VTH Board Minutes 4/28/22

Updates: Info Only

Personnel Updates

• Faculty Search Updates – Jason Walker and Sarah Gray coming on, Rose Peters has accepted, progress with Canaan Shores (UCC). Negotiation with one surgeon, Topolous accepted. Todd Marlow coming next week for Ophtho, John Stack coming in May for cardio, 2nd candidate coming in June. WL/Zoo Amb being scheduled. Anesthesia and Zoo Med zooming. ER instructor position is open, ECC faculty position submitted. Offer extended to consider for Dr. Lonc.
• Technicians/Assistants – surgery OR tech offer, 2 other current tech students interviewing (IMC, Anesthesia, IM, and Onc). 
  Animal Caretaker list
• VCM Admin – Taylor Smith has resigned, Karen Stahl is supporting role until position refilled, New hire for M. Malloch’s position, Candy (May 5th). 
• VTH Admin – Jenny Chen (Med Disp) will be starting as the VTH Admin Aide May 9th
• Interviews for Asst. Director for Finance (Vice Camp) interviews today 

Facilities

• Lobby renovation on schedule – Phase 2 underway
• Orthopedic Sx rounds room – plans are underway (SAC 160). Will likely move 2nd week of April.
• SAC storage – shelving units pending, waiting on 9.
• FARMS unloading – panels made in May, job complete in June. 
• Ward 4 door – has arrived and will be scheduled for installation.
• Should have plans for equine surgery by end of week. Will schedule time to review with faculty/staff. Plan is to still do work this summer. Need pricing before starting.
• Med Disp humidity issue – will be examining options.
• Exterior windows in VMSC replaced – no cost to us. 
• Architectural feasibility study for CUBE in VMSC, cost around $2.50-4.00 per sq ft (900)
• MRO room divider – waiting on quote
• Shower in Chemo ward – looking at code requirements
• Drawings received for VTH Offices – pricing currently
• Ward 3 phantom – waiting on labor shop to pour floor to set post.
• Hook up drain and water for new lactation room – will have to go above the ceiling in clin path to access.
• No additional water issues for addition, still working on fascia/roof – water soffit in vestibule, TKB is responsible for addressing
• Oncology Addition – Awaiting information
• Cameras and E phones – pending
• VDL Incinerator is being installed – capital project, incinerator to ship on July 15th. 

Programs

• $1M gift with naming rights for VTH SA Lobby project.

Other

• Illinois Christie Clinic ½ Marathon – this Saturday, traffic to Vet Med will be impacted between 7:30-10:00 am.
• Update Teleradiology – We are evaluating Vital Rads as teleradiology vendor. 
• Purina Kitchen is well received.
  
  

VTH Review of Financial Statements - March 2022

Overall

• The VTH had expenses higher than revenue by $(48,586) for clinical operations (fund 301732) for the month of March. YTD expenses over revenue (excluding July) = $(48,705).
• On a YTD basis, VTH revenue over expenses is $(789)k unfavorable to last year (fund 301732).
• March 2022 Banner activity (includes all funding types) = $(139,984). YTD overall activity (excluding July) = $405,575. 

Revenue

• Revenue for the month of March was $1,806,814 for VTH operations and $1,914,379 including storeroom figures. Current month activity is favorable compared to budget, while YTD is unfavorable to budget by $(1.0M). 

• YTD revenue is higher than prior year by $575.5k.

• Please see attached for a breakdown of revenue/admissions per service. 
  o There is overall unfavorability compared to budget for admissions of -9% and unfavorability compared to budget for revenue of -6%.
  o There is overall favorability YTD compared to prior year for admissions of 2% and revenue of 4%.

Expenses

• YTD expenses on VTH operations (301732) are $1.4M (11%) higher than YTD prior year.

     Personnel

• • There is YTD favorability to last year of $176k in academic salaries on fund 301732.
  • $325k favorability in academic salaries is due to “swap” with VTH locums. This moves an amount of faculty salary equivalent to the locums charged on 301732 to state funds to save benefits.
  • Offsetting the above favorability in academic salaries on 301732 are additional resident salaries of $92.6k in FY22. In addition, there is $103.4k additional salary expense for new instructors in FY22 (surgery, ER, Urgent care).
  • Wages are unfavorable to prior year since locums are now being charged to VTH operations.

     Services

• • There is higher spending in services (which includes most staff salaries) compared to prior year of $1.3M.
  • It appears there are several expense categories that are higher than last year.
    o $812k Vet tech and other staff salaries
    o $231.5k maintenance contracts
    o Oncura/VetCT charges
    o VDL and outside lab charges

Budget Update and Caseload Philosophy 

• Discussion RE what is realistic caseload and revenue for the VTH.
  We have always been a specialty center, that is the same for all Teaching Hospitals. “Tertiary Care Center”. What do we need to grow – could be service specific. 
• Growing revenue – what are the areas where price increase could be tolerated.
• Suggestion was made that strategic increases in pricing could be madefor certain services, but not others. Some services are already servicing a select group of clients who could probably afford higher prices. 
• Could we balance the budget by service?
•  Philosophy of teaching students to be considered. – Should specialists be teaching DVM competencies to students?
• Agreed that caseload is sufficient to meet teaching mission.
• Price bias needs to be considered – downstate vs metro
• Can some services with capacity be encouraged to grow? Diagnostic Imaging – teleradiology is extremely expensive.
• Even if we want staffing, we may not be able to fill. Sometimes we spend the most time doing the procedures that we charge the least for. Cost analysis evaluating charge integrity/master is needed. 

Salary Pressure 

• There has been compression in senior faculty salaries and increasing equity issues with current salaries and those being required for successful recruitment. The VTH Director/VCM Dept. Head and Dean are exploring possible ways to address.
• The Board Members felt it might be useful to engage faculty in discussions, which may also have a positive effect on building positive culture. Dr. Barger to address with the Dean.

Hands-Free Imaging Initiative 

• The VTH will be moving towards a hands-free imaging culture, primarily for radiograph acquisition. Sedation patients will be considered standard. Concern was raised at VTH Hospital Services Group regarding what would constitute appropriate monitoring. There were also questions about the availability of a crash box, or the presence of emergency procedures for patients experiencing a negative incident while in imaging. Dr. Billhymer is going to meet with services to determine issues/challenges. Additional discussion Implementing sedation could be challenging at first, could decrease the number of imaging requests being made. Will there be a charge associated with the administration of sedation? Suggestion was that a charge would be appropriate. Time commitment will be less but equipment costs will need to be covered. 

Service Head/ Section Head Discussion

• The VCM Department Advisory Committee will be reviewing the position duties for Service Head and Section Head. We would like services to provide feedback. JW will send job descriptions out to board members and service heads.

Strategic Initiatives 

• The VTH will be preparing the FY23 Budget report and will be listing goals and initiatives. 
• Board Members are asked to brainstorm with section members.
• Current Ideas:

• • Facilities – VMSC addition
  • Programs – Expanded (enhanced) primary care education, Clinical trials
  • Services – Equine Medicine and Surgery
  • Initiatives – culture and wellness

VCM Updates 

• D. Hague will be SAND Section Head for next year.
• M. Ridgway will be CAZAM Section Head.

Other Updates 

• SANDI – Tina Olszewski will be training service personnel on the new HIS in May
• Intern/Resident training – Amy Schnelle sent out, needs to be update