Agenda - Muskoka Algonquin Healthcare

BOARD OF DIRECTORS MEETING
Open Session Agenda
January 12, 2012
6:00 PM
Huntsville District Memorial Hospital Boardroom
Elected Directors: Sven Miglin Larry Saunders Charlie Forret Eric Spinks
Wayne Twaits William Garriock John Sinclair Gregg Evans
Philip Matthews Catherine King Rick Durst Evelyn Brown
Ex-Officio Directors: Natalie Bubela Dr. Jan Goossens Dr. A. MacLennan
Bev McFarlane Dr. Nancy Bozek (R)
Executive support: Tim Smith Harold Featherston Robert Hughes Vivian Demain
Resources: Tammy Tkachuk
PAGE
#
(R) - denoted regrets received
TIME
TOPIC -
WHAT IS TO BE ACCOMPLISHED/MOTION
♦ denotes attachment ⌧ denotes attachment to follow
1.0 CALL TO ORDER - To welcome members and call the meeting to order.
6:00 –
6:02
1.1 Approval of Agenda
Motion: That the meeting agenda be approved as circulated.
1.2 Declaration of Conflict of Interest
To remind members that conflicts are to be declared for any agenda
items and the Director is to excuse him/herself from the meeting for
the duration of the discussion.
♦ denotes attachment ⌧ denotes attachment to follow
LEAD
POLICY
FORMULATION
MAHC Board of Directors Open Session Agenda | Page 1 of 2
DECISION MAKING
S. Miglin X
OVERSIGHT
S. Miglin X
2.0 CONSENT AGENDA - To approve/receive the items listed below without further debate.
Motion: That the following items be approved or received as
indicated:
3 2.1 Approval of the Minutes from December 8, 2011 ♦ S. Miglin X
7 2.2 Executive Committee Standing Committee Report ♦ S. Miglin X
9 2.3 Receipt of the Corporate Communications Plan Dashboard ♦ S. Miglin X
11 2.4 Receipt of the Expense Reports for October 2011 ♦ 16 2.5 Receipt of the Consultant Use Report
S. Miglin X
♦ 18 2.6 Receipt of the Board Goals Dashboard
S. Miglin X
♦ S. Miglin X
19 2.7 Approval of the Revised Expense Policy ♦ S. Miglin X
25 2.8 Receipt of the Resources Committee Standing Committee Report ♦ C. Forret X
27 2.9 Receipt of the Human Resources Report ♦ 6:02 –
6:05
R. Hughes X
32 2.10 Receipt of the Compliance Report as at November 2011 T. Smith X
33
2.11 Receipt of the Medical Advisory Committee Report ♦ J. Goossens X
NA
3.0 PATIENT STORY
6:05 –
6:10
3.1 Patient Story N. Bubela X
INFORMATION/
EDUCATION
...Cont’d

PAGE
#
34
35
38
NA
41
42
51
60
NA
TIME
TOPIC -
WHAT IS TO BE ACCOMPLISHED/MOTION
♦ denotes attachment ⌧ denotes attachment to follow
4.0 PROGRAM QUALITY AND EFFECTIVENESS
6:10 –
6:15
6:15 –
6:30
6:30 –
6:40
5.0 REPORTS
6:40 –
6:45
6:45 –
6:55
4.1 Quality & Patient Safety Committee Report ♦
To receive the Standing Committee Report.
4.2 Balanced Scorecard Report as at October 2011 ♦
To receive and review the Balanced Scorecard which includes the
Quality Improvement Plan and Patient Safety Plan metrics.
4.3 Patient Values, Rights and Responsibilities ♦
Motion: That the revised Patient Values, Rights and
Responsibilities document be approved.
5.1 Report of the Board Chair
To receive the Chair’s Report.
5.2 Report of the Chief Executive Officer ♦
To receive the CEO’s Report.
6.0 FINANCIAL VIABILITY
7:00 –
7:15
7:15 –
7:25
6.1 Financial Results as at November 30, 2011 ♦
Motion: That the Financial Statements for the period ending
November 30, 2011 be approved.
6.2 DRAFT Operating Plan for 2012-2013 ♦
For information only at this time.
7.0 FOSTER RELATIONSHIPS AND ITEMS FOR INFORMATION
7:25 –
7:30
7.1 Report of the Auxiliaries
To receive the report of the Huntsville Hospital Auxiliary and the
South Muskoka Memorial Hospital Auxiliary.
7.2 Other Business
8.0 IN-CAMERA SESSION
NA 7:30
Motion: That the open session be terminated and the Board of
Directors proceed into the in-camera session.
Break: 7:30 – 7:40
LEAD
POLICY
FORMULATION
MAHC Board of Directors Open Session Agenda | Page 2 of 2
DECISION MAKING
OVERSIGHT
L. Saunders X
L. Saunders X
L. Saunders X
INFORMATION/
EDUCATION
S. Miglin X
N. Bubela X X
C. Forret
C. Forret
S. Miglin
S. Miglin X
S. Miglin
X
X
X

