BOARD MEETING:  Regular Meeting   DATE:  September 24, 2019    MEMBERS PRESENT:  Robert T. Green, Jr., Ronnie Festavan, David Norman, Brenda Smith, Patricia White.      MEMBERS ABSENT: Kenneth Clay (arrived at 6:14 p.m.), Mary Irvin, Kenneth Cochran, Helen Godfrey-Smith (arrived at 6:02 p.m.)    TIME CALLED TO ORDER:  5:30 p.m.   OTHERS PRESENT: David Jones, CEO,  Pam Hughes, COO, Dakota Robinson, CFO, Dr. John Woods, M.D., Chief of Staff, Walter D. (Doug) White, Hospital Attorney, Mary Coil, Foundation Executive Director / Marketing Director, Lanell Audirsch, Admin. Asst.  LOCATION:  NCMC Events Center          BOARD CHAIR:   Robert T. Green, Jr.          SECRETARY:  David Jones

  1. CALLED TO ORDER – Robert T. Green, Jr., Chairman, called    the      meeting  to   order.
  2. Invocation and Pledge of Allegiance – Robert Green offered the Invocation. Brenda Smith led the group in the Pledge of Allegiance. III. Approval / Amend Agenda – David Jones noted there was one amendment to the agenda. He asked for Board approval of the Executive Session to be moved up on the agenda before New Business. Brenda Smith made a motion to approve the agenda as amended. Ronnie Festavan seconded the motion. The vote: Yeas: Robert T. Green, Jr., Ronnie Festavan, David Norman, Brenda Smith, Pat White.  Nays: None.   Absent: Kenneth Clay, Kenneth Cochran, Mary Irvin, Helen Godfrey-Smith.  Abstained: None.   The motion passed by unanimous vote in favor.  IV. Community Comments – Robert T. Green, Jr., Chairperson noted there were no signed Visitor Recognition Cards requesting to address the Board.   V. Minutes – Regular Meeting August 27, 2019 –  The minutes of the Regular Meeting held August 27, 2019 were mailed prior to today’s meeting for review.    Robert Green stated he would entertain a motion to approve the minutes. Pat White made a motion to approve the minutes of the Regular Meeting held on August 27, 2019 as mailed.  David Norman seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Ronnie Festavan, David Norman, Brenda Smith, Pat White.  Nays: None.   Absent: Kenneth Clay, Kenneth Cochran, Mary Irvin, Helen Godfrey-Smith.  Abstained: None.   The motion passed by unanimous vote in favor.   VI. Old Business – 1) All Scripts Interface Update: David Jones stated he talked to Ross Hansen, IT Director, today. He said there is some type of lag time that they are trying to work through now. The systems are communicating but they are not communicating in a timely fashion so it is causing, in computer lingo, timeouts to occur. We are going to stay on them until it is done. Allscripts is our software in our clinic and Cerner is our software in our hospital. The only way around this is to change one or both of those. That is much more costly than the interface would be.  2) X-Ray Room Update:  The MRI equipment should be in before the next Board meeting. The CT and the chemistry analyzer are probably next on the docket for large equipment to be replaced in the hospital. Once the CT is replaced Radiology will be as new as anything in the State. The Room, the CT, the MRI, the Ultrasound, the Mammography equipment – we are where we want to be with that.  Brenda Smith said that is good news.    3) Blanchard Clinic Project Update:  David Jones reported that we have contacted three different architects because it is not just a build out now we are talking about a total build. Just a guestimation, a build out would cost somewhere around $850,000 to $875,000. Dakota replied $750,000 to $1,000,000 as just sort of the range.  There will be continuing news on that to come.   Ronnie Festavan spoke up. I know you spoke on that, but to put a visual in my head, out of the 5 acres, if we get everything we want out of it, do you have any estimation of what part of the 5 acres that will take. Dakota Robinson replied 1 acre. Ronnie Festavan said 1 acre to do what we want to do. Dakota replied yes Sir – or less. Ronnie Festavan said so there might be a possibility of approximately 4 acres to do something else with whether that be sell, add to, add on or rent out. Dakota stated it will be designed with the intent that we will not waste the extra acreage. Ronnie Festavan said I agree with you that could be an area if it continues to grow, it is one of the fastest growing areas, according to our statistics, in the State. So that could come to be a very valuable piece of property. Hopefully it will work out that way. That is good news. Thank you.  Brenda Smith, said if I may, the spot we are looking at is facing Highway 1. David Jones replied that is correct. Dakota will have a visual to present in a little bit.   4) Surplus Equipment List Update:  David Jones reported that the bids are set to be opened this Friday. Currently we have received zero bids on the equipment. Ronnie Festavan asked do you anticipate, and this might be a question for Mrs. Hughes, because we have been through this once before, so we have a procedure if we don’t get any bids and it is all declared surplus property to be disposed of. Would that be correct? Do we have a plan for disposing of it and tracking that disposal? I know I went through this once before but it is important that we know what happened to it, even though we don’t sell it. That is the easy part. It is when we start throwing it away or something like that, that sometimes questions arise about where it went and that sort of thing. I would just caution us to do that right by the book as we have done before. David Jones said yes Sir. Ronnie Festavan said thank you.   VII. 1) Review August 2019 Statistics – Dakota Robinson, CFO:  Dakota noted on the first slide you will see through the slides, that this month, especially for the month of July, we have seen increases pretty much across the board.  