Scotland County Hospital Board Holds November Meeting

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Submitted by Brenda Prather, Record Keeper

DRAFT SUMMARY – November 29, 2022 – Board Members attending in person: Christine Musgrove, Aarron Holt, Nic Hatfield, Lori Fulk. Attending via Zoom: Jesse Zeiset. Absent: Travis Trueblood. Administration in person: Meagan Weber, CEO, Brent Peirick, COO, Ashley Ward, RN-CNO, Dr. Celeste Miller-Parish, COS, Lori Nelson, RN-RHC Supervisor, Angela Schmitter, RHIT-HIM/Revenue Cycle Manager, Lezah Cline-HR, Heather Ayer, RN-QI Coordinator, Alisa Kigar, PR/Marketing. SCH Employees/Staff in person: Sonya See, WHNP, Dr. Kelsey Davis- Humes, Jonathan Holton, IT. Guests: Echo Menges from The Edina Sentinel/NEMOnewsMedia Group and Kevin Brown.

Nursing Home Update: Next Step is to set up train the trainer program with hospital nurses. Nursing Home has agreed to pay for this training. Motion: Musgrove moved for COO Peirick to pursue an agreement to provide Train the Trainer Program. This is followed by a second from Hatfield and approval by roll call vote: 4-0 YEA.

Wyaconda Medical Services Update: Sparks Construction preparing estimate on roof, condensation in roof, internal water damage. The city of Wyaconda has expressed interest in gifting the clinic building to the hospital. Proposal: Accept the building as a gift, lease basement for $1.00, start repairs at 50/50, gradually shift to 60/40, 70/30, 80/20. Brent is working on agreement with city. Will follow.

FEMA Funds: Earlier in the year application was submitted. Follow up on lack of progress. He has received word of possible reimbursement in December.

CEO Report

Recruitment with Delta. Have dinner planned Dec 2 with a family practice physician with OB training. Interested in rural area where he can make a difference.

340B Update: 20 Manufacturers online. Quarterly 340B Net Revenue for 2022: Jan-Mar $61,803.03; April-June $13,699.78; July-Sept $23,453.34; Oct 1-Oct 31 $298,518.48; Sept 1 to current $656,988.

Matt McKee has worked timelessly to help us through this process and getting 20 manufacturers online with our 340B program, which is the most we’ve ever had, getting lower cost drugs to our community. We have 16 manufacturers on with Clark County, and will continue to look into contracted pharmacies with the data that is provided to us from our TPA, and where our scripts are going.

Scotland County Care Center Update: The Northeast Regional Planning Commission have identified two possible grants for a feasibility study, one through HRSA, and one through USDA. This would entail a market study to bring in multiple services on our campus to improve the healthcare to our community, and create a more viable future for the Hospital and Care center working together. We are thankful to both boards to let us establish good relationships to create a better future for our community and the people we care for.

Billing/Revenue Update: We have a great team of people in the billing office working on grabbing claims, putting out accurate statements, and improving our cash flow. Brent and Achim have done very well with this process. Brent had a report built that caught all the visits on the hospital and clinics that had no payments for the fiscal year 21-22. We were able to bill for those services that hadn’t timed out, and recovered hundreds of thousands of dollars. I can’t thank these two enough for the hours they are putting in to help “fix” our broken processes. Revenues and claims are definitely improving.

Billing is getting caught up, close to 10 days behind in hospital, and three weeks in clinic. A big thank you to Angela for working hard on creating a team that is competent, improving efficiency, and accuracy of our billing and cash flow.

Med Club: Scotland and Schuyler County schools have both started a Club for 9-12 grade students.

National Rural Health Association CEO Certification: I have registered for the webinar for the CEO certification through the NRHA.

The Immediate Need: Well-prepared leaders in rural hospitals. The Solution: The NRHA Rural Hospital CEO Certification Program.

Leadership makes the difference. Today’s rural hospitals and clinics have tremendous challenges and uncertainty and are closing at an unprecedented rate. One out of three rural hospitals have been identified as “at risk.” Nearly half of rural hospital CEOs are first time CEOs. Hospital CEO turnover continues to lead all industries, and when CEO turnover occurs, the pool of qualified candidates is limited. The NRHA Rural Hospital CEO Certification Program was developed by successful rural hospital CEOs for rural hospital CEOs with the intent of assisting current rural hospital CEOs strengthen their leadership skills to help lead their hospital to success. An individual with this certification will immediately be recognized as someone qualified to lead a rural hospital with excellence.

Staff Incentives: We are working on incentives for staff to identify and implement grants. That will be a work in progress as many grants become available through HRSA, USDA, etc.

Lori Nelson has done a great job with a grant, and we want to use staff as we can to get as many projects funded as we look at growing our services.

Knox County Nursing Home: I went to visit with the Knox County nursing home administrator about a lab contract. We are looking into that. Angela and I also visited with Katlind, administrator, and their billing office. They had some bills sent to residents, and it looks like we had some wrong insurance information, but we are working on problem solving with them on our processes, so they can get us accurate intake information for when our providers see their residents. We are here to help the community, and want to look into any concerns they may have.

