BOARD MEETING:  Regular Meeting   DATE:  June 22, 2021    MEMBERS PRESENT:  Mary Irvin, David Norman, Kenneth Cochran, Ronnie Festavan, Robert T. Green, Jr., Brenda Smith, Helen Godfrey-Smith, Pat White.    MEMBERS PRESENT VIA TELECONFERENCE: None.   MEMBERS ABSENT:  Kenneth Clay (arrived at 4:07 p.m.)  TIME CALLED TO ORDER:  4:03 p.m.    OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Dakota Robinson, CFO, Walter  D. (Doug) White, Hospital Attorney, Mary Coil, Foundation Executive Director / Marketing Director,  Stacy Alexander, Director of Nursing Service, Britney Stringham, Administrative Assistant, Lanell Audirsch, Admin. Asst.    LOCATION:  NCMC Café and Via Teleconference – Conference ID 518 266 853 #    BOARD CHAIR: Mary Irvin    SECRETARY:  David Jones      I.  CALLED TO ORDER – Mary Irvin, Board Chair called the meeting to order at 4:03 p.m.     II. Invocation and Pledge of Allegiance – Helen Godfrey-Smith offered the Invocation and David Norman led the group in the Pledge of Allegiance. Brenda Smith will offer a word of encouragement.     III. Approval / Amend Agenda – Mary Irvin noted we do have some amendments to share. David Jones stated we need to add #3 under New Business to engage Lester, Miller and Wells CPA Firm for the Single Audit for the Year 2021 – 2022. If I can get a motion and a second I will answer any questions you have. Brenda Smith made a motion to amend the agenda to include #3 under New Business to engage Lester, Miller and Wells CPA Firm for the Single Audit for the Year 2021 – 2022. Robert Green seconded the motion. There was no discussion. The vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: Kenneth Clay, Abstain: None. The vote is unanimous 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.  Board Education – David Jones stated we are going to have the Board Education but we felt it prudent to be talked about in Executive Session versus open forum. Mary Irvin stated our first five will be our last five of education.    VI. Minutes – Regular Meeting May 25, 2021 – Mary Irvin stated we need a motion and a second to approve the minutes of the regular meeting held May 25, 2021 with discussion, if any, to follow. The minutes were mailed prior to today’s meeting for review. Robert Green made a motion to approve the minutes of May 25, 2021 as presented. Helen Godfrey-Smith seconded the motion. (Kenneth Clay arrived at 4:07 p.m.)   There was no discussion or corrections noted. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: None.  Abstained: None. The motion passed by unanimous vote in favor.  VII. Foundation Report – David Jones stated Mary Coil is on her way. She asked me to remind the Board that the big drawing is this Friday for the Foundation’s big fundraiser they are doing this year. David Jones said it should be a fun time.  VIII. Chief of Staff Report – David Jones said we have three fulltime ER doctors. Dr. Woods is working a lot this week. He will be here at 6:00 p.m. He was not going to be able to make it here for the Board meeting. He said business is usual. They will be getting the new Residents in. We did a couple of things to say goodbye to the two third year Residents that are leaving and they are pretty solid.  They should have very good careers – high expectations.   IX. Old Business – 1) Update on Building Projects:  David Jones said the building projects are progressing.  The roof project should start in August and hopefully we will have six to eight weeks of fairly dry weather.    2) Update on Pyxis Drug Cabinets:  David Jones stated that the Pyxis Drug cabinets should be live and installed and in use on July 19th. We finally have a date. Training was going on today on site for Nursing Staff as far as use of those. Luckily we’ll finally have this project, hopefully, put to bed by next Board meeting.  X. 1) Review May 2021 Statistics – Dakota Robinson:   Dakota Robinson said turning to the Statistic page you’ll see that the Admissions, there was a slight decrease of about a 6% decrease from last month from 47 to 44 and year to date we have seen an 11% decrease in Admissions. Swing, we had a 3% decrease from the previous month and we’re about 10% down from the previous year. Inpatient Days, you’ll see went from 315 to 230, so the stays that we did have were much shorter. It is still higher than the 171 that we had in March and there were 77 Inpatient days in Swing. Surgeries – the threshold right there is about 10. You can see it went from 14 in April to 16 in May. We’ve had 159 surgeries year to date and that equals about a 22% increase from the previous year. Endoscopies –  we saw sort of the same trend – up from 14 to 15 and we’ve seen a 20% increase year to date and part of that large increase number is we were now into those months where surgeries and endoscopies were shut down in the previous year. Mammograms –You see that it went from a high of 54 in December down, which wasn’t that high. There was a previous month that was higher than that, but May at 24. If we remember back in statistics pre-COVID that was about our range somewhere in the mid 20’s, possibly bumping into the 30’s, so we’re in that area where I think, historically, we’ll keep seeing that trend go forward and I think we we’ll lose those spikes of 50 visits and 60 visits. That backlog has been cleared in that department.  