Welch Cancer Center

Sheridan Radiology

The Foundation

Big Horn Surgical

Wound Care Clinic


 

Taking
Your Health
to Heart
 

for BOARD MINUTES 2003 - click here      for BOARD MINUTES 2002 - click here
for BOARD MINUTES 2001 - click here

2004 BOARD MINUTES
● JAN 7 (December 2003 meeting)   ● FEB 3 (January 2004 meeting)
● FEB 25     ●MAR 5    ● MAR 24   ● APRIL 28   ● MAY 26  
● JUNE 30    ● JULY 28  ● AUG 25   ● SEPT 13   ● SEPT 28
● OCT 25    ● NOV 30    ●  DEC 7  (note Regular December meeting held Jan 5, 2005)

Board meeting minutes are added to this page after they are officially approved at the next month's regular meeting.

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES SPECIAL MEETING
DECEMBER 7, 2004      4:30 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Harlan Rasmussen, Anthony Spiegelberg, Gary Miller, Dixie See; Larry Roos; Scott Nickerson

The Board held a special meeting to approve the additional medical staff reappointment applications that were submitted to the Medical Executive Committee on December 2^nd.

Dr. Wohl submitted the list of Active, Courtesy and Consulting Staff reappointment applications for 2005-2006 as approved by the Medical Executive Committee at their meeting on December 2^nd.  All applicants have been approved by their appropriate department(s).

Anthony Spiegelberg made a motion to approve the list of Active Staff for reappointment and privileges requested.  Dixie See seconded the motion and motion carried.

Scott Nickerson made a motion to approve the list of Courtesy Staff for reappointment and privileges requested.  Harlan Rasmussen seconded the motion and motion carried.

Anthony Spiegelberg made a motion to approve the list of Consulting Staff for reappointment and privileges requested. Gary Miller seconded the motion and motion carried.

There being no further business, the meeting adjourned at 5:15 p.m.

Recorder, Joanne Redder
Larry Roos, Secretary

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
NOVEMBER 30, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Harlan Rasmussen, Anthony Spiegelberg, Gary Miller, Dixie See; Larry Roos; Scott Nickerson

APPROVAL OF MINUTES – OCTOBER 25, 2004
The previous meeting minutes of October 25, 2004 were reviewed. After review, Harlan Rasmussen made a motion that minutes be approved.  Anthony Spiegelberg seconded the motion and motion carried.

MEDICAL STAFF REPORT
Dr. Wohl submitted the names of the Active, Courtesy & Consulting Medical Staff who have applied for reappointment for 2005-2006.  Dr. Wohl explained that each application was reviewed and approved by the appropriate department(s) as well as by the Medical Executive Committee.  The Medical Executive Committee will meet again on December 2^nd to review those applications completed after the November meeting. 

Scott Nickerson made a motion to approve the list of Active, Courtesy & Consulting Medical Staff for reappointment and requested privileges, as recommended by the Medical Executive Committee.  Dixie See seconded the motion and motion carried.

QUALITY COUNCIL REPORT
Larry Roos reported that the committee met on November 16^th and reviewed patient satisfaction results.  Mr. Roos also noted that a Policy & Procedure Project is underway with some polices being updated.

ADMINISTRATION REPORT
Service Excellence – Ken Huey gave an update on the hospital’s Service Excellence Program and the activities of each team.

Nursing Service Director – Ken Huey introduced Peggy Callantine as the hospital’s new Director of Nursing Services, replacing Denise Krajewski.  Mr. Huey thanked Mrs. Krajewski for her four years of service to the hospital.

Physician Needs Assessment – Ken Huey reported that ECG Management of Seattle, Washington recently conducted a physician needs assessment for the Sheridan service area and this report has been shared with the Medical Executive Committee.  The Board was requested to form a committee to review the study and to make final recommendations to the full Board.

Wellness Council – Kate Taylor, Wellness Council Coordinator, shared with the Board a report prepared in March, 2004 by the Wellness Council of Sheridan County Safe Communities Task Force.  Ms. Taylor explained that there was a community meeting held in September, 2003 due to concerns over the increase in traffic deaths among the county’s young drivers. Ms. Taylor noted that a “Docs & Cops” presentation will be held on December 9^th where views from the eyes of the police officers and the emergency department physicians will be shared. 

IMRT – Scott Nickerson asked when IMRT will be ready to be offered at the Cancer Center.  Peggy Callantine stated that the hospital is awaiting approval by the Radiation Physicist which, hopefully, will be next week.  An open house will be scheduled for the physicians and public. 

Rezoning – Ken Huey reported that the hospital’s rezoning to an R-3 was approved by the City Council on the third reading.

FINANCE COMMITTEE REPORT
Voucher Approval – Scott Nickerson reported that the committee has reviewed the vouchers and made a motion for their approval.  Gary Miller seconded the motion and motion carried.

Financial Statements – The financial statements for October, 2004 were reviewed, noting a decrease in discharges from budget projections of 9.5% and a decrease in patient days of 16%.  Mr. Roos asked why professional services were over budget by $140,000.  It was noted that this was payment to Quest Diagnostics for the September Health Fair.

Capital Equipment – The following capital equipment requests were submitted for approval:

1)      Stereotactic Breast Biopsy Unit – It was noted that this was budgeted at $200,000 and the bids came in at $211,000.  John Miller stated that the hospital’s current unit is no longer in service.  Scott Nickerson made a motion to approved the purchase of a new stereotactic breast biopsy unit, Gary Miller seconded the motion and motion carried.

2)      OR Equipment Requests:

a.       Orthopedic Power Equipment – This equipment was budgeted at $42,000, total cost is $80,680.90, but includes the additional equipment to allow for two cases to be done at one time.

b.      Pediatric Video Gastroscope – This has not been available at the hospital and was budgeted for $16,000.  Total cost is $16,600. 

c.       Video Bronchoscope – Replaces a non-video older scope and was budgeted at $28,000.  Current cost is $19,000. 

Anthony Spiegelberg made a motion to approve the OR equipment requests totaling $116,347.40, as presented.

FOUNDATION REPORT
Tom Ringley reported that the mailing for the ED Campaign will soon be sent out.  Mr. Ringley also reported that the Hospital Foundation received a $250,000 gift from the Watt Foundation.
Mr. Ringley announced the Employee Partner breakfast from 6:30 a.m. - 8:30 a.m. on December 15^th.  Cash drawings will be held and employees will be able to vote on how to spend the money they have donated. The Board was invited to the celebration.

BUILDING COMMITTEE REPORT
ED Project - Harlan Rasmussen presented a recommendation from the Building Committee to increase the cost of the ED Project by $297,000 for the front canopy and some parking lot changes.

Harlan Rasmussen made a motion to approve the recommendation and Dixie See seconded the motion.  Concerns were expressed regarding the potential increase in the price for the canopy and Board members felt they need to be sure that money is being spent appropriately.  Lengthy discussion ensued.  It was noted that the canopy is a separate project and was not included in the ED Project budget.  The Hospital  Foundation has committed $83,000 towards the canopy.  Mr. Rasmussen felt that if the canopy and parking lot work were done now, it would be less costly than to wait and do this portion separately.

Harlan Rasmussen and Dixie See then withdrew their motion and the recommendation will be taken back to the Building Committee.  It was agreed that this will be bid as a separate project so it will not hold up the work on the Emergency Department. 

Medical Arts Complex – Mr. McCafferty reported that the project is on schedule and proceeding well.

OTHER BUSINESS
Outpatient Surgery Center – Mr. Roos reported that he has, on two occasions, met with the outpatient surgery center private investors regarding the hospital becoming an investor/partner.  Mr. Roos said that the physicians want to focus on starting up the business and then will come back to the Board with their offering.  There was discussion of mutual cooperation for sharing equipment, supplies, etc.  Administration will look into protocols for the hospital serving as an emergency backup for the surgery center. 

Diabetic Neuropathy Education – The Board commended Scott Nickerson on his work with the Diabetic Neuropathy Education Program.  Dr. Nickerson’s promotion has drawn people to the community.

Community Relations – Cecile Pattison reminded the Board of upcoming holiday events:
    December 3^rd  -  Tree decorating by the Hospital Auxiliary
    December 3^rd  -  Hospital Christmas Party
    December 5^th  -  Tree of Love Lighting Ceremony
    December 12^th - Hospice Celebration of Life
    December 21^st-  Judging of Hospital decorations 

There being no further business, the meeting adjourned at 7:00 p.m.

Recorder, Joanne Redder
Larry Roos, Secretary

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
OCTOBER 25, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Harlan Rasmussen, Anthony Spiegelberg, Gary Miller, Dixie See; Larry Roos; Scott Nickerson

MEMBERS PRESENT: Evelyn Ebzery, Harlan Rasmussen, Scott Nickerson, Anthony Spiegelberg, Dixie See, Larry Roos, Gary Miller. 

APPROVAL OF MINUTES – SEPTEMBER 28, 2004
The previous meeting minutes of September 28, 2004 were reviewed. After review, Scott Nickerson made a motion that that minutes be approved.  Harlan Rasmussen seconded the motion and motion carried.

MEDICAL STAFF REPORT
Teresa D. Smith, FNP – The application of Teresa D. Smith, Family Nurse Practitioner, was presented to the Board for approval.  Ms. Smith’s privileges will be that of a Dependent Limited Health Practitioner and she will be working for the Sheridan Clinic with Dr. Michele Bennett as her supervising physician.

Scott Nickerson made a motion to approve the application of Teresa Smith, as recommended by the Medical Executive Committee.  Harlan Rasmussen seconded the motion and motion carried. 

Harlan Rasmussen asked if Ms. Smith’s privileges are consistent with what other hospitals are doing for Limited Health Care Practitioners.  Administration will follow-up on this. 

ADMINISTRATION REPORT
Employee of the Quarter – A plaque was awarded to Roxanne Araas as the hospital’s employee of the 3^rd quarter.  Roxanne is the Administrative Supervisor at Wyoming Rehab.  Roxanne’s co-workers say she wears many hats and is always willing to help out with whatever is needed, whenever it is needed.  Mr. Huey pointed out that October marked the one year anniversary of Wyoming Rehab’s merger with the hospital.

Rezoning – Mr. Huey reported that the first reading of the Planning Commission for the hospital’s rezoning went well and the two subsequent readings will be on November 1^st & 15^th.

