care – Cancer, Perinatal Care

• Utilization ManagementHospital Services, Service Lines, Panel Cost Management


2015 InitiativesPerformance Improvement Program

Closing Care Gaps• Improve the quality of care provided to patients• Prevent complications of disease• Screen for preventative diseases



Care Transitions Goal • Improve communication and coordination of patient

care handoffs• To reduce unnecessary ED Visits, Admissions and

Readmissions



Enhanced Primary Care Model Goal • Promote an enhanced Primary Care Provider model

proven to deliver quality and cost effective primary care.

• Improve patient engagement in their care


Next Steps• Continue Implementation of PI Programs• Continue Work with CI Program Physicians to Review

and Validate Reports• Continue Outreach and Education• Continue Payer Expansion Work

___________________



SOUTH LEE

UPDATE VERBAL REPORT

(Suzanne Bradach, System Director Special Projects)

System-Wide Bed

Capacity

Scott Kashman CAO CCH

May 14, 2015

©Copyright Lee Memorial Health System • All rights

reserved

Key Bed Capacity Measures

What will we achieve

• Number of ER Holds/Boarders Goal = Zero

• Available and staffed acute care beds

• Left without being seen and Left without treatment <1%

• EMS off loads <30 min at least 90% of the time

• Idea must impact metrics• Doable in immediate, medium or long term • Prioritized projects must be designed for standardized

enterprise deployment

Ideas worth doing

Key Bed Capacity Measures

1. ED Scheduling to physician offices

2. ED to IP Reverse Report

3. Housekeeping and Transport staffing to ensure enhanced turnover times

4. IP Discharge Planning and IP Discharge Execution

5. Dispensing DME

6. Operations Resource Center (more information pending)

• Other:– Staffing, additional Bed Options and Surge Plans

ADJOURNMENT __________________

L E E M E M O R I A L HEALTH SYSTEM BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS

DATE OF THE NEXT REGULARLY SCHEDULED

MEETING

PLANNING FULL BOARD MEETING

August 13, 2015

Gulf Coast Medical Center- Boardroom Medical Office Building

13685 Doctors Way Ft. Myers, FL 33912

LIAISON TO CHAIRMAN:

Lee Memorial Health System

FULL BOARD OF DIRECTORS MEETING Thursday, May 14, 2015

BOARD CHAIRMAN: Sanford Cohen, M.D.

OPERATIONS REPORT March 31, 2015

Cape Coral Hospital

Scott Kashman, CAO

Admissions – YTD March FY15

Admissions: Up from budget 11.1% / Up 11.0% from PY

7,500

8,000

8,500

9,000

9,500

Admissions

8,170

9,079

8,180

Budget

Actual

Prior Year

Budget Actual Prior Yr Var Bud Var PYAdult 7,373 8,274 7,378 12.2% 12.1%Obstetrics 797 805 802 1.0% 0.4%

Patient Days – YTD March FY15

Patient Days: Up 15.9% from budget / Up 14.2% from PY

30,000

35,000

40,000

Patient Days

33,727

39,104

34,254

Budget

Actual

Prior Year

ALOS: Up 4.3% from budget / Up 2.9% from PY

4.00 4.10 4.20 4.30 4.40

ALOS

4.13

4.31

4.19

Budget

Actual

Prior Year

Statistics – YTD March FY15

32,000

32,500

33,000

33,500

34,000

34,500

35,000

ED Visits

34,128

34,777

33,169

3,300

3,400

3,500

3,600

3,700

3,800

3,900

4,000

Surgeries

3,933

3,5443,597

0

50

100

150

200

250

300

Cath Lab Cases

147

288

141

658

660

662

664

666

668

670

672

Deliveries

664

671

667

Budget Actual Prior Year

Revenue – YTD March FY15

Net Revenue: $104,749,497– Up 1.3% from budget Up 6.2% from PY

Net Rev. per Adj. Admit: $7,236 – $216 less than budget$47 less than PY

Medicare55.4%

Medicaid12.5%

HMO/PPO20.4%

Self Pay / Charity

6.6%

Other5.1%

Budget

Medicare57.2%

Medicaid11.8%

HMO/PPO19.6%

Self Pay / Charity

6.1%

Other5.4%

Actual

Payer Mix

Salary Expense – YTD March FY15

Staffing:

