North Caddo Medical Center

BOARD MEETING:  Regular Meeting   DATE:  November 22, 2022    MEMBERS PRESENT:  David Norman, Jennifer Fant, Ronnie Festavan, Robert Green, Brenda Smith, Pat White. MEMBERS ABSENT: Kenneth Cochran, Mary Irvin (Arrived at 4:07 p.m.) Michael Nation, TIME CALLED TO ORDER:  4:04 p.m.    OTHERS PRESENT: David Jones, CEO, Drew Burnham, Attorney, Dr. John Woods, Chief of Staff, Dakota Robinson, CFO, Brent Leonard, NCMC Controller,  Kourtney Tyson, Foundation Director, Britney Stringham, Administrative Assistant.     LOCATION:  NCMC Café     BOARD CHAIR:   David Norman   SECRETARY: David Jones   I.  CALLED TO ORDER – David Norman, Board Chair called the meeting to order at 4:04 p.m.     II. Invocation and Pledge of Allegiance – Robert Green offered the Invocation and Ronnie Festavan led the group in the Pledge of Allegiance.    III. Approval / Amend Agenda – David Norman stated we need a motion and a second to amend the agenda. Brenda Smith made a motion to approve the agenda as presented.  Robert Green seconded the motion. There was no discussion. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Robert Green, Brenda Smith, Jennifer Fant.  Nays: None.  Absent:  Kenneth Cochran,   Mary Irvin,   Michael Nation.  Abstained: None. The vote was unanimous in favor.   IV. Community Comments – David Norman, Board Chair stated there was no one present requesting to make community comments.   V. Minutes – Regular Meeting October 25, 2022 – David Norman stated we need a motion and a second to approve the minutes with discussion, if any, to follow. Robert Green made a motion to approve the minutes of October 25, 2022 as presented. Ronnie Festavan seconded the motion. There was no discussion or corrections noted. The vote: Yeas: Pat White, Ronnie Festavan, David Norman, Robert  Green,  Mary Irvin,  Brenda Smith, Jennifer Fant.  Nays: None.  Absent:  Kenneth Cochran, Michael Nation.  Abstained: None. The vote was unanimous in favor of approval of the October 25, 2022 minutes as presented. (Mary Irvin arrived at 4:07 p.m.)   VI. Foundation Report – Kourtney Tyson, Foundation Director, reported that we ended the month of October with our Cupcakes for Cure. Analyce Jeane, who is a local high school student, came and presented us with a check. We are working with the Radiology Department to get them some things ordered to benefit the Mammography Department. VII. Chief of Staff Report – Dr. John Woods, Chief of Staff, stated we met with Ochsner about obtaining the Telestroke that we were referencing to. What it is going to do is give us the capability to have almost an on call Neurologist / Neurosurgeon that we can bedside using the current technology and basically give us an in on getting these people where they need to go to a stroke center. That’s our main goal is getting people where they need to go faster and get the quality care that they need. So far everything is good to go. David Norman thanked Dr. Woods.   VIII. Old Business – 1) Update Building Projects:  David Jones said I will go over the building projects or the Benton project update. There is progress, not like starting from day one. There will be some issues for the contractor taking over to make changes. From Benton and the Extended Services project we are kind of waiting for final things to be done from an architectural standpoint. David Norman asked if there were any questions on old business. There were none.   IX. Review October 2022 Statistical and Financial Reports:   1) Statistics – Brent Leonard, NCMC Controller, stated looking at our stats as a whole for the month of October across inpatient and outpatient you are not going to see any huge variance from September. You will see across inpatient there on the year to date comparisons we have some decreases that are largely attributable to the previous year. Starting off with Inpatient Admissions we had 47 for October and Swing we had 12. There was 167 year to date for inpatient admissions which is a 30% decrease from the previous year. Swing does make up the difference slightly. Year to date they are at 40 which is a 60% increase from the previous year. ER visits saw 4% decrease from September to October. We are at 511 for October. Year to date that puts us at almost 2,200. EMS Runs – we are at 152 for October. EMS transports – 96.  