BOARD OF COMMISSIONERS MINUTES
FEBRUARY 25, 2016
REGULAR BOARD MEETING – 4:00 PM
RIVERSIDE MEDICAL CENTER
CAFETERIA
Item No. 1- Call to Order –Chairman King called the meeting to order and established a quorum.
Item No. 2- Invocation -Board Member Gill gave the Invocation.
Item No. 3- Pledge of Allegiance –Chairman King called for the Pledge of Allegiance.
Item No. 4- Roll Call –Board Clerk Sherae Killingsworth called the roll. Those present: Barry Kennedy, Lionel Jones, Lavern Jenkins, Pamela Breland, Rachel Gill, James Knight, Frank Voelker, M.D., and Gerald King. Those absent: Violet Tate, and James Thomas.
Item No. 5- Approval of Minutes -Board Member Jones offered a motion seconded by Board Member Breland to accept the minutes of the January 28, 2016, regular meeting as presented. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Item No. 6- Board of Commissioners Committee’s for 2016 – Chairman King appointed the Committees for the year 2016, a copy of which is on file with these minutes. Board Member Jones seconded by Board Member Gill to approve the Committee’s as appointed. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Item No. 7- Finance & Capital Planning Committee Report-Disposal of Sharps Policy – Board Member Jenkins presented the Disposal of Sharps Policy, a copy of which is on file with these minutes. The policy is to prevent injury and exposure to blood borne infections of staff handling sharps including needles, syringes, knife blades and opened ampoules of medication. Board Member Jenkins offered a motion seconded by Board Member Jones to approve the policy as presented. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Security Policy – Board Member Jenkins presented the Security Policy, a copy of which is on file with these minutes. The purpose of this policy is for Security for the patients, visitors and employees will have a safe and secure facility in which to stay, visit or work. The hospital maintains “zero tolerance” philosophy regarding violence. A hospital-wide Security program is provided and maintained, with adequate resource dedicated to it to provide reasonable protection from suspicious, dangerous or illegal activities. Board Chairman Jenkins offered a motion seconded by Board Member Breland to approve the policy as presented. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Revised Organizational Chart- Board Member Jenkins presented the revised Organizational Chart to the Finance Committee, a copy of which is on file with these minutes. Board Member Jenkins made a motion to approve the revised Organizational Chart seconded by Board Member Gill. Board Member Breland made a motion to table and defer the revised Organizational Chart to Executive Session for further discussion. Board Member King stated that we have a motion on the floor to table and to defer the Revised Organizational Chart to Executive Session, we need a seconded to that motion or we will refer back to the original motion on the floor. Board Member Kennedy seconded the motion to table and to defer the Revised Organizational Chart to Executive Session. Roll call vote to table and defer the Revised
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FEBRUARY 25, 2016
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Item No. 7- Finance & Capital Planning Committee Report-Continue- Werfen Contract Proposal
Organizational Chart as follows: YEAS: (3) Kennedy, Jenkins and Breland. NAYS: (5) Jones, Gill, Knight, Voelker, and King ABSENT: (2) ABSTAIN: (0). Board Chairman King said then we will go back to the original motion. Board Member Kennedy requested to discuss it. Board Member Kennedy asked what is the definition of an Assistant Administrator and why do we have so many. Lesia McQueen and Dr. Magee provided details for the definition of an Assistant Administrator to the Board of Commissioners. There was discussion regarding the Assistant Administrators qualifications as well as the responsibilities within the organizational chart. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Werfen Contract Proposal- Board Member Jenkins presented the Werfen Contract proposal for the Laboratory, a copy of which is on file with these minutes. He reported that RMC in collaboration with Tulane Medical Center launched the TeleStroke program which has been a significant improvement to the
quality of care for our stroke patients. This initiative requires certain Lab test such as coagulation studies to be available immediately upon arrival to the Emergency Department. During the times of instrument failures and unscheduled maintenance a backup instrument for coagulation is needed to keep RMC from going on TeleStroke diversion. This proposal is the same platform as our current instrument just a smaller version allowing us to utilize the same reagent, controls etc. Board Member Jenkins offered a motion seconded by Board Member Kennedy to recommend the Werfen Contract Proposal to the Board in the amount of $1,585.00 with the service maintenance contract at $520.00 a month with the total monthly cost at $2,105.00 for a five year period. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Item No. 8- Chief Financial Officer Report for January 2016- Dr. Magee stated there were 27 admissions for the month compared to a budget of 38 and prior year of 41. There were 3 swing beds for the month compared to a budget of 3 and the prior year was at 6. He reported that there were 46 observation stays compared to 40 last year. For the total admissions, there was 38% decrease for the month and 45% decrease for the year. There were 106 acute and 29 swing beds patients’ days. Dr. Magee reported that during January the acute average daily census was 3.42 compared to 4.13 for the prior year and 4.06 budgeted. The average daily census for swing beds for the month of January was .94 and the prior year was 2.48. The average daily census of all admissions including swing bed, acute and observation for the month is 6.06. The average length of stay for acute during the month of January for the hospital was 3.93 and for swing bed is 9.67.
Total equivalent patient days for the month were 1,636 compared to a budget of 1,350 and prior year of 1,510. Total emergency department visits were 1,154 for the month, compared to 1,219 for prior year and 1,275 budgeted. The emergency room visit average per day for the month was 37. There were 58 surgical procedures performed during the month compared to budget of 63 and prior year of 66, with 58 surgeries year-to-date. There were 27 Cardiology Procedures for the month compared to 15 for the prior year.
