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MEETING
OF THE HEALTH
AFFAIRS COMMITTEE
Thursday,
January 18, 2001
4:00 p.m.
Board
Room, The Rotunda
Committee
Members:
Charles
M. Caravati, Jr., M.D., Chair
H.
Christopher Alexander, III, M.D. William H. Goodwin, Jr.
Thomas
J. Bliley, Jr. Terence P. Ross
Vincent
F. Callahan, Jr. Elizabeth A. Twohy
William
G. Crutchfield, Jr. Harry J.G. van Beek
John
P. Ackerly, III, Ex Officio
AGENDA
I.
REPORTS BY THE VICE PRESIDENT AND PROVOST FOR
THE HEALTH SYSTEM (Dr. Cantrell)
A.
Medical Center Financial Report (as of November
30, 2000) (Mr. Sandridge to introduce
Mr. Larry Fitzgerald; Mr.
Fitzgerald to report)
B.
Bed Status (Mr. Sandridge to report)
C.
Clinical Issues - Telemedicine
Dr.
Cantrell to introduce Dr. Karen Rheuban;Dr.
Rheuban to report)
D.
School of Nursing Response to the Nursing Shortage
(Dr. Cantrell to introduce Dean Jeanette
Lancaster; Ms. Lancaster to report)
E. Remarks
by the Vice President and Provost for the
Health System
II.
EXECUTIVE SESSION
Discussion
and evaluation of the performance of specific public officers, appointees
and employees of the Medical Center; and discussion and evaluation
with Legal Counsel of the performance of Medical Center departments
complying with regulatory requirements which will also necessarily
involve discussion of the performance of specific individuals. Discussion
of proprietary business development and market share information
regarding employment strategies and hiring goals for health care
providers, where disclosure of such information would adversely
affect the competitive position of the Medical Center. Discussion
and consideration of proprietary, business related information pertaining
to the operations of a joint venture formed by the University Medical
Center, and evaluating the status of negotiations with respect to
provider service contracts, where disclosure of such information
would adversely affect the Medical Center’s competitive position
and its financial interests. Discussion with Legal Counsel on the
status of pending litigation and complying with regulations governing
clinic billing as provided for in Section 2.1-344(A)(1),(6),(7),(8)and
(23) of the Code of Virginia.
AGENDA
ITEM: I.A. Medical Center Financial Report
as
of November 30, 2000
ACTION
REQUIRED: None
BACKGROUND:
The Medical Center prepares a financial report and reviews it with
the Executive Vice President and Chief Operating Officer before
submitting the report to the Health Affairs Committee of the Board
of Visitors. The Health Services Foundation (HSF) prepares and presents
financial statements to the Vice President and Provost for the Health
System.
DISCUSSION:
Discharges from the Medical Center for Fiscal Year 2001 are below
budget by 1.6 percent, and below Fiscal Year 2000 by 1.5 percent.
The Psychiatry and Surgery service lines experienced the most significant
increases in discharges over last year while the Neurology and Pediatrics
service lines experienced the most significant decreases in discharges
over last year. Although discharges are slightly below expectations,
patient days are 1.9 percent above budget and 5.2 percent above
prior year. A higher than expected case mix index led to a higher
than expected average length of stay (5.5 days) for patients discharged
through November.
Net
operating revenue for Fiscal Year 2001 through November is 5.7 percent
above budget and 15.7 percent above prior year. The increases in
revenue are primarily due to lower indigent care write-offs, the
conversion of the outpatient clinics to provider based entities,
and the opening of the Augusta Dialysis Center.
Total
operating expenses through November Fiscal Year 2001 are 5.8 percent
over the $201.3 million budget and 14.6 percent over prior year
expenses. Salaries and wages, Medical Center contracts and medical
supplies are higher than budget and higher than prior year. The
higher cost of pharmaceuticals is a contributing factor to the increased
medical supplies expense. Pharmaceuticals expense through November
is $2.8 million (20.6 percent) higher than prior year.
