University Medical Center of Southern Nevada Governing Board May 30, 2018

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University Medical Center of Southern Nevada Governing Board May 30, 2018 UMC Emerald Room 901 Rancho Lane, Suite 180 Las Vegas, Clark County, Nevada Wednesday, May 30, 2018 2:00 p.m. The University Medical Center Governing Board met in regular session, at the regular place of meeting in the Emerald Room, 901 Rancho Lane, Suite 180, Las Vegas, Clark County, Nevada, on Wednesday, May 30, 2018 at the hour of 2:00 p.m. The meeting was called to order at the hour of 2:07 p.m. by Chair John O Reilly. The following members were present, which constituted a quorum of the members thereof: CALL TO ORDER Board Members: Present: John O Reilly, Chair Donald Mackay, M.D., Vice-Chair Robyn Caspersen Jeff Ellis Harry Hagerty (Via Phone) Laura Lopez-Hobbs Jeff Ellis Christian Haase Mary Lynn Palenik Renee Franklin Absent: Ex-Officio Members: Present: Barbara Fraser, Ex-Officio (Via Phone at 2:30) Barbara Atkinson, M.D., UNLV School of Medicine Dr. Frederick Lippmann, Chief of Staff Absent: Also Present: Mason VanHouweling, Chief Executive Officer Susan Pitz, General Counsel Terra Lovelin, Board Secretary

May 30, 2018 Page 2 of 8 SECTION 1. OPENING CEREMONIES PLEDGE OF ALLEGIANCE ITEM NO. 1 PUBLIC COMMENT Chair John O Reilly asked if there were any persons present in the audience wishing to be heard on any item on this agenda. Speakers: None ITEM NO. 2 Approval of minutes of the regular meeting of the UMC Governing Board on April 25, 2018. (Available at University Medical Center, Administrative Office) (For possible action) FINAL ACTION: A motion was made by Member Franklin that the minutes be approved as recommended. Motion carried by unanimous vote. ITEM NO. 3 Approval of Agenda (For possible action) Member Caspersen commented that with regards to Business Item Number 7, instead of the word, Replacement, perhaps it should have said Implementation, when referring to the Epic update. FINAL ACTION: A motion was made by Member Franklin that the agenda be approved as presented. Motion carried by unanimous vote. SECTION 2. CONSENT ITEMS ITEM NO. 4 Approve and recommend for approval by the Board of Hospital Trustees for University Medical Center of Southern Nevada, the Third Amendment to Preliminary Affiliation Agreement with the Board of Regents of the Nevada System of Higher Education (NSHE) on behalf of the University of Nevada, Las Vegas and its School of Medicine (UNLV School of Medicine or School); and take action as deemed appropriate. (For possible action) - UNLV Third Amendment FINAL ACTION: A motion was made by Vice-Chair Mackay to approve as recommended. Motion carried by unanimous vote.

May 30, 2018 Page 3 of 8 ITEM NO. 5 Approve Amendment One to RFP No. 2016-10 Service Agreement for release of medical information and copying services between MRO Corporation d/b/a MRO and University Medical Center of Southern Nevada; and take action as deemed appropriate. (For possible action) - Amendment 1 to Service Agreement FINAL ACTION: A motion was made by Vice-Chair Mackay to approve as recommended. Motion carried by unanimous vote. ITEM NO. 6 Approve Amendment Six to Agreement for Staff Augmentation Services between Optimum Healthcare IT, LLC and University Medical Center of Southern Nevada; and take action as deemed appropriate. (For possible action) - Amendment 6 to Staff Augmentation Services FINAL ACTION: A motion was made by Vice-Chair Mackay to approve as recommended. Motion carried by unanimous vote. SECTION 3: Business Items ITEM NO. 7 Receive an update on the replacement of the Electronic Health Record (EHR) product; and take any action deemed appropriate. (For possible action) - Epic Deployment and Phase II Overview DISCUSSION: Lonnie Richardson, Chief Information Officer updated the Board on Phase Two of the implementation. At this time staff is in the middle of implementing UNLV s 12 practice plans, imaging system and billing system and it is going quite well. Mr. Richardson praised Dr. Gardner and his team for their great teamwork as this has been a very tight deadline. The project will be completed by July 1, 2018. The second part of Phase Two is deployment of new modules which include Laboratory Beaker, which replaces the Cerner Environment, Oncology, and Transplant, along with a few others. Additionally, Epic is being upgraded to Epic 2018. Chair O Reilly asked if there was a way for patients to access their other medical records at UMC so their records are visible via the Share Everywhere function.

May 30, 2018 Page 4 of 8 Mr. Richardson replied that other hospitals can view UMC patient records even if they do not have Epic as the EHR. A discussion ensued regarding billing and what steps are being taken to ensure accurate billing with the modules. ITEM NO. 8 Receive a presentation by Deb Fox, CNO, on the progress of UMC toward Pathways to Excellence and Magnet designations. (For possible action) - Pathways to Excellence and Magnet Designation DISCUSSION: Deb Fox, CNO provided an overview on the progress of Pathways to Excellence and Magnet. The three main reasons why UMC would pursue both Pathways to Excellence and Magnet designation: 1. It is the right thing to do for our patients. 2. It is a part of being a premier academic health center 3. It creates a strong collaborative culture where every discipline is valued for their expertise. Each designation stands on its own and focuses on different standards and measures of success. Only 162 hospitals have Pathways to Excellence designation and there are zero hospitals in Nevada that have achieved Magnet. For most organizations it takes two to three years for the Pathways designation to be achieved. UMC is registering in June of this year, document submission will occur in late Spring of 2019, and we expect the designation in late summer of 2019. Magnet is considered to be the universal gold standard for clinical excellence across the world. Magnet hospitals attract top tier talent, foster a collaborative culture, advances nursing standards and grows the facility s business and financial success. The process for Magnet designation usually takes 4 to 4.5 years to achieve and UMC is on track for achieving this in the year 2021. UMC is on track for reaching the Pathways to Excellence designation in late Summer of 2019. Vice Chair Dr. Mackay asked if once UMC achieves Magnet status, can the status also be taken away. Ms. Fox replied that every four years there is a resurvey and a survey team will come out and look at a multitude of things. They can pull the designation if certain requirements are not met.

