BOARD MEETING:  Regular Meeting   DATE:  April 23, 2019    MEMBERS PRESENT:  Robert T. Green, Jr., Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Patricia White.      MEMBERS ABSENT: Ronnie Festavan, Mary Irvin (Arrived at 4:43 p.m.), Helen Godfrey-Smith. TIME CALLED TO ORDER:  4:07 p.m.   OTHERS PRESENT: David Jones, CEO,  Pam Hughes, COO, Dr. John Woods, M.D., Chief of Staff, Mary Coil, Foundation Executive Director/Marketing Director, Walter D. (Doug) White, Hospital Attorney, 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.  David Jones led the group in the Pledge of Allegiance.    III. Approval / Amend Agenda – Brenda Smith made a motion to approve the agenda as presented. Pat White seconded the motion. The vote: Yeas: Robert T. Green, Jr., Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White.   Nays: None.   Absent: Ronnie Festavan, Mary Irvin, Helen Godfrey-Smith. 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 March 26 2019 –  The minutes of the Regular Meeting held March 26, 2019 were mailed prior to today’s meeting for review.    Robert Green stated he would entertain a motion to approve the minutes.  Pat White made a motion to approve the minutes of the Regular Meeting held on March 26, 2019 as mailed.  Kenneth Cochran seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White.   Nays: None.   Absent: Ronnie Festavan, Mary Irvin, Helen Godfrey-Smith.   Abstained: None.   The motion passed by unanimous vote.  VI. Old Business – 1) All Scripts Interface Update – David Jones said we have been a little more aggressive with our computer software vendor who has been dragging their feet and giving us one excuse after another why this has not been done. Supposedly their programmers are way behind and they’re low staffed and this and that. We escalated it up to some of the executives at Cerner. There was an email that Ross received today that basically was what their kick off to write the program. The one that we ordered in November 2018, they are just getting their kick off ready. What makes it more frustrating is Allscripts, the other half of the interface, they are ready to roll. They have written their portion. They have to program their data coming in one area and the Cerner programs the data and then they see if it all mixes together. They have been ready to test their side for months, waiting on Cerner to get theirs ready. This is a multi-billion dollar company that has one little customer who is trying to be a squeaky wheel. Plus, we did lose our customer service rep. at the time who had a little seniority. We have had up to six customer rep in the six or seven years we have had this system. It is one of those positions they turn over and over again. We have escalated it up the line and we have been told how unhappy we are at the current level of service that we are receiving from them. Hopefully that will get a little further down the road with this. We are still continuing on doing what we were doing. It is not our best practice. Brenda Smith asked to be recognized. Robert Green did so. Brenda Smith asked if there were some things that were not functioning; the programs are not doing what we want. David Jones said we are having to manually enter in all of the information plus it’s causing the doctors have to multiple times check off something or the chart itself won’t close like it is complete. It is actually burdening the doctors a little bit more in the clinic. If someone in the Laboratory inputs in high or extremely low that is not a problem because it will flag it. What you are worried about is if it is a low or a high value that they transpose two numbers and turn a 413 glucose into a 143 glucose. If Dr. Woods sees a 143 glucose it doesn’t necessarily mean a whole lot to him. If he sees a 413 therefore he wants to do something with that. That’s what we are worried about happening and that’s why it is best to take the human element out of it and let the machine talk straight to the computer so you don’t have to worry about any of that. Brenda Smith said this is the way it has been for a while so it is nothing new to them to have to do this. David Jones replied correct. Dr. Woods said you are trying to get two data bases to talk to each other and there has to be an interface built and it seems like Cerner is just dragging their feet. Brenda Smith said what I’m saying is the other is working like it was before we are not having to do any extra or do anything to cover our tracks in any way because there is not a part of it that is not functioning. It is just still tedious. David Jones and Dr. Woods both replied yes Ma’am.  Dr. Woods stated that is mainly on the clinic side.  2) X-Ray Room and Mobile X-Ray Update – David Jones noted that the X-Ray Room and the Mobile X-Ray will be in long before the MRI unit is in because there is no room for the MRI to be installed right now. They are in line to order it. He talked with Melissa Martin, Director of Radiology, and she said probably is going to be up and running in June to late June or early July. Once they install and upgrade everything there is a training level that has to be done. They are having a kick-off meeting next Tuesday or Wednesday to get an exact timeline down as to what it will look like. That was her best guess. Robert Green asked if there were any questions. There were none.  