BOARD MEETING:  Regular Meeting   DATE:  August 25, 2020    MEMBERS PRESENT:  Mary Irvin, Patricia White, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran MEMBERS PRESENT VIA TELECONFERENCE: Robert T. Green, Jr., Helen Godfrey-Smith    MEMBERS ABSENT: Kenneth Clay (arrived at 3:44 p.m.), TIME CALLED TO ORDER:  3:30 p.m.   OTHERS PRESENT: David Jones, CEO,  Pam Hughes, COO, Dakota Robinson, CFO,  Greg Guest, Laboratory Director, Mary Coil, Foundation Executive Director / Marketing Director, Walter D. (Doug) White, Hospital Attorney (Via Teleconference), Britney Stringham, Administrative Assistant, Lanell Audirsch, Admin. Asst.    LOCATION:  NCMC Café and Via Teleconference – Conference ID 134 688 854#    BOARD CHAIR: Mary Irvin    SECRETARY:  David Jones      I.  CALLED TO ORDER – Mary Irvin, Board Chair called the   meeting to order at 3:30 p.m.         II. Invocation and Pledge of Allegiance – David Norman offered the Invocation. Brenda Smith led the group in the Pledge of Allegiance. Robert Green offered a word of encouragement referring to Psalms 37:23 – “The steps of a good man are ordered by the LORD: and he delighteth in his way.” Mary Irvin said thank you so much Brother Green. Those words were right on time as God always is. Thank you so much for those encouraging words.    III. Approval / Amend Agenda –  Brenda Smith made a motion to approve the agenda. David Norman seconded the motion. The verbal vote: Yeas: Pat White, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith   Nays: None.   Absent: Kenneth Clay    Abstain: 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 July 28, 2020 – The minutes of the Regular meeting held July 28, 2020 were mailed prior to today’s meeting for review. Pat White made a motion to approve the minutes of July 28, 2020 as mailed. Kenneth Cochran seconded the motion. Mary Irvin asked if there was any discussion or corrections to be made regarding the July 28, 2020 minutes at this time. There were none. The verbal vote: Yeas: Patricia White, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith   Nays: None.  Absent: Kenneth Clay   Abstain: None.  The motion passed by unanimous vote in favor.   VI. Foundation Report:  Mary Coil, Foundation Executive Director, stated this last month we did send out a newsletter. We did that through email as well as our website and social media. The Foundation is talking about some different things to be involved in having an event of some sort. It is still in the research phases. We are looking forward to what we have on the horizon and a lot of it is still in the planning stages but most importantly we just want to be involved with our supporters and keep them tuned in to the Foundation with them.  Mary Coil noted that we do have one new Board member. That is Ms. Stacy Alexander.  We are really looking forward to her service. Her first month will be the next meeting in September. Mary Irvin thanked Mary Coil.   VII. Chief of Staff Report – David Jones stated he talked with Dr. Woods earlier. He did say the ER numbers have picked up. Business is pretty close to being pre-COVID numbers wise for us. Things are going well. (Kenneth Clay arrived at 3:44 p.m.)  VIII. Old Business – 1) Purchase of ADP HR System Update:  David Jones reported that we had a few things we moved forward on with that this past month. We are doing the whole employee job offer, job application process, all the paperwork they have to sign is now electronic. David Jones said it really benefits a lot of our PRN staff as well with so many people that live in Shreveport and Bossier, they work here. Coming up to fill out that paperwork they almost have to take a day off from their fulltime work to do that. That will certainly alleviate those kind of things as well.  2) CT Scanner Update:  We told initially an August 28th install date for the new CT. I don’t know if anyone walked back that way but there is no new CT in the building as of right now. COVID has slowed everything down and all the manufacturing down so now we are getting a December install date.   IX.   1) Review of July 2020 Statistics – Dakota Robinson:  Dakota Robinson, CFO, stated I think once again, this is the third month that I get to show good trends across the board. On Admissions you will see we increased from 45 to 67 admission on the regular acute side, almost a 50% increase. It is definitely an increase from the previous July of about a 20% increase.   