BOARD MEETING:  Regular Meeting   DATE:  January 25, 2022    MEMBERS PRESENT:  David Norman, Kenneth Cochran, Pat White, Ronnie Festavan, Robert Green, Brenda Smith, Mary Irvin.    MEMBERS PRESENT VIA TELECONFERENCE: None   MEMBERS ABSENT: Michael W. Nation, Sr.  TIME CALLED TO ORDER:  4:01 p.m.    OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Dakota Robinson, Brent Leonard, Dr. John Woods, Paul Delaney, Lester Miller & Wells, CPA Firm,  Karliee Brister, Lester, Miller & Wells CPA Firm, Mary Coil, Foundation Executive Director / Marketing, Britney Stringham, Administrative Assistant, Ken Antee, Crews & Associates, Inc.,  Via Teleconference: Walter D. (Doug) White, Hospital Attorney      LOCATION:  NCMC Café and Via Teleconference – Conference ID 216 803 333 #    BOARD CHAIR:   David Norman   SECRETARY: David Jones   I.  CALLED TO ORDER – David Norman, Board Chair called the meeting to order at 4:01 p.m.     II. Invocation and Pledge of Allegiance – Brenda Smith offered the Invocation and Robert Green led the group in the Pledge of Allegiance.  III. Approval / Amend Agenda – David Norman stated we need a motion and a second to approve the agenda. Brenda Smith made a motion to approve the agenda. Ronnie Festavan seconded the motion. There was no discussion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin. Nays: None. Absent: Michael Nation. Abstained: None. The vote was unanimous in favor. The agenda was approved as presented.   IV. Community Comments – Ken Antee requested to address the Board. Ken Antee addressed the Chairman stating I am here in regards to Resolution #3. David Norman said thank you to Mr. Ken Antee. He asked if there were any other comments or questions. There were none.   V. Audit Report for FYE 2020-2021 Presented by Lester, Miller and Wells – David Jones, CEO, stated we have a couple of guests here in the room from Lester, Miller and Wells CPA firm. Paul Delaney introduced himself stating Mary Carroll is normally the face you would see however, she was unable to make the trip. The audit for year end 2021 was discussed.  David Norman said we need a motion and a second to approve the Audit Report for FYE 2020-2021 as presented by Lester, Miller and Wells. Robert Green made the motion to approve the audit report as presented. Mary Irvin seconded the motion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Mary Irvin. Nays: None. Absent: Michael Nation. Abstain: None. The motion to approve the Audit Report for FYE 2020-2021 passed by unanimous vote in favor.  David Norman said we thank the auditors for all the information they brought to us and it was good. David Jones said that’s not to be understated how much work Dakota and his team have to do to put all that information together. We are at their beckoned call whenever they come in. Everything shuts down to provide information for them. Dakota is the lead with that and his team has worked with that. I would say great job Dakota. VI. Minutes – Regular Meeting December 28, 2021 – David Norman stated we need a motion and a second to approve the minutes of the regular meeting held December 28, 2021 with discussion, if any, to follow.  Robert Green made a motion to approve the minutes of December 28, 2021 as presented. Brenda Smith seconded the motion. There was no discussion or corrections noted. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Robert Green, Mary Irvin. Nays: None. Absent: Michael Nation. Abstain: None. The motion passed by unanimous vote in favor.   VII. Foundation Report – Mary Coil, Foundation Executive Director, stated I will give you an update. We auctioned off the Christmas Trees. We had over 35 Christmas Trees that were auctioned. It was a great event once again. We are planning an August 27th event. We are all in prayer for that in hopes that it all goes through. So, if you want to go ahead and save the date for August 27th we are hoping to have a Safari themed fundraiser at the Petroleum Club. David Norman said thank you Mary for that report.  VIII. Chief of Staff Report – David Jones said the Chief of Staff is here, however, his absence in here means he is probably busy at this time. I did talk to Dr. Chance who is our Resident Coordinator now and I think the interviews for the three residency slots have been conducted. The medical staff will get together and rank the candidates they want to rank.   IX. Old Business – 1) Update on Building Projects:  David Jones asked Pam Hughes to give an update on the Dental Clinic and Blanchard projects. Pam Hughes stated that we are in the Dental and we’ve seen patients. Everything is going great there. Ms. Landreneau got moved into her area Monday and she is seeing patients there. Blanchard is going really good. They are working on flooring today and it’s looking great. I think he has some pictures of that. They are shooting for February 14th. I don’t know if that’s going to be it. They are starting to put up the canopy today and tomorrow we bring in the crane and lift up the steel. 2) Electronic Signage Update:  David Jones said we do have some good updates on it. They have actually have constructed the bottom portion there. The faux brick facade. Now they are just waiting on the digital screen to be ready. They will probably bring it and set it up and then set the screen top on it.  Ronnie Festavan said a word to the wise, when they get here and get it set up, make sure someone goes out there before they leave, turn it on programs it and makes sure it works. If it doesn’t you have to send in a service request to Alabama which we are currently waiting on for the Town of Vivian. It looks beautiful, but it just don’t work.   3) Update on Purchase of New Ambulance: David Jones reported the Ambulance will be picked up tomorrow. We were hoping to have it here today but it will be here and in service tomorrow.  X. 1) Review December 2021 Statistics – Dakota Robinson:  Dakota Robinson, CFO, said we tried to make the report a little bit better to read. We revamped the statistics a little bit.  Starting with Admissions you’ll see that Admissions went from 29 to 24 so we have seen a reduction in the number of admissions over the past six months. You’ll see that the Swing Beds, over the past four months has increased.  We went from 178 in November up to 236 in December.  The Average Daily Census ties hand in hand right there. We’ve seen a 31% increase from 5.8 to 7.6; that’s with everybody in-house both swing and acute stays.  ER visits – we saw a 10% increase from November. Year to date, we are actually almost a little over 3,200 visits. That’s a 23% increase from where we were at the previous year. Surgeries – You’ll see surgeries went from 18 in October, we’re down to 6 in December. I think the case load increased for January. I think we’ll see increase back in that. You’ll see MRI for the month, we did 20; we’ve done 110 on the year. CT – CT’s remain about steady.   CT stays relatively the same. There was very little change from the previous month 117 to 126.  Bone Density – you’ll probably see a request from management on this one next month. Bone Densities have gone from 32 in July down to 13 in December. That machine is actually end of life so for us to continue those in the future we are to have to make some upgrade in that department.  Endoscopies – You’ll see that we had a low of 3 in November up to 5 in December. Mr. Jones do you have anything on that? David Jones said yes. We finalized the contract today with LSU Ochsner to bring a GI doctor here that wants to come do procedures. I think they can do diagnostic scopes where ours is screening only. We did enter into a new partnership probably three years ago with Sleep Studies and we continually see that grow. This year, year to date we’ve done 262 sleep studies. We’ve actually seen a 54% increase in case load there. We actually did 51 in the month of December but you can see over the six month period 47 is our high.   Outpatient Physical Therapy – They’ve increased significantly over the past two years. The last month they have had a slight decline from 272 to 253 and year to date they’ve done almost 1,700 individual visits which is about 5% off from where it was last year. Some good numbers there. The Vivian Clinic remains almost unchanged from the previous month. They saw 1,724 patients. They’ve got a year to date volume of almost 11,500 and it’s down slightly about 5% from the previous year. Plain Dealing, a little bit different. They are off their high of 806 to 716. Year to date they’ve seen almost 4,400 patients. That’s about a 3% increase year to date. Benton – they are almost dead even where they were at year to date last year. We’ve all been to that clinic and they are maxed out. They did see 574 patients the last month in December. They’re doing great. Blanchard Clinic set their all-time high. Seems like we report that quite often. They saw 757 patients and are right at 4,200 patients year to date.  Brenda Smith asked year to date has been how many months. Dakota replied 6 months. Dakota continue stating the Fitness Center has a total membership of 311; right at 1,300 visits. They had 16 new total sign-ups in December. Should see that increase the first quarter of 2022 very similar that we do each and every year. Any questions on the statistics? 2) Review December 2021 Financials – Dakota Robinson:  Dakota stated if you look at Total Revenue over the six month period you’ll see that’s $24.1 million compared to $21.5 and when we look at net revenue there is about a $400,000 increase from where we were at the previous year. In Salaries and Wages, you’ll see that Salaries and Wages were lower than what they were reported in December.  