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VAN DYKE – The Board of Directors of the
Comanche County Consolidated Hospital District met at the Comanche
County Medical Center’s cafeteria in a partitioned meeting room on
Tuesday, January 30.
Five members were initially present for the meeting. Board president
Charles Mazurek presided and members Karen Carr, Mary Jane Atkins, Joe
Locke and John Mack Weaver were present. Gale Easley arrived later,
while the Board was in executive session.
Charles Mazurek opened the meeting with
an introduction of two representatives from PHNS, Inc., a hospital
consulting and services firm. Kurt Meyer was introduced as the new
interim administrator for the Comanche County Medical Center hospital,
along with Henry Stovall, the president of the PHNS Advisory Services
Division. Mazurek asked the men if they wished to make any comments
and Meyer thanked the Board for allowing the firm to come into our
community and help manage a major asset and commitment. He said, “It’s
a beautiful building and we want to help it to continue to be viable.”
Mazurek responded, “Thank you, and we’re
glad to have you all here.”
Following the review and approval of the
earlier regular and executive session minutes, with a clarifying
correction requested by Pam Rice, Chief Financial Officer, Dr. Howard
Dickey, Chief of Medical Staff, was called upon for his report.
Dr. Dickey said that not too much took
place at the recent Medical Staff meeting other than they approved
changes to the Medical Staff bylaws to make them in compliance with
current laws regarding timely signing of medical orders. Dr. Dickey
said that medical staffing regarding the Emergency Room was discussed
at the meeting and that he would further cover the matter with the
Board in the following executive session.
After that, the Board adjourned into
executive session to consider medical peer review regarding physician
staffing for the Emergency Department and for deliberation on the
DeLeon Hospital and Clinic property.
The Board held an executive session of
approximately one hour and ten minutes. Dr. Dickey left the meeting
after approximately 30 minutes. Kurt Meyer and Harry Stovall left the
meeting during the last 10-15 minutes.
Following resumption of the open session
portion of the meeting, Board president Mazurek commented that there
would be no action taken on the matter regarding physician staffing of
the Emergency Room.
Regarding the second subject matter, the
DeLeon Hospital and Clinic property, Mazurek announced “We’re going to
be in the process of developing a plan for marketing that property. We
want a plan that will be fair to everyone involved and so we are going
to put that together. We think it will probably be the position of the
Board that any use of that property in the future would be restricted
in regard to anything that will be in competition with the hospital
and its operations. We’ll be putting that plan together and making it
public.”
Toney Prather asked if the property would
be listed with a Realtor and Mazurek responded that they were not sure
and would have to decide it later.
Another question was posed by Hiram Smith
Jr. as to the definition of “in competition.” Mazurek responded, “I
think it would mean anything that would have a negative impact on the
revenues of our operation.” Smith then asked how that would be
determined and Mazurek responded that although it might be somewhat
subjective, that it was the Board’s responsibility to determine it.
Smith said he had some published information that he wished to provide
to the Board on the subject.
The next order of business involved
Administrative Report, with the first item being a report on
restructuring given by acting Administrator Shannon Steigleder.
Steigleder said that a brief summary of what had taken place in the
last two weeks was that several departments had been consolidated
under a single manager.
Derrall Moore had been re-employed on
January 22 as the new Environmental Operations Manager. Steigleder
said, “In his role, he will be overseeing Laundry, Housekeeping,
Maintenance, Dietary, Safety, and developing a security plan for us.”
Steigleder noted that Moore had previously worked for the hospital in
maintenance. She added that there were no longer any departmental
supervisors in the affected departments, with the single exception of
Dietary, and that everyone, including Dana Williams, the Dietary
Supervisor, reports directly to Moore. Steigleder added that Moore has
had significant experience in larger hospitals in the same
departmental areas.
Steigleder described a few other
departmental and administrative changes in patient scheduling, medical
records and the business office. She said she held meetings with the
affected personnel and heard very positive feedback. Everyone
expressed agreement that the hospital has to keep its doors open.
Steigleder then described the annual savings she estimated that the
consolidations and restructuring would produce as around $300,000, but
noted that it would take 60-90 days for the favorable financial impact
to be realized.
Steigleder said the hospital had
performed 67 surgeries and special procedures during December, well
over budget but down slightly from November. The average patient
census for December was 21.7. There were 493 emergency room visits.
