BOARD MEETING: Regular Meeting        DATE: September 26, 2017     MEMBERS PRESENT: Robert T. Green, Jr., Patricia White, Kenneth Clay, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker     MEMBERS ABSENT: Helen Adger, Mary Irvin     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, Allison A. Jones, Attorney, Mary Coil, Foundation Executive Director / Marketing Director, Mike 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  –  Helen Godfrey-Smith offered the Invocation and Brenda Smith led the group in the Pledge of Allegiance.   III.            Approval / Amend Agenda  –  Robert T Green, Jr. stated it is time for approval or amendment of the agenda. No amendments noted.     Pat White made a motion to approve the agenda as presented. David Norman seconded the motion. Yeas: Robert T. Green, Jr., Pat White, David Norman, Brenda Smith; Helen Godfrey-Smith, Bruce Walker Nays: None; Absent: Helen Adger, Kenneth Clay, Mary Irvin. Abstained: None.  The motion passed.       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 August 22, 2017  –   The minutes of the August 22, 2017 Regular Board meeting were mailed prior to today’s meeting for review.  Robert Green inquired if there are any corrections to be noted. If not, he would entertain a motion to approve the minutes.         Patricia White made a motion to approve the minutes of the regular meeting as mailed.  Brenda Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, David Norman, Brenda Smith; Helen Godfrey-Smith, Bruce Walker Nays: None; Absent: Helen Adger, Kenneth Clay, Mary Irvin. Abstained: None.  The motion passed.      VI.   Old Business  –  1)  Dialysis Clinic Partnership Update:  David Jones stated that you will notice that we are one shy on old business for the first time in about four years now. He didn’t know if members noticed when they drove up that the Dialysis Clinic is coming along nicely. He thinks it will definitely look like a building in the next month and a half. They certainly are getting it up as quick as possible. Brenda Smith noted that people everywhere are saying “what are you all building up there now?” David Jones noted that it is going to be a very good thing whenever it is done.      3)   Radiology and ER Expansion Update:  David Jones stated that he and Pam Hughes met with TEG, the Estopinal Group that designed our hospital. He has briefly mentioned this before; the initial place that they wanted to build the expansion was right out the back door behind Radiology. This basically sits on top of every major power line, every major water line, every major sewage line – everything that comes out of that build sits right there. They actually have now punted that part of it. They felt that it is a bad idea to build there. Even if we got the ultrasound done, it still does not guarantee that something bad isn’t going to happen right there. They are coming up with plans B,C and D.  They had some initial drawings of some things that looked pretty neat. We told them some things that it needs to bend back around and do, so they are going back to the drawing board and they are going to bring some more plans to us to see what those would look like. Brenda Smith said not to mention the cost involved in having to move all those types of power. David Jones stated that is where we are with that. We are waiting on them. They have contacted Pam Hughes about coming up sometime this week or early next week to talk about it.        VII.     1)   Review August  2017 Statistics – Allyson Allums:   Allyson Allums was unable to attend the meeting. Dakota Robinson, Controller, presented the August 2017 Statistical Report in her absence. There were 71 Admissions and 76 Discharges with Total Days Stayed –258. The Average Length of Stay – 3.4 Days. Total In-patient Days – 236; this six month trend is still positive. The average Daily Census – 7.6. Our Total Occupancy Rate was 50.80%. Total Surgeries for August (In-patient – 2 / Outpatient – 4). He noted that Dr. Banda has some more scheduled. You will see those in next month’s statistical report. We will be looking for this to trend up. Endoscopies performed in August – 11.  The total Emergency Room patients seen – 512.  Swing Bed Admission –12. There were 144 Total E.M.S. runs in August.  Observation Patients for August- 32.  There were 9 Newborns in August.  The total Patient Visits for the clinics – Medical & Surgical Clinic is 1870.  The Plain Dealing Clinic saw 722. Benton Medical saw 263. There were 26 Mammograms for August.      2)   Review August 2017 Financials – Allyson Allums:  Dakota Robinson presented the Financials. Hospital Revenue over Expense. Revenue –$3.7 million Expense – $1.9 million with a loss of $87,200. If you look at the year to date financials, they are healthy compared to this time last year. The AR Days for all three facilities – grew slightly to 63.0; for the hospital – it grew slightly to 54 days. Plain Dealing Clinic – Revenue over Expense. Revenue –$161,000, Expense – $95,000 with a profit of $28,000.00. Medical and Surgical Clinic – Revenue over Expense. Revenue – $530,000 Expense – $264,000 with a profit of $62,000. This is the exciting one looking at the graph – Benton Clinic – Revenue over Expense. Revenue –$60,000; Expense – $23,000. They had, basically, a breakeven – they lost $400 last month. Mr. Jones reviewed patients before the meeting and it seems to be another good month. This, hopefully, will continue in that trend. The Bad Debt Expense grew a little to 5.4. It is not out of the trend that we see every once in a while. Days cash on hand rose slightly – 12.00 days. That could be one of those timing issues. It is not dipping and that is good. He noted that this is leveling