BOARD MEETING: Regular Meeting   DATE:  March 27, 2018    MEMBERS PRESENT:  Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Helen Godfrey-Smith, Bruce Walker, Patricia White.      MEMBERS ABSENT:  Brenda Smith      TIME CALLED TO ORDER:  5:30 p. m.   OTHERS PRESENT:  David Jones, CEO, Pam Hughes, COO, Dakota Robinson, Controller, Lanell Audirsch, Admin. Asst., Walter D. (Doug) White, Hospital Attorney, Dr. John Woods, Chief of Staff, Mary Coil, Foundation Executive Director/Marketing Director, Michael Gray, Security      LOCATION:  NCMC Events Center     BOARD CHAIR: Robert  T. Green, Jr.     SECRETARY:  David Jones     I. CALLED TO ORDER –Robert T. Green, Jr., Chairperson called the meeting to order.   II. Invocation and Pledge of Allegiance – Kenneth Clay offered the Invocation and Mary Irvin led the group in the Pledge of Allegiance.    III. Approval / Amend Agenda – David Norman made a motion to approve the agenda as presented. Ronnie Festavan seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: Brenda Smith Abstained: None. The motion passed by unanimous vote.      IV. Community Comments – Robert T. Green, Jr., Chairperson, noted there were no signed Visitor Recognition Cards requesting to address the Board.     V. Minutes – Regular Meeting February 27, 2018 –The minutes of the February 27, 2018 Regular Board meeting were mailed prior to today’s meeting for review. Robert Green inquired if there were any corrections to be noted. If not, he would entertain a motion to approve the minutes. Pat White made a motion to approve the minutes of the Regular Meeting held on February 27, 2018, as mailed.      Bruce Walker seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: Brenda Smith. Abstained: None. The motion passed by unanimous vote.     VI. Old Business – 1) Radiology and ER Expansion Update:David Jones stated he wanted to thank the Board members that came to view the Radiology Department and possibly get a little better mental image of what it is going to look like there whenever we do this. The architects are working on the construction and bid documents. They gave us the timeline to which I attached to the CEO management report as to where they are at. They are looking at going for final USDA approval of those documents in June – June 1st. So the timeline is a little bit further back than he thought it was going to be. Ronnie Festavan confirmed the paper he was showing David Jones was the information he was referring to. David Jones said yes. David Jones noted that the information on the sheet was marked through, those were the things we have already hit and met. David Jones said he actually spoke to Wayne Estopinal today and he said he reviewed, yesterday, the 50% portion of the construction documents. He feels we might be able to exceed that. Some of those timelines we can’t affect how quickly USDA will approve them and all the approvals coming from the State level – those are guestimates on time as far as to how quickly they will get them back to us.       Robert Green asked if there were any questions. There were none.    2) Surplus Equipment Update: David Jones asked Pam Hughes when the final day for bids to be submitted on the Surplus Equipment? She replied that it is April 3rd.  David Jones noted that we have had a slew of interest. David Jones asked Doug White, hospital attorney, to be present for the opening of the bids. Doug White asked when. Pam Hughes stated April 3rd at 2:00 p.m. Doug White said he would be available. Someone inquired where. David Jones stated it would be in the Conference Room in Administration.    VII. 1) Review February 2018 Statistics – Allyson Allums: Dakota Robinson, Controller, presented the Statistical Report in Allyson Allums’ absence. He asked the Board to turn to the Statistical Report in their booklets. A statistic from the CDC shows you can see that in the box that is outlined as the month of February, you can see how it is dramatically reduced.  That will be the main topic to keep in mind as we go through the statistics and financials this month. Another thing to also note as you look at the statistics for this month, we have a 28 day reporting month, as opposed to a 31 day, which came in January. On these, he will point them out, but the graphs that are done based on this month and number of patients, those are affected. Starting with admissions – for the month, we had 54 admissions, and 13 Swing Bed admissions. If you do that per day – in January we had 2.3 admissions per day and in February 1.93 admissions per day. Newborns – there were 5 newborns. Dr. Taylor had a busy month. In-patient days – we were at 214. If that is broken down by day – In January we were 10 a day and in February we are at 7.6. So you see that trend down just a little bit. Our average daily census is at 7.6.  Endoscopies – there were 6 endoscopies. Emergency Room visits – 455. If you do the breakdown per day once again – in January there were 18 per day; in February 16 per day. Just looking at the graph, you need to break it by day to see a good comparison. Mammography – the best month in the last quarter at 27.    