BOARD MEETING: Regular Meeting DATE: March 26, 2019 MEMBERS PRESENT: Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Patricia White. MEMBERS ABSENT: Kenneth Clay (arrived at 5:56 p.m.), Kenneth Cochran, Ronnie Festavan. TIME CALLED TO ORDER: 5:33 p.m. OTHERS PRESENT: Pam Hughes, COO, Dakota Robinson, CFO, Dr. John Woods, M.D., Chief of Staff, Mary Coil, Foundation Executive Director/Marketing Director, Melissa Martin, Radiology Director, Lanell Audirsch, Admin. Asst. LOCATION: NCMC Events Center BOARD CHAIR: Robert T. Green, Jr. SECRETARY: David Jones I. CALLED TO ORDER – Robert T. Green, Jr., Chairman, called the meeting to order. II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation. Mary Irvin led the group in the Pledge of Allegiance. III. Approval / Amend Agenda – Dakota Robinson asked the Board to add to the agenda discussion of passing a resolution to hire a firm to seek bids for refinancing the Construction Bond. Robert Green said he would entertain that motion. Pat White moved to amend the agenda to add #3 under New Business To Discuss Approval of a Resolution #2 – 2019 to Hire a Firm To Seek Bids for Refinancing the Construction Bond. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Clay, Kenneth Cochran, Ronnie Festavan. 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 26, 2019 – The minutes of the Regular Meeting held February 26, 2019 were mailed prior to today’s meeting for review. Robert Green stated he would entertain a motion to approve the minutes. Brenda Smith made a motion to approve the minutes of the Regular Meeting held on February 26, 2019 as mailed. Helen Godfrey-Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Clay, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote. VI. Old Business – 1) All Scripts Interface Update – Pam Hughes stated all is well on that. She believes Ross has been able to get it expedited a little bit so it shouldn’t be too terrible long. She asked Dakota if he knows any more information on it. Dakota replied they said by the second quarter they should have somebody assigned to it so hopefully it goes live sometime in the second quarter. Robert Green asked if there were any questions. There were none. 2) IT Storage Hardware and Software Update: Pam Hughes reported that the IT Storage Hardware and Software Update – it is in your notes here and also Ross has worked on that and it is in progress. He is almost through with that. Dakota Robinson stated all the equipment is in and we are waiting for the right support personnel to bring all the systems down and bring them back up and we have to be strategic when we do that. Pam noted that it affects everybody. There was no further discussion. VII. 1) Review February 2019 Statistics – Dakota Robinson: Dakota Robinson, CFO, stated if you look at the In-patient Days – we have this average line that is sitting at about 214. You can tell that the numbers over the past six months have remained steady so we are not dipping on average and we are not climbing in the numbers. If we go to the Average Daily Census – this is with the acute stays and swing bed put together. We were at 9.7 so it is the second highest for six months. The Surgeries this month – 6. Pam noted we did two last week and he saw 19 in the Clinic. Dakota said Dr. Banda is still seeing plenty of patients. Endoscopies were at 17 again so that is two months in a row where they have been strong. Dr. Woods has been very busy in the Emergency Room especially last month he saw 542 patients compared to January’s number of 498. It is a good thing to see especially with the expansion of the Emergency Room. Mammography – Radiology did 34 last month and we have seen the numbers climb over the past two month and hopefully we can stay in that area. Melissa Martin does a good job with that Department. Newborns were down slightly. Pam Hughes noted this month will make up for it. Pam stated they were here all weekend delivering. Dr. Woods said there were probably three this weekend. Dakota continued stating if we look at the Clinics, it sort of carries over in the Clinics. We had a real strong month last month. In the Vivian Clinic we did it again – 2,312 patients. If we look that the Plain Dealing Clinic – they were down slightly but still a strong month at 675. Benton was down a little bit but still saw 447 patients. The Fitness Center changed by one member they had 414 members. Does anyone have any comments or concerns on the Statistics? There were none. 2) Review January 2019 Financials – Dakota Robinson, CFO, noted it was a pretty easy month and looking at the Financials, remember there were 28 days in this month. Looking at the Balance Sheet, the Cash position has continued to increase, especially in February. That is a good thing and we will probably see that trend carry over into March. We will look at the Financial Statements – even though some of the in-patient numbers are down slightly, a lot of the Ancillary Services are up. Days Cash on Hand – we are at 47.38 as of February. If we include the Board Restricted CD’s that are $700,000, it bumps it up to 58 Days Cash on Hand. When I pulled the bank accounts up today, we are at a little over $4 million dollars. Financially