BOARD MEETING:  Regular Meeting   DATE:  July 28, 2020    MEMBERS PRESENT:  Mary Irvin, Patricia White, Ronnie Festavan, David Norman, Kenneth Cochran MEMBERS PRESENT VIA TELECONFERENCE:    MEMBERS ABSENT: Kenneth Clay (arrived at 3:42 p.m.), Robert T. Green, Jr. (arrived per teleconference at 3:35 p.m.)  Brenda Smith (arrived per teleconference at 3:50 p.m.), Helen Godfrey-Smith (arrived per teleconference at 3:38 p.m.). TIME CALLED TO ORDER:  3:30 p.m.   OTHERS PRESENT: David Jones, CEO,  Pam Hughes, COO, Dakota Robinson, CFO,  Dr. John Woods, Chief of Staff, Mary Coil, Foundation Executive Director / Marketing Director, Walter D. (Doug) White, Hospital Attorney (Via Teleconference), Ross Hansen, IT Director, Adam Oliver, Ambulance Service Director, Lanell Audirsch, Admin. Asst.    LOCATION:  NCMC Café and Via Teleconference – Conference ID 626 735 880    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 Jones requested Brother Robert Green be remembered in our prayer. There was a death in his family of his first great-grandchild prior to delivery this past week. The family is struggling and dealing with that.  Kenneth Cochran offered the Invocation.     Ronnie Festavan led the group in the Pledge of Allegiance.     III. Approval / Amend Agenda – Mary Irvin stated we do need to amend our agenda and David Jones will explain that. David Jones said Madam Chair we need to add #3 under New Business which is the acceptance of the Legislative Auditor Questionnaire. This is something we typically do every year but we didn’t get it from Mary Carroll until after the agenda was set.   David Norman made a motion to approve the agenda as amended.  Pat White seconded the motion. The verbal vote: Yeas: Pat White, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Cochran, Robert Green.   Nays: None.   Absent: Kenneth Clay, Brenda Smith, Helen Godfrey-Smith.  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.   V. Minutes – Regular Meeting June 23, 2020 – The minutes of the Regular meeting held June 23, 2020 were mailed prior to today’s meeting for review. Pat White made a motion to approve the minutes of June 23, 2020 as mailed. David Norman seconded the motion. Mary Irvin asked if there was any discussion or corrections to be made regarding the June 23, 2020 minutes at this time. There were none. The verbal vote: Yeas: Pat White, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Cochran, Robert Green.  Nays: None.  Absent: Kenneth Clay, Brenda Smith, Helen Godfrey-Smith.  Abstain: None.  The motion passed by unanimous vote in favor.   VI. Foundation Report – Mary Coil, Foundation Executive Director, I will give a quick update. We are still thinking and hopefully we can throw something together if the mandates change and things change with COVID. We also had our new Board member attend our first meeting last month. She was a wonderful part of our team, joined right in and did a great job. We feel like she is going to be such an asset to our Foundation Board. Mary Irvin thanked Mary Coil. Mary Irvin wanted to let the Board know, if everyone is in agreement and on behalf of the Board, we are putting together a letter for Mr. Greg Hall and Mrs. Christy Hall just expressing our appreciation for their service to the Foundation from the Board as well as just welcoming the new member. We are going to take care of that the next month. (Helen Godfrey-Smith arrived via teleconference at 3:38 p.m.)   VII. Chief of Staff Report – Dr. John Woods, Chief of Staff, said we have our new Residents that started. They are working hard and no issues. Mary Irvin said so the Residents are here and working. David Jones said their names are Dr. McKenzie and Dr. Hopkins. VIII. Old Business – 1) Purchase of ADP HR System Update:  David Jones just give a quick update on the ADP HR System. We have had some steady progress with it. We are working to finish up the other things and hopefully by the end of this year we will have everything installed and in place. 2) Blanchard Clinic Update:   David Jones said Mrs. Irvin requested that we start going over some of the things that we were on target or strategically looking to move forward to from the Board Retreat last year. As all you know the Blanchard Clinic was our number one push and we fell into the trap of the census and how the census determines which plots of ground we can build a Rural Health Clinic on. We’ve been searching for open properties. (Kenneth Clay arrived at 3:42 p.m.) We will just have to see how that all shakes out and there will be more info coming, hopefully some good detail info coming next month.  3) CT Scanner Update:  David Jones stated we are limping along with our old scanner. We’ve got an install date of August 28th for the new CT to be put in.  4) Allscripts, 3M and Inter Qual License Renewal:  David Jones stated those were basically renewals. They’ve all been signed and done. You will be seeing those more than likely again next year except the one we did a multi-year on.    