ANNUAL ORGANIZATIONAL MEETING - leehealth.org · ANNUAL ORGANIZATIONAL MEETING Tuesday, JANUARY 6, 2009 ... (Jim Humphrey, Board Counsel) ... University of Miami, ...

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L E E M E M O R I A L HEALTH SYSTEM BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS

ANNUAL ORGANIZATIONAL

MEETING

Tuesday, JANUARY 6, 2009

12:00pm

LEE COUNTY PUBLIC EDUCATION CENTER 2855 Colonial Blvd, Ft. Myers, FL 33966

ELECTRONIC BOARD PACKET

Any Public input is limited to three minutes and a “Request to Address the Board of Directors” card must be completed and submitted to the Board Assistant prior to meeting.

LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS ANNUAL ORGANIZATIONAL BUSINESS MEETING

Tuesday, January 6, 2009, 12:00 p.m.

LEE COUNTY PUBLIC EDUCATION CENTER, 2855 Colonial Blvd, Ft. Myers, FL 33966

TENTATIVE AGENDA

1. 12:00pm - CALL TO ORDER (Board Vice Chairman Nancy McGovern, RN, MSM) LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS, sitting as the Lee Memorial Health System (LMHS) Board of Directors of Southwest Florida Regional Medical Center, Gulf Coast Hospital, Lee Memorial Hospital & HealthPark Medical Center and the Board of Directors of its subsidiary corporations: Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Medical Management, Inc.; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc.

2. Public Input - Agenda Items: Any Public input is limited to three minutes and a “Request to Address the Board of Directors” card must be completed and submitted to Board Assistant prior to meeting.

3. Invocation and Pledge of Allegiance (Reverend Cynthia Brasher, System Director/Spiritual Services)

4. Swearing In of Newly Elected Directors of the Board (Judge John Carlin)

5. Election of Board Officers (Jim Humphrey, Board Counsel & Cathy Stephens, Board Liaison)

6. Board Counsel Report (Jim Humphrey, Board Counsel) (Verbal) 7. Board of Director Meeting Minutes of Dec 4 & Dec 11, 2008 (Approvals) (Board Secretary)

8. Medical Staff Business (All Directors) A. Recommendations of December 15, 2008 (Approvals)

i. Lee Memorial Health System (Lee Memorial Hospital & HealthPark Medical Center) ii. Cape Coral Hospital

B. Medical Staff: Issues - Discussion

9. Old Business

10. New Business

11. President’s Report – Community Visioning Presentation (Presentation by Sally Jackson, System Director of Community Projects)

12. Board Liaison Report (Cathy Stephens, Board Liaison) A. 2009 Schedule B. Liaison & Committee Assignment Process

13. Date of the next regular LEE MEMORIAL HEALTH SYSTEM BOARD MEETING Thursday, January 29, 2009, 3:00pm,

Lee County Public Education Center, 2855 Colonial Blvd., Ft Myers, FL (Lee County Trauma Services District Meeting held concurrently)

14. ADJOURN LEE MEMORIAL HEALTH SYSTEM ANNUAL ORGANIZATIONAL BUSINESS MEETING

Followed by a BRIEF Lee County Trauma Services District Meeting

cs/BOD/Presentations/010609 Annual Org Business Meeting Tentative Agenda

___________________ L E E M E M O R I A L HEALTH SYSTEM

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PUBLIC INPUT – AGENDA ITEMS:

Any public input

pertaining to items on the Agenda is limited to three

minutes and a “Request to Address the Board of Directors”

card must be completed and submitted to the Board Assistant

prior to meeting.

Refer to Board Policy: 10:15E: Public Addressing the Board Non-Agenda Item: Individuals wishing to address the Board on an item NOT on the Agenda, the Board office must be notified of subject matter at least seven (7) days prior to the meeting to allow staff time to prepare and to insure the matter is within the jurisdiction of the Board.

Lee Memorial Health System Board of Directors Annual Organizational Business Meeting

January 6, 2009

THERE IS NO DOCUMENTATION FOR:

4. Swearing-In of Newly Elected

Directors of the Board (Judge Carlin)

Richard B. Akin

Current Board Officer Position: Treasurer

District: 2 Term: 2006-2010

Liaison Positions: Financial Operations, The Children's Hospital, Bonita Community Health Center, Chairman - Finance Committee of the Whole

Background/Experience

Mr. Akin has 35 years of health care management experience. For the past 26 years, Mr. Akin has served as the president and CEO of Collier Health Services, Inc., a not for profit, primary health care provider in Collier county.

Mr. Akin has a passion for children’s health care. He initiated the Children’s Health Network, a pediatric system of care which provides the majority of health care for children in Collier county, with 11 locations. He is also responsible for bringing the first Ronald McDonald Care Mobile to Florida, and for initiating a pedodontic dental residency program as a partnership with the University of Florida College of Dentistry. Currently, he is developing a pediatric center of excellence for the children of Immokalee.

Mr. Akin attended Florida State University and the University of Miami, and holds degrees in biology and chemistry. He has done graduate study in health care administration.

Mr. Akin has received numerous awards for his service and dedication to health care excellence, including most recently (February, 2006), the Harvey Kapnick award, given by the Collier County Community Foundation for the best managed not for profit in Collier county. He has received the Distinguished Service Medal from the Nova Southeastern University College of Medicine, and has served twice as the chairman of the Florida Association of Community Health Centers. Currently, he is the chairman of the Everglades Area Health Education Center, a part of the Nova Southeaster College of Medicine, and Vice-President of Ronald McDonald House Charities.


BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS BOARD OFFICER POSITION SURVEY

Board Members, If you are interested in being considered for an Officer position on this Board, (Chairman, Vice-Chairman, Treasurer, Secretary) please complete the Bio/Questionnaire below.

Submit back to Cathy Stephens no later than December 15, 2008.

Name: Lois Barrett

Officer Position(s) you are interested in: (CIRCLE your choice(s) Chairman – Presides at Full Board Meetings; approves agenda; Assigns liaison positions and chairman/vice-chairman of each Board committee; requires public speaking skills; addresses major donors and other formal audiences on behalf of the board annually; is interviewed on board matters by media; Physician Leadership Council Member.

Vice-Chairman – Responsible for all duties of Chairman, when Chairman unavailable.

Treasurer – Chairman of Finance Committee; formulates agenda with Chief Financial Officer (CFO) & Board Liaison; Oversees all finance matters with CFO.

Secretary – Responsible for overseeing official legal noticing of Board & Committee meetings; responsible for oversight of minutes for each official meeting of the Board or it’s committees. Please express in 50 words or less, why you would like to seek the office you are interested in? I’m interested in continuing as Board Secretary. Bio: (May attach CV or Resume) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

V:\PRESENTATIONS\2009\FULL BOARD\010609 Annual Org\Barrett-Board Officer Position Survey.doc

Lois C. Barrett, MBA

Current Board Officer Position: Secretary District: 3 Term: 2008-2012

Liaison Positions:

The Children’s Hospital of Southwest Florida Executive Council

Post Acute Services

Background/Experience

First Elected to LMHS Board in November 1980

Began term in January, 1981

Administrator of a medical surgical hospital (holds a master’s

degree in Hospital Administration)

Administrative experience in an outstanding teaching hospital,

specifically as administrator of their children's hospital.

