BOARD MEETING: Regular Meeting   DATE: July 25, 2017   MEMBERS PRESENT: Patricia White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith   MEMBERS ABSENT: Helen Adger, Robert T. Green, Jr., Helen Godfrey-Smith, Bruce Walker   TIME CALLED TO ORDER: 5:30 p.m.   OTHERS PRESENT:David Jones, CEO, Pam Hughes, COO, Allyson Allums, CFO, Dakota Robinson, Controller, Lanell Audirsch, Admin. Asst., John Woods, Chief of Staff, Walter D. (Doug) White, Hospital Attorney, Allison A. Jones, Attorney, Mike Gray, Security   LOCATION: NCMC Events Center   BOARD VICE-CHAIR:Patricia WhiteSECRETARY:  David Jones   I. Called to Order –Patricia White – Vice-Chairperson, called the meeting to order.     II.   Invocation and Pledge of Allegiance –David Jones offered the Invocation and Brenda Smith led the group in the Pledge of Allegiance.   III. Approval / Amend Agenda –Patricia White stated it is time for approval or amendment of the agenda. She noted there are a couple of items to be added to the agenda. She asked for a motion.   Brenda Smith made a motion to amend the agenda to add item #2 under New Business to Approve an Addendum to the Medical Staff By-Laws and add an Executive Session for Strategic Purposes between #9 – Administrative Reports and #10 – Medical Staff Reports. Kenneth Clay seconded the motion. Roll call to approve: Brenda Smith – Yea; David Norman – Yea; Mary Irvin – Yea, Kenneth Clay – Yea; Pat White – Yea.      Nays: None   Absent: Helen Adger, Robert T. Green, Jr., Helen Godfrey-Smith; Bruce Walker. Abstained: None. The motion passed.   IV.   Community Comments –Patricia White, Vice-Chairperson, noted there were no signed Visitor Recognition Cards requesting to address the Board.   V.   Minutes – Regular Meeting June 27, 2017 –The minutes of the June 27, 2017 Regular Board meeting were mailed prior to today’s meeting for review. Pat White inquired if there are any corrections to be noted. If not she would entertain a motion to approve the minutes.   David Norman made a motion to approve the minutes of the regular meeting as mailed. Mary Irvin seconded the motion. The vote: Yeas: Pat White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith; Nays: None; Absent: Helen Adger, Robert T. Green, Jr., Helen Godfrey-Smith, Bruce Walker. Abstained: None. The motion passed.     VI.   Old Business: 1)   Construction Update:David Jones asked Pam Hughes to give an update on the Construction. Pam Hughes stated that we are finishing up everything. They are doing some of the last little things. The fountain has a leak in it and they are trying to figure that out and get it repaired. It will then be filled up and turned on. We will finish the landscaping probably this week. Tomorrow they are supposed to do the hydro mulch seeding. They are working on some of the punch list. We got the rest of the overages today and all the plans. We had some but the rest of them, the ones that were stamped, and all of the O&M manuals that we didn’t have any updates. That is about it.   David Jones said it is all but done – a few more shrubbery and grass and a few touch ups. We are ready to party on the 24th.         2)   Dialysis Clinic Partnership Update:  David Jones noted, as you can tell, they have broken ground on the dialysis clinic. They had a slight speed bump with a sewage line that needed to be moved and re-routed. Other than that, it is really kicked off. This is not a bid out project so the faster they do this the more cost effective it is. He has a feeling there will be a building there before you can blink an eye. We have seen a building that these same people have built in Gilmer, Texas. If we get anywhere near that there will be a lot of people pleased with how nice it is. We are looking forward to that.           Brenda Smith commented that the water wall is beautiful. It does make a good barrier between the clinic and the hospital. Pam commented that was what Mr. Jones wanted. David Jones noted that it is a nice centerpiece. He noted that Pam Hughes picked that out. He said it would shock you how many water walls there actually are. Pam said there are colors, features, bubbles or no bubbles to choose from. David Jones said it is kind of like building a house. We have not built 10 of these. This is the first $25 million dollar hospital we have built and things like the water wall. Pam came up with a great idea – she painted some boards black and got black rocks and epoxied them to the boards. We didn’t want loose rocks with all the glass. We thought that would work. She went down last week and a child had already pulled one off of the epoxy. They were well glued on. She had to go to plan “B” and put ivy on there. One thing after another as you go. It is a learning experience. The roses are a deterrent from someone getting into or putting something in the fountain.       