BOARD MEETING:  Regular Meeting   DATE:  November 26, 2019    MEMBERS PRESENT:  Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Patricia White.      MEMBERS ABSENT: Kenneth Clay (arrived at 3:04 p.m.), Robert T. Green, Jr. (arrived at 3:12 p.m.)    TIME CALLED TO ORDER:  3:00 p.m.   OTHERS PRESENT: David Jones, CEO,  Pam Hughes, COO, Dakota Robinson, CFO, Dr. John Woods, M.D., Chief of Staff, Mary Carroll, CPA, Lester, Miller & Wells, Paul Delaney, CPA, Lester, Miller & Wells, Mary Coil, Foundation Executive Director / Marketing Director, Lanell Audirsch, Admin. Asst.  LOCATION:  NCMC Events Center BOARD CHAIR: Robert Green    SECRETARY:  David Jones    I.  CALLED TO ORDER – Mary Irvin, Board Vice-Chair called    the   meeting to order.   (Kenneth Clay arrived at 3:04 p.m.) II. Invocation and Pledge of Allegiance – Helen Godfrey-Smith offered the Invocation.  David Norman 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: Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None.  Absent: Robert T. Green, Jr.  Abstain: None.  The motion passed by unanimous vote in favor.   IV. Community Comments – Mary Irvin, Vice-Chair noted there were no signed Visitor Recognition Cards requesting to address the Board.   Mary Irvin congratulated Mrs. Brenda Smith on her recent retirement. Brenda Smith said thank you.   V. Presentation of Fiscal Year End Audit – 2018 – 2019 By Lester, Miller & Wells, CPA Firm: Paul Delaney introduced himself stating that he is a partner at Lester Miller and Wells and is here with Mary Carroll to present the audit. The financial statements are presented with no material mistakes, which is good. I know it goes on for 2 ½ pages. On page 4, starts the statement of net position. Your cash and cash equivalents plus your limited use assets and your investments, if we add all that together, you have about $5.8 million and the year before that it was $5.3. The next item we want to look at is your Net Accounts Receivable. Last year was $3.3; it went up to $3.8 million but your days of revenue in Accounts Receivable is right at about 50. You see 51 in the prior two years. You are keeping your Accounts Receivable and getting them paid within two months. If you look at the other hospitals they range from 46 to 54 nationwide and in Louisiana somewhere between 60 and 83. You are doing well on your Accounts Receivable. Right now you are in good cash position. Your total Current Assets is about $8.7 million. The year before that was $7.9. What we like to use a graph to look at is what we call the Current Ratio.  You are at 2.8; it was 1.6 two years ago. They said anywhere between 2 and 3 – you are at the top of that scale which is good. (Robert Green arrived at 3:12 pm.) Capital Assets – the average age of your plant, when I first looked at this it took me a little while because I was like why are you so young, but, you built a new facility. I’m used to seeing everybody around the 18 and 20 and since you have a new facility you are at 5 to 8. Your Debt Service Coverage – This is how many times over you can cover your principal and interest payments from operations. In 2017 it was flat; 2018 three times, two times last year – that’s good. You can cover your debt over two times if needed from operations. If you look at other hospitals nationwide you are right there with the 75th percentile at 2.2 and 1 at the median is a lot lower. Equity – you are at 10%, the year before that 26.3 and if you look at your hospitals nationwide, your rural hospitals, especially critical access, they are losing money. There’s a lot of hospitals nationwide, small rural hospitals that are closing down. I think there are at least 10 in Georgia, and other states were hit hard like Texas and Mississippi. On page 5 this is your Statement of Revenue and Expenses. If you look toward the bottom, Increase (decrease) in net position, think of that as your bottom line. You made a little over $900,000, the year before that was $2.2 million and you had a loss the year before. The Net Patient Service Revenue – your net revenue increased about 1%. The year before that was 9%. I mentioned earlier this is my sixth hospital to be at, four of those six hospitals, their revenues were flat.  Noncapital Grants and Contributions – the bulk of that is your intergovernmental transfer- grant that you receive for uncompensated care. That should go up next year. Currently in the State budget it is the same pool as last year, plus an additional $283,000 payment because the governor promised that last year and I think you may have recognized just part of that, that is why I am saying it will go up plus you have another $283,000 this year. Other Operating Revenue, your biggest thing is your 340B program increased. You are doing well in that program. A few things I saw going through the foot notes, in the future two years from now, there’s a new accounting pronouncement that came out where you going to have to look at all your rental agreements and they want to categorize those as debt. We have three management comments starting on page 49. The first is a repeat finding – segregation of duties. Most rural hospitals, because of limited staff, there is a problem with trying to segregate the duties of recording the cash, collecting the cash, or dispersing the cash. What you could do is just look at those areas and see if you could put a compensating control that would fit instead of hiring someone else. What we could do, is get with Mary and see what areas