BOARD MEETING:  Regular Meeting   DATE:  March 23, 2021    MEMBERS PRESENT:  Mary Irvin, David Norman, Robert T. Green, Jr., Brenda Smith, Helen Godfrey-Smith,    MEMBERS PRESENT VIA TELECONFERENCE: None   MEMBERS ABSENT: Patricia White (arrived at 4:03 p.m., Kenneth Clay, Kenneth Cochran (arrived at 4:05 p.m.) Ronnie Festavan.  TIME CALLED TO ORDER:  4:01 p.m.   OTHERS PRESENT: David Jones, CEO, Dakota Robinson, CFO, 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 734 279 548 #    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 the Invocation and Brenda Smith led the group in the Pledge of Allegiance. Helen Godfrey-Smith read Luke 24:13-16 as a word of encouragement.    Mary Irvin thanked Helen Godfrey-Smith for the words of encouragement. times of depended onsion and ca     III. Approval / Amend Agenda – Mary Irvin noted we need a motion and second to approve our agenda. Brenda Smith made a motion to approve the agenda. Helen Godfrey-Smith seconded the motion. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: Kenneth Clay, Ronnie Festavan. Abstained: 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. Mary Irvin noted there are no community comments.  V. Minutes – Regular Meeting February 23, 2021 – The minutes of the regular meeting held February 23, 2021 were mailed prior to today’s meeting for review. Pat White noted that in those listed present Robert Green was listed, however, he was absent, and Kenneth Clay, Kenneth Cochran and Helen Godfrey Smith were present but not listed. Pat White made a motion to approve the minutes of February 23, 2021 with corrections as noted. Robert Green seconded the motion. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: Kenneth Clay, Ronnie Festavan.  Abstained: None.  The motion passed by unanimous vote in favor.   VI. Foundation Report – Mary Coil, Foundation Executive Director, stated I talked you all about the Raffle that was going to come up; well, it is here. We have raffle tickets for sale. As you know we have the Gala every year, except for last year, we decided we could not do that again this year so we came up with a raffle. On April 23rd we will have an Early Bird drawing for a $1,000. If your name is drawn it will be returned to the drawing for the Grand Prize drawing on June 25th. On June 25th we will draw for the first prize which is $25,000, second prize is $10,000, third prize is $5,000, 4th prize is $2,500 and our fifth prize is a half of beef processed by Wooldridge Meats. We only have 1,000 to sell and we have sold close to half of those already.  Mary Irvin thanked Mary Coil.  VII. Chief of Staff Report – David Jones said the Chief of Staff is working very odd shifts this month. He and I had a phone conversation today. He’ll be working a 24 tomorrow so he didn’t think he could make it up today. We matched two of our three slots for the Residency Program so they are doing the scramble for the third, which is not unusual. We’ve had years where we scrambled all the slots before. The interview process was a little odd this year because no one could actually come here. It was all done virtually. Other than that everything is going along fairly nicely.  Brenda Smith asked about the funding for that program. David Jones said we pay for one and Ochsner pays for the rest.   VIII. Old Business – 1) Update on Blanchard Clinic: David Jones stated on the Update on Blanchard Clinic – we are seeing patients live as of last Thursday afternoon.  Kenneth Cochran said when he passed there today the parking lot there was full. David Jones said Dr. Chance was actually doing his clinic there today. The plan is for him to do one day a week there and then Mrs. Hart to do the other four days.  Brenda Smith said if I could ask a question please. I know back in previous planning sessions we talked about the possibility of having a physical therapy portion there. Is that going to be in the new building? David Jones replied yes.  David Jones said we have high hopes for that clinic for sure. 2) Update on Surplus Van: David Jones said we are still using it of course. We are in the process of ordering a separate work vehicle for the hospital and once that comes in then we’ll be surplusing the van. The gray van, basically housekeeping and maintenance use it now, we don’t use it for any transport. 3) Update on Pyxis Drug Cabinets:  David Jones said we are pressing now to late summer, maybe early fall we might actually get them. That’s just part of the new norm. It will be a much newer system.  