BOARD MEETING:  Regular Meeting   DATE:  October 23, 2018    MEMBERS PRESENT:  Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Patricia White.      MEMBERS ABSENT: Kenneth Clay (arrived at 6:05 p.m.) TIME CALLED TO ORDER:  5:30 p.m.   OTHERS PRESENT:  David Jones, CEO, Pam Hughes, COO, Dakota Robinson, Interim CFO, Mary Coil, Foundation Executive Director/Marketing Director, Dr. John Woods, Chief of Staff, Jim Kent, Physical Therapy Director, Lyn Hay, Cardio-pulmonary Director, Lanell Audirsch, Admin. Asst.,     LOCATION:  NCMC Events Center     BOARD CHAIR: Robert T. Green, Jr.     SECRETARY:  David Jones     I. CALLED TO ORDER – Robert T. Green, Jr., Chairman, called the meeting to order.   II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation.  Mary Irvin led the group in the Pledge of Allegiance.    III. Approval / Amend Agenda – Pat White made a motion to approve the agenda. Ronnie Festavan seconded the motion. The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.   Nays: None.   Absent: Kenneth Clay   Abstained: None.   The motion passed by unanimous vote.   IV. Community Comments – Robert T. Green, Jr., Chairperson noted there were no signed Visitor Recognition Cards requesting to address the Board.   V. Minutes – Special Meeting September 18, 2018 –    The minutes of the Special Meeting held September 18, 2018 were mailed prior to today’s meeting for review.  Ronnie Festavan made a motion to approve the minutes of the Special Meeting held on September 18, 2018 as mailed.  Brenda Smith seconded the motion.   The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White   Nays: None.   Absent: Kenneth Clay.   Abstained: None.   The motion passed by unanimous vote.   Minutes – Regular Meeting September 25, 2018 – The minutes of the Regular Meeting held September 25, 2018 were mailed prior to today’s meeting for review.  Pat White made a motion to approve the minutes of the Regular Meeting held on September 25, 2018 as mailed.  Mary Irvin seconded the motion.   The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White   Nays: None.   Absent: Kenneth Clay.   Abstained: None.   The motion passed by unanimous vote.   Minutes – Special Meeting October 9, 2018 – The minutes of the Special Meeting held October 9, 2018 were mailed prior to today’s meeting for review.  Brenda Smith made a motion to approve the minutes of the Special Meeting held on October 9, 2018 as mailed.  David Norman seconded the motion.   The vote: Yeas: Robert T. Green, Jr., Mary Irvin, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White   Nays: None.   Absent: Kenneth Clay.   Abstained: None.   The motion passed by unanimous vote.   VI. Old Business – 1) Purchase of Portable Ventilator Update:  David Jones stated the Ventilator is in and all the training was actually completed last week and it is in use. Maybe we can give a quick presentation before the next Board meeting if the Board would like.  There was no further Old Business to be addressed. (Kenneth Clay arrived at 6:05 p.m.)    VII. 1) Review August 2018 Statistics  –  Dakota Robinson: Dakota Robinson, Interim CFO, stated they would start with Admissions – 78 admissions and 11 Swing Bed Admissions. That is the highest number since May of this year and we are keeping that trend going. It has been on the upward trend since June. Newborns – 9 for this month. That is actually a 38% increase from the prior year at this point in time. In-patient Days – 280 days. That was a sharp incline from the previous three months – a 31% increase this month. Average Daily Census, with acute and swing together, was at 14. You can see that the hospital was pretty full in the month of September.  Endoscopies – 16. Surgeries were down a little. You still see they are at 8. Dr. Banda continues to be busy doing surgeries. Emergency Room visits climbed to 487. Mammographys – there were 29 which is not out of the normal. Medical and Surgical visits were 2,007 with the year-to-date of 5,897 and the prior year-to-date there were 5,260. They are up 108 in the Vivian Clinic. They had a profit of $89,307. We will talk more about each one of the clinics in the financial piece. The Plain Dealing Medical Clinic saw 605 patients; down just a little bit. They still had a profit of $1,925. The Benton Clinic was down slightly to 400 and they had a loss of $11,978. We will discuss that more in the financial piece he will have some discussion on that. Days-Cash –On Hand is at 63.45. You can see that it is holding steady for the past three months we have been over 63 days cash on hand. That is a very strong number and we don’t see a negative trend in that right now. We profited $236,348, to turn a profit for three months in a row. AR days are down to 44.49.   Fitness Center memberships are at 427, down three from the previous month. Dakota asked if there were any questions statistics wise.  