BOARD MEETING: Regular Meeting  DATE: November 28, 2017     MEMBERS PRESENT: Robert T. Green, Jr., Patricia White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker   MEMBERS ABSENT: None    TIME CALLED TO ORDER: 5:30 p.m.   OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Allyson Allums, CFO, Dakota Robinson, Controller, Lanell Audirsch, Admin. Asst., Walter D. (Doug) White, Hospital Attorney, Allison A. Jones, Attorney, Dr. John Woods, Chief of Staff, Mary Coil, Foundation Executive Director/Marketing Director, Mike Vaitkus, Security   LOCATION: NCMC Events Center     BOARD CHAIR: Robert T. Green, Jr.   SECRETARY:   David Jones    I.   Called to Order – Robert T. Green, Jr., Chairperson, called the meeting to order.   II.   Invocation and Pledge of Allegiance – Brenda Smith offered the Invocation and David Jones led the group in the Pledge of Allegiance.   III.   Approval / Amend Agenda – Brenda Smith made a motion to amend the agenda with the approval of the Board. She requested to add #5 after Community Comments; Board acceptance of the resignation letter of Helen Adger and Item #6 Acknowledge the appointment of Ronnie Festavan to the Board. Helen Godfrey-Smith seconded the motion.  Roll call to amend the agenda: Pat White, yea; Brenda Smith, yea; Helen Godfrey-Smith, yea; Bruce Walker, yea; David Norman, yea; Mary Irvin, yea; Robert T. Green, yea; Kenneth Clay, Absent; Ronnie Festavan, abstained. The motion passed. IV. Community Comments – Robert T. Green, Jr., Chairperson, noted there were no signed Visitor Recognition Cards requesting to address the Board.   V.   Board Acceptance of the Letter of  Resignation by Helen Adger  –  Pat White made a motion to accept the formal letter of resignation from her position on the Board submitted by Helen Adger. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Absent: Kenneth Clay. Abstained: Ronnie Festavan.    Helen Godfrey-Smith noted that the letter received from Helen Adger should be a part of the minutes and records. Otherwise there is no evidence that she has resigned. David Jones noted that he does not have the letter with him, however it is in his office.     VI.   Board Acknowledgement of the Appointment of Ronnie Festavan to the Board  –    Robert Green stated we are at the point of accepting and welcoming our new Board member, Mr. Festavan.         Helen Godfrey-Smith made a motion that the position that was declared vacant by Mrs. Helen Adger’s resignation be officially filled by Ronnie Festavan. Pat White seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Absent: Kenneth Clay. Abstained: Ronnie Festavan.         Robert Green extended a welcome to Ronnie Festavan to the Board of Directors of North Caddo Medical Center. Ronnie Festavan stated it is his honor to be here. Robert Green then asked the Board members to introduce themselves to Ronnie Festavan – Pat White – Hosston; Brenda Smith – Oil City; Helen Godfrey-Smith – Gilliam; Bruce Walker – Mooringsport; David Norman – Rodessa; Mary Irvin – Vivian; Robert Green – Vivian and, not currently present, Kenneth Clay – Vivian. Robert Green asked Ronnie Festavan if he would like to make a comment. Ronnie Festavan said yes, just for the record. Ronnie Festavan stated he is honored to be here. He had to wait his turn, but that’s o.k. Patience is a virtue. He is looking forward to working with everyone in a positive vein for basically what was included in Brenda Smith’s prayer – and that is the best services for the people of our community and making sure that is happening. That is what he is about. He was born and raised here in Vivian. As most of you know, he spent 33 years in the public school system in Caddo Parish. He retired as Assistant Superintendent. He served a year as interim Superintendent. He has done everything in the school system except teach Home Ec. and girls PE. He was Personnel Director for six years, Assistant Superintendent for six years. He has had his hands in a lot of different things. He has a Master’s Degree in Public School Administration. He thinks he has the credentials it takes to serve on a Board. This is not a lot unlike the School Board with this being the Superintendent (referring to David Jones) – stating that he is glad David Jones is in that spot and he is no longer in that spot. As he read, trying to get caught up as much has he could about the duties and responsibilities of the Board, which he was sure all of them had read. These duties are somewhat enormous and the duties and responsibilities of David Jones are enormous. Blending those two together appears to be the method that you get the best service for your people; which he personally, and he hopes that everyone that he works with, would keep that in mind. That the best service for the folks in this community and this district that this Board serves is what he is here about. He does not bring any other agendas; he does not bring any skeletons with him. He does bring that with him, and brings that with him with passion. That will be his goal. All of the family that he has left lives in Vivian. They all go to this hospital. He wants to make sure they are well taken care of. Thank you for welcoming him and he is honored to be here.         Robert Green, along with all members, appreciated his well said comments. Robert Green noted that Ronnie Festavan would be receiving a packet with the Board By-laws.        VII.  Minutes – Regular Meeting October 23, 2017  –  The minutes of the October 23, 2017 Regular Board meeting were mailed prior to today’s meeting for review.  Robert Green noted that there was one slight issue.     Brenda Smith noted that she missed the last meeting and she apologized. In the mail out minutes she was listed as present and absent as well as Bruce Walker.  This was caught prior to the meeting and the minutes in the binders tonight are corrected. Brenda made a motion to approve the minutes of the Regular Meeting, held on October 23, 2017, as presented.  David Norman seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: Kenneth Clay. Abstained: Ronnie Festavan. Ronnie Festavan noted that he is going on record again as  abstaining because he was not a member at the time those minutes were recorded so he does not believe it would be proper for him to vote on the approval. He would like to be listed as a voting member but abstaining from that vote. The motion passed.