Newborns – very cyclical and you’ll see that we went from five in April to six, so it’s one more and year to date, we’ve had a 9% increase year to date. The Vivian Clinic is very, very close to their year to date that they were last year. They are down about 1.5% but they’ve had almost 22,000 patient visits year to date.  Plain Dealing clinic went from 663 in April to 595, so even though they had a slight decrease over the past month they actually have hit 7,253 year to date which puts them 5% over where they were the previous year and we see very similar numbers both on the month and year to date and the Benton clinic, you’ll see last month they did 440; year to date they’re actually over 5,600 visits which puts them in a 7% increase from last year. Blanchard Clinic, and obviously not a lot of historical data, but their high of 504. Dakota continued with total visits for the Fitness Center were up to almost 1,500 and 319 members. Any questions on the Statistics? There were none.    2) Review May 2021 Financials – Dakota Robinson:  On the Financial Analysis, starting with the Balance Sheet, I’ll just give you a brief overview.  If we look at page one of the Balance Sheet you’ll see that Unrestricted Cash at the top is almost at the $17.9 million range. When you look at Days Cash on Hand you’ll see that without the CD’s we went from 252 Days Cash on Hand to 258 and by the time we add the CD’s in on it we’re almost right at 270 Days Cash on Hand. Since that time period, I took a snapshot yesterday. The cash balance is up to $18.9 million and 285 Days Cash on Hand as of June 2lst.  If you look at Capital Assets, you’ll see this is an area that will continue to sort of bounce around as we add buildings, we add equipment.  If we get in the Income Statement on page 3, we will start at the top. We’ll see that Net Patient Revenue for the month was almost $4 million compared to $3.3 million the previous month. About a $673,000 increase and if you look at year to date we’re almost 7% above where we were at in 2020. Also, contractual adjustments are down.  Employee Benefits and Payroll Taxes are almost neck and neck where they were at through 11 months last year at $2.7 million. There’s actually slightly under where we were at by .4%, so not much of a change there. One of the areas where you see the biggest discrepancy, if you would from the previous years, medical supplies and drugs. Remember that the two main categories there are going to be your actual medical supplies. A lot of that’s related to the supply increase due to COVID. When we get down in the revenue side we’ll talk slightly about that, but when you get the Total Operating Expenses you’ll see that the Total Operating Expenses were about $2.2 million compared to the almost $2.5 million the previous year, and when you look year to date, it’s up about 7% to $25.1 million. In the Non-operating Revenue side under the Grant section you’ll see there’s a $285,000 revenue booked into that category. That puts us in a Net Increase bottom line of a little over a quarter of a million dollars at $263,000 and through 11 months a little over $2.5 million dollars. Any questions on the Income Statement? There were none. I’ll quickly go through the Departmental Revenue and Expenses. One of the areas where we do see an uptick from the previous year, it’s partially skewed by the ER and where they were at the previous year, but with us getting back up to almost 500 visits you actually see that the ER had a revenue of about $428,000, which when we look at it, historically about $88,000 net better than where we were at the previous year. If we get down in the Physical Therapy and Speech Therapy, all of our therapies, you see a pretty good increase there both on the current month and year to date. One of the areas where we’ve seen one of the largest increases is obviously our Treatment Room and our Surgery. We’ve put a lot of focus in that area and at the same time we’ve put a lot of focus on PT, OT and Speech Therapy. When you look at the Financial Statements, especially on page 6 you’ll see when you look at Physical Therapy, Speech and Occupational you will see that they’re are almost $400,000 better than what they were at last year. When you look at Total Operating Expense though, we budgeted for $25 million. We’re at $25.1 million. That’s only a .5% over budget on expense, so we’re very, very close to that total budgeted number on a $25 million budget total there. A budget for an $85,000 profit at the end of 11 months, we’re sitting at almost $2.6 million. Dakota asked if there were any questions on the Financial Statements. There were none. Mary Irvin 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 May 2021 Statistical and Financial Statement subject to audit. Pat White made a motion to approve the Statistical and Financial Statement as presented subject to audit. David Norman seconded the motion. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: None. Abstained: None. The motion passed by unanimous vote in favor.   XI. New Business – 1) Approval of Budget Fiscal Year 2021 – 2022: David Jones stated that we need a motion and a second to approve the budget for fiscal year 2021 – 2022 then we can speak to any questions. Helen Godfrey-Smith made a motion to approve the budget for fiscal year 2021 – 2022 and Brenda Smith seconded the motion. Mary Irvin stated that we all received a draft and the budget was up for reviewed at our last Board meeting and requested your review of it on your own time and any questions to be submitted and if there are any questions or discussions or concerns regarding our annual budget Dakota can speak to it and then if you have any questions forward.  Mary Irvin thanked Helen Godfrey-Smith and the Finance Committee for their input on the budget. If there is no further discussion it is time to vote on the budget for fiscal year 2021 – 2022 to be approved.  The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: None.  Abstain: None. The vote was unanimous in favor of approving the budget for fiscal year 2021 – 2022.  2) Approval of the Policy and Procedure Committee’s Recommendations for the Policy and Procedure Review for 2021:  David Jones noted that this is a yearly bookkeeping item. A little over a year ago we got together. We formed a multidisciplinary committee from multiple departments, some of our larger Policy and Procedure departments have representation there, we have physician representation and our Director of Nursing, Stacy Alexander, heads that up. Any type of major changes in the policy and procedures, they change, they review and they approve and then their approval then comes to the Board and the Board then has reassurance that the Medical Staff and the multidisciplinary committee has looked at the policy and procedure manuals and approved them. He asked Stacy Alexander if she would like to add anything to that. She said that pretty much sums it up.  David Jones continued stating each year the state requires that the Board of Trustees approves them for that year. The committee has the same approval letter that if we do have the motion and second and the approval that the Chairman of the Board will sign and we will keep with the records. Mary Irvin said it is available for anyone who would like to read it. David Jones said yes, if anybody would like to read the policy and procedure manuals for the hospital. Stacy Alexander, Director of Nursing is here available if anyone has questions. Ronnie Festavan made a motion to approve the Policy and Procedure Committee’s Recommendations for the Policy and Procedure Review for the year 2021. Kenneth Cochran seconded the motion. There were no questions or further discussion. The vote: Yeas:  Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None.   Absent: None.   Abstain: None. The motion carried by unanimous vote in favor.   3) Approve the Engagement of Lester, Miller and Wells CPA Firm to Perform the Single Audit to Fulfill the Bond Recommendations for the USDA Loans:  Brenda Smith made a motion to approve the Engagement of Lester, Miller and Wells CPA Firm to perform the single audit. Helen Godfrey-Smith seconded the motion. Helen Godfrey-Smith said I believe that the total budget for the audit is between $9,000 to $12,000. David Jones said yes ma’am. We got word yesterday that they have expanded some of the rules with these single audits and we’re looking at more than likely to be required to perform one each year that we have bonds set out. Mary Irvin asked if there were any other questions about it or any other discussion to clarify what’s going on. David Jones said those are typically kind of higher stress, higher use type audits so no fun for Dakota and his staff.  There was no further discussion or questions.  The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran.  Nays: None.  Absent: None.  Abstain: None.  The motion passed by unanimous vote for engagement of Lester, Miller and Wells CPA Firm to perform the single audit.    