BOARD MEETING:  Regular Meeting   DATE:  May 22, 2018    MEMBERS PRESENT:  Robert T. Green, Jr. , Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Patricia White.      MEMBERS ABSENT: None   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. Catherine Sharpe,  Mary Coil, Foundation Executive Director/Marketing Director    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 T. Green, Jr. offered the Invocation and David Jones led the group in the Pledge of Allegiance.      Robert T. Green, Chairman, noted that David Jones will be introducing our guest in the event she may need to leave.  David Jones said that she tried to meet everyone prior to the meeting. In case anybody didn’t get to meet her directly, this is our newest attending physician beginning July 1. – Dr. Catherine Sharpe. She will be primarily taking Dr. Taylor’s practice in doing O.B. and Family Practice. Dr. Taylor will be transitioning to the Emergency Room.  He wanted everyone to meet Dr. Sharpe. Everyone extended a warm welcome to Dr. Sharpe.     III. Approval / Amend Agenda –   Mary Irvin made a motion to approve the agenda as presented. Ronnie Festavan seconded the motion.    The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: Kenneth Clay    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 April 24, 2018 – The minutes of the April 24, 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.  There were none.     David Norman made a motion to approve the minutes of the Regular Meeting held on April 24, 2018 as mailed.      Bruce Walker seconded the motion. Robert Green asked if there was any discussion or any corrections that need to be made before we approve the minutes. There was none.  The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: Kenneth Clay   Abstained:  None. The motion passed by unanimous vote.     VI. Old Business – 1) Radiology and ER Expansion Update:   David Jones stated he had a handout to give them. He just realized that it is sitting on his desk. They, the Estopinal Architect Group, have hit their targets. They should, within the next two weeks, actually have all the construction documents complete and they will submit those to the USDA for approval and then on to DHH for approval after that.  It is really a hurry up and wait situation after that. You are at their mercy on where ever we are in line for them to review to make sure the documents are o.k.  We will know exactly cost wise what we have going on and if we need to readjust plans.  Robert Green asked if he had something to give them. David Jones said yes but he does not have it with him.  Robert Green asked if anybody would like to have that before they leave.  David Jones stated that he can email that to them as soon as the Board meeting is over or he could go to his office and get it right after the meeting.  He said it is an updated timeline. Updated with were we are now.  Brenda Smith said emailing would be fine with her.  Robert Green asked again if anybody would like to have that before they left tonight.  Pat White asked if she could have a copy before she left.   Ronnie Festavan asked to be recognized.  Robert Green acknowledged Ronnie Festavan.  Ronnie Festavan asked if we are still pretty much set on what we are going to do. Have there been any changes or anything like that. We have a plan in place?  David Jones replied yes Sir.  Ronnie Festavan – We are pretty well set with that plan. We are basically waiting to see what costs are going to come in after the 60 days. A lot will depend on the bids, he assumes.  David Jones replied absolutely. It will pretty much all depend on that at the time.    Mary Irvin inquired about the blueprints that they saw a three or four months ago – are they still the same? David Jones replied that they moved a door but nothing major changes at all.  Ronnie Festavan thanked Mr. Chairman.  Robert Green noted it is subject to bid and then we may have to make adjustments. David Jones replied that is right.  Mary Irvin said if you got the newsletter there was an informational article about what is going on. She doesn’t know if that has been put in the Caddo Citizen or anywhere else, but if you haven’t read the newsletter it explains what is going on – making way for the MRI.  David Jones stated that is the Foundation Newsletter.  Ronnie Festavan asked Mary Irvin when she got the newsletter. She said it has been a while.     Robert Green asked if there were any other questions on this matter. There were none.      2) Opioid Litigation Suit Update: David Jones noted as a quick update, we did engage the firm and joined the suit going against the pharmaceutical companies that created the Opioid Crisis, or certainly helped to create the Opioid Crisis.  This could take years to complete. He wanted to give the Board a quick update to say that we had followed through and engaged them. They will be asking for information as time goes on trying to get a figure because we are somewhat unique being a healthcare provider and a quasi-governmental healthcare provider. In his opinion, it probably cost us far more that individual situations because of the Emergency Room.  