Hospital Board Reorganizes, Regular and Closed Session Minutes 

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Submitted by Brenda Prather, Recording Secretary 

Reorganization Meeting 

DRAFT SUMMARY – April 25, 2023 – Those in attendance: Board Members: Lori Fulk-Chair, Nic Hatfield-Vice Chair, Christine Musgrove- Secretary, Aarron Holt- Treasurer, Jesse Zeiset, Travis Trueblood. Administration/ Employees: Meagan Weber, CEO, Brent Peirick, COO, Ashley Ward, RN-CNO, Heather Ayer, QI/ Safety, Michael Buford, Patient Access Navigator, Carolyn Davies, CFO, Anna Olfus, Staff Accountant, Lezah Cline-HR Director, Alisa Kigar, Marketing Director, Jonathan Holton, IT Specialist, Cheyenne Neagle, RN-Supervisor of RHCs, Kevin Brown, Attorney, Tara Schultz- Rudowsky, Grants, and Brenda Prather, Recording secretary. 

Medical Staff: Dr. Celeste Miller-Parish, Sonya See, WHNP. 

Chair Lori Fulk calls the meeting to order at 5:32 pm. 

Motion by Musgrove with second by Hatfield to approve agenda. (All in favor.) 

Reorganization of Board. Acknowledgement given to Hatfield, Musgrove, Zeiset, and Holt for their filing of candidacy and achieving their directorships unopposed. Nomination for election of offices. Lori Fulk opens floor for nominations. Motion from Nic Hatfield to retain current officers by acclimation. Travis Trueblood seconds the motion. No discussion. (All in favor.) (Executive Officers: Chairman- Lori Fulk, Vice-Chair- Nic Hatfield, Secretary- Christine Musgrove, Treasurer- Aarron Holt.) 

Committee Appointments- Pursuant to District Bylaws Article VI- Committees, the following standing and special were designated. Motion to retain previous committee members by Zeiset with second by Musgrove. (All in favor.)Executive –(Standing) Fulk and Hatfield. Quality and Safety – (Standing) Fulk and Musgrove. Finance – (Standing) Hatfield, Trueblood and Holt. Disaster Planning- (Standing) Hatfield and Zeiset. Affiliation- (Special) Fulk and Hatfield. 

Motion by Musgrove with second by Holt. (All in favor.) 

Regular Meeting 

DRAFT SUMMARY – April 25, 2023 Chair Fulk opens regular meeting and calls for action on the following: 

Approval of Open Session Agenda – Motion by Holt to approve agenda; Hatfield offers second; followed by roll call vote: (All in favor.) 

Approval of Closed Session Agenda. Motion by Holt; second from Trueblood to approve topics of discussion under Sections (1) Legal matters, (3) Hiring, firing and discipline of employees (13) individually identifiable personnel information, as Pursuant to Missouri Sunshine Law, 610.021. Motion approved by roll call vote: 5-0 

Approval of Minutes – Motion by Zeiset to approve the minutes from March 28, 2023 Open Session. Second received from Holt followed by roll call vote: 4-0 YEA. Holt-YEA, Musgrove-YEA, Trueblood-YEA, Zeiset-YEA, Hatfield-Abstains as he was absent from the meeting. 

Public Comment- No requests were received for this meeting. 

Monthly Departmental Reports- Motion by Zeiset to accept reports as presented; second from Musgrove, followed by roll call vote: 4-0 YEA. 

Chief Nursing Officer – attached with Ashley Ward adding her progress on negotiating a current CRNA who is also an instructor in pain management classes to perform this service at SCH. Great recommendations have been received on his behalf and she hopes to be able to report initiation of a pain clinic soon. 

Health Information Management – attached 

Human Resources – attached 

Maintenance- attached 

Material Management -attached 

Quality Improvement and Safety – Quarterly report included in March meeting minutes. 

Rural Health Clinic Updates – attached with Cheyenne Neagle highlighting: First provider meeting which went very well. All provider office visits have been streamlined to be consistent in length. 20-minute appointments for all, with the exception for first time patients which will be 40 minutes. 

Supervisor Quarterly Mtg. attached. 