out. Self-Funded Insurance, he noted is still running a little high which has been the trend all year. The total expense was $140,000 for this month and the specific reimbursement, for any claim over $50,000, we received $15,278. The aggregate cost this year for the self-funded health insurance plan is right at 1.5 million dollars. Where we were at this time last year was 1.3. Costs have gone up and that is why we have made some decisions here recently about the health insurance that we have talked with the Finance Committee. There is not too much we can do about it. We have added two new slides – one is the number of claims through the 340B program and a breakdown of where those claims come from. The blue is Walmart, red is Benzer Pharmacy and the yellow is Kelly Pharmacy in Plain Dealing. This is a breakdown of the number of prescriptions that we capture from their pharmacy. You can see Walmart, obviously, is the biggest of the bunch. There is one with 340B revenue. It is the same colors again with the purple being added in being the total revenue. We just turned on the referral portion of this and we should see the numbers go up slightly in the next few months. David Jones stated that Dr. McCommon texted him just before the meeting and informed him that she saw 27 patients today in Benton. It is finally taking off a little bit. It has taken some time. He had a feeling that sooner or later that clinic would be too busy as opposed to not busy enough. Brenda Smith noted that she was glad to see that a pharmacy in the Plain Dealing area is participating in the 340B program. Dakota stated there is only one currently participating. Hopefully we are in negotiations with Walker Brothers Pharmacy to get them on. The new owner was reluctant to participate due to a previous bad experience. Dakota has diligently worked with him to bring him onboard with the program. His numbers should be similar to the other Plain Dealing pharmacy. Brenda Smith thanked Dakota for adding 340B slides.            Robert Green asked if there was any more discussion or comments. If not he would entertain a motion to accept the Statistical and Financial Reports.         David Norman made a motion to accept the Statistical and Financial Reports as presented subject to audit. Bruce Walker seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Pat White, David Norman, Brenda Smith; Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: Helen Adger, Kenneth Clay, Mary Irvin. Abstained: None.  The motion passed.      VIII.   New Business  –    1) Change October Meeting Date From Tuesday, October 24th to Monday October 23rd:      David Jones said they briefly talked about this at the Special Called Meeting. We need to change the Board meeting date from the regular fourth Tuesday to the Monday right before to give us another day to get the millage rate adopted for the coming year. This will allow time to get that in the appropriate hands in Baton Rouge for our Tax Assessor to get everything approved through the state.  Helen Godfrey-Smith asked for a reminder to be sent to the Board members of the date change. David Jones replied absolutely.        Helen Godfrey-Smith made a motion to change the Board meeting date for the month of October from Tuesday, October 24th to Monday, October 23rd for legal obligations. Pat White seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, David Norman, Brenda Smith; Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: Helen Adger, Mary Irvin. Abstained: None.  The motion passed.      IX. Administrative Report  –   1)   NCMC – Current Activities:   David Jones said we are in that hang over phase from the Grand Opening. That was an outstanding event and he appreciates everybody that came. It was an exceptional turn out. There was not a final tally but it was somewhere around the 220 people mark that was in there for the event. We actually got a pretty good picture of all the physicians together for the first time in about two to three years. It was very good event and good turn out and we are glad to finally be up and running without worry of doing that. Now, keeping the building up and running is another subject to tackle.      2)   Finance  Committee Report:   David Jones stated he added in a Finance Committee report to be given by Helen Godfrey-Smith.  The committee has been meeting quite often over the last month to month and one half. He wanted to give the Board an update.        Helen Godfrey-Smith stated that she is very pleased, and she believes that  Administration is as well, that the Finance Committee has been activated and getting their legs. They are learning what they need to do and what they need to know and what they need to report. That might change over time, but right now there are couple of things that they are really focusing on. One is the budget and cutting expenses and looking at ideas to generate some revenues and some supporting finances. This leads us to our thoughts to try to buff up a little bit our financial partnership that we have with a tertiary care hospital. Right now, as you know, that is with Willis Knighton. Over time the effectiveness of the partnership seemingly has not been enhanced. It has either leveled out or, in some cases, digressed; not as effective as it should be. The Finance Committee, in due diligence, are considering looking at other options. One of the things that we decided in our last week’s meeting, after it was discussed and the decision was made after all the Board members that were contacted concurred, that it was a good idea to send a letter to Willis Knighton alerting them of our interest in enhancing our partnership agreement with whoever we can get the best partnership agreement and actually putting out a RFP (Request for Proposal). Hopefully we have that letter edited and ready to go. We have also worked on an RFP letter that we will send out if we don’t get a very positive response. Bruce Walker suggested we can’t expect Willis Knighton to have a formal proposal by the October 17th date. They could at least let us know if our partnership is worth them meeting with us and negotiating with us; to open up some communication.  We will be waiting with bated breath on our October 17th date to see what the response is. We would like to send out a copy of the letter to each of the Board members so they can read the letter. Then we will be ready to send out our requests for proposals. We are offering the ones that we are sending the requests out to, to sit down with the Finance Committee and extended Board members, if we get a meeting set up, of course, you would be invited to join us for that particular meeting so that you could have input and hear what they are saying, because this is going to be a big decision for us as a Board. We want to be as prepared as possible.        3)   Foundation:    Mary Coil, Foundation Executive Director, stated that she had placed a copy of the Foundation minutes at each of the Board members’ binder. She noted that these are the July minutes.  There was not a meeting held in August. She noted that they are already looking into plans for the Gala 2018. That is what they have going on right now. They are checking into a few things and planning ahead. We will be doing our Memorial and Honorary Ornaments that we do each year. She will be sending out more information about that. On another note, she wanted to let them know the hospital is ordering tee shirts and jackets.  There are order forms in the middle of the Board table. The order goes in on Friday. Several of you have asked her about doing this. If you would like to participate, these are available to order.      X.   Medical Staff Report  –    1)   Recommendations – Allyson Allums:    David Jones presented the Medical Staff recommendations for the Governing Board approval:   MEDICAL STAFF APPOINTMENTS:   1.   Michael A. Nissenbaum, M.D. – Requests Provisional Privileges in the field of Radiology for the period of September 26, 2017 through September 30, 2018.    2.   Alecia Rideau, M.D. – Requests Provisional Privileges in the field of Radiology for the period of September 26, 2017 through September 30, 2018.    3.   John E. Crouch, M.D. – Requests Provisional Privileges in the field of Radiology for the period of September 26, 2017 through September 30, 2018.    4.   Christina Geatrakas, M.D. – Requests Provisional Privileges in the field of Radiology for the period of September 26, 2017 through September 30, 2018.    5.   Karen S. Caldemeyer, M.D. – Requests Provisional Privileges in the field of Radiology for the period of September 26, 2017 through September 30, 2018.    6.   Vibhu Kapoor, M.D. – Requests Provisional Privileges in the field of Radiology for the period of September 26, 2017 through September 30, 2018.        MEDICAL STAFF REAPPOINTMENT:     1.   Dean Batten, M. D. – Requests Courtesy Privileges in the field of Radiology for the period of October 1, 2017 through October 31, 2019.    2.   Vivek Khare, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of September 26, 2017 through September 30, 2019.    3.   Jill Ferguson, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of September 26, 2017 through September 30, 2019.    4.   Richard J. Blanchard, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of November 1, 2017 through November 30, 2019.   ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:     1.    Jason T. Horn, CRNA–  Requests Provisional Privileges in the field of Certified Registered Nurse Anesthetist for the period of September 27, 2017 through September 30, 2018.      EXTENSION REQUEST:    NONE.        VOLUNTARY RESIGNATIONS:     NONE.             Pat White made a motion to accept the Medical Staff Recommendations for Medical Staff Appointments, Medical Staff Reappointments, Advance Practice Professionals Appointments/Reappointment. Helen Godfrey-Smith seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: Helen Adger, Mary Irvin. Abstained: None. The motion carried.     2)   Chief of Staff Comments: David Jones noted that the Chief Staff requested a day off today. He wanted David Jones to tell the Board that everything is going well and that he didn’t really have a whole lot of comments to talk about today any way. He plans be at the next Board meeting.        XI.   Executive Session –   Robert T. Green stated we are at the point to enter into Executive Session. He will need a motion to enter in to Executive Session for the purpose of strategic planning.     Helen Godfrey-Smith made a motion to enter into Executive Session for the purpose of strategic planning. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: Helen Adger, Mary Irvin. Abstained: None. The motion carried.        The Executive Session was entered into. No action was taken during the Executive Session.       Bruce Walker made a motion to enter back into regular session. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: Helen Adger, Mary Irvin. Abstained: None. The motion carried.          XII. Adjourn  –    There being no further business Kenneth Clay made a motion to adjourn. Brenda  Smith seconded the motion. The vote: Yeas: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: Helen Adger, Mary Irvin. Abstained: None. The motion carried.    Meeting adjourned at 6:16 p.m.

 

Aproved by the Board of Directors at the regular meeting held October 23, 2017

NORTH CADDO HOSPITAL SERVICE DISTRICT

North Caddo Medical Center

Vivian, Louisiana