4) Ultrasound Purchase for OB Update: David Jones said it has been purchased but not delivered yet. It’s built for ease of use. Training is going to be very minimal for them to be able to use it. I talked with Dr. Sharpe today and she is ready for it to be in and it should be any week now.  5) Increase for CEO Purchase Amount Update: David Jones asked if Dakota or Helen Godfrey-Smith, the Chair for the Finance Committee, wanted to speak on that. Helen Godfrey-Smith said yes, I will. We looked at our CEO’s purchase limit and we actually approved increasing his purchase limit from $10,000 to a maximum of $30,000 per incident. The Finance Committee standpoint we thought it was important to have some checks and balances in place so that what we approved at Finance Committee this week was that we would ask him to report quarterly on any purchases that were made that. We would maintain monitoring his year to date total for those purchases and as long as he did not max out more than $400,000 for the year. Dakota said and that’s roughly 13 on the year, a little over one a month. Helen Godfrey-Smith said we felt like that volume, and it doesn’t matter if he does them all in one month or one a month, however he does them, once he hits the threshold of $400,000 then he would again bring those purchases to the Finance Committee and Board like we are doing right now. Otherwise, he is free to carry on, and we want that to be effective immediately so that he can use that purchasing authority as we move forward with our clinics and so on. Brenda Smith stated if I could just clarify, it was the Board that okayed and voted last time to approve the $30,000 each month, I wanted to make sure that is clear that it was the Board that approved that and not the Finance Committee. I just wanted to make sure that was clear and not mistaken. The only thing we’ve done is come back with the annual cap and put in some safeguards. Mary Irvin said, just for the record, to state that this Board brought this as an agenda item based on the recommendation from our auditors not from our CEO. That was never requested from the CEO. That was something that the auditor made us aware of and then we brought it to the table for discussion. Mary Irvin said with what they just shared and what’s on the screen right now we need a motion and a second and then if there is any added discussion about it we can do that. Helen Godfrey-Smith made the motion to accept the Finance Committee recommendations regarding the checks and balances for the CEO purchase amount increase. Pat White seconded the motion. Mary Irvin asked if there is any other questions or discussion. There were none. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None. Absent: Kenneth Clay, Ronnie Festavan. Abstain: None. The motion passed by unanimous vote in favor.     IX. 1) Review February 2021 Statistics. – Dakota Robinson: Dakota Robinson said everyone is aware of what happened last month. We basically had a week’s worth of shutdown due to the weather. With that being said you can see that the Admissions went from 58 to 42. It’s not too far off from what our December and October numbers were. One of the areas where we saw a dramatic decrease, not in admissions, but with Swing Bed. We had 5 admissions compared to 9 in the previous month. Now, if we look at Inpatient days actually sort of stayed the same. They went from 205 to 207. Swing days is where we saw a large drop. I believe that month prior we were around 100 and something Swing inpatient days and we dropped down to 54, so we saw a significant decrease in that category. If we look at the Average Daily Census, both of those combined both our Swing and Acute stays. This is where you can see the difference, you can see that it was trending up in January to 10.1 and we saw it come back down to almost where it was in December at 7.4 so we had about a 27% decrease from January to February.  When you look at Surgeries we’ve actually had 11 for the past three months. When we look at surgeries we look at that 10 threshold every month. If you look at the year to date numbers we’re at 110 year to date, which is actually a 7% increase over where we were at the previous year. Endoscopies – we actually increased those from 12 to 14. We’re at 105 year to date, which is actually 4% increase over where we were at the previous year. Newborns – Newborns went from 6 in January to 7 in February. Year to date we’re at 57 so we’ve seen a 6% increase this year.  2) Review February 2021 Financials – Dakota Robinson:  Dakota Robinson stated just a brief overview – obviously the statistics with the ice affects the total revenue, some of the expenses. Dakota stated looking at page 1 of the Balance Sheet the main thing that you’ll see here is there wasn’t significant change in Days Cash on Hand at the end of February. Does anybody have any concerns with the audit? There were none. On page #3 we’ll look at the Income Statement. You’ll see that we did revenue of almost $3.5 million compared to $3.6 million the previous year. I keep talking about contractual adjustments. Last month, our contractual adjustments stepped over that 50% threshold. I said we should expect that this month again. We’re in that 53.5% threshold which puts us through eight months contractual adjustments that pushes it up to 48 almost 48.5%. We’re pushing ourselves up to that 50% threshold we think we are going to be at.   