wise, cash in hand, some of the best positions we have seen in a long time. Going to page 1 of the Balance Sheet, we have discussed the Days Cash on Hand, that it has been coming in, and we will see that reflected in Other Receivables line item. The Other Receivables line item have gone down significantly. These are receivable that were booked as revenue in a previous period and we have just now collected on them – that can be Ambulance Tax, 340B money, UCC payments. We have made a lot of those collections and that has been part of the driving force in increasing the Days Cash on Hand. Going to the Construction area where Assets Whose Use is Limited – I’ll point out that a Balance at the end of February was $715,000. You authorized me to move $200,000 from that account into the operating account. That has taken place. As of right now we moved that money on 3/24/2019. A little further down under Other Assets – Assets not in Service, you see an amount of $222,000; compared to a previous year of $21,000. We will continue to see that rise with the construction of the new building. As we pay invoices for the new construction, they are going into this pot until construction is complete and then it will show up as a capital asset further up on the Balance Sheet. Any questions on page 1? There were none. Moving on to page 3 – the Income Statement – you will see that in February we had an increase in the revenue of 3.39% – that is a good thing, however you will see that I noted on the slide that Contractual Adjustments for the year are sitting around 55.5%. Typically we like to see that number in the 52 – 53 range. I think the budgeted number was right at 54. A lot of that has to do the cost report. We talked about it in the Finance Committee. This time last year we filed an Interim Cost Report to settle up the payments because we knew we owed Medicare money. I think it is the reverse in this. AR – the AR has remained steady over the past month – it is at 58%. If we look at the Salaries and Wages – we are up $500,000, but we did institute the 4% raise. We are doing well there and if you go to Employee Benefits and Payroll Taxes, we are under by $156,000 from this time last year. That is directly related to a reduced number of high dollar claims on the health insurance that we have at the hospital. It is doing what we need it to. Down in the Total Operating Expense, we are actually $39,000 less than the previous year and on the year we are only up 2.6% on the year from the previous year. Pretty strong numbers. In the Non-Operating Revenues, you will see the Sales Tax has been recorded. You will see the 340B revenue is right at $900,000 – that is $227,000 more than the previous year. We will talk more about this. There are some good things on that front as well. The bottom line a $19,000 profit for the month of February and on the year, $897,000. Are there any questions on the Income Statement? There were none. He noted to Helen Godfrey- Smith that we moved the building from Operating Other Miscellaneous account to below under Non-Operating. So that $372,000 line item on the bottom is that change. Moving on to page #5 – Departmental Schedule for the year. I want to point out when we are going down it, you can see that Routine patient Care is down slightly, but we will look at the Ancillary Services. All of the Ancillary Services that are more than the previous year and the month. This is February – the ER had a $75,000 increase in the month of February, and the OR, on page 6, is actually up by almost $800,000. We talked about Dr. Banda’s numbers, it is directly reflected in that OR number of $800,000. That is a significant increase in revenue that we weren’t realizing in prior years and especially with the new facility. Budget Comparison on page 8 – we had a very lofty budget goal. We set the goal for Gross Revenue quite high. It was something that we felt was obtainable especially after the year we had previously. We are still not too far off of it when you are talking $30 million budget right now – we are off by $1.3 million. The contractual adjustments are actually a little bit under what we budgeted, but you have to remember with less revenue you would expect a lower contractual adjustment. Hopefully those will start to come together. The bright aspects of this if you look at Salaries and Wages – $500,000 under budget; Employee Benefits and Payroll Taxes – a quarter of a million under budget and then you just continue down into the line items – Other Expenses – $100,000 less than budgeted. This is what we wanted to see. Where we lack in the Revenue and Contractual, we are making up for on the expense side which is good. Then we get down in the Non-Operating Revenue. We have the same case where our 340B Revenue is $150,000 over budget and that budget number was a pretty lofty goal especially for the 350B plan. On the year, $897,000 versus a budgeted $684,000, even if you were to back out that Willis Knighton donation, we are still pretty close to that number and I think we will be closer after that cost report is filed. Dakota asked if there were any questions on the budget. Mary Irvin said she has one question – under the Health and