Dakota continued saying looking at Inpatient Days even though we had more Admission the Average Length of Stay fell slightly. We did have a few more inpatient days. It went from 196 to 200. A slight increase of about 2%. The total Swing Days, we had 175. One of the areas that we look at that took a little bit of time to pick back up but it was one of the ones that got hit the hardest was surgeries, you see we had 24 surgeries for the month of July. We will see that also, not necessarily in Endoscopies, but Endoscopies are holding steady at 15, that is about normal. It is probably above what the average was pre-COVID.  If we look at ER visits, Mr. Jones said Dr. Woods has noticed an increase in patient volume in the ER. It went from a low of 283 and then slowly progressed up to where we are at in the month of July to 517. The clinics have done well through this. They’ve adapted and changed the way they do things. You can see this from the slide. We went from a low of a little under 1,700 to hit 2,038 visits last month for July. We see that also in Plain Dealing. We went from 651 to 712 and the lowest that we’ve seen in this calendar year is 527 in the middle of COVID. Benton clinic is sort of the same thing. We went from 537 to 545 so the numbers are steady. One of the areas that is back up and running is the Fitness Center. You can see total new sign ups on the graph. They saw almost 2,000 visits last month. That is almost 1,000 more visits than the month before. 2) Review July 2020 Financials – Dakota Robinson:     Mary Irvin said at this time we need to stop to have a motion and a second for the June 2020 Financials. Pat White made a motion to accept the June Financials. Brenda Smith seconded the motion. Mary Irvin asked if there was further discussion or questions for the June Financials and what caused us to have to delay that. There were none. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith.  Nays: None. Absent: None.  Abstain: None.  The motion passed by unanimous vote in favor of approving the June Financial Statement as presented.  Mary Irvin noted we will now continue on with the July Financials. Dakota Robinson continued stated carrying over in to the financial statements the numbers that we see in the statistics directly correlate to the financial statements. When we look at page one of the Balance Sheet, you’ll see that we have the Certificates of Deposit still in place. If we had not already put those in motion, the bank accounts, you’ll see that there’s $14.2 million in unrestricted cash. Days Cash on hand, without the CD’s is almost 230 days Cash on Hand, and if you add the CD’s into that, that climbs to almost 242 Days Cash on Hand. If we look at the Income Statement, you’ll see it looks a little bit different than what we usually see month to month. That’s only because there’s no year-to-date, obviously, July is the first month, so there’s no year-to-date yet. You’ll see that Revenue for July sort of matches our statistics in that we saw almost $3.9 million worth of Revenue. One of the areas that I’ll point out on the Income Statement is the contractual adjustment. There’s almost $1.7 million dollars in contractual adjustments there.  One of the areas we expect an increase with the way we passed the salary increases, you’ll see that there is an increase there from almost $1.1million to a little over $1.2 million. On the Grants, there was only a small grant received in July. Right now we don’t know what the UCC money is going to be. If you get down to 340B revenue, you’ll see that it also increased from $127,000 the previous period to $151,000, so the changes that we’ve done over the past three to six months are continuing to pick up and we’re starting to see that and expect more increases in that number here over the next few months as we roll some more stuff into play in 340B. We get down to a total increase or profit of $406,000 compared to $183,000 the previous year, so for the month of July, really solid number. Any questions on the Income Statement? There were none.  Dakota continued with AR Days. Since we saw such a substantial increase in Revenue, we see the flip effect of that in AR Days. AR Days dramatically declined, so the AR days went from almost 60 to 39.32, to what I would expect to see as the year goes on, that number sort of meet in the middle to where we expect to see it in the 40’s, but 39 is great as well. If we look at the budgeted number, you’ll see on page 8, the Gross Revenue of almost $3.9 million surpassed the budgeted revenue of almost $3.7 million. The contractual adjustments were also down. Like I said, I think those will pick up a little bit in the next few months. So if we get down to Net Patient Revenue, we’re in the plus by $365,000 which is a really, really good thing. We look at Expenses – one of the areas that I’ve already pointed out is Employee Benefits and Payroll Taxes, you see that’s a difference of $175,000 from budget. It’s just the way that the plan year falls and the way that those expenses occurred that’s very loaded on the front end of the plan than it is on the later part. If we look at the Total Operating Expenses compared to budget, $52,000 under budget on the expense and then we get down into Non-Operating Revenues, you’ll see that it’s very, very close to get to an increase difference in profit. We budgeted for $7,755 and the increase that we actually saw is $407,000, so budgeted number wise, we’re in a very good spot. Any questions on the Budget? Ronnie Festavan requested to speak. Mary Irvin acknowledged him. Ronnie Festavan stated going back to Non-Operating Revenue under Sales Tax Revenue.  