August Board Meeting Report

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 The Scotland County Hospital Board of Directors met in regular session on Tuesday, August 25, 2020, via Zoom Meeting and in person. The Open Session was broadcasted via Facebook Live. In accordance with the Missouri Sunshine Law §610.020.1. As a best practice and if possible, public governmental bodies should take advantage of their website and social media pages to post recordings or live streams of public meetings. Board members attending in person: Chair-Lori Fulk, Vice Chair- Joni Lloyd, Secretary-Joseph Doubet, Treasurer-Robert Neese, Member-Nic Hatfield 

Others attending in person: Dr. Jeff Davis, CMO, Maureen Kahn, CEO/President BCS, CEO, Pat Gerveler, EVP/CFO BCS, Dr. Celeste Miller-Parish, COS, Elizabeth Guffey, RN CNO, Michael Brandon, Controller, Alisa Kigar, Marketing Director, Terri Schmitt-QA/Safety/HR Director, Ken McMinn, IT Director, Jamie Kice-Maintenance. 

Present via Zoom: Dr. Randy Tobler-CEO, Board member-Dwight DeRosear, Angela Schmitter-Health Information and Compliance Director, and Brenda Prather-recording secretary. 

Chairman Fulk called the meeting to order at 5:35 pm. Motions were moved and unanimously approved for the Open Session Agenda, with this addition to Old Business: C. GPS Contract for Ionization throughout the facility, Executive Session Agenda, Consent Agenda and Approval of Minutes. There were no public comments. 

There were no members of the community present to comment on setting the tax rate at $.04953 to general operations fund for the 2020-2021 fiscal year. General discussion introduced by Dr. Tobler on researching the idea of raising the tax rate. He gave a general recap on recent increases by Health Department, Water District and past attempts by School District. The certificate from State Assessor’s office received and the board decided on no rate change at this time. 

Michael Brandon, MBA, Controller, gave the Financial Report: Gross Patient Revenue-June 30, 2020	$3,348,790
Contractual Adjustments – YTD	53.31%
Net Patient Revenue-June 30, 2020	$ 496,205	Net Patient Revenue per day: $50,640
Total Operating Expense- June 30, 2020	$2,351,845	Expenses per day: $58,285
Net Profit (Loss) June 30, 2020	$ (916,795)
Net Profit (Loss) before Depreciation-June 30, 2020	$ (833,345)
Net Profit (Loss) YTD 2020	$ 139,610	Net Profit (Loss) YTD FY ’19 ($1,762,792.84)
Net Profit (Loss) YTD before Depreciation	$ 1,168,195

 

Blessing Health System Report by Maureen Kahn: Mrs. Kahn reported she attended the Board Meeting at Illini Community Hospital in Pittsfield, IL, that morning. That hospital is looking into child care for their employees. She also discussed Blessing’s child care and innovations put into place since COVID-19. She has had conversations with BHS Board on wages and salaries. She is aware that they are being conservative, but they are already ahead of 2021 Illinois State mandate of $11.25/hr. minimum wage. She reported that regional agri-businesses are expanding. At the same time some businesses are closing from COVID-19, there are some positives in the Quincy community. The Ambulatory Surgery building construction is getting along well and current surgery numbers up. Moorman Pavilion expansion is complete. The Moorman Pavilion offers additional patient rooms at Blessing Hospital. They are currently waiting for the State to inspect the building. They are stockpiling PPE and assuring all standards set by CDC are met. Mrs. Kahn reported that Adams County numbers of COVID-19 are starting to decline. 42 college kids were not admitted to Quincy University Campus at the start of the semester, due to their testing positive. She reported that BHS officials will be talking with SCH about the Clark County market and strengthening the relationship in those communities. And finally, Blessing is setting up food pantries in some surrounding communities. 

ADMINISTRATIVE REPORT: 