2) Review February 2018 Financials – Allyson Allums –Dakota continued reporting the Financials for February – Medical and Surgical Clinic visits – 1954. Even though it looks like a downward trend, if you break it down by day – in January we had 87 per working day and in February we had 97 per working day. There was actually more per day in the month of February. You will see that on the financial piece when we go through their stats. Profit and Loss – this is where you see the Profit and Loss. It was $43,000 compared to $21,000 the prior month.  The Plain Dealing Clinic saw 686 patients. That breaks down to 34 a day and in January they saw 33 a day. Profit and Loss – they made $18,011. Benton Medical Clinic – in February they saw 19 patients per day and in January they saw 16 patients per day. With the account rule changing, one of the provider’s salaries to match the work that they are actually doing in Benton produced a loss of $2,330. Ronnie Festavan said might I expect in the future that this graph is a real up and down and variable. Is that true? Pam Hughes replied yes. Dakota said if you turn back to the Plain Dealing slide, three or four slides before that, you can see the real upward and downward trends. David Jones noted that the patient numbers at Benton are going to be similar to half of what Plain Dealing sees for the next few months. But the reimbursement has been about one third. Now, since we have passed our inspection, with flying colors he might add and kudos to Mrs. Hughes and her team for doing that, they had zero deficiencies, which is something he wants to make sure the Board hears and knows – the inspector themselves stated that they couldn’t remember the last time when they had zero deficiencies in an inspection like that. The reimbursement level will go up and very close to matching Plain Dealing’s. For the most part, like Plain Dealing, you see several month in the black and then it will be a big cost. We do have a mid-level that gets an incentive every so often as well. Ronnie Festavan, said with the permission from the Chairman, he would like to expand on that just a little bit. He asked Pam Hughes. Could you tell us a little bit about what you did to make this no deficiencies? How about bragging on yourself a little bit. Tell him how that happens, that even the people that are inspecting are bragging on us. That is good because he likes to replicate things that we do well.  Tell me a little bit about how you were able, and your team, to pull that off. Pam Hughes said o.k. Number one, she said she is not very good at bragging on herself. This is not the first rural health clinic that she has implemented from the ground up. That is one reason that Mr. Jones, about eleven years ago, asked her to come to work for North Caddo, because she has put light on for Willis Knighton. The Vivian Clinic, in 1993, she did that one. A lot of it is knowing what they are going to be looking for. It is not something that is easy. It is a massive undertaking. She had a lot of help. The employees at the clinic were great. Rachel Bouchard helped a lot. A manual that is large has to be done. We have to do QA, Infection Control, Disaster, a huge disaster drill, even a huge disaster with the community, itself. All of that has to be done, documented and signed off on by all the parties. We have to have a crash cart stocked with certain items. Everything in that clinic has to be dated and we cannot have any expired items – drugs, vacutainer tubes for blood. They go through employee folders, all their credentialing, education for the employees, licensures, and TB skin tests –everything. It is a huge, huge undertaking to do that. The State actually has to o.k. it to start off with. These are independent people that come in. There are two companies that do this all over the United States. Ronnie Festavan asked if it is a certification tool. Do they use it for certification purposes? Pam Hughes replied yes. Pam Hughes said it is just like Joint Commission.  Then, every three years they come back and survey. We have to stay on top of the game. Ronnie Festavan said that was his next question. It occurs every two years? Pam replied three. Pam said when they come back they inspect their charts; how they are done, how the Nurse Practitioner has done. The Nurse Practitioner has to have an overview by the Physician. These are Federal guidelines. Ronnie Festavan thanked Pam. Ronnie Festavan thank Mr. Chairman.  Robert Green, Chairman, asked Dakota Robinson to continue. Dakota stated that Days Cash on Hand rose slightly to 42.01. We didn’t receive any large sums, but he would say that is a healthy trend there. The Profit/Loss – there was a profit of $44,155 for the month of February. The AR days are 57.84. The Fitness Center memberships declined to 380 for the month. He asked if there are any questions related to the statistics. Robert Green asked if there were any questions at this time. There were no questions. Pat White made a motion to accept the Statistical and Financial Reports as presented subject to audit. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Helen Godfrey-Smith, Bruce Walker, Pat White.   Nays: None. Absent: Brenda Smith. Abstained: None. The motion passed by unanimous vote.     VIII. New Business – 1) Board Approval of Resolution #4 – 2018 To Create a Reserve Fund to Meet the Bond Covenant of the Revenue Bond –  David Jones stated that #1 and #2 are Resolutions #4 and #5 for 2018. One of the things that our auditors wanted us to do, of course, is to make sure that we went through our Bond Covenants and make sure that every detail of our Bond Covenants are being kept and met. Upon discovery, there are two accounts that need to be created and if he can get a motion on item #1 he will speak on it and item #2, if that is o.k. Doug White noted that when it comes to money and bonds the Legislative Auditor would really like to see recorded votes or at least be able to tell from the minutes who was for it or against it. Doug White said a voice vote to where when someone reads the minutes you can tell who votes yes and who voted no. Helen Godfrey-Smith made a motion to approve Resolution #4 and Resolution #5 to create contingency funds to meet our Bond Covenants and we will have to do some aggressive funding we got to catch them up – one for 12 months and one we have to start funding for 2018. Doug White noted these should be voted on separately. Helen Godfrey-Smith stated Resolution #4 that should have been funded for 2017. Dakota Robinson stated #4 – they are all the same time period but they are two separate sets of bonds. They are in the same body of issuance but they are separate bonds. We have to have a reserve account set up and a contingency account. Resolution #4 is the Reserve Fund for both of them and Resolution #5 is the Contingency Fund for both of those bonds. Helen Godfrey-Smith said Resolution #4 is the $1,366 per month. Dakota Robinson said they are both the same amount in the accounts. But in 2017, those are the amounts that were supposed to be issued in both accounts. As of January 2018 those amounts increased. Helen Godfrey-Smith stated so you can know what you are approving, for 2017 the amount that should have been in those reserve funds and contingency funds an amount of $1,366 per month. At this point we should have –  Dakota said he did the math and as of the January and February amounts being deposited to total $41,840 to be moved into two separate accounts in total. Helen Godfrey-Smith said the 2018 the amount is $2,264 per month and we will catch that up through March with this vote so that is roughly $7,000 that will be transferred into the account. The motion was seconded by Mary Irvin. Robert Green asked if there was any further discussion. There was none. The verbal vote for Resolution #4 – 2018 to create a Reserve Fund to meet the Bond Covenant of the Revenue Bond is as follows: Yeas: Robert T. Green, Jr., Mary Irvin, Helen-Godfrey-Smith, Bruce Walker, David Norman, Pat White, Kenneth Clay, Ronnie Festavan. Nays: None. Absent: Brenda Smith. Abstained: None. The motion passed by unanimous vote. Helen Godfrey-Smith made a motion to create a 2018 Contingency Fund to meet the Bond Covenant of the Revenue Bond. The motion was seconded by Mary Irvin.     The verbal vote for Resolution #5 – 2018 to create a  Contingency Fund to meet the Bond Covenant of the Revenue Bond is as follows:  Yeas: Robert T. Green, Jr., Mary Irvin, Helen-Godfrey-Smith, Bruce Walker, David Norman, Pat White, Kenneth Clay, Ronnie Festavan. Nays: None. Absent: Brenda Smith. Abstained: None. The motion passed by unanimous vote.          3) Approve New Policies to Comply with Agreed Upon Procedures for Fiscal Year End 2017 –  David Jones noted that #3 is also those agreed upon procedures that we went through and talked about in the audit. That was the special section of the audit that was added to for the past year that will be going forward, he would imagine, would be getting bigger over the next few years on what they are looking for. Dakota and Allyson have been working with Mary Carroll to develop these policies. There were several findings that they had that we didn’t have a policy for. They have been working together developing these policies to help us meet those agreed upon procedures. Anytime we add a procedure to anything we seek Board approval. There are a lot of these policies. We went over them in the Financial Committee, going over the audit findings.  