BOARD MEETING:  Regular Meeting   DATE:  November 24, 2020    MEMBERS PRESENT:  David Norman, Patricia White, Kenneth Clay, Ronnie Festavan, Brenda Smith, Kenneth Cochran MEMBERS PRESENT VIA TELECONFERENCE: Robert T. Green, Jr. (via teleconference)   MEMBERS ABSENT: Mary Irvin, Helen Godfrey-Smith (arrived at 4:10 p.m., via teleconference)     TIME CALLED TO ORDER:  4:05 p.m.   OTHERS PRESENT: David Jones, CEO, Dr. John Woods, Chief of Staff, Dakota Robinson, CFO, Mary Coil, Foundation Executive Director / Marketing Director (arrived at 4:45 p.m.), Walter D. (Doug) White, Hospital Attorney (via teleconference), Britney Stringham, Administrative Assistant, Lanell Audirsch, Admin. Asst.    LOCATION:  NCMC Café and Via Teleconference – Conference ID 127 695 955 #    BOARD CHAIR: Mary Irvin    SECRETARY:  David Jones      I.  CALLED TO ORDER – David Norman, Board Vice-Chair called the meeting to order at 4:05 p.m.     II. Invocation and Pledge of Allegiance – Ronnie Festavan offered the Invocation. Kenneth Cochran led the group in the Pledge of Allegiance.     III. Approval / Amend Agenda – David Norman noted we need a motion and second to approve our agenda. Brenda Smith made a motion to approve the agenda. Kenneth Clay seconded the motion. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None.  Absent: Mary Irvin, Helen Godfrey-Smith.  Abstained: None. The motion passed by unanimous vote in favor.   IV. Community Comments – David Norman, Vice Chair, inquired if there was anyone from the community logged on. Dakota Robinson stated there were no visitors logged on. David Norman noted there are no community comments.    V. Minutes – Regular Meeting October 27, 2020 – The minutes of the Regular meeting held October 27, 2020 were mailed prior to today’s meeting for review.  Kenneth Cochran made a motion to approve the minutes of October 27, 2020 as mailed. Pat White seconded the motion. David Norman asked if there was any discussion or corrections to be made regarding the October 27, 2020 minutes at this time. There were none. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None.  Absent: Mary Irvin, Helen Godfrey-Smith.  Abstained: None. The motion passed by unanimous vote in favor.  VI. Foundation Report:   David Jones stated he would give a quick Foundation report. Mary Coil could not attend at this time. She is doing something last minute for us. We have a couple of things going on. We still have the facial hair growth contest for Men’s Health going on. I think you can vote on our face book page. Brenda Smith asked if there were pictures of each individual. David Jones replied yes ma’am.  The trees behind you are for sale. They are also scattered throughout our local businesses throughout town and beyond in the service district. It is just getting started. I think there’s another two weeks to go. David Norman thanked Mr. Jones. Ronnie Festavan said Mr. Jones let me make a comment based on what you said about what’s going on with your auction. I want to commend Mary Coil. She represents the hospital so well, but Mary is also involved in the Town, she is also a member of the Chamber of Commerce. She also brought this to the Chamber of Commerce, and that’s what has, I believe, has engaged the town’s people with this hospital project. I think it’s a real good example that we should note before, when the town and the hospital work closely together and both lifting the same load it’s a lot lighter. I just wanted to make note of that. David Norman thanked Mr. Festavan.    VII. Chief of Staff Report – Dr. John Woods, Chief of Staff, stated the main thing I was going to bring up briefly is I mentioned about us evaluating ultrasounds because our current ultrasound is quite outdated. We got three bids on the top three ultrasounds that are out and utilized by the majority of the hospitals. General Electric makes one. Sonosite, which is the current ultrasound company that we use right now and Philips. (Helen Godfrey-Smith arrived via teleconference @ 4:10 p.m.). The other companies, Philips and GE, will normally point them towards Sonosite’s website and videos to learn to use their products. I just wanted to mention that we have narrowed it down to three companies. All of them have their advantages and disadvantages and all of them are light years ahead of what we have now. I can’t believe it hasn’t replaced a stethoscope yet because it tells you so much information. You could just go on and on and on what you can utilize this for. David Norman thanked Dr. Woods.   