Salaries and Benefits: $43,272,167

• $831,251 less than budget

FTEs: 1,327

• 24 less than budget

FTEs per AOB: 3.87

• 0.42 less than budget

3.80 3.90 4.00 4.10 4.20 4.30

FTE'S Per AOB

4.29

3.87 4.07

Budget

Actual

Prior Year

Supply Expense – YTD March FY15

Supply Expense per Adj Admit: $1,314

• Down 3.7% from budget

• Up 0.6% from PY

1250

1300

1350

1400

Supply Expense/Adj Admit

1,364

1,314 1,306

Budget

Actual

Prior Year

Profitability – YTD March FY15

EBITDA: $36.1 million, $4.6 million more than budget

EBITDA %: 33.5% vs. Budget of 30.2%

Gain From Operations : $29.97 million, $4.44 million more than budget

Operating Margin: 27.8% vs. Budget of 24.5%

22,000

24,000

26,000

28,000

30,000

Gain from Operations

25,529

29,967

26,904

Budget

Actual

Prior Year

Service

HCAHPS:2Q FY15 Overall Rating was 64% Down 3 point (67% vs 64%) from the previous quarter ED CAHPS- T &R (Adult) CCH 45.5% GOAL 64.7% ED T&R (Peds) CCH 45.6% GOAL 69.1%

ED Team Completed “ADVANCE” to enhance culture and process improvement efforts

Key Challenges & Opportunities

Challenges1. ED volumes remain higher than previous years despite “season end” with > 190 visits/daily.

2. Continuing challenges to get experienced staff to balance nurse intern hires to meet actual need and increasing complexity of patient population.

Opportunities1. Relocation of stroke patients to 4 North and develop a Neuroscience presence/service line

focus..

2. Relocation of cardiac decision unit to 3 North and incorporation of CHF, other cardiac services for a total of 39 beds.

3. Recruit staff for expanded bed utilization in preparation for 2015-2016 seasonal plan for 291 staffed beds.

4. Healthy Garden (Wellness Education Park) continues to influence our optimal healing environment (OHE) with produce being served in CCH Cafeteria and continued student participation with Caloosa Elementary and Middle Schools, part of the School District of Lee County.

PeopleRecognition:

Quarterly Recognition Winners Bobbi Jesse- Outstanding Ancillary

Lynnette Morrow- Outstanding Support/Corporate

Dr. Saunders- Outstanding Physician

Solange Coulanges- Outstanding Patient Care Services

Arlene Tompkins- Outstanding Volunteer

Sterling The Florida Governor’s Sterling Award is a method to assess an organization’s model for high performance.

CCH submitted an application for the Governor’s Sterling Award in November, 2014 and completed the full review in February 2015. Final Report and decisions expected May 2015.

Sterling matches the Malcolm Baldrige-based assessment. Our management system is assessed against research-based best practices in seven categories:

Leadership Strategic Planning Customer Focus Measurement, Analysis, Knowledge Management Workforce Focus Operations Focus Results

DNVThere were two findings:

Fall Risk in ICU patients History and Physical Update before Surgery

People

Connectivity! Over 1,000+ staff have participated this year. Started Connectivity/OHE Rounds (Optimal Healing Environment) with Healing

Environment and HR Business Partners to focus on practical applications of supporting our operational priorities and key performance indicators.

Staff working on 2nd edition of Connectivity Video: Around the Cape in 90 seconds focused on showcasing “Because We Care” examples and operational stories specific to safety, flow and experience.

Health & Wellness Speaker Series: Dr. Joel Fuhrman – May 19, 2015. Joel Fuhrman, M.D. is a family

physician, five-time New York Times best-selling author and nutritional researcher who specializes in preventing and reversing disease through nutritional and natural methods. Dr. Fuhrman is an internationally recognized expert on nutrition and natural healing, and has appeared on The Dr. Oz Show, The Today Show, Good Morning America, and Live with Kelly.

Stroke “Ability” Fair held on April 30, 2015, with over 200 community members and staff attending. Focus was on education of signs and symptoms of stroke but more importantly on what services are available in our community for stroke survivors and their families.