Helen Godfrey-Smith asked if she may add something to what he just said. She said the policy itself, unless you have a copy of the agreed upon procedures, it is just the policy. She would recommend, they have a document that they have formed in the Finance Committee meeting that has every one of these 33 agreed upon procedures. Every piece of it is broken out so that they can monitor and make sure that they are accomplished. It also says what needs to be done as per that particular part of the agreed upon procedure. For instance, under budgeting, under the agreed upon procedure it said budgeting including preparing, adopting, monitoring and amending the budget. Our policy did not have a process for amending the budget, so it is important that you know that so when you read this policy, for approval, you know what you are looking for and that you can also find it in the policy that is there now and then you feel comfortable, once you approve this policy, we are going to be in compliance. Does that make sense? Robert Green asked if everybody has a copy of that. David Jones said no but it can be provided. Robert Green said with that along with this each Board member can know exactly what you just said. We can put them together and look at them and we can decide what we are going to do. Helen Godfrey-Smith this will be the document we will report on as these things are done. You see done and you will understand why. Robert Green noted you see what has been done and what is pending. That way, we as a Board can keep up with it and I think each one of us need both documents. Ronnie Festavan asked how we can get the needed document. David Jones stated that he can email all the Board members that have emails tomorrow and hard copies to those who don’t. Helen Godfrey-Smith stated that each month the document will change – it is a dynamic document – a living document – an updated document. You will know how much and where we are. Ronnie Festavan said these policies won’t change though. Helen Godfrey-Smith said no. These policies will turn to “dones” on here but then there will be other things next month that we may have to approve or do in order to make some other things turn to “dones”. Robert Green stated that the form will be a tracking device for us to know what is getting done and what is not. Once it is done it will be off of that list. He asked if he is correct. David Jones and Helen Godfrey-Smith replied yes. Robert Green said that way we can keep up with it until it is completed. Helen Godfrey-Smith stated that there are quite a few o.k.’s on there. She thinks that you are going to find and be very encouraged. Ronnie Festavan stated the way he understands it you have a guideline there and then you have completion of that guideline here. He needs to marry those two and then he will take his magic marker and mark it done and we will be good to go. Helen Godfrey-Smith replied yes. This item will be tabled until the April Board meeting.       4) Board Approval to Adopt Resolution #6 – 2018 for Ambulance Millage Rate for 2018:       David Jones stated that #4 is Board approval to adopt Resolution #6 which is adopting our 2018 Ambulance Millage Rate. If he can get a motion and a second he will get Dakota to go over this. We have to do this every year. We typically do this later in the year – end of June. That is probably not the best practice because it has to be approved and sent in that month. Helen Godfrey-Smith asked if it is here the amount. David Jones stated not that Dakota has that amount. Dakota noted that 4.77 mills is the amount. David Jones asked Dakota if he has the verbiage to please read it aloud. He read the Resolution aloud to the Board.  Robert Green, Chairman asked if there is a motion. Kenneth Clay made a motion to approve adoption of Resolution #6 – 2018 for Ambulance Millage Rate for 2018 of 4.77 mills. The motion was seconded by Pat White. He inquired if there was any further discussion. There was none. Robert Green called for a verbal vote. The following is the record of the verbal vote: Yeas:  Mary Irvin, Helen Godfrey-Smith, Bruce Walker, David Norman, Pat White, Kenneth Clay, Ronnie Festavan; Robert Green.  Nays: none. Absent: Brenda Smith. Abstain: none. The motion carried by yes vote.        IX. Administrative Reports –  1) NCMC – Current Activity:   David Jones there are a few things he wanted to talk on. One being the Redbud Parade and the Basket Ball Teams sponsorship. We would like to thank the Board and the kids had a good time; very good turnout. The kids had a good time. Celebrating a State Champion should not be a minor thing. In his opinion, they should almost have their own parade aside from Redbud. You are witnessing some excellence that you may never get to witness again. That something that he is certainly proud of. Mary Coil has a copy of a base marketing strategy that we are going through for 2018 that he is going to have her pass out so you can take it home and review. He is sure people around this table may have some ideas to go forward with some other things as well. The last thing he wants to go over, we kind of have an opening date for our partner dialysis center. He wants the Board to know, however, it is probably going to have a May opening, but that May opening is just going to be for insurance patients only. That is a very, very, very small amount of patients that are on dialysis, that are on commercial insurance. There is going to be some confusion in the community. He would certainly like the Board to help diffuse some of that. It is going to be a lengthy process getting certification and approvals from the Federal and State government. Mrs. Hughes has talked to Senator Tarver and Representative Morris quite a bit here in the last few weeks over a separate matter that