ED Project – Mike McCafferty reported that TSP has completed the final phase of the construction documents and these will be sent to the Wyoming Office of Health Facilities.  Mr. McCafferty said he will be providing information on the temporary relocation of the ED as soon as the decision is made.  The hospital is looking at the north med/surg area for the relocation.

 Medical Arts Complex – Mr. McCafferty reported that work is underway on the Imaging Center and office building, which are scheduled to open in the fall of 2005.  It was noted that this project does not require oversight by state officials, as does the ED Project and, therefore, can move more quickly.

Mr. Del Acker from TSP shared samples of some of the external materials that will be used for the Medical Arts Complex Project.

IMRT – Outreach Services Director, Peggy Callantine, announced that IMRT is now installed at the Cancer Center and training is currently being done.  An open house will be scheduled.

PACS (Picture Archive Communication System) - Radiology Manager, John Miller, reported that PACS is up and running and will be integrated into the physician offices.  Scott Nickerson asked about PR and education on virtual colonoscopy and Mr. Miller said this is in process. 

OP Surgery Pricing – Mr. Huey said that the new OP surgery pricing has been initiated.

Employee Benefits – Mr. Huey announced that the hospital is looking at changes in the employee medical insurance plan and will also be initiating a Health Savings Plan for employees.

Coffee Shop – Mr. Huey asked the Board’s approval for a coffee shop in the hospital, noting that a survey of hospital employees showed very favorable support.  The area currently used for the hospital’s switchboard is being considered for the coffee shop and the switchboard would be moved to a more private area.  One of the Board’s concerns was that they did not want this lounge area to change too much or turn into a café.   

Dixie See made a motion that the Board support the concept of a coffee shop, Harlan Rasmussen seconded the motion and motion carried.  Anthony Spiegelberg abstained. 

FINANCE COMMITTEE REPORT
Voucher Approval – Scott Nickerson reported that the committee has reviewed the vouchers and made a motion for their approval.  Anthony Spiegelberg seconded the motion and motion carried.

Financial Statements – Mr. Alan Dow reported that the hospital’s financial performance is at budget.

Audit Report – Mr. John Church with TCA Partners presented the hospital’s audit report for the year ending June 30, 2004.  Mr. Church commended the hospital’s accounting department and said that the audit went very smoothly.  The hospital received an unqualified opinion.

Scott Nickerson made a motion to accept the audit report, Anthony Spiegelberg seconded the motion and motion carried. 

FOUNDATION REPORT
Tom Ringley reported that he will give a presentation on the ED Project at the Rotary Club on November 13^th and the Chamber of Commerce on December 13^th.  Mr. Ringley said that brochures on the ED Project are at the printers.

Mr. Ringley also noted that a brunch for Emeritus members will be held on Wednesday, November 3^rd at the hospital. 

QUALITY COUNCIL REPORT
Doreen Campbell informed the Board that the 3^rd quarter Quality Forums were held on October 19^th and many hospital departments displayed their improvement projects.

OTHER BUSINESS
Cecile Pattison reported that October 29^th is the hospital’s annual Halloween Party from 2:30-3:30 and there will be costume judging.

A Diabetes Workshop will be held at the Sheridan Center on November 6^th.  

Scott Nickerson reported that he was on the Speakers Group at a state-wide diabetes workshop in October held in Cody, Wyoming.  Dr. Nickerson noted that Sheridan Memorial is the only hospital in the state that performs neurosensory testing. The Board commended Scott on his work with the program, stating that this procedure will help a lot of people.

Anthony Spiegelberg asked if there was an update on educational programs for the area’s youths.  Cecile Pattison said that the availability of educational programs has improved.  It was suggested that Kate Taylor, Wellness Council Coordinator, be asked to give a report at the November Board meeting and to let the Board know what they can do to help.

There being no further business, the meeting adjourned at 6:00 p.m.

Recorder, Joanne Redder
Larry Roos, Secretary

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
SEPTEMBER 28, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Harlan Rasmussen, Anthony Spiegelberg, Gary Miller, Dixie See; Larry Roos; Scott Nickerson

APPROVAL OF MINUTES – AUGUST 25, 2004 & SEPTEMBER 13, 2004
The previous meeting minutes of August 25, 2004 were reviewed. After review, Harlan Rasmussen made a motion to approve the minutes, Dixie See seconded the motion and motion carried.  The meeting minutes of September 13, 2004 were reviewed.  After review, Harlan Rasmussen made a motion to approve the minutes, Anthony Spiegelberg seconded the motion and motion carried.

MEDICAL STAFF REPORT
Dr. Wohl reported that the officers for 2005 were elected at the September 14^th Quarterly Staff Meeting.  Dr. Barry Wohl – Chief of Staff, Dr. David Schultz – Vice Chief of Staff, Dr. Susan Snyder – Secretary/Treasurer.

ADMINISTRATION REPORT
New Med/Surg Manager – Ken Huey introduced and welcomed the hospital’s new Medical/Surgical Unit Manager, Gina Millegan.  Gina introduced Lauren Zietlow as the hospital’s new Med/Surg Clinical Coordinator.

Service Excellence Celebration – Mr. Huey reported that the hospital’s Service Excellence kick-off  is planned for September 30^th from 6:45 a.m. – 10:00 a.m. in the Patient Lobby.  The event will give employees an opportunity to learn more about Service Excellence and meet the individual team members.

Medicare – Mr. Huey reported that the hospital will continue to receive its full Medicare reimbursement because it complied with the new data submission requirements.  Mr. Huey commended Quality Services and Health Information & Records for their work in meeting this requirement.

Employee Gain Sharing – Mr. Huey reviewed a new benefit for employees, the Employee Gain Sharing Plan, and requested the Board’s approval of the plan.  Scott Nickerson made a motion to encourage Administration to adopt the Employee Gain Sharing Plan.  Dixie See seconded the motion and motion carried.

Project Prep Work- Mr. Huey reported that the east entrance to the hospital’s back parking lot is now closed to allow for preparation work for the new building project.  The parking lot can be accessed by turning off Fifth Street at Kentucky Avenue.

FINANCE COMMITTEE REPORT
Voucher Approval – Scott Nickerson reported that the committee has reviewed the vouchers and made a motion for their approval.  Anthony Spiegelberg seconded the motion and motion carried.

Dr. Nickerson noted that the hospital has closed on the $5.65 million dollar bond issue and said that the Board is grateful for the support of the community.

Financial Statements – Mr. Alan Dow reported that the hospital’s revenue and expenses are under budget for the first two months of the fiscal year.  Dr. Nickerson noted that Administration and staff have done an excellent job in meeting budget. 

Capital Requests – Several capital equipment requests were presented to the Board for approval: 

Storage Building – Request was made for the purchase of a new 40 ft. x 60 ft. storage building.  The cost is approximately $50,000 and includes the concrete slab.  It was noted this is a non-budgeted item, three bids were received.  Scott Nickerson made a motion to approve the purchase of a new storage building, Gary Miller seconded the motion and motion carried. 

Basement Floor Replacement – Request was made for replacement of floor tiles in sections of the hospital’s basement at a cost of $20,000.  This is a non-budgeted item.  Scott Nickerson made a motion to approve replacement of the floor tiles in the basement, Anthony Spiegelberg seconded the motion and motion carried. 

Photocopier – Request was made for replacement of a high volume photocopier at a cost of approximately $18,000.  This is a budgeted item.  Anthony Spiegelberg made a motion to approve the purchase of the photocopier, Scott Nickerson seconded the motion and motion carried. 

C-Arm   - Request was made for purchase of a third C-arm x-ray machine for the surgical suite.  This item was budgeted for $123,000 and the hospital can purchase a demo unit for $109,000.  OR Manager, Dee Gilson, stated that the oldest unit will be kept as a backup.  Scott Nickerson made a motion to approve the purchase of the C-arm at a cost of $109,000, Larry Roos seconded the motion and motion carried.

Scheduling Software – Request was made to purchase employee scheduling software for $25,000.  It was explained that this system will not be interfaced with the hospital’s system, but will provide what is needed at a considerably lower price than anticipated.  Scott Nickerson made a motion to approve purchase of the software, Larry Roos seconded the motion and motion carried.

Sleep Lab Equipment – Replacement of the hospital’s sleep lab equipment for a cost of  approximately $40,000 was requested.  Sleep Lab Coordinator, Rick Pointer, explained that the hospital has exceed their hardware capabilities and the new equipment will allow for two computers as well as increase employee productivity.  Ken Bonnette, Cardio/Pulmonary Manager, noted that our hospital is the only hospital in the state that performs pediatric sleep studies.  Scott Nickerson made a motion to approve the replacement of the sleep lab equipment, Larry Roos seconded the motion and motion carried.

Deb Anderson, Information Systems Manager, asked about networking with the hospital system, cabling, etc. Rick Pointer will meet with Mrs. Anderson.  It was then moved, seconded and passed that the motion be amended to reflect the additional expense involving the new equipment and Information Systems, not to exceed a total of $41,000.

Boiler Emission Control – It was recommended that the hospital hire Charles Schmidt & Associates of Cleveland, Ohio at a cost of $33,500 to ensure that emission levels from the hospital’s boilers comply with the new Environmental Protection Agency standards.  Mr. McCafferty noted this will include emissions for the Medical Arts Complex.  Scott Nickerson made a motion to employee Mr. Schmidt as requested, Larry Roos seconded the motion and motion carried.

FOUNDATION REPORT
Tom Ringley reported that due to the success of the Partner Program, the hospital now has a popcorn machine donated by First Federal Savings Bank.  Mr. Ringley thanked Evelyn Ebzery for volunteering to train staff on the use of the machine. 

Mr. Ringley noted that there is ongoing preparation for the Emergency Department Campaign. 

Dr. Wohl invited Mr. Ringley to give a report at the Quarterly Medical Staff Meetings to keep the physicians apprised of the membership.

QUALITY COUNCIL REPORT
A report will be given at the October Board Meeting.

BUILDING COMMITTEE REPORT
Mr. McCafferty reported that the hospital is currently working with TSP to address points of the contract.Harlan Rasmussen noted that the Board of Adjustments will be meeting this evening to consider the hospital’s request for a zoning exemption.  Mr. Rasmussen said he appreciated the unanimous support of the Planning Commission to the hospital’s zoning request.

OTHER BUSINESS
Cecile Pattison reported that this year’s Health Fair was a huge success with 60 booths.  Many employees and community members volunteered. 

The 5-Year-Old Birthday Party was well attended with 40 5-year-olds enjoying the fun. 

Anthony Spiegelberg complimented Cecile Pattison and Ronda Holwell for their work on the hospital Teamworks publication.

