BOARD MEETING: Regular Meeting DATE: January 26, 2021 MEMBERS PRESENT: Mary Irvin, David Norman, Patricia White, Ronnie Festavan, Robert T. Green, Jr. MEMBERS PRESENT VIA TELECONFERENCE: Helen Godfrey-Smith MEMBERS ABSENT: Kenneth Clay (arrived at 4:12 p.m.) Brenda Smith, Kenneth Cochran. TIME CALLED TO ORDER: 4:01 p.m. OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Dakota Robinson, CFO, Mary Carroll, CPA with Lester, Miller & Wells CPA Firm (via teleconference), Mary Coil, Foundation Executive Director / Marketing Director, Walter D. (Doug) White, Hospital Attorney, Britney Stringham, Administrative Assistant, Lanell Audirsch, Admin. Asst. LOCATION: NCMC Café and Via Teleconference – Conference ID 717 819 009 # BOARD CHAIR: Mary Irvin SECRETARY: David Jones I. CALLED TO ORDER – Mary Irvin, Board Chair called the meeting to order at 4:01 p.m. II. Invocation and Pledge of Allegiance – Robert Green offered a word of encouragement and the Invocation. Ronnie Festavan led the group in the Pledge of Allegiance. III. Approval / Amend Agenda – David Jones asked for an amendment to the agenda to move the XIII. Executive Session to in between IV. Community Comments and V. Minutes – Regular Meeting December 17, 2020 to discuss personnel and strategic planning. David Norman made a motion to approve the amendment to the agenda as requested by David Jones. Robert Green seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Helen Godfrey-Smith. Nays: None. Absent: Kenneth Clay, Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote. . 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. Executive Session – Mary Irvin noted we need a motion to enter into Executive Session for the purpose of discussing a personnel matter and strategic planning. Ronnie Festavan made a motion to enter into Executive Session. David Norman seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman. Nays: None. Absent: Kenneth Clay, Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote in favor. Mary Irvin stated the plan is to have a very short Executive Session to accommodate our auditor, Mary Carroll, who is joining the meeting via teleconference. (Kenneth Clay arrived @ 4:12 p.m.) The Executive Session was entered into. No action was taken during the Executive Session. Ronnie Festavan made a motion to enter back into regular session. Robert Green seconded the motion. The vote: Yeas: Pat White, Robert T. Green, Jr., Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote in favor. David Norman made a motion to accept the CEO Incentive Goals as printed. Pat White seconded the motion. Ronnie Festavan was recognized by Mary Irvin to speak. Ronnie Festavan said I wanted, for the record that the entire Board, at this time, is voting on a recommendation that was made by the Finance Committee in conjunction and collaboration with the Executive Committee. The Finance Committee studied all the provisions that are laid out in our policies as to the Chief Executive and the Incentive pay. He asked Mary Irvin if that is correct. Mary Irvin replied yes Sir. After that review and analysis of our provisions for that they have made a recommendation along with the Executive Committee to the entire Board to accept that. Helen Godfrey-Smith spoke up and said that is correct. Ronnie Festavan said now the entire Board is about to vote on accepting the recommendation of the Financial Committee and the Executive Committee after their study and providing documentation for it. Is that correct? Mary Irvin stated that is correct. Mary Irvin asked if there were any other questions or discussion. There were none. Mary Irvin stated we are now ready for a vote. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay, Helen Godfrey-Smith. The motion passed by unanimous vote. VI. Minutes – Regular Meeting December 17, 2020 – The minutes of the Regular meeting held December 17, 2020 were mailed prior to today’s meeting for review. Robert Green made a motion to approve the minutes of December 17, 2020 as mailed. Pat White seconded the motion. Mary Irvin asked if there was any discussion or corrections to be made regarding the December 17, 2020 minutes at this time. There were none. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay, Helen Godfrey-Smith. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstained: None. The motion passed by unanimous vote in favor. VII. Foundation Report – Mary Coil, Foundation Executive Director, stated there is not a lot to update on. We have decided that 2021 is not going to be a year that we are going to plan a Gala. Unfortunately that is not going to happen this year. We are looking at different avenues for a fundraiser. We are looking at some outdoor things. We are in the research phases of that and we look forward to be able to bring forth more information as they make those decisions. VIII. Chief of Staff Report – David Jones reported that Dr. Woods, Chief of Staff, was not able to attend due to some scheduling conflicts due to working 24 straight hours. He did stated that he is extremely proud and pleased to have the Ultra Sound that