VIII. Old Business – 1) Purchase of Lab Analyzer for COVID – Ag Testing Update:  David Jones stated the lab analyzer for the antigen testing we are still waiting on a delivery date for that. It’s a must for us to have especially now that there has been an uptick nationally with the amount of positive COVID patients. We are trying to get this in as fast as possible. It is just we are at the mercy of the manufacturer at this point to get this in.   2) Purchase of 5948 North Market Street 2 Acres Update:  David Jones reported the update on the North Market property. We have the property completely cleared. We are going to go ahead and build the pad for the temporary building. We should be just sitting on go waiting on it to be rezoned. We are on the MPC’s agenda for the December 2nd meeting. Unfortunately the Commission meets on the third. We are going to miss the December meeting and have to get the final approval in January. As soon as it gets final approval for rezoning we can start business the next day. We are working with the town of Blanchard to try and get us annexed into the town of Blanchard but I don’t think it’s going to be any quicker than going through this process. They are trying. Once again, you’ve got Thanksgiving and Christmas, basically two weeks of do nothing during this whole process. That’s where we are with that.  3) Transport Van Replacement Purchase Update:  David Jones asked Dakota Robinson if we have a date on that yet. Dakota said we are hoping by the end of the year we will have it in hand. David Jones said that is another reason we have slow rolled the bid process for the current van. We have to have the replacement in before we get rid of it. We do still use the old van to do some transports. Unfortunately we can’t do it on a cloudy day like today. It is still functioning and we will talk about that a little bit later on.  4) Nurse Call System Upgrade Update:  Dakota Robinson stated the vendor is on site and they are running the extra pieces that we need in order to get that nurse call system upgraded. There is a lot of infrastructure in the ceilings that system changed in the mere three years and four years in part of this building. The infrastructure has changed in that period of time. We are adding multiple lines. The good thing is that we have channels in these ceilings that were built and meant for that. It’s been pretty easy for the vendor but they are here on site and working. I would assume within 30 to 60 days that whole process will be wrapped up.    IX.   1) Review of October 2020 Statistics – Dakota Robinson:  Dakota Robinson, CFO, stated there is a sort of a mixed bag that we will look at today. When we look at Admissions, we are looking at inpatient admissions here, you’ll see our high was in July of 67 admissions and October there were 43 admissions and 4 swing bed admissions. If you look at the total inpatient days you’ll see that last month that we had 232 inpatient days. Our swing bed program this time last year had 495 patient days and this year is at 718. If you look at Surgeries – our threshold here is about 10 to 12. We actually had 11 which is a slight decrease. A decrease of 1 from the previous month. Year to date we actually have an 11% increase. We’ve done 61 surgeries year to date. Endoscopies – we went from 14 to 15. Total ER visits, we’ve sort of seen that it is steady out over the past three month at least. We went from 426 in September to 415 in October. Mammograms, you will see that we went from 57 in September to 55 for the month of October. We’ve actually seen a 31% increase year to date in Mammograms. You’ll see that in September the Vivian Clinic saw 2,106 patients and in the month of October they increased that by about 2% to 2,141 patients. We also saw a slight increase at the Plain Dealing. They went from 697 visits in September to 702 in October. We see the exact same thing in the Benton Clinic. They went from 568 to 578. The year to date is what is impressive when we look at the Benton Clinic, we see a 20% increase in patient volume year to date from what we did last year in the Benton Clinic. The Fitness Center – they have 319 total members in the month of October. They had 17 members sign up for new memberships and they had almost 1,500 total visitors in October.   2) Review September 2020 Financials – Dakota Robinson:  If you look at page 1 of the Balance Sheet you will see that the Total Cash on Hand, unrestricted, is $17.7 million. You’ll see that we increased the Days Cash on Hand from 243 to 257 Days Cash on Hand if you include the CD’s, basically the entire pot of the unrestricted cash that Days Cash on Hand goes up to almost 270, right at 268.36. If we look at the Income Statement on page 3 you’ll see that we had Revenues at $3.6 million compared to $3.8 million the previous year. If you look at Salaries and Wages, last year at this time we did $1,144,000. This month it was $1,236,000; an increase of $91,000.  