Surgeries – we are at 8 in October and year to date we’re right at 50 which is a 12% increase from the previous year. MRI saw a little bit of a bounce back from September, we had a low of 8 and October we had 15, and 49 year to date. CT – 161 for October with 548 year to date. Blanchard PT, this is one that we are going to continue to see grow. We are at 582 year to date and 176 for the month of October. Dental had a strong month in October with 175. The most she has seen since she started and year to date she is at 571. Community Rx total scripts filled for October is 2,047. A 15% increase from September and year to date they are at 6,755. Fitness Center is at 347 total members and 1,668 total visits. That is it for the stats.    2) Review October 2022 Financials – Dakota Robinson: Dakota Robinson stated as we get into the Financial Statements as you can see the stats look pretty good across the board. As we get through the Financial Statements we’ll look at the budget numbers, they look great as well. Looking at the Income Statement on page 3, you’ll see that the Gross Revenue for the month, almost $4.2 million is an increase from the previous period of about $218,000. When we look at the Net number, we see that net number increase for the month as well at $171,000 but when we look at four months, the good news is through four months Net Patient Revenue has increased about 5.7% from a little over $8.1 million to $8.6 million. If you look at Operating Expenses under Salaries and Wages you’ll see there’s really no net change on the one month time period and through four months there’s a slight increase of $111,000 which if fully expected with the raise increase that was implemented this year. Looking at Total Operating Expenses at $2.68 million compared to $2.66 million we did spend $25,000 more than in the previous period and through four months we’ve seen about 5.6% increase in total expenditures in $10.8 million. In Non-Operating Revenues you’ll see that under the Grant line items there’s about $293,000 booked there. The Vivian Clinic, you’ll see that they did a little under $500,000 in patient revenue and they did turn a profit of $28,000. On the Plain Dealing Clinic they did a little over $175,000 which I’ll point out here is contractual adjustments are pretty high. Through four months they’ve seen a profit of $51,907. In the Benton Clinic they saw a little over $100,000 in revenue and turned a profit of $8,500 and profit through four months right at $34,000. Blanchard Clinic, they did almost a quarter of a million in revenue and $30,000 in profit. I believe from last month was sort of the first month you can look at the graph that curve starts to increase.  Community Rx, this slide does change a little bit, we’ve been trying to develop a way to explain just what it does for the entity. The odd thing about Community Rx is that they have two profit drivers. One of that is actually filling the scripts and the net revenue that is generated Community Rx by itself and then there’s a whole other aspect of Community Rx as part of our 340B program and what that brings to North Caddo since 340B is such a large number on our financial statements these days. This is the first month that you will see outside of the period adjustment here which is mainly an offset of inventory. I threw that out and we look at profitability. You’ll see that they did turn a profit of $2,200 and that is a $2,200 profit on their operations by itself not including 340B. David Norman said if there are no further questions I would entertain a motion and a second to approve the Statistical and Financial reports. Ronnie Festavan made a motion that the Statistical and Financial Report be approved as presented. Pat White seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant. Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval of the Statistical and Financial reports as presented.  X. New Business – 1) Sick Time Buyback:  David Jones said we have four items for new business for this month first of which is the Sick Time Buyback. Dakota has a slide of a comparison of over the last six years what we’ve done and how it’s increased. We’ve seen an increase in number of employees that are eligible this year. Amount is a little higher as well. Again, we’ve discussed this in the past and wish it was a way that we could put a dollar figure on directly on how this benefits us from a financial standpoint but it is just impossible to do. It is a huge morale boost. We’ve had numerous employees that have already asked if we are going to do it again this year or not. It is certainly my recommendation that we move forward with the buy back. David Norman recognized Ronnie Festavan to speak. Ronnie Festavan said so Mr. Jones let me ask a question and I’m certainly understand to quantify these in terms of money and all that that could be a pretty good task, I agree 100% with that. Could you at least tell us, because this was the question, I remember back when we started this, and the question that was raised at that time, so has this helped with people showing up for work. David Jones replied absolutely. From a Department Head’s they totally think it has. Ronnie Festavan, said so the original thought of this was if we do this it is going to put on the employee’s mind if I show up for work and do all this at some point in time I’m going to get a reward.  