ashington · ashington 2000 mowry avenue, ... lean/kaizen update construction report ... may 2?1h...

ashington 2000 Mowry Avenue, Fremont, California 94538-1716 " (510) 797-1111

Nancy Farber, Cbief Executive Officer

Board of Directors Patricia Danielson, RHIT Jacob Eapen, M.D. William R Nicholson, M.D. Bernard Stewart, D.D.S. Michael j Wallace

BOARD OF DIRECTORS' MEETING

Wednesday, July 13, 2016- 6:00 P.M. Conrad E. Anderson, MD Auditorium

I.

II.

CALL TO ORDER & PLEDGE OF ALLEGIANCE

ROLL CALL

AGENDA

III. EDUCATION SESSION:

Graduating Neurosurgery Residents Keynote Speech, Cleveland Clinic - June 2016

IV. CONSIDERATION OF MINUTES

June 8, 14, 15, 20, 27, and 30, 2016

V. COMMUNICATIONS

VI.

A. Oral

B. Written

From Kranthi Achanta, MD Chief of Staff, dated June 27, 2016 requesting approval of Medical Staff Credentialing Action Items.

INFORMATION

A. Service League Report

B. Medical Staff Report

PRESENTED BY:

Michael Wallace Board Member

Christine Flores District Clerk

Moses Taghioff, MD, F ACS, FAANS Medical Director, Perioperative and Strategic Services

Motion Required

Motion Required

PRESENTED BY:

Debbie Jackson Service League President

Kranthi Achanta, MD Chief of Staff

Board Meeting Agenda July 13, 2016

c.

D.

E.

F.

G.

H.

Hospital Calendar

Lean/Kaizen Update

Construction Report

Quality Report Optimizing Quality and Patient Experience in Neonatal Care

Finance Report

Hospital Operations Report

VII. ADJOURN TO CLOSED SESSION In accordance with Section 1461, 1462, 32106 and 32155 of the California health & Safety Code and Sections 54962 and 54954.5 of the California Government Code, portions of this meeting may be held in closed session.

A. Report and discussion regarding California Government Code section 54957: Personnel matters

B. Report involving a trade secret pursuant to Health & Safety Code section 3 2106

New Program

Estimated date of public disclosure: July 2017

VIII. RECONVENE TO OPEN SESSION & REPORT ON CLOSED SESSION

IX. ADJOURNMENT

Nancy Farber Chief Executive Officer

Kimberly Hartz Senior Associate Administrator

Donald Pipkin Chief of Strategic Management

Ed Payen Senior Associate Administrator

Mary Bowron, DNP, RN, CIC Senior Director of Quality & Resource Management

Chris Henry Associate Administrator and Chief Financial Officer

Nancy Farber Chief Executive Officer



A meeting of the Board of Directors of the Washington Township Health Care District was held on Wednesday, June 8, 2016 in the Conrad E. Anderson, MD Auditorium, 2500 Mowry Avenue, Fremont, California. Director Nicholson called the meeting to order at 6:01p.m. and led those present in the Pledge of Allegiance.

Roll call was taken: Directors present: William Nicholson, MD; Bernard Stewart, DDS; Jacob Eapen, MD; Patricia Danielson, RHIT Excused: Michael Wallace

Also present: Nancy Farber, Chief Executive Officer; Kranthi Achanta; Chiefg~l·>. Medical Staff; Debbie Jackson; Service League 1st President; Christine Flo1~~4;:· .. District Clerk ·

~::,~::

Guests: Kimberly Hartz, Ed Fayen, Chris Henry, Bryant Welch, St~~~ff~ie Williams, Tina Nunez, Kristin Ferguson, Mary Bowron, John Le Al~~rt BrooIC MD, Angus Cochran

Nancy Farber, Chief Executive Officer introduced Chris~~~y, Chief\financial Officer and Dan N ardoni, Assistant Chief Financial Officeni:~~p prese~~~·~ the Budget Estimate for Fiscal Year 2016-2017. Mr. Henry shareq.; ! J\1j$sion. Statement as well as the East Bay Economy, Impact ofUnemplo,. • ''t, the California and National environment, Gove,~nt pay or reimburse /~~~' Medicare & Medi-Cal Shortfalls, the Payor Mix Shift pri~;> '.:!~ ... Medi-Cal. Mr:·~~~f:.~ continued by sharing our many accomplishments.\, ~~~··~:~!~de the Heaitl1,~~ges Distinguished Hospital A ward, Healthgrades Pati~~t ·s~re~¥;iJ~~~;~' as welW~s awards for Cancer Care, N eurosciences/Stroke, Ort~ppedi9:p~atS!;;:j~:~~g~.~testinal Care, General Surgery, Cardia~S~~~}·~ritical Care, R~~~onary Cartti~ntl Laboratory. Washington Hospital receiv~dBest.o~;~~~mont Awara~;for Best Doctor, Pediatrician, OB/GYN, Qpl';!lhalmologi§~'-Orthopedic Stjtgeon, Podiatrist, Surgeon and Urologist. · · · ·

Mr. Henry presented the budg~t·'.~0 • .a~~.l~:??··· ··districL.}fhe Fiscal Year 2016-2017

provides for: . :t;;;;;•sr >>;~F

• To~~k~~Yenue'''6 ) ·/ ... <r:~ .. mil i ~~1~:;:; • ~.~~~i~g of Depreciat1\•;•:: ;~xpen~e~·g~;~.}~~2 million • Funa.i·n.~ ... ?f contribution. the Reti~lffient Plan of $22.0 million • Debt Setvice on the 200 ~·{;'.~09, 2ofo and 2015 Revenue Bonds of $15.9

million ''.!Jr,·;;. • Net Income;r:~~~.~ts:

o Operaiitl,~J:~~f Oll}~·Hf $14 .1 million o Net incorri~i'9l:'$B4.1 million o Property T~~iRevenue of $16.8 million for Debt Service on our

General OBiigation Bonds. • The funding of $18. 9 million in support of the Development Corporation • Compliance with all Bond Requirements (Debt Service coverage of 4: 1) • New capital spending requests of $9.3 million

Mr. Nardoni presented the Fiscal Year 2016-2017 Volume Budget discussing admissions, admission by payor, inpatient days, deliveries, total surgeries, emergency room visits and outpatient visits.