Under Operations-SCH COVID situational status: No COVID (+) inpatients to date, 6 active COVID patients currently, positive rate of 6.98% (7 day rolling average). SCH experienced an imminent shortage of surgical gowns last week due to allocation realities. Blessing provided a bridge supply. Dr. Tobler thanked the community for participating in the universal masking policy for all within the building. Patient volumes are at 90% in clinic and are near pre-COVID levels for inpatient, adjusting for historical seasonal variations. The pre-op testing policy provides for implementation/suspension of testing based on the 4-county primary service area and larger regional disease activity. Currently SCH is testing all elective hospital procedures here. Thus far, none positive. SCH has applied for a possible additional source of HHS Cares Act funding, but eligibility is uncertain, and the amount would be small, to make up short funds from a previous funding. SCH has recognized $2.2 M in HHS funds out of $4.2 M received, for revenue loss and extra COVID expenses. Dr. Tobler reported the hospital is hiring staff and opened up contracted specialist services, only as justified by demand or program necessity. The COVID/Respiratory Care Clinic has opened in the “annex” as an extension of the Rural Health Clinic under the “Alternative Sites of Care” 1135 Emergency Waivers issued by the federal administration. It is going well, though straining nursing staffing. Centers for Medicare/Medicaid Services has issued a final rule that a Condition of Participation daily reporting of several measures pertaining to COVID activity at the hospital and PPE resources. This is quite cumbersome however noncompliance could result in being excluded from participation in Medicare. SCH remains 100% compliant with this new requirement. Stephanie Ketchum, LPN, has rejoined the Memphis Medical Services team, to support Crossriver Quality Health Partners and Accountable Care Organization initiatives. SCH is continuing to work with Annual Wellness Visits (AWV), Hierarchical Condition Category (HCC) coding, and Advanced Care Planning (ACP) to improve the health of our Medicare patients and cooperate with our population health initiative partners. The Accountable Care Organization is on track to realize significant shared savings and SCH benefits by participation. SCH is still behind other participant entities in all but ACP, however this is to be expected as we were the latest to join. The Crossriver Quality Health Partners Board of Directors and Operations/Finance Committee meetings in August focused on overall performance, influences and operational challenges presented by COVID-19, and possible expansion of the CIN to entities in the Blessing sphere. Dr. Tobler reported that all relevant documents have been executed, engineering in progress after a site visit by TMI and engineering personnel on 8/4/20 on the HVAC renovations and that installation is to begin in the October time frame. Recently, Blessing and SCH Compliance and Risk Management leadership peers met for a review of the SCH compliance policies and needs. A full assessment and follow-up plan is pending. Surgical clinic hours between Drs. Miller-Parish, Nastav or Phan will be available 6 days a week. The on-call surgeon will be available for scheduled patients on Saturday mornings during Urgent Care hours. Dr. Davis will meet with employed clinicians to discuss contract amendments allowing performance-based incentive distributions, converting vacation/benefit terms to Paid Time Off, and performance reviews starting next week. A MMS entrance screener and patient access team members have been hired to support increased clinic volume. One of 2 offered maintenance staff accepted job offers. Dr. Tobler told the board that SCH continues to express concern that the Paycheck Protection Program funds, and according to all guidance gleaned, all COVID-related funds received from various sources will be offset against revenues in the cost report. Congressman Graves and others are aware and have expressed their intent to address this reality, which results in only delaying long-standing structural reimbursement and regulatory threats to Critical Access Hospitals. 

CMO REPORT: 

Dr. Jeff Davis, Chief Medical Officer, reported he is working with the Quality & Safety Committee on strategies for implementation of the new employee performance evaluation and wage adjustments and the development of a framework for a Human Resources management relationship with Blessing Health System. He gave updates on testing, positive cases, inpatient and outpatient utilization, finances & supplies in his report. He reported that Edina Medical Services is now offering DOT physicals. Dr. Davis reported that he had presented 2 lectures for the Montana Osteopathic Medical Association on August 14. He told the Board that on Wednesday, September 2nd, Congressman Sam Graves will be visiting the Edina Clinic at 2:45 pm. and the Board and leadership are invited to attend. Mrs. Kahn and Mr. Gerveler plan to attend. 

OLD BUSINESS: 

Jamie Kice, Maintenance Supervisor, was present to discuss rebidding of the roof replacement. The board’s recommendation is to collect revised bids from both contractors that submitted bids, incorporating increased insulation on the underlayment. Mr. Kice further reported on the Penthouse equipment failure during the City of Memphis’ recent planned power outage. All went well at SCH during the process. However, there was an additional unanticipated outage later in day after the Penthouse chiller was restarted and running at capacity. It has been operating since then. It is Kice’s recommendation to continue as is until planned renovation and replacement of HVAC system is carried out later in fall. During this time, a contingency for managing environmentally sensitive areas is in place. The GPS Contract for ionization viral and bactericidal air cleaning technology for the entire facility was discussed. A motion was moved and unanimously approved to execute that contract. 

NEW BUSINESS: 

A motion was moved and unanimously approved for the Notice of Decision-County Cares Act Funds to execute the document and develop a policy for the procedures in order to provide SARS CoV-2 antibody testing for all county residents who desire it. 

Regarding bids for the demolition of fire damaged storage shed, Mr. Kice discussed difficulty receiving bids for demolition of the shed on Watkins Street. Only one bid has been obtained, however, this company did not carry full insurance. The consensus of the board is to accept the bid with a prepared contract in place waiving SCH of any damages or liability by the construction company. 

CLOSED SESSION: 

Matters discussed: Negotiations on an early termination of the current CT lease to facilitate replacement with an updated unit coinciding with HVAC renovation, , administration’s denial of request from a pharmaceutical company for personally identifiable information regarding the 340B of which SCH has no contract or obligation to provide. Under Compliance, the Board discussed counterfeit work excuses received by an area employer. Under Personnel, an Employee FMLA claim was discussed. 

Meeting adjourned at 8:21 pm.

The next board meeting is on September 29, 2020, at 5:30 pm in the Library Conference Room. There are limitations on visitors allowed in the Hospital at this time and no guests will be allowed in the meeting. According to CDC guidelines, social distancing will be practiced by board and staff in attendance. The meeting will be on Facebook Live. Public Comment Policy and Request For Time on a Board Meeting Agenda forms are available online at www.ScotlandCountyHospital.com. Due to the limited visitor policy, citizens can complete the form and scan and email to caring4u@scotlandcountyhospital.com or mail to Administration at SCH, 450 E. Sigler Avenue, Memphis, MO, 63555. The form must be received by 9 am on 09/29/20.