VII. 1) Review March 2019 Statistics – David Jones: David Jones asked the Board to bear with him because Dakota does such a good job with this it actually kind of intimidated him a little bit following him up. I used to do these before we had Allyson start doing them. Dakota has taken over and taken it to another level. Statistically March was one of the busiest month we had of the year. Typically January or March are one of our two biggest months of the year anyway. All across the spectrum of the hospital from inpatient to outpatient, Plain Dealing, Benton. The one thing that was down a little bit for the month, and we will go into that a little bit later, was the clinic. There is a very legitimate reason for that. The ER was extremely busy as I’m sure Dr. Woods can attest to. Moving through our first slide. From an admission standpoint, you can see the 78 matches the highest month we have had with the nine months that are on the chart. As you can see the 78 equals September. September was an unusually busy month as well. Of course the admissions high, inpatient days are reflective of the same. There were 279 and in September you had 280 which were our two highest admit months of the year so far so you can tell the days are very similar to that. The Average Daily Census, of course, those three slides coincide each other. Our average census was 13 patients per day. It is very hard to imagine what .6 of a patient looks like I figured it would be alright to round. There were 6 surgeries for the month. We had a little hiccup with Dr. Banda for early in the month of March we got everything lined out. Dr. Banda is now a contracted surgeon for us. The likely hood of him going anywhere has been pretty much eradicated thanks to the efforts of Dr. Woods and himself and the Contract Committee. David Jones said he believes that Dr. Banda did 5 last week and he knows there were some lined up for Friday and he did some on Wednesday. He had not done a Friday day in quite a while. He did the first amputation that has been done in quite a while. Dr. Woods tends to find quite a few of the surgeries coming through the Emergency Room. Dr. Woods said we used to have to send them South and now we are able to do them here. David Jones said our surgical numbers for the year are probably what six or seven years combined used to look like here. From a statistical standpoint, I think year to date our surgeries, inpatient and outpatient, are at 91 so far. You could probably add at least six or seven years together and not get those numbers. On the next slide, scopes had a little dip for the month but also for the year, we are 15 ahead of 2017-2018 for the year itself. Dr. Mc Common had three or four scopes, alone, last week. She and Dr. Taylor are the only two that does them. Dr. Taylor does a rare one now. Dr. Mc Common has taken over the practice of doing the majority of our scopes. There is a different test that is used for screening instead of a screening colonoscopy. Dr. Woods said you have probably seen it advertised on TV. It is called Cologard. It is cancer DNA test that comes from a stool sample. Kenneth Cochran asked if it is an identifier. Dr. Woods replied it can tell you are shedding DNA cancer but you are still going to have to have a procedure done. It is set for patients that are very leery about doing a scope at all. At least it is a good screening measure that will reinforce you really need to get a scope because a scope is the only way you can actually identify and remove them. David Jones asked Dr. Woods what age you should start. Dr. Woods replied over 40. Dr. Woods said he thinks it is a good idea. It has been around for a while. It is one of the most preventable cancers that you can absolutely take care of. David Jones said even though we had a dip for the month we are actually 15 ahead of the pace we had set for last year. Emergency Room visits, you can see that we had one of the highest months of the year – 562. I don’t know what April is looking like ER wise. He asked Dr. Woods if he had a guess. Dr. Woods replied no but it has not slowed down. David Jones said you can see February and March – February you take three days that you could have added to it or it probably would have had even more than March. February and March both were extremely busy months. As Dr. Woods said April hasn’t slowed down. I know it hasn’t slowed down inpatient wise, so I doubt seriously that it reflects downward trend of our ER for sure.  