There was suggestion of changing the date of the October Board Meeting.  The Board will be contacted regarding their availability.

There being no further business, the meeting adjourned at 6:15 p.m. 

Larry Roos, Secretary
Recorder,  Joanne Redder

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
SPECIAL MEETING
SEPTEMBER 13, 2004      12:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Harlan Rasmussen, Anthony Spiegelberg, Gary Miller, Dixie See

Chair, Evelyn Ebzery, called the meeting to order at 12 noon to hear a recommendation from the Building Committee to proceed with the Imaging Center and Medical Office Building.  Mr. Del Acker of TSP gave an overview of the project and reviewed the schematics with the Board.  Mr. Acker stated that the 33,800 square foot building will be two levels with 26,400 square feet of lease space. 

Mr. Dick Horak of TSP reviewed budget numbers, noting a guaranteed maximum price for Phase I of $4.1 million.  This price is with the lease space only shelled in.  The total building guaranteed maximum price is $5.65 million and a site guaranteed price of $444,000.  Anthony Spiegelberg pointed out that the project price breaks down to $167 per square foot. Mr. Dow noted that the charge for the lease space will be $12.50 per square foot.  Mr. Rasmussen asked about the possibility of a second road for employee and vendor access.  Mr. Acker said this could be done but is not part of the project.  A thorough discussion occurred among the entire board concerning the services this building will offer.

Mr. Spiegelberg asked about the required permits from the city in light of the Board of Adjustments’ non-favorable vote last week on a special exemption from city zoning codes requested by the hospital. Mr. Huey stated that the hospital will be immediately filing a request to rezone the property, but in the interest of time, will again request an exemption from the Board of Adjustments.  Acceptance of the TSP contract is subject to approval by the City for the zoning change.

Mr. Spiegelberg asked if TSP will be signing a performance bond and Mr. Acker said that they would sign a bond.

Mr. Huey said that demolition will proceed at the site in correlation with necessary services for this project and the ED Project.

Harlan Rasmussen made a motion to contract with TSP for construction of a Medical Arts Complex, to include an imaging center and medical office space, for a total of $5.65 million, plus $444,000 for site improvements.  Anthony Spiegelberg seconded the motion and motion carried.  Substantial completion date of the building is planned for September 17, 2005 with completion date for the imaging suite being July 31, 2005.

There being no further business, the meeting adjourned at 1 p.m. 

Recorder, Joanne Redder

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
AUGUST 25, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Harlan Rasmussen, Anthony Spiegelberg, Scott Nickerson, Gary Miller, Dixie See, Larry Roos

Board Chairperson, Evelyn Ebzery, expressed the Board’s condolences to Dr. Saunders and his family for their recent loss. 

APPROVAL OF MINUTES – JULY 28, 2004
The previous meeting minutes of July 28, 2004 were reviewed.  A typographical error was noted on pages 2 & 5.  A correction to the motion on page 6 regarding the selection of TSP as the design build team was also noted.  There were two, not one, opposing votes to the motion.  Scott Nickerson made a motion to approve the minutes with the changes noted, Anthony Spiegelberg seconded the motion and motion carried.

MEDICAL STAFF REPORT
No report was available.

ADMINISTRATION REPORT
Liability Insurance - Ken Huey reported that OHIC, the hospital’s current liability insurance carrier, is leaving the state.  The hospital can renew for one more year with OHIC, but is looking at other options.  The hospital will need to make a decision by September 1^st and it is estimated that there will be an approximate 13% increase in the hospital’s insurance premiums.

OSC – Mr. Huey reviewed the history and previous actions regarding the outpatient surgery center.  In May the Board voted not to proceed with a hospital owned outpatient surgery center, but instead to try to work with the private investors who are building a surgery center.  Evelyn Ebzery asked the three new Board members if they agree with the Board’s vote.  The three new Board members, Dixie See, Larry Roos, and Gary Miller agreed with the Board’s previous decision.  Former Board member, Ernie Schmidt, had represented the Board in discussions with the physician group and Evelyn Ebzery asked Larry Roos if he would make contact with the physician investors.  Mr. Roos agreed to be the Board’s representative.

FINANCE COMMITTEE REPORT
Voucher Approval – Scott Nickerson reported that the committee has reviewed the vouchers and made a motion for their approval.  Gary Miller seconded the motion and motion carried.

Financial Statements – Scott Nickerson reviewed the financial statements with the Board.

Bond Resolution – Mr. Dan Baxter from Kaiser & Company in Cheyenne was selected by the Board to be the consultant for the sale of the revenue bonds.  These bonds will partially fund the ED Project and other significant expenditures.  Mr. Baxter reviewed the background of the revenue bond placement and asked the Board to consider a resolution authorizing the sale of the revenue bonds.  Mr. Baxter noted that if the Hospital Board and County Commissioners pass a resolution authorizing the sale of the bonds, the following banks have agreed to purchase them: First Interstate Bank for $2.58 million; Community First Bank for $2.25 million; and Sheridan State Bank for $825,000.   

Scott Nickerson, for the Finance Committee, recommended to the Board the sale of $5.65 of revenue bonds, upon approval by the County Commissioners.  Harlan Rasmussen seconded the motion and motion carried.  Anthony Spiegelberg abstained.   

Scott Nickerson on behalf of the entire Board, thanked the lending institutions for their continued support of the hospital. 

Capital Requests – Two capital equipment requests were presented to the Board for approval. 

Dictation System – A new dictation system at a cost of $38,750, with future potential for a voice recognition upgrade.  This is non-budgeted item.  Scott Nickerson stated that the Finance Committee recommends this purchase and made a motion for approval of the new dictation system.  Anthony Spiegelberg seconded the motion and motion carried. 

Patient Education System – In last month’s Board meeting, it was reported that the Hospital Foundation agreed to pay for an education system for patients, as well as the annual service fee at an approximate cost of $68,000.  Scott Nickerson made a motion to approve the purchase of the Patient Education System, Anthony Spiegelberg seconded the motion and motion carried.

FOUNDATION REPORT
Tom Ringley gave a report and noted that there are approximately 600 current members of the Hospital Foundation.

BUILDING COMMITTEE REPORT
Harlan Rasmussen noted three items (Outpatient Imaging Center, Medical Office Building and the Emergency Department Project) to be reviewed.  Mike McCafferty gave an update on the projects. 

Imaging Center & MOB – Mr. McCafferty reported that Phase I is nearly completed which includes the geotechnical work and a site survey.  After the geotechnical study it was recommended by TSP that a two story building, instead of a three story be built.  The total square footage will be 32,500 with 26,000 square feet being space that can be rented by private physicians.  Dr. Nickerson said that this would be enough space for 8 suites. 

Mike McCafferty stated that the guaranteed maximum cost of the project will be received from TSP by September 2^nd and the Building Committee will be meeting and giving direction.  The hospital will be making a final determination by September 7^th.  Mr. McCafferty said that the working with the architects and engineers has been very positive and they have been very responsive to the hospital. Evelyn Ebzery concurred.  If work begins next month, Mr. McCafferty said that date for completion of the Imaging Center will be July, 2005 with November, 2005 for completion of the Medical Office Building. 

Anthony Spiegelberg asked about the possibility of direct access from Highland and Mr. McCafferty said that this is being reviewed. 

ED Project – Mike McCafferty reported that bid opening and awarding of the construction contract is planned for late September with construction to begin in October. The new addition is expected to be completed in November, 2005 with renovation of the emergency department to be completed in December, 2005.  Mr. McCafferty stated that the canopy will be added at the end of the ED Project. 

QUALITY COUNCIL REPORT
The Quality Council did not meet in August.

OTHER BUSINESS
Cecile Pattison reported on upcoming activities.
Health Fair – Mrs. Pattison reported that 3,700 people to date have gotten their blood drawn and results can be picked up at the Health Fair to be held on September 11^th at the Sheridan College.
5-Year-Old-Birthday Party – The annual 5-year-old-birthday party will be held on September 18^th at the hospital.  

Nursing Program – Anthony Spiegelberg asked for an update on the nursing scholarship program.  Denise Krajewski reported that five have completed the nursing program and five are still in the program.  The hospital hires 2-3 per year from the program and two who graduated within the last two years are currently working in the hospital.  There are currently 21 students in this year’s nursing program. 

Conference – Scott Nickerson reported that he will be speaking at the Wyoming Diabetes Education Conference in Cody, Wyoming on October 14-15.  Dr. Nickerson encouraged hospital staff who are performing neurosensory testing be an exhibitor at the conference. 

There being no further business, the meeting adjourned at 6:15 p.m.

Recorder, Joanne Redder
Larry Roos, Secretary

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
JULY 28, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Ernie Schmidt, Harlan Rasmussen, Anthony Spiegelberg, Scott Nickerson, Gary Miller, Dixie See, Larry Roos

EMPLOYEE OF THE QUARTER PRESENTATION
Ken Huey announced that he was pleased to present to the Board the hospital’s employee of the  second quarter who is Jane Scott, Care Path Coordinator in the Quality Services Department.  Jane was presented with a plaque and it was noted that Jane has been with the hospital for 19 years as a past Manager of both our Intensive Care Unit and the Emergency Department.  It was noted that she is highly regarded for her clinical expertise and she was congratulated by all present.

APPROVAL OF MINUTES – JUNE 30, 2004
The minutes of June 20, 2004 were approved by the Board after a motion by Anthony Spiegelberg and a second by Harlan Rasmussen.   

NOMINATING COMMITTEE REPORT
Anthony Spiegelberg presented the Nominating Committee Report.  The committee members were Anthony Spiegelberg, Dixie See and Harlan Rasmussen.  The committee recommended Evelyn Ebzery for Chairperson; Harlan Rasmussen, Vice Chair; Dr. Scott Nickerson, Treasurer; and Larry Roos, Secretary.

A question was raised regarding whether there were term limits for officers and it was reported that there are no term limits. 

Dr. Scott Nickerson nominated Harlan Rasmussen for Chairman.  Gary Miller asked if Harlan was interested in putting his name up for consideration.  Harlan expressed his appreciation for being considered, but declined the nomination.  Dr. Nickerson moved that the Nominating Committee’s recommendations be approved.  It was seconded by Gary Miller and passed.  The committee was thanked for their work. 