Probably the most significant change in the financial statements right here is the $592,000 that you see under Employee Benefits and Payroll Taxes. We always talk about the self-funded insurance plan. The auditors talked about briefly in that last year was a great year for that. We saw some of the costs significantly reduced. We can’t always expect that; we would love that. Here’s a prime example of the month where it does the exact opposite. We have a million dollar claim. We had a one million dollar claim come in for one employee. Obviously we are not on the hook for that for the million dollars. Not even that a million dollars was paid out. The total payout on that right now is sitting at about $350,000. We fund that up front, then we have to wait on insurance to come in and kick in anything over our reinsurance amount of $60,000. We expect a repayment back somewhere around the range of $300,000. It’s usually around a 30 to 90 day delay in that payment. Total Operating Expenses you’ll see we had a little over $2.4 million compared to $2.2 the previous year. That’s a $200,000 increase, and on the year about $1.6. In Non-Operating Revenues you’ll see in the Grants $116,000. That is UCC dollars and some bonus payments from some of the insurance companies that we periodically get quarterly payments for reaching some incentive goals; those type of things.  On page 8 of the Budget you’ll see that we budgeted for $3.9 million in revenue and net revenue at $1.9 million. We’re about $100,000 off net patient revenue at $1.8 million and then year to date, we actually doing really good, we budgeted for $11.4 million and we are right at $12.1 million. Salaries and Wages, the auditor discussed salaries and wages being a sticking point that we’ll look at this year that our typical increase as we add staff and we grow service lines and we put raises in effect that’s about 6 to 7% that we will probably surpass that this year in what we’ve done but budget wise I think we’ve done a pretty good job in trying to peg that. We budgeted for 7.7 and we’re sitting at 7.14. David Norman 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 December 2021 Statistical and Financial Statements. Robert Green made a motion to approve the Statistical and Financial Statements as presented subject to audit.  Ronnie Festavan seconded the motion. The vote: Yeas:  Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin. Nays: None. Absent: Michael Nation. Abstain: None. The motion passed by unanimous vote in favor.   XI. New Business:  1) Approval of Resolution #1 – 2022 Granting Signatory Authority to David Jones, CEO, to Sign Contracts on Behalf of the Board of Directors –  David Jones noted that under new business we have three resolutions that we’ll do separately. The first one is pretty much housekeeping that we do every year. It’s Resolution #1- 2022 and that’s to grant me signatory authority on behalf of North Caddo Medical Center to sign contracts for the hospital.  David Norman stated we need a motion and a second for Resolution #1 – 2022. Brenda Smith made the motion to approve Resolution #1 – 2022 granting David Jones, CEO, signatory authority on behalf of North Caddo Medical Center to sign contracts for the hospital. Pat White seconded the motion. There was no discussion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin.  Nays: None. Absent: Michael Nation. Abstain: None.  The motion to approve Resolution #1 – 2022 passed by unanimous vote in favor.  2) Approval of Resolution #2 – 2022 Updating Authorized Signers for All North Caddo Medical Center Financial Accounts – David Jones noted another bit of housekeeping. Every two years when we change officers, we typically have the Chair and Vice Chair on the signatory card for our financial accounts. Right now Mr. Norman is on there listed as the Vice Chair and when we do this editing we will correct that and put him has the Chair. Mrs. Mary Irvin is on there as well and now Mr. Cochran is the Vice Chair so it is time to remove Mary Irvin and add Kenneth Cochran to the signatory card. David Norman stated we need a motion and a second for Resolution #2 – 2022. Pat White made a motion to approve Resolution #2 – 2022 updating authorized signers for all North Caddo Medical Center Financial Accounts making the changes as noted. Robert Green seconded the motion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin.  Nays: None. Absent: Michael Nation. Abstain: None.  The motion to approve Resolution #2 – 2022 passed by unanimous vote in favor.     