we have had to deal with. Getting the approval from Medicare, most of the patients that seek dialysis are on Medicare. That could take a few months to get. He has been saying as time goes on, to cloud the thing, there are a few patients that actually have commercial insurance and they are going to open the doors. Most of the patients that will be coming there won’t be able to come there until the license is approved from the Medicare and Medicaid standpoint. You, as Board members, are probably going to be asked questions about it and I know we will questioned about those kind of things. It is going to be a process getting those things. People have already been asking for several months when it is going to open. Technically it is going to open in May, but most of the patients that will be going there will not be able to go there in May. Mary Irvin asked if there is a way to communicate that through the newspaper. David Jones said there will be. Robert Green state they will open in May but not ready for the majority. David Jones replied yes. Helen Godfrey-Smith asked what the timeline you are expecting. David Jones said there is no guaranteed timeline within twelve months. Mary Irvin asked if that is all because of the government. David Jones replied yes. They are just waiting on approvals from the Federal and State government to be able to see Medicare patients, to treat Medicare patients and bill for Medicare patients.  Helen Godfrey-Smith asked if that is done by site not by the company level. David Jones stated that is correct. The company initiates it, like we did with the Benton Clinic, from a clinic standpoint, but dialysis centers are viewed very differently. They have very stringent guidelines they have to be checked through. Dr. Woods noted the best way is to tell them later not sooner. Then if it opens earlier that would be good. Helen Godfrey-Smith said she thinks it would almost be worth it, she believes, to have a professional PR person to help you craft that message because it could have long range implications if the message is not on point, if it is not clear, if it is not directed in the right places and if it does not get to the right ears. David Jones stated Mary Coil has been communicating with Jimmy Douglas, the point guy from Fresenius and they are aware of our concerns of how the community is going to view this. This is not the first one they have opened up in a rural area, of course, but this is our area. It doesn’t matter where they have opened it up anywhere else. Mary Irvin asked if there is a way to have all our dialysis patients in our area isolated where you could do a mail out just to those patients with a letter explaining what is going on then maybe they would understand. David Jones said he does not see why not. That would benefit Fresenius in the long run to have this like Mrs. Helen said, everybody be positive about this and not have any ill will at all about it. Ronnie Festavan asked David Jones if he could quantify anywhere close the group that she is talking about.  David Jones said he believes when it was first talked about, somewhere between 40 to 60 dialysis patients just in this area that will be coming here. Ronnie Festavan asked who would be affected by this twelve month delay. David Jones said he thinks about 90% of those. Ronnie Festavan said that is not a non-manageable group. He was afraid he was talking about two to three hundred people.  Each person talks then, he thinks David Jones’ idea is excellent, if you target those people that it most effects with your best message, be it written, a meeting, something and target that group and try to neutralize the concern of that target group. If you focus on that, he doesn’t know who is doing what, but if you focus on that target group and you neutralize their discomfort with this, then you prevent the spread of that discomfort to others who are relatives and people who are expecting this to happen to their grandmother, if grandmother can say she understands and is hopeful that it will be quicker than twelve months but maybe not. Let them be the positive force in that. Mary Coil said she thinks Fresenius is already working on that. They are already reaching out to their patients that they have. They have a large number of these patients in their system already so they are already working on that. We have run patients that are either on dialysis or may be needing dialysis. Dr. Woods said instead of hypothesizing about all this how about getting with Fresenius and ask them what is your game plan to let the community know?  David Jones stated that is it for the current activity. Ronnie Festavan asked if we are open to discussion of the handout from Marketing. Robert Green asked Mary Coil if she had an explanation of the information. Mary Coil stated what she gave to them is basically a budgetary calendar. These are some things we are looking at. Somethings we are already in the process and some things that we have the option of doing. It is just a list of things that we already do – website licensure, blogs, face book advertising, something for the clinic. There is not a whole lot allocated for Dr. Sharpe because she will go into the cycle of the other things that we already listed.  