BOARD MEETING: Regular Meeting DATE: June 25, 2019 MEMBERS PRESENT: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Patricia White. MEMBERS ABSENT: Kenneth Clay (arrived at 6:13 p.m.), Ronnie Festavan. TIME CALLED TO ORDER: 5:30 p.m. OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Dakota Robinson, CFO, Dr. John Woods, M.D., Chief of Staff, Walter D. (Doug) White, Hospital Attorney, Lanell Audirsch, Admin. Asst. LOCATION: NCMC Events Center BOARD CHAIR: Robert T. Green, Jr. SECRETARY: David Jones I. CALLED TO ORDER – Robert T. Green, Jr., Chairman, called the meeting to order. II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation. Kenneth Cochran led the group in the Pledge of Allegiance. III. Approval / Amend Agenda – Brenda Smith made a motion to approve the agenda as presented. Pat White seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Clay, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. IV. Community Comments – Robert T. Green, Jr., Chairperson noted there were no signed Visitor Recognition Cards requesting to address the Board. V. Minutes – Regular Meeting May 28, 2019 – The minutes of the Regular Meeting held May 28, 2019 were mailed prior to today’s meeting for review. Robert Green stated he would entertain a motion to approve the minutes. Pat White made a motion to approve the minutes of the Regular Meeting held on May 28, 2019 as mailed. David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Clay, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. VI. Old Business – 1) All Scripts Interface Update – David Jones reported that the All Scripts Interface continues to be on the agenda. He said there is progress and they do have somewhat of a solution. It is not a solution that I’m willing to accept at this point. You have one system trying to talk to the other system and how they make sure it is the same record is the problem. Brenda Smith asked was the temporary workaround, was it a temporary solution or that was the solution they wanted to give us. David Jones replied for now it is the solution that they asked if we would be willing to do. We are still working and waiting. 2) X-Ray Room and Mobile X-Ray Update – David Jones stated the X-ray Room and the Mobile X-Ray – we are getting closer with all of these. The Mobile X-Ray Room, of course, will be in before the main X-ray Room, but at some time in early August the Mobile X-Ray will be up and running and a few weeks after that the X-ray Room itself should be installed and running from there. From Radiology standpoint, you are going to have two different departments. You are going to have Main Radiology which is X-ray, CT and MRI right here on the south side of the Emergency Room and then your Ultrasound, Mammography and Bone Density is going to be over on the east side of the walking entrance of the Emergency Room. It is looking very good over there. Robert Green asked if there were any questions. There were none. VII. 1) Review April 2019 Statistics – Dakota Robinson, CFO – Dakota Robinson reviewed the statistics. We will see some that trended up and we will see some that trended down. It is a little odd for a month. Usually we see most everything move in the same direction. You will see a little bit of that as we go through the first few slides. When you look at Admissions you see this month we had 58 Acute Admissions and 11 Swing. The Swing Bed – that is the highest number of admissions we’ve had since January and that is a great thing. Also, the Acute stays went up from the previous period of 53. When you get over to the number of In-patient Days – what happened is we’ve got 166 in-patient days – obviously that’s a lot lower than the previous period of 230. Basically what happened is the average length of stay for those patients reduced. For April the average length of stay was 4.3 and the average length of stay for May was right at 3.0. On the second page of the Stats, you’ve got your Current Year-to-Date Total Observation Stays. It is something that will tie into some purchases we have later on; you can see on Observation we’ve got 1005 for this year versus 407 last year. When a patient is an in-patient typically they are one of two statuses – you are either deemed an in-patient or you are an observation status. Either way, you are staying overnight typically in a patient bed and you as a patient you have no idea what the difference is. From a billing standpoint that is where those two categories lie. If all of those were only one day stays, which some of them are two, three. Dakota noted we have some Observation stays that have gone 30 to 60 days. David Jones said which is crazy; but still you are talking about 600 more patient days there and if you add those to the total you are looking at a busier in-patient than we had for last year. If you look at it as a total overall thing as opposed to just this stat, in-patient wise we have been busier than last year. It has been a good year so far whether the stats reflect that. Kenneth Cochran asked what is the definition of Observation to that. It