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HGH Board Brief November 19, 2019

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

Medical Staff-Hospital Department Reports

Medical Staff Report

HGH Chief of Staff Paul Gaulin was called away. There was no medical staff report.

Administration Department Report: CEO

Cerner Go Live

HGH Chief Financial Officer Sandi Lehman updated board trustees on the hospital's conversion to the Cerner Electronic Health Record platform. The hospital had a successful "go live" at midnight November 11, 2019. Staff members were very prepared and the transition of patients to the new system was fairly seamless. Cerner staff members are here this week to help physicians customize the system to their practices and preferences. Sandi said all managers are meeting daily to review each day's charges to assist with billing accuracy. The hospital will begin submitting claims to insurance carriers this week.

Sandi reported on two interfaces with the new EHR that are in process: reference lab and radiology. Also, Sandi said her team is assessing how to best approach self-pay payments through the Apex system, a part of the original Cerner purchase. Apex does not allow merged billing. A possible solution may come through the sequel report, which would merge patient statements from Cerner and Medhost, the hospital's former electronic health record.

Physician Update

HGH Interim CEO Karen Cole updated board trustees on the hospital's newest physicians:

  • Rommel Adajar, MD - Dr. Adajar, an Internal Medicine specialist, began his practice at HGH on October 7. His practice is growing and the hospital is grateful to have him on staff.
  • Andrew Wesely, MD - Dr. Wesely, a Pain Management specialist, saw 18 patients during his first two days at HGH: November 13-14. He will return on December 18-19.
  • Shane Draper, DPM, and Quinn Lindstrom, DPM - Drs. Draper and Lindstrom will begin seeing patients at the HGH Physicians Clinic on January 6.
  • Subha Rajan, MD - Dr. Rajan, a Family Practice/OB physician, will begin her practice at HGH in April 2020.
  • David Masuck, MD - Dr. Masuck, currently Chief Resident of Humboldt General Hospital's Resident Physicians, will join the HGH Physicians Clinic in fall 2020.

CEO Cole also updated the board on the status of other providers at HGH:

  • CRNAs - Humboldt General Hospital continues to recruit for a third CRNA position; several candidates are under consideration.
  • Perry Guthrie - Perry is a locum Nurse Practitioner working in the HGH Walk-In Clinic.
  • Raafat Khani, DO - Dr. Khani is a locum Internal Medicine specialist, providing family medicine services.
  • Pamela Sherwill-Navaro - Pamela is a locum Nurse Practitioner, providing family medicine services in Suite A of the HGH clinic.

CEO Cole also updated board members on physician recruitment efforts:

  • Brittani Smith, MD - Dr. Smith is a Family Practice/OB physician who is scheduled for a site visit on December 1, 2019.
  • Dr. Muhad - Dr. Muhad, a Family Practice Resident at Mercy Medical Center in Iowa, will come for a site visit from January 11-14, 2020.

CEO Cole said other key recruitment efforts at HGH include the search for a third CRNA, an OR Manager and an OB Manager.

Remodel Projects

The Pharmacy Department will move into their new space December 13.

CEO Cole updated the board on the various expansion-remodel projects at HGH:

  • Pharmacy - Painting is now complete in the new Pharmacy Department. All interior and exterior glass has been installed, along with non-casework cabinetry and lighting. County inspectors will be on site December 9-11; Pharmacy will move into the new space December 13.
  • Physical Therapy and Cardiac Rehab - Construction will begin once the Pharmacy is complete, around mid-December.
  • Cafeteria - The board will consider a proposal to remodel the HGH Corner Cafe later in the meeting.

Consent Agenda

Board trustees approved the minutes for the October 22, 2019, meeting. Additionally, board members approved medical staff applications for appointments, reappointments and privileges for 11 medical providers.

Financial Reports

Financial reports for both October and November will be presented at the December meeting of the HGH Board of Trustees.