MEDICAL STAFF REPORT
Dr. Wohl reported that there was one application to be acted upon.  He noted that this application has been approved through the Medicine Department, the Medical Staff Executive Committee with a recommendation to approve to the Board of Trustees for Dr. Jacqueline Adler, Active Staff in Internal Medicine.  Dr. Adler is fellowship trained in Infectious Disease.  Dr. Wohl noted that it is anticipated Dr. Adler will be working at the Sheridan Clinic for at least three months while they search for a permanent replacement for Dr. Brown.  He explained that the reason she is being recommended for Provisional Active whether than being processed as Locum Tenens is because of the length of time she will be in our community.  Dr. Scott Nickerson moved to approve Dr. Adler for Provisional Active Staff membership in the Department of Medicine.  Harlan Rasmussen seconded the motion and it was unanimously approved.

ADMINISTRATION REPORT
Ken Huey reported that in the special Legislative Session this summer the Constitutional Amendment to allow for caps on insurance claims was approved to go to the voters.  We can expect to hear a lot between now and November regarding this matter with the Wyoming Hospital Association, among others, actively preparing information for the voters. 

Mr. Huey also reported that the hospital is proceeding with its Service Excellence Program with a roll out of the plan being presented at last Thursday and Friday’s Employee Forums.  Plans are to consider this roll out process with a major initiative this fall.  This is an exciting development and it is anticipated this will be a major driver of our activities at our hospital.

IMRT – Intensity Modulated Radiation Therapy Project is well underway as reported by Deb Anderson, Information Systems Manager.  The final phase of implementation will occur in approximately mid September.  Mrs. Anderson expressed appreciation of the hard work of everyone involved, specifically, Tom Cherewick, the hospital’s Physicist.

PACS -  Picture Archive & Communication System - It was reported that a number of major steps have been achieved and two employees have been to training in Connecticut regarding managing this new system.  John Miller, Imaging Manager, reported that a PACS System when up and running will enhance the through put of reports from the department to the ordering physicians.  He indicated the department is looking forward to having the ability of sending images from the CT and MRI to physician offices which should be a significant convenience and time saver for referring physicians. 

IMED – Mrs. Anderson also gave a report on IMED, noting they are currently working on getting external access for physicians which would be a significant enhancement. 

FINANCE COMMITTEE REPORT
Voucher Approval – Dr. Nickerson reported that the committee had reviewed the vouchers and made a motion for their approval.  Anthony Spiegelberg seconded the motion and motion carried. 

Financial Statements – A summary of the unaudited financials for the fiscal year ending June 30^th were reviewed, noting that we had obtained a 1.4% margin and had met budget projections.  The Finance Committee was pleased with the outcome of the year.  It was reported that we will be meeting a number of challenges this year, one being the anticipation of the opening of an Outpatient Surgery Center which will have a significant financial impact on our hospital. 

Authorization for Bond Sale – Alan Dow gave an update on the planned bond sale to be held to partial fund the ED Project and other significant expenditures.  He noted that Kaiser & Company has been selected as our bond consultants.  Bonds are being structured to net the hospital $5 million dollars.  These funds will be utilized to help fund the ED Project and reimburse the hospital for expenditures related to the CT scanner, the PACS System, the Chiller Replacement, other radiology equipment and the replacement of the current hospital elevators.  A request was made to have Kaiser put out prospectuses to banks.  The Finance Committee is recommending this step be taken.  It was moved by Dr. Scott Nickerson and seconded by Harlan Rasmussen.  Larry Roos asked what the interest rate would be and it was reported it was approximately 4.5% with final pricing to be established at time of placement.   

Discussion ensued regarding the hospital’s ability to fund future budget requirements with the bond repayment schedule.  After discussion, motion passed with Anthony Spiegelberg abstaining, declaring a potential conflict of interest as his bank may be a potential purchaser of bonds.   

Question was raised regarding the hospital exploring the creation of a for-profit entity and asked if there were any updates to this subject.  It was reported that this has been explored with legal counsel and it was the opinion of administration that the for-profit was problematic in that it would require the payment of taxes that currently as a non-profit public entity we do not have to pay.  It is not recommend that this be an avenue to be pursued. 

Anthony Spiegelberg complemented Administration on the work that has resulted in a successful budget year.  It was noted that the hospital is a significant employer in Sheridan with payroll and benefits totaling over $20 million dollars.

 FOUNDATION REPORT
Tom Ringley informed the Board of the Foundation Community Presentation at the hospital by Dr. Jerry Saunders on July 29^th @ 7 p.m. in Room A. 

Mr. Ringley noted that at last night’s Board of Directors meeting, hospital staff made a presentation for a patient education teaching system which will help the staff give better patient education.  The Foundation Board has agreed to pay for combination software and some hardware at a cost of $65,000, as well as an approximate $10,000 annual service agreement.  This purchase will allow the hospital to provide better and more consistent education to their patients.  Evelyn Ebzery thanked the Foundation Board for agreeing to purchase the education system for patients and for also offering to pay for the annual service fee. 

BUILDING COMMITTEE REPORT
Harlan gave a report on the proposed Imaging Center and explained why the committee is making such significant moves so quickly.  Mr. Rasmussen stated that Administration has looked at what a competing Imaging Center will do to the hospital’s debt structure, and said that the Building Committee has tried to get a broad scope in looking at the proposal for a new Imaging Center.

Mike McCafferty stated that what led Administration to make the recommendation to the Building Committee was the needs of the community – patient needs as well as physician.  Mr. McCafferty said that patients are expecting certain services and the hospital wants to try to develop these services.  The Board asked Administration to develop a proforma for an outpatient Medical Imaging Center and a Medical Office Suite and to present financial scenarios. 

Harlan Rasmussen stated that the Building Committee asked Administration to arrange for presentations to the committee.  The committee considers it a matter of importance to take a fast track to build as quickly and as reasonable as possible and came up with the design-build method.  Mr. Rasmussen reported that the Building Committee interviewed three different teams with the design build concepts.  A fourth firm, Marshall Erdman & Associates of Madison, Wisconsin has expressed interest.  The committee meet with three firms: TSP team including local contractors Fry Construction, Modern Electric, Prill Brothers and Zowada; Malone Belton Abel team including Fletcher Construction; and CTA out of Cody, Wyoming who just recently completed a similar facility in Cody.  Mr. Rasmussen said that the bids were very close on the three story building with 33,000 square feet (noting that the bottom floor would be for the Imaging Center.)  He noted the committee put in a lot of time and voted 2-1 to utilize the services of TSP and the subcontractors as previously mentioned.  Harlan Rasmussen made a motion to select TSP as the design build team for construction of a Medical Office Building with Imaging Center with approximate footage of 33,000 square feet, and to put this on fast track as proposed by the various combined teams.  Anthony Spiegelberg seconded the motion. 

Evelyn Ebzery asked if the Board would first approve proceeding with this project.  Scott Nickerson then made a motion that the Board approve moving forward with the concept of building a Medical Office Building and incorporating an Outpatient Imaging Center on hospital campus.  Harlan seconded motion. 

Gary Miller questioned whether it was necessary for a 2^nd & 3^rd floor to be built and felt there needs to be discussion on two phases  – Imaging Center and 2^nd & 3^rd floors – and if there is a cost savings involved in building a three story over a one story.    Harlan Rasmussen stated that the medical office portion has been discussed for years, with medical staff involvement.  Mr. Huey said that there is current interest and feels it is important to take this step if the hospital is going to have serious interest from physicians. Scott Nickerson said he felt that there is a window of opportunity here that could disappear for the hospital, noting that if the hospital loses a portion of the revenues from outpatient imaging it would be on an irreversible course of retraction of services.  Imaging allows the hospital to provide other services.  Dr. Nickerson said the hospital needs to stay strong as possible so it can be here 10 years from now and strongly supports going ahead with this project.  Anthony Spiegelberg said the hospital has been given an opportunity, not only to retain some of its market share, but an avenue to grow its services.  Evelyn Ebzery noted that the architects do not recommend adding a third floor later and that the intent is to develop a vital center for health care for this area.       

 Larry Roos stated he felt this is a hasteful decision and recommended considering tabling this for 30 days, noting projected losses as well as the costs in addition to the current ED Project.  Mr. Roos said he feels service excellence is very important and felt this may be put in the closet in the midst of all the projects going on.    Mr. Roos felt that 30 days would give everyone in the hospital time for their input, physicians and staff.   Dixie See stated she felt it important to proceed and there would still be time for input from everyone. 

Ken Huey said he appreciated what Mr. Roos said but noted that this has been talked about in the hospital for several years.   There has been discussion of an Outpatient Surgery Center and previous talk about a Medical Office Building took place before talk of an Imaging Center.  Mr. Huey said he feels the Medical Staff wants to see a proactive organization and that financially the data strongly suggests we can support this without putting the hospital in jeopardy.   

Anthony Spiegelberg asked CFO, Alan Dow, his opinion on where the hospital finds itself at greater risk: doing nothing or building an MOB/Outpatient Imaging Center.  Alan Dow said that an Imaging center is very lucrative and a benefit to the community because lower prices can be offered.  Mr. Dow said that if we don’t do this, there are others that will and we have a chance to control that destiny.  Mr. Dow said he was passionate about moving forward as far as an Imaging Center goes, and does support a Medical Office Building, but does not anticipate a large return on it. 

Scott Nickerson stated that the Board wants to work with a full consensus but this has led the Board in the past to delay decisions already made and lost opportunities.  The Board does not denigrate input of employees, physicians and the community, but a decision needs to be made. 

Dr. Wohl said he believes the spirit of ongoing collaboration is needed.  Sheridan wants to be able to attract the best and the brightest new doctors and needs a community where physicians get along well together.  Dr. Wohl said he feels the Medical Office Building, etc. is how the hospital gets to service excellence. Evelyn Ebzery repeated the motion on floor that the Board approve moving forward with the concept of building a Medical Office Building and incorporating an Outpatient Imaging Center on hospital campus.  The motion carried with one opposing vote by Larry Roos. 

 Evelyn Ebzery asked for a vote on the second motion to select TSP as the design build team for construction of a Medical Office Building with Imaging Center with approximate footage of 33,000 square feet, and to put this on fast track as proposed by the various combined teams.   

Scott Nickerson, as a Building Committee member, stated why he was in favor of Malone Belton for the design concept.  Dr. Nickerson stated that they have done a lot of work over the past several years and he likes their capabilities with design.  Dr. Nickerson said that both Fry Construction and Fletcher Construction are excellent contractors.  Harlan Rasmussen said this is not an easy choice and said the hospital is already using TSP for the ED Project and this would allow for continuity with the two projects.  Mr. Rasmussen stated that both TSP and Malone Belton are good hardworking firms in this community.  Gary Miller asked if working on the ED Project will impact TSP’s work on the Imaging Center.  Mike McCafferty explained that HLM Design in Denver is working with TSP on the design for the ED Project.  The motion carried with two opposing votes by Larry Roos & Scott Nickerson. 