is that convoluted. David Jones said it depends technically on acuity, but insurance companies, sometimes, will just basically say – we may do acuity and we say look here is the criteria it says it is an in-patient. So, either way the doctor is not going to change how they are going to treat the patient. Kenneth Cochran asked if this varies from insurance company to insurance company. David Jones replied absolutely. Dr. John Woods noted that it initially was all kind of stemmed off of how you initially thought that the patient was going into the hospital. If you thought you could fix them in about 24 hours – for instance – a typical observation would be chest pain for instance. They go from observation to acute. Acute of course could mean several days – more than 24 hours. I keep trying to tell you all, the insurance companies keep trying to redefine things to fit their window and now they have defined this so obscured they can’t even figure it out. Kenneth Cochran asked if Medicare simplifies it. The answer was no. Dakota Robinson said he will warn you that there are certain Medicare HMO plans that people are selecting that when they go into the hospital that don’t work out good for you when you are in the hospital. That is part of the problem; we are placing a lot of these patients in observation stays because they won’t approve Nursing Home stays where they really need to be. It is a big mess. Kenneth Cochran commented this is pressure on doctors, too. David Jones said absolutely. Kenneth Cochran asked do the insurance people have doctors in their employ to make those decisions. Doctors are involved with that, right. Dr. Woods said they will put them in there and pay them a little bit better. Kenneth Cochran said o.k. Dakota continued with the Average Daily Census for the month of May sort of trends with the total In-Patient Days – 8.9; in April it was 10.2 so it was a trend down for the month of May. Surgeries – there were 5 last month. Dr. Banda was on vacation and he is back so hopefully this number will climb more than 5 in the next month. Endoscopies – we saw a 30% increase from 13 to 17 last month. ER visits – we also saw almost a 7% increase from 524 to 559. You can see the upward trend over the past 6 or 7 months has been pretty good. I know that Mary has had some marketing campaigns to increase foot traffic in there. From the numbers it looks like they are increasing. Pat White said she thinks part of that, too, is more word of mouth about how much sooner you can get in to the Emergency Room here than you can if you go to one of the hospitals in Shreveport. People don’t feel like they are helping themselves to go to an Emergency Room and have to sit there for an hour and one half before they see anyone. It defeats the whole purpose. Dakota continued with Mammography stating we had a 31% increase from 32 to 42. You can see the graph. That is an area that is pretty cyclical – it will rise and fall depending on the month. Newborns stayed the same at 6. That is about the average for this year; maybe a little bit below. If we look at some of the outpatient areas, Vivian Clinic for instance, we had two providers that were on vacation in the Vivian Clinic. That is one of the reasons why we see a decrease in the clinic. Typically during the summers we see those numbers dip. You can see at the beginning of March and April it sort of starts to decline and then when school gets back in we will start seeing that number inch up some. They had 1,743 patients for the month of May. Plain Dealing was one where all the providers were there for the month and they were at 641. The Benton Clinic remained almost the same with a difference of 3 patients – they saw 447. Fitness Center membership – that is a nice graph to look at. They started the year off at 415 and right now are at 444. Membership has climbed quite a bit through the first five months of the year. Are there any questions on the Statistical Analysis? 2) Review April 2019 Financials – Dakota Robinson, CFO – Dakota Robinson, CFO, stated that you can see there are some areas in the hospital that we had some numbers were below the average patient numbers that we see. The good thing is, even with that reduction we had a lot of ancillary services that have increased over the months; 340B program is going strong and we have received UCC dollars so we haven’t taken a hit in cash. The cash as of this meeting is the highest it has been in a 12 month period. You will start seeing in this set of financials and in June, we start seeing some adjustments being made in the financial statements trying to tie these out to supplemental schedules, reporting that is done once a year and those type of things so when the audit comes these accounts are as close as possible so we don’t get those huge adjustments from the auditors at the end of the year. And, the bonds will close July 2nd. We should have all of that completed. That is next week and that is a good thing. There are $205,000 worth of savings in that bond process. I commend you all. That is a great