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for BOARD MINUTES 2004 - click here

2005 BOARD MINUTES
● JAN 5 (December 2004 meeting)   ● JAN 24    ● FEB 21   ● MAR 16  ● MAR 23 
● APR 1   ● APR 6   ● APR 14   ● APR 22    ● MAY 25   ● JUNE 22    ● JULY 27  
● AUG 24  ● SEPT 28  ● OCT 26   ● NOV 22   ● DEC 28


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   MEETING
December 28, 2005      5:00 P.M 

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

Anthony Spiegelberg chaired the meeting in the absence of Harlan Rasmussen.

APPROVAL OF MINUTES
The minutes from the November 22, 2005 meeting were presented.  An email was handed to the Board members at the request of Larry Roos.  Mr. Roos requested that some additional comments he had made at the Board Meeting regarding community acquired pneumonia be placed in the minutes.  There were no objections to Larry’s request to amend the minutes and the minutes were approved with Larry’s additional comments.
 

MEDICAL STAFF REPORT
Dr. Barry Wohl, Chief of Staff, presented medical staff candidates for new privileges and candidates for recredentialing.  All applications have been reviewed and approved by the appropriate medical staff departments and recommended for approval by the Medical Executive Committee. 

Suzanne E. Knepper Oss, M.D. – Dr. Oss has requested privileges in Pediatrics.  Evelyn Ebzery made a motion to grant Pediatric privileges, as requested, to Dr. Suzanne Knepper Oss.  Gary Miller seconded the motion and motion carried. 

Corey J. Jost, M.D. - New privileges for Corey J. Jost, M.D. in the Department of Radiology were presented and recommended for approval, with one exception.  Evelyn Ebzery moved to approve Dr. Jost’s request for Radiology privileges, with the one exception, Gary Miller seconded the motion and motion carried. 

Two locum tenens applications were presented with recommendations for approval, David A. Letts, M.D. and Joel M. Pull, M.D.  It was noted that these physicians have been given locum tenens approval with the proper information and signatures.   

David A. Letts, M.D. - Dixie See moved to approve the application and privileges of Dr. Letts, Evelyn Ebzery seconded the motion and motion carried.   

Joel M. Pull, M.D. - Evelyn Ebzery made a motion to approve the application and privileges of Joel Pull, M.D., Dixie See seconded the motion and motion carried. 

Jennifer A. Lansing, MS, PPC – The application of Jennifer Lansing, Independent Limited Healthcare Practitioner under the clinical supervision of Donald Boone, was recommended for approval.  It was noted that she is employed at Northern Wyoming Mental Health and fits under the category of Independent Limited Healthcare Practitioner.  It was moved, seconded and passed to approve Jennifer Lansing for privileges as requested. 

Colleen Butler, RN, FNP – The application of Colleen Butler, Dependent Limited Healthcare Practitioner under the supervision of Susan Snyder, D.O., was recommended for approval.  Evelyn Ebzery made a motion to approve the application of Colleen Butler, Gary Miller seconded the motion and motion carried. 

A list of 16 Independent Limited Healthcare Practitioners requesting re-credentialing for 2006-2007 was presented.  (attached)  The names of each candidate were read by Anthony Spiegelberg.  After review it was moved by Evelyn Ebzery and seconded by Dixie See that these Independent Limited Healthcare Practitioners be re-credentialed with privileges as recommended by the Medical Executive Committee. 

A list of 8 Dependent Limited Healthcare Practitioners requesting re-credentialing for 2006-2007 was presented (attached) with their names being read by Anthony Spiegelberg. Evelyn Ebzery moved and Gary Miller seconded the approval of these Dependent Limited Healthcare Practitioners.  Motion carried. 

PUBLIC COMMENT
Anthony Spiegelberg called for Public Comment.  Rusty Ludwig addressed the Board, introducing his wife Kirsi who is a pharmacist at Sheridan Memorial Hospital.  Mr. Ludwig explained that he had had an accident which left him with two options:  Either to have surgery or continue indefinitely on pain medication.  He had requested approval for the hospital’s health insurance to cover the cost of two artificial discs to be placed in his back and his request was denied by EBMS, the hospital’s third party administrator.  He decided to go ahead with the surgery with options of doing it in Billings, MT or in Germany and he selected to go to Germany.  He reports that the surgery was very successful.  Mr. Ludwig noted that artificial discs were approved by the FDA in Oct. 2004 and that they have been performed successfully for 17 years in Europe.  He noted that he was medically advised that getting a fusion instead of an artificial disc was not recommended in someone under the age of 45.  Mr. Ludwig provided a handout that gave information about the Charite artificial disc.  Mr. Ludwig thanked the Board for their time.    

Anthony Spiegelberg questioned the appropriateness of the Board intervening in the hospital’s health insurance approval process.  Ken Huey noted that it is not customary for

either the Board or Administration to intervene in the decisions made by our third-party administrator.  It has been our practice to rely upon experts utilized by our insurance carrier or third party administrator to determine the appropriateness of coverage.  The matter was left for follow-up by Administration. 

ADMINISTRATION REPORT
Medical Staff Bylaws - Dr. Wohl presented the proposed Medical Staff Bylaw changes that had been approved by the Medical Staff at their Quarterly Medical Staff Meeting in June, 2005.  Dr. Wohl proposed changes as presented on pages 3 – 41 which included additions and deletions as noted in the handout to the Board of Trustees.  (attached) Evelyn Ebzery reported that the Board Bylaw Committee reviewed the proposed changes to the Medical Staff Bylaws and recommended approval of all changes with the exception of the change in wording of the Preamble.  This will be reviewed by the Board Bylaw Committee along with Medical Staff Leadership for appropriate wording.  Evelyn Ebzery made a motion to approve all proposed changes to the Medical Staff Bylaws with the exception of the Preamble.  Gary Miller seconded the motion and motion carried. 

Patient Safety & Quality Improvement Plans – Both the Patient Safety & Quality Improvement Plans were presented to the Board.  It was noted that the plans have been signed off by all appropriate Chairs- the Safety Committee Chair, the Quality Counsel Chair, the Medical Executive Committee, the Chief of Staff, the Chief Executive Officer and Board of Trustees Chair.  Larry Roos moved the approval of the Quality Improvement Plan.  It was seconded by Dixie See.  Anthony Spiegelberg recommended that the Plan be reviewed by our insurance company and Gary Miller complimented the work done.  The motion passed unanimously.  Larry Roos moved that the Patient Safety Plan be approved, Evie Ebzery seconded the motion and noted that she felt it was an excellent plan.  The motion was approved unanimously. 

Disaster Drill - Ken Huey reported that a successful Disaster Drill was held earlier today and included outside first responders and volunteer “victims” from Normative Services.  Mr. Huey requested approval of the proposed Disaster Privileges Policy.  The question was raised if this was a new policy or a revision of a current policy.  Administration was requested to bring this policy back for review at the next Board Meeting with the answer to that question.   

Administration recommended using the phrase “CEO or Designee or Chief of Staff or Designee” rather than “CEO or Designee and Chief of Staff or Designee.” 

USP 797:  Ken Huey reported that Administration has been working with the hospital’s pharmacy and architects, TSP, developing a plan to comply with a new regulation that has been ratified by the U.S. Pharmacopeia, commonly referred to as USP 797, which

establishes minimum requirements for the sterile compounding of medications in all hospitals.  He noted that our plan must be implemented by 2007.  It is anticipated that this will be a major capital expenditure request in the 2006-07 budget with the intent that construction occur in the first 6 months of that budget year.  This will be a major consideration as it is Administration’s recommendation that, in order to meet this standard, we relocate the Pharmacy Department to the ground floor under the in-patient wing.   

Telepharmacy:  It was reported that a program planned by the hospital’s pharmacy that is being supported by the Wyoming State Board of Pharmacy and the University of Wyoming, is being developed to provide professional pharmaceutical services to those institutions in this State that are unable to staff their facilities with 24-hour a day pharmacist coverage.  Some hospitals presently only have this essential service a few hours a week.  This would require Sheridan Memorial Hospital to increase pharmacist coverage to 24 hours per day, which has frequently been requested by members of the hospital’s medical staff.  This system would include links between this hospital and other institutions for the purpose of transmitting pharmaceutical information. 