CALL TO ORDER

ROLL CALL

·:·t~~~~{(JN SESSION: B~'i/~~~ijifPs•timate for FiscaVifear 2016-2017

Board of Directors' Meeting June 8, 2016 Page 2

Director Nicholson moved action item A, Consideration of Resolution No. 1168, Budget Estimate Fiscal Year 2016-2017 out of agenda order.

Director Eapen moved for adoption of Resolution No. 1168, which is the Budget Estimate for Fiscal Year 2016-2017. This Resolution provides for the necessary funds required for the operation of the District and for the continued support of the Washington Township Hospital Development Corporation in its operations to promote the charitable and community '-'"!'.~··.L"-"'"" mission of the District.

Director Stewart seconded the motion. Roll call was taken:

The motion carried.

Michael Wallace - away William Nicholson, MD - aye Patricia Danielson, RHIT - aye Bernard Stewart, DDS - aye Jacob Eapen, MD - aye

Director Danielson seconded the motion. Roll call was taken:

Mic~~~l;:;W~i ~~~·i1~L away ~H,!~~W Nichols~~~ MD - aye Patricif:t;~,~nielso~;,8RHIT - aye Bemard§J~~an:~~~~~-~>(lye

;};:;i~ob EapeqHMD ~aye. ·

The motion carried. ~) .· '.·: ;: ~~·.'. . __ ..... --· -.. -:_ ,_

There wer~~-ho oral communi2:affaius.

The following ~g~.~communic~~~pn received from Kranthi Achanta, Chief of Staff, dated May 25;~~~~~c.6 requesti!)g approval of Medical Staff Credentialing Action Items as follo\vs{

Appointments: Beg, Sumbal, MD; Franzinb, Stephen, MD; Gadea, William, PA-C; Goldman, Robin, MD; Khok, Nee York, PA-C; Kwok, Joseph, MD; Lee, Simon, MD; Paro, John, MD; Siu, John, MD; Srinivas, Shekar, MD

Temporary Privileges: Beg, Sumbal, MD; Gadea, William, PA-C; Goldman, Robin, MD; Kwok, Joseph, MD; Lee, Simon, MD; Siu, John, MD; Srinivas, Shekar, MD

APPROVAL OF MINUTES OF MAY 9, 11, 16, 23, AND 25, 2016

COMMUNICATIONS: ORAL

COMMUNICATIONS: WRITTEN


Locum Tenens: Stephens, Melissa, PA-C; Riordan Silva, Nolli, MD; Luh, George, MD

Reappointments: Barzin, Ario, MD; Brooks, Rona, MD;Carpenter, Christopher, MD; Chen, Fulton, MD; El-Sayed, Yasser, MD; Haws, Kelly, PA-C; Henderson, Gavin, MD; Henstorf, Jan, MD; Jeffrey, Keith, PA-C; Jiang, Lei, PA-C; Krishnan, Savitha, MD; Kumar, Sandeep, MD; Mark, Nancy, MD; Okamoto, Eric, MD; Rodwell, Graham, Romano, John, MD; Rose, Barry, MD; Sah, Alexander, MD; Wadhwani, Wong, Christina, MD

Transfer in Staff Category: Lien, Kenneth, MD; Sheridan, Christina, MD; Cerruti, Remo, MD

Completion of Proctoring & Advancement in Staff Categor~::·; n <·;

Ranchod, Tushar, MD; Tang, Heng, MD; Israni-Jiang, M'lpj.sba, MD; Lin, Jeff, MD: Kane, Amy, MD

New Privilege Requests Multani, Kuljeet, MD

Delete Privilege Requests Brooks, Rona, MD; Carpenter, Chris, MD; Gavin, MD; Krishnan, Savitha, MD; Lien, .,..._""_ .. .u. .. ,,,.,,.q,,

Rodwell, Graham, MD; Romano, John, MD

Withdrawal of Application Rittenhouse, Douglas,

Resignations: Beatty, Megan, MD; MD

The motion carried.

-away ~_ .. ,., .... VJ.UVJLJ.' MD - aye

.\.a.'1~<J.;7•c:u111;;1;::i 1u11, RHIT - aye ..._,"" ............. -~Stewart, DDS - aye

Eapen, MD - aye

Debbie Jackson, Service League President presented the Service League Report. Ms. SERVICE LEAGUE

Jackson shared that on May 9th, the Scholarship Committee met with the candidates REPORT

applying for the Service League scholarships and selected the recipients. Ms. Jackson shared the names of the winners and thanked the committee for taking the


time to be on the committee. Ms. Jackson reported that for the month of May 2016, volunteers contributed a total of 2,932 hours.

Dr. Kranthi Achanta Tsoi reported there are 573 Medical Staff members.

The Hospital Calendar video highlighted the following events:

Past Health Promotions & Outreach Events On Thursday, May 12th, the Washington Hospital Green Team hosted an station, which was cosponsored by the Washington Hospital (WHEA) and the City of Fremont, as part of the National Bike to

On Tuesday, May 17th, Dr. Tam Nguyen, family medicine, n-..Ac.i:iiiri•-i-,,,.r1

What You Need to Know"; 40 people attended.

On Thursday, May 26th, Washington Hospital hosted event featured stories of survival and hope for cancer

On Friday, May 2?1h Searles Elementary School in Union City fle~:r~.,:.its first annual health fair for students, teachers and parents. ~~~~~ington Hospitafst~~~·~rovided information on hand hygiene and the preventiotts~~'.W~~ spread of gernis~;~i¥~r 7 5 people attended. ·· · · ·

L.· ·····.·····\. •; ':.... ·•

On Tuesday, May 31st, Dr. Sangeetha Balakrishnafl;.cardi<?J9gi§~~l~f~sent~d;~~Heart Health: What You Need to Know''· people attend~fl. · ·

<.:.,·. .::<z,·;

On Friday, June 3rd, Wa~~f:~? on Ho Senior Health Fair. Thi,~:?~'1~., information for seniors. Was

OI~ providing ensity screenings for

Over 1,500 people

,.,·;,; ..... , ..