What we saw is 70 Acute Admissions, 14 Swing Bed Admissions. That is up almost a 43% increase. We have increased our Swing days from 161 over a two month period to 276 in the same two month period. There is an added effort on the part to increase the Swing Bed days. (Helen Godfrey-Smith arrived at 5:40 p.m.) Looking at Inpatient days, you can see there is a trend up over the past three months. We saw a 21% increase from the month of July. The Average Daily Census was at 9.3. Surgeries – we remained over that 10 mark. Dr. Banda was actively doing surgeries in the month of August – we did 11. Endoscopies, still over that 10 threshold. ER visits – They saw 490 patients for the month of August. We did 23 mammographies for the month of August. Newborns – you can see that newborns have remained pretty high. We had 9 in August. Currently for this fiscal year we are at 17 and we were at 16 at this point last year.   Vivian Clinic – Vivian Clinic did see 2,170 visits. A slight increase from the previous month of 1,823. We saw the same thing in Plain Dealing when they went from 571 visits in July to 693 in August. Benton remained about the same. They had a slight change from 442 to 433.  Fitness Center members – there were 427 – only a difference of 1 from the previous year. Are there any questions on the Statistics portion? There were none. It was pretty straight forward this month. 2) Review August 2019 Financials – Dakota Robinson, CFO:  We can move into the Financial Statements. As we went through the Statistics we pretty much all saw that August was a strong month considering the time of year. Looking at page 1 of the Balance Sheet you will see the Total Cash On Hand at the end of August. Days Cash on Hand, without the CD’s is right at 56. If you add the CD’s into it the Days Cash on Hand goes up to 67 with those reserved CD’s. Cash is remaining in a good position. Are there any questions on the Balance Sheet? There were none.   Moving on to the Income Statement – page 3. Looking at the Income Statement the Total Revenue for the month of August $3.6 million. Very little change – only $15,000 difference from this period last year. If you look on the year as a whole, there is actually a slight increase of almost $50,000. Moving to the Total Operating Expenses, we are $145,000 higher than this period last year. If you look at it on the two months, $3.8 million opposed to $3.6 million. Looking at the AR Days, AR Days went up slightly to 49.24; still below the six month average and below 50. Looking at page 5, Departmental Revenue and Expenses for one month, really nothing stands out on this.   On the Budget you will see that we are below budgeted revenue. That difference is mainly made up in contractual adjustments. You can see on the two months, Net Patient Revenues were down about $93,000; that is not anything to worry about on an almost $3.5 million dollar budget on that line item. If we get down in the Salaries and Wages, this is where I said we will see the difference even though we are higher than what we were in the previous year, we are below what we budgeted for the time period – we are at $2.2 million on the year, we budgeted for almost $3.5 million. That is a $146,000 difference. Then we are also below on Employee Benefits and Payroll Taxes so that is another one of the categories that we are doing pretty well. If you look at Total Operating Expenses as a whole, $3.8 million – budgeted $4.2 million. Then you get down into Non-Operating Revenue, even though there is a difference between the $547,000 which is what we brought in and the $730,000, the majority of the difference sits in that Grant Revenue that we talked about where there is nothing booked for the UCC dollars of the Cost Report. Any questions on the Budget page. There were none.  Vivian Clinic saw 2,170 patients last month. Vivian is one of the areas where I expect we are going to make a difference on contractual adjustments in this account. Looking at the Financial Statements, they had $608,000 in revenue and they only had $135,000 in contractual adjustments; that is a 22%. On page 10, the Plain Dealing Clinic had 693 visits. They brought in $156,000 in revenue and produced a profit of $1,814. In two months they have brought in a little over $15,000. Benton Clinic saw 433 patients. Their visits are remaining up there.  Ronnie Festavan said I hope I live long enough to understand the method. Is this part of what we have been dealing with ever since I have been on the Board? This is just pieces of it and it is just ongoing.   Pam Hughes replied yes Sir. We were a regular clinic to begin with. We went from a Regular to a Free Standing to now a Provider Base. We have made three changes and the only reason we made those changes is because we were given information from the Louisiana Department of Health to license this way. When Blanchard goes live we will open with the license that we are actually finishing with in Benton. We are not going through the steps we are going for the final step.  Dakota asked if there were any questions on the Financials or Stats for this month. There were none.  Robert Green stated he would entertain a motion to approve the Statistical and Financial report.  Helen Godfrey-Smith made a motion to approve the Statistics and Financial reports as presented subject to audit. Pat White seconded the motion.  The vote: Yeas: Robert T. Green, Jr., Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.   Absent: Kenneth Clay, Kenneth Cochran, Mary Irvin.  Abstained: None.   