Ronnie Festavan said going back to the clinics. When he looks at the Vivian Clinic, he can see we were down 270 visits in the clinic. He sees that expenses are up almost $23,000 even though we served 270 less patients. Will you talk about that a little bit? Dakota replied absolutely. There are multiple aspects of the income statement for each clinic. A majority of that comes from physician’s salaries, physician’s pay, and the other side of that becomes the expense side – anything from drugs – everything it takes to run the clinic material wise. In this case, the way the physicians are paid on WRVU – it basically, each thing they do, each widget they turn out is assigned a value. Obviously, if they give a shot, it will have a lower value. If they make some kind of complex decision with this patient and there are a lot of things going on that patient would have a higher value. Just because there are a lower number of patients seen in that period, that doesn’t mean that the complexity of all the cases together are lower than what the previous month was. This is a prime example of what happened. There were higher complexity cases in this and that is why you saw an expense side increased over what the previous period was even though there were less patients. There were also flu vaccines. This is the part of the year where we purchase flu vaccines for all of our clinics. Those are high cost drugs all at one time. They those are administered, we don’t administer them all in September. He would venture to say that the majority of them don’t even start until October. That is an expense that hits the books where the revenue isn’t captured until months after that. That is where you can see a difference in patient volume could decrease with some expenses still going up.  Helen Godfrey-Smith said she would like to call our attention to the number of days for the last six months. Our cash on hand has averaged over 60 days since March and that has been averaging at about 62 days or so for six months consecutively and dropped a little bit in June but not significantly and it is holding its own so that is a very good pattern.  David Jones noted that is the highest figure in the last fifteen years. The only reason he can’t go back further, he does not have any data that goes back further than that. Ronnie Festavan said based on that comment, Mrs. Smith, with you being on the Finance Committee, what you attribute that to. What can you tell us about that? Helen Godfrey-Smith said she can tell you that it has to do with management and it has to do with our planning and it has to do with our UCC money and just a collision of several good things that are happening. It is promising to go into the future and whether we can hold it to 63 days or not, she would be comfortable even if it were to go to 40, 45, 50; it would still be a comfortable cash position for us. Dakota stated he would like to interject on that, too, which got brought up in the Finance Committee, is that the reserve money that the Board has set aside is not figured in that days cash on hand. That would actually, even though that is easily converted cash being in the form of the CD, that number is not in that 63 days cash on hand. He thinks when we ran the numbers for the Finance Committee; it looked around the 75 day mark if we included the CD’s that are in reserve. Ronnie Festavan said he raises that question, Mrs. Smith, for this reason. He thinks it is important, in our minutes, that we get that dialogue out there to let our public know that we are doing well, and we are doing well because of good planning and good management skills at the hospital level. That is the only reason he raised that, but he thinks it is important that our public knows that we are doing a good job. That is why and he appreciates that answer. Helen Godfrey-Smith said that is part of the reason she wanted to bring it to the attention of the Board. It is one of the measures that has to do with our financial stability.  Ronnie Festavan, said if he could, Dakota, he would like to go back to the clinics, and he appreciates the explanation on the Vivian Clinic. Might he apply that same scenario when he sees us down in the Plain Dealing Clinic 128 for the month and we still made a profit? Would you judge that the same? It depends on what you are doing with the individual patient that drives the revenue due to the expenses and the expenses are variable depending on the level of care that each individual may be getting. Would that be a safe way of putting that? Dakota Robinson replied yes Sir.  Pam Hughes said she would like to interject, like Dakota said, of the flu shots. That goes for each clinic. We are paying for those in September and we are going to give them from October thru January, but we had to pay for them all at one time. Ronnie Festavan said if you would indulge him one more time. He still, with his limited knowledge, he still wrestles a little bit with the Benton Clinic. He can see, we went from $7,000 loss and now we are at an $11,000 loss. He tries to put himself in the place of our public reading this document. He knows you understand it and Mrs. Smith has a good grip on it and others may, but he tried to put himself in their shoes and they are looking and they are seeing a $7,000 loss last month, $11,000 this month. Could you give him some comfort with that for the sake of the minutes? Dakota replied yes. Dakota said the $7,675 last month, of the increase in loss, $5,000 of that was attributable to the flu shots that are expensed all at one time. The revenue will be recognized in the next four to five months.  