Robert Green asked if there were any questions.  (Kenneth Clay arrived at 5:42 p.m.)     Brenda Smith asked if she is correct that there are other people now who are doing lawsuits against them; other entities. Not just this lawsuit but others.  David Jones replied yes. He said there will be multiples.         3) Linen Contract Update:    David Jones asked Dakota Robinson to give an update.  Dakota Robinson noted that after the last Board meeting, after the approval to switch companies, our lawyer, Doug White, sent certified notice to Aramark about the termination of the contract within the window that it was supposed to be sent. He thinks the date is July 27th that we will turn over to ALSCO.   Robert Green asked if there were any questions.  There were none.    VII. 1) Review April 2018 Statistics – Dakota Robinson:    Dakota Robinson noted that each Board member should have a packet with the statistics in it.  This month you will see a trend throughout the financials. It was the lowest number of admissions in the quarter at 53; Swing Bed was up slightly from last month with 12 admissions.  Newborns – there were 4.  In-patient Days – you see a 4 month downward trend – 148 in-patient days. This is the time of year that Mr. Jones addressed in one of the documents that he prepared. The end of flu season has come and it is summertime – things are bright and sunshiny – people don’t want to be in the hospital.  This is the trend that you will see if you look back historically. The Average Daily census goes hand in hand with the other ones at 4.9. There were 9 Endoscopies last month. We had 11 surgeries – we are still over the 10 threshold which is very good. Emergency Room visits are 505.  The threshold over the 500 mark is what we are looking for. This goes hand in hand with the ER expansion that we have talked about constantly. Mammography is the highest in the quarter at 29. Medical and Surgical visits dipped a little bit at 1875. This goes hand in hand with in-patients.  You see the spike in Medical and Surgical profit and loss. This is due to some contractual adjustments.  You saw it in last month where there was a loss of $63,000. That was a large write off of accounts and you always see that adjustment in the contractual percentages the following month. That is why that spike has gone up. When we get to the financial statements he will show you the line item to look at on the clinic income statement and that will explain it a little bit better.  Plain Dealing saw 657 patients. They had a slight loss of $2,768. For the year they are still in the black.  Benton Medical, once again, saw their patient number rise to 408. That is a big achievement. They had a profit/ loss once again. You see the spike here the same you do in the Vivian Clinic. There was a write off of accounts and you see the contractual adjustment affects this number of a $20,000 profit last month. Days Cash On Hand shot to 62. He checked the bank accounts today. This is a little bit old data today. Unrestricted accounts are about $3.5 million, adding the restricted accounts back it is over $4 million. That is a significant difference from a year ago today. In that the reason we saw such a large jump, every once in a while Medicare/Medicaid will do an interim cost report separate from us. They will do a lump sum adjustment where they think we have been overpaid or underpaid.  That is part of the reason why this shot up so much in one time period.       If you will go to the profit/loss you will see a loss of $638,000. He will get more in detail on that when we talk about the Financials.  The AR days are holding steady at 50.  The Fitness Center memberships – 413. Are there any questions related to the slides.  Ronnie Festavan asked if there is any reason for the increase in the Fitness Center memberships that we know of.  Dakota replied not that he knows of but he can ask.  Ronnie Festavan said he was just curious that when you see something like that go up that has been pretty static for a while.  Brenda Smith said she noticed that from December to January. It is strange to see a jump that big at this time of the year.  David Jones said it never came then all of a sudden there was an influx of some 30 members.      Brenda Smith asked to be acknowledged.  Robert Green acknowledged her. Brenda Smith asked when Dr. Banda came on and started doing surgeries.  David Jones said he thinks it was October.   Brenda Smith said we went up to 10 surgeries in October and it has been steadily rising since then.  She remembers it was a big thing we talked about after getting the hospital completed was to utilize those surgical suites.    Brenda Smith said when you were talking about line item, she is thinking since that was a push that we went toward to get another source of revenue coming in, she was curious as how it has changed things since Dr. Banda came on board.  You can actually see the trend. That is a trend in numbers but the trend in dollars is probably the same thing.  She thanked Mr. Chairman.    