Crook Co. Medical Services District Board – July 24

(NOTE: These minutes were submitted to The Sundance Times on October 21)




       July 24, 2014


BOARD MEMBERS PRESENT: Sandy Neiman, President; Bruce Brown, Trustee; Judy Bettmann, Treasurer; Connie Lindmier, Secretary; Judy Hutchinson, Trustee.


ADMINISTRATION/STAFF PRESENT: Ken Archer, Interim CEO; Kyle Richards, Rapid City Regional; Steve Francis, Accounting Manager; Audrey Finn, AP/Purchasing; Laura Moller, HIM, Medical Records.


GUESTS PRESENT: William Rogers


CALL TO ORDER: Chairman Sandy Neiman called the meeting to order at ­­­­2:33p.m.


PUBLIC COMMENTS: Bill Rogers discussed newspaper minutes and articles. He is concerned with staff member turnover. Discussion followed. Sandy Neiman and Ken Archer responded. Ken stated that things had to be corrected before we could move on. Bill is reading the minutes from 30 to 60 days previous, because minutes from the last month must be approved at the next board meeting before they can be sent to the press.



Additions: Windows in New Business. Medical Insurance thru County Commissioners discussion.

Bruce Brown moved and Judy Bettmann seconded to adopt the Agenda. Motion carried.





Judy Hutchinson moved to approve the minutes with changes and corrections. Bruce Brown seconded the motion. Motion Carried.



Steve Francis presented the revised draft budget for review and approval.

Discussion followed:

The Medicare Reimbursement rate showed that Medicare requested payback of $418,000.00. Net requested is $274,000.00. It can be made in payments. Ken will request that Medicare let us make payments over time, zero percent interest.

#1: 3 person maintenance department with Manager Position as working manager.

#2: Home Health Service has dwindled. Ken recommended we close the Home Health Service and recommend patients to existing Home Health Services in the county. The positions can be moved to other areas. Ken recommended we see what other outpatient services we can provide to be of value.

#3. Insurance. Discussion of providers and levels of contribution to employees accounts.

#4: Revenue adjustment – charges to patients. Utility costs are expected to increase 4.9% to 6.2%.

Ken recommended we ask for research on costs in incentives for couples in Long Term Care. Judy Hutchinson recommended we do a trial basis reduction for couples. Discussion followed. Connie Lindmier moved 2% increase except the cost of clinic calls. Judy Bettmann seconded the motion. Motion carried unanimously. A Charge Master review will need to be done possibly in January 2015.

#5: Windows. The Foundation is ready to contribute to the cost of windows. Discussion followed concerning steps. Specifications must be posted twice in the newspaper with 15 day posting period. The Goal is to have windows complete in November. New windows and insulation around windows can result in approximately $12,000 savings.

#6. Ambulance Call rate. Ken recommended bringing up the call rate from 1.50 to 2.50 to be more in line with other departments. It could help with recruitment of additional EMTs. Costs would increase by $10,692.   We will budget this in and review it at 6 month and 12 month intervals.

Ken Maston and EMS is working with the Fire Department to collaborate emergency services. First Responders used to be available. Bruce Brown suggested we make sure they know we as a board support the collaboration.

#7. Medicare contractual amount. We will have lower Medicare (reimbursement) payments. With lower Medicare payments in the future we will have a lower contractual loss.

#8. DON (Director of Nursing) for LTC (Long Term Care). Ken Archer will present to the Board a long term staffing recommendation for RNs & CNAs.


Bruce Brown moved to accept items recommended on the CEO report 1,2,3,5,6,7,8 to adjust the budget. Judy Hutchinson seconded. The motion carried unanimously.


Bruce Brown moved to accept FY2015 Budget as adjusted. Judy Bettmann seconded. Motion carried.



Steve is preparing reports. They are working on Razr Electronic Medical Records to complete and correct “glitches” in the system. They are working on the cashier section so it posts right away to access accounts. We have just over $1 million in the account.

Bear Lodge Financials – Report was reviewed. Bear Lodge Rehab would like to set the annual meeting.

District Balance Sheet – Not available

Patient Statistics – Not available. LTC (Long Term Care) has 29 clients as of Monday, July 21. Ken recommended we tell Razr from the Administration and Board’s perspective that we need more proactive support from Razr to enable correct processing.

District Income Sheet – Not available.

Collections/Uncompensated Care/Bankruptcy/Admin Adjustments – Not available. Steve Francis requested to send to Rocky Mountain Recovery for collections $62,173.50, uncompensated care none.

Bad Debt Write off: $62,173.50. Uncompensated Care: none. Bankruptcy: None. Administrative Adjustment: None.