FINANCE COMMITTEE REPORT 
Gary Miller reported that the vouchers from the previous month had been reviewed and he moved that they be approved.  Evelyn Ebzery seconded the motion.  It was moved, seconded and passed that the vouchers be approved for payment.  Mr. Miller reported that the financial reports for November were tracking the events that have been happening over the first months of the fiscal year with volumes being lower than budgeted.  He noted that bad debts continue to be high and have a significant negative effect on the hospital’s financial performance.  Alan Dow reported that there is a $350,000.00 accounting adjustment in November that reflects an anticipated year-end Medicaid supplemental payment which we are now accounting for through the fiscal year rather than at the end of the fiscal year.  For the remainder of the fiscal year there will be a $70,000.00 accounting adjustment each month.  Alan Dow reported that year-to-date we have written-off  $1,500,000.00 in bad debt expenses.  Gary Miller also reflected on the $420,000.00 of charity care in the first five months of the fiscal year.  

Alan Dow recommended to the Board that a 5% increase in charges be made on selected categories that would have an overall effect of increasing hospital charges by 4%.  He noted that per the hospital’s price-increase policy, any increase that would be more than 10% of the hospital’s bottom line requires Board approval, therefore this proposal would require Board action.  Evelyn Ebzery commented that, at the time of the budget, there were uncertainties regarding some events that could affect financial performance.  Mrs. Ebzery noted that this mid-year rate increase was contemplated when the budget was prepared and approved.  Larry Roos stated that he would vote against the motion feeling

there should be other alternatives to increasing prices and reducing staff.  He noted his concern that price increases may drive customers away from the hospital.  Gary Miller stated that the need to increase prices illustrates the importance of our need to improve our operating efficiency.  Dixie See indicated she supports the increase but believes we need to continue to work in other areas to strengthen revenue opportunities and contain costs.  Gary Miller moved the approval of the selective 5% increase, Evelyn Ebzery seconded the motion and the motion carried with 4 in favor and 1 against the motion. 

Capital Equipment Requests - The purchase of the following items were recommended by the Finance Committee for Board approval:  Vascular instrument sets, Abdominal Retracting System, Haemonetics Cell-Saver Blood Recovery, and a Sentinel Lymph Node Mapping Unit.  It was noted that at the time the budget was prepared, the hospital did not know that it would benefit from services of a vascular surgeon, Dr. Corey Jost.  These non-budget items are recommended in order for Dr. Jost to be able to practice this specialty in our hospital.  Total dollar amount for the four items is $109,923.00.  Evelyn Ebzery moved approval, Gary Miller seconded the motion and the Board approved these purchases unanimously.  

The additional capital equipment requested items were in the budget.  The following were presented for approval - Anesthesia Invasive Monitoring System ($39,261.00) and a Bi-pap Ventilator Machine ($10,180.00).  The first is a Surgical Department request and the second is a request by the Respiratory Therapy Department.  It was noted that both items are less than the amount budgeted..  Gary Miller moved approval, Evelyn Ebzery seconded and the Board unanimously approved these items. 

A final request by Pharmacy was made to purchase 24 PCA pumps totaling $81,408.00 and four PCEA (epidural pump) totaling $15,800.00.  This is non-budgeted request as the hospital had one more year remaining on the lease of the current pumps.  The recommendation is based upon the willingness of the supplier to forego the last year’s lease, the opportunity to significantly upgrade the quality of the pumps, and the financial advantage of purchasing over leasing.  Larry Roos moved approval of this request, Dixie See seconded the motion and motion carried. 

FOUNDATION REPORT
Tom Ringley reported that a Partner’s (employees who are making donations on a regular basis to the Foundation) party was held Dec. 14 with 115 employees in attendance. Mr. Ringley thanked Lee Morgareidge  and the Nutritional Services Staff for preparing the food for the party.  It proved to be another opportunity to sign up other Partners.  Mr. Ringley reported the Foundation currently has 247 employees as Partners, noting that this is an impressive commitment from our employees.  Each year the Partners vote to determine how their aggregate funds will be spent.  Mr. Ringley reported that the Partners

voted to spend this year’s funds ($16,000.00) towards the Emergency Department Project.  The employees selected the Emergency Department Project last year as well.  The two-year total is almost $27,000.00.  Mr. Ringley reported that we are within $52,000.00 of our original $2.4 million goal for the project, noting the end of this successful campaign is in sight. 

BUILDING COMMITTEE
Dixie See reported that the current goal for completion of the Medical Arts Complex is the end of January, 2006.  She further noted that the Emergency Department Project is approximately 5 weeks behind schedule but the Project is going well.  Rob Forister commented on the limited access to available labor in the area.  Regarding the Board-approved Operating Room Renovation Project, the hospital is still awaiting State Health Inspector approval.   

Mike McCafferty reported an $18,002.00 change-order has been approved for physician suite upgrades.  He noted that the hospital will be reimbursed by the physician purchasers.   

QUALITY COMMITTEE REPORT
Larry Roos stated that he had no report for this meeting.  Mr. Roos’ written report from the last Quality Services Council Meeting had been submitted.
 

OTHER BUSINESS
Howard Mussell, M.D. - Evelyn Ebzery paid tribute to Dr. Mussell who has announced his retirement to be effective at the end of the month (December) for his many years of service to the hospital, the medical staff and to the community.  She noted that Dr. Mussell joined our medical staff in October 1979 and throughout his 26 years on the staff not only fulfilled important roles in the medical staff structure, but also volunteered in the community and at the State level in matters related to medicine.  On behalf of the Board, she expressed appreciation for the significant medical role he played in our community and wished him the very best in his retirement. 
 

Community Relations – Cecile Pattison reported tremendous participation throughout the hospital in decorating for the holidays.  Cecile reported that the Cardio-Pulmonary/Tobacco Cessation Department took top honors for the best decorations.  She also noted that the hospital had an increase in the number of carolers that came through during the season. 

Anthony Spiegelberg - Mr. Spiegelberg reported on his recent outpatient surgery experience.  He applauded the physicians, staff and rehabilitative services for their outstanding work in helping him through his care and recovery.

Alan Dow - Mr. Dow was thanked for what is becoming an annual tradition, making his special pizza recipe for staff on Christmas Eve. 

There being no further business, the meeting adjourned.

Recorder, Kenneth R. Huey
Larry Roos, Secretary

 

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES   MEETING
November 22, 2005      5:00 P.M 

MEMBERS PRESENT:  Evelyn Ebzery, Larry Roos,  Scott Nickerson, Anthony Spiegleberg, Dixie See, Harlan Rasmussen

MEMBERS ABSENT:    Gary Miller

Evelyn Ebzery asked hospital employee, Sharon Shaffer to attend the meeting.  Mrs. Ebzery observed Mrs. Shafer making a special trip to the Post Office to make sure that lab results were in the mail by 4 p.m. to enable patients to receive their results sooner.  Mrs. Ebzery stated that this was truly an example of Service Excellence.

APPROVAL OF MINUTES – October 26, 2005
The minutes of October 26, 2005 were reviewed.  After review, Anthony Spiegelberg made a motion to approve the minutes, Dixie See seconded the motion and motion carried. 

PUBLIC COMMENTS
There were no public comments.  Alan Dow noted that he and Mike McCafferty did meet with Mr. Brumm to answer questions he asked at the October meeting.

MEDICAL STAFF REPORT
On behalf of Dr. Wohl, Ken Huey presented two medical staff applications for approval.  Mr. Huey stated that the appropriate committees as well as the Medical Executive Committee have reviewed these applications and make their recommendation for approval. 

Corey Jost, M.D. – Dr. Jost is a general and vascular surgeon, receiving his fellowship in vascular surgery from Mayo Clinic in Rochester, Minnesota.  Dr. Jost formerly practiced in Wichita, Kansas. 

After review of his application and credentials, Dr. Strahan made a motion to approve the application of Corey Jost, M.D. for surgical privileges as requested, Evelyn Ebzery seconded the motion and motion carried. 

Amy Rabon, RN, MSN, CNM, WHNP  - Amy Rabon, Dependent Limited Health Care Provider, is requesting an addition to her current privileges to be a first assistant in surgery. 

After review of her application and credentials, Dr. Strahan made a motion to approve Amy Rabon for additional privileges as a first assistant in surgery, Anthony Spiegelberg seconded the motion and motion carried. 

ADMINISTRATION REPORT
Ken Huey expressed his appreciation to Dr. Strahan for offering to pay for the meal for those employees working on the Thanksgiving holiday. 