VIII.       Old Business –  1)  Radiology and ER Expansion Update: David Jones stated there is not a lot of update. We did get kind of a finalized contract from the architect, but there were a few things on there that he wanted amended before he brings it the Board for final approval. They are small items, but things that he does not think necessarily that we should be paying for. He is going to get them to adjust that and then he should be bringing that to the December meeting to get it finalized.         Brenda Smith commented that she was absent at the last meeting and read in the minutes where they are looking at the possibility of putting it outside of the clinic rather than initially out behind radiology. David Jones stated initially they thought about coming out behind radiology. They just really felt that was a horrible idea because there are so many power lines, so many water lines – everything that ties into the hospital. Just stay away from the back of the building. They shifted course and where the small flower bed is right by the Emergency Room walk in entrance. All of that concrete will be taken in making the entrance there and expand the Emergency Room and put pieces of Radiology over there – have a Women’s Center as soon as you walk into the left where the Emergency Room will be to the right.  Robert Green asked if there were any further questions. There were none.     2) Formation of Nominating Committee for Board of Trustees – Robert Green inquired if there was a report from the Nominating Committee.  Helen Godfrey-Smith stated that they do. Mary Irvin, Brenda Smith and yours truly, Helen Godfrey-Smith were appointed by the Board to serve in that capacity. They have had a couple of meetings and they were very productive. They met and talked about what their charge is and what the scope of their duties would be. They are intentional upon bringing something to our December meeting that would be in a format that they could actually get the Board to approve their charge and officially set and have some input, even, as to what you think they should do. Some of the things, from an initial meeting standpoint, they would establish a formalized nomination process for future Board vacancies and for term expirations. One of the things that they would do would is to ascertain, within 60 days of an expiration of the term, whether or not a sitting Board member would be interested in being reappointed and if not, then it would trigger a process to go out into the community through a variety of ways to find names to get depending on what skill sets the voice would have on the Board. They met with Doug Dominick today and Doug was very much in agreement with the thought processes that they had gone through. We are looking forward to in December having a real product to present to the Board that would give us some guidance and direction as to how to proceed. Mary Irvin said if she could add on to that – before the meeting is adjourned today, if we could ask every Board member to give them a current email address. The Chairman and she feels they need a better flow of communication with each other as long as it is within the proper guidelines that they are allowed to do that. For instance, their minutes from their meetings, especially as they are a new committee and newly being formed, they would like everyone’s input and they would be able to give you that information earlier than the minutes would come out in the mail, plus, she knows for her personally, she would love to have more of a paperless trail of communication at least as an option for them. They would like to get everyone’s email address if that is within proper guidelines; legally for them to be able to communicate that way – attach documents and ask for feedback. If that would be acceptable; if the attorneys think that is o.k. to do that. Doug White and Allison Jones agreed they did not think there would be anything wrong with that. Doug White’s only caution would that it would have to meet the open meeting guidelines; you can’t vote on anything unless it is truly an emergency and it meets those criteria. Mary Irvin said no sir; this would just simply be communication to gather feedback. Doug White said administrative communication would be a good idea. Mary Irvin stated that they would like to send an attachment to the Board members between now and the next Board meeting to ask for their thoughts; their feedback and ideas, just to give them a little bit more step into feedback directly at the Board meeting and put some things in place for that committee. She thinks they all left the meeting today with the Commissioner  feeling like there was a very positive line of communication being established in working together, understanding his position, understanding their desires, and being able to communicate with him and he would likewise. She thinks they all walked away feeling very positive about it. Helen Godfrey-Smith stated, of the other things they agreed upon yesterday, they would take the responsibility to practice the orientation for new board members process for Ronnie Festavan. At some point they will get with him over the next week or so to come up with a time when it would be convenient to spend some time with them in the Board room and meet some of the Department Heads. Also, to go through and make sure he has all his documents in a resource binder and to answer any questions. Ronnie Festavan said he would appreciate that. He is coming in a little bit behind. Helen Godfrey-Smith said they would provide him some historical minutes. He said he has been keeping up with the minutes on line. She said they would put them in a binder for reference. He stated he would love to have it in hard copy; he is not quite graduated to the online. He would love to do that so he could come up to speed and speak intelligently to what we are doing. He asked Robert Green if they were entertaining comments. Robert Green responded yes. Ronnie Festavan stated Mary Irvin had mentioned something about talking with the Commissioner and she felt like she knew his position. Can she share his position with them? Mary Irvin responded she thinks that what happened was we simply have a line of communication with each other. Like, in this situation, there was not a line of communication between the Commissioner and them. Mary said she thinks she can stated he seemed very open to their thoughts about the next upcoming vacancy and they had a little dialogue about that. Helen Godfrey-Smith stated that they were in agreement that they did not want to go before the Commission in the future, if possible, at odds. They would like to go with a unified voice. Starting that process much earlier and getting input from him and from the Board and really vetting the names jointly together. He said he does not want to be going to another committee meeting or anything like that, he was very much open to them trying to come to some kind of consensus before we deal publically with these appointments. Ronnie Festavan said two questions in his mind arise from that. First question would be to counsel – is there any statutory requirements or is the law silent on the requirements of that to Mr. Dominick? Mary Irvin began to speak – Ronnie Festavan stated he was addressing legal counsel – Mary Irvin apologized – she thought he was addressing her – she thought he was looking at her. Doug White stated that Doug Dominick being on the Commission, he has a strong voice in this. Ronnie Festavan said he feels like, from what he has read, that the law is pretty much silent on it as best as he can tell. Doug White it does come from being that this entity is a function of the Caddo Parish Commission. His position in the past has varied a little bit, from he has the power to do whatever he feels best. And when we explained this is a function of trying to represent the entire hospital district – the towns and villages that are in it, he seemed to listen then. Doug White thinks that is probably where we are at now. That has been a time and a thing in progress. He thinks we are at that point now where he is at least listening. Ronnie Festavan said that brings him to question number 2. In the past, and he does not know who is the oldest; and he means by oldest not age wise, but longest serving member; what is history of appointments. Have we always gone to the Commissioner with names and that sort?  