BOARD MEETING:  Regular Meeting   DATE:  August 27, 2019    MEMBERS PRESENT:  Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Patricia White.      MEMBERS ABSENT: Kenneth Clay, Helen Godfrey-Smith (arrived at 6:02 p.m.)    TIME CALLED TO ORDER:  5:30 p.m.   OTHERS PRESENT: David Jones, CEO,  Pam Hughes, COO, Dakota Robinson, CFO, Dr. John Woods, M.D., Chief of Staff, Walter D. (Doug) White, Hospital Attorney, Mary Coil, Foundation Executive Director / Marketing Director, Lanell Audirsch, Admin. Asst.  LOCATION:  NCMC Events Center   BOARD CHAIR: Robert T. Green, Jr.     SECRETARY:  David Jones     I. CALLED TO ORDER – Robert T. Green, Jr., Chairman, called the meeting to order.   II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation.  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. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Pat White.  Nays: None.   Absent: Kenneth Clay, Helen Godfrey-Smith.  Abstained: None.   The motion passed by unanimous vote in favor.  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 July 30, 2019 –  The minutes of the Regular Meeting held July 30, 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 July 30, 2019 as mailed.  Kenneth Cochran seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Pat White.  Nays: None.   Absent: Kenneth Clay, Helen-Godfrey Smith.  Abstained: None.   The motion passed by unanimous vote in favor.   VI. Old Business – 1) All Scripts Interface Update – David Jones reported that our IT Director said in the next thirty days we may have a workable interface. They do have some things moving forward. Hopefully at the next Board meeting maybe we could take that one off the agenda. We won’t be there until we have something working.   2) X-Ray Room and Mobile X-Ray Update:  We are still working on the X-ray Room. We actually have the mobile device in. David Jones said they are extremely pleased and happy. He asked if Dr. Woods if has seen the images off it. Dr. Woods replied yes and they are really good. Pam Hughes said you can walk up to it and see the image real time. Dr. Woods said it is immediate. David Jones said the X-ray Room is supposed to be just as quick. Dr. Woods said it is definitely a needed update and is going to be used. 3) Purchase of Exchange Server Update: David Jones noted a quick update on the Exchange Server which the purchased was approved at the last Board meeting. This isn’t actually a physical device. It is a cloud purchase. The server is going to be transitioned into the cloud per se long term wise. It is going to be a slow transition into that. Ross said it may take a couple of months to get everything off of the physical server that it is on into that storage area that everybody calls the cloud.    4) Blanchard Clinic Project Update:   David Jones asked Pam Hughes if she would give a report. Pam Hughes stated that we have met with the architects and given them a list and actually then Dakota and I met with them again this week. We are scheduled to get some preliminary plans in the next few weeks and prices.    VII. 1) Review July 2019 Statistics – Dakota Robinson, CFO – Dakota Robinson, CFO, said this month is a lot easier compared to the June’s set of Financials that we had. The Statistics look pretty good compared to last month. You will see on the Admissions slide with 49 acute admissions and 13 swing bed admission. Previous month was 34 and 12 so that was a dramatic increase in admissions. We saw the Inpatient days increase to 171. Also, we had 194 swing days. In July of 2018 we had 60 swing days. That is a huge difference we are putting quite a bit more emphasis on the swing bed program with a few ideas that we have kicked around lately. We had an average daily census of 10. You will see that surgeries, we had 15.  Dr. Banda was back at it this month. Previous two months were 5 and 3 respectively. 15 is back at where we would like to see it. We want to see that number over 10 consistently. We look at Endoscopies – we went from 4 to 19. You will see across the board, the hospital was quite a busy place for the month of July. If you go to the Emergency Room visits – we went from 459 to 501. Looking at Mammographys – you will see that we did 50 mammographys last month. If you look at Newborns – we had 8. In the month of June we had 1. Another category where things were looking up. If you look at the Vivian Clinic, there was a slight increase. We saw 1,823. We did see a dramatic increase in the number of Plain Dealing visits. Last month Dr. Mc Common was on vacation. We went from 480 to 571. In the Benton Clinic, Dr. Mc Common sees patients in the Benton Clinic as well so when she is on vacation it affects both of them. We are back to the average at 442. Are there any questions on the statistics? It is pretty bright for the month. There were none. Fitness Center members, I left that one off – there were 428 – a slight reduction.    2) Review April 2019 Financials – Dakota Robinson, CFO – Dakota Robinson stated on the Financial Analysis, I like to pick out a few things to review. As we saw with the numbers the numbers picked up in the month of July and that is a positive. If you look at Days Cash on Hand, Days Cash on Hand rose significantly to 60.75. That does not include the Board reserve that we have in the CD’s. When we include those in we are looking at 73 Days Cash on Hand. So cash on hand that is non-restricted, we’re almost at $4.3 million dollars. That is a significant achievement at North Caddo. David Jones said the 73.18 Days Cash on Hand, we have been talking for over a decade that 90 was always our goal, which basically was a fantasy goal. Dakota said that was the unicorn. David Jones said that is right. But, that was always what we were shooting for. We are going to get that. It is within reach now. The UCC filing that we just received, that is going to help. Dakota’s 340B program that he spearheaded and brought in, that is a lot of this cash can be attributed to that. We’ve been doing very well and Dakota has been doing a great job.  