The motion passed by unanimous vote in favor. VIII. Executive Session:   Robert Green stated he would entertain a motion to enter into Executive Session for the purpose of Strategic Planning.  Ronnie Festavan made a motion to enter into Executive Session for Strategic Planning. David Norman seconded the motion. The vote: Yeas: Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Mary Irvin, Kenneth Clay, Kenneth Cochran.    Abstained: None.  The motion passed by unanimous vote in favor. (Kenneth Clay arrived at 6:14 p.m.)     The Executive Session was entered into.   No action was taken during the Executive Session.  Pat White made a motion to enter back into regular session.  Ronnie Festavan seconded the motion.   The vote: Yeas:  Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Mary Irvin, Kenneth Cochran.   Abstained: None.   The motion passed by unanimous vote in favor.   IX. New Business – 1) Ratify Phone Poll Giving CEO Authority to Purchase 5 Acres Along Hwy 1 in the amount of $145,000.00: David Jones stated we need a motion to ratify the phone poll of the Board giving the CEO authority to purchase 5 acres along Hwy 1 in the amount of $145,000. David Norman made a motion to ratify the phone poll of the Board giving David Jones, CEO, authority to purchase 5 acres along Hwy 1 in the amount of $145,000.  Brenda Smith seconded the motion.  David Jones stated our initial offer was $125,000 and we were able to negotiate and they accepted our offer of $145,000. There is an old existing house and old barn in there as well. Dakota stated he is showing Highway 1 going to the rear of the property heading west. David Jones said he believes it has 300 feet of Highway 1. It is on the same side of the road of the Silver Star. It is approximately a quarter of a mile from the Interstate. Dakota stated it is actually already zoned for commercial, we just have to get it zoned for medical use. Ronnie Festavan stated that across the street from that all the way to 49 is just about all zoned and for sale. That could be a big industrial or business district at some point in time. David Jones said at that the price we are getting it at, it is very unlikely that we will lose money on the purchase. Brenda Smith if there is a road that goes back in there. David Jones said it is an old drive way. On the ground you can see it. David Jones said going forward with the project, we will be contacting the Board on the architects and moving forward with plans and of course it will have to be bid out. David Jones asked if there were any questions. There were none. Robert Green stated if there was no further discussion he it was time for a vote. The vote:  Yeas:  Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Mary Irvin, Kenneth Cochran.   Abstained: None.   The motion passed by unanimous vote in favor.  2) Management Contract:  Robert Green stated he would entertain a motion. Pat White made a motion the Management Contract be approved as presented. The motion was seconded by David Norman. The vote: Yeas:  Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Mary Irvin, Kenneth Cochran.   Abstained: None.   The motion passed by unanimous vote in favor.  David Jones stated that Mrs. Irvin and Mr. Cochran both wanted to be here and did want him to make a statement for the record. They did want to express their support for the affiliation and that they are pleased to move forward with it. They did want to be here add their names to the vote but for other reasons, family and other such they couldn’t be here. They wanted me to let the Board know that. 3) Approval of Recommendations From the Policy and Procedure Committee:  David Jones stated this is a yearly item and it comes from a Standard in the Conditions of Participation that the Board is aware and approves of the current Policy and Procedures for the hospital. Digging into that and some discussion, the way we gone about that and have done that in the past is basically I’ve met with the Department Heads, they bring their manuals to look at and review and then we go from there. It is just not a centralized way to do things. We formed a Multi-Disciplinary Committee that has Administration on it, our clinical departments, which is our main procedural departments. I do have a letter from the Chair of the Committee, which is Stacy Alexander, our DON, which basically states that the departmental policies and manuals from North Caddo Medical Center have been reviewed and/or revised for the year 2019. Going forward all additions to any policy and procedure manual at North Caddo Medical Center must be approved by this committee before they can be put into play.  Brenda Smith asked if the Board Chair still needs to sign off. David Jones replied that is correct. David Jones said I am looking for an approval that the Policy and Procedure Committee recommended that we approve all the Policy and Procedure Manuals for the year 2019.   Ronnie Festavan asked if there was a motion on the floor. Robert Green replied he would entertain a motion. Ronnie Festavan said he would wait for a motion and then speak to it.  