In other words, is there some precedence to it? Doug White stated he has been here for almost 30 years. Ronnie Festavan said he would take his word then. Doug White said since he has been here the process has been – the problem has not been with the Commission – the problem has been finding people willing to serve. Once that is accomplished, then the Board would make a recommendation, which, traditionally, has been honored by the Commission. Ronnie Festavan said that was his question. Helen Godfrey-Smith stated that Kenneth Clay is the longest serving Board member – since 1991. Ronnie Festavan said he has all this experience sitting next to him. Ronnie Festavan thanked the Chairman, Robert Green, stating he was just trying to get caught up on what is going on.        Robert Green asked Helen Godfrey-Smith if she had additional reporting. She stated no.      Robert Green stated that he has a recommendation for the Nominating Committee. December meeting is coming up and in December is our time for new officers. He asked the Nominating Committee to talk to the Board members and bring back a recommendation at the December meeting. We have had a pattern that you have the Chairman and the Vice-Chair. The Chairman serves and the Vice-Chair moves up and a new Vice-Chair is selected to follow. Lately we have kind of let things roll on because of how we were going in this pattern. He asked how many years they have served? Pat White stated two years. Robert Green asked the committee to talk with Mrs. Pat and bring a recommendation back at the next meeting. Brenda Smith stated they can do that. Allison Jones, Attorney, noted that they can make a recommendation but any Board member can make a nomination. Robert Green agreed. He said that at the time anybody can. Helen Godfrey-Smith, stated that the positions, by the by-laws, would be Chair, Vice-Chair, Secretary, Treasurer. David Jones noted that the standing Secretary is the CEO. Robert Green stated that is coming up in December. Pat White stated that the President does sit in on the Agenda Setting meetings and all, kind of a committee, after he goes out, he is still involved as far as that goes. Brenda Smith stated the Executive Committee. Brenda Smith noted Pat White called Robert Green the President. Pat White said Chair – President – interchangeable. Helen Godfrey-Smith said the Nominating Committee accepted the charge.       IX.  1) Review October  2017 Statistics – Allyson Allums:  Allyson Allums presented the October 2017 Statistical Report. There were 81 Admissions and 83 Discharges with Total Days Stayed –362. The Average Length of Stay – 4.4 Days. Total In-patient Days – 359; It was a busy October. We stayed in the 20’s for several weeks. We were at max capacity a couple of days. The average Daily Census – 11.6. Our Total Occupancy Rate was 77.20%. Total Surgeries for October (In-patient – 2 / Outpatient – 8). Endoscopies performed in October – 9.  The total Emergency Room patients seen – 488.  Swing Bed Admission –14. There were 157 Total E.M.S. runs in October.  Observation Patients for October- 48.  There were 6 Newborns in October.  The total Patient Visits for the clinics – Medical & Surgical Clinic is 1984.  The Plain Dealing Clinic saw 674. Benton Medical saw 335. They are on an uphill swing. This is probably the largest month they have had. There were 38 Mammograms for October.         2)   Review September 2017 Financials – Allyson Allums:    Allyson Allums presented the Financials. Hospital Revenue over Expense. Revenue –$4.0 million Expense – $2.0 million with a profit of $959,000. The AR Days for all three facilities –59 days; for the hospital we are at 39 days. Plain Dealing Clinic – Revenue over Expense. Revenue –$152,000 Expense – $88,000 with a profit of $15,000.00. Medical and Surgical Clinic – Revenue over Expense. Revenue – $530,000 Expense – $264,000 with a profit of $24,000. Benton Clinic – Revenue over Expense. Revenue –$76,000.00; Expense – $22,000. They had a profit of $1,300. The Bad Debt Expense is right at 1%. Days cash on hand is – 6 days.  In review of the 340B program – we had 134 claims with Walmart, Benzer – 167, and 60 with Kelly in Plain Dealing. The total revenue that the 340B generated for October is $90,000. Helen Godfrey-Smith asked if that is becoming the norm or is it fluctuating. Allyson deferred that to Dakota Robinson. Dakota stated that the graph has slowly gotten to the top of the bell curve. It looks like it is averaging about $90,000 a month. The hopes are that when Walker Brothers Drug in Plain Dealing, which we just signed the contract with, goes live in January, that will start increasing a little bit more. The referral piece of the 340B program was just put in place last month.  We expect that to grow a little bit. He does not expect that to be the top of what we would reach in a month. Helen Godfrey-Smith said we know that it is somewhat costly to enter into those relationships, so from the standpoint of what the return on investment is – Dakota interjected that it is actually very high because there is an initial startup cost in software, which we have already invested in that, since we already have the other three going. It is a onetime implementation fee to get those extra pharmacies up and going. It is $5,000 but at the end of the day when they are having returns like that it is minimal at best. Ronnie Festavan asked if the slides were in the packets. Allyson told him they were not but if he would like a copy she would be glad to provide them for him. Brenda Smith asked Allyson to go back to the Plain Dealing Clinic slide. She might have been looking at the wrong numbers. Dakota stated that there were revised financials in there. The book is a little different to what was mailed. There should be a revision. Brenda Smith said what is in her book was not what Allyson reported. She asked Allyson to review the total revenue, expenses and profit loss. Revenue is $152,000 – Dakota said the revenue was off – it should be $152,000, expenses $88,000 and profit is $15,000. Dakota said it may be her book; she had not received the correct revision. Dakota provided her with his copy. The slides were correct.        Robert Green asked if there was any discussion or comments. If not he would entertain a motion to accept the Statistical and Financial Reports.         Pat White made a motion to accept the Statistical and Financial Reports as presented subject to audit. Bruce Walker seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: None. Abstained: None.  The motion passed.     X.   New Business  – 1) Purchase of Surgical Equipment:   David Jones stated that he need a motion to purchase through Karl Storz,  a surgical tower,  which includes the equipment given in the quote for a total price of $64,638.60 opposed to $59,995.00 that he gave to the Finance Committee. That is going through the GPO of Novation is the reason we do not have to put this out to bid. If he can get a motion on this he will speak on this after that. Helen Godfrey-Smith asked if it has been shared with the Board the necessity as far as the fact that the surgical tower is very much – at this point Robert Green stated if he can get a motion and a second, then we will discuss this. David Jones stated that technically the discussion comes after the motion and second.        Helen Godfrey-Smith made a motion to Purchase the Surgical Tower in the amount of $64,638.60. Bruce Walker seconded the motion.        Robert Green noted the floor is open for discussion.        Ronnie Festavan inquired if we are going to vote on purchasing this without comments on it? The response was that is what we are doing now. Allison Jones, Attorney, stated that now that the motion and the second has been made, now you can discuss it. The vote will not be made until after the discussion.          