Thankfulness: It’s hard to put into words how grateful I am for this opportunity. I want to thank the Board, for allowing us to work hard, keep our services open, and create an environment that we can grow as a team. The hard work that I have witnessed over the past few months in a challenging time, is moving, and it is what motivates me to continue to problem solve and use resources that we have to improve our solvency. It is no secret that rural hospitals, all over the nation are struggling, and I firmly believe that it is from sheer will and determination from our physicians, nurses, and staff across the board that we continue to overcome obstacles, and from the support of the community to continue their trust in our care. On this Thanksgiving holiday, I have definitely felt a little more grateful for all of you.

Old Business

Hospital Bylaws- Committee formed to review, evaluate and recommend revisions. Volunteering for the Committee were Musgrove, Zeiset, Fulk.

New Business

Policies and Procedures- Those policies, which have been revised or received their annual review, are listed as attached. SCH policies, both facility wide and pertaining to various areas or departments, are wet up on a rotational basis throughout the year. Approval and recognition of this review are monthly action items in order to document for State licensure requirements. Motion by Musgrove to accept both the October and November lists of annual review and/or revisions as presented. Second to motion by Holt with approval by roll call vote 4-0 yea. Hatfield-yea, Holt-yea, Musgrove-yea, Zeiset-yea.

Notice of election – District 1, 3, 5 and 6. Notice for publication submitted to The Memphis Democrat, beginning this week’s issue.

Medical Staff Credentialing – Motion by Hatfield to approve the following list, as recommended by Medical Staff. Zeiset offers second followed with approval by roll call vote: 4-0 yea: Hatfield-yea, Holt-yea, Musgrove-yea, Zeiset-yea.

Erin Protsman, FNP-Allied Health- Reappointment

Irving Schwartz, MD-Associate-Cardiology Services

Kathleen Weaver, MD-Associate-Orthopedic Services/Surgery

Motion by Musgrove to enter Closed session pursuant to Sunshine Law Sections 610.021, to discuss matters that pertain to section (1) Legal matters, (3) Hiring, firing and discipline of employees, (13) Individually identifiable personnel information. Second received from Hatfield and approved by roll call vote 4-0 yea, Hatfield-yea, Holt-yea, Musgrove-yea, Zeiset-yea. Time is 6:15 pm.

Administration, employees and guests not required for Closed session exited at this time. Short break taken.

Closed Session

Attending: Board Members: Lori Fulk, Nic Hatfield, Christine Musgrove, Aarron holt, Jesse Zeiset.

Others: Meagan Weber, Brent Peirick, Achim Hoyal and Brenda Prather, Recording Secretary

Approval of Minutes: Minutes from closed session on October 27, are approved as follows: Motion by Zeiset to approve with second from Musgrove with roll call vote of 4-0 YEA, Hatfield-YEA, Holt-YEA, Musgrove-YEA, Zeiset- YEA

Legal-

Bylaws amendment discussed for qualifications of board directors.

Update on pending legal processes

Personnel

Discussion of Employee Holiday Gift – Motion by Hatfield to approve recommendations from administration for holiday gifts in the amount of $150 for full time employee and $100 for part time employees. Second received from Holt and approval by roll call vote: 4-0 YEA. Hatfield-yea, Holt-yea, Musgrove-yea, Zeiset-yea.

Formula for salary increase reviewed.

Physician contracts.

Motion by Hatfield with second by Musgrove to exit Closed session and return to Open. Approval received with roll call vote: 4-0 YEA. Hatfield-yea, Holt-yea, Musgrove-yea, Zeiset-yea. Time 7:30 pm.

Additional Business:

Motion by Hatfield to amend Article III- Directors, Section 3.1 Numbers and Qualifications, third sentence, to read as follows: “Each director shall have resided within the State of Missouri for one (1) year preceding his election, and shall be at least twenty-four (24) years of age. Holt offers second and motion is approved with roll call vote: 3-1. YEA. Hatfield-yea, Holt-yea, Musgrove-yea and Zeiset-Abstains

Resolution to ratify earlier vote to temporarily fill District 5 by appointing Mr. Zeiset as a temporary director. Motion by Hatfield to ratify with second from Musgrove. Approved with roll call vote: 3-1 YEA. Hatfield-yea, Holt-yea, Musgrove-yea and Zeiset-Abstains

Jesse Zeiset’s Oath of office is discharged once again, led by Lori Fulk.

Resolution for the ratification of all votes, motions, and committee appointments and other actions taken by Mr. Zeiset in his capacity as temporary director from 10/10/22 through present. Motion to ratify all actions taken or performed by Jesse Zeiset by Holt with second from Hatfield and approval by roll call vote: 3-1 YEA. Hatfield-yea, Holt-yea, Musgrove-yea and Zeiset-Abstains.

Adjournment

Motion by Hatfield with second from Holt to adjourn meeting. Motion approved by roll call vote: 4-0 YEA. Hatfield-yea, Holt-yea, Musgrove-yea, Zeiset-yea. Time is 7:38 pm.