Brenda Smith made a motion that we approve the recommendations from the Policy and Procedure Committee that the Policy and Procedure Manuals have been reviewed for the year 2019. Kenneth Clay seconded the motion. Robert Green asked for discussion. Ronnie Festavan said it is just a short one. You said basically that we are taking your word. I think that we are stronger than that because we have a written statement that they have been reviewed. I think that helps me with that, and that takes some onus off of everybody that we have had a very competent person here review it; the head of the committee has signed off on it. So if thing ever, we can fall back on that signed statement that we didn’t just take someone’s word. For that reason I am going to support the motion. Brenda Smith said if she could say something. Being a member of the Compliance Committee, this was brought up in our last committee meeting trying to figure out a way that would make it more streamlined rather than Board members having to go look at manuals that you have no idea what’s even in there, and yet we have to be able to say that yes we approve them. The committee was discussed and it is a good work around to make sure that we are staying compliant and that the committee has of the various departments and Administration and a physician has reviewed those policies and procedures and any changes that would have to go to them so that keeps us compliant. David Jones said going forward with the policies and procedures manuals, once it is streamlined in one format, what we will do for next year, if it is o.k. with the Board, of course, is just bring to the Board additions and/or revisions of any policies that we have in there. Those additions or revisions will be brought to the Board, you won’t be getting 20 manuals that are extremely thick but you may get 10 to 15 or 20 different procedures to look and see these are the ones that have been updated and revised and accepted by the committee for next year. Robert Green asked if there any other questions. There were none. He asked for a vote.  The vote: Yeas:  Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Mary Irvin, Kenneth Cochran.   Abstained: None.   The motion passed by unanimous vote in favor.     X. Administrative Reports –  1) NCMC – Current Activity:  David Jones stated that the current activity really boils around what we did in #2 under New Business. We do have some things pushing forward and moving forward. We do want to plan a Fall Event for the employees. It has at its infancy stage right now. It has been a while since we have done something as a group together. If you will look, the newsletter that we have there is put out by the employees for the employees. That comes about from a Board Retreat a couple of years ago. Our Employee Enhancement Committee, it is one of the things that we have centered on, to not only tell what is going on in the department but as you can tell, there is a lot of personal flavor in it as well; personal accomplishments from employees or their family members or milestones.      2) Foundation:   Mary Coil stated that right now we are piecing together as to what is next after Havana Nights and looking at some different options. We are going to have a wrap up meeting with the committee that worked so hard on Havana Nights and looking forward to seeing all of them again and getting to deliver the good news that we had a very successful event and we like to do feedback on the event and do that now that it is a short timeframe so we can remember that for next year. We are looking forward to that and also looking at some different options for the months to come for fund raising.     3) Construction Report:  David Jones asked Pam Hughes to give the Construction Report. She made reference to some visuals presented.  The current picture is of the MRI room. All of that is copper and the door is really heavy – almost like a vault door. Pam Hughes said everything in there has to be a certain thing so the magnet can’t draw it out. Brenda Smith said they will be able to get the MRI in there after it is built. Pam Hughes said they still have the hole in the wall. Once it goes in, Johnnie fixed it where if we ever have to take it out, the wall actually comes out. We don’t have to tear everything out. The whole wall slips out and goes over it. Lincoln designed that. Ronnie Festavan said he had to ask – what is a quench pipe. Pam said that is what she is calling a pop-off valve. It’s like on a hot water heater that is what it does.  Pam said it is just for an emergency, it is not something that happens daily. Robert Green asked if there were any questions on the construction. There were none.  Robert Green stated that Mary Irvin left a letter addressed to all of the Foundation Board members. She would like for everybody to sign it and add a personal note. This will be passed around.  XI. Medical Staff Report – 1) Recommendations – Dakota Robinson:   Dakota Robinson presented the Medical Staff recommendations for the Governing Board approval:  MEDICAL STAFF APPOINTMENTS: None.  MEDICAL STAFF REAPPOINTMENT:  1. William Wong, M.D.  – Requests Courtesy Privileges in the field of Radiology for the period of September 24, 2019 through September 30, 2021.  2. Jason DiPoce, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of September 24, 2019 through September 30, 2021.  3.  Jonathan Lee, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of September 24, 2019 through September 30, 2021.  4.  Shailendri Philip M.D. – Requests Courtesy Privileges in the field of Radiology for the period of September 24, 2019 through September 30, 2021.  5. Jill Ferguson, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of September 24, 2019 through January 31, 2021.  6. Vivek Khare, M.D – Requests Courtesy Privileges in the field of Pathology for the period of September 24, 2019 September 30, 2021.  7. Mark Cimino, M.D. – Requests Active privileges in the field of Emergency Medicine for the period of September 24, 2019 through September 30, 2021.  8. Chi-Tai Peter Lau, M.D. – Requests Active Privileges in the field of Emergency Medicine for the period of September 24, 2019 through August 31, 2020.      ADVANCE PRACTICE PROFESSIONALS  APPOINTMENTS/REAPPOINTMENT:  None.   EXTENSION REQUEST:    None.