Do you have any kind of feel for what our Sales Tax Revenue have been say from January this year? Dakota replied yes. I did the numbers on it actually to do these financial statements. The average between January and July’s collections averaged about $103,000 a month. One of those months is off. There’s almost no difference compared to last year. Ronnie Festavan said I think that was my point. I’m not sure I can put my finger it either. The Town is up and we’re up 17% last month in revenue. Dakota continued stating when we look at the clinics, you’ll see that the Vivian Clinic with their high patient count and good numbers they’ve had they turned a profit of $130,000 up from a slight loss last month. We look at Plain Dealing we see another profit. We went from a slight loss last month to a profit of almost $5,500 and 712 visits. Then we look at the Benton Clinic.  We went from profit of $2,700 to a profit of $11,498. I wanted to chart out it starts at zero and ends at 600. This is from the beginning of time at Benton to current date. You can see the trend is good.  Are there any questions. There were none. Mary Irvin called for a motion and a second for the Statistical and Financial Reports for July. Pat White made a motion that the Statistical and Financial Reports for July be approved as presented subject to audit. David Norman seconded the motion. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith.  Nays: None.  Absent: None.  Abstain: None.  The motion passed by unanimous vote in favor.   X. New Business – 1) Purchase of Lab Analyzer for COVID-Ag Testing:  David Jones requested a motion and a second to purchase the Cepheid Lab Analyzer for a total of $58,689 to do COVID antigen testing. We have a guest here as well, our Lab Director, Greg Guest. David Norman made a motion to approve the purchase of the Cepheid Lab Analyzer for a total of $58,689. Brenda Smith seconded the motion.  David Jones asked Greg Guest to speak. Greg Guest said we do want to purchase a new analyzer for COVID antigen testing. It will allow our providers to diagnose and treat quicker than they can right now. It takes anywhere from four to six hours to get the results. If you get a positive result you can pretty much rest assured it is positive. I looked earlier from March through now we have done about 1,200 tests. The revenue is good on it but unfortunately right now we are having to pay out $80 each test that we perform. David Jones asked if it decreases what else can the analyzer process. Greg stated we can do a flu and strep on it. Just use a different kit. You can also do a C-dif.  David Jones said our current process is a patient comes to the ER with flulike symptoms and they have a fever of any sort, we keep them in the Emergency Room until we get these results back and like Greg said it could take upwards to 6 to 8 hours to get back. It’s not only a help to the doctors and staff but it is a little more patient friendly. Brenda Smith asked what is the discrepancy between the amount that is listed and the amount that we were told. David Jones replied it is a $995 power supply.  Brenda Smith said thank you. Mary Irvin asked if there were any other questions. There were none. Mary Irvin called for a vote. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith. Nays: None.  Absent: None. Abstain: None.  The motion to approve the purchase of the Cepheid Analyzer passed by unanimous vote in favor.  David Jones said he wanted to take an opportunity to brag on Greg Guest. We have had several employees since I have been here to get their graduate degrees. Mr. Guest is one of them. He graduated with his masters in 2018. Mary Coil is also another, Mrs. Lorrie LaCaze, Rachel Bouchard, when she was here got her master’s degree, Adam Oliver will very soon has his masters and Stacy Alexander, our DON, is working on her PhD. Numerous people have gotten their undergrad degrees, Mrs. Hughes is one of them and several others. These six people are something I would personally like to brag about. They have done a great job.  2) Purchase of Benton Clinic and Adjacent Property: David Jones said we have an offer that’s been verbally agreed upon for the purchase of the Benton Clinic and the property that it sits on for $550,000 and the adjacent piece of property for $120,000 that could go to further expansion of the Benton Clinic. Ronnie Festavan said I was blown away at what they were doing with very limited space. It was almost miraculous with what they are doing. If I’ve ever been in support of anything I would support spending funds to enlarge that. That is a market there can explode, absolutely. I would say I’ve never been more for something in the years I’ve been here to do something to give that place its potential for growth there. I just see that continuing.  