Members Present:
Elected Directors:
Board of Directors Meeting
Thursday, December 8, 2011
5:30 p.m.
South Muskoka Memorial Hospital Boardroom
OPEN SESSION MINUTES
Approval Pending
Sven Miglin Bill Garriock Gregg Evans Eric Spinks
John Sinclair
Philip Matthews
Rick Durst Wayne Twaits Catherine King
Ex-Officio Directors: Natalie Bubela, CEO Dr. Jan Goossens Dr. Nancy Bozek Bev McFarlane
Dr. Adam MacLennan
Executive Support: Harold Featherston Robert Hughes
Staff Resource: Tammy Tkachuk
Guests: Sharon Pattinson Dawn Major Noreen Chan Catherine Racine
Regrets: Larry Saunders Evelyn Brown Charlie Forret Tim Smith
1.0 CALL TO ORDER/DECLARATIONS OF CONFLICT OF INTEREST
With quorum present, the meeting was called to order at 1732 hours by the Chair, Sven Miglin.
1.1 BOARD EDUCATION SESSION – SOUTH MUSKOKA MEMORIAL HOSPITAL AUXILIARY UPDATE
The Chair welcomed Sharon Pattinson, President of the South Muskoka Memorial Hospital Auxiliary.
Mrs. Pattinson explained that in the past 8 months of the year, volunteers have contributed 17,848 hours
of service. At the recent General meeting, a $100,000 commitment to central monitoring equipment was
approved; this will be a joint venture with the Huntsville Hospital Auxiliary and Foundation as well as the
South Muskoka Foundation. The four organizations will work together to raise dollars needed for the
replacement of central monitoring systems across the organization totaling almost $1 million dollars.
The Auxiliary recently hosted a Christmas House Tour for the first time; the event was a great success
raising over $7,000 over a two-day period December 4 & 5, 2011. It was a self-guided tour, featuring six
Bracebridge buildings decorated for Christmas and ended off with a silent auction at the Rotary Centre.
This initiative is also supported financially by the Scotia Bank.
The third annual ‘Little Things Mean A Lot’ initiative was held recently. The initiative involves purchasing
items up to a maximum of $1,000 for patient care areas. The Diagnostic Imaging booking desk was the
winner for this year. The Auxiliary Executive is considering increasing the number of gifts.
In other areas, the Auxiliary is in the process of setting up a new program to assist in directing patients for
the fracture clinic and will also be receiving code training in the near future.
Mrs. Pattinson thanked board and staff for their support and assistance.
1.2 APPROVAL OF AGENDA
It was moved, seconded and carried that the agenda be approved as circulated.
Upon review of the agenda, there were no declarations of conflict of interest.
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Open Session Minutes Board of Directors December 8, 2011
Approval Pending Bracebridge Site Boardroom
2.0 CONSENT AGENDA
It was moved, seconded and carried that the following items be approved or received as indicated:
� Approval of the Minutes from November 10, 2011
� Receipt of the Governance Committee Report
� Approval of the Community Representative Policy
� Receipt of the Medical Advisory Committee Report
� Receipt of the Senior Leadership Team Report
3.0 PROGRAM QUALITY AND EFFECTIVENESS
3.1 PATIENT STORY
Due to technical difficulties, the patient story will be circulated electronically following the meeting.
3.2 OUTBREAK PREVENTION IMPROVEMENT UPDATE AND PATIENT SAFETY PLAN EDUCATION
Dawn Major, Manager of Infection Prevention and Control provided an update regarding the Outbreak
Prevention Improvement Project. Directors were reminded that the project received funding from the
District of Muskoka and included implementing the following recommendations:
1. Increase Infection Control Coverage
2. Increase Environmental Services staffing
3. Replace Beds and Furniture
4. Disposable Stool Management Systems
5. Hub Scrub Cart Washers
The project involved a two-phased approach. The first phase is almost complete and with the $367,000 of
funding from the District of Muskoka, the following items have been purchased and installed:
– 37 beds
– 5 Vernacare Macerators
– 66 bedside units
– Microfibre Mopping Systems
– 74 overbed tables
– 8 dedicated Hand Hygiene sinks
– 10 commode chairs
Phase two of the project will commence when the final installment of $100,000 is received in the New
Year from the District of Muskoka and will include the following items:
– 4 additional macerators
– 2 Hub Scrub cart washers, one per site
– 8 more dedicated hand hygiene sinks
– 8 additional commode chairs
The original request was for a total of $567,000, hence remaining on the capital list for purchase are 17
beds and 8 dedicated hand hygiene sinks.
To date, Muskoka Algonquin Healthcare has been able to contain infection rates below outbreak levels
without full implementation of the proposal. In November, there was a slight increase case count but
transmission was prevented with some of the new initiatives in place but not fully rolled out. This is a
testament to all staff and physicians for their dedication and focus in the area as well as the vigilance in
isolating patients early.
Next steps in the C-Difficile will include a more focused approach to antibiotic stewardship. The 2012
Quality Improvement Plan will include developing clinical expertise in guiding antibiotic therapy and have
access to infectious disease consultants for complex situations. Antimicrobial stewardship involves
limiting inappropriate use, optimizing antimicrobial selection, dosing, route, and duration of therapy in an
effort to maximize clinical cure or prevention of infection while limiting the unintended consequences, such
as the emergence of resistance, adverse drug events, and costs.
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Open Session Minutes Board of Directors December 8, 2011
Approval Pending Bracebridge Site Boardroom
The Patient Safety 2012 Education Plan will begin to be rolled out in January 2012 and will involve a
communiqué sent to all staff on the first working day of each month with a different monthly them
throughout the year. In addition, lunch and learn sessions will be held and the Board of Directors will also
receive monthly education sessions. The patient safety monthly themes will include
1. What is Patient Safety? A conceptual framework. MAHC’s Patient Safety Plan
2. Gaps in Patient Safety: A Call to Action
3. External Influences: Issues of Law, Capacity and Policy
4. Systems Thinking: Moving beyond Blame to Safety
5. Human Factors Design
6. Communication
7. Teamwork
8. Organization and Culture
9. Patients as Partners: Engaging Patients and Families
10. Leadership
11. Methods for Improving Safety
12. Year One in Review. How is MAHC doing in relation to our plan? Next steps
Questions from Directors were welcomed and included further information regarding the antibiotic
stewardship as well as clarification regarding the funding from District of Muskoka.
Sven Miglin thanks Mrs. Major and all of the staff for working on this very important initiative to help
improve patient safety at MAHC.
Dawn Major left the meeting at this time.
3.3 PROCESS IMPROVEMENT PROJECT
Catherine Racine, Manager of Emergency and Oncology Services along with Noreen Chan, Manager of
Cardio Respiratory, Surgical Services and Reprocessing provided the Board of Directors with an overview
of the next phase of the Process Improvement Project.
The HDMH Site of MAHC has been re-identified as one of 74 Pay for Results (P4R) Emergency
Departments for the 2011/12 fiscal year. This funding, based on successfully meeting targets, is allowing
MAHC to refocus on performance improvement. This year during the provincial wave 4 of P4R, we will be
concentrating on improving the coordination of care for our patients by streamlining the processes that
occur from admission to discharge. This will potentially improve our time from decision to admit to transfer
to the inpatient bed. The first phase will be looking specifically at the HDMH Site and the second phase
that will occur from April to June will look at these processes at the SMMH site. Although the Ministry
funding is allocated to the HDMH Site, MAHC is using this funding to develop improvement capacity
throughout both sites. The latest results show that the HDMH Site number one in the province of the 74
P4R Sites.
Discussion ensued regarding the areas of focus and some of the potential causes. It was noted that
increased time to being admitted could be attributed to a number of reasons including the impact of ALC
patient and isolation requirements. A root cause has not yet been determined and will be one of the
focuses of the project.
Noreen Chan and Catherine Racine left the meeting at this time.
4.0 REPORTS
4.1 REPORT OF THE BOARD CHAIR
The Chair mentioned the Pay For Results information for the Huntsville Site and congratulated and
thanked the staff. In addition, on behalf of the Board, all staff, physicians and volunteers were wished
happy holidays and in particular those that will be working on the holidays. The Community appreciates
their dedication to healthcare.
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Open Session Minutes Board of Directors December 8, 2011
Approval Pending Bracebridge Site Boardroom
4.2 REPORT OF THE CHIEF EXECUTIVE OFFICER
Natalie Bubela reviewed the report included in the meeting package provided for information. Of note, it
was explained that the new Senior Director candidate will be assisting with the Process Improvement
project. Also discussed was the accreditation results. There is no benchmark or average however it was
mentioned that the previous Accreditation result for Muskoka Algonquin Healthcare was 87%, hence
MAHC has improved.
5.0 CONTRIBUTE TO THE STRATEGIC DIRECTION
5.1 STRATEGIC PLANNING COMMITTEE REPORT
Bill Garriock explained that the Committee will be bringing forward a final Strategic Plan for approval at
the January 12, 2012 Board of Directors meeting. The Committee had a good working session recently
and undertook an exhaustive review of the draft making some revisions. Board members were asked to
carefully review the final draft which will be circulated electronically prior to Christmas. A final medical
visioning exercise will also be hosted in the near future which will provide the physician leadership with
one final opportunity to provide feedback and commentary. Over the course of the Strategic planning
process several stakeholder sessions were held, over half of the physician community have been
engaged.
6.0 FOSTER RELATIONSHIPS AND ITEMS FOR INFORMATION
There was no other business raised at this time.
7.0 IN-CAMERA SESSION
It was moved, seconded and carried that the open session be terminated and the Board of
Directors proceeds to the in-camera session.
Sven Miglin, Board Chair Natalie Bubela, Secretary
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STANDING COMMITTEE REPORT
EXECUTIVE COMMITTEE – December 13, 2011
♦denotes
attachment
Items Discussed
1. Corporate Communications Plan Dashboard – April 1 – December 1, 2011 ♦
o 74% positive coverage rating.
o Some of the reds are directly related to the communications position vacancy. It is anticipated that these
will be back on track when the individual is recruited. An offer will be extended very soon.
o The new website is in development. The content of the site will be siginifantly enhanced with much more
information related to services. However, this has caused some delay as the development of the content
is taking additional time to ensure that it is right. The new website will be launched in the new year.
2. 2012-2013 Corporate Communications Strategy
o The Committee discussed the 2011-2012 Strategy and tactics to inform the development of the 2012-
2013 Strategy
o The new strategy will be developed with the recruitment of the new individual. One area of focus for the
coming year will be improved evaluation of the individual tactics.
3. Expense Reports ♦
o The expense reports were received.
4. Consultant Use Report ♦
o The report for the period ending October 31, 2011 was received. The Process Improvement Project will
be added shortly when contract details are finalized.
5. Board Goals 2011-2012 Dashboard
o The dashboard was reviewed and received.
6. Expense Policy ♦
o The Committee reviewed the results of a survey of allowable expenses at six partner hospitals
o Discussion ensued regarding the vagueness of the current policy related to Board mileage reimbursement
within Muskoka. It was agreed that any mileage expenses incurred for travel outside of Muskoka related
to hospital business or education would be reimbursed.
MOTION: That the Expense Policy is revised to include the following:
Directors will not be compensated for travel for hospital-related business with Muskoka
except in exceptional or extenuating circumstance. Any exceptions due to extenuating
circumstances must receive prior approval of the Executive Committee.
7. Freedom of Information & Protection of Privacy Update
o The Committee reviewed the Freedom of Information & Protection of Privacy communications and roll out
plan which includes a number of tactics including staff information brochures, website updates and a
number of policies.
8. Physician/Board/Management Meeting Agenda Review
o The Committee discussed the agenda for the December 13th meeting which will include an update on the
ALC issue as well as an overview of the network outage issues.
9. MAHC Branding Discussion
o With the divestment of responsibility for the Burk’s Falls & District Health Centre, changes to the current
memo and letterhead templates were reviewed. MAHC still provides satellite service at the Centre,
however also provides satellite services at other location across Muskoka.
o The Committee agreed to remove Burk’s Falls from the templates.
o The Committee also discussed if any further changes were need to the site names; it was agreed that no
further changes were needed.
Attendees:
Executive Committee Report re October 17, 2011 Meeting| Page 1 of 2

Meeting Dates Aug Oct Dec
Members:
17 17 13
S. Miglin � � �
L. Saunders � � �
B. Garriock R R R
E. Brown � � �
J. Sinclair � � R
C. Forret
Ex-Officio:
� � �
J. Goossens
N. Bubela
Resource:
NA
�
�
�
�
�
T. Tkachuk � � �
STANDING COMMITTEE REPORT | Executive Committee | December 13, 2011 Meeting| Page 2 of 2
Feb
16
Apr
23

22%
• Sven Miglin (18)
• Natalie Bubela (17)
• Robert Hughes (6)
YTD Media Coverage - Tone
4%
MAHC CORPORATE COMMUNICATIONS DASHBBOARD
April 1 to December1, 2011
74%
Positive (69) Neutral (20) Negative (4)
Primary Spokespersons
Quoted in 3 or more articles
• Dr. David Mathies (4)
• Bev McFarlane (3)
• Harold Featherston (3)
Driving Headlines
Positive
• Auxiliary Reaches Mammography Goal
• Patients Rate Satisfaction High at MAHC
• Local Diabetes Educator Says Latest Study No
Surprise
• Wonderful care offered by Bracebridge Staff
• Lab Services Staying Put
Negative / Neutral
• ER Doctor Needs Better Manners
• Muskoka health care poised for major changes
• Alleviating the Healthcare Crunch

Approved Communications Plan Versus Actual
TACTICS Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar
INTERNAL
MAHC Matters x x x x x x x x x x x x
Intranet Updates (daily/wkly) x x x x x x x x x x x x
Breakfast with the CEO 2x 2x 2x 2x 2x 2x 2x 2x 2x 2x 2x 2x
Chair/CEO Media Training x
MBWA (weekly) x x x x x x x x x x x
Town Hall x x x x x x x x x x x x
Board Award of Excellence x x
Metrics (i.e. Dashboard) x x x x x x x x x
Medical staff / Board Mtg x x x x
Ambassador Training x
Internal Survey x
Staff Recognition Ads x x x x x x
EXTERNAL
Awareness Column x x x x x x x x x x
Board Meeting x x x x x x x x x x
Media Call Sheet x
Meet the Media x
MAHC Corporate Ad x x x x x x x x
Council Updates (6) x x x x x x x x
Mayoral Update x x x x
Annual General Meeting x
Community Update x x x
Community Members x x x x x x x
External Survey x x x x
Organizational Brochure x
Service Fact Sheets x
Speakers Bureau x x x
Website Reconstruction x
Radio PSAs x x x x x
MAHC TV x x x x x x x
You Tube Hospital Tour x
In Person Hospital Tours x x x x x x x
Legend:
Complete
Scheduled to be on target
Behind schedule
Target experiencing challenges

DECISION SUPPORT DOCUMENT FOR
EXECUTIVE COMMITTEE
Prepared by: Tammy Tkachuk Date: December 2011
Subject: Expense Reports
DECISION SOUGHT FOR INFORMATION ONLY
RECOMMENDATION:
• That the Senior Leadership Expense Reports for October 2011 be received.
• There were no Director related expenses claimed for October 2011 at the time of the creation of this report.
BACKGROUND & ANALYSIS
• The Broader Public Sector Accountability Act, 2010 received Royal Assent on December 8, 2010.
• Hospitals are required to publicly post the expenses of board members, the CEO and members of senior
management that report directly to the CEO
o The types of expenses that are to be posted include vehicle rental or mileage, train or air travel,
taxi or public transportation, accommodation, travel incidentals (insurance, parking), meals and
hospitality.
o The required posting cycle is semi-annually with expenses posted on the hospital’s public website
60 days after the end of each reporting period
� April 1 – September 30: to be posted by November 30
• Of interest, the Local Health Integrations Networks contacted each hospital last
week to ensure that reports were posted and requested to be directed to those
reports. MAHC has been posting expenses on the MAHC Website and can be found
by following this path: www.mahc.ca > About Us > Board of Directors > Disclosure
of Expenses.
� October 1 – March 31: to be posted by May 31
• In addition, as per the revised Travel policy of MAHC, Board of Director expense report are to be approved by
the Executive Committee prior to the processing of the payment.
OPTIONS CONSIDERED
• To demonstrate MAHC’s ongoing commitment transparency and openness with our stakeholders, these reports
will be presented through the Executive Committee monthly to the Board of Directors and posted publicly
following receipt by the Board of Directors.
SUPPORTING DOCUMENTS/ATTACHMENTS
• Senior Leadership Expense Reports for October 2011
Briefing Note re Expoense Reports for July 2011 | January 6, 2012| Page 1 of 1