U12comi!~:~~alth Pro~~ 10~~~t c~if~~~!f);,Outreach Events On Sa~µrun;~~··~~ne 11th from lQ:i~~ to 3 Ptq~·::~ashington Hospital will participate in the Fremontr~g~}~~ Safety Fair. ~~~ .. event ~fl feature safety booths, activities for children, crime·n~~y;~ntion semin · · ¥ child safety seat inspections and more.

"j ·:'-:~>.;·:;

On Thursday, June' .; 5om 7 t?:···,:30 pm, as part of the Women Empowering Women series, Dr. Vfo .. ~~f:! .. L~.i.t?Hart, gynecologist, will present "Stress Management."

On Saturday, June 25th from 10 am to 1 pm, Dr. Ash Jain, cardiologist, and Dr. John Thomas Mehigan, vascular surgeon, will screen community members for Peripheral Vascular Disease. This free screening includes a Doppler study of the circulation in the legs and an interpretation of results. This event is co-sponsored by Fremont Bank Foundation.

On Tuesday, June 28th from 1 to 3 pm, as a follow up from the Peripheral Vascular Seminar, Dr. John Thomas Mehigan, vascular surgeon, and Dr. Gabriel Herscu,

MEDICAL STAFF REPORT

HOSPITAL CALENDAR: Community Outreach


vascular and endovascular surgeon, will present "Pain When You Walk? It Might Be PVD"

On Tuesday, July 5th from 6 to 8 pm, as part of the Stroke Education Series, Dr. Ash Jain, cardiologist, and Doug Van Houten, R.N., will present "Introduction - Stroke" and "Risk Factors for Stroke."

On Tuesday, July 12th from 6 to 8 pm, Dr. Mary Maish, thoracic surgeon, will present "Learn the Latest Treatment Options for Gastroesophageal Reflux Di§~~§~~ also known as GERD."

On Saturday, July 16th Washington Hospital and the Taylor McAdatl.J;,J~;en~ 11 ,,1;;~'\ Neurosciences Institute will host the Advances in Neurosciences EigltfP Bay}\\~'"· Symposium. Nationally and internationally recognized experts~~l~:1gis~!1ss a wi range of topics focused on neurological diseases, disorders, a ·· '·~feattnent approaches.

Washington Hospital Healthcare Foundation Repor .h

The Washington Hospital Healthcare Foundation is preparing ,, .;~~:,r th l:nnual Top Hat gala. This year's gala will be chaireq~y Marlene Weibe};;;~~t;;,tlbert Brooks and Dr. Elizabeth Kurkjian. The trustees of the). ,µn,,~ation have desi'g~a ed the proceeds from this year's Top Hat gala towards > ';yy: .. frenatal Diagno, ,;dfBl~r, which will provide much needed service to expec.,, in~!' especially c"~se who are high-risk. The Center will provide exceptionaf~~nefit <''i:'<:, ·comm~~ty, including decreasing instances o!}~: birth weight, iW;p;.8,~illg pre ? , .• Y outcomes and improving newborn and ~~~((lQ~';i~~;~M.h. Additional\~;t(H will enab? many highrisk expecting mothers to 2;~pver at \~~~~9.ington Hospit5J;J without having to travel outside the District for tbi~?·§I?.~cialized §~J,Nice.

~<-.:..-:.:·:.,:~ ·-:·:·''>. · •. :- ·:'::.:·::·:.- >:· ;,

The Washington Township;~~~lthca~~mistrict Board}~/ Directors Report On May 13th, t~~,,~~~.~~RRton Ta~~~R~p"FI~'ti1tij~~~.;\~isfrict Board members attended the QJie@nHu;;~·~!Tu·;:&nnuafE!ffi,graiser. · · ., ·

:'.-:.:·.; .. · \:::-.., .. _ .... ,11 ... ,.. ':';\._

Washihgt '!~Hospital Employee:,·

In the month 6 , . ·~~'·· WHEA kier·· those served by Pt ·,~;~~.,>and SA V terns collected were new socks, undergarments, diapers and personalt~~~E~>items, ·;+ ddition to monetary donations. Overall, 68 packages of items weres(:J; . ted:to Abode Services and SA VE.

On Monday, June 20th frorn:J;f2 to 6pm, WHEA will hold a blood drive with The American Red Cross in th:~ Anderson Auditorium at Washington West.

Washington On Wheels Mobile Health Clinic, W.O.W. During the month of May, the Washington On Wheels Mobile Health Clinic (W.O.W.) continued to serve community members at the Fremont Family Resource Center, the Fremont Senior Center and the Ruggieri Senior Center in Union City. The W.O.W. Clinic also provided health care services to students and their family

Was~f~gton Hospital Foundation Report

HOSPITAL CALENDAR: The Washington Township Healthcare District Board of Directors Report

HOSPITAL CALENDAR: Washington Hospital Employee Association, W.H.E.A.

HOSPITAL CALENDAR: Washington On Wheels Mobile Health Van


members at the Fremont Unified School District Office.

In addition, W.O.W. conducted hearing and vision screenings for 127 students of the Fremont Unified School District State Preschool Program. The total number of community members receiving health care from the Washington On Wheels Clinic during the month of May was 232.

Internet Marketing

There were over 27,724 visits to the hospital website in the month of May. /<r•·•

hospital's Employment section was the most viewed webpage with 11, 1 ~~.1;~~ge views, followed by the About WHHS section with 8,919 page views. .~'efa~~~~ician Finder had 8,729, the Volunteers section had 4,155 page views and tt\~·/Worri~. ·'· Health and Pregnancy section had 1,919 page views. .. ··

HOSPITAL CALENDAR: Internet Report

InHealth - Channel 78

During the month of May, Washington Hospital's cable.g~~~el 78, In~ealth, captured new programming including two Health and Wellil~f~·progra~§1.;it1ed

···: J:j(!SPITAL

~~/iNDAR: IflFJ.~(JltlJ

"Skin Health: What You Need to Know," and "Heart Health:';\¥: J;t~tfNeed to Know," a Sports Medicine Program called "Think Running is a \·:,;Km2 It Doesn't Have to Be," and a Diabetes Matters program:titJed "The History df1Kl~J.~petes."