Ronnie Festavan asked for clarification, the Fitness Center numbers are a reflection for as of March, but our paperwork is a reflection of April of 427, that would be an even more significate increase – almost 47 more.  Dakota said he would verify that. It should be correct.    Robert Green said he has a question about the Fitness Center. He knows we have a 24 hour access. What if something happens in there? Could the police get in there?  Pam said they have a code to get in.  She noted that it is a generic code for them. The radio dispatcher can tell them.   Robert Green said that is good to know.     2) Review April 2018 Financials – Dakota Robinson – Dakota Robinson stated he is starting on page 1 of the Financial Report. In case, the $3.35 million represents the 62 days cash on hand. Speaking about cash, at the last Board meeting the Board approved the setup of the USDA Reserve and Contingency Account. You will see that reflected in Assets Whose Use is Limited.  That is $23,000 in each account and each month you will see those accounts increase over the next 25 years in increments. That is an automatic increase that we have to put those back to match the bond documents. Those are the main things on page 1 and 2 that he wanted to point out before we get to the meat and potatoes on page 3 – the Income Statement.  You will see here, underneath Revenue, you have contractuals of $2.6 million dollars. That is very high for a one month time period. That is comprised of two main adjustments. The first being the interim cost report that we talked about at the last Board meeting of about $650,000. That number is booked directly into that contractual amount because we owe it back to Medicare. It is funds that we received that we were not due.  That was from the time period of July 1 to December 31st.  From January 1 to April 30th we had to make some assumptions. We took the percentages from the interim cost report and applied them to the payments that were made by Medicare. We knew that we were overpaid, which the numbers showed. It was amount of about $350,000. We added all of those together and that is how we got the extra contractuals to book into this number. That is why ultimately at the end of the month you see a net loss on the month of $638,000. It is because of the contractual percentage number that we increased significantly.  Helen Godfrey-Smith asked if she was clear that we should not have to make another contractual adjustment possibly before the end of our fiscal year. Dakota replied correct. He said we can never know for certain unless we file a cost report, obviously. But yes, we should be much closer at the time we file the cost report than what we would have done if we had waited until July.  The audit came, the cost report came and now we booked this $1.2 million by then; a million dollar contractual adjustment. That is the correct accounting. Once we get any kind of estimate in, whether it is revenue, expense; if it is an estimate accounting says that we have to book that into the financial statements, because it is reasonably estimated.  Ronnie Festavan said we get those in from them and you term them as guestimates?  Dakota replied the first part, the largest part, the $650,000; that is not a guestimate we actually filed an interim cost report with Lester, Miller and Wells where they pulled interim data from the first part of the fiscal year to December. Those are set in stone. We owe that money back. It is to the dollar. After that, from January 1 to April 30th, that is where we throw some estimations in there. We use percentages from the first six months of the year, applied them to the last four months and that is how we got what we think we have been overpaid.  Ronnie Festavan said so that process, that goes on how many times in the course of a budget year. Dakota replied that it actually fluctuates. It depends on if you see fluctuations in your revenue. This year we saw large fluctuations in revenue. That is an immediate light bulb that says hey, we need to check this. Chances are that we are overpaid if you keep the expenses the same but you see an increase in revenue, because it is costing you less per Medicare patient to treat them, and vice versa, if you see a drop in revenue or patient days that significant but your expenses are remaining the same, then you should file one also because you have probably been underpaid.  Ronnie Festavan said that is just a moving target that you have to deal with from time to time.  Dakota replies absolutely.  We have done it in the past when we rolled on new depreciable assets, the building here, we were putting on $10 million dollars on the depreciation schedule. When you look at this throughout the year, you see the depreciation now is about a $139,000 a month, where that number used to be $60,000. We had an increase in expense. That means that the cost to treat per patient increased. There is a lot of different things that you have to look at to see is it worth filing that. It cost time and money to do that. We have a pretty good meter on whether we should or should not. Ronnie Festavan said that is what is important that you do and he trusts that you do. Thank you. Thank you Mr. Chairman.   