thing that we could do for North Caddo. If we look at page #1 of the Balance Sheet you will see that the total cash on hand as of the end of the month was almost $3.9 million. That is a good balance to have in our accounts. As I said $700,000 of that is restricted. As we go down the line, I know we keep talking about this, but be on the lookout in two Board meetings from now we will see this disappear – the reserve funds for $389,000, that is actually going to come out of restricted funds and is actually going to flow up to current asset line item. That is what is being released as part of the bond refinancing. So you have almost $400,000 in that line item. Any questions on that section of the balance sheet. There were none. Moving to the Income Statement on page #3. You will see Salaries and Wages from the previous year for the month of May were only up $64,000. On the year it is a little under a million dollars – right at an 8% increase. We have gone through, especially on the Finance Committee and discussed some of the reasons behind that. Good news on the Employee Benefit side is we had a meeting with the Self-funded Insurance Plan. We are expected to come in around $200,000 less than what the total cost was expected. The plan year, once again that is an estimate. That is a 7% decrease from the previous year. If you go down to Total Expenses, the Total Expenses of $2 million, that is $92,000 more than the previous year and if you look at the year as a whole, we at almost $21.5 million; that is a $725,000 increase this year. That equates to about 3.5%. That is a reasonable increase in expenses. If you go to the Non-Operating Revenues and Expenses you will see that the 340B revenue, that is not a true $143,000. There is a slight adjustment in there to tie out some of the revenue and expense reports from our third party vendor. I do believe that it came in at about $135,000. Walmart in Blanchard will go live January 1 on our 340B Program. That is expected to be about $100,000 increase for the next 12 months. We are continuing to expand and grow that program in multiple different areas. We are expected to still receive the bonus payment from the DSH money that the State of Louisiana found in this budget year. That is about $300,000 and that has not been booked yet. For the month it shows a $267,000 loss. For the eleven months ended in May we are looking at $974,000 profit. Dakota asked if there were any questions on the Income Statement. There were none. Moving to page #9 – the Vivian Clinic. You will see that they saw for the year – they saw almost 23,000 patients. At this point this last year they saw 20,474. That is a pretty big increase in that clinic. 2019 profit is $636,000 and they had a profit this month of $20,000. Plain Dealing is sort of the similar story. Their numbers have remained very similar to the prior year but down slightly. Part of that is that we have Dr. Mc Common going to Benton. Their profit this year has gone to $83,427 and their profit for the month of May was right at $20,000. Any questions related to any of that. There were none. Robert Green stated he would entertain a motion. Pat White made a motion that the Statistics and Financials be approved as presented subject to audit. Helen Godfrey-Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Kenneth Clay, Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor. VIII. New Business – 1) Approval of Budget Fiscal Year 2019 – 2020: David Jones noted that #1 under new business is the Approval of Budget for Fiscal Year 2019 – 2020. Mary Irvin made a motion to accept budget for Fiscal Year 2019 – 2020. Brenda Smith seconded the motion. Robert Green asked if there were any questions or comments. Pat White stated she had a comment. I think that Dakota has done a wonderful job on preparing the budget and the explanations and everything that goes with it. It makes it so much easier to follow it and understand it. David Jones said I know I am putting words in his mouth, but I would certainly would like to thank the Finance Committee and Mrs. Helen in particular for her help guiding us to progress the budget with the explanations. It is a lot of work putting it together but it is progressively getting larger and larger as time goes on. We are going to need that expertise as far as explanation. (Kenneth Clay arrived at 6:13 p.m.) It is almost impossible, in my opinion, for a Board member to just look at the budget without any kind of working knowledge of being in the hospital and such to be able to explain what is going on from a line item standpoint. Dakota, as the CFO, has been working diligently in progressing that and honestly it is light years ahead of what it was a year and one half to two years ago. Robert Green asked if there were any other questions concerning the budget. Helen Godfrey-Smith stated probably talking about this building, extending the life of this building from a budgeting standpoint, our auditors and Dakota recommended that it be put on the books with a five year useful life and that equates to roughly $6,200 a month amortization or depreciation, Helen Godfrey-Smith said and for our purposes and for the auditor’s purposes, it would be a good idea, I think, if we would approve that, that useful life of this building with a motion. Did we think that was necessary? Dakota Robinson replied I don’t think that we need a formal motion, but that is completely up to you. Helen Godfrey-Smith replied alright. Helen Godfrey-Smith said I think the reason that I would suggest that we approve it is because of the impact that it could have on our Cost Report. Robert Green said right now we have a motion on the budget and a second and we had a question concerning our budget then we got on the depreciation of the building. Kenneth Cochran asked could we not just consider that an acknowledgement within the budget knowing that it is a fluid number anyway. Doug White said why don’t you just call it a point of clarification which if it is already in the budget, everybody acknowledges it and move on to the main motion. Mary Irvin said so we don’t need that motion is that what is decided? Helen Godfrey-Smith said I withdraw the motion. Robert Green asked for a vote to accept the budget. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor to approve the budget for fiscal year 2019-2020. 2) Approval of Inter Qual Software License – 2019: David Jones stated that #2 and #3 on the agenda under New Business are related. The Inter Qual Software License we touched on briefly before. Once there is a motion and a second I will talk further on it. This is, as the Board remembers, something we purchase every year. I will discuss in more detail exactly what it is again for those that would like a replay. Brenda Smith made a motion to approval the purchase of the Inter Qual Software License for 2019. Mary Irvin seconded the motion. Robert Green asked if there was discussion. David Jones stated that the Inter Qual criteria is something developed by a third-party software vendor that our Case Management uses on every patient that comes in. Depending on criteria for admission that the physician stated, should it be in-patient or should it be observation or that is not enough criteria to meet anything. It is a license you have to purchase every year so it is just time to renew that. Without that it almost impossible for Case Management to do their job. It is really not even an option. We need to purchase it from Inter Qual or from another third party and Inter Qual is the major company. It is what our Case Managers are used to using. Brenda Smith inquired is there an amount Dakota Robinson replied the amount is $13, 996.13. David Jones said it is very similar to what it was last year. It will be coming up next year and years after that. Mary Irvin asked is that license is on the hospital side. David Jones replied that is correct. Robert Green asked if there were any further question. There were none. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor to approve the purchase of the Inter Qual Software License for 2019. 3) Renewal of 3M Encoder Software License – 2019: David Jones stated that #3 – Renewal of the 3M Encoder Software License for 2019 is very similar to the Inter Qual software. The Encoder software is what our Coders use to interpret and transfer diagnoses and procedures into numbers. Dr. Woods touched on ICD-9 and ICD-10 – those are codes that actually equate out to a diagnosis of left plural effusion or whatever it is from a diagnosis standpoint, it converts it into a number. The Encoder is what the actual people that are doing that it helps them come up with those codes. The actual book is a huge book which is another place where insurance companies kind of wait and lurk. Once again, this is another purchase that is a must for us to do business; for us to build a claim, it must be converted into a number and you can’t manually put anything out. David Jones asked Dakota what the cost of the 3M Encoder Software License for 2019 is. Dakota Robinson replied it is $18, 992.12. This is what our Coders are used to using and is what they recommend and what they want. Robert Green asked if there were any other questions. David Norman inquired if this is a user license also. David Jones replied yes. Brenda Smith made a motion to approve the renewal of the 3M Encoder Software License for 2019. Kenneth Cochran seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: Ronnie Festavan. Abstained: None. The motion passed by unanimous vote in favor of the renewal of the 3M Encoder Software License for 2019. IX. Administrative Reports – 1) NCMC – Current Activity: David Jones stated that the summer months, especially these summer months have been extremely odd. The amount of weather that we have received over the past four or five weeks has been extreme to say the least. We’re actually dealing with a few construction issues back from our phasing project. We’ve identified a few leaks. It’s odd when you have the wind blowing in a certain direction for a certain period of time and you have no leaks then a major thunder storm rolls