Employee of the Quarter – Ken Huey presented a plaque to Cecile Pattison, Community Relations, Sheridan Memorial Hospital’s Employee of the 3^rd Quarter.  Cecile was thanked for all of her hard work  and how the hospital is represented  through the high quality of her work.  It was noted that Cecile makes everyone feel important and valued and is a real team player. 

Transitional Care Unit – Peggy Callantine, Director of Nursing, reported that the new Transitional Unit has been a real success, with a fully dedicated staff.  The average length of stay is one week with 4-5 patients per day. 

Home Care/Hospice Annual Report – Mr. Lee Ingalls, Home Care & Hospice Manager, share with the Board the 2004-2005 annual report.  Mr. Ingalls reported that the Home Care Program has grown and the clients are very pleased with their quality of care. 

Mr. Ingalls noted that the Hospice Program is receiving referrals earlier and the staff provides great support to the patients, and all are certified.  Harlan Rasmussen said that the Board is very pleased this program can be offered. 

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

Review of Financials – Anthony Spiegelberg reported that October was not a strong month financially.  Mr. Spiegelberg noted a net loss of $191,000 with a budgeted net loss of $68,000.  Mr. Spiegelberg said that inpatient admissions and discharges are down for the year. 

Mr. Spiegelberg asked Alan Dow about the hospital’s bad debt.  Mr. Dow stated that there is an increase in numbers of charity care and bad debt, with 80% of the bad debt being the emergency department.  Mr. Roos asked why the number of patients seen in the ED are down.  It was noted that some of this is due to the urgent care clinics and also because some physicians have expanded their office hours. 

Capital Equipment – One capital equipment item was submitted for approval: 

1.               Bariatric Equipment – Alan Dow explained that the hospital would like to purchase a bed for very large patients.  Initially, this bed will be shared with a local nursing home and then will be returned to Sheridan Memorial Hospital.  The nursing homes currently cannot take these patients.  Total cost is $33,050 and it was noted this is not a budgeted item. 

Evelyn Ebzery made a motion to approve the purchase of the bariatric equipment, Dr. Strahan seconded the motion and motion carried. 

There was question regarding the hospital’s Capital Equipment Policy and it was noted that equipment requests over $10,000 need to come before the Board for approval. 

FOUNDATION
Tom Ringley reported that the Foundation today received a $50,000 supplemental grant from the Joe & Arlene Watt Foundation, noting $75,000 remaining to reach their goal for the ED Campaign.  Mr. Ringley said that he is working with Rob Forister on signage for the Emergency Department and a sign has been approved by the Griffith Foundation Board.

Mr. Ringley reported that there are currently 232 hospital employee partners and a breakfast party is planned for December 14^th.  The Board will be receiving an invitation. 

BUILDING COMMITTEE
MAC – Dixie See reported that Sheridan Radiology is up and running and the physicians’ office spaces will be completed in January.

ED Project – The ED Project is approximately 30 days behind with project contractors. 

OR Renovation – Dixie See reported that the OR Project is awaiting approval by the State Health Department. 

QUALITY COMMITTEE
Larry Roos shared a report form the Quality Committee on Community Acquired Pneumonia. The report included length of stay and cost analysis.

Mr. Roos said that he or the Quality Committee staff have discussed these statistics and potential cost savings with most of the appropriate staff and management who would be involved on an improvement project, noting that one of the CMS improvement goals for 2006 is in the same area.   The potential annual cost improvement savings, taken from our previous 6 quarters of complete data, could be as high as $500,000 to $600,000.   It is now up to our CEO and Leadership Team to pursue this opportunity. 

OTHER BUSINESS
Holiday Activities -  Cecile Pattison passed out information on the upcoming hospital Christmas activities. 

Service Excellence - Harlan Rasmussen stated that the Board is very pleased with the hospital’s commitment to Service Excellence. 

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   MEETING
October 26, 2005      5:00 P.M 

MEMBERS PRESENT:  Evelyn Ebzery, Larry Roos,  Scott Nickerson, Anthony Spiegleberg, Dixie See, Gary Miller

MEMBERS ABSENT:  Harlan Rasmussen

Mr. Anthony Spiegelberg chaired the meeting in Harlan Rasmussen’s absence. 

APPROVAL OF MINUTES – SEPTEMBER 28, 2005
The minutes of September 28, 2005 were reviewed.  After review, Evelyn Ebzery made a motion to approve the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS
Mr. Spiegelberg asked if there were any public comments.

Mr. Dan Brumm asked questions regarding the hospital’s cash reserves, as well as questions about leasing/selling space in the new Medical Arts Complex.  Mr. Alan Dow stated that he would be happy to set up an appointment with Mr. Brumm to address his questions.
 

MEDICAL STAFF REPORT
Dr. Wohl presented two Limited Health Care Practitioner applications for review.  Dr. Wohl said that both applications have been reviewed and approved by the appropriate clinical departments.  The Medical Executive Committee recommends, to the Board of Trustees, approval of the following applications.

Donald E. Boone, MS, LPC – Donald Boone has held clinical privileges as an Independent Limited Health Care Practitioner at SMH since 1990 and is requesting additional privileges in Pediatrics.

Dr. Strahan made a motion to approve the additional privilege request of Donald Boone, as recommended by the Medical Executive Committee.  Evelyn Ebzery seconded the motion and motion carried. 

Shawna B. Ragan, MSW, PCSW – Shawna Regan is requesting privileges in Social Work as an Independent Limited Health Care Practitioner. Ms. Regan has been granted privileges as a Provisional Clinical Social Worker with Donald Boone, Licensed Professional Counselor, as her supervisor. 

Dr. Strahan made a motion to approve Shawna Regan as a Provisional Clinical Social Worker under the supervision of Donald Boone, as recommended by the Medical Executive Committee. 

Dr. Wohl reported that the Medical Staff Bylaw Committee is working on changes to the Bylaws. A special Medical Executive Committee meeting is scheduled for November 17^th, with the entire Medical Staff invited.  Dr. Wohl said the Board is welcome to attend this meeting for discussion of Bylaw issues. 

ADMINISTRATION REPORT
New Employee Orientation – Ken Huey reported that a Service Excellence Pin was given to all new employees who attended the new employee orientation.  Mr. Huey noted that Jill Bates, HR Director, restructured the hospitals orientation program, which has been very successful. 

November Board Meeting – Due to the Thanksgiving Holiday, it was agreed to move the Board meeting from the 23^rd to the 22^nd of November.

 Swing Beds – Peggy Callantine, Nursing Director, reported that the hospital opened a Transitional Care Unit (Swing Beds) on October 24^th with the ability to receive seven patients.  The Transitional Care and Rehabilitation Services will allow the hospital to provide a step down level of care to patients who need additional services.  This is another revenue source and these beds also can be used for acute patients if the hospital is full.

FINANCE COMMITTEE REPORT
Audit Report  - Mr. Jerrel Tucker from TCA Partners presented the hospital’s fiscal audit for 2004/2005, noting the hospital received an unqualified opinion.  There were no issues or adjustments and Mr. Tucker commended the financial staff for their excellent work.

Evelyn Ebzery made a motion to accept the audit for 2004/2005, Gary Miller seconded the motion and motion carried. 

Voucher Approval – Gary Miller reported that the committee has reviewed the vouchers and made a motion for their approval.  Evelyn Ebzery seconded the motion and motion carried.

Review of Financials – Gary Miller discussed the financial statements, noting that September was a good month with revenue and net income above that budgeted.  Year-to-date Mr. Miller said the hospital is below budget with bad debt expenses of $841,000 and a shortfall for the first three months of the fiscal year of $162,574.

Gainsharing – The Finance Committee recommended a gainsharing payout of $325 per full time employee, totaling $106,000.  Mr. Dow said that the hospital’s positive financial operations and patient satisfaction are key to the program’s success.  Mr. Dow explained that part time employees, or those who have been with the hospital less than one year as of June 30, 2005 will receive a pro-rated amount. 

Evelyn Ebzery made a motion to approve the payout of the gainsharing program, Gary Miller seconded the motion and motion carried.  The Board commented that it is a pleasure to approve this request.

Capital Equipment – Gary Miller presented two capital equipment items for approval:

1.       Elevator Replacement – Replacement of the hospital’s elevator at a cost of $169,000.  This is a budgeted item.  Gary Miller made a motion to approve replacement of the hospital’s elevator at a cost of $169,000, Dr. Strahan seconded the motion and motion carried. 

