Agendas and Minutes

City Council (View All)

Joint Council/ACH

Tuesday, July 20, 2010



July 20, 2010

Council Chambers

1175 E. Main Street


Mayor Stromberg called the meeting to order at 6:30 p.m. Annual General Meeting for Hospital Board and City Council.


Councilor Voisin, Navickas, Lemhouse, Jackson, Silbiger and Chapman were present.


Mark Marchetti, C.E.O. and Board Chair Doug Diehl, M.D. presented the annual report.


Dr. Diehl reported that the hospital ended the year with a positive financial result.  He stated that the Board of Directors had spent much of their time and effort ensuring that changes implemented in 2008 and 2009 related to operating efficiency and labor productivity.  The focus on financial indicators and operational benchmarks was increased and recognized that, Ashland Community Hospital is an anomaly which can only survive through careful attention to efficiency.


The Board began a strategic planning process to help set direction for the coming years and noted concern for the future relationship of the hospital and its medical staff.  A new committee was created for the new fiscal year, Board Medical Affairs Committee, which will be comprised of representatives of the Board and the medical staff.  This will be a forum for sharing information and ideas between the two groups and for the consideration of strategies related to hospital-physician relationships, programs and services.


Dr. Diehl noted re-appointments to the Board and the Officers.


Chief Executive Director Mark Marchetti presented the overview from the past year.  He reported that it had been a successful year despite service level being down which is attributable to economic downturn and increased competition.  He noted the Ashland Community Hospital statistics for the fiscal year 2009-2010 year which included number of admissions, inpatient care, baby deliveries, surgeries and special studies, Emergency Department treatments, outpatient registrants, home health visits and hospice care.


The hospital generated net patient revenues in excess of $48 million after deductions for contractual adjustments, charity care and bad debt.  Total operating expenses for the year were approximately $47.5 million.  This combined with non-operating revenues, resulted in a gain from operations of approximately $2.2 million, and a profit margin of 2.43%.


Mr. Marchetti reported that in 2008 the hospital conducted an organization-wide change initiative involving analysis of all aspects of the hospitalís operations.  Operational benchmarks and financial indicators were established based on industry-wide best practices and progress toward these goals has been significant in the past fiscal year. 


In addition, time and energy has been spent on the redesign of the hospitalís quality management programs, quality indicators were redefined for all departments and processes for physician peer review are being evaluated.  Increased emphasis has been placed on action planning and resolution and greater focus on government mandated reporting of outcomes data through Hospital Consumer Assessment of healthcare Providers and Systems (HCACPS) and Core Measures programs.  He reported that the hospitals scores related to these programs have increased.


In 2010 the hospital aligned with a new accrediting body, DNV Healthcare Inc., which is a division of a larger international corporation known for quality certification, standards development, and risk management in a wide range of industries including healthcare.  Standards are based on Centers for Medicare and Medicaid Services (CMS) Conditions of Participation.


The hospital has continued implementation of its electronic medical record and is currently working on computerized physician order entry.  The hospital also continues its implementation of the Planetree model of patient and family centered care.  It is hoped that the hospital will achieve designation status through the Planetree Program by 2012.


Mr. Marchetti noted other significant accomplishments at the hospital over the past fiscal year which included: Self-insured plan for employee health benefits, wellness services as part of employee health benefit program, growth in Center for Internal Medicine, growth in hospitalist program, renovation to several clinical departments, relocation of Patient Accounts Department to Talent, automated time and attendance system, more structured processes for patient insurance pre-authorization and up-front collections, growth in comprehensive would program and recruitment of a Volunteer Coordinator to facilitate the recruitment, training, and scheduling of volunteers.


The hospital remains committed to the support of education and training for staff and examples were noted.


The hospital is committed to the community it services, it provides support for student health services in elementary and middle schools in Ashland and Talent, support for the Community Health Center and La Clinica del Valle, the Cityís Fourth of July and Festival of Lights celebrations.


The Board of Directors is working with ECG Management Consultants for a strategic planning process to help set direction for the hospital.  It is expected that the planning process will be completed by fall of this year and a number of defined strategic and operational initiatives were noted. 


Mr. Marchetti stated that the future will be challenging for the hospital and the healthcare industry and the decline of reimbursement through the Medicare Program.  The impact of healthcare reform is very uncertain and technology continues to evolve at a rapid pace and at great cost and pressure on wages and benefit costs.  Completing his report, Mr. Marchetti stated that the hospital is confident that they are in a good position to meet the challenges ahead.


City Administrator Martha Bennett commented on the six requested changes in the relationship between the City of Ashland and the Ashland Community Hospital.  These options are on the agenda for council discussion during their Regular Council Meeting: Status of the official City Liaison as an ex-officio, non-voting member of the Hospital Board, increase of number of members of the Board of Directors to 14, hospital to provide mid-year reports to City Council, remove two of the financial benchmarks from the facilities Lease and the Definitive Agreement, add provisions to both the Definitive Agreement and Facilities Lease about other circumstances when the City should either consulted or should resume operation of the hospital and ensure that the language that indemnifies the City from liability is all three agreements meets the new case law.


Mr. Marchetti explained that the hospital is continually asked what their role with the City is and voiced concern that a council member has the potential to entangle the City with hospital issues.  He stated that a position on the Board whether voting or non-voting creates concern, that guests would be okay sometimes and suggested looking into a different reporting format.


Mayor Stromberg and council members noted concern with not having awareness when there is no presence at the meetings by the City.


Council agreed to discuss the issue further as an agenda item during their Regular Meeting that evening.


Meeting was adjourned at 7:00 p.m.


Barbara Christensen, City Recorder

John Stromberg, Mayor

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