through and you find some leaks. The think they have identified the problem. It is one little strip of metal – a splash guard in all these metal inserts along the walls that has taken about twenty people and about a hundred different phone calls and a hundred different types of conversations, I guess I’ll call them. We have McInnis that has come up with the people that actually installed everything and we think we have a solution to some of those but a lot of the stuff is bent around that. Also, from a Doctors standpoint, June is our graduation date. We have two Residents that we just graduated out into the world. We are getting two more new second years in. Dr. Woods said he is set up to meet them this week. David Jones said there is always a learning curve with them. I am kind of curious – there is always a major mentality shift from them coming from a University or LSUMC to here. I am curious as Oschner goes along their path of doing things how that is going to evolve and what it is going to look like from our Residents. That will be a really good window as to how many changes that they have done. Typically there is a massive difference from the way we do things and the way they do things. There is a major shift in how the Nursing Staff adjust to those new Residents. Robert Green asked who the two were that graduated. David Jones replied that is was Dr. Irving and Dr. Brown. Dr. Irving is going back to the Houston area to set up a clinic. Dr. Brown is the one that is slated to go into Benton for Willis Knighton. Both are very good people and very solid Doctors. David Jones said that is where we are with the activity. June is always that lull month of ending and new beginnings in July. The auditors will be here tomorrow doing inventory. 2) Foundation: David Jones stated that Mary Coil is not here tonight but he does have a report from the Foundation. She is actually in a meeting about what I’m going to report on. We have the Gala flying towards us. Which is about a month and one half from now – Havana Nights is the theme. It is going to be at the Petroleum Club. There are going to be different rooms with a piano, a bar area, a saxophonist area, and the main band will be in a different room. The tickets are $125 per person. (Helen Godfrey-Smith left the meeting at 6:35 P.M.) You can payroll deduct. There are some payroll deduction forms next to your folder. Dakota Robinson said there is a limited set of tickets this year. If you are going to get them, please go ahead and get them. David Jones said as far as the main number is pretty much sold out. They did hold a number in reserve because there is typical who always wait till the last minutes. Please, if you are, and I hope you do, because it is going to be a fun night. It is always fun to go and show support for the Foundation – a) this is their major fund raiser for the year and b) all that money comes back to us. There is a lot of work that goes into planning and putting together these kind of things. That is where Mary is now. She is in a meeting to go over the plans with her committee. Mary Irvin asked if they could give the forms to him. David Jones replied, yes, you can give the forms to him and he will give them to Mary. Dakota stated that Mary, also, wanted him to show some of the brochures that they had been doing. Dakota said we have identified some areas that we’ve tried to draw some patients that don’t really know anything about North Caddo. When we talk about Blanchard and North Shreveport. A lot of the people don’t even have a vision of what North Caddo is. We are trying to reach out and develop some different marketing strategies. One of those was to come up with an internet based brochure that someone could either go to our website, we could send them a link to it. Basically it is in book form and we are developing them for each and every department. This one for instance is the Emergency Room. We do a little bit about the actual service. We do a little about the Physicians. This one was developed for Swing Bed patients. We go through the different things that a Swing Bed patient might run into or need. We describe a little bit about the Out-Patient things we offer and the In-Patient. David Jones said in my opinion the photos look stock but those are actual photos of our OR, our In-patient Room and bathroom. Dakota said we are developing these for a lot of areas within the facility and hopefully we will have those either out on our website. It is good. David Jones said that is the Foundation / Marketing report. 