QUALITY COUNCIL REPORT
Doreen Campbell reported that the second quarter Quality Forums was held on July 20^th, noting all presenters did an excellent job.

Mrs. Campbell noted that one of the projects (Care Path Project) was reviewed by the Director of the Heart Failure Program in Mayo Clinic, Scottsdale and he told Jane Scott, who headed the team, he thought this was a model and no suggestions for change were made.    

The Care Path Case Management Initiative is a focus on ensuring patients receive intervention in appropriate manner and the outcome is decrease in length of stay.  Mrs. Campbell noted the hospital’s average length of stay was 7.2 days and now is at 3.8 (for community acquired pneumonia ).  This is a significant cost savings, especially when the majority of these patients are Medicare.   Alan Dow said that he is seeing a noticeable decrease in the hospital’s contractual write-offs with the current month being 33% of revenue compared to 36% budgeted.   Evelyn Ebzery asked that the media be invited to the next quality forums.     

OTHER BUSINESS
Cecile Pattison reported that the Health Fair phone line has opened to take appointments for blood draws which will be August 16 – 27.

Mrs. Pattison gave dates and times for viewing the meeting broadcast on cable television. 

Larry Roos thanked management for giving the Service Excellence Presentation at the Board Orientation.  Mr. Roos said the most important assets are the staff and physicians and he is looking forward to the improvements that will be seen in leadership skills and communication.  Mr. Roos said he feels that service excellence is more important than bricks and mortar.    

There being no further business, the meeting adjourned at 7:20 p.m.

Recorder, Jill Bates
Larry Roos, Secretary

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
JUNE 30, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Ernie Schmidt, Harlan Rasmussen, Anthony Spiegelberg, Scott Nickerson.  The Board welcomed Dixie See, Gary Miller and Larry Roos, newly appointed members as of July 1, 2004. 

APPROVAL OF MINUTES – MAY 26, 2004
The previous meeting minutes of May 26, 2004 were reviewed.  It was requested that, under the medical staff report, the term elevated from provisional to senior staff status be changed to advanced.  It was also requested that, under the budget report, dollar signs be placed before 6.5 and 4 million.  Harlan Rasmussen made a motion that the minutes be approved as amended, Ernie Schmidt seconded the motion and motion carried.

ADMINISTRATIVE REPORT
Radiology Contract - Mr. Alan Dow, interim Chief Executive Officer, reported that an exclusive contract to provide the hospital’s radiology services was entered into on June 15, 2004 with Daniel Alzheimer, M.D.

Facilities Manager - Mr. Dow reported that Facilities Service Manager, Bob Spear, announced his retirement and thanked Mr. Spear for his contributions to the hospital.  Environmental Services Manager, Clarence Montano will be appointed as interim Facilities Service Manager.

County Support - Mr. Dow announced that the county declined the hospital’s request for additional support from this year’s budget.  The hospital will receive the same support as the previous year which equals approximately one-half of one percent of the hospital’s $40 million dollar budget.

For-Profit Entity - In response to a request from the May Board meeting, Mr. Dow said that he has been researching the possibility of creating a for-profit arm of the hospital to help in partnering with the OSC investors.  Mr. Dow stated that if a for-profit entity was formed, the hospital would need to pay income tax.  It was requested that Casper and Cody, Wyoming be contacted as they have both invested in outpatient surgery centers.  Administration will follow-up on this request. 

Imaging Center – Mr. Mike McCafferty, Director of Planning & Business Development, reported that data is being gathered on a future hospital projects to include an Imaging Center and Medical Office Building.  This information will soon be presented to the Building Committee who will report to the full Board. 

OSC – Ernie Schmidt reported that, since the May Board meeting, he has attempted to make contact with the OSC physician group regarding a Letter of Intent, but was not able to reach them.  Mr. Schmidt recommended that the Board take a vote and endorse in principal a partnership between the hospital and the physician group building an Outpatient Surgery Center.  Mr. Schmidt asked that the three new Board members be informed about the importance of a partnership.   

MEDICAL STAFF REPORTDr. Wohl welcomed the three new Board members, on behalf of the Medical Staff.

Douglas Carr, M.D. – Dr. Wohl informed the Board that Dr. Douglas Carr has been granted locum tenens privileges for 30 days to cover for Dr. Chris Brown.  Dr. Carr’s credentials were approved by the Medicine Department Chairman, the Chief of Staff and the CEO and presented to the Board for review.  Harlan Rasmussen made a motion to approve Douglas Carr, M.D. for locum tenens privileges as granted, Anthony Spiegelberg seconded the motion and motion carried. 

Jennifer Lindsey, M.D. – Dr. Wohl announced that Dr. Jennifer Lindsey has recently received her board certification from the American Board of Ophthalmology.  

Rules & Regulations Change – Dr. Wohl reported that a change was approved to the Medical Staff Rules & Regulations regarding discharge summaries.  The current Rules & Regulations state that a discharge summary shall be dictated on all inpatient medical records except those short stay patients with visits less than 24 hours.  The approved change is for a discharge summary to be dictated on visits less than 48 hours. This change was voted on and approved at the June 9^th Quarterly Medical Staff Meeting. 

FINANCE COMMITTEE REPORT 
Voucher Approval - Scott Nickerson reported that the Finance Committee heard a report from  Community First Bank regarding the Wilson Trust.  The committee also reviewed the vouchers prior to the meeting and recommended they be approved for payment.  Anthony Spiegelberg seconded the motion and motion carried.

Mr. Dow presented several capital requests:

ICU Monitors – Replacement of monitors in the ICU.  It was noted that $160,000 has been budgeted for the ICU monitors, but to standardize all monitors, which would include med/surg and  ED, total cost would be $350,000.  $245,000 of this total would come from this year’s budget and the $105,000 balance for the ED monitors will be purchased separately out of the ED Project budget.

Dr. Nickerson recommended approval of the proposal and authorization of the $245,000 from this year’s capital budget.  Ernie Schmidt seconded the motion and motion carried.

Copier – Recommendation was made to purchase a high speed, high volume copier at a cost of $19,789. This is a budgeted item.  Dr. Nickerson made a motion to approve the purchase of this copier, Harlan Rasmussen seconded the motion and motion carried. 

Software – Recommendation was made to purchase data management software for automation of the plant maintenance logs, at a cost of $40,000.  This is a budget item and the price was noted to be under budget.  Harlan Rasmussen made a motion to approve the purchase of the software, Scott Nickerson seconded the motion and motion carried. 

Blood Gas Machine – Recommendation was made to purchase an arterial blood gas machine at a budgeted cost of $29,682.  Scott Nickerson made a motion to approve the purchase of the arterial blood gas machine, Anthony Spiegelberg seconded the motion and motion carried.

FOUNDATION REPORT
Tom Ringley reported that the Foundation’s annual meeting was held today and presented an annual report to each member for their review.

BUILDING COMMITTEE
Harlan Rasmussen reported that the Building Committee has met and received a project budget for the Emergency Department Project.  The initial budget for the project was $4.1 million and now totals $4.9 million, due to inflationary costs as well as an elevator for a basement that will be added.  Mr. Spiegelberg asked about acquiring the additional money for this project.  Alan Dow said that the money could come from reserves or expansion of the planned bond issue.  Harlan Rasmussen made a motion to approve the proposed budget for the ED Project, up to $4.9 million.

Mr. Del Acker with TSP Architectural firm reviewed the plans for the ED and Master Plan with the Board.  There was discussion regarding exterior improvements to the building, as well as parking and patient access to the basement.  Mr. Rasmussen amended his motion to include the conceptual design and parking in relation to the Emergency Department.  Dr. Nickerson seconded the motion and motion carried. 

QUALITY COUNCIL REPORT
Doreen Campbell reported that the second Quality Forum will be held from 10 a.m. – 12 p.m. on July 20^th.  Mrs. Campbell said that hospital departments will be displaying their system improvement projects.

NOMINATING COMMITTEE
Evelyn Ebzery asked Anthony Spiegelberg, Dixie See, and Harlan Rasmussen if they would serve as the Nominating Committee. Nomination of officers will be on the July Board meeting agenda.

OTHER BUSINESS
Community Relations – Cecile Pattison reported that 150 teams participated in the 4^th Annual Hoop Jam basketball tournament held earlier in June and said that they exceeded their goal of $20,000.

The hospital had two teams participating in the 11the annual Relay for Life and over $60,000 was raised.

Mrs. Pattison reported that, as of July 25, 2004, the hospital will have been at its current site for 50 years.

Mrs. Pattison reported that the hospital grounds are being very well maintained by the hospital’s new groundskeeper, Amanda Nelson

The Board wished Ernie Schmidt well and thanked him for the many contributions he has made to the hospital during his ten years serving on the Board. 

There being no further business, the meeting adjourned at 6:15 p.m.  The next regular Board meeting will be held on July 28, 2004.

Recorder, Joanne Redder
Harlan Rasmussen, Secretary

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
MAY 26, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Ernie Schmidt, Harlan Rasmussen, Anthony Spiegelberg, Scott Nickerson. 

APPROVAL OF MINUTES – APRIL 28, 2004
The previous meeting minutes of April 28, 2004 were reviewed.  After review, Anthony Spiegelberg made a motion to approve the minutes, Ernie Schmidt seconded the motion and motion carried. 

MEDICAL STAFF REPORT
Dr. Wohl presented four physicians for advancement from provisional staff to senior staff status.  The performance of Thomas Niethammer, M.D., Roberto Fars, M.D., Jennifer Lindsey, M.D. and Jason Lindsey, M.D. was reviewed by the Medical Executive Committee who recommended they be advanced to senior staff status. 

Scott Nickerson made a motion that all four physicians be advanced to senior staff status, Harlan Rasmussen seconded the motion and motion carried. 

Dr. Wohl presented the applications of two new physicians for approval.

Daniel Alzheimer, M.D. – Dr. Alzheimer has applied for Active Staff privileges in Radiology.  Dr. Alzheimer’s credentials have been reviewed and approved by the appropriate department and recommended for approval by the Executive/Credentials Committee.  Harlan Rasmussen made a motion to approve the application of Daniel Alzheimer, M.D. Ernie Schmidt seconded the motion and motion carried. 