Pam said we won’t get our money until the cost report for the flu shots. Dakota said the revenue is recognized later on that. The main thing with Benton, that you don’t see in the other clinics, is the rate that they are paid currently thru Medicare and Medicaid. That is what we have talked about each month is that we have gotten approval for the increased rate, but they have not started paying that yet. We have also not got our money that we can back bill to June 1st. Dakota said what we will see in the future, we bill $100, and we use to get $33, we can contract off the rest of that. When you look at the financial statement for Benton and the contractual adjustment line, you will see percentage wise it is much higher than the other two clinics because we have to contract off such high percentage for Medicare and Medicaid. With the increase payment from those two we will see the contractual adjustment line item in that clinic start reducing itself which will affect the bottom line of Benton Clinic as we go forward. Ronnie Festavan, if you could, and you could join in Mrs. Hughes with this also, it’s probably much more complicated than this, but he will ask it in this form. What would we need to see happen for the Benton Clinic to become profitable – what perfect storm will we need to see. Pam Hughes stated that are five Medicaids. It is Medicaid, but they go out to five different insurance companies that actually pay. Out of those five, she has one that is paying. She has all of the rest of them; we had to re-contract with them, so as soon as all that is completed, when we get all of our money, it should be profitable; it will be profitable. Mary Irvin asked if she mentioned we will be able to back bill. Pam Hughes, said yes, we will be back billing to June. We have already sent a lot of the MCO spreadsheets to the ones that will accept that. They will pay back to June. We became rural health in March, but they would only go back to June. Ronnie Festavan said thank you. Dakota Robinson asked if there were any other questions related to the statistics. There were none. He stated we will move on to the Financial Statements.        2) Review September 2018 Financials – Dakota Robinson – Dakota Robinson noted on page #1 of the Balance Sheet – he is going to highlight the biggest changes on this from the previous periods. We have already talked about 63 Days Cash on Hand. We can see that reflected in $3.8 million dollar worth of cash in the bank accounts as of September 30th. The cash certificates of deposit line item in the previous was at $500,000. You will see that that account has reduced itself from the prior period. 1) Due the payment that was made on the bonds and 2) the $200,000 that was moved into a Certificate of Deposit. Those are correctly reflected on the Balance Sheet. Those were the two main changes that he wanted to point out on that. On page 2 of the Balance Sheet – the Liability Section – Accounts Payable. As of the Finance Committee, there was a $169,000 in accounts payable through vendors, not necessarily all of them, but the ones that run through AP; none of them were past due. AP is looking very healthy as of right now and is being monitored through the Finance Committee. We will go to page 3 – Income Statement. Everybody will be pleased to see this page. It reflects similar to the statistics with the good trends. Revenue this past month, over the last September, was up about 10% at $3.9 million dollars. Contractuals – this Income Statement matches the flow similar to the clinics when I talk about Contractuals and percentages to revenues. The contractuals this month are about 49 – 50% of what the total revenue is. When he is talking percentages, those are the two line items that he is looking at.  