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HGH Board Brief March 31, 2020

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

Medical Staff Report

Chief of Staff Paul Gaulin commented there have been daily meetings with action committees and medical staff personnel chaired by Interim CEO Karen Cole regarding COVID-19. He acknowledged the efforts of all the providers and support staff in dealing with the pandemic.

Administration Department Reports

EMS Report

Interim EMS Director Jordan Kohler updated Trustees on EMS transport activity, staffing, services, quality assurance/performance improvement studies, Burning Man preparation and grants. CEO Cole advised that staff is interviewing candidates for the EMS Director position and other positions have not been filled pending the direction position appointment. CEO Cole will develop a plan for providing a good group of candidates and timeline for filling the positions.

MedX AirOne

Trustee Bill Hammargren updated board members on the MedX AirOne air ambulance service. MedX sent protocols for COVID-19 patient transport; the company is also available to transport COVID-19 patients via fixed wing. 

COVID-19 Update

CEO Cole thanked Chief Nursing Officer Leeann Cushway and Executive Assistant Alicia Wogan for their assistance in dealing with the COVID-19 pandemic. She provided a brief sequence of COVID-19 events to date:

  • November 2019 China virus breakout
  • January 2020 began inventory of PPE and other equipment and supplies
  • March 2020 applied for federal funding, participated in the incident tabletop exercise, developed huddle notes-posts, expanded daily safety huddles to community members, opened the screening clinic, developed sourcing and reporting for pharmaceutical supplies, stopped elective surgeries, implemented and presented to medical staff multiple policies forLTC/inpatient services, implemented Acute and LTC visitor restrictions, purchased four additional ventilators, limited building access and imposed screening, investigated childcare for healthcare workers, made a swab pod request, created an emergency credentialing policy, suspended the remodel project, finalized the site for inpatient COVID-19 handling, established availability of cots from the Red Cross, transferred responsibility for the COVID-19 incident reporting to the County Medical Officer, reduced clinic visits, explored telehealth visits, had the first positive COVID-19 test and first inpatient admission with COVID-19, communicated with governmental bodies and professional associations, and identified additional sites that may be needed beyond hospital capacity.

Cole thanked all those who have participated in the process.

Consent Agenda

Board trustees approved the minutes for the following meetings: February 25, 2020; February 28-29, 2020; and March 13, 2020. Additionally, board members approved medical staff applications for appointments, reappointments and privileges for 11 medical providers.

Financial Reports

HGH Interim CFO Tim Powers presented and explained the financials, noting that due to COVID-19 there are significant impacts, such as Radiology being down by 30%. CFO Powers commented on the revenue cycle stabilization strategy, patient days, admissions, average daily census, AR aging, days cash on hand, and the budget calendar. CFO Powers went over the fiscal year 2021 tentative budget. Trustee Ken Tipton questioned if Net Proceeds revenue will be shown once the numbers are known. CFO Powers explained the revenue is usually only shown when it is received. CFO Powers commented on the stimulus monies earmarked for hospitals due to COVID-19 and said under normal conditions it would be a good deal; however, Medicare payments due to the conversion are suppressed by as much as 60 percent. CFO Powers noted some grant assistance may be available. Controller Kim Plummer commented on the 2 percent sequestration and said the hospital should see an increase with Medicare remits.

Business Items-Other Reports

1. Hospital Administration-EMS-Nursing / proposal to purchase twelve (12) new Zoll cardiac monitors-defibrillators and accessories for $341,209.34 / EMS-Administration - Interim EMS Director Jordan Kohler explained the use of the monitors by EMS and nursing staff, including the flight service. The current monitors are at the end of their useful life. Trustees unanimously approved the purchase as presented.

2. Hospital Administration/proposal to purchase MD-Staff credentialing and insurance enrollment web-based software for a five (5) year term at $16,800 per year / Administration - CEO Cole explained the detailed and involved credentialing processes for medical staff, allied health professionals and payers for insurance companies, noting the process has historically been done manually but it is now becoming too complex and there is software available which will assist with the entire process. Cole recommended obtaining the software, which trustees unanimously agree to purchase for a five-year term at $16,800 per year. 

3. Hospital Administration-Cardiac Rehab/proposal to purchase two (2) SciFit Inclusive Fitness arm ergometers with seats for cardio rehab workouts for $9,300 plus shipping and service-maintenance agreement charges / Cardiac Rehab-Administration - CEO Cole suggested the item be tabled since there are other more critical expenses right now and there are no cardiac rehab patients at this time. The item will be considered at a later date.

Trustee Comments

Board Secretary Michelle Miller said there have been meetings with BE Smith on the CEO search. To date there are 190 applicants, 32 interviews have been conducted, 18 second interviews and nine candidates are being prepared to present. The next round will be video interviews which should take about two days. After that, candidates will be presentedfor in-person interviews. It is estimated it will be July or August 2020 before there is a CEO in place. Trustee Tipton questioned what happened with the proposal to bring three or four candidates to the board for interviews. Secretary Miller explained that three or four will be invited for site visits. Trustee Hammargren said he is agreeable with a couple of board members interviewing candidates and bringing three or four to the board. Legal Counsel Kent Maher advised that the Open Meeting Law will apply to that process because there will be a recommendation to the board. Board Chairman JoAnn Casalez will appoint a committee to consider candidates at noon Friday May 8, 2020, and at 8 a.m. Saturday, May 9. Board Secretary Miller commented about a new format for the financial reports. CFO Powers indicated he is able to assist.

Trustees Gene Hunt, Bill Hammargren, Alicia Cramer and Chairman Casalez all expressed their appreciation for the work and effort of the HGH staff in taking care of the community.

Next Meeting

The Humboldt County Hospital District Board of Trustees will meet next at 5:30 p.m. Tuesday, April 28, in the Sarah Winnemucca Conference Room.

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