In Total Operating Expenses we had $2.2 million in Total Operating Expenses compared to $2.1 million the previous year and if you look at the four months $8.7milion compared to $8.1 million. Looking at 340B Revenue you’ll see that 340B Revenue is up from $134,000 in the previous year to $165,000 in October. Over the four month period we’ve gone from $514,000 in revenue to $706,000 revenue. Under Increase in Net Assets or Profit, we had an increase of $168,000 compared to $131,000 the previous year. If you look at a four year time period we are at $1.4 million compared to $658,000. If you look at the Budget, one of the main things that I note on here is the contractual percentage. You’ll see that we budgeted for $1.9 in contractual adjustments for the month of October we’ve done $1.8. If you look at year to date we are about a million dollars under the contractual adjustment number that we are looking at. We are pretty close to the revenue. Last year revenue we weren’t quite where we wanted to be but we are only about $297,000 off of the revenue number which is really, really good. If you look at Salaries and Wages you’ll see we are actually $67,000 under Salaries and Wages that we budgeted for at $4.9 million and we are also still under budget for Employee Benefits and Payroll Taxes. The Vivian Clinic turned a profit last month of $93,000 and this month they turned a profit of $38,000. At the Plain Dealing, they had a volume of 702 and turned a profit of $11, 595. In the Benton Clinic on their 578 visits they turned a profit of $23,162.  David Norman asked if there was any more discussion on the Statistical and Financial reports. There was none. David Norman stated we are now at the point where we need a motion and a second to approve our Statistical and Financial reports. Pat White made a motion to approve the reports as presented subject to audit. Brenda Smith seconded the motion. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green, Helen Godfrey-Smith. Nays: None.  Absent: None. Abstained: None. The motion passed by unanimous vote.  X. New Business – 1) Sick Time Buy Back: David Jones said if I can get a motion and a second I would like to speak on the Sick Time Buy Back. Ronnie Festavan made a motion to approve the Sick Time Buy Back. Brenda Smith seconded the motion. David Jones noted that Dakota has a graph on the screen and you have a copy in your book, also. We try to make sure that the employees understand that this is not a guarantee. There is no way for us to predict whether we can do this next year or not. It is a massive morale boost for the hospital and for the employees. Especially in a year like we have had this year. (Helen Godfrey-Smith departed the meeting @ 4:57 p.m.)  David Norman asked if there was any more discussion. There was none.   The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green.  Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstained: None. The motion to approve the Sick Time Buy Back passed by unanimous vote.   2) Set Fair Market Value of Surplus Van:  David Jones stated under new business I will have Dakota explain a little more on but to be able to send the van to a bid process via some type of auction, the Board has to actually set a minimum sale value to establish what the fair market value is. Now I know we are asking somewhat the impossible but we do have a suggestion that we set the fair market value at $1,000 for the van. If we get the motion and second we will go over that process a little bit and explain how that works. Ronnie Festavan made a motion to set the fair market value of the surplus van at $1,000. Kenneth Cochran seconded the motion. David Jones stated that we have talked to Mary Carroll and gone over this process because it is extremely new for us. I think this was discussed with Mary Carroll and she didn’t object to that number and to be totally honest, I personally will be surprised if we get $1,000 for it but if we don’t get $1,000 it’s kind of like when those things we either get this number or it doesn’t sell, so then we come back the next Board meeting after the auction and we will probably reduce that number even more and try to sell it again. Dakota said it is a 2003 year model and I believe its got 108,000 miles on it but it’s rough.  The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstain:  None.  The motion passed to set the fair market value of the surplus van at $1,000 by unanimous vote.   3) Phone System Upgrade:  David Jones said we actually had the phone system upgrade on the agenda for last month and we had some adjustments that was going on last minute with it. There are some upgrades that we will either have to pay to financially upgrade the software and everything that goes with our phone system now, which will be slightly above just about or equal to amount what it would be to get brand new phones.  