OPERATIONS REPORT YTD March 31, 2015

Gulf Coast Medical Center

Joshua DeTillio, CAO

Admissions - YTD March 31, 2015

Admissions: Up 6.6% from budget/Up 7.0% from PY

10,50011,00011,50012,00012,500

Admissions

11,351

12,095

11,301

Budget

Actual

Prior Year

Budget Actual Prior Yr Var Bud Var PYAdult 10,402 11,173 10,399 7.4% 7.4%Obstetrics 949 922 902 -2.8% 2.2%

Patient Days - YTD March 31, 2015

Patient Days: Up 15.4% to Budget/Up 15.4% from PY

45,000

50,000

55,000

60,000

Patient Days

49,177

56,758

49,166

Budget

Actual

Prior Year

ALOS: Up 8.3% from budget/Up 7.9 from PY

4.00

4.50

5.00

ALOS

4.33

4.69

4.35

Budget

Actual

Prior Year

Short Stays - YTD March 31, 2015

Short Stays: Down 24.5% to Budget/Down 11.0% from PY

02,0004,0006,0008,000

Short Stays

6,1964,679 5,260

Budget

Actual

Prior Year

Statistics - YTD March 31, 2015

31,00031,50032,00032,50033,00033,50034,00034,50035,00035,500

ED Visits

33,090

35,120

32,702

4,950

5,000

5,050

5,100

5,150

5,200

5,250

5,300

Surgeries

5,227

5,276

5,090

0

5

10

15

20

25

30

35

Kidney Transplants

32 30

20

830835840845850855860865870875

Deliveries

846

871

862


Revenue - YTD March 31, 2015

Net Revenue: $162,780,000 – Up 7.1% from Budget/Up 9.3% from PYNet Rev. per Adj. Admit: $9,594 - $229 more than budget

$367 more than PY

Medicare60.0%Medicaid

11.3 %

HMO/PPO17.9%

Self Pay / Charity5.6 %

Other5.2%

Budget

Medicare61.3%

Medicaid10.9%

HMO/PPO18.2%

Self Pay / Charity4.4 %

Other5.2 %

ActualPayer Mix

Salary Expense -YTD March 31, 2015

Staffing: Salaries and Benefits: $713,953 over budget

FTEs: 1,801 – 16 over budget

FTEs per AOB – 4.21 vs. Budget 4.66

4.00 4.10 4.20 4.30 4.40 4.50 4.60

FTE'S Per AOB

4.66

4.21

4.51 Budget

Actual

Prior Year

Supply Expense - YTD March 31, 2015

Supply Expense per Adj Admit: $2,264 Actual vs. $2,196 BudgetUp 3.1% from BudgetUp 11.4% from PY

1,900

2,000

2,100

2,200

2,300


2,1962,264

2,031

Budget

Actual

Prior Year

Profitability - YTD March 31, 2015

EBDITA: $54.3 million, $7.0 million more than budget

EBDITA %: 33.4% vs. Budget of 31.2%

Gain From Operations : $36.7 million, $7.2 million more than budget/$4.9 million more than PY

Operating Margin %: 22.5% vs. Budget of 19.4%

-

10,000

20,000

30,000

40,000


29,446 36,687

31,741

Budget

Actual

Prior Year

Key Challenges and Opportunities

Challenges1. Seasonal volumes have been extremely high. ED volumes are up 17%

YOY

Opportunities1. Physician’s Regional closed their Neuro-interventional program in April

20152. Looking at opportunities for incremental bed capacity and additional staff

for Season 2016

Celebrations1. Recently certified as a DNV Comprehensive Stroke Center2. Door-to-Needle times for Stroke patients are world class, 20-30 minutes


HealthPark Medical Center

Donna Giannuzzi, CAO


Admissions: Up 7.5% from Budget/Up 7.4% from PY

11,500

12,000

12,500

13,000

Admissions

11,989

12,893

12,009

Budget

Actual

Prior Year

Budget Actual Prior Yr Var Bud Var PYAdult 7,439 7,994 7,370 7.5% 8.5%Obstetrics 1,853 2,184 1,956 17.9% 11.7%Pediatrics 2,333 2,313 2,317 -0.9% -0.2%NICU 364 402 366 10.4% 9.8%


Patient Days: Up 8.2% from Budget/Up 7.1% from PY

52,00054,00056,00058,00060,000

Patient Days

54,295

58,731

54,824

Budget

Actual

Prior Year

ALOS: Up 0.6% from Budget/Down 0.2% from PY

4.50

4.55

4.60

ALOS

4.53

4.56 4.57

Budget

Actual

Prior Year


Short Stays: Down 4.6% to Budget/Up 9.7% from PY

3,000

3,500

4,000

4,500

Short Stays

4,2014,009

3,656

Budget

Actual

Prior Year


30,000

31,000

32,000

33,000

34,000

35,000

36,000

37,000

ED Visits

33,672

36,340

32,702

5,200

5,300

5,400

5,500

5,600

5,700

5,800

Surgeries

5,466

5,782

5,415

380

400

420

440

460

480

500

Open Hearts

420

499

438

1,4501,5001,5501,6001,6501,7001,7501,8001,850

Deliveries

1,602

1,811

1,691



Net Revenue: $189,048,000 – Up 7.0% from Budget/Up 10.6% from PYNet Rev. per Adj. Admit: $9,911 - $94 less than Budget

