BOARD OF DIRECTORS
AGENDA PACKET
July 14, 2014
The mission of Palomar Health
is to heal, comfort and promote health
in the communities we serve.
BOARD OF DIRECTORS
T.E. Kleiter, Chairman
Stephen P. Yerxa, Vice Chairman
Linda C. Greer, RN, Secretary
Jerry Kaufman, PTMA, Treasurer
Bruce G. Krider, MA
Jeffrey D. Griffith, EMT-P
Aeron D. Wickes, MD
Michael H. Covert, FACHE, President and CEO
Regular meetings of the Board of Directors are usually held on the second Monday
of each month at 6:30 p.m., unless indicated otherwise.
For an agenda, locations or further information
call (760) 740-6375, or visit our website at www.palomarhealth.org
MISSION STATEMENT
The Mission of Palomar Health is to:
Heal, Comfort, Promote Health in the Communities we Serve
VISION STATEMENT
Palomar Health will be the health system of choice for patients, physicians and employees, recognized nationally for the
highest quality of clinical care and access to comprehensive services
CORE VALUES
Patient’s Well-Being
We passionately give and support heartfelt care that encourages patient comfort and safety
Professionalism
Each of us takes pride in teamwork, self-discipline, our skills and trustworthiness
Highest Quality
We are each accountable for providing the safest, most effective and innovative care
Affiliated Entities
*Palomar Medical Center * Palomar Health Downtown Campus* Arch Health Partners*
*Palomar Health Foundation * Palomar Home Care * Pomerado Hospital*
*Palomar Health Development, Inc.* North San Diego County Health Facilities Financing Authority*
*San Marcos Ambulatory Care Center * Villa Pomerado * Palomar Health Concern * Palomar Health Source*
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PALOMAR HEALTH
BOARD OF DIRECTORS
MEETING AGENDA
Monday, July 14, 2014
6:30 p.m.
Pomerado Hospital
Meeting Room E
15615 Pomerado Road
Poway, CA 92064
Mission and Vision
“The mission of Palomar Health is to heal, comfort and
promote health in the communities we serve.”
“The vision of Palomar Health is to be the health system of choice for patients,
physicians and employees, recognized nationally for the highest quality
of clinical care and access to comprehensive services.”
Time
I.
II.
CALL TO ORDER
2
OPENING CEREMONY
5
Form A
Page
A. Pledge of Allegiance
III.
15
PUBLIC COMMENTS
(5 mins. allowed per speaker with cumulative total of 15 mins. per group - for
further details and policy see Request for Public Comment notices available
in meeting room.)
IV.
* MINUTES April 14, 2014 (ADD A)
5
A. Regular Board Meeting - June 9, 2014 (Pp13-17)
B. Closed Session Board Meeting - Performance Evaluation and Contract Review:
Chief Executive Officer - June 9, 2014 (Pp18-19)
C. Closed Session Board Meeting: Appointment of Public Employee - June 23, 2014 (Pp20-21)
D. Closed Session Board Meeting: Appointment of Public Employee - June 25, 2014 (Pp22-23)
E. Closed Session Board Meeting: Arch Health Partners - June 25, 2014 (Pp24-25)
F. Quality/Patient Safety Annual Report to the Board – October 7, 2013 (Pp26-29)
V.
* APPROVAL OF AGENDA to accept the Consent Items as listed
1
2
3
4
5
6
5
A. Approval of Revolving, Patient Refund & Payroll Fund Disbursements – May 2014 (P30)
1. Accounts Payable Invoices
$38,284,096.00
2. Net Payroll
$13,131,409.00
Total
$51,415,506.00
B. Ratification of Paid Bills
C. May 2014 and YTD FY2014 Financial Report - Finance Committee (ADD B- Pp32-68 )
D. Summary of Executed Budgeted Routine Physician Agreements - Finance Committee
(ADD C- Pp70-87 )
"In accordance with the ADA (Americans with Disabilities Act) please notify us at 760-740-6375 48 hours
prior to the meeting so we may provide reasonable accommodations"
Asterisks indicate anticipated action. Action is not limited to designated items.
7
VI.
PRESENTATIONS
15
There are no presentations this month
VII.
REPORTS
A.
15
Medical Staffs
*1. Palomar Medical Center - Richard C. Engel, M.D. (ADD D)
A. Credentialing and Reappointments (Pp89-101 )
B. Modification to the PMC/POM Core Privilege Checklist for Emergency
Medicine Specific to Maintenance of Ultrasound Privileges (Pp102-106)
9
10
*2. Pomerado Hospital - Paul Neustein, M.D.
A. Credentialing and Reappointments (ADD E- P108 )
VIII.
11
Administrative
1. Chair of the Palomar Health Foundation - John Forst
5
2. Chair of the Board - Ted Kleiter
5
3. President and CEO - Michael Covert, FACHE
5
INFORMATION ITEMS
2
A. ACHD Update Report for June 2014
IX.
COMMITTEE REPORTS
10
A. Governance / Audit and Compliance Committee (P109)
B. Human Resources Committee (Pp110-111)
C. Community Relations Committee (P112)
D. Strategic & Facilities Planning Committee (P113)
E. Quality Review Committee (P114)
F. Finance Committee (P115)
G. Other Committee Chair Comments on Committee Highlights
X.
BOARD MEMBER COMMENTS/AGENDA ITEMS FOR NEXT MONTH
XI.
ADJOURNMENT
5
Minutes
Board of Directors
Monday, June 9, 2014
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Debbie Hollick, Board Assistant
Background: The minutes of the Board of Directors meeting held on Monday,
June 9, 2014 are respectfully submitted for approval
Budget Impact:
N/A
Staff Recommendation: Staff recommends approval of the Monday, June 9,
2014 Board of Directors meeting minutes.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
1
Minutes
Board Closed Session Performance Evaluation
and Contract Review: Chief Executive Officer
Monday, June 9, 2014
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Debbie Hollick, Board Assistant
Background: The minutes of the Board Closed Session Performance
Evaluation and Contract Review: Chief Executive Officer meeting held on
Monday, June 9, 2014 are respectfully submitted for approval.
Budget Impact:
N/A
Staff Recommendation: Staff recommends approval of the Monday, June 9,
2014 Board Closed Session Performance Evaluation and Contract Review: Chief
Executive Officer meeting minutes.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
2
Minutes
Board Closed Session
Appointment of Public Employee
Monday, June 23, 2014
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Debbie Hollick, Board Assistant
Background: The minutes of the Board Closed Session - Appointment of Public
Employee held on Monday, June 23, 2014 are respectfully submitted for
approval.
Budget Impact:
N/A
Staff Recommendation: Staff recommends approval of the Monday, June 23,
2014 Board Closed Session - Appointment of Public Employee minutes.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
3
Minutes
Board Closed Session
Appointment of Public Employee
Wednesday, June 25, 2014
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Debbie Hollick, Board Assistant
Background: The minutes of the Board Closed Session - Appointment of Public
Employee held on Monday, June 25, 2014 are respectfully submitted for
approval.
Budget Impact:
N/A
Staff Recommendation: Staff recommends approval of the Monday, June 25,
2014 Board Closed Session - Appointment of Public Employee minutes.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
4
Minutes
Board Closed Session - Arch Health Partners
Wednesday, June 25, 2014
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Debbie Hollick, Board Assistant
Background: The minutes of the Board Closed Session – Arch Health Partners
held on Monday, June 25, 2014 are respectfully submitted for approval.
Budget Impact:
N/A
Staff Recommendation: Staff recommends approval of the Monday, June 25,
2014 Board Closed Session – Arch Health Partners minutes.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
5
Minutes
Quality/Patient Safety Annual Report to the Board
Monday, October 7, 2013
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Debbie Hollick, Board Assistant
Background: The minutes of the Quality/Patient Safety Annual Report to the Board
held on Monday, October 7, 2013 are respectfully submitted for approval.
Budget Impact:
N/A
Staff Recommendation: Staff recommends approval of the Monday, October 7, 2013
Quality/Patient Safety Annual Report to the Board minutes.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
6
May 2014 & YTD FY2014 Financial Report
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Bob Hemker, CFO
BY:
Board Finance Committee
Wednesday, June 25, 2014
Background:
The Board Financial Reports (unaudited) for May 2014 and
YTD FY2014 are submitted for the Board’s approval.
N/A
Budget Impact:
Staff Recommendation:
Approval
Committee Questions:
COMMITTEE RECOMMENDATION:
The Board Finance Committee
recommends approval of the Board Financial Reports (unaudited) for May 2014
and YTD FY2014.
Motion:
X
Individual Action:
Information:
Required Time:
Form A - Financial Report.doc
7
Budgeted Routine Physician Agreements
Board Summary Report
TO:
Board of Directors
MEETING DATE:
Monday, July 14, 2014
FROM:
Bob Hemker, CFO
BY:
Board Finance Committee
Wednesday, June 25, 2014
Background:
The following Budgeted Routine Physician Agreements became effective during the months of
April & May 2014. The standard Form A and Abstract Table for each signed Agreement are included in
Addendum C.
PHYSICIAN AND/OR GROUP
TYPE OF AGREEMENT
APRIL 2014
 Engel, Richard, MD & Richard C.
Engel, MD, Inc.
Amendment #1 – Chief of Staff Agreement – PMC

Galen Inpatient Physicians, Inc.
Amendment #2 – Hospital Medicine Services Agreement

Malek, Mikhail, MD
Amendment #1 – Medical Director Agreement – Cardiology
– PMC
 Rosenburg, Jeffrey, MD & Jeffrey
Rosenburg, MD, Inc.
Amendment #1 – Chief of Staff Elect Agreement – PMC
MAY 2014

Ghosh, Kris, MD
Amendment #1 – Medical Director Agreement – Robotic
Surgery Program

Macleay, Lachlan, MD
Department Chair Agreement – Pathology – POM
 North County Emergency Medical
Associates, Inc.
Amendment #2 – OB Consultative Services Agreement –
PHDC
 North County Neurology Medical
Group
Practice Recruitment Agreement – Neurology

Medical Director Agreement – Villa POM
Thaper, Mohinderpal, MD
COMMITTEE RECOMMENDATION: The Board Finance Committee recommends approval of the Budgeted
Routine Physician Agreements that became effective during the months of April & May 2014, as listed above.
Motion:
X
Individual Action:
Information:
Required Time:
8
9
10
11
ADDENDUM A
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Board of Directors Meeting Minutes – Monday, June 9, 2014
Agenda Item

I.
Conclusion/Action
Discussion
FollowUp/Responsible Party
CALL TO ORDER – ESTABLISHMENT OF QUORUM
The meeting – held in the Graybill Auditorium at Palomar Health Downtown Campus, 555 E. Valley Parkways, Escondido, CA 92025 92025 - was called to order at 6:29 p.m. by
Chair Ted Kleiter

Quorum comprised of Directors Kleiter, Kaufman, Greer, Wickes, Yerxa, Griffith

Excused Absences: Director Krider
II. OPENING CEREMONY

The Pledge of Allegiance was recited in unison
MISSION AND VISION STATEMENTS
The Palomar Health mission and vision statements are as follows:

The mission of Palomar Health is to heal, comfort and promote health in the communities we serve

The vision of Palomar Health is to be the health system of choice for patients, physicians and employees, recognized nationally for the highest quality of clinical care and
access to comprehensive services
NOTICE OF MEETING

The Notice of Meeting was published consistent with legal requirements
III. PUBLIC COMMENTS

Erik Olson-Fernandez spoke about hospital access

Esther Glina Montagner spoke about art displays in the hospital
060914 BD Meeting Minutes.doc
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Board of Directors Meeting Minutes – Monday, June 9, 2014
Agenda Item

Conclusion/Action
Discussion
FollowUp/Responsible Party
IV. APPROVAL OF MINUTES

Regular Board Meeting – May 12, 2014

Closed Session Board Meeting – May 12, 2014

No discussion
nd
MOTION: by Director Yerxa, 2 by Director Kaufman and carried to
approve the May 12, 2014 Regular and Closed Session Board meeting
minutes as submitted. All in favor. None opposed
V. * APPROVAL OF AGENDA to accept the Consent Items as listed including –
A. Approval of Revolving, Patient Refund & Payroll Fund Disbursements – April 2014
1. Accounts Payable Invoices
$36,987,220.00
2. Net Payroll
$13,110,263.00
Total
$50,097,483.00
B. Ratification of Paid Bills
C. April 2014 and YTD FY2014 Financial Report - Finance Committee
E. Motion to Approve the Following: (ADD C)
1. Board Responsibilities Policy - Lucidoc #26952
2. Expense Reimbursement and Advances Policy - Lucidoc #21806
3. Credit Card Policy - Lucidoc #21807
4. Palomar Medical Center Medical Staff Bylaws

Director Kaufman pulled Consent Agenda item E.2. “Expense Reimbursement and Advances
Policy - Lucidoc #21806” for review, citing the lack of precise verbiage re: documentation of
expenses
nd
Motion: by Director Griffith, 2 by
Director Kaufman and carried to
approve Consent Agenda items E.1.
E.3. and E.4. as presented. All in favor.
None opposed
Consent Agenda item E.2. to
be returned to Governance /
Audit & Compliance committee
for review
VI. PRESENTATIONS
There were no presentations
VII. * REPORTS
A. Medical Staffs
nd
1. Palomar Medical Center
a. Credentialing Recommendations

MOTION: by Director Griffith, 2 by Director Kaufman and carried to
approve the PMC Medical Staff Credentialing Recommendations as
presented. All in favor. None opposed
Palomar Medical Center Chief of Staff Dr. Richard Engel presented the PMC Medical Staff Executive Committee reports referenced above for review and approval
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Board of Directors Meeting Minutes – Monday, June 9, 2014
Agenda Item

Conclusion/Action
Discussion
MOTION: by Director Kaufman, 2 by Director Wickes and carried to
approve the POM Medical Staff Executive Committee Credentialing
Recommendations as presented. All in favor. None opposed
2. Pomerado Hospital
a. Credentialing Recommendations

FollowUp/Responsible Party
nd
Pomerado Hospital Chief of Staff Dr. Paul Neustein presented the POM Medical Staff Executive Committee reports referenced above for review and approval
B. Administrative
nd
1.
Palomar Health Foundation

Palomar Health Foundation Board Chair John Forst presented the May 2014 Palomar Health
Foundation Board report; electronic copies were distributed to the board

Mr. Forst reported that the Foundation Board approved a motion to create a Palomar Health
Employee Emergency Disaster Fund, and is bringing it to the full board for their review and
approval
o
MOTION: by Director Yerxa, 2 by Director Griffith and carried to
approve creation of the Palomar Health Employee Emergency Disaster
Fund as noted by Mr. Forst in his report. All in favor. None opposed
President and CEO Michael Covert noted that this would be a separate and discreet
fund from the 2007 Emergency Disaster Fund in that it will support funding that could
be used in to support people in various disasters

Mr. Forst reported that the Foundation CEO selection process is underway, with interviews
ongoing; progress updates to be provided at future board meetings
2.
Chair of the Board

Chair Kleiter reported that he and Director Kaufman attended the ACHD Annual meeting