We currently have a newsletter that goes out through the Foundation but the majority is things about the hospital. Also, we are looking at patient retention that is something that we strive for. It cost more to get one patient than it does to keep one patient. That is something that we focus on to have them return for their annual exams, have they had their colonoscopy, have they come back for their wellness check or their mammogram. We put a tremendous amount of support into our community. It is hard to put an exact number on that because it changes from time to time. The schools, the different organizations that are in town that really help to bring a lot of people to our area, such as Redbud. They give a key service for our area. It is definitely an advertising opportunity as a community outreach opportunity as well. These are just some different things that we have listed. Mary Irvin asked Mary Coil to talk to them about the special direct mail for Dr. Sharpe. Just the dollar amount compared to everything else. Mary Coil stated when you chose a demographic for mailing, like direct mail, that is pretty much what it cost you. You have to pay for art design, postage and the distribution of, because Dr. Sharpe does not have a narrow demographic. She is going to be seeing patients from birth to geriatrics. Ronnie Festavan said so the figures that he is looking at, are those commitments from your budget to do these things.  Mary Coil said these are, if we chose this route and if we do these things, which is the price we are looking at. Ronnie Festavan asked is this projected budget. Mary Coil said yes. David Jones stated he thinks the answer truly is that some of them yes, some of them no. Some of them are current expenditures we are already doing, some of them are projected are costs for possible things that we could do. Robert Green asked about the parade festival events, what is that? Mary said that is just the different things that she put it all in one. They do have an annual parade and 5K. Last year we did both. We did a 5K where we handed out bananas and water to the runners and we were in the parade where we had throws. David Jones stated that he had Mary to present this so the Board could review it at a later date and possibly add to. Mary Irvin asked if she could ask a question. She was recognized. She asked if it would be possible for those Board members who are interested in reviewing the marketing plan and have thoughts to have a meeting separate from the regular meeting to share ideas. David Jones stated that right now, Marketing is a one man show. We would love and accept any help and efforts. He said actually it is about a half woman show. The other half of the woman does the Foundation as well. The rest of us chip in with ideas and thoughts. It is an area, in his opinion, that we should grow, an opportunity, to maybe even add staff members down the road. If we can quantify some of these efforts in bringing in dollars for these things it is easy to justify more employees if we can generate more revenue. Mary Irvin asked if it is acceptable if between now and the next board meeting, the Board could get with Mary and schedule a day in advance where everybody knows about it and gather one evening to share about Marketing. Ronnie Festavan said he is in agreement with that. He would like a little more time sit down time and a chance to digest this. There is one thing he would like to know, if you could possibly do that, if we agree that we can do that, Mr. Chairman, he would like to know in these figures – Mr. Jones said that some of these are expenditures that are ongoing and some are proposed expenditures; could you highlight those for us so he would know the difference, rather than just have a blanket set of numbers. He is somewhat confused about what is being spent, what might be spend, that sort of thing. If we could do that at that meeting that would be a good time for us. Mary Coil said that won’t be a problem. He is looking for what is designated and already ongoing; set that figure aside. Then, what is proposed and that would be a figure that would be more fluid that you could work with. He has some questions and some ideas about what could we possibly do and that meeting would be a good time to do that. Mary Irvin said she is going to step out there, maybe consider April 5th or April 19th and maybe we could decide before we leave; the first or third Thursday.       2) Foundation:    Mary Coil said she hoped you received your newsletter. If you did not receive your newsletter, please let her know. She needs to know because Hilborn Printing mails these out.  