Governance

Washington County Hospital
Board of Directors Meeting Minutes
Tuesday, December 28, 2010, 7:00 p.m.
Conference Rooms A and B

Members Present:
Dale Blohm, Chair
David Behr via teleconference
Jim Cange
Greg Engele
Victor Lopez
J. W. Metcalf
Diane Nottmeyer
Rich Tomaszewski

Members Not Present:          
Bill Manier, excused

Others Present:
Nancy Newby, CEO
Tammy Amizich, CNE (exited 8:24 p.m.)
Christine Bening, HR Coordinator (exited 8:24 p.m.)
Ruth Kellerman, QA Coordinator (exited 8:24 p.m.)
Elaine Matzenbacher, CFO

Others Not Present:
Kim Larkin, excused
Marc Zerbe, M.D., Medical Staff President, absent

Called to Order:         7:10 p.m.
Adjourned:                 8:47 p.m.

Meeting Agenda
The agenda of the December 28, 2010, meeting of the Washington County Hospital Board of Directors was presented for review and approval. 

On a motion by Victor Lopez and second by Rich Tomaszewski, the Board unanimously voted to approve the December 28, 2010, meeting agenda.

Board of Directors Meetings Minutes
Finance Committee Meetings Minutes
The following meetings minutes were presented for review and approval:

• Special Board of Directors, November 22, 2010.
• Board of Directors, November 22, 2010. 
• Finance Committee, November 11 and 22, 2010.

Jim Cange requested that the meeting agenda be distributed with meeting minutes, and this will be done.

On a motion by Greg Engele and second by J. W. Metcalf, the Board unanimously voted to approve the aforementioned meetings minutes.

Financial and Statistical Report
Elaine Matzenbacher, CFO, presented the Financial and Statistical Report for November 2010.  Highlights of the report were:

Total Patient Revenue was $1,927,447.  Total Provisions were $854,457.  Total Net Operating Revenue was $1,271,105.  Total Operating Expenses were $1,287,107.  Income (Loss) from Operations was ($16,002), with YTD Income (Loss) ($325,119).  Total Non-Operating Revenue was $37,935, with YTD Total Non-Operating Revenue of $251,139.  Total Income (Loss) was $21,933 with YTD Total Income (Loss) of ($73,980), as compared to a budgeted $48,699.

Additional noted items:

• Total Patient Revenues were 10.9% ($236,447) under budget for the month of November.  
• Contractual Adjustments were 7.7% under budget.  Charity care was $13,174.
• Other Operating Revenue was significantly over budget ($160,985) in the month as the Department of Health and Family Services (Medicaid) sent us their entire fiscal year’s worth of CHAP, SNAP and RAP payments and a one-time incentive payment that was promised in 2009 of approximately $78,000. 
• Total Operating Expenses were 1.6% under budget.
• Non-Operating Income was 3.5% under budget as there was little in the way of grant receipt/rental income for the month.  We did receive $7,619 from the Auxiliary as a donation for a piece of equipment.

On a motion by Diane Nottmeyer and second by Rich Tomaszewski, the Board unanimously voted to approve the November 2010 Financial and Statistical Report.

Imaging Update:  Nuclear Medicine Services Agreement

• At the previous meeting, the Board approved a new agreement with DHS (Diagnostic Health Services) for nuclear medicine services.
• At that time, the Board requested to amend (italicized) the agreement to read “….monthly fees on average $3,500 or better required with no yearly minimum….”
• In follow-up to this, Nancy reported that a minimum fee was non-negotiable; however, a minimum quarterly fee of $10,500 will be required, which is about $1,000 less than what WCH is paying now.

Board Member Oath of Office
Led by Chair Dale Blohm, all Board members recited in unison an oath of office for the position of Washington County Hospital Board Member.  Oath forms were then signed by each member and forwarded to the Washington County Clerk’s Office for recording.  In the future, any new WCH Board appointee’s oath will be administered by the Washington County Clerk and recorded at that time.
 
Endoscopy Equipment Request
Tammy Amizich, CNE, presented the following equipment information:

• Several times over the past year, Jose Ramirez, M.D., gastroenterologist, has requested the purchase of pill cam equipment.
• This is a camera system encapsulated in a pill which allows visualization of the GI tract, in particular the smaller intestines, not accessible by scope procedures.  Images are sent to a pouch recorder worn by the patient.  Recorded images would be downloaded and sent to Dr. Ramirez for interpretation.
• During the past year, three or four patients have been sent elsewhere because WCH did not have this equipment.
• Bids from Olympus and Given Pill Cam were reviewed in detail and discussed (copy on file). 
• Olympus is an exclusive vendor requiring a three-year contract with package totaling $30,000.
• Given Pill Cam standard pricing package totaled $20,834; year-end promotion package totaled $13,495.
• Dr. Ramirez uses Given Pill Cam at his office.
• Equipment launch could be as quickly as two weeks; however, staff training would be required first.
• Nancy stated the number of requests for this in the upcoming year is unknown and will require pre-certification.