of concern are there and see what we can do to try and fix that. On #2 – Monthly Financial Statements – Our biggest part in entry was the Medicare and Medicaid Cost Report Settlement. That is a very difficult test to make. Typically it takes hiring someone outside to make those calculations, it can be done, but with critical access it is very important. The way they pay Medicare on in-patient, they base it off so much per patient day, and if your patient days go down, they owe you a lot of money because you didn’t get very much money. The last one is a compliance issue that is uninsured bank accounts. You had opened up a new bank account. What they say is you have to have all your deposits fully insured between FDIC and pledge securities and you had some money over the FDIC limit and you worked with the bank but it took a while to get it in place. That one is really resolved. You are in compliance now.  We appreciate the opportunity and time. Mary said she had pleasant visits up here. The staff was very cooperative. This is not easy because we ask for a lot of information. We also have to prepare the Medicare and Medicaid Report, we ask for a lot of unusual things – time studies, FTE hours for each department, how many hours the physicians work. We break that down between productive hours and non-productive hours. It is all in order to try to get you the best reimbursement we can. We appreciate serving you and thank you for the opportunity. If you want us to stay for any other items on the agenda we are more than happy to stay otherwise we will head right on back. Mary Irvin thanked Paul Delaney for the visuals he presented. Helen Godfrey-Smith addressed Paul Delaney stating you had mentioned yesterday about our reimbursement from our Cost Report, the $826,000 adjustment, there were several financial adjustments of $300,000 but the $826,000 was the biggest, if you would talk about that. Paul Delaney said he will ask Mary Carroll to address that. Mary Carroll said the biggest adjustment was the Cost Report receivable which was good news because it was over $800,000. Helen Godfrey-Smith said it was interesting to mention that the $320,000 for the pension adjustment was not one that Dakota could have caught because we did not have the Actuarial Report prior to the end of the fiscal year. It would have been impossible for him to make that one. And the Cost Reporting, of course, is, we all know, he is always stabbing in the dark with that one. He was giving us as much information as he could. Any other items. There were none. Paul Delany and Mary Carroll thanked the Board and departed the meeting. Helen Godfrey-Smith said she would like to give Mary Carroll a little shout out because during the course of the year I call her from time to time with questions or just asking for information and she is always so courteous and she treats my questions as though they make good sense and she always gives good feedback and follow ups. Helen Godfrey-Smith asked Dakota to provide the members of the Finance Committee a copy of the Agreed Upon Procedures Report. Dakota will provide that copy. Helen Godfrey-Smith said three years ago they first put it in place and we were monitoring and making sure that we made the changes that we needed to make. We got them all done and this is our evidence and I want us to go through and look at it. Robert Green, Chairman, said at this time he would entertain a motion to accept the end of the year audit. Helen Godfrey-Smith, as Chair of the Finance Committee, made a motion that we accept our audit for our 2019 fiscal year ending June 30th.  Pat White seconded the motion. Robert Green asked if there were any questions or comments at this time. Helen Godfrey-Smith said it was a very good audit and hats off to Dakota and the team that he has. I want you all, as Board members, to know that we discussed whether or not if you remember that our accounting team would be considered thinner than it had been at one time as we promoted Dakota to our Chief Financial Officer, we did not replace that interim level position. We talked to him and David about that from time to time and they still think using the individual we hired someone from outside that supplement him and support him in his duties, as a result of this audit we believe it is working ok with us not hiring that second person right now. David Jones stated for right now. But we are looking and we haven’t forgotten that we are a little bit thinner. We don’t want to burn Dakota out. He knows I talk about this. He is very valuable. Robert Green asked if there were any other comments from any Board member. There were none. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.   Absent: None.  Abstain: None. The motion passed by unanimous vote in favor.     VI.  Minutes – Regular Meeting October 22, 2019 –   The minutes of the Regular Meeting held October 22, 2019 were mailed prior to today’s meeting for review. Robert Green stated he would entertain a motion to approve the minutes. Brenda Smith made a motion to approve the minutes of the Regular Meeting held October 22, 2019 as mailed. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None.   Absent: None. Abstain: None. The motion passed by unanimous vote in favor.    VII.    Old Business – 1) All Scripts Interface Update:  David Jones said we have quite a few under Old Business since we had quite a few under New Business from last meeting.  