Kenneth Cochran asked is this due primarily the upswing of more illness related or more activity related. Dr. Woods replied both. Oddly enough we have a lot of viral illnesses popping up. It is not the flu it is just getting people really sick both gastrointestinal and upper respiratory. We have been seeing a lot of both of these. David Jones stated that somebody had a positive flu in the ER. Dr. Woods said the ones that are getting the flu there are really not that bad. They have the flu but they function fine. The other viral illness seems to be a lot worse for some reason. Pat White noted that she had a friend that had the gastrointestinal illness and it took her a long time to get over it. Dr. Woods said it is pretty bad and he has had to hospitalize quite a few of them. Another thing is that people are getting out moving around because the weather is pretty and of course that is when the accidents start happening one right after another. So we pretty much are going to see a lot of that.  David Jones continue with stating that Mammography – 38, you can see reflected of course of the month also. You have the second busiest month reflected on the slides. Newborns – we had 9. It was a very busy month in April as well for newborns. That is another thing as far as statistically, we are 21 ahead of the pace that we were on last year already. That is Dr. Sharpe’s first year delivering babies. She delivered a baby today – one of our employees. She hasn’t slowed down from that perspective that is for sure.  Clinic visits in our Clinic is the only thing that was actually kind of down for the month. One of our busiest providers, our nurse practitioner took a vacation this month, so her numbers were considerably down versus what she had been doing for the last six months. I believe Dr. Chance took a couple of days as well.  Anytime Dr. May, Ms. Landreneau or Dr. Chance are out of the clinic then they will be reflective of the month. They are extremely busy providers. Still 2,135 in one month is still pretty busy. Plain Dealing, you can see they had the busiest month in the last six with 725 visits and Benton had a slight tick down at 415. If you are talking about a 32 patient over a month, you are talking about one less a day. Pam Hughes stated there was a vacation there too. David Jones said it is not like it is any major kind of trend. Fitness Center memberships, the summer is coming, and we up ticked membership by 22 people. That is typically the trend we have always seen. It up ticks until about July and then for the rest of the year it continually falls off. Then at the beginning of the year it will crank back up again. Dr. Woods said due to New Year resolutions.  David Jones agreed. He noted that someone said typically you see January is when it shoots up and now we are just getting lazier and lazier and now we just push it closer towards the summer and then it shoots up and then it slowly goes down again. 2) Review March 2019 Financials – David Jones:  Financially, of course, anytime statistically there is a strong month financially it is pretty much going to reflect the same thing. Our Cash On Hand is truly at record levels which is not to say where we want it but it is the highest in the history of the hospital. Total cash reflective at March 31st was $3,988,502. That is with the CD and not counting the restricted assets. Without those, the Days Cash on Hand is at 53 days. If you add those, the restricted cash in, it is at 64. Many months that I have been the CEO here, we have hung around the single digits as far as cash on hand. It is definitely a breath of fresh air to be able to live in this kind of environment. I don’t want the Board to think that this is where I want this to be. I kind of let the wind out of Dakota’s sails because he was so excited because we hovered above the four million for a little while there and then a payroll hit and kind of knocked us back down. He was so excited, he came in and he said look at this we are at four million. I replied oh I’m sorry I got excited there for a second I thought you said $40 million. He just looked at me like are you kidding me. I laughed and I said that is awesome, don’t get me wrong, but when we get to something like that, that is monumentally changing the way we do things here. That is ultimately my goal is to get us to that level to where it is bigger. That is the goal. There is no end point to that for us to stay financially sound and in today’s healthcare environment we have to keep pushing in that direction. How fast we can get there or not I don’t know but we are certainly going to keep trying to go in that direction anyway. Brenda Smith said but to think of where we are now and where we were just a few years ago. A few years ago it would have been hard for me to comprehend us being here at this time, so, it might be hard for us to comprehend being further down the road, but it is very doable. David Jones said we have taken out loans to make payroll here before and that is certainly not a fun environment or fun situation to be in. Luckily it has been quite a while since we have done that. Here a couple of years ago we thought it was going to get close to looking like that again. It is just the environment that we live in and the reality that we live in as far as healthcare goes in this country and it is not going to get easier. It is only going to continue to go in this direction. We are going to work as hard as