May 30, 2018 Page 5 of 8 ITEM NO. 9 Receive a report from the Governing Board Human Resources and Executive Compensation Committee; and take any action deemed appropriate. (For possible action) - None submitted DISCUSSION: Jeff Ellis, Chair of the Human Resources Committee provided a summary on the May 21, 2018 meeting. The Committee received a report from the Nevada State Hospital Association on Board certification. It didn t sound like it would be too time consuming for our board to get the educational hours required as most of the training can be achieved through our own board meetings. A summary was received from CEO VanHouweling on his committee s goals and achievements thus far. ITEM NO. 10 Receive a report from the Governing Board Audit and Finance Committee; and take any action deemed appropriate. (For possible action) - None submitted DISCUSSION: Robyn Caspersen, Chair of the Audit and Finance Committee, provided a summary of the meeting that was held on May 16, 2018. The committee received an audit report from Nathan Strohl, Internal Auditor on Emergency Medicine Physicians. An update from Mr. Richardson was presented on Phase Two of the Epic implementation. The April monthly financials were discussed and the Board will be presented with those. DNFB days were discussed and Ms. Wakem presented a plan to reduce the number of days to eight by the end of the fiscal year. The committee approved the changes to the CEO s delegation of authority and recommended it for approval by this board today.

May 30, 2018 Page 6 of 8 ITEM NO. 11 Approve and adopt the changes to the Resolution delegating authority of certain agreements to the Chief Executive Officer; and take action as deemed appropriate. (For possible action) - Resolution Redlined - Resolution Final DISCUSSION: Mr. VanHouweling explained that changes to the language in this resolution, in place since 2014, clarify such things as, the dollar amount of contracts that come to the board, clinical research agreements and training agreements that have no cost to the hospital and accepting grants over a certain amount. FINAL ACTION: A motion was made by Member Caspersen to approve as recommended. Motion carried by unanimous vote. ITEM NO. 12 Receive the monthly financial report for April FY18; and take any action deemed appropriate. (For possible action) - April FY2018 Financials DISCUSSION: Jennifer Wakem presented the following financial summary for FY2018 for April. -Net patient revenue for the month exceeded budget by $68,000 -Total operating expenses were above budget by $657,000 -Income from operations was $400,000 on a budget of $1.3 million -Salaries, wages and benefits were over budget by $856,000 -Total admissions were 2,233, which was up by 31.2% -In-Patient Surgery cases totaled 917, an increase of 42% from prior year -ER visits totaled 9,619, down from prior year 7.7% -Length of Stay was down 4.77% The status of the DSH repayment was discussed. The state auditors for DSH are currently reviewing FY15 and have given us a preliminary look at what we would have to pay back for FY2015. Ms. Wakem remains hopeful that we will not have to pay back the amount suggested.

May 30, 2018 Page 7 of 8 ITEM NO. 13 Receive an update on the University of Nevada Las Vegas School of Medicine; and direct staff accordingly. (For possible action) - None submitted DISCUSSION: Dean Atkinson provided the following updates. -The Governor s task force met this morning and the school received $800,000 for 2 programs; the Critical Care program and Pediatric Emergency Medicine -New Designated Institutional Officer, Kate Martin, who replaced Dr. Bar On -New class of residents start June 19 -Medical student second class starts July 16 -Practice plan is now in a revenue stage -New faculty announced ITEM NO. 14 Receive an update from the Hospital CEO; and direct staff accordingly. (For possible action - None submitted DISCUSSION: Mason VanHouweling provided the following operating updates. -The 18 bed Emergency Department Clinical Decision Unit is slated for survey by the state the week of June 18, and the open house will be held on June 15 -A contract to purchase two new cardiac catheter labs will be brought to the A&F committee on June 20 -Tesla magnets are coming and should arrive mid-august -A Trumpf Surgical table to accompany the DaVinci Robot will be arriving June 1 -Dr. Michael S., UNLV pediatric surgeon is being recognized by Vegas Inc. -EMS week/trauma Survivor s luncheon celebration last week -Medical District insert in the LV Review Journal John Espinoza was recognized as Friday is his last day after 32 years. He is retiring and there is a celebration tomorrow that everyone is welcome to attend. It was also mentioned that Brenna Leising was promoted to Director of Operations for HR. FINAL ACTION: None

May 30, 2018 Page 8 of 8 SECTION 4: EMERGING ISSUES ITEM NO. 15 Identify emerging issues to be addressed by staff or by the Board at future meetings; and direct staff accordingly. (For possible action) No emerging issues. COMMENTS BY THE GENERAL PUBLIC: No comments There being no further business to come before the Board at this time, at the hour of 3:06 p.m. Chair O Reilly adjourned the meeting. Minutes Prepared by: Terra Lovelin APPROVED: June 27, 2018