I talked to the Laboratory Director last week. They did have some things that they sent through and sent in and actually from an admitting standpoint and also they had some things that were actually working but then the question was posed – because there is a manual process where they have to match these patients from one computer system to the other. They are working on it but there is still some work to be done. 2) X-Ray Room and Mobile X-Ray Update:  David Jones stated this item should be taken off after this month. The X-ray room is in and it is being used live with patients. That will be part of the tour on Tuesday. We will show you what the new room looks like and the mobile unit.  3)  Blanchard Clinic Project Update: David Jones reported there is not a ton of update there. We are at a standstill for now. We are still looking for appropriate property there. Kenneth Cochran asked if the Census Bureau responsible for the waiver decision. David Jones replied yes Sir.  Helen Godfrey-Smith said there was some urgency with this property in order for us to meeting the deadline of having the clinic opened by a certain point in 2020. Are we missing that deadline? David Jones replied we are becoming extremely unlikely to meet that June 30th deadline. For the most part it was to get the 340B settled because you have to have it in a cost report from the previous year to be able to file it for the coming. It is not like it would stop the duties of the clinic itself but it would stop one of our cash flows that comes in from those clinics. We are still working. Helen Godfrey-Smith said I was going to say because we do not have a lot invested but it is going to definitely appreciate as that corridor is developed and might behoove the Board to consider holding it. David Jones said it may end up being one of our best investments. With interest rates the way they are, which are almost non-existent now thorough CD’s and/or bank accounts. Ronnie Festavan asked David Jones if he knew how much our taxes are on it. David Jones asked Dakota to reply. Dakota stated that taxes would be nothing because we will remove it from the roll. David Jones said we had to prorate something for this year. Ronnie Festavan said o.k. Thank you.   4) Purchase of New Chemistry Analyzer Update:  David Jones said this one is probably going to be on the agenda for a couple of months. We had to do some electrical adjustments in the clinical lab. We have to have both machines running to do a correlation between the machines, and do normal studies to get reference ranges and so on. Greg and his staff will be working quite a lengthy time period. Probably will be another 30 days before it is up and running. But it will encompass at least one more Board meeting if not two. 5) Purchase of Valley Lab FT10 Platform Update: David Jones stated this is the cauterizer. It is in and is in use. 6) Purchase of Olympus EGD HQ190 Scope Update: David Jones stated the Olympus EGD HQ 190 Scope is also in and is in use.   7) Purchase of (2) Stryker Electric Stretchers for Ambulance Update: David Jones stated the Stryker Electric Stretchers will actually be in next week and if we can get them in by the time we do the tour we will have them in there just to have Adam and his team to show you what they are. They are actually pretty neat how they work.   VIII. 1) Review October 2019 Statistics – Dakota Robinson, CFO:   Dakota Robinson stated you will see through the slides today that October was a slightly better month than September. We did see a 15% increase in Acute Days. We had 63 admissions and in the Swingbed, we have 11 admissions. On the whole year we have had 495 Swing Days, whereas that same period the previous year, we had 363. That has been a positive change that we have seen. We also saw Acute In-patient days go from 155 to 174. Hopefully we will see that trend continue through these winter months. If you look at the Average Daily Census you will see that it went from 8.3 to 9.5. If you look at the Surgeries, we only did one less than we did the previous year. Dr. Banda is continuing to stay busy month over month. Endoscopies, once again, we had the same amount of 13. ER visits went from 529 to 479, but on the year, it was interesting that we went from 1,807 through four months in 2018 to 1,999 through four months of this year. If you look at Mammographies, we actually had 47 again. You can see that three out of the last four months have been very strong and the month of October was above the six month average. If you look at Newborns – there were 10 newborns. That is the highest in the six month average. We had 34 in 2019 which is one more over the same period in 2018. Clinic visits – you will see a rise. You will see that winter trend start in the clinics and it usually flows over in the hospital and the ancillary departments. You will see that they had 2,295 visits for the month of October up from a little over 2,000. Plain Dealing saw a slight rise from 619 to 641 and the Benton went from 463 to 510. The Fitness Center membership – historically in January people make their New Year’s resolutions and if they are anything like me they just wain through the year. You see the graph in January it is up and then wains through the year. Hopefully we will see the uptick again in January. Are there any comments on the Statistical Analysis for the month of October? There were none.   2) Review October 2019 Financials – Dakota Robinson, CFO:  Dakota Robinson stated obviously with them presenting the audit is