Pershing General Hospital and Nursing Home

PERSHING GENERAL HOSPITAL& NURSING HOME BOARD OF TRUSTEES REGULAR BOARD MEETING MINUTES August 24, 2017

ENTITY: Pershing General Hospital DATE: August 24, 2017 TIME: 5:30pm PLACE: Pershing General Hospital Conference Room 850 6th Street Suite 103

Attendees: Board: Carolyn Hultgren, Carol Shank, Joe Pierce, Charlie Safford, Dana Tueller, Ted Bendure. Staff: Patty Bianchi, Debbie Mock, Steve Boline, Cindy Hixenbaugh, KayDawn Hughes, Helen Joubert, Patti Speer, Kirsten Hertz Public: Clancy Hultgren 1) CALL TO ORDER – by Chairman Joe Pierce at 5:30 p.m. 2) PUBLIC COMMENT - None 3) CONSENT AGENDA - The Board will consider, for possible action, these items in their entirety, without discussion; For Possible Action a. Meeting minutes for Regular Board Meeting July 27, 2017 b. Warrants (Check Register) c. Patient Account Write-Offs for July 2017 d. Approval of Proxy Credentialing for vRad physicians Priti Ram and Thomas Vreeland

Board took the following action: Motion to approve the Consent Agenda as presented by Carolyn Hultgren, second by Dana Tueller. Motion carried unanimously.

4) REPORTS a. Risk Management – KayDawn Hughes reported, as required, the quarterly statistics including sentinel events and facility acquired infections. One sentinel event was reported occurring July 19, 2017, involving a long term care patient who fell and sustained a broken hip. The patient was transferred, had surgery, returned to the facility as a Swing patient and subsequently returned to Long Term Care. Three hospital acquired infections were reported, two patients responded to initial treatment. One patient was resistant to initial treatment requiring a second antibiotic and is now responding well.

b. Administrator/CEO: Update b.i. Date of September Board Meeting – Consensus of the board was to change the September meeting date to September 21, 2017 b.ii. Board Retreat – Board Members concurred that the Board Retreat could be scheduled for November 1, 2017 at the NRHP Conference Room. b.iii. Kathryn Harter, CNO, has submitted her letter of resignation and Christina Dickerman, Long Term Care Director, has been appointed interim CNO. b.iv. Bianchi is working with a Locum tenens company to recruit for Emergency Room coverage. CFO Boline will be talking with Battle Mountain General Hospital to work cooperatively in recruitment efforts as they are looking for Emergency Room coverage as well. b.v. Bianchi anticipates the CAH survey at any time. Surveyors were at Mount Grant Hospital in Hawthorne.

Pershing General Hospital and Nursing Home is pleased to make reasonable accommodations for members of the public who are disabled and wish to attend the meeting. Please notify Administration, as soon as possible at (775) 273-2621 ext. 245. This institution is an equal opportunity provider and employer.

Page 1 of 4 b.vi. Long Term Care received a generous donation from a residents family as well as the family’s church congregation. They were extremely pleased at the care their family member had received. b.vii. Bianchi attend the NRHP & LiCon meetings at Lake Tahoe which were very informative. b.viii. Bianchi has updated the facilities organizational chart to reflect the changes in interim leadership with the Departure of CNO Harter. b.ix. Bianchi will be attending the National Rural Healthcare conference in Kansas City, MO the last week of September. b.x. Senator Catherine Cortez-Masto visited the facility as outreach to rural communities. c. Chief Financial Officer: Update c.i. Financial Statements for the period ended July 31, 2017– For Possible Action

Board took the following action: Steve Boline, CFO, detailed the draft financial statements indicating that the facility had realized a loss of $117,859.52. Boline reviewed financial materials as included in the packet in detail with the board. Boline also informed the board the external audit will begin August 28, 2017.