That amount for $22,906.39 through Enterprise Computing Systems and if I can get a motion and second I’ll answer any questions. Ronnie Festavan made the motion to approve the phone system upgrade for $22,906.39. Kenneth Cochran seconded the motion.  David Norman asked if there was any discussion. There was none. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstain:  None.  The motion passed to approve the phone system upgrade for $22,906.39 by unanimous vote.   4) Purchase of Pyxis Drug Cabinets: David Jones stated the drug cabinets are the things that contain the medicines and IV solutions and a few other pieces of vital supplies for our patients. The current lease it up on our drug cabinets and we’re using Omnicell now. We contacted Omnicell, got a quote from them through our Vizient contract and that amount was around $338,278 and we got a quote from Pyxis. But, going through our partner health system, Ochsner, who is a super spender with Pyxis, we were able to get a price and actually got more equipment from Pyxis for a price tag of $192,093, which is roughly $146,000 in savings going through our partner hospital. That is a direct savings. So either we can re-sign our lease, because we don’t own the current equipment, or we can basically purchase/lease this equipment for a $192,000 or we continue to pay $200,000 for the old equipment. Brenda Smith made a motion to approve the purchase of the Pyxis Drug Cabinets for the price of $192,093. Robert Green seconded the motion. There was no further discussion. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstain:  None.  The motion passed to approve the purchase of Pyxis Drug Cabinets for the price of $192,093 by unanimous vote.   5) Mobile CT Rental: David Jones stated we are trying to figure out a way to have as little down time as possible with the CT unit so they contacted basically the same company for a couple of the companies that we’ve used in the past. The cheapest one or the one that actually had one available and ready to go was Insight Imaging and that one month rental is $28,350. We run about 140 CT’s in a month and the average charge somewhere around $800 a CT, that’s plus or minus as far as what type of CT is being done, so revenue wise, we certainly will make a lot more than $28,350 and that’s just a revenue/expense side. Pat White made a motion to approve the mobile CT rental as presented. Dakota said and for the approval of $23,000 for any additional months needed. I just don’t want there to be any questions. Ronnie Festavan asked David Jones to amend the motion to include the language that Dakota is talking about. I think Mr. Jones needs to go back and amend his initial stated we need a motion to rent the mobile CT from Insight Imaging for $28,350 for the initial month and $23,000 for any additional months needed. David Jones amended his request for a motion to rent the mobile CT from Insight Imaging for $28,350 for the initial month and $23,000 for any additional months needed. Brenda Smith made the motion to approve the Mobile CT Rental from Insight Imaging for $28,350 for the initial month and $23,000 for any additional months needed. Robert Green seconded the motion. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstain:  None.  The motion passed to approve the Mobile CT Rental.   6) Allscripts Addition for Blanchard Clinic:  David Jones said #6 under new business is just one of the many things that will be coming down the pike with the addition of the Blanchard Clinic. We have to create another module in Allscripts which is our electronic medical record for the clinic. I need a motion and a second to approve the Allscripts addition for the Blanchard Medical Clinic for $50,578. Ronnie Festavan made a motion to approve the Allscripts addition for the Blanchard Medical Clinic for $50,578. Kenneth Cochran seconded the motion.  There was no further discussion. The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstain:  None.  The motion passed to approve the Allscripts addition for the Blanchard Medical Clinic for $50,578.  7) Purchase of Airport Road & Hwy. l Property: David Jones stated I’m excited to bring to the Board. We finally have a signed contract from the owner of the property at the corner of Airport Road and Hwy. l.   Ronnie Festavan made a motion to approve the purchase of Airport Road and Hwy. 1 Property for $180,000 plus closing cost.  Brenda Smith seconded the motion.  Ronnie Festavan said I would just encourage all of our Board members to support this motion. For our future that’s going to get critical, critical piece of property. David Jones said we are land locked as far as growth. Our footprint will be expanded considerably there. It will allow us to do something with the old bait shop which is an eyesore which blocks the view coming down Hwy. 1 of a very beautiful hospital. There are numerous reasons, as Mr. Festavan said, to go forth with this. Ronnie Festavan said I would like to encourage us, if we buy that property, I would like to encourage us to make some move to go ahead and start cleaning up because you framed it well. I would just encourage us to keep moving forward with the development of that. Thank you Mr. Norman. David Norman asked if there was any more discussion.  