Served for 11 years as Chairman of the LMHS Board, during which

time the System built HealthPark Medical Center, purchased Cape

Coral Hospital, added many needed services to the System, and

partnered with other health systems

Cs/updated Jan 2009

LINDA L. BROWN - Resume.doc Page 1 of 2

LINDA L. BROWN, MSN, NP, CS

Family Nurse Practitioner 14890 Shrike Way, Ft. Myers, FL 33908

Phone (239) 229-3363

PROFESSIONAL EXPERIENCE: Board of Directors, Lee Memorial Health System

Publicly elected 2000, re-elected 2004, 2008 Chairman 2003, 2004, 2005, 2006; Vice Chairman 2002 Planning Committee Chairman 2003 - Present

Board of Directors, Lee County Trauma Services District

Initial Chairman 2003, 2004, 2005, 2006 McDonalds Restaurants, College Parkway, Ft Myers, FL

Owner/Operator with husband, Bob Meisenheimer since 1991 Hope Select Care / Hope Hospice, Ft. Myers – Nurse Practitioner

2006 – present Allergy and Asthma Care Centre, (Joseph Zeterberg MD & Larry Castillo MD)

Ft. Myers/Cape Coral, FL • Research Coordinator/Sub Investigator for clinical trials 2002 - 2005 • Nurse Practitioner for Adults and Children in Allergy Diagnosis and Management

1993 – 1996, 2004 – 2007

Cleveland Clinic, Naples, FL Otolaryngology Clinic Healthcare Provider 2000 - 2002

University of Miami, School of Nursing

Adjunct Faculty – Preceptor for graduate students 1992 – 2001

Military Officer, U. S. Navy Reserve Nurse Corps Lt. Commander, United States Navy Reserve 1989 - 2002

Family Practice, (Terrance Johnson MD) Naples, FL (HCA)

Acute interventions and health maintenance in all age groups, women’s health. 1996 - 2000 Florida Dept. of Health 1991 - 1993

• Dade County Hurricane Andrew Relief, Miami, Florida Primary Care and disaster relief in devastated areas.

• Collier County Public Health Unit, Naples, FL

ARNP, Adult Infectious Disease Clinic, Pediatric Clinic, Adolescent Health Program

LINDA L. BROWN - Resume.doc Page 2 of 2

1978 – 1990 • Began RN career in PICU, Wolfson Children’s Hospital Jacksonville, FL. Volunteered in

early stage hospice program. • Became Patient Care Coordinator of Hospice Northeast in Jacksonville and introduced

pediatric hospice concept. • Owned and operated Prescribed Pediatric Extended Care with Medi-Kid, a grant funded

day care center that provided skilled nursing to technology dependent infants. This model evolved into a national project.

• Opened and supervised a free standing inpatient hospice unit, Hospice by the Sea, Boca Raton, FL

EDUCATION & BOARD CERTIFICATIONS:

MSN 1991 Florida Atlantic University, Boca Raton, FL BSN 1989 Florida Atlantic University, Boca Raton, FL ADN 1977 Florida Community College, Jacksonville, FL

Foreign studies at Universities in Sao Paulo, Brazil and Quito, Ecuador.

• Spanish spoken fluently; Portuguese spoken RN Licensed in Florida Since 1977, Community Health Nurse ANCC Certified. Nurse Practitioner Licensed since 1991, State of Florida. ANCC Certified since 1991 as a Family Nurse Practitioner

SERVICE:

• American Hospital Association (AHA) Regional Policy Board, Term 2006 – 2009 • Lee Memorial Health System “Healthcare 2017 Visioning” Committee 2007 • Hadassah Nursing Award Project, 2006 - Present • Barbara Lumpkin Institute Founding Committee 2007 • Healthy Florida Foundation 2003 – Statewide committee of 100 selected leaders • Ombudsman ACHA District 8 Managed Care Board of Directors, Initial Chairperson 1999-

2000, service until 2004 • Florida Nurses Association

• Board of Directors 1993-1995 • Legislative District Coordinator 1992 - Present • Florida Nurses Political Action Committee 1993-2001

• Chairman 1998-2001 • Florida Nurses Foundation Board of Trustees, 2001 - Present • Lee County Republican Executive Committee, 1994 - 2004 • Lee Republican Women Federated, 1994 - Present, Vice-President 2000 • Ft. Myers Republican Women Federated, 2003 – Present • Ronald McDonald House, Initial Board, Jacksonville, FL, 1984-1987 • Member, Saint Luke’s Episcopal Church

VOLUNTEER ACTIVITIES:

• Mt. Hermon Mission to Zambia 2007 (Healthcare) • Project Perfect World Medical Mission, Quito, Ecuador, 2005 • Ronald McDonald Care Mobile Project, Naples, FL, 2004 – Present • Ronald McDonald Charities, Ft. Myers, FL, 1991 - Present • Medical Reserve Corps, Lee County, Florida • Costa Rica – Methodist Dental Mission, 2000 & 2001 • Honduras Health Mission 1999


BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS BOARD OFFICER POSITION SURVEY

Board Members, If you are interested in being considered for an Officer position on this Board, (Chairman, Vice-Chairman, Treasurer, Secretary) please complete the Bio/Questionnaire below.

Submit back to Cathy Stephens no later than December 15, 2008.

Name __Nancy M. Mc Govern, RN, MSM Officer Position(s) you are interested in: (CIRCLE your choice(s)

Chairman – Presides at Full Board Meetings; approves agenda; Assigns liaison positions and chairman/vice-chairman of each Board committee; requires public speaking skills; addresses major donors and other formal audiences on behalf of the board annually; is interviewed on board matters by media; Physician Leadership Council Member.

Vice-Chairman – Responsible for all duties of Chairman, when Chairman unavailable.

Treasurer – Chairman of Finance Committee; formulates agenda with Chief Financial Officer (CFO) & Board Liaison; Oversees all finance matters with CFO.

Secretary – Responsible for overseeing official legal noticing of Board & Committee meetings; responsible for oversight of minutes for each official meeting of the Board or it’s committees. Please express in 50 words or less, why you would like to seek the office you are interested in? __________I have been on the Board for ten years and have grown in my knowledge about the healthcare system and the role as a BOD. I have, in the past, been voted in as Secretary (for two and a half years), and as Vice Chairman (twice). I am grateful to serve the system in any capacity. I would be honored to serve any of the above positions, Chairman, Vice Chairman, Treasurer, or Secretary, that my fellow board members see fit for me to fulfill. Bio: (May attach CV or Resume) __See my CV attached.

V:\PRESENTATIONS\2009\FULL BOARD\010609 Annual Org\Nancy McGovern - BioinfoforElectionsofOfficers.doc

1

Nancy M. McGovern 785 South Entrada Drive Fort Myers, Florida 33919

[email protected] A goal driven nurse advocate who works toward solutions to support optimal patient outcomes through political and social changes. An activist and visionary, who derives great satisfaction by affecting change for the promotion of the nursing as a profession. Work Experience: Lee Memorial Health System, Vice Chairman- Board of Directors-1999- present As Vice Chair, this position serves as liaison to nursing, corporate compliance, risk management, and women’s services. As a liaison my responsibilities include regular meetings for updates on critical issues that may need to be relayed to the Board of Directors. Examples of how I affected change includes sensitizing Board Members and voted to increase nursing salaries, voted to seek Magnet status, and voted to increase the budget to hire more nurses. Family Home Health- September 2006-present Case Manager Responsible for holistic nursing care of home-based patients including primary care nursing interventions and preventative measures which includes patient and family teaching. Southwest Florida Home Care August 2006- present Case Manager Responsible for leading a multi-disciplined healthcare team that provides quality care to individuals within the home setting. Home Health Corporation of America- August 2004- August 2006 Case Manager

2

Provided coordinated care with multiple disciplines to home-based patients. Housecalls Home Health 2002-2004 Case Manager Responsible for holistic nursing care of home-based patients including primary care nursing interventions and preventative measures which includes patient and family teaching. Portamedic- 2000- 2005 The duties included insurance physical which included overall assessments, full blood work-ups, and EKG’s. Legal Nurse Consultant- 1998- 1999 Case Reviewer Bill Berke, Esquire Provided expert nursing assessments to determine gaps in care and outcomes to determine cause for legal action. Health Corporation Inc. Home Health- 1996-1998 Case Manager Home Health Services of Lee- 1994-1995 Case Manager Olsten Kimberly Home Health- 1990-1994 Case Manager, Research Nurse Provide individualized care within the home setting. Clinical Physiology Associates Clinical Research Coordinator As a Clinical Research nurse I was responsible for conducting hypertension, diabetes and Alzheimers and multi-Dementia studies. Most of the medications for the studies were approved and are being prescribed today. Calusa Harbour- 1983-1984 Head Nurse, Geriatric Facility