Looking at Net Patient Revenue – we actually were only $12,000 off where we were at the previous year and when you look at net patient revenue in eight months, we’re actually almost a million and a half more than where we were at sitting at $14.8 million. If you look at Salaries and Wages, you’ll see that salaries and wages were actually lower than they were in the previous period at $1.1 million and if you look at the eight months, If you look at the Total Operating Expense you’ll see we did almost $2.2 million in expense compared almost $2.1 million the previous month and year to date we’ve seen about a $1.1 million increase to a total of $18.1 million in expense. When we get into Non-Operating Revenues, you’ll see that there’s $303,000 has been booked to the Grants section. Part of that is the UCC dollars and part of that is MCIP money. So if you look into eight months, you’ll see that we’re at $2.5 million compared to a little over $2 million the previous year, so that’s $500,000 increase. Sales Tax Revenue looks like it’s lower at $47,000.  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 February Statistical and Financial Statement. Robert Green 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, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None.  The motion passed by unanimous vote in favor.  X. New Business – 1) Board Approval of Building Project Bids: David Jones stated that three weeks ago we had our bid date which was actually delayed a bit due to the snow and ice. We had our openings of our bids. We had five different representatives from different companies, we had our architects there from TEG, a representative from Vintage Designs and our attorney, Doug White to oversee. It is time to look at the final numbers to see if we can vote and go forward with that.  A summary of the bids was presented to the Board members. a) Roof Replacement: Trumble Construction was the low bid at $377,704 for the roof replacement that we received hail damage on many months ago. We went through the entire process of bidding that out. If I could get a motion and a second I will be glad to answer any questions you may have. Brenda Smith made a motion to approve the bid by Trumble Construction in the amount of $377,704 for the roof replacement. Robert Green seconded the motion. Mary Irvin asked if there was any discussion about the roof replacement bid by Trumble Construction. Kenneth Cochran asked where they were located. David Jones replied I believe they were from Texarkana. No further discussion. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None.  The motion passed by unanimous vote in favor of approving the Trumble Construction bid to replace the roof for $377,704.  b) Dental Expansion:  David Jones stated the Dental Expansion, as you can tell from the highlighted groups there, we had four different winning bids for these four different projects which was pretty unique, but Thrash Construction was the low bid at $809,000 for the Dental Expansion. We are adding rooms to the back portion of the clinic to move Medical/Surgical exam beds there we’re going to have Dental where those were. Plus, it will afford us to have an emergency area for, if a pandemic does hit again, where we can have immediate access in and out and have a pandemic waiting room in that area with people with fever, plus doing curb side check to make it easier to step outside the door and come back in. Mary Irvin stated we need a motion and a second for the Dental Expansion from Thrash Construction in the amount of $809,000. Pat White made a motion to approve the Dental Expansion from Thrash Construction. Kenneth Cochran seconded the motion. Mary Irvin asked if there was any discussion. There was none. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None.  The motion passed by unanimous vote in favor of the Dental Expansion by Thrash Construction.  c) Benton Expansion: David Jones stated the clinics will be the higher price. The Benton Expansion, the ELA Group out of Shreveport was the low bid at $1,491,600. This will double the size of our Benton Clinic and afford us room to have two fulltime providers in there at any given time. That clinic is at capacity.  Robert Green made a motion to approve the Benton Clinic Expansion bid by the ELA Group in the amount of $1,491,600. David Norman seconded the motion.  Mary Irvin asked if there was any discussion. There was none. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None.  