BOARD MEETING:  Regular Meeting   DATE:  September 28, 2021    MEMBERS PRESENT:  Mary Irvin, David Norman, Ronnie Festavan, Michael W. Nation, Sr., Brenda Smith, Pat White.    MEMBERS PRESENT VIA TELECONFERENCE:  None.   MEMBERS ABSENT:  Kenneth Cochran, Robert T. Green, Jr. (arrived at 4:09 p.m.) Helen Godfrey-Smith.  TIME CALLED TO ORDER:  4:01 p.m.    OTHERS PRESENT: David Jones, CEO, Pam Hughes, COO, Dakota Robinson, CFO, Dr. John Woods, Chief of Staff, Mary Coil, Foundation Executive Director / Marketing Director, Britney Stringham, Administrative Assistant, Lanell Audirsch, Admin. Asst.    LOCATION:  NCMC Café and Via Teleconference – Conference ID 216 803 333 #    BOARD CHAIR:   Mary Irvin SECRETARY: David Jones   I.  CALLED TO ORDER – Mary Irvin, Board Chair called the meeting to order at 4:01 p.m.     II. Invocation and Pledge of Allegiance – Mary Irvin offered the Invocation and Pat White led the group in the Pledge of Allegiance. Michael Nation offered a word of encouragement.      III. Approval / Amend Agenda – David Jones stated we need to amend the agenda to add under new business #5 – Approval of Ambulance Bid.  Mary Irvin stated we need a motion and a second to approve an amendment to the agenda as stated.  Brenda Smith made a motion to approve the amendment to the agenda as requested.  Michael Nation seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Nays: None.  Absent: Kenneth Cochran, Robert Green, Helen Godfrey-Smith.  Abstain: None. The vote is unanimous in favor. Mary Irvin asked for a motion and a second to approve the amended agenda. Ronnie Festavan made a motion to approve the amended agenda. David Norman seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Nays: None.  Absent: Kenneth Cochran, Robert Green, Helen Godfrey-Smith.  Abstain: None. There was no discussion. The vote: The vote is unanimous in favor.  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.  Board Education – Mary Irvin stated this is information we have discussed at our last few Board meetings. (Robert Green arrived at 4:09 p.m.) Dakota Robinson has been working with us to advance our technology and our communication with one another. Dakota Robinson gave an overview of how the Board Effect program works with a plan of rolling it out in October, November and December.  Ronnie Festavan said this is a great idea moving us from the personal realm of communication. Mary Irvin said Board Effect is a leading company, very well established. We are going to take a little piece of it and as time goes on we may want to add to it. Mary Irvin asked if there were any questions or further discussion. There was none.    VI. Minutes – Regular Meeting August 24, 2021 – Mary Irvin stated we need a motion and a second to approve the minutes of the regular meeting held August 24, 2021 with discussion, if any, to follow. Pat White made a motion to approve the minutes of August 24, 2021 as presented. Brenda Smith seconded the motion. There was no discussion or corrections noted. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  There was no discussion. The vote: The vote is unanimous in favor.   VII. Foundation Report – Mary Coil, Foundation Executive Director, stated in October we will have Boo Bags, which we did last year. Also, Cupcakes for a Cure; she has reached out to us again and is planning to do that for us, selling cupcakes to raise money to donate to the Foundation for Breast Cancer Awareness. Analyce Jeane does this. She is a sophomore at North Caddo Magnet and this is a wonderful service that a young person does for the community. Mary Irvin asked when those would be available. Mary Coil replied I believe beginning October 1. Mary Coil said that is our October events and we will have fun with the Boo Bags and Cupcakes.   VIII. Chief of Staff Report – Dr. John Woods, Chief of Staff, stated everything is going fine and if anyone has questions I will be glad to answer them.  IX. Old Business – 1) Update on Building Projects:    David Jones said I will give an update on the Building Projects. The roof is very close to being completed. The main roof on the main building has been totally replaced. The next project – the Benton Clinic – has not progressed that much. Pam has a meeting over there tomorrow. After Pam’s meeting tomorrow she should be able to give an update on the timeline as to where we are at. We have video cameras at both remote sites – Blanchard and Benton. As you can tell our Dental expansion is just about dead on schedule. We may end up being a week or so behind but other than that it is very close. Blanchard is moving along quite nicely. Mary Irvin said if I could add, as I rounded the corner I saw the bait shop was coming down. David Jones said that is just about complete.   