North Caddo Medical Center
BOARD MEETING: Regular Meeting DATE: April 25, 2023 MEMBERS PRESENT:David Norman, Kenneth Cochran, Jennifer Fant, Ronnie Festavan, Michael W. Nation, Sr., Brenda Smith, Pat White. MEMBERS ABSENT: Robert T. Green, Jr. (arrived @ 4:07 p.m.), Mary Irvin TIME CALLED TO ORDER: 4:00 p.m. OTHERS PRESENT: David Jones, CEO, Drew Burnham, Attorney, Dakota Robinson, CFO, Stacy Alexander, RN, CNO, Kourtney Tyson, Foundation Director, Britney Stringham, Administrative Assistant LOCATION:NCMC Extended Services Building Board Chair: David Norman SECRETARY: David Jones I. CALLED TO ORDER – David Norman, Board Chair called the meeting to order at 4:00 p.m. II. Invocation and Pledge of Allegiance – Michael W. Nation, Sr. offered the Invocation and Kenneth Cochran led the group in the Pledge of Allegiance. III. Approval / Amend Agenda – David Norman stated we need a motion and a second to approve the agenda. Brenda Smith made a motion to approve the agenda as presented. Michael Nation seconded the motion. There was no discussion. The vote: Yeas: David Norman, Kenneth Cochran, Ronnie Festavan, Pat White, Jennifer Fant, Brenda Smith, Michael Nation. Nays: none. Absent: Robert Green, Mary Irvin. Abstained: None. The vote was unanimous in favor. IV. Community Comments – David Norman, Board Chair stated there was no one present requesting to make community comments. V. Minutes – Regular Meeting March 24, 2023 – David Norman stated we need a motion and a second to approve the minutes with discussion, if any, to follow. Ronnie Festavanmade a motion to approve the minutes of March 24, 2022 as presented. Pat White seconded the motion. There was no discussion or corrections noted. The vote: Yeas: David Norman, Kenneth Cochran, Ronnie Festavan, Pat White, Jennifer Fant, Brenda Smith, Michael Nation. Nays: none. Absent: Robert Green, Mary Irvin. Abstained: None. The vote was unanimous in favor. VI. Foundation Report – Kourtney Tyson, Foundation Director, reported we are still in the throes of planning our raffle. We are currently waiting on the state and the Louisiana Department of Revenue Insurer of Gaming Commission to get our license so that we can get that ball rolling. Prizes will be cash prizes with the grand prize to be $25,000. We are working on it. That is all I have. Thank you. VII. Chief of Staff Report – David Jones I don’t have a report at this time. Dr. Woods has patients in the ER and may come in later. VIII. Old Business – 1) Update Building Projects: David Jones, Administrator, CEO, said the update on our building projects, we’ll be talking about our Benton project which is our main ongoing/new construction project. We signed the agreement as far as the Ramtech building for the South Bossier Clinic and we should be coming, hopefully, in the May Board meeting, for bids, which we hope we don’t have to actually have to advertise, just go get bids, for the parking lot and the dirt work for that building. Estimated completion is October of this year. Things should be progressing pretty quickly. We will give a little bit more on the Benton construction later. David Norman asked if there were any questions. There were none. IX. Review March 2023 Statistics and Financials – 1) Statistics: Dakota Robinson stating with the Statistics, there’s a little bit of trend here. I think we’ve seen it over, at least, the past quarter, where we’ve seen them sort of shift in the outpatient here lately. Looking at Admissions, Admissions did go up in a one month period. You can see the trend has been down a little bit. Though the year we’ve seen a 26% decrease on Inpatient stays but we’ve seen a 6% increase on Swing Bed days. We look at the Average Daily Census over the past three months. We’ve gone from 7.7 to 6.2. Newborns – we had three up from 1 the previous but year we are at 33 which is a 40% decrease from the previous year. Emergency Room visits you see a one month uptick to 449 from 386. Surgeries, we’ll see a time period where we had a relatively lower numbers in the surgical department, we went from 6 the past month to 17 in March. We did have a significant uptick. MRI – it did see a decrease from 18 to 14 over the past month but 14 is still over what the average would be over the past 4 months.Looking at CT – CT did see a slight increase from 116 to 127. Endoscopies went from 9 to 7 in one month and Sleep Studies remain steady at 55. These are therapies, the first being Outpatient PT here in Vivian, the second is Blanchard PT at Blanchard Medical. You see that both saw significant increases – Vivian went from 302 to 362 and Blanchard went from 342 to 437. There was a slight increase in Vivian Medical from 1,660 to 1,832. Plain Dealing remains little change there from 620 to 611. In Benton Medial we did see a pretty good increase. I think year to date they are a 2% increase but they went from 570 to 647. Blanchard Medical, obviously, it’s not good to compare a year back because Dr. Chance hadn’t been there a full year but they did see an increase up to 1,177, which is the second most behind January of this calendar year. Dental did have an increase from 201 to 234 visits. Community Rx did see an increase from 2,241 to 2, 590 scripts. The Fitness Center did have almost 1,800 member visits and 8 new signups. Any questions on the Statistical Analysis. There were none. 2) Financials: Dakota Robinson continue stating we are going to look at the cash balance. There’s some good things that have gone on with cash over the past 9 months, especially what that’s looked like from the audit. Revenue, where we at Revenue wise both one month and budget and how the contractual adjustments are playing in and where we expect to see those. (Robert Green arrived at 4:07 p.m.)Looking at page 1 of the Balance sheet, you’ll see that Days Cash on Hand has increased 138 days cash on hand to 159. On the Income Statement you’ll see that revenue came in at $4.1 million compared to $4.3 million. There was a reduction in gross revenue but we also saw a reduction in a contractual adjustment to offset that, so when we look at net patient revenue you see it increased in a one month period of almost $81,000, which is great. When we look at Salaries and Wages you’ll see that Salaries and Wages through one month is up and through three months is up slightly. When we go down in Employee Benefits and Payroll Taxes you’ll see that for the month it is lower, we did book an accrual for a stop loss payment that we expect to receive back. Looking at Medical Supplies and Drugs, if anybody was to look this you would say this is the biggest discrepancy on the report. Any questions on the Income Statement. There were none. On the one month Departmental Revenue, you’ll see on the inpatient basis inpatient numbers are down, especially year to date, so you see a lot of ancillary services related to the inpatient have seen reductions, but a lot of outpatient departments, especially your therapies, your clinics have seen increases that help offset those changes. Looking at the Budget you’ll see a few things with the Budget. Net Patient Revenue, for the nine months is up by $611,000, that’s about 3% increase from the expected budget. Employee Benefits and Payroll Taxes, the next line item down, you’ll see that we are about a quarter of a million dollars under what we budgeted. Looking at Medical Supplies and Drugs it is up but the good thing about that is that it is a line item that as that increases proportionally revenue side increases as well because the changes we see here, it is directly related to Community Rx’s cost of goods sold. Total Operating Expenses for the one month is up by about $202,000 and through 9 months up about $1 million dollars. Non-Operating Revenue, Grant Revenue, continues to surpass the budgeted expectation for one month and year to date just because the UCC number came in higher than expected. Any questions on the financial analysis? There were none. David Norman said if there are no questions or discussion I would entertain a motion and a second to approve the Statistical and Financial reports as presented. Robert Green made a motion to approve the Statistical and Financial reports as presented. Pat White seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The vote was unanimous in favor of approving the March 31, 2023 Statistical and Financial report as presented. X. New Business – 1) Benton Medical Bid Acceptance: David Jones said the first two items under new business I think we’ve kind of discussed in the past. We did get to open up the bids for the completion of the Benton Medical Clinic. We did have a low bid from the Testament Construction. If we get a motion and a second, I’ll answer any questions you may have on this. Brenda Smith made a motion to accept the bid. Robert Green seconded the motion. There were no questions or discussion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The vote was unanimous in favor of acceptance of the bid from the Testament Construction for completion of the Benton Medical Clinic. 2) Blanchard Land Purchase: David Jones stated we have negotiated the price for a .15 acre on the western side of the Blanchard Clinic. If I get a motion and a second I will answer any questions you may have. Ronnie Festavan made a motion to approve the purchase of the .15 acre land for Community Rx Blanchard as presented. Pat White seconded the motion. David Norman asked if there was any more discussion. There was none. David Norman called for a vote. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The vote was unanimous in favor of the Blanchard land purchase as presented. 3)Money Market Account – First Guaranty Bank: Dakota Robinson, CFO, said we have been talking a lot about money interest payments over especially the past six months in the Finance Committee and the Board. We’ve made some significant strides in making the most of our money by investment products and negotiating with Citizens Bank and Trust of Vivian for some interest rate changes. We’ve also done the same thing at First Guaranty. We are asking for a resolution to open up a money market account with First Guaranty Bank. They have come to an agreement where they would peg our interest rate to the 90 day T-bill. We are asking for a resolution to do that. Dakota Robinson read the Resolution aloud. Brenda Smith made a motion to approve Resolution #2 – 2023 to open a money market account at First Guaranty Bank of Vivian. Kenneth Cochran seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The vote was unanimous in favor of theResolution #2 – 2023 to open a money market account at First Guaranty Bank of Vivian. 4) Credit Card Limit Transfer: David Jones said #4 is kind of a housekeeping item that we should have already taken care of. Basically we have two credit cards that added together had an $8,000 credit limit on them. One was in Mary Coil’s name and the other one was in Mrs. Pam Hughes’ name. Mrs. Pam retired and we cancelled that card, so we’ve been bouncing off one credit card for the better part of about 6 to 8 months. $4,000 dollars, when you have to do purchases and on line things, educational, hotel stays and etc., it pretty much stays full. We would like to open a second card in Mrs. Brittney Stringham’s name and get our total limit where it was back when Mrs. Pam was here to $8,000. Dakota Robinson read Resolution #3 – 2023 granting the transfer of the credit limit of $4,000 to a new credit card issued in the name of Britney Stringham under North Caddo Medical Center. David Norman called for a motion and a second. Kenneth Cochran made a motion to adopt Resolution #3 – 2023 as presented. Robert Green seconded the motion. David Norman recognized Ronnie Festavan to speak. David Norman asked if there was any other discussion. David Norman called for a vote. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The vote was unanimous in favor of the Resolution #3 – 2023 as presented. 5) North Market Land Declared Surplus: David Jones said the North Market land that we purchased initially that we thought we were going to be able to build the Blanchard Clinic on, we need to declare it surplus and we’ve got a minimum appraisal. Once we declare it surplus we will be able to list it with a real estate agent and that would be the least amount of money that we can accept for the piece of property, but we need to declare it surplus first. Ronnie Festavan made a motion to declare the 5 acre tract of land on North Market as surplus. Pat White seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The vote was unanimous in favor to declare the 5 acre tract of land on North Market as surplus. Dakota Robinson said the state says when we surplus something we have to assign a value to it. On land and real estate it’s through an appraisal process. That just establishes the bottom line. There were no further comments or questions. XI. Administrative Report: David Jones said you will see in there I did a review on the Board Retreat. It’s an overview of what we discussed and what we had come up with on some of our dream projects and our strengths and our weaknesses. Look at that at your leisure and know that Hospital Week is quickly approaching. It is pretty much a wild and wooly time around here at the hospital during that week. I believe it starts the May 8th. If anybody wants to come up we have different vendor for lunch and we have some games going on and that kind of thing. Please attend if you can. XII. Medical Staff Recommendations – April 2023 Medical Staff Recommendations were presented by Dakota Robinson for Board approval. MEDICAL STAFF APPOINTMENTS: None. MEDICAL STAFF REAPPOINTMENT: 1) Thomas Gallagher, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of April 25, 2023 through December 31, 2024. 2) Steven Edson, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of April 25, 2023 through April 30, 2025. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: 1) Kristen Hill, NP – Requests Affiliated Privileges in the field Family Medicine for the period of April 25, 2023 through April 30, 2024. EXTENSION REQUEST: 1) Catherine Sharpe, M.D. – Requests extension upon completion of reappointment application. VOLUNTARY RESIGNATIONS: 1) Kirtesh Patel, M.D. – Voluntary resigns his Privileges in the field of Pathology effective 04/07/2023. 2) Neil Staib, M.D. – Voluntary resigns his Privileges in the field of Radiology effective 03/29/2023. 3) James Chen, M.D. – Voluntary resigns his Privileges in the field of Radiology effective 04/07/2023. David Norman said we need a motion and a second to approve the Medical Staff recommendations. Michael Nation made a motion to approve the (2) Medical Staff Reappointments, (1) Advance Practice Professional Appointment. (1) Extension Request and (3) Voluntary Resignations. Kenneth Cochran seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The vote was unanimous in favor to approve the Medical Staff recommendations. XIII. Executive Session: David Norman stated we need to enter into a brief Executive Session for the purpose of Strategic Planning. I would entertain a motion and a second. Brenda Smith made a motion to enter into Executive Session. Michael Nation seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The motion passed by unanimous vote to enter into Executive Session. The Executive Session was entered into. No action was taken during the Executive Session. Ronnie Festavan made a motion to enter back into regular session. Robert Green seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The motion passed by unanimous vote to enter back into regular session. David Norman stated we are now back in our regular Board session. XIV. Adjourn – There being no further business Robert Green made a motion to adjourn. Pat White seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Brenda Smith, Jennifer Fant. Nays: None. Absent: Mary Irvin. Abstained: None. The motion passed by unanimous vote in favor to adjourn the meeting. The meeting adjourned at 5:35 p.m.
North Caddo Hospital Service District
North Caddo Medical Center
Vivian, Louisiana
___________________________
David C. Jones, Secretary
Reg Bd Mtg 04/25/2023