It shined real big with the save the date for the Gala – July 21st. We have had a great response to that. Everything is going smoothly. We had a group go to listen to another band. We are moving forward with that band. She told you last month that we added Billie Goodson and Jamie LaCaze to our Foundation Board. We also added Missy Moore to the Foundation Board. We are very excited to have her. She definitely has a heart for the community, a heart for the Hospital and Foundation. We are happy that she has joined us on the Board. Robert Green asked for clarification of the date for the Gala. Mary Coil said it is July 21st at Sam’s Town and it is cocktail attire. This time we are making a list of potential sponsors for the event, if you know someone that feel would like to be approached or have more information on the Gala or the Hospital Foundation, please let her know. We want to include them as well. Mary asked if there were any other questions. There were none.         X. Medical Staff Report – 1) Recommendations – Allyson Allums:   Dakota Robinson presented the Medical Staff recommendations for the Governing Board Approval: MEDICAL STAFF APPOINTMENTS:  1)  Carl Schofield, M.D. Requests Provisional Privileges in the field of    Radiology for the period of March 27, 2018 through March 31, 2019.      MEDICAL STAFF REAPPOINTMENT:  1)  Korey Burgin, M.D.Request Courtesy Privileges in the field of Radiology for the period of March 27, 2018 through March 31, 2020.   2)  David Burdette, M.D. Request Courtesy Privileges in the field of Radiology for the period of March 27, 2018 through November 31, 2019.   3)  Michelle Goni, M.D. Request Courtesy Privileges in the field of Radiology for the Period of March 27, 2018 through March31, 2020.   4)  Brent Boudreaux, M.D. Request Courtesy Privileges in the field of Radiology for the period of March 27, 2018 through September 30, 2019.   5)  John Nwankwo, M.D. Request Courtesy Privileges in the field of Radiology for the period of March 27, 2018 through May 31, 2019.   6)  Glenn Mason, M.D. Request Courtesy Privileges in the field of Radiology for the period of March 27, 2018 through May 31, 2019.   7)  Nicole McCommon, M.D. Request Active Privileges in the field of Family Medicine for the period of March 27, 2018 through March 31, 2020.   8)  James Price, M.D. Request Courtesy Privileges in the field of Radiology for the period of March 27, 2018 through August 31, 2019.    ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:       None.    EXTENSION REQUEST:   1) Thomas Siskron, M.D., Requests extension pending completion of credential application. Physician will need “PAPA” (Physician Assessment) Per By-Laws.   2)  Kevin Nesbit, M.D., Requests extension pending completion of Performance evaluation.   3)  Cornelius Bos M.D., Requests extension pending completion of credential application. Physician will need “PAPA” (Physician Assessment) Per By-Laws.      VOLUNTARY RESIGNATIONS:    1) Mark Banks, M.D.  – Voluntary Resignation due to failure to comply with the Medical Staff By laws of the reappointment process.       David Norman made a motion to accept the Medical Staff Appointments, Reappointments, Extension Requests and Voluntary Resignation.  Kenneth Clay seconded the motion. Robert Green asked if there was any discussion or questions. There were none.      The vote:   Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Helen Godfrey-Smith, Bruce Walker, Pat White.   Nays: None. Absent: Brenda Smith. Abstained: None. The motion passed by unanimous vote.       2) Chief of Staff Comments: Dr. Woods, Chief of Staff, stated that to touch back on something that he brought up earlier, we talked about. We are having some of the physicians, if you look on this list, it is requiring these credentials reviewed based off our by-laws.   One of these things he recently looked at is the organization for Alzheimer’s that has done a lot of research in this area.   They have specific screening tools that they have done a lot of research on and they are very well documented and pretty straight forward. They may be an option to be utilized as a screening tool that we could use locally that is validated nationally. We could use that as the beginnings of screening tool to be a big net that says these people need further evaluation. It is an option and something we need to look into as we try to maintain patient standards as per our bylaws and be able to do this within our local area with the amount of expertise that we have in this area versus at Stanford University. We are looking into that option. As he understands it David Jones is not an employee of the hospital, he is an employee of Willis Knighton. He is currently doing our bidding and looking at other facilities. At some point in time, as Mr.  Festavan brought, we need to look at that and look at widening this position; maybe it is his misunderstanding, he would like something. Robert Green stated he should tell them we are fine. Keep doing what you are doing. The leadership will be here; especially coming from the Board. Robert Green said that is his opinion. There should be no flag or emergency. Things are going good. Robert Green recognized Ronnie Festavan. Ronnie Festavan stated that Reverend Green echoed what he was going to say. He would not be willing to give any to give any long term commitment on anyone in this room. An evaluation of performance is an ongoing, every day thing. He would tell you as of tonight he would agree 100%. He talked with Mr. Jones today and everything seems to be going well. As a Board member speaking only for himself, he has come to appreciate David Jones greatly, but as a Board member he has an oath to the hospital, he does not have an oath to David Jones. At any point in time that the quality diminished, he would be raising his right hand for another vote.  