Trustees present: JoAnn Casalez, Chairman; Bill Hammargren; Ken Tipton; Gene Hunt; and Alicia Cramer. Not present: Michelle Miller, Secretary.

Medical Staff Report

There was no medical staff report.

CNO Report

Chief Nursing Officer Leeann Cushway reported:

• From March through June, over 1,000 COVID tests were conducted, with 83 testing positive for Humboldt County
• Elective surgeries resumed at the end of May
• The new OR Director is MaryJo Nazer
• There is a reduction in COVID related admissions since March
• There is increased availability for the rapid tests
• The screener job positions were posted and hiring is in process
• Limited visitation has resumed with the exception of Long Term Care (LTC)
• Daily state surveys for Acute continue
• There are weekly state surveys for LTC
• There is an increase in behavioral health patients in the Emergency Department and nursing criteria and admission to Acute Care have been developed
• Care nurses were approved to be in Acute Care and the Emergency Department 24/7.

Trustee Bill Hammargren asked if the mental health facilities are refusing to take behavioral health patients. CNO Cushway said there have been delays but not due to refusals; instead, they are not taking patients who are not cleared from COVID and beds are not always available. Trustee Gene Hunt asked about rapid testing. CNO Cushway advised that the hospital obtains the tests from the state lab and they have been able to order 100 per week.

COO Report

Chief Operating Officer Tiffany Love reported that a new cloud-based camera system that will allow security to monitor on their cellular phones is being considered for purchase. In addition, equipment for the EZ Lab was purchased to make it run more efficiently, and the current patient load ranges from zero to 15 per day with an average of two per day. Security has resumed normal rounding, and screeners have been provided with iPhones to call security for assistance as needed. Trustee Hunt asked if there is a direct dial to security. COO Love said there is not; however, there was discussion in today’s Safety Huddle meeting to make sure all front-line staff have the phone number for security. Trustee Hunt commented that it may be more efficient to have radios for direct contact to security. Board Chairman JoAnn Casalez suggested there is a radio app for mobile phones. COO Love advised she will look into it.

Clinic Report

Practice Administrator Robert Johnson reported that the Care Adopt program implementation has had some setbacks which were resolved and the program is moving forward. The number of clinic visits have increased. Dr. Subha Rajan is picking up new patients; she has been well received by both patients and staff. Dr. Rajan has been taking call for labor and delivery/neonatal patients and is an active member of the Medical Staff.

Residency Program

Interim CEO karen Cole said the residency graduation program was held June 23, 2020 for Dr. David Masuck and Dr. Hind Elsanousy. A faculty position has been posted through UNLV and Dr. Lacy Fettic will be on site to interview for the position July 20, 2020.

Recruiting Update

CEO Cole reported:

• Brittani Smith, MD, an FP/OB, will start in the fall of 2020
• David Masuck, MD, FP, is scheduled to start August 1, 2020
• There is continuing interest from a psychiatrist to provide services
• Kirit Saigal, NP, who specializes in Behavioral Health, will be available soon
• Danny Lambert, PA, is awaiting a license
• David Fielder, NP, starts in Long Term Care July 27, 2020.

Cole said:video interviews were scheduled with two external candidates for the EMS Director position; the candidates will also have site visits and there is one internal candidate for the position. The hospital is currently recruiting for a Community Relations/Marketing person, an Obstetrics Nurse Manager and a Clinic Nurse Manager.

Construction Update

CEO Cole reported that Owners Representative Mike Sheppard advised that Sletten Construction has rescheduled its subcontractors. A meeting has been scheduled for July 7, 2020, to outline the process for moving forward with the cafeteria flooring, kitchen hood replacement, pharmacy metal doors, epoxy paint and an IV hood.

COVID-19 Funding

CEO Cole commented there is a possible funding opportunity to use unused county COVID funds, which could result in payment for screening technology and ultraviolet infection control lights, but the timeline is tight and may require a special meeting of the board to consider.

EMS Report

Interim EMS Director Jordan Kohler said two Paramedic positions are posted and they will help with Orovada, which hasn’t been staffed since last year. The Community Paramedicine program is going strong; community paramedics are still contacting COVID patients daily. All ambulances have passed state inspection. The Community Paramedicine program received a grant with NRHP, which was supposed to end July 1, 2020, but it has been extended to December 31, 2020, to provide a half- to full-time employee for the program and some equipment. The EMS service experienced its busiest month ever for calls. EMS members Anthony Pasquale, Stephanie McGilvrey, Charles Paddock and Ken Whittaker provided an Honor Guard for the passing of Winnemucca Police Department officer Matt Morgan.