The motion passed by unanimous vote in favor to approve the bid of the ELA Group for the Benton Clinic expansion.  d) Blanchard Clinic: David Jones stated that Weiland Davco was the low bid. The bids were tight but they were the low bid at $2,063,000.  Total for all four projects is pretty much where we thought it was going to be.  We thought $4,500,000 or $4,600,000 is where we thought we were going to be – it is $4,700,000 total. Weiland Davco was the low bid for the Blanchard Clinic at $2,063,000. Helen Godfrey-Smith made a motion to approve the Weiland Davco bid of $2,063,000 for the Blanchard Clinic. Brenda Smith seconded the motion. Mary Irvin asked if there were any question. There were none. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None.  The motion passed by unanimous vote in favor of the low bid by Weiland Davco of $2,063,000 for the Blanchard Clinic.   The Board reviewed what was recorded as the low bids. The bid list was returned to administration. David Jones stated most of the companies stayed and are aware of the bid status. Mary Irvin said I have one question. Did you get any conversation about how all of that is going to connect with the money we received through the pandemic? David Jones said we can’t officially say that that will go into that because we still don’t have, as Dakota mentioned earlier, the specific guidelines. They keep kicking the can down the road to say what exactly the monies can be used for. The roof replacement is separate, but certainly the clinic expansions and the dental expansion because we did design it in a way to where it is going to be effective in a pandemic type situation.  2) Resolution #2 – 2021 – Adopt Ambulance Millage Rate of 4.77: David Jones said believe it or not it is almost April 2021. It’s time to have a resolution to adopt the millage for the 2021 tax roll season and the millage is 4.77 mills. We suggest that we keep it at the same level. David Norman made a motion to approve Resolution #2 – 2021 to adopt the Ambulance Millage Rate of 4.77. Helen Godfrey-Smith seconded the motion. Mary Irvin asked if there were any questions or discussion. There was none. The verbal vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran. Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None.  The vote was unanimous in favor to approve Resolution #2 – 2021 to adopt the Ambulance Millage Rate of 4.77.   XI. Administrative Reports –   1) NCMC – Pandemic Update:  David Jones said I wanted to give a quick update of where we are with the vaccines, what we’re seeing pandemic wise. The COVID amount has dropped significantly. We’re guessing numerous factors. One of course a lot of people are getting vaccinated, we’ve been wearing masks for the better part of the year. These infections are cyclical anyway. You could just be getting a crest in a wave down as well. Praise God, whatever it is, the combination of all three one of the three whatever it is we have seen a drastic decline in the number of respiratory cases period but certainly COVID cases. David Jones said we are in a different time now.     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.) Neil Staib Jr. M.D. – Requests Courtesy Privileges in the field of Radiology for the period of March 23, 2021 through March31, 2023.   2.) Robert B Williams M.D. – Request Courtesy Privileges in the field of Pathology for the period of March 23, 2021 through March 31, 2022.    3.) Stephen Taylor, M.D. – Request Active Privileges in the field of Family Medicine for the period of March 23, 2021 through December 31, 2021.   ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS / REAPPOINTMENT:  None.     EXTENSION REQUEST:  None.   VOLUNTARY RESIGNATIONS:  1.) Magdy Eskander M.D Voluntary resigns his Privileges in the field of Emergency Medicine effective 02/01/2021.  Robert Green made a motion to approve the (3) Medical Staff Reappointments and (1) Voluntary Resignation as presented. David Norman seconded the motion. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran.  Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None. The motion passed by unanimous vote in favor.     XIII. Executive Session – Mary Irvin noted there was no business for Executive Session.    XIV. Adjourn – There being no further business Mary Irvin called for a motion to adjourn. Robert Green made a motion to adjourn. Kenneth Cochran seconded the motion. The vote: Yeas: Pat White, Robert Green, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Kenneth Cochran.  Nays: None.  Absent: Kenneth Clay, Ronnie Festavan.  Abstain: None. The motion passed by unanimous vote in favor. The meeting adjourned at 6:10 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 April 27, 2021

 

 

 

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