2006

JANUARY 3, 2007 5:00 P.M. (This was the regular December 2006 meeting - rescheduled due to the holidays)

MEMBERS PRESENT: Anthony Spiegelberg, Dixie See, Ron Mischke, Harlan Rasmussen.

Dixie See made a motion to approve the minutes of November 29, 2006, Ron Mischke seconded the motion and motion carried.

Dixe See made a motion to approve the minutes of December 11, 2006, Ron Mischke seconded the motion and motion carried. Anthony Spiegelberg noted that the Board received in their packets a list of the Active Medical Staff approved at this meeting, but did not receive the list of Courtesy and Consulting Staff. This will be provided.

Dixie See made a motion to approve the minutes of December 13, 2006, Harlan Rasmussen seconded the motion and motion carried.

ADMINISTRATION REPORT
Strategic Planning - Mike McCafferty reported that he continues to work with the Medical Staff on strategic planning for the next 3-5 year period.

Medical Oncology - Mr. McCafferty noted that he continues to work with Hematology-Oncology of Billings, Montana to put together a full compliment of cancer care services. A Medical Oncologist will be in Sheridan for an interview in late January.

Psychiatry Search - Mr. McCafferty reported that the hospital has engaged the services of Pacific Companies, Inc. of Irvine, California for recruitment of a Psychiatrist.

New Managers - Mr. McCafferty reported that Lajune Bacon will be taking on the duties of Quality Services Manager. Lajune is currently the ED/ICU Manager. Mr. McCafferty said he appreciates Dave Westlake’s work as interim Quality Services Manager for the past five months, along with his role as Health Information & Records Manager. John Miller, Medical Imaging Department Manager, continued in his role after his planned retirement a few months ago, but the hospital has now hired Gail VanBuren, formerly of Ivinson Memorial Hospital in Laramie, to serve in this role. Mr. McCafferty also reported that Ed Johlman, formally with Wheatland Hospital, will take on the role of CFO, replacing Alan Dow who will be retiring.

FINANCE COMMITTEE REPORT
Voucher Approval - Anthony Spiegelberg and Ron Mischke reviewed the vouchers in Finance Committee prior to the meeting and Ron Mischke made a motion for their approval. Harlan Rasmussen seconded the motion and motion carried.

Financial Statements - Alan Dow thanked the Board for their support of his planned retirement and said he felt Ed Johlman will be an excellent CFO for the hospital. Mr. Dow reviewed the financial statements, noting that November was an exceptionally strong month.

Management Letter - The hospital’s audit was presented last month and the management letter was received after that meeting as part of internal control. Anthony Spiegelberg explained that a response to the management letter will be available at the next Board meeting.

Capital Equipment - Replacement of the laboratory’s vehicle was anticipated for next year, but the car is in need of replacement now and approval was requested to accelerate the acquisition and pursue funding through the Hospital Foundation, not to exceed $21,000.

Ron Mischke made a motion to approve the purchase of a new car for the laboratory, not to exceed $21,000. Dixie See seconded the motion and motion carried.

Income Statement Changes - Anthony Spiegelberg said there will be a small change to formatting of the income statement to bring it more inline with its use. These changes will be reflected on next month’s financial statements.

Mr. Spiegelberg thanked Alan Dow for the excellent job he has done and welcomed Ed Johlman to his role as the hospital’s new CFO.

BUILDING COMMITTEE REPORT
Medical Arts Complex - Dixie See reported that the Medical Arts Complex is full now with the move of Dr. Strahan’s office into the building.

Pharmacy - TSP is working on the final design and construction documents for the Pharmacy.

CT - The CT scanner will be moved into the Emergency Department the second week of January.

Master Plan - Mike McCafferty introduced Mark Johnson of HLM in Denver and Del Acker of TSP in Sheridan who will be presenting the hospital’s final Master Facility Plan.

Mark Johnson reviewed the Strategic Plan document for 1-3, 3-5, and 5-10 years, noting that a lot of community and campus goals on the east side made this a long process. Copies of the site plan were distributed and reviewed by Mr. Johnson. The hospital’s core building will be utilized, with expansion of outpatient services. Mr. Johnson reviewed the recommendations for each level of the hospital. Mike McCafferty stated that this document will help the hospital look at what future services they are going to try to provide, and their costs.

QUALITY COMMITTEE REPORT
Dave Westlake, Interim Quality Services Manager, reported that the committee met on December 19^th. Jane Scott, RN presented Core Measures, what they are, the components, etc. and reviewed these in detail with the committee. The top ten diagnoses were reviewed, along with length of stay. Mr. Westlake noted that Sheridan Memorial Hospital has been very good in coming in under the national average for length of stay. A monthly quality report will be shared with the Board.

OTHER BUSINESS
Anthony Spiegelberg recognized Steve Meier who was in attendance as the appointed hospital representative for the County Commissioners.

Anthony Spiegelberg welcomed Peggy O’Neil, a new reporter for the Sheridan Press.

Wednesday, 12/13/06 -- 7:00am

Board Members Present: Harlan Rasmussen, Evelyn Ebzery, Michael Strahan, M.D., Gary Miller, Dixie See

Administration: Alan Dow, Mike McCafferty

Community: Pat Blair – Sheridan Press

Meeting was called to order at 7:00am specifically to consider the Immulite 2500 Lab Analyzer. Brief presentation was made and recommendation from Administration to purchase the analyzer prior to the end of the calendar year to receive a discount of $9,000 from the vendor. This capital item was budgeted to be purchased in February 2007.

A motion was made by Dr. Michael Strahan and a Second by Dixie See and the motion passed. As this was the only business for the board the meeting was adjourned at 7:08am.

Respectfully Submitted, Mike McCafferty

SHERIDAN MEMORIAL HOSPITAL BOARD OF TRUSTEES
Special Meeting
December 11, 2006 5:30 p.m.

MEMBERS PRESENT: Anthony Spiegelberg, Harlan Rasmussen, Evelyn Ebzery, Dixie See, Gary Miller, Ron Mischke, Michael Strahan, M.D.

The purpose of the meeting was to review and approve the reappointment applications for the Active, Courtesy and Consulting Medical Staff for the two year period January 1, 2007 through December 31, 2008. (attached)

Dr. Wohl presented the list of those physicians who have reapplied for privileges at Sheridan Memorial Hospital. All applications have been reviewed and approved by their appropriate department(s) and approved by the Medical Executive Committee (Credentials Committee).

Active Staff - Harlan Rasmussen made a motion to approve the list of Active Medical Staff, Evelyn Ebzery seconded the motion and motion carried.

Courtesy Staff - Harlan Rasmussen made a motion to approve the list of Courtesy Medical Staff, Evelyn Ebzery seconded the motion and motion carried.

Consulting Staff - Harlan Rasmussen made a motion to approve the list of Consulting Medical Staff, Evelyn Ebzery seconded the motion and motion carried.

MEMBERS PRESENT: Anthony Spiegelberg, Evelyn Ebzery, Harlan Rasmussen, Michael Strahan, M.D., Gary Miller, Dixie See, Ron Mischke.