ACHD Governing Board handbooks were distributed to all board members

Chair Kleiter noted that today’s celebrations for the new chapel, Medical Education Resource Center and lobby grand piano at Palomar Medical Center remind us that these
are very exciting times for the organization
3.
President and CEO

Palomar Health President and CEO Michael Covert reminded the board members to forward him any best practices, board activities or education that could be shared with
VHA

Mr. Covert reported on the upcoming Academy of Applied Physician Leadership Year One Celebration Gala, stating that it will be an opportunity for the medical directors and
nurse leaders to share presentations with the board on the progress made this year. He noted that their work has been very impressive, and is already impacting the
organization in meaningful ways

The June Board Strategic & Facilities Planning Committee meeting agenda will include a year-end review of the FY14 Strategic & Operational initiatives and updates from IT
and Facilities. The July meeting will focus on what will get stripped off next year for the FY15 initiatives, as well as an update on the Rehab hospital. Both will be full-board
meetings

Mr. Covert requested that Chief Administrative Officer Pomerado Dr. David Tam provide the board with a report on the Integra Center, an organization that works with the
San Diego Balboa Wounded Warrior Detachment to provide rehabilitation services to wounded veterans. Dr. Tam shared that the military is looking to move this program
offsite to a civilian partner who would be capable of providing a high level of rehabilitation services. Since Palomar Health has one of the top-rated programs in the country,
Balboa has approached us with this partnership. The organization is currently performing due diligence on this exciting opportunity, and will provide the board with ongoing
updates

We are continuing with recruiting activities for the Arch Health Partners CEO position – more to follow
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Information only
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Board of Directors Meeting Minutes – Monday, June 9, 2014
Agenda Item

Discussion

Recruitment activities are also ongoing for the Foundation CEO position

As a Mayo Clinic Care Network Member, Palomar Medical Center is proud to host the Mayo Clinic Mobile Exhibit. The exhibit will be on campus Tuesday,
th
June 10 , and will provide an impressive interactive, historical timeline of Mayo and the impact they have on our community. That evening, leaders from
both organizations will come together to share conversation around physician culture and future state. Last month Mr. Covert and Palomar Health leaders met
Conclusion/Action
FollowUp/Responsible Party
with Mayo at their Rochester, New York location to continue furthering the relationship between the two organizations

Mr. Covert addressed Mr. Olson-Fernandez’ public comments, noting that the administration is listening and will respond in a fair and reasonable way

Re: the art installation discussed by community member Montagner, Mr. Covert allowed that there is opportunity to make a joint effort in this regard that would work well for
all involved. He requested that the issue be followed up on via the appropriate Board committee; Director Kaufman stated that he will bring it to the Board Community
Relations Committee
VIII. INFORMATION ITEMS
A. The February 2014 ACHD Update Report was forwarded electronically to the board members prior to the meeting
IX. * COMMITTEE REPORTS
nd
MOTION: by Director Kaufman, 2 by Director Griffith and carried to
approve the Board Resolution Authorizing Signature Authority for
A. Governance / Audit and Compliance Committee
Michael H. Covert to Finalize the Sale of 1817 Avenida Del Diablo,
Escondido, CA to Torrey Pines Development Group, LLC . Roll-call
voting was utilized. In favor: Directors Kleiter, Kaufman, Greer, Wickes,
Yerxa, Griffith. Opposed: none. Absent: Director Krider

Committee Chair Linda Greer noted that the meeting summary was included in the board meeting packet

The Board Resolution Authorizing Signature Authority for Michael H. Covert to Finalize the Sale of 1817 Avenida Del Diablo, Escondido,
CA to Torrey Pines Development Group, LLC was brought for board approval
B. Human Resources Committee

Information only
Committee Chair Kleiter noted that the meeting summary was included in the board meeting packet
C. Community Relations Committee – no meeting in May

Information only
th
Committee Chair Kaufman provided highlights from the June 4 meeting
o
Government Relations Manager Elly Garner presented an update on State Legislative Bills that potentially will affect Palomar Health in 2014, and discussed the
bills that are of high interest to Palomar Health
o
Service Excellence Manager Tina Pope provided a detailed report on the Patient and Family Advisor Council. She also shared videos from two Patient Voice
meetings
o
Janet Klitzner, Director of Marketing and The HealthSource informed the committee that the HealthSource magazine is now available in electronic format. The new
format provides realistic page flipping and fast content delivery. Readers can also subscribe to receive future issues electronically
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Board of Directors Meeting Minutes – Monday, June 9, 2014
Agenda Item

Conclusion/Action
Discussion
FollowUp/Responsible Party
D. Strategic & Facilities Planning Committee - no meeting in May
E. Quality Review Committee
Information only

Committee Chair Linda Greer noted that the meeting summary was included in the board meeting packet

Chief Nurse Executive Lorie Shoemaker gave an update to the Committee on the status of the Patient Flow project. The outcomes of Phase 1 as well as the
recommendations for the projects in Phase 2 were discussed. The Committee was pleased with the progress that has been made to date
F. Finance Committee – no meeting in May
G. Other Committee Chair Comments on Committee Highlights
There were no comments
X. BOARD MEMBER COMMENTS / AGENDA ITEMS FOR NEXT MONTH
There were no comments or agenda items for next month
XI. ADJOURNMENT
The meeting was adjourned at 7:15 p.m.
Board Secretary
LINDA C. GREER, R.N.
Board Assistant
DEBBIE HOLLICK
Signatures:
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BOARD OF DIRECTORS CLOSED SESSION CEO EVALUATION – MEETING MINUTES MONDAY, JUNE 9, 2014
AGENDA ITEM

I.
CONCLUSION/ACTION
DISCUSSION
FOLLOW UP
RESPONSIBLE PARTY
CALL TO ORDER - ESTABLISHMENT OF QUORUM
The meeting, held at the Palomar Health Downtown Campus, Graybill Auditorium, 555 E. Valley Parkway, Escondido, CA 92025, was called to
order at 7:30 p.m. by Board Chair, Ted Kleiter.
Quorum comprised of Directors Kleiter, Kaufman, Yerxa, Greer, Griffith, Wickes
Excused Absences: Director Krider was excused from the meeting.
NOTICE OF MEETING
Notice of Meeting was mailed consistent with legal requirements. Pursuant to Government Code Section 54957: Public Employee Performance
Evaluation and Contract Review: Chief Executive Officer
II. PUBLIC COMMENTS

There were no public comments
Closed Session - June 9, 2014
18
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III. ADJOURNMENT TO CLOSED SESSION
Chair Kleiter adjourned the meeting to closed session.
Pursuant to Government Code Section 54957: Public Employee Performance
Evaluation and Contract Review: Chief Executive Officer
IV. RE-ADJOURNMENT TO OPEN SESSION
Chair Kleiter resumed open session.
V. ACTION RESULTING FROM CLOSED SESSION DISCUSSION, IF ANY
VI. FINAL ADJOURNMENT
MOTION: No actionable items to
report.
The meeting was adjourned at 8:20 p.m. by Chair Kleiter
BOARD SECRETARY
LINDA C. GREER, R.N.
SIGNATURES:
BOARD ASSISTANT
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BOARD OF DIRECTORS CLOSED SESSION – MEETING MINUTES – Monday, June 23, 2014
AGENDA ITEM

DISCUSSION
I.
CALL TO ORDER - ESTABLISHMENT OF QUORUM

The meeting – held in the 1 Floor Conference Room of the Palomar Health Administrative Office located at 456 E. Grand Ave Escondido, CA 92025 – was called to order at
6:00 p.m. by Chair Kleiter
CONCLUSION/ACTION
FOLLOW UP
RESPONSIBLE PARTY
FINAL?
st
Quorum comprised of Directors Kleiter, Krider, Kaufman, Greer, Wickes, Yerxa, and Griffith – who attended remotely
NOTICE OF MEETING
The Notice of Meeting was mailed consistent with legal requirements
Pursuant to California Government Code § 54957(b)
Personnel Exception - Appointment of Public Employee
II.
PUBLIC COMMENTS
There were no public comments
III. ADJOURNMENT TO CLOSED SESSION
Chair Kleiter adjourned the meeting to closed session
APPOINTMENT OF PUBLIC EMPLOYEE
Pursuant to California Government Code § 54957(b)
Personnel Exception - Appointment of Public Employee
IV. RE-ADJOURNMENT TO OPEN SESSION
Chair Kleiter re-adjourned the meeting to open session
V. ACTION RESULTING FROM CLOSED SESSION DISCUSSION, IF ANY
MOTION: by Director Krider, 2nd by Director Greer to unanimously appoint
Robert A Hemker as the permanent President and CEO of Palomar Health
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BOARD OF DIRECTORS CLOSED SESSION – MEETING MINUTES – Monday, June 23, 2014
AGENDA ITEM

CONCLUSION/ACTION
DISCUSSION
FOLLOW UP
RESPONSIBLE PARTY
FINAL?
effective August 15. Contract terms to be determined at a later date. Roll-call
voting was utilized. In favor: Directors Kleiter, Krider, Kaufman, Greer, Wickes,
Yerxa and Griffith. Opposed: None. Motion passed unanimously.
VI. FINAL ADJOURNMENT
The meeting was adjourned at 7:00 p.m. by Chair Kleiter
BOARD SECRETARY
LINDA C. GREER, R.N.
BOARD ASSISTANT
DEBBIE HOLLICK
SIGNATURES:
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BOARD OF DIRECTORS CLOSED SESSION – MEETING MINUTES – Monday, June 25, 2014
AGENDA ITEM

DISCUSSION
I.
CALL TO ORDER - ESTABLISHMENT OF QUORUM

The meeting – held in the 1 Floor Conference Room of the Palomar Health Administrative Office located at 456 E. Grand Ave Escondido, CA 92025 – was called to order at
6:00 p.m. by Chair Kleiter
CONCLUSION/ACTION
FOLLOW UP
RESPONSIBLE PARTY
FINAL?
st
Quorum comprised of Directors Kleiter, Krider, Kaufman, Greer, Wickes, Yerxa, and Griffith – who attended remotely
NOTICE OF MEETING
The Notice of Meeting was mailed consistent with legal requirements
Pursuant to California Government Code § 54957(b)
Personnel Exception - Appointment of Public Employee
II.
PUBLIC COMMENTS
There were no public comments
III. ADJOURNMENT TO CLOSED SESSION
Chair Kleiter adjourned the meeting to closed session
APPOINTMENT OF PUBLIC EMPLOYEE
Pursuant to California Government Code § 54957(b)
Personnel Exception - Appointment of Public Employee
IV. RE-ADJOURNMENT TO OPEN SESSION
Chair Kleiter re-adjourned the meeting to open session
V. ACTION RESULTING FROM CLOSED SESSION DISCUSSION, IF ANY
There was no action resulting from closed session
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BOARD OF DIRECTORS CLOSED SESSION – MEETING MINUTES – Monday, June 25, 2014
AGENDA ITEM

CONCLUSION/ACTION
DISCUSSION
VI. FINAL ADJOURNMENT
The meeting was adjourned at 7:00 p.m. by Chair Kleiter
BOARD SECRETARY
LINDA C. GREER, R.N.
BOARD ASSISTANT
DEBBIE HOLLICK
SIGNATURES:
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FOLLOW UP
RESPONSIBLE PARTY
FINAL?
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BOARD OF DIRECTORS CLOSED SESSION – MEETING MINUTES – Monday, June 25, 2014
AGENDA ITEM

DISCUSSION
I.
CALL TO ORDER - ESTABLISHMENT OF QUORUM

The meeting – held in the 1 Floor Conference Room of the Palomar Health Administrative Office located at 456 E. Grand Ave Escondido, CA 92025 – was called to order at
5:31 p.m. by Chair Kleiter
CONCLUSION/ACTION
FOLLOW UP
RESPONSIBLE PARTY
FINAL?
st
Quorum comprised of Directors Kleiter, Krider, Kaufman, Greer, Wickes, Yerxa, and Griffith – who attended remotely
NOTICE OF MEETING
The Notice of Meeting was mailed consistent with legal requirements
Pursuant to California Civ. Code Section 3426.1(d)
REPORT INVOLVING TRADE SECRET
Discussion will concern Arch Health Partners
II.
PUBLIC COMMENTS
There were no public comments
III. ADJOURNMENT TO CLOSED SESSION
Chair Kleiter adjourned the meeting to closed session
APPOINTMENT OF PUBLIC EMPLOYEE
Pursuant to California Civ. Code Section 3426.1(d)
REPORT INVOLVING TRADE SECRET
Discussion will concern Arch Health Partners
IV. RE-ADJOURNMENT TO OPEN SESSION
Chair Kleiter re-adjourned the meeting to open session
V. ACTION RESULTING FROM CLOSED SESSION DISCUSSION, IF ANY
24
1
BOARD OF DIRECTORS CLOSED SESSION – MEETING MINUTES – Monday, June 25, 2014
AGENDA ITEM

CONCLUSION/ACTION
DISCUSSION
FOLLOW UP
RESPONSIBLE PARTY
FINAL?
MOTION: by Director Greer, 2nd by Director Krider to approve Arch Health
Partners request for $3.5 million for budgeted capital expenditures through
June 30, 2015, and a $16.4 million increase to the Line of Credit effective July
1, 2014, for budgeted operating expenses through June 30, 2015 for a total
Line of Credit of $49.9 million. Roll-call voting was utilized. In favor: Directors
Kleiter, Krider, Kaufman, Greer, Wickes, Yerxa and Griffith. Opposed: None.
Motion passed unanimously.
VI. FINAL ADJOURNMENT
The meeting was adjourned at 6:48 p.m. by Chair Kleiter
BOARD SECRETARY
LINDA C. GREER, R.N.
BOARD ASSISTANT
DEBBIE HOLLICK
SIGNATURES:
25
2
D
DR
RA
AFFTT
Quality/Patient Safety Annual Report to the Board – Monday, October 7, 2013 – Open Session
NOTICE OF MEETING
Notice of meeting was mailed consistent with legal requirements.
CALL TO ORDER
6:02 p.m. Chair Ted Kleiter, called to order the open session.
ESTABLISHMENT OF
QUORUM
Quorum comprised of Director Bruce Krider, Director Aeron Wickes, Director Linda Greer, Chair Ted Kleiter, Director Steve
Yerxa, Director Jeff Griffith, and Director Jerry Kaufman.
AGENDA ITEM/
PRESENTER
DISCUSSION
CONCLUSIONS/ACTION
PUBLIC COMMENTS
There were no public comments.
2013 Quality/Patient Safety
Annual Report to the
Board – October 7, 2013
Chair Ted Kleiter turned the agenda over to Linda Greer, Chair
of the Board Quality Review Committee who introduced Opal
Reinbold, Chief Quality Officer.
Opal Reinbold, MBA, Chief Quality Officer, presented the 2013
Quality/Patient Safety Annual Report to the Board Binder. Opal
highlighted the following:
Key Accomplishments 2012 – 2013:
 Patient Safety
 Physician Engagement
 Quality Improvement
 Clinical Resource Management
 Regulatory
Challenges 2012 – 2013:
 Patient Satisfaction
 Reducing Harm to Patients
 Maximizing Decision Support Tools
 Patient Throughput
 Physician Engagement
 Involving Patients and Families in All We Do
Key Focus Areas 2013 – 2014:
 Full Implementation of the VHA/IHI Patient Satisfaction
Best Practices
 Continued Improvement of the Culture of Safety
26
FOLLOW-UP/
RESPONSIBLE
PARTY/FINALIZED
Quality/Patient Safety Annual Report to the Board – Monday, October 7, 2013 – Open Session