the Board approved at the last Board meeting. He feels that is going to be a huge asset. Other than that everything is going well. David Jones stated we should have a Medical Staff meeting sometime in February. IX. Old Business – 1) Update of Lab Analyzer for COVID-Ag Testing: David Jones stated we have a lot of updates that I will go through and please stop me if you have any questions on any of them. The COVID antigen testing, our main PCR analyzer, we are still at a major deficit as far as reagents go to be able run this test. We can average about 4 or 5 tests per week, which is the amount of reagents that we are getting. We had hoped by this time that there would be an opening up or more abundance of supplies that we could get for the analyzer, but that’s not the case. Mary Irvin recognized Ronnie Festavan to speak. Ronnie Festavan said to Mr. Jones I heard what you said and maybe you can clarify just a little bit. Folks in the public had a question. I think I had a few calls lately, not complaints but more information, as to why it takes us here 3 to 4 days to know the results of tests when they can drive to Quick Care in Blanchard and know in a couple of hours or an hour or quicker that than sometimes. I was at somewhat of a loss to answer that. I think that’s what you just went through so would you explain. David Jones said it is and to be specific with that, Mr. Festavan, the PCR test that we run here and Willis Knighton has, it is a send out test. It is the gold standard for the COVID antigen. That’s the one that takes, typically, a minimum of 48 hours to get back, a maximum of 5 days to get back. The ones they are running at Quick Care, it will give you a positive. Really, the main plus of it is, if it is negative there’s a high probability that you are negative. But the specificity and sensitivity is nowhere near what the other test is. When we first looked at those the doctors weren’t really pleased with the level of sensitivity that the test but and at this point it is better than nothing. Ronnie Festavan said whereas we did not have, up this to this point in time the capability to do a quick test. David Jones said that’s correct. We have decided that we’re going to order the equipment where we would be able to at least do that minimal test and be on a level playing field with that obviously will not have the quality or accuracy of our original thoughts. Basically we just sort of shifted gears to stay up with the times. David Jones stated that’s correct. Ronnie Festavan said might our public expect here shortly that if they come in we could give them at least the service they could get in Blanchard. David Jones replied yes Sir. That will be in the next couple of weeks. Mary Irvin asked if there were any further questions about that. This definitely is something out in the community that people question and it’s helpful for us to be able to answer that question and we appreciate you sharing that with us. 2) Update on 5948 North Market Street 2 Acres: David Jones said I think we can change gears and call that the Blanchard Clinic now because it has been approved for rezoning by the Commission. The temporary parking lot south of the clinic we will be talking about this later on in new business. Mary Irvin asked if anyone else had a question or comment. There were none. Mary Irvin stated it looks beautiful in the sketch. David Jones said it will be a nice addition once it is completed. 3) Transport Van Replacement Purchase Update: David Jones we were hoping to actually have it here and park it out so the Board could at least take a look at it. The decaling is actually being done now. The van is complete. There were several hold ups in transportation but it will be here by the next Board meeting. We assumed it would be here by this Board meeting. 4) Nurse Call System Upgrade Update: David Jones reported the Nurse Call System is complete. It is all put in and set up. We are current and up to date on that. 5) Update on Surplus Van: David Jones said the Surplus Van, again, we are just waiting for the new van to come here before we can actually send it to get a bid on. Hopefully the auction will work a little bit better than our typical bid procurement does because that typically does not work well for purchases. 6) Update on Pyxis Drug Cabinets: David Jones asked Dakota Robinson if he has a timeframe. Dakota said we had our kickoff call Friday. We have an initial timeline of the middle of April. The team lead said because of COVID that’s a pretty lofty goal so it may be sometime in May. 7) Update on Purchase of Airport Road & Hwy. 1 Property: David Jones said the update on the purchase of Airport Road & Hwy. l property really is more of an update on the use of it. We did sign a lease with Les & Jake Seafood until June of this year. We did have requirements in it; insurance, a current fire and sanitation certificate. We’ve gotten the insurance and fire certificate. They are working on getting the sanitation certificate. Other than that he’s pretty much complied with everything we’ve asked him to do. We, nor he, has any