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HGH Board Brief February 25, 2020

Trustees present: JoAnn Casalez, Chairman; Michelle Miller, Secretary; Bill Hammargren; Gene Hunt; Alicia Cramer; and, Ken Tipton.

Medical Staff Report

There was no medical staff report.

Administration Department Report

Interim CEO Cole recognized Chief Nursing Officer Darlene Bryan for 36 years of service.

CEO Cole also introduced HR Director Dianelis Almendares and Interim CFO Tim Powers. A search firm that specializes in OR personnel was retained to find OR Manager candidates. In the interim, Glenna Montgomery is acting as the OR Manager. Candidates for the EMS Director are being screened.

Medical Staff Updates

  • Dr. Subha Rajan, an FP/OB provider, will start in April.
  • Dr. David Masuck, an FP provider, will start in the fall.
  • Dr. Brittany Smith, an FP/OB provider, is reviewing her contract with her attorney.
  • Arthur Johnson, PA, is working in the Walk-In Clinic Thursday through Saturday.
  • Dan Lambert, PA, interviewed for the Walk-In Clinic.
  • Laurie Parker, APRN is working as a locum and will be here until March 6.
  • Pamela Sherwill-Navaro, NP, will cover the Walk-In Clinic until permanent PAs are hired.

Other Administrative News

  • Hours in the Walk-In Clinic have expanded to 8 a.m. to 8 p.m. Monday through Saturday, beginning February 22.
  • Gregory McClain, MD, vice-president of Surgical Services for RPG, visited on February 12.
  • Sleep Medicine clinic equipment will be installed January 30, 2020. The first study is expected in mid-March.
  • A consultant from Midwest Health Care visited regarding the Rural Health Clinic.
  • The floors in the fluoroscopy room were installed, painting was completed, the ceiling is removed, and a new ceiling will be installed when the ceiling strut is replaced; the equipment will be installed April 6. Training will take place on April 27, 2020.
  • CEO Cole attended the recent LICON meeting where it was announced that legal counsel Steve Balkenbush will be replaced with Katherine Parks; Risk Manager Ken Maiolini will retire next year; and Linda Lilleboe has replaced Linda Garrett to handle risk activities.

CEO Cole attended the NRHP meeting where the following topics were discussed:

  • A Medicaid proposal to include cost-based outpatient reimbursement in next the next state budget;
  • Cultural competency training for a new law, which has no regulations for implementation;
  • Reporting requirements for a cancer registry;
  • A workplace violence prevention workshop;
  • Infection control and PPE;
  • The appointment of Dr. John Packham, Office of Statewide Initiatives for UNR School of Medicine, as chair of the Governor’s Patient Protection Commission; and,
  • The availability of grants through NRHP.

Upcoming Events

A Board mini retreat is scheduled for February 28-29, 2020, where Trustees will discuss various matters affecting the district. Additionally, the Western Regional Trustee Symposium is scheduled for June 10-12, 2020, in Reno, Nevada.

Consent Agenda

Board trustees approved the minutes for the January 28, 2020, meeting. Additionally, board members approved medical staff applications for appointments, reappointments and privileges for 13 medical providers.

Financial Reports

HGH Interim CFO Tim Powers Interim CFO Powers explained the financials and gave an update on the Cerner conversion. Powers said it was not possible at this time to present meaningful financial reports because the financial reporting system is unreliable. Community Links Consultants were contracted to assist with finances; they started today. Powers explained the Multiview financial system and commented on the accounts receivable.

Business Items-Other Reports

1. Hospital District / CEO recruitment update / Board of Trustees - Board Chairman Casalez said the Board is in regular contact with B.E. Smith; they have 90 people being vetted through the CEO selection process. Chairman Casalez briefly explained the candidate selection and interview process, which should result in site visits being offered to three persons over two days. No action was taken.

2. Hospital Administration / proposal to employ and enter into an employment agreement with Arthur Johnson, PA, to provide physician assistant health care services / Administration - HGH Trustees unanimously approved the employment agreement for Arthur Johnson, PA, as presented.

3. Hospital Administration / proposal to enter into a contract with Sara Thorp, MD, to provide newborn nursery coverage, C-section assistance coverage and Pediatric call coverage services / Administration - HGH Trustees unanimously approved the employment agreement with Sara Thorp, MD, as presented.

4. Hospital Administration / proposal to enter into an employment agreement with Kirit Saigal, ARNP, to provide psychiatric nurse practitioner services / Administration - HGH Trustees unanimously approved the employment agreement with Kirit Saigal, ARNP, as presented.