Fitness Center, it looks like that we had a substantial increase in that expense. Do you know what was purchased or is that just typical on the expense side of the Health and Fitness Center? I know I was there and I saw some new machines. Pam Hughes replied that we did buy some rolling machines but that should not be in that. Dakota said I will have to look up that number. Pam Hughes stated we bought some small items. Dakota said I will get you an answer on that. Dakota stated moving to page 9 on the Vivian Clinic income statement. It is pretty straight forward – for the month they had $25,417 profit and on the year right at $511,000. They have seen 16,912 for this year. At this point last year they say 14,808. Dakota stated just to remind them that our depreciation threshold is $5,000. If we purchase a piece of equipment that is $3,000 it goes directly to the expense in that month it does not get put on a depreciation schedule so a lot of times when the Board is aware of purchasing, you don’t typically see that show up as an expense in that month, you are seeing it depreciated out over 5 years or 3 years or whatever that is in smaller increments. But when the purchase is below $5,000 it doesn’t get depreciated. Mary stated if you haven’t been to the Fitness Center, she was there with her students, and we have some really nice equipment in there now. Pam Hughes stated a lot of it is still the same equipment, we have just refurbished it. Dakota Robinson stated on page 10 you will see there was a $31,000 profit in Plain Dealing Clinic and on the year a little over $50,000. In the Benton Clinic, you will see that there is a loss of $16,000. This clinic has significant potential with the 340B program. We are in the process of that. When you look at this number of a loss of $16,000, there is almost $8,000 in there that we had to pay to re-license this clinic and expedite it. We have to have this clinic licensed as a Provider Based Clinic by June 30th in order for it to go on the Cost Report and filed by 12/31/19. If it gets filed by 12/31/19, I can license that clinic January 1 as a 340B clinic. (Kenneth Clay arrived at 5:56 P.M.) Dakota said that completes the Financial report. Robert Green recognized Brenda Smith. Brenda Smith said I have a question about the Plain Dealing Clinic. She asked Dakota if he explained the extreme spike. Dakota said yes last month, remember we had some incentive pay for the providers that were paid in that and that is why you saw the dip and this month you see a profit. He said he would expect that in the next month for it to come down. Dakota said those clinics are very cyclical so you will typically will see a large spike in one month and that could be how they are working the AR and then in the next month it will typically come down. You are not going to see multiple spikes like that because the volume is not changing that rapidly in the clinic. Pam Hughes said that incentive was for a whole year also. Brenda Smith said that is why it brought it down so low. But then when it went up it went extremely high. Brenda Smith thanked Dakota. Robert Green asked if there were any other questions. There were none. Robert Green asked if there were any other questions or comments at the time for our Financials. If not he would entertain a motion for the approval of the Statistical and Financial Reports. 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, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. VIII. New Business – 1) Purchase of X-Ray Room and Mobile X-Ray / with MRI: Pam asked Melissa Martin, Radiology Department Director, to speak to the Board. Melissa Martin stated as Mrs. Pam said, we want to go digital. Going digital will increase our work flow, it will be more accurate, digital gives you a better picture. Right now we do CR – computed and it digitizes the images. We are asking for a new portable and a new room and as she said Medicare has started cutting reimbursement. All of our radiology equipment is Philips. I just want you all to consider improving all of this for us. Dr. Woods said he has had to come personally come and fix that x-ray himself to try to get it going and limping through another day. It is very prone to going down. You have to actually take the cassettes and put them in a machine and it pulls the cassettes out and it goes through these rollers and it is very prone to malfunction just because of all the moving parts. Granted, the service life of this thing – I remember having something very similar to this in the 80’s. Melissa said we brought that room brand new. We have had that room for 13 years. They bought it before I got here and I have been here 13 years. They just got it a few months before I came here. It has served us well. Even with our CT scanner. It was a refurbished unit and we bought it in 2010 so we have had it for almost 10 years. We spend a little money on it but not where you would say I need a new scanner. Philips is a good company and I trust them. Dakota Robinson said he is going to expound on what Melissa said. We use our equipment here at North Caddo pretty much to end of life. That could be a patient related device; as long as they are working and are safe. But it does reach a point, just like IT, it reaches a point that they just don’t make parts for it. It becomes a hassle for staff, maintenance issues. It is a good time to purchase everything together. You have some buying power that North Caddo typically does not have. So I think, for instance, I left this MRI analysis in your packet. That is what was presented at the last Board meeting, I just wanted you to have that in front of you all when we are referencing this type of purchase. There are three separate purchases like Melissa said. You’ve got the MRI unit, the X-ray Room and the mobile x-ray. Those are all three listed separately on top of this slide. The Diamond Select – the purchase price on that is $879,000; the typical purchase price on that is over a million dollars. By us lumping all three of these purchases in together we basically reduced the cost on these units all together. Not only the cost of the unit, we’ve also reduced the interest rate that when we capital lease these items, if they are approved, we’ve gotten better interest rates. When I made these slides this morning we had an interest rate of 4.17 they have since come down to 3.97. It is sub for interest rate and with all the negotiations that we’ve done, we have not been able to get around that number. Not only did they want Philips, we did out due diligence and bid it out to GE as well and Performance Medical we did the X-ray system. Performance Medical on the X-ray came in almost $150,000 over both GE and Philips. GE’s price came in under on the X-ray Room and the Mobile Unit, but since we are not currently on GE, we’re on Philips, they were going to have to renovate the room, which the renovation cost was almost $40,000 to redo that. It basically put GE in a higher price point than what Philips was. That is what we wanted internally; we still did our due diligence of getting the bids from all the companies and Philip’s came in as the cheapest. We are looking for an approval to purchase through a capital lease these three pieces of equipment. Obviously the X-ray systems could be delivered right away seeing that the rooms are already there and built. We would wait until the end of the third to beginning of the fourth quarter to actually take delivery of the MRI unit that is when they expect payment on that unit. In these calculations, the Foundation has done a remarkable job of raising money for the MRI unit and I believe that we’ve got about $300,000 that we can apply to the purchase of this unit. We would be looking at monthly pays with all three of those together of about a little bit over $15,000 after we adjust the interest rate. Dr. Woods said he had a question. Does the Mobile portion have flouro capability? Melissa Martin replied no. Mary Irvin asked what was that question? Dr. Woods said that would allow you to see in real time what you are looking at. You can look at bones in real time in the event you are trying to reset a fracture. It is handy. Robert Green said we have heard from Melissa Martin, and Dakota and we have the figures in front of us and also comes with a recommendation from the Finance Committee that we approve this purchase. I would entertain a motion. Brenda Smith made a motion to approve the purchase of the X-ray Room, Mobile X-ray and MRI from Philips as presented. The motion was seconded by Pat White. Robert Green asked if there were any further questions. He recognized Mary Irvin. Mary Irvin asked on the Foundation amount, you all have that worked out on how you are going to apply it. Dakota Robinson replied it is going to be applied directly to the capital lease for the MRI purchase. So there are going to be three separate issuances for capital leases they are not going to be lumped all into one. Typically when we make a big purchase with multiple things we will lump them all together. We felt it appropriate, since the Foundation is donating $300,000 that it is just a little bit of extra accounting work, we will do three separate capital leases and we will apply the $300,000 directly to the MRI so there will be no question as to what that money was used for. Robert Green asked if there were any other questions. He recognized Brenda Smith. Brenda Smith said she need to make sure that the last time with the Ambulance. Our Foundation, there was an issue with the Auditors on how it was done. When they bought the Ambulance. Dakota replied yes the bid law. Yes, on that they were trying to piggyback a State purchase. This was actually sent to Mary Carroll and she approved it. It is no different than the ultrasound. Brenda Smith said o.k., thank you. Robert Green asked if there were any further questions. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan. Abstain: None. The motion passed by unanimous vote in favor. Brenda Smith asked if they will bring the X-ray equipment first. Dakota Robinson said yes the X-ray will probably go ahead get that delivered to get that going and with the MRI, we don’t expend the cash or even create the loan until the MRI is up and running. Pam said we also needed to get this going because the room is being built for which MRI we get. We have to have the specs. Dakota said that is where the problem came last time in the audit. We got so deep in construction that they specked it for one unit and then when we got to bidding it out and looking at all the quotes coming back, we just was not done that way. We are trying to head that off. Dr. Woods said once they implement the digital x-ray that will help our work flow in the Emergency Room tremendously. There is a large amount of lag time with the antiquated equipment. The digital is just so much faster. Pam said it will be faster for the tech. Dr. Woods said the faster we will be can see what is going on with the patient a lot of times it makes a big difference in the outcome. Robert Green said it is on the way. Brenda Smith said she was curious – Dakota, is there anywhere on here that shows the total amount we saved by doing this. Dakota replied, no. That is a hard number to come from. They have list price but we never pay list price. I know through the process, we started with a machine that was right at a million dollars and by adding them together and negotiating through the phone and business meeting we’ve gotten the price to come down significantly. Brenda Smith said it looks like all three of them were at a million. Dakota replied when we started the building project we were fully expecting to spend one million dollars at least on a MRI unit. It was remarked good job on the negotiations. 2) Resolution #1 – 2019 – Adopt Ambulance Millage Rate 4.61 to 4.77: Dakota Robinson stated that the millage rate that was passed last month, we need to redo the resolution. It was done for a 4.61 mills and we had an address wrong. I am going to re-read this and we will re-pass this resolution at 4.77 mills. Resolution #1 – 2019 – Be it further resolved that the proper administrative officials of the Parish of Caddo, State of Louisiana, be and they are hereby empowered, authorized, and directed to spread said taxes, as have set forth upon the assessment roll of said Parish for the 2019 year and to make the collection of taxes imposed for and on behalf of the taxing authority, according to law, that the taxes herein levied shall become a permanent lien and privilege on all property subject to the taxation as herein set forth, and collection there of shall be enforceable in the manner provided by law. The millage will be set at 4.77 mills. I am looking for a Resolution #1 for 2019. Robert Green said he would entertain a motion. David Norman made a motion to adopt Resolution #1 – 2019 as read. Kenneth Clay seconded the motion. Robert Green asked if there was any discussion. Helen Godfrey-Smith asked why did he say it has to change; did he say. Robert Green asked Dakota. Dakota said the address and the mills went from 4.61 to 4.77 mills. Dakota said when we did the initial millage last year it was at 4.77 and through research I guess it was a typo on my mistake. It was done at 4.61 at the last Board meeting so I need to revise that to 4.77. It is at the same level it was the previous year. Helen Godfrey-Smith said o.k. Robert Green asked if there were any further questions. There were none. Robert Green called for a verbal vote: Helen Godfrey-Smith – Yes; Brenda Smith – Yes; Mary Irvin – Yes; Kenneth Clay – Yes; Pat White – Yes; David Norman – Yes; Robert Green – Yes. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan. Abstain: None. The motion passed by unanimous vote in favor. 3) Resolution #2 – To Hire a Firm To Seek Bids for Refinancing the Construction Bond: Dakota Robinson said as most of you all are aware we have a $24 million dollar Bond issuance and that is broken up into multiple different sections. When the initial bonds were put out there was a $5 million of those Bonds had to be acquired by a local bank. That local bank was Citizens National at the time. Since the bond markets have taken a hit and the rates have dropped significantly when you are talking large bonds like this, we have $4 million dollars left on this $5 million dollar issuance and 15 years. Mrs. Helen said she had a business contact that issued some bonds at 3.34%. Dakota said we know the rates are significantly lower. There are two ways to go about this. I made contact with a firm Raymond James Financial. They have a municipal arm of their company that deals with municipal finances through bonds. Our attorney, Foley & Judell, have actually worked with this broker and this firm and recommends them. Obviously there are fees associated with it. Those fees are only put into place at the closing of a bond. They are like an insurance broker. That is basically what I’m looking for. I’m needing a resolution from the Board that hires this firm to work with the Bond Attorneys to put out prospectus to all these banks to say here is all of our information, financially as North Caddo, what are you willing to do. What are you willing to issue these bonds for? Is it going to be 3 ½ %, is it going to be 4 % – what is that number. In the handout, I’ve said there is a savings, this is a savings after fees of $115,000 to $180,000 at the rate of 3.75% you would see that lower amount of $115,000 savings after fees and all that being taken out. If we were to get a 3.5 issuance – that would be about $180,000 savings over the life of the bonds. If we can down to the range of what Mrs. Helen had some bonds issued at or what the Bossier Parish Police Jury had bonds, we are talking well over $200,000 on these bonds by refinancing them. The State Bond Commission sets a threshold of 3%, so anytime we do stuff with bonds, the State Bond Commission has to basically put their blessing on it. If you would go to the next slide you would see the Resolution #2, you would see the wording in this resolution to “hire” Raymond James Financial and Foley and Judell to basically go out and get these rates. There is no fee on Raymond James to do this. This is just a resolution for them to go out and get these on our behalf. I have talked with Mary Carroll before this. She said this is very common. Helen Godfrey-Smith asked if we stay with Citizens and they determine that they were going to lower our rate, would we have to go through a full bond closing process with fees and all of that. Dakota replied no Ma’am. That would be the advantage of Citizens coming to the table. You are looking at between a $50,000 and an $80,000 fee to reissue bonds. When I’m talking $115,000 savings that is after the $80,000 has come out. The true savings before all the excess fees is over $200,000. Helen Godfrey-Smith said this savings really is the net savings after refile fees. Dakota replied yes Ma’am. There is Foley and Judell work that has to be done to change the interest rates, and just off the top of the head, Alan Offener at Foley and Judell, said $15,000 to $30,000 to do that and not actually reissue the bonds. So the best case scenario would be is Citizens would come down to the 3 ½ range, we would keep it at Citizens. I feel like that is fair to Citizens and we are giving them the opportunity but at the same time we are doing like we would do on an expense and getting multiple quotes. Robert Green asked what can I hear. Helen Godfrey-Smith asked did we send Citizens the request in writing or did we just call them. Dakota replied he called them with Tommy Boggs. Helen Godfrey-Smith said for future reference I promise you if you would send it to them in writing, they would respond. Dakota said he has responded but he told me that they don’t issue the bonds. He was making the calls to see if they could get it turned around. Tommy is the Vice-President. I do agree, in the future I will send an email to them. Helen Godfrey-Smith said she would. That would push them a little bit more. It is just a matter of a paper trail. Brenda Smith asked what exactly is Dakota needing right now. Dakota replied he is needing a resolution. It will be Resolution #2. Robert Green said he would entertain a motion. Helen Godfrey-Smith made a motion to approve Resolution #2 – 2019 that will allow the exploration of a more favorable bond rates. Pat White seconded the motion. Robert Green asked if there were any further questions or comments. There were none. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. IX. Administrative Reports – 1) Current Activity: Pam Hughes said if you came down the back street. You will see a lot going on. We actually have a wall put up in the ER. This is a permanent wall. They have been taking out some windows. They almost have the roof on the new part. They are going to pour cement after we get the roof on so we won’t have leaks. This construction company has been excellent so far. Any problem that I have had, all I have had to do is talk to the Job Foreman and it has been taken care of right then. We had a small problem yesterday. They didn’t realize the welding machine exhaust was getting into room #21 in the clinic. I went out there and told the Foreman and he profusely apologized. She told him it wasn’t a big deal, but can we move it and they moved it. They have just been wonderful. It is going up really good. It is looking like we are going to make the dates. The next part, they are going to be coming in, so it is going to be a little more difficult. So far it has been really great. When they were taking the bricks off the side that was kind of rough for a few days, but otherwise it has been really good. That’s mainly on the construction. Dakota did a bunch of pictures of the wall. They decided there was no point in doing a temporary wall when he can do a permanent wall one time. That is where our extra rooms are going to be. Everything is going really, really good, so far on the construction. 2) Foundation: Mary Coil said she had a little update. We had some Board members term off the Foundation. Justin Courtney finished his second term. A Foundation Board member can only serve two term. They will be off for a period before they can be asked back. Justin Courtney fulfilled his six years with us. He did a great job for our Board. Mark Farguson and Beck Hale fulfilled their first term and decided due to personal and professional reason not to re-up for a second term but really expressed their gratitude of how much they enjoyed the Foundation and the cause. I look for them to still be around, just not on meeting night. If you do see them, you will express to them what a great job they did for the Foundation. Also, we have welcomed one new Board member. She has not made her first meeting yet, but she has signed on. That is Mrs. Edie Festavan. She has been working with us. The Festavans were supportive before they moved back to Vivian of the Foundation. Of course, they have been so involved. Mrs. Edie helped us with the Gala last year. She worked really well with all the Board members. We are very excited to have her on board. We are talking about a few other names, so if there is someone you would like for us to keep in mind please let me know. Other than that we’re just on the ground floor of planning Havana Nights at the Petroleum Club on August 17th. Pam Hughes noted on the Employee Enhancement Committee, we’ve done very well. We have met and institutes some really neat stuff. That is going good. Also, in each of the exam rooms in all of the clinics, we have put a frame where we put advertisement up of Patient Survey Satisfaction. When people call you and you don’t know where they are calling from you don’t answer or just hang up. That is to let our patients know to expect a call to see your satisfaction. In each of the exam rooms in all the clinics is that information. We are going to change it out. Mary is working on things to change it out. Each room has a frame on the wall when you are going out the door. We cannot put anything on the door because they are fire proof doors and you can’t put screws or nails in them so they are on the wall. At the Plain Dealing Clinic we have an informational TV in the main waiting room. We implemented it at the Plain Dealing Clinic going live today. It has advertisement on it such the Fitness Center, our X-ray and MRI scrolling on the screen. We chose to do that instead of a TV because it’s been difficult having a TV there. We are going to put one in Benton also. We are waiting on Benton since the internet is slow. They are upgrading their internet in the whole town. When we get the faster internet we going to implement that there, too. That is another form of advertisement for us right here at home. Robert Green asked Mary Coil her or someone from Administration to get a letter thanking the Foundation Board members that are going and those that decided not to go to a second term and welcoming the new Board members that he could sign on behalf of the Board. Mary replied yes Sir. X. Medical Staff Report – 1) Recommendations – Dakota Robinson: MEDICAL STAFF APPOINTMENTS: Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval: MEDICAL STAFF APPOINTMENTS: 1) Richard Owings, M.D. – Requests Provisional Privileges in the field of Pathology for the period of March 26, 2019 through March 31, 2020. MEDICAL STAFF REAPPOINTMENT: 1) Steven Lengle, M.D. – Request Courtesy Privileges in the field of Radiology for the period of March 26, 2019 through March 31, 2020. 2) William Liles, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of March 26, 2019 through July 31, 2020. 3) James Turner, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of March 26, 2019 through February 28, 2021. 4) Thomas Siskron, M.D. – Requests Active Privileges in the field of Pathology for the period of March 26, 2019 through December 31, 2020. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: None. EXTENSION REQUEST: None. VOLUNTARY RESIGNATIONS: 1) Kenneth George Harrison, M.D. – Voluntary resigns his privileges for Pathology effective 02/28/2019. Helen Godfrey-Smith made a motion to accept the Medical Staff Appointments, Reappointments, and Voluntary Resignation. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. 2) Chief of Staff Comments: Dr. John Woods, Chief of Staff, said everything seems to be going quite well considering the construction. Some patients kind of find it hard to find the ER through the gauntlet but they manage and once they get the hang of it they are good to go. Believe it or not it is almost time for fresh new set of Residents. That is coming up soon. It goes fast. We have had some really good Residents this year. I will be losing a couple and gaining a couple; it is just a cyclical thing. Hopefully we will maintain good Residents. We have been really blessed. They have all been really hard workers. Dr. Woods said that is all he had at this time. Robert Green asked if there were any questions. He thanked Dr. Woods. XI. Executive Session: Robert Green stated he would entertain a motion to enter into Executive Session for Strategic Planning. Brenda Smith made a motion to enter into Executive Session for Strategic Planning. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. Robert Green noted there will be a brief break prior to entering into Executive Session. The Executive Session was entered into. No action was taken during the Executive Session. Mary Irvin made a motion to enter back into regular session. Brenda Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. XII. Adjourn: There being no further business Kenneth Clay made a motion to adjourn. Brenda Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Cochran, Ronnie Festavan Abstained: None. The motion carried by unanimous vote. Meeting adjourned at 8:30 pm.
NORTH CADDO HOSPITAL SERVICE DISTRICT
North Caddo Medical Center
David C. Jones, Secretary
Approved by the Board of Directors at the regular meeting held April 23, 2019