Cook County property taxpayers can expect some increases in their 2013 property taxes, but they won’t see an increase in the hospital levy. On December 20, 2012, the hospital board voted to keep it at $800,000 for another year.
“My hope had been to decrease it,” said North Shore Hospital & Care Center Administrator Kimber Wraalstad. Given financial projections for next year, she was not comfortable recommending that the levy be decreased but thought they could handle keeping it the same.
Board member Tom Spence pointed out that they expect to go to the taxpayers for a lot of money in facility renovations in the next several years. He said he wanted taxpayers to see that the hospital was trying to do the right thing with their money.
Administrator Wraalstad said she was disappointed to see a projected loss of $200,000 when working on the new year’s budget. The loss could be greater with potential federal funding cuts of over $200,000 and up to $400,000 that could go toward building renovation if the board decides to pursue it.
A reduction in care center beds, a change in funding structure called Equitable Cost-Sharing for Publicly Owned Nursing Facilities, an increase in swing bed volume, the ability to do MRIs, and the addition of occupational therapy all helped enable the hospital to end 2012 in the black for the first time since 2008.
Hospital health challenge
The board voted to get on board with other Minnesota hospitals in promoting health initiatives intended to lead communities toward better health. “Hospitals have a role in public health, and public health helps everyone,” said Dr. Jenny Delfs of the Commons Health Hospital Challenge.
Delfs said the challenge, aimed to reduce consumption of sugar-sweetened beverages, promote breastfeeding, and increase use of local, sustainably produced foods, is similar to the effort of a decade ago to support community health by banning smoking on hospital grounds. “It takes some policy changes that will need to come from the top,” she said.
According to a document disseminated by the Commons Health Hospital Challenge, the U.S. healthcare system is dealing with rising costs and an increase in obesity and “ecologically related health impacts.”
“Expensive health care is a burden on communities,” the document states, “draining precious resources that might otherwise be spent on parks, libraries, schools, roads or other community needs.
“…These challenges are an important reminder that we all share in the health of one another, our communities and the health of our planet. And it is why physicians, nurses, citizens, business leaders, elected officials and others are coming together to help improve the health of their communities.
“ …In the context of the global obesity epidemic and ecological health crisis, hospitals following a commons health agenda will recognize, promote, and support health-promoting policies and practices within their institutions and throughout the communities that they serve.
“…Across Minnesota and the country, many hospitals have already begun to demonstrate leadership in our common health agenda. Hospitals are promoting farmers markets, CSA’s [community service announcements], and community gardens.
“…The Commons Health Hospital Challenge was developed to recognize and promote these hospitals that are leaders as institutions at linking clinical practice with health promotion and primary prevention. …Hospital facilities that adopt any one or more of these components will be publicly recognized.”
The first goal is to eliminate selling sugar-sweetened beverages on hospital grounds and serving them to patients unless medically indicated. The Commons Health Hospital Challenge document states, “Sugar sweetened beverages, few of which have any nutritional value, account for half of all added sugars in the average American diet.” Diet pop, milk, and 100 percent fruit or vegetable drinks would still be available, and people could still purchase approved beverages from vending machines or bring in whatever they wanted to drink.
Administrator Wraalstad said the top-selling vending machine beverages in the hospital complex are Diet Coke, Coke, Sprite, and root beer (in that order).
Regarding the second goal, promotion of breastfeeding, the document stated, “Research and practice has reinforced the conclusion that breastfeeding and the use of human milk confer unique nutritional and other benefits to the infant and the mother and, in turn, optimize infant, child, and adult health as well as child growth and development. Recently published evidence based studies have confirmed and quantitated the risks of not breastfeeding. Thus, infant feeing should not be considered as a lifestyle choice but rather as a basic health issue.”
The third goal requires “measureable commitment to source and serve local, sustainable food.” The document states, “Communities recognize that their hospitals are important anchor institutions— those institutions that, once established, tend not to move location and are important economic drivers. Through their purchasing policies, hospitals can be an important driver for the local agriculture community, thereby supporting economic and social resilience.”
Tom Spence said the third goal sounded like it was more about “social programming” than health. He was concerned that this initiative could result in higher food costs for the dietary department and decreased sales for other local food vendors and wondered if the locally produced food supply would be able to keep up with the hospital’s needs. The challenge calls for hospitals in northeast Minnesota to purchase 20 percent of their food from producers within a 200- mile radius by 2020.
Dr. Sandy Stover said she realizes that some foods cannot be produced locally but said, “Do we really need grapes from Chile when we could have apples from Bayfield?”
The board approved taking on the Commons Health Hospital Challenge, with the third goal to be accomplished “to the extent practical.” An employee committee will be assembled to develop a plan.
Computerized billing system
Teresa Hanson outlined the Chargemaster computerized billing system used by the hospital. She said they have to make sure all the right information is entered into the system, including diagnoses that justify the medical procedures that are carried out. Keeping up with new requirements is challenging, she said, because “it changes all the time.”
The standard ICD-9 diagnosis system is being updated to the ICD-10, a change that will replace one big book with about 10. “It will be a universal language, this ICD-10,” Hanson said, and it will require increasing the amount of details provided in billing. For example, the ICD-10 will have a code for accidents involving turtles. “There’s even codes in there for accidents involving spaceships,” she said.
Dr. Stover said she anticipates that being specific enough to keep insurance companies from rejecting claims will “drive us all nuts.”
Commissioner compliments hospital
With his second term up at the end of the year, County Commissioner Jim Johnson gave his last report as county board liaison to the hospital board. He thanked the hospital for their quality care and said he believes the hospital is a vital asset to Cook County.
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