3)   Surplus Equipment Update:  Pam Hughes noted there were no bids. He said he gave an update at the previous meeting that we had no bids. The reason for this was the ad never got put in the paper. It was run the appropriate time frame; we received no bids. It will be disposed of. This was more like the typical ones we have done in the past. This was not a lot of older stuff from the old hospital. It was broken chairs, computers, etc. It was noted that after five years computers are so out of date. David Jones said if you can run one little thing on one it is useful, but other than that, they are not. Computers really are cheap now, especially a desk top. Brenda Smith asked if these are thrown away. Pam Hughes answered yes. The hard drives are removed and they are disposed of. Brenda Smith asked if there would be a Technical School that would like to have them for their kids to work on. Pam Hughes stated no these are too old. The only use may be for taking them apart for training. David Jones said they would be willing to call to ask if they are interested.         Mary Irvin asked what the dialysis center is going to be called. David Jones said he thinks it will be the North Caddo Dialysis Center by Fresenius. North Caddo Medical Center will be somewhat inferred. It will be awesome whenever it is open. Dr. Woods is eagerly awaiting the ER patients that will come from there.

4) Radiology and ER Expansion Update:  David Jones stated he really does not have an update right now. The architect that is over this project and that will be helping with that project has been out of the country for the last three and one half weeks. He said he thinks she will be back this week. We are waiting on her word. She was trying to get the waiver passed through DHH when she left. As soon as that gets approved, hopefully we can go out to bid to see how much it is going to cost and if it falls within the cost parameters, then he will be back to the Board to discuss going forward with the project. We don’t foresee any issues with any of that, but we will see. The waiver is a 50/50 shot. Brenda Smith inquired what if the waiver is not passed. David Jones said we will still go out to bid to see how much it will cost. It would be cheaper, of course, because it would be less square footage if we don’t have to build that room. We will see. It is a complete waste of space, but then again, there is plenty of complete wasted space we had to build in this one.       5)   Reappointment of Robert T. Green, Jr. Update:David Jones reported that the Commission put the reappointment of Robert t. Green, Jr. on their agenda and he was told by Doug Dominick that it was approved.   VII.   1)   Review June 2017 Statistics – Allyson Allums:   Allyson Allums presented the June 2017 Statistical Report. There were 86 Admissions and 84 Discharges with Total Days Stayed –207. The Average Length of Stay – 2.5 Days. Total In-patient Days – 210. The average Daily Census – 7. Our Total Occupancy Rate was 46.70%. Total Surgeries for June (In-patient – 6 / Outpatient – 2). Endoscopies performed in June – 9. The total Emergency Room patients seen – 429. Swing Bed Admission –13. There were 165 Total E.M.S. runs in June. Observation Patients for June- 51. There were 11 Newborns in June. The total Patient Visits for the Medical & Surgical Clinic is 1791. The Plain Dealing Clinic saw 564. Benton Medical saw 121. There were 24 Mammograms for June.     2)   Review June 2016 Financials – Allyson Allums:   Allyson Allums presented the Financials. Hospital Revenue over Expense. Revenue –$3.7 million Expense – $1.9 million with a profit of $49,000. The AR Days for all three facilities – 58.0; for the hospital only is at 46.8 days. Plain Dealing Clinic – Revenue over Expense. Revenue –$129,000, Expense – $79,000 with a profit of $5,500. Medical and Surgical Clinic – Revenue over Expense. Revenue – $518,000 Expense – $241,000 with a profit of $116, 000. Benton Clinic – Revenue over Expense. Revenue –$30,000; Expense – $18,000 with a loss of $6,500. The Bad Debt Expense is at 4.0%. Days cash on hand– 9.00 days. This is due to several things. We had takebacks that we are still trying to recover from. Our length of stay – – last year we struggled to meet the 4 days; well, this year we worked a little too hard to get them out a little too fast and it cost us in revenue. We also had to make some audit entries from last fiscal year that Mary Carrol brought at the start of the audit this year which affected the cash. So, we are sitting at around 9 or 10.   Self-Funded Insurance –The total expense was $122,000 for this month and the specific reimbursement, for any claim over $50,000, we received $667. Comparing the two years which are self-funded to self-funded, we are running a little over last year. Last year at the end of the fiscal year, we had spent $1,000,080 – this year we are at $1.2 million. We have had several large claims to come through on our employees.       