Expense Report
Name: Natalie Bubela
Title: Chief Executive Officer
Reporting Period: October 1 - 31, 2011
Date Amount Expense Category Description
10/17/2011 92.59 Travel - mileage HSAA Meeting at LHIN, Orillia
10/19/2011 120.32 Travel - mileage CCC Operations Committee, Barrie
10/26/2011 92.59 Travel - mileage Mental Health Coordinating Council, Orillia

Expense Report
Name: Tim Smith
Title: Senior Director, Corporate Services and CFO
Reporting Period: October 1 - 31, 2011
Date Amount ($) Expense Category Description
10/17/2011 92.59 Travel - Mileage Travel to Orillia re Hospital Services Accountability Agreement Meeting

Expense Report
Name: Bev McFarlane
Title: Senior Director, Patient Care/Clinical Services and Chief Nursing Officer
Reporting Period: October 1 - 31, 2011
Date Amount ($) Expense Category Description
10/07/2011 86.95 Travel - mileage ALC Think Tank Meeting, Orillia
10/14/2011 86.95 Travel – mileage Chief Nursing Executive meeting, Orillia

Expense Report
Name: Harold Featherston
Title: Senior Director, Non-Acute, Clinical Support and Planning Services
Reporting Period: October 1 - 31, 2011
Date Amount ($) Expense Category Description
9/27/2011 39.48 Travel – Mileage travel to Bracebridge for meeting
10/4/2011 39.48 Travel – Mileage Travel to Bracebridge - long service awards
10/21/2011 39.48 Travel – Mileage travel to Bracebridge Local Leadership Council
10/17/2011 39.48 Travel – Mileage Travel to Burks Falls - tour insurer
10/28/2011 39.48 Travel – Mileage travel to Burks Falls - hand over keys
10/19/2011 97.59 Travel – Mileage travel to Orillia - DIR implementation / park
10/26/2011 97.59 Travel – Mileage travel to Orillia - Cardiovascular Steering Committee

DECISION SUPPORT DOCUMENT FOR
EXECUTIVE COMMITTEE
Prepared by: Executive Committee Date: December 2011
Subject: Report on Consultant Use
DECISION SOUGHT FOR INFORMATION ONLY
RECOMMENDATION:
• That the Report on Consultant Use as at October 31, 2011 be received.
BACKGROUND & ANALYSIS
• The Broader Public Sector Accountability Act, 2010 received Royal Assent on December 8, 2010.
• As of April 1, 2011, under the Act every hospital, in order to be in compliance with the directives issued by the
Minister of Health and Long-Term Care is required to prepare and publicly report on the hospital’s use of
consultants
o The directive outlines a requirement to provide an annual report to the Local Health Integration
Network on consultant use. This is due June 30 th of every year.
o The first report for the period April 1, 2011 – March 31, 2012 must be sent to the LHIN by June 30,
2012.
o Hospitals are not required to report on instances where they have retained lawyers and law firms
to provide legal advice, draft legal documents or conduct litigation on behalf of the hospital
OPTIONS CONSIDERED
• To demonstrate MAHC’s ongoing commitment transparency and openness with our stakeholders, these reports
will be presented through the Executive Committee monthly to the Board of Directors on a year-to-date basis
and posted publicly following receipt by the Board of Directors.
NEW CONTRACTS SINCE PREVIOUS REPORT
• Rosemary MacGilchrist Communications – to assist in the development of the content for the new website.
• An additional contract that will be added in the near future the Process Improvement Project. The details are
in the final stages.
SUPPORTING DOCUMENTS/ATTACHMENTS
• Report on Consultant Use as at October 31, 2011
Briefing Note re Broader Public Sector Accountability Act – Reporting Requirements | January 6, 2012| Page 1 of 1

MAHC Report on Consultant Use
Reporting Period: April 1, 2011 to October, 2011 (Year to Date)
Consultant Firm/Name Description of Services Contract Term Contract Value Selection Process Utilized
Blackthorn Management Management Advisory Services –
Environmental Services
HIO Group Incorporated Pay For Performance Project – Emergency
Department
Healthtech Consultants Interim IT Leadership Services for both
MAHC and OSMH
Ongoing $12,000 Non-competitive
October 18, 2010 to June 30,
2011
Quality Care Consulting Accreditation Support September 2010 – November
2011
Odgers Berndtson Executive Search – Chief of Staff December 2010 – Conclusion of
Search
PRISM Partners To fulfill responsibilities of the Manager of
Financial Services
Date Contract
Terminated
$78,500 Competitive RFP 30-Jun-11
$207,000
(shared cost with OSMH, MAHC
responsible for 50% of contract
value - $103,500)
$125 hourly rate: Year to Date
charges = $5,395.93
Non-competitive 31-Oct-11
$30,000 Competitive RFP 30-Sep-11
April 2011 - May 31, 2011 $48,790 Non-competitive 31-May-11
Cowan Insurance Group Short Term Disability Claims Management April 2011 – March 2013 Costs dependent upon
complexity/number of cases:
Year to Date charges =
$47,731.91
Kemerer Group Inc Strategic Planning June 2011 - October 28,
2011/end of project
eSolutions Website Redesign July 2011 - November
2011/project extended, no
additional costs.
Rosemary MacGilchrist
Communications
March 29, 2011 to September
30, 2011 - extended
Website Content Development October 24 - Completion of
Project
Competitive RFP
$48,000 Competitive RFP
$18,000 Competitive RFP
Competitive Procurement: MAHC conducts open, competitive procurements where the estimated value of the procurement of goods, services or construction is $25,000 or greater
Non-Competitive Procurement: The hospital shall make every attempt to participate in open competitive process or an invitational competitive process to increase the chances of achieving the greatest value for money. When the
hospital bypasses the competitive process for any reason Board approval is required along with formal documentation must be completed to support and justify the decision as per approved policy.
$4,800
Competitive RFP

Committee
Goal Tactic
1.0 Complete the recruitment process and appoint a new Chief of Staff.
1.1 Recruitment Complete EX X
2.0 Approve a new strategic plan by December 31, 2011 for implementation over the next three years.
2.1 Strategic Plan Progress Update SP X X X X
2.2 Action Plan Development Update SP X X X X
2.3 Approve Strategic Plan SP X
2.4 Mission, Vision, Values Policy Update SP X
2.5 Strategic Directions Policy Update SP X
2.6 Strategic Plan 6 Month Update SP X
3.0 Foster continued integration between the two hospital sites as well as external relationships.
3.1 Receipt of Human Resources Report RE X X X X X X
3.2 Joint Physician/Board/Management Meetings EX X X X X X
3.3 Board Award of Excellence Nominations RE X
3.4 Corporate Communications Plan Dashboard EX X X X X X
3.5 Corporate Communications Plan for 2012‐2013 EX X
3.6 Professional Staff Bylaw Revisions GO X X X X X
3.7 Community Representatives on Standing Committees GO X X X X X X X
3.8 Corporate Partnerships Report EX X
3.9 Auxiuliary Reports na X X X X X X X X X X
4.0 Attain a successful and favourable Accreditation.
4.1 Accreditation Updates & On‐Site Survey Report GO X X X X
4.2 Accreditation Updates & Final Decision GO X X X X
5.0 Maintain a culture of quality and safety through the development and monitoring of the Quality Improvement Plan.
5.1 CEO Personal Business Commitments Updates EX X X X X X
5.2 Chief of Staff Personal Business Commitments Updates EX X X X
5.5 Ethical Framework Update QP X X X
5.6 Quality Improvement Plan Quarterly Results QP X X X X X
5.7 MAHC Safety Plan Approval and Reports QP X X X X
5.8 Complaints Report QP X X X
5.9 Quality Matters Report QP X X X
5.10 2012‐2013 Quality Improvement Plan Approval QP X
6.0 Be efficient and fiscally prudent to position the organization for financial health both in the medium and long term.
6.1 Energy Project Update RE X X X X X X
6.2 IMIT Strategic Plan Update RE X
6.3 Hospital Services Accountability Agreement RE X X X X X
6.4 Financial Statements RE X X X X X X
6.5 Operating Plan RE X
6.6 Capital Plan RE X
6.7 Receive Expense Reports EX X X X X X
6.8 Receive Consultant Use Report EX X X X X X
6.9 Audited Financials Statements AU X
Legend:
Complete
Behind schedule/experiencing challenges
EX = Executive Committee; SP = Strategic Planning Committee; GO = Governance Committee; RE = Resources Committee; QP = Quality & Patient Safety
Committee; AU = Auxiliary
September
October
November
Board of Director Goals
Dashboard 2011‐2012
December
January
February
March
April
May
June

DECISION SUPPORT DOCUMENT FOR
BOARD OF DIRECTORS
Prepared by: Executive Committee Date: December 2011
Subject: Mileage Reimbursement for Directors
DECISION SOUGHT FOR INFORMATION ONLY
OPTIONS
Hospital Allowable Mileage Multi-Site Hospital
Waypoint Mental Only mileage claims in excess of a total 48 km (to and from No
Health Centre
home/office to hospital will be reimbursed)
Georgian Bay General
Hospital
Orillia Soldiers
Memorial Hospital
Rouge Valley Health
System
Niagara Health
System
Hamilton Health
Sciences
Mileage is reimbursed for conference/Education related
transportation only
Mileage is reimbursed for conference/Education related
transportation only
Do not reimburse Board members for any expenses Yes
Mileage is reimbursed for conference/Education related
transportation only
Mileage is reimbursed for conference/Education related
transportation only
DISCUSION POINTS:
• The MAHC policy regarding mileage reimbursement for Directors within Muskoka (see page 2 of attached
policy).
SUPPORTING DOCUMENTS/ATTACHMENTS
• Travel Reimbursement Policy
Yes
No
Yes
Yes
Briefing Note re [TITLE] | January 6, 2012| Page 1 of 1