There was none.  The verbal vote: Yeas: Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstain:  None.  The motion passed to approve the purchase of Airport Road and Hwy. 1 property for $180,000 by unanimous vote in favor.   XI. Administrative Reports:    David Norman asked how we are going to distribute the Sick Time Buy Back check. David Jones said we are just going to have to give them just like we would a normal paycheck. Mary Irvin did help develop a letter that will come from Administration and the Board telling the employees thank you and for all their hard work we reviewed and thought it would be best to do it this year. We could get the Board members to sign it; have each Board member put their own signature on it. Whatever the Board would like. David Norman asked if the checks would go out Monday. David Jones said yes. David Norman asked if there was any further discussion. Brenda Smith stated whatever we are going to do we will need to do it quick if they are going out Monday. David Norman thanked Mr. Jones.  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) Richard Blanchard, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of November 24, 2020 through November 30, 2022.     ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:     1) Kirk Martinson, CRNA – Request Affiliated Privileges in the field in Anesthesia for the period of November 24, 2020 through November 30, 2021.  2) Jennifer Hart, FNP – Requests Affiliated Privileges in the field of FNP for the period of November 24, 2020 through November 30, 2021.     EXTENSION REQUEST:  1.) Samantha Thompson, FNP – Requests extension upon completion of her reapplication.   2.) Matthew Mastrodomenico, M.D. – Requests extension upon completion of his reappointment application.   3.) John Chandler, M.D. – Requests extension upon completion of his reappointment application.   VOLUNTARY RESIGNATIONS: 1.) Fleurette Wilhemia Abreo Requests voluntary resignation of his privileges in the field of Pathology effective 07/01/2020.  Kenneth Clay made a motion to approve the (1) Medical Staff Reappointment and (2) Advance Practice Professionals Appointment (3) Extension Request and (1) Voluntary Resignation as presented. Pat White seconded the motion. David Norman asked if there was any discussion. Brenda Smith said yes. There hasn’t been a place to jump in and do this and now that Jennifer Harts’ name is up there, I would like Mr. Jones to share with you what she is doing already doing and the clinic isn’t even there. David Jones stated that she has already reached out to the Mayor of Blanchard and got on their face book page. I think there’s a community face book page there in Blanchard and introduced herself and told them when approximately she thought she would be starting. Pat White stated that I met her last week and she is a lovely person. The whole family is wonderful. David Jones said she is already a provider in Shreveport that the practice is retiring. We really feel that from day one she’s going to be almost full from day one. Dr. Chance, our busiest provider here, on his day off is going to work there as well. Brenda Smith said it’s the most unique clinic that started so far because starting from scratch with no patient base, no building or anything. This is going to be a unique experience for us. I just wanted you to say that because I was so impressed when you talked about her the other day and everything that she’d done and there are people that are going to be coming that can’t wait for her to get there. That’s just a plus. David Jones said I have very high expectations for it and for Mrs. Hart.  Brenda Smith said thank you.   David Norman asked if there any other questions. There were none.   The verbal vote:  Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor.  XIII. Executive Session:   There is no business for Executive Session.         XIV. Adjourn – There being no further business David Norman called for a motion to adjourn.  Kenneth Clay made a motion to adjourn. Ronnie Festavan seconded the motion.  The verbal vote:  Pat White, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Kenneth Cochran, Robert Green. Nays: None. Absent: Mary Irvin, Helen Godfrey-Smith. Abstained: None. The motion passed by unanimous vote in favor.  The meeting adjourned at 5:38 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 December 17, 2020

 

 

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