Finance Report – Anna Olfus, Staff Accountant began this portion of the meeting by highlighting areas through Balance Sheet, Income Statement, Statistics, etc., for March. She was followed by CFO Carolyn Davies reporting on Payor mix, accounts receivable, cash on hand, processes for evaluating charges versus reimbursement of various services. Brief discussion on capital budget components. Full budget will be presented at later meeting. 

Medical Staff Advisory with Dr. Celeste Miller- Parish – Dr. Miller-Parish’s report is attached. 

We continue to have department heads come to staff meeting to present what things we can do in their department that are under-utilized. At our April Med Staff meeting Andrea Graham from dietary gave a presentation. 

We are working on chart completion to meet our 7-day requirement as per Med Staff Bylaws, and the numbers are improved. 

Currently working on Med Staff Bylaws, to update, and move some items into policy/ procedure format. 

COO Update – Provider Recruitment and Specialty updates: ENT, Pulmonology, General Surgery, Hospitalist, OB/GYN: We talked with Dr. Orange about becoming a SCH employee and working part time, Rheumatology: Dr. Jackson has started coming an extra day per month to provide better access for patients needing Rheumatology services, Brenna Smith: Brenna will start on May 3rd. She will be collaborating with Dr. Neisen and will be following him as he cares for patients in the hospital as well as the RHC, Clinic Restructuring: We are making many moves in the clinic to make room for new providers. We will be renovating the old retail pharmacy space to make room for our specialty providers and Dr. DeBlieck, Revenue Cycle: We have hired a few more coders in the billing department and have been able to significantly decrease the number of unbilled accounts. We will be working with our providers on keeping up with their clinic documentation so that we can stay as current as possible with our clinic billing, Infection Preventionist: Upon recommendation by Administration and in compliance with state statues, the established position of Infection Preventionist is recognized to be Thelma Norton. This position has previously been identified through SCH Committee appointments. Motion by Trueblood to acknowledge Thelma Norton as Infection Preventionist with second from Hatfield. This was followed by roll call vote: 5-0 YEA. 

CEO Report – Expanse: Delivery and implementation will begin in June of this year. We have hired some part time staff to help with the build and implementation to reduce the workload of full time, clinical staff. Meditech was on site April 12-13, and we have specific deadlines we must meet with vendors to allow successful interface. 

Bank RFP’s: We have delivered requests for proposals from the four banks in town. We will see what each bank has to offer with the services, and bring those to the next board meeting. 

Employers: The hospital administration will be meeting with local employers to see how we can help them. (Ex: making sure they know our services, seeing what special help we can provide to employers, DOT physicals, work comp issues, contracts, etc.) One discussion with Pepsi, showed our provider list was not up to date through HealthLink, so we have corrected that, and will continue to check this with other organizations. I have meetings set up with Tri County, SCR-1, and am working on meeting the city, county, Hill Phoenix, All States, Mo Dot. We want to promote DOT physicals, pre-employment physicals, and any other services we can help with for local businesses. 

Grant Team: We implemented a grant team three weeks ago to help fund our capital items, and we were able to compile around 30 grants to review. Tara Shultz has been hired PRN as a grant committee organizer/writer, and she will also be helping organize our Med Club program. We are going to add more schools next year, and it has become too much for me to do without help, a good thing, as four schools are participating! There is a grant opportunity that can link the Med Club and the Hospital for substance abuse prevention, which is $375K for five years. 

Positivity Campaign: We continue to market our services, and I have received great feedback on our OB flier that went out last week. Hospital week is coming up, and I am working on a “My Why” campaign with employees, to allow them to reflect why they are here. Our admin continues to brainstorm on improving work culture and teamwork throughout the facility. 

Surgery and Anesthesia Charges: Full cost and charge analysis has been performed and charges have been adjusted to insure that OR procedures are consistent with a contribution margin. 

Service Lines: We will be bringing in a CRNA that specializes in pain management, and will start a pain management clinic. These are known to be profitable, and Ashley Ward has worked hard to get this going. The CRNA that will be coming is also an educator, and we have two physicians that are interested in learning how to do the injections. 