3) Approval of Resolution #3 – 2022 Authorizing the Issuance of Sales Tax Refunding Bonds of the North Caddo Hospital Service District of the Parish of Caddo, State of Louisiana; Making Application to the State Bond Commission for Approval of Said Bonds: and providing for Other Matters in Connection therewith –  David Jones stated that is to deal with our bond refinancing. It’s a resolution required by the bond commission to be able to seek out an improved rate for our bonds. Dakota Robinson said we did this about two years ago. Basically it is an application to the State Bond Commission where we will get approval of refinance. David Norman said we will need a motion and a second to approve Resolution #3 – 2022. Ronnie Festavan made a motion to approve Resolution #3 – 2022 as noted. Pat White seconded the motion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin.  Nays: None. Absent: Michael Nation. Abstain: None.  The motion to approve Resolution #3 – 2022 passed by unanimous vote in favor.  XII. Administrative Report – 1) NCMC – Pandemic Update:  David Jones said the Covid outbreak that we are currently suffering through. It’s kind of burned through our staff pretty quickly. I think the majority of the nursing staff has had it and probably the majority of the hospital staff period have gotten it or some type of flulike illness so we will be hopefully moving beyond acute infections with some follow ups there. I have some things to add to but we will discuss that in the Executive Session.  XIII. Medical Staff Report – 1) Recommendations – Dakota Robinson:   Dakota Robinson presented the Medical Staff recommendations for Board approval. MEDICAL STAFF APPOINTMENTS: 1) Jennifer Ngo, M.D. – Requests Provisional Privileges in the field of Radiology for the period of January 25, 2022 through January 31, 2023. 2) Steven Mszyco, M.D. – Requests Provisional Privileges in the field of Radiology for the period of January 25, 2022 through January 31, 2023.        MEDICAL STAFF REAPPOINTMENT:  1) Travis Henley, M.D. –  Requests Courtesy Privileges in the field of Radiology for the period of January 23, 2022 through January 30, 2024.  2) Jill Ferguson, M.D. –  Requests Courtesy Privileges in the field of Pathology for the period of January 23, 2022 through January 30, 2024.  3) Samreena Sara, M.D. – Requests Courtesy Privileges in the field of Sleep Medicine for the period of January 25, 2022 through January 31, 2023. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:  None.    EXTENSION REQUEST:  None.  VOLUNTARY RESIGNATIONS:   1) Stephen Taylor, M.D. –  Request to voluntary resign his Privileges in the field of Family Medicine/OBGYN effective 01/07/2022.   2)  Ann Marie Marciel, M.D. –  Request to voluntary resign his Privileges in the field of Radiology effective 12/13/2021.  3) Josh John, M.D. –  Requests to voluntary resign his privileges in the field of Radiology effective 09/10/2021.  4) Daniel Clark, M.D. – Request to voluntary resign his privileges in the field of Emergency Medicine effective 12/31/2021. David Norman said we need a motion and a second to approve the Medical Staff recommendations.  Brenda Smith made a motion to approve the (2) Medical Staff Appointments, (3) Medical Staff Reappointments, and (4) Voluntary Resignations as presented. Kenneth Cochran seconded the motion. There was no discussion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin.  Nays: None. Absent: Michael Nation. Abstain: None.  The motion passed by unanimous vote in favor.   XIV. Executive Session – David Norman he would entertain a motion a second to enter into Executive Session for Strategic Planning purposes. Robert Green made a motion to enter into Executive Session. Mary Irvin seconded the motion. The vote:  Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin.  Nays: None. Absent: Michael Nation. Abstain: None.  The motion passed by unanimous vote in favor of entering into Executive Session for the purpose of Strategic Planning.   The Executive Session was entered into.   No action was taken during the Executive Session. Robert Green made a motion to enter back into regular session. Ronnie Festavan seconded the motion.   The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin.  Nays: None. Absent: Michael Nation. Abstain: None.  The motion passed by unanimous vote in favor.    XV. Adjourn – There being no further business Robert Green made a motion to adjourn. Ronnie Festavan seconded the motion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green, Mary Irvin.  Nays: None.  Absent: Michael Nation. Abstain: None.  The motion passed by unanimous vote in favor to adjourn the meeting. The meeting adjourned at 6:20 p.m.

North Caddo Hospital Service District

North Caddo Medical Center

Vivian, Louisiana

 

 

____________________________

David C. Jones, Secretary

 

 

 

 

 

 

 

 

 

 

 

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