I would encourage our fellow Board members to support this to move forward with that. Putting my eyes on it and getting a visual and hearing the doctor talk I was sold on that immediately. I’m somewhat skeptical sometimes but I was definitely sold on that. Mary Irvin said I apologize I didn’t bring with me, I’ll make sure I do it next time, but we have an amazing staff there, as we do at all of our facilities. They are the furthest away and maybe sometimes might feel the least connected to our main property but I’ve always been amazed at the people, I’m going to give our Administration credit, but just that the Lord brings to our organization. If there’s anybody else would like to share that would be awesome. Brenda Smith said I think the timing right now is perfect. That the building is up for sale and the land also is up for sale. And you said the land is not big enough to put one single business or anything else there. That’s why is has kind of not sold but the location is absolutely perfect where this place is at, and for the building and the land both to come up for sale at the time we have the money to purchase it to me is one of those God things. It’s like it is put in your lap. I think we would be remiss not to go for the opportunity that we have because that place can only grow. The two people who provide the service there can’t even work on the same day because the parking lot is not big enough and the building is not big enough to house that many. I think it would be remiss in not going for the opportunity that we have to expand that place. Mary Irvin asked if there was anyone else. Mary Irvin said I also just want to say just knowing our history of Benton, I appreciate our Administration being willing to take a risk because I know some of us were skeptical about what we were about to step into and our Administrator had all the confidence that it was the right thing to do. I’m thankful that we have a Board that trusts in him. I know that when we say the building is up for sale and the land is up for sale I know that has not gone without a lot of work. On the phone, the communication, I know that is enormous. That does not go unnoticed. I know that you have so much going on. As Brother Green said taking that step forward and trust in God. Mary Irvin asked if there were any questions. Mary Irvin called for a motion and a second. David Norman made a motion to purchase the Benton Clinic and adjacent property for a total of $670,000. Ronnie Festavan seconded the motion. Mary Irvin asked if there was any questions or comments. There were none. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith.  Nays: None.  Absent: None.  Abstain: None.  The motion passed by unanimous vote in favor.   3) Authorization to Move Forward with Design Phase of Benton and Blanchard Clinics: David Jones said I am looking for authorization to move forward with the design phase, meaning engaging an architect for the design for the Benton Clinic expansion and the Blanchard Clinic. We actually got bids from Vintage, NWA Design Group and TEG which is architects here. Vintage was the low-priced. Vintage’s fees are based on a percent of the overall project. This will only be for the design portion. Budget will have to be approved. Pre-bid budgets will be brought back to the Board for preliminary approval and the bid process will have to go, of course, and then we will find out what the real budget will be for the buildings and then we will come back for approval of that as well. Brenda Smith said I have a clarification question. That was designed for Blanchard but we are using it in Benton. Am I correct? David Jones said not that exact one. It will have to be different because we are using a pre-existing building. That will be in addition to. That’s the Blanchard Clinic design. They knew nothing about the Benton Clinic. Brenda Smith said so we are using that one for the Blanchard. David Jones replied yes. Brenda Smith said that is after we put the temp building in Blanchard. That would be the future for Blanchard. David Jones said that’s correct. Brenda Smith said thank you.  