BOARD MEETING: Regular Meeting DATE: September 22, 2020 MEMBERS PRESENT: Mary Irvin, Patricia White, Robert T. Green, Jr., Ronnie Festavan, Brenda Smith, Kenneth Cochran MEMBERS PRESENT VIA TELECONFERENCE: David Norman, Helen Godfrey-Smith MEMBERS ABSENT: Kenneth Clay (arrived at 3:54 p.m.), TIME CALLED TO ORDER: 3:30 p.m. OTHERS PRESENT: David Jones, CEO, Dakota Robinson, CFO, Dr. John Woods, Chief of Staff, Mary Coil, Foundation Executive Director / Marketing Director, Walter D. (Doug) White, Hospital Attorney (Via Teleconference), Britney Stringham, Administrative Assistant, Lanell Audirsch, Admin. Asst. LOCATION: NCMC Café and Via Teleconference – Conference ID 672 620 6 # BOARD CHAIR: Mary Irvin SECRETARY: David Jones I. CALLED TO ORDER – Mary Irvin, Board Chair called the meeting to order at 3:30 p.m. II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation. Pat White led the group in the Pledge of Allegiance. Brenda Smith offered a word of encouragement. Mary Irvin thanked Brenda Smith noting that it is amazing how encouraging just one scripture can be to your everything so we do thank you for sharing that word. III. Approval / Amend Agenda – Mary Irvin noted there is an amendment that needs to be made to our agenda. David Jones stated we just got the engagement letter for the accounting firm that computes our Uncompensated Care – Langlinais, Broussard & Kohlenberg Certified Public Accountants (LBK). Mary Irvin stated we are going to add that to the New Business – #4 on the agenda. David Jones stated it will be the engagement of LBK CPA Firm for UCC purposes. Mary Irvin asked if there were any other amendments to the agenda. There were none. Mary Irvin stated we need a motion and second to approve our amended agenda. Brenda Smith made a motion to approve the amended agenda adding the item under #4 of New Business. Robert Green seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: Kenneth Clay. Abstained: None. The motion pass by unanimous vote. IV. Community Comments – Mary Irvin, Chair, inquired if there was anyone from the community logged on. Dakota Robinson stated there were no visitors logged on. Mary Irvin noted there are no community comments. V. Minutes – Regular Meeting August 25, 2020 – The minutes of the Regular meeting held August 25, 2020 were mailed prior to today’s meeting for review. Robert Green made a motion to approve the minutes of August 25, 2020 as mailed. Ronnie Festavan seconded the motion. Mary Irvin asked if there was any discussion or corrections to be made regarding the August 25, 2020 minutes at this time. There were none. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: Kenneth Clay. Abstained: None. The motion pass by unanimous vote. VI. Foundation Report: Mary Coil, Foundation Executive Director, stated there are some things coming up in the fall for us. October is coming and that is a big month for healthcare as far as awareness goes which includes Breast Cancer Awareness. We actually have a student who is now a freshmen, but she was the Student of the Year for Caddo Parish from our Elementary Middle School. Her name is Analyce Jeane and she is doing a fund raiser called Cupcakes to the Cure. Also, in October we’re going to have something called Boo-bags. A lot of this is just a small thing for employee morale but it will also be something for the candy as well. To give you a heads up on what is going on in November, the Foundation will be having a Movember Event. For anybody who is not familiar with Movember, it is a mustache challenge and what we are going to do is raise awareness for men’s health. David Jones noted Board members are invited to join. Looking forward to it. VII. Chief of Staff Report – Dr. John Woods, Chief of Staff, stated everything is going great. There is nothing really exciting but all is good. No problems and no worries. VIII. Old Business – 1) Purchase of Lab Analyzer for COVID – Ag Testing Update: David Jones stated the purchase of the Lab Analyzer is going to be a lengthy process. As you can probably guess, nationwide there’s a shortage of testing equipment and testing analyzers. I would say this is probably going to be a six month process in getting this in and done. This will stay on the Old Business until we get it completed. 2) Purchase of Benton Clinic and Adjacent Property Update: David Jones said I am proud to announce that we are the new owners of the clinic and the dirt underneath it in Benton and the dirt right next to it as well. We are getting plans drawn and Dakota is going to share some with us in a little while of what that potentially will look like. We are excited for the folks in Benton. Mary Irvin said on behalf of the Board I would like to send a letter out to congratulate them on their success because without them being successful we would not have pursued these next steps. I think that staff really needs to be commended on the success that they have brought to that clinic and that venture. IX. 1) Review of August 2020 Statistics – Dakota Robinson: Dakota Robinson, CFO, stated starting with Admissions you will see over the past quarter we definitely see trends up across the Board. We had 52 Admissions on the Acute side and 8 on the Swingbed. There was a reduction in both of those areas but we are still running a census anywhere between 13-18 with 18 today. Looking at In-patient days we are just below the moving average. We had 164 In-patient compared to 200 the previous month but well above what we saw as a lull in March of 133. The Average Daily Census dropped slightly from 12.1 to 10.7. Looking at Surgeries obviously last month was an anomaly with everything opening back up. We saw 24 surgeries last month. We had a total of 14 in August. Endoscopies – we saw a dramatic increase after the closure in April and part of May. ER visits – ER visits were down slightly. I think the numbers is around 475. It is reported at 409 but we will get that corrected on the next slide if there is a difference. Once again well above 283 and 325 that we saw in the COVID initial days. Even 37 is high for Mammography and still doing well. Newborns is very cyclical. You see the past two months have been very busy. We had 9 in the month of July and 7 in August. (Kenneth Clay arrived at 3:54 p.m.) In the Vivian Clinic there was a slight decrease from 2,038 in July to 1,881. In the Plain Dealing Clinic you see that we went from 712 to 652 visits for the month. That’s still more than a 100 what we saw in the lows of COVID. In the Benton Clinic they are pretty steady. They went from 545 to 521. We are not seeing a huge fluctuation there from month to month. The Fitness Center for the month of August, there were 16 new members signed up compared to 31 in the previous month. We had right a little under 1,600 total visits. That is slightly down from 1,900 the previous month. The previous members last month we had 326 members and in August we had 333 members so we did increase the total membership over the past month. Any questions on the statistics? There were none. 2) Review July 2020 Financials – Dakota Robinson: Dakota Robinson noted you’ll see based on the stats even though it wasn’t the month of July that we saw it’s still is a good August. You see that on page 1 of the Balance Sheet Cash on Hand that is unrestricted is $15,731,000. That equates to 250 days Cash on Hand. Dakota continued you’ll see that we had a revenue of $3.4 million compared to $3.6, so it is a slight decrease, but what we’re seeing in the first two months, at least this year, is that the contractual revenues are coming in around 45%. We expect that number to be about 52% historically. You’ll see that Net Patient Revenue of $1.8 million compared to $1.855, so it’s very similar to what it was the previous year. You’ll see that Salaries and Wages came in at $1.16 million compared to $1.14 million. That’s an increase of almost $50,000 and if you look on the year, it’s just an increase of $187,000. You’ll see Employee Benefits and Payroll Taxes came in less than it did in the previous year at $163,000. On two months we’re looking at $208,000 compared to $285,000. That’s a good sign, once again, as we continue to see that plan progress. If you look at ER Services, or under Professional Services, that’s probably the largest increase in the financial statements. If we get down in the Total Operating Expenses, we had $2.1 million compared to $2,069,000 the previous year, so just a slight increase of $34,000 in one month. If we look in Non-Operating Revenues and Expenses you’ll see $32,000 was booked into Grants. If you get into 340B Revenue, you’ll see that that increased from $139,000 to $154,000. We’re continuing to make changes in there. Dakota continued stating what we see in AR days you’ll see AR days increased slightly from a little under 40 to 43.85. That’s still in a really good threshold. We’re looking at 40 day range as being the gold standard. Looking at the Budget on page 8 you’ll see that we did come in under Budget on revenue, but with the contractual adjustments included in there we’re only $13,000 off and if you look on the two month period we’re $322,000 over net patient revenue which is good. We get down into Salaries and Wages, you’ll see that $100,000 less than budgeted on salaries and wages and the biggest difference comes here in Employee Benefits and Payroll Taxes. In Total Operating Expense, you’ll see that we’re $332,000 less than budgeted coming in at almost $4.2 million and if we get into Non-operating Revenue you’ll see that the only difference here, for the most part, is Grant Revenue. If you look at the Vivian clinic, with their 1,881 visits, which is a slight decline from the previous month of 2,000 visits, they turned a profit of $21,550. The Plain Dealing Clinic had a slight reduction in visits and the Plain Dealing Clinic is very cyclical like this. They went from almost $6,000 profit last month to a slight loss of $1,385. In the Benton Clinic actually saw an increase with going from $11,498 to $18,971. Mary Irvin stated we are at the point where we need a motion and a second to approve our Statistical and Financial reports. Kenneth Cochran made a motion to approve the reports as presented, subject to audit. Pat White seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Kenneth Clay, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: None. Abstained: None. The motion pass by unanimous vote. X. New Business – 1) Purchase of 2 Acres at 5948 North Market Street: David Jones stated we need a motion and a second to purchase 2 acres of property at 5948 North Market Street for $350,000 total. I’ll speak on it a little further. Ronnie Festavan made a motion to purchase 2 acres of property at 5948 North Market Street. Brenda Smith seconded the motion. David Jones stated that Dakota has a visual, and you have one in your handout as well. We’ve got a verbal approval to purchase that front 2 acres there. We are going to have to remove some buildings – an old house and old pool and pool house and a couple of buildings. It is almost right at 300 feet of frontage of Highway 1, just slightly over 2 acres in there. Mary Irvin noted that North Wood Baptist Church is where the rural line is. David Jones replied yes, on that side of the road maybe about ¾ of a mile back up and then it switches back to urban. Kenneth Cochran asked if the owner have any knowledge of that being a factor. David Jones replied no not that I’m aware of. Kenneth Cochran asked who is the prime negotiator. David Jones replied me. What we have submitted 5948 North Market Street to the state and the state has approved that as a rural healthcare site. This will be one that will have to put a temporary building on. Mary Irvin asked was it is going to be called. David Jones replied the Blanchard Medical Clinic. We are rebranding. Our Marketing Department is coming up with some ideas. The Benton Medical, I don’t know if you saw the sign but it’s really hard to tell that North Caddo Medical Center owns the Benton Medical Clinic. We are fixing to change that. Now that Jere and Dr. Mc Common has a patient base established there it’s time to brand it with North Caddo Medical Center. We are coming up with sign ideas. We are going to do something now with North Caddo Medical Center so people will start saying that is a North Caddo Medical Center Clinic. Brenda Smith said so we will do that on each one of the clinics. David Jones replied that is correct. Mary Irvin said there is a possibility that we may need to do something when we get an estimate on clearing of the land prior to the next Board meeting so be aware of that. David Jones said we are getting bids right now and we have about 5 or 6 companies looking at clearing and getting us offers. Those aren’t in yet and of course we don’t own the property yet. Mary Irvin asked if there was any more discussion or questions about our purchase of this land. There was none. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Kenneth Clay, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: None. Abstained: None. The motion pass by unanimous vote. 2) Resolution #4 -2020 to Allow a Bank Account to be Funded for Blanchard Clinic: David Jones stated #2 is related to #1. Resolution #4 -2020 to allow a bank account to be funded for the Blanchard Clinic. Robert Green made a motion to approve Resolution #4 – 2020. Pat White seconded the motion. Dakota Robinson, CFO, said we are setting it up just like all the other clinics for billing purposes. Setting up a separate account makes it easier. It will be with CBT – Vivian. There is a branch across the road and that works out nicely. Dakota noted that the resolution will include the signers as David Jones, Pam Hughes, Mary Irvin and David Norman. Mary Irvin asked if there was any further discussion or questions. There were none. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Kenneth Clay, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: None. Abstained: None. The motion pass by unanimous vote. #3) Resolution #5 – 2020 Adopt Current Millage Tax Rate of 4.77 for Tax Year 2020: David Jones said we need a motion and a second. Dakota will explain this. We got some communication with the Tax Accessor and he suggested we re-word the resolution this year and Dakota will explain. Brenda Smith made a motion to approve Resolution #5 – 2020 to Adopt the Current Millage Tax Rate of 4.77 for Tax Year 2020. Robert Green seconded the motion. Dakota stated the wording is actually the same this year. Reassessment was done in this year. It happens every four years. We’re levying 4.77 mills so we’re actually not even going to what the auditor we should republish the rates at. I think it is good for the constituents. David Jones said this is something that Board typically has chosen to do each year because this has happened a couple of times since I’ve been here. The Board has typically chosen to not do that. Dakota said we will still bring in what we budgeted for we’re not going to increase it based on property tax. Kenneth Cochran asked if this resolution is to spread it out? Dakota replied no the Legislative Auditor just wanted us to pass the resolution after knowing that we could have increased the millage rate to the maximum adjusted millage rate which we’re not doing. They said that we needed to re-pass this. Ronnie Festavan asked if this is the rate that we were at. Dakota replied correct – 4.77. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Kenneth Clay, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: None. Abstained: None. The motion pass by unanimous vote. 4.) Engagement of LBK CPA Firm for the UCC Purposes: David Jones stated the last item of new business, we need a motion and a second to engage the LBK CPA Firm for to perform our Uncompensated Care Report for fiscal year 2021 with the State. Brenda Smith made the motion to engage LBK CPA Firm to perform our Uncompensated Care Report for fiscal year 2021. Robert Green seconded the motion. David Jones said Dakota works with them. They have been very businesslike, very matter of fact. He’s worked with the same CPA compiling the data and responds quickly. I would say we have been very pleased with how LBK has calculated our UCC. Mary Irvin asked about the rate they will be charging. Dakota relied they do it on estimation and I think it is right at $10,000 which is a $500 increase from the estimate of the estimate of last year. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Kenneth Clay, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: None. Abstained: None. The motion pass by unanimous vote. XI. Administrative Reports – 1) NCMC – Pandemic Update: David Jones said I will give a couple of updates under the administrative reports. One could have been in the old business but the CT that was voted to purchase, we are in line but they are like a lot of manufacturers and distributors are saying COVID is slowing the process down greatly so they’re giving us a December install date for the new CT. I will keep the Board updated. Also, the Employee Enhancement Committee, Administration and myself thought it time to get the employees together and do a little release of steam. On October 17th we’ve got a place in Ida, LA, off of Munnerlyn Chapel Road. We are going to have a little barbeque and we are going to have areas for anybody who would like to isolate themselves and stay appropriate space away from anybody. From a morale standpoint, it’s been a long time since the employees have gotten together outside of work. There’ll be mask there if anybody wants to wear a mask. XII. Medical Staff Report: 1) Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval. MEDICAL STAFF APPOINTMENTS: None. MEDICAL STAFF REAPPOINTMENT:
None. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: None. EXTENSION REQUEST: 1.) Chi-Tai Peter Lau, M.D – Requests extension upon completion of his reappointment application. 2.) Clifton Coffman, M.D. – Requests extension upon completion of his reappointment application. VOLUNTARY RESIGNATIONS: 1.) Jeffrey Holt, M.D. – Voluntary resigns his privileges in the field of Cardiology effective 09/30/2020. Dr. Holt is retiring and has recommended a replacement, Dr. Caughman, who is in the process of being credentialed and Dr. Zang is still coming up. Kenneth Clay made a motion to approve the two Extension Request and one Voluntary Resignation as presented. Robert Green seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Kenneth Clay, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: None. Abstained: None. The motion pass by unanimous vote. XIII. Executive Session: There is no business for Executive Session. XIV. Adjourn – There being no further business Mary Irvin called for a motion to adjourn. Kenneth Clay made a motion to adjourn. Pat White seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, Mary Irvin, Kenneth Clay, Brenda Smith, Kenneth Cochran, David Norman, Helen Godfrey-Smith. Nays: None. Absent: None. Abstained: None. The motion pass by unanimous vote to adjourn. The meeting adjourned at 5:02 p.m.
North Caddo Hospital Service District
North Caddo Medical Center
David C. Jones, Secretary
Approved by the Board of Directors at the regular meeting held October 27, 2020