Approved by: Chief Executive Officer
Signature:
1. Purpose
Policy: Travel Reimbursement
Number: ADM-II-027 v2.0
Manual: Administration
Section: General Administration
Page: Page 1 of 5
TABLE OF CONTENTS
1. Purpose
2. Policy Statement
3. Approval Criteria
4. Procedures
4.1 Accommodation
4.2 Meals
4.3 Transportation
4.4 Miscellaneous Items
4.5 Entertainment
4.6 Expenses Not Covered
4.7 Expenses for Consultants and Contractors
1.1 Muskoka Algonquin Healthcare recognizes that travel is an essential part of operating in
a multi-site environment. MAHC is committed to supporting and assisting staff members
who must travel as a result of their functions and duties. At a minimum, this support and
assistance will consist of reimbursement of travel expense claims. The purpose of travel
and related expenses must be consistent with MAHC’s mission, vision and values.
1.2 This policy is based on four key principles:
� Accountability
� Transparency
� Value for Money
� Fairness
2. Policy Statement
2.1 These travel reimbursement rules apply to any person making an expense claim at
MAHC, including appointees, board members, employees, contractors and consultants.
For more detail regarding allowable expenses for contractors and consultants, see section
4.6.
2.2 MAHC Staff and Board members may travel for hospital-related purposes within
Muskoka without advance approval; however, the reimbursement of travel costs must be
approved as per Section 3 of this policy.
MAHC’s Travel Reimbursement Policy will be made available to all stakeholders on
www.mahc.ca and in hardcopy by request.
MAHC Employees
2.2.1 Where an employee, after commencing their shift, is required to attend another site
to perform work, MAHC will provide mileage between sites at the current
Effective Date: April 22, 2008 Last Review: April 2011 Next Review Date: April 2012 Version: 2.0
File Location: TravelReimbursement_ADM_II_027_2.0.doc

approved rate per kilometre. Staff are to make every effort to minimize these
occurrences through proper planning and/or electronic solutions.
2.2.2 Employees that are required to travel outside of Muskoka for work-related
purposes must receive advance written approval from their appropriate Manager or
Senior Manager
2.2.3 Any travel related to education events are to adhere to the Education Policy.
MAHC Board of Directors
2.2.4 Directors will not be compensated for travel for hospital-related business with
Muskoka except in exceptional or extenuating circumstance. Any exceptions due
to extenuating circumstances must receive prior approval of the Executive
Committee.
2.2.5 Directors that are required to travel outside of Muskoka for hospital-related
purposes must receive advance written approval from the Chair and will be
reimbursed at the approved rate.
3. Approval Criteria and Signing Authority
3.1 The travel will produce substantial benefit to the organization;
3.2 There is no other preferable means of obtaining the knowledge or benefit;
3.3 The travel is economically justified (it is the most efficient and economic means of
obtaining the information or benefit);
3.4 The travel is deemed essential by the Manager or Senior Manager. Discretionary travel
should only be approved depending on available funds and identified benefits.
3.5 As per the Signing Authority Policy (GOV-IV-029); all expense claims under $1,000
shall be approved by the manager of the area as per the schedule below. All expense
claims over $1,000 must have approval of the Manager and Senior Director of the area:
EXPENSE CLAIM SUBMITTED BY PAYMENT AUTHORIZED BY
Board Chair Executive Committee
Board of Directors Board Chair
Chief Executive Officer Board Chair
Chief of Staff Board Chair
Senior Directors Chief Executive Officer
Directors and Managers Senior Director
Staff Director or Manager of Department
Contractors/Consultant Senior Director or Executive Sponsor
4. Procedures
Policy Number: ADM-II-027 v2.0 Effective Date: April 22, 2008 Page 2 of 5

The following guidelines dictate the nature of reimbursement for travel purposes:
4.1 Accommodation
Necessary single room hotel accommodations will be reimbursed if required based on
start/end times of session at the standard room rate. When accompanied by a spouse and
there is additional charge for double occupancy, the member must determine the added
cost of double occupancy and make the appropriate reduction on the hotel bill submitted
for reimbursement.
Unless the member has other hospital business or a meeting is unusually late in ending,
one overnight hotel stay is all that is normally required. However, if necessary, an extra
day or days will be reimbursed where transportation schedules are not suitable or are
interrupted for some reason, or when weather conditions delay the departure of those
travelling by automobile.
4.2 Meals
MAHC will reimburse for meals for paid professional development days to a maximum
of $60.00/day as per the following scale. This does not include alcoholic beverages.
Breakfast: a maximum of $15.00 per day
Lunch: a maximum of $15.00 per day
Dinner: a maximum of $30.00 per day
4.3 Transportation
The mode of transportation chosen - air, train or car, should be that which enables the
member to attend to business with the least cost to the organization, consistent with the
least amount of interruption to the member's regular business and personal schedules.
If travel is by automobile and the staff member wishes to use their personal vehicle,
reimbursement will be at the mileage rate specified by MAHC as per the following
schedule:
Mileage Rate: $0.47/km (as of May 1, 2011)
Standard Mileages:
Toronto - Huntsville Return: 450 km
Gravenhurst - Huntsville Return: 105 km
Bracebridge - Huntsville Return: 84 km
Burk's Falls - Huntsville Return: 80 km
If a staff member wishes to rent a vehicle from a local dealer, MAHC will reimburse the
staff member the lesser of the two options. Proof of Rental Agreement must be attached
to the Travel Expense Form.
If a member's own car is used for personal reasons when air or train travel is clearly the
better mode, only the lesser of the equivalent of return air or train fare may be claimed,
plus the usual costs of local transit. In these instances, en route meals and hotel
accommodations are not reimbursable.
Policy Number: ADM-II-027 v2.0 Effective Date: April 22, 2008 Page 3 of 5

4.4 Miscellaneous Items for Reimbursement
Telephone - necessary telephone calls occasioned by absence from home base.
Tips/Meals - reasonable and necessary gratuities for service attendance and
porterage. Meal tips are to be included with meal claims.
Taxi Fares - taxi or transportation services to and from air terminal or train
stations.
- taxi fares required in the course of performing organization
business.
Parking - charges incurred when a personal car is used to travel to and from
the origin airport.
- parking at destination when travel is by car.
Summary Paid By
MAHC
Multi-Day Event:
�
Mileage – as per Organizational policy/approved rate
�
Parking – receipts to be provided
�
Accommodation - if required based on start/end times of session at the �
standard room rate
�
Meals – paid professional development day
(alcoholic beverages not included)
- unpaid professional development day
Multi-Day Event:
�(to a max
of $60/day
Mileage – as per Organizational policy/approved rate
�
Parking – receipts to be provided
�
Accommodation – standard room rate
�
Meals (alcoholic beverages not included)
�(to a max
of $60/day
Paid By
Employee
4.5 Entertainment
Charges for entertainment are not generally reimbursable. Such charges are considered
to be a personal expense. In certain circumstances entertainment, for business purposes,
may be approved by the Manager.
All travel receipts must be accompanied by a Travel Expense Form summarizing all
receipts.
4.6 Expenses not covered
Expenses that will not be paid or reimbursed by MAHC include the following:
• Interest charges on outstanding credit card balances
• Entertainment videos and movie channels
• Traffic and parking fines
• Expenses as a result of staff member’s failure to cancel transportation or hotel
arrangements
• Valet or laundry services
• Liquor and bar bills
• Loss of money or personal effects
Policy Number: ADM-II-027 v2.0 Effective Date: April 22, 2008 Page 4 of 5
�
�
�

• Additional days beyond the business purpose of the trip
• Flight cancellation insurance
4.6 Expenses for Consultants and Other Contractors
All Consultants and Other Contractor expenses must be discussed and agreed to during the
contract negotiation process.
Under no circumstances can hospitality, incidental or food expenses be considered
allowable expenses for consultants and contractors under the expense rules of MAHC or
in any contract between MAHC and a consultant or contractor. Therefore, they cannot
claim or be reimbursed for such expenses, including:
• Meals, snacks and beverages
• Gratuities
• Laundry or dry cleaning
• Valet services
• Dependant care
• Home management
• Personal telephone calls
Policy Number: ADM-II-027 v2.0 Effective Date: April 22, 2008 Page 5 of 5

Summary of Items Discussed
RESOURCES COMMITTEE
Open Session – December 22, 2011
STANDING COMMITTEE REPORT
1. Human Resources Report ♦
• The report for December 2011 was reviewed.
• Significant discussion around vacancies and recruitment, grievances and absenteeism occurred.
♦ denotes attachment
2. Short Term Disability Update
• A comparative analysis of the outsourced Short Term Disability adjudication including a comparison of MAHC’s
spend on short term disability between the 2010/2011 (Pre-Cowan) and 2011/2012 (Post-Cowan) fiscal years.
• MAHC has experienced an overall reduction in Short Term Disability use that amounts to $76,318.60 over what
was spent last year (between April 1 to November 30) and has paid Cowan $25,398.25 to set up the program and
manage the Short Term Disability between April 1, 2011 and November 30, 2011. Therefore, MAHC has
experienced a net savings of $50,920.35 in Short Term Disability Costs over last fiscal year, up to November 30.
3. Hospital Services Accountability Agreement Update
• The Committee reviewed the dashboard of measures related to the HSAA.
4. Insurance Overview
• The Committee received a five year comparison report of insurance claims for MAHC and other HIROC hospitals.
MAHC has performed significantly better than other hospitals both in the number of claims and the average cost
per claim.
• MAHC averaged just over three claims per year, almost half the number of peer hospitals, and the average claim
was $12,350 compared to our peers who averaged $43,569 per claim.
5. Compliance Report: ♦
MOTION: That the Compliance Report for the period ending November 30, 2011 be received.
6. Accounts Receivable Analysis
• Accounts Receivable from patient services has been increasing over the past year. Analysis of the Accounts
Receivable function has indicated that the resources assigned to this duty have decreased over the past two
years.
• In the past, additional resources were assigned to Accounts Receivable collection to drive the balances down; the
reduced hours have corresponded with an increase in the outstanding Accounts Receivable balances.
• An increase to part-time hours assigned to Accounts Receivable will be implemented using existing budget dollars.
7. Policy Review
• The following three policies were reviewed as part of the normal three-year review cycle, no changes were
recommended:
� Capital Assets and Capitalization
� Financial Planning/Condition
� Financial Statements & Returns
8. Other matters to be discussed separately from the Consent Agenda:
• Financial Statements for the period ending November 30, 2011
• DRAFT Operating Plan for 2012-2013
Attendees:
Meeting Dates Aug
25
Elected Members:
C. Forret �
G. Evans �
P. Matthews �
Ex-Officio Members:
S. Miglin �
Oct
27
Dec
22
Feb
23
Apr
26
May
24
Resources Standing Committee Report re December 22, 2011 Meeting| Page 1 of 2

N. Bubela R
Dr. A. MacLennan �
Executive Support:
T. Smith �
R. Hughes R
Resource:
T. Tkachuk � � � � � �
Resources Standing Committee Report re August 25, 2011 Meeting| Page 2 of 2

HR Report
December 2011

Vacancy Rate
Vacancy Rate (%)
3.50
3.00
2.50
2.00
1.50
1.00
0.50
0.00
Overview
The purpose of this report is to provide:
1. Identification/analysis of relevant HR metrics
2. Updates on the status of initiatives
Vacancy Rates
Jan Feb March April May June July Aug. Sept. Oct. Nov. Dec.
2010 2.52 1.25 2.37 2.23 1.11 1.93 3.10 1.95 2.78 1.81 2.34 1.54
2011 2.24 0.14 0.57 0.71 0.71 0.85 1.13 1.39 2.48 1.66 2.64
Month
Posted Vacancies (Includes full-time, part-time, casual and temporary positions)
Vacancy Type
Ultrasound Technologist
Executive & Comm.
Assistant
Speech Languange
Pathologist
Management
CT Technologist
Registered Nurse
Current Vacancies
0 2 4 6 8 10 12
Number of Vacancies
2
2010
2011

New Hires
Number of Hires
25
20
15
10
5
New Hires By Month
0
Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.
2009 11 4 8 6 14 10 6 7 13 9 10 12
2010 2 2 5 7 14 6 21 4 10 5 4 3
2011 4 9 0 8 19 6 2 10 6 4 3
Exits and Turn Over
Number of Exits
40
35
30
25
20
15
10
5
0
Resignation 2009
Retirement 2009
Discharge 2009
Resignation 2010
Month
Exits by Profession
Retirement 2010
Discharge 2010
Exit Reason
Resignation 2011
Retirement 2011
Discharge 2011
Death 2011
3
2009
2010
2011
Nursing
Allied
Health
Service
Clerical
Admin.