If you go to Salaries and Wages – a little under $1.1 million – that is $96,000 higher than the previous year. Pay raises were in effect last month. Even year-to-date, we are about $119 over the previous period. Employee benefits and payroll taxes – very similar to this period last year – but over a three month period it is down $162,000. A lot of this has to do with the health insurance. We have seen a lot less claims come in of high dollar values. Basically, not reaching the aggregate insurance limit for a claim. That is good news. Also, we are paying a half percentage less to Parochial Retirement System at this point in time. If you look at medical supplies and drugs over this point last year, last year we saw a huge difference in it. If you look at the three months this year, we are about $1,600 different. That is the effect of the 340B being on it for a whole year. We are seeing those levels being the same month to month. Those are good things to see. If you look at the professional services and other expenses line items, you will see a reduction of $106,000 over the previous September in other expenses and you will see an increase in professional services of $85,000. This is where when we were discussing the sleep studies, the sleep studies were showing up on the other expense, which is page four. It was in supply expense. He moved it to professional services. From now forward, it is a professional service provided through Respiratory. That is where you are going to see that. That was an $86,000 move. That is why you see one account lower and the other account higher. When we get to page four you will see the adjustment take place in the first line item. We will get to that in one second. The Interest Expense is directly related to the bonds. You can see over this point last year it is much higher. Further down under Grants, if you look at the grants last month you saw a much larger number in there. After the UCC was filed with Lester, Miller & Wells it goes to an accounting firm that LDH has contracted with for audit review. Their name is Myers & Stauffer basically applied some different calculations to it and different rates of pay and also excluded some payers that we typically get paid for, specifically out of state Medicaid. The State is trying to get tighter on the UCC dollars, they disallowed $222,000 of the UCC payment. This month, since he has a reasonable estimate of a reduction that was accounted for in this account, he has accrued what should be accrued in that account and each month after this we will book the correct accrual based on the $500,000 that the UCC has now been adjusted to. Lester, Miller and Wells has appealed that decision to Myers & Stauffer but as of this afternoon there is still no word back on that and he has no timeline as to when we will get a decision on that. David Jones said so that possibly may be reversed. Is that correct Dakota? Dakota replied yes. Myers and Stauffer is the intermediary between our accounting firm and Louisiana Department of Health. It previously went directly from our accounting firm to the LDH and they would do some calculations on their end. They have contracted with Myers and Stauffer. They are trying to catch more things on the front end and they have even changed the rules on some of this on what is allowed and what is not. Hopefully he can report to the Board next month, these things that we have appealed that they have accepted. Be looking for an update at the next Board meeting on that.  Dakota asked if there were any questions on the Income Statement. There were none. On page 4, Other Expense Schedule – We talked about the sleep studies on the first line of supply and expense. You will see a $79,000 difference between the previous year. That is directly related to $86,000 being moved out of that account and into another one. He would like to point out each time, in the previous accounting periods, the software EHR, for our Cerner expense, is being expensed to finance collection expense – that was moved so the accounting in that is correct in that as of today. That is where you see the big difference in those two. Ronnie Festavan said for clarification for him under 2018 Ambulance Fuel Expense. There is no notation in there. Is there a reason for that? Dakota said the invoice for that was not received by AP cutoff time. You will see that every once in a while where an expense account might not have something in there that they needed but AP has to be cut off by a certain day so you will see that expense show up in the next month. You might see a higher expense in the next month. Ronnie Festavan said the other one was Laundry. Is that a result of change that we made in our carrier for that? Dakota said it is a little bit of both. Yes, there is a drastic reduction in expense with the change in contract that we made in mid-summer. The other part is that – sort of like Ambulance. An AP cutoff date from the previous September where there were multiple invoices posted in that time period.  Helen Godfrey-Smith said she thinks that is probably going to be more likely the posting of the invoice. There is a big difference in the cost of the linen. As we go further, you will see this start pulling away. Dakota asked if there were any other questions. Helen Godfrey-Smith stated the actual month of September definitely shows a significant reduction. Ronnie Festavan said the only other one that jumped out at him was postage. Is there something different there? Pam Hughes said it might be the cards that we have been sending out. Dakota said if you look at three months just because of the way invoices come in and posting of payments. If you look at three months, we are actually down $173 – very little difference in that category. If we have questions on that then we can work our way back in to the one month detail. Ronnie Festavan said thank you.  