The
number of full-time equivalent employees (FTEs) is 205 above budget
and 388 above prior year. The increase in salaries and FTEs over
prior year is primarily the result of University and HSF employees
moving to the Medical Center’s payroll with the conversion
to provider-based clinics in Fiscal Year 2001.
Clinic
and non-clinic FTEs are:
FY 2000 FY 2001 2001 Budget
Non-Clinic
FTEs 4,257 4,412 4,435
Clinic
FTEs 127 360 132
Total
4,384 4,772 4,567
The
number of non-clinic FTEs is approaching the budgeted number. A
vacancy factor was assumed for the budget which means that the actual
number of FTEs which could be hired is greater than the number of
FTEs in the budget. The operating margin for Fiscal Year 2001 through
November is 5.0 percent, which is slightly below the budgeted margin
of 5.1 percent, but above the prior year’s 4.0 percent margin.
University
of Virginia Medical Center
Income Statement, Balance Sheet, and Operating Statistics
(IN WORD 98 FORMAT)
AGENDA
ITEM: I.B. Bed Status
ACTION
REQUIRED: None
BACKGROUND:
The President reported to the Board in his memorandum of December
8, 2000, and the accompanying interim report that 80 beds were closed
in the Medical Center as of mid-October because of staffing shortages
(primarily nurses) and building renovation. The President stated
that Mr. Sandridge would report on this situation at the January
Board meeting.
DISCUSSION:
At the Health Affairs meeting, Mr. Sandridge will present a report
that will give updated information on the beds that are now closed,
why they are closed and what steps are being taken to ensure that
they are placed back on line as quickly as possible. He will also
provide additional information on the impact that the bed closures
have had on occupancy and limited diversions over the course of
the last year.
AGENDA
ITEM: I.C. Telemedicine
ACTION
REQUIRED: None
BACKGROUND:
Through the use of broadband telecommunications advanced computer
technologies, peripheral devices and other applications, the Office
of Telemedicine has facilitated enhanced outreach services to patients
and health professionals located throughout the Commonwealth of
Virginia and beyond since 1996. Services provided include clinical
consultations and follow up visits, continuing medical education
programming, patient education, training of other professionals
and high school student programs.
DISCUSSION:
A review of the medical applications and outreach services provided
under the aegis of the Office of Telemedicine will be presented.
To date, more than 2500 clinical consultations in 22 different specialties
and subspecialties have been facilitated to patients for whom access
to healthcare services is otherwise limited. Currently, the Health
System provides these services through telemedicine relationships
with 25 facilities in the Commonwealth of Virginia, to include community
hospitals, regional health departments, clinics, state mental health
facilities and state correctional facilities. A new project in development
linking the Children’s Medical Center with the Craig County
school system will be presented. The use of these technologies in
the provision of healthcare services in the international market
will be discussed along with legal and regulatory issues that have
impeded broader deployment in the domestic marketplace.
AGENDA
ITEM: I.D. School of Nursing - Response
to
the Nursing Shortage
ACTION
REQUIRED: None
Background:
The current nursing shortage is expected to continue well into the
21st century. The School of Nursing is committed working
with the Health System to alleviate the shortage. The discussion
will highlight specific approaches to be taken in 2001.
DISCUSSION:
Dean Jeanette Lancaster of the School of Nursing will provide an
overview of the ways in which the School of Nursing is responding
to the statewide nursing shortage. Descriptions of enrollment statistics,
the applicant pool, and other planned recruiting strategies will
be described. Some strategies will require new resources (increased
space and additional faculty), and these requirements will be specified.
Dean Lancaster will respond to questions following her presentation.
AGENDA
ITEM: I.E. Remarks by the Vice President
and
Provost for the Health System
ACTION
REQUIRED: None
Background:
The Vice President and Provost for the Health System will utilize
this portion of the Health Affairs Committee meeting to inform the
Board of Visitors of recent events which do not require formal action,
but of which they should be made aware.
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