She noted that they have a new slide on the 340B to show the revenue that is starting to come in from this program. Showing is April, May and June. A little over $21,000 for April, $74,000 in May and June, another $70,000. There are some expenses that did go along with that; some start up fees. Some one time fees that we had to pay that will be taken from this. If we calculate our figures, we are looking at about $50,000 extra a month that we are going to be receiving from this program which will really, really look good on our bottom line at the end of the year.         David Jones noted that this is the year end and so you can take an overview look at the statistics and financials versus year to date for 2017 versus 2016 and a couple of things stand out. One, our patient days were down considerably but our total admissions were not. It was fairly equal, even though we were down 19 over a 12 month period. Patient days is what we get paid off of. We have $3 million dollars in outstanding AR, but that does not equate out to tomorrow we can get $3 million dollars back from that. We have to work to collect that. Most of that, like she said, our net AR system is 58 days – it is 60 days to collect any of that. Our expenses don’t wait 60 days. With what happened to us last year, it has become a tight rope just about every week to every other week from our cash standpoint. It’s going to be a slow, steady climb. It may take five to ten years to get out with the amount of cash that has been excessively used over the last few years, with the building of this building, legal costs, things you can’t budget for, etc. This is the first $25 million dollar facility that we have built. We are going to call a meeting of the finance committee to start strategizing a little bit more on what is going on. He ask David Norman if he would be available. David Norman asked if he knew what date. David Jones said not yet. He will have someone call. They will try to work around David Norman, Bruce Walker, Robert Green and Helen Godfrey-Smith’s schedule. He noted that in June we lost the PA in Benton. The numbers that were seen there were actually fairly impressive with only having Dr. McCommon there about one day a week. We have the new nurse practitioner up and working. She has a lot of energy. She wanted to paint her office herself. She is not afraid of work. He has very high hopes for her over the next six months. Brenda Smith asked about the Plain Dealing Clinic. The clinic numbers were down. David Jones said one of the providers went on vacation and it is summer months. This has been a pretty good June for us for the summer. June, July and August are typically our worst three months of our year. Another thing that hurt us, December and January were horrific, number wise, for our hospital. The worst we have had in twelve years. There just were not that many admits, clinic visits – not a lot going on. We had the busiest March in the last ten years which helped to dig us out a little bit. Still, you have a two month pause, that’s a problem. He and Pam just came back from the LHA Conference this past week. There are a couple of major health systems that they are predicting to go bankrupt this year. Pam noted millions and millions of dollars lost. Kaiser Permanente – $250 million lost in the first quarter. The ones that typically make money typically – they are hurting right now. There are a few for profits that are still making money, but other than that everybody is hurting. Not to doom and gloom you too much, this job is not going to get any easier is the take away. Healthcare in the United States; it is on the news every day. It is just the fun we signed up for.       Pat White asked if there was any more discussion. If not she would entertain a motion to accept the Statistical and Financial Reports.     Brenda Smith made a motion to accept the Statistical and Financial Reports as presented pending the audit. David Norman seconded the motion. The vote: Yeas: Pat White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith, Nays: None; Absent: Helen Adger, Robert T. Green, Jr., Helen Godfrey-Smith; Bruce Walker. Abstained: None. The motion passed.       VIII. New Business – 1)   Security Assessment of IT System:David Jones asked to table this until next month. He thinks it may actually be taken off the agenda for next month. We found a loop hole to prevent us from having to outsource this security assessment. It is for our Meaningful Use Program. We think we can do an internal assessment. We are trying to get a direct answer as to whether we can do that or not. If we can do one, it’s not going to cost us; if we don’t it is probably going to cost around $12,000. Allyson said she had an amount of $4,300. Cerner came in at $12,000 but we have credits of $7,700. David Jones said that is even better. Allyson said she received another one at $24,000. Brenda Smith, asked if she remembered correctly – one year we can do an internal and the next we do an external. David Jones said we are trying to get that because we didn’t do an external last year. We are trying to get someone to give us an official answer on that. We don’t want to get audited and find out that you can’t do an internal assessment.     