BOARD MEETING: Regular Meeting DATE: April 27, 2021 MEMBERS PRESENT: Mary Irvin, David Norman, Kenneth Cochran, Robert T. Green, Jr., Brenda Smith, Pat White MEMBERS PRESENT VIA TELECONFERENCE: None. MEMBERS ABSENT: Kenneth Clay (arrived at 4:11 p.m.), Ronnie Festavan (arrived at 4:21 p.m.) Helen Godfrey-Smith. TIME CALLED TO ORDER: 4:00 p.m.. OTHERS PRESENT: David Jones, CEO, Dakota Robinson, CFO, Walter D. (Doug) White, Hospital Attorney (via teleconference), Mary Coil, Foundation Executive Director / Marketing Director, Brent Leonard, Financial Analyst, Britney Stringham, Administrative Assistant, Lanell Audirsch, Admin. Asst. LOCATION: NCMC Café and Via Teleconference – Conference ID 799 317 532 # BOARD CHAIR: Mary Irvin SECRETARY: David Jones I. CALLED TO ORDER – Mary Irvin, Board Chair called the meeting to order at 4:00 p.m. II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation and Kenneth Cochran led the group in the Pledge of Allegiance. times of depended onsion and ca III. Approval / Amend Agenda – Mary Irvin noted we need a motion and second to approve our agenda. Brenda Smith made a motion to approve the agenda. Robert Green seconded the motion. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran. Nays: None. Absent: Kenneth Clay, Ronnie Festavan, Helen-Godfrey Smith. Abstained: None. The motion passed by unanimous vote in favor. IV. Community Comments – Mary Irvin, Chair, inquired if there was anyone from the community logged on. Dakota Robinson stated there were no visitors logged on. Mary Irvin noted there are no community comments. V. Minutes – Regular Meeting March 23, 2021 – The minutes of the regular meeting held March 23, 2021 were mailed prior to today’s meeting for review. The minutes of the regular meeting held March 23, 2021 were mailed prior to today’s meeting for review. David Norman made a motion to approve the minutes as presented. Robert Green seconded the motion. There was no discussion or corrections noted. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran. Nays: None. Absent: Kenneth Clay, Ronnie Festavan, Helen-Godfrey Smith. Abstained: None. The motion passed by unanimous vote in favor. VI. Foundation Report – Mary Coil reported that Friday we went to West Monroe to hold our Early Bird Drawing for the Raffle. Bill Stansberry, a CPA who has done some work for our Foundation, is donating his time and service. He did the drawing. It was very exciting. I said when I left here everybody was very excited. We’re planning our June 25th drawing. We are planning to have it here. Mr. Stansberry will come here. We have 200 tickets left for the 1,000 to be sold out. VII. Chief of Staff Report – David Jones said the Chief of Staff was entering a patient room just as I was coming to the meeting so he is unavailable at this time. VIII. Old Business – 1) Update on Building Projects: David Jones noted as you know we have the four projects going on. We are basically at the beginning phases. I don’t know if anybody saw the back Emergency Entrance is pretty much walled off and the notice to proceed has already been signed for the Dental Clinic expansion and we are looking at a preliminary date of October 23rd or 24th, one or the other for the completion. That’s if zero weather days are taken. (Kenneth Clay arrived at 4:11 p.m.) The roof replacement will only be a couple of months before it is done so it should be a 60 day project. They have 90 days to complete it via the contract but it should be 60 day project. The two larger projects we have – the Blanchard Clinic and the Benton Clinic, we still don’t have timelines for that. They are still pulling permits and getting things established. We haven’t had the preconstruction meetings yet. He asked Pam Hughes if we had dates on those yet. She replied not yet. David Jones said the architect firm that is overseeing part of that beginning phase were actually out all last week. Things should probably start snowballing here in the next week or so, so we should have timelines and everything for the next Board meeting as far as possible completion dates for those. 