Number of Exits
82
80
78
76
74
72
70
68
66
64
62
Grievances
Number of Grievances Filed
60
50
40
30
20
10
0
Absenteeism
Total Exits
2009 2010 2011
Year
55
28
Total Exits
Grievances
19
1
TURNOVER
Measurement Percentage Turnover by %
January 2009 - December 2009 9.74%
January 2010 – December 2010 11.50%
January 2011 – Present 9.58%
Group OHA Benchmark (2010-2011) MAHC Average 10-11
Service TBA 16.69
Nurse TBA 20.32
Paramedical TBA 13.83
Clerical TBA 9.63
Administration TBA 10.85
38
13
2007
2008
2009
2010
2011
4

Initiatives
Initiative Milestones Timeframes
SEIU Local Negotiations • Prepare Local Proposals
• August 2009
• OHA and SEIU to Vet
Proposals
• November 2009
SEIU and MAHC begin
Negotiations
• June 2010
• Target Completion
• Local Interest Arbitration
• August 3, 2011
Awaiting Award
SEIU Central Negotiations • Participation on Central
Bargaining Committee
• Ongoing
OPSEU Office and Clerical
Negotiations
• Next Round Begins • April 1, 2012
HR Benchmarking Project (Saratoga • June 2010
• 3 year
Survey)
• Year One Complete
benchmarking
initiative
Absenteeism/Claims Management • Business Plan
• May 2010
and Adjudication Project
• RFP
• July 2010
• Vendor Selection
• November 2010
• Go Live
• April 2011
• Ongoing monitoring
Leadership/Management
• Needs Assessment Survey
• November 2011
Development Modules
• Module Development
• February 2012
• Implementation
• April 2012
Absence Management Policy
• Draft Complete
• November 2011
Implementation
• Communication/Changes
• January 2011
• Implementation
• February 2011
Employee Engagement Survey • Survey Set up
• December 2011
• Conduct Survey
• January 2012
• Survey Results
• March 2012
Workwell Audit • Re-Audit • January 2012
Pay Equity – SEIU • Anticipated Completion • Winter 2012
5

MUSKOKA ALGONQUIN HEALTHCARE 2011-12
MONTHLY COMPLIANCE REPORT
MONTH APRIL MAY JUNE JULY AUG SEP OCT NOV DEC JAN FEB MAR
Payroll and other statutory withholdings remitted 5-Apr 4-May 3-Jun 6-Jul 10-Aug 6-Sep 5-Oct 3-Nov
19-Apr 18-May 17-Jun 12-Jul 24-Aug 19-Sep 19-Oct 17-Nov
HST 16-May 17-Jun 18-Jul 22-Aug 22-Sep 21-Oct 18-Nov Dec 14
EHT 15-Apr 13-May 15-Jun 15-Jul 15-Aug 15-Sep 15-Oct 15-Nov
HOOPP (pension) 15-Apr 13-May 15-Jun 15-Jul 15-Aug 15-Sep 15-Oct 15-Nov
Banks Reconciled (Y/N) Y Y Y Y Y Y Y Y
T3010* 30-Sep-11
Compliance with Borrowing
Undertaking and Conditions (Y/N) Y Y Y Y Y Y Y Y
Line of Credit used at Month End $0 $0 $0 $0 $0 $0 $0 $0
Maximum line of credit used during month $5,570,000 $2,620,000 $1,980,000 $1,450,000 $830,000 $1,660,000 $0 $70,000
Changes in Legal Issues n/a n/a n/a n/a n/a n/a n/a n/a
Changes in Contingent Liabilities n/a n/a n/a n/a n/a n/a n/a n/a
Compliance with WSIB Programs
16-Dec-11
Chief Executive Officer Date
16-Dec-11
Chief Financial Officer Date

Summary of Items Discussed
MEDICAL ADVISORY COMMITTEE
Open Session – December 19, 2011
1. The Medical Advisory Committee received the following reports and minutes:
• Patient Order Sets
• Pharmacy and Therapeutics
• Emergency Department
• OBS Committee
• Surgical Services
2. The following processes, policies and forms were discussed and approved:
• Investigational and Emergency Release Policy
• Potassium Phosphate Policy
Attendees:
Meeting Dates April May June Sept Oct Nov Dec
Members:
18 16 20 19 17 21 19
D. Mathies � � � � �
Dr. J. Goossens � � �
Dr. N. Bozek R � R � � � �
Dr. A. Shearing � � � � � � �
Dr. T. Kappos � � � � � � �
Dr. A. Deketele � � � � � � �
Dr. T. Drohomyrecky � � � �
Dr. D. Johnstone � � � � � � �
Dr. M. Marr � � R � � �
Dr. S. Herr R � R R � � �
Dr. A. MacLennan
Ex-Officio Members:
� � � �
N. Bubela
Bev McFarlane
Harold Featherston
Staff Resource:
�
�
�
�
�
�
R
R
R
�
R
�
�
�
�
�
�
�
R
�
R
L. Parrott � � � � � � �
STANDING COMMITTEE REPORT
Medical Advisory Committee Report reDecember 19, 2011 Meeting| Page 1 of 1

Summary of Items Discussed
QUALITY AND PATIENT SAFETY COMMITTEE
Open Session – December 21, 2011
1. Quality Council Update
• The Committee received the report of the Quality Council.
STANDING COMMITTEE REPORT
2. 2012-2013 Quality Improvement Plan Development
• An analysis of the year one QIP is being undertaken and will be submitted to the Health Quality
Ontario Council as required
• The second year plan will see the implementation of new metrics including the Surgical Safety
Checklist, Physical Restraints and Overall Quality of Care satisfaction results.
• A new dimension has also been added to the second year – Integration. The readmission rates and
ALC metrics will be moved to this dimension
• The draft plan will be presented to the Senior Team in January followed by Quality & Patient Safety
Committee in February with Board approval by March
3. Accreditation Update
• The Committee received a detailed workplan that has been developed along with assigned
accountabilities to guide the work over the coming months in order to be fully compliant by March
2012
4. Items to be discussed separate from Consent Agenda include:
• Balanced Scorecard as at October 2011
• Patient Values, Rights and Responsibilities
Attendees:
Meeting Dates Aug Oct Dec
Elected Members:
24 26 21
L. Saunders � � �
R. Durst � � �
C. King
Ex-Officio Members:
� � R
S. Miglin � R R
N. Bubela � � R
Dr. J. Goossens R � �
Dr. N. Bozek � � �
B. McFarlane
Resource:
� � �
T. Tkachuk � � �
Feb
22
Apr
25
Quality and Patient Safety Committee Report re August 24, 2011 Meeting| Page 1 of 1

Dimension
Patient Safety and Quality of Care
Reference Date As
October
Reduce hospital acquired clostridium difficile associated diseases
Improve provider hand hygiene
compliance Before and After patient
environmental contact
Prevent Venous Thromboembolism
Objective
1 November-11 Dawn Major 0.65 0.30 0.47
Before patient environmental contact 67.10% 77.14% 72.14%
1 2 November-11 Dawn Major
After patient environmental contact 85.80% 88.25% 83.25%
21
Metric Under
Const.
Implement medication reconcillation process PSP 14 November-11
Use of Patient Order Sets PSP
To reduce the number of Incident
occurrences that results in injury
(Minor/Moderate/Major)
Protect patients and staff and reduce
the rates of health care associated
infections
Reduce wait times in Emergency
Department
13 September-11
Project Sponsor: Bev
McFarlane; Project Lead:
Metric Under Const.
Karen Moore/Kathleen
Vom Schiedt
MAC/Dr.
Goossen/Catherine
Racine
HDMH
38.00% >=80%
SMMH
Minor/Moderate 99.00%
Major near miss/Major (Sentinel) 1.00%
46.00% >=80%
5 45
Injurious FALLS 24.00 25 27.5
Non-Injurious FALLS 60.00
90th Percentile ER length of stay for
Admitted patients
90th Percentile ER length of stay for
Non-Admitted Complex Condition
patients
Priority Tab #
Data
Reporting
Period
Responsible Performance Target Baseline
4 November-11
Project Sponsor: Harold
Featherston; Project
Lead: Cheryl Dakin
PSP 16 Q2-FY 2011/12 Bev McFarlane/Diane Veit
VRE PSP 17 Q2-FY 2011/12
VAP Q2-FY 2011/12
Patients Leaving ER Unseen 20 Q2-FY 2011/12
Reduce new hospital acquired pressure ulcers
Surgical Check List Compliance
MRSA
Central Line Infection Q2-FY 2011/12
2
PSP
2 8
2
Jan until June
2011
Q2-FY 2011/12
September-11
Dawn Major
Catherine Racine
Frankie
Dewsbury/Catherine
Racine
Diane Veitch and Patricia
Connick
HDMH
100.00% 98.94%
SMMH
99.62% 98.94%
HDMH
0.18 0.02
SMMH
0.00 0.02
HDMH
0.00 0
SMMH
0.00 0
HDMH
0.00 1.01
SMMH
0.00 1.01
HDMH
0.00 0.77
SMMH
0.00 0.77
22.5 25 12.7
5.5 8 5.8
HDMH
3.40% 4.80%
SMMH
6.00% 4.80%
4.00 3.15 3.7