Helen Godfrey-Smith stated – under collection expense – refresh her on that one. Dakota that could be any of the collections that have been collected on an account – that is where those expenses flow to. Helen Godfrey-Smith said it seems in 2018 that either our collections are down or something. Dakota said that has shifted – we were posting Cerner, which is our EHR, they have an aspect where they charge us per bill that is sent out. The system had coded it to the collection expense because it was part of billing. Helen Godfrey-Smith said that is what she wanted to be refreshed on. Dakota said we moved that up to where we created the software and EHR code.    Dakota said before we go to page 5 – the Departmental, we are going down this list seeing all the positives we have – In-patient Routine Care is up; Pharmacy is up; Laboratory is up; Operating and Recovery; Inhalation Therapy, which Lynn is about to discuss – it basically goes hand in hand with the income statement and the statistics that have been presented to you. Are there questions? He didn’t see anything odd or that was out of the norm on that schedule or even schedule #3 which is the next page – page #6. He asked if there were any questions? There were none. Dakota directed them to page #8 – the Budget. He is going to look at a lot of year-to-date aspects on this. Revenue wise, we are slightly under budget by $355,000; but if you look at the contractual adjustments and bad debt, we are also under budget on that. If you look at net patient revenues, it puts us over what we budgeted by $123,000. The Budget is pretty good three months through on the revenue and adjustments side. If we drop down into the Operating Expense, we can go down almost line item – Salary and Wages is less than budgeted for. Employee Benefits and Payroll Taxes is less. Professional Services shows up here more than budgeted because it was one of those aspects that we changed the Sleep Studies. Those didn’t start until after the budget was prepared. Leases and Rentals are down. Accounting and Cost Report – we have with the better cash position and the way the invoices and audit is going, we have paid four out of the five invoices for the annual audit. We have booked those and they are on the books and that is why you see an increase cost in cost report as of this time. You will see those two start meeting each other over the next few months. Legal fees – I’m sure we are all aware that legal fees are more than what was budgeted for just what is going on in this year. Everything else – nothing in expenses is over budget. We are doing great in that. Actually, expense wise, we are $531,000 under budget. The good thing is, Sales Tax Revenue is coming in over budget and 340B revenue is actually coming in over budget. That puts us at a $686,000 profit through three months and budgeted was a $258,000 profit. You can see that is a pretty hefty difference from what was budgeted. Any questions on that page? There were none.   Kenneth Cochran said he is curious on the drugs. Are there drugs are bought in bulk for a longer period time versus the drugs that have shelf life issues or are they pretty well staggered evenly? Dakota said like the flu shots – you can’t hold those on the self. Kenneth Cochran asked do you have shelf life purchases other than flu shots. Dakota replied yes. He stated that almost everything in the hospital has shelf life – not only drugs but items such as gauze. There are dates on all these packages. Pharmacy is very aware so we don’t have to dispose of medications. They pay attention to dates and if we see something is nearing expiration dates in the clinic we can sometime shift that over to the hospital and vice versa to be sure that we are using the drugs that have been purchased and they do not have to be thrown out or supplies. Kenneth Cochran said his question dealt spikes – obviously there will be spikes in this process. That is what you were referring to earlier. Dakota replied yes. Dakota inquired if there any questions on the Plain Dealing Clinic. There were none.  Moving on to the Benton Clinic – you will see that same thing.  Contractual adjustments – this is where he was talking about the percentage of contractual adjustments against the gross patient revenue is higher in this clinic and we will start seeing the contractual adjustments go down with the increase reimbursement rates that we are going to see there. The drugs – $4,185 dollars directly related to the flu shots; especially when there is only $7,000 spent in that clinic over the last three months. Those are the Financial Statements. Does anyone have any questions, comments or concerns? There none. Robert Green stated 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. Helen Godfrey-Smith 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.   Abstained: None.   