BOARD MEETING:  Regular Meeting   DATE:  June 23, 2022    MEMBERS PRESENT:  David Norman, Kenneth Cochran, Pat White, Ronnie Festavan, Brenda Smith. MEMBERS PRESENT VIA TELECONFERENCE:  None   MEMBERS ABSENT: Robert T. Green, Jr. (arrived at 4:11 p.m.,) Mary Irvin, Michael W. Nation, Sr.  TIME CALLED TO ORDER:  4:00 p.m.    OTHERS PRESENT: David Jones, CEO, Dr. John Woods, Chief of Staff, Drew Burnham, Attorney, Dakota Robinson, CFO.    Via Teleconference: None.  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 4:00 p.m.     II. Invocation and Pledge of Allegiance – Brenda Smith offered the Invocation and Kenneth Cochran 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. Pat White seconded the motion. There was no discussion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Nays: None.  Absent:  Robert Green, Mary Irvin, Michael Nation.    Abstained: None. The vote was unanimous in favor. The agenda was approved as presented.   IV. Community Comments – David Norman, Board Chair inquired if there was anyone from the community logged on. There were none.  V. Minutes – Regular Meeting May 24, 2022 – David Norman stated we need a motion and a second to approve the minutes with discussion, if any, to follow. Kenneth Cochran made a motion to approve the minutes of May 24, 2022 as presented. Ronnie Festavan seconded the motion. There was no discussion or corrections noted. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith. Nays: None. Absent: Robert Green, Mary Irvin, Michael Nation. Abstain: None. The vote was unanimous in favor. The minutes were approved as presented. (Robert Green arrived at 4:11 p.m.)  VI. Foundation Report – David Jones stated that Mary Coil was on vacation. She wanted me to tell you the tickets should go on sale pretty soon for the Safari that they are having this year for the Gala Event. I think it’s going to be another big event this year.   VII. Chief of Staff Report – Dr. John Woods, Chief of Staff, the only major thing we have going on this month we have the outgoing Residents and the incoming Residents. They graduate Friday evening and then we should be getting the new ones in a couple of weeks after that. Besides that everything is going great. David Norman thanked Dr. Woods.  VIII. Old Business – 1) Update Building Projects: David Jones said we will go over the building projects.  A) Blanchard: The Blanchard Clinic is pretty much all but complete.  B) Benton: David Jones said Benton is supposed to be totally complete next month. I don’t quite think we’re going to make that milestone. There has been a ton of progress over the last month and a half to two months but their still behind schedule.   IX. Review May 2022 Statistical and Financial Reports:   1) Statistics – Dakota Robinson stated we’ll see a few good things for the month of May. Admissions went up to 36. Looking at the actual days stayed you’ll see that there was a slight increase in the Inpatient days stayed from 105 to 113.   Newborns – Newborns remain steady at 3. We have had a slight decrease on the year. We’ve done 61 year to date.  One of the areas that saw an increase over the past month is the ER.  They’ve had a 16% increase from this time last year. EMS went hand in hand with the ER.  Surgeries had a decline from 13 to 4. We’ve seen 23% more sleep studies than what we did the previous year.  The Outpatient Physical Therapy will change a little bit. The Vivian Outpatient Physical Therapy is 360.  For those who haven’t seen or heard of it Blanchard Physical Therapy is up and running. Their schedule has started expanding and they’ve started seeing quite a bit of patients down there. Looking at visits, you see the Vivian Clinic remained relatively unchanged. We’ve seen 21,400 year to date and last year we were at 21,600. Plain Dealing Clinic did see an increase of about 4% to 530 patients. Benton saw an increase as well, about 9% and year to date they’ve seen about an 8% increase. They’ve seen just over 6,000 patients. The Blanchard Clinic had a 20% increase. This is the first full month that Dr. Chance has been there. Vivian Dental did see an increase from 107 to 115.  The Fitness Center – they do have 344 members and saw right at 1,642 visits. Any questions on the statistics. There were none. 2) Review May 2022 Financials – Dakota Robinson:   We looked through the Statistics and we saw increases some of the inpatient and outpatient numbers. When we get into the Financial Statements were getting towards the end of the fiscal year so we’ll talk a little bit about Contractual Adjustments and then we’ll look at some of the weird things we’re going to see with 340B and I’ll spend a little bit of time on that. On page 1 of the Balance Sheet, at the top you’ll see Total Unrestricted Assets is a little over $13 million – $13.1, almost $13.2 million. The Days Cash on Hand, you’ll see at least over the past five months, has steadily increased. We went from 166.53 last month to 175 for the month of May so we have seen that steadily tick up.  On page 3 – the Income Statement, looking the total Revenue we did $3.7 million in total revenue compared to $3.9 million the previous year but Net Patient Revenue, by the time we take contractual adjustments into play it’s almost zero change; just about an $8,000 change in the month.  