A motion was made by Judy Hutchinson and seconded by Judy Bettmann to approve the write off of $62,173.50 to be sent to Rocky Mountain Recovery. Motion carried unanimously.



Accounts Payable Audrey will need $150,000.00 to pay bills within the next two weeks. Bruce Brown reviewed the Payroll Ratification.


AP & Payroll – We will need around $200,000.00 to catch up on bills. Steve is processing approximately 40% of vendors who have never been processed before. Bruce suggests we have a reconciled bank account to get financials monthly. We will have the complete financials reviewed for June and July at next month’s meeting.


Bruce Brown moved to transfer $200,000.00 from the trustee account to General account for operational expenses. Judy Bettmann seconded the motion. Motion carried unanimously.


Judy Bettmann moved to approve $325,514.89 payroll as presented. Bruce Brown seconded the motion. Motion carried unanimously.


BOARD TREASURER’S REPORT – Trustees Bank Account Status – Judy Bettmann


Balance as of July 24, 2014 is  $ 581,138.53

Deposits – Mill levy 6/12         $ 164,836.75

Mill levy 7/10         $     9,216.28

Interest           April 30   (May?) $        84.03

Interest                        June                    $         76.19

Interest           July                     $         64.72



Bruce Brown moved to ratify the Trustee account. Judy Hutchinson seconded. Motion carried unanimously.


Connie Lindmier moved to ratify May financials. Bruce Brown seconded the motion. Motion carried unanimously.



May old and new payroll will be presented next month. AP check registers are on hold until next month.


County Commissioner meeting – Ken Archer and Sandy Neiman will meet with the County Commissioners August 4, 2pm.



Laura requested that they have an organizational meeting next Thursday to see Federal regulations on compliance.


Contributions: Bruce Brown made a motion to pay for TVs and Mounts. Judy Bettmann seconded the motion. $2,255.00 donated dollars were put into the trustee account for this purpose. Motion carried unanimously. The board will write thank you (Sandy) to Arley and the donors on behalf of the board.


5:09 pm. Bruce Brown moved to go out of regular session and into Executive session. Judy Bettmann seconded the motion. Discussion of personnel and privacy matters. No motions made.


5:15 pm. The board went into Executive session. Not motions made.

5:42 pm. The Board went out of Executive session.




Radiology Remodel Update:

Ken did send the information to the attorney. We could have bought new equipment for what we bought from the present company. Ken has a report from Rapid City Regional. He will send a copy to the board of the information.

Digitizing X-Ray machines at Hospital and Clinics.

Table until August.


Scheduling future board meetings.

Next meeting August 28, 2:30 p.m. Changed from August 21st so Ken & Steve and take care of Audit.


County Health Insurance. The County (Connie Tschetter-Clerk’s Office) will come to a board meeting and present how we can join the County Health Insurance as a separate entity.




Hulett Town Hall Meeting: Reschedule to August. August 21, 6:00 p.m. Community Center.


Pine Haven Town Hall: Camp Beard Public Forum August 6th, Pine Haven August 8th. Can we take part in them?


Roof: There are a few drips through the vents. The vent hood was replaced. Hail and Heavy rains cause drops.






Ken will contact windows sources and update the board at the August meeting.

HVAC – they will wrap the vents.



Ken Archer gave his administrator’s report. Ken has not had a chance to review the organizational chart. He plans to review that with the board at the September meeting.

Rally is set up. Extra people will work during Rally.

Oxygen Room – the manifold is old. It needs to be upgraded. Ken will check into costs and information.


Cost Master Charges review and update will cost $35,000.00


Ken stated that a “Meaningful Use and Incentive Program” exists. We may potentially be able to get $320,000.00 to offset Razr costs. Ken discussed the Medicaid Incentive payment.



Sandy will take policies home to review. She will get them to Connie to review when completed.


NEXT MEETING: August 28, 2014 at 2:30 p.m.


Bruce Brown moved to adjourn, Judy Bettmann seconded the motion. Motion carried. The meeting was adjourned at 5:26 p.m.


Special Board Budget Meeting July 24, 2014 at 6:00 p.m.


6:03 pm The board moved into the Budget Meeting.

No public present.

6:06 pm Bruce Brown moved, Judy Bettmann seconded to go back into regular session.


Bruce Brown moved to accept items recommended on the CEO report 1,2,3,5,6,7,8 to adjust the budget.

Bruce Brown moved to accept FY2015 Budget as adjusted. Judy Bettmann seconded. Motion carried.


Bruce Brown moved to adjourn, Judy Bettmann seconded the motion. Motion carried. The meeting was adjourned at 6:26 p.m.


Respectfully submitted and approved:




Connie Lindmier, Board Secretary­­espectfully submitted and approved:

Judy seconded. Motion carried.ssed in executive session.

y machine – $5,000.00 donation.