APPROVAL OF MINUTES - OCTOBER 25, 2006
The previous meeting minutes of October 25, 2006 were reviewed. After review, Harlan Rasmussen made a motion to approve the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS
Mr. Dan Brumm raised a question regarding wages for hospital staff, noting that Wyoming is rated 49^th of 50 states and stated that he felt nursing staff should not have to correct physicians regarding pharmacy prescriptions. Mr. Brumm also asked for a letter (within 10 working days) explaining why he can’t attend Board of Trustee committee meetings.

MEDICAL STAFF REPORT
David A. Napoliello, M.D. - Dr. Wohl presented the application of David a. Napoliello, M.D. for privileges as a locum tenens physician in general surgery. Dr Napoliello’s application was approved by the Department of Surgery Chairman, Chief of Staff, and CEO. Dr. Napoliello worked as a locum physician the week of Thanksgiving. H arlan Rasmussen made a motion to approve Dr. Napoliello’s application, Gary Miller seconded the motion and motion carried.

Dr. Wohl announced that the hospital has invited the Medical Staff to attend the Dec 15^th Christmas Party at the Holiday Inn. Walter Gould, M.D., Christopher Smith, M.D., and Richard Cole, D.O. will be recognized for their years of service to the hospital and community.

ADMINISTRATION REPORT
Strategic Planning - Mike McCafferty reported that the hospital continues to move forward with strategic planning.

Cancer Care - Mr. McCafferty reported that proposals were requested from the Medical Oncologists who practice in Sheridan outlining how they might work with the hospital to deliver medical oncology care and chemotherapy. The hospital is moving forward with Hematology-Oncology Centers of the Northern Rockies in Billings, Montana to lease space at the Welch Cancer Center. Mr. McCafferty said that this will enhance the services already provided at the Welch Cancer Center by Dr. John Stamato. Patients will be able to stay in Sheridan for their total cancer care and receive this care in one location. It is planned to have these additional services available within approximately six months.is a great opportunity for the patients – looking at 6 months – Will work with Dr Stamato.

Home Care Annual Report - Manager, Lee Ingalls, reviewed the Home Care Annual Report, noting all quality measures were met. Gary Miller asked if these numbers could be included in the hospital financial reports and Evelyn Ebzery asked if a breakout could be given on VA patient payments. Anthony Spiegelberg asked Mr. Ingalls if he would share with the media some information on both the Home Care and Hospice services.

Harlan made a motion acknowledging receipt of the Home Care Report. Dr. Strahan seconded the motion and motion carried.

Hospice Annual Report - Lee Ingalls reviewed the Hospice Annual Report, noting that the numbers are stable. In home Hospice is currently provided but inpatient Hospice is being explored. Mr. Ingalls said that the Hospice nurses have become certified in Pain Management and comfort care is provided to the patients.

Harlan Rasmussen noted that he personally had experience with the Hospice Program and feels the community needs to be aware of the flexibility of this program and the very caring staff. Harlan Rasmussen made a motion to approve the Hospice Annual Report, Evelyn Ebzery seconded the motion and motion carried.

FINANCE COMMITTEE REPORT
Audit Report - Alan Dow passed out the audit reports for the year ending June 30, 2006 and introduced Auditor, Gerald Tucker.

Mr. Tucker reported that the audit went very well and gave unqualified opinions. No instances were found that needed to be reported. Harlan Rasmussen asked if there was a management letter. Mr. Tucker explained that a report to the Board of Trustees will be sent out soon and this takes the place of the management letter. It was noted that some key elements were the consistency of the administrative team and the longevity of staff.

Evelyn Ebzery made a motion to approve the Audit Report, Gary Miller seconded the motion and motion carried.

Voucher Approval - Gary Miller reported that the vouchers were reviewed by the Finance Committee prior to the meeting and made a motion for their approval. Dr. Strahan seconded the motion and motion carried.

Financial Statements - Gary Miller noted October was a very good month. Alan Dow noted that there were higher inpatient and outpatient volumes, as well as emergency department visits.

FOUNDATION REPORT
Tom Ringley reported that the Foundation’s annual membership drive is going very well.

Mr. Ringley gave a reminder of the Foundation’s Partner breakfast scheduled from 6:30-8:30 a.m. on Thursday, December 14^th.

A Tea for nursing scholarship students is scheduled for 4:00 p.m. on December 19^th. Mr. Ringley discussed the four year nursing program at Sheridan College, noting that there is an excellent relationship between the college and the Foundation.

BUILDING COMMITTEE REPORT
Dixie see reported that Dr. Strahan will move into his new office this weekend. Rob Forister, Facilities Manager, explained that since parking is at a premium at the Medical Arts Complex, 5-6 parking spaces will be installed north of the building for Dr. Strahan’s staff.

Mr. Forister noted that the hospital’s laboratory staff will go to the patient’s car and take blood samples if they are not able to come into the building, and the hospital would like to put in some handicap parking spaces.

Operating Room #3 will be completed in December, 2006.

A draft of the site and facility plan will be available the first week of December and will be presented at the December Board Meeting.

Rob Forister recommend that TSP be approved for the design portion of the Pharmacy Project. Mr. Forister explained that the mandate is to provide a sterile environment for compounding drugs and mixing chemo drugs and the pharmacy will be expanded some and the area remodeled. The design portion is 10-15% of the total cost of the project.

A motion was made to engage TSP for the design of the Pharmacy Project. There was question as to a dollar range for the design portion of the project. Dixie See amended the motion to add that the design portion of the project budget not exceed $35,000. Evelyn Ebzery seconded the motion and motion carried.

Evelyn Ebzery noted that the work on operating room #3 is under budget, the new elevator is working well, and the CT room in the emergency department is nearly completed – OR #3 is under budget and elevator is working well, and it is planned to move the CT into the Emergency Department in December.

QUALITY COMMITTEE REPORT
Dr. Strahan gave a report on the November 21^st Quality Council Meeting. Dave Westlake, Interim Quality Services Manager, reviewed the Avatar Report with the committee, and the Core Measure Reports. Dr. Wohl will review criteria for meting core measures with the Medical Staff at their December 12^th Quarterly Staff Meeting.

OTHER BUSINESS
Evelyn Ebzery commented on the hospital’s new signage and thanked Cecile Pattison for her work in this.

Anthony Spiegelberg reported that Ron Mischke will replace Gary Miller on the Quality Council and Ron Mischke will replace Anthony Spiegelberg on the Finance Committee.

Anthony Spiegelberg reported that he and Mike McCafferty will be meeting with the County Commissioners next week.

Anthony Spiegelberg thanked Joanne Redder, Executive Assistant, for all of her help keeping the Board informed during the transition of the new CEO.

The Board will be contacted regarding the date change for the December Board Meeting which is scheduled for December 27^th.

There being no further business, the meeting adjourned at 6:30 p.m.