When you get down to the Employee Benefits and Payroll Taxes, you will see a reduction. There is $19,000 in that expense account. We all know that $19,000 wasn’t technically cash going out for the month of July. That is an accounting function where that expense is reduced on the financial statements because we actually expensed it in the month of June, so we increased the expense in the month of June. One of the main things I talked about almost all of last year was the contractual adjustment. When you’ve got $3.5 million dollars in revenue and a contractual adjustment $1.9 million dollars. That is a significant piece of this financial statement. That comes out to be a little over 53%. For the year last year we were seeing numbers up to 55% on a contractual adjustment. A 2% difference in that is dramatic. We’ve seen it come down, and hopefully we will keep seeing that trend throughout the year and hopefully that helps us out on the Cost Report, too, once we finally get that filed. If you look at Total Operating Expenses for the month, $1.799 million dollars as opposed to $1.756 million the previous year. That is only a $43,000 increase. We jump down into Non-Operating Revenues, I will say that in this number, we are used to seeing a large UCC being accrued each and every month, there is no UCC in this yet. Dakota said I think that is part the reason you have seen the cash balances not just 340B, not just UCC, but we have had multiple different things across the board that have contributed to having $4.3 million dollars in unrestricted cash. It is not because we’ve budgeted on it and we have put it in the budget to become an expenditure next year. It is there was a surplus and we’ve recognize that and we didn’t adjust the budget for it in the next year to go out and spend that money, but instead put across in a $700,000 CD. Dakota said obviously there is no UCC accrued on here. You will probably see that number pop in there next month. We have the typical $105,000 Sales Tax accrual, and 340B brought in almost $128,000 last month. That gives us an increase in assets of $152,000. The budgeted increase that we had budgeted was $64,000 so we have surpassed the budget this month which is good. AR days decreased to 44.29. That is the first decrease below 50 days since September of 2018. That is another positive in the Income Statement. On page #5, we will look at the Departmental Revenue and Expense. You will see that it’s a mixed bag in the departments. You’ll see that inpatient routine care compared to the previous month is down a hair, not enough to be worried about. We are once again talking about the therapies, which is speech, physical and occupational and inhalation therapy. We have quite a few ancillary departments that have increased their business and added to an increased bottom line.  On page 8, the Vivian Clinic, we will look at that page. They had 1,823 visits and they produced a profit of $45,052. The Vivian Clinic, in the past 12 months, has been one of those departments that has done very, very well for North Caddo and has actually done better than it has in previous years. Hopefully we can continue seeing that in the future. Page 9 – the Plain Dealing Clinic, you will see that they had 571 visits and produced a profit of $12,402.  Then we get into Benton Clinic that requires description each month. They had 442 visits and produced a loss of $2,600. This clinic, we finally did get our license converted. Dakota asked if there were any questions.  There were none.  Robert Green stated he would entertain a motion. Pat White made a motion that the Statistics and Financials be approved as presented subject to audit. David Norman seconded the motion.  The vote:  Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Pat White.  Nays: None.  Absent: Kenneth Clay, Helen Godfrey-Smith.  Abstained: None.  The motion passed by unanimous vote in favor. (Helen Godfrey-Smith arrived at 6:02 p.m.)   VIII. Executive Session:   Robert Green stated he would entertain a motion to enter into Executive Session for the purpose of Strategic Planning.  Pat White made a motion to enter into Executive Session for Strategic Planning. Ronnie Festavan seconded the motion. The vote: Yeas: Robert Green, Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Kenneth Clay.    Abstained: None.  The motion passed by unanimous vote in favor.  The Executive Session was entered into.   No action was taken during the Executive Session.  Brenda Smith made a motion to enter back into regular session.  Ronnie Festavan seconded the motion.   The vote: Yeas:  Robert Green, Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Kenneth Clay.   Abstained: None.   The motion passed by unanimous vote in favor. Due to a prior commitment Robert Green asked to be excused with Mary Irvin, Vice-Chair to preside over the meeting. (Robert Green departed the meeting at 6:39 p.m.)   IX. New Business – 1) Board Approval of Surplus Equipment List: David Jones noted that #1 under new business we have a Surplus List. The list will be published in the paper. Mary Irvin said so it will run in the paper for three weeks and then after the three weeks there will be a deadline for the bids. David Jones replied yes. The opening will be the next week. David Jones stated we need a motion. Pat White made a motion that the Surplus List be approved. Ronnie Festavan seconded the motion to approve the Surplus Equipment List.   