David Jones replied correct. Ronnie Festavan said so that will sort of simplify the reason for doing all this. I will trust your judgement. Jennifer Fant asked if she could ask a question. Can you carry over sick time or what you accrued unused? David Jones replied sick time you can up to a maximum. Dakota Robinson said we have rolling period so we don’t really carry over time into years. David Norman asked if there were any other questions on the sick time buy back. I entertain a motion that we approve the Sick Time Buy Back. Robert Green made a motion to approve the Sick Time Buyback purchase as presented. Mary Irvin seconded the motion.  The verbal vote:  Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin,  Jennifer Fant, Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval of the purchase of the Sick Time Buyback.   2) Approval of Surplus List: David Jones said we need Board to approve the Surplus List to be put into the paper for final disposal/selling of our surplus equipment. We have 30 items up for surplus. David Norman said I would entertain motion and a second to approve the Surplus Equipment List. Ronnie Festavan made a motion to approve the surplus equipment list. Pat White seconded the motion. David Norman recognized Ronnie Festavan to speak. Ronnie Festavan asked where did we get a grand piano in the hospital.David Jones said that came with the excess building that we bought from the church across from Sam Curry’s. David Jones said it’s in pretty good shape. Ronnie Festavan asked if it was set up for the bid process. David Jones replied yes. Ronnie Festavan said thank you Mr. Norman. David Norman called for a vote. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval of the Surplus List as presented.    3) Purchase of Stretchers for EMS: David Jones said item #3, we have purchased some Stryker Power Stretchers in the past and technologyhas come to the point to where picking up people from the ground up is just a bad way to do business. Dakota has a video of something I propose that we purchase. We’re going to be purchasing it but the Foundation has already approved to fund it. Dakota said we already own these stretchers.  David Jones said it is the track system that brings it in and out of the actual ambulance. The maximum capacity is 700 pounds and sadly enough that has been exceeded multiple times and our people are actually picking them up and getting them in there. Brenda Smith asked if that included the stretcher.  David Jones replied no just the power-loading cot fastener system. David Norman said we need a motion and a second to approve the Power-Load cot fastener system for the EMS. Mary Irvin made a motion to approve the purchase of the power-loading system as presented. Brenda Smith seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, JenniferFant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval of the purchase of the Stryker Power-Load system for EMS.   4) Direct TV:  David Jones if I could get a motion and second we are going to move our cable services for our TV’s for our patients and our common areas of our waiting rooms from cable to Direct TV. If I can get a motion and a second I’ll go in as to why we are doing that and that process. Ronnie Festavan made a motion to move from cable to Direct TV. Robert Green seconded the motion.  David Jones said basically from our standpoint our cable company kind of forced us into a move because our TV’s aren’t at a technological level that the want them at so to upgrade to the cable service would be fairly costly so we looked at an alternative service and basically chose to go with similar system to what hotels use. It will actually give us more channels for them to use, a little more functional. We were able to select what channels we want to offer. It offers some streaming services that we could do as well and it will be some slight additional purchases but it does work with our nurse call system that we currently have. Ultimately it is only going to be close to $20 a month more than what our current service is but we have to sign a five year contract which puts it above my purchasing amount. I think it is somewhere around $47,000 for the five years. Once again, you take the TV’s away from the patients and it might get real ugly around here fast.  