complete. Thorough this year we’ve seen pretty good numbers. I feel like it is very similar to last year in terms of where we are at. The Cost Report is a major factor that we will be receiving a significant sum of money, even though it is broken into smaller payments and we do have to work to get those in, that is a receivable that will be booked. You’ll see the Days Cash on Hand are 58.98. What that is, that is unrestricted cash and cash only. They threw up a figure of 95 days; that is with every piece of liquid cash, CD’s, restricted cash all lumped together to get that amount. When I report it, I’m giving you, usually, just the liquid cash. If you look at page 1 on the Balance Sheet, you will see total cash is in a good spot. I do want to point out, in Other Assets – Assets Not in Service. You will see that there is a big difference there between $4,000 and $1.3 million this year. That will roll up into that line item once we get all of the construction invoicing in and we can convert that to the depreciation schedule. You’ll see that asset move in the Balance Sheet and that Asset Not in Service is going to go down into a significantly smaller number. Any questions on the Balance Sheet. There were none.  Moving to the Income Statement on page 3; we did $3.8 million in revenue for the month of October compared to $3.4 million the previous year. Actually, on a four month window, we’ve done $31,000 more in revenue than we did this time last year. If you do look at the contractual adjustments you will see that they are at 52.9 for the month. This time last year we were looking at the 55 and that’s when we were sitting here saying well we expect Cost Report receivables. If we come in to Salaries and Wages, we are seeing sort of that same trend that the auditors discussed earlier. If you look at Employee Benefits and Payroll Taxes, you will see that we are less than we were at this point last year. One of the main reasons is because health, dental and life is $50,000 under what we had expensed last year. Our plan year starts in October so we are trying to get all those claims in and hopefully we can report a historical data on our self-funded insurance plan and I think the Board will like that and the data that that will give us. Going into the Non-operating Revenues, obviously the UCC dollars are booked in here and we received the grant under the grant line item. Further down, 340B that’s more than what it was last year. We’ve seen that trend up. We are in the process of trying to add a few more pharmacies and obviously when Benton rolls on line we will accomplish adding to the pot as well. If you look at the increase of Net Assets of $131,000 and on a four month total of $546,000. It’s been a good four months. Any questions on the Income Statement.   Dakota said I was glad to see they mention AR days in their slide. Currently we are sitting at 54 which is very little change from the previous month just comparing us to other facilities. We sit here and we show you these slides all the time and we say this is a good range to be. It is nice for the auditor to come in and say hey this really is a good range compared to other facilities your size across the state or across the nation. Brenda Smith said that was something they’ve not done up until this year. I know they mentioned in our Finance Committee meeting with them yesterday that they were going to do that. I think it helps us see the bigger picture not just how we are doing. You kind of see other rural hospitals and how we are doing and how they are doing and how the Louisiana hospitals are doing in general. I think it was a good visual for me. David Jones said the point to make out about those slides is they weren’t just rural hospitals they were comparing to all hospitals in Louisiana and we were in the 75th percentile we’re better than in most of the very good categories.  Dakota continued on page 5 – Departments Revenue and Expense.  Across the board for the month of October we say increases from the previous year, but I did want to point out the Emergency Room. I know that is one thing I said I would talk about this for the next few months. I believe through July and August, we were about $100,000 down from what we had done in July and August of 2018. I can’t really ever tie anything to one specific event or the health of patients. There’s a lot of factors there, but we make reasonable guestimates and construction has a lot to do with it I believe. We’ve actually sort of turned that corner in that department as we’ve seen a $54,000 increase in the month of October. We’ve pulled ourselves out of a hole if you look at a four month period, now we are $6,000 more than the previous year. Dr. John Woods, Chief of Staff, spoke up and said I have to comment is that one of the goals, too, is to try to open up the access to the clinics, because a lot of the town’s people would utilize the Emergency Room for clinic visits. That was a huge problem when we got here, and then it was specifically going around that the wait times were just awful in the clinics. That has been totally taken care of. The improper utilization of the Emergency Room has gone down significantly which is not such a bad thing. People are still getting the care that they need just in the proper place. David Jones said we have four providers in the clinic that are top notch – three of them went through our residency program here and the volume of patients that they can see should alleviate any type of