Reduce Falls with injuries to zero
Truven Decision Support Data Tool Kit implementation
Continued Success and Support of the Nurse/Physician
Dyads
 Full Implementation of the Patient Flow Best Practices
 Utilize the Joint Commission preparation Process to
Enhance Patient Safety and Quality
 Maximize the Use of All Resources
(Please refer to tabs 1- 4 in the binder.)
A brief discussion ensued supporting the zero falls with injury
goal.
Jerry Kolins, MD, Chief Medical Quality Officer, introduced the
Medical Director/Nurse Manager Dyad (see tab 5, page 1).
Rae Anne Watson, RN, Sunny Bhalla, MD, George Moore, MD
(Kaiser), and Diana Agnello, RN presented 8E & 8W Medical,
Oncology, Palliative Care (see tab 5, page 4).
Keyvan Esmaeili, MD and Virginia Barragan presented Inpatient
Rehabilitation Unit (see tab 5, page 13).
Jaime Rivas, MD and Joanne Barnett, RN presented Emergency
Department Leadership Dyad (see tab 5, page 18).
Meghan Jaremczuk, RN presented 4E and 4NW Surgical Acute
Care, Surgical Progressive (see tab 5, page 22).
Dr. Kolins presented a video featuring himself, Jay Grove, MD
and Meghan Jaremczuk discussing the challenges and solutions
to those challenges on the surgical units.
Roger Acheatel, MD and Mel Russell, RN presented the 5E
Cardiovascular Progressive Care (see tab 5, page 31).
The Board and guests gave a round of applause to the panel for
their presentation.
Open Discussion:
Michael Covert, CEO commented that he would like for the
physician/nurse dyads to continue to meet as a group and
27
Quality/Patient Safety Annual Report to the Board – Monday, October 7, 2013 – Open Session
reinforce each other’s dyads. He would like for these ideas to be
shared across the system so it becomes more hardwired for
these well-established dyads and nurtures the newer dyads and
helps them to grow.
Dr. Kolins commented that during his rounds he has observed
different styles in different locations being used to achieve
excellence, so the key to the successfulness of the dyads may
be in the freedom to use creativity and real time quick problem
solving.
Opal Reinbold, CQO announced that the filming of the panel’s
presentation is being done to make a composite video that can
be taken “on the road” as a training tool for best practices and
lessons learned to all of the dyads.
Chair Ted Kleiter communicated that he was very impressed
with this presentation and asked for comments from the Board.
Bruce Krider stated that this presentation went above and
beyond his expectations.
Dr. Wickes stated that it was a great presentation.
Linda Greer commented that she has seen the progress of
quality through the years and she is thrilled and proud of
everyone. She stated that the binder is very fulfilling and well
organized. She is excited about the hourly rounding for nursing
and rounding with the MDs and feels it will make a difference in
becoming a partner with the physician.
Steve Yerxa stated that this is his third year hearing this report
and every year it gets exponentially better. It was an excellent
report from everyone. Patient care and safety is what it is about,
and it is rewarding to see such progress being made.
Jeff Griffith stated that the crew mentality leads to problem
solving which benefits patients and employees. He feels very
positive and excited about what is happening.
Jerry Kaufman stated that the collaboration and communication
with physicians and nurses is really impressive. It is amazing to
him how fast we have moved forward. It is a great example of
what we can do when we communicate. He congratulated
everyone for having done an outstanding job.
28
Quality/Patient Safety Annual Report to the Board – Monday, October 7, 2013 – Open Session
Chair Ted Kleiter stated that the next challenge is to involve
patients and families in reviewing our quality.
Opal Reinbold, CQO presented the ISBARR video.
MEETNG ADJOURNMENT
7:50 p.m. Chair Ted Kleiter, adjourned meeting.
SIGNATURES


