business plan presentation to palm drive health care district board of directors january 26, 2015
TRANSCRIPT
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Business Plan
Presentation to Palm Drive Health Care District
Board of Directors
January 26, 2015
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Agenda for Today’s Meeting
• Overview/ Executive Summary of Business Plan R. Hino
– Introduction of Sonoma West Medical Center Team
• Details of the Business Plan R. Hino
– Governance
– Services
– Specialty Institutes
– Financial Strategy
– Marketing
– Start Up Capital
• Financial Projections G. Minervini-Zick/D. Yarbrough
• Questions
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Contributors To the Plan
• Jim Maresca
• Sandra DeBella Bodley
• Raymond Hino
• Jim Gude, MD
• Dan Smith
• Glenn Minervini-Zick
• David Yarbrough
• John Rinset
• Alan Bernstein, MD
• Kathy Norris
• Gail Thomas
• Tom Boag
• Kurt Hoffman
• Beth Deutsch
• Terry Newmyer
• Gerald Sullivan
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Plan Overview/ Executive Summary
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What’s Going to Be Different About Sonoma West Medical Center
• New Outpatient Service Lines for Urology, Endocrinology, Rheumatology, and Integrative Medicine
• No Wait Emergency Department
• Cloud based Electronic Medical Record System
• Marketing Plan
• Patient Education Center
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Introduction of SWMC Team
• Raymond T. Hino, MPA, FACHE CEO• Glenn Minervini-Zick Interim CFO• James Gude, MD CMO• To Be Determined Chief of Staff• David Yarbrough, RN, BS, MS, JD Interim COO/CNO• John Rinset Interim Med
Staff/Support Svcs• Kathy Norris Dir, Human
Resources• Jerry Sullivan Project Manager• Bruce Espinoza Information
Technology• Tom Boag Interim
Facilities Support
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Plan Overview/Executive Summary
Obligations of Sonoma West Medical Center
• Re-Open Palm Drive Hospital under new name of Sonoma West Medical Center
• Comply with Federal, State and Accreditation Requirements for General Acute Care Hospital
• Comply with Federal, State and Accreditation Requirements for Additional Services to include: Emergency Department, Specialty Medical & Surgical Institutes
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Plan Overview/Executive Summary
Obligations of Sonoma West Medical Center
• Staff Sonoma West Medical Center, according to State and Federal requirements with a competitive wage and benefits structure
• Bill, collect and retain all patient accounts receivable, Federal, State revenues (e.g. Intergovernmental Transfers, AB 915 Supplemental Funds, HITECH)
• Implement an Electronic Medical Record System
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Plan Overview/Executive Summary
Obligations of Palm Drive Health Care District
• Cooperate with SWMC to bring Palm Drive Hospital up to SB 1953 (Hospital Seismic Safety Law) Compliance for NPC2 requirements
• Maintain Hospital License
• Approve Physician Appointments and Reappointments, following a thorough vetting of physician applications by SWMC
• Contribute a Minimum of $1.5 Million per year beginning in Year 2 for Operations
• Cooperate with SWMC to transition from Management Agreement to Lease Agreement in the future
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Plan Overview/Executive Summary
SWMC & PDHCD Agree to:
• Enter into a Management Agreement between Sonoma West Medical Center, Inc & Palm Drive Health Care District (5 year term + Two additional 5 year terms)
• Work together on a Chapter 9 Bankruptcy Exit Plan
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Details of the Business Plan
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Details of the Business Plan
Governance
• SWMC Directors are selected for business and/or health care knowledge, community involvement, governance skills and related experience.
• Initial SWMC Board Officers for Year 1 are as follows:
• Dan Smith, Chair
• Raymond Hino, President & CEO
• Paul Caracciolo, Secretary
• Mary Ely, CPA, Treasurer
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Details of the Business Plan
Governance
• PDHCD Invited to Add Up to 2 District Board Directors, if desired and approved by District Counsel
• SWMC Board to Meet Monthly in Open Session Meetings
• SWMC Board to Appoint Initial SWMC Finance Committee
• Mary Ely, Treasurer/ Finance Committee Chair
• John Balletto
• Andy Pforsich
• Paul Caracciolo
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Details of the Business Plan
Services
• General Acute Care Hospital Required License Services
• Outpatient Institutes
• No Wait Emergency Service
• Intensive Care Unit
• Hospitalist Service
• Telemedicine
• Patient Education Center
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Upgraded Inpatient Services
• Specialists on Site and Through Telemedicine
• Accredited Continuing Medical Education
• Inviting Private Rooms for All Patients
• Organic Food on Menu
• Integrative Medicine
• Room for Relatives
• The Hospital of Choice15
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Outpatient Medical and Surgical Services
• Orthopedic Surgery• Urology• Minimally Invasive Spine
Surgery• Neurology• Endocrinology• Rheumatology 16
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No Wait Emergency Room
• The No Wait ER is 1 example of the emphasis that SWMC intends to implement to improve medical services and increase patient satisfaction.