2) Purchase of Electronic Signage Update:  David Jones reported along with the white building being gone, we are putting a very large electronic sign out front. We don’t have an exact date of install yet.    X. 1) Review August 2021 Statistics – Dakota Robinson:   Dakota Robinson said it was a straight forward month with a lot of good trends. Admissions – we did increase admissions from 56 to 74. When we put the Swing and Inpatient together June was at 6.1 and this last month in August we had 7.6 – a 17% increase in Average Daily Census. Looking at Endoscopies, you’ll see the opposite effect here. We went from 8 in July to 14 in August. Emergency Room – this is one of the ones that we watch closely. You see the number is at 627. That rates up there with pre-pandemic high levels. Newborns – you can see the past two months has been pretty busy – 11 in July and 9 in August with 20 year to date – a 25% increase. Another outpatient area we saw significant increase – we saw a 31% increase in Vivian Clinic. They went from 1,727 to 2,257. That is the highest number all the way back to March. We see a similar trend in Plain Dealing – they went from 669 to 775 – a 16% increase and year to date they’ve seen about a 6% increase in total patient numbers. Benton did see an increase. It wasn’t quite as high. Theirs was only a 13% increase from 443 to 502. They’re a little bit behind where they were last year at 945 year to date. Blanchard Clinic. You can see they still grow – 615 in July with 691 in August. Dakota continued stating the Fitness Center has 305 members. For the month of August they had 11 new members, with 1,400 visits.    2) Review August 2021 Financials – Dakota Robinson:   Dakota Robinson stated if you look at the inpatient and outpatient numbers it was pretty much running steady. A few of the areas, especially the outpatient increased significantly. Also, at the end of the month in August there is a slight increase in the cash balance. Moving to the Income Statement you’ll see that we did $4.6 million in revenue compared to $3.4 the previous year. That’s a significant increase. You’ll see that we had almost 52% in contractual adjustments, actual 51.3% at $2.3 million. We look at on the year contractual adjustments are still high. Last month we talked about that being in the 50 – 56% range. That should draw down as we get closer to December. Looking at Salaries and Wages we see $1.3 million. Looking at Employee Benefits and Payroll Taxes you can see that remains high $283,000 compared to $163,000 the previous year. We’ll pay close attention to that.  It’s health, dental and life insurance and we have had some high health claims. We’ve had one health claim worth $275,000 come through. Looking at Medical Supplies and Drugs you’ll see that category is also high at $222,000 compared to $81,000. When you drill into that account the main culprit here is Remdesivir.  We have done almost 100 of those infusion. That medication is very expensive. In Non-Operating Revenue and Expenses we have Grants typically this time of year. We don’t have grants coming in. That’s typically UCC dollars, that’s MCIP revenue. What we have here is a bonus payment that we get from FNP monies. We did turn a profit of just under $100,000 for the month and on the year a loss of $112,000.  On Departmental Revenue and Expenses on page 5 you’ll see that Inpatient Routine Care is slightly down. Same thing in Pharmacy. Dakota continue with the Budget on page 8. Gross Revenue is over budget. We budgeted for $3.9 million and it is $4.6 million. If you look on the year $8.6 compared to $7.8. Down in the Net Patient Revenue we are exceeding that by 19%. If you will look at Salaries and Wages, even though compared analysis to the previous year it looks significantly higher. You’ll see that we’re really only about $100,000 through two months from the budget. Net Patient Revenue is obviously more than we budgeted for. We’ll pay attention to the contractual adjustments. Salaries and Wages – it is a little bit more than budget but not significantly. I think those two will tie back together.  Employee Benefits and Payroll Taxes – even though it is running a more than what it was last year it’s not over budget. That’s a good sign. One of the areas that we continue, and who knew when we developed this budget we would be doing Remdesivir and Regeneron in the amount that we are doing so we’re a $122,000 over budget on Medical Supplies and Drugs and the majority of that category falls into drugs. In Total Operating Expenses, you see we are $4.9 million compared to budgeted of $4.8 million; about $73,000 difference.  