issue. You are still going to have those people, you can’t kick them out of there once they get there. There was a massive problem at one time about wait times here. Kenneth Cochran asked wasn’t there a time when the group insurance plans paid the Emergency Room visit better than the clinic visit? That was rumored in the teachers’ arena for a long time that they could do better financially by going to the emergency room. There was no credence to it that I knew of, but I heard that discussion over and over. Maybe that has been put to rest. Dr. Woods said I think the biggest think is the hospital done a fantastic job of trying to alleviate road blocks and log jams where people can get in and out as soon as they can. Dakota said we have actually moved dedicated staff that is doing what his main complaint used to be, is we’ve got dedicated staff now that’s actually calling every patient that leaves the ER to educate them on let’s make a clinic visit, let’s do this, we do precerts quicker now. We do a lot of things that held them up – better – across the board. On page 8 – the Budget. If we look at the page you will see that Gross Revenue is down 2% from what we budgeted, but if you look at the contractual adjustments we see that same thing. We are about 2% down, almost 3% down on what we budgeted for contractual adjustment. When we look at four months on the year actual budget, net patient revenues, a slight difference of $356,000 and then obviously when we get down into the operating expenses, we’ll see where that gap is sort of made back up. When you look at salaries and wages; that’s down. When you look at employee benefits and payroll taxes that is down from what budgeted. We knew that there would be a lot of changes this year. We knew we would be adding MRI services so you will see some of these start increasing a little bit more. We will have to add MRI staff, we’ll have the cost of the MRI; there are certain things that will go into this and why we budgeted for those numbers. Looking at expenses as a total – $8.19 million as opposed to $8.6 so there is a 5% below the budgeted expense which is good. Looking at Non-operating Revenue, obviously the grant revenue is going to continue the rest of the year significantly more than what we budgeted for due to the UCC payment. Then we look at sales tax revenue – we are out-pacing what we budgeted for.  340B revenue – we were lofty with our budget because we knew we would be adding new lines, new pharmacies so we are only $5,000 off on that. Total increase in Unrestricted Net Assets – $546,000 as opposed to budgeted almost $54,000. Compared to what our budget is we are doing quite well.  Looking at page #10, the Vivian Clinic had $2,295 visits which equated to $129,000 profit. Plain Dealing Clinic had 641 visits with a loss of $11,000. A lot of it is from the vaccine cost to that clinic. We see this trend, especially in our outlying clinics, where you drop in revenue and then you come back up. A lot of it has to do with contractual adjustments. We will continue to monitor that. Break even at Plain Dealing and a little bit more and we have won the game there. That is what we are looking for out of the clinics. Benton Clinic saw 510 patients. Again, they’ve got the certification to be the free standing provider based clinic that Pam has been trying to get licensed. That has been done. Now we are waiting on the government to issue a new rate. He asked Pam to speak on that. Pam said I talked with the lady yesterday, Ms. Sullivan. She said she is trying to speed it through. You know all the State’s computers got hacked. Dakota said that was computers across the board – the DMV, everything, but there was one computer system in the State of Louisiana that didn’t go down. Everybody here is probably familiar with the WIC office up there. We operate State computers on the State network up there and ours was the only one that didn’t go down. We are the only WIC office in the State of Louisiana that didn’t get hacked. David Jones said that is due to our IT Director, Ross Hansen. They were referring them all throughout the State to our office because we were the only ones up. Dakota asked if there were any questions on the financial piece. I know there’s been a lot of financial data over the past hour and one half. There was none. Robert Green stated he would entertain a motion to approve the October 2019 Statistics and Financial reports. Pat White made a motion to approve the Statistical and Financial reports as presented subject to audit. David Norman seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None.   Absent: None.   Abstain: None. The motion passed by unanimous vote in favor.  IX. New Business – 1) Sick Time Buy Back:  David Jones stated it is holiday time yet again. If I could get a motion and a second to discuss the approval of the Sick Time Buy Back for 2019 we will talk about this some more. Helen Godfrey-Smith stated we received this report in the Finance Committee and heard a presentation. From the Finance Committee we would like to make a motion to approve the Sick Time Buy Back for 2019 as presented for $84,575.58 that will affect 92 employees. Kenneth Cochran seconded the motion.  