3

Responsible for 24/7 care to a geriatric population and functioned as the nurse leader to coordinate personalized care to clinical study participants. Upjohn Health Care- 1979-1983 Private Duty, Staff Relief R.N. Professional Nursing Affliliations: American Nurses Association- 1998-present Florida Nurses Association (FNA) Bylaws Committee-member- 2006-present FNA Political Action Committee (PAC)- past Board member-2002-2006 FNA Awards Committee-past Chair-2002-2004 FNA District 7- President, 1999-2001 FNA State Board of Directors, Member-2001-2003 Nurses Study Council at University of South Florida, past member /Chair Sigma Theta Tau- Member, 2000-present, 436 Tau Zeta Legislative District Coordinator for FNA- 1999-present Clinical Excellence committee- FNA-2006 and FNA District 7 2001-2004 Political Activites Elected official- Trustee, Lee Memorial Board of Directors-1998, 2002, 2006 Member President George Bush campaign 2000 and 2004 Member Presidential Detail: Bush family trip to Boca Grande Chair: Bill Mc Collum’s Senate Campaign, Ft. Myers Multiple trips to Tallahassee to fight for nursing legislation

Worked with Kathy Whitson (who is this?) and legislators to promote operating room nurses bill (passed) Majority Dinner in 2000- Republican fundraiser with FNAPAC Serve as a Legislative District Coordinator for the FNA in the Lee County area

Member: Buckley for Senate campaign –1960 Nancy: 47 years ago

4

Speaking Engagements Advanced Registered Nurse Practitioner Fort Myers chapter- Politics and Nursing Veterans Association Nurses- Politics and Nursing Statewide Clinical Excellence in Fort Myers in 2006-Nursing in the Political Arena Organizations: Rotary International Fort Myers Rotary South-member 2006-present Presidents Club, International College- 2005- present American Heart Association- Heart Walk Committee member, Community Board member Republican Executive Committee-Committeewoman, District 91 Catholic Charities Advisory Committee-Board Member 2004-present Catholic Charities Venetian Ball Committee-member 2003-present Florida Risk Management Society, Member- 2002- 2005 Legal Consultants Association, Member- !999-2000 Professionals Organized for Leadership and Opportunity Fort Myers, past Board Member 1996-2000 Fundraising Jazz on the Green committee 1996-present (benefiting The Children’s Hospital at LMHS) Fundraiser for the Children’s Hospital of Southwest Florida (Lee Memorial) American Cancer Society, past Board Member 1986-1989 American Diabetes Association, past Board Member 1980-1981 Muscular Dystrophy Association, past Board Member United Tennis Association- Lifetime Member Fundraising committee for Representative Carole Green Education: Masters in Management, International College, Fort Myers, Florida 2005

5

Medical-Legal Consultant, Florida Risk Management Institute 1999 Risk Management, Florida Risk Management Institute 1996 Bachelor of Science in Nursing, University of South Florida 1981 Associate of Arts, Hillsborough Community College, Tampa, Florida 1980

Associate of Science in Nursing, Edison Community College, Fort Myers,

Florida

Lee Memorial Health System Board of Directors Annual Organizational Business Meeting

January 6, 2009

THERE IS NO DOCUMENTATION FOR:

6. Board Counsel Report

(Jim Humphrey, Board Counsel)

VERBAL REPORT

LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS MEETING MINUTES

Thursday, December 4, 2008 LOCATION: Lee County Public Education Center (LCPEC), 2855 Colonial Blvd., Fort Myers, FL 33966 MEMBERS PRESENT: John Donaldson, M.D., Chairman; Nancy McGovern, RN, MSM, Vice Chairman; Richard Akin, Treasurer; Linda Brown, MSN, ARNP, Director; Jason Yost, Director; Kerry Babb, Director; James Green, Director MEMBERS ABSENT: Lois Barrett, MBA, Secretary; Marilyn Stout, Director; Frank La Rosa, Director OTHERS PRESENT: Jim Nathan, CEO/President; Jim Humphrey, Esq., Board Counsel/Fowler & White; Cathy Stephens, Board of Directors’ Liaison; Mary McGillicuddy, Chief Legal Officer; John Wiest, Chief Financial and Institutional Services Officer; Jon Cecil, Chief Human Resources Officer; Donna Gianuzzi, RN, Chief Patient Care Officer; Chuck Krivenko, M.D., Chief Medical Officer/Clinical and Quality Services; Gaile Anthony, Chief Administrative Officer/LMH; Doug Luckett, Chief Administrative and Ancillary Services Officer/SWFRMC/GCH; Larry Antonucci, M.D., Chief Administrative Officer/CCH; Sharon MacDonald, Chief Foundation Officer; John Iacuone, M.D., Executive Director/The Children’s Hospital; Wendy Piascik, Vice President/Patient Care/CCH; Charles Bisbee, M.D., Vice Chairman/Physician Leadership Council (PLC); Sandy Wharton, System Director/Medical Staff Services; Reverend Cynthia Brasher, System Director/Spiritual Services; Sally Jackson, System Director/Community Projects; Karen Krieger, System Director Public Affairs; Chaplain Bill Miller, Spiritual Services/LMH; Michelle Vargas, Executive Secretary/The Children’s Hospital; Jack Hess, Auxiliary President/CCH; Anna Lou Sonderman, Auxiliary President/SWFRMC; Nora Harmon, Auxiliary President/LMH/HPMC; Stephen Brown, M.D., Community Representative/ Quality and Education Committee; Marliese Mooney, Physician Leadership Council Consultant/Planning Committee; Robert Arnall, M.D., Guest; Sam Arnall, Guest; Dawson McDaniel, Guest; Bob Johns, Guest; Isabel Firth, Administrative Secretary/Board of Directors; Beth Finney, Executive Secretary/Board of Directors

NOTE: Documents referred to in these minutes are on file by reference to this meeting date in the Office of the Board of Directors and on the Board of Directors website at www.leememorial.org/boardofdirectors for public inspection.

SUBJECT DISCUSSION ACTION FOLLOW-UP

MEETING CALLED TO ORDER

The LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS, sitting as the Lee Memorial Health System

Board of Directors of Southwest Florida Regional Medical Center, Gulf Coast Hospital, Lee Memorial Hospital,

HealthPark Medical Center and the Board of Directors of its subsidiary corporations: Cape Memorial Hospital, Inc.

doing business as Cape Coral Hospital; Lee Memorial Medical Management, Inc.; Lee Memorial Home Health,

Inc.; and HealthPark Care Center, Inc. meeting was CALLED TO ORDER

by Chairman John Donaldson, M.D. at 3:00 p.m.

INVOCATION AND

PLEDGE OF ALLEGIANCE

The Invocation was given by Chaplain Bill Miller and was followed by the Pledge of Allegiance.

CHAPLAIN

BILL MILLER RETIREMENT

ANNOUNCEMENT

Cynthia Brasher announced the retirement of Chaplain Bill Miller. She thanked him for his service with Lee Memorial Health System and wished him the best of luck with his future mission work.

PUBLIC INPUT There were NO “Public Input” items.