Dimension
Effectiveness Integrated
Patient-Centered
Legend:
Reference Date As
Objective
Reduce unnecessary hospital readmissions
WHITE Non-indicator Data
Note: The indicators with a Priority belong to the "QIP"
October
Reduce percentage of ALC Days 2
We are not keeping our patients in hospital longer than we should. (Relative
Acute and Relative Total LOS)
Reducing wait times for key health
services is one of the Ontario
government's top priorities (Wait
Times)
Improve organizational financial health
(Total Margin)
Lost days due to Workplace Injury
Current Ratio
NRC Pickers/HCAHPS: "Would you
recommend this hospital to your friends
and family?
Improve Patient Satisfaction
Not meeting the target
On target
Priority Tab #
Data
Reporting
Period
Responsible Performance Target Baseline
5 Q4-FY 2010/11 Quality Council 14.60% 13.40% 13.40%
MAHC Performance
918
MAHC + CCAC
Performance
761 793
918 635 793
YTD-ALC Days
Saved
380
-657 380
HDMH HDMH
5.5 5.1
SMMH SMMH
5.9 4.5
Cataracts (HAA) October-11 Noreen Chan 86 133 133
CT (HAA) October-11 ED Gannon 21 28 30
Securing additional $1.5 million in
base funding from the MOHLTC
10% to 15% reduction in Sick Days
expenses from the FY 2010/11
MOHLTC Ministry of Health and Long Term-Care
ALC Alternate Level of Care
Abbreviations: NRC National Research Corporation
Hospital Consumer Assessment of Healthcare Providers and
HCAHPS Systems
ER Emergency Room
3
2
6
7
Beverley McFarlane and
Diane Veitch
October-11 1.80% (-3)%
October-11 $92,090 $91,957 $104,628
22 Q2-FY 2011/12 Laurene Wittich 3 5
23 Q2-FY 2011/12 Tim Smith 3.90 1
Emergency Room (ER) Q1-FY 2011/12 94.90% 89.70% 89.70%
2
9
November-11
10 September-11 Frankie Dewsbury
12
Tim Smith
Quality Council
Inpatient Services (IP) Q1-FY 2011/12 83.37% 73.20% 73.20%
Overall Satisfaction Results: IP Q1-FY 2011/12 80.80% 73.80%
Overall Satisfaction Results: ER
2 24
Q1-FY 2011/12
Frankie Dewsbury
74.90% 67.20%
All dimensions of care: IP Q1-FY 2011/12 83.37% 73.20%
All dimensions of care: ER Q1-FY 2011/12 94.90% 89.70%
41%
Indicators
ELOS
Target Met Target Not Met
59%

Distribution of Indicators (monitored)
25 16
Target Met C-Diff Rate Hand Hygiene: Before Contact Hand Hygiene: After Contact Reconciliation: HDMH Reconciliation: SMMH
Pt Order Sets MRSA; HDMH Pt Leaving ER: SMMH Pressure Ulcers Hospital Readmissions ALC Days MAHC
ALC: MAHC + CCAC Relative LOS: HDMH Relative LOS: SMMH Reduction in Sick Days Current Ratio

DECISION SUPPORT DOCUMENT FOR
STRATEGIC PLANNING COMMITTEE
Prepared by: Strategic Planning Committee Date: November 30, 2011
Subject: Patient Values, Rights & Responsiblities
DECISION SOUGHT FOR INFORMATION ONLY
BACKGROUND & ANALYSIS
• The Excellent Care For All Act included a requirement that organizations have a Declaration of Patient Values developed
through community consultation.
• Muskoka Algonquin Healthcare has had a patient rights and responsibilities document in place for several years.
• The Quality & Patient Safety Committee upon review of the documents agreed that it would be timely to initiate a review and
update of the document through public consultation.
• Appreciating the need to leverage opportunities and initiatives, the Quality & Patient Safety Committee requested that the
Strategic Planning process incorporate a public consultation of the Rights and Responsibilities document.
IMPLEMENTATION
• A survey was developed and posted for a one month period. The Community Health Bulletin included an article from Sven
Miglin and Natalie Bubela requesting the public visit the website or contact us to complete the survey. A news release was also
issued.
• In addition, Clinical Managers provided the survey in hardcopy with patients and requested them to complete the survey.
SURVEY RESULTS
Q1. If I were a patient at Muskoka Algonquin Healthcare, the Patient Rights and
Yes 100.0%
Responsibilities document says what is important to me. No 0.0%
Q2. Does anything need to be added or removed from this document?
Q3. Are there any other ways this document could be improved?
Yes 16.7%
No 83.3%
Yes 25.0%
No 75.0%
Q4. The Patient Rights and Responsibilities document is available on MAHC’s
Yes 83.3%
website (www.mahc.ca) and in the Patient Safety Guide available at our
hospitals. Does having the document available in these ways meet your needs? No 16.7%
Q5. Tell us a bit about you. The following best describes who you are:
Patient 58.3%
Family member of patient 8.3%
Caregiver 8.3%
MAHC Employee 16.7%
Survey Comments:
Two comments suggested the document be provided to patients upon admission.
MAHC Volunteer 8.3%
One comment suggested that the document should include the responsibility of the substitute decision maker.
• As a result of the above, the Patient Values, Rights and Responsibilities document has been revised and written in the first
person and reformatted to provide clarity and ease of reading for patients/substitute decision makers.
• The Patient Safety Brochure includes these rights and responsibility statements and is provided at admission as part of the
Patient Safety Plan.
RECOMMENDATION
• The Strategic Planning Committee reviewed the report and have recommended that the Quality & Patient Safety Committee
review and consider approval of the revised Patient Values, Rights and Responsibilities.
MOTION
• That the revised Patient Values, Rights and Responsibilities document be recommended for approval by the Board of Directors.
Page 1 of 1

PATIENT VALUES, RIGHTS & RESPONSIBILITIES
As a patient or substitute decision maker at Muskoka Algonquin Healthcare, this is important to me:
Patient Rights Patient Responsibilities
QUALITY CARE I have the right to quality care delivered by professional
staff in a setting that meets established quality
standards.
HEALTH AND
SAFETY
PRIVACY AND
CONFIDENTIALITY
I have the right to receive care in a safe, clean and
accessible environment.
I have the right to reasonable privacy. The privacy and
confidentiality of all personal information and clinical
records regarding care will be maintained in accordance
with the law.
INFORMATION I have the right to ask for, and receive, in terms that I
understand, information about my health care. I have
the right to know the names, positions, titles and
professional designations of members of my health care
team. I have the right to participate in my plan of care
and to be consulted about plans for my discharge.
RECOGNITION AND
DIGNITY
CONSENT TO
TREATMENT
I have the right to be treated with respect and
consideration and to be called by my preferred name
without undue familiarity. I have the right to share my
views, observation and problems with my healthcare
team. I also have the right to get a satisfactory reply to
my requests for services that we can reasonably obtain
or provide. I have the right to the most comfort we can
provide.
I have the right to receive all information necessary to
give informed consent for diagnostic or treatment
interventions, including knowing the risks, benefits and
alternatives. I have the right to have someone act for
me if you cannot act for myself.
MY HEALTH CARE I have the right to refuse any procedures or medical
treatment and I have the right to know the
consequences of my decisions. I have the right to
refuse to join in any teaching or research trials. My
decision will not affect the quality of care I receive.
EXPLANATION OF
MY BILL
COMPLAINTS,
COMPLIMENTS,
SUGGESTIONS
I have the right to an explanation of any charges,
including those not covered by a provincial health care
plan.
I have the right to register compliments, complaints or
offer suggestions in a manner, which is convenient,
accessible and responsive to me. If I have any
questions or concerns about the service I received, I
can report this to any member of the Muskoka
Algonquin Healthcare staff, a Department Manager or
Administrator.
I have the responsibility to work as a partner with my
health care team, treat them with respect and respect
the rights, property and privacy of other patients and
families.
I have the responsibility for assisting my health care
team in maintaining a safe environment. I will ask
questions, listen and talk about any concerns I may
have regarding the safety of my surroundings or care.
I am responsible for respecting the privacy of others.
I am responsible for giving my caregivers accurate
information about my health. I am responsible for
asking questions about anything I do not understand. If
I am admitted, I must help in planning for my discharge.
I am responsible for maintaining my treatment and
notifying my health care professional of any changes in
my health after being discharged. I am responsible for
keeping or cancelling appointments.
I am responsible for treating others with respect and
consideration.
I am responsible for telling health care providers if I do
not understand my test or treatment, the risks, benefits,
alternatives, or what is expected of me. I am
responsible for choosing someone in advance to act for
me, should the need arise.
I have a responsibility to actively participate in my
treatment and will accept responsibility for my health
care decisions.
I have a responsibility to pay bills on time.
I am responsible for providing feedback to MAHC about
my experience and will make my complaints,
compliments and suggestions known so that
improvements can be made.

Proudly serving our communities through quality healthcare
QUALITY/RISK – PATIENT OUTCOMES
Report of the Chief Executive Officer
for the Board of Directors
Open Session – January 12, 2012
Own-Funds Dialysis Expansion and Renovation Capital Stages 1 & 2 Submission
• Under the new Ministry-LHIN Capital Planning Framework, the LHIN is required to review the MAHC
Proposal and Functional Programs as they relate to the program and service elements. The LHIN review
does NOT entail a review of construction and functional design as they relate to construction
requirements that the Ministry reviews. The LHIN’s responsibility is to review and, upon successful
alignment and need associated with the outlined project and future program and service delivery in the
LHIN, final Board approval is required for the Stage 1 and Stage 2 (Program and Service elements).
Upon Board approval, the health service provider is required to submit a copy of Stage 1 and Stage 2 to
the Ministry for final approval after which design, drawings, contracts and construction can begin. This
process and approval can expedited if the health service provider has their own funds to support the
cost associated with he capital project, which is true for this submission.
• On November 22, 2010, the NS< LHIN Board approved the Pre-capital Submission for this project with
the following motions: “That the Board support the pre-capital proposal for the replacement of the
water treatment system and retrofit for Muskoka Algonquin Healthcare Own Funds Dialysis Expansion
Project with the understanding that there are no additional operating costs to MAHC and that the
addition of the sixth dialysis station will operate under the current staffing model.”
• MAHC submitted the Stage 1 and Stage 2 program and service elements on October 25, 2011 to the
LHIN for review.
• The MAHC proposal is an own-funds submission which means that no capital dollars will be required
from the Ministry to support the own-funds project. The total cost of the capital project is $334,912.
The Foundation has currently raised $150,000 with the remaining $184,912 being allocated through
budget investment from MAHC’s hospital Infrastructure Renewal Fund (HIRF), which was approved by
the LHIN.
• The proposed MAHC Dialysis Expansion and Renovation project is an essential part of the Care
Connections Chronic Disease Prevention and Management Area of Focus. MAHC Dialysis is one of the
sex Regional Dialysis satellite centres in North Simcoe Muskoka, with Orillia Soldiers’ Memorial Hospital
being the Regional Lead. The proposed expansion and renovation will ensure that services are delivered
in a timely, equitable, accessible, high-quality, evidence based and patient-centred way. As such, the
proposed space increase from the current 45 square feet per station to the proposed 90 square feet per
station will enhance patient and staff safety through accessible, easier mobile space, decreased
infection transmission and maintain care closer to home for Muskoka and North East Parry Sound
residents.
• Next Steps: (1) At the NSM LHIN December 19, 2011 Board, support will be required for Stage 1 and
Stage 2 for the project. (2) Following December 19, 2011, once LHIN Board support is approved, a
letter from the LHIN will be forwarded to the Capital Branch of the Ministry acknowledging the NSM
LHIN’s support for the project – Stages 1 and 2.
STRATEGIC – SYSTEM ACCESS, INTEGRATION & CAPACITY
Invitations
Open Session Report of the CEO, Natalie Bubela | December 8, 2011| Page 1 of 2

