BOARD MEETING:  Regular Meeting   DATE:  February 22, 2022    MEMBERS PRESENT:  David Norman, Kenneth Cochran, Pat White, Michael W. Nation, Sr., Robert Green, Brenda Smith. MEMBERS PRESENT VIA TELECONFERENCE:  None   MEMBERS ABSENT: Ronnie Festavan, Mary Irvin.    TIME CALLED TO ORDER:  4:00 p.m.    OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Walter D. (Doug) White, Hospital Attorney, Dakota Robinson, Brent Leonard, Dr. John Woods, Mary Coil, Foundation Executive Director / Marketing, Britney Stringham, Administrative Assistant.  Via Teleconference: None. LOCATION:  NCMC Café and Via Teleconference – Conference ID 216 803 333 #    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 – Robert Green offered the Invocation and Pat White 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. Robert Green made a motion to approve the agenda. Brenda Smith seconded the motion. There was no discussion. The vote: Yeas: Pat White, Michael Nation, David Norman, Kenneth Cochran, Brenda Smith, Robert Green.  Nays: None.  Absent: Ronnie Festavan, Mary Irvin.  Abstained: None. The vote was unanimous in favor. The agenda was approved as presented.   IV. Community Comments – David Norman, Board Chair inquired if there was anyone from the community logged on. There were none.  V. Minutes – Regular Meeting January 25, 2022 –  David Norman stated we need a motion and a second to approve the minutes of the regular meeting held January 25, 2022 with discussion, if any, to follow.  Robert Green made a motion to approve the minutes of January 25, 2022 as presented. Michael Nation seconded the motion. There was no discussion or corrections noted. The vote: Yeas: Pat White, Michael Nation, David Norman, Kenneth Cochran, Robert Green. Nays: None. Absent:    Ronnie Festavan, Mary Irvin.  Abstain: None. The motion passed by unanimous vote in favor.  VI. Foundation Report – Mary Coil said the Foundation doesn’t have a lot to update on just keep remembering August 27th for our Safari that we’ll hold at the Petroleum Club. David Norman thanked Mary Coil.  VII. Chief of Staff Report – David Jones noted Dr. Woods must be busy at this time. He was planning to be here. David Jones said he will probably be here later.   VIII. Old Business – 1) Update on Building Projects: David Jones asked Pam Hughes to give some updates on our building projects.  Pam Hughes stated on Blanchard we are doing a punch list on Friday morning now to look at what the contractor needs to come back in and make any repairs noted. Benton, we have got some progress in Benton, slowly but it is going now. The dentist is moved in and seeing patients and everything is going good with that. The roof, we’ve had some hiccups on. Mary Coil got the EMS house sign painted on it and it looks great. The maintenance crew finished everything down there that needed to be done. Brenda Smith inquired if there was plenty of room in both buildings. David Jones said absolutely. We thank Mrs. Brenda for getting us in touch with them.  2) Electronic Signage Update:  David Jones said I regret saying what I said at the last Board meeting because now officially the manufacturer is still on target for their dates but now the installer has pushed it back almost another month. David Jones said I think I will only say this. I have confidence that it will be in by Christmas.  3) Update on Purchase of New Ambulance:  David Jones said I take full responsibility for the ambulance not being here. I told the Ambulance Service Director, who is bringing the ambulance, the meeting time was 4:30 p.m. So the new ambulance will be here at 4:30. Unless there is an emergency run it will be there for us go walk through after the meeting if anybody would like.   IX. 1) Review January 2022 Statistics – Dakota Robinson:  Dakota Robinson, CFO, said throughout the Statistics it’s a pretty good month. Looking at Admissions, you see admissions went from a low of 24 and 9 Swing Bed admissions up to 43 acute admissions and 8 swing beds. Inpatient days climbed dramatically from 236 to 331 so there was about a 40% increase in the month of January. Both of those together increased the Average Daily Census about the same percentage. It went up to 10.7. You’ll see in the ER we did see a 17% increase from 529 to 621. EMS remain about steady. Surgeries – Dr. Banda when from 6 in December up to 13.   MRI – we had about a 35% decrease from 20 to 13 in the MRI department. CT – remains steady. A little fluctuation from December from 126 to 117. Year to date we’ve seen about a 7% increase. We’ve done a little over 900 CT’s. Bone Density – this is one of the things that will be brought up later on in the meeting. Unchanged, we’ve actually seen a 5% increase year to date and we’ve done about 157 Bone Densities year to date. Endoscopies saw a slight increase of 6. Sleep Studies did see an increase to 33 but year to date we are well surpass where we were at the previous year.  In the clinics you see definitely a trend there. Vivian increased their patient volume a little over 1,700 to 2,233.  Plain Dealing you’ll see, as far back as my records go, I’m counting this as an all-time high of 814 visits. Year to date they’ve done over 5,000. They’ve actually had about a 6 to 7% increase in visits. Benton has another all-time high from 574 to 636. They’ve seen a 2% increase in that clinic. Blanchard surpassed Plain Dealing and saw 828 patients. They’ve seen right at 5,000 year to date in Blanchard in a mobile clinic. David Jones said a little perspective. Plain Dealing basically has two fulltime providers there. Benton has 1 fulltime provider working five days a week.  