Dakota continued by noting that he will go down salaries – down $100,000. This, once again, goes to their push to cut salaries and wages when we were in a financial strain. Depreciation, once again, is $139,000 and interest expense at $105,000. Those are two large pieces of this puzzle that we are not used to having and that will continue to be there. 340B revenue – $91,000. Not quite as high as it was last year. But when you look at patient volumes in the hospital, that is a correlation, those two are directly related. The less number of patients you have, the less prescriptions that are going out the door.  Dakota asked if anyone had any questions on that page. That was a lot this month.   If not, we will go to the Direct Departmental. If you look over the Direct Departmental list, he believes that there were only three departments that were not in a better position than they were last year. Once again, it goes back historically, this was a good month compared to years prior.  Helen Godfrey-Smith asked Dakota if it was possible that the 340B decreased after the Finance Committee meeting. Dakota replied that he did not think there was an adjustment there. He knows there were some moving targets that information wasn’t in but he does not believe there was an adjustment.   He asked the Board to turn to the Budget page #7.  The initial budget predicted over 10 months an increase in net assets of $405,000. We saying there is an increase of $1.3 million. The largest difference comes in an increase in gross revenue of half a million dollars and if you look at the contractual adjustments, this factor, when we look at the budget, this is a large, large number and at the beginning of the year is an estimate. We are within $29,000 as of this month on the contractual adjustments. He feels that was a good ballpark on the budget. Salaries and wages, once again, at the 500 number.  If you go down the list each and every category, except employee benefits and taxes, is down. We have seen significant increase in cost for the health insurance. We tried to mitigate some of that this year with some changes on who is eligible, who is on the plans, and we feel like we’ve done a good job of restructuring it to shield us a little bit from that being an even higher number. The UCC accrual is in grant revenue of $165,000. $1.3 million over 10 months is a significant difference from this period last year.  If you will turn to page 8 – this is the Vivian Clinic income statement.  Look at the contractual adjustments – it only has $9,743 on it. That is because there were large adjustments in the prior month to bad debt or write off accounts. What that does, it reduces the total outstanding accounts receivable. We have to make adjustments to those accounts which put us at $218,000 profit for the month and $323,000 on the year. They are definitely operating in the black. The same thing with the Plain Dealing clinic on page 9; they are $59,000 in the black even with the $2,700 loss in the last month. The last one, Benton Clinic, they had the same type of adjustment going on in the contractual adjustment account. They still have not received their increased reimbursement rates due to the reclassification to an RHC (Rural Health Clinic).  He asked Pam Hughes if she had any information. She said she has received the Medicare number and she is waiting on DHH to tell her what the rate is.     Ronnie Festavan asked to be recognized. Robert Green did so.   Ronnie Festavan asked Dakota to tell him, and maybe Mrs. Hughes might have addressed this; you asked what we were waiting on and she said yes we are waiting on that. And there was some conversation there – tell him what is going to happen when whatever we are waiting on gets here.  Pam Hughes replied the Department of Health and Hospitals sets our rate for Medicaid and Medicare patients. What they do, they average it. They take so many rural health clinics in the area and do an average. That will be our rate that the MCO’s, Medicaid / Medicare has to pay us. Then, when we do the cost report at the end of the year that will be our real rate. Determined on how much it costs us to see the patient. In the meantime, we are waiting on the Department of Health and Hospitals to set that rate.  We have our Medicare number, all the letters have gone to the Department of Health and Hospitals waiting for them to tell us how much.  Then at that point she will send those letters to the MCO, which are the Medicaid carriers. They will pay us at that rate that the Department of Health and Hospitals has set. David Jones asked Pam what is the average right now, Medicaid rate, per patient. Pam said right now if we were a provider base – David Jones said he is talking about our current one right now, what we got paid yesterday. Pam Hughes replied $34. David Jones what possibly could it go up to. Pam replied it could go up to $155. David Jones stated that is a massive difference and that is per patient per visit. Ronnie Festavan said let say that happens. Dakota Robinson stated that what you will see on your financial statements the only changes that you will see is in that contractual adjustment line. They will be contractually adjusting off a smaller amount of accounts. That number will shrink, thus giving you a higher profit.  