Crook County Medical Services District Board of Trustees – April 24, 2014


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

ADMINISTRATION/STAFF PRESENT: Jan Van Beek, CEO; Kyle Richards, Rapid City Regional; Steve Francis, Accounting Manager, Sam Hogue, HR; Rhonda Dick, Clinic Manager, Director Home Health; Marsha Erickson, Radiology; Audrey Finn, Purchasing; Sam Waugh, Maintenance.

GUESTS PRESENT: Guest wished to remain anonymous.

CALL TO ORDER: Chairman Sandy Neiman called the meeting to order at 2:30 p.m.

PUBLIC COMMENTS: The anonymous visitor who was in the Emergency Room a couple of months age discussed his concern about the condition of the building – roof, etc. He sees no long range plan. He questioned condition of the roof, no hot water in patient rooms, equipment busted, EKG broken. He had to make a trip to Spearfish for a scan due to broken equipment. It appears that we spend a lot of time on personnel issues.

The board and staff present discussed steps taken and items to be worked on. The visitor recommended a circulating main – which may solve the water heat problem.

ADOPTION OF THE AGENDA: Bruce Brown moved to adopt the updated agenda as approved. Judy Bettmann seconded the motion. Motion carried.


APPROVAL OF MINUTES: Bruce Brown moved to approve the minutes as amended. Judy Hutchinson seconded the motion. Motion carried.


Maintenance – Sam Waugh, manager of maintenance discussed the redesigned work orders. They are pushing to have people use them. They are working better. The maintenance started a list of items to be done. Four maintenance employees, including 1 housekeeping/maintenance worker handle the maintenance issues.

Radiology – Marsha Erickson stated that we are approved to get digitizer for Sundance. Front Range may not have the proper information. Cost for the digitizers with Front Range is $715.00/month. One digitizer for Sundance is included in the contract. Digitizers for the other clinics is not included. Yearly maintenance thru Rapid City, thru Bio-Med company, is in place now.

X-Ray digital currently being used is a cassette. Digital with digitizer is clearer and of higher quality.

Sandy Neiman directed to move forward to get financing costs for purchase or leasing with Rapid City. Usually the turnaround time for installation is quick. Price quote shown is $138,611.84 plus $900.

Radiology Update – Jan Van Beek, CEO stated that we’ve had delays on detailed plans. Bill Sharon is the architect. The physicist stated that walls are ok, so plans can move ahead.

Home Health and clinics – Rhonda Dick. Rhonda presented the Home Health annual report. (See Home Health 2013 Annual Report). There is not a medical Director listed yet. They made some significant changes to Home health. Reimbursement went to $17.50 vs costs of $70 to $80. They are cutting costs. Rhonda and Sheryl introduced themselves to Spearfish, to check for referrals.

FY2015 BUDGET ASSUMPTIONS – wages. Steve Francis stated that the ICD 10 implementation is postponed to October 2015. This gives time to work with the budget. 2% and 3% raises are being evaluated. Health Insurance evaluation is included.

Razor, CT, and X-Ray will be add-ons to the budget. Overview: Staff will work on submitting needs. They will have to justify any increases.


Collections/Uncompensated Care/Bankruptcy/Admin Adjustments – None.

Steve Francis explained the financials and discussed the Balance Sheet and Income Statement, Patient Statistics, Bear Lodge Financials.


Accounts Receivable is 72.19 days. Days cash on hand 69.68 days.

Judy Bettmann moved to accept the financial statements for March as presented by Steve Francis, Bruce Brown seconded the motion. Motion carried.

Board Treasurer’s Report – Trustees Bank Account Status – Judy Bettmann

Deposits $2,839.77 + $4,041.34, and $74.35 interest February, $86.29 interest March. Expenses None. Balance as of April 24, 2014 is $682,398.16.

Judy Hutchinson moved to approve the treasurer’s report as presented. Bruce Brown seconded the motion. Motion carried.


Payroll Ratification: A motion was made by Bruce Brown and seconded by Judy Bettmann to ratify payroll in the amount of $346,769.91. Motion carried.

Check Register. Jan discussed questions on the website. They are looking for a new website person. Newspaper schedule was discussed, as well as petty cash.

The amount presented for Accounts Payable was $287,947.84 from checks #39875 – 40128. Bruce Brown moved and Judy Hutchinson seconded to ratify Accounts Payable. Motion carried.


Medical Staff – No meeting in March.

Risk and Safety: Minutes were presented.

QAPI: Minutes were presented from February.

Infection Prevention Meeting: 03/20/2014: Minutes were presented.

Resident Council: Minutes were presented.

LTC Resident Council: Minutes were presented.

Chuckwagon: None

Compliance Committee: None


Auditor – Eide Bailey Contract – official approval. Questions were raised whether Eide Bailey was recommended in open session or executive session. See motion made at end of minutes, after executive session.

HIS/EMR Project Update: The board asked if communication is better between staff and employees. Jan stated that it depends on the day. Razor – the listed presented is to be fixed May 6th from Razor. Communication is still an issue. Tomorrow (April 25th) a meeting is set up to go thru Razor information and training. There have many repeats of calls to Razor – too much overlap. Internal issues still needing to be worked on/improved include employees / managers. Follow thru and communication, training, and accountability. It is improved. The May 6 upgrade should fix many Razor issues. Many problems are due to operator error, as discussed in the Medical Staff Meeting.