Robert Green asked if there was any discussion. Ronnie Festavan asked from last year we are up almost $20,000. Is that right. David Jones replied yes Sir. Dakota stated the main difference there is if you look at the employees that did not use one hour of sick time that went from 31 employees to 47. If you look at the breakdown of where those employees actually operate, a significant number of our employees operate in a setting where you would have to call someone in, either a PRN employee or someone would have to work overtime in that area because you cannot run a lighter staff than what you do in a different day. Dakota said it is not like the Business Office where if I have a staff member, I don’t call somebody in to fill that person’s area. David Jones said which is the ultimate business goal. Pam noted that is the same thing for the clinics; you can’t operate without nurses. David Jones said that is correct. That is a clinical area. Dakota said I think what you see, too, obviously we’ve got about 320 employees total. A lot of those are PRN. The only people eligible for this are fulltime, obviously, with benefits. I believe the fulltime number is somewhere around 150. It is a significant portion of the population. David Jones said you are talking about over 60% of our employees are eligible to do this. So 60% of our fulltime employees are not calling in sick. To some degree there is some luck involved in that. If you have to have surgery or an accident there is nothing you can do about that. The incentive is to reward you for stepping up and coming in on those gray days that I could be here working or I could be at home in bed. Ronnie Festavan stated so the expenditure of the additional funds could be interpreted as success in the program. Is that what you are saying? David Jones replied yes Sir. Dakota said I think that would be one of the leading aspects of why this is done. A – Moral is good, but it is very important to – Kenneth Cochran interrupted and said well it is obviously a culture that is being established of not being out. Helen Godfrey-Smith said a computation that would be very interesting would be to do an estimate of the number of days affected and the average, it wouldn’t be difficult to figure the average per hour cost you’ve got 34,000 hours and that’s 84,000 so you kind of know what that average cost is and you would have to pay it anyway and you would have to pay the PRN, too. Just for knowledge. Ronnie Festavan said I think that is exactly where I’m going, Mrs. Smith, and I appreciate it, is a cost analysis of it. I’m not against it. I think it is great morale wise. I’m not knocking it. What if nobody missed any, how much would that cost us? Is there a point of diminishing returns with the program? Maybe not. I’m not saying there is. Pat White said it is so great that we don’t have to worry whether we are going to be able to meet it or not. Dakota said I see exactly what you are saying. I think where the gray side of it comes in, and we try to express on the employees that this is not a guaranteed thing, but I think the year you saw it go down significantly, people were worried, that is coming off a bad financial year. You do have a sect of employees that calls in because they are going to get their time. Ronnie Festavan said generally anytime you have a program that is established like this your goal is 100%. That is why you establish the program. So, I’m just thinking out loud. Would it be great for everybody to show up every day for work and not miss a day? I would say the answer to that is yes. Could we afford it if they did if we continued this program then would our goal be met? I’m just thinking out loud. Thank you. Robert Green asked if there was any further discussion. Brenda Smith asked if we are going to repeat last year at the Christmas party. David Jones replied yes I would like that to happen – yes Ma’am. Mary Irvin said some people may not have been there, that’s when the checks were passed out to the employees. Call their name out. David Jones said I thought it was very good. The Board is approving this and it is directly coming from the Board, so the Board could get the opportunity to interact with the employees at the Christmas party and handing out the checks because it is a very good time. Employees are very grateful for it. It is one of the few things that we do we get multiple employees thanking us throughout the following few days of this. It’s certainly not gone unnoticed by the employees. Robert Green asked if there were any other questions. There were none. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None.   Absent: None.   Abstain: None. The motion passed by unanimous vote in favor.   2) Confirmation to Move December Board Meeting Date: Robert Green stated we need a motion for confirmation to move the December Board meeting date to Thursday, December 19th. Helen Godfrey-Smith asked if it was at 3:00 o’clock again. Mary Irvin stated that was something we wanted to ask your opinion about if you planned to come to the Pot Luck, we were thinking if we could consider to moving it to 2:00 o’clock, that way, if you were able to attend the Pot Luck we could just go from the Pot Luck to the Board meeting. If we did it at 3:00 o’clock there may be some lag time. It is at the will of the Board. There is a staff Pot Luck that they always encourage us to attend. Ronnie Festavan said on Thursday, the 19th. Kenneth Cochran said the 19th right at 3:00 o’clock. Mary Irvin said that is what we are discussing. Pat White spoke up and said move it to 2:00 o’clock rather than 3:00 o’clock. Mary Irvin said we are just asking for thoughts on that. Pat White said if you come for the Pot Luck it is kind of foolish to have to go somewhere and