That is where he was coming from.  Last month a lot of questions were answered for him. A lot of history was shared with him and it made it make sense to him. It gave him a comfort level with how we got David Jones. He is much more comfortable now. He would never want to make a definitive statement in this Board room – that this is the way it is and this is the way it is always going to be. He is not going to do that. Dr. Woods stated that is not what he was asking for. Ronnie Festavan said that he understood that he is not but you understand where he is coming from. His oath to the Board is greater than his personal feelings about anyone in this room. He intends to maintain that. In agreement with Mr. Chairman, things are fine. He does not know if that helps any or hurts any, but he thinks he understands where he is coming from.   Robert Green said he is going on not what happens in the future, he is going on what has happened in the past and where we got to where we are. If David was not doing what he is supposed to do, he would have already heard from the Board. He has done a great job and that is why he said go tell them that everything is fine. He has not done anything that would make us want to change. We all know if you don’t do your job, you have got to go. Mary Irvin said she is echoing his sentiments that she knows as a Board member, for her personally speaking, the evidence is in where we are right now as a hospital in a hospital district, that only happens with the leadership and the things you are concerned about as he said, it is all fine. Robert Green said Mrs. Helen has something to say. Robert Green said one reason that he wants to say that David has not just been here because he likes him. It is not about like, it is about our commitment to our community. It is because of his performance. Helen Godfrey-Smith said very briefly, it is a little bit troubling that something has occurred that has made our doctors have some unrest. She doesn’t take that lightly because the doctors are such a strong part of what we do in this hospital and the image that we put forth. She takes this serious and not give them a commitment or contract, but she does not think it would hurt for him to take some time at the next meeting with them, not making a commitment, but say the words they are looking for.  Robert Green said that is why he said to tell them it is fine. Dr. Woods said you can understand; change inevitably makes anyone nervous. Robert Green said he is saying in a relaxed tone and for him to share that with them. Dr. Woods said he will pass it on and he didn’t want to speak on the Boards behalf without visiting with them about it. Robert Green said you have three legs – you have Administration, you have the Board and you have the doctors. That is what it takes for the hospital to run. Let them know it is fine. We have a strategy. Dr. Woods said he thinks that is what they were looking at. They feel all three legs are strong, why are we changing a leg.  Robert Green said we need to move on and he does not know where it comes from that they would be worried. We shall have leadership. Ronnie Festavan spoke up to say that as a Board we will always be committed to quality leadership. Robert Green stated that is his point. Robert Green stated that he believes that if is not broken don’t fix it. Please let them know that and if they need to see him, he will come by and reassure them that things are fine and if it were not Dr. Woods would.  Dr. Woods thanked the Board and he will pass the information along.        XI. Executive Session:     Robert Green stated we are at the point to enter into Executive Session for Strategic Planning.     Ronnie Festavan made a motion to enter into Executive Session for the purpose of strategic planning.     Mary Irvin seconded the motion.  The vote:  Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Helen Godfrey-Smith, Bruce Walker, Pat White.    Nays: None. Absent: Brenda Smith. Abstained: None. The motion passed by unanimous vote.     The Executive Session was entered into. No action was taken during the Executive Session.      Pat White made a motion to enter back into regular session.    Ronnie Festavan seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: Brenda Smith. Abstained: None. The motion carried.      XII. Adjourn:         There being no further business Bruce Walker made a motion to adjourn.   Ronnie Festavan seconded the motion.   The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: Brenda Smith.   Abstained: None. The motion carried.          Meeting adjourned at 8:00 p.m.






North Caddo Medical Center

Vivian, Louisiana




David C. Jones, Secretary