we can to reflect that. Dakota did the slides. I can’t take credit for slides 1 through 28. I did add one at the end but I think you will enjoy that one. There is a slight down tick in the Sales Tax fund you can see from 2018 but there was an interest payment that came out of that that actually knocked it down to that level. The profit for the month you can see and as you can tell black is good, red it bad. We try to stay in the black but that is not always the case. We did show a profit of $229, 281 in the month of March. We did have an increase in revenue but of course that is reflective of the increase in patient numbers that we had. Our contractual adjustments, as Dakota has pointed out in the last few Board meeting, they are high versus what they have been in the past. That is reflective of our payments that are set based off of our Cost Report. Remember our last Cost Report stated we were getting paid too much so they decreased our payment which we bill out this dollar amount but we get paid this dollar amount. From that to that is called our Contractual Adjustment and that number, Cost Report determines what this number is. Our cost or charges pretty much stay the same. We are thinking, and this is a best guess scenario, there will be some upward tick of our payment when our new cost report is done at the end of the fiscal year. How much of that will up tick or what dollar amount we will get back based on our Cost Report, I can’t even guess what that is. We feel for certain there won’t be a payment back. Once again that is a guess more than an actual. It is a very convoluted type of thing that Lester, Miller and Wells put together. They have to wait until the audit is done before they can do the cost report and finish out that. We will find out sometime October / November what that is looking like. That is typically what they have done throughout the year. The AR Days fell to a 6 month low of 5l.94. That is a direct reflection of the Billers and Clinics and the Business Office because that is a combined AR with the Clinics and the Hospital. To reiterate, we had some lab changes to add some revenue. You can see on page 5 of the Financials, your one month ended, you can see your inpatient revenue is up from this time last year, it was $50,000. Our March in 2018 was a little down tick which was odd in its own right. You can see how much more revenue we did versus in March of 2018, you got a net increase of $368,000 as far as revenue goes for the month. The net overall with expenses it was $196,000 versus 2018. Overall it is just reflective of the busy month we had. Budget Comparison, this is one that Dakota is very proud of, as am I. It is on page 8 of the Financials. You can see for the month our revenue was up versus budgeted dollars and expenses were within $8,000 of budget. You can see for the year we are down revenue wise we budgeted at $752,000 but our expenses are also down almost $950,000 which actually puts us right at $200,000 above what we are budgeted for.  (Mary Irvin arrived at 4:43 p.m.) If you go for the year, we are actually in the plus right now, $1.1 million. Budgeted wise we are above $361,000 for the year. We did budget for a profit, we are $360,000 above that. 340B revenue is actually coming in around $188,000 above what we guesstimated. That is actually not reflective of anything coming in from Benton yet, so we are hoping fiscal year 2020, our 340B revenue will be even higher than what it is now. Kenneth Cochran asked what you pick as the ideal if you say we want to show this and this is the number for the 340B. Is this close to being ideal? David Jones replied yes. It is pretty close for that. We are talking a million dollars right now as far as 340B revenue coming in. It is something we are going to talk in the Board Retreat as well. With the 340B program the way it is right now, as long as you can get the clinic to close to break even, with the 340B revenue it brings in somewhere around $150,000 in profit. That is a pretty conservative estimate as far as 340B revenue coming in for the clinic. That ties into something we will be going over in the Board Retreat. Brenda Smith spoke up and said so that is where that revenue actually shows up at is with the clinics. David Jones replied no it funnels in the 340B but it comes from the clinic. The clinics don’t technically get credit for that it goes into that bucket. They are directly generating that based off the prescriptions they are writing. David Jones continued stating that the Vivian Clinic had another very good month at $51,621 and as of 2019 there is a profit of $562,927. Could there be some correction of that via our Cost Report, possibly, but still we are having a very, very good, and in my opinion record setting month as far as Clinic numbers go, because really with the influx of Dr. Sharpe, she hit the ground running from day one and is almost just as busy as any other provider we’ve got in that Clinic. Brenda Smith said she was noticing her numbers – 479 for March and Landreneau – 486. David Jones said Landreneau took a week off. She