2.       Pneumatic Tube System – Mike McCafferty explained that he received a bid of $68,000 for a pneumatic tube system that will allow, by forced air, for messages and small items to be sent from the laboratory in the Medical Arts Complex to the hospital’s laboratory. A second bid for an upgraded system to include the Pharmacy & Emergency Department was received at $119,000.  Mr. McCafferty recommended approval of the upgraded tube system for $119,000.  Mr. McCafferty noted that this system is expandable.Gary Miller made a motion to approve the upgraded tube system for $119,000, Dixie See seconded the motion and motion carried.

FOUNDATION
Tom Ringley reported that the Foundation Board is recommending to the Board of Trustees that the new Emergency Department be named after Vernon S. & Rowena W. Griffith.  Due to the Griffith Foundation’s generous contributions of over $7 million to the hospital since 1976, Mr. Ringley said that the Foundation Board makes this recommendation to the Board of Trustees.

Dixie See made a motion to approve the recommendation from the Foundation Board to name the new Emergency Department after Vernon S. & Rowena W. Griffith, due to their generous support of the hospital and community.  Evelyn Ebzery seconded the motion and motion carried.

BUILDING COMMITTEE
MAC – Dixie See reported that Sheridan Radiology will be open for business on Monday, November 7^th and an open house for the Medical Arts Complex will be scheduled sometime after the first of the year when the entire project is complete.

ED Project – The ED Project is approximately one week behind schedule, but on budget.

QUALITY COMMITTEE
Larry Roos reported that the Quality Council met on October 25^th.  The committee continues to look at pneumonia admissions as well as chest pain as they relate to cost reimbursement.  The hospital’s outpatient surgery staff made a presentation to the committee on plans they have to increase customer satisfaction and clinical outcomes. 

Mr. Roos said that the job description for the Quality Committee, as requested at the September Board Meeting, may be complete by the November meeting.  

Mr. Roos reported that he continues to be in contact with the Sheridan Surgical Center.

BYLAW COMMITTEE

Evelyn Ebzery reported that the Board Bylaw Committee did meet with the Medical Staff Bylaw Committee and suggested changes to the bylaws are being reviewed by the medical staff.
 

OTHER BUSINESS
Strategic Planning – Dr. Strahan reported that the committee continues to meet and will be meeting over the next six months with hospital staff and physicians.

Halloween – Cecile Pattison invited the Board to the Hospital Halloween Party/Costume Judging on October 31^st.

Books for Babies – Cecile Pattison reported that 28 second graders from Tongue River Elementary School presented Women’s Health with books this week they had purchased for new babies and their parents.  The children write letters to the new babies and place them with the books. 

There being no further business, the meeting adjourned at 6:40 p.m.

Recorder,  Joanne Redder
Larry Roos, Secretary
 

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES   MEETING
September 28, 2005      5:00 P.M 

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

APPROVAL OF MINUTES – AUGUST 24, 2005
The minutes of August 24, 2005 were reviewed.  After review, Gary Miller made a motion to approve the minutes, Dixie See seconded the motion and motion carried. 

ADMINISTRATION REPORT
New HIR Manager - Ken Huey introduced Dave Westlake as the hospital’s new Manager of Health Information & Records.  Dave comes to the hospital from St. James Healthcare in Butte, Montana and will also hold the position of Privacy & Compliance Officer. 

Medical Liability Insurance - Ken Huey reported that the hospital’s annual renewal premium with Zurich for medical liability insurance is $296,202, with a front-end $100,000 deductible. The hospital previously had a $25,000 deductible and this year was given the choice of $50,000 or $100,000 deductible.  If the hospital chose to go with a $50,000 deductible the annual premium would increase $65,000.  Alan Dow recommended the hospital go with the $100,000 deductible, based on his analysis of the hospital’s past claim history.  Mr. Huey said that a letter of credit is required with a $100,000 deductible and the hospital is in the process of securing this letter.

OR Renovation –Ken Huey reported that Skytron will deliver the lights and booms in October for the first operating room to be renovated, with completion of the one room by the end of the year.  The hospital is committed to new lights for all four operating rooms, but booms for each room are contingent upon costs.  The State Health Department requires a structural engineer to sign off on the renovation and TSP will supply this information.  $1.3 million has been budgeted for renovation of four operating rooms.

Seclusion Rooms – Ken Huey reported that work is being done on the patient seclusion rooms to make them safer for patients, and an infection control assessment is also being done. 

Physician Recruitment – Ken Huey reported that recruitment for a General Surgeon is going well.    Dr. Mark Walter, a 4^th year resident in Psychiatry, will be visiting Cody, Wyoming and Sheridan this week.  Dr. Jacqueline Adler has returned to Sheridan and will open her practice in Internal Medicine/Infectious Disease in early October. Ken Huey also reported that Dr. Cody Wagner, Family Practice, has contacted the hospital about practice opportunities in Sheridan.  Dr. Wagner has family in Sheridan. 

Rob Forister – Ken Huey congratulated Rob Forister on his article regarding elevator electrical safety  printed in the Electrical Inspectors Association Magazine. 

Mammography – Ken Huey reported that the hospital’s mammography team received a 100% compliance rating from a recent inspection under the Food & Drug Administration’s Quality Authorization Act. 

Cardio/Pulmonary Program – Ken Huey reported that the hospital’s Pulmonary Program has been certified for five years and the Cardiac Program is now also certified.  Sheridan Memorial Hospital is the only hospital in the state with both of these certifications.  

Strategic Planning Meeting – In a recent strategic planning meeting, there was discussion regarding  whether the Joint Commission on Accreditation of Health Care Organizations (JACHO) is the most appropriate accrediting body for our hospital. It was reported that, without a strong desire by the Medical Staff to make a change, the hospital will continue to be a JCAHO surveyed hospital.  It was pointed out that in addition to the JCAHO, the hospital is surveyed by a number of other agencies, therefore, JCAHO is not the only means in which the hospital assures the high quality of its services. 

Dr. Strahan and Larry Roos reported on their contacts regarding the Sheridan Surgical Center.  Both Dr. Strahan and Mr. Roos reported that they anticipate meetings with the physician owners shortly. 

Wyoming Nurses Association Award – Peggy Callantine reported that Surgical Services Manager, Dee Gilson, has won the award for outstanding service to the Wyoming Nurses Association.  Dee will receive this award in Jackson, Wyoming at the WNA meeting.  Dee Gilson has been very involved with the WNA as a key member of that state organization. 

A congratulatory letter will be sent from the Board to Dee Gilson, Surgical Services Manager, and Ken Bonnette, Cardio/Pulmonary Services Manager. 

Public Comments - Harlan Rasmussen noted that there is now a public comment item on the agenda and in the future public comments will be on the agenda after approval of the minutes.  Comments will be limited to approximately five minutes.   

Visitor, Dan Brumm, addressed the Board. Mr. Brumm asked that the hospital be careful with their arrangements with physicians occupying the Medical Arts Complex and referred to a case in Rapid City, South Dakota where an agreement between a hospital and physicians in a medical office building is being legally challenged. 

Mr. Brumm also expressed his frustration with a local physician who he said is pressuring him to have his medical procedure performed at the physician’s facility.  Mr. Brumm suggested a survey be taken as to why Sheridan physicians and the hospital Administration cannot get along. 

Mr. Brumm also stated that he felt a hospital manager breached patient confidentiality regarding a procedure he was to have. 

Harlan Rasmussen thanked Mr. Brumm for his comments.  Ken Huey responded to Mr. Brumm, stating that the hospital has paid close attention, with guidance by legal counsel advice, to assure regulatory compliance regarding the Medical Arts Complex.  He also said that the hospital takes patient confidentiality very seriously and noted that Quality Services Manager, Jane Scott, has reviewed case scenarios with the hospital managers to help increase understanding and the appropriate handling of patient confidentiality matters.  He further stated that case examples will be used throughout the hospital to increase patient confidentiality awareness and compliance. 

MEDICAL STAFF REPORT
Dr. Wohl reported that the Quarterly Medical Staff Meeting was held on September 13^th and the following 2005 officers were re-elected for 2006:

                        Barry Wohl, M.D. – Chief of Staff
                        David Schultz, M.D. – Vice Chief of Staff
                        Susan Snyder, D.O. – Secretary/Treasurer

Dr. Wohl noted that the medical staff is addressing credentialing procedures and are looking forward to working with the Board on their bylaws.  Dr. Wohl noted that Brad Hanebrink, D.O. is the County Representative for the Wyoming Medical Society.   