David Norman asked after visiting Benton will Benton move up on the priority list. David Jones replied absolutely. David Norman said they will be first. David Jones said from a speed standpoint these are pretty much where we can have these projects going on at the same time. Mary Irvin said we also have the census to contend with in our new clinics. David Jones said for the new places that we build like Blanchard we will have to have an existing clinic running. That is where move in will be and we will have to come back and get that approved from the Board as well. April 1st in generally when the census data starts coming out. Kenneth Cochran said I think Mr. Jones referred to this earlier, I am assuming we use our clinic leadership as input for this. David Jones replied absolutely.  The design process with Benton, the clinic manager, Jere and Dr. Mc Common will be the three people involved with Mrs. Hughes’ leadership. David Jones said we did that with the hospital. We brought the end users in and of course we had space restrictions. We showed them the square footage and then had the user to design. We definitely want their input.  Mary Irvin stated we are in need of a motion and a second to authorize administration to move forward with the design phase of Benton and Blanchard Clinics. Ronnie Festavan made a motion to authorize administration to move forward with the design phase of Benton and Blanchard Clinics. David Norman seconded the motion. Mary Irvin asked if there was further discussion. There was none. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith.  Nays: None.  Absent: None.  Abstain: None.  The motion passed by unanimous vote in favor.   XI. Administrative Reports: 1) NCMC – Pandemic Update:  David Jones said I wanted to give a quick update from a pandemic standpoint. We are still seeing COVID patients come in the clinics and Emergency Room with varying degrees of severity still. Seems to be on the decline versus what we’ve seen the last three weeks. I said this before months ago and I will say it again, that is the pattern that you should be ready to expect over the next twelve months. You’ll have flair ups of this and you will have declines of this. If this follows the typical colds/flu immunity, those of us that have been infected should still be able to be infected sometime in the beginning part of 2021. Until there is a vaccine that is functional and working and accepted in the community, this is life from here on out. Until that happens we’re going to fight it the way we’ve have been fighting it.    XII. Medical Staff Report – 1) Recommendations – Dakota Robinson:  Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval.  MEDICAL STAFF APPOINTMENTS:  1) Daniel Clark, M.D. – Requests Provisional privileges in the field of Emergency Medicine for the period of August 25, 2020 through August 31, 2021.    MEDICAL STAFF REAPPOINTMENT:   1) Jonathan Koehler, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of August 25, 2020 through August 31, 2022.  2) Omar Mahood, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of August 25, 2020 through August 31, 2022.  3) Yulia Bronstein, M.D. – Request Courtesy Privileges in the field of Radiology for the period of August 25, 2020 through August 31, 2022.    ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:  1) Candace Funderburk, CRNA – Requests Affiliate privileges in the field of Anesthesia for the period of August 25, 2020 through August 31, 2021.      EXTENSION REQUEST:  1) Chi-Tai Peter Lau, M.D – Requests extension upon completion of his reappointment application.  VOLUNTARY RESIGNATIONS: None.   David Norman made a motion to approve the (1) Medical Staff Appointment, (3) Medical Staff Reappointments, (1) Advance Practice Professional Appointment and (1) Extension Request as presented. Kenneth Clay seconded the motion. The verbal vote: Yea: Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith.   Nays: None.   Absent: None.  Abstained: None. The motion passed by unanimous vote in favor.   XIII. Executive Session:   There is 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. Pat White seconded the motion. The verbal vote: Yeas:  Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith  Nays: None.  Absent: None. Abstain: None.  The motion passed by unanimous vote in favor. The meeting adjourned at 4:58 p.m.

 

North Caddo Hospital Service District

North Caddo Medical Center

Vivian, Louisiana

 

 

 

                                                           

David C. Jones, Secretary

Approved by the Board of Directors at the regular meeting held September 22, 2020

 

 

 

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