David Jones stated that the last surgery that Dr. Banda performed went well and had a very positive outcome. During the surgery, one of the pieces of the equipment malfunctioned, to the point that it basically broke. The piece of equipment that we are replacing is over 20 years old. It is actually a gift from Willis Knighton that was replaced right at 20 years ago. They had no longer a need for it. It was actually an upgrade at the time we got it, which was somewhere around 11 years ago, of the surgical equipment that we had. It is no longer serviceable, as far as parts go; we can’t order any parts for it. It is basically unusable to the point our surgeon said that he no longer felt comfortable doing surgery unless we went forward and purchased some equipment. Going through the GPO, Novation, this is huge discount off of what you would buy this for just out right. This is the piece of equipment that Dr. Banda is most comfortable using. It has his blessing on it. That is why he wanted the recommendation to purchase this. The Finance Committee, we did discuss, like he said the price did go up $5,000 because they actually included two more pieces of equipment. This comes with his blessing and he is the one that has basically tripled our surgical output over the last month. The physicians are backing him 100%. He thinks we need to get the proper equipment to have him do his job. Helen Godfrey-Smith said she will add on that this is one of our new revenue streams. We are very, very optimistic as to our surgery area bringing funds into the hospital. It would behoove us to have proper equipment and the best that we can afford.  Robert Green stated, we don’t want to leave it on the table that you said that he fixed it. David Jones stated that he spliced wires to enable him to finish the surgery. He patched it. He basically said he would not perform surgery with the current equipment. Dr. Woods stated that was what he understood. Dr. Woods continued to get potential surgeries after that. When he would talk to him in the Emergency Room, he would say he really didn’t feel safe doing those here, he will have to bring them somewhere else. There were a few surgeries that had to go South because we did not have the appropriate equipment. He personally called David Jones on the weekend and they had a discussion about it. Doug White inquired if this is the soul source where you can acquire this equipment, or are there multiple sources. He is thinking about the bid law. David Jones responded you don’t have to go through the bid because it goes through a group purchasing organization. We are going through Novation. Doug White said o.k. Dr. Woods stated that Karl Storz is a very well known, very recognized piece of equipment that is the standard.         Ronnie Festavan asked if they would expand on this a little for his purposes. Tell him why we do not have to bid on this. David Jones noted that this goes through a group purchasing organization. That is why it is highlighted on the contract name. They give discounted pricing through groups that band together. Once you become a member of that group, you get a discounted price for that piece of equipment. Bruce Walker noted that the group bids it out. If you are in that group you get that price. Allyson Allums stated that it guarantees you the lowest price for that piece of equipment. Ronnie Festavan asked if it is like state contracts on certain things. The answer was yes, similar. Mary Irvin asked if a letter stating this would be attached to something of this nature for auditing purposes? David Jones said this quote would be. Allyson Allums said they will be provided with a copy that states that we received Novation pricing when we get our paperwork. Mary Irvin stated that on this particular quote, it has a ninety day warranty – that is it? David Jones stated that different pieces has different warranties on it. Bruce Walker said everything that he has read has been 1 year to two years. Only one was for 90 days. Mary Irvin inquired what the process is if we have a malfunction after that one year warranty. David Jones said our current process is that we would probably extend this warranty out in some type of service agreement after this year. That is part of the negotiation piece that we would like to do with Willis Knighton to help with Bio-med and Bio-rad to help service these kind of things so it is more cost effective if we can use them from that standpoint. Mary Irvin said she is assuming that the longevity is long term, one year is a short amount of time. Helen Godfrey-Smith asked Allyson and Dakota how we are going to pay for this. We talked about it in the Finance Committee. Dakota said several options are being considered. Before the meeting tonight, they discussed a capital lease or financing for this piece of equipment. That is probably the main option right now. He said Mr. Jones could speak to that. David Jones said the sales rep said they have a special going on through Karl Storz. Helen Godfrey-Smith said we are expecting a lump sum in December that should be more than adequate to cover this expenditure if we chose to pay. David Jones stated this is an expenditure like Helen Godfrey-Smith said that goes straight to revenue. It is not for any type of non-revenue stream. It is something that is going directly to help the hospital. Brenda Smith said this will be able to go on the cost report. Brenda Smith said she would like to ask a question which may be a doctor question. She said although Dr. Banda seems to be our go to guy now, but can this be used for other things other than the surgeries that Dr. Banda has been doing. Is she correct? Dr. Woods said this is fiber optic equip for doing laparoscopic surgeries. It has to involve laparoscopic surgery we can definitely. He does not see it being used outside that purpose. She saw it was for laparoscopic but was wondering if it could be used for other things other than the laparoscopic surgeries that Dr. Banda does. Dr. Woods said that pretty much entails the bulk of it and he can’t see it being used outside of that. David Jones said if another surgeon could if that is what she is asking – such as OB/GYN if they wanted to perform some type of laparoscopic surgery. Dr. Woods said anything that is in the belly area – absolutely. Brenda Smith stated that was the answer to her question.         Robert Green asked if there was any further discussion. If not he would entertain a vote.        The vote:  Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: None. Abstained: None.  The motion passed.        2) Sick Time Buy Back:   David Jones said it has come to the time again for the Board to move on the Sick Time Buy Back. His recommendations, and from the Finance Committee as well, that we do the 48 hours Sick Time Buy Back that will cost $59, 518.90. Once there is a motion he will speak on this.       Pat White made a motion to approve the 48 hour Sick Time Buy Back. Helen Godfrey-Smith seconded the motion.          Robert Green stated that it is time for discussion or comments.        David Jones said we have been doing this for about eleven years. We are piggybacking off Willis Knighton who has been doing this for upwards of 22 to 23 years. It is basically an incentive for a monetary thank you for employees who have sacrificed and had an attendance record of which they have not spent six days of sick time outside of the organization. We certainly understand people are going to get sick. We understand that those kind of things happen; people have babies, surgeries and illnesses. But, there are times when you are staffing a 24 hour / 7 days a week / 375 day operation, you have people who will have a tendency to call in. This is an incentive to get them to second guess once they have a headache or just not feeling good from the day before, but yet they are not medically ill, for them to come in and come to work. Finding a nurse at midnight to come in to work because the patients are still sick. They have got to have a nurse there. Getting them there and them working becomes extremely difficult from that standpoint. This is a huge morale booster. It’s one time he knows that multiple employees thank the Board, they thank Administration for this. You have employees which, we tell them every year not to bank on this, but throughout the year they constantly talk about it. He knows the rest of the executives in the room, probably Dr. Woods has heard about this. The employees are really anxious and really want to know because we do this at Christmas time. We have done it every year at Christmas time and it is an extra little amount that they can buy Christmas presents with or spend it during the holiday season. Finance Committee wise, we have had several good months in a row; it tends to be trending back up again. UCC wise we are looking at $l.9 million throughout the year. Of course those are not guaranteed funds, if something happens