David Souvenir, M.D. – Dr. Souvenir practices in Casper, Wyoming and has applied for Consulting Staff privileges in Infectious Disease.  Dr. Souvenir’s credentials have been reviewed and approved by the appropriate department and recommended for approval by the Executive/Credentials Committee.  Scott Nickerson made a motion to approve the application of David Souvenir, M.D., Harlan Rasmussen seconded the motion and motion carried.

ADMINISTRATIVE REPORT
Dr. Michael Hiller (Director of the Whedon Cancer Foundation) gave a presentation regarding the Foundation and a complimentary Medicine and Cancer Learning Retreat they will be sponsoring at the HF Bar Ranch in September, 2004.  Dr. Hiller asked for the hospital’s support and participation.  Hospital Foundation Director, Tom Ringley, said that the Foundation Board favors this program.  Ernie Schmidt asked that funding be provided from the hospital’s education fund, leaving the Hospital Foundation for capital projects.  Mr. Schmidt made a motion to support the

Whedon Cancer Foundation’s Retreat in the amount of $5,000 for the entirety of the program, using hospital funds.  Anthony seconded the motion, adding that the Hospital Foundation be included as a co-sponsor.   

Environment of Care Plans – Mr. Huey reviewed the 2003 Environment of Care Plans and asked for the Board’s approval.  The ECO includes the seven required JCAHO Programs – Life Safety, Security, Safety, Equipment Management, Emergency Management, Utilities Management, and Hazardous Materials Management.  Anthony Spiegelberg made a motion to approve the 2003 Environment of Care Plans, Scott Nickerson seconded the motion and motion carried. 

Home Care – Mr. Huey reported that the Hospital Home Care Department has been nominated for a Centers for Medicare and Medicaid Services Award.  Home Care was nominated because of their Outcome Based Quality Improvement Project.  The Board will send a letter of commendation to the Home Care Department. 

Laboratory – Denise Krajewski reported that the laboratory received a deficiency-free three year accreditation as a result of their recent Anatomical Pathology Survey.

FINANCE COMMITTEE REPORT   
Voucher Approval - Scott Nickerson reported that the Finance Committee reviewed the vouchers prior to the meeting and recommended they be approved for payment.  Anthony Spiegelberg seconded the motion and motion carried.  Dr. Nickerson noted that 10 months into the fiscal year, the hospital is running 5% below the margin set forth in the budget.  CFO Alan Dow reported that the last two months have been better financially for the hospital and that our earnings are very volatile month-to-month. 

Capital Request – Scott Nickerson reported that while more bids were sought, only one was received for replacement of a portion of the roof at the Welch Cancer Center.  The one bid received was from Kosma for approximately $58,000, which also includes the necessary duct work.  It was noted that this roof replacement was budgeted. 

Anthony Spiegelberg asked if the hospital should look at replacing the entire roof at the Welch Cancer Center.  Mr. Bob Spear said that only the old portions of the building needed re-roofing. 

Scott Nickerson made a motion to accept the single bid for replacement of the old portions of the roof at the Welch Cancer Center.  Harlan Rasmussen seconded the motion and motion carried. 

Fiscal Year 2004/05 Budget – Dr. Nickerson reported that the Finance Committee has reviewed the budget for fiscal year 2004/2005 and recommended its approval.  The budget has been provided to the County Commissioners.  Alan Dow reviewed the budget with the full Board, noting a total budget of $6.5 million for capital expenses which includes $4 million for the ED Project.  Mr. Dow said that $350,000 is budgeted for replacement of the hospital elevators which were purchased in 1952.  Mr. Dow stated that the budget is in full compliance with bond and financing requirements. 

Scott Nickerson made a motion for approval of the 2004/2005 fiscal budget, Anthony Spiegelberg seconded the motion and motion carried.

FOUNDATION REPORT
Tom Ringley reported that the Baxter Black fundraiser netted over $14,000 and was a great success.  Anthony Spiegelberg complimented the Foundation for their work on this event. 

It was noted that nearly 25 % of hospital employees are now members of the Foundation and that number continues to grow.  Mr. Ringley also reported that a $1,000 contribution was made by Smith Barney for support of Home Care.

OUTPATIENT SURGERY CENTER
Ernie Schmidt reported that he met on May 11^th with Dr. Scott Bateman and that Mayor Jim Wilson was also present.  Dr. Bateman expressed concerns about the Board’s support  in light of the shifts in Board members.  Since that meeting, the County Commissioners voted to increase the number of Hospital Board members to seven.  The expansion of the Board, along with the fact that Ernie Schmidt is going off the Board, concerns the investors.  Ernie feels that the private OSC is moving ahead and that several of the investors have committed to the hospital being a partner in the center. The OSC will not be up and going for at least one year and during that time the Hospital Board will have a chance to partner.  Mr. Schmidt said he truly believes the hospital will be a partner, but the timing will not allow this to happen before he leaves the Board.  He encouraged the Board to continue to pursue this and to 1) take action to reverse their decision to build a separate outpatient surgery center; 2) research and move forward to create a for-profit arm of the hospital to help in partnering with the OSC investors. 

Ernie Schmidt made a motion to take action to reverse the Board’s decision of one year ago for the hospital to build their own outpatient surgery center.  Anthony Spiegelberg seconded the motion and motion carried.  Ernie thanked the Board stating that this vote was a clear message that the hospital does want to work with the OSC investors.  Harlan Rasmussen noted that there are different circumstances from one year ago, but wants to continue negotiations in good faith. 

Evelyn Ebzery asked Ernie Schmidt to assist the Board and new Board members as they go forward to purse a joint venture with the investors, even after his term on the Board is complete.

Mrs. Ebzery also asked Mr. Schmidt to pursue making a deal “in principle” with the OSC investors. 

The Board instructed the hospital Administration to research the creation of a for-profit arm of the hospital to partner with outside entities such as the OSC partners.

BUILDING COMMITTEE
The Building Committee recently met and reviewed the schematic for the new Emergency Department expansion.  Harlan Rasmussen made a motion recommending that the Board vote to direct the architect to move to the design stage for reconstruction of the ED.  Scott Nickerson seconded the motion and motion carried.  It was noted that the square footage was scaled down some, but the area will still meet the needs of the patients, staff and physicians, but at a lower cost.  

The Building Committee also recommended that the Board ask Administration to start investigating the concept of an Outpatient Imaging Center as a futuristic plan that would be in the best interest of the health care in Sheridan County.  The Board asked that Administration gather the best information they could for the June 30^th Board of Trustees Meeting.

OTHER BUSINESS
Quality Council - Harlan Rasmussen noted that the newly instituted Quality Council was creating very positive dynamics in the hospital to include embracing national patient safety goals, JCAHO standards self-assessments, and obtaining more information about how our hospital functions.  The Board thanked Quality Services Director, Doreen Campbell for her work. 

Board Orientation - There was discussion about the orientation of new Board members.  It was noted that Larry Roos has begun the orientation process and that it is being done in segments because there is so much information to share.  It is anticipated that the two new Board members will be appointed by July 1st. 

Mr. Gary Miller, guest at the meeting, asked the Board about the possibility of a public awareness campaign.  Evelyn Ebzery noted that the Board does have a speaker’s bureau and welcomes the opportunity to go out and speak to groups about the hospital.  Board members have spoken to many groups over the past eight months and now have a Powerpoint presentation that covers current information.  Mrs. Ebzery said the Board would be happy to come back to update previous groups or present to new groups.

Community Relations – Cecile Pattison reported the times that the Board meeting will be broadcast on Bresnan Cable Channel 14.   Cecile also noted that Wyoming Rehab’s Wild West Hoop Jam will be held in downtown Sheridan on June 5 & 6.  It benefits Wyoming Rehab’s Athletic Training Program.  The American Cancer Society Relay for Life will be June 25 and 26 and the hospital is a major sponsor of this community event. 

There being no further business, the meeting adjourned at 6:30 p.m.  The next regular Board meeting will be held on June 30, 2004. 

Recorder, Joanne Redder
Harlan Rasmussen, Secretary

 

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES
APRIL 28, 2004      5:00 P.M 
MEMBERS PRESENT:      Evelyn Ebzery, Ernie Schmidt, Harlan Rasmussen, Anthony Spiegelberg, Scott Nickerson.

Prior to the start of the meeting, Ken Huey recognized Susan Rhodes as Employee of the 1^st Quarter and presented Mrs. Rhodes with a plaque.  Susan is a Registered Technologist in Radiology and Mammography.

APPROVAL OF MINUTES – March 5, 2004 & March 24, 2004After review, Scott Nickerson made a motion to approve the minutes of March 5, 2004, Harlan Rasmussen seconded the motion and motion carried. Mr. Rasmussen noted that he was not listed as presented in the minutes of March 24, 2004. Scott Nickerson made a motion to approve the minutes with the one correction noted,  Ernie Schmidt seconded the motion and motion carried.

MEDICAL STAFF REPORT
Dr. Wohl presented five applications for medical staff privileges.  All applications were previously reviewed and approved by the appropriate departments and recommended for approval by the Executive Committee. 

Alan E. Smith, M.D. – Dr. Smith has requested Active Staff privileges in Anesthesia.  Dr. Smith will be on Provisional Staff status for the first six month, per the Medical Staff Bylaws.  Scott Nickerson made a motion to approve Dr. Smith for Provisional Staff Privileges, Ernie Schmidt seconded the motion and motion carried.

Deanne Wyssmann – Deanne Wyssmann is a licensed professional counselor and has requested privileges as a Limited Health Practitioner.  Anthony Spiegelberg made a motion to approve Deanne Wyssmann for privileges are requested, Harlan Rasmussen seconded the motion and motion carried.

Diane Brooks – Diane Brooks is a licensed professional counselor and has requested privileges as a Limited Health Practitioner.  Harlan Rasmussen made a motion to approve Diane Brooks for privileges as requested, Anthony Spiegelberg seconded the motion and motion carried.

James Biela – James Biela is a licensed social worker and has requested privileges as a Limited Health Care Practitioner.  Harlan Rasmussen made a motion to approve James Biela  for privileges as requested, Anthony Spiegelberg seconded the motion and motion carried.

Frances Lee Lujan – Frances Lujan is a licensed social worker and has requested Privileges as a Limited  Health Care Practitioner.  Ernie Schmidt made a motion to Approve Frances Lujan for privileges as requested, Harlan Rasmussen seconded the motion and motion carried.
 