Pat White said we will take this and table it until the next meeting.   2) Approval of Addendum to the Medical Staff By-Laws:  Dr. Woods said this will be an addition to our current Medical Staff By-laws. They have discussed via email, which is appropriate with the new by-law adjustment, for basically a matter that was going on. Since we do have clinical departments now, Dr. Chance recognized this as being an issue in the Medical/Surgical Clinic dealing with timely completion of medical records. They have tried to enforce the current policy and it doesn’t seem to be a stringent enough and/or incorporate the Nurse Practitioners as well. This is an addendum to our current policy that will basically be all inclusive to cover the matters of timely completion of medical records. He read it aloud. In order to provide safe and effective care to the patients of this clinic the following policy will be implemented in regards to clinic charts for patients under our care. All clinic charts must be closed within two business days from the date the patient was seen, i.e., if the patient was seen on 7/24/2017, the physician or mid-level   will have until the open of business on the 7/27/2017 to complete the chart or they will be considered delinquent. Saturday, Sunday and hospital approved holidays are considered non-business days. Scheduled days off during Monday through Friday will still be considered business days for the purpose of this policy. If at the open of business on the third business day the chart is delinquent the physician or mid-level will be notified by email and in person by the office administration that they have delinquent charts. If the chart remains delinquent by the open of business on the fourth business day, the physician or mid-level will be notified in person, or by phone and in writing by their department head or in their absence, a member of the executive committee, that they have a delinquent chart. If the chart remains delinquent on the open of the fifth business day that clinic day will be cancelled for the physician or mid-level, that they will forfeit their scheduled day off to make up for the missed day. If the chart remains delinquent by the open of business on the 6th business day, the physician or mid-level, will be considered to have voluntarily resigned their clinical privileges to see the patients in the Medical and Surgical Clinic. They will no longer be allowed to see patients in the clinic until all charts have been completed. If a physician’s or mid-level’s clinic privileges are suspended three times in a six month period, this will be considered evidence of voluntary resignation from the Medical Staff. Physician or mid-level, so affected, must pay $300 reinstatement fee and petition the department head and the executive committee for reinstatement. Such reinstatement will not be considered and no reinstatement granted until all medical records have been completed. If the physician or mid-level has a scheduled absence i.e., vacation days off, that will cause them to violate this policy, it is expected that they will complete all charts prior to the scheduled absence. It will not be considered an exception to this policy that charts become delinquent during the scheduled absence. Violation to this policy caused by unscheduled absence, i.e., sickness and emergencies, will be considered on a case by case basis by their respective department chairman. Repeated delinquencies at any level will subject the physician or mid-level to counseling by hospital administration and medical staff which may result in disciplinary action as deemed necessary.          Dr. Woods said as you can tell just by the verbiage here there has been repeated hit and miss so we had to clearly define this in order to corner those into doing what they are supposed to be doing in the first place. This lays it down in black and white. As we learn from our previous encounters is – what are the by-laws – what do they say. This is in black and white. This will expedite people doing what they are supposed to be doing in the first place. David Jones stated the emphasis and it hit home that when they went to the Greely seminar, every question that someone posed to one of the speakers, that was the immediate answer – what does your by-laws say. That is the first question you pose back when someone has an issue. Dr. Woods stated that takes away all the steam out of it too. Brenda Smith inquired about when it infers to the people who are responsible for delivering the delinquency notification, who is the executive committee? Dr. Woods responded – David Jones, Dr. McCommon and Dr. Woods. Then it referred to the Department Head or the Executive Committee. David Jones noted that Dr. Chance is currently the Department Head. Brenda