sit for an hour and then come back. Mary Irvin asked if there is acceptable with everybody. Robert Green said he would entertain a motion. Brenda Smith made a motion for confirmation to move the December Board meeting date to December 19th. Kenneth Clay seconded the motion. Robert Green asked for discussion. Ronnie Festavan so the motion on the table is to move it to 2:00 o’clock after the Pot Luck. Robert Green stated we are still in discussion phase on the 19th. Brenda Smith said the motion is to move it to the 19th, so the discussion is the time. Ronnie Festavan said there’s a motion on the table to do something and I’m just trying figure out what the motion is. The motion is to move it to the 19th at 2:00 p.m. Kenneth Cochran asked what time is the Pot Luck. Brenda Smith replied that the Pot Luck is at 12:00. David Jones said I highly recommend that Board come. We are probably going to do the contest again if we can get some of the Board or all of the Board to judge. Robert Green asked if there was any further discussion. There was none. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None.   Absent: None.   Abstain: None. The motion passed by unanimous vote in favor.   X. Administrative Reports1) NCMC – Current Activity:  David Jones said the current activity, of course he made mention a little bit earlier, we are going to have our Open House, Tuesday, December 3rd. Mary Irvin handed out a calendar with reminders. We debated on how to do a ribbon cutting because it is in a clinical area and we have multiple clinical areas. We decided on an Open House and we can regulate the amount of people that circulate in those clinical areas, because it is a hospital and we can’t shut it down to show everybody. There will be a check presentation from the Foundation Board to the hospital Board for the MRI unit. They were a huge part in helping fund that. We’ve invited a list of local dignitaries as well, and we have all the news media’s coming. Helen Godfrey-Smith asked if we invited our Commissioners. David Jones replied yes we did. On Thursday, two days later, is the Christmas party. Since it is now approved we will be handing out the Sick Time Buy Back checks. If we could get the Board’s help in passing those out, I think that is a huge event. I’m actually looking at possibly doing some small door prizes, too, to liven the employees up even more. We looked at getting the same caterer, and the saxophonist. It will be in the front area of the hospital. The mayor has been working diligently on, I see for the future, a very nice place, if all plans go through. But if we could get the community center open that would be a great venue for that and then other things that we could have for the hospital and employees. I don’t know if anyone has been in the front of the hospital lately, but Mrs. Hughes and her staff have been working a ton to get it very festive looking. We’ve already got the wreaths on the patient doors and the rest of the areas and it looks fantastic.  I wanted to give her and her staff kudos for the. On December 19th is the Pot Luck. Miss it at your own risk. That’s all I can say. It is typically some very good food and we would love for the Board to be there. It is also another environment that the Board can interact with the employees and it not a formal event – a social gathering. Kenneth Cochran asked what is the date of the Christmas party. David Jones replied the 5th. Helen Godfrey-Smith asked is at 6:30 p.m. David Jones replied yes, at 6:30 p.m. Mary Coil passed out an invitation card with the information on it. David Jones stated that was all on current activity.   2) Foundation:   Mary Coil stated I am real excited about the Open House. We have a lot of people who were very generous to the Foundation because of that project and because of what they felt like it would bring to the hospital and to the patients of the area so  we are very excited to share with them what has gone on behind the scenes and what their gifts go for. We are excited about that. We also have ornaments Christmas gifting. If you would like to donate in honor or in memory of someone we will hang an ornament on the tree and send notification as well to the family if you choose. These are available at $10 each. Looking forward to wrapping up the end of the year.    Pat White asked if she could make a statement. Helen Adger is in need of everybody’s prayers. She is not doing well at this time.  She is very confused. Prayers are needed.   3) Construction Report: David Jones said this will be the last construction report for a while.  Pam Hughes said it is done. There are still a few things that we found. One of my maintenance people made a list of things that we found. The architects made their list and they’ve worked on all of them, but we made one of our own. It is about three pages. They are going to come back and redo a few things, but otherwise, we are completed. Robert Green stated that is good. We were still using money from the first project. Pam Hughes replied yes Sir. XI. Medical Staff Report – 1) Recommendations – Dakota Robinson:  Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval:  MEDICAL STAFF REAPPOINTMENT:  1.) Marc Paul, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of November 26, 2019 through November 30, 2021.  2.) Cathleen Ivy, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of November 26, 2019 through November 30, 2021.  3.) Taro Aikawa, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of November 26, 2019 through November 30, 2021.  