In addition, InHealth aired the April Board of~l~t~~~~eeting; two'~~~~:t~~ Matters programs called "Ready, Set, Goal Settin:~:( d'Irt··:• · ~livery,' th.. ay Citizen's Bond Oversight Committee Meeting and1~.: e M · Directors meeting. :

Awards and Recogniti~~~Jlll!l!;;i Washington Hospital has·•l)e·~~l1~:~cogni~~ with a 2016 P~mu~r for Change Environmental Excellence A W<:t~~iE~ P : .: · .• ~;~;r·8,;~enhea1,~~~i

1

iThe award honors environmental S.~~~~i~~~Hity acliie~~··;•·r. hintU*!\ .... ~b·;care sector. The Greenhealth Partner for cg~u:ge~~~~\~~r?gnize~fi~alth care' cilities that continuously improve ~~.~;;;e~pand upon:·t~$!!:;uiercu . ] · ination, waste reduction, recycling, and source ~~er:· ·on programs.· · ·.

Alame~a ~6 ft~~ater Districi~1irded Jt~hington Hospital with a Business of the Year Certifica:t~.8f Recognitio~12ffhe award recognizes individuals and organizations that H~~~·:r:ade out§~~nding contributions in advocating the conservation of wat~r;guring·~O 15.

Washington Hospital's S;;~t~t:ogram earned top honors by receiving the Target: Stroke Honor Roll-Elite Plus and Gold Plus Performance Achievement Award as part of the American Heart Association's Get With The Guidelines-Stroke program, a national evidence-based initiative to improve stroke patients' outcomes.

Employee of the Month

HOSPITAL CALENDAR: Awards and Recognitions

HOSPITAL

Business Assistant, Shayna Mann is June's Employee of the Month. Shayna joined CALENDAR: Employee of the Month - Shayna

Washington Hospital August of 2005 as a Unit Clerk on SW then transferred to Mann Nurse Staffing Officer as a Staffer. Shayna recently transferred to Maternal Child


Health as a Business Assistant and continues to support the Birthing Center. In her day to day, Shayna keeps the unit in order and is a huge asset to her manager. She displays compassion and patience with over 130 colleagues in the division. Her knowledge, integrity, dedication and friendly nature makes her an excellent team player and a perfect candidate for the Employee of the Month award.

Nancy Farber, Chief Executive Officer introduced Kimberly Hartz, Senior Associate Administrator, and Donald Pipkin, Chief of Strategic Management. Ms. Hartz . presented the Lean Leader Certification presentation. The purpose of the certification is to promote and lead Kaizen activities in the institution. It J · others in lean methodology. The goal is to make Lean the philosophy: methodology for all improvement activities. The Lean certification.~;i1 , cess ~<·n:;P:}n September 2014. There have been 3 Lean Certification cohorts,.~,~Eli'e~ntaining;•~~~ 30 participants. The Lean Certification Training is a 12-18 mql,}tfiprocess. It requires proficiency in Lean concepts and tools. Candidat~·*pfifo evaluated for successful performance in each step of the process. M~.:.:;M;~.f. continu~g by presenting the Lean Certified Leaders with their pins arid be ·" .. ~rtific,~~~~i.Tigist Awel, MSN, BA, RN; Cheryl Bernal, MSN, MBA, RN-BC; t, .....••.• ,~·~;~rennan, MSN, RN, CEN; Christopher Brown, Harpreet Dhillon, MD; Ruth Trayl~f'~~:·MHA, F ACHE; and Stephanie Williams, MHA, CPNW, RN, NE-BC 1i''ht;·1;,~·l;l';.;•;::

Nancy Farber, Chief Executive Officer introducJij;~~·:~~~~p,,,Senior As~~~~;~t~•<' Administrator. Mr. Fayen presented the construdiwn updat~i.:g~s~2Fparking·fgarage and the Morris Hyman Critical ~~~e Pavilion. Mr. E~ye~ 1snarechpq$1:~~\ofthe North Side biorentention area ands .. ~.~~~~~!' pe North entra~~et~ the Bar~J]puilding and the Elevator Lobby on level 2:,..;;:~r:Fay· '·· ·~nt on to shar~;:~rogress on the Morris Hyman Critical Care P~y;.\l,~~~h Photos he sheathing.,~ i~sulation for the top of the wall on the ground Iioofi.~~~~.shar s well as drain :~~:fire water lines on the first floor, fireproofing of the.Stt~· he firs~Jldor and terrace areas on the west side oft4~·.t· il,oor folt·/, 'lioto as of May 31, 2016.

Nancy Farql!t~i;;~~;tef{if~~~is£ffi:~r .. ,,~~uc:d Mary Bowron, Senior Director of Qualit~<··· .@~~ource Managem~~~h. Ms. B~~gn reported on Core Measure Complianc·~t~~~;~h included hea~IJ~~ilure, ~µeumonia, acute myocardial infarction, venous throrrit5~~~~olism, stoke,7~~fgical care improvement and hospital outpatient surgery. Ms. Bo~~~~"°:ontinued 9~f;sharing the Infection Prevention Indicators which included centr~~;~!~p.e assoc.i~fed bloodstream infections (CLABSI), surgical site infection (SIR), csu~~~.!~~0·;.9~1theter associated urinary tract infections (CAUTI), and hospital acquired MR~~);Dloodstream infections. The nurse sensitive indicators were also discussed: reducing hospital acquired pressure ulcers and reducing inpatient falls with injury.· Ms. Bowron shared the Joint Commission National Patient Safety Goals which comprised of hand off communication, patient identification, procedure time out and hand hygiene as well as the readmission rates for Medicare pneumonia and heart failure.

Chris Henry, Chief Financial Officer, presented the Finance Report for April 2016. The average daily census was 167.2 with admissions of 1,054 resulting in 5,016

PRESENTATION OF LEAN CERTIFICATES AND PINS

CONSTRUCTION REPORT Construction Update

QUALITY REPORT: IHI Quality Dashboard -Quarter Ending 0312016

FINANCE REPORT


patient days. Outpatient observation equivalent days were 252. The average length of stay was 4.69 days. The case mix index was 1.515. Deliveries were 164. Surgical cases were 400. Joint Replacement cases were 139. Neurosurgical cases were 27. Cardiac Surgical cases were 8. The Outpatient visits were 6,925 and Emergency visits were 4,501. Total productive FTEs were 1,275.7. FTEs per adjusted occupied bed were 6.38.