MEMBERS PRESENT: Harlan Rasmussen, Evelyn Ebzery, Gary Miller, Dixie See, Michael Strahan, M.D., Anthony Spiegelberg, Ron Mischke.

APPROVAL OF MINUTES - September 27, 2006
The previous meeting minutes of September 27, 2006 were reviewed. Harlan made a motion to approve the minutes, Dixie See seconded the motion and motion carried.

Anthony Spiegelberg welcomed Mr. Ron Mischke as the newly appointed member of the Hospital Board.

PUBLIC COMMENT
Mr. Dan Brumm expressed his thanks to the Board for re-arranging the room setup so Board members were facing the public.

Mr. Brumm thanked Mike McCafferty for getting requested documents to him in a timely manner. He also asked why the Board does not question the finance report more in the Board meeting. Harlan Rasmussen explained that there are subcommittees of the Board and the Finance Committee clearly reviews these numbers prior to the Board meeting.

MEDICAL STAFF REPORT
Barry Wohl, M.D., Chief of Staff, presented three applications for Medical Staff privileges to the Board for their approval:

Elizabeth A. Wuerslin, M.D. - Dr. Wohl reported that Elizabeth A. Wuerslin, M.D. was granted Locum Tenens privileges in Pediatrics for the period October 5-11, 2006 while he was out of town. Dr. Wuerslin’s application was approved by the CEO, Pediatric Department Chairman, and Chief of Staff. Dr. Wuerslin’s application is presented to the Board for approval after the fact, per JCAHO requirements. After review, Evelyn Ebzery made a motion to approve the application of Elizabeth A. Wuerslin, M.D., Dr. Strahan seconded the motion and motion carried.

Martin Kirk Lucas, M.D. - Dr. Lucas has been granted Consulting Privileges by the Medical Staff in Medical Oncology, with Hematology Oncology . Dr. Wohl noted that Dr. Lucas’s application has been approved by the appropriate departments as well as the Medical Executive Committee. Dr. Strahan made a motion to approve Dr. Lucas for privileges as requested, Dixie See seconded the motion and motion carried.

Travis H. Preszler, PA-C – Mr. Preszler previously had privileges in the hospital as a Limited Health Care Practitioner under the supervision of a physician associated with Hematology/Oncology Centers of the Northern Rockies. This physician is no longer with Hematology/Oncology Centers and Mr. Preszler’s privileges in the hospital as a Physician Assistant ceased. These privileges have been reinstated under the supervision of John Stamato, M.D. and approved by the Medical Executive Committee. Evelyn Ebzery made a motion to approve the reinstatement of Travis Preszler’s privileges under the supervision of Dr. John Stamato, Harlan Rasmussen seconded the motion and motion carried.

ADMINISTRATION REPORT
Employee of the Quarter - Mike McCafferty introduced Donna Frey, Home Care Clerical Assistant, as the hospital’s Employee of the Third Quarter. Mr. McCafferty thanked Donna for her loyalty to the hospital, noting her employment since 1983, and presented her with a plaque. Lee Ingalls, Home Care Manager, said that Mrs. Frey is very organized and an irreplaceable staff member.

JCAHO Reports - Mike McCafferty invited Gary Sellenrick, Laboratory Manager, and Clarence Montano, Compliance Officer, to report on the JCAHO (Joint Commission on Accreditation of Health Care Organizations ) Surveys.

March 2006 Survey – Clarence Montano reported the hospital has submitted an action plan to the JCAHO and have received notice that the action plan was accepted. A periodic performance review will be due in March, 2007. Mr. Montano explained that there is a Compliance Committee to gather information to submit to JCAHO.

Laboratory Survey - Gary Sellenrick reported that the Laboratory was surveyed on October 20^th and it went very well. There were a few, easily corrected, deficiencies and the Laboratory will receive a corrective action report from JCAHO. The Laboratory will post the corrective action online and if the JCAHO have questions, they will notify the hospital.

Dr. Wohl noted that the JCAHO requirement for abbreviations is changing physicians’ behavior and when physicians deviate this needs to be brought to their attention. Dr. Wohl said that the physicians need feedback and changing specific behaviors will take

time. Clarence Montano said that this information will be presented to the Pharmacy &Therapeutics Committee and the Pharmacy will give feedback to physicians. Dr. Wohl asked that individual reports be given to each physician.

Strategic Planning - Mike McCafferty reported that the hospital is continuing to work on healthcare strategic planning for the community.

FINANCE COMMITTEE REPORT
Voucher Approval - Gary Miller reported that the Finance Committee met today and reviewed the vouchers. Mr. Miller said the vouchers were approved at that meeting and made a motion for their approval. Evelyn Ebzery seconded the motion and motion carried.

Financial Statements – Alan Dow reviewed the Financial Statements for the month of September, 2006, noting the hospital was on budget across the board. Patients days were down and noted the Emergency Department has been over budget since the opening of the new facility.

Employee Gain Sharing Plan – Gary Miller reported that the hospital did not meet the financial goals for gain sharing but did have a net profit with a positive cash flow. Administration recommends that a bonus of $250 per full time employee be awarded to recognize the staff in helping achieve this accomplishment. Mr. Miller said that the Finance Committee recommends approval of the Gain Sharing Plan payment of $250 per full time employee and made a motion for approval. Dr. Strahan seconded the motion and motion carried. Harlan Rasmussen said the employees work hard in making this organization successful and he supports Administration’s recommendation.

Capital Equipment - Alan Dow presented two capital equipment items, noting that both are in the budget.

1. Video System Upgrade for Surgery - This is a planned upgrade of older video scopes and attachments that are used in many minimally invasive surgical procedures at a cost of $231,992. This item is in the current capital budget at $232,000. All surgeons who use this equipment were involved in the selection and endorse the proposal. Dr.

Strahan asked if the next upgrade will be a full system or could additional modules be added. Mr. Dow said that this system will bring the hospital up to standard and additional scopes can be added. Gary Miller made a motion to approve the Video System Upgrade for surgery, Evelyn Ebzery seconded the motion and motion carried.

2. Radio Frequency Ablation – This item is in the current capital budget at $25,000 and actual cost is $19,800. Radio frequency ablation will allow the hospital to offer a new service for in-operable cancer and it is anticipated that there will be 8-10 cases per year with payback point of 6 cases. This item has been approved by the Medical Executive Committee and supported by the hospital’s Radiologists, Radiation Oncologist, and General Surgeons. Gary Miller made a motion for approval of the radio frequency ablation equipment, Evelyn Ebzery seconded the motion and motion carried.

Audit Report - Alan Dow noted that the Finance Committee has reviewed a draft of the audit report for year ending June 30, 2006 and the hospital’s auditor will present the report at the November Board Meeting. The draft had no proposed adjustments.

FOUNDATION REPORT
Tom Ringley reported that there was a modest attendance at the Wine Festival Benefit held on October 20^th, but everyone had a good time and approximately $4,000 was raised for the Diabetic Program. The Foundation’s annual benefit will be held on April 14^th at the Wyo Theater and November is the Foundation’s annual membership drive.