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

Review of Financials – Anthony Spiegelberg reported that August was the second month of relatively low activity, noting a $156,000 net loss for August and year-to-date net loss of $131,000.  Mr. Spiegelberg said that the committee continues to monitor the expenditures for the capital projects.

 Alan Dow explained the restated financial for July, 05. Mr. Dow said that the hospital had anticipated a Medicaid year-end supplemental payment estimated at $300,000, based on previous years.  Medicare has reported that the hospital will be receiving approximately $678,000 and this will be rolled into the July financial statement.  Mr. Dow noted that, while this is good news, we should be reminded that the hospital has a $20 million dollar write-off per year in State and Federal Medicare & Medicaid claims. 

Alan Dow reported that we will have a new Medicare Intermediary, however, the hospital has not received a letter from CMS regarding who the new intermediary will be. 

Gary Miller, referring to the activity report, pointed out that in the last five years the hospital has reduced the patient length of stay from 4.7 or 4.8 to less than 4 days, which is better for the patient and the hospital.  Dr. Strahan added to Mr. Miller’s comments by stating the physicians receive an individual   “report card” of their patient care activity which includes length of stay comparisons.  He noted that this information is helpful to physicians in providing the best patient care. 

FOUNDATION

Cecile Pattison gave a report from Tom Ringley, noting that there is $135,737 remaining to reach their goal for the ED Campaign.

BUILDING COMMITTEE
MAC – Dixie See reported that the project is on schedule and occupancy for the Imaging Center is planned for late October, with completion of the other areas by the first of the year.

ED Project – Dixie See reported that the project is on schedule, noting that a large part of the basement’s concrete did not pass inspection and this will be re-poured.  It was noted that the shortage of concrete may affect the timing of the curb & gutter portion of the project.

QUALITY COMMITTEE
Larry Roos reported that the Quality Council met on September 21^st.  Regarding case management, he noted that one patient had a 72-day stay with the hospital receiving only 40% reimbursement for this stay.  Mr. Roos reported that the pneumonia report was reviewed and one of the things the committee will be looking at is cost reimbursement.  

Mr. Roos said that six potential breaches of patient confidentiality were reported in August and stated he was very disappointed in this number.  Anthony Spiegelberg, upon reviewing the report, noted that these are not found to be valid breaches of patient medical information.  It was reiterated that there is zero tolerance for breaches of patient confidentiality. 

BYLAW COMMITTEE
Evelyn Ebzery reported that the Bylaw Committee did meet.  Under Section 6 of the Board of Trustees Bylaws, it was recommended that the Quality Committee be added as a standing committee, in line with the Board’s commitment to Service Excellence. Evelyn Ebzery made a motion to adopt this change to the Board of Trustees Bylaws, Dr. Strahan seconded the motion and motion carried.  The Bylaw Committee will also be meeting with the Medical Staff regarding changes to the Medical Staff Bylaws.

Since there is now a standing Quality Committee, Anthony Spiegelberg asked for an outline of their responsibilities.  Larry Roos will research this.  Harlan Rasmussen said he supports this request, noting that the Board’s responsibility is Quality Control and Finance.

OTHER BUSINESS
Health Fair – Cecile Pattison reported that the recent Health Fair was very successful with approximately 70 booths and 50 hospital staff helping at the event. 

Wellness Council – Cecile Pattison reported that Shannon Lassle has been hired as the new Wellness Council Coordinator.

Katrina Donations – Cecile Pattison reported that Nancy Hooge and Lisa Nicholls spearheaded a donation drive for Katrina hurricane victims.  Hospital employees were very generous and the drive was a huge success.

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   MEETING
AUGUST 24, 2005      5:00 P.M 

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

APPROVAL OF MINUTES – JUNE 22, 2005 and JULY 27, 2005
June 22, 2005 – After review, Anthony Spiegelberg made a motion to approve the minutes, Dr. Strahan seconded the motion and motion carried.

July 27, 2005 – After review, Dr. Strahan made a motion to approve the minutes, Dixie See seconded the  motion and motion carried.

MEDICAL STAFF REPORT
Dr. Wohl reported that the Medical Executive Committee is working with the Hospital Board on proposed changes to the Medical Staff Bylaws.  Also, the Medical Executive Committee is working with Administration on a physician newsletter that will be used to help keep physicians informed on happenings at the executive level.

ADMINISTRATION REPORT
Ken Huey congratulated Sandra Boll, CNA on her nomination as Employee of the 2^nd Quarter.  Mrs. Boll was described by her coworkers as “sunshine on a gray day” and received her recognition plaque along with her daughter, Maddie.

Mr. Huey reported that the hospital is looking at options for their medical liability insurance.  At this time it looks as though the premium will not be increasing, which Mr. Huey said is very encouraging.

Establishing Cooperative Ownership for Medical Arts Complex (MAC) – Mr. Huey explained that the County Commissioners have adopted a resolution for the development of the Medical Arts Complex as a cooperative venture and Mr. Huey recommended that the Board authorize Administration to create a cooperative ownership for utilization of the Medical Arts Complex.  Mr. Huey said that the hospital will continue to be the majority owner, but would allow for other owners in the building, noting that it is very typical for hospitals to share ownership.

There was question as to the advantages of condominium versus a co-op.  Mike McCafferty explained that in a condominium you own the property and with a co-op you own an interest in the corporation who owns the property.  Each co-op member is responsible for their percentage of the building.  Mr. McCafferty noted that only members of the Active Medical Staff can be involved in the MAC and the hospital will have first right of refusal.  The proposed name is the Sheridan Medical Cooperative Association.  Anthony Spiegelberg made a motion to pursue formation of the Sheridan Medical Cooperative Association, Gary Miller seconded the motion and motion carried.

Establishing Sheridan Radiology, LLC – Mr. Huey recommended the organization of Sheridan Radiology, LLC.  Mr. Huey explained that the hospital wants to formalize their relationship with Dr. Daniel Alzheimer in a company that would own the Imaging Center.  The hospital will be the major owner and manager of the facility. Dixie See made a motion for the formation of Sheridan Radiology LLC, Dr. Strahan seconded the motion and motion carried. 

Dr. Strahan asked about the equipment in the MAC.  John Miller, Radiology Manager, said that equipment includes a GE 1.5 magnet MRI (noting much clearer pictures with patient motion), new mammogram analog machine & processor in the Women’s Center, 16 slice CT, Ultra Sound machine, Siemens RAD Room with computerized radiography, Dexa Scan and Stereo Tactic Biopsy.  Mike McCafferty said that the Imaging Center facilities will be owned by the hospital and leased by the new cooperation.  Larry Roos noted that two Radiologists will be providing services, Dr. Daniel Alzheimer and Dr. Jason White.

OR Renovation – Mr. Huey asked Clarence Montano, Facilities Manager, for an update on the OR Renovation.  Mr. Montano reported that he has met with the Skytron staff regarding the equipment and the submittals were sent to  Mr. Milt Werner’s office at the State Health Department.  The hospital is waiting for final approval from the state.  It was noted that delivery of equipment will be 60-90 days.  Mr. Montano said there are no final numbers for costs at this time because the ceilings in the operating suites have not been open.  Construction is expected to take one month. 

Judgment Hearing – Ken Huey reported that the hospital received the decision from US District Court Judge Downes regarding the suit filed against the hospital by Dr. Robert Stears and Dr. Jason Lindsey.  Judge Downes ordered the hospital’s motion for summary judgment be granted and the Radiologists’ motion for partial summary judgment was denied.  Harlan Rasmussen said that the Board is pleased to hear this and the hospital will continue to provide the best service possible.

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

Review of Financials – Mr. Spiegelberg reported a modest profit of $18,000 for July with activity levels lower than budgeted. There was a positive $27,000 over budget and Mr. Spiegelberg credited Administration for the good expense control.  The Finance Committee is tracking the hospital’s capital projects – the MAC, ED & OR with a 12.5 million dollar budget and will continue to monitor. Evelyn Ebzery noted that $500,000 has been received from the Hospital Foundation for the ED Project.  Harlan Rasmussen commended the Foundation for their efforts. 

Capital Equipment Requests - The following capital equipment items were presented for approval:

1.                  Alan Dow asked for ratification of the previous email approval of a new fluroscopy unit for Radiology due to a major power failure in July.  Replacement cost for the 8 year old machine is $300,546.00.  Evelyn Ebzery made a motion to formally approve the purchase of the fluoroscopy unit, Anthony Spiegelberg seconded the motion and motion carried.