On a motion by Greg Engele and second by Diane Nottmeyer,  the Board unanimously voted to accept the lowest bid of Given Pill Cam’s year-end promotion and take advantage of the six months same as cash payment plan at a cost of $13,495.

Medication Dispensing Cabinet
Nancy presented the following equipment information:

• Bids from four vendors were presented and reviewed in detail for replacement medication dispensing cabinet equipment (copy on file).  Initial Cost bids ranged from $99,711 up to $204,439.  The preferred vendor was MDG-Basic.
• It will serve as an after-hours pharmacy and will hold almost 1,000 medications compared to 300 currently.
• It has barcoding capabilities, will process charges immediately, has entry safety features, and should address charge issues, medication errors, improve medication administration accuracy and patient safety.
• It will interface with OPUS and Hanns On.
• Equipment installation will take 90-120 days.
• The Finance Committee has reviewed the bids and planned for financing the purchase.
• Purchase costs, if equipment is installed and operational by 9/30/11 and meets Meaningful Use criteria, would be 100% reimbursed by the federal government and go on the next year’s cost report.
• J. W. expressed opposition to the purchase of such a high-cost item with WCH’s uncertain financial picture and a 100% federal cost reimbursement—an unreliable expectation.

On a motion by Diane Nottmeyer and second by Rich Tomaszewski, the Board voted to accept the bid from MDG-Basic at a cost of $109,660.

With opposing votes from J. W. Metcalf and David Behr, the motion carried.

Joint Conference Committee Meeting
A Joint Conference  Committee meeting was scheduled for Thursday, February 17, 2011, at 7:00 p.m. in the boardroom.

Auditing Firm Services
Elaine Matzenbacher, CFO, presented the following information:

• Four RFPs from auditing firms were received and reviewed by the Finance Committee. 
• The Committee recommended two for final consideration by the Board:  (1) KEB of Carbondale and former WCH auditor; and (2) Eide Bailly of Iowa.  Audit RFP Financial Summaries and Referrals were reviewed and discussed (copy on file).

On a motion by J. W. Metcalf and second by Jim Cange, the Board unanimously voted to accept the lowest bid by KEB for a three-year contract starting at $35,000.

Community Comments/Questions and Answers
Clarification was provided to the press regarding:  endoscopy equipment, medication dispensing cabinet equipment, auditing firm services and financials regarding other operating revenue.

Closed Meeting
At 8:24 p.m. on a motion by Rich Tomaszewski and second by Diane Nottmeyer, the Board took a roll call vote to enter closed session under Open Meetings Public Act 88-621 Sections 2(C)(17)(21).  Blohm AYE, Behr AYE, Cange AYE, Engele AYE, Lopez AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried.

At 8:45 p.m. on a motion by Jim Cange and second by Victor Lopez, the Board took a roll call vote to leave closed session and re-enter open session.  Blohm AYE, Behr AYE, Cange AYE, Engele AYE, Lopez AYE, Metcalf AYE, Nottmeyer AYE, Tomaszewski AYE.  Motion carried.

Board of Directors Closed Meetings Minutes
Medical Staff Meeting Minutes

QA/CQI Meetings Minutes
The following meetings minutes were presented for review and approval:

• Special Board of Directors closed, November 22, 2010.
• Board of Directors closed, November 22, 2010.
• Medical Staff, October 6, 2010.
• QA/CQI, September 16 and October 21, 2010.

On a motion by Greg Engele and second by Rich Tomaszewski, the Board unanimously voted to approve the aforementioned meetings minutes.

Medical Staff Membership Status
Board members reviewed the Medical Executive Committee’s recommendations and information received during the probationary processes.  Based on this review, it was the Board’s opinion that the following members have met the requirements for Medical Staff change of status as recommended. 

On a motion by Greg Engele and second by J. W. Metcalf, the Board unanimously voted to approve the following Medical Staff changes of status:

• Eileen Figuerres, M.D. – Status change from Provisional to Courtesy, teleradiology services.
• Gene Spector, M.D. – Status change from Provisional to Courtesy, teleradiology services.
• Brandon Wynn, D.O. – Status change from Provisional to Courtesy, teleradiology services.
• Sharma Saith, M.D. – Status change from Provisional to Courtesy, cardiology services.

RHC Physician Increase of Hours
On a motion by J. W. Metcalf and second by Jim Cange, the Board unanimously voted to approve the increase of Dr. Robert Davidson’s hours to include eight hours on Fridays at his current hourly rate, which will begin after Dr. JenKins relocates to the new SMGSI medical office building.

Adjournment
On a motion by Rich Tomaszewski and second by Greg Engele, the Board unanimously voted to adjourn the meeting at 8:47 p.m.

Respectfully submitted,
Richard Tomaszewski, Secretary
Board of Directors
Washington County Hospital

WCH Board

Administrative Team

Nancy Newby, Chief Executive Officer

Tammy Amizich, Chief Nurse Executive
Kim Larkin, Chief Information Officer
Elaine Matzenbacher, Chief Financial Officer

Christine Bening, Human Resources Coordinator
Ruth Kellerman, Quality Coordinator

>  2011 board meeting dates
>  Board of Directors agenda & minutes