• I have been invited to become a new member on the Ontario Hospital Association’s Medium Sized
Hospital Council (MSH Council) and have accepted that invitation.
• The MSH Council was established in 2008 to give medium-sized hospitals – defined as having between
4,000 and 10,000 weighted cases - - a voice on issues impacting them.
• The first teleconference meeting I will be participating in is scheduled for January 31, 2012.
FINANCIAL HEALTH & SUSTAINABILITY
One-Time Funding – Chronic Kidney Disease Services
• The hospital will receive an additional $27,196 in one-time funding for incremental Chronic Kidney
Disease services for fiscal year 2010-2011.
• We have also received notification regarding a funding rate increase of $3,839; therefore the total net
funding through the 2010-2011 year end reconciliation process is $31,035.
2011 – 2012 Base Funding – Senior Assessment and Support Outreach Team (SASOT)
• We have received notification of new base funding in the amount of $150,000 for fiscal year 2011-2012
to support a Seniors Assessment and Support Outreach Team and beginning in fiscal year 2012 – 2013.
• This funding will be annualized at up to $600,000 to continue to support the SASOT. It is expected that
this investment will contribute to a positive, evidence-based impact on our ALC/ER targets.
Wait Time Strategy Reconciliation for 2010-2011 Fiscal Year (Cataracts)
• Given we were unable to complete the allocated volumes, the Ministry is recovering $56,250 of funding
through the semi-monthly electronic funds transfer.
• Our incremental target was 147 but we reported 72 leaving a variance of 75 cases not completed.
Budget & Strategy Meeting with North Simcoe Muskoka Local Health Integration Network
• Bernie Blais, NSM LHIN CEO has invited all hospital CEO’s in the LHIN to a full-day budget meeting for
the end of January. His message in the invitation was that it is expected that the 2012-2013 fiscal year
will begin a new era of austerity measures that will require a higher degree of regional cooperation to
address financial challenges and to develop a sustainability strategy in future years as well. It seems
that we are at a time where we need to work together even more so as this new fiscal reality sets in.
We need to have courageous, transparent and constructive dialogue if we are going to be successful
together.
Open Session Report of the CEO, Natalie Bubela | October 13, 2011| Page 2 of2

November 2011
YTD Financial Results
A presentation for
Resources Committee
December 16, 2011
Tim Smith,
Senior Director, Corporate Services and CFO

Muskoka Algonquin Healthcare
Income Statement
For the Six Months Ending November 30, 2011
Prior Month Current Month YTD Annual Prior Year
Fav. / Fav. / Fav. /
Actual Budget (Unfav.) Actual Budget (Unfav.) Actual Budget (Unfav.) Budget Actual
REVENUE
4,766,565 4,667,088 99,477 4,721,821 4,667,088 54,734 LHIN / MOHLTC Revenues 37,671,324 37,028,420 642,904 55,696,767 55,259,374
814,625 911,603 (96,978) 883,649 911,603 (27,953) Patient Revenues 7,193,612 7,292,822 (99,209) 10,939,232 12,085,787
63,558 85,717 (22,159) 63,879 85,717 (21,838) Differential / Copayment 623,946 685,733 (61,787) 1,028,600 1,192,791
279,652 249,377 30,275 208,312 249,377 (41,065) Other Revenues 2,084,893 1,995,015 89,878 2,992,522 2,654,567
109,297 109,297 0 109,297 109,297 0 Amortization 874,379 874,379 0 1,311,568 1,377,683
6,033,696 6,023,081 10,615 5,986,959 6,023,081 (36,122) Total Revenues 48,448,154 47,876,369 571,785 71,968,689 72,570,202
EXPENSES
$184,533 $184,865 $332 $184,533 $184,865 $332 Amortization $1,476,264 $1,478,919 2,656 2,218,379 2,482,213
4,802 3,333 ($1,469) 4,802 3,333 ($1,469) Bad Debts 38,419 26,667 (11,752) 40,000 59,284
234,058 300,775 $66,717 263,979 300,775 $36,796 Drugs 1,951,453 2,406,200 454,747 3,609,300 3,293,083
8,798 14,169 $5,371 8,967 14,169 $5,202 Interest 91,701 113,350 21,649 170,025 253,796
285,076 245,708 ($39,367) 262,504 245,708 ($16,796) Medical Surgical Supplies 2,121,989 1,965,667 (156,322) 2,948,500 2,788,427
559,679 531,169 ($28,511) 544,835 531,169 ($13,666) Medical Staff Renumeration 4,308,060 4,249,348 (58,712) 6,374,023 7,489,260
3,410,104 3,956,440 $546,336 3,646,016 4,018,600 $372,584 Salaries and Benefits 30,607,323 31,216,403 609,080 47,042,163 45,440,257
865,202 898,092 $32,890 803,556 906,997 $103,441 Supplies and Other 6,805,496 7,169,288 363,792 10,828,683 10,714,693
5,552,253 6,134,551 582,298 5,719,191 6,205,615 486,424 Total Expenses 47,400,704 48,625,842 1,225,137 73,231,072 72,521,013
481,443 (111,470) 592,913 267,768 (182,534) 450,302 Surplus (Deficit) 1,047,450 (749,473) 1,796,922 (1,262,383) 49,189

Muskoka Algonquin Healthcare
Payroll Statement
For the Six Months Ending November 30, 2011
Prior Month Current Month YTD Annual
Fav. / Fav. / Fav. /
Actual Budget (Unfav.) Actual Budget (Unfav.) Actual Budget (Unfav.) Budget
$1,978,103 $2,628,424 $650,322 $2,436,689 $2,677,923 $241,234 Worked Salaries $19,005,344 $20,680,901 $1,675,557 $31,194,598
$579,298 $393,745 (185,553) 322,745 395,702 72,956 Benefit Sick 3,674,542 3,136,262 (538,279) 4,711,242
$0 $0 7,000 0 (7,000) Severance Payout 7,000 0 (7,000) 0
$41,024 $36,097 (4,927) 38,254 36,097 (2,157) Call Back 350,809 288,773 (62,036) 433,159
$80,835 $53,546 (27,289) 72,750 53,546 (19,204) Overtime 676,968 428,367 (248,601) 642,551
$660,362 $798,090 137,728 673,085 808,794 135,710 Employee Benefit Contribution 6,248,835 6,309,793 60,958 9,502,154
$4,500 $0 (4,500) 4,500 0 (4,500) Retro Accrual 36,000 0 (36,000) 0
$0 $646 646 0 646 646 Uniform Allowance 53 5,170 5,117 7,755
$51,783 $31,692 (20,091) 20,314 31,692 11,378 Purchased Service 430,692 253,536 (177,157) 380,304
$14,200 $14,200 0 70,680 14,200 (56,480) Future Benefits Accrual 170,080 113,600 (56,480) 170,400
3,410,104 3,956,440 546,336 3,646,016 4,018,600 372,584 Total Expenses 30,600,323 31,216,403 616,080 47,042,163
2,679,260 3,111,812 432,552 2,870,437 3,163,267 292,830 Total Salaries 23,707,663 24,534,304 826,641 36,981,550
660,362 798,090 137,728 673,085 808,794 135,710 Total Contributions 6,248,835 6,309,793 60,958 9,502,154
24.6% 25.6% 1.0% 23.4% 25.6% 2.1% Contribution Percentage 26.4% 25.7% -0.6% 25.7%
Wages

TOTAL TOTAL TOTAL TOTAL
TOTAL
2010/11 2011/12 2010/11 2011/12 2010/11 2011/12
Acute Patient Days (Census Data) 8,410 8,922 13,044 11,333 21,454 20,255
CCC Patient Days (Census Data) 2,156 1,815 3,249 3,681 5,405 5,496
ER Visits (Unscheduled only) 17,044 17,470 14,196 14,578 31,240 32,048
Average LOS
Average LOS for CCC patients 159 49 65 71
Average LOS for Acute patients 6 6 8 7
% Occupancy
Year to Date (YTD): Comparison 2010/11 and 2011/12
as of November 30, 2011
Site: HDMH Site: SMMH MAHC

Income Statement: Variance Explanations
Patient Revenues $( 99)k Unfavourable
� CCO‐Drug recoveries were over budgeted, down YTD $(132)k
Differential / Copayment $( 62)k Unfavourable
� YTD lower than budget
5

Income Statement: Variance Explanations
Salaries & Benefits $609k Favourable
� Continues to trend lower than budget
6

CURRENT ASSETS
November March
2011 2011
Cash 1,108,338 10,651
Accounts Receivable - Patients 1,170,595 970,156
Accounts Receivable - Other 878,169 622,541
Due from MOHLTC 0 311,110
Inventory 1,139,802 1,103,135
Due from Related Parties 498,764 110,013
Prepaid Expenses 451,567 483,236
5,247,234 3,610,842
CAPITAL ASSETS 43,535,621 44,964,378
TOTAL ASSETS 48,782,855 48,575,220
CURRENT LIABILITIES
Muskoka Algonquin Healthcare
Balance Sheet
As of November 30, 2011
Short-Term Demands Loans 3,381,719
Due to MOHLTC 4,274,322 1,097,655
Accounts Payable 7,580,418 9,264,333
Current Portion of Long-Term Debt 944,686 944,686
12,799,426 14,688,393
LONG-TERM DEBT 2,894,444 3,194,444
DEFERRED CONTRIBUTIONS RELATED TO CAPITAL ASSETS 41,234,548 39,835,164
POST-RETIREMENT BENEFIT OBLIGATIONS 1,447,680 1,277,600
TOTAL LIABILITIES 58,376,098 58,995,601
DEFICIENCY IN ASSETS
Opening Balance (9,775,238) (10,148,408)
Year to Date: Capital Equipment Equity (872,454) (321,162)
Year to Date: Surplus / (Deficit) 1,054,450 49,189
TOTAL DEFICIENCY IN ASSETS (9,593,242) (10,420,381)
TOTAL LIABILITIES AND SURPLUS 48,782,855 48,575,220