Larry Roos asked what actually happened during the power failure.  John Miller explained that the hospital had a voltage drop, not a power surge, and lost one of their phases.  Rob Forister said that MDU estimated the fuse was damaged through lightening, one phase was lost and two additional phases overheated.  Mr. Forister will give the Board a copy of his report.  Mr. Miller explained that power conditioning distribution units (PCDU) are built into high priced machines such as MRI’s and CT’s at $50,000 each.  It was noted that these are built into the hospital’s high priced units, but the less expensive pieces of equipment do not have PCDU ‘s.   Mr. Forister explained that the MAC does have phase drop protection, but said it would be very, very expensive to do this for the hospital with the multiple number of breakers that would need to be replaced.  Mr. Montano noted there was some additional equipment affected by the power outage such as the air handling, coffee bar area, Welch Cancer Center and in the OR. Mr. Huey said that the hospital will be meeting with their insurance carrier regarding the equipment damages.

2.                  Fitness Equipment for Wyoming Rehab, a budgeted item at a cost of $13,130.  Anthony Spiegelberg made a motion to approve the purchase of the fitness equipment, Gary Miller seconded the motion and motion carried.

3.                  Request to grant authorization to Administration to purchase the MAC and ED furniture and equipment within a budget of $300,000 for the MAC and $400,000 for the ED.  Anthony Spiegelberg made a motion to delegate the purchase of the individual items to Administration, Evelyn Ebzery seconded the motion and motion carried.  Mr. McCafferty noted that all packages will be competitively bid.

4.                  Venous Closure Instrument device at a cost of $26,000 for the treatment of varicose veins.  Alan Dow explained that the procedure will be performed at the Imaging Center and the cost will come back in form of rent. Anthony Spiegelberg made a motion to approve the purchase of the venous closure instrument, Gary Miller seconded the motion and motion carried.

Resolution - Anthony Spiegelberg presented a Board resolution for authorization of signatures for depository accounts.  Mr. Spiegelberg made a motion to approve the resolution, Dr. Strahan seconded the motion and motion carried.  Mr. Spiegelberg noted that checks over $50,000 will require two signatures and this is a new requirement.

FOUNDATION
Tom Ringley report that the Foundation received an additional $1000 donation toward the ED Project and a mailing will be sent out to local businesses encouraging their support of the ED Project for the remaining $140,000. 

Mr. Ringley presented the Foundation’s new Board List:

Frank Boley, President
Karen Miller, Vice President
Kathy Strahan, Secretary
Seymour Thickman, M.D., Treasurer
Gary Gold, Member
Ken Huey, Member
Rose Marie Madia, Member|
Everett Mohatt, Member
Dixie See, Board of Trustees Member
Davis M. Swan, M.D., Medical Staff Member
Delphine Toner, Auxiliary Member 

BUILDING COMMITTEE
MAC - Mike McCafferty reported that the certificate of occupancy for the MAC is planned for October.  He explained that a climate controlled sky bridge will connect the MAC & ED when the ED is completed next spring.  The committee discussed change orders , but these are not anticipated to drive the costs up.  The main change order is a cooling unit approved by the committee for $40,000 which is part of the MRI Unit.  

ED Project – Mike McCafferty reported the ED Project will start taking shape and O’Dell Construction is subbing out the steel construction which should go quickly.  Rob Forister reported that the project is one week behind schedule and noted an issue with the steel.  Mr. Forister explained that there are two very heavy beams and these are the furthest away from crane.  The crane cannot be moved because the hospital’s parking lot is not built for its weight.  Mr. Forister said this is being addressed and a solution will be found. 

Phase II – Mike McCafferty explained that notice to proceed will be given very soon on Phase II which is the tenant finishes, office suites, OP Lab, Pharmacy, and Coffee Shop.  This does not include the 3,800 sq feet remaining for physicians to lease or purchase.  Evelyn Ebzery asked if an open house is planned and Mr. McCafferty said this is being discussed. 

QUALITY COMMITTEE
Larry Roos noted that the Quality Council met on August 16. It was reported that Avatar, who compiles the patient surveys, will place a national ad for hospitals exceeding 2004 expectations and Sheridan Memorial Hospital  will be one of those hospitals.  Mr. Roos said that Jane Scott, Quality Services Manager, is working with the OB staff to help improve scores.  Mr. Roos reviewed Avatar scores, noting that for a 12 month period our score was 89.4, with perfect score being 100.  Mr. Roos noted that our hospital is in the 41^st percentile and we want to be over the 50^th percentile.  Eight hospital departments are currently working on QI Projects.  Mr. Roos complimented the medical staff and nursing staff for helping lower the patient length of stay.  The Board applauded Larry Roos for the thoroughness of his report.   

Mr. Miller said that the Operational Plan recently mailed to the Board for review was appreciated and thanked all who worked on the document.  Mr. Miller also said that his wife had two recent patient experiences in the hospital and received wonderful care.

BYLAW COMMITTEE

No report at this time.  The Medical Staff Bylaw Committee and Board Bylaw Committee will be meeting in the near future.

OTHER BUSINESS
Committee Assignments – Harlan Rasmussen reviewed the new Board of Trustee Committee Assignments.

OSC – Larry Roos reported he hopes to meet next week with Dr. Bateman and Dr. Holst. 

Orthopedic Beds - Mr. Roos asked if there are beds dedicated for orthopedic use in the Med/Surg area.  Mr. Huey said that the hospital is looking very seriously at a skilled nursing (swing bed) unit which should be implemented in the near future and will be an enhancement for orthopedic patients as well as other patients.  After the Emergency Department is moved from its present temporary location, the hospital will have more bed capacity with which to meet the special needs of the orthopedic patient.   

Community Relations – Cecile Pattison reported that just under 4,000 have participated in the blood screening to date.  The Health Fair is scheduled for Saturday, September 17^th. 

The 5-year- old birthday party is scheduled for Saturday, September 10^th.  Also on September 10^th the Cancer Center is planning a picnic for its patients on their lawn. 

Mrs. Pattison reported the broadcast times for today’s Board Meeting.

Nursing Service - Peggy Callantine, Director of Nursing, reported that three of the hospital’s nurses have been nominated for awards by the Wyoming Nurses Association.  Shanna Shumaker, RN (Outpatient) and Victoria Milne, RN (Med/Surg) have been nominated for excellence in clinical practice and Dee Gilson, RN, OR Manager, for Outstanding service to the Wyoming Nurses Association.

There being no further business, the meeting adjourned at 6:45 p.m.

Recorder, Joanne Redder
Larry Roos, Secretary

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES   MEETING
JULY 27, 2005      5:00 P.M 

MEMBERS PRESENT:  Evelyn Ebzery, Harlan Rasmussen,  Larry Roos,  Scott Nickerson, Anthony Spiegleberg, Dixie See

MEMBERS ABSENT:  Gary Miller 

The Board welcomed Dr. Michael Strahan to his first meeting as the hospital’s newly elected trustee.

APPROVAL OF MINUTES – JUNE 22, 2005
Evelyn Ebzery asked that the adoption of the June 22^nd minutes be postponed until the Board’s August meeting.  The minutes were not available to the Board in enough time for their review.

NOMINATING COMMITTEE REPORT – ELECTION OF OFFICERS
Larry Roos stated that the Nominating Committee met on July 7^th and presented the following recommendations for the Board of Trustees Officers for 2005/2006.
                                Harlan Rasmussen – Chairman
                                Anthony Spiegelberg – Vice Chairman & Treasurer
                                Larry Roos – Secretary

The motion to approve the slate of officers for 2005/2006 was made by Larry Roos, seconded by Evelyn Ebzery and unanimously passed.

The Board thanked Evelyn Ebzery for her five years as Board of Trustees Chairman and the meeting was turned over to new Board Chairman, Harlan Rasmussen.

MEDICAL STAFF REPORT
Dr. Wohl presented four Medical Staff applications for approval by the Board:

Harlan Rasmussen asked Dr. Wohl if he was personally satisfied that these applicants meet the qualifications for staff membership and are recommending them to the Board.  Dr. Wohl stated that they did.

Scott Sample, D.O. – Dr. Sample has requested Consulting staff privileges in Cardiology.  After review, Dr. Strahan made a motion to approve Dr. Sample’s application as presented, Evelyn Ebzery seconded the motion and motion carried. 