Consent Agenda

Board trustees approved the minutes for the following meetings: May 25, 2020; June 8, 2020; June 9, 2020; and, June 15, 2020. Additionally, board members approved medical staff applications for appointments, reappointments and privileges for two medical providers.

Interim CFO Tim Powers presented and explained theMay 2020 financials, including: gross patient revenue; contractual allowances and bad debt; operating revenue; operating expenses; non-operating revenue; net income; and, AR and days cash on hand. CFO Powers said Cerner is discontinuing their use of the Trust coding service, but the hospital can now contract directly with Trust at significantly reduced coding rates. REV Works plans to move to R1, but the entire REV Works team should be intact, so nothing should be lost. CFO Powers explained the Long Term Care revenue cycle process and noted that Medicaid and the self-pay portions run smoothly, but there is difficulty with Medicare because they require everything to be placed on one claim. As of today, the billing for every month is complete with the exception of February, which should be fixed tomorrow. When June is billed, everything will be up to date. CFO Powers thanked everyone who worked to fix the process.

Business Items-Other Reports

1. Hospital Administration/ Nevada Public Agency Insurance Pool (POOL) liability insurance program / Public Agency Compensation Trust (PACT) Workers Compensation insurance program / renewal proposals and premium payment from fiscal year 2020-2021 funds / POOL-PACT--A&H Insurance - Scott Rottman and Marianne Dente with A&H Insurance thanked the hospital for its continued support. Dente explained that last year the maintenance deductible was increased to $25,000, which saved $33,000. She outlined the coverages for earthquake and flood; ordinances and law; liability through LiCON; Cyber events; and environmental events. This year’s premium is $189,094.31, a decrease of 26.23%, which is due to an update of the total insured values from the appraisals. Trustees unanimously approved the insurance proposal in the amount of $189,094.31.

2. Hospital Administration-Maintenance / proposal topurchase of chiller compressor replacement from RHP Mechanical Systems for the sum of $13,676 / COO-Administration - Trustees unanimously approved the purchase of the chiller compressor replacement in the amount of $13, 676.

3. Hospital Administration-IT / proposal to purchase 15 Verkada security-surveillance cameras, software, mounting equipment and five-year service agreement from CDW Government for the estimated sum of $22,500+/ IT Director-Administration - Trustees unanimously approved the purchase as presented in the amount of $22,500.

4. Hospital Administration-EMS / proposal to purchase a previously owned 2017 Ford Explorer SUV from Hincklease for the sum of $18,000 and to paint the vehicle and update-repair the vehicle emergency services equipment for the estimated sum of $4,000 / EMS Director - Administration - Board members approved the purchase of the used 2017 Ford Explorer, including paint and equip, for a total of $22,000.

5. Hospital Administration-EMS / determination that six Delta units and one Medic 5 unit from the EMS fleet are no longer required for public use and authorization to sell or dispose of such equipment in any manner, including public auction or donation/ EMS Director-Administration - Interim EMS Director Kohler advised that these are the vehicles that were used for Burning Man and since services are no longer being provided for Burning Man, there is no use for the units by the department. Trustees unanimously approved the motion as presented.

6. District Administration / proposal to approve Board of Trustees Bylaws / Board of Trustees - Board Chairman Casalez indicated that Board Secretuary Miller (who is absent) is in favor of approving the Board of Trustees Bylaws. The bylaws were unanimously approved as presented.

7. District Administration / terms and conditions of employment and employment agreement with Tim Powers to provide administrator-chief executive officer services / Board of Trustees - Board Chairman Casalez stated she received a signed letter of intent (LOI). Board members approved the terms and conditions of the proposed employment agreement as presented.

Trustee Comments

Trustee Ken Tipton welcomed Tim Powers.

Trustee Gene Hunt thanked the staff for their work.

Trustee Bill Hammargren welcomed Tim Powers and thanked Interim CEO Karen Cole for her assistance with the organization.

Trustee Alicia Cramer welcomed Tim Powers and thank staff for taking on the challenges in Long Term Care.

Board Chairman JoAnn Casalez passed around a thank you note for the drug free graduation and a thank you card from a patient who received prompt medical care. Chairman Casalez thanked staff for their work in Long Term Care and welcomed Tim Powers. Chairman Casalez said she appreciated Interim CEO Cole and the work she has done. Chairman Casalez thanked EMS for providing the Honor Guard for Matt Morgan

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

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