Pam Rice gave the financial report. She
said that December was a little bit slower month. She described the
operating account cash balances for that day as being only around
$11,000, although she had around $350,000 in reserves with tax funds
coming in. She said she would receive around $400,000 of tax funds
that can be used for operations with the balance going into the bond
sinking fund accounts. She noted that the funds for the bond payment
due in the following week had already been set aside. Rice added that
the $350,000 of Medicare cost settlement funds had not yet been
received and that she was working to expedite that payment.
Rice noted that the Whitestone Assisted
Living Center owes the Hospital District “quite a bit of money” and
that she did receive a check for $40,000 that same day, leaving a
balance of around $64,000. She added that they were requesting
permission from the USDA to defer payments on assisted living center
construction debt (which is not a Hospital District liability) in
order that it could get caught up on payments to the Hospital
District.
Rice noted that the District purchased
the $73,000 laparoscopic surgical equipment, with the Healthcare
Foundation having contributed half of the cost. She added that a grant
application is in process for the balance. If the grant application is
not approved, the Healthcare Volunteers organization has indicated
that they could help out in the purchase cost. She said that they have
45 days to complete payment on the equipment, and that if the grant
was not approved in the meantime, the District might have to fund the
balance of the price.
Rice noted that the District sold the old
nursing home building for approximately $36,000 and been paid in full
for it.
Rice said that not much progress had been
made on the accounts payable totals, with over $1,000,000 owed,
representing an average of 47.5 days of operating expense. She said
that all loans and insurance payments were current. She added, “We’ve
been worse.” She also noted that an approximately $80,000 annual
payment was coming up in April on an equipment financing note. She
said they had been trying for a while to get the note converted to a
monthly payment but had so far been unable to do so. She expressed
hope that it could be converted to monthly payments after completing
the annual payment.
Rice referred to the income and expense
statement in the Board member’s book which showed a profit for
December of $187,755. She noted that a favorable prior year cost
settlement of $181,877 had accounted for the bulk of the reported
profit. She pointed out that salaries and benefits were being well
controlled and were almost $25,000 below budget. The six month
year-to-date bottom line figure shows a loss of $240,000.
Rice displayed graphs of revenue, expense
and cash balances activity. At the conclusion of her presentation,
Charles Mazurek noted that even without the prior year settlement
effect, that December was one of the better months of the year.
Shannon Steigleder gave the Board a brief
report on her and Linda Moore’s meeting with the Comanche County
Commissioners Court regarding the cost of medical services provided to
in-county jail inmates. She noted there would be work meetings held in
the next 60 days to work out procedures between the hospital and the
county. In response to a question from Gale Easley, Steigleder said
that they had agreed to continue providing unreimbursed medical
services to the in-county jail inmates during the interim. She added
that the hospital had total unreimbursed inmates medical care cost of
around $9,000 in the prior year.
Kathy Johnston was called upon to report
on the upcoming Board elections. She said that she had been
researching the matter. Johnston said there was a potential problem
regarding the election date. The District’s enabling legislation
called for an election to be held on the first Saturday in May;
however, the uniform state election date was now the second Saturday
in May. She added that it would be a special election if they had to
hold it on the first Saturday, which would affect everything from the
time of posting election notices to the deadline for filing, as well
as the cost of the election. She said that the election would have to
be ordered at the next Board meeting. She added that there was no
official first day for filing for the election, but the last day for
filing would be either April 4 or April 11.
Joe Locke inquired if there needed to be
a change in the District’s enabling legislation and whether the
Legislature should be asked to make such a change. Johnston replied
that she assumed there would need to be a change, but that she didn’t
know for sure. Charles Mazurek commented that there might be a
provision in the legislation that changed the state’s uniform election
date that would pertain to the matter.
Kurt Meyer said he would be pleased to
investigate the election dates matter.
Johnston inquired if the Board election
alternative had ever been decided. Mazurek responded that “at large,
by place” had been the Board’s earlier decision. He said, “I think we
had the option of at large, or at large by place, and we made the
decision to do it at large by place.” Other Board members expressed
agreement with Mazurek’s statement.
Mazurek then concluded, “I would like to
say that we’re glad to have these two guys (Meyer and Stovall) on
board with us and we look forward to working with them. I also want to
thank Shannon for all the good work that she’s done. It probably
hasn’t been a real fun time, but we appreciate her work. If there’s
nothing else, we’re adjourned.” |