QUALITY COMMITTEE REPORT
Dr. Strahan reported that the committee did not meet due to members’ attendance at the VHA meeting. Information from the VHA Meeting will be shared at the November Quality Council Meeting. Dr. Strahan said that VHA is a helpful organization to the hospital in helping us understand how we compare to like hospitals. Mike McCafferty concurred.

BUILDING COMMITTEE REPORT
Dixie See reported that Dr. Strahan’s office is planned for completion by the first of December. The State Health Department has inspected the new CT room and OR Room #3, and work on the new elevator is nearly complete. The hospital is moving forward on the plan for the Pharmacy to be in compliance with USP737, and Mrs. See noted that the Site and Facility Plan should be ready by the end of the year for Board review.

Mike McCafferty thanked the department leaders for their attendance at the meeting and would like them to be involved in reporting to the Board.

MEMBERS PRESENT: Harlan Rasmussen, Evelyn Ebzery, Gary Miller, Dixie See, Michael Strahan, M.D.

APPROVAL OF MINUTES – AUGUST 30, 2006
The previous meeting minutes of August 30, 2006 were reviewed. After review, Dr. Strahan made a motion to approve the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS
Mr. Dan Brumm addressed the Board, stating that he felt it was rude and unprofessional for some of the Board members to be sitting with their backs to the staff and public. Mr. Rasmussen asked that the Board members email their thoughts on this to chairman, Anthony Spiegelberg.

MEDICAL STAFF REPORT
Dr. Wohl reported on the past month’s medical staff department and quarterly staff meetings, noting that improving the depth of support for physician education, i.e. core privileges, credentialing, and paying for med staff officer services is being addressed. Core privileges have been revised as required by JCAHO and the new privileging process will be implemented. Also being looked at is the Emergency Department coverage of unassigned patients.

ADMINISTRATION REPORT
Strategic Planning - Mike McCafferty reported that he has met with Dr. Strahan and Dr. Wohl regarding strategic planning, and off site employee planning sessions are scheduled for September 29^th and October 2^nd.

Information Systems – Mr. McCafferty said that he is working with Information Systems regarding hiring a consulting firm to look at the hospital’s current system and its capabilities.

CFO Position – Mr. McCafferty reported that the selection for the CFO position is ongoing with approximately 50 responses received. Four or five candidates will be selected for on site visits.

Wyoming Rehab Manager – Mr. McCafferty reported that Tony Smith has been selected as the new manager of Wyoming Rehab.

FINANCE COMMITTEE REPORT
Voucher Approval - Gary Miller reported that the Finance Committee met today and after review, recommended approval of the vouchers. Mr. Miller made a motion to approve the vouchers for payment, Evelyn Ebzery seconded the motion and motion carried.

Financial Statements - Alan Dow reviewed the Financial Report, noting that the hospital had one of its best months ever in revenue. While revenues were above budget, bad debt expenses rose in August. Mr. Dow stated that the hospital is right on budget year-to-date.

Mr. Dow also reported that the hospital’s auditor was here last week and will plan to present the audit report to the Board in October.

FOUNDATION REPORT
Tom Ringley reported on upcoming Foundation events:

September 28, 2006 - Foundation Employee Partner function at 7 a.m. by the hospital’s Courtyard Barista Coffee Shop

October 20, 2006 - 2006 Fall Wine Festival Benefit at the Best Western Sheridan Center

December 14, 2006 – Foundation Partner Breakfast Celebration – employee partners will decide how their contributions will be spent

Mr. Ringley passed out a Grateful Patient Program brochure that will be placed in each admission packet. The brochure lists the projects and programs if a patient wishes to make a donation, or a form is included if they want to express words of gratitude to their caregivers.

BUILDING COMMITTEE REPORT
Dixie See reported that work on the final punch list for the Emergency Department is being done and that work on operating room #3 should be completed in early December. Construction will then begin on room #2, until all four operating rooms are complete. Dr. Strahan’s office at the Medical Arts Complex should be completed by the end of the year.

QUALITY COMMITTEE REPORT
Dr Strahan reported that he attend his first Quality Council meeting on September 19^th, noting that the format may change with more of a clinical focus, ie core measures and patient satisfaction.

OTHER BUSINESS
Health Fair - Mike McCafferty reported that the Health Fair went extremely well and thanked all who participated.

Christmas Party – Mr. McCafferty noted that the employee Christmas party has been scheduled for December 15^th and the Medical Staff has been encouraged to attend. Dr. Strahan felt that inviting physicians was a nice idea.

MEMBERS PRESENT: Anthony Spiegelberg, Harlan Rasmussen, Evelyn Ebzery, Gary Miller, Dixie See, Michael Strahan, M.D.

APPROVAL OF MINUTES – JULY 26, 2006
The previous meeting minutes of July 26, 2006 were reviewed. After review, Dr Strahan made a motion to approved the minutes, Dixie See seconded the motion and motion carried.

EMPLOYEE OF THE 2^ND QUARTER
Lee Ingalls, Home Care and Hospice Manger, was named Employee of the 2^nd Quarter 2006. Lee joined the hospital as a Home Care nurse in 1995 and was promoted to manager in December, 2004. His coworkers noted his dedication to his leadership role, his professionalism, and his willingness to help others. Lee was presented a plaque by Ken Huey and was joined by his wife, Melissa, and their two children, Kaylee and Matthew.

PUBLIC COMMENTS
Dan Brumm addressed the Board. He asked for a completed copy of Ken Huey’s contract with the hospital as well as all other management contracts. Mr. Rasmussen noted that this information is available, but per hospital policy, there is a fee for the copying of documents.

Mr. Brumm asked the Board if Administration is addressing the nursing shortage. Mr. Rasmussen said that the public is welcome to address the Board, but the Board cannot always be prepared with answers at the time of the meeting.

MEDICAL STAFF REPORT
Dr Wohl presented one medical staff application for approval by the Board.

Stephen M. Edfors, MS, LPC – Mr. Edfors is requesting privileges as an Independent Limited Health Care Practitioner in the Department of Medicine as a Licensed Professional Counselor. Mr. Edfors is employed by Northern Wyoming Mental Health and specializes in mental health and substance abuse counseling. Dr. Wohl noted that Mr. Edfors’ application has been approved by both the Department of Medicine and the Medical Executive Committee.

Harlan Rasmussen made a motion to approve the application of Stephen M. Edfors, Evelyn Ebzery seconded the motion and motion carried.

Capital Acquisition Policy – Dr. Wohl presented, for Board approval, a medical staff policy for capital equipment acquisition. This was discussed at the Board’s July meeting and was approved by the Medical Executive Committee. Dr. Strahan made a motion to approve the policy, Gary Miller seconded the motion and motion carried. This policy will be shared with the full medical staff.

Quarterly Staff Meeting – Dr. Wohl announced that the Quarterly Medical Staff Meeting is scheduled for Tuesday, September 12^th.

ADMINISTRATION REPORT
Senior Living Center Presentation –Mr. Ron Patterson gave a presentation on the Holly Ponds Senior Living Center he would like to begin construction this winter. Mr. Patterson explained that he looked at the need for senior housing, obtained a market analysis and drafted a preliminary plan. The cost of the project will be approximately $12 million dollars and Mr. Patterson said he would like to schedule a meeting with the Board about the possibility of developing apartments in this center for family members of patients in the hospital.

Gary Miller stated that a study is being conducted through the Sheridan Senior Citizens’ Center for a Greenhouse Project that would be a more home oriented nursing home unit and wondered if this may play a part.

HR Director - Ken Huey introduced Len Gross, the hospital’s newly appointed HR Director. The Board welcomed Mr. Gross to the hospital and community.

Facilities Manager – Ken Huey introduced Rob Forister, newly appointed Facilities Manager. Rob has been with the hospital for one year and oversaw the hospital’s ED Project.

Public Relations - Cecile Pattison reported that the health fair blood draws during the last two weeks were very successful with over 8,000 screenings. Cecile noted upcoming events – September 16^th from 9 am – 1 pm will be the Health Fair at the Sheridan College Golden Dome, the 5-year-old birthday party will be held on Saturday, September 9^th and the second annual Cancer Center picnic for current and past cancer patients will be held on Friday, September 22^nd.

Ken Huey thanked the Board for their hard work and commitment during his 4½ years as CEO, noting that it was a real pleasure to work at the hospital. Anthony Spiegelberg said that a lot has been accomplished since Ken has been at the hospital, i.e. the Medical Arts Complex and ED Project, and said the hospital is in a much stronger position. Mr. Spiegelberg said he attributes this to Mr. Huey’s leadership and wished him well on his planned travels upon retirement.

FINANCE COMMITTEE REPORT
Voucher Approval – Gary Miller reported that the Finance Committee met on Monday, due to Alan Dow being out of the office today. Mr. Miller said the vouchers were approved at that meeting and made a motion for their approval. Evelyn Ebzery seconded the motion and motion carried.

Financial Statements - Gary Miller reviewed the Financial Statements, noting that July’s numbers were lower than budgeted, but contractual allowances were at a lower percentage, as were expenses overall. Mr. Miller noted that Sheridan Radiology volumes were 12% higher than budgeted and the Emergency Department numbers were up 20% over budget. Mr. Spiegelberg noted that there is one payment left for the AML Grant Funds and thanked the prior Board for their work in obtaining these funds.

Capital Equipment - One capital equipment item was added to the agenda. Facilities Manager, Rob Forister, explained that the hospital’s number one gas/diesel boiler was found to have developed cracked tubes and is on an emergency basis at this time. The cost to bring the boiler back on line is $15, 096. Mr. Forister said that the primary source of heat is coal with natural gas as backup. Administration requested approval for the repair of the boiler. Harlan Rasmussen made a motion to approve repair of the boiler at a cost of $15,096. Dr. Strahan seconded the motion and motion carried.

Board Resolution – A Board Resolution for depository of funds and authorized signers was presented for approval. Gary Miller made a motion to approve the resolution, Evelyn Ebzery seconded the motion and motion carried.

FOUNDATION REPORT
Tom Ringley reported that the Best Western Sheridan Center has selected the Hospital Foundation as recipient of the proceeds from a wine & food tasting event on October 22^nd. $1,000 of the proceeds will go to the diabetes education fund, with the rest of the proceeds going to the general support fund. Mr. Ringley will provide more information at a later date.

BUILDING COMMITTEE REPORT
ED - It was reported that the punch list for the Emergency Department is nearly complete.

CT - The hospital is waiting for state approval to move the CT into the Emergency Department and it is hoped this will take place in October.

OR - Remodel of operating suite three is in process with completion scheduled for December.

Dr. Strahan’s Office – The work on Dr. Strahan’s new office at the Medical Arts Complex is going well and a late fall completion is expected.

Elevator - Rob Forister noted that the elevator project should be complete within the next two weeks. Anthony Spiegelberg asked about projects planned within the next 3-6 months. Mr. Forister said that the pharmacy remodel to comply with USP797 is scheduled.

COMMITTEE ASSIGNMENTS
Anthony Spiegelberg reviewed the new list of Board committee assignments for 2006.

Mr. Spiegelberg stated that the County Commissioners have asked for input from the Board regarding individuals who may be interested in serving on the Hospital Board.

OTHER BUSINESS
Radiology Manager Retires - Ken Huey noted that John Miller, Radiology Manger, plans to retire September 1^st and thanked John for his many contributions to the hospital.

Strategic Planning - Anthony Spiegelberg reported that he recently met with Mike McCafferty and Ken Huey to discuss future goals of the hospital. This strategic planning will involve both the Medical Staff and Board.

CEO Contract - Mike McCafferty’s contract was presented for approval. Anthony Spiegelberg thanked Evelyn Ebzery and Dr. Strahan for their working with Mike McCafferty on the contract, noting that the contract has been reviewed by legal counsel. Evelyn Ebzery made a motion to approve the new contract for Mike McCafferty as CEO

of Sheridan Memorial Hospital, Dr. Strahan seconded the motion and motion carried. The Board congratulated Mike on his appointment.

MEMBERS PRESENT: Harlan Rasmussen, Anthony Spiegelberg, Dixie See, Michael Strahan, M.D., Gary Miller.

APPROVAL OF MINUTES – June 28, 2006 & July 13, 2006
June 28, 2006 - The previous meeting minutes of June 28, 2006 were reviewed. After review, Dixie See made a motion to approve the minutes, Anthony Spiegelberg seconded the motion and motion carried.

July 13, 2006 - The minutes of the special meeting of July 13, 2006 were reviewed. After review, Harlan Rasmussen made a motion to approve the minutes, Dr. Strahan seconded the motion and motion carried.

NOMINATING COMMITTEE REPORT
Harlan Rasmussen asked that the Nominating Committee Report be moved to the second item on the agenda.

The Nominating Committee (Harlan Rasmussen, Dixie See, and Gary Miller) had met and presented the following recommendations:
Anthony Spiegelberg - Chairman

Harlan Rasmussen made a motion to approve the nominations, Dixie See seconded the motion and motion carried.

Anthony Spiegelberg thanked Harlan Rasmussen for his term as Board of Trustees Chairman and Mr. Spiegelberg proceeded as newly appointed chairman.

PUBLIC COMMENTS
There were no public comments.

MEDICAL STAFF REPORT
Capital Equipment Policy –Dr. Wohl presented a draft of a policy for medical staff capital acquisition approval. There was discussion as to whether this should be an administrative or medical staff policy. Since the purpose of the policy is to give guidance to the medical staff, it was agreed this should be a medical staff policy. A copy of the policy will be given to each Board member and will be submitted for approval at the August Board Meeting.

IT System – Dr. Wohl stated that the Medical Staff is very supportive on moving ahead with the hospital’s IT system and appreciates the work that has been accomplished.

Mammotome Purchase – Dr. Wohl noted that in the May Board meeting, a request was made by Dr. Corey Jost for the purchase of a Mammotome unit for breast biopsies. This was approved by the Board at that meeting, contingent upon approval by the Medical Executive Committee. At the July 20th Medical Executive Committee Meeting, it was recommended that sharing the current hospital Mammotome Unit be tried and re-evaluated at a later date.

Physician Executive – Dr. Wohl explained that there was also discussion and suggestion at the Medical Executive Committee to consider a physician executive position to provide some services that the Chief of Staff currently does, i.e. medical staff organization, Bylaws, etc. Dr. Wohl said he looks forward to working with the Board on this idea.

Dr. Wohl thanked the Board for allowing him to participate in the CEO selection process. Anthony Spiegelberg thanked Dr. Wohl and the Medical Staff for their participation.

ADMINISTRATION REPORT
Patient Satisfaction Awards – Ken Huey displayed Patient Satisfaction Awards from Avatar for years 2002, 2004, and 2005. Avatar compiles the hospital’s patient satisfaction surveys and Sheridan Memorial Hospital received these awards for exceeding patient expectations.

Personnel Changes – Ken Huey announced that Dave Westlake, Manager of Health Information & Records, has taken on the role as interim Quality Services Manager and Kirsi Ludwig has been selected as Pharmacy Manager. Len Gross, newly appointed HR Director, plans on joining the hospital on August 15^th and interviews have been conducted for the position of Facilities Manager, with a decision to be made soon.

OR Remodel – Ken Huey reported that OR room four is in operation as of Monday and work on room three will begin after it is confirmed that room four is working well.

Dixie See asked how long the work on room three should take and Mr. Huey said it should be approximately two months, with all work in the OR planned for completion in six months.

Health Fair – Ken Huey reported that the hospital is taking appointment calls for blood draws August 14^th through August 25^th. There have been 1,300 appointments made to date and the results will be available at the Health Fair on September 16^th.

Camp Huff & Puff – Ken Huey announced that Camp Huff & Puff, an asthma camp for children, will be held on August 7^th -13^th. The hospital initially funded this program, and the Respiratory Care Department staff continues to raise money to support this camp.

Smoke-Free Campus – Harlan Rasmussen asked if the hospital is looking at becoming a smoke free campus. Administration thinks this is an important issue and will be assessing the implications of such a move.

FINANCE COMMITTEE REPORT
Gary Miller reported that operationally the hospital had a pretty good financial month, noting that both May and June were good months financially. It was noted that July’s inpatient volume has been down. Alan Dow reported that the hospital showed a $2 million dollar gain over budget for the last fiscal year. Anthony Spiegelberg complimented administration and the staff, stating that this does not happen on its own.

Voucher Approval - Gary Miller reported that the vouchers were reviewed prior to the meeting and made a motion for their approval. Harlan Rasmussen seconded the motion and motion carried.

Capital Equipment Request – Alan Dow requested approval of a new stress testing machine at a cost of $24,624. Mr. Dow said this is a budgeted item and has already been ordered due to the failure of the hospital’s current unit. It was noted that this is a highly utilized machine and the medical staff supports this purchase. Dr. Strahan made a motion to approve the purchase of a new stress testing machine, Harlan Rasmussen seconded the motion and motion carried.

Fiscal Year Activity Report – Dr. Wohl asked about the prior fiscal year’s activity. Alan Dow reported that total patients days were below budget at 10,630, ED visits were 9,209, which was 300 under budget, surgery visits were under budget at 2,552 and total deliveries were 25 under budget at a total of 316.

FOUNDATION REPORT
Tom Ringley reported that a joint endeavor between the Foundation and hospital has been formed to improve educational opportunities for nursing staff. Both the Foundation and hospital will contribute $50,000 for nursing education. Mr. Ringley noted that this idea was presented to the Foundation by Dr. Tom Richards and this specialized training for nurses will ultimately benefit our patients. Some of the areas for training could be wound care nurse, ostomy nurse, psych nurse, etc. The hospital’s nurse managers will make the decisions on the programs and share this with the Foundation. This report will also be shared with the Board of Trustees.

Mr. Ringley reported that two more students were selected for the Foundation’s Nursing Scholarship Program, Kari Griffin of Dayton and Shannon Biesterfeld of Sheridan.

BUILDING COMMITTEE
It was reported that the punch list for the new Emergency Department is continuing and moving the CT into the Emergency Department should take place in approximately two weeks.

Work on expanding the Pharmacy to comply with USP797 regulatory requirements continues.

Dr. Strahan announced that construction on his new office space at the Medical Arts Complex has begun.

OTHER BUSINESS
CEO Contract - Anthony Spiegelberg reported that the hospital is working through contract discussions for Mike McCafferty as he will take on his duties as CEO on September 1^st. Ken Huey will continue on a consultative basis through Sept 30^th.

Appointments to Committees – Anthony Spiegelberg noted that he will be in contact with Board members as to what committees they would like to serve on in the coming year.

SHERIDAN MEMORIAL HOSPITAL
BOARD OF TRUSTEES SPECIAL MEETING
July 13, 2006 12 Noon

MEMBERS PRESENT: Harlan Rasmussen, Anthony Spiegelberg, Evelyn Ebzery, Gary Miller, Dixie See, Dr. Michael Strahan

The Board of Trustees held a special meeting for the purpose of hearing a report from the CEO Search Committee (Anthony Spiegelberg, Chair, Dixie See, Gary Miller & Dr. Barry Wohl).

Mr. Spiegelberg reported that the final three CEO candidates were interviewed by the full Board, the Administration Team as well as twelve members of the Medical Staff, noting that all were excellent candidates.

The Search Committee strongly recommended to the Board of Trustees that Mr. Mike McCafferty be appointed as Sheridan Memorial Hospital’s new CEO, upon the retirement of Ken Huey. It was also recommended that the Board move forward immediately in negotiating a contract with Mr. McCafferty. The Search Committee’s recommendation was unanimously approved by the Board of Trustees.

Recognition was given to Dr. Barry Wohl for his work on the Search Committee as well as to Phyllis Domm of Solutions M2 for her work in the CEO search process.

The Board adjourned at 12:15 to meet in executive session regarding a real estate matter.

MEMBERS PRESENT: Harlan Rasmussen, Chairman, Evelyn Ebzery, Michael Strahan, M.D., Gary Miller, and Anthony Spiegelberg, Dixie See

PRESENTATION:

Ø Wellness Council Presentation
Shannon Lassle, Wellness Council Coordinator, presented information about the Wellness Council. Shannon considers the relationship with the Hospital one of the strengths of the Wellness Council. Shannon presented a letter from a Sheridan County resident who praised our health fair. Next year the health fair will include a tour of the new Sheridan College nursing lab.

Shannon also discussed the Worksite Wellness program. There are currently 18 sites. Shannon presented a letter from the wife of a man who had a PSA at one of the worksite programs. The letter reported that the PSA was the first indicator they had that he had prostate cancer and expressed the wife’s appreciation. Shannon believes that the Worksite Wellness program has opportunity for growth.

The Safe Communities Program is funded through an annual $25,000 grant from WYDOT with a partial match from the hospital and the Wellness Council. The programs that are funded include:

1. Child Passenger Safety. In 2005 during the 4 annual inspections 276 safety seats were inspected and 73 care seats were given out. They added this year car seat inspections for special needs children. They have also partnered with Women’s Health at SMH. A brochure was developed and is now included in the newborn packets given out to all new mothers. They are also in physician offices. Buckle Up education is being done in elementary schools. They also do a Bike Rodeo and give helmets out to children that do not have one. The Buckle those you love program is also done.nt2. The Wellness Council has identified teen drivers and unsafe driving practices as a concern. The Wellness Council attempted to have Drivers Education back in the high school. It was discontinued in 1995. They were able to accomplish getting the classroom training included in the freshman year health class. Since the health class is mandatory, all freshmen will get this training. The Wellness Council has a goal of obtaining simulators for the high schools.

2. Driven is a peer-to-peer prevention class on drug and alcohol. This program has had limited success but will continue and will include the junior highs this year.

3. The Wellness Council is looking for a building to have a teen center. The Cook Ford building is being looked at currently.

The Wellness Council has sponsored a needs assessment. It shows that Sheridan has a problem with alcohol and drugs. The Sheridan County Prevention Program has brought in speakers on abstinence, meth, underage drinking, etc. There is a subtle resistance. The Wellness Council will continue to provide community education and increase awareness.

Everyone was invited to hear Clint Haskins at CTEL tonight speaking on the consequences of drinking and driving.

BOARD MEMBER RESIGNATION
Harlan Rasmussen reported that Larry Roos has resigned from the Board of Trustees and has submitted his resignation to the County Commissioners. Mr. Roos will be moving to Colorado. Mr. Roos was unable to attend tonight’s meeting due to a death in the family. Harlan acknowledged Mr. Roos intensity and dedication to what Mr. Roos felt was in the best interest of the hospital and wished Mr. Roos well. A formal letter of thanks will be sent to Mr. Roos from the Board with Mr. Rasmussen’s signature.

APPROVAL OF MINUTES – May 24, 2006
Dr. Strahan moved to approve the minutes of the May 24, 2006 board meeting as they were written. Anthony Spiegelberg seconded the motion. There being no discussion the minutes were approved unanimously.

PUBLIC COMMENTS
Mr. Dan Brumm addressed the Board asking why he has not received a copy of Ken Huey’s contract extension. Mr. Huey clarified that the contract is a public record. Since Mr. Huey will be on vacation until next Thursday, July 6^th, Mr. Brumm was instructed that he could pick up a copy of the contract on that date. Mr. Brumm also asked for a copy of the minutes for the last two meetings. Mr. Brumm was instructed that the minutes are on the website.

CEO SEARCH COMMITTEE REPORT
Anthony Spiegelberg reported that Phyllis Domm, from the contracted firm, met with the Search Committee and Medical Staff physician representatives to determine what qualification and attributes candidates should posses. The candidates have been narrowed down from 61 to 4 who will be interviewed via telephone this Thursday, June 29, 2006. On site interviews will occur the 2^nd or 3^rd week of July for candidates with whom the Search Committee decides to continue the process. The on site interviews will include physicians, administration, physicians, staff, etc.

MEDICAL STAFF REPORT
Dr. Patricia Tobi, Anesthesiologist, has submitted a privilege application. She has 10 years experience in anesthesiology, most recently at Campbell County Memorial Hospital. Dr. Barry Wohl, on behalf of the Department of Surgery and Medical Executive Committee, recommended Dr. Tobi to be granted Active Medical Staff privileges. Dr. Strahan moved to grant active medical staff privileges to Dr. Patricia Tobi. Dixie See seconded the motion. The board unanimously approved the motion.

Dr. Wohl reported that the Quarterly Staff meeting included a presentation by Dr. Jacqueline Adler on a resistant staff infection that our hospital and community needs to “gear up on”. The next Quarterly Medical Staff Meeting is September 12, 2006. Dr. Wohl invited the Board to attend.

ADMINISTRATION REPORT

Ø Ken Huey requested approval of a new Board of Trustee Policy, which delegates’ responsibility for effective operation of the grievance process to the Chief Executive Officer. This is not a new process, but documentation for CMS of what we currently do. Gary Miller made a motion that the new policy be approved. Anthony Spiegelberg seconded the motion. The Board unanimously approved the motion.

Ø The new Emergency Department opened at 0700 this morning (6-28-06). Everything went smoothly. Ken Huey expressed appreciation to Deb Anderson, Rob Forister, Facilities Staff and others for their part in the smooth transition.

Ø Ken Huey reported that the operating rooms renovation for room #4 is approximately $115,940.88. The estimated cost was $136,000. If the Board of Trustees approves additional renovation operating room #3 will be started in July. When we started the first room it was decided to move forward one room at a time since we did not know what was above the ceilings and there were many unknown potential costs. The last upgrade was in the 1980’s. We cannot longer

find parts for lights. There are also air handling issues and humidity issues that must be addressed. The ceiling must be opened in order to address the air handling and humidity problems. We have the perfect opportunity to take care of these issues as well as allow greater flexibility to optimize services to surgeons and specialties by renovating all four rooms.

Dee Gilson, OR Manager, discussed the technology changes that have occurred since our last remodel. Dee also reported that the new operating rooms are a recruitment tool that gives us a competitive edge.

Clarence Montano, Facilities Manager, reported that the next rooms would probably take about 2 months each since we have learned so much from the first room.

Mrs. Gilson reported that the initial idea of doing room 4 then room 1 is not the most logical way to progress due to infrastructure needs including conduit. The progression needs to be 4, 3, 2 and 1. It will be much easier for infection control purposes also.

Anthony Spiegelberg made a motion to move forward with the 3 additional OR rooms with a total budget of 1.3 million dollars. Evelyn Ebzery seconded the motion. Mr. Spiegelberg reminded everyone that the appropriation for the 1.3 million dollars was from last year and stated that the Finance Committee supports moving forward with all 4 rooms.

Harlan Rasmussen stated that in this competitive environment we need to offer the best we can afford for the people of our county. This is another reason we need revenue in excess of expenses. Mr. Rasmussen stated that he is firmly convinced this is the proper thing to do.The Board of Trustees unanimously approved the motion.

Ø Moving the CT Scanner close to the New Emergency Department due to heavy use for by the Emergency Department had been planned. The shell space was built with the ED project. It will cost about $80,000 to complete the space. The actual move of the CT scanner will be done at no additional cost.

Evelyn Ebzery made a motion to allocate $80,000 to complete the space for the CT scanner. Dixie See reported that the Building Committee recommends we go ahead with the project. Mrs. See seconded the motion.