intention of extending it past June of this year. Mary Irvin recognized Ronnie Festavan to speak. Ronnie Festavan said I think I’ve asked this question but just to clarify; the mobile home on the property does that belong to the property. David Jones said that does belong to the prior owner. We gave them 90 days past closing to move it and 90 days will be up sometime in lateish February. Ronnie Festavan said thank you. 8) Purchase of Ultra Sound Update: David Jones said on the Ultra Sound Update I gave a quick synopsis in the Chief of Staff report. The Chief of Staff is very proud of this purchase and he really does feel that this will be a compliment and a sincere help to what he does and what the other ER doctors do in the Emergency Room. He is very excited about a new tool that we will be using to help our patients. Mary Irvin asked if it is being used on patients. David Jones replied yes it is. IX. 1) Review December 2020 Statistics – Dakota Robinson – Dakota Robinson, CFO, said if you look at the Admissions, you will see that over the past 5 months we hit sort of a high of 59 to 60. It did decrease to 46 acute admissions for the month of December and then we also saw a reduction in the Swingbed number admissions. That’s sort of the typical for December to see that trend down. If you look at the Average Daily Census you’ll see that has tapered down over the winter months. In December we went from 9.5 to 7.5. Surgeries is above the 10 threshold. We went from 15 in November to 11 in December. Year to date we have done 87 surgeries which is an 18% increase over this point last year. Endoscopies we went from 9 in November to 16 in December. That’s a significant increase. That is sort of where we were at two month prior. Year to date we are one shy of where we were at the prior year. I think we had 80 the prior year and we are at 79 year to date. ER Visits – We talked about in the Finance Committee. Mammograms – This in one of those areas that was obviously behind like surgeries. We went from 38 in November to 54 in December and year to date is 310 which is actually a 40% increase over the prior year. Newborns – we went from 9 in November to 6 in December. It is very cyclical. The Vivian clinic remains really unchanged from the prior month. They saw 2,049 patients. Year to date they are less than 1% below where they were last year. We see similar things in Plain Dealing; actually better. We went from 676 patients in November to 755. An actual 14% increase this year in the Plain Dealing clinic. We see very similar things in Benton. They went from 488 to 512. They’ve seen right over 3,200 patients this year which is a 16% increase. When we look at aggregate outpatient volume we’re seeing really good numbers through the clinics and a lot of the ancillary departments. The Fitness Center – total members is at 307 and they almost had 1,300 visits in December. Any questions on the Statistics. There were none. 2) Review December 2020 Financials – Dakota Robinson: Dakota Robinson said obviously we saw in some of our largest areas like inpatient care, swing bed we saw reductions in numbers which reflect in the financial statements a little bit. If we look at the Days Cash on Hand on the Balance Sheet you will see that we’ve got 257 days cash on hand. Unrestricted without the CD’s is 246 days cash on hand. Dakota continued stating we will move to the Income Statement on page #3. At the top, you will see Revenues of $3.4 million compared to $3.7 million. That is a reduction from the previous year. We saw that in the statistics. One of the areas that helps to make up that difference, when we get down to the Net Patient Revenue that sort of puts us in the black, is when we filed the Cost Report obviously we are receiving a large chunk back so that means that we booked too much in contractual adjustments. That is one of the reasons why when we look at Net Revenue we actually beat the previous year by $65,000 and if we look at the year to date we’ve done $11.6 million in Net Revenue compared to $9.9 million and that’s about a $1.7 million difference. Pretty good in revenue and contractual adjustments. If you look at the revenue on the six month period we are actually $209,000 more than what we were at the previous year. In Salaries and Wages you see that we are actually $1.24 million, $20,000 less that then previous year. In Employee Benefits and Payroll Taxes you’ll see that there’s a big difference – $311,000 last year, $169,000 this year and through six months we are still $200,000 less than what we were. Looking at Total Operating Expenses of $2.2 million compared to $2.3 million the prior year it’s a reduction of almost $71,000. If you look at the six month period we’ve see an increase from $12.5 million to $13.5 million. We are just trying to catch it up to where it should be at December. We also had the MCIP that we entered into the agreement with Ochsner. Part of that agreement was we were allowed into the MCIP program. We received, last year, right at $500,000 by joining into that program and doing some compliance things through