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04/18/1984CLEARWATER HEALTH FACILITIES AUTHORITY APRIL 18, 1984 The City of.Clearwater Health Facilities Authority met in in the Conference Room, City Hall on Wednesday, April 18, 1984. The following members were present: C. J. Wollett George Bouse (Arr. 4:39 p.m.) Ruth Condon Clinton Holden Frank George Also present were: John Gray Thomas Bustin Lucille Williams The meeting was called to order at He presented the minutes of the October to the members of the Authority. Upon he declared the minutes approved. Chairman Vice- Chairman regular session Administrator, Morton Plant Hospital City Attorney City Clerk 4:31 p.m. by Chairman C. J. Wollett. 12, 1983 meeting which had been mailed hearing no corrections or additions, The Chairman reported the annual financial report for the Clearwater Health Facilities Authority was prepared and filed in a timely fashion. The report records the monies channeled from revenue received from Morton Plant Hospital to pay on the financing at First National Bank. John Gray gave an update on information presented to the Board at a prior meeting. He reported nothing had been finalized on the $50,000,000 Non - Profit Hospital Venture Group loan because of changes in the law. Morton Plant will probably only receive $8,000,000 for financing equipment they have purchased in the last two years. It is anticipated that this will be a 6i% loan and should be finalized within the next 30 to 60 days. The hospital is also a member of the Sun Alliance Group that is negotiating a $25,000,000 commercial paper loan. Plans for a parking garage are viable and they anticipate six or seven stories with parking for 1,000 cars which should solve their parking problem for several years. The parking at the front of the hospital will remain. However, there has been some discussion of covering this parking area with a Butler (metal) building and using it for storage purposes. Some problems have arisen with the rehab hospital. They asked for and were certified for 65 beds., The certification was challenged and a hearing held. The final decision awarded Bayfront Hospital 60 and Morton Plant 40 beds. The Bayfront Hospital construction will be less expensive as they do not need a new building. The next question to be decided is the feasibility of a facility for only 40 beds. 1. 4/18/84 There is also discussion about building a 110 bed psychiatric hospital which has been challenged by Horizon House. Morton Plant anticipates they will receive an additional 30 beds, making a total of 65. Once again the question, "is it feasible to build a facility for 65 beds." The solution could be to combine the rehab and psychiatric units into one building. Finalization should come within the next 30 to 60 days. The financing will run $10,000,000 to $12,000,000. Medicare reimburses the hospital according to Designated Related Groups - -a set price for each operation. At the present time they are reimbursing for capital improvement projects in addition to the Designated Related Group payment. This year Medicare is reimbursing 25% on the DRG system and 75% on the capital improvement system. Next year this drops to 50% DRG and 50% capital improvements. The third year it drops further to 75% DRG and 25$ capital improvements and the fourth year totally DRG reimbursement. The hospital will benefit if these improvements are paid for in the next three years. A question was raised regarding the new State bill for cost control and, if it passes, what effect it will have on Morton Plant Hospital. Mr. Gray responded the Hospital Cost Containment Board requires hospitals to submit their budgets every year. A budget in the top 20 percentile is checked very carefully and challenged if they feel it is wrong. Generally, the hospitals cooperate but if they do not, the Board has the authority to publish the budget in the largest circulation newspaper in their County. It has been a case of pressure only since they have had no real authority over the hospitals. However the new State bill will give the Board more authority to approve charges. There are nine geographic regions in the United States and the hospitals are categorized in each' area according to size. Morton Plant has an advantage because of its size. The patient discharges are increasing, the number of hospitals is decreasing, (292 went out of business last year), and this is an advantage with the DRG's. The length of patient stay is decreasing and out- patient services are increasing which also cuts expenses. There was discussion as to whether the Clearwater Health Facilities Authority should continue as a Board. The City Attorney reported Florida Statute requires the Board. John Gray felt the Board was needed for several reasons, one being financing for non- profit nursing homes and the need to replace some of the existing buildings at Morton Plant Hospital. The floor was then opened for nominations for Chairman and Vice- Cnairman. Mr. Holden moved the present Chairman and Vice- Chairman be re- elected. This motion was duly seconded and carried unanimously. By consensus, the Authority agreed to hold its annual meeting for next year on April 17, 19_85_0-A:30 p.m. The meeting adjourned at 5:15 p.m. 2. 4/18/64