LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING. THURSDAY, April 28, 2016

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LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING THURSDAY, April 28, 2016 GULF COAST MEDICAL CENTER - Boardroom 13685 Doctors Way, Fort Myers, FL 33912 (Held concurrently with the Lee Memorial Health System Board of Directors Meeting)

LEE COUNTY TRAUMA SERVICES DISTRICT BOARD of DIRECTORS OFFICE 239-343-00 FAX: 239-343-99 P.O. BOX 2218 FORT MYERS, FLORIDA 33902 BOARD OF DIRECTORS DISTRICT ONE Stephen R. Brown, M.D. Therese Everly, BS, RRT DISTRICT TWO Donna Clarke Nancy M. McGovern, RN, MSM LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING April 28, 2016 - *1:00 p.m. *Held concurrently with Lee Memorial Health System Board Meeting Gulf Coast Medical Center (Medical Office Building) Boardroom 13685 Doctor s Way, Ft. Myers, FL 33912 AGENDA 1. CALL TO ORDER (Sanford Cohen, M.D., Board Chairman) LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS 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 the Board Administrator prior to meeting. 3. Trauma District Minutes (Approve) (Therese Everly, Board Secretary) 4. Trauma District Financials (Accept) (Ben Spence, Chief Financial Officer) 5. Operations Report (Accept) (Dr.Ernst Vieux, Medical Director, Trauma) DISTRICT THREE Sanford N. Cohen, M.D. David F. Collins 6. Legislative Update on Trauma (Verbal) (Sally Jackson, System Director of Community Projects) DISTRICT FOUR Diane Champion Chris Hansen DISTRICT FIVE Jessica Carter Peer Stephanie L, Meyer, BSN, RN 7. Other Items 8. DATE OF THE NEXT REGULAR LEE COUNTY TRAUMA SERVICES DISTRICT MEETING - Thursday, August 25, 2016, at 1:00 p.m., held concurrently with Lee Memorial Health System Board Meeting 9. ADJOURN (Sanford Cohen, M.D., Board Chairman)

LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS 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 Staff prior to meeting. Refer to Board Policy: 10:F: 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 three (3) days prior to the meeting to allow staff time to prepare and to insure the matter is within the jurisdiction of the Board.

LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING MINUTES Thursday, February 11, 2016 LOCATION: Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom, 13685 Doctors Way, Fort Myers, FL 33912 MEMBERS PRESENT: Sanford Cohen, M.D, Board Chairman; Chris Hansen, Board Vice Chairman; David Collins, Board Treasurer; Diane Champion, Board Secretary; Steve Brown, M.D, Board Member; Therese Everly, Board Member; Nancy McGovern, RN, MSM, Board Member; Donna Clarke, Board Member; Jessica Carter Peer, Board Member; Stephanie Meyer, BSN, RN, Board Member --------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 County Trauma Services District Board of Directors Meeting was CALLED TO ORDER at 1:32 p.m. by, Sanford Cohen, M.D., Board Chairman. PUBLIC INPUT AGENDA ITEMS CONSENT AGENDA None at this time. Dr. Cohen asked for approval of the Consent Agenda consisting of: A. Trauma District Minutes of November 5, 20 B. Trauma District Financials A motion was made by Chris Hansen to approve the Consent Agenda consisting of: A. Trauma District Minutes of November 5, 20 B. Trauma District Financials The motion was seconded by Therese Everly and it carried with no opposition. OPERATIONS REPORT Dr. Cohen asked for acceptance of the Operations Report A motion was made by Chris Hansen to accept the Operations Report. The motion was seconded by Nancy McGovern and it carried with no opposition. LEGISLATIVE UPDATE ON TRAUMA Sally Jackson presented the Legislative Update on Trauma. OTHER ITEMS None at this time. NEXT REGULAR SCHEDULED MEETING The date of the next meeting of the Lee County Trauma Services District Board of Directors is on Thursday, April 28, 2016, at *1:00 p.m., in the Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom. *(Meeting concurrent with the Lee Memorial Health System Meeting) ADJOURNMENT The Lee County Trauma Services District Board of Directors meeting was ADJOURNED at 2:08 p.m. by Sanford Cohen, M.D., Board Chairman. Minutes were recorded by Donna Shapiro, Assistant to the Board of Directors Therese Everly Date Board Secretary

Trauma District Financials FISCAL YEAR TO DATE as of March 31, 2016

Definitions in Transition Reports show significant increases compared to previous period but also reflect several changes in the definitions Coding Change ICD 9 to ICD 10 Inclusion Criteria Changes (Florida DOH changes) Certain previously excluded codes for seniors now included

Trauma Volumes Inpatient Discharges: 1,323 vs. 1,023 prior year Increase of 300 cases or 29% Inpatient Days: 7,529 vs. 5,721 prior year Increase of 1,808 days or 32% ALOS: 5.69 vs. 5.59 prior year Increase of 2% from prior year Trauma Surgeon Visits: 6,336 vs. 6,243 prior year Up 1% from prior year, 93 visits CMI: 2.03 vs. 2.04 prior year Down 0.5% from prior year

Trauma District March 2016 FYTD Inpatient Discharges 449 Auto/PIP 34% 460 Medicare/Medicare HMO 35% 136 HMO/PPO/Commercial 10% 92 Medicaid, Medicaid HMO 7% 103 Self Pay or Charity 8% 83 Other Government 6% 1,323 TOTAL 100%

Payer Mix Comparison 40% 35% 36% 35% 34% 30% 25% 27% 20% % 10% 5% 8% 12% 10% 10% 7% 4% 3% 4% 3% 7% 0% FY' MAR YTD FY'16 MAR YTD Medicare Medicaid Auto/Liab Workers Comp Commercial State/Emp/Champ Charity/Self Pay

Special Payments Special Trauma Funding 12/31/20 03/31/2016 6/30/2016 9/30/2016 MAR 16 FYTD Extra Court Fines $5,025 $1,603 $6,628 Red Light Running $42,883 $13,061 $55,944 Enhanced Speed Zones $1,450 $552 $2,002 Improper passing a school bus $,217 $5,257 $20,474 Racing on highways & reckless driving $68,825 $20,192 $89,016 Camera Bill $213,368 $69,404 $282,771 Total $348,768 $110,068 $456,835

Trauma District FYTD March 31, 2016 FYTD FYTD 16 Change Hospital Net Revenue 21,229,359 24,860,095 3,630,736 Physician Net Revenue 1,3,229 1,349,090 33,861 Other Operating Revenue 200,563 465,390 264,827 Total Revenues 22,745,1 26,674,575 3,929,424 Hospital Expenses 17,284,483 21,0,447 3,730,964 Physician Expenses 3,727,191 4,086,278 359,087 Total Expenses 21,011,674 25,101,725 4,090,051 Net Gain/(Loss) 1,733,477 1,572,851 160,626 Less Trauma Readiness Costs 1,350,000 1,350,000 Total Operating Gain/ (Loss) 383,477 222,851 160,626

Lee County Trauma Services District Board of Directors Meeting Trauma Report April 28, 2016

Trauma Registry Entries 250 200 0 # Registry Patients 100 50 6% 0 Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-16

Trauma Alerts 120 100 80 60 # Trauma Alerts 40 7% 20 0 Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-16

County of Injury County of Injury %YTD Injured Patient %YTD Trauma Alert Lee 74% 54% Collier 13% 24% Charlotte 7% 13% Hendry 3% 4% Glades / Highlands 2% 2% Other 1% 3%

Trauma Service Admissions 120 100 80 60 # Trauma Svc. Admits 40 20 7 % 0 Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- M ay- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- 16

0 10 20 30 40 50 60 Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- 16 # ISS> ISS > 5%

Questions?

LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS LEGISLATIVE UPDATE ON TRAUMA Sally Jackson System Director, Government & Community Relations (Verbal)

LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS OTHER ITEMS

ADJOURNMENT LEE COUNTY TRAUMA SERVICES DISTRICT DATE OF THE NEXT REGULARLY SCHEDULED LEE COUNTY TRAUMA SERVICES DISTRICT MEETING: Thursday, August 25, 2016 at 1:00pm* GULF COAST MEDICAL CENTER - Boardroom 13685 Doctors Way, Ft. Myers, FL 33912 *(Held concurrent with the Lee Memorial Health System Board of Directors Meeting)