David Norman recognized Ronnie Festavan to speak. Ronnie Festavan said I am assuming from what you say that this is a locked in cost for five years. David Jones replied yes. The verbal vote:  Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval of the moving from cable to Direct TV as presented for a five year period.   XI. Administrative Report:    David Jones said from our standpoint, it is the festive season. Those of you who were able to come to our Thanksgiving potluck got full I can promise you that.  There was food everywhere. The turkeys that were fried outside were done very well by an expert cook. It was phenomenal and it is always a good time. Christmas party is coming up on the December 13th and it will be at Main Street. Honestly, my opinion, last Christmas party was the best party we have ever had at North Caddo Medical Center since I’ve been here, going on 18 years. We are going to try to duplicate that as best we can, keep it festive and have fun. There will be a bar area on the other side but that will not be supplied by us. We will have good food, door prizes and we are going to have a good time. Hope all of you can make it to that as well.  David Norman asked if there were any questions. There were none.   XII. Medical Staff Recommendations – November 2022 Medical Staff Recommendations: David Jonespresented the Medical Staff recommendations for Board approval.  MEDICAL STAFF APPOINTMENTS:  1) Robert Miller, M.D. – Requests Provisional Privileges in the field of Radiology for the period of November 22, 2022 through November 30, 2023.  2) Matthew Smetko, D.O. – Requests Provisional Privileges in the field of Radiology for the period of November 22, 2022 through November 30, 2023.  MEDICAL STAFF REAPPOINTMENT:  1) Richard Blanchard, M.D. – Requests Courtesy Privileges in the field of Pathology for the period of November 22, 2022 through November 30, 2024.   2) Matthew Mastrodomenico, M.D. – Requests Courtesy privileges in the field of Radiology for the period of November 22, 2022 through October 31, 2024.  3)  Charles McCathran, M.D. – Requests Courtesy Privileges in the field of OB/GYN for the period of November 22, 2022 through July 30, 2024.  4) SanjeeviTiakaran M.D. – Requests Courtesy Privileges in the field of Sleep Medicine for the period of November 22, 2022 through November 30, 2024.   ADVANCE PRACTICE PROFESSIONALS  APPOINTMENTS/REAPPOINTMENT:   None.     EXTENSION REQUEST:  None.   VOLUNTARY RESIGNATIONS:  None.    David Norman said we need a motion and a second to approve the Medical Staff recommendations. Brenda Smith made a motion to approve the (2) Medical Staff Appointments and (4) Medical Staff Reappointments. Ronnie Festavan seconded the motion. The verbal vote:  Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval of the Medical Staff Report as presented.   XIII. Executive Session:   David Norman stated we will need to go into a brief Executive Session for Strategic Planning. Robert Green made a motion to enter into Executive Session for Strategic Planning. Ronnie Festavan seconded the motion. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval to enter into Executive Session for Strategic Planning.   The Executive Session was entered into. No action was taken during the Executive Session. Ronnie Festavanmade a motion to enter back into regular session. Pat White seconded the motion. The verbal vote:  Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor of the approval to enter back into regular session.   Brenda Smith made a motion to pay the full contractual amount allowed incentive pay for Mr. David Jones. Robert Green seconded the motion. David Norman called for a verbal vote. The verbal vote: Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor to pay the full contractual amount allowed incentive pay for David Jones, CEO.   XIII. Adjourn – There being no further business Ronnie Festavan made a motion to adjourn. Pat White seconded the motion. The verbal vote:  Yeas: Pat White, Robert Green, Ronnie Festavan, David Norman, Brenda Smith, Mary Irvin, Jennifer Fant.  Nays: None.  Absent: Kenneth Cochran, Michael Nation.  Abstained: None. The motion passed by unanimous vote in favor to adjourn the meeting. The meeting adjourned at 6:22 p.m.

North Caddo Hospital Service District

North Caddo Medical Center

Vivian, Louisiana

___________________________

David C. Jones, Secretary

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Reg Bd Mtg 11/22/2022

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