Board Chair
____________________________________________
Ted Kleiter
Secretary to Committee
____________________________________________
Lissa Melan
29
30
ADDENDUM B
31
FINANCIAL PERFORMANCE
FOR MAY 2014
FISCAL YEAR 2014
32
FYTD14 MAY - TABLE OF CONTENTS
EXECUTIVE YEAR-TO-DATE FINANCIAL PERFORMANCE DASHBOARD ....................................................................................................................................... 3
BALANCE SHEET
EXCLUDES G.O. BONDS........................................................................................................................................................................................... 6
INCOME STATEMENTS
MONTH-TO-DATE .................................................................................................................................................................................................. 7
YEAR-TO-DATE ...................................................................................................................................................................................................... 8
CURRENT VS. PRIOR YEAR-TO-DATE .......................................................................................................................................................................... 9
FISCAL YEAR PROJECTION ...................................................................................................................................................................................... 10
MONTHLY TREND................................................................................................................................................................................................. 11
CASH FLOW STATEMENT ............................................................................................................................................................................................. 12
BUDGET COMPARISON STATISTICAL INDICATORS
STATISTICAL INDICATORS ....................................................................................................................................................................................... 13
PAYOR MIX......................................................................................................................................................................................................... 31
SUPPLEMENTAL INFORMATION
BALANCE SHEET
INCLUDES GO BONDS ........................................................................................................................................................................................... 36
YEAR-TO-DATE SUPPLIES EXPENSE ................................................................................................................................................................................ 37
33
FYTD14 MAY - EXECUTIVE FINANCIAL PERFORMANCE DASHBOARD
Year-to-Date
Month-to-Date
Indicator
Actual
3,978
5,927
10,191
329
592
1.49
Adjusted Discharges
Case Mix Adjusted Discharges
Acute Patient Days
Average Daily Census
Observation Discharges
Case Mix Index
Operating Income
Net Income
Operating Expenses (w/o Depr. ) / Adj. Dschg
$ (872,556) $
$ (2,124,486) $
$
12,228 $
Adjusted Discharges
Case Mix Adjusted Discharges
Acute Patient Days
Average Daily Census
Observation Discharges
Case Mix Index
42,623
64,787
107,132
320
6,492
1.52
3
Budget
4,029
5,923
10,682
345
695
1.47
(355,504) $
(1,779,902) $
11,925
43,843
66,641
115,473
345
6,601
1.52
Change
(1.3%)
0.1%
(4.6%)
(4.6%)
(14.82%)
1.36%
(517,052)
(344,584)
(2.5%)
(2.78%)
(2.78%)
(7.22%)
(7.20%)
(1.65%)
0.00%
Operating Income
Net Income
Operating Expenses (w/o Depr. ) / Adj. Dschg
$ (6,047,200) $ (7,073,952) $
$ (21,404,394) $ (22,749,667) $
$
11,970 $
11,969
1,026,752
1,345,273
(0.01%)
EBIDA Margin %
EBIDA $ (Earnings before Dept. & Int. Exp.)
11.12%
10.75%
$ 61,871,678 $ 61,396,566 $
0.37%
475,112
34
4
FYTD14 MAY - EXECUTIVE FINANCIAL PERFORMANCE DASHBOARD
EBIDA
GROWTH
EXPENSES
TRAILING YTD
Dec-13
PAYOR MIX
PATIENT DAYS
47
9
56
1,038
457
44
1,011
77
24
937
439
985
7
6
469
969
1,048
REHAB-ACUTE
MHU
26%
10,559
Mar-14
25%
11%
10%
10%
6%
26%
9,770
Feb-14
25%
11%
11%
10%
6%
24%
13%
9%
24%
10,987
Jan-14
9,315
Dec-13
27%
9,372
Nov-13
26%
14%
10%
12%
24%
13%
Oct-13
9,016
Sep-13
25%
9,068
Aug-13
25%
9,174
Jul-13
26%
11%
10%
9,226
PY AVG
26%
12%
8%
0%
10%
11%
MEDICARE
NICU
400
PMC O/P
600
PMC I/P
800
POM O/P
1,000
POM I/P
30%
3%
10%
9%
8%
8%
1%
3%
4%
3%
4%
30%
10%
5%
32%
9%
5%
32%
10%
5%
4%
31%
9%
4%
5%
31%
9%
3%
50%
MEDI-CAL
MCAL MGD
60%
70%
SELF PAY
80%
MGD CARE
CAP
90%
100%
OTHER
1,447
1,600
1,800
35
PY AVG
-
PMC O/P
4,000
PMC I/P
POM O/P
66
86
90
89
57
96
9,770
49
95
10,019
57
101
10,331
16
10,261
31
112
22
1,694
PHDC I/P
12,125
21
48
119
289
1,802
1,379
14
15
1,708
8,000
PHDC O/P
61
85
386
336
POM I/P
52
69
299
325
305
2,230
6,000
69
84
308
2,252
0
2,000
10,060
2,257
10,099
18
10,229
17
77
Jul-13
10,922
25
1,595
23
9,587
34
79
1,613
1,651
320
Aug-13
10,618
24
21
281
1,548
11,225
34
1,956
1,624
260
Sep-13
1,900
304
Oct-13
1,504
2,023
1,845
296
1,640
986
1,516
Nov-13
1,025 922
Dec-13
2,254
1,524
1,876
Jan-14
955
1,583
937
Feb-14
926
Mar-14
1,434
894
1,503
865
Apr-14
876
1,499
839
111
97
106
May-14
885
92
101
119
120
128
1,400
PHDC I/P
1,590
-
4,734 5,254 5,111 5,078 5,139 4,860 4,703 5,840 4,888 5,252 5,219 5,469
100
97
151
126
125
1,200
PHDC O/P
108
143
158
166
156
179
167
164
161
77
125
85
129
114
198
118
147
169
295
286
280
276
499
471
243
491
452
200
174
236
436
PY AVG
343
248
291
270
551
409
Jul-13
-
203
475
525
464
460
385
359
Aug-13
264
385
385
387
385
Oct-13
Sep-13
133
Nov-13
135
Dec-13
126
499
Jan-14
147
515
368
Feb-14
247
369
Mar-14
569
0
329
Apr-14
6%
3%
6%
40%
32%
4%
11%
26%
5%
3%
5%
10%
TOTAL ER VISITS
Jun-14
May-14
6%
10%
24%
3%
6%
9%
30%
MCAR MGD
6%
9%
11%
20%
6%
8%
11%
27%
2%
6%
6%
8%
TOTAL SURGERIES
Jun-14
9%
9,948
12,000
3%
10%
7%
12%
27%
8%
14%
2,133
LAB/DEL/REC
10,000
Apr-14
2,187
PROGRESSIVE/MED-SURG
8,000
9,732
2,140 2,002
2,120 1,997
ICU/CCU
6,000
May-14
1,219 1,900
4,000
10,191
2,160
2,000
42
970
991
894
404
434
491
451
859
414
727
836
-
876
5,830
816
906
5,825
880
5,745
980
PY AVG
51
945
486
521
1,076
473
849
884
749
7,260
6,206
6,171
937
Jul-13
1,120
6,410
1,162
859
Aug-13
5,842
Oct-13
Sep-13
37
966
Nov-13
1,091
6,428
1,282
Dec-13
40
7,012
1,124
Jan-14
1,084
6,216
1,119
Feb-14
606
6,531
995
Mar-14
940
976
Apr-14
916
Jun-14
Jun-14
May-14
20
10,000
TRAUMA O/P
12,000
TRAUMA I/P
14,000
5
FYTD14 MAY - EXECUTIVE FINANCIAL PERFORMANCE DASHBOARD
Statistical Indicators
Actual
Adjusted Discharges
Average Daily Census
Acute Patient Days
Acute Average Length of Stay
Total Surgeries
Births
ER to Admit Rate
SNF Patient Days
Total ER Visits & Admits
OP Registrations
Budget
Variance
Ratios & Indicators
Var %
42,623
320
43,843
345
(1,220)
(25)
(2.8%)
(7.2%)
107,132
4.02
16,954
4,163
13.4%
115,473
4.11
16,724
4,774
12.6%
(8,341)
(0.09)
230
(611)
0.8%
(7.2%)
(2.2%)
1.4%
(12.8%)
6.3%
42,261
115,659
62,498
47,943
116,072
58,962
(5,682)
(413)
3,536
(11.9%)
(.4%)
6.0%
Actual
EBIDA w/Prop Tax
OEBIDA w/Prop Tax
EBIDA Margin w/Prop Tax
OEBIDA Margin w/Prop Tax
Expenses/Adj. Discharges
SWB/Adj. Discharges
Supplies/Adj. Discharges
Productivity %
Productive FTEs
Paid FTEs
Days Cash-on-Hand
Balance Sheet
Current Month
Budget
61,871,678 61,396,566
58,291,881 58,438,247
11.12%
10.75%
10.48%
10.23%
13,194
13,185
7,474
7,340
1,831
1,769
98.2%
100.0%
3,087.1
3,031.8
3,443.3
3,346.8
77
80
Income Statement
Prior Month
Actual
Budget
Variance
Var %
Gross Revenue
Net Patient Revenue
Total Revenue
2,466,394,726
537,616,729
556,313,221
2,506,037,239
560,169,381
570,998,697
(39,642,513)
(22,552,652)
(14,685,476)
(1.6%)
(4.0%)
(2.6%)
SWB
Supplies
Depreciation
Total Expenses
318,555,817
78,061,018
52,147,414
562,360,421
321,820,100
77,562,796
53,320,532
578,072,649
3,264,283
(498,222)
1,173,118
15,712,228
1.0%
(.6%)
2.2%
2.7%
(6,047,200)
12,191,667
31,128,658
1,521,524
(21,404,394)
(7,073,952)
12,191,667
30,825,701
1,465,775
(22,749,667)
1,026,752
0
(302,957)
55,749
1,345,273
14.5%
0.0%
(1.0%)
3.8%
5.9%
Assets:
Total Cash
98,784,218
Net A/R
114,729,069
Current Assets
241,704,594
Net PPE 1,209,831,727
Total Assets 1,605,712,826
85,998,362
115,098,545
232,146,406
1,213,325,483
1,618,545,229
Liabilities:
Current Liabilities
97,109,349
L-T Liabilities 1,155,952,652
Fund Balance
352,650,825
107,848,757
1,154,348,895
356,347,577
Operating Income
Property Tax
Interest Expense
Interest Income
Net Income
36
Variance
475,112
(146,366)
0.37%
0.25%
(9)
(134)
(62)
(1.6%)
(48.3)
(90.9)
(3)
6
FYTD14 MAY - BALANCE SHEET CONSOLIDATED (EXCLUDES G.O. BONDS)
Current
Month
Prior
Month
Prior Fiscal
Year End
Current
Month
Assets
Current Assets
Cash on Hand
Cash Marketable Securities
Total Cash & Equivalents
$35,339,617
63,444,601
98,784,218
$23,410,985
62,587,377
85,998,362
$19,031,791
99,631,070
118,662,861
Patient Accounts Receivable
Allowance on Accounts
Net Accounts Receivable
331,547,200
(216,818,131)
114,729,069
365,218,918
(250,120,373)
115,098,545
311,476,029
(193,391,186)
118,084,843
Inventories
Prepaid Expenses
Est Third Party Settlements
Other
Total Current Assets
10,123,632
7,221,950
8,614,217
4,624,896
244,097,982
10,131,755
7,140,001
8,614,217
6,494,378
233,477,258
9,775,241
3,129,770
10,412,883
7,532,655
267,598,253
55,894,850
341,201
20,495,968
76,732,019
77,981,205
331,811
21,164,598
99,477,614
67,969,815
329,089
0
68,298,904
Property Plant & Equipment
Accumulated Depreciation
Construction in Process
Net Property Plant & Equipment
1,546,182,686
(369,677,813)
33,326,854
1,209,831,727
1,546,481,986
(365,205,484)
32,048,981
1,213,325,483
1,546,149,850
(318,680,264)
33,110,920
1,260,580,506
Investment in Related Companies
Deferred Financing Costs
Other Non-Current Assets
Total Non-Current Assets
2,132,218
11,786,002
35,533,849
1,336,015,815
2,159,251
11,869,283
33,845,540
1,360,677,171
3,159,356
12,552,853
15,825,246
1,360,416,865
$1,580,113,797
$1,594,154,429
$1,628,015,118
Non-Current Assets
Restricted Assets
Restricted by Donor
Board Designated
Total Restricted Assets
Total Assets
Prior Fiscal
Year End
Liabilities
Current Liabilities
Accounts Payable
Accrued Payroll
Accrued PTO
Accrued Interest Payable
Current Portion of Bonds
Est Third Party Settlements
Other Current Liabilities
Total Current Liabilities
$14,885,856
16,014,419
19,870,985
2,086,583
0
10,743,459
25,691,410
89,292,712
$11,037,354
13,146,852
19,716,776
12,715,877
7,855,000
9,472,422
27,122,351
101,066,632
$26,246,477
17,257,634
19,922,142
4,305,410
7,455,000
8,693,463
23,348,093
107,228,219
Long Term Liabilities
Other LT Liabilities
Bonds & Contracts Payable
Total Long Term Liabilities
763,322
586,649,174
587,412,496
793,513
586,583,178
587,376,691
1,014,105
593,961,506
594,975,611
General Fund Balance
Unrestricted
Restricted for Other Purpose
Board Designated
Total Fund Balance
882,571,420
341,201
20,495,968
903,408,589
884,214,697
331,811
21,164,598
905,711,106
925,482,199
329,089
0
925,811,288
$1,580,113,797
$1,594,154,429
$1,628,015,118
Total Liabilities / Fund Balance
37
Prior
Month
FYTD14 MAY- INCOME STATEMENT: MONTH-TO-DATE
CONSOLIDATED – ADJUSTED DISCHARGES
Actual
Statistics:
Admissions - Acute
Admissions - SNF
Patient Days - Acute
Patient Days - SNF
ALOS - Acute
ALOS - SNF
Adjusted Discharges
Revenue:
Gross Revenue
Deductions from Rev
Net Patient Revenue
Other Oper Revenue
Total Net Revenue
2,473
44
10,191
3,577
4.13
67.49
3,978
$
Expenses:
Salaries, Wages & Contr Labor
Benefits
Supplies
Prof Fees & Purch Svc
Depreciation
Other
Total Expenses
Property Tax Revenue 1
Non-Operating Income 12
EBIDA Margin
OEBIDA Margin w/o Prop Tax
OEBIDA Margin with Prop Tax
$
2,597
51
10,682
3,713
4.11
72.80
4,029
233,618,360 $ 231,072,712 $
(182,036,723)
(179,518,702)
51,581,637
51,554,010
984,999
994,882
52,566,636
52,548,892
23,613,014
6,404,580
7,311,587
8,227,355
4,797,381
3,085,275
53,439,192
Net Inc Before Non-Oper Income
Net Income (Loss)
Budget
23,703,201
5,696,170
7,132,906
8,388,580
4,857,608
3,125,931
52,904,396
7
Variance
Volume
Rate/Eff
Variance
Actual
$/Adjusted Discharges
Budget
Variance
(124)
(7)
(491)
(136)
0.02
(5.31)
(51)
2,545,648
(2,518,021)
27,627
(9,883)
17,744
90,187
(708,410)
(178,681)
161,225
60,227
40,656
(534,796)
F $
U
F
U
F
(2,924,971) $
2,272,389
(652,582)
(12,593)
(665,176)
5,470,619 $ 58,727.59 $ 57,352.37 $
(4,790,410)
(45,760.87)
(44,556.64)
680,209
12,966.73
12,795.73
2,710
247.61
246.93
682,920
13,214.34
13,042.66
F
U
U
F
F
F
U
300,041
72,103
90,290
106,185
61,489
39,569
669,676
(209,854)
(780,513)
(268,971)
55,040
(1,262)
1,087
(1,204,472)
5,935.90
1,610.00
1,838.01
2,068.21
1,205.98
775.58
13,433.68
5,883.15
1,413.79
1,770.39
2,082.05
1,205.66
775.86
13,130.90
1,375.22
(1,204.23)
170.99
0.68
171.67
(52.75)
(196.21)
(67.61)
13.84
(0.32)
0.27
(302.78)
(872,556)
(355,504)
(517,052) U
4,500
(521,552)
(219.35)
(88.24)
(131.11)
1,108,333
(2,360,263)
1,108,333
(2,532,731)
172,468 F
(14,030)
32,060
14,030
140,408
278.62
(593.33)
275.09
(628.63)
3.53
35.30
(2,124,486) $
(1,779,902) $
(534.06) $
(441.77) $
10.38%
7.47%
9.57%
11.19%
8.57%
10.68%
(344,584) U $
(0.81%)
(1.10%)
(1.11%)
F= Favorable variance
U= Unfavorable variance
1= Property Tax Revenue does not include G.O. Bonds Levy
2= Interest Expense does not include G.O. Bonds Interest
38
22,530 $
(367,114) $
(92.29)
FYTD14 MAY - INCOME STATEMENT: YEAR-TO-DATE
CONSOLIDATED – ADJUSTED DISCHARGES
Actual
Statistics:
Admissions - Acute
Admissions - SNF
Patient Days - Acute
Patient Days - SNF
ALOS - Acute
ALOS - SNF
Adjusted Discharges
Revenue:
Gross Revenue
Deductions from Rev
Net Patient Revenue
Other Oper Revenue
Total Net Revenue
26,603
538
107,132
42,261
4.02
65.83
42,623
252,132,045
66,423,772
78,061,018
84,725,003
52,147,414
28,871,169
562,360,421
Net Inc Before Non-Oper Income
Property Tax Revenue 1
Non-Operating Income 2
EBIDA Margin
OEBIDA Margin w/o Prop Tax
OEBIDA Margin with Prop Tax
28,097
725
115,473
47,943
4.11
53.33
43,843
$ 2,466,394,726 $ 2,506,037,239 $
(1,928,777,997)
(1,945,867,858)
537,616,729
560,169,381
18,696,492
10,829,316
556,313,221
570,998,697
Expenses:
Salaries, Wages & Contr Labor
Benefits
Supplies
Prof Fees & Purch Svc
Depreciation
Other
Total Expenses
Net Income (Loss)
Budget
$
259,240,626
62,579,474
77,562,796
91,199,878
53,320,532
34,169,343
578,072,649
8
Variance
Volume
Rate/Eff
Variance
$/Adjusted Discharges
Budget
Variance
(1,494)
(187)
(8,341)
(5,682)
(0.09)
12.50
(1,220)
(39,642,513)
17,089,861
(22,552,652)
7,867,176
(14,685,476)
7,108,581
(3,844,298)
(498,222)
6,474,875
1,173,118
5,298,174
15,712,228
U $
F
U
F
U
(69,734,403) $ 30,091,890 $ 57,865.35 $
54,146,814
(37,056,953)
(45,252.05)
(15,587,589)
(6,965,063)
12,613.30
(301,343)
8,168,519
438.65
(15,888,931)
1,203,455
13,051.95
196,844
829,908
(141.88)
(161.35)
19.47
(339,252)
775,453
339,252
(456,932)
286.03
(646.34)
278.08
(635.62)
7.96
(10.72)
(502.18) $
(518.89) $
1,026,752 F
12,191,667
(27,548,861)
12,191,667
(27,867,382)
318,521 F
(21,404,394) $
(22,749,667) $
11.12%
8.29%
10.48%
10.75%
8.10%
10.23%
1,345,273 F $
0.37%
0.19%
0.25%
F= Favorable variance
U= Unfavorable variance
39
633,045 $
712,228 $
5,915.40
1,558.40
1,831.43
1,987.78
1,223.46
677.36
13,193.83
5,912.93
1,427.35
1,769.10
2,080.15
1,216.17
779.36
13,185.06
706.00
(869.41)
(163.41)
191.65
28.23
7,213,776
1,741,372
2,158,306
2,537,779
1,483,727
950,815
16,085,775
(7,073,952)
(105,195)
(5,585,670)
(2,656,528)
3,937,096
(310,609)
4,347,359
(373,547)
57,159.35 $
(44,382.63)
12,776.71
247.00
13,023.71
F
U
U
F
F
F
F
(6,047,200)
1= Property Tax Revenue does not include G.O. Bonds Levy
2= Interest Expense does not include G.O. Bonds Interest
Actual
(2.47)
(131.05)
(62.33)
92.37
(7.29)
102.00
(8.76)
16.71
FYTD14 MAY - INCOME STATEMENT: CURRENT VS. PRIOR YEAR-TO-DATE
CONSOLIDATED – ADJUSTED DISCHARGES
Variance
May 14 YTD
Statistics:
Admissions - Acute
Admissions - SNF
Patient Days - Acute
Patient Days - SNF
ALOS - Acute
ALOS - SNF
Adjusted Discharges
Revenue:
Gross Revenue
Deductions from Rev
Net Patient Revenue
Other Oper Revenue
Total Net Revenue
26,603
538
107,132
42,261
4.02
65.83
42,623
252,132,045
66,423,772
78,061,018
84,725,003
52,147,414
28,871,169
562,360,421
Net Inc Before Non-Oper Income
Property Tax Revenue 1
Non-Operating Income 2
EBIDA Margin
OEBIDA Margin w/o Prop Tax
OEBIDA Margin with Prop Tax
24,679
1,114
101,330
66,921
4.11
60.56
39,648
$ 2,466,394,726 $ 2,184,660,964 $
(1,928,777,997)
(1,662,608,048)
537,616,729
522,052,916
18,696,492
10,797,561
556,313,221
532,850,477
Expenses:
Salaries, Wages & Contr Labor
Benefits
Supplies
Prof Fees & Purch Svc
Depreciation
Other
Total Expenses
Net Income (Loss)
May 13 YTD
$
Variance
Volume
9
$/Adjusted Discharges
Rate/Eff
Actual FY14 Actual FY13
Variance
1,924
(576)
5,802
(24,660)
(0.09)
5.27
2,975
281,733,762
(266,169,949)
15,563,813
7,898,931
23,462,744
F $ 163,926,714 $
U
(124,754,312)
F
39,172,403
F
810,198
F
39,982,601
117,807,048 $ 57,865.35 $ 55,101.42 $
(141,415,637)
(45,252.05)
(41,934.22)
(23,608,590)
12,613.30
13,167.19
7,088,733
438.65
272.34
(16,519,857)
13,051.95
13,439.53
264,172,366
67,278,083
75,121,120
75,555,495
52,042,466
28,547,793
562,717,323
12,040,321
854,311
(2,939,898)
(9,169,508)
(104,948)
(323,376)
356,902
F
F
U
U
U
U
F
(19,822,256)
(5,048,232)
(5,636,737)
(5,669,330)
(3,905,023)
(2,142,093)
(42,223,669)
31,862,577
5,902,543
2,696,839
(3,500,178)
3,800,075
1,818,717
42,580,571
(6,047,200)
(29,866,846)
23,819,646 F
(2,241,068)
26,060,714
(141.88)
(753.30)
611.42
12,191,667
(27,548,861)
12,191,667
(23,155,977)
(4,392,884) U
914,806
(1,737,516)
(914,806)
(2,655,368)
286.03
(646.34)
307.50
(584.04)
(21.46)
(62.30)
(21,404,394) $
(40,831,156) $
19,426,762 F $
(3,063,778) $
22,490,540 $
(502.18) $ (1,029.84) $
11.12%
8.29%
10.48%
7.14%
4.16%
6.45%
3.98%
4.13%
4.03%
F= Favorable variance
U= Unfavorable variance
1= Property Tax Revenue does not include G.O. Bonds Levy
2= Interest Expense does not include G.O. Bonds Interest
40
5,915.40
1,558.40
1,831.43
1,987.78
1,223.46
677.36
13,193.83
6,662.94
1,696.88
1,894.70
1,905.66
1,312.61
720.03
14,192.83
2,763.93
(3,317.82)
(553.89)
166.31
(387.58)
747.54
138.48
63.27
(82.12)
89.16
42.67
999.00
527.66
FYTD14 MAY - INCOME STATEMENT: FISCAL YEAR PROJECTION
CONSOLIDATED – ADJUSTED DISCHARGES
11 Act + 1 Bud
Statistics:
Admissions - Acute
Admissions - SNF
Patient Days - Acute
Patient Days - SNF
Adjusted Discharges
Revenue:
Gross Revenue
Deductions from Rev
Net Patient Revenue
Other Oper Revenue
Total Net Revenue
29,127
588
117,483
45,855
46,540
$
Expenses:
Salaries, Wages & Contr Labor
Benefits
Supplies
Prof Fees & Purch Svc
Depreciation
Other
Total Expenses
Property Tax Revenue 1
Non-Operating Income 2
$
30,621
775
125,824
51,537
47,760
2,690,240,168 $ 2,729,882,681 $
(2,102,747,247)
(2,119,837,108)
587,492,921
610,045,573
19,672,336
11,805,160
607,165,257
621,850,733
275,119,922
72,037,811
84,983,158
92,874,848
57,005,022
31,940,603
613,961,364
Net Inc Before Non-Oper Income
Net Income (Loss)
FY 14 Budget
282,228,503
68,193,514
84,484,936
99,349,723
58,178,140
37,238,777
629,673,593
Variance
Volume
Variance
Rate/Eff
$/Adjusted Discharges
Actual
Budget
Variance
(1,494)
(187)
(8,341)
(5,682)
(1,220)
(39,642,513)
17,089,861
(22,552,652)
7,867,176
(14,685,476)
7,108,581
(3,844,298)
(498,222)
6,474,875
1,173,118
5,298,174
15,712,228
U $
F
U
F
U
826,923
(146.03)
(163.80)
17.77
(339,740)
776,598
339,740
(458,077)
285.78
(646.40)
278.48
(636.56)
7.30
(9.84)
(506.65) $
(521.87) $
15.23
13,300,000
(30,083,363)
13,300,000
(30,401,884)
318,521 F
(23,579,470) $
(24,924,744) $
1,345,273 F $
636,687 $
(100,774)
(5,586,259)
(2,656,338)
3,937,047
(313,007)
4,346,932
(372,398)
708,587 $
5,911.47
1,547.87
1,826.02
1,995.59
1,224.86
686.30
13,192.12
5,909.31
1,427.84
1,768.95
2,080.19
1,218.14
779.71
13,184.12
646.56
(796.31)
(149.75)
175.52
25.77
199,830
1,026,752 F
41
30,090,671 $ 57,804.90 $ 57,158.35 $
(37,060,082)
(45,181.51)
(44,385.20)
(6,969,411)
12,623.40
12,773.15
8,168,732
422.70
247.18
1,199,321
13,046.09
13,020.33
7,209,355
1,741,962
2,158,116
2,537,828
1,486,125
951,242
16,084,627
(7,822,860)
F= Favorable variance
U= Unfavorable variance
(69,733,184) $
54,149,943
(15,583,241)
(301,556)
(15,884,797)
F
U
U
F
F
F
F
(6,796,107)
1= Property Tax Revenue does not include G.O. Bonds Levy
2= Interest Expense does not include G.O. Bonds Interest
10
(2.17)
(120.03)
(57.08)
84.59
(6.73)
93.40
(8.00)
FYTD14 MAY - INCOME STATEMENT: CURRENT YEAR TREND
CONSOLIDATED
Jul
Statistics:
Admissions - Acute
Admissions - SNF
Patient Days - Acute
Patient Days - SNF
ALOS - Acute
ALOS - SNF
Adjusted Discharges
Revenue:
Gross Revenue
Deductions from Rev
Net Patient Revenue
Other Oper Revenue
Total Net Revenue
2,311
43
9,124
5,466
3.97
51.57
3,867
$
Expenses:
Salaries, Wages & Contr Labor
Benefits
Supplies
Prof Fees & Purch Svc
Depreciation
Other
Total Expenses
Net Inc Before Non-Oper Income
Property Tax Revenue 1