5. Hospital Administration / proposal to employ and enter into an employment agreement with Dan Lambert, PA, to provide physician assistant health care services / Administration - HGH Trustees unanimously approved the employment agreement with Dan Lambert, PA, as presented.

6. Hospital Administration / proposal to amend and extendagreement with Roger Brecheen, M.D., Arroyo Medical, Inc.to provide OBGYN services / Administration - Board Trustee Bill Hammargren asked if the requirement to use the district medical records system was included in the agreement. CEO Cole advised it is included. Trustees unanimously approved the amended agreement with Roger Brecheen, MD - Arroyo Medical, Inc. as presented.

7. Hospital Administration / proposal to enter into agreement with Humboldt County to provide health care services for the Humboldt County Detention Facility / Administration - Board Chairman Casalez asked if the $80 flat fee statement in the proposed agreement is for Walk-In Clinic services. CEO Cole explained the flat fee is for detention center visits. If an inmate is brought to the WIC, the normal charges apply. Legal Counsel Kent Maher said the intent of the agreement is that most services will be provided at the detention facility. Board Secretary Michelle Miller asked about the frequency of detention facility visits. Practice Administrator Robert Johnson said that regular visits presently occur on Thursday; if there is an emergency the patient is taken to the ER. Legal Counsel Maher advised the payment items will be made clear in the final version of the agreement. Board Trustees unanimously approved the agreement with Humboldt County to provide healthcare services for the Humboldt County Detention Facility with the changes as discussed.

8. Hospital Administration-Maintenance / proposal to authorize repair, replacement and possible relocation of the kitchen hood-exhaust systems on a time and materials basis at an estimated cost of $150,000 / Maintenance Director-Administration - Board Trustees unanimously agreed to authorize the repair, replacement and possible relocation of the kitchen hood-exhaust systems on a time and materials basis at an estimated cost of $150,000 as presented.

9. Hospital Administration-Maintenance / update on the pharmacy project-hood/ Maintenance Director-Administration - HGH Owners Representative Mike Sheppard stated the pharmacy is in operation except for the exhaust hoods, which are functioning properly but are unable to pass required testing. After completion of the larger duct work and motors in early March, the system will be tested again. CTA Architects brought in experts to analyze the system. Board Trustee Hammargren asked why the hospital must absorb the cost. CEO Cole advised that CTA agreed to pay some of the costs. Board Secretary Miller believes the hospital is being asked to bear the cost of a poor design. Owner Representative Sheppard explained the project history and noted the only item of the project that has come back to the board is the casework. CEO Cole related her conversation with CTA about the hood system design. Hammargren questioned if there is something wrong with the testing method. Pharmacy Director Dave Simsek explained the testing. No action was taken.

10. Hospital Administration/ proposal to authorize five year term interlocal agreements and amendments to existing five year interlocal agreements with the Nevada Division of Health Care Finance and Policy for: payment of the outpatient supplemental payments at a cost not to exceed $5,076,036; payment of the total supplemental inpatient and outpatient upper payment limit payments at a cost not to exceed $9,251,303; increase the outpatient supplemental payments at a cost not exceed $3,957,348; and, increase the total supplemental inpatient and outpatient upper payment limit payments at a cost not to exceed $7,238,727 / Administration - Interim CFO Tim Powers advised the existing interlocal agreements need to be amended and the two proposed new interlocal agreements should be entered into to facilitate the cost sharing for Medicaid. Trustees unanimously authorized five-year-term interlocal agreements and amendments to existing five-year interlocal agreements with the Nevada Division of Health Care Finance and Policy for: payment of the outpatient supplemental payments at a cost not to exceed $5,076,036; payment of the total supplemental inpatient and outpatient upper payment limit payments at a cost not to exceed $9,251,303; increase the current term outpatient supplemental payments to a cost not exceed $3,957,348; and, increase the current term total supplemental inpatient and outpatient upper payment limit payments to a cost not to exceed $7,238,727.

11. Hospital Administration-Respiratory / proposal to purchase pulmonary machine from PulmOne for $40,565 / Respiratory Director - Board Trustees unanimously authorized the purchase of a PulmOne pulmonary machine at a cost not to exceed $40,565.

Trustee Comments

All Trustees thanked CNO Darlene Bryan for her service.

Board Trustee Ken Tipton suggested the hospital's financial condition will improve once the Cerner Electronic Health Record system is operable.

Board Secretary Miller welcomed HGH's new staff members.

Board Trustee Alicia Cramer reported she has heard positive comments about the extended hours at the Walk-In Clinic.

Next Meeting

The Humboldt County Hospital District Board of Trustees will meet next at 5:30 p.m. Tuesday, March 31, in the Sarah Winnemucca Conference Room.

Meeting agendas, board minutes and more will be/are available at: