Crook County Medical Services District

CROOK COUNTY MEDICAL SERVICES DISTRICT DRAFT

BOARD OF TRUSTEES MINUTES

October 29, Tuesday, 2019, 1:00 p.m. – CCMSD Conference Room

Persons in Attendance: Sandy Neiman, President; Connie Lindmier, Secretary-Treasurer; Mark Erickson, Trustee; Trish Habeck, Trustee; Joey Kanode, Trustee

Nathan Hough, CEO; Karl Rude, HMS; Bonnie LeSueur, HMS by phone; Scott Murray, WPDN legal.

Judy Hutchinson, CCMF Foundation; Sandy Kellogg, CCMF Foundation; Sarah Pridgeon, Sundance Times.

Call to Order: President Sandy Neiman called the meeting to order at 1:01 p.m.

Public Comments: Joey Kanode stated that the last Executive meeting was called into question. Joey said our due diligence is to be visible to the public. Discussion followed.

Sarah Pridgeon was asked what she had heard. She heard rumors that it would be the end of HMS. Sandy asked why they did not come to the Board to ask us any questions.

Agenda: Mark Erickson made the motion to accept the agenda as presented. Joey Kanode seconded the motion. Motion carried.

Approval of Minutes: Joey Kanode made the motion to approve the minutes as presented. Mark Erickson seconded the motion. Motion carried.

Foundation: Judy Hutchinson reported. Judy showed a draft plan of the proposed clinic in Hulett. The front of the clinic faces the highway.

Corrections and location changes will be shown as completed.

The size of the clinic is under 8000 sq ft limit.

Foundation is looking at a grant writer, and working to get funding / donations.

Joey Kanode asked if PT can be in clinic. Karl explained the research and checking for options, to insure that all plans and building is within State and Federal guidelines.

Judy Hutchinson explained two options for ownership of the clinic. Foundation will own the building.

Impacts to hospital’s cost report is based on who owns, and who uses the building.

Mark Lyons will work to check options.

Judy Hutchinson and Sandy Kellogg explained to Mark Erickson the differences between options.

Discussion about Foundation and CCMSD Board followed.

Costs were discussed. Karl Rude explained methods to get to numbers, etc.

We don’t get paid the way a normal business does. Expert (Mark Lyons) will analyze and get the reimbursement, etc. that is best for us.

Mark Erickson stated that the nursing home needs help. Lights, paint, etc.

Nathan Hough stated how he has worked with foundations. Working together to get a list to the Foundation is a good way to have them help and to fundraise for projects.

Ambulance – Nathan Hough has worked on several aspects of the ambulance. Waiver (since April) to have it be a cost based reimbursement for ambulances. Noridian has approved it. It will be submitted this fall. The next step will be to approach City or County for grant for ambulance for us to lease. This will relieve the burden for City or County, etc.

We can go direct to Rapid City when transporting patients – this will help reimbursement (distance between Sundance hospital ER and Rapid City (miles)).

Nathan Hough has talked to the County and Mayor, so hold off on the letter to meet with the city.

Judy Hutchinson stated that funding from the Foundation can be provided for equipment, but not leased equipment.

People can earmark monies for any project.

Nathan Hough has found a potential ambulance for purchase in Buffalo. Nathan stated that he could approach the City to buy ambulance for our use.

Sandy Neiman requested to have Foundation members attend meetings, or send in documents, or attend by Zoom. This will keep CCMSD and Foundation members up-to-date on issues.

LTC – needs paint, light shades, etc. Nathan Hough stated that it is a balancing act with lights – too bright lights are dangerous to patients, uncomfortable.

Karl Rude stated that the strategic planning, with a County-wide facilities plan, is needed. Over next 25 years. Discussion followed. We need to replace about 80% of our buildings in the next 10 years.

Sandy Neiman stated that we need to be aware that we’ve come a long way, and I (Sandy) am proud of where we are. We have a long way to go.

Judy Hutchinson said that if we have needs, please approach the Foundation to see if they can help. We can provide them a list with highest priorities. They can review the list and either provide funds or help with fundraising to get those funds. The Foundation works for the entire County. The Hulett clinic is the first major project requested since the new Foundation Board has been here.

Audit Report: There should be a copy for the board members to sign after each annual audit. Bonnie stated she has not seen a report like that. Eide Bailey needs to be contacted to get the report to the Board.

Financial Report: Bonnie LeSueur

Bear Lodge Rehabilitation - reviewed

AR Aging: 1.4 – pretty good. Some back payments good. Over 80% on payments.

Balance Sheet: reviewed

Income Statement: reviewed

Bank Listing: reviewed

Days Cash on hand: 17 days

Check Register: reviewed

Vendor Aging: reviewed. Vila Pharmacy is keeping up on payments. Lab is doing a great job. Good high level tests. Advertisement for CCMSD – change to once a month. Add “rheumatology (example) in ads. Proudly accepting Medicare patients. Discussion followed.

Policy on bids – Karl showed an example of State law compliance on bids. Discussion

Scott Murray recommended leaving a specific dollar amount out. Specific plans for expansion compliant with most stringent of state or local. Crook County currently has limit of $25,000.00. In accordance with Crook County

The policy reads as follows:

“CCMSD will be compliant with Wyoming State law and Crook County law for the purposes of putting capital projects out to bid to ensure community knowledge and participation in the bidding process. Planned projects for capital expansion in excess of the lesser of the State of Crook County limit shall be put out for public bid by placing notice of the same in the local newspaper of record. These projects will be advertised at least one time with a minimum of 30 days’ notice to submit to CCMSD.