to the State, we could not receive those. Cost report wise we are guestimating that is going to be in the positive as well. We have not receive the final from Lester, Miller and Wells as yet, but we are guessing that to be a positive as well. We have quite a bit of cash that is supposed to be coming in for the month of December, but even without that case, this is still a doable function. David Jones asked Helen Godfrey-Smith if she wanted to say something from the Finance Committee wise. She said the Finance Committee looked at this. They received a detailed report and it was the consensus of the committee to support the staff’s recommendation. It is important for the staff morale because we have been doing quite a bit of belt tightening since the Finance Committee has been functioning budget wise. They have been cutting overtime, there have been a few layoffs, some positions not filled; some belt tightening by attrition and that sort of thing. There may have been a little bit of discomfort at the staff level not being sure of the strength of everything with the new hospital and all. They are of the mind that this is something that we could do and it would definitely be a real boost to the employee morale at this time and the season. We had some found money thanks to Mr. Doug White. We had a settlement of a real big hospital bill without going into names – $138,000 bill that was about five years old. We were able to settle that bill. We should be receiving those funds within the next 30 days or so to the tune of $67,000. We don’t like to spend money just because we get it, but it is always good to know that we are not going to be coming out of our regular bottom line if we do this for our employees. Ronnie Festavan asked what percentage of the total employment will this affect – how many people. David Jones stated about one-third of the employees. They have to be employed for a year and not spent the 48 hours. Ronnie Festavan said basically what we are rewarding people for coming to work. Not using sick time. David Jones said yes that is correct. Ronnie Festavan said we are rewarding one-third of them; approximately. Helen Godfrey-Smith said if they took the time we would pay them because this is paid sick time. It would have a budgetary impact if they had taken this time off. It would hit us twice because we would be missing that expertise of during the course of running the hospital and it would hit us financially budget wise. David Jones made a correction – it is almost half. There are around 181 fulltime employees. This is right at ninety. Eligible for some portion of that is right at half. We have right at 30 that have not taken a single sick hour throughout the year. Brenda Smith noted in times past we have had to go out to nursing agencies to try to find nurses to cover those positions. David Jones said they did that the year before he came here 12 years ago. We started implementing these kind of things and changed the huge morale things within the hospital and that has not been the case in the twelve years since he has been here. We have not used a single agency nurse. Pat White commented when you use an agency nurse you are paying more and you still paying the employee because they taking sick leave so you are getting double hit on that. Ronnie Festavan, statistically, could you say, that throughout the history of this, that it has improved. Could you show that in numbers? David Jones said since the first year we did this it has probably quadrupled in the number of employees that have been eligible and have become eligible. Ronnie Festavan said that is the reason he was asking the number was to determine, you need some place to start, for him to start, to see if you are spending this money and if the money you are spending is doing any good. Just to arbitrarily think that this is a good idea, is one thing. To show results for the money you spend is wise spent money.  Bruce Walker said if they come to work you don’t pay overtime. Mary Irvin stated if the School Board would consider a program such as that, their teachers would be there more.  Pat White said a lot of people can go to work with a headache where if they know they are going to get paid later in the year and it is going to benefit them and it always comes in around Christmas time. Most all families are strapped about this time of the year so it is a win, win overall.          Brenda Smith asked are we firm on that amount? David Jones said it can only go down from there. There is still one pay period which we are currently closing right now that could deduct from that $59,518.90. It’s probably not because there’s been no less than 20 employees that have inquired whether we are going to do this.         Robert Green inquired if there were any other questions. If not he would entertain a vote.        The vote:  Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: None. Abstained: None.  The motion passed.        Mary Irvin asked if it is fair to say that a little note from David Jones could be included in that?  He said if you could hold up for the answer he will speak on that.        3)   Move December Board Meeting Date:   David Jones noted the December Board meeting date falls the day after Christmas. Staff wise, it would be beneficial if we could change that to the 19th as opposed to the 26th. Of course, it is the Board’s pleasure on that and it is the Board’s ultimate say so on that. We will make it work either way, but staffing wise, with vacations and such it would be good.        Mary Irvin made a motion to make an adjustment to the December Board meeting to the third Tuesday of the month, December 19th. Ronnie Festavan seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: None. Abstained: None.  The motion passed.        XI. Administrative Report  –  1)   NCMC – Current Activities:    David Jones stated that concerning a Christmas Party – he does not know if any of them have had the opportunity, other than the committees that have been meeting, to go throughout the hospital, but if you have driven by the front of the hospital and even the back you can actually see the ornaments. Mrs. Pam Hughes has been working her fingers to the bone – it is very nice. Pam noted it was with help from Mrs. Billie Goodson. Pam has spearheaded the entire operation. They collected pine cones, had Mrs. Billie cook the pine cones, and they made ornaments. David Jones said if you want it done frugally and done nice, you want these ladies on it he can promise you that. Pam said she saves money. Helen Godfrey-Smith inquired what you do with cooked pine cones. David Jones replied that they put these in the bows that are on the wreaths that are on the patient doors. It was Mrs. Hughes’ idea, which he is totally and 100% behind her; we have not had a Christmas party, per se, at the hospital, for the hospital, really in a decade. We have the beautiful front lobby of hospital with all the glass and all the beautiful decorations, you have a huge tree out front there. She has been working behind the scenes, and we said how much it is going to cost. We have been doing a lot of cost figures lately. She has been talking to food vendors anyway. We are trying to renegotiate pricing with a couple of the food vendors we have been using. Actually, she got one of the companies to help us along with those. We will keep budgetary wise, the entire party can be thrown somewhere around $1,200. This will be for the entire staff, Board members, the Foundation Board, the Ministerial Alliance and we can invite others as well. During that, he would like to see if the Board themselves would like to pass out the Sick Time Buy Back Checks. He thinks that would be a great. They know that it comes from the Board. It gives the employees an opportunity to say thank you, plus it gives the Board an opportunity to interact with them a little more and get to know them a little more. Brenda Smith stated that will guarantee that they will be there that night. David Jones said it will be a certain incentive to be there. Mary Irvin jokingly said they will have to be present to receive it – Mr. Jones said he would not be that hard core on them, but it will be an incentive to come. He just thinks we have a beautiful area. That part of the hospital can be cordoned off in the afternoon, there is nothing that goes on in that area; no patient care area. Just have finger foods and a social event; and a blessing for the hospital, the employees, just to mingle. Pat White said to show our appreciation to them. David said, really for each other. It is definitely a group effort. The job you all do is very thankless; it’s very stressful at times, takes time to review things you are unfamiliar with and getting invested in. You are the focal point of your particular area you live in for the hospital. There are a lot of things that go on from the Board standpoint. The employees are thankful for the Board and what they do and it gives them an opportunity to talk with you all as well. It is his suggestion that we do this. Helen Godfrey-Smith stated that she does not know if would we need a motion or even the Board would need to approve this event, she does not think would it hurt if we did go on record as supporting.      