Ms. Farber presented the Hospital Operations Report for May. Preliminary information indicated inpatient revenue for the month of May at approxim'!t~~l~f' $169,900,000; government sponsored patient revenue made up 70.5% ~.~,J~; revenue. There were 1,029 patient admissions with an Average Lengtb;lof 4.47 and patient days of 4,691. There were 352 Cath Lab procedurest!ind 41 surgical cases at the Hospital. Deliveries for May were 177. ~.~l}~~pl~t;gency Outpatient visits were 7,212. FTEs per Adjusted Occupied :§.~t1'\vere•6.82. The clinics saw approximately 3, 778 patients. · ,

In accordance with District Law, Policies and Procedu;::','iJt~\~or E,~~~~,oved the Chief Executive Officer be authorized to enter into the necessar, .. ntracts aiid proceed with the purchase of the hardware, and implem ,·~~£~ services, for the GE Centricity Radiology Information Upgrade, for a·t~;~~l;.~mount not to exceed $190, 102. This is an approved 16 IS Capifal(~.JJ;gget.


The motion caffi~a.· ;un;; •

In accor,\l:~,,,with DistrictC~, ~focedures, Director Eapen moved the Chief Execu~~M~··:?fficer be autli \'.;::·F·f d to e .. ::·· f into the necessary contracts and proceed with tn~I~·M:chase of copi~fl~replacements for a total amount not to exceed $52,429.00. This•i§}:WJ approved y~pense in the 2016 Capital Budget.

'.)_'.";\\:J\~-. ;·:·::.'f~2;}

Director Stewart seco1

ff~e,<.ithe mSii~n. Roll call was taken:

The motion carried.

MicljaeI Wallace - away William Nicholson, MD - aye Patricia Danielson, RHIT aye Bernard Stewart, DDS - aye Jacob Eapen, MD - aye

HOSPITAL OPERATIONS REPORT

APIJ.DVAL OFGE CENTRIC/TY RADIOLOGY INFORMATION SYSTEMS UPGRADE

APPROVAL OF COPIER REFRESH 20 I 6


In accordance with District Law, Policies and Procedures, Director Eapen moved the Chief Executive Officer be authorized to enter into the necessary contracts and proceed with the purchase of the BrainLab Spine Accessories for an amount not to exceed $62,907.75. This item was not included in the Fiscal Year 2016 Fixed Asset Capital Budget.


The motion carried.

Michael Wallace - away William Nicholson, MD - aye Patricia Danielson, RHIT - aye Bernard Stewart, DDS - aye Jacob Eapen, MD - aye

,.:··:

In accordance with District Law, Policies and Procedu~ys;.J~~0~ctor Eap~~ moved the Chief Executive Officer be authorized to enter into the nece:ss~ contHJFts;,~nd proceed with the purchase of an Upgrade to the Brainlab Navi /ysterri'for an amount not to exceed $31,83 7 .13. This item was not included in · cal Year 2016 Fixed Asset Capital Budget.


Michael President

Michael Wallace - away

wmia~,~~~~~+~en, MD -Patri~~~rbaliiel~~~1 RHIT -Be . · :: ~ Stewart;;.~~PS - aye

en M ,' . '

Patricia Danielson, RHIT Secretary

APPROVAL OF NEUROSURGICAL INSTRUMENTS

ADJOURNMENT

A meeting of the Board of Directors of the Washington Township Health Care CALL TO ORDER

District was held on Tuesday, June 14, 2016 in the Boardroom, 2000 Mowry Avenue, Fremont, California. Director Wallace called the meeting to order at 6:00 p.m. and led those present in the Pledge of Allegiance.

Roll call was taken. Directors present: Michael Wallace, William Nicholson, MD; ROLL CALL

Bernard Stewart, DDS; Patricia Danielson, RHIT; Jacob Eapen, MD

Also present: Nancy Farber, Chief Executive Officer; Christine Flores, Clerk; Paul Kozachenko, Tim Fallon

There were no oral communications.

There were no written communications.

In accordance with Health & Safety Code Sections 1461, Government Section 54954.5(h) Director Wallace LI.\..1.1•.JLI.•llU"' ......

session at 6:01 p.m., as the discussion pertained to Resources matters and Risk Management.

Director Wallace reconvened the meeting to no reportable action was taken in closed 0....,..,..,.lVJ;!

There being no further business, Director at 7:30 p.m.

Michael Wallace President

COMMUNICATIONS

TO CLOSED

RECONVENE TO OPEN SESSION & REPORT ON CLOSED SESSION

ADJOURNMENT

A meeting of the Board of Directors of the Washington Township Health Care District was held on Wednesday, June 15, 2016 in the Boardroom, 2000 Mowry Avenue, Fremont, California. Director Wallace called the meeting to order at 6:00 p.m. and led those present in the Pledge of Allegiance.

Roll call was taken. Directors present: Michael Wallace, William Nicholson, MD; Bernard Stewart, DDS; Patricia Danielson, RHIT; Jacob Eapen, MD

Also present: Nancy Farber, Chief Executive Officer; Kimberly Hartz, Senior Associate Administrator; Ed Fayen, Senior Associate Administrator; Flores, District Clerk; Paul Kozachenko, Tim Fallon



In accordance with Health & Safety Code Sections 1461, J~o2 and 3 2) 06 and Government Section 54954.5(h) Director Wallace adjoµrrt~~~i·~~ meetiry~.to closed session at 6:01 p.m., as the discussion pertained to Hospital tq:l.~.~1~ec~~~s;Mµman Resources matters and Risk Management.

Director Wallace reconvened the meeting to v:o.<~·""·'""''"''"'J'""· ... · at 8:09 p.m'..~J'.19 reported no reportable action was taken in closed '"'"""'''"' .. "' ............. , ........• :>.·

There being no further business, Director Wallace ft~jornm~stth.~.•~~~:t~1l}g, at 8:10 p.m.