2) Update on Surplus Van: David Jones said this is on the agenda for update. We are still waiting on our second truck to arrive before we completely surplus the van because it is used almost every day for running back and forth. We are going to auction this thing off, so I wanted to keep the Board appraised as to how that goes. 3) Update on Pyxis Drug Cabinets: David Jones stated I think we do finally have a set date, which we got late July, early August. It’s another thing that could potentially be delayed due to COVID. We are having weekly calls on it and it should pick up speed here in the next month as far as getting all that lined out. Does anybody have any questions on any of those? There were none. IX. 1) Review March 2021 Statistics – Brent Leonard: I am Brent Leonard. I am the Financial Analyst here at North Caddo Medical Center. Starting off in Admissions, we had 37, which is about a 12% decrease from last month and year to date we’re at 456. Inpatient days a slight decline, Swing days was at 57 last month. Our Average Daily Census, as well, went down about 26% and all those stats are all directly related to each other that’s why they’re all kind of trending in the same direction. Looking back to like 2018, it’s typically a slow time of year early. Surgeries are at 19, and year to date we’re at 129 and all those surgeries were for outpatient. Endoscopies – 7% increase from last month with year to date where we’re about on track in comparison to last year. Moving to the ER visits, a slight increase there. About 10% increase with year to date we’re at 4,052. Clinic visits saw another big increase but primarily due to the storms last month. Year to date we’re at 17,957 visits. Plain Dealing, about a 37% increase with year to date almost 6,000 which is a 7% increase over last year’s year to date. Benton, about a 35% increase, year to date 4,656, which is about a 10% increase over last year’s year to date. Our new addition, the Blanchard Clinic, I thought it was a really good month to start off at 146 visits. Dakota will get into the financial side of all that. Fitness Center, right now we have 316 total members and activity there for last month is at almost 1,700 visits. That is all on the stats. Are there any questions? Dakota Robinson said if there’s no questions we’ll move on to the financial piece. 2) Review February 2021 Financials – Dakota Robinson: If you look at page 1 of the Balance Sheet, you’ll see that there has been a significant increase in Cash from the previous month. You’ll see that Cash on Hand is right at 236.8 if you include the CD’s all of that, it’s a little bit wonky. It’s not really 236. (Ronnie Festavan arrived at 4:21 p.m.) On page 2 of the Balance Sheet you’ll see that Accounts Payable actually is lower than what it was this time last year at $490,000 and we hadn’t seen much change across all the other liability accounts. Accrued Salaries, Withholdings and Retirement slightly up and that’s just partially due to where our wages are at comparted to the previous year. If you look at the Income Statement on page 3, you’ll see that Revenue wise we did almost $3.8 million in Revenue compared to $3.3 million in the previous year and contractual adjustments were up slightly from the previous year, but that’s obviously because we had more revenue and I believe we talked about that 50% threshold, The first few months of the year we were at 47, 48%. I told you as we progress into the year we’re going to see that number increase and increase to about 50.6% this month, which puts us almost to 49% contractual in the year. It gets us to a Net patient Revenue for the month of $1.85 million compared to almost $1.5 the previous year. Look at Salaries and Wages. You’ll see that there is an increase in Salaries and Wages for the month. So when we look at the differences between Salaries and Wages historically from the previous period, we’re going to start seeing some distancing there, and as the year will progress we’ll start seeing those come back together. Robert Green asked where you are reading that from. Dakota replied from page 3 of the Financial Statements. You’ll have to pull out the Income Statement. I’m referencing the Income Statement. Robert Green said thank you. Dakota replied you are welcome. Dakota continued. A part of that will also flow into Salary or Employee Benefits and Payroll Taxes. You saw reduced claims at that point because nobody was going and getting surgeries, nobody was doing all that kind of stuff, so you’re going to see that in those two categories the most. You’ll see in the Employee Benefits and Payroll Taxes, it’s about a $143,000/$144,000 increase from the previous year, mainly related to health, dental, life insurance. One of the main adjustments that we did in these financial statements was for the 340B administration. We did add a lot of depreciable assets this month. We try to do that quarterly and it just happened to be that month that we worked with the auditors. That’s why you see a pretty good increase for the month and on the year we’ve got about a $21,000 increase on the year, and as we continue we’re going to see that as we add new buildings and those projects come to close in October you’re going to see that depreciable expense increase. If you look at Total Operating Expenses $2.6 million compared to almost $2.1 