Balance Sheet: Variance Explanations
Cash
� Cash balance at over $1m at month end
Accounts Receivable
� Increased an additional $100k since Oct‐11
Accounts Payable
� Trade payables: catch up on outstanding, overdue payables reducing
balance by $4.7m since Oct‐11
8

MONTH
Opening Bank
Balance MOH
GOVT
RECEIPTS OHIP
DEPOSITS
(DIR, CC,
BANK) FAIRVERN
FOUNDATION
FUNDING
OTHER
RECEIPTS
CAPITAL
FUNDING
(HIRF, LHIN)
Subtotal
Receipts SALARIES
HDMH & SMMH
REC GEN
HOOPP/
WSIB/EHT
CAN SAVINGS
BONDS
DOCTOR
PAYMENT
LEASE/LOAN
PYMT TRADE PAYABLES
FY 2011 (3,374,418) opening balance HIRF 651,143 3,260,000
LHIN (DRP)
Apr Actuals (3,374,418) 7,664,786 672,360 422,949 473,554 0 0 (110,862) 9,122,787 1,790,030 955,214 959,172 38,445 653,076 18,681 1,403,883 49,503 5,868,002 (119,633) -3,260,000
May Actuals (119,633) 4,616,527 229,530 391,082 235,157 0 0 69,870 5,542,165 1,856,176 979,747 501,931 38,480 516,883 13,082 1,558,921 13,828 5,479,047 (56,514) 0
Jun Actuals (56,514) 4,420,989 440,691 390,517 342,990 0 0 453,633 651,143 6,699,963 1,867,515 925,730 608,771 38,450 535,677 12,032 1,400,970 0 5,389,145 1,254,303 0
Jul Actuals 1,254,303 4,633,212 303,093 378,871 526,750 0 0 268,918 6,110,844 2,037,403 1,394,208 739,908 36,843 555,597 10,325 1,433,620 0 6,207,903 1,157,244 0
Aug Actual 1,157,244 4,748,006 395,846 502,528 558,557 0 0 208,319 6,413,257 2,978,615 786,343 637,614 37,415 559,405 310,330 1,775,394 4,236 7,089,352 481,149 0
Sep Actual 481,149 5,134,407 354,994 278,841 315,589 0 300,000 604,429 6,988,260 1,970,632 701,711 974,528 56,205 583,897 9,474 1,454,074 0 5,750,521 1,718,888 0
Oct Actual 1,718,888 4,583,614 399,392 507,277 895,570 0 500,000 71,136 6,956,988 2,089,574 893,912 541,129 37,320 551,498 8,798 2,307,608 105,131 6,534,970 2,140,906 0
Nov Projected 2,140,906 4,804,659 483,756 268,159 415,406 0 0 157,585 6,129,566 1,990,254 685,884 736,983 36,495 539,318 8,967 1,907,797 288,327 6,194,026 2,076,446 0
Dec Projected 2,076,446 5,288,464 355,543 506,378 460,000 0 0 49,507 6,659,892 1,868,836 803,559 831,757 40,000 646,663 18,681 1,400,050 260,250 5,869,796 2,866,542 0
Jan Projected 2,866,542 4,622,772 355,543 350,000 440,000 0 288,889 49,507 6,106,711 1,868,836 1,395,000 771,932 40,000 650,000 663,367 1,400,050 160,250 6,949,434 2,023,819 0
Feb Projected 2,023,819 3,161,931 355,543 350,000 380,000 0 0 49,507 4,296,981 1,868,836 930,000 691,969 40,000 650,000 18,693 1,400,050 160,250 5,759,798 561,001 0
Mar Projected 561,001 3,161,931 355,543 350,000 660,263 0 0 49,507 4,577,244 2,769,454 930,000 673,797 60,000 650,000 18,681 1,400,050 160,250 6,662,233 (1,523,987) 0
Fiscal 2011 Forecast 56,841,298 4,701,834 4,696,601 5,703,836 0 1,088,889 1,921,057 651,143 75,604,659 24,956,161 11,381,308 8,669,491 499,653 7,092,014 1,111,110 18,842,466 1,202,024 73,754,228 0
Check No. Vendor
Amount
Nov-2011
24540 ELLESMERE MEDICAL MANAGEMENT I 111,247.86
24612 Physician Payment
102,991.05
MAHC Cash Flow
Actuals and Forecast
Summary by Month FY12
CAPITAL
EXPENDITURES
Subtotal
Disbursements
Closing Bank
Balance
Line of Credit
Used/(Repaid)

Draft 2012/13 Operating Budget

Budget Assumptions
Draft 2012/13 Budget
Status quo
No new positions
Minor adjustments to labour based on actuals
No Increase in Base Funding
If Approved for Seniors Initiative – Cost Neutral
(Additional $600k of revenue and expenses)

Draft 2012/13 Budget
Year to Date variances from budget
� Drugs
� 2011/12 actuals trending much lower than budget
� 2012/13 budget reduced by $636k from 2011/12
� Wages
� Unfilled positions create a favourable variance from
budget
� Positions are budgeted for in 12/13

Draft 2012/13 Budget
Vacant Positions – Budgeted but not filled
� Ultrasound Technologist
� Part time CT Technologist
� Pharmacy Director/Students (2)
� Part time Stroke RN
� Clinical Coordinators (2)
� Senior Director
� Communications (mid-year)

Draft 2012/13 Budget
Wages and Benefits – Increases in 2012/13
� Labour Increases - $400k
� Non-union
� SEIU
� OPSEU Clerical
� No Wage Increases (per contracts)
� ONA
� OPSEU Paramedical

Draft 2012/13 Budget
Wages and Benefits – Increases in 2012/13
� Future Benefits
� Actuary re-assessment after ONA contract
� 2011/12 expense $280k over budget – recognized Nov
to Mar
� 2012/13 expense $218k higher than 11/12 budget
� Retiree Benefits
� Based on actual cost
� 12/13 expense $55k higher than 11/12 budget

Supplies
Draft 2012/13 Budget
� Provision for general building maintenance
Revenue declines
� Burke’s Falls rent
� Differential payments (semi-private, private)

Draft 2012/13 Budget
2012/13
Budget
2011/12
Budget
Budget
Variance
LHIN/MOH REVENUES 56,802,501 56,946,767 * (144,266)
PATIENT REVENUES 11,310,825 10,939,232 371,593
DIFFERENTIAL/COPAYMENT 841,787 1,028,600 (186,813)
OTHER REVENUES 2,813,163 2,992,522 (179,359)
AMORTIZATION 1,311,568 1,311,568 0
Total Revenues 73,079,844 73,218,689 (138,845)
AMORTIZATION 2,218,379 2,218,379 0
BAD DEBTS 57,628 40,000 (17,628)
DRUGS 2,972,962 3,609,300 636,338
INTEREST 173,024 170,025 (2,999)
MEDICAL SURGICAL SUPPLIES 2,955,677 2,948,500 (7,177)
MEDICAL STAFF REMUNERATION 6,349,312 6,374,023 24,711
SALARIES AND WAGES 47,715,279 47,042,163 (673,116)
SUPPLIES AND OTHER 10,956,206 10,828,683 (127,523)
Total Expenses 73,398,467 73,231,073 (167,394)
Surplus/(Deficit) (318,623) (12,384) 306,239
* For comparative purposes, 2011/12 LHIN Revenue has been adjusted to include the $1.25million base
funding adjustment

Base Funding Increases
% Increase in
Base Funding
Draft 2012/13 Budget
Additional
‘000$
2012/13
Surplus/Deficit
0.25 138.0 (164.9)
0.50 276.0 (26.9)
0.75 414.0 111.1

The Board of Directors for Muskoka Algonquin Healthcare
Report from the Auxiliary to the South Muskoka Memorial Hospital
Board Meeting of January 12, 2012
On behalf of the SMMH Auxiliary Executive, I would like to wish the
members of the Board of Directors and Senior Management team a Happy
New Year. May 2012 bring you happiness, success, and good health.
I do not have a great deal to report this month as the holiday season has
kept our members socially busy.
However, I would like to thank Allyson Snelling for writing the wonderful
story concerning our Christmas House Tour in the December 23 rd issue of
the Weekender. Allyson received the information for the editorial from the
presentation I made at the December 8th MAHC board meeting. The article
certainly increased the awareness of our Auxiliary in South Muskoka.
On December 26 th a very kind individual dropped off a generous donation at
our Muskoka Mocha Coffee Bar. Was it just a coincidence or was this timely
donation because of the article in the paper? Perhaps.
I would like to welcome Allyson to the MAHC team as our new
Communications and Executive Assistant and look forward to working with
her in this new capacity.
Several members of our leadership team will be attending the Freedom of
Information and Protection of Privacy Act educational sessions over the
next few days.
Respectfully submitted
Sharon Pattinson
SMMH Auxiliary President

HUNTSVILLE DISTRICT MEMORIAL HOSPITAL AUXILIARY
Report to the Muskoka Algonquin Healthcare Board
January 2012
I would like to wish the members of the Board a healthy and prosperous new year. The Auxiliary members are
currently planning their fund raising for 2012 and look forward to your continued support.
This was the first year for our staff $1,000 “Christmas Wish” draw and the winning area is the Imaging
Department We received entries from seven areas of the hospital.
1. South Wing: request to freshen the patients’ dining room including paint and new curtains
2. Garden Court: request for a Bose Wave music system for staff and patients
3. Physiotherapy Department: request for a handheld pulse oximeter
4. Obstetrics area: request for new bili-blankets
5. Day Surgery/OR/Endoscopy: request for IV fluid warming station
6. Imaging Department: request for a fund to provide small stuffed toys to children after treatment
An additional entry from East Wing for an ice-water machine was disqualified because of cost.
We are very pleased to support Ed Gannon and the Diagnostic Imaging Department staff with their idea to
improve the care for their young patients by rewarding them with a small stuffed toy. In their entry letter, the
staff wrote that the children are typically scared of the hospital experience and are usually feeling unwell or in
pain.The staff will strive to ensure that all children have a positive memory when they undergo difficult
examinations.
The Auxiliary members are excited to play a small part in this plan to improve patient care in our hospital.
Joanne Matthews
Vice-president, Huntsville Hospital Auxiliary
Supporting Huntsville Hospital since 1955 Proud member of HAA0 since 1956