Agenda 12/11/2018 Item #10A12/11/2018
EXECUTIVE SUMMARY
Recommendation to authorize the Chairman to send a letter on behalf of the Board of County
Commissioners to the NCH Healthcare System Board of Trustees asking for reconsideration on
the implementation of a recently announced admissions policy until they have completed an
independent process of gathering input from the residents of Collier County with respect to such a
policy.
OBJECTIVE: To send a letter to the NCH Healthcare System Board of Trustees asking to delay
implementation of their recently announced admissions policy.
CONSIDERATIONS: NCH Healthcare System leadership recently announced that the practice of
employed hospital-based doctors - known as hospitalists - handling admissions and patient care on one
floor of two hospitals will be expanded further throughout their healthcare system.
Over the summer, the NCH Healthcare System conducted a pilot study, termed patient-centered care,
where only NCH-employed hospitalists would care for the patients on the two floors chosen. The pilot
project has been in place on 4N at the Baker Hospital since June 21, 2018 and on 4E at the North Naples
campus since August 2, 2018.
In the locations this program expands to, independent family physicians, internists, concierge physicians
and hospitalists not employed by NCH would no longer be able to admit their patients and would not
oversee their care while hospitalized.
On October 23, 2018, NCH medical staff held a meeting where physicians voted unanimously against the
planned admissions change. The medical staff vote and many requests from the public have been made to
NCH leadership for reconsideration of the policy. At the December 5, 2018 Naples City Council meeting,
Council authorized the Mayor to send a letter to the NCH Board of Trustees asking for a pause to the new
admissions policy.
The Collier County Medical Society is concerned that under this new policy the standard of care could be
diminished, stating, “patients will lose the freedom they now have to choose a trusted specialist, hospital-
based physician, or primary care provider during sometimes unavoidable hospitalization. The physician
the hospital assigns to the patient will not have access to outpatient records, nor will the patient’s
primary care physician be allowed to document input on the patient’s hospitalization treatment plan”
NCH officials say the pilot resulted in reduced lengths of stay and fewer readmissions, and that patients
liked it. NCH has sent out information stating handling admissions and patient care on one floor of two
hospitals will be expanded but that it will not lead to a closed medical staff.
FISCAL IMPACT: There are no fiscal impacts associated with this Executive Summary.
GROWTH MANAGEMENT IMPACT: There are no Growth Management Impacts associated with
this Executive Summary.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is approved as to
form and legality, and requires a majority vote for approval. -
RECOMMENDATION: To authorize the Chairman to send a letter on behalf of the Board of County
Commissioners to the NCH Healthcare System Board of Trustees asking for reconsideration on the
implementation of a recently announced admissions policy until they have completed an independent
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process of gathering input from the residents of Collier County with respect to such a policy.
Prepared by: Commissioner Penny Taylor, Collier County District 4
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COLLIER COUNTY
Board of County Commissioners
Item Number: 10.A
Doc ID: 7512
Item Summary: ***This item to be heard at 11:15 a.m.*** Recommendation to authorize the
Chairman to send a letter on behalf of the Board of County Commissioners to the NCH Healthcare
System Board of Trustees asking for reconsideration on the implementation of a recently announced
admissions policy until they have completed an independent process of gathering input from the residents
of Collier County with respect to such a policy. (Commissioner Taylor)
Meeting Date: 12/11/2018
Prepared by:
Title: Executive Secretary to County Manager – County Manager's Office
Name: MaryJo Brock
12/05/2018 4:55 PM
Submitted by:
Title: County Manager – County Manager's Office
Name: Leo E. Ochs
12/05/2018 4:55 PM
Approved By:
Review:
County Attorney's Office MaryJo Brock CAO Preview Skipped 12/05/2018 4:51 PM
Office of Management and Budget MaryJo Brock Level 3 OMB Gatekeeper Review Skipped 12/05/2018 4:55 PM
County Attorney's Office MaryJo Brock Level 3 County Attorney's Office Review Skipped 12/05/2018 5:06 PM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 12/05/2018 5:08 PM
Board of County Commissioners MaryJo Brock Meeting Pending 12/11/2018 9:00 AM
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