Ronnie Festavan said his concern is the bottom right hand number.  If you are losing money somewhere you try to figure out why you are losing it. That makes sense. And that should help and then we get into all of the other things you explained will now apply to the Benton Clinic.  Dakota replied correct. Dakota stated once that clinic goes live it becomes part of the cost report, which then means in turn we can turn it on for 340B.  It would not show up on this set of financials but it would be a lump sum in the 340B accounts if we can get them 340B eligible like our other clinics.  Ronnie Festavan thanked the Chairman.  Helen Godfrey-Smith asked to be recognized. Robert Green did so.  She stated if she is hearing correctly, all of our other properties will be reimbursed at the higher amount which is the rural health level. Pam Hughes replied yes. Helen Godfrey-Smith said this won’t be like millions of dollars until that clinic grows but it will be some revenue. It is just that one piece right now that is not being reimbursed at the higher level. Ronnie Festavan asked when do we anticipate that will come in. Pam Hughes said she looks for the rate letter any day. Then she has to get the MCO’s credentials.  Ronnie Festavan asked if you will put that in process as soon as you get that letter. Pam Hughes replied that they have already put it in process to get the new Medicaid number. You have to get a new Medicaid RHC number. She will then send that letter out and they will set our rate and start paying us at that amount. Ronnie Festavan thanked Mr. Chairman.  Brenda Smith asked if there will be any retroactive pay. Pam Hughes replied no ma’am.   Robert Green, Chairman, asked if there were any other questions of Dakota regarding the Financials. The Board expressed their appreciation to Dakota for his report.  There were no further questions or discussions regarding the Statistical and Financial reports.      Pat White made a motion to accept the Statistical and Financial Reports as presented subject to audit. Brenda Smith seconded the motion.    The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: None.  Abstained: None. The motion passed by unanimous vote.       VIII. New Business – None.       IX. Administrative Reports:  – 1) NCMC – Current Activity:   David Jones, from the bottom of his heart and on behalf of the employees, wanted to thank the Board for their participation in Hospital Week. It was a massive undertaking. There was a committee formed and Mary Coil took point in doing a lot of the activities there. He wanted to give her some thanks from the Board. Once again, the snow cones were a huge hit. Mary stood out there about the entire time. There was a pretty big line for the most part for the entire time. Everybody came out. It culminated with the largest water balloon fight that has occurred in Vivian for quite some time. We came up with a way to raise money for the Foundation.  All the department heads and Administration had jars out. He is proud to say that he was not the highest garner of money, but the five highest were to line up and then we did a food drive. If you brought a can of food you got to get a water balloon and a chance to throw it at one of the people lined up. We raised quite a bit of food for the local food pantry. He asked Mary Coil how much money did we total was that was raised.  Mary Coil replied $850. It was fun. Mrs. Hughes threw way too many balloons – she almost threw her arm out.    He can’t tell you how many employees he has had to talk about that since it happened. They did a dunking booth several years ago. It really had that kind of feel to it. There was a line of employees at the dunking booth that almost stretched to the street at the old hospital. It was a lot of fun for everyone.  Mary Irvin said just a quick side note, employees that were waiting to get snow cones; she interacted with a lot of them. They thanked her, saying wow thank you all so much, speaking to them as a Board. They were very appreciative of the Board.  She thanked everyone who participated in that and we are passing our funds to Mary Coil.  David Jones stated it is good to have a week. It is not the easiest job sometimes. No one is real happy about going to the hospital or seeing a doctor, or being stuck by a nurse or by a lab tech or whomever. Dealing with death and those kinds of things, it is certainly good to have an opportunity to let off some steam.     Mary Irvin noted that they did take slushies to the night crew. They went to Sonic and got slushies for every employee. They took them to the crew on a cart and they were very appreciative.   David Jones stated that was all he had on current activity.       Brenda Smith inquired if there was an update on Fresenius? She was just wondering.   David Jones said they are open for business for insurance patients. It is not going to be as long as it was thought for them to be open for full patient access. He asked Mary Coil if she knew of any grand opening ceremony plans. She stated she did not. They want to wait until they get their Medicare/Medicaid approval.  