Helen Godfrey-Smith made a motion to approve the Christmas party as presented. Mary Irvin seconded the motion.             Robert Green asked if there were any questions or comments. Brenda Smith spoke up and said yes. What would be the date and time? David Jones replied December 12th from 6:30 p.m. to 8:30 p.m. We will put a backend on it because we don’t want to party all night. Pat White stated she might be out of town for a family gathering. David Jones said we will do this during the week. It will be a morale boost for the hospital. It is Christmas time and we are definitely grateful for being able to open such a beautiful building and we have such a great staff, great group of Doctors – all the Medical Staff, all the Ancillary Staff to support. He really thinks it will be well received and a good time. Mary Irvin stated if it is the pleasure of the Board, would it be acceptable if a few of them take the challenge to formulate a little note of thanks to attach to the Sick Time Buy Back checks and if each Board member would sign a document today that we could add signatures to the letter, if you will trust them with that. She would like to put something with the check, not just the check; attach a Christmas note with the Board’s signatures below it. If that would be acceptable with the Board. Robert Green asked Mary Irvin if she would take care of that. She said she would and again requested that Board members provide her with their signature.        Robert Green asked if there any other questions. If not he would entertain a vote.        The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen Godfrey-Smith, Bruce Walker. Nays: None; Absent: None. Abstained: None.  The motion passed.            David Jones stated that he has a second item under current activity. The Contract Committee met and they offered a contract to one of the third year residents. She is one of the more popular residents we have had in the twelve years he has been here. She is a very gifted doctor. He will let Dr. Woods speak on it from his view. From the staff’s standpoint, she is extremely well liked. She is a very hard worker and she is one of the few family practice residents that we’ve had that is extremely interested in doing OB type work. She sits in and actually has performed the last few C-Sections for Dr. Taylor. Dr. Taylor gives her his blessing 110%. We had a meal with her and all the Medical Staff and surprised her with it. It was just a great night. It was a good night of fellowship. She signed the contract right then and there. She is very eager. She will not start until July 1st when she finishes her residency. We felt it prudent to offer her before somebody else did. We have lost one about 12 years ago because Willis Knighton drug their feet; we lost a potentially good doctor. Guys have been with us that have worked out; we have been able to hire Dr. Chance, Dr. McCommon, Dr. May and Dr. Woods from our residency program. They are like the all-stars of what we have had come through the residency program. We have had some very solid doctors come through that program. We have gone outside a few times. Dr. Chandler is an awesome physician as well.  He didn’t go through our residency program, but we have had an opportunity to watch them grow, because they are here for their entire second and third year for the most part. They have some away rotations that they do. Dr. Sharpe is one of those that is extremely gifted and will fit right in with the rest of the staff. David Jones addressed Dr. Woods to comment on this. Dr. Woods said he remembers when Dr. Sharpe got here she was extremely eager to learn; very pleasant to work with. You don’t find that too often. Sometimes you will see them intimidated – she is always very willing to jump right in there and asks appropriate questions –not aggressive but eager to learn. It is always a pleasure to work with her. She always seems to jump in there when work needs to be done; this is a very good property to have. She is a good team player – just a well-rounded, good physician to work with. He knew she was an asset in the beginning. He just thought she was going somewhere else. He has coaxed her to stay here, noting that we could make this a very nice place for her to work. He kept giving her a hard time asking if she had had enough of the OB yet – she responded no each time. Usually people get burnt out with OB/GYN – he will be honest – he was one of them. It takes a special person that wants to do that; when you find somebody that really wants to do that and very interested in it, that is a benefit. She did not tire at all – in fact she has become more and more aggressive about it. He was elated to find out that she did want to stay and is eager to work with her. He thinks she is going to make this hospital a little pearl here when it comes to the OB department; he thinks she will make it grow like adding water to it. David Jones said it has always been his wish and goal to get a female to do the OB here. That is pretty much what the field has moved to – it use to be the exact opposite. From his personal standpoint, it is extremely understandable. She’s almost a no brainer from that standpoint, and Dr. Woods downplayed the advent of Dr. Banda and Dr. Sharpe – he has been doing some sideline recruiting from multiple angles for multiple doctors for us. He and Dr. Chandler both; Dr. Chandler has a personal relationship with Dr. Banda, Dr. Woods has been working as best he could to get him here and get him comfortable. He has actually had his eye on Dr. Sharpe to keep her here. He thinks Dr. Woods may have been getting a little impatient with him at times asking what was going on with Dr. Sharpe – are you going to sign her or not? It is fun to watch the co-worker that has the best interest of the hospital, not his own interest. Dr. Sharpe is planning to be at the December Board meeting to meet the Board. He wants them to put a face to the name. Oddly enough, she has reminded so many of Dr. Bellmann. She has done her entire month rotation with Dr. Bellmann. They hit it off very well to the point the secondary person told him that their staff want to keep her. To which she responded that she is not an OB resident. They were taken aback with that. They are getting along very well. Dr. Bellmann still works with Dr. Taylor quite a bit. Dr. Taylor, for some family reasons has been out of town over the last month, month and one half, quite a bit. Dr. Bellmann always takes the call for that to send them to her. She will take care of them. The ones that Dr. Taylor knows, he will notify her. Dr. Bellmann still cares for the hospital from that standpoint. She was always great to work with. Brenda Smith, asked David Jones to talk about the role that he would like Dr. Sharpe to have. David Jones said that she has worked so close with Dr. Taylor, it is kind of a talking point. We are still talking with Dr. Taylor to get some details lined out. Dr. Taylor has expressed some interest in moving, transitioning to the emergency room, fulltime. He is a Board Certified Emergency Room Physician. The amount of hours that he would have to put in would be lesser with the same amount of pay. Also, share a little bit of clinic he talked about. They typically work four days on and one day off. From a physician’s standpoint, her day off, he could then fill in that day in the clinic to work, which would give him a different avenue of treatment for his patients. Some of them he has had for the thirty plus years he has been here. They could continue to see him. It is just a very easy, smooth transition from that standpoint. Brenda Smith thanked Mr. Jones.         