Steve Rabon, D.P.M. – Dr. Rabon is a Podiatrist who will be employed by Sheridan Orthopedics.  Dr. Rabon is requesting privileges as an Independent Limited Health Care Practitioner and will be conducting surgical procedures with the collaboration.of the orthopedic surgeons.  Evelyn Ebzery made a motion to approve Dr. Rabon’s application as presented, Dr. Strahan seconded the motion and motion carried. 

Amy Rabon, RN, MSN, CNM, WHNP  - Amy Rabon is an Advanced Practitioner of Nursing and Certified Nurse Midwife requesting privileges as a Dependent Limited Health Care Provider. Mrs. Rabon is employed by Dr. Scott and, per the Medical Staff Bylaws, Dr. Scott will be her supervising physician.  Evelyn Ebzery made a motion to approve Amy Rabon’s application as presented, Dixie See seconded the motion and motion carried.   

Bridgette Gill, RNC, APN-C, CNM, MS – Bridgette Gill is requesting an addition to her current privileges to include surgical assistant in obstetric and gynecologic procedures.  Anthony Spiegelberg made a motion to approve Bridgette Gill’s application for additional privileges as presented, Dr. Strahan seconded the motion and motion carried.

 ADMINISTRATION REPORT
Ken Huey introduced Lajune Bacon, RN who has been serving as the interim manager of the ED/ICU and has accepted this position on a permanent basis.  Mrs. Bacon will continue her work in Infection Control and Dr. Strahan complimented Lajune on the excellent job she has done in her Infection Control role.

Mr. Huey reported that the OR Renovation team met today at noon and he will keep the Board updated as to the status of the project.

Mr. Huey reported that Mark Walter, M.D. visited this past weekend and plans a return visit within the next couple of months with his wife.  Dr. Walter is a 4^th year resident in the field of Psychiatry and will complete his residency in June, 2006.

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

Financial Statements – Alan Dow reported the month of June ended on a strong note with a positive bottom line from operations of $950,000.  Mr. Dow said that the hospital’s new coffee shop saw a $3,000 profit for the first four months of operation.  Anthony Spiegelberg noted that with all the projects the hospital has going on all of these, to date, have successfully been funded out of cash flow.  Mr. Spiegelberg said that hospital reserves have been maintained, but some of the reserves will be used to pay for part of the current projects, i.e. MAC & ED Projects. 

Capital Equipment – Alan Dow presented five Capital Equipment Items for approval:
1.                  Holter Monitor – This is a budgeted item at a cost of $12,000. Anthony Spiegelberg made a motion to approve the purchase of the Holter Monitor, Evelyn Ebzery seconded the motion and motion carried.
2.                  Replacement of Lab Instrument in Microbiology – Mr. Dow stated that the manufacturer will no longer support the lab’s current instrument.  This was a budgeted item at $59,000.  Anthony Spiegelberg made a motion to approve the replacement of the lab’s current instrument, Evelyn Ebzery seconded the motion and motion carried.
3.                  Ortho Trauma System – Mr. Dow explained that this is an upgrade to the equipment used for orthopedic trauma and was budgeted at $75,000.  The amount requested is  $57,000.  Evelyn Ebzery made a motion to purchase the Ortho Trauma System, Dr Strahan seconded the motion and motion carried.
4.                  Forms Automation System – Mr. Dow explained that the vendor is Optio and is a system that will automate forms throughout hospital.  Forms will be available on demand from the computer.  It is planned to start at the Imaging Center to avoid purchasing an $11,000 blue card machine, which the hospital currently uses, and this cost can be put towards the purchase of the system.  Mr. Dow said that Jona Horner is the project leader and Mrs. Horner said that this is a major undertaking with approximately 2,000 forms currently being used in the hospital and the implementation process will take 18-24 months.  It was noted that this is the first step towards patient electronic medical records and in the future, patient’s medications, etc. will be bar coded. The system was initially budgeted for software only at $35,000, but the request is for $55,000 which includes the hardware. Evelyn Ebzery made a motion to approve the purchase of the Forms Automation System, hardware & software.  Dixie See seconded the motion and motion carried.
5.                  CAD System for Radiology –  Mr. Dow explained that this system is a computerized over-read for mammography.  The second reading is done by computer which is allowable and payable by Medicare.  Mr. Dow said this is state- of-the-art and a new revenue source with estimated 22 month pay back. Radiology Manager, John Miller, explained that CAD is a Computerized Aided Detection Machine that digitizes analog mammogram and scans for abnormalities.  It can pick out an abnormal density, mark it, and the Radiologist who previously read the regular mammogram can compare the two.  This is a budgeted item at $84,180.  Anthony Spiegelberg made a motion to approve the purchase of the CAD System for Radiology, Evelyn Ebzery seconded the motion and motion carried. 

Mr. Spiegelberg asked if there are applications to anything beyond mammography and Mr. Miller said that CT CAD systems are on the horizon. Larry Roos noted that the Radiology staff is functioning very well during a high volume month.

FOUNDATION
Tom Ringley reported that there is $151, 000 yet to be raised to reach the ED campaign goal and noted that the Foundation has given $500,000 towards the ED Project.

Mr. Ringley noted that there is one scholarship student in the new extern program (graduate nurse in her six month internship) and one in the new preceptor program (student between her first and second year). Nursing Director, Peggy Callantine feels the programs are working well.  

BUILDING COMMITTEE
Harlan Rasmussen reported that the committee met on July 26^th.  Mr. Rasmussen introduced Rob Forister, master electrician, who recently joined the hospital.  Mr. Forister will be doing the timeline management of the ED Project and will be coordinating this with the State of Wyoming.

MAC - Mr. Rasmussen said that work for completing spaces for the Women’s Center and Imaging Center is in the final stages and equipment will be arriving the first part of August.

Mr. Rasmussen reminded the Board that in the bidding process, although we do have fixed cost for project, there was an option wherein the hospital retains the right to select some equipment.  Mr. Rasmussen said that the committee is not anticipating changes at this time.

ED Project – Mr. Rasmussen reported that the ED Project is on schedule.  Mr. Rasmussen explained a change order approved by the Building Committee for $4,500.  The change order revealed an existing sewer line not properly sized and not noted in the design plan. Mr. Rasmussen said that TSP will absorb the difference.  Mr. Rasmussen also reported there is an option of delaying asphalt paving on a portion of the parking lot due to weather and this is being monitored.

QUALITY COMMITTEE
Larry Roos reported that the committee met on July 26^th.  Gary Sellenrick, Laboratory Manager, presented his analysis of Avatar’s customer satisfaction report and ways to improve their scores, noting that these scores are inter-related with all hospital departments working as a team. 

Mr. Roos said that with the closing of Sheridan Medical Laboratory, the hospital’s pricing and service excellence should help in attracting their customers.

OTHER BUSINESS
Larry Roos reported that he will contact the Sheridan Surgical Center to reinitiate discussions.  Dixie See said this is important to keep open and was the consensus of those Board members present.

Evelyn Ebzery presented a resolution from the Board supporting the application for designation of area trauma hospital in the State of Wyoming Trauma System.  Lajune Bacon explained the resolution and said that the state is recruiting a State Trauma Coordinator.  Focus the next three years will be towards community based trauma and disaster management.   Mrs. Bacon said that the hospital meets all requirements and can bill for trauma activations which will pay our trauma coordinator salary.

Mr. Huey recommended that the Board approve the resolution and sign after a correction is made to add the signature of the Board of Trustees’ new member.  Evelyn Ebzery made a motion to adopt the resolution, Dr. Strahan seconded the motion and motion carried.

Evelyn Ebzery noted that in the Finance Committee Meeting it was noted that Alan Dow and Jona Horner are keeping track of funds the hospital has received from the County totaling $258,000.  These funds have been designated to the hospital’s cardiac monitor capital expenditure.

Harlan Rasmussen said that he will send out a list of each Board Committee and asked each member to list three committees they would like to serve on, and prioritize.  Mr. Rasmussen also asked if anyone had a preference in time/date for the Board’s monthly meeting.

Cecile Pattison gave the following report:
Approximately 100 people participated in the hospital’s rodeo parade entry.

The appointment lines for the Health Fair are open and 1,600 have scheduled appointments.  The blood draws will be from August 16-26 and results will be available at the Health Fair on September 17^th.

Camp Huff & Puff is scheduled for July 31^st in Story and 17 children have registered.

The Diabetes Triathlon will be held on August 6^th.