The vote: Yeas: Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Kenneth Clay, Robert T. Green, Jr.   Abstained: None.   The motion passed by unanimous vote in favor.    2) Management Contract:  Mary Irvin ask for a motion on behalf of the Management Contract. Helen Godfrey-Smith made a motion that the Board empower our CEO to move forward to negotiate with Ochsner – LSU, a management contract, with the understanding that North Caddo Medical Center remain autonomous as an organization, and he will address with them the other important pieces and bring it back to the Board at the next meeting. Brenda Smith seconded the motion. The vote:  Yeas: Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Kenneth Clay, Robert T. Green, Jr.    Abstained: None.   The motion passed by unanimous vote in favor for the CEO, David Jones, move forward with negotiation of a management contract to be brought back to the Board at the next meeting.  X. Administrative Reports – 1) NCMC – Current Activity:   David Jones said under current activity, I’m just briefly going to touch on, because I can’t brag on or say enough on the Havana Nights. That was the best party the Foundation has thrown so far. To me it was the best one so far. That certainly could be laid at our Foundation Executive Director’s feet. David Raines recently had their annual banquet and we had good representation from the hospital there as well. Between that and the construction, which we will give a report on in a little bit, that is our current activity.   2) Foundation:   Mary Coil said we had a big party. We had a great, great turn out. The Foundation Board did a great job. We had several sponsorships from the Board members. I think Edie Festavan sold 22 tickets and then sponsored. They worked so hard and we had a committee, also, that is not on the Board, but joined in to help with the Havana Nights. They were exceptional. They were talented and hands on. It was truly a great experience. The night was hopping. We also had entertainment in two other rooms including a pianist and a saxophonist. We’ve heard just great compliments and great feedback. I am very proud of that. It has been our tenth event. Mary Irvin said we hope next year that we can encourage everyone to come that can and I know that sometimes things happen in life where we can’t use our tickets and if that happens and you don’t have anyone to give it to call Mary because we can do creative things with our own hospital staff. She did some really fun things. I wasn’t able to attend last year and wanted to do something with the tickets. There are some neat things that we can do to encourage and show appreciation to some of our staff employees. Mary Coil said we had some fun things with that this year.   3) Construction Report:    Pam Hughes stated that we have moved into the new part. We got the Fire Marshall okay, the Sanitation and I sent all that to DHH and they decided to not come and survey us. They gave us clearance with coming to survey. That was good thing so we got to open up the two ER rooms that were added and whole Women’s Center. We moved out of the old X-ray side and the next day they had the temp wall up, the end of the hospital torn down and was gutting the inside. David Jones said they blew a hole in the wall there. That was all in one day. Ronnie Festavan asked when will the Emergency Room be fully functional so you can drive in in the drive way. Pam Hughes replied it should be at the end of this week or the first part of next week. Mary Irvin said that it is very exciting. Ronnie Festavan stated that it seems like we just started. David Jones stated that it is impressive.  Mary Irvin asked if there was more discussion. There was none.  XI. Medical Staff Report – 1) Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval:  MEDICAL STAFF APPOINTMENTS: 1. Jonathan Loehler, M.D – Requests Provisional Privileges in the field of Pathology for the period of August 27, 2019 through August 31, 2020.  MEDICAL STAFF REAPPOINTMENT: 1. James Price, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of August 27, 2019 through August 31, 2021.  2. Gregory Wellman, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of August 27, 2019 through August 31, 2021.   3. Thomas Fiorito, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of August 27, 2019 through August 31, 2021.  4. Omar Mahmood M.D. – Requests Courtesy Privileges in the field of Radiology for the period of August 27, 2019 through August 31, 2020.  5. Yulia Bronstein, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of August 27, 2019 through August 31, 2020.  6. Kurtis Tedesco, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of August 27, 2019 August 31, 2021.   ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS / REAPPOINTMENT: None.  EXTENSION REQUEST: None.   VOLUNTARY RESIGNATIONS: None.  David Norman made motion to accept the Medical Staff Reappointment and Reappointments as presented. Kenneth Cochran seconded the motion. The vote: Yeas: Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Kenneth Clay, Robert T. Green, Jr.    Abstained: None.   The motion passed by unanimous vote in favor.  2) Chief of Staff Comments:  David Jones stated that the Chief of Staff, Dr. John Woods, had to leave to go to the Emergency Room. He said he gave his comments during the Executive Session. They were strategic in nature. XII. Adjourn:  There being no further business, Mary Irvin called for a motion to adjourn. David Norman made a motion to adjourn. Pat White seconded the motion. The vote: Yeas: Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Kenneth Clay, Robert T. Green, Jr.    Abstained: None.   The motion passed by unanimous vote in favor. The meeting adjourned at 7:00 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 24, 2019