IX.   1) Review of June 2020 Statistics – Dakota Robinson:  Dakota Robinson, Chief Financial Officer, said come to you with news very similar to last month. Going through the Statistics first what you will see on Admissions is we went from 41 admissions to 45 admissions on the In-patient side. We actually increased Swingbed Admissions up to 17 for the last month. We went from 262 inpatient days the previous month to 196. Not a significant decline. If we look at the Average Daily Census it went from 19.5 last month to 16.9. Surgeries went from 11 to 9. If you look at Endoscopies, they went from 12 to 16 in the past month. Year to date we are actually one more that what we were last year. Looking at Mammography you’ll see that they did 79.  Looking at Newborns, we went from 5 to 4. (Brenda Smith arrived via teleconference at 3:50 p.m.) Looking at the Vivian Clinic you’ll see that we did a little over 2,000 visits for the month of May and we did 1,944 visits for the month of June. Plain Dealing had 746 for the month of May and the month of June they did 651. Benton we saw them go from 551 in the month of May to 537 in June. You can see that those two months were significantly above the previous three. We have seen some good numbers come through in Benton as well. Year to date in Benton, they are up 26% in total visits of 5,792 compared to 4,600 the previous year. It has turned into a pretty busy clinic. The Fitness Center, we don’t have a lot of rolling data on this. It was closed down for the better part of two months. We do have a current member count of 349 members and they did have 1,346 visits last month. Any questions on the statistics before we get into the Financial Statements?  There were none.   2) Review April 2020 Financials – Dakota Robinson:  Dakota Robinson stated just like we saw on the Statistics you’ll see that the increased volume is pretty much across the board in most departments. When we look at the Balance Sheet you’ll see that there is a total of $13,288,000 in Unrestricted accounts that is made up of three separate categories – Certificates of Deposit, Payroll Protection Program and the unrestricted bank account that is like the Operating Account. If you look at the Sales Tax fund, the prior year it was at $677,000. The previous year saw almost $22 million in Notes Payable and currently this year it’s sitting at $29 million. Cash on Hand, if you look at all of cash together, total unrestricted cash, it is right at 159 Days Cash on Hand. Since we are in this weird pandemic where monthly fluctuations happen so much I’ll point out that revenue was almost $3.6 million compared to $3.2 million in the previous year. In Salaries and Wages you will see there is an increase there but you will see there is a decrease in Employee Benefits and Payroll Taxes of $130,000. Looking at Total Expenses for the year we are at $26, 051,000 compared to $24.5 million the previous year. There is a significant increase in Other Expenses this year, mainly related to increased COVID related expenses for supplies. In Non-Operating Revenue and Expenses you will see that the grant number is a negative number that’s where we are re-classing previously booked grant revenue. You can see that Foundation did donate money this year booked to the revenue. In the Sales Tax Revenue, they did see an increase which is a good thing. The 340B Revenue we went from $1.4 million in 2019 to $1.6 million in 2020. We expect that number continue to grow. Under Increase in Net Assets or profit for the year it’s very little change from the previous year, a matter of $20,000. We saw $837,000 in profit compared to $857,000 in the previous year. Are there any questions.  There were none.  The AR Days – we see the AR Days did come down in May to 58. We saw a very slight increase to 59. On page 5, Departmental Revenue and Expense for one Month. With the almost no restrictions in the hospital and the numbers that came because of that and increases in patient volume, we saw increases in almost every department, even departments that have losses on the books we saw significant increases. If we look at Operating Expenses we look at Salaries and Wages and you will see we budgeted for $14.1 and we came in at $13.7 but we did see an increase in Employee Benefits and Payroll Taxes. In the history that we’ve seen I seen things booked anywhere from $70,000 to $150,000. Non-operating Revenue – obviously Grant Revenue came in over budget which is good. Then we looked at Sales Tax Revenue, pretty close to what we budgeted for and 340B was an increase of $41,000 from budgeted. On page 9, the Vivian Clinic did post a slight loss of $9,570. For the year they did have $746,000 in profit. Very comparable to where they were sitting last year. Plain Dealing saw very similar numbers for the month. They had a loss of $9,000 and posted a 2020 profit of $27,821.  