• A June 30, 2014 Impact Assessment by Coastal Valleys EMS agency concluded that 20-22 patients per day will travel to Santa Rosa.
• CVEMS supports efforts to re-establish a licensed ED and hospital services.
• Both Memorial and Sutter are seeing volume above their licensed capacity.
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Intensive Care Unit
• 5 bed Unit
• Staffed According to Title 22 Regulations
• The ICU Medical Director is Dr. Jim Gude, a Board Certified Intensivist
• Covered by On sight Day Hospitalist Coverage and Telemedicine Coverage at Night
• The ICU is critically important to support Inpatient Surgery
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Hospitalist Service
• Led by Shelleen Denno, MD, an experienced and well known internist and hospitalist in Santa Rosa
• Hospitalists enhance the performance of hospitals by providing prompt and complete attention to all patient care needs
• Enhance care by employing quality and process improvement techniques
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New Telemedicine Programs
– Array of Specialty Services Capable of Handling Complex Cases
– Stroke Intervention
– Research Support
– High Acuity Medicine
– ER Specialties20
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Patient Education Center
• Single Point of Contact with Patients for phone communication, e-mails and visits
• Critical for Coverage Verification
• Interfaces with Case Managers
• Important Physician Liaison Service
• Critical for New Patient Acquisition
• Also important for Customer Relations and Patient Retention
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Specialty Institutes
• The term “Institute” is a popular label that Hospitals and Doctors currently use to describe an integrated medical delivery system (doctors and hospitals working together).
• SWMC is using the label to describe new outpatient and inpatient Service Lines (Urology, Neurology, Endocrinology, Rheumatology)
• Legal forms of an integrated system include coverage agreements, co-management, medical service organizations (MSOs), 1206(d) clinics, or physician recruitment agreements.
• Doctors pay fair market value for services received from SWMC Medical Service Organization (typically based upon a % of collections).
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Specialty Institutes
Services to be Provided by SWMC to Institute Doctors
• Practice Site
• Non-professional staff
• Practice Management
• Billing and Collections
• Group Purchasing Discounts
• Managed Care Contract Negotiations
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Specialty Institutes
SWMC Institutes
• Bollinger Orthopedic and Sports Medicine Institute
• Pereira Brain and Spine Institute
• Bretan Urology Institute
• Integrative Medicine Institute
• North Bay Endocrinology Institute
• North Bay Rheumatology Institute
• North Bay Rheumatology Institute
• North Bay Wound Care Institute
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Financial Strategy
• Recruit Specialists in Clinical Care Specialties where demand exceeds supply (Neurology, Endocrinology, Rheumatology, Integrative Medicine)
• Manage Cost Structure (FTE management, supply expenses, outsource when services can be provided more efficiently by outside resources)
• Revenue Cycle Management (Increase collections from Palm Drive Historical performance)
• Market SWMC Clinical Services Aggressively
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Marketing
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Marketing
The goal of Sonoma West Medical Center is to maximize revenue through the following Four Strategy Initiatives, using data driven metrics and constantly evaluating effects on profitability:
– Branding Identification
– Acquisition of New Patients
– Retention of Former Palm Drive Hospital Patients
– Physician Alignment (through Institutes)
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www.sonomawesthealth.org
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www.sonomawesthealth.org
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Marketing New Health Plans
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Start Up Capital Requirements
Total Capital Required to Open Hospital$11.4 Million*
Sources of Capital
Philanthropy ($5.0 Million Pledged, Committed) $9.0 Million**
Palm Drive Health Care District– Parcel Tax Revenue in Year 1
$2.0 Million
– Transfer from Bond Reserve Fund$2.0 Million
Lending$2.4 Million
* Includes $2.0 Cash Reserve Fund
** Includes Capital Campaign Goal of $5.0 Required for Start Up + $4.0 for Capital
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Financial Projections
Glenn Minervini-Zick, Interim CFODavid Yarbrough, RN, BS, MS, JD, Interim
COO/CNO