Approval of the process for putting projects out to bid will be acknowledged by the majority vote of the Board of Trustees of the Crook County Medical Services District.

Projects that exceed this amount but are an issue of immediate or emergency replacement following damage or destruction will be allowed to by-pass the bidding process by hosting an emergency meeting that allows Hospital leadership to resolve the matter without bidding the repair.”

Mark Erickson made the motion to accept the policy as worded with corrections above. Joey Kanode seconded the motion. Motion carried.

Mark Erickson made the motion to approve financials as presented. Joey Kanode seconded the motion. Motion carried.

Payroll:

Joey made the motion to ratify payroll for September 2019.

9/6/2019 - $178,205.70

9/20/2019 - $R179,939.48 = $358,145.13 total

Mark Erickson seconded the motion. Payroll ratified.

Mark Erickson made the motion to approve financials as presented in June, 2019. Joey Kanode seconded the motion. Motion carried.

Board Treasurer’s report:

Super Now: 8/31/2019 Balance = $11,105.24

9/4/2019 To Trustee checking - 2,864.15

9/30/2019 Interest + 4.82 = $ 8,245.91

9/30/2019 Deposit Mill Levy

($99,941.23) + 89,941.23 = $ 98,187.14

10/8/2019 To Trustee Checking - 20,000.00

10/17/2019 Deposit-Mill Levy +32,300.51 = $110,487.65

Checking: 8/31/2019 Interest + .67

9/4/2019 Deposit from Super Now + 2,610.00

9/4/2019 Check #509 = 674.00

9/4/2019 check #510 - 2,190.15

9/30/2019 Deposit-Mill levy (99,941.23+ 10,000.00

9/30/2019 Check #511 - 697.50

9/30/2019 Check #512 - 883.65

9/30/2019 Interest + . = $ 10,084.10

10/8/2019 Deposit from Super Now + 20,000.00

10/8/2019 Check #513 - 1,774.60

10/8/2019 Check #514 - 330.00

10/8/2019 Check #515 - 787.50

10/8/2019 Check #516 - 14,096.17 = $ 13,095.83

Joey Kanode made the motion to approve Board of Trustee financials as presented. Mark Erickson seconded the motion. Motion carried.

OLD BUSINESS:

CT – signs – Nathan presented.

PreCorp – ER – PreCorp / Basin Electric – to go on Gurney

Leona – CT

Freida Dent – to be done by FFA in Hulett

Hulett Clinic / Foundation: see above

CEO Report & Management Report:

Moorcroft clinic – done

Hallway Ceiling – on hold

Privileging – done

LTC – moving forward. Painted last time – input from residents last time. Nathan asked if it would be valuable to get information to the Board for scheduling repairs, maintenance, etc. Discussion followed.

Website – none - ongoing

Generator – 12-15 weeks to deliver. Contract was updated to bigger tank. They are checking on free-standing tank with catch basin. Planning for worst case scenario.

Ambulance prices – grants. City and County can get grants on behalf of CCMSD. Paramedic on staff / paramedic in training on duty 24 hours.

Policy – done

Updates –

HCaps surveys – check results next months. Quarterly reports are the norm.

Beds – No new beds

Employee Satisfaction Surveys – to be done Wednesday

Clinical performance – Reports requested: would like to see patients seen – face to face visits - Clinic, ER, Hospital.

Security Cameras – Nathan passed around a document showing security cameras. Scott Murray will check with Wyoming Medical Center to see rules for privacy, etc. (PT – ex).

Nathan will check further also.

Strategic Planning – Kyle Cameron had discussed Best on Board training for Boards. This was recommended during the Strategic Planning meeting October 18.

Strategic planning report was sent out by Kap Wilkins team, the Board was to review first and then it will be sent to other “stakeholders”

Medical Staff Bylaws – Board to review and compare to old bylaws. Review and vote on next month

Signatures – Sandy and Connie will complete the closing of the accounts.

Board members signed clinic account. Completed.

NEW BUSINESS

Best On Board Training – Eric Boley from WHA is happy to work with us, and training is available online for board members. Kyle Cameron and Eric Boley will get information to Trish and Mark and Joey. Discussion followed.

EXECUTIVE SESSION

Trish Habeck made the motion to go into Executive Session at 3:35 p.m. Mark Erickson seconded the motion. The Board moved into Executive session. Purpose: to discuss contracts and legal. Karl Rude & Nathan Hough left Executive session at 4:20 p.m.

Mark Erickson made the motion to go out of Executive Session at 5:00 p.m. Joey Kanode seconded the motion.

The Board moved into regular session at 5:01 pm.

Mark Erickson made the motion to have CCMSD Board develop RFP criteria for forthcoming management services contract at CCMSD in conjunction with our legal team, as per State statute. Joey Kanode seconded the motion. Motion carried.

Scott Murray with WPDN will work with it.

Mark Erickson made the motion to go back into Executive Session at 5:02pm to HIPPA. Connie Lindmier seconded the motion.

Mark Erickson made the motion to move out of Executive Session at 5:12 into public meeting. Connie Lindmier seconded the motion. Discussion only. Board members are to follow up with written information to follow up.

The Board discussed best date and time for next meeting.

Adjourn

Mark Erickson made the motion to adjourn at 5:16 pm. Connie Lindmier seconded the motion. Meeting adjourned at 5:16 pm.

Next Meetings:

November 21st Thursday, 1:00 p.m. Hospital Conference Room.

(Thanksgiving 28 Thursday)

Respectfully submitted,

Connie Lindmier, Secretary-Treasurer

CCMSD Board