The motion passed by unanimous vote.     VIII. New Business – None.     IX. Administrative Reports – 1) NCMC – Current Activity:   David Jones noted there is a lot going on but a lot of it is bound around what is further in the Administrative Reports. We will have some updates later on but he would like to take the opportunity to introduce two guest speakers here today. 2) Cardio/Pulmonary Rehab: We have Mr. Jim Kent from our Rehab Department and Mrs. Lynn Hay who is our Respiratory Therapy Director. They are going to talk about new addition of Pulmonary Rehab area.  David Jones asked Lynn Hay to begin.  Lynn Hay stated we are going to start an outpatient Pulmonary Rehab and the purpose of this is to educate our patients who frequently come for respiratory issues whether it is COPD, chronic bronchitis, asthma, emphysema and so forth. It will include extensive education on the type of physiology; learning their disease, how to manage their disease, their medications, why they are prescribed their medications and how to properly take those medications.  We will also teach them when to come into the hospital and when not to; hopefully cutting down on unnecessary visits. Jim’s department is also going to work with us and they are going to take over the physical aspect of it. Jim will enlighten you on this. Jim Kent stated he appreciates the opportunity to come in.  He will piggyback in on the reverse side of Lynn’s pulmonary patients who are debilitated because of that whole process. These are patients might not necessarily have gotten from the clinic before or identified. Hopefully as they buy into her outpatient here, they are there same day they come across the hallway to us, cutting down their travel time and those types of problems.  On top of that, a year ago we were called by the Highland Clinic Cardiology Department who was looking for someone to treat their Level 2 patients which means those people have to wear telemetry heart monitors during their work outs. They are good enough to go home but still need quite a bit of monitoring, and then their rehab is pretty lengthy, up to three to six months, depending on the individual. They had a great need in this area between us, East Texas and Southern Arkansas. There was nobody to help capture these patients and get them in because they didn’t want to drive all the way back to Shreveport, so they are not being compliant with their care, they are having a lot of secondary complications. We basically already see telemetry patients down stairs, but we are having problems bringing people in as outpatients in an accommodating time schedules. We cannot mix inpatients and outpatients. As you may or may not know, we have been doing outpatient care for nearly two years in May. We have been highly successful with that and treating the patients and giving the local folks what they need, and needing to do business generating a profit on top of it with our fixed cost. This will be another avenue for us to do this so now with Mr. Jones’ suggestion and Mrs. Pam following though, we have a treatment room upstairs to keep our inpatients on the second floor. There is no more traveling down and having a problem intermixing patient care; for hygiene and many other things. Now we can accommodate these patients. We need someone to monitor literally the monitor while the patient is working out. We did not have that accessibility with Nursing before because is fluctuates with their need. We couldn’t tie up our ER Staff. Now we will have a monitor right across the hall from us and Respiratory will be watching while the patient is in the Therapy room. We will probably not have more than two at a time in case we had an emergency, we don’t want to disrupt things going on in the hospital. This is good for our patient. Under current activity they had a grand opening of our partner dialysis clinic. He appreciated the Board members who were able to attend that as well. That is a project of passion for over the last decade of one community member in particular. He would feel remiss if he didn’t mention his name – Pastor Jimmy Carroll.  He came to me about twelve years ago after the urging of our Board Chair to come and talk to me. He is a dialysis patient. He has a Church here and parishioners, community members and family who also have to take dialysis as well. He came to me with the idea of doing that some twelve years ago. We looked at a feasibility study of us just building one and doing one ourselves and financially it never made sense for us to do it. He kept that alive with me every time he saw me – if we could just get that done and finally we found the right partner who would get it done. We had some property and we knew we wanted it here on the campus and the way things unfolded it is finally up and running. That will be a real big asset to the community for one, but two definitely for the patients in the area that have to go through that.  Ronnie Festavan said was he correct in hearing that we are almost at capacity the day we opened?  