If you look at the clinics on 2,257 visits for the Vivian Clinic they turned a profit of $50,991. Plain Dealing Clinic on 775 visits had a slight loss of $2,200. Remember this clinic is sort of cyclical the way the contractual adjustments do. They don’t typically stray too far away from that profit line. They are usually 5 to 10 in the profit or 2 to 5 in the loss. They pretty much stay right there. Looking at the Benton Clinic they had 502 visits and had a profit of $30,986. Blanchard Clinic did 691 visits so they significantly increased their visits and they had a loss of $35,067.  Remember when we look at this it all goes back to the Benton Clinic. When we brought on the Benton Clinic, until we can get contracted with all the different insurance payers what we’re going to see is the contractual adjustments that are significantly higher than all the other clinics. For instance we did $173,000 in revenue in the Blanchard clinic. There were $140,000 in contractual adjustments.  Mary Irvin  said if there are no further questions or discussion on the Statistics or Financial Statement we need a motion and a second to approve our August 2021 Statistical and Financial Statement subject to audit. Ronnie Festavan made a motion to approve the Statistical and Financial Statement as presented subject to audit. Robert Green seconded the motion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  There was no discussion. The vote is unanimous in favor.  XI. New Business – 1) Board Approval of Resolution #6 – 2021 to Open a Banking Account for the Pharmacy:  David Jones noted that #1 under new business is more of a housekeeping procedure as is #2 under new business. We need a motion and a second to approve Resolution #6 – 2021 to open a banking account for the outpatient pharmacy with Citizens Bank and Trust in Vivian. Robert Green made a motion to approve Resolution #6 – 2021 for the opening of a banking account for the outpatient pharmacy with Citizens Bank and Trust in Vivian as requested. Michael Nation seconded the motion. Mary Irvin asked if there were any questions or discussion about the opening of this account. There was none. The verbal vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  The vote is unanimous in favor.   2) Board Approval of Resolution #7 -2021 to Open a Banking Account for the Dental Clinic:  David Jones stated he needs a motion and a second for Board approval of Resolution #7 – 2021 to open a banking account for the Dental Clinic at Citizens Bank and Trust of Vivian. Pat White made a motion to approve Resolution #7 – 2021 to open a banking account for the Dental Clinic at Citizens Bank and Trust of Vivian. David Norman seconded the motion. The verbal vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  The vote is unanimous in favor.   3) Approval to Proceed with New Pharmacy Renovations at 1003 S. Spruce:  David Jones said if I can have a motion and a second. We finally have, from our architect, some plans to proceed and possibly out to bid with the new pharmacy renovations at 1003 South Spruce Street. Brenda Smith made a motion for approval to proceed with the new pharmacy renovations at 1003 S. Spruce Street. Michael Nation seconded the motion. David Jones stated we’ve been talking about it for quite some time about how once we open an outpatient pharmacy we felt that one of the most important things was to have a drive through area. We knew by purchasing the building at 202 South Avenue that that wasn’t going to really going to really open us so we could do something like that. We’ve been talking about for quite some time trying to get plans to possibly renovate the old clinic building. The building itself is in desperate need of renovation. Ronnie Festavan said I just want to say for the record that I really think you’ve done a great job of thinking ahead – as the old saying – thinking outside the box. You had a plan to do something – build a dental clinic and as you did that, you said this is good but this can be better. You’ve been thinking very aggressively and thinking ahead. That takes a skill for all of you. What I’m seen happening in the last year even with everything that has happened to us what I see happening is just exemplary thinking ahead. I been part of projects in my life and you all are doing a good job of thinking out of the box. If you’ve got something good don’t stop there let’s see if we can make it better. I appreciate that. It’s great work. David Jones said God has blessed us with a great team, a great Board that really adds to.  It is a team effort and God led.   Mary Irvin stated we now need to vote on the approval to proceed with the new pharmacy renovations at 1003 South Spruce. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  The vote is unanimous in favor.   