XII. Administrative Reports:  David Jones there were some pretty big things to happen over the last few weeks. We had our state survey. All in all, Stacy had her team going around with them and Pam was assisting with that. We did an excellent job with three surveyors who were really extremely thorough. Regardless it helps to keep us on our toes and helps keep us, regulatory wise, up and ready. We had a couple of Department Heads that had not gone through one of that nature. He asked Stacy if she wanted to comment. She was exhausted by the end of it because she running around with them the entire time. Stacy said they only give us ten days to respond and you have to correct everything prior to sending in all our paperwork. We had Pam’s team running around taking pictures and correcting. We made corrections and took pictures and sent them a nice package. David Jones said our certification is state. Joint Commission is another certification process that hospitals pay to go through. It’s a very large amount of money typically that they pay to go through that process. More than likely we won’t have another for another three years. They tell you that at any time they can come back in three years.   David Jones said I also wanted to share a bit of good news. We have a dentist. Dr. Cristin Jackson has signed a contract to come on board fulltime with us. She’s extremely happy to be here. I really feel that she is going to be a massive fit for our organization. She has met all or most of the department heads.  David Jones said she will accept all insurances, see all patients regardless of pay type. She is that younger dentist who’s excited about starting. I think it is going to be a massive plus to the community. Brenda Smith said I’m not quite sure about this past year, but in years past they have had a mobile dentist unit that came to the schools – Miles for Smiles. It would amaze me how they would bring them back to class still numb. It just amazed me how the kids reacted to it. I’m sure it still was a drop in the bucket with the dental issues and things that families and our kids have. If you have a toothache you are not learning anything, you may be sitting in that class but you are not learning anything. I could see this being a huge positive. Mary Irvin said it would definitely be an opportunity to reach out to our schools when it is open. David Jones said we are going to have a little meet and greet with her later on and schedule like we do with all our new physicians. We will set something up in Town and try to get some business leaders together and just to welcome her into the community.  XIII. Medical Staff Report – 1) Recommendations – Dakota Robinson: MEDICAL STAFF APPOINTMENTS:  1. Samuel Oats M.D. – Request Provisional Privileges in the field of Radiology for the period of June 22, 2021 through June 30, 2022.     MEDICAL STAFF REAPPOINTMENT: 1. Louis Sardenga M.D. – Request Courtesy Privileges in the field of Radiology for the   period of June 22, 2021 through June 30, 2022.  2. David Hilton M.D. – Request Courtesy Privileges the field of Sleep Medicine for Sleep Medicine for the period of June 22, 2021 through June 30, 2023.   3. Daniel Hennigan M.D. – Requests Courtesy Privileges in the field of Radiology for the period of June 22, 2021 through June 30, 2023.   4. Justin Skweres M.D. – Request Courtesy Privileges in the field of Radiology for the period of June 22, 2021 through June 30, 2023.   ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:  1. Kayci Wilson, FNP – Request Affiliated Privileges in the field of Family Nurse Practitioner field for the period of June 22, 2021 through June 30, 2023.    EXTENSION REQUEST:  1. Catherine Sharpe, M.D. – Request extension per completion of reappointment application.    VOLUNTARY RESIGNATIONS:   None.   Robert Green made a motion to approve the (1) Medical Staff Appointment, (4) Medical Staff Reappointments, and (1) Advanced Practice Professional Reappointment as presented. Pat White seconded the motion. The vote: Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: None.  Abstained: None.  The motion passed by unanimous vote in favor.    XIV. Executive Session:   Mary Irvin stated she would entertain a motion to enter into Executive Session for Strategic Planning. Helen Godfrey-Smith made a motion to enter into Executive Session for Strategic Planning. Ronnie Festavan seconded the motion. The vote:  Yeas: Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith.  Nays: None.  Absent:  None.    Abstained: None. The motion passed by unanimous vote in favor. Mary Irvin stated there will be a brief five minute break prior to entering into Executive Session.   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, Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith.  Nays: None.  Absent:  None.   Abstained: None.   The motion passed by unanimous vote in favor.  XV. Adjourn:  There being no further business Kenneth Clay made a motion to adjourn. Pat White seconded the motion. The vote:  Yeas:  Pat White, Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith.  Nays: None.  Absent:  None.  Abstained: None. The motion carried by unanimous vote in favor.    Meeting adjourned at 6:07 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 July 27, 2021

 

 

 

 

 

 

 

 

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