David Jones said they are expecting in six months to be at full capacity and can’t accept another patient without expanding. Brenda Smith stated there is room for expansion. Helen Godfrey-Smith said that was the one thing that impressed her is there is room for expansion so that we are not locked into the number of stations we have now.  3) Foundation: Mary Coil, Foundation Executive Director and Marketing Director, reported we had the pleasure of having some guests last week. We invited some members from the community and the area to visit the hospital and meet our leadership. We also had our Board of Directors represented by Reverend Green and a few of the Foundation Board representatives. What we wanted to accomplish with that was to have a smaller group session; one on one time with these guests so we could give them more information about the hospital; what we do. A lot time we just drive by the hospital and don’t really get to see the full story. We also displayed a lot of the equipment, or as much as we were able to, of the equipment that the Foundation had purchased. We want to educate everyone on our cause and yes we are a hospital, yes we have all these fabulous services, but this is also what the Foundation is able to do. You want them to know, if they want to join a cause, what would their charity actually be.  That is what that meeting was about and it was a great turn out. She felt like it was successful. We definitely planted seeds and we will see what happens in the future. We are actually going to have another one on Friday and a few more before the year’s end. She is looking forward to that.  David Jones said he may ask Mr. Festavan to speak, piggybacking on top of that.  There were a couple of special visitors that came a few days before that. We put up the legacy wall not long ago and two of the children of two of the physicians got to come. Mr. Festavan spearheaded that. It was just a neat kind of experience to have. That was their father that was on the wall. We got to take them around. They were telling stories that he had never heard. We were showing them around the new hospital. Mary was with us but Mr. Festavan pretty much spearheaded it. If you would like to share some of that. Mary Coil said it was great, it was a great time. Dr. Speer’s youngest daughter was able to come and Dr. Ferguson’s daughter was able to come. Dr. Ferguson’s daughter doesn’t live around here but she was able to come in. The other doctor family individual members were invited but unable to attend.  It was great hearing stories you had not heard before like sitting in the Nurses Station after school. There is a picture of a birthday cake on the ER table, when the hospital was first built, for Dr. Speers. There was a picture that come around of Dr. Speer’s purchasing the very first bond for the building of North Caddo Medical Center. She believes that article stated that it was bought three years prior to the opening date; it may have been more than that. You see the planning that these individuals that are on that wall; theirs went back before 1965 when these doors opened. They were part of the Board that started the hospital and the purchase of the bond. It was really neat to see their reaction to what all we have going on here and part that their Dads played. She really appreciated Mr. Festavan bringing them in and inviting their classmates and us having that time with them. Ronnie Festavan said the youngest Speer’s daughter was much younger than him, but he went to school with one of his daughters and he went to school with Dr. Ferguson’s daughter. There are actually two daughters but only one could come. She drove from Houston and spent the day. She was overwhelmed emotionally and everything else. He really appreciates the kindness that they were shown.  He really appreciates you indulging him on that. David Jones said it was an honor to see them and to see the pride they had in their father and make sure they understood that they were still a part of this place whether they had walked the halls or not. That is the truth of the matter. Ronnie Festavan wanted to acknowledge Pam Hughes on the legacy wall. It is really nice and special. Pam Hughes stated that she had Mary Coil and Mary Haddox and others to help but she appreciates his recognition. He understands that it takes everybody but it was really nice and he really appreciates it.    4)  Construction Report:   David Jones said hopefully next month will be a little longer. Right now we are just finishing the USDA required forms through the architect and the contractor. We have everything signed and sent in. Once USDA blesses it there should be a pre-construction meeting going forward to get timelines and those kinds of things down.  We do have a copy of the plans and what the new construction is going to look like. There is a copy on the table of the plans and we will probably put it up on the wall and get a better visual from the architect. Look for that to come at the next Board meeting.  