Medicare Cost Report: Requested to Medicare to move our statistics to the “simplified basis” which will allow more costs to be reimbursed appropriately by Medicare. 

Video. At this time, CEO Weber played a video; “History of SCH Hospital” which was reminiscent of the hard work and devotion which began in 1966 and lead to the establishing SCH, and rekindles the value of SCH and our commitment to this community. Video may be viewed at History of Scotland County Hospital – YouTube. 

Old Business 

SCH Committees. The list of committees was approved at the March meeting, however, with Dr. Wilson leaving a new Chair of the Utilization Review Committee was needed. It was determined that Dr. Aaron Neisen would fill this role. Motion to approve revisions was offered by Musgrove with second from Zeiset followed by roll call vote: 5-0 YEA: Hatfield- YEA, Holt-YEA, Musgrove-YEA, Zeiset-YEA, Trueblood-YEA, Trueblood-YEA. 

Lock box. It was hoped that all the information to decide would be ready for this meeting, however, a few details are yet to come. 

New Business 

Bylaws Revision. Following discussion by Chair Fulk and CEO Weber, a revision was proposed to the board members for the addition of Article III – Officers, Section 3.7 Evaluations. “The directors of the Board shall conduct an Individual Performance Evaluation of themselves, on an annual basis”. Motion by Holt to approve the proposed addition with second from Trueblood and followed with roll call vote: 5-0 YEA. 

Personal Financial Disclosure Statements- MEC Deadline May 1, 2023. Deadline for filing annual personal financial disclosure statement with Missouri Ethics Commission is May 1st. As of this reporting all current board members and employees required to file have done so. One former employee has yet to file. 

Policies and Procedures – renewal/review of policies presented since March 28th meeting. Motion by Holt to accept the review with second by Musgrove followed by roll call vote: 5-0 YEA. 

Credentialing Motion by Holt to approve the action listed below, as recommended by Medical Staff. Zeiset offers second followed by roll call vote: 5-0 YEA. 

Initial Appointment 

Brenna Smith, FNP-C Allied Health Emergency Depart/Urgent Care – Governance: BoardRoom Press, February 2023. This edition contains articles on the following, which were distributed for the board members to review at their leisure. 

Enhancing Community Connections to Improve Care 

Building the Leadership Triad for Sustainable Success 

Expanding Board Criteria Beyond Competencies to Enable More Holistic Recruitment 

From Value to Cost Effectiveness of Health 

Balancing Long-Term Strategy and Short-Term Challenges 

CEO Weber announced that an MHA sponsored webinar on governance will be available at noon in SCH Library this Friday, April 29. All board members are invited to attend. 

Motion by Hatfield to enter Closed session pursuant to Sunshine Law Statute 610.021, to discuss matters that pertain to sections (1) Legal matters, (3) Hiring, firing and discipline of employees, (13) Individually identifiable personnel information. Second received from Holt, followed by roll call vote 4-0 YEA: Hatfield- YEA, Holt-YEA, Musgrove-YEA, Trueblood-YEA, Zeiset abstains as he will be unable to remain for closed meeting. Time is 6:45 pm 

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

Closed Session 

DRAFT SUMMARY – April 25, 2023 – Zeiset was unable remain for closed session. 

Those present: L. Fulk, N. Hatfield, A. Holt, T. Trueblood, C. Musgrove, CEO Weber, COO Peirick, CFO Carolyn Davies, Kevin Brown, Attorney and B. Prather, recording secretary. 

Approval of Closed Session minutes-March 28, 2023. Motion by Holt to approve with second from Trueblood. Motion approved by roll call vote: 3-0 YEA, Holt-YEA, Musgrove-YEA, Trueblood-YEA, Hatfield-abstains as he was not present at that meeting. 

Legal – Update of current legal matters. 

Discussion of variations in Missouri State Statutes. 

Personnel – Development of personnel/processes in self-pay and payment plans. 

Discussion of role in position for recovery of denied claims. 

Motion to adjourn closed session and return to open session by Hatfield with second by Trueblood, followed by roll call vote: 4-O YEA. Time is 8:30 

With no further business for this meeting, Motion by Hatfield with second by Trueblood to adjourn open meeting followed