RECOGNITIONS:

DR. ARNALL RETIREMENT

SHARON MACDONALD SAKS 5TH AVE LIFETIME

ACHIEVEMENT HUMANITARIAN

AWARD

John Donaldson and Jim Nathan recognized Dr. Arnall for his forty-five years plus service to Lee Memorial Hospital. John said Bob has served LMH as a medical voice and as the director for The Children’s Hospital. John Donaldson presented him with a Proclamation of Appreciation (Exhibit 1). Jim said Bob is truly a pioneer physician and without his leadership, commitment, and integrity the System would not be where it is today. Applause followed. John Iacuone also thanked Bob for being his mentor and teaching him the dynamics of the medical community. Bob thanked the LMHS Board of Directors for recognizing him and thanked the System and his colleagues for many wonderful years. Photographs were taken and applause followed. Jim Nathan provided an overview of the Saks Fifth Avenue Annual Key to the Cure Humanitarian Award and recipient (Exhibits 2-3) Sharon MacDonald. He said Sharon has been a crusader for making a difference in the lives of cancer patients and continues to be an advocate for patient care and cancer research. He said she has done a phenomenal job in the creation of the recently opened LMHS Regional Cancer Center. He congratulated and recognized her for being the first

http://www.lememorial.org/boardofdirectors

LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS MEETING MINUTES Thursday, December 4, 2008 Page 2 of 5


JASON YOST TERM OF SERVICE

JOHN DONALDSON TERM OF SERVICE

recipient of the Lifetime Achievement Humanitarian Award. Sharon thanked Jim and the Board for recognizing her however she said the privilege is truly hers. She said she is fortunate for being able to connect with those physicians who have been able to change the face of cancer, creating a beacon for health and wellness for both the body and the mind of cancer patients. Applause followed. Cathy Stephens invited Jason Yost to the podium. Cathy provided an overview of Jason’s service and his various liaison responsibilities. John Donaldson presented Jason with a plaque honoring and recognizing him and wishing him the best of luck in his future endeavors. Jason said thank you for the opportunity of working with the Board and he is proud of the Board for all their successes. Applause followed. Cathy Stephens provided an overview of John Donaldson’s service as Director and Chairman on the LMHS Board. Jim Nathan said John has served LMHS as a champion for quality across the System especially during a very trying time. Jim Nathan presented John with a plaque honoring and recognizing his service on the LMHS Board of Directors. John Donaldson thanked Jim and the Board for his recognition. Applause followed and photographs were taken.

(James Green entered the meeting at 3:34pm)

APPROVAL OF

MINUTES John Donaldson asked if anyone wished to make any additions or corrections to the October 30, 2008 Board of Directors Meeting Minutes.

A motion was made by Nancy McGovern to approve the October 30, 2008 Board of Directors Meeting Minutes. The motion was seconded by Kerry Babb and it carried with no opposition.

PHYSICIAN

LEADERSHIP COUNCIL (PLC)

REPORT

MEDICAL STAFF RECOMMENDATIONS NOVEMBER 14, 2008

BYLAWS UPDATE

Charles Bisbee reviewed the Physician Leadership Council (PLC) Report of December 4, 2008 (Exhibit 4). He said there was a tremendous amount of work and time involved in drafting the Medical Staff Bylaws and he thanked Steve Levine and all of those involved in this process. John Donaldson reviewed the following Medical Staff Recommendations of November 14, 2008 (Exhibits 5-8):

1. Lee Memorial Hospital/HealthPark Medical Center (Exhibit 5) 2. Cape Coral Hospital (Exhibit 6) 3. Southwest Florida Regional Medical Center (Exhibit 7) 4. Gulf Coast Hospital (Exhibit 8)

John Donaldson provided an update on the Medical Staff Bylaws. He said the System Medical Staffs have approved the Bylaws as drafted. He said there has been a great deal of work to unify the Bylaws while ensuring compliance with the Enabling Legislation. Jack Diamond said he has been working with the Board to answer questions and he will continue to be available as a consultant to the Board and Board Counsel. John Donaldson requested the Board review his comments with regard to possible solutions to conflicts in the Bylaws. He said any remaining questions or comments will be addressed at the December 11, 2008 Reconvened Board of Directors meeting. Linda Brown said she is confident with the expertise of the physicians involved in drafting the Medical Staff Bylaws. Discussion continued. James Green asked for clarification with regard to recessing the Board of Directors meeting as opposed to tabling the Medical Staff Bylaws for discussion at the December 11, 2008 Board meeting. Jim Humphrey advised the Board to acknowledge receipt of the Medical Staff Bylaws approved by each Medical Executive Committee and ‘continue’ this public meeting of the Board to December

A motion was made by Linda Brown to accept the Physician Leadership Council (PLC) Report (Exhibit 4). The motion was seconded by James Green and it carried with no opposition. A motion was made by Nancy McGovern to approve the following Medical Staff Recommendations of November 14, 2008 (Exhibits 5-8): 1. Lee Memorial Hospital/HealthPark Medical Center

(Exhibit 5) 2. Cape Coral Hospital (Exhibit 6) 3. Southwest Regional Medical Center (Exhibit 7) 4. Gulf Coast Hospital (Exhibit 8)

The motion was seconded by Linda Brown and it carried with no opposition. A motion was made by Linda Brown to accept the Medical Staff Bylaws as presented. There was NO second for this motion therefore the motion failed.


FOLLOWSUBJECT DISCUSSION ACTION -UP

11, 2008 for further discussion. Discussion ensued with regard to maintaining legal compliance and physician relationships throughout the approval process of the Bylaws.

CONSENT AGENDA John Donaldson asked if anyone wished to pull any items listed on the Consent Agenda

(Exhibit 8) for discussion. Richard Akin requested to pull Consent Agenda Item #6:

Adoption of a RESOLUTION Authorizing and Approving a plan of Finance with Respect to certain outstanding variable rate debt; authorizing the issuance of not exceeding an aggregate principal amount of $240,000,000 Lee Memorial Health System indebtedness in the form of Hospital Revenue Refunding Bonds, in one or more series, and/or a direct bank loan, in both cases secured by an obligation or Note of the System; Approving and Awarding the issuance and sale of said Bonds and/or Note at negotiated sale; Delegating to certain officers of the Board and System the authority, within certain parameters, to execute one or more Bond purchase agreements with respect to the Bonds and a Loan Agreement with respect to the Note; Authorizing the Execution and Delivery of various documents, Agreements and Certificates necessary in connection with the issuance of said Bonds and/or Note, and providing an effective date. With regard to Consent Agenda Item #6: Richard Akin addressed the Board regarding the interest rate Swap agreement. He requested to

A motion was made by James Green to approve the Consent Agenda consisting of the following:

1. Acceptance of the FY 08, 4th Quarter Risk Management Report.

2. Acceptance of the FY 08 Corporate Compliance Report.

3. Acceptance of the FY 08, 3rd Quarter Performance Improvement Indicator Report.

4. Approval of the 2009 Legislative priorities for submission to the local legislative delegation.

5. Approval of Capital Request of $200,000 to purchase furniture and equipment at the Lee Physician Group facility (Colonial Blvd., East Fort Myers) (previously approved in FY 2009 Capital Budget).

6. Item pulled by Richard Akin. 7. Accepted the FY 2008 4th Quarter Investment

Performance Report. 8. Approval to lease Suite #140 (2,371 sq ft) at Med

Plaza One near HealthPark for 5 years with options for additional terms. To create a marketable neuroscience center that can service patients from 3 counties of all neurological issues. This space is highly market competitive and allows us to expand into further square footage without additional capital cost, if necessary in the future. In addition to the lease cost, there is also an amendment for the repayment of capital dollars (Approx $28,000) to Lee HealthCare Resources for expenses paid by their organization in the build out and I/T needs of the office due to the absence of LMHS capital dollars. Repayment is over the 5-year term of the lease.

9. Approval to consolidate and move both SWFRMC and LMH Wound Care Programs to 13810 Plantation Road, Fort Myers, Approval of lease for 10,000 sq. ft. medical office space with Gulf Coast Medical Park, LLC, Approval of moving capital expenditure of $650,000 from 2010 to 2009.

10. Acceptance of the Financial and Statistical Reports for September 30, 2008 Year End FY 2008 and October 31, 2008, FY 2009.

11. Acceptance of the 4th Quarter, FY 2008 Quarterly Capital Update.

The motion was seconded by Linda Brown and it carried with no opposition.



delete Section 11 of the Resolution therefore allowing the System the flexibility for considering a Swap agreement when they deem the economy is financially stable to do so. Discussion ensued with regard to safeguarding System finances.

A motion was made by Richard Akin to adopt the RESOLUTION Authorizing and Approving a plan of Finance with Respect to certain outstanding variable rate debt; authorizing the issuance of not exceeding an aggregate principal amount of $240,000,000 Lee Memorial Health System indebtedness in the form of Hospital Revenue Refunding Bonds, in one or more series, and/or a direct bank loan, in both cases secured by an obligation or Note of the System; Approving and Awarding the issuance and sale of said Bonds and/or Note at negotiated sale; Delegating to certain officers of the Board and System the authority, within certain parameters, to execute one or more Bond purchase agreements with respect to the Bonds and a Loan Agreement with respect to the Note; Authorizing the Execution and Delivery of various documents, Agreements and Certificates necessary in connection with the issuance of said Bonds and/or Note, and providing an effective date (with deletion of Section 11). The motion was seconded by Nancy McGovern and it carried with no opposition.