Robert Green asked if there were any other questions or comments. Helen Godfrey-Smith inquired if there was a motion needed. There was no need.        2)   Finance Committee Report:   Helen Godfrey-Smith stated that she has minutes of their meeting. They are in the process of really getting their meetings to be productive. One of their major projects, she would call it, is our partnership agreement with a major tertiary hospital. Right now we have that agreement with Willis Knighton. Of course, you all know the history, the last several months, we have hesitated reaching past them. We have been allowing time for Mr. Elrod and organization to get through their politics and their tough spot and apparently they are back on track. We got a call this month and David Jones was invited to sit down with Mr. Elrod and his top team. She asked David Jones to give some details on that. David Jones stated that it was a very positive meeting. Once he told Mr. Elrod the angle of what we are here to do, because the management agreement that Willis Knighton currently has with North Caddo Medical Center is getting long in the tooth. It is somewhere twenty plus years old. David Jones asked Mr. Elrod if he has seen the contract lately. Mr. Elrod’s response was no. David Jones said he could show him and the paper is turning yellow. Mr. Elrod laughed. David Jones said we feel that we are a benefit to Willis Knighton. If we are going to be a true affiliate hospital then we don’t want to be a stepchild; we want to be thought of as any Willis Knighton facility would be thought of and be treated as such from that standpoint. There are some things that a tertiary care facility of that size could bring to the table for us. Biomed was one thing that he talked about. Getting someone who could work on our CT machine as opposed to spending $70,000 a year on maintenance contracts. They have 8 people who work on theirs 24/7. Trying to get help with those kind of things. He was extremely apologetic that he did not know that some of these things weren’t getting met; he assumed that they were getting met. He is very eager to work with us to see what can be accomplished to bridge the relationship between Willis Knighton and North Caddo Medical Center. He told him that he was a representative of the Finance Committee and we look eager and forward to hearing back from them as to what that relationship looked like. He was supposed to meet with one of their representative today at 10:30. They requested, late yesterday evening, that if they could wait until this coming Tuesday, there was a last minute meeting that was scheduled and he wanted to attend it. He asked David Jones if it would be o.k. to move the meeting and David Jones agreed. We will have representatives from Willis Knighton at 10:30 next Tuesday and he will report back to the Finance Committee and the Board on that. Helen Godfrey-Smith stated there were a couple of particular things that we were asking David Jones to carry the water on and that is the reduced lease amount on this Extended Services facility. It is exorbitant. Helen Godfrey-Smith that discussion was received very positively. We are asking them to do away with it. We think that we have already paid for the building. If it doesn’t disappear, we would certainly want a much more favorable lease amount going forward. There is some x-ray equipment in particular that we are needing to purchase before 2018 or early in 2018 in order to maintain our preferred rate with our Medicare reimbursement. We want to add our equipment along with Willis Knighton’s purchase so we can the absolute best price on that equipment. Those are a couple of things that is immediate of value that we are hoping that come from this discussion. We will be keeping you up to date as we move forward in the discussion and hopefully this can work out with Willis Knighton. We have some other folks standing in the wings waiting if it doesn’t. But, if it can work out with Willis Knighton we think it will be a win and it is the best of both worlds because we have had the relationship for so long. Ronnie Festavan asked if David Jones present a list to Mr. Elrod that these are things that we would like to have so that this is somewhat of a formal negotiating process. David Jones replied yes. Ronnie Festavan asked if that is what his people are looking at to see the possibilities. David Jones replied yes. Ronnie Festavan asked if he anticipated when they come up here that they will possibly make a counter offer or accept our offer? David Jones said he does not think so; not at this point. He thinks they as still gathering more information on what exactly what we want and how that would work out. He thinks it is something to wait; it is his experience with Mr. Elrod throughout the years that he is basically sending them out here to gather more information; come back to him and then he will present a formal presentation for a formal agreement. Ronnie Festavan thanked David Jones. Brenda Smith said from our standpoint we send patients to them. David Jones stated yes; they are the largest healthcare system in Northwest Louisiana. Our doctors have a firm relationship with most of their doctors. That is an easier handoff from that standpoint – not to say that they are the only option. It is a normal thought process that they would be the primary referral source. It is does not have to be that way.         Mary Irvin inquired if it would be an appropriate time to mention that our administrator is still an employee of Willis Knighton. Mary Irvin stated that her speaking personally as a Board member, she would like to see the Board take some action on making those decisions that need to be made in order for him become a North Caddo Medical Center employee. David Jones said to speak from his standpoint, to bring it up again kind of what Mr. Festavan said, he is a Willis Knighton employee, but he considers himself here to represent North Caddo Medical Center – period. And its needs and its requirements come before anything that Willis Knighton wants or needs. Honestly, that is what he point blank told Mr. Elrod.  He totally understood that. He said that is why we have you out there. In a way, it was a little odd to go to, technically his employer, and tell him that we need more from you. But, that is why he is here. Mary Irvin, said, maybe a good step would be to ask the Finance Committee to look into what would be behooving to both parties and what would be the most appropriate action to take. She is just speaking about protecting our interest. If she is remembering correctly we just kind of set it aside with all the other activities we have had going on the last three or four years. She is definitely not an expert on what is the appropriate thing to do, but it just seems like she would want to do what is in the best interest of David. It seems to her that that is something that we put aside to look at as another date and it seems like that other date should be here. Helen Godfrey-Smith said she remembers that early on in her tenure here on the Board that was some of the discussion. She really thought we had done something about it. Robert Green said no, we had set aside. Robert Green stated number one, we are already paying. They pay him but we pay them. He works for them. Helen Godfrey-Smith said maybe the Contract Committee and Finance Committee can work together to come back with a recommendation as soon as the Board would like. Do you have an annual time to consider, a month during the course of the year when you would consider. David Jones stated normally last month. Ronnie Festavan asked Mary Irvin to articulate what she sees in the value of that. You have obviously put some thought in that. Assuming we pay and it is kind of a trade off,  and he is here, his knee jerk is that is probably a good idea – he would rather him be our employee rather than their employee, but he does not know enough yet. Would she articulate to him the value of doing that. Mary Irvin stated, that without having discussion with other Board members, it really came to her mind when things were a bit tumultuous at Willis Knighton, and sometimes with us, even the relationship between our hospital and Willis Knighton, she thought that she would never want to see David put in jeopardy of his position that he holds in our hospital. Recognizing that ultimately that Willis Knighton has the ultimate call on who sits in that chair, she would assume that is fair to say. Whether he is there in his office here, they could say David we want you to be here. They make that call just as the Superintendent can say you are the Principal here today but tomorrow you will be there. It seems to her, if he is an employee of Willis Knighton, unless there is a contract that states something different, if there is she does not remember. And maybe there is something that protects that. She would like for him to be our employee, not Willis Knighton’s. But if it behooves him or it behooves the hospital for it to continue the way it is and everyone is protected, she thinks we should look into it is what she is really asking. What is in the best interest of everyone and commission the committee to do that and have some more discussion about it at this point.  