Blanchard is the same way. You have a Nurse Practitioner that works four days and Dr. Chance fills in on that fifth day. Blanchard saw 828 patients versus Plain Dealing’s 814 and that’s one provider versus two. Dakota continues stating that our Dental Clinic there’s not a lot of data so you get a start of 63 patients for the months. The Fitness Center had 318 members, a little over 1,300 visits and the new sign-ups for the months of January was at 20.  Any questions on the statistics. There were none.   2) Review December 2021 Financials – Dakota Robinson:  Dakota Robinson stated looking at the statistics shows us that we saw increases in most all areas of the facility. There are multiple changes that affected the month’s financials. On page one of the Balance Sheet. When we look at the construction spent, we’ve spent a little over $3.2 million dollars already on those construction projects there is about $1.5 million left in those projects. Pretty good cash on hand balance considering the expenditures we’ve done on construction projects. The Sales Tax Fund continues to outpace the previous period. You’ll see Days Cash on Hand has gone to 140 days. The main culprit there is the increase in expenses. I’ll point that out when we get to the Income Statement. All in all a good Balance Sheet. On page 3 of the Income Statement, we look at the top that Revenue at $4.3 million compared to $3.7 million the previous year.  Professional Services – you’ll see there is an increase in Professional Services. With Dr. Taylor’s retirement we are covering some extra call through Ochsner physicians so you’ll see that in that line item and will remain an increase over this next year. We look at Total Operating Expenses for the month of $2.6 million compared to almost $2.4 and on the year Operating Expenses about $1.9 more than what it was the previous year. ER Revenue is up for the month significantly at $242,000 in net difference. So we’ve seen a lot of positives across the board in the financial statements. On the Budget on page 8, the main thing you’ll see there is for Net Patient Revenue we surpassed it by about $336,000 for the month and we are a little over a million dollars over what we budgeted in revenue through seven months. Salaries and Wages you’ll see we are above where we expected Salaries and Wage wise by about $489,000 and we’ve actually gotten Employee Benefits and Payroll Taxes below where we budgeted for the first time this year. About a $59,000 reduction from what we budgeted. All in all we look at Total Operating Expenses, we are about $877,000 over in the expense category. In the Total Operating Revenue you’ll see that we are almost where we budgeted through seven months and then when we look at the increase or profit we’re about $3,000 more than where we budgeted for. Pretty close to those numbers. In the clinics, the Vivian Clinic turned a profit of $3,915. The Plain Dealing Clinic saw a profit of $3,276. The Benton Clinic turned a profit of $51,000 and on the year they are sitting a little under a quarter of a million. The Blanchard Clinic, $41,605 in profit and through seven months, $118,000.  Any questions on the financial statements. There were none.  David Norman said if there are no further questions or discussion on the Statistics or Financial Statement we need a motion and a second to approve our January 2022 Statistical and Financial Statements. Michael Nation made a motion to approve the Statistical and Financial Statements as presented subject to audit.  Pat White seconded the motion. The vote: Yeas:  Pat White, Michael Nation, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin. Nays: None. Absent:. Abstain: None. The motion passed by unanimous vote in favor.  X. New Business:  1) Approval of Resolution #4 – 2022 – Raymond James Bond Resolution – David Jones we need approval of Resolution #4 -2022- Raymond James Bond Resolution. This is for refinancing of our bonds. If we can get a motion and a second for approval of the Resolution, I will talk a little bit more on it and answer any questions. Brenda Smith made a motion for approval of Resolution #4 – 2022 – Raymond James Bond Resolution.  Michael Nation seconded the motion. David Jones asked Dakota to tell the Board about our two suitors and what the fees were between the two. Dakota said Crews and Associates was present at the last meeting and we’ve had some prior dealings with Raymond James. At that point we decided we would submit a request for proposal to both of those firms; submit what is your cost to proceed down this path. Both submitted responses back. Those responses are linked in your Board documents. You’ll see one that is labeled Crews and Associates and the other one should be labeled Raymond James. A synopsis of that they basically all give you a fee for their placement services based on every thousand dollars. So at Finance Committee they selected Raymond James to be presented to the Board for the Resolution. We’re wanting a resolution basically hiring Raymond James to serve as the underwriter/placement agent for refinancing of the District’s series 2013 Sales Tax Bond issue.  The vote: Yeas: Pat White, Michael Nation, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None. Absent: Ronnie Festavan, Mary Irvin. Abstain: None.  