David Jones stated that there is one patient in particular that he is trying to get to speak at that Grand Opening. In his opinion, he was at the forefront of trying to get this unit set up. He is also a patient and a local community leader and he thinks it would be great.  He told Robert Green he may need his help to convince him of that.   Brenda Smith asked to be notified when that is planned.    David Jones replied absolutely.      2) Foundation:     Mary Coil thanked the Board for sponsoring the snow cones for the employees. They said this is always their favorite.    For the Foundation, she sent out letters for sponsors to ask for sponsorships of the Gala. We are receiving activity already. Basically, the very next day we were receiving payments for sponsorships. We are very excited to see that come through.  She is spending some time with the Gala Committee. This consists of people that are Board and non-board members who want to participate and help to plan the event and the different things that come with it. We have had a couple of meetings. It is rocking along and the announcements will be in the mail this week and tickets are available. Just see her and she can fix you up with that.  Helen Godfrey-Smith asked how much the tickets were. Mary Coil responded that the tickets are $100.  She has laid out a cover letter and a sponsorship form, whether it be for you or someone you know that would like the opportunity to be involved with the Foundation and we would appreciate it.      She noted that this is not regarding Foundation, but Mr. Jones wanted to get shirts for the Board. She is going to need everyone’s shirt size.   Helen-Godfrey Smith said she brought a sheet to put everyone’s information to help out.  Pat White said they had received a notice regarding the retreat they were talking about shirts. Helen-Godfrey Smith said this is the same. Helen Godfrey-Smith said Pat White was the only response that she received.  There were others that stated that they did respond.  Helen Godfrey-Smith said she apologized that she overlooked those.        Mary Irvin said if she could tag on to Mary from the Gala.  The following day we leave for our trip to the Conference. As of right now, she thinks there are three Board members committed and one Board member coming for the North Oaks portion. She just wanted everybody to know that is still available for a few more weeks.        X.   Medical Staff Report  –  1) Recommendations  –  Dakota Robinson:     MEDICAL STAFF APPOINTMENTS:   1)   David Hilton, M.D. Request Provisional Privileges in the field of Sleep Medicine for the period of May 22, 2018 through May 31, 2019.     MEDICAL STAFF REAPPOINTMENT:  1)   Robert Williams, M.D. Request Courtesy Privileges in the field of Pathology for the period of May 22, 2018 through March 31, 2020.    2)   Thomas Vreeland , M.D. Request Courtesy Privileges in the field of Radiology for the period of May 22, 2018 through May 31,2020.  ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:   None.      EXTENSION REQUEST:         None.      VOLUNTARY RESIGNATIONS:  1)   Russ Savit, M.D. Voluntary resigns his privileges for Radiology effective 4/31/2018.     2) Ann Tran, M.D. Voluntary resigns her privileges for Radiology effective 05/31/2018.        Pat White made a motion to accept the Medical Staff Appointment, Reappointments and Voluntary Resignations.   David Norman seconded the motion.     The vote:  Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: None.  Abstained:   None. The motion passed by unanimous vote.        2) Chief of Staff Comments:  David Jones noted that Dr. Woods was off today and had a family function to attend. He asked David Jones to tell the Board that it is all good.   Robert Green asked if Dr. Woods has an assistant.  David Jones replied that Dr. Nicole Mc Common is his Vice-Chief.  We are trying to get her more involved.               XI. Executive Session:   Robert Green stated at this time we are down to Executive Session for Strategic Planning.    Kenneth Clay made a motion to into Executive Session for Strategic Planning with a short break before entering into the session. Mary Irvin seconded the motion.      The vote:     Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: None.  Abstained:   None. The motion passed by unanimous vote.        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.   Mary Irvin seconded the motion.   The vote:   Yeas:  Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: None.  Abstained: None.   The motion carried.      XII. Adjourn:         There being no further business David Norman made a motion to adjourn.   Mary Irvin seconded the motion.   The vote:    Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker, Pat White.  Nays: None. Absent: None.  Abstained:  None.  The motion carried.          Meeting adjourned at 8:30 p.m.





North Caddo Medical Center

Vivian, Louisiana





David C. Jones, Secretary



Approved by the Board of Directors at the regular Board meeting held June 26, 2018