has not been taking any days off during the week that is why her numbers are as high as they are. Most of them work 4 days a week and on the 5th day they do their charting or whatever they need to catch up on. She has not been taking that day off, she has been working. She is a worker. We have three very good nurse practitioners that work for us. Kenneth Cochran asked what the source for employees like that. Where do you find them – are they local? Mrs. Hughes found Ms. Landreneau at a very successful clinic in Arcadia. I think happenstance and God brought Ms. Landreneau and Mrs. Hughes in contact. Kayci Wilson actually lived in the area and was working for Dr. Holt at the time. When we decided we wanted to start looking for one, she decided she was taking too much call so she got in touch with us and that worked out well. Jere Thompson lives in Benton. Pam Hughes said she worked in Coushatta for years and the drive was just getting too much for her. David Jones said she found out we had the opening and she applied. With her being from Benton that was an immediate attraction. Anytime you can have people that know their patients that is always going to be beneficial. We wanted somebody to hit the ground running and she was an experienced Nurse Practitioner. The quality of all three of them is extremely high. Our Attendings – Dr. Chance and Dr. Mc Common have been here for over a decade. They will be here for over 11 years as an attending come June. David Jones asked Dr. Woods how many years do you have in now? Dr. Woods replied either seven or eight. Dr. Woods said after a while it is kind of like your birthday it just kind of blurs together. David Jones said honestly is seems like a year or two ago that he graduated. It is impressive how fast time goes by. David Jones continue saying you see on the slide of the Income Statement we had a profit of $58,847 in Plain Dealing. Benton still had a slight loss. He asked Pam Hughes to talk on that because we are still waiting on some things to get lined out. Pam Hughes said two things – for United Healthcare to pay us the correct amount they started taking all the money back that they had paid us. That is what they are doing right now. We are starting to get the correct payment in now. David Jones said like they paid us $50 for something we did. Based off our new status they owe us $100 now. The only way to give us that amount is they wanted their money back. We gave them their $50 back and refile a claim and then they sent us the $100 back. Basically they had a month and one half of free service there. Kenneth Cochran asked if United Healthcare was a private or are they contracted. Pam Hughes replied it is an MCO. Kenneth Cochran asked if it is a government contract. Pam Hughes replied yes. Medicaid contracts them. There are five of them to do their plan for them. Kenneth Cochran said so oversight comes from the government Medicaid. Pam Hughes replied it is each MCO. She said thank goodness that we found a person at DHH that has helped us. Healthy Blue has been one of the ones too that wouldn’t pay us. They kept saying we weren’t contracted.  Finally after we had tried so much we called this lady at the Department of Health and Hospitals. The next day Blue Cross called us and said o.k. we’ve got it and we started getting the money in. Before we had nobody. It is getting better. United Healthcare is notorious for dragging and trying everything to make it hard. David Jones asked if we got a large payment in last week. Pam Hughes replied we got about $20,000 in Blue Cross. David Jones noted for just Benton. Robert Green said when you say four it is for four different settings or what you called them. David Jones replied MCO’s. Pam Hughes said there is Aetna, AmeriHealth, Healthy Blue, Louisiana Healthcare and United Healthcare. When you are a Medicaid recipient you can pick which one you want to go with. Robert Green said it is up to the patient. Pam Hughes replied yes Sir. Then we have to contract with all of them. David Jones said it is basically whichever one markets the best because most patients have no idea. David Jones said the Medicare recipients, they do the same thing. Humana Gold and those kind of things, they actually tied in with Walmart and started setting up booths in most Walmarts and convincing the elderly that this is way better than normal Medicare and it typically is not. It’s very good if you don’t use it. Kenneth Cochran asked if appropriate oversight take care of that. Pam Hughes said what I would like, and it doesn’t matter what I would like I don’t guess, but if they would go back to having one payer for Medicaid. Now each of the five have different ways that we have to file something so that means that each one we have to set up their insurance to pull different things to make it go. Robert Green asked if would be wrong for us to suggest. Pam Hughes said it would be wonderful for you to suggest. Robert Green said I mean through the hospital to educate them on which group they should choose. Pam Hughes replied no we can’t do that; they have our hands tied on