Motion to approve the Draft July 2017 financial statements offered by Charlie Safford, second by Ted Bendure. Motion carried unanimously.

c.ii. Revenue Cycle Dashboard July 2017 CFO Boline discussed the two measures that did not meet target – net revenue per patient encounter and net revenue as percent of gross – and that these two measures move together. d. Chief Nursing Officer: CEO Bianchi provided a quick update as CNO Harter was unable to attend. Focus for nursing is the recruitment of CNA’s and nurses. We are experiencing a severe shortage of CNA’s currently.

e. Chief Operating Officer: Update e.i. USDA PROJECT UPDATE – For Possible Action e.i.1.a. A Resolution authorizing the issuance of Pershing General Hospital District, Nevada, Hospital Revenue Bond, Series 2017 in the maximum principal amount of $2,999,900 to pay in part the cost of financing and refinancing a hospital project; providing the forms, terms and conditions of the bonds and other matters relating to the bonds.

Documents need completed as follows: 1. Resolution 2. Original Bond 3. Federal Tax Exemption-Certificate 4. Procedures for ongoing compliance with Sections 141 and 148 of the Internal Revenue Code 5. General and No-Litigation Certificate 6. Initial Principal Advance Request 7. IRS Form 8038-G This item was removed from the agenda as the proper materials including closing date and amortization table were not received.

Other items of report by COO:  Generator will be installed week of August 28, 2017

2  New telemetry unit up and running with training complete.  Recruitment continues with creative ideas – will be using more social media for recruitment.  COO Hixenbaugh will assume supervision of the Lab and looks forward to working with the new Lab Manager that will be starting in a couple of weeks.  Hixenbaugh and Plant Manager Loren Bianchi, met with the Dube Group team in regard to the USDA project to review project designs. Some adjustments were made to flooring, paving and design. The team walked the roof and discovered that another material will have to be used for roofing due to venting demands. Updates to the plans will be available in about two weeks. f. Chief Procurement Officer: Update

CPO Helen Joubert reported that June, July and August are busy months in her Department completing inventory and preparing for the audit. The treadmill has been installed in the Clinic. New shelving has been completed in Dietary pantry. Joubert is covering for the Dietary Manager, who is out for a week. Housekeeping is still experiencing occasional staff shortages, however, the Department is managing as best it can. The Laundry processed 103,343 pounds of laundry in Fiscal 2017, the highest amount ever recorded.

5) CRITICAL ACCESS HOSPITAL (CAH) ITEMS a. UNFINISHED BUSINESS b. NEW BUSINESS: b.i. Wage Committee Recommendation – For Possible Action Board took the following action: Chairman Joe Pierce, also member of the Wage Committee, detailed the recommendations as attached to the meeting packet.

Ted Bendure presented motion to approve the new position, Medical Assistant, to the Clinic with a salary range of $15.00-$22.51 per hour on wage scale dependent upon experience and certification. It is also recommended to approve the full time Medical Technologist or Clinical Lab Technologist position in the Laboratory with a salary range of $25.56-$38.35 per hour on wage scale dependent upon experience and experience in a rural hospital setting. Second to the motion by Charlie Safford. Motion carried unanimously. 6) PERSHING HEALTHCARE FOUNDATION: UPDATE Carolyn Hultgren reported on the PHF Annual Dinner held August 12. Attendance was down, believed to be due to people off on vacation, etc. before school starts. The Foundation awarded two scholarships in the amount of $15,000.00 total, which was covered in the August 23, 2017 edition of the Lovelock Review Miner. The Foundation Board will conduct a recap of the dinner at their next regular meeting. Hultgren noted that meetings are public and posted at Pershing General Hospital, Lovelock Post Office, Pershing County Library and the Pershing Courthouse. 7) OTHER ITEMS a. CORRESPONDENCE - None b. LEGAL b.i. None c. OPEN SESSION c.i. None d. OTHER

Page 3 of 4 d.i. Board Member Safford thanked the Hultgrens for coming to Lovelock and praised them as an addition to the community with special thanks to Carolyn for her tireless work to establish the Pershing Healthcare Foundation. Safford also thanked CFO Boline, County Commissioner Shank and PGH staff for their efforts. 8) PUBLIC COMMENT – None

9) ADJOURN: - Meeting adjourned by Chairman Joe Pierce at 6:50 p.m.