$95 more than PY

Medicare45.6%

Medicaid24.4%

HMO/PPO20.7%

Self Pay / Charity

4.6%

Other4.7%

Budget

Medicare47.4%

Medicaid24.1%

HMO/PPO19.9%

Self Pay / Charity

3.9%

Other4.7%

ActualPayer Mix

Salary Expense -YTD March 31, 2015

Staffing: Salaries and Benefits: $506,000 over Budget

FTEs: 1,970 – 21 more than Budget

FTEs per AOB – 4.24 vs. Budget 4.52

4.00 4.10 4.20 4.30 4.40 4.50 4.60

FTE'S Per AOB

4.52

4.24

4.43

Budget

Actual

Prior Year


Supply Expense per Adj Admit: $2,017 Actual vs. $2,112 BudgetDown 4.5% from BudgetUp 2.2% over PY

1,9001,9502,0002,0502,1002,150


2,112

2,0171,973

Budget

Actual

Prior Year


EBDITA: $70.909 million, $10,828,000 more than Budget


Gain From Operations : $63.977 million, $11,018,000 more than Budget/$11,401,000 million more than PY


-

20,000

40,000

60,000

80,000


52,960 63,977

52,576

Budget

Actual

Prior Year

People – Nurse’s Week 2015

The Nurses Week 2015 theme this year is the story of the Redwood Theory

• The tallest trees on earth, the redwoods grow to heights of 350 feet. Yet, their shallow root system extends more than 100 feet from the base. The roots from one redwood intertwine with the roots of others, and each redwood is connected to another—thus increasing the bond and stability of the forest of trees. The metaphor of the redwoods shows how clinicians, too, are connected to one another to be the strongest team possible. Each member of our team brings strengths, as well as opportunities for growth. Our nurses offer the nurturing strength of interlocking roots linking together and strengthening the teams of a caring organization.

• Each year, the system recognizes over 3561 nurses in the system with a special lunch and celebration.

People Continued

• On April 9th Lee Memorial Health System announced the creation of The Shipley Center for Cardiothoracic Surgery Innovation, Education & Research to advance the care and treatment of heart and vascular disease. The center, when built in 2017, will expand upon the health system’s current cardiac care expertise by establishing an innovation hub focused on patient care optimization, research, and learning opportunities for surgical teams worldwide.

• For the 2nd straight year in a row, the HPMC and LMH have ranked in the Top 1% in the nation which equates to one of the 50 Best Hospitals in the nation.

• On May 19th, HPMC will celebrate the end of season and Hospital Week with a “Picnic in the Park” in the Atrium Courtyard for employees and volunteers.

Construction

• March 2015: Major Diagnostic Equipment arrived for Cath Lab and EP Labs• April 2015: Completion of CEP generator fuel tanks and bulk oxygen tank farm• July 2015: Cath/EP/COU open for Business • August 2015: Begin Phase 1 of the Surgery Renovation Project

• Construction Fun Facts:o Over 240 miles of electrical wire and low voltage cabling has been installed

on the project to date. This represents only the Cath Lab Renovation and OR build out phases of the project. That is enough wire to stretch from Fort Myers to the Bahamas

o In our continued focus on infection control, we have used over 30,000 sticky mats through the end of February 2015 that prevent dust and debris from being tracked out of the construction areas by the contractors. That is enough sticky mats to cover 3 ½ football fields.

o 1,951 tons of steel will be hidden in the concrete to help reinforce the Golisano Children’s Hospital structure. This equates to 1,204 Toyota Camry’s!

Construction Continued

• Thank you for approving the expansion of 16 Observation beds at HealthParkMedical center. The beds will be constructed, staffed and ready for season by converting meeting rooms 1A/1B to eight Cardiac Observation bends and Endoscopy (once relocated) will become an eight bed cardiac intervention unit.