Non-Operating Income12
Net Income (Loss)
EBIDA Margin
OEBIDA Margin w/o Prop Tax
OEBIDA Margin with Prop Tax
Aug
$
220,887,303 $
(167,967,281)
52,920,022
964,356
53,884,378
Sep
2,323
52
9,044
3,897
3.91
46.95
3,873
217,226,828 $
(166,640,306)
50,586,522
1,036,527
51,623,049
23,530,644
6,673,813
7,389,287
8,352,115
4,956,574
2,977,765
53,880,198
22,136,700
6,233,749
7,181,924
8,261,013
4,947,529
2,804,863
51,565,778
4,180
57,271
Oct
2,317
52
8,986
3,829
3.85
81.47
3,759
210,963,387 $
(164,825,934)
46,137,453
3,711,135
49,848,588
22,629,978
6,198,245
6,510,236
7,879,093
4,448,348
2,675,652
50,341,552
(492,964)
Nov
2,494
54
9,906
3,826
4.04
64.85
3,876
234,825,988 $
(185,082,521)
49,743,467
1,015,155
50,758,622
22,972,363
5,904,093
7,296,628
7,577,415
4,759,922
2,103,813
50,614,234
144,388
Dec
2,334
47
9,336
3,559
3.95
77.37
3,752
215,056,684 $
(167,514,812)
47,541,872
980,941
48,522,813
22,834,299
5,822,820
6,475,443
7,478,322
4,759,059
1,955,553
49,325,496
Jan
2,443
41
9,497
3,453
3.80
80.30
3,893
219,997,081 $
(173,889,450)
46,107,631
1,006,335
47,113,966
22,344,212
5,582,819
7,338,190
6,513,013
4,760,543
1,975,724
48,514,501
(802,683)
(1,400,535)
1,108,333
(2,576,791)
1,108,333
(2,768,091)
1,108,333
(2,372,889)
1,108,333
(2,584,851)
1,108,333
(2,521,652)
1,108,333
(2,388,401)
(1,464,278) $
(1,602,487) $
(1,757,520) $
(1,332,130) $
(2,216,002) $
(2,680,603) $
11.78%
9.21%
11.26%
11.95%
9.69%
11.84%
11.09%
7.93%
10.16%
12.48%
9.66%
11.85%
10.88%
8.15%
10.44%
10.39%
7.13%
9.48%
1= Property Tax Revenue does not include G.O. Bonds Levy
2= Interest Expense does not include G.O. Bonds Interest
42
11
2,723
57
10,987
3,773
4.10
73.98
4,150
244,390,833 $
(194,511,620)
49,879,213
1,013,796
50,893,009
23,444,663
6,014,601
7,154,371
7,652,254
4,690,328
1,887,854
50,844,071
48,938
1,108,333
(2,141,842)
(984,571) $
12.98%
9.31%
11.49%
Feb
Mar
2,306
52
9,770
3,401
4.23
60.73
3,622
216,335,653 $
(170,699,970)
45,635,683
998,303
46,633,986
21,950,209
5,173,976
6,812,762
6,887,454
4,687,010
2,538,319
48,049,730
2,490
51
10,559
3,772
4.12
78.58
4,000
232,172,711 $
(184,632,883)
47,539,828
5,763,592
53,303,420
23,536,139
6,171,470
7,564,764
7,879,958
4,698,667
3,703,734
53,554,732
Apr
May
2,389
45
9,732
3,708
4.08
74.16
3,853
220,919,898 $
(170,976,492)
49,943,406
1,221,354
51,164,760
23,139,764
6,243,664
7,025,825
8,017,009
4,642,053
3,162,615
52,230,930
2,473
44
10,191
3,577
4.13
67.49
3,978
YTD
26,603
538
107,132
42,261
4.02
65.83
42,623
233,618,360 $ 2,466,394,726
(182,036,723)
(1,928,777,997)
51,581,637
537,616,729
984,999
18,696,492
52,566,636
556,313,221
23,613,014
6,404,580
7,311,587
8,227,355
4,797,381
3,085,275
53,439,192
252,132,045
66,423,772
78,061,018
84,725,003
52,147,414
28,871,169
562,360,421
(1,415,744)
(251,312)
(1,066,170)
(872,556)
(6,047,200)
1,108,333
(2,575,556)
1,108,333
(2,575,239)
1,108,333
(2,683,288)
1,108,333
(2,360,263)
12,191,667
(27,548,861)
(2,882,967) $
(1,718,218) $
(2,641,125) $
(2,124,486) $
(21,404,394)
9.89%
7.01%
9.39%
10.79%
8.34%
10.42%
9.55%
6.99%
9.16%
10.38%
7.47%
9.57%
11.12%
8.29%
10.48%
12
FYTD14 MAY - CASH FLOW STATEMENT
May
CASH FLOWS FROM OPERATING ACTIVITIES:
Income (Loss) from operations
Adjustments to reconcile change in net assets to net cash
provided by operating activities:
Depreciation Expense
Provision for bad debts
Changes in operating assets and liabilities:
Patient accounts receivable
Property Tax and other receivables
Inventories
Prepaid expenses and other current assets
Accounts payable
Accrued compensation
Estimated settlement amounts due third-party payors
Other current liabilities
Net cash provided by operating activities
CASH FLOWS FROM INVESTING ACTIVITIES:
Net (purchases) sales of investments
Income (Loss) on investments
Investment in affiliates
Net cash used in investing activities
CASH FLOWS FROM NON-CAPITAL FINANCING ACTIVITIES:
Receipt of G.O. Bond Taxes
Receipt of District Taxes
Net cash used in non-capital financing activities
CASH FLOWS FROM CAPITAL AND RELATED FINANCING ACTIVITIES:
Acquisition of property plant and equipment
Deferred Financing Costs
G.O. Bond Interest paid
Revenue Bond Interest paid
Payments of Long Term Debt
Net cash used in activities
$
(872,556)
YTD
$
4,797,381
6,257,018
(6,047,200)
52,147,414
103,244,305
(5,887,542)
(20,035)
8,123
(54,916)
3,848,502
3,021,776
1,271,037
(313,757)
12,055,031
(99,888,526)
(14,752,342)
(348,391)
(8,787,194)
(9,929,101)
(1,294,372)
3,848,662
23,267,477
41,460,732
19,575,669
288,439
(1,685,643)
18,178,465
24,416,895
1,528,893
(18,285,473)
7,660,315
2,312,537
1,723,000
4,035,537
16,222,344
14,120,717
30,343,061
(1,290,353)
125,218
0
(13,290,075)
(7,885,191)
(22,340,401)
(2,328,493)
1,228,390
(12,220,223)
(31,574,833)
(18,261,124)
(63,156,282)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS
11,928,632
16,307,826
CASH AND CASH EQUIVALENTS - Beginning of period
23,410,985
19,031,791
CASH AND CASH EQUIVALENTS - End of period
43
$ 35,339,617
$
35,339,617
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
ADJUSTED DISCHARGES - CONSOLIDATED
13
4,500
50,000
45,000
4,000
40,000
3,500
35,000
3,000
30,000
2,500
25,000
2,000
20,000
1,500
15,000
1,000
10,000
500
5,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
2,989
859
3,867
2,994
858
3,873
2,866
876
3,759
2,965
894
3,876
2,854
878
3,752
2,984
886
3,893
3,141
987
4,148
44
2,747
854
3,622
3,025
954
4,000
2,949
884
3,853
3,015
949
3,978
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
32,529
9,879
42,623
34,148
9,695
43,843
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
PATIENT DAYS – ACUTE
14
12,000
140,000
120,000
10,000
100,000
8,000
80,000
6,000
60,000
4,000
40,000
2,000
20,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
7,066
2,108
9,174
7,173
1,895
9,068
7,139
1,877
9,016
7,816
2,132
9,948
7,377
1,995
9,372
7,277
2,038
9,315
8,611
2,376
45
10,987
7,669
2,101
9,770
8,389
2,170
10,559
7,729
2,003
9,732
8,032
2,159
10,191
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
84,278
22,854
107,132
93,680
21,793
115,473
-
MEDICARE
17
4915
35-
14
15
19
6
30
14
6-
602
30
636
KAISER
MEDI-CAL
SELF PAY
CMS
8
-
26
19
1-
33
11
17
500
600
OTHER
606
700
COVERED CA
689
668
17
5-
14
400
46
36
9
215
221
162
MANAGED CARE
300
584
3-
9
216
192
200
13
4-
13
4-
554
5
209
6
35
17
12-
9
44-
2
532
175
488
182
187
218
100
581
5
7
185
19
213
174
201
185
165
240
PY AVG
592
566
39
254
190
Jul-13
221
Aug-13
182
146
Sep-13
206
151
Oct-13
237
142
130
147
132
Nov-13
133
Dec-13
153
Jan-14
140
Feb-14
149
Mar-14
19
22
133
Apr-14
15
161
-
May-14
-
Jun-14
136
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
OBSERVATION DISCHARGES
800
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
AVERAGE LENGTH OF STAY – ACUTE
16
4.25
4.65
4.15
4.45
4.05
3.95
4.25
3.85
4.05
3.75
3.85
3.65
3.55
3.65
3.45
3.45
3.35
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
3.92
4.27
3.99
3.87
4.11
3.92
3.88
3.81
3.86
4.03
4.16
4.06
3.98
3.88
3.96
3.74
3.99
3.81
4.12
4.02
47
4.10
4.24
4.17
4.23
4.18
3.90
4.12
4.11
3.97
4.08
4.13
4.11
4.13
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
3.25
North
3.25
FY2014
Budget
4.02
4.03
4.02
4.13
4.02
4.11
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
AVERAGE DAILY CENSUS – ACUTE
17
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
228
68
296
231
61
293
238
63
301
252
69
321
246
67
312
235
66
300
Jan-14
278
77
48
354
Feb-14
Mar-14
Apr-14
May-14
274
75
349
271
70
341
258
67
324
259
70
329
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
0
South
0
North
50
Cons
50
South
100
North
100
Cons
150
South
150
North
200
Cons
200
South
250
North
250
Cons
300
South
300
North
350
Cons
350
South
400
North
400
FY2014
Budget
252
68
320
280
65
345
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
SURGERIES – INPATIENT ONLY
18
900
9,000
800
8,000
700
7,000
600
6,000
500
5,000
400
4,000
300
3,000
200
2,000
100
1,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
598
158
756
562
166
728
605
156
761
654
179
833
553
167
720
545
164
709
Jan-14
607
161
49
768
Feb-14
Mar-14
Apr-14
May-14
545
169
714
576
174
750
621
147
768
660
147
807
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
6,526
1,788
8,314
6,103
1,922
8,025
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
SURGERIES – OUTPATIENT ONLY
19
900
10,000
9,000
800
8,000
700
7,000
600
6,000
500
5,000
400
4,000
300
3,000
200
2,000
100
1,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
564
286
850
534
280
814
494
243
737
504
295
799
518
270
788
513
291
804
Jan-14
536
264
50
800
Feb-14
Mar-14
Apr-14
May-14
510
203
713
497
248
745
487
236
723
527
247
774
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
5,684
2,863
8,547
5,174
3,449
8,623
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
SURGERIES - CVS
20
16
100
90
14
80
12
70
10
60
8
50
40
6
30
4
20
2
10
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
7
0
7
6
0
6
6
0
6
8
0
8
8
0
8
11
0
11
Jan-14
15
0
51
15
Feb-14
Mar-14
Apr-14
May-14
7
0
7
8
0
8
8
0
8
9
0
9
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
93
0
93
76
0
76
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
TOTAL SURGERIES
21
1,800
18,000
1,600
16,000
1,400
14,000
1,200
12,000
1,000
10,000
800
8,000
600
6,000
400
4,000
200
2,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
1,169
444
1,613
1,102
446
1,548
1,105
399
1,504
1,166
474
1,640
1,079
437
1,516
1,069
455
1,524
1,158
425
52
1,583
1,062
372
1,434
1,081
422
1,503
1,116
383
1,499
1,196
394
1,590
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
12,303
4,651
16,954
11,353
5,371
16,724
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
OUTPATIENT REGISTRATIONS (EXCLUDES LAB)
22
8,000
70,000
7,000
60,000
6,000
50,000
5,000
40,000
4,000
30,000
3,000
20,000
2,000
10,000
1,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
3,384
1,958
5,342
3,302
1,904
5,206
3,030
1,792
4,822
3,726
2,118
5,844
3,087
1,720
4,807
3,545
2,042
5,587
4,156
2,286
53
6,442
3,507
2,015
5,522
4,025
2,287
6,312
4,182
2,308
6,490
3,998
2,126
6,124
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
39,942
22,556
62,498
33,033
25,929
58,962
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
ER VISITS (INCLUDES TRAUMA) – OUTPATIENT ONLY
23
12,000
120,000
10,000
100,000
8,000
80,000
6,000
60,000
4,000
40,000
2,000
20,000
North
South
Cons
C/Day
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
6,872
2,120
8,992
290
6,823
1,997
8,820
285
6,808
2,140
8,948
298
6,957
2,002
8,959
289
6,526
1,876
8,402
280
6,348
2,254
8,602
277
8,111
2,230
54
10,341
334
6,754
1,900
8,654
309
7,233
2,187
9,420
304
7,143
2,133
9,276
309
7,526
2,252
9,778
315
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
77,101
23,091
100,192
299
77,187
24,262
101,449
303
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
ER ADMISSIONS (INCLUDES TRAUMA) – INPATIENT ONLY
24
1,800
18,000
1,600
16,000
1,400
14,000
1,200
12,000
1,000
10,000
800
8,000
600
6,000
400
4,000
200
2,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
933
304
1,237
1,019
260
1,279
1,032
281
1,313
1,052
320
1,372
1,079
289
1,368
1,081
336
1,417
1,398
386
55
1,784
1,101
305
1,406
1,177
325
1,502
1,043
299
1,342
1,139
308
1,447
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
12,054
3,413
15,467
11,434
3,189
14,623
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
TOTAL ER VISITS (INCLUDES TRAUMA & ADMISSIONS)
25
14,000
140,000
12,000
120,000
10,000
100,000
8,000
80,000
6,000
60,000
4,000
40,000
2,000
20,000
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
7,805
2,424
10,229
7,842
2,257
10,099
7,840
2,421
10,261
8,009
2,322
10,331
7,605
2,165
9,770
7,429
2,590
10,019
9,509
2,616
56
12,125
7,855
2,205
10,060
8,410
2,512
10,922
8,186
2,432
10,618
8,665
2,560
11,225
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
89,155
26,504
115,659
88,621
27,451
116,072
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
ER CONVERSION (ER ADMISSIONS AS %-AGE OF ER VISITS)
26
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
12.0%
12.5%
12.1%
13.0%
11.5%
12.7%
13.2%
11.6%
12.8%
13.1%
13.8%
13.3%
14.2%
13.3%
14.0%
14.6%
13.0%
14.1%
14.7%
14.8%
14.7%
57
14.0%
13.8%
14.0%
14.0%
12.9%
13.8%
12.7%
12.3%
12.6%
13.1%
12.0%
12.9%
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
8.5%
Cons
8.5%
South
9.5%
North
9.5%
Cons
10.5%
South
10.5%
North
11.5%
Cons
11.5%
South
12.5%
North
12.5%
Cons
13.5%
South
13.5%
North
14.5%
Cons
14.5%
South
15.5%
North
15.5%
FY2014
Budget
13.5%
12.9%
13.4%
12.9%
11.6%
12.6%
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
TRAUMA CASES
27
160
1,400
140
1,200
120
1,000
100
800
80
600
60
400
40
200
20
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
100
0
100
130
0
130
141
0
141
117
0
117
111
0
111
116
0
116
Jan-14
103
0
58
103
Feb-14
Mar-14
Apr-14
May-14
106
0
106
111
0
111
93
0
93
118
0
118
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
1,246
0
1,246
1,180
0
1,180
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
TRAUMA ADMISSIONS
28
140
1,200
120
1,000
100
800
80
600
60
400
40
200
20
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
77
0
77
112
0
112
119
0
119
101
0
101
96
0
96
95
0
95
Jan-14
89
0
89
59
Feb-14
Mar-14
Apr-14
May-14
85
0
85
86
0
86
69
0
69
84
0
84
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
1,013
0
1,013
1,003
0
1,003
FYTD14 MAY - BUDGET COMPARISON: STATISTICAL INDICATORS
DELIVERIES
29
500
6,000
450
5,000
400
350
4,000
300
250
3,000
200
2,000
150
100
1,000
50
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
277
91
368
282
116
398
288
124
412
292
105
397
253
121
374
233
98
331
237
142
379
234
113
347
252
122
374
272
115
387
266
130
396
60
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
0
North
0
FY2014
Budget
2,886
1,277
4,163
3,663
1,111
4,774
FYTD14 APRIL - BUDGET COMPARISON: STATISTICAL INDICATORS
KAISER AVERAGE DAILY CENSUS
30
100.00
100.00
90.00
90.00
80.00
80.00
70.00
70.00
60.00
60.00
50.00
50.00
40.00
40.00
30.00
30.00
20.00
20.00
10.00
10.00
Jul-13
North
South
Cons
68.20
Aug-13
64.10
Sep-13
67.40
Oct-13
62.70
Nov-13
66.80
Dec-13
66.90
Jan-14
69.90
61
Feb-14
64.00
Mar-14
56.30
Apr-14
65.80
May-14
77.00
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
-
North
-
FY2014
65.80
Budget
87.40
FYTD14 MAY - PAYOR MIX
31
PAYOR MIX
Jun-14
May-14
24%
14%
10%
8%
3%
27%
10%
Apr-14
26%
Mar-14
25%
11%
10%
10%
6%
26%
Feb-14
25%
11%
11%
10%
6%
24%
Jan-14
24%
13%
9%
Dec-13
27%
Nov-13
26%
Oct-13
27%
Sep-13
25%
Aug-13
25%
12%
14%
13%
6%
6%
30%
8%
6%
9%
9%
PY AVG
26%
12%
8%
MEDICARE
30%
MCAR MGD
6%
6%
10%
40%
MEDI-CAL
3%
3%
3%
5%
6%
50%
62MGD
MCAL
10%
3%
11%
10%
26%
8%
11%
20%
6%
32%
26%
10%
24%
5%
Jul-13
0%
2%
6%
11%
11%
9%
7%
12%
11%
10%
4%
9%
8%
8%
1%
3%
4%
3%
4%
30%
10%
5%
32%
9%
5%
32%
10%
5%
4%
31%
9%
4%
5%
31%
9%
3%
60%
SELF PAY
70%
MGD CARE
80%
CAP
OTHER
90%
100%
FYTD14 MAY - CASE MIX INDEX
32
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
1.39
1.40
1.39
1.40
1.30
1.38
1.40
1.30
1.38
1.39
1.40
1.39
1.34
1.36
1.34
1.41
1.37
1.40
1.38
1.34
1.37
1.45
1.37
1.43
1.45
1.30
1.42
1.46
1.27
1.42
1.38
1.30
1.37
63
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
1.25
South
1.25
North
1.30
Cons
1.30
South
1.35
North
1.35
Cons
1.40
South
1.40
North
1.45
Cons
1.45
South
1.50
North
1.50
FY2014
Budget
1.40
1.34
1.39
1.38
1.40
1.38
FYTD14 MAY - CASE MIX INDEX (EXCLUDES DELIVERIES)
33
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
1.51
1.55
1.52
1.51
1.50
1.51
1.36
1.60
1.40
1.51
1.60
1.53
1.58
1.58
1.58
1.50
1.53
1.51
1.46
1.55
1.48
64
1.56
1.55
1.56
1.56
1.48
1.55
1.58
1.45
1.55
1.49
1.51
1.49
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
1.25
Cons
1.25
South
1.30
North
1.30
Cons
1.35
South
1.35
North
1.40
Cons
1.40
South
1.45
North
1.45
Cons
1.50
South
1.50
North
1.55
Cons
1.55
South
1.60
North
1.60
Cons
1.65
South
1.65
North
1.70
Cons
1.70
South
1.75
North
1.75
FY2014
Budget
1.51
1.54
1.52
1.50
1.56
1.52
FYTD14 MAY - CASE MIX INDEX
MEDICARE
34
1.80
1.80
1.75
1.75
1.70
1.70
1.65
1.65
1.60
1.55
1.60
1.50
1.55
1.45
1.50
1.40
1.45
1.35
North
South
Cons
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Apr-14
May-14
1.71
1.51
1.65
1.60
1.57
1.59
1.63
1.57
1.61
1.74
1.70
1.73
1.76
1.63
1.72
1.64
1.58
1.63
1.59
1.61
65
1.60
1.66
1.61
1.64
1.62
1.50
1.58
1.69
1.40
1.61
1.55
1.72
1.60
Jun-14
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
North
Cons
South
1.40
North
1.30
FY2014
Budget
1.65
1.58
1.63
1.64
1.58
1.62
SUPPLEMENTAL INFORMATION
66
35
FYTD14 MAY - BALANCE SHEET
CONSOLIDATED (INCLUDES G.O. BONDS)
Current
Month
Prior
Month
36
Prior Fiscal
Year End
Current
Month
Assets
Current Assets
Cash on Hand
Cash Marketable Securities
Total Cash & Cash Equivalents
$35,339,617
63,444,601
98,784,218
$23,410,985
62,587,377
85,998,362
$19,031,791
99,631,070
118,662,861
Patient Accounts Receivable
Allowance on Accounts
Net Accounts Receivable
331,547,200
(216,818,131)
114,729,069
365,218,918
(250,120,373)
115,098,545
311,476,029
(193,391,186)
118,084,843
Inventories
Prepaid Expenses
Est Third Party Settlements
Other
Total Current Assets
10,123,632
7,221,950
8,614,217
2,231,508
241,704,594
10,131,755
7,140,001
8,614,217
5,163,526
232,146,406
9,775,241
3,129,770
10,412,883
7,611,610
267,677,208
75,194,979
341,201
20,495,968
96,032,148
94,968,632
331,811
21,164,598
116,465,041
86,074,690
329,089
0
86,403,779
Property Plant & Equipment
Accumulated Depreciation
Construction in Process
Net Property Plant & Equipment
1,546,182,686
(369,677,813)
33,326,854
1,209,831,727
1,546,481,986
(365,205,484)
32,048,981
1,213,325,483
1,546,149,850
(318,680,264)
33,110,920
1,260,580,506
Investment in Related Companies
Deferred Financing Costs
Other Non-Current Assets
Total Non-Current Assets
2,132,218
20,478,290
35,533,849
1,364,008,232
2,159,251
20,603,508
33,845,540
1,386,398,823
3,159,356
21,706,680
15,825,246
1,387,675,567
$1,605,712,826
$1,618,545,229
$1,655,352,775
Non-Current Assets
Restricted Assets
Restricted by Donor
Board Designated
Total Restricted Assets
Total Assets
Prior Fiscal
Year End
Liabilities
Current Liabilities
Accounts Payable
Accrued Payroll
Accrued PTO
Accrued Interest Payable
Current Portion of Bonds
Est Third Party Settlements
Other Current Liabilities
Total Current Liabilities
$14,885,856
16,014,419
19,870,985
6,521,048
3,382,172
10,743,459
25,691,410
97,109,349
$11,037,354
13,146,852
19,716,776
16,115,830
11,237,172
9,472,422
27,122,351
107,848,757
$26,246,477
17,257,634
19,922,142
9,593,962
10,262,977
8,693,463
23,348,093
115,324,748
Long Term Liabilities
Other LT Liabilities
Bonds & Contracts Payable
Total Long Term Liabilities
763,322
1,155,189,330
1,155,952,652
793,513
1,153,555,382
1,154,348,895
1,014,105
1,148,726,979
1,149,741,084
331,813,656
341,201
20,495,968
352,650,825
334,851,168
331,811
21,164,598
356,347,577
389,957,854
329,089
0
390,286,943
$1,605,712,826
$1,618,545,229
$1,655,352,775
Bonds & Contracts Payable
Unrestricted
Restricted for Other Purpose
Board Designated
Total Fund Balance
Total Liabilities / Fund Balance
67
Prior
Month
FYTD14 MAY - SUPPLIES EXPENSE: YEAR-TO-DATE
Account
631000
642000
634000
633000
639000
632000
636000
635000
640000
644000
646100
645000
637000
647000
641000
648000
646000
649000
638000
643000
650000
Description
Prosthesis
Supplies Food/Meat
Supplies Surgery General
Supplies Surgical Pack
Supplies Radioactive
Sutures/Surgical Needles
Supplies Oxygen/Gas
Supplies Anesthesia Material
Supplies X-ray Material
Supplies Linen
Supplies Forms
Supplies Cleaning
Supplies IV Solutions
Supplies Employee Apparel
Supplies Other Medical
Instruments/Minor Equipment
Supplies Office/Administration
Other Minor Equipment
Supplies Pharmaceutical
Supplies Food Other
Other Non Medical
TOTAL Supplies
37
Actual
20,211,855
3,162,410
9,308,861
2,702,472
682,549
2,415,857
148,196
46,578
14,468
19,944
326,464
545,690
674,868
186,586
13,633,592
630,591
590,166
1,252,527
11,821,179
893,076
8,793,089
68
78,061,018
Budget
15,896,438
662,358
7,863,903
2,340,261
498,749
2,233,687
114,548
37,700
24,459
37,854
351,646
583,291
785,225
325,449
13,952,980
1,027,122
1,199,741
1,972,111
13,365,503
3,040,476
11,249,295
77,562,796
Variance
(4,315,417)
(2,500,052)
(1,444,958)
(362,211)
(183,800)
(182,170)
(33,648)
(8,878)
9,991
17,910
25,182
37,601
110,357
138,863
319,388
396,531
609,575
719,584
1,544,324
2,147,400
2,456,206
(498,222)
ADDENDUM C
69
Palomar Medical Center
Administrative Services Agreement
Medical Staff – Chief of Staff
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 25, 2014
FROM:
Gerald E. Bracht, Chief Administrative Officer
Background:
Palomar Medical Center Medical Staff Chief of Staff and
Chief of Staff Elect are provided a stipend for services performed as required by
the Medical Staff Bylaws. These agreements serve to document the relationship
of the Medical Staff Chief of Staff and Chief of Staff Elect to Palomar Health, and
the duties to be performed as consideration for the stipend to assure compliance
with Federal regulations.
Presented is the Contract for the following:
Chief of Staff – Richard C. Engel, M.D.