Tablets CCMSD purchased for use by Providors are for sale $850. each.

Radiology Remodel Update: Jan stated she has a phone call in to the architect for the plans. He has had major delays. Discussion followed.

Digitizing Clinics X-Ray Machines: See previous report by Marsha Erickson in Department Head reports.

Mammography Grant – Maureen was sending in the proposal letter. She did not send a specific application. Jan signed off on the proposal only. The process will take at least 12-18 months to begin the process. Maureen was looking for collaboration to see enough interest was shown.

Sandy asked Jan to please thank Long Term Care for voting to put minutes in the packet.

Scheduling future board meetings. Steve Francis requested to please defer scheduling future board meeting scheduling to the June meeting.


Credentialing Judy Bettmann moved to recommend Samantha Davidson for credentialing for 4/23/2014 thru November 30, 2015, based on the Medical Staff recommendations. Judy Hutchinson seconded the motion. Motion carried.

Bruce Brown moved to accept updated re-amended minutes as discussed and presented (including mammography and credentialing). Judy Bettmann seconded the motion. Motion carried.

Laundry/Courier contract Jan Van Beek stated that the Courier van had been totaled. Rapid City has done courier service three days a week for two months. Discussion following comparing costs for doing laundry ourselves vs thru Rapid City. Costs were $190/day with $200-250/month revenues. Costs thru Rapid city are $218.50/day. Costs to continue to do laundry in-house are high. Rapid City owns the laundry now.

Connie Lindmier moved to approve the contract with Rapid City Regional Courier service for three days a week, for laundry, etc. courier contract of $34,000/$218.50 per day. Bruce seconded the motion. Discussion followed. Motion carried.

Moorcroft Clinic walk thru The board discussed the Moorcroft clinic and its condition. It is in very poor condition, “disgusting”.The Dentist is moving out. After discussion, Bruce Brown moved to start the process to raze the old clinic. Judy Hutchinson seconded the motion. Motion carried.

The board discussed doing walk-thrus of the Hulett Clinic and Sundance old clinic. The Sundance Old Clinic is now used for sleeping rooms for locums, traveling staff.

The toilet in the hallway near the conference room – a new toilet is ordered from Menards. Sandy offered to pick it up. The toilet in the ER and sink faucet were discussed.

Physician Recruiter Contract Jan has been sent information on one person. They are setting something up for this week. When Sandy listened to the Medical Staff meeting it was stated that a physician will need to supervise PAs and NPs. Renewal contract dates of Providers was discussed.

Board – Committees for repairs —-future.

Roof Jan has a phone call to the person to fix the roof. Windows Jan has a phone call in with the Department of Health to see the proper procedure for windows.

Flooring No discussion


ADMINISTRATOR REPORT: Jan stated that Roni will let Jan known the Bearlodge Rehabilitation meeting can be set up.

The Medicaid person was here. They discussed the #s needed to fill out for Medicaid incentive money.

A grant was written about a year ago. The payment was $236.00 over costs. It was an educational grant (Workforce Development) for Bruce Link-dietetics to go to an educational training.

Lab – A Traveler named Mike will work here until Mid-June. Lilly has been out due to injury, on medical leave, she comes in part-time on Monday. One other person is full-time, two others work three days a week.

Newcastle and Lusk would like to meet with our board to see if there are things we can work with them together.

Employee forums. Four are set up. Moorcroft/Hulett is set up for Tuesday. 56 employee engagement surveys were filled out. This is 45%. The board noted that 45% is not a high rate of employees taking part. Forums were done during the day (night shift or other shifts were not taken into account). They have included some very interesting comments. Standards of Performance were discussed.

Forums: Employees are to fill out information. Information goes to Jan (not Rapid City), and is done is a very professional manner, with confidentiality insured. 18 people attended.

Board Education Kyle Richards, COO RHN – deferred to next meeting.

Strategic planning meeting: Schedules will be checked to see when is a good time. It was recommended that we wait until after County Fair and Rally. Jan will be gone most of the week of May 7, 8, 9, 10, 11, 12.

Next Meeting: May 22, 2014

A­­­­­­­t 6:01 p.m. Bruce Brown moved to adjourn and move into executive session for Board only.

Judy Hutchinson seconded

The board moved into Executive Session at 6:05 p.m.

At 7:45 p.m. Bruce moved, and Judy Bettmann seconded to move the meeting out of executive session.

At 7:57 Bruce moved, and Judy Bettmann seconded to go back into executive session.

At 8:14 Bruce moved to come out of executive session. Judy Hutchinson seconded the motion.

To clarify and insure that a record shows the hiring of Eide Bailey, Bruce moved to use Eide Bailey for the Audit and Cost Reports, as discussed April 9, and in the executive session April 24. Judy Hutchinson seconded the motion. Motion carried. Bruce moved to use Eide Bailey for the Audit and Cost Reports, as discussed April 9, and in the executive session. Judy Hutchinson seconded the motion. Motion carried.

Bruce made a motion to act on the recommendations made in the executive session. Judy Hutchinson seconded the motion. Motion carried.

Steam table – tabled until next meeting.

At 8:15 p.m. Bruce moved to adjourn, Judy Bettmann seconded. Motion carried.

NEXT MEETING: May 22, 2014 at 2:30 p.m.

Submitted by Chairman Sandy Neiman