CALL TO ORDER

ROLL CALL

COMMUNICATIONS

TO CLOSED


ADJOURNMENT

A meeting of the Board of Directors of the Washington Township Health Care District was held on Monday, June 20, 2016 in the Boardroom, 2000 Mowry Avenue, Fremont, California. Director Wallace called the meeting to order at 6:00 p.m. and led those present in the Pledge of Allegiance.

Roll call was taken. Directors present: Michael Wallace, William Nicholson, MD; Bernard Stewart, DDS; Patricia Danielson, RHIT; Jacob Eapen, MD

Also present: Nancy Farber, Chief Executive Officer; Kimberly Hartz, Senior Associate Administrator; Ed Fa yen, Senior Associate Administrator; Bryant .. ·:)';r?"".J.'"'J~."'' Associate Administrator, Tina Nunez, Associate Administrator, Chris Associate Administrator; Stephanie Williams, Associate Flores, District Clerk; Doug Penner; Martin Alsip, Mike Engle



Director Wallace reconvened the meeting to op1~!Wi:&~~:$.i~~p no reportable action was taken in closed session.

There being no further business~J)irnctor Wallace .... ~ .. ,.., ~ .... :u .... ,~

at 7:57 p.m.


CALL TO ORDER

ROLL CALL

TO CLOSED


ADJOURNMENT

A meeting of the Board of Directors of the Washington Township Health Care District was held on Monday, June 27, 2016 in the Fremont Conference Room, Washington Hospital, 2000 Mowry A venue, Fremont, California. Director Nicholson called the meeting to order at 7:30 a.m.

Roll call was taken. Directors present: William Nicholson, MD; Bernard Stewart, DDS; Patricia Danielson, RHIT; Jacob Eapen, MD; Excused: Michael Wallace

Also present: Nancy Farber, Chief Executive Officer; Kranthi Achanta, MD; Timothy Tsoi, Peter Lunny, MD; Jan Henstorf, MD; John Romano, MD; Albert Brooks, MD

There were no oral or written communications.

Director Nicholson adjourned the meeting to closed session at 7:30 a.m. as the discussion pertained to Medical Audit and Quality Assurance Matters pursuant to Health & Safety Code Sections 1461 and 3 215 5.

Director Nicholson reconvened the meeting to open session at 8: 10 a.m. and reported no reportable action was taken in closed session.

There being no further business, the meeting was adjourned at 8:10 a.m.



CALL TO ORDER

ROLL CALL

COMMUNICATIONS

ADJOURN TO CLOSED SESSION


ADJOURNMENT

A meeting of the Board of Directors of the Washington Township Health Care District was held on Thursday, June 30, 2016 in the Newark and Union City Conference Room, Washington Hospital, 2000 Mowry A venue, Fremont, California. Director Wallace called the meeting to order at 9: 3 0 a.m.

Roll call was taken. Directors present: Michael Wallace, William Nicholson, MD; Bernard Stewart, DDS; Patricia Danielson, RHIT; Jacob Eapen, MD;

Also present: Nancy Farber, Chief Executive Officer; Kimberly Hartz, Senior Associate Administrator; Ed Fayen, Senior Associate Administrator; Chris Henry, Associate Administrator; Tina Nunez, Associate Administrator; Bryant Welch, Associate Administrator; Stephanie Williams, Associate Administrator; Donald Pipkin, Chief of Strategic Management; Dee Antonio, Senior Executive Assistant; Robert Alfieri; Ray Graves; Mike Matson; Douglas Strout; Warren Pottebaum; Dan Wetherell

There were no oral or written communications.

In accordance with Health & Safety Code Sections 1461, 1462 and 32106 and Government Section 54954.5(h) Director Wallace adjourned the meeting to closed session at 9:31 a.m., as the discussion pertained to Hospital trade secrets.

Director Wallace reconvened the meeting to open session at 12:40 p.m. and reported no reportable action was taken in closed session.

There being no further business, the meeting was adjourned at 12:40 p.m.



CALL TO ORDER

ROLL CALL

COMMUNICATIONS

ADJOURN TO CLOSED SESSION


ADJOURNMENT

E~1 \fa~hington ~Healthcare System

WASHINGTON HOSPITAL

MONTHLY OPERA TING REPORT

May 2016

WASHINGTON HOSPITAL INDEX TO BOARD FINANCIAL STATEMENTS

May 2016

Schedule Reference

Board -1

Board - 2

Board - 3

Schedule Name

Statement of Revenues and Expenses

Balance Sheet

Operating Indicators

Washington Hospital Healthcare System s N C E 9 4 8

Memorandum

DATE: July 8, 2016

TO: Board of Directors

FROM: Nancy Farber

SUBJECT: Washington Hospital-May 2016 Operating & Financial Activity

SUMMARY OF OPERATIONS - (Blue Schedules)

1. Utilization - Schedule Board 3

May ACUTE INPATIENT: Actual

Average Daily Census 151.3 # of Admissions 1,029 Patient Days 4,691 Discharge ALOS 4.47

May OUTPATIENT: Actual

OP Visits 7,212 ER Visits 4,554 Observation Equivalent Days- OP 246

Budget

157.4 1,024 4,878

4.76

Budget

7,416 4,683

272

Current 12 Month Avg.

157.1 1,015 4,790

4.68

Current 12 Month Avg.

7,175 4,422

247

Comparison of May acute inpatient statistics to those of the budget showed a higher level of admissions and a lower level of patient days. The average length of stay (ALOS) based on discharged days was below budget. Outpatient visits were lower than budget. Emergency Room visits were below budget for the month.

Washington Township Health Care District, 2000 Mowry Avenue, Fremont CA (510) 797-1111 Nancy Farber, Chief Executive Officer

Board of Directors July 8, 2016 Page 2

2. Staffing - Schedule Board 3

Washington Hospital - May 2016 Operating & Financial Activity

Total paid FTEs were 5.7 above budget. Total productive FTEs for May were 1,255.8, 36.9 above the budgeted level of 1,218.9. Nonproductive FTEs were 31.2 below budget. Productive FTEs per adjusted occupied bed were 6.07, 0.43 above the budgeted level of 5.64. Total FTEs per adjusted occupied bed were 6.82, 0.32 above the budgeted level of 6.50.

