Board of Commissionersminutes

BOARD OF COMMISSIONERSMINUTES

APRIL 30, 2015

REGULAR BOARD MEETING – 4:00 PM

RIVERSIDE MEDICAL CENTER

CAFETERIA

Item No. 1- Call to Order-Chairman Jones called the meeting to order and established a quorum.

Item No. 2- Invocation -Board Member Gillgave the Invocation.

Item No. 3- Pledge of Allegiance –Chairman Jones called for the Pledge of Allegiance.

Item No. 4- Roll Call -Board Clerk Sherae Killingsworth, called the roll. Those present: Frank Voelker, M.D., James Knight, Rachel Gill, Pamela Breland, James Thomas, Lavern Jenkins,Gerald King, and Lionel Jones. Members Absent: Violet Tate, and Barry Kennedy. Board Member Thomas was in attendance at the meeting at 4:15 p.m.

Item No. 5- Approval of Minutes -Board Member King offered a motion seconded by Board Member Kingto accept the minutes of the March 26, 2015 regular meeting as presented. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3)ABSTAIN: (0).

Item No. 6- Public Participation-Chairman Jones asked if anyone would like to come forth regarding setting the tax millage. No one had comments. Board Member Jenkins offered a motion, seconded by Board Member Gill, to close public participation.

Item No. 7- Verbal Announcement of Meeting to Adopt Millage for 2015 on April 30, 2015 at 4:00 p.m. –Chairman Jones stated that per the correspondence received from the Washington Parish Tax Assessor it is time to set the millage for the year 2015. He reported that 18 mils will be set for acquisitions and maintenances. Board Member Jenkins offered a motion seconded by Board Member Breland to authorize Dr. Magee to execute the affidavit and resolution with an 18 mill rate. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3) ABSTAIN: (0).

Item No. 8- Annual Code of Conduct Review–Chairman Jones stated that the Code of Conductwas emailed to the Board members prior to the meeting for annual review. Board Member King offered a motion seconded by Board Member Breland to approve the Code of Conduct as presented. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3) ABSTAIN: (0).

Item No. 9- Finance & Capital Planning Committee Report- Code of Ethics & Conduct Board Policy-Board Member Jenkins offered a motion seconded by Board Member King to approve the policy as presented. The Code of Ethics and Conduct provides guidance to Riverside Medical Center board members and assists us in carrying out our daily activities within appropriate ethical and legal standards. These obligations apply to our relationships with patients, affiliated physicians, third-party payers, subcontractors, independent contracts, vendors, consultants and one another. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3) ABSTAIN: (0).

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Item No. 9- Finance & Capital Planning Committee Report-Continue

Revised Code of Ethics & Conduct Administrative Policy-Board Member Jenkins offered a motion seconded by Board Member Breland to approve therevised policy as presented. The Code of Ethics and Conduct was revised to have employee’s review and sign annually. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3) ABSTAIN: (0).

Revised Terminal Clearance Personnel Policy-Board Member Jenkins offered a motion seconded by Board Member Breland to approve therevised policy with amended to include the notification process to be complete through Human Resources and also to stated that Human Resources will notify the departments at the time of interaction of the employee. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3) ABSTAIN: (0).

Louisiana Compliance Questionnaire- Board Member Jenkins offered a motion seconded by Board Member Breland to approve the Louisiana Compliance Questionnaire as required each year in conjunction with the Financial Audit. Board Member Jenkins stated that the questionnaire verifies that the hospital is in compliance with laws governing Louisiana governmental units and entities. He stated that no changes were made to the questionnaire. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3) ABSTAIN: (0).

Surgery Equipment Purchase-Board Member Jenkins offered a motion seconded by Board Member King to approve the Force Triad equipment which is used to cauterized sites during surgery procedures in the amount of $25,628.14 with $7,960.00 being applied for the rental portion with the remaining $17,668.14. Roll call vote as follows: YEAS: (7) Voelker, Knight, Gill, Breland, Jenkins, King, and Jones. NAYS: (0) ABSENT: (3) ABSTAIN: (0).

Autoclave Equipment-Board Member Jenkins offered a motion seconded by Board Member King to approve the Getinge Autoclave System purchase in the amount of $46,140.40. Roll call vote as follows: YEAS: (8) Voelker, Knight, Gill, Breland, Thomas, Jenkins, King, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0).

Utilities & Equipment Management Manual-Board Member Jenkins offered a motion seconded by Board Member King to approve the annual review of the Utilities Equipment Management Manual as presented. Roll call vote as follows: YEAS: (8) Voelker, Knight, Gill, Breland, Thomas, Jenkins, King, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0).

Item No. 10- Chief Financial Officer Report for 2015-Mr. Magee said the cash balance as of today is $1.5 million. The account payable is at $1 million. Mr. Magee stated there were 43 admissions for the month compared to a budget of 38 and prior year of 37. He reported that there were 45 observation stays compared to 35 last year. For the total admissions, there was 12% increase for the month and 4% increase for the year. There were 137 acute and 13 swing beds patients’. There was 18% increase for the month and 12% increase for the year. Mr. Magee reported that during March the acute average daily census was 4.42 compared to 3.84 for the prior year and 3.90 budgeted. The average daily census for swing beds for the month of March was 0.42 and the prior year was 0.90. The average daily census of all admissions including swing bed, acute and observation for the month is 6.84. The average length of stay for acute during the month of March for the hospital was 3.19 and for swing bed is 13.00. The average length of stay for acute Medicare for March is 3.83 days which was an increase from last year at 3.33.

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Item No. 10- Chief Financial Officer Report for 2015- Continue

Total equivalent patient days for the month were 1,569 compared to a budget of 1,576 and prior year of 1,134. Total emergency department visits were 1,373 for the month, compared to 1,351 for prior year and 1,302 budgeted. The emergency room visit average per day for the month was 44 with prior year at 42. There was a 2% increase for the month and 4% for the year. There were 61 surgical procedures performed during the month compared to budget of 52 and prior year of 53, with 198 surgeries year to date.

There were 1,767 outpatient registrations during the month with 5,125 year-to-date which is an increase of 2% or 103 registrations from prior year. The outpatient registration average per day for the month was 57 which remained about the same from the prior year. There were 214 FTE’s for March compared to 196 for the prior year and 209 budgeted. The accounts payable was at 78 for March, with last month at 86 and for the prior year at 55.

Total Patient Revenue for the month of March was $5,089,762 which was more than budget by $314,132. Total Other Revenue for March was $339,227. Total Gross Revenue for March was $5,428,990.

Total Deductions fromRevenue for March was $3,267,435. He presented the contractual allowances for Medicare and Medicaid broken down by inpatient and outpatient by payer for Medicare, Medicaid,

Bayou Health Plans, Champus, Riverside Family Care Clinic, and Pediatric Internal Clinic. Mr. Magee

stated a breakdown by Medicaid and Medicare contractual allowances with the total contractual

allowance for March is $1,779,032. The year to date contractual allowances is $4,651,965. The breakdown by Medicare allowance for the Riverside Family Care Clinic is ($9,545) and the year to date is ($30,030). He reported that the Pediatric Internal Clinic Medicare allowance is $3,427 for March and the year to date is $14,017. The Total Hospital Other Allowances was $952,805 and the year to date is $2,670,745. The Total Riverside Family Care Clinic Allowances is $8,883 and the year to date is $17,034. The Total Pediatric Clinic Other Allowances was $40,014 and the year to date is $89,996. The Total Riverside Surgical Clinic Allowances is $42,725 and the year to date is $72,223. The Total Other Allowances is $1,044,427 and the year to date is 2,849,997.

Net revenue for March was $2,161,554 which was above budget. Personnel expenses totaled $1,397,184 for the month which was above budget by $102,375. Other operating expenses were $746,816 during March which was under budget by ($89,431). Total Operating expenses for March was$2,144,000 which was more than budget by $12,941.

The net operating profit for the month of March was $17,554 compared to a budgeted loss of (31,266). The hospital experienced a net profit for the month of $1,659,042 and a net profit of $1,639,773 for the year.

Mr. Magee reported that we received $1.103 million from UPL. He stated that we are still owed $1.243 million with the monthly payment being $248,000. We received $1,665,714 for the EHR incentive payment in March as well.

The itemized list of the income statement was emailed to the committee in detail prior to the meeting.

The current assets were $7,299,802 with current liabilities at $3,609,459providing a current ratio of 2.02 for March, with the prior month at 1.31 and the prior year at 1.38. Mr. Magee stated that the current ratio measures the ability of the hospital to rely solely on its liquid assets to pay current liabilities.

Mr. Magee presented a Cash Flow Statement for March 2015 which identified the activities of the hospital

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Item No. 10- Chief Financial Officer Report for 2015- Continue

that are generating or consuming the cash. Total Cash Generated Year to Date is $2,208,426. The Beginning Operating Cash on Hand is $709,124 with the ending balance is $2,917,549. He said cash expenses per day average are $66,172 for March and the prior month was $65,879. The daily operating revenue is $69,021 with the prior month at $68,650. The Daily Net Operating Margin was at $2,849 and the prior month was at $2,771. The Daily Net Operating Margin Percent for March is 4.13% and for February at 4.04%. 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 March. The days cash on hand for the month is 44 and the prior month was at 14.

Mr. Magee presented the Operating Cash On Hand from January 2013- to present, a copy of which is on file with these minutes. He stated that the average cash on hand for the month was 26 with the highest

being at 45 and the lowest at 12. We received half of the UPL funds in the amount of $1.1 million and five monthly payments will be received for the remainder of the funds.

For employee insurance cost, he stated the estimated fixed costs for the year is $512,192.15. The claims issued outside of the contract were at $210,917.90. The net issued claims were at 1,854,292.51. The total hospital insurance cost was $2,577,402.56 less the employee portion of ($288,320.00) which is 11%. The total cost for the hospital was $2,289,082.56.

Mr. Magee presented a cash projection statement for January through March being actual and April through December 2015 is projected. The projections reflect the payments for the UPL funds were adjusted for April to May. He reported that the average daily cash on hand for the year projection would be 22 with lowest at 13. Mr. Magee reported that there was one capital expenditure during the month of March. The total for the month is $37,735. The Total Capital Expenditure for the year was $778,623.

Mr. Magee reviewed the Accounts Receivable Analysis totals and graph. Gross Accounts Receivable as of March 31, 2015 was $8,594,340 which reflected an increase of $858,262. Total days of gross revenue uncollected were 56.74 compared to 50.68 for the prior month. Net days uncollected were 61.36 compared to December 31, 2014 of 68.83 days. He reported the State average benchmark has been updated to the 2013 median which is 72.47.

There was no recipientthat qualified for the Charity Program during the month of March. The year-to-date written off balance for the Charity program is $1,207.18. Accounts written off as bad debts during March 2015 totaled $296,294. The year-to-date bad debt is $1,266,803. Board Member Jones offered a motion seconded by Board Member King to approve the bad debt list as presented. Roll call vote as follows: YEAS: (5) Breland, Kennedy, Jones, Jenkins and King NAYS: (0), ABSENT: (0), ABSTAIN: (0). He reported that the accounts written off as uncollectible in March for the Franklinton Rural Health Clinic were $536.69. He reported that the accounts written off as uncollectible in March for the Pediatric and Internal Medicine Clinic were $22.98. There was a brief discussion regarding the Charity program and the Medicaid plans as well as reimbursement for the hospital.

Item No.11- Medical Staff Report- Chairman Jones called for the Medical Staff Report to be given by Luis Alvarado, Chief of Staff, a copy of which is on file with these minutes. The last meeting of the Riverside Medical Center Medical Executive Staff was held on April 23, 2015. The Quality Council Committee continues to review monthly dashboard indicators for alldepartments. The MEC approved the Quality Council policies as follows: Revised RT Protocol, Revised Parenteral and Nutrition Policy and

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Item No.11- Medical Staff Report

Order Form as presented. Upon review, the MEC approved the Performance Improvement Plan for 2015

as presented. Upon review, the MEC approved the following manuals as presented:Anesthesia Policy & Procedure Manual and the Blood Gas Laboratory Policy & Procedure Manual. The MEC approved Dr. Perdigao as the Chairman for the Medical Records Review Committee. The MEC request approval from the Board of Commissioner for the policies, forms and manuals as presented. Upon review, by the MEC to approve the initial appointments and reappointments for privileges are as follows:

Initial Appointments:Frederick Brazda-Consulting-Pathology and Mica Sood-PNP-Allied Health

Reappointments-Monica Smith-WHNP-Allied Health, Christopher Keating-FNP-Woundcare

Allied Health and Todd Shaffett-NP-Woundcare-Allied Health

Dr. Alvarado discussed some issue we are currently having Lab Corp that are being addressed. Board Member Thomas offered a motion seconded by Board Member Gill the PI Plan and policies as presented.Roll call vote as follows: YEAS: (8) Voelker, Knight, Gill, Breland, Thomas, Jenkins, King, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0). Board Member King offered a motion seconded by Board Member Jenkins to approve the manuals as presented. Roll call vote as follows: YEAS: (8) Voelker, Knight, Gill, Breland, Thomas, Jenkins, King, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0). The MEC request approval from the Board of Commissioner for the initial appointments and reappointments as presented. Board Member Knight offered a motion seconded by Board Member Jenkins to approve the policy and form as presented. Roll call vote as follows: YEAS: (8) Voelker, Knight, Gill, Breland, Thomas, Jenkins, King, and Jones. NAYS: (0) ABSENT: (2) ABSTAIN: (0).

Item No. 12- Patient Care Report- Chairman Jones called for the Patient Care Report to be given by Ben Lott, Asst. Admin/VP Clinical Services, a copy of which is on file with these minutes.

Item No. 13- Management Report- Chairman Jones called for the Management Report to be given by

Kyle Magee, M.D, Chief Executive Officer, a copy of which is on file with these minutes. Dr. Magee asked Reggie Simmons if he had any items to report from the Legal Department. Mr. Simmons stated he had nothing to report. Dr. Magee invited the Board of Commissioners to the hospital week picnic scheduled for Friday, May 15th from 11:30 p.m. until 1 p.m. located behind the hospital. Dr. Magee announced that Kristina Knight has been hired for the Community Outreach Director position with her start date being Monday, May 11th.

Item No. 14- Public Participation-Claire McGuire said that she was invited to the blessings for Our Lady of the Angels Hospital today. The plan is to have another dedication in three months for the new addition. She discussed transfers information and our process. Ben Lott stated that the Emergency Department is diligentlyworking to obtain all admissions that we can. Ben Lott stated that he will report the transfer numbers at next month’s meeting. Ben Lott stated that we can start accepting transfers from Our Lady of the Angels for cardiac procedures now.