Budget Impact:
$2500 for current FY14. Budgeted item FY 15.
Staff Recommendation:
Approval
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
Form A - Engel 04-22-14.doc
70
PALOMAR HEALTH - AGREEMENT ABSTRACT
Section
Reference
Term/Condition
TITLE
Term/Condition Criteria
Chief of Staff Agreement – Amendment
AGREEMENT DATE
Original: January 1, 2012
Amendment: April 22, 2014
Chief of Staff – Richard C. Engel, M.D., Palomar Medical Center
Medical Staff and Palomar Health
PARTIES
PURPOSE
To provide administrative services on behalf of Palomar Medical
Center Medical Staff in accordance with Medical Staff Bylaws,
Plans and policies
SCOPE OF SERVICES
As per duties defined in Palomar Medical Center Medical Staff
Bylaws and policies.
PROCUREMENT
METHOD
TERM
 Request For Proposal
RENEWAL
None
TERMINATION
As described under §5
COMPENSATION
METHODOLOGY
BUDGETED
Monthly.
EXCLUSIVITY
 NO
JUSTIFICATION
This position is elected by the Medical Staff in accordance with
Medical Staff Bylaws.
POSITION POSTED
 YES  NO
Methodology & Response:
Elected by the Palomar Medical Center Medical Staff
 Discretionary
January 1, 2012 – December 31, 2014
□ YES  NO – IMPACT: Additional amount per month to be paid
by Palomar Health for May and June. To be included in budget
effective July, 2014.
 YES – EXPLAIN:
ALTERNATIVES/IMPACT N/A
DUTIES
Defined in the Palomar Medical Center Medical Staff Bylaws
COMMENTS
APPROVALS REQUIRED
 VP CFO CEO BOD Committee FINANCE BOD
71
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 25, 2014
BY:
Gerald Bracht, Chief Administrative Officer, PMC
BACKGROUND:
Galen Inpatient Physicians has been contracted to provide
hospitalist services on a 24/7 basis to Palomar Health effective 4-1-13. The physicians
providing coverage under the agreement are well respected by both the medical and
hospital staff. Additionally these physicians serve on multiple hospital committees in
support of initiatives to improve patient safety and care and overall operational
efficiency. This second amendment reflects a revision to Exhibit “C” Performance Goals
Opportunity for Additional Compensation.
BUDGET IMPACT: Budgeted
STAFF RECOMMENDATION:
Approval.
COMMITTEE QUESTIONS:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
72
PALOMAR HEALTH - AGREEMENT ABSTRACT
Section
Reference
Term/Condition
TITLE
Preamble
AGREEMENT DATE
Preamble
Term/Condition Criteria
Hospital Medicine Services Agreement
Original: April 1, 2013
Amendment 2: April 28, 2014
1) Palomar Health
2) Galen Inpatient Physicians, Inc.
To provide adult medicine hospitalist services.
Medicine on-call and rounding professional services for
unassigned patients at PH hospitals.
Preamble
PARTIES
Recitals D
Section 1
PURPOSE
SCOPE OF SERVICES
 Request For Proposal
8.1
PROCUREMENT
METHOD
TERM
8.1
RENEWAL
8.2, 8.3
8.4
TERMINATION
5.2
COMPENSATION
METHODOLOGY
BUDGETED
Automatic renewal for additional 1 year terms unless otherwise
terminated.
- Either party may terminate with 180 days written notice.
- Either party may terminate immediately for cause as defined in
the agreement.
Monthly based on Fair Market Value
X Discretionary
April 1, 2013 through March 31, 2015
 YES NO - IMPACT: Yes
EXCLUSIVITY
 NO
JUSTIFICATION
Required adult medicine on-call coverage for the emergency
room for unassigned patients at PH hospitals.
 YES  NO – METHODOLOGY & RESPONSE:
AGREEMENT NOTICED
 YES – EXPLAIN:
ALTERNATIVES/IMPACT Contract with National Hospitalists provider.
Exhibit B
DUTIES
COMMENTS
APPROVALS REQUIRED
 Provision for Staff Education
 Provision for Medical Staff Education
 Provision for participation in Quality Improvement
 Provision for participation in budget process development
This second amendment will replace Exhibit “C”.
VP CFO CEO BOD Committee
BOD
73
TO:
Board Finance Committee
MEETING DATE:
:HGQHVGD\-XQH, 2014
FROM:
Gerald Bracht, Chief Administrative Officer
BACKGROUND: Palomar Medical Center is required to identify an active Medical Director
to provide oversight for the Diagnostic Cardiology Services program, according to the State of
California Code of Regulations, Title 22, and by the TJC, Hospital Bylaws, and Medical Staff
Bylaws or by the Medical Staff Executive Committee. The position requires a physician
member of the active medical staff who has special interest and specific knowledge in the
assessment, diagnosis and treatment of patients with cardiovascular disease and/or problems.
The Medical Director shall be qualified as a board-certified cardiologist by the American Board
of Internal Medicine, Cardiovascular Diseases and be in good standing with that organization.
Dr. Malek has served as Medical Director and this amendment will reflect an increase in hourly
compensation in order to fall within fair market value.
BUDGET IMPACT: None
STAFF RECOMMENDATION:
COMMITTEE QUESTIONS:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
74
PALOMAR HEALTH - AGREEMENT ABSTRACT
Section
Reference
Term/Condition
AGREEMENT DATE
Term/Condition Criteria
Medical Directorship Agreement – Cardiology
Mikhail Malek M.D., First Amendment
April 1, 2014
PARTIES
Palomar Health & Mikhail Malek, M.D.
PURPOSE
Medical Directorship Agreement – Cardiology Services
SCOPE OF SERVICES
Perform Medical Director services and functions as required by
State, by The Joint Commission, Hospital Bylaws and Medical
Staff Executive Committee.
PROCUREMENT
METHOD
TERM
 Request For Proposal
RENEWAL
Roll-over for additional year.
TERMINATION
Either Party may terminate this Agreement without cause,
expense or penalty, effective Ninety (90) days after written notice
of termination is given to the other Party.
COMPENSATION
METHODOLOGY
BUDGETED
Compensation increase to fall within fair market value.
EXCLUSIVITY
JUSTIFICATION
 NO X YES – EXPLAIN: Medical Director is singular position
for the service line
Regulatory required for Cardiology services.
AGREEMENT NOTICED
 YES
TITLE
X Discretionary
One year with automatic roll-over
X YES
 NO – IMPACT:
 NO
Methodology & Response:
ALTERNATIVES/IMPACT NA
Duties
x Provision for Staff Education
x Provision for Medical Staff Education
x Provision for participation in Quality Improvement
x Provision for participation in budget process development
COMMENTS
APPROVALS REQUIRED
 VP  CFO  CEO  BOD Committee ____________  BOD
75
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 2, 2014
FROM:
Gerald E. Bracht, Chief Administrative Officer
Background:
Palomar Medical Center Medical Staff Chief of Staff and
Chief of Staff Elect are provided a stipend for services performed as required by
the Medical Staff Bylaws. These agreements serve to document the relationship
of the Medical Staff Chief of Staff and Chief of Staff Elect to Palomar Health, and
the duties to be performed as consideration for the stipend to assure compliance
with Federal regulations.
Presented is the Contract for the following:
Chief of Staff Elect – Jeffrey Rosenburg, M.D.
Budget Impact:
$1250 for current FY14. Budgeted item FY 15.
Staff Recommendation:
Approval
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
76
PALOMAR HEALTH - AGREEMENT ABSTRACT
Section
Reference
Term/Condition
TITLE
Term/Condition Criteria
Chief of Staff Elect Agreement – Amendment
AGREEMENT DATE
Original: January 1, 2012
Amendment: April 22, 2014
Chief of Staff Elect – Jeffrey Rosenburg, M.D., Palomar Medical
Center Medical Staff and Palomar Health
PARTIES
PURPOSE
To provide administrative services on behalf of Palomar Medical
Center Medical Staff in accordance with Medical Staff Bylaws,
Plans and policies
SCOPE OF SERVICES
As per duties defined in Palomar Medical Center Medical Staff
Bylaws and policies.
PROCUREMENT
METHOD
TERM
 Request For Proposal
RENEWAL
None
TERMINATION
As described under §5
COMPENSATION
METHODOLOGY
BUDGETED
Monthly.
EXCLUSIVITY
 NO
JUSTIFICATION
This position is elected by the Medical Staff in accordance with
Medical Staff Bylaws.
POSITION POSTED
 YES  NO
Methodology & Response:
Elected by the Palomar Medical Center Medical Staff
 Discretionary
January 1, 2012 – December 31, 2014
□ YES  NO – IMPACT: Additional amount per month to be paid
by Palomar Health for May and June. To be included in budget
effective July, 2014.
 YES – EXPLAIN:
ALTERNATIVES/IMPACT N/A
DUTIES
Defined in the Palomar Medical Center Medical Staff Bylaws
COMMENTS
APPROVALS REQUIRED
 VP CFO CEO BOD Committee FINANCE BOD
77
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 25, 2014
FROM:
Gerald Bracht, Chief Administrative Officer
Palomar Medical Center
Background:
The Robotics Program at PH has seen significant growth
over the past several years. As the program continues to grow it is important that
PH have strong physician leadership and involvement to improve the program for
our patients and the community. With the healthcare reimbursement changes,
the robotics team needs strong physician leadership to assist in developing
efficiency strategies that will improve resource utilization over the next year. This
Amendment will increase hourly compensation to fall within fair market value.
Budget Impact: Budgeted.
Staff Recommendation: Approval
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
78
PALOMAR HEALTH - AGREEMENT ABSTRACT
Section
Reference
Term/Condition
TITLE
Term/Condition Criteria
Medical Directorship Agreement – Robotic Surgery
AGREEMENT DATE
Original: November 1, 2011
Amendment: May 1, 2014
PARTIES
Kris Ghosh, M.D., and Palomar Health
PURPOSE
As PH continues to grow the Robotics program, the organization
needs active medical staff leadership to manage education,
development and infrastructure development for the program to
ensure effective growth over the next year.
SCOPE OF SERVICES
The scope of services includes education, program development
(cost savings, process improvement, etc), marketing and
community education.
PROCUREMENT
METHOD
TERM
RENEWAL
 Request For Proposal
TERMINATION
30-day termination
COMPENSATION
METHODOLOGY
Hourly compensation increased to fall within fair market value
effective 5-1-14.
BUDGETED
x YES
 NO – IMPACT:
EXCLUSIVITY
 NO
 YES – EXPLAIN: N/A
JUSTIFICATION
Budgeted for FY14
AGREEMENT NOTICED
 YES
x Discretionary
1 year
Automatically renewed for 1 year terms
x NO
Methodology & Response:
ALTERNATIVES/IMPACT
Duties
x Provision for Staff Education
x Provision for Medical Staff Education
x Provision for participation in Quality Improvement
x Provision for participation in budget process development
COMMENTS
APPROVALS REQUIRED
 VP  CFO  CEO  BOD Committee ____________  BOD
79
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 25, 2014
FROM:
Gerald Bracht, Chief Administrative Officer
Palomar Medical Center
BACKGROUND:
NCEMA has provided emergency and trauma on-call coverage services
for Palomar Health for a number of years. With the opening of the new PMC, the Physicians
Advisory Council for the Downtown Campus identified the need for certain specialties to
provide on-call coverage for the obstetrical program located there. NCEMA has agreed to
provide on-call OB Consultative Services for the specialties of General Surgery, Vascular
Surgery and Urology in order to provide and coordinate continuous high quality and efficient
patient care at the Palomar Health Downtown Campus.
The scope of services in the original OB Consultative Services agreement has been correct to
read “OBGYN” instead of the original “OB”.
BUDGET IMPACT:
Budgeted
STAFF RECOMMENDATION:
Approval.
COMMITTEE QUESTIONS:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
80
PALOMAR HEALTH - AGREEMENT ABSTRACT
Section
Reference
Term/Condition
Term/Condition Criteria
TITLE
Preamble
OB Consultative Services Agreement
AGREEMENT DATE
Preamble
Original: August 19, 2012
Amendment #1: February 18, 2014
Amendment #2: May 9, 2014
PARTIES
Recital
1) Palomar Health
2) North County Emergency Medical Associates Inc. (NCEMA)
PURPOSE
Recital
1) With the opening of the new PMC, the Physicians Advisory
Council for the Downtown Campus identified the need for
certain specialties to provide on-call coverage for the
obstetrical program located there. NCEMA will provide OB
Consultative Services for the specialties of General Surgery,
Vascular Surgery and Urology in order to provide and
coordinate continuous high quality and efficient patient care at
PHDC.
2) Amendment #2 added Gynecological Services to the Scope
of Services
SCOPE OF SERVICES
Section 1
1) General Surgery, Vascular Surgery and Urology specialty
consultations
2) Unassigned inpatients requiring specialty consultations
PROCUREMENT
 Request For Proposal
 Discretionary
METHOD
TERM
Section 6
1) Effective August 19, 2012 thru February 28, 2014
2) Amendment #1 extended the expiration date to July 8, 2014
RENEWAL
Section 5
None, parties agree to meet no later than (5) five months prior to
expiration of this agreement to review utilization and discuss
dissolution or continuation of this on-call coverage.
Section 7
TERMINATION
1) Either party may terminate without cause at any time (1) one
year after the effective date of this agreement by written
notice.
2) Either party may terminate immediately for cause as defined
in the agreement.
COMPENSATION
METHODOLOGY
BUDGETED
EXCLUSIVITY
JUSTIFICATION
Fair market value analysis
AGREEMENT NOTICED
 YES  NO – IMPACT:
 NO  YES – EXPLAIN: Specialty Physician
PH has established specialty physician on-call panels in order to
assure the availability of adequate physician coverage for OB
patients at PHDC.
 YES  NO
Methodology & Response:
ALTERNATIVES/IMPACT
Duties
 Provision for Staff Education - NA
 Provision for Medical Staff Education - NA
 Provision for participation in Quality Improvement - NA
 Provision for participation in budget process development
- NA
COMMENTS
APPROVALS REQUIRED
 VP  CFO  CEO  BOD Committee ____________  BOD
81
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 25, 2014
FROM:
David A. Tam, M.D., Chief Administrative Officer
Background:
Pomerado Hospital Department Chairs are provided a
stipend for services performed as required by the Medical Staff Bylaws. The
agreements serve to document the relationship of the Department Chairs to
Palomar Health, and the duties to be performed as consideration for the stipend
to assure compliance with federal regulations.
Presented is the Administrative Services Contract Agreement for the following
Department Chair:
Chair, Pathology Department – Lachlan Macleay, Jr., M.D.
The attached Agreement Abstract is for 20 months ending on December 31,
2016.
Budget Impact:
None.
Staff Recommendation:
Approval.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
82
PALOMAR HEALTH – AGREEMENT ABSTRACT
Section
Reference
Term/Condition
TITLE
Term/Condition Criteria
Medical Staff Department Chair Agreement Amendments
AGREEMENT DATE
May 1, 2014
PARTIES
PURPOSE
Chair, Pathology Department – Lachlan Macleay, Jr., M.D.
To provide administrative services on behalf of Pomerado
Hospital Medical Staff in accordance with Medical Staff Bylaws,
plans, and policies.
SCOPE OF SERVICES
As per duties defined in the Pomerado Hospital Medical Staff
Bylaws and policies.
PROCUREMENT
METHOD
TERM
 Request For Proposal
RENEWAL
As described in Section 4 of the Agreement.
TERMINATION
As described in Section 5 of the Agreement.
COMPENSATION
METHODOLOGY
Monthly.
BUDGETED
 YES  NO – IMPACT:
EXCLUSIVITY
 NO
JUSTIFICATION
These positions are elected or appointed by the Medical Staff in
accordance with Medical Staff Bylaws.
AGREEMENT NOTICED
 YES  NO
Methodology & Response:
Elected/Appointed by the Pomerado Hospital Medical Staff
 Discretionary
May 1, 2014-December 31, 2015
 YES – EXPLAIN:
ALTERNATIVES/IMPACT N/A
Duties
Defined in the Pomerado Hospital Medical Staff Bylaws.
COMMENTS
APPROVALS REQUIRED
 VP  CFO  CEO  BOD Committee Finance  BOD
83
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 25, 2014
FROM:
Robert Trifunovic, MD MBA
Physician Integration and Recruitment Officer
Background:
The Palomar Health (PH) community lacks an adequate
number of Neurologists as verified by Medical Development Specialists (MDS), a
national consulting firm that specializes in physician manpower studies. PH has
an established physician recruitment program and has allocated resources to
attract additional Neurologists to relocate to Inland North San Diego County.
North County Neurology Associates Medical Group has signed the Palomar
Health Physician Recruitment Agreement in order for Dr C. Tracy Wang to join
the group and establish a practice in Escondido and Poway. She intends to
begin practicing in August, 2014.
Budget Impact:
Budgeted
Staff Recommendation:
Approval of the Physician Recruitment Agreement
with The North County Neurology Associates Medical Group and Palomar Health
for the recruitment and relocation of Dr C. Tracy Wang.
Approval is
recommended by the full Board of Directors.
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
84
PALOMAR HEALTH - AGREEMENT ABSTRACT
Section
Reference
Term/Condition
TITLE
Term/Condition Criteria
Physician Recruitment Agreement - Neurology
AGREEMENT DATE
Original Agreement: April 9, 2014
PARTIES
1) Palomar Health
2) North County Neurology Associates Medical Group
Recitals
PURPOSE
Provide recruitment/relocation assistance to the group above to
enable the joining of C. Tracy Wang, MD to their practice after
the determination of community need.
Article 4
SCOPE OF SERVICES
2.1; 2.2;
6.2; 6.4; 6.5
Recruitment
procedure
D.2
Article 8;
9.17
Article 2
TERM
RENEWAL
Dr C. Tracy Wang will establish a full-time Neurology Practice in
the Escondido and Poway area, and will participate in
government-funded programs.
There will be a one year (1) assistance period followed by a two
year (2) forgiveness period.
None available
TERMINATION
Contract stipulates conditions for termination
COMPENSATION
METHODOLOGY
For monthly income guarantee group will submit monthly report
of expenses and collections. For relocation and start-up cost
assistance group will submit receipts.
BUDGETED
X YES
EXCLUSIVITY
X NO  YES – EXPLAIN: Government prohibits hospitals from
requiring physician to exclusively have privileges or make
referrals only to their hospital. The contract does include a noncompete clause.
Medical Development Specialists, a national consulting firm who
performed our Physician Manpower Study, completed an
analysis which confirmed there is a justifiable community need for
this recruitment
5.1; 9.19
PHYSICIAN
MANPOWER STUDY
 NO – IMPACT: None
EXTERNAL FINANCIAL
VERIFICATION
X YES  NO
Methodology: MGMA was used to develop
a pro forma for the practice to establish the contract value to
cover income guarantee and cash flow needs. MGMA also was
used for the market comparison to establish an appropriate
income guarantee.
LEGAL COUNSEL
REVIEW
X Yes  NO Exceptions to the standard agreement are noted in
redlined agreement. Legal Counsel has approved this contract.
APPROVALS REQUIRED
X Director, Physician & Business Development X General
Counsel X CFO X CEO X BOD Finance Committee X BOD
85
TO:
Board Finance Committee
MEETING DATE:
Wednesday, June 25, 2014
FROM:
Sheila Brown, Chief Administrative Officer, PHDC and Villa
Pomerado
Background:
The California Code of Regulations, Title 22, Section 72305,
requires a Medical Director for Villa Pomerado Skilled Nursing Facility. Following
Dr. Teja Singh’s resignation as of March 20, 2014, Dr. Mohinderpal Thaper
accepted the position of Medical Director starting May 7, 2014 through May 7,
2016.
Budget Impact:
Budgeted
Staff Recommendation:
Approval
Committee Questions:
COMMITTEE RECOMMENDATION:
Motion:
Individual Action:
Information:
Required Time:
86
PALOMAR HEALTH – AGREEMENT ABSTRACT
Section
Reference
Term/Condition
TITLE
Term/Condition Criteria
Medical Director Agreement
AGREEMENT DATE
May 7, 2014
PARTIES
Dr. Mohinderpal Thaper
PURPOSE
Define the Villa Pomerado Medical Director Role
SCOPE OF SERVICES
Provide medical oversight to the Villa Pomerado patient
population. In order to meet the requirements as outlined in Title
22 Section 72305 Physician Services-Medical Director.
 Request For Proposal
 Discretionary
PROCUREMENT
METHOD
TERM
2 years: May 7, 2014 – May 7, 2016
RENEWAL
TERMINATION
COMPENSATION
METHODOLOGY
Monthly stipend for 29 hours
BUDGETED
 YES  NO – IMPACT:
EXCLUSIVITY
NO
JUSTIFICATION
AGREEMENT NOTICED
Requirement of Licensing Title 22
 YES  NO
Methodology & Response:
 YES – EXPLAIN:
ALTERNATIVES/IMPACT
Duties
 Provision for Staff Education
 Provision for Medical Staff Education
 Provision for participation in Quality Improvement
 Provision for participation in budget process development
COMMENTS
APPROVALS REQUIRED
 VP  CFO  CEO  BOD Committee ____________  BOD
87
ADDENDUM D
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
ADDENDUM E
107
108
MEM OR AND UM
Debbie Hollick, Executive Assistant to the Board
TO:
FROM: Nicolette Borseth, Assistant to the Board Governance Audit
& Compliance Committee
DATE:
Thursday June 5, 2014
RE:
Governance Audit & Compliance – Meeting Summary
INFORMATION ITEMS:


Internal Audit Activities
o Drew Sutter and Hiral Shah from Deloitte & Touche, LLP presented the Palomar Health
Planned Scope and Timing of the Audit of the 2014 Financial Statements.
 Deloitte presented and defined the scope of their audit. The audit will review
the financial statements of Palomar Health District for the year ending June 30,
2014.
 Deloitte will plan and perform the audit to obtain reasonable assurance about
whether the financial statements are free of material misstatement caused by
error of fraud.
 Michael Covert explained that the Information Technology Department was
outsourced to Cerner last year and would like Deloitte to analyze whether
Cerner has completed obligations under the agreement.
o District Audit Officer Tom Boyle discussed Audit activities including on-going audit
projects for 2014 and on-going analytic tests that are performed monthly.
Compliance and Ethics Summary
o Corporate Compliance Officer Mark Neu discussed the Compliance and Ethics
Committee items for June 2014.
ACTION ITEMS:

No action items.
109
MEMORANDUM
TO:
Debbie Hollick, Executive Assistant to the Board
FROM: Denise Baker, Executive Assistant to the Chief Human Resources Officer
DATE:
June 19, 2014
RE:
Board Human Resources Committee – June 18, 2014 Meeting Summary
INFORMATION ITEMS: N/A
INTERNAL COMMMUNICATIONS STRATEGY
Nina Kim, Manager of Internal Communications and Leslie Solomon, Director of Organizational
Development presented the FY14-17 Internal Communications Strategic Plan. Their vision is that
“Palomar Health’s Internal Communications will connect staff to its mission and business direction and
build two way communication with leadership.”
In order to achieve this vision, the following three imperatives have been targeted:
Imperative One: Strategy and Business Direction
Internal Communications will help build a personal connection for every employee to the organization’s
mission so that every employee knows why their work is important and how it connects to outcomes;
Imperative Two: Trust in Leadership
Internal communications will build trust between leaders and their staff by driving two-way
communication and providing tools that ensure accurate and reliable information sharing; and
Imperative Three: Building Engagement
Internal communications will build momentum and engagement for excellence in quality, safety and
compassionate service.
Feedback provided on employee engagement surveys will be the main metric used to track the success
of these imperatives.
AAPL UPDATE:
The Academy of Applied Physician Leadership recently celebrated its one year milestone. Leslie
Solomon explained the 5 modules that led to the culmination of 19 group presentations at the First
Annual AAPL Gala held June 11th. The modules, which included engagement, change and culture,
emotional intelligence, dyad partnership and building teams, gave physicians the tools they needed to
successfully create, plan and present their project. The camaraderie and respect demonstrated by the
physicians at the gala was inspiring and culturally, a huge step in the right direction for the organization.
Board member Steve Yerxa commented that “the level of participation by everyone involved is the
biggest deal that’s happened at Palomar in a while. It is remarkable.”
110
Board HR Committee Summary
June 18, 2014 Meeting
Leslie also shared plans for FY15 AAPL Cohort and a sneak peek at FY16 Cohort #2. They are looking
to incorporate mentoring into the next modules. Joe Molinoski, Facilitator, shared that “apple slices,”
helpful pieces of information such as agenda templates, will be readily available to assist in furthering
skills.
ACTION ITEMS None
111
MEM OR AND UM
Debbie Hollick, Executive Assistant to the Board
TO:
FROM: Tammy Chung, Assistant to the Board Community Relations Committee
DATE:
June 6, 2014
RE:
Board Community Relations Committee – June 4, 2014 Meeting Summary
INFORMATION ITEMS:

Elly Garner, Government Relations Manager, presented an update on State Legislative Bills that potentially will affect
Palomar Health in 2014 and discussed the bills that are of high interest to Palomar Health.
State Legislative Bill -- AB 1805 (Skinner)

This bill reverses the 10% Medi-Cal reimbursement cuts authorized by AB 97 (2011); eliminating retroactive
payments cuts (“clawback”) for Medi-Cal reimbursements between July 2011-Sept. 2013.

This bill prevents the state from withholding $4 million from PH for the distinct-part skilled nursing facility
“overpayments.”
SEIU-UHW Initiative Concepts

Hospitals Pricing Initiative.
o Would limit private hospitals’ charges (excluding children’s hospitals) to individual patents to 25% above
actual cost.

Hospital Executive Compensation.
o Would cap not-for-profit hospital and health systems executives’ total compensation at the President’s salary
($450,000).
Negotiations
•
SEIU filed initiatives in November 2013
•
Negotiations between CHA and SEIU began in early 2014
•
On May 5, CHA and SEIU signed a final agreement
•
Initiative signatures were not filed with the State AG
CHA/SEIU Agreement
•
Some California Hospitals signed an MOU or Code of Conduct with SEIU to improve relations
•
Created a $100M joint advocacy committee
•
Contingent access for SEIU to hospital employees in 2017
Remaining November Healthcare Initiatives
•
Medi-Cal Funding & Accountability Act of 2014.
o Earlier this week, the Attorney General's office announced that the Medi-Cal Hospital Fee Ballot Initiative's
signatures revealed duplication meaning the initiative will not qualify for the November 2014 ballot. Because
of the duplication, all signatures must be verified to qualify and the state has 30 days to verify those
signatures. The 30- day period will extend beyond the deadline to qualify for the November 2014 ballot will
mean the initiative will be pushed to the November 2016 ballot.
•
Only two of the five potential initiatives (mentioned at the April meeting) will be on this fall's ballot - the insurance rate
regulation and MICRA initiatives.


Tina Pope, Manager, Service Excellence provided a detailed report on the Patient and Family Advisor Council. She
also shared videos from two Patient Voice Meetings, one lending itself to a learning/improvement opportunity for Palomar
Health and the other extremely complimentary.

Janet Klitzner, Director of Marketing and The HealthSource informed the Committee that the HealthSource
magazine is now available in digital format. Visit www.PalomarHealth.org/HealthSource, choose a publication and select
“View Digital Magazine.” We currently have 10 issues loaded. The new format provides realistic page flipping and fast
content delivery. You can share, create bookmarks, view thumbnails, zoom in and download the magazine from a
desktop computer or mobile device. Readers can also subscribe to receive future issues electronically as well as USPS
or both. Our goal is to have all issues available on line.
ACTION ITEMS:

Minutes – Wednesday, April 2, 2014: Approved
112
MEM OR AND UM
FROM:
Debbie Hollick, Assistant to the Board Strategic & Facilities Planning Committee
DATE:
6/22/14
RE:
6/17/14 Board Strategic & Facilities Planning Meeting Summary
INFORMATION ITEMS:

The June 17, 2014 Board Strategic & Facilities Planning meeting was called as a full board meeting to review
the FY2014 Year-end Strategic & Operational Initiatives updates.

Chief Medical Informatics Officer Ben Kanter and Director Information Technology Prudence August
presented the Information Technology review, sharing the many accomplishments that have been achieved
this year such as the ITWorks transition to Cerner, completion of Phase 1 for the Enterprise Data Warehouse
and the integration of Sotera Vital Sign with the electronic medical record.

Chief Administrative Officer POM David Tam and Director Facilities Operations POM Dan Farrow provided
and update on the Innovation move.

Chief Administrative Officer POM David Tam and guests from the Integra Center and San Diego Balboa
Wounded Warrior Detachment discussed a possible partnership program with Palomar Health that would
enable wounded veterans to receive rehabilitation services in a civilian setting.
ACTION ITEMS:
There were no action items
113
MEMORANDUM
TO:
Debbie Hollick, Executive Assistant to the Board
FROM:
Christine Breese, Assistant to the Board Quality Committee
DATE:
June 30, 2014
RE:
Board Quality Review Committee – June 16, 2014 Meeting Summary
INFORMATION ITEMS:

Dan Farrow, Director of Facilities Operations gave a presentation to the Committee on the 2013
accomplishments for Emergency Management and Environment of Care. Several projects that were of focus
during 2013 as well as the goals for 2014 were also reviewed.

Lisha Wiese, Disaster Preparedness Coordinator updated the Committee on the recent fires that occurred in
the Escondido area. Based on the formal Disaster Review that was completed by leaders in the health
system, there were several positive observations noted as well as opportunities for improvement which the
organization will be working to improve. Palomar Health did an outstanding job responding to the region-wide
event.

Valerie Martinez, Director of Quality, Patient Safety and Infection Control provided an update on Infection
Control measures and outcomes for 2013. Palomar Health is below benchmark on most measures and has
maintained zero infections in several areas.

Barbara Buesch, Stroke Program Coordinator presented the key activities and outcomes for the Stroke
program during 2013. Procedures for processing patients that have a stroke while in one of the hospitals was
also reviewed as well as success and failure rates with administering t-PA (Tissue Plasminogen Activator).

Elissa Hamilton, Director of Home Health Services provided an update on the Performance Improvement
activities for Home Health during 2013 and as well as the key areas of focus for the next reporting period in
2014.

Opal Reinbold, Chief Quality Officer informed the Committee that due to the fires in May, the Patient Safety
Conference has been rescheduled to July 1st.
ACTION ITEMS:

None
114
MEM OR AND UM
Debbie Hollick, Executive Assistant to the Board
TO:
FROM: Tanya Howell, Assistant to the Board Finance Committee
DATE:
Monday, July 14, 2014
RE:
Board Finance Committee – June 25, 2014, Meeting Summary
INFORMATION ITEMS:
 Increase in Births at POM: In response to a request at the last meeting, the Committee
was apprised of the drivers for the increase in births at Pomerado Hospital.

Real Estate Update: The Committee was given a status update on the three District
properties that are currently either for sale or in escrow.
ACTION ITEMS:
 Summary of Executed Budgeted Routine Physician Agreements: Reviewed and
recommended approval of the Executed Budgeted Routine Physician Agreements that had
been administratively approved, signed and became effective in the months of April & May
(background materials may be reviewed elsewhere in the agenda packet).

May 2014 and YTD FY2014 Financial Report: Utilizing the standard Financial Reporting
Packet, reviewed and recommended approval of the May 2014 and YTD FY2014 financial
performance, which reflected a YTD EBIDA of $61.9M compared to a budget of $61.4M.
YTD operating income was $1.0M better than budget, and YTD net income was $1.35M
better than budget.
115

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