4.) Bernadette McLaren, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of November 26, 2019 through November 30, 2021.   5.) Richard Blanchard, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of November 26, 2019 through November 30, 2020.  6.) Alpesh Patel, M.D. – Requests Courtesy Privileges in the field of Anesthesiology for the period of November 26, 2019 through November 30, 2021.  7.) David Burdette, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of November 26, 2019 through November 30, 2021.     ADVANCE PRACTICE PROFESSIONALS  APPOINTMENTS/REAPPOINTMENT:  1.) Samantha Thompson, FNP/Surgical Asst. – Requests Courtesy Privileges in the field of Surgery Assistant for the period of November 26,2019 through November 30, 2020.    EXTENSION REQUEST:

1.) Almas Syed, M.D. – Request extension for completion of reappointment application.

VOLUNTARY RESIGNATIONS:   1.) Joseph Martin, FNP – Voluntary resignation in the field of Surgical Asst. effective October 31, 2019.      Brenda Smith made a motion to approve the Medical Staff recommendations for Reappointments, Advance Practice Professionals Appointment, Extension Request and Voluntary Resignation as presented.   Mary Irvin seconded the motion. The vote:  Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None.   Absent: None.   Abstain: None. The motion passed by unanimous vote in favor.    2) Chief of Staff Comments:   Dr. John Woods, Chief of Staff, said briefly I was going to say since we have strengthened our alliance with Ochsner, so far it appears to be seamless. It seems like nothing has changed on our end. Everybody is working with everybody nicely. I’m supposed to be getting with Dr. Greer who is in charge of the ICU to set up a tella ICU for support on the people that are in the dire straits in the Emergency Room just to get them coordinated care from the Emergency Room to the ICU. David Jones said I want to jump in on the Chief of Staff comments, because this is something he would never do, nor would any of any of the other ones ever do, but your employees and of course they are your employees as well, over Friday and Saturday gifted 110 families with a box that would supply them with a meal for about 4 days, could probably be stretched out to 7 to 8 days. They paid for that out of their own pockets. The Medical Staff, everybody likes to talk about the doctors and how much money the doctors make, fed 37 families out of their own pockets this year. That was gifting straight from them to people in our community. We got the names of the people anywhere from the Ministerial Alliance to our Principals here in the area because they know which families would benefit. It stretched all the way to a Cotton Valley address and all the way to a Shreveport address. We sprawled all across northern Caddo Parish. Did we hit every needy family – no – but we hit as many as we could over those days. I could be no prouder of the Medical Staff for sure and of the employees. The Medical Staff didn’t deliver them. They delivered them means. Then Mary Coil and Adam Oliver and others delivered them. I apologize to those who tried to go to Walmart and buy a few items on Friday. We hit Walmart and Super Value for almost all of the things that we purchased except for the turkeys and we got those from a person in East Texas. That was just part of the Employee Enhance Committee. The thing we did with the Christmas presents last year, we decided to do something for Thanksgiving this year. That is what your employees have done representing you. Brenda Smith asked what did the label say on the side of the box. Mary Coil said it was – Happy Thanksgiving. Best Wishes Employees of NCMC. I just wanted the Board know that. Especially what the Medical Staff did. Mary Irvin said she thought the boxes weighed about 30 pounds. Mary Coil said yes they were very heavy.  Mary Coil told Mary Irvin that we appreciate you coming to help us.  Pam Hughes said I would like to thank my guys. They always do everything without being noticed. They are the ones that go get things and haul them. They were here, too. They are a special bunch. David Jones said those guys always step up. There’s never a thing we’ve done in the 14 years I’ve been here, a lot of stuff would not get done if not for them. Pam said my maintenance men, too.   XII. Executive Session:  Robert Green stated he would entertain a motion to enter into Executive Session for the purpose of Strategic Planning. Ronnie Festavan made a motion to enter into Executive Session for Strategic Planning. Kenneth Cochran seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: None.  Abstain: None. The motion passed by unanimous vote in favor.   There will be a brief break. The Executive Session was entered into.   No action was taken during the Executive Session.  Ronnie Festavan made a motion to enter back into regular session.  Mary Irvin seconded the motion.   The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: None.  Abstain: None. The motion passed by unanimous vote in favor. XIII.  Adjourn:  There being no further business, Robert Green called for a motion to adjourn.  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, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White. Nays: None. Absent: None.  Abstain: None. The motion passed by unanimous vote in favor to adjourn. The meeting adjourned at 5:32 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 19, 2019