Meeting InformationMEETING OF THE HEALTH AFFAIRS COMMITTEE
Thursday, January 18, 2001
Room, The Rotunda
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
P. Ackerly, III, Ex Officio
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)
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 Centers 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 Centers 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 FTEs4,257 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 years 4.0 percent margin.
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 Childrens 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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