The Scotland County Memorial Hospital (dba Scotland County Hospital) Board of Directors met in regular session on Tuesday, July 30, 2019. Board members present: Joe Doubet-Vice Chairman, Lori Fulk-Secretary, Robert Neese-Treasurer, Members Dwight DeRosear and Joni Lloyd. Absent: Curtis Ebeling-Chairman

Administrative & personnel present: Dr. Randy Tobler, CEO; Dr. Jeff Davis, CMO; Angela Schmitter, RHIT-Compliance; Suzie Lister, Revenue Cycle Manager; Lori Nelson, RN, Rural Health Clinics; Jessica Christen, NP; Dr. Neil Hoyal, Emergency Physician; Jonathan Holton, IT; Alisa Kigar, Marketing Director and Brenda Prather, recording secretary.

Guests: Lynn Fincher, Sandra Blake, Lee Shultz, Tara Shultz, Heliene Tobler and Kathy Miller.

Vice-Chairman Doubet called the meeting to order at 5:34 p.m. After approval of the Open Session Agenda and Executive Session Agenda, Vice Chairman Doubet offered a public comment opportunity. Sandra Blake, Lynn Fincher and Lee Shultz spoke. Following Public Comments, Secretary Lori Fulk read a letter of appreciation from a family member of a recent in-patient.

Tax Hearing

There was a short discussion on retaining the present tax levy rate, which stands approved by the State of Missouri. It was noted that SCH provides services to the surrounding counties while not receiving any tax dollars from those counties. The likelihood of consolidating and receiving funding through a referendum as such is slim at best in context of recent tax increases for Health Departments and failure of local school district bond issues. Dr. Hoyal commented that if the community is legitimately concerned about the sustainability of the hospital, they should not object to paying more taxes and take advantage of services. At the present rate of $.04953 per $100 valuation, SCH will receive county tax revenues of $391,459 representing less than 2% of SCH’s operating budget. A motion was made and unanimously approved to set the tax rate for 2019-2020 fiscal year at $.04953.

Quality & Safety

The Quality Corner report was given by Terri Schmitt, QI and Safety Director via teleconference. She led a review of SCH Patient Safety Plan & Hospital Wide Quality/Safety Performance Improvement Projects with significant focus on avoidance of falls.  

Financial Report

Michael Brandon, Controller, reported this month’s financial report is deferred due to the closing of the fiscal year end 2018-2019. Dr. Tobler reported revenues for June were above average and expenses will reflect substantial reconciling because self pay transfers to insurance are an ongoing manual process until complete.

Administrative Report

Under Operations, CEO, Randy Tobler, MD, reported on Crossriver Quality Health Partners progress, Caravan Accountable Care Organization (ACO) and Executive leadership/ Executive Committee recommending SCH’s involvement; revenue cycle review of self-pay transfers; retirement plan review of investment options, funds retired and replaced per plan rules. Additionally, Dr. Tobler updated the board on the EMS-Ambulance District transition progress and a meeting held with Matt McKee for re-engagement with SCH’s 340B Contract Pharmacy program. Finally, under operations, Dr. Tobler reported on Annual Clinic Meetings for Lancaster Medical Services, Memphis Medical Services and Wyaconda Medical Services as required by State Licensure.

Under Medical/Allied Staff, Dr. Tobler thanked Drs. McNabb and Martin for their services to Scotland County Hospital & Clinics and that both physicians indicated their wish to stay on the Medical Staff to help out when needed. He reported that Kelsey Davis-Humes, DO, and Aurora Bell, DO, start at MMS/WMS/SCH and LMS/SCH respectively on August 1st with Lois Quenneville, PA, working alongside Dr. Davis-Humes at WMS.

Under Personnel, Dr. Tobler reported on staff resignations and transfers to other hospital/clinic departments.

Dr. Tobler wrapped up the Administrative report by addressing Mrs. Shultz and Mrs. Fincher. 

Chief Medical Officer Report

Dr. Jeff Davis, Chief Medical Officer gave the CMO report starting with Quality Assurance and Safety, reporting that he participated in a Missouri Hospital Association Quality Initiative webinar, a Clinical Quality Improvement Collaboration (CQIC) member informational webinar and a Department of Health & Senior Services seminar on pneumonia and flu vaccination initiatives. Additionally he reported on clinician relations activities and wrapped up his report with comments regarding his attendance at the certification courses for Post-Acute and Long-Term Care Medicine, completion of an Advanced Trauma Life Support (ATLS) course and, American Osteopathic Association Annual Business Meeting in which he is the Missouri’s Caucus Chairman.

Old Business

Dr. Tobler gave a report on the Edina clinic project, followed by an Affiliation Committee Report from Mr. Neese. Mr. Neese reported that upon initial comparison of SCH and Blessing Health System’s (BHS) similar missions and strategic plans, the horizon looks positive for further integration. A tele-presentation was then given by Sue Dietz, Vice President of Business Development for Caravan Health, which is an accountable care organization (ACO). The presentation outlined the Medicare shared savings programs amongst the ACO’s 250 health systems and 14,000 clinicians. She presented Caravan Health’s track record with population health management outcomes of 95% success in achieving better health of patients at lower cost.

New Business

The required annual review of the updated policies and procedures has been conducted. A motion was moved and unanimously approved to accept the annual review. A motion was moved and unanimously approved for the Ethics Resolution regarding the Code of Ethics which is required to be reviewed every two years according to the The Missouri Ethics Commission. Dr. Tobler gave the clinician credentialing report. A motion was moved and unanimously approved, following the recommendation by Medical Staff and contingent on pending approval of three request to approve clinician credentials.

Guests exited.

Closed Session

Those present for closed session were: DeRosear, Doubet, Fulk, Lloyd, Neese, Dr. Tobler, Dr. Davis, Suzie Lister and Brenda Prather.

The following items were discussed: Legal actions and contracts in negotiation. Personnel.

Meeting adjourned at 9:15 pm

The Board invites the community’s questions and suggestions. If a community member wants to hear the discussions about their local hospital, please attend the board meetings. Public comment policy and request for time are available online at and at the hospital’s Administration Office. The next meeting is Tuesday, August 27, 2019, in the hospital conference room at 5:30 pm.