million the previous year and if you look on the year an increase of $1.7 million. Get down into Non-Operating Revenue and Expense, you’ll see that under Grants we’ve got $285,000 booked compared to $405,000. Really the only difference there is some MCIP money was booked in that month. The increase in assets, actually the decrease of $128,000 for the nine months, that puts us at $2.164 million compared to $1.1 million the previous year. Any questions on the Income Statement? There were none. Dakota continue stating the Departmental Revenue and Expense – the one month, they follow pretty closely to the statistics that we laid out earlier. One of the areas we continue to sort of lag behind is the Emergency Room. Looking at the Budget on page 8, you’ll see that we did almost hit the Gross Revenue right on the head at $3.75 million, about $32,000 off, but our contractual adjustments came under what we budgeted as well. It actually put us $10,000 within Net Patient Revenue, which I know last month I told you I wouldn’t come here and tell you we’re 0.6% off budget in that, we’re .5% so it actually got better over a nine month period. Pretty good in that category. When we get into salaries and wages, even though we had an increase over the previous period, you’ll see that we’re $270,000 under budget for salaries and wages and right at half a million for employee benefits and payroll taxes. We’ll move to the Vivian Clinic, there is, with the allocation of, we did add a nurse practitioner on board for two month now. She did work in the Vivian Clinic partially, some of the Blanchard staff. When I’m referencing that I’m referencing our Blanchard clinic, so we had to reallocate some costs out of the Blanchard clinic into some of our other clinics. That’s what you see sort of affecting this number here in the Vivian clinic. They did have increased visits up to 2,202 and they had a slight loss of $30,000. Still through nine months though they have $431,000 in the black, so they’re in a great spot. The reason why you see that little blip there is we did allocate some expenses from the Blanchard clinic over and you’ll see that here in just a second. If we move to the Plain Dealing Clinic on their 658 visits, they had a profit of almost $8,000 and through nine months a little over $12,000. The Benton Clinic, on their 521 visits, turned a profit of a little over $20,000 and through nine months are at $135,000. Since there’s only one month’s worth of data there is not a graph, but you see that there was net patient revenue of $14,632 and net income of $14,000. Mary Irvin asked if there were any questions. David Jones said in regards to the numbers as far as patients go in Blanchard, I think it took us about nine months to hit 140 something patients in Benton, so we did that in the first two weeks in Blanchard. Don’t have the numbers for the last week yet, but I think the number and I will say conservatively at 350 patients for the month of April in Blanchard which I think is well over a year and a half before we approached those numbers in Benton. Mary Irvin said if there are no further questions or discussion on the statistics or financial statement we need a motion and a second to approve our March Statistical and Financial Statement. Pat White made a motion to approve the Statistical and Financial Statement as presented subject to audit. Kenneth Cochran seconded the motion. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran. Nays: None. Absent: Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor. X. New Business – 1) Engagement of Architect for Preliminary Plans for Outpatient Pharmacy: David Jones stated if I could get a motion and a second for engaging architecture firm Advantage Design for the preliminary plans for the outpatient pharmacy and the redesign of our extended services building. Brenda Smith made a motion to approve engaging the architecture firm Advantage Design for the preliminary plans for the outpatient pharmacy and the redesign of our extended services building. Robert Green seconded the motion. Brenda Smith said it was very exciting. Mary Irvin said it went into depth about it. Ronnie Festavan asked has there been anything significant since our last week’s update on what’s going on? David Jones said no Sir, not anything significant. I was hoping to have a little more detail from the architect. They actually, the whole firm went on vacation last week and were out of pocket. So nothing has moved forward as of yet, but we will have plenty of motion by the next Board meeting. Mary Irvin asked if there was anyone else to comment. There were none. Mary Irvin stated we have a motion and a second, all in favor accepting this engagement letter to the architect Advantage Design. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran. Nays: None. Absent: Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor. 2) Approval of Board of Commissioners Revised Bylaws: Mary Irvin said, also, at our meeting last Tuesday, we appreciate the Bylaws Committee discussing with us their revisions of the bylaws. Each Board member was sent a copy and it was discussed at our meeting. We are now at the time of approving those bylaws. We need a motion and a second and then discussion if there is any. Pat White made a motion to approve the revised bylaws as presented. Robert Green seconded the motion. Mary Irvin asked if there was any further discussion or questions. After much discussion Ronnie Festavan said, Madam Chair, I would like to offer a substitute motion based on discussion. I’d like to offer a motion that we table the original vote that was scheduled for today. I didn’t hear any drop dead date that this needed to be done. Mr. Cochran and I would be glad, and I’m sure Mr. Norman would, too, to let us review one more time, possibly what we had intended to do. Mary Irvin said we are looking for a second. Robert Green seconded the substitute motion. Mary Irvin said all in favor of tabling our bylaws we are ready to vote. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran. Nays: None. Absent: Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote to table the vote on the revised bylaws until the next Board meeting. XI. Administrative Reports – 1) NCMC – Pandemic Update: David Jones wanted to give a quick Pandemic Update. Vaccines are basically trickled down. We are going to start transitioning them into the clinic. We are going to try to group as many as we can with that, but we’ll just have to see how that goes really because we still don’t have long term storage capabilities of the vaccine nor do most places. It’s just something that the state is tackling, even as a country. Dakota said it’s almost like one in three. David Jones said it’s almost a third of the country, basically, that’s been vaccinated. Honestly, probably a realistic target somewhere between 30 to 40% of the country to be vaccinated. Robert Green asked have they decided when the booster is coming out. David Jones replied not yet, but I’m sure that will be coming out probably the next two or three months. Robert Green said thank you Sir. XII. Medical Staff Report – 1) Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval. MEDICAL STAFF APPOINTMENTS: 1.) Carlos Encarnacion M.D. – Requests Provisional privileges in Radiology for the period of April 27, 2021 through April 30, 2022. 2.) Matthew Abraham, M.D. – Requests Provisional Privileges in the field of Sleep Medicine for the period of April 27, 2021 through April 30, 2022. MEDICAL STAFF REAPPOINTMENT: 1.) Almas Ali Syed M.D. – Request Courtesy Privileges in the field of Radiology for the period of April 27, 2021 through March 31, 2022. 2.) Steven Edson, M.D. – Request Courtesy Privileges in the field of Radiology for the period of April 27, 2021 through April 30, 2023. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: None. EXTENSION REQUEST: None. VOLUNTARY RESIGNATIONS: None. Robert Green made a motion to approve the (2) Medical Staff Appointments, (2) Medical Staff Reappointments as presented. Ronnie Festavan seconded the motion. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran. Nays: None. Absent: Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor. Ronnie Festavan asked Britney to tell them a little bit about a form she gave the Board members. Britney Stringham said yes. This is the Financial Disclosure. Your instructions are the front two pages. They are due in May. Mary Irvin said the internet said the 17th, but I’m going to go with the 15th as stated on the form. You can e-file upload, fax or mail, so there’s a variety of ways to file. Ronnie Festavan said even though you only have to fill out two pages you have to check every page on that top left hand corner or they will send it back. Brenda Smith asked if we can bring these to you and you can upload them. Britney replied yes ma’am absolutely. XIII. Executive Session – Mary Irvin noted there was no business for Executive Session. XIV. Adjourn – There being no further business Mary Irvin called for a motion to adjourn. Kenneth Clay made a motion to adjourn. Robert Green seconded the motion. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran. Nays: None. Absent: Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor. The meeting adjourned at 5:04 p.m.
North Caddo Hospital Service District
North Caddo Medical Center
David C. Jones, Secretary
Approved by the Board of Directors at the regular meeting held May 25, 2021