Business Items-Other Reports

1. Hospital Administration-Emergency Services / proposal for amending the agreement with MedX AirOne regarding medical staff services and communications center services / Board - Trustee Bill Hammargren relayed information to board members regarding a recently received letter from MedXAirOne President Joel Hochhalter. The letter proposes to amend MedX's agreement with the hospital to (1) move MedXAirOne's communications center to Elko; and, (2) employ all flight paramedics and nurses through MedXAirOne. Currently, HGH employs HGH AirOne's paramedics and nurses. The proposed agreement would mimic MedX's agreements with all other hospitals in its service area. Trustee Hammargren noted the proposed agreement would allow the HGH AirOne helicopter to remain at Humboldt General Hospital. CEO Cole stated that 14 HGH employees would be displaced through the comm center and flight staffing changes. Mr. Hochhalter said he will try to relocate any employees to Elko's operation who are interested; CEO Cole said Humboldt General will relocate interested employees to positions within HGH. Secretary Michelle Miller said she would prefer to table a decision on the matter until the next board meeting to allow board members more time to consider the proposed amendments and HGH's potential response. Chairman JoAnn Casalez reminded board members that MedXAirOne is a private company choosing to do business with HGH. After some discussion, board members unanimously agreed to direct CEO Cole to work with Legal Counsel Kent Maher and Mr. Hochhalter to negotiate a revised contract.

2. Hospital Administration-Personnel / proposals and recommendation for employee healthcare benefits insurance coverage / HR Director-Administration - Staff presented eight bids for employee health insurance to the board, four from the current broker, Nevada Rural Hospital Partners, and four from broker, A and H Insurance. Hospital staff recommended proceeding with the lowest bidder, Aetna. Following discussion the board determined to select A and H Insurance as a new broker and proceed with the Anthem bid. As Trustee Gene Hunt said, the decision came down to service and "not necessarily price." Hospital officials said they are hopeful that reduced premiums may allow the hospital to reduce the cost of its dependent coverage; currently, the hospital only pays employee premiums.

3. Hospital Administration-Remodel Project /proposals for cafeteria area remodel project / acceptance of proposal for cafeteria area remodel project/ Owners Representative-Administration - HGH Owners Representative Mike Sheppard presented cost estimates for completing an expansion-remodel of the hospital cafeteria. Mike said Sletten Construction is estimating the project at $324,569. Trustees agreed to a change order to the hospital's current construction projects to allow Sletten to carry out plans submitted by CTA Architects. The board authorized construction costs not to exceed $400,000; work should begin in the new year.

4. Hospital Administration-EMS / determination that ambulance vehicles are no longer required for public use and authorization to dispose of the vehicles/ CFO -HGH Trustees determined that several EMS vehicles are no longer of use to the hospital and will be disposed of through auction.

5. District Administration / proposals to provide administrative management services for the hospital district administrator-chief executive officer position and to implement a plan to select and employ a permanent administrator-chief executive officer / Board of Trustees - Trustees unanimously agreed to work with B.E. Smith, a professional services firm specializing in executive recruitment services for healthcare organizations, to begin the process of hiring a permanent CEO. HGH Interim CEO Cole was asked to assist with the search for a permanent CEO. Chairman Casalez thanked Cole for all she has done over the past year to help move the hospital forward. "You've made excellent changes and hard changes," said Casalez. CEO Cole responded, "This has been an excellent opportunity for me." However, she noted that she is not in a position to accept the position permanently. Trustees said the recruitment process could take from 6-12 months.

6. District Administration / Western Regional Trustee Symposium / Administration - CEO Cole shared information about the Western Trustees Symposium, scheduled for June 10-12 in Reno. The conference is designed specifically for hospital board members and executive leadership.

Trustee Comments

Trustee Gene Hunt shared his positive experience with Andrew Wesely, MD, who provides pain management services at HGH two days each month. Trustee Hunt said he was impressed that Dr. Wesely is concerned about designing his practice to fit HGH's needs. He also thanked CEO Cole, and said he felt the board moved in the right direction with their selection of A and H Insurance.

Chairman JoAnn Casalez welcomed new Trustee Alicia Cramer and asked her to serve on the HGH Community Giving Committee.

Trustee Ken Tipton welcomed new Trustee Cramer. He also thanked CEO Cole for all she has done and for her promise to help HGH recruit a permanent CEO.

Secretary Michelle Miller thanked CEO Cole for helping over the past year. She said she appreciated the opportunity to have CEO Cole help the hospital recruit a permanent replacement.

Trustee Hammargren welcomed Trustee Cramer. He also thanked CEO Cole for her work over the past year.

Next Meeting

The Humboldt County Hospital District Board of Trustees will meet next at 5:30 p.m. Tuesday, December 17, in the Sarah Winnemucca Conference Room.

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