CAPE CORAL

HOSPITAL OPERATIONS REPORT

Larry Antonucci reviewed the Cape Coral Hospital Operations Report (Exhibit 10).

A motion was made by Nancy McGovern to accept the Cape Coral Hospital Operations Report (Exhibit 10). The motion was seconded by Linda Brown and it carried with no opposition.

SUPPORTING AGENCY

BUSINESS

SOUTHWEST FLORIDA REGIONAL MEDICAL CENTER AUXILIARY

REPORT

CAPE CORAL HOSPITAL

AUXILIARY REPORT

FOUNDATION FISCAL YEAR 2008 REPORT

Anna Lou Sonderman reviewed the Southwest Florida Regional Medical Center Auxiliary Report (Exhibit 11). Nancy McGovern on behalf of the Board, thanked Anna Lou for her service as the Southwest Florida Regional Medical Center Auxiliary President and presented her with a flower bouquet and a dinner gift card in appreciation. Applause followed. Jack Hess reviewed the Cape Coral Hospital Auxiliary Report for 2008 (Exhibit 12). Nancy McGovern of behalf of the Board, thanked Jack for his service as the Cape Coral Hospital Auxiliary President and presented him with a dish garden and a dinner gift card in appreciation. Applause followed.

Sharon MacDonald presented the Fiscal Year 2008 Foundation Report (Exhibit 13). Discussion ensued with regard to seeking lead gifts and possible funding opportunities.

A motion was made by Linda Brown to accept the Southwest Florida Regional Medical Center Auxiliary Report (Exhibit 12) and the Cape Coral Hospital Auxiliary Report (Exhibit 13). The motion was seconded by Richard Akin and it carried with no opposition. A motion was made by Linda Brown to accept the Fiscal Year 2008 Foundation Report (Exhibit 13). The motion was seconded by Nancy McGovern and it carried with no opposition.

OLD BUSINESS/ NEW BUSINESS

There was NO “Old Business” or “New Business” to be discussed.



PRESIDENT’S REPORT Jim Nathan deferred the President’s Report to the January 6, 2009 Annual Organizational Meeting containing a Community Vision Report by Sally Jackson.

BOARD OF DIRECTORS’

REPORTS The Board collectively thanked John Donaldson and Jason Yost for their service on the LMHS Board of Directors and wished them the best of luck in all future endeavors.

BOARD LIAISON

REPORT

DECEMBER BIRTHDAYS

Cathy Stephens reviewed the LMHS Board of Directors December 2008 Calendar (Exhibit 14). Birthday wishes went to: Gene Principi December 3rd, James Green December 12th, and Joe Catti December 31st.

NEXT REGULAR

MEETING The date of the next REGULAR meeting of the Lee Memorial Health System Board of Directors is the Annual Organizational meeting (being held concurrently with the Lee County Trauma Services District meeting) on Tuesday, January 6, 2009, 12:00 p.m. at the Lee County Public Education Center (LCPEC).

RECESSED MEETING

Chairman Donaldson RECESSED this meeting of the Lee Memorial Health System Board of Directors at 4:51 p.m. to RECONVENE on Thursday, December 11, 2008 at 1:00 p.m. in the Lee Memorial Hospital Boardroom,

2776 Cleveland Avenue, Fort Myers, FL 33901.

Minutes were recorded by Beth Finney, Executive Secretary/Board of Directors Office

_________________________________________________ Lois C. Barrett, MBA

Board Secretary

LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS MEETING MINUTES

RECONVENED FULL BOARD OF DIRECTORS MEETING FROM DECEMBER 4, 2008 Thursday, December 11, 2008

LOCATION: Lee Memorial Hospital Boardroom, 2776 Cleveland Avenue, Fort Myers, FL 33901 MEMBERS PRESENT: John Donaldson, M.D., Chairman; Nancy McGovern, RN, MSM, Vice Chairman; Richard Akin, Treasurer; Lois Barrett, MBA, Secretary; Marilyn Stout, Director; Linda Brown, MSN, ARNP, Director; Kerry Babb, Director; Frank La Rosa, Director; Jason Yost, Director MEMBERS ABSENT: James Green, Director OTHERS PRESENT: Jim Nathan, CEO/President; James Humphrey, Esq., Board Counsel/Fowler & White; Cathy Stephens, Board of Directors’ Liaison; John Wiest, Chief Financial and Institutional Services Officer; Chuck Krivenko, M.D., Chief Medical Officer/Clinical and Quality Services; Donna Gianuzzi, RN, Chief Patient Care Officer; Gaile Anthony, Chief Administrative Officer/LMH; Doug Luckett, Chief Administrative and Ancillary Services Officer/SWFRMC/GCH; Larry Antonucci, M.D., Chief Administrative Officer/CCH; Charles Swain, Chief Compliance and Internal Audit Officer; Sharon MacDonald, Chief Foundation Officer; John Iacuone, M.D., Executive Director/The Children’s Hospital; Cathy Kahle, System Director/Counsel; Mike Polito, System Director/Human Resources/ SWFRMC/GCH; Sandy Wharton, System Director/Medical Staff Services; Marilyn Kole, M.D., System Medical Director/Clinical Services; Tom Presbrey, M.D., Physician Leadership Council (PLC) Chairman; Karen Krieger, System Director/Public Affairs; Kandy Dewitt, Director/Surgical Services/HPMC; Joe Tienstra, M.D., Radiology/LMH; John Rodriguez, PRN, Radiology/LMH; Greg Michaels, PRN, Radiology/LMH; Steve Brown, M.D., Community Representative/Quality and Education Committee; Dawson McDaniel, Guest; Mike Ellis, Guest; Jennifer Reed, Reporter/News-Press; Isabel Firth, Administrative Secretary/Board of Directors; Beth Finney, Executive Secretary/Board of Directors

NOTE: Documents referred to in these minutes are on file by reference to this meeting date in the Office of the Board of Directors and on the Board of Directors website at www.leememorial.org/boardofdirectors for public inspection.

SUBJECT DISCUSSION ACTION FOLLOW-UP MEETING

CALLED TO ORDER

The RECONVENED MEETING of December 4, 2008 of the LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS, sitting as the Lee Memorial Health System Board of Directors for Southwest Florida Regional Medical Center/Gulf Coast Hospital & Lee Memorial Hospital/ HealthPark Medical Center and the Board of Directors of its subsidiary corporations: Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Medical Management, Inc.; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc. was CALLED TO ORDER by Chairman John Donaldson, M.D. at 1:02 p.m.

PUBLIC INPUT John Donaldson announced Stephen Brown has requested to address the Board later in the

meeting concerning the Medical Staff Bylaws (Exhibit 1).

CHAIRMAN’S

TURNOVER SUMMARY

John Donaldson said before turning over the role as Chairman he would like to update the Board on various items that have been reported on detail throughout the year. John began reviewing the Chairman’s Turnover Summary Presentation (Exhibit 2) and requested Senior Leadership to provide any additional information they may have with regard to topics included in the presentation. Clinical Services – Hospitalist Standards: Chuck Krivenko provided an update regarding hospitalist standards. He said there will be a hospitalist scorecard and performance update presented to the Board in February. Larry Antonucci said three of the four hospitalist groups are now engaged, working collaboratively on the scorecard program. He said these groups have joined to present a consensus on standards to send to the Physician Leadership Counsel and for future approval by the Board. Clinical Services – Surgical Operations Group: Donna Giannuzzi said they are continuously working toward improving quality and specialization. Clinical Services – Orthopedic Implants: Gaile Anthony said they are still in line with the matrix and will continue working on improving implant pricing. Kerry Babb said there has been a great deal of cooperation between the physicians and System Administration. He said everything is going smoothly and everyone is engaged in the process.

Dr. Krivenko Hospitalist Scorecard and performance update in February 2009

http://www.lememorial.org/boardofdirectors

LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS MEETING MINUTES Reconvened Board of Directors meeting from December 4, 2008 Thursday, December 11, 2008 Page 2 of 3

SUBJECT DISCUSSION ACTION FOLLOW-UP Clinical Services – Quality pro-forma: Donna Giannuzzi said the System welcomes any suggestions with regard to quality issues. She said they are collaborating with all stakeholders on all patient care issues. Discussion ensued with regard to future plans for creating a quality pro-forma committee. Clinical Services – Radiology: There was discussion regarding Tail insurance and premiums. Clinical Services – Anesthesia: Chuck Krivenko said the intention is to eventually have one anesthesia group with equal workload and compensation. He said there will be challenges regarding the recent recalibration of reimbursements for Diagnosis Related Groups (DRG) by the Centers for Medicare and Medicaid (CMS) however they are working toward making an attractive and agreeable situation for both anesthesia groups. Clinical Services - Medical Staff: Chuck said they are currently in the process of separating the Lee Memorial Hospital and HealthPark Medical Center medical staff’s and creating an effective call system. Physicians’ Services – Recruiting: Jim Nathan said developing a structural relationship with the medical staff’s is crucial. He said we will need a more organized process for recruiting physicians in the future especially with the current situation of the economy. Physicians’ Services – The Children’s Hospital: John Iacuone said the biggest issue in moving forward is recruiting pediatric specialists. He said they are working on developing a long-term strategy to improve this situation. Physician Hospital Alignment: Discussion ensued regarding the national shortage of physicians and recruiting physicians to complete their residency programs in Florida. Fundraising: There was discussion with regard to false advertisement and donations being made to support the local children’s hospital as opposed to children’s hospitals outside our community. Further discussion ensued regarding charities and corporate programs competing for the same charity dollars.

(Nancy McGovern entered the meeting at 1:36 pm)

MEDICAL STAFF

BYLAWS

PUBLIC INPUT STEPHEN BROWN

John Donaldson said the proposed Medical Staff Bylaws have been provided to the Board. Jack Diamond presented a quick overview regarding the processes that took place to ensure the Medical Staff, Administration, and Board all agree on the provisions and revisions made to the Medical Staff Bylaws. John Donaldson began reviewing the Objections to Medical Staff Bylaws (Exhibit 3) for further explanation and discussion. With regard to Part I, Section 2.3.1 discussion ensued regarding the importance of defining economic credentialing and quality. Stephen Brown requested to address the Board (Public Input, Exhibit 1) regarding physician privileging and credentialing. He said credentialing is a right and not a privilege and contracted physicians should not have their privileges tied into their contract. Stephen said the Bylaws must be solid to protect the System against legal issues in the future. Discussion ensued regarding physician privileging and pricing for services. There was further discussion regarding the need for open dialogue and communication with the Medical Staff regarding the Bylaws. John Donaldson said it is important for the Medical Staff to know the tremendous amount of work they have put forth to create the Bylaws is appreciated

(Linda Brown entered the meeting at 2:19pm)

LEE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS MEETING MINUTES Reconvened Board of Directors meeting from December 4, 2008 Thursday, December 11, 2008 Page 3 of 3


PART III

however there are still many issues to be addressed before they can be passed. John suggested passing the portion of the Bylaws that requires no further discussion and bringing the remainder of the Bylaws back to the Physician Leadership Council for review. Discussion ensued with regard to recruiting new physicians, consolidating services, creating exclusive contractual arrangements with high quality doctors, residency requirements for physicians, and eliminating competition for services in the hospital. Jim Humphrey suggested tabling the Medical Staff Bylaws until the March 2009 Board of Directors meeting based on the need for further discussion on specific topics. He also recommended representatives of the Medical Executive Committee, Physician Leadership Council, and the Board hold a joint conference to further review the remaining items for discussion and clarification. Discussion ensued with regard to having a closed or open meeting with the Board and physicians and whether to include the entire Board or just the Chairman initially, to discuss the Bylaws.

A motion was made by Marilyn Stout to Table the Medical Staff Bylaws as recommended by Board Counsel to not later than the March 26, 2009 Board of Directors meeting and that a joint meeting be held with Board Chairman, each Medical Executive Committee President, Physician Leadership Council Chairman and Board Counsel to clarify any further information. The motion was seconded by Nancy McGovern and it carried with no opposition.

Prior to March 26, 2009 - Joint Bylaw Review Meeting

TIME SENSITIVE

ISSUES There were NO ‘Time Sensitive Issues’ to be discussed.

OTHER ITEMS Frank La Rosa thanked John Donaldson and Jason Yost for serving on the Lee Memorial Health

System Board of Directors and wished them both good luck in their future endeavors.

NEXT REGULAR

MEETING The date of the next REGULAR meeting of the Lee Memorial Health System Board of Directors is the Annual Organizational Meeting (being held concurrently with the Lee County Trauma Services District Annual Organizational meeting) on Tuesday, January 6, 2009, 12:00 p.m. at the Lee County Public Education Center (LCPEC).

ADJOURNMENT The Lee Memorial Health System Board of

Directors meeting was ADJOURNED by Chairman John Donaldson, M.D. at 3:41p.m.

_________________________________________________ Lois C. Barrett, MBA

Board Secretary

Minutes were recorded by Beth Finney, Executive Secretary/Board of Directors Office


BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS MEETING

MEDICAL STAFF

BUSINESS

LEE MEMORIAL HEALTH SYSTEM Lee County, Florida

#1 M E M O R A N D U M

To: Board of Directors From: Sandra L. Wharton, CPMSM, CPCS System Director, Medical Staff Services Subject: Lee Memorial Health System (Lee Memorial Hospital and Health Park Medical Center) Medical Staff Recommendations Date: December 15, 2008 The Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws:

1. Affiliate Staff Appointments: a. Andrew Jaffe, M.D. – Dermatology b. Mark Kagen, M.D. – Dermatology c. Andrew Kontos, M.D. - Dermatology

2. Provisional Staff Appointments: a. Ryszarda Hejmej, M.D. – Internal Medicine

3. Reinstatement from LOA and Reappointment: a. Anne Lord-Tomas, D.O. – Surgical Assist

4. Privilege Requests:

a. Lynne Einbinder, M.D. – Cardiac CT, Level II b. Viswanathan Nagarajan, M.D. – Class II EKG

5. Resignations: a. Desiree Spehn-Roland, M.D. – Emergency Medicine, effective 11-15-08 b. Islam Elfayoumi, M.D. – Internal Medicine, effective 12-01-08 c. Aldith Lewis, M.D. – Internal Medicine, effective 12-18-08 d. Robert Balbis, D.O. – Family Practice, effective 08-12-08

Memorandum to Board of Directors December 15, 2008 Page 2 of 2

6. Allied Health Practitioners:

a. Janet Maiocco, ARNP – Nurse Practitioner for Dr. Hobson b. Lauren Nunez, ARNP – Nurse Practitioner for Dr. A. Khan c. Helen Robbins, PA – Physician Assistant for Dr. Orr d. Rafael Romero, PA – Physician Assistant for Dr. Manzanares e. Kathleen Mahan, ARNP – Nurse Practitioner for Dr. Snodgrass

7. Practitioners-in-Training: a. Luke Marcus – medical student with Dr. Hannon, 02-09-09 to 03-08-09 b. Mary Beth Gelomine – PA student with Dr. Kovacevic, 12-01-08 to 12-17-08

Approved by the Board of Directors – January 6, 2009

_________________________________________________ Chairman - Board of Directors

LEE MEMORIAL HEALTH SYSTEM

Lee County, Florida #2

M E M O R A N D U M To: Board of Directors From: Sandra L. Wharton, CPMSM, CPCS System Director, Medical Staff Services Subject: Cape Coral Hospital Medical Staff Recommendations Date: December 15, 2008 The Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws:

1. Reinstatement from LOA and Reappointment: a. Anne Lord-Tomas, D.O. – Surgical Assist

2. Privilege Request: a. Viswanathan Nagarajan, M.D. – Class II EKG

3. Allied Health Practitioners: a. Jonathan Sigg, PA – Physician Assistant for CCH Emergency Physicians

4. Practitioners-in-Training: a. Mary Beth Gelomine – PA student with Dr. Kovacevic, 12-01-08 to 12-17-08

Approved by the Board of Directors, January 6, 2009

________________________________________________ Chairman – Board of Directors


BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS MEETING

MEDICAL STAFF BUSINESS

Issues – Discussion



OLD BUSINESS



NEW BUSINESS



PRESIDENT’S REPORT

Jim Nathan CEO/President

Community Visioning

Presentation By Sally Jackson

System Director of Community Projects

1

Lee Memorial Health System Board of Directors

President’s Report

Community Health Visioning 2017 Status UpdateJanuary 6, 2009

2

Purpose

Update the LMHS Board of Directors on the progress

regarding recommendations made by the Community

Health Visioning 2017 Steering Committee.

LMHS was awarded an Honorable Mention for

“Community Engagement” by the

National Association of Public Hospitals and Health Systems for Community Health

Visioning 2017.

3

Community Health Visioning Steering Committee

• Mike Biel, Administrator, Internal Medicine Associates• Dr. James Browder, Superintendent, Lee County Public Schools• Linda Brown, Director, LMHS Board of Directors• Dr. Erick Burton, President, Lee County Medical Society• Joe Catti, President & CEO, FineMark National Bank and Trust• Frank D’ Alessandro, Partner, Gates, D’Alessandro & Woodyard (deceased)• Scott Edmonds, President & CEO, Chicos• Leonardo Garcia, Executive Director, SW Florida Hispanic Chamber of Commerce• Todd Gates, Chairman, Gates, McVey• Lalai Hamric, President & CEO, Family Health Centers of SW Florida• Dr. Judith Hartner, Director, Lee County Health Department• Karen Hawes, Director, Lee County Human Services Department• Dr. Denise Heinemann, Dean, College of Health Professions, FGCU• Sandie Horvath, Chairman, Health & Human Services Planning, North Fort Myers• Dr. Ed Houck, Executive Director, District Eight Health Planning Council• Gary Hudson, Owner, Hudson Consulting• Sam Levy, Vice President, Estero Council of Community Leaders• Mellone Long, Community Development Director, City of Fort Myers• David Lucas, Chairman, Bonita Bay Group

4

Community Health Visioning Steering Committee cont.

• David Lucas, Chairman, Bonita Bay Group• Gail Markham, Partner, Markham Norton Mosteller Wright & Co., P.A.• Dr. Joe Mazurkiewicz, President, BJM Consulting, Inc.• Marliese Mooney, Consultant, Hospital Operations• Fred Morgan II, Coordinator, Student Activities, Minority Student Services, Edison

College• Steve Personette, Public Affairs Manager, Embarq• Fred Pezeshkan, President/CEO Kraft Construction• Robbie Roepstorff, Chairman, Horizon Council Foundation• Bill Schroeder, Senior Vice President, Bank of America• David Shellenbarger, Secretary, Treasurer, Bonita Springs Community Foundation• Cliff Smith, President, United Way of Lee County• Michael Smith, Vice President Investor & Community Relations, Chicos• Regina Smith, Executive Director, Lee Co. Economic Development Office• Roxi Smith, President, Pink Shell Development• Sandy Stilwell, Owner, Stilwell Enterprises• J. Nathan Stout, President, J. Nathan Stout, CPA, P.A.• Rev. Dr. Israel Suarez, Executive Director, Nations Association• Elmer Tabor, President, Wonderland Realty• Gary Trippe, Chairman/CEO, Oswald Trippe & Co.• Dr. Ken Walker, President, Edison College

5

Community Health Visioning 2017

• LMHS Board established Visioning Steering Committeein early 2007.

• Purpose: Recommendations to LMHS Board to improve the health status & health care delivery system in Lee County over the next 10 years.

• Organized 150 focus groups and four town hall meetings, PRC Community Health Needs Assessment and online surveys. Reached more than 4,000 community members.

• Committee’s recommendations presented to LMHS Board in August 2007.

• September 2007 LMHS Board accepted the recommendations.• Encouraged LMHS and the community to pursue the eight

recommendations over the next 10 years.• October 9, 2008 reconvened Steering Committee for first year

status update.

6

Community Recommendations

• Behavioral Health

• Primary Care Alternatives

• Electronic Medical Record

• Workforce Shortage

• Public Awareness of Services

• Preventive Healthcare

• Chronic Disease Management

• Focus on Quality

7

Community Collaboration

LMHSHealth & Social

Services

Physicians

Business & Community

Community Care

Community Care

8

Community Health Visioning 2017Behavioral Health Update

presented byBrian Lucas, Vice Chairman, Bonita Bay Group

Greg Gardner, Vice President, Allocations & Planning, United Way

9

Key Accomplishments

• Assembled a community Mental Health and Addiction Coalition led by Bob Janes, Jim Nathan and Brian Lucas.

• Developed a strategic plan for the Coalition with four specific goals to improve the lives of those with mental health and addiction needs:

• Implement a model to deliver assistance to those in need, both existing and future.

• Obtain and allocate funding to meet needs.

• Develop community leadership groups to implement strategic plan.

• Create awareness of mental disorders as a serious health issue.

• Created a task force for each goal with community ownership.

• Implemented a Triage Center.

• Started converting 15 beds at LMH to a Geriatric Psychiatric program.

• New investors pursuing CON for The Pavilion at HealthPark.

• New service providers are now operating.

10

Community Health Visioning 2017Primary Care Alternatives

presented byLalai S. HamricPresident/CEO

Family Health Centers of Southwest Florida, Inc.

11

Key Accomplishments

• Established Dunbar United Way House.• Opened East Fort Myers United Way House.• Renewed Lee We Care, the Volunteer Health Care Connections specialty

referral program serving patients living below poverty level.• Established a pediatric Healthy Living and Weight Management Clinic at

fixed sites and a regional Ronald McDonald mobile van.• Implemented regional expansion of the Centering Pregnancy pre-natal care

program.• Launched Area Health Education Centers smoking cessation program.• Instituted new emergency room patient follow-up referral process.• Doubled breast and cervical cancer screenings for uninsured, low-income

women with the Healthy Body-Healthy Soul Program.• Offered pre-school dental exams and annual school physicals.• Launched three First Choice Pediatrics offices in Lee County.

12

Community Health Visioning 2017Electronic Medical Record

presented byMike Smith

Chief Information Officer, Lee Memorial Health System

13

Key Accomplishments

• Established Community Communication Infrastructure success with Embarq.• Created county patient identifier numbering system managed by LMHS with

more than 1 million participants.• Established a managed, secure, reliable IT environment.• Created successful track record with physicians. (Net Access, Heartlab, etc.)• Defined Community Healthcare IT Draft strategy.• Selected Integrated Software Platform and began first phase of the installation.

(Epic for Lee Physician Group)• Garnered significant interest from some non-employed physicians to take

advantage of Epic, the LMHS Next Generation integrated Electronic Medical Record in their practices.

• Established additional strategy of building interfaces for non-integrated physician electronic records in our community.

• Discovered solutions to most of the National RHIO challenges in our community. (i.e. lack of funding and interest, questions about confidentiality, etc.)

14

Community Health Visioning 2017Workforce Shortage

presented byDr. Denise Heinemann, Dean, College of Health Professions, FGCU

1515

Key Accomplishments

• FGCU announced plans to build a health sciences building. Planning funds have been released by State. Completion 2010.

• Increased interest in health profession programs at all levels, and, as a result, applicants continue to exceed number of seats available.

• Retained interest from licensed professionals due to attractive salaries. • Established Edison State College as having the largest capacity to

educate RNs locally.• Created new Doctor of Physical Therapy Program at FGCU and the

Acute Care Nurse Practitioner option. Considering nursing psychiatry.• Enticed private universities to continue entering Southwest Florida

with nursing, physician assistant and health administration programs.• Embraced simulation training in clinical programs as an educational

strategy to prepare students before exposure to patients.

