PLATEAU VALLEY HOSPITAL DISTRICT MINUTES
September 20, 2004
MEETING CALLED TO ORDER AT 17:20 PM by Helen Spence, President.
BOARD MEMBERS: Helen Spence, Bob Wilson, Frank Wagner, Dave Bristol and Denny Holmes.
PVHD STAFF MEMBERS: Dr. Woodyard, Vicki Benning, Jessi Clark, Dr. Rollins and Sharon Hill. Rene Castillo excused.
GUESTS PRESENT: Deb Johns, Chad & Tammy Entwistle.
1. CHAD & TAMMY ENTWISTLE: A discussion with the Entwistle’s resulted in the following conclusions:
· Entwistle’s need to sell their current property prior to making an offer on the grounds as they wish to purchase as a private entitity and then apply for a non-profit status to operate
· The estimated cost for 2 handicap parking spaces is $25,000
· Splitting the upper and lower levels was discussed and this space would be utilized by the Entwistle’s for day care
· Entwistle’s would like to rent to own with a balloon payment at the end of a specific time frame, the board prefers total payment at time of contract
· Commercial Appraisal: Sharon spoke with Jack Knutson and Denny Holmes regarding a real estate value for the property to be sold. A commercial appraiser was recommended. Pam Sant was contacted. She said an in-house appraisal for District use only would cost between $1,500 and $2,000. A full blown appraisal could be as high as $5,000.
· Discussed using the 2002 appraisal with current comps, Sharon will contact Pam Sant for this review
· The property needs to be listed.
Resolution #1: Be it resolved that the Board of Directors contract with Bray & Company Realtors Commercial Division to list Sections 1 and 2 of the property at $388,000.
Dave Bristol motioned and Frank Wagner seconded. Motion carried unanimously.
· Sharon will contact Bray & Co. Commercial Division for a multiple listing for a 90 day period at $388,000
2. NO EXECUTIVE SESSION needed at this time.
3. MINUTES: 08/16/2004 Meeting Correction: Old Business: Mesa Clinic Progress Report paragraph 4-change “leasing a building with a purchase option” at the end of the sentence to “purchase a clinic building0”.
Resolution #2: Be it resolved that the Minutes of the August 16, 2004, meeting be approved as corrected.
Frank Wagner motioned and Denny Holmes seconded. Motion carried unanimously.
Resolution #3: Be it resolved that the Minutes of the August 23, 2004, meeting be approved as presented.
Bob Wilson motioned and Frank Wagner seconded. Motion carried unanimously.
Resolution #4: Be it resolved that the Minutes of the August 30, 2004, meeting be approved as presented.
Denny Holmes motioned and Dave Bristol seconded. Motion carried unanimously.
4. CLINIC CONSULTANT REPORT presented by Deb Johns.
· There is a need to up-grade the Medical Manager program to version 10. PVMC’s system can not be up-graded.
o It is suggested at this time to terminate support from Web MD and then add PVMC to Monument Medical Consultants (MMC) program. This would allow for greater flexibility in statements and electronic filing. The system would be down for 48 hours for the transition which would be started on a Wednesday night so the services could be back in operation the following Monday.
o The contract would continue at $2800 / month, $25 / hour for additional services not included in the contract and $138 / month for EDI services or the amount billed by EDI to MMC each month. MMC would be asked to train staff as changes in HIPAA and OSHA requirements occur, this would come under the $25/hr clause in the contract.
Resolution #5: Be it resolved that the Board of Directors wishes to terminate support from Web MD.
Bob Wilson motioned and Dave Bristol seconded. Motion carried unanimously.
· Consultant contract renewal.
Resolution 6#: Be it resolved that the Board of Directors renew the Monument Medical Consultant contract at $2800/month, $25 / hr for additional services and a monthly EDI fee of $138 / month or the amount billed by EDI to MMC.
Frank Wagner motioned and Dave Bristol seconded. Motion carried unanimously.
· Changing the procedure for deposits was discussed. Sharon spoke with Mike Nelson of CSD & Co., the facilities auditors, in regards to sending all monies daily to MMC for deposits, copies, posting and delivery to the Palisade Bank. There needs to be a process in place to assure that all sums sent are received by MMC. This service is included in the $2800 monthly contract. Sharon, Jessi and Deb will work out the specifics and begin the process October 1st.
· New ICD-9 codes for procedures will become effective October 1st. There is no grace period this year and new codes must be used beginning on that date. Jessi will order the new ICD-9 code book.
· There are still patients who continue to refuse to pay their bills. The practice fired 15 patients from the practice this month for non-payment. This policy was discussed and the procedure that is used is appropriate. No further discussion.
· Deb reported that there are only 3 physicians in Grand Junction taking new patients and Denny Holmes asked how we could market for new patients using this information.
· Deb will be attending an OIG Medicare Compliance workshop on October 2nd and will pass on the information to our clinic.
· The IPA will hold a meeting at Community Hospital on October 20th from 11:30-1:30 on how to look at statements and insurance information. Deb will be attending and Jessi will also attend.
· There are 3 certified coders at MMC—Deb, Dawn and Kate.
· MARKETING:
o Jessi reported that our Clinic sponsored three ads on KISS Country Radio this week
o In order to increase revenue we need to have a better marketing plan to increase the number of patients seen each day.
o An updated brochure needs to be done and placed in all visitor centers, the Chamber of Commerce, local businesses, and real estate offices to increase utilization of our clinic services. Jessi and Dr. Rollins will work on this project.
o New lighted signs for both the Mesa Clinic and the Collbran Clinic were discussed. A cost estimate needs to be requested.
o We all need to continue to come up with innovative ways to market our services.
5. OLD BUSINESS:
· Mesa Clinic Progress Report:
o Dr. Rollins reported that floor plans were given to Golden Villa Homes and the cost including foundation of a 28x70 building is just under $150,000.
o Nathalie Ames is in the process of securing the financing for this structure and the permit requests.
o Golden Villa is in the process of meeting with the planning department.
o Dr. Rollins noted that the Cedaredge Clinic is seeing 60 patients a day.
· Collbran Clinic:
o Frank Wagner reported that the drawings should be completed by the end of the week.
o Competitive bidding would be ready to begin when the plans were final.
· Service Plan: Kirsten Kurath, Attorney, made her final review and revision which was presented. Sharon will talk to Valerie Robison to set a date for the hearing with the Mesa County Commissioners.
Resolution #7: Be it resolved that the Board of Directors accepts the Service Plan as revised on September 16, 2004.
Dave Bristol motioned and Frank Wagner seconded. Motion carried unanimously.
· Job Descriptions: The Accountant, Bookkeeper and Business Administrator job descriptions were presented.
o Committee report: The committee met and discussed the lack of funds for a full-time position of Business Administrator. At this time it is felt that the position could be divided into three parts and Job Descriptions were completed for each:
§ Accountant Consultant: This position would be outsourced to a CPA
§ Bookkeeper: Responsible for the day to day accounting
§ Business Administrator: Responsible for Marketing. Accountable for district employees, contracts, board of director agendas and minutes, insurance and other tasks as outlined in the job description
§ Deposits: Deb Johns said that they would do deposits daily and deliver to the Palisade bank daily. This would be included in the current monthly fee.
o Job descriptions will be sent to Larry Jokerst for his review and comments.
6. NEW BUSINESS:
· Policy Committee: Final revisions to the Board of Directors and Medical Staff By-Laws were presented.
Resolution #8: Be it resolved that the Board of Directors approves the Amended Board of Directors By-Laws as presented.
Dave Bristol motioned and Bob Wilson seconded. Motion carried unanimously.
Resolution #9: Be it resolved that the Board of Directors approves the Amended Medical Staff By-Laws as presented.
Frank Wagner motioned and Denny Holmes seconded. Motion carried unanimously.
Helen Spence requested that the Faith in Action report be given at this time.
7. FAITH IN ACTION: Report given by Vicki Benning.
· Our Faith in Action board meetings have been set to begin again in September. The first meeting was on September 15th and a few members were unable to attend. At the next meeting there will be a discussion on appointing another board member
· Currently the Faith in Action By-Laws are being reviewed to see if it is time to rotate board members.
· The Collbran Christmas Fair and January 5th bake sale at Powderhorn plans are progressing. Vicki will be working with the Plateau Valley School National Honor Society on a project that will help them as well as Faith in Action. She will be working with Saran Jennings and the PVSNHS who are applying for an El Pomar Grant for both entities.
· Vicki will be attending the regional meeting in October that will be held in Salida, Colorado
2004 Faith in Action Statistics / Jan / Feb / Mar / Apr / May / Jun / Jul / Aug / Sep / Oct / Nov / Dec / TotalCommunity Donations / 160 / 25 / 1,033 / 1,019 / 200 / 25 / 1,549 / 75 / $4,086
Grants / 250 / 5,000 / 250 / $5,500
# volunteers providing services / 41 / 41 / 41 / 41 / 44 / 45 / 45 / 45 / 45
# of community members receiving services / 13 / 9 / 12 / 15 / 10 / 17 / 10 / 12 / 98
# of hours of service provided / 130 / 81 / 90 / 85 / 100 / 90 / 130 / 92 / 798
# of transportation miles provided / 750 / 953 / 912 / 525 / 950 / 756 / 1300 / 1033 / 7179
8. BUSINESS REPORT: Report presented by Sharon Hill.
AugustGross / Operating / Net Ordinary / Other / Net
Charges / Write Offs / Profit / Expense / Income / Income/Exp / Income/(Loss)
Misc. Inc.
1 / Clinic / 32,049.08 / -7,430.85 / 24,618.23 / -41,874.63 / -17,256.40 / 5,548.88 / -11,707.52
Clinic-Mesa / 706.01 / -71.96 / 634.05 / -226.71 / 407.34 / 407.34
2 / Construction / 0.00 / -1,719.40 / -1,719.40 / -1,719.40
Energy Impact / 0.00 / -26,281.00 / -26,281.00
3 / Administration / 985.67 / 985.67 / -7,271.97 / -6,286.30 / 1,645.35 / -4,640.95
4 / FIA / 75.00 / 75.00 / -452.02 / -377.02 / 1.02 / -376.00
5 / Total / 33,815.76 / -7,502.81 / 26,312.95 / -51,544.73 / -25,231.78 / -19,085.75 / -44,317.53
· Financial report review:
o Cash available is down due to payment of the Electronic Medical Record program. A request for reimbursement has been made and the check was received in September. Tim Sarmo asks that requests be at least $25,000.
o A/R is down due primarily to payment at the time of service
o Property Taxes to be collected the remainder of the year is about $12,000
o There is a $44,317 loss for the month and $79,926 year to date partly due to the energy impact monies spent and not reimbursed in August
o The Cash Basis report shows a month loss o f$45,965 and a year to date loss of $47,634
o The Finance Committee met on the 14th and went over the cash basis report and the preliminary budget.
o 2005 Budget: A preliminary budget is included in the packet as well as a second page with 5%, 7% and 10% increase in patient revenue. The 2005 budget is based on the expected 2004 income and expenses with changes in job positions taken into account.
o 2004 Supplemental Budget: Included in packet-it will need a resolution next month.
Resolution #10: Be it resolved that the Accounts Payable and Payroll Checks (#43295-43357) be approved.
Frank Wagner motioned and Dave Bristol seconded. Motion carried unanimously.
Resolution #11: Be it resolved that the Board of Directors approves the August write-offs in the amount of $7502.81.
Dave Bristol motioned and Denny Holmes seconded. Motion carried unanimously.
9. ENVIRONMENTAL SERVICES: Report given by Sharon Hill in Rene’s absence.
· Most of the offices have been completely moved upstairs. Sharon’s was completed today.
· ESI-Elevator Services Inc.:
o Elevator testing has been completed and replacing parts. The cost was $1,602.20.
o A proposal for the remainder of the up-grades to meet ADA standards includes an Emergency Telephone, Replacement of the Emergency Light System and a Micro-Screen for a total of $2675.00.
o ESI-Elevator Services Inc. presented a proposal for routine maintenance that would cost $721 per month.
o The proposals were discussed and Sharon will work with Rene to see if other bids can be obtained prior to approval.
· Faucets have been replaced in the upstairs.
10. CLINIC REPORT:
· Census
2004 CENSUS / Jan / Feb / Mar / Apr / May / Jun / Jul / Aug / Sept / Oct / Nov / Dec / Year to DateTotal Dr Appt / 271 / 283 / 292 / 266 / 267 / 285 / 246 / 294 / 2204
# Days / 21 / 20 / 22.5 / 21 / 20 / 22 / 21 / 22 / 169.5
Ave/Day / 12.90 / 14.15 / 12.98 / 12.67 / 13.35 / 12.95 / 11.71 / 13.36 / #### / #### / #### / #### / 13.00
Lab/Inj / 77 / 85 / 77 / 68 / 79 / 81 / 75 / 71 / 613
Pharm / 24 / 41 / 24 / 36 / 20 / 17 / 13 / 20 / 195
AH Pharm / 6 / 0 / 1 / 1 / 6 / 0 / 0 / 0 / 14
After Hours / 10 / 10 / 9 / 23 / 18 / 24 / 23 / 26 / 143
Other / 19 / 25 / 20 / 18 / 24 / 18 / 11 / 31 / 166
Paged Calls / 86 / 57 / 65 / 87 / 68 / 68 / 80 / 511
Mesa Clinic Dr / 0 / 7 / 16 / 18 / 7 / 8 / 1 / 10 / 67
Mesa Clinic Nu / 0 / 1 / 2 / 1 / 3 / 3 / 0 / 6 / 16
Mesa New Pt / 0 / 0 / 0 / 0 / 0
Clinic New Pt / 7 / 4 / 7 / 20 / 38
· The decline in census over the past 5 years was discussed. There was a 13% drop from 2003 compared to 2004. Why? Possibly some are not coming due to non-support of the mill levy increase. No conclusions as to why the drop in census.