Smith asked if these people are aware that they have a job to do. It is not going to do any good if they are not aware. Dr. Woods stated actually there has been a lot of changes and actually the improvement of people getting their documentation done. It was a big stalemate; people were dragging their feet and all of a sudden when this was put out, this was the stragglers. This should take care of that. Brenda Smith asked if they are aware this is going to be implemented. Dr. Woods replied, absolutely. Dr. Woods said they will know tomorrow after this is approved also. David Jones noted the physicians are aware, the mid-levels do not know but will be notified. Dr. Woods stated that ironically, one of the mid-levels that is requesting reappointment, there is a stipulation noted that all the medical records must be completed prior to reappointment.     Mary Irvin noted that on #4 – it seems like it is a little bit contradictory – where it stated the Physician or Mid-Level will be considered to have voluntary resigned their clinical privileges to see patients at the clinic. They will no longer be allowed to see patients until all charts have been completed. Is that accurate or would it be more accurate to say that their clinical privileges will be suspended until. Because it says they will would be considered to have voluntary resigned their privileges. The last sentence says they will no longer allowed to see patients at the clinic until all charts are completed. As if they would be reinstated. Maybe it should be reworded. Dr. Woods said it should be worded as being placed on suspension. Mary asked them to define mid-level. Dr. Woods noted that is a Nurse Practitioner, Physician Assistant, CRNA. As they continue to lobby, they will soon be called doctor. Mary asked if they will sign off and date saying that they know this policy. Brenda Smith stated that #5 does refer to the privileges that were suspended. That does clarify it more.       Pat White asked if there were further comments.           Brenda Smith if there is a need for Board approval. The answer is yes. Mary Irvin asked if it should state that this will be placed in their personnel file. If they get suspended, that would be an obvious outcome, but should it state that? Allison Jones stated it should say shall be suspended and record of the same shall be placed in the personnel file. Instead of where it shall resign. Allyson Allums asked if they wanted it in their credentialing file or personnel file. Normally this would be placed in their credentialing file. Brenda Smith asked Allyson to repeat what she said. Allyson stated that usually when you do disciplinary things like that this is usually placed in the credentialing file, so that when you are doing peer review or the physicians are looking at reappointment they see those type of things. They do not look at personnel files for peer review of the physicians. She thinks it should be in the credentialing file. Mary Irvin asked who does look at the Personnel file. Personnel files are in the HR department, the Credentialing files are kept by the credentialing coordinator. Mary Irvin asked if there were other issues, something Mr. Jones was dealing with, would have access to this information. The answer is yes. Brenda Smith commented that it would be more useful to put in the credentialing file. Allyson Allums answered yes and they are very confidential. That is what the physicians would look at upon reappointment. If you had a practitioner that has a documentation problem, that is where they would see it. You would see how many times they had been reprimanded. Their evaluations would be based on that and placed in the credentialing file. Mary Irvin inquired who would be responsible for this. David Jones stated it would be the department head – Dr. Chance. If there is a suspension or disciplinary action, Dr. Chance would fill this out. Dr. Woods said the records should be Administration. Allison Jones asked who keeps the credentialing files now. Allyson Allums stated for the hospital side, for delinquency, the credentialing coordinator does that. We have a log that we log. We have standard letters for these type of things. Allison Jones stated you can say – shall be placed in their credentialing file in accordance with hospital policy. That way if you change your policy it doesn’t matter. You do it another way.     Pat White asked if there were further comments. If not she would entertain a motion to approve the policy.      David Norman made a motion to approve the addendum to the Medical Staff By-laws as presented with verbiage changes as noted. Mary Irvin seconded the motion.           Mary Irvin inquired about the wording of #5 it states very specifically what happens if it is repeated 3 times in 6 months and on #8 regarding repeated delinquencies at any level subject the physician to counseling by hospital administration and the medical staff. This may result in disciplinary action at deemed necessary. Maybe that is exactly what it needs say.         