Ronnie Festavan commented that he certainly thinks there is wisdom in that. He addressed Doug White – based on what Mrs. Irvin has said, that Willis Knighton makes that call on Mr. Jones, is that correct? Doug White stated that they have the power to deal with their employee as they see fit. This issue was discussed some months ago. He is a little uncomfortable talking about it in an open Board meeting. He suggests that we address this when we go into Executive Session and he can be a little more candid. Ronnie Festavan stated that he would like to do that at some point in time. Helen Godfrey-Smith said that from the Finance Committee and Contract Committee standpoint that could be something that they could explore and bring back and bring something to an Executive Session. Mary Irvin asked if it would be fair to say in January? Helen Godfrey-Smith replied yes. Mary Irvin noted since December is really only two weeks away and that is not a lot of time. We can give everybody a time frame for it to be on the January meeting Executive Session agenda or whatever is appropriate to have a discussion about it. She addressed Mr. Chairman.  Robert Green he noted that we should wait. Doug White said we could do it tonight during the Executive Session. We can speak about briefly if you would like. Robert Green agreed and stated it will be at the will of the Board. Mary Irvin was referring to what information the committee would gather. Pat White noted that Allison Jones is here tonight. She inquired if she was going be making a presentation tonight in the Executive Session? Allison Jones replied yes. Pat White said she hates to see the meeting to run late. The first Board meeting she attended ran to 11:00 p.m. that night. She would hate for Mr. Festavan’s first meeting to be the same. Mr. Festavan stated that he has been to school board meetings that lasted all night. She noted that she had been in court that lasted to midnight. Robert Green stated we will wait and finish this discussion in Executive Session tonight.           3)   Foundation:  Mary Coil she has a few things. It is the end of the year and she is hoping that our donors will remember us at the end of the year giving. We are doing our part to remind them about our mission and what we are here to do. A newsletter should have gone out telling what is going on and that we are working toward the purchase of an MRI unit for the hospital. It is a necessary service for our patients and that it will be a revenue origin for the hospital. We also have Christmas ornaments that may be given in honor of a family member, friend or co-worker, as well as in memory of a loved one. The ornaments are $10.00 each. We will hang these ornaments on the tree in front of the hospital. There will be a tag attached to show who the ornament is honoring or in memory of and who it was given by. These can be payroll deducted and she is providing order forms. If this something you are interested in please leave the form on the table and Mr. Jones will give them to her. If you have any questions please let her know. She placed a copy of the Foundation minutes by their packets. We are getting ready to finish up the year and all is going well.           XII.   Medical Staff Report  –   1)   Recommendations – Allyson Allums: MEDICAL STAFF APPOINTMENTS:    1.   Joshua T. Blunck, D.O. – Requests Provisional Privileges in the field of Radiology for the period of November 28, 2017 through November 30, 2018.      2.   Christine Lamoureaux, M.D. – Requests Provisional Privileges in the field of Radiology for the period of November 28, 2017 through November 30, 2018.      3.   Charles S. Henry, M.D. – Requests Provisional Privileges in the field of Radiology for the period of November 28, 2017 through November 30, 2018.      4.   John K. Chang, M.D. – Requests Provisional Privileges in the field of Radiology for the period of November 28, 2017 through November 30, 2018.      5.   Donald Nicell, M.D.  – Requests Provisional Privileges in the field of Radiology for the period of November 28, 2017 through November 30, 2018.      MEDICAL STAFF REAPPOINTMENT:  1. Mark Cimino, M.D. – Requests Courtesy Privileges in the field of Emergency Medicine for the period of September 1, 2017 through September 30, 2019.     2. Bernadette McLaren, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of November 28, 2017 through November 30, 2019.     3.   Alpesh Patel, M.D. – Requests Courtesy Privileges in the field of Anesthesiology for the period of November 28, 2017 through November 30, 2019.     4.   Elaine Khatod, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of December 31, 2017 through December 31, 2019.       ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT:   NONE.      EXTENSION REQUEST: Jose Alba, M. D. – Requests Courtesy Privileges in the field of Radiology for the period of October 31, 2017 through October 31, 2019.     Physician will need “PAPA” (Physician Aging Assessment) Per By Laws.     VOLUNTARY RESIGNATIONS:     1.   William Wise, M.D. – Resigns Courtesy Privileges in the field of Emergency Medicine effective of November 09, 2017.     2.  Eugene Patterson, M. D. – Resigns Courtesy Privileges in the field of Radiology effective November 09, 2017.         Kenneth Clay made a motion to accept the Medical Staff Recommendations for Medical Staff Appointments and Medical Staff Reappointments, Extension Requests and Voluntary Resignations.  David Norman seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: None Abstained: None. The motion carried.    2)    Chief of Staff Comments:  Dr. John Woods, Chief of Staff, stated that it has become a difficult task to evaluate how to navigate approval of radiology and pathology due to the huge turnover every month. We grant them privileges as long as they meet our credentialing criteria. Dr. Woods would like to recommend a possible section delineation regarding these job titles concerning the age of 70 years old since they do not participate in patient care while in the hospital and normally come to us through a group that has their own credentialing process. Allison Jones recommended that any further discussion of this policy should be deferred to Executive Session due to an ongoing litigation that involves this policy.       XIII.   Executive Session:    Robert T. Green stated we are at the point to enter into Executive Session. He will need a motion to enter in to Executive Session for the purpose of strategic planning.             Ronnie Festavan made a motion to enter into Executive Session for the purpose of strategic planning. Mary Irvin seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: None. Abstained: None. The motion carried.          The Executive Session was entered into. No action was taken during the Executive Session.

Mary Irvin made a motion to enter back into regular session.  Bruce Walker seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: None. Abstained: None. The motion carried.          XIV. Adjourn:    There being no further business Kenneth Clay made a motion to adjourn. Helen Godfrey-Smith seconded the motion. The vote: Yeas: Robert T. Green, Jr., Pat White, Kenneth Clay, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Helen-Godfrey-Smith, Bruce Walker. Nays: None. Absent: None. Abstained: None. The motion carried.       Meeting adjourned at 7:58 p.m.  





North Caddo Medical Center

Vivian, Louisiana