Salaries and Wages are $78,000 more than the previous period. We continue to talk about the added revenue producing departments that have been added in Dental, added expense in Blanchard and Community Rx that make up a significant portion of that. Year to date it’s about a 9.9% increase. Medical Supplies and Drugs – you’ll see that Medical Supplies and Drugs looks very high. What I will tell you is that when we started the year the reason for the increase there was we had a lot of Covid drugs. What we’re seeing over past two months in that increase is we have added Community Rx.  Under Total Operating Expenses you’ll see Total Operating Expenses a little over $2.3 million compared to $2.2 million and on the year we’ve had about a 12% increase in that. Dakota asked if there were any questions on the Financial Statements.  Kenneth Cochran said just one quick question. If you are seeing a real impact with the inflation situation, are we looking ahead for a longer term inflation problem with what we are seeing? Is that something that we are preparing for? Dakota replied I think if you look at the budget, when we sat down and looked at the budget this year we obviously have data now what inflation has looked like at least for the past twelve months. Inflations didn’t just pop up the last three months with gas prices. Unfortunately we’ve been dealing with inflation in the medical sector now for an entire year. Ronnie Festavan asked Dakota do we have the capability or is there any need, do we do budget amendments? Dakota replied we do not do budget amendments. Ronnie Festavan asked is it a requirement that we do amendments. Dakota replied it is not a requirement. Dakota said we do look at the budget, it is sent out. We do pay close attention to it. We don’t have to go through the rigorous process of amending each line item in the budget depending on if they are 5% over, 5% under like some other governmental entities do. Ronnie Festavan said o.k. that was my question. Thank you. David Norman asked if there was any other discussion. I would entertain a motion and a second to approve the Statistical and Financial Reports. Ronnie Festavan made a motion that the Statistical and Financial Report be approved. Robert Green seconded the motion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith, Robert Green.  Nays: None.  Absent: Mary Irvin, Michael Nation.  Abstain: None. The motion passed by unanimous vote in favor.  X. New Business – 1) Approval of Resolution #7 – 2022 – David Jones stated I’m going to kind merge New Business in my Administrative Summary to some degree.  We have Resolution #7 – 2022 to remove Mrs. Pam Hughes from the signatory card and add Ms. Stacy Alexander, or Chief Nursing Officer. If I can get a motion and a second I will go a little further into that.  Robert Green made a motion to approve Resolution #7 – 2022 and Brenda Smith seconded the motion. David Jones said for some time, about three years now, I have known personally that Mrs. Hughes has been contemplating retiring. August 1st is going to officially be her last day here as the COO of North Caddo Medical Center. I can’t state in words what she’s meant to this organization and to me personally. She’s been, if you were going to say that I had a right hand, she would definitely be it; sometimes my right and left.  Over her tenure here, which will be fifteen years in August, this organization has significantly changed. The Board members that were here before know we hired her in regards to the preparatory then of buying the Medical and Surgical Clinic; not the building the practice itself.  Bringing her on, at one time, she was just over clinic and merged into what was basically full operations of the hospital because her ability and her skill level at that time. Then the constructions came along. She really had a passion for that. She headed the projects which was constructing the building you see here. She was the reason we came in under budget. She’s a little lady by stature but I promise you there’s a lot of steel underneath that skin and she has very little fear of when it comes to doing what she feels is right and she will sorely be missed. We have to have two people to sign our checks. Stacy has been our Chief Nurse here for over sixteen years. She’s an outstanding asset of ours as well. Ronnie Festavan said may I ask a related question. David Jones said yes sir.  Ronnie Festavan said will we fill her position? David Jones replied at first no. That type of position at a place this small is very hard to find someone with that kind of skill set. Luckily, with the structure we have in place, the departments that report to her, most of them will report to me directly, but let’s just say the financial end of the clinics. really has fallen underneath her as opposed to our Chief Financial Officer, and that has worked because of the skill set that Pam has but there’s no one else that I could find that I would trust doing that. We’re going to transition all the financial end underneath Dakota and tie them together.  Kenneth Cochran said we made some contact with her about using her as support down the road, a contract situation. David Jones said yes, construction management.  Ronnie Festavan said so what you plan basically is you are going to take her duties and responsibilities and farm them out to places that you believe have strength to do that. David Jones replied yes.  