X. Medical Staff Report – 1) Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval: MEDICAL STAFF APPOINTMENTS:   1.) Dawood Malik, M.D.  – Requests Provisional Privileges in the field of Radiology for the period of October 23, 2018 through October 31, 2019.     MEDICAL STAFF REAPPOINTMENT: 1.) Wayne Homza, M.D.  – Request Courtesy Privileges in the field of Radiology for the period of October 23, 2018 through October 31, 2019. 2.) Robert Morley, M.D. Request Courtesy Privileges in the field of Radiology for the period of October 23, 2018 through April 30, 2020.   3.) Matthew Smith, M.D. Request Courtesy Privileges in the field of Radiology for the period of October 23, 2018 through August 30, 2019.   4.) Stephanie Runyan, M.D. Request Courtesy Privileges in the field of Radiology for the period of October 23, 2018 through December 31, 2020.   ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS / REAPPOINTMENTS:  None.       EXTENSION REQUEST:  1.) Kenneth Harrison, M.D.  – Reappointment Pending Medical Staff Verdict on Physicians 70 and Older.    VOLUNTARY RESIGNATIONS:  1.) Andrew Marsala M.D. – Requests Resignation in the field of Radiology effective 10/31/2017.   Brenda Smith made a motion to accept the Medical Staff Reappointments, Extension Requests and Voluntary Resignation.    Pat White seconded the motion. The vote:  Yeas:  Robert Green, Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Pat White.  Nays: None.  Absent: None.    Abstained: None.   The motion passed by unanimous vote.   Helen Godfrey-Smith requested to ask a question. Robert Green recognized her. Helen Godfrey-Smith noted that the Medical Staff reappointments generally seem to be in the area of Radiology. David Jones noted that we have so many Radiologists that are on contract that read the exams and you never know which one is going to be there so they have a long list of Radiologists. Dr. Woods stated that will not change in our near future. It is a 24 hour service. We have to use VRad and it may be a physician in Australia reading the image. There is just a continual turnaround of whoever is on call and constantly covering for these hospitals. That is just the nature of the game. Every month we will get a Radiologist that will be appointed or resigned and moving on to some other place. Helen Godfrey-Smith said so these doctors are not necessarily local doctors is what you are saying. She said o.k. that explains it.  2) Chief of Staff Comments:  Dr. Woods said as far as what is going on in the hospital we are about to meet with two of the doctors tomorrow and celebrate their 10 years of service at North Caddo Medical Center and give them an atta boy and an atta girl  –  Dr. Jody Chance and Dr. Nicole Mc Common. Everybody seems to be pretty happy – no problems and no worries.   Robert Green thanked Dr. Woods.     Helen Godfrey-Smith stated that before we go into executive session, she would like to give the hospital a review – a personal review. Today, her granddaughter, LaShannon Sanders had a 6 lb. 5 oz. baby – the most beautiful little baby girl, that she believes, has ever been born here.  Helen Godfrey-Smith replied yes.  She said they were just raving over the atmosphere because when she had her first little girl it was four years ago in the old hospital and the difference that they experienced going thorough this time was just night and day. They are just so happy.  David Jones asked if she got to hear the lullaby played overhead. Whenever a newborn is born there is a key in the nurses’ station and they tap it and it plays just a little short lullaby. Helen Godfrey-Smith said the special touches are so appreciated.  David Jones said it is funny because you can hear the collective “awe” when it is played!  XI. Executive Session: Robert Green noted that we needed a motion to enter into Executive Session for Strategic Planning.    Helen Godfrey-Smith made a motion to enter into Executive Session for Strategic Planning with a short break before entering into the session.   Kenneth Clay seconded the motion.  The vote: Yeas:  Robert Green, Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None. Absent: None.   Abstained: None.   The motion passed by unanimous vote.  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.    Pat White seconded the motion.   The vote:   Yeas:  Robert Green, Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None. Absent: None.  Abstained: None.   The motion carried.      XII. Adjourn:    There being no further business Kenneth Clay made a motion to adjourn.  David Norman seconded the motion.   The vote:    Yeas: Robert Green, Mary Irvin, Kenneth Clay, Kenneth Cochran, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None. Absent: None .   Abstained: None.  The motion carried.      Meeting adjourned at 8:55 p.m.




North Caddo Medical Center

Vivian, Louisiana



David C. Jones, Secretary

Approved by the Board of Directors at the regular meeting held November 27, 2018