The Scotland County Memorial Hospital (dba Scotland County Hospital) Board of Directors met in regular session on Tuesday, August 27, 2019. Board members present: Curtis Ebeling, Chairman, Lori Fulk-Secretary, Robert Neese-Treasurer, Members Dwight DeRosear and Joni Lloyd. Absent: Joe Doubet-Vice Chairman

Administrative personnel & staff present: Dr. Jeff Davis, CMO, Dr. Lisa Rollison, COS, Michael Brandon, Controller, Elizabeth Guffey, RN, CNO, Angela Schmitter, RHIT-Compliance, Lori Nelson, RN, RHC, Missy Smith, HR, Alisa Kigar, Communications Specialist, Ken McMinn, IT Director, Carla Cook, RN-Spirit Award Winner and Brenda Prather, recording secretary.

Absent: Randy Tobler, CEO, Joe Doubet, Vice-Chairman

Guests:  Lee Shultz, Sandra Blake, Lynn Fincher,

Chairman Ebeling called the meeting to order at 5:34 pm. After approval of the Open Session Agenda and Executive Session Agenda, Chairman Ebeling offered a public comment opportunity. Lee Shultz spoke.

Quality & Safety

The Quality Corner report was given by Terri Schmitt, QI and Safety Director via teleconference. She led a review of Code of Conduct. This is representative of expectations for best practice standards of SCH. Each new hire, current employees, physician/practitioners and Board of Directors will be asked to sign and comply. Motion moved and unanimously approved to adopt this Code of Conduct.

Financial Report

Michael Brandon, Controller, presented the Financial Report stating the July & August financials will not be available until the annual audit is completed. He reported the June balance sheet and income statement.  

Gross patient revenue for June: $4,343,437

Net Patient Revenue, June: $2,382,880

Net Patient Revenue Per Day, June: $57,890

Expenses per day, June: $60,410

Total Operating Expenses, June $1,836,377

Net Profit/Loss June: $661,865

Net profit/loss before depreciation, June 2019: $750,960

 Net profit (loss) YTD June ($1,165,640); Net Profit (Loss) YTD June FY 2018 ($790,566);

Net profit (loss) YTD before Deprecation $373,135

Administrative Report

Dr. Tobler was absent and submitted this report.

Under Operations, a contract was executed with Caravan (Medicare Accountable Care Organization). Regarding the revenue cycle, statements will go out the end of the month with a message requesting patients to call with any questions regarding accuracy. A complimentary pre-pay discount for all accounts settled by October 15th will be offered. Financial Services Department staff will preview the statement file as sent, review for accuracy, and proactively call patients with large balances to either confirm the amount or discuss an amended amount.

Regarding the Edina Clinic, a framework for subleasing the build-out space has been developed with Blessing and the board reviewed the updated financial proforma.

Dr. Rollison reported on Tiger Cub Care and noted there has been on-going research to expand eligibility for other than employee children.

Under Personnel, the current employee health insurance provider has presented another option for administering employee health plan claims. Two vendors have been interviewed. Applications are being received for the HR Director. Lezah Cline has moved from Lab and has joined the Quality Improvement & Safety Department as a QI and Safety Specialist. A search will be forthcoming for a Facility Manager to administer physical plant operations..

Advocacy: State Senator O’Laughlin visited SCH on August 8th to see Tiger Cub Care and to discuss the direct to employee model of healthcare coverage. Dr. Tobler accompanied (Missouri Hospital Association) MHA lobbying delegation on August 15th to meet with State Representative Steve Helms, Chair of the House Committee on Health Care Reform, then testified at his interim hearing addressing the topics: Drivers of Healthcare Costs and Access to Care. CEO Tobler is on MHA’s Medicaid Payment Reform committee and Rural Health subcommittee, purposed to advise MO Healthnet on reforming the program responsibly.

Chief Medical Officer Report

Dr. Jeff Davis, Chief Medical Officer gave the CMO report starting with Quality Assurance and Safety, reporting the Quality & Safety Committee met to review the unfinished safety project list and he participated in the Crossriver quality metric data webinar. Dr. Davis reported that both Dr. Bell and Dr. Davis-Humes are being denied contracts by certain insurance companies, even though they were granted same coverage under same insurances, while in their residency programs, simply because insurance companies can deny up to 90 days in order to delay payment. He further reported that there have been conversations with state legislators regarding the absurdness of this practice by insurance companies, which proved their lack of awareness and has led to plans for draft legislation for next year.

Old Business

Dr. Davis gave a report on the 340B Drug Program, reporting that Dr. Tobler has had conversations with Clark County Pharmacy, Benzer Pharmacy in Lancaster and Scotland County Pharmacy regarding contracts to participate in the drug program. Benzer executives cited they were interested and will develop further conversation. Clark County will defer contracting until Scotland County Pharmacy has entered into one. SCH is awaiting a response to the standard 340B contract offer presented by Dr. Tobler.

New Business

Dr. Davis reviewed the process used to develop the new organizational chart. After discussion, a motion was moved and unanimously approved to accept the chart, pending pertinent revisions. Ken McMinn, IT Supervisor, presented an outline of choices for the impending electronic medical record upgrades.

Guests exited.

Closed Session

Those present for closed session were: Ebeling, DeRosear, Fulk, Lloyd, Neese, Dr. Rollison, Dr. Davis, Missy Smith and Brenda Prather. Absent: Doubet

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

Meeting adjourned at 8:30 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, September 24, 2019, in the hospital conference room at 5:30 p.m.