ADMINISTRATIVE REPORT

Home Care Inspection - Mr. Huey congratulated Peggy Callantine, Home Care Director, and her staff for the deficiency-free inspection by the State Department of Health Quality that took place last week.  Mr. Huey noted that Sheridan Memorial Hospital’s Home Care Department has had two consecutive deficiency-free surveys and the only Home Care Department in the state with three total deficiency-free surveys. 

Malpractice Insurance – Mr. Huey reported that the hospital will be able to renew with OHIC for their liability insurance for one more year, but are looking at other options. 

Board Size – Mr. Huey reported that the County Commissioners will soon be voting on whether or not to increase the size of the Hospital Board from 5 to 7 members. 

Laboratory Grant – Mr. Huey reported that Gary Sellenrick, Laboratory Manager, was successful in securing a $14,000 Bio-terrorism Community Laboratory Capacity Building Grant.  This means the laboratory has secured grant money to enhance their microbiology department and the capabilities to identify micro-organisms, safety training, education and equipment. 

OSC – Ernie Schmidt reported that, after the March Board meeting, a letter was sent to Doctors Bateman & Holst expressing the Board’s interest in joining with them to build an Outpatient Surgery Center.  Doctors Bateman & Holst were out of town for a period, but a meeting has now been scheduled for May 11^th between Mr. Schmidt and a representative from the physicians’ group.  Mr. Rasmussen expressed concern in that it will be six weeks between the time the Board sent their letter in March and the date a meeting was scheduled. 

FINANCIAL REPORT
Voucher Approval - Scott Nickerson reported that the Finance Committee reviewed the vouchers prior to the meeting and recommended they be approved for payment.  Anthony Spiegelberg seconded the motion and motion carried.  Dr. Nickerson stated that the Finance Committee is reviewing the preliminary budget for the upcoming fiscal year.  Mr. Dow reviewed the financial statements with the Board.

 Audit Services – Mr. Dow recommended the hospital change auditing firms as it is good practice to change auditors periodically.  Mr. Dow recommended TCA Partners of Fresno, California for $15,000 which is considerably less than what the hospital was previously paying for their audit.  Mr. Dow said he did look at firms in Wyoming, but noted that TCA specializes in hospitals. Scott Nickerson made a motion to accept the bid from TCA Partners of Fresno, California to provide the hospital’s audit services for the next year, at a base cost of $15,000.  Harlan Rasmussen seconded the motion and motion carried.

CAPITAL REQUESTS
The following items were presented to the Board for their approval: 

IMRT – Purchase of the software and multi-leaf collimator for the IMRT (Intensity Modulated Radiation Therapy) at a cost of $300,000.  Scott Nickerson made a motion to approve the purchase of the software and multi-leaf collimator at a cost of $300,000.  Anthony Spiegelberg seconded the motion and motion carried.  The Board expressed their appreciation for the help from the Hospital Foundation and their donors.  It was noted that IMRT should be available to patients by September, 2004. 

Document Folder/Inserter - Replacement of a document folder/inserting machine at a cost of $12,500.  Scott Nickerson made a motion to recommend approval of the machine at a cost of $12,500, Anthony Spiegelberg seconded the motion and motion carried. 

PACS - Purchase of the PACS (Picture Archive and Communication System) at a cost of  approximately $375,000.  This system will enable the hospital to store digital images from all of the hospital’s radiology equipment. It was noted that if the hospital continued to use film, without PACS, they would spend $ 200,000 per year.  With PACS, images do not need to be printed on film and the hospital’s cost of film will drop to approximately $40,000 per year.  In addition, it was reported that the hospital will be able to electronically send images from any of their radiology equipment to physician offices, hospitals, etc.  Scott Nickerson made a motion to approve the purchase of the PACS System, Harlan Rasmussen seconded the motion and motion carried. 

FOUNDATION REPORT
Tom Ringley reported that tickets are on sale at the Wyo Theater for the upcoming Baxter Black performance on May 15^th. 

Mr. Ringley also reported that 65 employees have joined the Partner Program and this would amount to $18,000 from these employees by December, 2005.

OTHER BUSINESS
Quality Forums – Ken Huey reported that several departments were involved in the Quality Forums held on April 20th and they all did an excellent job presenting their quality projects.  Several of the Board attended to review the projects, as well as staff and physicians. 

Public Concern – Scott Nickerson said that the public needs to be kept informed on hospital events and needs an opportunity to ask questions.  Mrs. Ebzery stated that the public is welcome to attend the open Board meetings and also said that the Board will be happy to speak again at the various clubs, organizations in town.

Hospital & Nurses Week – Cecile Pattison reported that May 9-15 is National Hospital Week and a schedule of activities is being planned.  Denise Krajewski reported that National Nurses Week is May 6-12.

 There being no further business, the meeting adjourned at 5:55 p.m. 

Recorder, Joanne Redder
Harlan Rasmussen, Secretary
 

BOARD OF TRUSTEES
March 24, 2004      5:00 P.M.

MEMBERS PRESENT:       Evelyn Ebzery, Ernie Schmidt, Anthony Spiegelberg, Harlan Rasmussen and Scott Nickerson, M.D

APPROVAL OF PREVIOUS MINUTES – Feb. 25, 2004 & March 5, 2004
The previous meeting minutes of February 25, 2004 were reviewed.  After review, Scott Nickerson made a motion to approve the minutes, Harlan Rasmussen seconded the motion and motion carried.

The previous meeting minutes of March 5, 2004. After review, it was requested that these be tabled and revised to better reflect the discussion at the meeting. 

MEDICAL STAFF REPORT
Dr. Wohl reported that at the March 9th Quarterly Staff Meeting physicians were presented awards for their timely completion of medical records.

Dr. Wohl thanked the Board for the opportunity to attend the February Medical Staff Conference in Florida.
Scott Nickerson asked if the Board minutes could be placed on the website earlier so the information is more current.  It was agreed that the highlights of the Board meeting be placed on the website shortly after the meeting, and to note that these are being provided in advance of Board approval. 

ADMINISTRATION REPORT
OHIC -Ken Huey reported that OHIC Insurance is planning to leave the state and will not be offering renewals after October 1, 2004.  It was noted that the hospital’s renewal date is September 1, 2004.  Mr. Huey said that the hospital will be exploring other options.

Radiology Contract – Ken Huey corrected a report in the newspaper which stated that the contract between Wyoming Radiology and Memorial Hospital of Sheridan County had been terminated.  Mr. Huey said that the contract has not been terminated, but is under review and asked the Board’s permission to continue to pursue this contract termination.  The Board concurred with this recommendation.  Mr. Huey noted that there will be no interruption in Radiology services during this period.

MRI – Ken Huey also noted a misrepresentation in the newspaper regarding MRI, stating that there are no delays in service with the hospital’s MRI.

CT Scanner - Radiology Director, John Miller, reported that the new CT scanner has been up and running for three weeks, noting approximately 20 minutes per patient for an exam. 

OSC - The Board discussed the Outpatient Surgery Center.  Ernie Schmidt reported that he met with Dr. Scott Bateman and Mayor Wilson regarding the hospital joining with the physicians who plan to build an OSC.  Mr. Schmidt said he felt it was a very positive meeting.  The next step will be for the hospital to send a letter documenting specifications of the contract for further negotiating.

Ernie Schmidt made a motion that the hospital negotiate with the physician group to join in their OSC, on their land, as long as the terms reflect the financial responsibility that Sheridan Memorial Hospital has to the county and to the continuance of high quality patient care. Motion was voted upon with a 3-2 vote.

Harlan Rasmussen said that he did not agree with the motion.  Mr. Rasmussen felt that basic principles involved in the governance need to be determined first. 

Ernie Schmidt said he felt there were previous misunderstandings on both sides and feels the Board needs to move forward and that it is in the hospital’s best interest that there be one OSC.

Mr. Spiegelberg stated that he will not enter into an agreement that is not legal or abandons the hospital’s fiduciary responsibilities.  Mr. Spiegelberg said that for the good of the community and hospital an agreement be created that will work for both parties, noting that the Board has agreed to the OSC being built off hospital land.

A letter will be directed to the physician group and Evelyn Ebzery asked that Ernie Schmidt be part of the negotiations and help with the letter. 

FINANCE COMMITTEE REPORT
Voucher Approval - Scott Nickerson reported that the Finance Committee reviewed the vouchers prior to the meeting and recommended they be approved for payment.  Anthony Spiegelberg seconded the motion and motion carried.

Financial Report – Alan Dow, CFO, gave a financial report, noting that the month of February was a rough month financially, reporting a loss of $250,000 due to contractual allowances. 

Mr. Dow addressed the guest opinions in the Sheridan Press regarding an audit of the hospital.  He reported that the hospital is audited yearly, as well as reviewed by the State Heath Department and surveyed by the JCAHO.   

FOUNDATION REPORT
Tom Ringley reported that Dr. Sy Thickman has been appointed to fill the vacancy on the Foundation Board.

Mr. Ringley gave a report on the Partner Program whereby hospital employees volunteer to support the Foundation with a minimum one-dollar deduction per pay period.  The funds will be used for hospital projects and employees will vote on how the money is spent. 

OTHER BUSINESS
County Commissioners Meeting – County Commissioner, Ky Dixon, reported that there will be a meeting on April 20^th to discuss the pros and cons of increasing the size of the Hospital Board from five to seven members.

New Board Member – Ky Dixon reported that the Commissioners will make the appointment to the Hospital Board on April 6^th.  Ernie Schmidt’s term will expire on June 30, 2004.

Doctors’ Day – Cecile Pattison reported that the hospital will be providing a breakfast for Doctors’ Day at 7:30 a.m. on March 30^th.  Cecile extended an invitation to the Board. 

Guest Opinion – Hank Songer addressed the Board with regard to the Outpatient Surgery Center.  Mrs. Songer proposed that the Board not partner with the physicians on an OSC, but rather look at other services, i.e. extended care and temporary housing for patients undergoing treatment. 

Meeting Time – The Board agreed to continue with the 5 p.m. start time for the next few months.

There being no further business, the meeting adjourned at 6:25 p.m.

Recorder, Joanne Redder
Harlan Rasmussen, Secretary

 

BOARD OF TRUSTEES  Special Board Meeting
MARCH 5, 2004      11:30 A.M.

MEMBERS PRESENT:       Evelyn Ebzery, Ernie Schmidt, Anthony Spiegelberg, Harlan Rasmussen and Scott Nickerson, M.D. 