Where we saw the big turnaround from last year is Benton Clinic on page 11. You see last month they had a profit of $36,000 and they turned a profit of $2,700 this month and had a profit on the year of $98,919. One of the main areas to point out in the Benton Clinic with the conversion to a provider based RHC. Any questions on the Financial Statements. There were none. David Jones stated that basically these financials are still in draft form and we will not approve them at this Board meeting. Mary Irvin thanked Dakota. Mary Irvin stated if everybody heard Mr. Jones, based on this is just draft form for the June Statistics and Financials, they will not be approved at this meeting. They will be at the upcoming meeting in August.    X. New Business – 1) Approval of Budget Year 2020 – 2021:    1) New Ambulance Remount:  David Jones stated if we can get a motion and a second we do have a Department Head here who would like to talk on the matter but it is rotationally time to either buy or remount a new unit for our Ambulance Department. We made the decision well over a decade ago to start going to units that we could just take box off and get a new chassis and refurbish the box and put it back on for cost saving purposed. This year we will be able to do that to Medic 7. That is going to Excellance again for $95,824.98. If we can get a motion and a second Adam Oliver, Director of Ambulance Service, has some more information along with that. David Norman made a motion to approve the new ambulance remount. Kenneth Cochran seconded the motion. Adam Oliver said I appreciate it I really do. Mr. Jones and I about a decade ago flew out to Excellance and looked at their units when I first got here in 2008. We had three different Ambulances from three different companies with no real plan at all. They would just buy an ambulance whenever they felt like they needed one.  Ronnie Festavan said for the record, we are going to take the box off of a chassis and motor and put it on a new chassis and motor, that’s what the definition of a remount is, am I correct? Adam Oliver replied yes Sir. Ronnie Festavan asked who furnishes the actual vehicle. Adam Oliver replied that will be through Excellance. We make the whole purchase through Excellance and they purchase all of that, they have an agreement with every manufacturer. Ronnie Festavan said so we get whatever they establish as far as a vehicle. Adam said we can chose which vehicle we would like but they have an agreement with those manufacturers to purchase those. Ronnie Festavan addressed David Jones are they the only people that do this. Adam asked as far as remount. Ronnie Festavan said remounts. David Jones said we found one other company that does this.  Obviously, is there a bid process for this and we followed all those guidelines and we’ve done that due diligence? Adam said Dakota and I have been on the phone today talking to our auditor about all this and making sure we have all that in place and taken care of. That is the letter you see on the screen. It’s a soul source letter but also it has a breakdown of what the chassis is and what the conversion and the breakdown of the price. Ronnie Festavan said so we have done this before, and obviously our auditors had no problem with the way it worked out before. David Jones said that was who they called.  I sat in and listened in and she was talking to Dakota and Adam about it. She actually referenced 2015 and actually had the numbers in front of her. Ronnie Festavan said they were good with what happened then so we are sort of duplicating that process, would that be accurate. David Jones it is exactly the same process. Ronnie Festavan said the process that has previously been approved. David Jones said correct. If there is no further questions or discussion about it then we are in a position to move forward with a vote on the purchase of an ambulance remount for Medic #7. The verbal vote: Yeas:  Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Helen Godfrey-Smith. Abstain: None.  The motion passed by unanimous vote in favor. Mary Irvin stated I want to let you know that when our ambulance comes back from the remount that we want to make sure that we get a special tour and let everyone see what that looks like. Thank you Mr. Oliver.      2) Konica Minolta Copier / Printer Lease:  David Jones said if I could get a motion and second I want to talk more on our copiers and printers, most of our printers, are under a lease. Our current lease is expiring in September; very soon. It was a five year lease as well. We are going back with the same company which is Konica Minolta. Though some efficiencies and decreased printers we are only going to spend $83,400 on this lease. The last lease was $183,780. That is for all of our printers and copiers for all three sites. Ronnie Festavan made a motion to approve the Konica Minolta Copier / Printer Lease. Robert Green seconded the motion.  