3. Income - Schedule Board 1

For the month of May the Hospital realized a gain of $1,357,000 from operations.

Total Gross Patient Service Revenue of $169,862,000 for May was 1.4% below budget.

Deductions from Revenue of $131,451,000 represented 77.39% of Total Gr~ss Patient Service Revenue. This percentage is above the budgeted amount of 76.81 %.

Total Operating Revenue of$38,617,000 was $1,514,000 (3.8%) below the budget.

Total Operating Expense of $37,260,000 was $600,000 (1.6%) below the budgeted amount.

The Total Non-Operating Gain of $1,352,000 for the month of May includes an unrealized loss on investments of $368,000 and property tax revenue of $1,364,000. This property tax revenue will be used to pay the debt service for the general obligation bonds.

The Total Net Gain for May was $2,709,000, which was $1,280,000 less than the budgeted gain of $3,989,000.

The Total Net Gain for May using F ASB accounting principles, in which the unrealized loss on investments and property tax revenues are removed from the non-operating income and expense, was $1,713,000 compared to a budgeted gain of $2,625,000.

Board of Directors July 8, 2016 Page 3

4. Balance Sheet - Schedule Board 2

Washington Hospital - May 2016 Operating & Financial Activity

There were no noteworthy changes in assets and liabilities when compared to April 2016.

NANCY FARBER Chief Executive Officer

NF/CH:cd

SCHEDULE BOARD 1

WASHINGTON HOSPITAL STATEMENT OF REVENUES AND EXPENSES

May 2016 GASB FORMAT (In thousands)

MAY YEAR TO DATE

FAV FAV ACTUAL BUDGET (UNFAV) %VAR. ACTUAL BUDGET (UNFAV) %VAR.

VAR VAR

OPERATING REVENUE $ 124,171 $ 125,403 $ (1,232) -1.0% 2 INPATIENT REVENUE $ 1,374,684 $ 1,376,646 $ (1,962) -0.1%

45,691 46,882 {1,191} -2.5% 3 OUTPATIENT REVENUE 490,444 507,267 {16,823} -3.3%

169,862 172,285 (2,423) -1.4% 4 TOTAL PATIENT REVENUE 1,865,128 1,883,913 (18,785) -1.0%

(131,451) (132,328) 877 0.7% 5 CONTRACTUAL ALLOWANCES (1,434,855) (1,449,516) 14,661 1.0%

77.39% 76.81% 6 CONTRACTUAL AS % OF REVENUE 76.93% 76.94%

38,411 39,957 (1,546) -3.9% 7 NET PATIENT REVENUE 430,273 434,397 (4,124) -0.9%

206 174 32 18.4% 8 OTHER OPERATING INCOME 4,025 3,587 438 12.2%

38,617 40,131 (1,514} -3.8% 9 TOTAL OPERATING REVENUE 434,298 437,984 (3,686} -0.8%

10 OPERATING EXPENSES 14,735 14,742 7 0.0% 11 SALARIES & WAGES 161,339 161,669 330 0.2%

5,459 5,605 146 2.6% 12 EMPLOYEE BENEFITS 63,775 62,051 (1,724) -2.8% 4,113 4,145 32 0.8% 13 SUPPLIES 46,858 46,600 (258) -0.6% 4,245 4,751 506 10.7% 14 PURCHASED SERVICES & PROF FEES 51,697 54,221 2,524 4.7% 1,188 1,458 270 18.5% 15 INSURANCE, UTILITIES & OTHER 13,874 15,745 1,871 11.9% 3,808 3,469 (339) -9.8% 16 PROVISION FOR DOUBTFUL ACCOUNTS 37,641 38,440 799 2.1% 2,921 2,921 0 0.0% 17 DEPRECIATION 30,409 30,263 (146) -0.5%

791 769 {22} -2.9% 18 INTEREST EXPENSE 8,972 8,941 {31} -0.3%

37,260 37,860 600 1.6% 19 TOTAL OPERATING EXPENSE 414,565 417,930 3,365 0.8%

1,357 2,271 (914} -40.2% 20 OPERA TING INCOME (LOSS) 19,733 20,054 (321} -1.6%

3.51% 5.66% 21 OPERA TING INCOME MARGIN % 4.54% 4.58%

22 NON-OPERA TING INCOME & {EXPENSE} 268 277 (9) -3.2% 23 INVESTMENT INCOME 2,675 2,658 17 0.6%

4 0 4 0.0% 24 REALIZED GAIN/(LOSS) ON INVESTMENTS (52) 0 (52) 0.0% 84 77 7 9.1% 25 RENTAL INCOME, NET 805 853 (48) -5.6%

0 0 0 0.0% 26 OTHER NON-OPERATING, NET (1, 177) (966) (211) -21.8% 1,364 1,364 0 0.0% 27 PROPERTY TAX REVENUE 14,425 14,424 1 0.0% {368} 0 {368} 0.0% 28 UNREALIZED GAIN/(LOSS) ON INVESTMENTS {42} 0 {42} 0.0%