• The final phases of the Courtyard Improvements have been completed. New plantings have been placed in all of the Landscape Beds and are integrated with the dry stream bed using black lava rock. The sound system has been reactivated which will allow for unlimited choices of sound to be introduced into the area when the piano is not in use. The beautiful copper patina birds have all found new homes within the plantings.

• Watch for the “facelift” of the courtyard with new furnishings, lighting and whimsical “sails.”


Challenges:• The renovation and move of the Cath Labs from

the third floor to the second floor is on schedule for a July opening

• Phase two of the cafeteria renovation is beginning

• Parking for visitors• Air handler changes due to upgrades• Managing significant unexpected inpatient

volumes• Volume increases have necessitated the

postponement of major renovations of the Surgical Progressive Care Unit

• Crowding impact on Patient Experience results


Opportunities:• The addition of 16 observation beds• “State of the Art” Cath and EP Labs• Endoscopy Lab renovation will

provide needed space relief• Continued Philanthropic interest in

the Shipley Center

Patient Experience

HPMC- Rolling Average is

• The three month rolling percentage is 72.7% which is meeting the goal of 70.9% and just shy of the Exceeds goal of 73.5%.


Lee Memorial Hospital

Lisa Sgarlata, CAO


Admissions: Up 8.7% from Budget/Up 11.7% from PY

6,5007,0007,5008,0008,500

Admissions

7,616

8,281

7,413

Budget

Actual

Prior Year

Budget Actual Prior Yr Var Bud Var PYAdult 7,616 8,281 7,413 8.7% 11.7%


Patient Days: Up 15.6% from Budget/Up 15.7% from PY

30,000

35,000

40,000

45,000

Patient Days

35,858

41,461

35,839

Budget

Actual

Prior Year

ALOS: Up 6.3% from Budget/Up 3.6% from PY

4.50

5.00

5.50

ALOS

4.71

5.01 4.83

Budget

Actual

Prior Year


Short Stays: Down 2.6% to Budget/Down 3.9% from PY

2,7002,7502,8002,8502,9002,950

Short Stays

2,868

2,794

2,907Budget

Actual

Prior Year


26,20026,40026,60026,80027,00027,20027,40027,60027,80028,000

ED Visits

26,796

27,980

26,844

5,100

5,150

5,200

5,250

5,300

5,350

5,400

5,450

Surgeries

5,353

5,443

5,246



Net Revenue: $134,444,442 – Up 5.9% from Budget/Up 17.7% from PYNet Rev. per Adj. Admit: $11,201 - $18 less than Budget

$809 more than PY

Medicare46.7%

Medicaid13.3%

HMO/PPO16.3%

Self Pay / Charity

9.5%

Commercial10.1%

Other4.1%

Budget

Medicare48.8%

Medicaid12.5%

HMO/PPO15.4%

Self Pay / Charity

8.4%

Commercial10.1%

Other4.1%

ActualPayer Mix

Salary Expense - YTD March 31, 2015

Total FTEs: 1,408 – 44 more than Budget

OT and Contract FTEs: Up 56.4% from Budget/Up 44.9% from PY

0

50

100

Premium Labor - OT + Contract

3860

41

Budget

Actual

Prior Year

FTEs per AOB: 4.25 vs. Budget 4.68

4.00

4.50

5.00

FTEs per AOB

4.68

4.25 4.51

Budget

Actual

Prior Year


Supply Expense per Adj Admit: $2,677 Actual vs. $2,589 BudgetUp 3.4% from BudgetUP 4.6% from PY

2,500

2,550

2,600

2,650

2,700


2,589

2,677

2,559

Budget

Actual

Prior Year


EBDITA: $48.7 million, $7.1 million more than Budget


Gain From Operations : $43.9 million, $8.6 million more than Budget/$13.7 million more than PY


-

20,000

40,000

60,000


35,317 43,867

30,174

Budget

Actual

Prior Year

Celebrations

Employee of the Quarter Dan Carlson , Supply Chain Management

Lab Week (April 12, 2015)

Nurses’ Week (May 7, 2015)

Operational Highlights

Quality Readmissions: VSM for COPD (System-wide)

Hospital Acquired Conditions (CAUTI)

Sepsis Improvement Team

Physician/Nurse Rounding Spread: 4W

Transfusion Safety – MTP and Blood product management (Trauma)

“Save of the Month”