that. Michele Heflin is actually the lead on that and has done a great job. We are half way through the program this year and just received a payment of about $201,000. We expect to get similar to where we were last year at $500,000, but right now we know the cash in hand we received $201,000. We’ve got some benefit from that in this year. You’ll see the 340B Revenue at $132,000. We will see an increase in probably February’s 340B number. It’s not lost revenue it’s just delayed because of some system upgrades; the way that everything talks together. Looking at six month data, this time last year we had $704,000 and we are sitting right a million. That’s a 42% increase in 340B and we are continuing to make changes there. If we look at Increase in Net Assets for the month of December you’ll see that there is a profit of $453,000; six months that’s $2,070,000 compared to $706,000 in 2020. Any questions on the Income Statement. There were none. You look at Physical Therapy, Speech, OT, PT – those are in the plus from the previous year. I know there’s been changes in how we run those, what those look like. We’ve got a lot of optimistic things when it comes to ancillary departments. The Budget on page #8 you’ll see that we budgeted for $3.7 million in Revenue. We actually did $3.4 million. When you look at the Net Patient Revenue we actually did $46,000 more than we budgeted for in Net patient Revenue in the month of December. We look at the six month data, we did $575,000 more than we budgeted for which is about 5.2% over what was budgeted. We get into Salaries and Wages we were at $1.2 million we were actually hit our budget within $183 for the month of December and on the six month period we are below budget by $52,000. Non-Operating Revenues, obviously the Grant Revenues has surpassed the budget by almost $1.3 million over six months and then we were very lofty on the 340B with our budget of $900,000. Mary Irvin stated if there are no further questions or discussion on the statistics or financial statements we need a motion and a second to approve our December Statistical and Financial Reports. Pat White made a motion to approve the Statistical and Financial Statements as presented subject to audit. Robert Green seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote in favor. X. New Business – 1) Purchase of Hematology Analyzer for Blanchard Clinic – David Jones stated the first two items under new business are related to the Blanchard Clinic. If I could get a motion and a second on #1 To Purchase a Hematology Analyzer from Beckman Coulter for $19,950.00 for use inside the Blanchard Clinic I will answer any questions the Board may have. Robert Green made a motion to approve the purchase of a Hematology Analyzer from Beckman Coulter for $19,950.00 for use inside the Blanchard Clinic. David Norman seconded the motion. Mary Irvin said we have a motion and a second. Are there any questions or discussion about it? If not we are ready to vote. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote in favor. 2) Approve Asphalt for Temporary Blanchard Clinic Parking Lot: David Jones said #2 as well we need a parking lot for our temporary building. We couldn’t wait for the parking lot for the main building. It would be useless to put a temporary clinic up. We had to go with the plans to build a temporary parking lot with asphalt that will be removed once the permanent building is put in place. We had a couple of bids for that. The lowest bid is for Johnson Construction Services at $17,874.00 and that is for completion of the temporary parking lot of the Blanchard Clinic. Mary Irvin said we need a motion and a second and then discussion. Ronnie Festavan asked how many bids did we have? David Jones replied we sent to three companies but only two chose to bid. Kenneth Clay made a motion to approve the asphalt for the temporary Blanchard Clinic parking lot. David Norman seconded the motion. Mary Irvin asked if there was any discussion on the temporary parking lot for Blanchard. Mary Irvin stated I have a question. You mentioned it would be removed. Dakota Robinson showed a visual of the main parking that will permanent and the temporary one is an overlaid. This will not exist in phase 2, but phase 1 will be this temporary outline of the parking lot and obviously that will need to be removed to finish the main building. David Jones said they are bringing up the grade and then put 2 inches of asphalt on top of that so it is easy to be removed. Pat White asked if the price presented included removal of it later. David Jones replied no Ma’am. Mary Irvin asked if there were any other questions. There were none. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote in favor. 