Pat White inquired if there was any further discussion. If not, she asked for the vote.     The vote: Yeas: Pat White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith, Nays: None; Absent: Helen Adger, Robert T. Green, Jr., Helen Godfrey-Smith; Bruce Walker. Abstained: None. The motion passed.         IX. Administrative Report – 1) NCMC – Current Activities:  David Jones noted that we have the Grand Opening coming up on August 24th at 2:00 p.m. We have two speakers confirmed; Mr. James Elrod, CEO of Willis Knighton Health System and Paul Salles, the CEO of the Louisiana Hospital Association. We have either asked or are asking our Representative, our Senator, our US Representative and our Caddo Parish Commissioner to say a few words to keep the program short as possible. We will be doing this inside as much as we can. We will go outside to cut the ribbon. We will re-route clinic hours to keep the lobby as empty as possible for everyone. Please, if at all possible, we would love for everybody to be there. Brenda Smith inquired if that is Thursday. Mr. Jones replied yes; in the front lobby, on the hospital waiting room side, not the clinic waiting room side. We will have chairs set up. Pam Hughes and Mrs. Billie have designed a watermelon cake that looks pretty neat. It is three layers. Pam said it has strawberries, grapes – fruit. No cake involved in it. Only Mrs. Billie could execute this. We are looking to have a very good time. This is something we have been looking and working for, for almost 4 years. We broke ground in September 2013. Four years prior to that – 2009 we started working on all of this. We are talking about an eight year project. He doesn’t know if Dakota had graduated high school yet. Dakota said he has never known this place not in construction. David Jones said we have multiple employees like that, sadly enough. But then again, it won’t be too long before they will be telling stories to the young folk about whenever. That’s a ton of our current activity.         We have our new second year residents in. He has been encouraging our chief resident to make a Board meeting. She was birthing a baby at the last meeting. He failed to remind her of this one so he takes the blame on this one. She will be at the next one. Brenda Smith asked her name. David Jones replied – Catherine Sharp. He stated she is one of the best residents that we have ever had at North Caddo Medical Center – in his opinion. He repeated – one of – not the. She is from Canada. There are two residents from Canada – the other one is Dr. Sylvia Maniscalco – a second year. We will try to get all six of them here. The group of third years; and he will say this, with current present company included, they are the best group of three, by far, we have ever had. Dr. Woods and Dr. Durant were a good pair as were Dr. McCommon and Dr. Chance. This is, by far, the best group of three, we have had so far. We have not had a ton of groups of three. Getting two great residents; all of our residents have been solid, but getting the entire class great, it takes some work. It’s not a lot of glamor involved in rural medicine.. Trying to find the right people here and getting them here, it’s not an easy process. Pat White asked if those three are planning to stay. David Jones replied that Dr. Sharp is strongly considering staying. We will see what the final say is on her. Dr. Woods can comment on this more than him; she tends to have the entire package – personality, work ethic, quality of her decision making. He is going by what doctors are saying about that. She has a lot of potential. Dr. Woods said it was kind of random. He was not expecting her to stay since she is from Canada. David Jones stated that she hates the cold. Dr. Woods said she is engaged to a guy that is doing a surgery residency. He is originally from Australia. He wanted to pack up and move to Australia but she said she wanted to stay here. Dr. Woods stated she is a great physician and he thinks she will do fine. David Jones said she is a petite, high energy person. She looks a little soft, however, she has a tiger in her when it needs to come out. It’s impressive.     2) Foundation:David Jones reported that the Foundation had their big fund raiser. He believes they netted around $25,000 which is, from what they have been told, is outstanding for a shoot. There were so many that wanted to play Bingo inside while they were shooting. He thinks their team had a respectful result thanks to Dakota. It is amazing – there were 15 stations. It is impressive how much shooting actually goes on there. There were a couple of teams that were there for the win – they were serious.       They were good! There was no missing going on – they were hitting everything moving. They were celebrating every time they hit one. Except for Dakota. Dakota actually represented us well. Dr. May could shoot as well. His team did fairly well. David Jones’ team was there for fun. It was about half and half – half for fun – half to do well. He thinks the winner got 98 out of 100. Fairly solid. He thinks the kid winner got 98 out of 100. We had an adult division and a kid division as well. They were pretty serious about it. Everybody was worried about it. It was the first year we did this. We had thirty teams and they did Bingo in the main area of Los Paloma and it was standing room only as the shooting ended. Mrs. Billie catered with a barbeque sandwich lunch; they raffled off a gun – it was fun. He would do it again. He wouldn’t bet he would beat Dakota, but he would do it again. Just make sure he is on his team. Dakota may wish to go to an upgrade. Dr. Woods said it is not precision and you have to keep your gun moving. David Jones said his team were going too slow for the team behind them – they went around them. David Jones said when you go to a hospital fund raiser, you are probably going to have people that have never done this before. It was fun.      Brenda Smith asked if the Foundation was pleased with what they made. David Jones said they were blown away with the turn out. For a first shoot, first time with an event like this – it was good. It is something we will do again. He does not know if they will do it next year; he thinks they are planning to have a gala next year. It was a good time.

  1. Executive Session –Pat White stated we are at the point to enter into Executive Session.   Brenda Smith made a motion to enter into Executive Session for the purpose of strategic planning. Mary Irvin seconded the motion. The vote: Yeas: Pat White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith. Nays: None. Absent: Helen Adger, Robert T. Green, Jr., Helen-Godfrey-Smith, Bruce Walker. Abstained: None. The motion carried.         The Executive Session was entered into. No action was taken during the Executive Session.       David Norman made a motion to enter back into regular session. Kenneth Clay seconded the motion. The vote: Yeas: Pat White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith. Nays: None. Absent: Helen Adger, Robert T. Green, Jr., Helen-Godfrey-Smith, Bruce Walker. Abstained: None. The motion       XI. Medical Staff Report – 1)   Recommendations – Allyson Allums: David Jones presented the Medical Staff recommendations for the Governing Board approval: MEDICAL STAFF APPOINTMENTS: 1. Kirtesh H. Patel, M.D. – Requests Provisional Privileges in the field of Pathology for the period of July 25, 2017 through July 31, 2018.   2.   Anisha Turner, M.D. – Requests Provisional Privileges in the field of Emergency Medicine for the period of July 25, 2017 through July 31, 2018. 3.   Luis R. Soto, M. D. – Requests Provisional Privileges in the field of Pathology for the period of July 25, 2017 through July 31, 2018.   4.   Allison M. Robinette, M. D.– Requests Provisional Privileges in the field of Radiology for the period of July 25, 2017 through July 31, 2018.     MEDICAL STAFF REAPPOINTMENT:   1.   Louis Sardenga, M. D. – Requests Courtesy Privileges in the field of Pathology for the period of June 30, 2017 through June 30, 2018.     2.   Fleurette Abreo, M. D. – Requests Courtesy Privileges in the field of Pathology for the period of June 30, 2017 through January 31, 2019.     3.   Joseph Heard, M. D. – Requests Courtesy Privileges in the field of Pathology for the period of June 30, 2017 through July 31, 2019.     4.   Thomas Fiorito, M. D. – Requests Courtesy Privileges in the field of Radiology for the period of August 01, 2017 through August 30, 2019.     5.   Magdy Eskander, M. D. – Requests Courtesy Privileges in the field of Emergency Medicine for the period of June 30, 2017 through February 28, 2019.     ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:   1.   Sean Landreneau/FNPC– Requests Courtesy Privileges in the field of Family Nurse Practitioner for the period of July 27, 2017 through July 30, 2019.     EXTENSION REQUEST:     NONE.     VOLUNTARY RESIGNATIONS:NONE.    Brenda Smith made a motion to accept the Medical Staff Recommendations for Medical Staff Appointments, Medical Staff Reappointments, Advance Practice Professionals Appointments/Reappointment, Extension Request, Medical Staff Voluntary Resignations. David Norman seconded the motion. The vote: Yeas: Pat White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith. Nays: None. Absent: Helen Adger, Robert T. Green, Jr., Helen-Godfrey-Smith, Bruce Walker. Abstained: None. The motion carried.     2)   Chief of Staff Comments:None.     XII. Adjourn –There being no further business Kenneth Clay made a motion to adjourn. Brenda Smith seconded the motion. The vote: Yeas: Pat White, Kenneth Clay, Mary Irvin, David Norman, Brenda Smith. Nays: None. Absent: Helen Adger, Robert T. Green, Jr., Helen-Godfrey-Smith, Bruce Walker. Abstained: None. The motion carried.    Meeting adjourned at 8:04 p.m.