that. David Jones said the only thing we typically can do is with Medicare we can try to self-educate the patients as far as the difficulties that we have filing claims and what you can have. Pam Hughes said we can’t tell them this one is better. Mary Irvin asked what if they ask. David Jones we can tell them what our problems are but we can’t suggest. Dr. Woods said you would be surprised at some of these insurance companies when these patients go to the clinic and they are complaining of right lower quadrant pain and fever and nausea and vomiting and the physicians needs to get a CT of the abdomen and pelvis to confirm appendicitis the company said you need preapproval for this and they will make these patients wait. Then the physician has to say I’m sorry they won’t approve it, which is ridiculous, then the patient is forced to leave there and go to the emergency room. Kenneth Cochran asked has it always been that way. Dr. Woods said it has not always been that way but it has gotten worse. All the ICD 10 codes they want and all the IDC 10 codes have to mesh with another book that has to say that your documentation has to have x y and z on there or you are not getting paid, which is ridiculous. They set it up that way. Every year they go back through there and they will say well we used to like that but now we like this. That sets up an entire another industry for a new set of books and a new set of rules. David Jones asked if anyone has any questions. He said the next slides are just for informational purposes. We are going to talk about it a little bit more at the Board Retreat, but we are looking at possibly refinancing some of our bonds. The interest rates have decreased and due to the balances, you are talking about over the life span of the bond itself, it is pretty significant savings. The next couple of slides, we do have a solid offer at 4% but we may try to get a lower rate. It just shows you some of the savings at 3.75 and 3.5% if we can make it down to that, but we will talk more about that at the Board Retreat. I have a few images of the construction. The construction has actually moved inside now. What I wrote the management update, we weren’t inside and now we are. It is coming along. Kenneth Cochran remarked weather delays. David Jones said they are doing some work. He and Mrs. Hughes talked and we seriously would have loved to have seen if Lincoln had put a bid in and won the bid on the initial building, how much time would have been taken off the completion date. How many, I don’t know 100%, but I promise you it would have been months taken off of the whole time. Just from a very high level quality wise, they seem to be an extremely solid quality builder as well. We had a new addition. On April 17, 2019 Benjamin James Robinson was born. The mother and baby are doing well.  Robert Green said he would entertain a motion.  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, Kenneth Cochran, David Norman, Brenda Smith, Pat White.  Nays: None.  Absent: Ronnie Festavan, Helen Godfrey-Smith.   Abstained: None.  The motion passed by unanimous vote in favor. VIII. New Business – 1) Purchase of Emergency Room Lights: David Jones stated we have two items under new business and we will do them separately but they are related. We did not budget for equipment to be able to get the building under the funds we had for USDA and we had very little that we needed to buy equipment wise for the rooms. We excluded those from our USDA budget. It is getting to the point where we need to go ahead and order the lights and the stretchers for the ER rooms. I assume Dr. Woods would agree that light and stretchers would help if he is actually running and an exam room for the Emergency Room. If I could have a motion for the Emergency Room lights I will talk more on it. Brenda Smith made a motion to approve the Purchase of Emergency Room Lights. Mary Irvin seconded the motion. Board members where provided information on the lights. The company Steris is a major manufacturer. This is going through our GPO so we don’t need to bid this out. It is our recommendation. David Jones ask Dr. Woods if he had anything to say about the lights. Dr. Woods said these lights work great. They are LED and they use less energy and last longer. They are definitely bright. David Jones said we are just buying what is currently in the ER now. Brenda Smith asked if these lights needed any special wiring. Pam Hughes said Lincoln has that in the specs and how it is supposed to be hung. Brenda Smith said before that got us in a predicament having to put it through the walls. David Jones said yes they had already cut the walls and luckily these are almost like a ceiling fan. David Jones asked if there were any more questions. Robert Green called for a vote for the approval of the purchase of the emergency room lights in the amount of $12,087.38 as recommended by David Jones.  The vote:  Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White.  Nays: None.  Absent: Ronnie Festavan, Helen Godfrey-Smith.   Abstained: None.  