The motion to approve Resolution #4 – 2022 passed by unanimous vote.  2) IT Storage Array – David Jones said when we first envisioned building an offsite campus, one of the things we had to make sure was in it because backup storage capacity is very important to us. We are so computer dependent now that once they go down, everybody is scurrying. We built Blanchard and planned on creating an offsite storage there so now it’s time to purchase the equipment to do that. The servers are from Insight and they are $32,506.96. If I can get a motion and a second I will answer any questions you have. Robert Green made a motion to approve the purchase of the IT Storage Array as presented. Kenneth Cochran seconded the motion.  David Jones said it is storage that will keep five years of backup. There was a brief discussion. The vote: Yeas: Pat White, Michael Nation, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Ronnie Festavan, Mary Irvin. Abstained: None.  The motion passed to purchase the IT Storage Array as presented.   3) Bone Density Machine Purchase:  David Jones said the Bone Densitometer that we purchased with the help of our Foundation is at end of life. That means they no longer create parts to service the piece of equipment that we have. So it’s time to purchase a new one. Hologic is the vendor that we are currently using and it is the one that the Radiology Department wants to use as well. Their new unit is $64,155.00. If I can get a motion and a second I will be glad to answer any questions you have.  Brenda Smith made a motion to approve the purchase of the Hologic Bone Density Machine as presented. Michael Nation seconded the motion. David Jones commented this machine has been a workhorse and it’s one of the things that Hologic are experts in women’s health. Our Mammography unit is from them. It is going through our GPO, so it does not need to be bid out. Any questions. Brenda Smith asked would that have anything to do with the fluctuation Bone Densities in our statistics. David Jones replied to some degree yes. The technology hasn’t changed that much but there are some things that make the scans easier. David Norman called for a vote. The vote: Yeas: Pat White, Michael Nation, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Ronnie Festavan, Mary Irvin. Abstained: None.  The vote was unanimous in favor of the purchase of the Bone Density Machine. David Norman asked what do you do with the old machine. David Jones replied we typically have a trade in and it’s a minuscule value. Being governmental it would have to be declared surplus and sell it from there so typically we trade them in.   XI. Administrative Reports – 1) Pandemic Update:   David Jones asked Dr. Woods if he had any comment. Dr. Woods said basically this has played out exactly like I told you it would. We have an abundance of test kits. We are seeing influenza, mainly in kids.  David Norman asked if there is a shelf life on the test kits. Dr. Woods replied I’m sure there is. David Jones said it’s typically a year.   Hopefully no variation to the virus becomes extreme certainly like it was back in 2020.  We’ll be prepared as well as we can be moving forward. The supply chain issues are still in question with the current state of the world right now. We’ll take it one day at a time as we have the last few years.    XII. Medical Staff Report – Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for Board approval.  MEDICAL STAFF APPOINTMENTS:  1.) Ioannis Papayannis, M.D. – Requests Active Privileges in the field of Gastroenterology/Herpetology for the period of February 22, 2022 through February 28, 2023.  MEDICAL STAFF REAPPOINTMENT:  1.) Kevin McDonnell, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of February 22, 2022 through February 28, 2024.  ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:   1.) Brady Thompson, CRNA – Request Privileges in the field of Anesthesia for the period of February 22, 2022 through January 30, 2024.  2. Troy Armandt, CRNA Request Privileges in the field of Anesthesia for the period of February 23, 2022 through February 28, 2023.   EXTENSION REQUEST:   None.     VOLUNTARY RESIGNATIONS:   1.) Brian Cornelius, CRNA – Requested to voluntary resign his privileges in the field of Anesthesia effective 02/22/2022.   David Norman said we need a motion and a second to approve the Medical Staff recommendations.  Robert Green made a motion to approve the (1) Medical Staff Appointment, (1) Medical Staff Reappointment, (2) Advance Practice professionals Appointment/Reappointment and (1) Voluntary Resignation as presented. Brenda Smith seconded the motion. There was no discussion. The vote: Yeas: Pat White, Michael Nation, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Ronnie Festavan, Mary Irvin. Abstained: None.  The motion passed by unanimous vote in favor.  XIII. Executive Session – David Norman stated there are no items of business to be discussed in Executive Session.   XIV. Adjourn – There being no further business Michael Nation made a motion to adjourn. Robert Green seconded the motion. The vote: Yeas: Pat White, Michael Nation, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Ronnie Festavan, Mary Irvin. Abstained: None.  The motion passed by unanimous vote in favor to adjourn. The meeting adjourned at 4:47 p.m.

 

North Caddo Hospital Service District

North Caddo Medical Center

Vivian, Louisiana

 

 

____________________________

David C. Jones, Secretary

 

 

 

 

Approved March 22, 2022

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