Critical Care Outreach Nurse Recognition

Trauma Seminar: Surgical Interventions for the Critically Injured

2nd QTR 2015 Board Update

Golisano Children’s Hospital of Southwest Florida

Kathy Bridge-Liles, CAO

Admissions – 2nd Quarter 2015

Admissions: Up 0.8% from Budget / Up 1.3% from PY

2,7402,7602,7802,8002,820

Admissions

2,791

2,814

2,777

Budget

Actual

Prior Year

Budget Actual Prior Yr Var Bud Var PYPediatrics 2,333 2,313 2,317 -0.9% -0.2%NICU 364 402 366 10.4% 9.8%SCN 94 99 94 5.3% 5.3%

Patient Days – 2nd Quarter 2015

Patient Days: Up 2.5% from Budget / Up 2.3% from PY

16,000

16,500

17,000

Patient Days

16,232

16,644

16,268

Budget

Actual

Prior Year

ALOS: Up 1.7% from Budget / Up 1.0% from PY

5.75 5.80 5.85 5.90 5.95

ALOS

5.82

5.91 5.86

Budget

Actual

Prior Year

Short Stay Days 2nd Quarter 2015

Short Stay Days: Up 93.2% from Budget/Up 98.1% from PY

0200400600800

Short Stay Days

325

628

317

Budget

Actual

Prior Year

Statistics – 2nd Quarter 2015

Actual Prior Year

1,400

1,450

1,500

1,550

1,600

1,650

1,700

ED Admits

1,699

1,505

46.0%

47.0%

48.0%

49.0%

50.0%

Pediatric ED Visits as % ofTotal ED Visits

49.7%

47.3%

1,7001,7501,8001,8501,9001,9502,0002,0502,100

Peds Surgeries

2,073

1,845

Ed Visits +2,090 and ED Admits +194 from Prior Year

10,000

10,500

11,000

11,500

12,000

12,500

13,000

13,500

Ed Visits

13,299

11,209

Salary Expense- 2nd Quarter 2015

Staffing*:

Salaries and Benefits: $314.6 thousand under fixed budget

FTEs: 340 vs. fixed budget of 355

FTEs per AOB: 3.48 vs. fixed budget 3.79

3.20

3.40

3.60

3.80

FTE'S Per AOB

3.79

3.48 3.54

Budget

Actual

Prior Year

*This does not include ancillary departments

Supply Expense – 2nd Quarter 2015

Supply Expense per Adj Admit*: $351 Actual vs. $363 Fixed BudgetDown 3.5% from BudgetDown 0.6% to PY

Anesthetics, Raw Food and Medical Gases are the top three expenses with a favorable variance to budget

340

350

360

370


363

351 353

Budget

Actual

Prior Year

*This does not include ancillary departments

Quality

Pediatric Asthma Core Measures

CAC 1 100% Reliever ordered and administered

CAC 2 100% Systemic corticosteroid ordered and administered

CAC 3 82% Written Home Management Plan of Care at discharge

Service - continued

GCHSWF Overall Stoplight Report (return dates from Feb 1, 2015 to April 30, 2015)

Child HCAHPS Overall (TOP Box “Rate this Hospital)Apr 2015 Mar 2015 Feb 201583.3% 75.0% 80%

Opportunities Opportunity to improve score related to “Communication with

Nurses”

Key Opportunities

FHA-HEN contract completed to participate through Florida Association of Children’s Hospitals 30 Day Readmission rates

ADE - John Armitstead is representing Golisano in the Pediatric HEN

Central Line Associated Blood Stream Infections in 3 units: PICU, NICU and Hematology/Oncology

Began design phase for the new Golisano Pediatric Urgent Care Facility and sub specialty offices in Naples

PDCA completed to begin comprehensive physical and cultural transition to the new hospital – in progress

Golisano now participating in CIT (Care Innovation & Transformation) Program (AONE). Focus- strengthen the nurse/physician relationship to improve patient experience and outcomes.

Planning pediatric genetic telehealth consults with MCH (in progress)

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OLD

BUSINESS

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NEW BUSINESS

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BOARD MEETING CRITIQUE

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BOARD OF

DIRECTORS’ REPORTS

__________________________________ L E E M E M O R I A L HEALTH SYSTEM


DATE OF THE NEXT REGULARLY SCHEDULED

MEETING:

TRAUMA District & FULL BOARD OF DIRECTORS

MEETINGS Thursday, May 28, 2015

1:00pm

Gulf Coast Medical Center Boardroom 13685 Doctors Way, Ft. Myers, FL 33912