There were 1,945 outpatient registrations during the month with 1,945 year-to-date. The outpatient registration average per day for the month was 63 with the year-to-date at 63. There were 216 FTE’s for January compared to 208 for the prior year and 215 budgeted. The accounts payable was at 89 for January, with prior year at 75.
Total Patient Revenue for the month of January was $5,484,385 which was more than budget by $634,956. Total Other Revenue for January was $425,688. Total Gross Revenue for January was $5,910,073. Total
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FEBRUARY 25, 2016
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Item No. 8- Chief Financial Officer Report for January 2016- Continue
Deductions from Revenue for January was $3,724,661.
Net revenue for January was $2,185,412 which was below budget. Personnel expenses totaled $1,529,352 for the month which was above budget by $48,756. Other operating expenses were $2,465,732 during January this was below budget by $39,785. Total operating loss for January was ($280,320) which was above budget by ($225,093).
The net operating loss for the month of January was ($280,320) compared to a budgeted loss of ($55,227). The hospital experienced a net loss for the month of ($284,794) and a net loss of ($284,794) for the year. There was some discussion on the personnel expenses were over budget. Bill Toujouse stated that he is in the process of reviewing each payroll period to the number of dollars as well as the number of FTEs for each department in comparing it to the budget. Bill Toujouse said each director/manager needs to monitors their department respectively to make sure that we are not having more staff than what is needed for patient care. There may be some overtime but unnecessary overtime will be addressed. He will also separate the Thomas Clinic to determine how much purchasing the clinic has impacted our financials and report back to the Committee.
Dr. Magee presented a Cash Flow Statement for January 2016 which identifies the activities of the hospital that are generating or consuming the cash. The current assets were $4,913,071 with current liabilities at $4,595,319 providing a current ratio of 1.07 for January, with the prior month at 0.97 and the prior year at 1.41. Dr. Magee stated that the current ratio measures the ability of the hospital to rely solely on its liquid assets to pay current liabilities.
Dr. Magee presented a Cash Flow Statement for January 2016 which identifies the activities of the hospital that are generating or consuming the cash. The Beginning Operating Cash on Hand is $306,192 with the ending balance is $556,313. He said cash expenses per day average are $75,890 for January and the prior month was $70,541. The daily operating revenue is $70,497 with the prior month at $69,150. The Daily Net Operating Margin was at -$5,392 and the prior month was at-$1,391. The Daily Net Operating Margin Percent for January is -7.65% and for December at -2.01%. He stated that the Daily Operating Expense amounts are based on cash expenses calculated by removing all non-cash expenses. He presented a graph of cash on hand on a day by day basis for the month of January. The day’s cash on hand average for the prior month was at 12 with low at 3 and the high at 20. Dr. Magee presented the deposits verses the expenses for the month of January, a copy of which is on file with these minutes.
Dr. Magee reported that there was one capital expenditure during the month of January in the amount of $13,800 for the new roof for the medical clinic building 1&2. The Total Capital Expenditure for the year was $13,800. Dr. Magee reviewed the Accounts Receivable Analysis totals and graph. Dr. Magee presented and discussed the daily cash collections to the Committee, a copy of which is on file with these minutes. Net days uncollected were 65.20 compared to December 31, 2015 of 65.03 days. He reported the State average benchmark has been updated to the 2013 median which is 72.47. Dr. Magee reported that he had a meeting with Mallory Yellverton from Pioneer regarding the gross accounts receivable days as of today is at 61. The goal is around 50 to 55. We will continue to work toward meeting our goal. The Coding Analysis was presented for review by the Committee, a copy of which is on file with these minutes. The Coding Analysis for January is at 10.02. He stated that Pioneer continue to work to achieve the goal set between 5 to 7 days.
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FEBRUARY 25, 2016
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Item No. 8- Chief Financial Officer Report for January 2016- Continue
There were no recipients that qualified for the Charity Program during the month of February. Accounts written off as bad debts during January 2016 totaled $371,396. Board Member Jones offered a motion seconded by Board Member Knight to approve the bad debt list as presented. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Item No. 9- Building & Grounds Report-Board Chairman King called for the Building & Grounds Report to be given by Board Member Knight, a copy of which is on file with these minutes. Board Member Knight thanked the Med Gas company for working with our maintenance department to make sure the project was complete in a timely manner. Board Member Breland requested additional signage be placed for the location of physicians. Board Member Gill requested that a light be placed at night on the flag.
Item No.10- Medical Staff Report- Chief of Staff Luis Alvarado provided details of the last meeting of the Riverside Medical Center Medical Executive Staff which was held on February 18, 2016. The MEC approved the Guidelines for Isolation Precautions as requested by the Infection Control Committee.
The MEC request approval from the Board of Commissioner for the policy as presented. The Colon Cancer Symposium is scheduled for Friday, March 11th from 5 p.m. to 7 p.m. in the Cafeteria. The MEC request approval from the Board of Commissioner for the policy as presented. Board Member Knight offered a motion seconded by Board Member Jones to approve as presented. Roll call vote as follows: YEAS: (8) Kennedy, Jones, Jenkins, Breland, Gill, Knight, Voelker, and King. NAYS: (0) ABSENT: (2) ABSTAIN: (0).
Item No. 11- Patient Care Report- Board Chairman King called for the Patient Care Report to be given by Lesia McQueen, a copy of which is on file with these minutes.