4) Approval of Dental Equipment Bid from Patterson Dental: David Jones said I need a motion and second for the approval of the dental equipment bid from Patterson Dental. They were the winning bid at $81,459.89. Robert Green made a motion to approve the dental equipment bid from Patterson Dental in the amount of $81,459.89. Michael Nation seconded the motion. David Jones said that is for the chairs, the drilling equipment, and all the devices the dentist uses. Mary Irvin recognized Brenda Smith to speak. Brenda Smith said there was a question at the Finance Committee about the timeline of getting chairs. David Jones said when we asked for that in writing the company backtracked.  We probably will buy some temporary chairs. We are looking at 14 to 18 weeks lead time to get the chairs in. Mary Irvin asked if there were any other questions about the dental equipment bid. There was none. The vote:  Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  The vote is unanimous in favor.   5) Approval of Ambulance Bid:    David Jones asked for a motion and a second for approval of the Ambulance Bid. That was the one that Mr. Marze came and spoke on for one of our replacement units. It is a brand new unit and Medix Specialty Vehicle was the sole bidder at $121,120.00. David Norman made a motion to approve the bid from Medix Specialty Vehicle of $121,120 for a new ambulance. Ronnie Festavan seconded the motion. Mary Irvin asked if there were any questions or discussion. There was none. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  The vote is unanimous in favor.   XII. Administrative Reports – 1) NCMC – Pandemic Update:  David Jones stated I will give a quick Pandemic update. For the most part numbers are trending down as far as this latest surge has gone. I said this before, throughout the last year and one half, two years, this is a cyclical thing. It’s a respiratory virus and that happens all the time. The need for boosters and those kind of things more than likely will be ongoing from here on out.    XIII. Medical Staff Report – 1) Recommendations – Dakota Robinson: Dakota Robinson presented the Medical Staff recommendations for Board approval.   MEDICAL STAFF APPOINTMENTS:  None.   MEDICAL STAFF REAPPOINTMENT: 1.) Gregory Wolfe, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of September 28, 2021 through September 30, 2023.  2.) Shailendri Philip, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of September 28, 2021 through September 30, 2023.  3.) Jonathan Lee, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of September 28, 2021 through September 30, 2023. 4.) Clifton Coffman, M.D. – Requests Courtesy Privileges in the field of Radiology for the period of September 28, 2021 through September 30, 2022.  5.) Jill Ferguson, M.D.  –  Requests Courtesy Privileges in the field of Pathology for the period of September 28, 2021 through January 31, 2023.  6.) Vivek Khare, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of September 28, 2021 through September 30, 2023.  7.)  Mark Cimino, M.D. – Requests Courtesy Privileges in the field of Emergency Medicine for the period of September 28, 2021 through September 30, 2023. ADVANCE PRACTICE PROFESSIONALS APPOINTMENTS/REAPPOINTMENT: None. EXTENSION REQUEST: None.    VOLUNTARY RESIGNATIONS:  1.) Jose Perez Alba, M.D. – Voluntary Resigns his Privileges in the field of Radiology effective 08/01/2021.    Robert Green made a motion to approve the (7) reappointments and (1) voluntary resignation as presented. Pat White seconded the motion. There was no discussion. The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green.  Nays: None.  Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstain: None.  The vote is unanimous in favor of approving the Medical Staff recommendations as presented.    XIV. Executive Session:  Mary Irvin stated she would entertain a motion to enter into Executive Session for Strategic Planning. Brenda Smith made a motion to enter into Executive Session for Strategic Planning. Robert Green seconded the motion. The vote:  Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith, Robert Green. Nays: None. Absent: Kenneth Cochran, Helen Godfrey-Smith.  Abstained: None.  The motion passed by unanimous vote in favor of entering into Executive Session for the purpose of Strategic Planning.   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. Robert Green seconded the motion.   The vote: Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith. Nays: None. Absent: Kenneth Cochran.  Helen Godfrey-Smith. Abstained: None.  The motion passed by unanimous vote in favor.   XV. Adjourn:  There being no further business Ronnie Festavan made a motion to adjourn. Michael Nation seconded the motion. The vote:  Yeas: Pat White, Michael Nation, Ronnie Festavan, Mary Irvin, David Norman, Brenda Smith. Nays: None. Absent: Kenneth Cochran.  Helen Godfrey-Smith. Abstained: None.  The motion passed by unanimous vote in favor. The meeting adjourned at 6:22 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 26, 2021

 

 

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