The motion passed by unanimous vote in favor of purchasing the emergency room lights. 2) Purchase of Emergency Room Stretchers:  David Jones asked for a motion to approve the purchase of the Emergency Room stretchers. Kenneth Cochran made a motion to approve the Purchase of Emergency Room Stretchers as recommended by David Jones. Kenneth Clay seconded the motion. David Jones stated a total cost for the two stretchers from Stryker is $15,919.32. David Jones said these match the stretchers we have currently in the ER. Dr. Woods said one of the nice features is when you place the patient on the bed it automatically weighs them and especially if they are non-ambulatory you already know what their weight is. Robert Green asked if there were any questions. There were none. He stated he would entertain a vote. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White.  Nays: None.  Absent: Ronnie Festavan, Helen Godfrey-Smith.   Abstained: None.  The motion passed by unanimous vote in favor of purchasing the emergency room stretchers.   IX. Administrative Reports – 1) Current Activity: David Jones said we have a little meeting on Friday. I hope everybody is going to make it. If you are not going to make it let us know. Something that we have been talking about for years – getting a cumulative Board photo and then Board members with bios possibly put on the website and individual photos that we can have. Honestly, I take pride in everything that you have done for this place and I think people should know who has sacrificed and actually helped push forward our hospital. You are our hospital Board. Most people know you and know who you are, but still, it does bring a level of professionalism to what is going on. I appreciate Mary for putting it together, getting the photos and everything done. I think mine and Mrs. Hughes photo is pushing eight years old that is on the wall. Mary Irvin said our Board Retreats are on the casual side and relaxed, however, when we arrive, that is outside of having breakfast together, our Board photos will follow our breakfast. We are asking that all Board members come professionally dressed. The pictures that will be taken will be framed and placed in the Board Room of each one individually and then we will take a group picture in a little bit of a larger size for inside the hospital. We are asking the ladies to wear solid colors. Then if we want to change we can. Brenda Smith asked if the group picture would be full body and individual head shot. Mary Irvin said the individual would be head shot and the group would be all. Mary Irvin said as of right now the plan is to use a back drop for the professional pictures and because of group size it will be in the atrium of the Hilton for the group picture. If anybody is interested I have what is going to cost and it includes the framing and all that. Creative Imaging will be doing the pictures. Pat White inquired what time the breakfast starts. David Jones replied at 8:00 a.m.  Robert Green asked if anybody had received the schedule on the internet. Brenda Smith said she received one but she didn’t know if there would be another one after the Finance Committee meeting. Pat White said she didn’t have it as of yesterday. Mary Irvin said we will resend it. The plan is to arrive at 8:00 a.m. for breakfast at the Hilton. Pat White said she had an appointment and will have to change it. Mary Irvin said then it will be followed by the individual settings with each Board member and some of the Executive Staff and then the group shots. The agenda will show an hour but hopefully if it takes a little bit more time that’s understandable. As soon as we wrap those photo sessions up we will begin the meeting agenda. Dr. Woods said he might be a little late he will be coming off a 24 shift. Kenneth Cochran asked if everybody was coming. Was Pam going to be there? David Jones replied yes and then we will have the Department Heads come in at noon. David Jones said it would be nice to have a professional photo of our Chief of Staff but that is up to you. David Jones said we are shooting for it to end by 3:30 p.m. It is Friday afternoon and trying not to hold you too late. I think at 3:00 o’clock we have a planned Executive Session and I believe it will last around 30 minutes. Robert Green asked where it is going to be. David Jones replied the Hilton downtown. Mary Irvin said they will have it posted the room that we will be assigned to and the front desk will know. Pat White asked if we will have parking provided or do we pay our parking fee. Mary Irvin said Helen Godfrey-Smith has that information, but that is a good question. David Jones said he will find that out and let you know. Mary Irvin said along with the agenda we will ask that question and any other questions that anybody may have to Mrs. Helen Godfrey-Smith. The parking garage is across the street.  