VOLUNTARY RESIGNATIONS:  1. Kristin Casey, M.D – Request’s voluntary resignation in the field of Radiology effective September 10, 2019.   2. Scott Baginski, M.D. – Request’s voluntary resignation in the field of Radiology effective September 3, 2019.  Pat White made a motion to approve the Medical Staff recommendations for Reappointments and Voluntary Resignations as presented.   Ronnie Festavan seconded the motion. The vote: Yeas:  Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Mary Irvin, Kenneth Cochran.   Abstained: None.   The motion passed by unanimous vote in favor.     2) Chief of Staff Comments: Dr. John Woods said I just wanted, on behalf of all the physicians, we officially endorse wholeheartedly our affiliation agreement with Ochsner and look forward to the future.   XII. Adjourn:  There being no further business, Robert Green called for a motion to adjourn.  Ronnie Festavan made a motion to adjourn. Kenneth Clay seconded the motion.  The vote: Yeas:  Robert Green, Kenneth Clay, Ronnie Festavan, David Norman, Brenda Smith, Helen Godfrey-Smith, Pat White.  Nays: None.  Absent:  Mary Irvin, Kenneth Cochran.   Abstained: None.   The motion passed by unanimous vote in favor to adjourn. The meeting adjourned at 6:58 p.m.

 

 

 

North Caddo Hospital Service District

North Caddo Medical Center

Vivian, Louisiana

 

_________________________________

David C. Jones, Secretary

 

Approved by the Board of Directors at the regular meeting held October 22, 2019