1,352 1,718 (366} -21.3% 29 TOTAL NON-OPERATING INCOME & EXPENSE 16,634 16,969 (335} -2.0%

$ 2,709 $ 3,989 $ (1,280} -32.1% 30 NET INCOME (LOSS) $ 36,367 $ 37,023 $ (656) -1.8%

7.02% 9.94% 31 NET INCOME MARGIN % 8.37% 8.45%

$ 1,713 $ 2,625 $ (912) -34.7% 32 NET INCOME (LOSS) USING FASB PRINCIPLES** $ 21,984 $ 22,599 $ (615) -2.7%

4.44% 6.54% NET INCOME MARGIN % 5.06% 5.16%

**NET INCOME (FASB FORMAT) EXCLUDES PROPERTY TAX INCOME AND UNREALIZED GAIN(LOSS) ON INVESTMENTS

(~ \fa'lhington Ho::.pi.tal ~ Healthcare System

ASSETS AND DEFERRED OUTFLOWS

CURRENT ASSETS

CASH & CASH EQUIVALENTS

2 ACCOUNTS REC NET OF ALLOWANCES

3 OTHER CURRENT ASSETS

4 TOTAL CURRENT ASSETS

ASSETS LIMITED AS TO USE

6 BOARD DESIGNATED FOR CAPITAL AND OTHER

7 GENERAL OBLIGATION BOND FUNDS

8 REVENUE BOND FUNDS

9 BOND DEBT SERVICE FUNDS 10 OTHER ASSETS LIMITED AS TO USE

11 TOTAL ASSETS LIMITED AS TO USE

13 OTHER ASSETS

14 NET PROPERTY, PLANT & EQUIPMENT

15 TOTAL ASSETS

16 DEFERRED OUTFLOWS

17 TOTAL ASSETS AND DEFERRED OUTFLOWS

MAY

2016

$ 45,829

63,233

7,673

116,735

186,270

193,447

10,439

16,438

15,509

422,103

139,181

473,453

$ 1,151,472

14,010

$ 1,165,482

WASHINGTON HOSPITAL BALANCE SHEET

May 2016 (In thousands)

AUDITED LIABILITIES, NET POSITION AND DEFERRED INFLOWS

JUNE 2015

CURRENT LIABILITIES

$ 19,275 CURRENT MATURITIES OF UT OBLIG

61,503 2 ACCOUNTS PAYABLE

6,713 3 OTHER ACCRUED LIABILITIES 87,491 4 INTEREST

5 TOT AL CURRENT LIABILITIES

LONG-TERM DEBT OBLIGATIONS 184,164 6 REVENUE BONDS AND OTHER

121,657 7 GENERAL OBLIGATION BONDS

10,390

21,349 OTHER LIABILITIES

15,112 10 NET PENSION LIABILITY 352,672 11 WORKERS' COMP

12 SUPPLEMENTAL MEDICAL RETIREMENT

122,848

416,245 14 NET POSITION

$ 979,256 15 TOTAL LIABILITIES AND NET POSITION

24,472 16 DEFERRED INFLOWS

$ 1,003,728 17 TOTAL LIABILITIES, NET POSITION AND DEFERRED INFLOWS

SCHEDULE BOARD 2

MAY AUDITED

2016 JUNE 2015

$ 6,166 $ 5,995

19,571 28,024

50,437 49,107

16,544 9,872

92,718 92,998

204,049 208,626

343,088 197,346

52,060 66,440

9,068 8,609

39,328 36,523

418,354 381,987

$ 1,158,665 $ 992,529

6,817 11, 199

$ 1,165,482 $ 1,003,728

SCHEDULE BOARD 3

~ \Vll..\hington Hospital WASHINGTON HOSPITAL Healthcare System

OPERATING INDICATORS May 2016

MAY YEAR TO DATE

12 MONTH FAV FAV

AVERAGE ACTUAL BUDGET (UNFAV) %VAR. ACTUAL BUDGET (UNFAV) %VAR.

VAR VAR

PATIENTS IN HOSPITAL

157.1 151.3 157.4 (6.1) -4% 1 ADULT & PEDS AVERAGE DAILY CENSUS 157.6 159.9 (2.3) -1% 8.1 7.9 8.8 (0.9) -10% 2 OUTPT OBSERVATION AVERAGE DAILY CENSUS 8.1 8.8 (0.7) -8%

10.9 12.1 11.2 0.9 8% 3 WELLBORN NURSERY AVERAGE DAILY CENSUS 10.9 11.0 (0.1) -1%

176.1 171.3 177.4 (6.1) -3% 4 TOTAL 176.6 179.7 (3.1) -2%

3.9 5.0 3.5 1.5 43% 5 SPECIAL CARE NURSERY AVERAGE DAILY CENSUS * 3.9 3.4 0.5 15%

4,790 4,691 4,878 (187) -4% 6 ADULT & PEDS PATIENT DAYS 52,942 53,723 (781) -1%

1,015 1,029 1,024 5 0% 7 ADMISSIONS-ADULTS & PEDS 11,229 11,427 (198) -2%

4.68 4.47 4.76 (0.29) -6% 8 AVERAGE LENGTH OF STAY-ADULTS & PEDS 4.65 4.69 (0.04) -1%

OTHER KEY UTILIZATION STATISTICS

1.517 1.479 1.503 (0.024) -2% 9 OVERALL CASE MIX INDEX (CMI) 1.516 1.503 0.013 1%

SURGICAL CASES 135 137 116 21 18% 10 JOINT REPLACEMENT CASES 1,482 1,295 187 14% 25 24 26 (2) -8% 11 NEURO SURGICAL CASES 270 296 (26) -9%

8 12 10 2 20% 12 CARDIAC SURGICAL CASES 87 122 (35) -29% 231 238 215 23 11% 13 GENERAL SURGICAL CASES 2,550 2,262 288 13%

399 411 367 44 12% 14 TOTAL SURGICAL CASES 4,389 3,975 414 10%

384 352 421 (69) -16% 15 TOTAL GATH LAB PROCEDURES 4,086 4,703 (617) -13%

154 177 164 13 8% 16 DELIVERIES 1,710 1,734 (24) -1%

7,175 7,212 7,416 (204) -3% 17 OUTPATIENT VISITS 78,236 81,170 (2,934) -4% 4,422 4,554 4,683 (129) -3% 18 EMERGENCY VISITS 48,779 49,947 (1,168) -2%

LABOR INDICATORS

1,212.1 1,255.8 1,218.9 (36.9) -3% 19 PRODUCTIVE FTE'S 1,217.5 1,231.1 13.6 1% 176.9 156.4 187.6 31.2 17% 20 NON PRODUCTIVE FTE'S 175.4 185.1 9.7 5%

1,389.0 1,412.2 1,406.5 (5.7) 0% 21 TOTAL FTE'S 1,392.9 1,416.2 23.3 2%

5.69 6.07 5.64 (0.43) -8% 22 PRODUCTIVE FTE/ADJ. OCCUPIED BED 5.69 5.63 (0.06) -1% 6.52 6.82 6.50 (0.32) -5% 23 TOTAL FTE/ADJ. OCCUPIED BED 6.51 6.47 (0.04) -1%

*included in Adult and Peds Average Daily Census

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