3) Approval of Resolution #1 -2021 Granting Signatory Authority to David Jones, CEO, to Sign Contracts on Behalf of the Board of Directors: David Jones said we’ve talked about doing this before but it is just a bookkeeping item, but from time to time different places that we purchase from needs proof that I am the CEO and I do have signatory authority for the organization. This is Resolution #1 – 2021 Granting Signatory Authority to David Jones, CEO, to Sign Contracts on Behalf of the Board of Directors. Mary Irvin stated we need a motion and a second. Pat White made a motion to approve Resolution #1 – 2021 as presented. Robert Green seconded the motion. Mary Irvin recognized Ronnie Festavan to speak. Ronnie Festavan asked David Jones are these double signed checks or are you allowed to sign. David Jones replied the checks require two signatures. Ronnie Festavan said so it requires two signatures. Dakota replied yes. Everything we have here requires two signatures. The people that are authorized to sign are Mrs. Hughes, Mr. Jones, the Chairperson and Vice Chair. Ronnie Festavan said thank you. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote in favor. Mary Irvin said this is a procedure that we did in 2020, it’s just a new year. It is a common practice. David Jones replied yes. XI. Administrative Reports – 1) NCMC – Pandemic Update: David Jones stated regarding the Pandemic Update, I want to take minute to brag on our CFO and our staff. I’m sure you’ve heard or seen that we were the first organization in the area – small, big, medium, little – to deliver the vaccine to the general public. The first day Ochsner actually had planned to do, but remember that was our snow day, and everybody cancelled all of their things in Shreveport, which we did not. Dakota and his team, and I will let him speak on it because I’m sure he would like to brag on some folks, but delivered around 140 doses on that first day. It went unbelievably smooth to be totally honest. We shifted gears and went over to Bossier Parish and delivered some in the Benton area and to Plain Dealing and finished up here. Dakota stated we were talking four days’ worth of about six and one half to seven hours a day of just giving vaccines. We gave a little over 500, almost 600 vaccines and did it very, very efficiently. Nursing Service had some great nurses out there, Adam Oliver with our Ambulance Service did a great job helping man everything, set it up. Then my Business Office people being able to get all the patient information and registered. Some of you, I saw your faces there so you saw the process. It went very, very well. David Jones said like everything else, support staff, we had maintenance help set up the tents and while they were over here the cafeteria cooked food for them that we brought out there. It was incredible. Marketing was out there and we put some pamphlets together and gave to numerous patients that said about the same thing they all say whenever they see the building for the first time. We had people all the way from Stonewall to southern Bossier Parish, and a little into Webster Parish. We were the only small hospital to get the first round in this section of the state and we delivered them. We do have a wait list. David Jones said we do request their insurance information. We are billing their insurance for this but there is no out of pocket whatsoever. If there’s a deductible or their insurance plan doesn’t pay for anything there is no charge to the patient but we are billing for the ones that we can. It’s just a slight $17 charge but the patient doesn’t pay any of it and the second dose is $28. Mary Irvin asked if anyone else had any questions. There were none. Mary Irvin thanked Mr. Jones. XII. Medical Staff Report – 1) Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval. MEDICAL STAFF APPOINTMENTS: None. MEDICAL STAFF REAPPOINTMENT: 1) Kirtesh Patel M.D. – Requests Courtesy Privileges in the field of Pathology for the period of January 26, 2021 through January 31, 2023 2) Manish Dhawan M.D. – Request Courtesy Privileges in the field of Hematology/Oncology for the period of January 26, 2021 through January 31, 2023. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: 1) Alicia Lowery, FNP – Requests Affiliated Privileges in the field of Hematology/Oncology for the period of January 26,2021 through March 31, 2022. EXTENSION REQUEST: 1) Stephen Taylor, M.D. – Request extension upon completion of his reappointment application. 2) Walker May, M.D. – Requests extension upon completion of his reappointment application. 3) Michael Banda, M.D. – Requests extension upon completion of his reappointment application. 4) Pamela Hall, CST – Requests extension upon completion of her reappointment application. VOLUNTARY RESIGNATIONS: None. David Norman made a motion to approve the (2) Medical Staff Appointments, (1) Advance Practice Professionals Appointment/Reappointment and (4) Extension Request as presented. Kenneth Clay seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstain: Helen Godfrey-Smith. The motion passed by unanimous vote in favor. 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 verbal vote: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Clay. Nays: None. Absent: Kenneth Cochran, Brenda Smith. Abstain: Helen-Godfrey Smith. The motion pass by unanimous vote in favor: The meeting adjourned at 5:35 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 February 23, 2021