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   MEETING
JUNE 22, 2005      5:00 P.M 

MEMBERS PRESENT:  Evelyn Ebzery, Harlan Rasmussen,  Larry Roos,  Scott Nickerson, Gary Miller 

MEMBERS ABSENT:  Anthony Spiegleberg, Dixie See

APPROVAL OF MINUTES - May 25, 2005
The previous meeting minutes of May 25, 2005 were reviewed.  After review, Scott Nickerson made a motion to approve the minutes as submitted, Harlan Rasmussen seconded the motion and motion carried.

MEDICAL STAFF REPORT
Dr. Wohl requested that the Board adopt revisions to the Medical Staff Bylaws, Rules and Regulations.  He stated that there would be more revisions proposed n the near future.  Among the recommended changes, Dr. Wohl stated that the Medical Staff was proposing to add a statement in the Preamble that would prohibit unilateral amendments to the Bylaws by the Board of Trustees, Medical Staff, or Administration.  He pointed out the quorum recommendation that would eliminate attendance requirements and those Active Medical Staff members present would constitute a quorum.  Dr. Wohl noted these proposed changes are consistent with JCAHO standards.

After discussion, Mr. Rasmussen moved to refer these proposals to the Board Bylaw Committee for review and recommendation to the full Board.  Dr. Nickerson seconded the motion and motion was approved.  Mr. Rasmussen requested that future Bylaw recommendations be referred to the Board Bylaw Committee prior to coming to the full Board.

ADMINISTRATION REPORT
Ken Huey reported that there is a Quality Improvement Project led by Jona Horner to enhance the quality of our services to patients in the admission process.  He stated this is an excellent Service Excellence Project that has great potential to positively impact our patients’ experience here at the hospital.

Mr. Huey noted, with regret, that Ronda Holwell, Public Relations Specialist and Employee of the 1^st Quarter, will be leaving to work for the Wyoming Department of Transportation.

Mr. Huey pointed out that Board pictures taken by Betsy Higgs are located in the Patient Wing Lobby along with our Medical Staff Executive Committee.

Jill Bates gave a recruitment report, noting an emphasis on recruiting for experience.

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

 Capital Equipment – Four Capital Equipment Items were presented for approval:

 1.                   Washing Machine - Scott Nickerson made a motion to replace a washing machine (25 years old) for $19,280.  Gary Miller seconded the motion and  motion carried.
2.                   Call System Upgrade - Scott made a motion to replace the Patient “Call System” – Hillrom Bid to update system $42,005 (computer system upgrade not supported by vendor anymore).  System will be compatible with Emergency Department Project and additional monitoring for patient safety.  Gary Miller seconded the motion and motion carried.
3.                   Rebuild Elevator – After much discussion regarding the need to rebuild at least one of our two 1953 elevators, a motion to rebuild one elevator at a cost of $174,000 was made and passed.|
4.                   OR Renovation – Although discussed and approved at the last meeting, Ken Huey reviewed proposals and recommends for moving forward with the OR Renovation.  Mr. Huey estimated we might save $100,000 from what was approved at the last meeting.  He reminded everyone that, because it is not known what exactly is in each OR room ceiling, we are going on best guesses at this point.

Review of Financials - Scott reported that we are 11 months into the fiscal year and that it appears we are headed for overall operations to “break even” by year-end.  Larry Roos asked why bond reserve funds increased by $2.4 million.  Alan Dow said that this was in preparation for making a semiannual bond payment of approximately that amount.

Budget – Alan Dow
Alan Dow presented the FYE 6/30/2006 budget.  This budget reflects a $1.2 million net loss that is partially due to the anticipated impact from the two Imaging Centers and the Surgery Center that will all be competing with the hospital.  It was noted that one of the two imaging centers is partially owned by the hospital, and the hospital’s share of income from this joint venture is included in the budget.  The budget reflects approximately 25 fewer employees.  Because of grant funding and other non-operating cash flow, we are still able to budget a positive cash flow after debt service of two million dollars, which will also meet our debt service requirements.

Larry Roos asked why discounts double from 2005 to 2006.  Alan Dow explained that the 40% discount for employees (due to higher deductibles under the new health plan) and outpatient elective surgery discounts are both new and were not reflected in the full current year. 

Larry Roos and Scott Nickerson both noted that a good job was done on the budget and Alan thanked Jona and her staff.   

Evelyn Ebzery did confirm that the media had received a copy of the budget.  Scott Nickerson moved to accept the 2005-2006 budget and Gary Miller seconded the motion and motion carried.

FOUNDATION
Tom Ringley reported on the 4^th Annual Hospital Foundation Benefit which was held on June 18^th and featured the Craft Brothers.  This year was a record with $16,000 profit with proceeds going to the ED Project.  After this fund raiser there remains $152,000 left to meet the minimum goal of $2.4 million.  Tom Ringley announced that the Foundation Annual Meeting will be held on Friday June 24, 2005 at  10:30 a.m..

BUILDING COMMITTEE
Harlan Rasmussen reported that the MAC is on schedule as reported in the Sheridan Press on 6/21/05.  The ED will be “out of ground” next couple of weeks.  There were reported change orders for an additional cost of $17,500 for sewer line connection from the hospital to connect with the MAC line.  The Building Committee approved the change.

ED Project went to bid expecting additional comments from Dept of Health Milt Werner.    Building Committee approved Change Order #1 for $17,010 additional cost.  Change Order #2 was also approved for a savings in cost of $1,415 to change door hinge to door pivots. 

Issues involving retaining wall and ED/MAC connecting link were reviewed regarding construction access and timing.  The Building Committee will meet the third Wednesday of the month for further discussion.  Gary asked about the liaison status between the contractor and the hospital.  Harlan explained that the committee was taking a different approach and will report back next month on the planned internal approach.

QUALITY COMMITTEE
Larry reported that the committee met on Tuesday, June 21 and covered normal reports.  Clarence will be the Corporate Compliance Officer, until a replacement for Corrine Meyer is hired.  Patient Satisfaction Surveys suggest that there are at least five departments for improvement opportunities.  Larry reported that John Miller gave a great report on Radiology and his business plan to improve satisfaction ratings for his area.  It was noted that there are three types of patients; inpatient, outpatient and Emergency Department and separating out Radiology for better analysis of patient satisfaction is being explored.  Larry Roos said he felt it was the best Quality Committee meeting in the year he has been on council and applauded Mr. Miller’s staff.  Gary Sellenrick, Laboratory Manager, will make a presentation at the next Quality Committee Council meeting in July.

Larry Roos reported there are a number of physicians who are not happy with how the patient medical charts are organized.  Mr. Roos said this is being addressed by the Medical Executive Committee.

OTHER BUSINESS
A motion was made by Dr. Nickerson and seconded by Gary Miller to accept the report from Greg Carlson regarding the matter of Leslie Martin.  Harlan Rasmussen declared a conflict and abstained from voting.  The motion carried.

Evelyn Ebzery appointed the Nominating Committee for election of officers to include Anthony Spiegelberg, Dixie See and Larry Roos.  The committee will give their report at the July meeting.

Cecile Pattison announced that the Relay for Life “Radiating Stars” raised $5100 and were awarded the prize for the most money raised.  The Rodeo Parade on July 15th will include current employees and past employees to honor the 100^th anniversary of the hospital with past, present and future floats.  The Asthma Camp in Story is July 31^st and the Diabetes Triathlon is on August 6^th. 

Evelyn Ebzery acknowledged Dr. Nickerson’s last Board Meeting as he has completed his second term and has served for ten years on the Hospital Board.  Mrs. Ebzery thanked Scott on behalf of the Board for his service to the hospital.  Mrs. Ebzery noted that Scott Nickerson was a surgeon at the hospital and, while on the Board, helped with fundraising.   Harlan Rasmussen concurred with Mrs. Ebzery’s comments and noted that Dr. Nickerson’s medicine background was helpful while serving on the Board.  Mr. Rasmussen said that Dr. Nickerson has always had the hospital’s best interest in mind and wished him good luck in his new ventures.  Dr. Nickerson thanked everyone for their kind comments and Mrs. Ebzery announced that the Board would be honoring Scott with a retirement dinner in late July.

There being no further business, the meeting adjourned at 6:50 p.m.

Recorder,  Jill Bates
Larry Roos, Secretary

 

SHERIDAN  MEMORIAL HOSPITAL
BOARD OF TRUSTEES   MEETING
MAY 25, 2005      4:30 P.M 

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

COMPLIANCE VIDEOS -
The Board viewed two compliance training films prior to the start of the regular meeting.