Ronnie Festavan said that was my point and that is a great strategy. I can tell you that from leadership all my life to fill those gaps, it’s o.k. for your people to take on those chores, we just don’t know this day in time what times. You need somebody to setup. You do a great job and I know you have weighed all this out, but I don’t want to see you get loaded down to where you can’t do a great job. The financial guy is your guy. I’m just thinking out loud. You are right you’re probably not going to replace her, but we can keep operating without her. David Jones said we have a bunch of good people that work here, there’s a lot of people that have advanced themselves here since I’ve been here, several master’s degrees.  David Norman called for a vote for Resolution #7 – 2022. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith.  Nays: None.  Absent: Mary Irvin, Michael Nation. Abstain: None.  The motion passed by unanimous vote in favor.   (Robert Green departed the meeting at 5:00 p.m.)  2) Approval of 2023 Budget: David Jones stated the next item of business if the approval of the 2023 Budget that was presented at the last Board meeting. I do want to say just a word or two on it if we get a motion and a second. Brenda Smith made a motion to accept the budget. Ronnie Festavan seconded the motion. David Jones said my main thing is to tell Dakota and his team that I appreciate the level of work and the amount of work that goes in to doing that. The afore mentioned, Mr. Brent Leonard, got him a large dose of this budget this year. From Mrs. Helen Godfrey-Smith spurning the level of explanation, line wise, when you print off this it’s about 140 pages, that’s because of all the explanation pages that goes behind. It’s even daunting for someone like me who has done this for seventeen years and looked at just about every line item that we’ve ever had a hundred times it’s still, once you’ve looked at about 30 pages of it, it all starts to blur together. The level of going in with the department heads and getting explanations, because going in and trying to get the department heads to understand what you need on that line is an undertaking. I just wanted to officially voice my appreciation to Dakota and his team for doing that. David Norman called vote. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith. Nays: None. Absent: Robert Green, Mary Irvin, Michael Nation.  Abstained: None.  The vote to approve the Budget for 2023 pass by unanimous vote in favor.   3) Purchase of C-Arm:  David Jones stated the only purchase we have, and this is the first one we’ve had in a while, we need a C-Arm. If I can get a motion and a second I will explain what that is and why that is. Ronnie Festavan made a motion to approve the purchase of a C-Arm and Kenneth Cochran seconded the motion. David Jones stated that basically a C-Arm is a piece of x-ray equipment that is used during surgery to give real time as to what is going on in the body for whatever procedure is going on. Several months ago Dr. Brian Dupree, who is actually from our area, contacted me and wanted to know if we had any want for him to come and start doing interventional pain management here, which is basically spine injections, neck injections and those kind of things. He’s been working at the VA for quite some time. The main benefit from this would be from our patient population. That’s where we are with the C-Arm. David Norman said we are now at the point of voting. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith. Nays: None.  Absent: Robert Green, Mary Irvin, Michael Nation. Abstained: None. The vote was unanimous in favor to approve the purchase of the C-Arm for $85,000.    XI. Administrative Report –   David Jones said I was just going to go over Mrs. Hughes’ retirement so unless the Board has and questions they want to bring up on that that is all. David Norman asked if there were any questions. There were none.  XII. Medical Staff Recommendations – June 2022 Medical Staff Recommendations: Dakota Robinson presented the Medical Staff recommendations for Board approval.  MEDICAL STAFF APPOINTMENTS:  None.  MEDICAL STAFF REAPPOINTMENT:  1) Louis Sardenga, M.D. Requests Courtesy Privileges in field of Pathology for the period of June 28, 2022 through June 30, 2023.  ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: 1) Samantha Teer, FNP, Requests Affiliated Privileges in the field of Surgical Assistance for the period of June 28, 2022 through June 30, 2024. EXTENSION REQUEST:  None.  VOLUNTARY RESIGNATIONS:  None.   David Norman said we need a motion and a second to approve the Medical Staff recommendations.  Pat White made a motion to approve the (1) Medical Staff Reappointment and (1) Advance Practice Professionals Reappointment. Brenda Smith seconded the motion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith. Nays: None. Absent: Robert Green, Mary Irvin, Michael Nation. Abstained: None.  The vote was unanimous in favor of approval of the Medical Staff Recommendations.  XIII. Executive Session – David Norman stated there is no business to be discussed for strategic planning. XIV. Adjourn – There being no further business Kenneth Cochran made a motion to adjourn. Ronnie Festavan seconded the motion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Kenneth Cochran, Brenda Smith. Absent: Robert Green, Mary Irvin, Michael Nation. Abstained: None. The motion passed by unanimous vote in favor to adjourn the meeting.  The meeting adjourned at 5:28 p.m.

 

North Caddo Hospital Service District

North Caddo Medical Center

Vivian, Louisiana

 

 

____________________________

David C. Jones, Secretary

 

 

 

 

 

 

 

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