Are there any questions. There were none. Mary Irvin noted that the printer lease lasts for five years. Dakota stated it was purchased under the GPO (Group Purchasing Organization) like we do most other purchases. The verbal vote: Yeas:  Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Helen Godfrey-Smith. Abstain: None.  The motion passed by unanimous vote in favor.    3) Louisiana Legislative Auditor Compliance Questionnaire:  David Jones noted the last item of the New Business is the Louisiana Legislative Auditor Compliance Questionnaire. The Board just has to approve that to go forward to the Legislative Auditor. Dakota Robinson stated it basically goes through and asks questions – do we have a budget, are we aware of any theft that has taken place, do we employ anybody that is against regulations that the employee is hired after a Board member takes their seat. It goes through compliance questions and then is signed by Mr. Jones and Mrs. Mary once it is all reviewed for accuracy. Mary Irvin asked for a motion and a second. Ronnie Festavan made a motion to approve the Louisiana Legislative Auditor Compliance Questionnaire. Kenneth Cochran seconded the motion. The verbal vote: Yeas:  Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Helen Godfrey-Smith. Abstain: None.  The motion passed by unanimous vote in favor.   XI. Administrative Reports: 1) NCMC – Pandemic Update:  David Jones said we have seen an uptick as far as COVID-19 patients go but severity has decreased.   Mary Irvin said I do want to make note we are planning a gathering of the Board on August 18th, Tuesday, from 10:00 to 12:00 as a supplement to adjusting our Strategic Planning Retreat. This will the Board with some Administration on August 18th to do some strategic planning and updating on some if the goals that we’ve set in the previous retreat. We have set August 18th from 10:00 to 12:00 and we will have lunch together at that time. We will be sending out some information regarding that through your email. Is there anyone that objects to that date or time? It’s the Tuesday prior to the next Board meeting to have some continuity there. Pat White said she might be out of town but she has not fully decided. Mary Irvin asked Pat White to keep her posted. Mary Irvin said we will send out some information on email asking for your thoughts and as of right now we will wait to hear from Mrs. Pat. If there are no other objections we will plan to move forward on that date. 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) Andrew Sholl, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of July 28, 2020 through October 31, 2021.  2) Joseph Heard, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of July 28, 2020 through July 30, 2021.  3) William Wesche, M.D. – Request Courtesy Privileges in the field of Pathology for the period of July 28, 2020 through July 30, 2022. 4) William Liles, M.D. – Request Courtesy Privileges in the field of Pathology for the period of July 28, 2020 through July 30, 2021.   5) Sanjeevi Tivakaran, M.D. – Requests Courtesy privileges in the field of Sleep Medicine for the period of July 28, 2020 through November 30, 2022.  ADVANCE PRACTICE PROFESSIONAL APPOINTMENTS / REAPPOINTMENT:     1) Jere Thompson, FNP – Request Affiliate Privileges in the field of Family Medicine/FNP for the period of July 28, 2020 through July 30, 2022.   2) Ruthie McRae, CRNA – Requests Affiliate privileges in the field of Anesthesia for the period of July 28, 2020 through July 30, 2022.  EXTENSION REQUEST:  None.      VOLUNTARY RESIGNATIONS: 1) Ellen Hauptmann, M.D. Voluntary resigns her privileges in the field of Radiology effective 07/01/2020.   David Norman made a motion to approve the (5) Medical Staff Reappointments, (2) Advance Practice Professionals Reappointments and (1) Voluntary Resignation as presented.  Pat White seconded the motion. The verbal vote: Yeas:  Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Cochran, Robert Green, Brenda Smith. Nays: None.  Absent: Helen Godfrey-Smith. Abstain: None.  The motion passed by unanimous vote in favor. (Brenda Smith exited the meeting via teleconference).  Mary Irvin said we wanted to take just a few minutes to thank Mr. Festavan and Mr. Norman. On July 9th they were reappointed to the North Caddo Medical Center Board on their reappointment and we want each of you to know how much we appreciate your willingness to continue your service and how much of a valued member you are to us. Thank you for being willing to do that.  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. David Norman seconded the motion. The verbal vote: Yeas:  Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Kenneth Cochran, Robert Green, Nays: None.  Absent: Brenda Smith, Helen Godfrey-Smith. Abstain: None.  The motion passed by unanimous vote in favor. The meeting adjourned at 4:45 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 August 25, 2020

 

 

 

 

 

 

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