Evelyn Ebzery called the meeting to order at 11:30 a.m. 

The purpose of the special meeting was to address the Mayor’s request for the hospital and the physicians of the private OSC to meet again and to act upon the architect contract for the Emergency Department expansion.  

Response to Mayor’s Request:  Mrs. Ebzery stated the Board, believes they have a responsibility to meet with the Mayor and honor his request and try to get together with the other group through the Mayor. Mrs. Ebzery proposed to appoint Board representatives to contact the Mayor and suggest some meeting dates. 

Mr. Schmidt voiced his support of the idea and Mr. Spiegelberg agreed. Mr. Spiegelberg said he believes the Mayor is trying to act as a facilitator to try to give the two sides one more try to come together.  

Dr. Nickerson said he supported giving it one more try. He requested that all the decision makers of both groups meet to address the goals. Dr. Nickerson expressed his desire for open discussion in public regarding all issues, and a desire to have the public understand the implications, including our desires, hopes, and fears. 

Mr. Spiegelberg felt the Mayor had requested that the meeting of the parties be a public meeting.  

Mr. Rasmussen stated that he supports this public approach and that negotiations continue.  Mr. Rasmussen also expressed his feeling that negotiations have never ceased, noting the Board has not heard from the other side in some time.  He also stated that a decision was made in July after considerable analysis and felt there should not be further delay.  However, he supporting making an effort to come together with the surgeons involved. Mr. Rasmussen also indicated he sees no reason to change the established course and supported proceeding with the development of the hospital’s surgical center development plans.  Mr. Rasmussen stated he voted in favor of building the OSC because he felt it was the right thing to do and still does.   

Dr. Nickerson said he supported what Mr. Rasmussen was saying, but said he is willing to set up a public meeting to see if there is a better option for the hospital. 

Mr. Schmidt said he feels it is important to try one more time.  Mr. Schmidt felt if the surgeons proposing the center want to meet publicly that would be fine, however, he noted that the hospital had signed a confidentiality agreement with the surgeons.  He noted the surgeons would have to release the hospital from the agreement to talk publicly about the details. Mr. Schmidt supported a meeting with the surgeons, with the Mayor as a facilitator, and to do whatever it takes to be successful. He supported trying something different to work through basic issues in the document. 

Dr. Nickerson reiterated his support that all decision makers for both sides be present to reach a decision. 

Mr. Rasmussen voiced concern that Trustees cannot abrogate their responsibility to track public funds and that the hospital has a responsibility for quality control of the health care services that fall under the hospital’s umbrella. He felt these two issues must be addressed in an acceptable manner.   

Mrs. Ebzery stated she supports meeting with the Mayor in a public meeting to discuss the document and its details. If the private OSC representatives are not willing to meet in a public, Mrs. Ebzery indicated the Board should still try to arrange a meeting.  

Mr. Schmidt said if the group is unwilling to meet publicly he would support a private meeting, noting it is important to the community to not have two surgery centers and to focus on the goal of one surgery center. 

Mr. Schmidt introduced Chief Financial Officer Alan Dow’s document, Projected Impact From Competing Independent For-Profit Surgery Center and Imaging Center.  He said the document has been available to the public for two weeks and was released to the City Council and County Commissioners.  Mr. Schmidt stated he would propose the document be printed in the newspaper via a series of letters to the editor or buy space to effectively communicate the issues with the public.    It was reported the document is posted on the hospital’s website and copies will be provided to the public at the hospital’s main desk.  Mr. Schmidt noted the Board has developed a speaker’s bureau to provide programs  to various groups around town. 

Dr. Nickerson made a motion to communicate with the Mayor indicating the Board’s support of a public meeting between the principles involved and failing the ability to do that, the Board stands ready to support a fall back discussion with a limited number of representatives that would not be empowered to make decisions.  Anthony Spiegelberg seconded the motion.  Motion carried.  Dr. Nickerson amended the motion to state that they meet within the next two weeks.  Motion carried. 

Mrs. Ebzery pointed out that it was not the Board’s intent to keep any information from the community, but the hospital and Board has been honoring the confidentiality agreement. 

Mr. Schmidt asked those present to watch the commercial on KOTA television about the basic essential services provided by the Rapid City Hospital and requesting community support, which indicates that other communities are facing the same problem. 

ED Architect Contract - Mrs. Ebzery asked Mr. Huey for a report to the Board. Mr. Huey stated he would like to clarify that the contract is for architectural and engineering services, and not for construction.  It was reported that the contract has been reviewed by legal counsel and TSP is  agreeable to a large percentage of the changes. Mr. Huey recommended that the Board vote in favor of the contract.   

Mrs. Ebzery said there are issues with the hospital’s ED, pointing out patient confidentiality issues raised by the JCAHO (accrediting body) and HIPAA Regulations.  

Mr. Spiegelberg noted the project budget is $4,140,000 with the scope of the project incorporating approximately 12,300 square feet of new space on the main level and an extensive renovation of approximately 3,600 square feet of existing Emergency Department and adjoining space.  He further noted the project incorporates a full unfinished basement under the main level addition and the project will be developed in general compliance with the concept floor plan dated January 22, 2003.

Robert Waggener of the Sheridan Press asked Mr. Huey where the expansion funds are coming from.  Mr. Huey said the State Planning & Investment Board has provided approximately $1,100,000. Mr. Huey said the hospital is planning a successful fundraiser campaign and has received a lead gift of $25,000 from the Hospital Auxiliary.  The Hospital Foundation is leading the fund raising project. 

Mr. Ernie Schmidt made a motion to approve the contract with TSP II for the ED expansion. Mr. Rasmussen seconded.  Motion carried. 

Response to Monday’s Editorial - Mrs. Ebzery stated she has concerns about some inaccuracies listed in the editorial on the part of the Board of Trustees and hospital employees.  She said they will get information out to the public via Mr. Dow’s document and continue to clarify the hospital’s position. 

Mrs. Ebzery said she met with the hospital’s administrative team and is impressed to see the high quality, competent individuals who have come together. She said that the administrative team has committed to develop a plan to set forth their suggestions in dealing with the hospital’s challenges and opportunities.   

Mrs. Ebzery stated that the document prepared by our Chief Financial Officer indicates that what lies ahead has huge ramifications to the community. Mrs. Ebzery said the Board is looking at the future of healthcare in Sheridan and the future of the hospital and the ability of the hospital to fulfill its mission to provide high quality healthcare to the entire community. The hospital Board is interested in comments from management and has been assured that management can provide a business plan that takes the hospital into the future. Mrs. Ebzery stated that we must be competitive in every part of our business to make us a better hospital.  Mrs. Ebzery has asked the hospital administrative team to begin the process of considering the options and offer suggestions at the next Board meeting.  

There being no further business, the meeting adjourned at 1:10 p.m.

BOARD OF TRUSTEES
FEBRUARY 25, 2004      4:00 P.M.

MEMBERS PRESENT:       Evelyn Ebzery, Ernie Schmidt, Anthony Spiegelberg, Harlan Rasmussen and Scott Nickerson, M.D. 

APPROVAL OF MINUTES – February 3, 2004
The previous meeting minutes of February 3, 2004 were reviewed.  Mr. Spiegelberg noted a misspelling under Approval of Depositories and also asked that, in the first paragraph of the third page, 1.1 million be typed as $1,100,000.  Mr. Spiegelberg  made a motion to approve the minutes as corrected, Mr. Schmidt seconded the motion and motion carried.

Evelyn Ebzery asked that a change be made to the agenda to allow the Board to give an update to attending County Commissioners, Ky Dixon and Charlie Whiton.

The Board of Trustees informed the Commissioners of the projected impact to the hospital of a competing independent for-profit Surgery Center and Imaging Center.  The hospital’s CFO presented an analysis of the impact these facilities would have on the hospital.  Mrs. Ebzery said she felt it was important to share this information with the County Commissioners.  It was stated in the analysis that the opening of either an independent for-profit Surgery Center or Imaging Center would cause significant financial harm to existing hospital operations with a potential loss of over $4,000,000 per year. 

Mrs. Ebzery said that it will be difficult to maintain the less profitable services such as psychiatric services, emergency services, cancer care, and home health and that this is a great concern for the Board.  Mrs. Ebzery stated that the Board seeks the community’s support to preserve the level of services we currently provide.  Ken Huey said that some do not understand the gravity of the situation and among changes that might have to be made would be a reduction in staff, since that is the hospital’s biggest expense.  Mr. Huey also said it is perceived that hospitals are surviving, but in order to survive they need to change the way they do business by eliminating services that benefit the community.   

Dr. Wohl said he feels that not one physician wishes the destruction of the hospital, but that physicians are trying to provide the best care for the patient, more efficiently and at the least cost.  Dr. Wohl felt there needs to be collaboration between the hospital, physicians, and community. 

No action was taken.

MEDICAL STAFF REPORT
Dr. Wohl stated that he felt there should be better representation on the Board by the Medical Staff and felt the Board would benefit from this leadership.

Dr. Wohl reported that the Medical Staff ,with the help of Health Information & Records Manager, Corrine Meyer, brought the delinquent records rate to zero.

ADMINISTRATION REPORT
Record Completion – Harlan Rasmussen made a motion to approve the recommendation from the Medical Staff to change the time allowed for completion of patient records from 14 to 30 days.  Ernie Schmidt seconded the motion and motion carried. 

Auxiliary – Mr. Huey reported that the Hospital Auxiliary, at their annual meeting on February 6^th, presented the hospital with a $25,000 check as a kick-off contribution to the ED Project. 

Hospice Annual Report – The Board reviewed the annual Hospice report. Ernie Schmidt made a motion to approve the report, Anthony Spiegelberg seconded the motion and motion carried. 

Patient Care Services – Denise Krajewski, Chief Clinical Officer, reported that the new CT scanner approved at the February 3^rd Board Meeting would be fully operational by March 3^rd.  In the interim, the CT scanner at the Welch Outpatient Center is being used. 

Mrs. Krajewski introduced Kelly Horn, the hospital’s new Manager of the  Medicine/Surgery Unit. 

Hospital Name - Evelyn Ebzery noted that since the County Commissioners were present it would be appropriate to discuss the shortening of the hospital name to Sheridan Memorial Hospital.  The legal name of the hospital will not change, but the shortened version will be used in a “doing business as” nature to help the public locate the hospital in many venues, including the phone directory.  Mrs. Ebzery said that it is more user-friendly and straightforward.  Mr. Huey stated that Sheridan Memorial Hospital is a concise name that still explains who