David Jones stated we also have Hospital Week coming up May 12th through May 16th. That is always a fun time. Please, we will get you on the agenda as well. Any and all times that you can come up will be greatly appreciated. It does give the staff a week to kind of pause. There is going to be some healthcare Olympics on Friday. There will definitely be some fun had on that day. Nobody will be throwing balloons this year – at least I hope. We tend to blow it out a little bit. Mary Irvin asked the Board to consider repeating what the Board supported last year. I think it was an amazing gesture for the Board to be involved in Hospital Week. That only makes sense to me. Last year we sponsored the Kona Ice Day and asked those who wanted to participate to participate. I think cost wise it was about $35 and we pay for any employee that would like to go out and get a Kona Ice; the truck comes in. We encourage Board members to be around at that time interacting with the staff. I know I spent a couple of hours and it was a lot of fun meeting people that I didn’t know. For the evening shift, we went and got Sonic slushies for all the staff that works at night so that they were part of the fun as well. We will send out something where you can respond on email if you are willing to participate so that we kind of know. I would love for everyone to participate in that with us. Unless anybody has any other suggestions it just seemed easy to repeat. Kenneth Cochran said you will let us know what days we need to come. Mary Irvin said we are trying to work it out for Wednesday or Friday but we will let you know. Kenneth said oh, it will be just one day. Mary Irvin replied yes just one day. Ours will be one of the things and maybe in conjunction with the Olympics which would be perfect to have Kona Ice while they are outside. We are having to coordinate. There is more than one Kona Ice and one of them is tied up on Friday and we are reaching out to another one. If someone else has another idea please let me know. Brenda Smith asked to be reminded why the one in Vivian could not do it. Mary Coil said they were contacted but didn’t want to pick up everything and bring it. They are not mobile and would have to move all their supplies. The Kona Ice is a mobile unit and drives up and lifts up the windows. We did check with her before we started using Kona Ice. Brenda Smith said thank you. She couldn’t remember but she knew there was a reason.     2) Foundation: Mary Coil we had our first kick off meeting for Havana Nights on Thursday night. You should be receiving the newsletter in the mail today. If you haven’t be expecting that. On our Havana Nights Party committee meeting. Our committee consists of people who have been great supporters in the past and some that are new to it that really just want to learn more about the Foundation and this event and want to be involved. Thursday night we will meet at our Chairperson Missy Moore’s home and really introduce ourselves and the vision for the evening and kick things off and get things started. So far there has been a lot of excitement and a lot of talk about the night. There is only going to be 250 tickets sold so that has been a big subject around here about when can they buy their tickets. We are excited for what it will bring.  David Jones asked to be excused. I want to thank the Board for indulging me and asked Mrs. Hughes to finish the Board meeting. My son’s playoff game is about to start. He is starting tonight. 3) Construction Report: Previously discussed.    X. Medical Staff Report – 1) Recommendations – David Jones: In David Jones’ absence Dr. Woods presented the Medical Staff recommendations for the Governing Board approval: MEDICAL STAFF APPOINTMENTS: None. MEDICAL STAFF REAPPOINTMENT: 1) Louis Sardenga, M.D. – Request Courtesy Privileges in the field of Pathology for the period of April 23, 2019 through June 30, 2020.  2) Jonathan Bold, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of April 23, 2019 through April 30, 2020.   ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:  1) Damein Burgess, CRNA – Request Courtesy Privileges in the field of Anesthesia for the period of April 23, 2019 through October 31, 2021.    EXTENSION REQUEST: None.   VOLUNTARY RESIGNATIONS: 1) Kathryn Wagner M.D. – Voluntary resigns his privileges for Radiology effective 03/30/2019. Kenneth Clay made a motion to accept the Medical Staff Reappointments, Advance Practice Professionals Appointment and Voluntary Resignation. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White.  Nays: None.  Absent: Ronnie Festavan, Helen Godfrey-Smith.   Abstained: None.  The motion passed by unanimous vote in favor.  2) Chief of Staff Comments: Dr. John Woods, Chief of Staff, stated that there is no new exciting business. Everything is good just a lot of construction and busy. XI Executive Session: None.  XII. Adjourn:  There being no further business Kenneth Clay made a motion to adjourn. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White.  Nays: None.  Absent: Ronnie Festavan, Helen Godfrey-Smith.   Abstained: None.  The motion passed by unanimous vote in favor.  The meeting adjourned at 5:09 p.m.



North Caddo Medical Center

Vivian, Louisiana




David C. Jones, Secretary



Approved by the Board of Directors at the regular meeting held May 28, 2019