16

Community Health Visioning 2017Public Awareness of Services

presented by

Anne RoseExecutive Director/System Director

Business Development and Contracting LEE PHO

System Communications Administrator Lee County Trauma Services District

17

Key Accomplishments

• Featured more than 237 members of the LMHS Medical Staff in “Healthy News” articles, video news releases and on www.LeeMemorial.org.

• Held first Annual Injury Prevention Fair in Lee County Sheriff’s Office. (“Healthy News” delivered to Lee County EMS stations.)

• Conducted Community Resource Fair for the uninsured. • Continued Child Advocacy and Career Development programs.• Partnered with local TV stations to air video news releases.• Teamed up with local newspapers to distribute “Healthy News.”• Partnered with the American Heart Association for the Start! Walking

campaign.• Hosted an Orthopedic Technology Expo.• Created “News & Notes” to keep community stakeholders informed.• Revised LMHS Home Page content.• Promoted research of John Kanzius, resulting in national media coverage.• Continued Parish Nurse and Community Leadership programs.• Established Health News Network in all hospitals.

18

Community Health Visioning 2017Preventive Health Care

presented byCliff Smith, President, United Way

Sarah Owen, Executive Director, Community Cooperative MinistriesDr. John Iacuone, Executive Director Children’s Hospital

19

Preventive Health Care

Circles reflect relativeCircles reflect relativereach of servicesreach of services

22% of a population22% of a populationroutinely seen inroutinely seen incore; 28% either notcore; 28% either notseen or without needseen or without need

Human services programsHuman services programsusually designed for usually designed for poor and/or wellpoor and/or well

Community-based Health

& Human Services

Community-based Health

& Human Services

Ambulatory, Ancillary & Complementary

Ambulatory, Ancillary & Complementary

Physician & Hospital Services

LMHS & Physicians

Physician & Hospital Services

LMHS & Physicians

20

Key Accomplishments

• United Way– Created Dunbar House model

– United Way Agencies, Lee Memorial Health System, Family Health Centers, other social services agencies

• Next Steps– Repeat Dunbar House at LMHS Medical Plaza IV on Palm Beach

Boulevard. Opened November 2008.

– Seek a North Fort Myers location for the model.

– Continue expansion in other profiled communities.

21

Key Accomplishments

The Children’s Hospital of Southwest Florida

• Participated in more than 18 community injury prevention programs.

• Ensured that 1,010 child safety seats were properly installed.

• Distributed and fitted 800 free bicycle helmets.

• Provided free parenting classes to more than 1,215 parents, in partnership with others.

• Provided free disease prevention programs to more than 5,000 kindergarten and first-grade students.

• Started offering the Safe Sitter program for certified babysitters.

•Next Steps

- Announced a new donor for childhood obesity project in partnership with St. Joseph’s Children’s Hospital in Tampa & Lee County Public Schools.

22

Community Health Visioning 2017Chronic Disease

presented byRebecca Linville, Chico’s Community Outreach Coordinator

Dr. John Iacuone, Executive Director Children’s Hospital

23

Key Accomplishments

START! Partnership• Committed to the American Heart Association’s Start!

campaign for three years to promote healthier lifestyles.• Co-chair LMHS and Chico’s FAS, Inc.• Mission: Achieve better than the state average for heart-related

risk factors.• Goals: Increase company/organization participation, achieve

Healthy People 2010 objectives and increase Start! awareness.• First corporate challenge completed October 2008.

The Children’s Hospital of Southwest Florida• Reduced hospital admissions and lengths of stay for sickle cell patients.

TCH is a state-designated Regional Sickle Cell Referral Center.• Initiated a community-based Sickle Cell Clinic model for children.• Educated more than 2,900 fourth- and fifth-graders through Mission

Nutrition in an effort to reduce childhood obesity.

24

Community Health Visioning 2017Focus on Quality

presented byDr. Mark Greenberg, Medical Director, Lee Memorial Hospital

25

Key Accomplishments

• Implemented programs to reduce hospital-acquired infections. (i.e. Hand hygiene program; “bundles” to prevent central line infections, etc.)

• Continued focus on improving safety by analyzing any operative or medical incident.

• Developed an improved after-hours call for surgeons to mitigate affects of general and vascular surgeon shortage.

• Expanded Q-Life, our palliative care program.• Developed LMHS Transfer Center with Lee EMS to

prioritize and optimize transfers.• Developed inpatient neurology consultation service to

increase timeliness and access to neurological care.• Expanded treatment options for stroke patients with

endovascular interventional procedures.• Continued reductions in mortality by developing strategies

to reduce complications.• Educated physicians on new evidence-based guidelines to

improve appropriate use of blood, reducing blood- associated complications and preserving blood supplies.

26

Barriers/Challenges

• Fragmented services and silos • Reallocation of funds to support goals• Shortage of Medical Professionals • Ongoing community volunteer leadership to

drive strategy implementation• Uninsured and uncompensated care• Lack of regional electronic health records

“network”

27

Critical Success Factors

• Community awareness• Leadership structure and innovation• Funding • Interagency Cooperation• Strengthen Community, Media & Physician

Partnership• Constant Communication• Recruitment of medical professionals• Development of a regional health

information system

28

Ongoing Community Engagement

• Support for a Community Health Scorecard– Communicate with general public

– Drive action and improvement

• Support for an ongoing formal leadership structure– Perhaps meet 2 – 3 times per year

– Support successes

– Help resolve barriers

• Workgroup will define purpose and recommend structure

• Agree to re-convene in 2009

29

Community Health Visioning 2017

Recognition & Best Practicespresented by Larry Gage

President, National Association of Public HospitalsNAPH Safety Net Award

“You do have a lot of the best practices I intend to export to other hospitals around the country.”



BOARD LIAISONREPORT

VERBAL UPDATES – No Documentation

A. 2009 Schedule

B. Liaison & Committee Assignment Process

Cathy Stephens Board Liaison/Assistant to the Board

Questions about this schedule: Contact the LMHS Board of Directors office at (239) 334-5943

HLLEEEE MMEEMMOORRIIAALL HEEAALLTTHH SSYYSSTTEEMM && LLEEEE CCOOUUNNTTYY TTRRAAUUMMAA SSEERRVVIICCEESS DDIISSTTRRIICCTT BBOOAARRDD OOFF DDIIRREECCTTOORRSS MMEEEETTIINNGG CCAALLEENNDDAARR

JJAANNUUAARRYY 22000099 Sunday Monday Tuesday Wednesday Thursday Friday Saturday

1

Board Office Closed

2 3

4

5

6 12:00 Noon LMHS Board of Directors

& Trauma Services Annual Organizational

Meeting (LCPEC)

7 8 1:00 pm

LMHS Marketing/ Branding Workshop (LMH Boardroom)

9

10

11 12

13

14

15 1:00 pm Planning

Committee of the Whole(LMH Boardroom)

2:00 pm Quality & Education


16

17

18

19

Martin Luther King Jr. Day

20

21

22 1:00 pm Finance


23

Isabel (Izzy)

24

American Cancer Society

Cattle Baron’s Ball & Reaching Out for

Cancer Kids 6:00 pm

Page Field Airport

25

26 27 28

29

3:00pm Full Board & Trauma

District Board of Directors

Meetings

30

31

Richard Akin

Key: LMH – Lee Memorial Hospital, 2776 Cleveland Avenue, Ft Myers, FL 33901 LCPEC – Lee County Public Education Center, 2855 Colonial Blvd., Ft Myers, FL 33966 DDAATTEESS TTOO RREEMMEEMMBBEERR: • February 11th – Lee Cancer Care Fashion Show • March 1st – Lee Memorial Cancer Center ng • March 9 & 10 – FHA “Hospital Day in the Legislature”, Tallahassee Grand Openi



ADJOURN*

Annual Organizational Business Meeting

*FOLLOWED BY A BRIEF TRAUMA DISTRICT MEETING

DATE OF THE NEXT REGULARLY SCHEDULED

FULL BOARD OF DIRECTORS MEETING:

THURSDAY, JANUARY 29, 2009

3:00pm

Held at: Lee County Public Education Center

2855 Colonial Blvd, Ft. Myers, FL 33966