3) Construction Report: Pam Hughes stated they are about through with the first area in the next few weeks. The other day, the only time we had some kind of interference into the hospital, they were sawing a wall and got dust everywhere. Other than that is was pretty good. Because they had to tie into the Clinic, and all of that is done. We are just waiting on them to finish everything. We have target dates to move everything. We are having a little bit of a delay because some of the doors did not come in. We are only talking about a few days. That really helped us because we are having to move the Mammogram and Bone Density. Hologic has to come in and do that. Getting them on the schedule so that is good. This company has been great. The GC is here daily. Johnny has been very good. Every time there has been any kind of issue he right there. Robbie has been with them daily and has done a wonderful job doing that. They have built the ER Rooms already. They look fantastic. Now we are waiting for the final touches and we will move into it. Then they will start tearing the wall down. They have to tear the outside wall down to get the MRI in. David Jones said it is a big unit. X. Medical Staff Report – 1) Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval: MEDICAL STAFF APPOINTMENTS: 1) James Faliszek, M.D – Requests Provisional Privileges in the field of Radiology for the period of June 25, 2019 through June 30, 2020. 2) Joseph John, M.D. – Requests Provisional Privileges in the field of Radiology for the period of June 25, 2019 through June 30, 2020. MEDICAL STAFF REAPPOINTMENT: 1) David Hilton, M.D. – Requests Courtesy Privileges in the field of Sleep Medicine for the period of June 25, 2019 through June 30, 2021. 2) Cornelius Bos, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of June 25, 2019 through May 31, 2020. 3) Adam Green, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of June 25, 2019 through September 30, 2021. 4) Christine Lamoureux, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of June 25, 2019 through June 30, 2021. 5) Maaya Wilton, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of June 25, 2019 through January 31, 2021. 6) Daniel Hennigan, M.D – Requests Courtesy Privileges in the field of Radiology for the period of June 25, 2019 through June 30, 2021. 7) Justin Skweres, M.D – Requests Courtesy Privileges in the field of Radiology for the period of June 25, 2019 through June 30, 2021. 8) Clifton Coffman, M.D – Requests Courtesy Privileges in the field of Radiology for the period of June 25, 2019 through September 30, 2020. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: 1) Kayci Wilson, FNP – Request Active Privileges in the field of Complimentary/Alternative Medicine for the period of June 25, 2019 through June 30, 2021. EXTENSION REQUEST: NONE. VOLUNTARY RESIGNATIONS: 1) Elaine Khatod, M.D – Voluntary resigns her Privileges in the field of Radiology effective 05/31/2019. 2) Matthew Smith, MD. – Voluntary resigns his Privileges in the field of Radiology effective 05/31/2019. Kenneth Clay made motion to accept the Medical Staff Reappointments, Reappointments, Advance Practice Professional Reappointment and Voluntary Resignations as presented. Pat White seconded the motion. The vote: The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White. Nays: None. Absent: Ronnie Festavan, Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor. 2) Chief of Staff Comments: David Jones stated in Dr. Woods’ defense he has been serving our country for the last few weeks. He could probably give us a large update on that. Dr. Woods said I have been out for two weeks. My first day back was yesterday and it was busy. Everything looks like a well-oiled machine and does not require any tweaking and everything is fine. Mary Irvin told Dr. Woods we are glad you are back. Dr. Woods said it is good to be back. Kenneth Cochran said so we really are safe now. Dr. Woods said it was very interesting. It was a good weight loss program. Brenda Smith said thank you for your service. Dr. Woods said you are welcome. As a side note, we have had quite a few physicians going through that meet the criteria for the Papa Program. No problem with it whatsoever with any of them. Everybody is going through without any complaints and everything is working there. XI. Executive Session: Robert Green stated he would entertain a motion to enter into Executive Session for Strategic Planning. Brenda Smith made a motion to enter into Executive Session for Strategic Planning. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White. Nays: None. Absent: Ronnie Festavan, Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor. Robert Green noted there will be a brief break prior to entering into Executive Session. The Executive Session was entered into. No action was taken during the Executive Session. Pat White made a motion to enter back into regular session. Brenda Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White. Nays: None. Absent: Ronnie Festavan, Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor. XII. Adjourn: There being no further business Kenneth Clay made a motion to adjourn. Pat White seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, David Norman, Brenda Smith, Pat White. Nays: None. Absent: Ronnie Festavan, Helen Godfrey-Smith. Abstained: None. The motion carried by unanimous vote. Meeting adjourned at 7:16 pm.
NORTH CADDO HOSPITAL SERVICE DISTRICT
North Caddo Medical Center
David C. Jones, Secretary
Approved by the Board of Directors at the regular meeting held July 30, 2019