John Miller, Radiology Manager, reported that there is a benefit to the patient to have the CT scanner closer to the trauma rooms, decreasing the time and increasing patient privacy. Mr. Miller also reported that with the CT scanner

closer to ED they expect to see increased usage. The communication between the Emergency Department physician and the radiologist will also be enhanced by the closer location.

Gary Miller asked what would go where the CT scanner is currently. There are no immediate plans but it may allow expansion of the radiology space. The Board of Trustees unanimously approved the motion.

Ø It was reported that Administration will be recommending a change from Avatar percent ranking to our raw score for our employee gain sharing plan. We believe this change will allow us to better track our improvement and patient satisfaction. Additional information will come to the board next month before implementing any change. Administration had also been asked to look at other patient care satisfaction vendors.

Evelyn Ebzery reminded everyone that Michael Anniston recommended we use Press Ganey. Ken Huey assured her that we would be looking at Press Ganey.

Ø Ken Huey reported that we have submitted an application and plan to have a float in the Rodeo parade with the theme centered on the new Emergency Department.

Ø Relay for Life was a success again this year for the hospital as well as the community.

Ø The Blood Bank has been at the hospital for the last 3 days. They come quarterly. This is another service to our community.

FINANCE COMMITTEE REPORT
Voucher Approval –

Anthony Spiegelberg made a motion to approve all vouchers. Evelyn Ebzery seconded the motion. It was approved unanimously.

May was a good month. Through the first 10 months of the fiscal year we were in the red ($160,000), but in May we made approximately a half million dollars. We had record revenues due to increased inpatient volumes, increased outpatient volumes, and an increased Emergency Department volume. We had a 39% write off vs. a 42% budgeted write-off. Bad debts have been running about 40% above budget all year but was only 20% in May. We are now $380,000 in the black. The year-end will probably be break even.

Gary Miller asked about bad debts and if this was peculiar to SMH. Alan Dow, Chief Financial Officer, explained that the same thing is being seen across the country. Mr. Dow had a graph that showed an upward trend in bad debts for all hospitals in WY.

Alan Dow explained the budget is based on expected flat volumes except the CT scanner in the Emergency Department, which is expected to have increased volume. A 7.4% average rate increase is expected. Write-offs and bad debt are expected to increase from 39 to 40.4%. Overall salary expenses are expected to remain flat even though staff will get raises. Cash flow will remain robust with 7.3 million dollars before debt service. We should have 1.5 million dollars to but back into reserves. It was reported that, based upon a five year projected analysis, we should see our cash reserves significantly strengthen in the future. back up to previous levels assuming a break-even budget within the next five years.

Anthony Spiegelberg reported that the Finance Committee supports this budget with the assumption that we will see a decrease in capital spending compared to the last several years. He commented the need to make sure cash reserves are built up to be able to cover planned and unexpected expenses, as previous boards have done.

Mr. Spiegelberg made a motion that the budget be approved as written. Gary Miller seconded the motion. It was approved unanimously. Mr. Dow was thanked for all his work in the budget preparation.

FOUNDATION REPORT
Tom Ringley reported that the donor recognition and public open houses for the Emergency Department were successful. Mr. Ringley thanked Evelyn Ebzery for her speech and thanked all the Board for attending.

The Foundation Annual Meeting was last week. Over 500 copies of the Foundation Annual Report were mailed to Foundation members. The Foundations fall retreat is being planned.

Kathryn Skatula raised more than $18,000 for the Diabetic Education Program. This is the most the Foundation has raised at their annual fundraiser.

Harlan Rasmussen commented that the Foundation has done an excellent job of tapping the generosity of our community in support of the hospital. On behalf of the Board, Mr. Rasmussen thanked Mr. Ringley for his support.

BUILDING COMMITTEE REPORT
It was reported that there are still a few things to be taken care of on the punch list at the Medical Arts Complex.

The Building Committee authorized a dollar amount for the old Emergency Department waiting room to be remodeled into 2 offices and for the replacement of handrails outside of the ED/ICU corridor. The Building Committee also recommended the CT be moved to the ED.

Mike McCafferty gave an update on USP797 and the plans to comply. Mr. McCafferty is working with TSP and Pharmacy staff to expand to the east of the current pharmacy. This will cost about $100,000 to meet all the regulatory requirements for sterile compounding vs. 1 million dollars to move to the basement.

Mr. McCafferty also discussed the master site planning. HLM, TSP, Leadership and the Board have been looking at the campus and facility to determine where we go in the next 1-3 years, 3-5 years, and 5-10 years to accommodate our future needs. We are looking at the most efficient use of space in Med/Surg North area. Mr. McCafferty and Dr. Strahan met with the pediatricians and obstetricians for input and suggestions. TSP will be back to finalize the concepts for Board approval.

OTHER BUSINESS

Ø Appointment of Nominating Committee
Harlan Rasmussen appointed Gary Miller and Dixie See. Mr. Rasmussen will call them between 0800-1000 am tomorrow 6-29-06. They will report to the Board their recommendations for new officers in July.

Anthony Spiegelberg invited the public to contact the County Commissioners regarding potential candidates for the Board of Trustees.

Ø Announcements
Ken Huey discussed the Quality Report. He noted that the Superior Performance Initiative from VHA compared us to other known hospitals that we can contact for information.

Utilization Management shows that our length of stay has decreased to an average of 3.24 days.

MEMBERS PRESENT: Harlan Rasmussen, Chairman, Evelyn Ebzery, Larry Roos, Michael Strahan, M.D., Gary Miller, and Anthony Spiegelberg

PRESENTATION:

APPROVAL OF MINUTES – April 26, 2006
The meeting minutes of April 26, 2006 were reviewed. It was moved by Dr. Strahan and seconded by Anthony Spiegelberg to accept the minutes and the motion passed. In addition, the minutes from the May 3, 2006 meeting were presented for consideration as public record. The meeting was held inadvertent without public notice. Mr. Spiegelberg moved and Evelyn

APPROVAL OF MINUTES – AUGUST 30, 2006
The previous meeting minutes of August 30, 2006 were reviewed. After review, Dr. Strahan made a motion to approve the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS
Mr. Dan Brumm addressed the Board, stating that he felt it was rude and unprofessional for some of the Board members to be sitting with their backs to the staff and public. Mr. Rasmussen asked that the Board members email their thoughts on this to chairman, Anthony Spiegelberg.

ADMINISTRATION REPORT
Strategic Planning - Mike McCafferty reported that he has met with Dr. Strahan and Dr. Wohl regarding strategic planning, and off site employee planning sessions are scheduled for September 29^th and October 2^nd.

FINANCE COMMITTEE REPORT
Voucher Approval - Gary Miller reported that the Finance Committee met today and after review, recommended approval of the vouchers. Mr. Miller made a motion to approve the vouchers for payment, Evelyn Ebzery seconded the motion and motion carried.

FOUNDATION REPORT
Tom Ringley reported on upcoming Foundation events:

QUALITY COMMITTEE REPORT
Dr Strahan reported that he attend his first Quality Council meeting on September 19^th, noting that the format may change with more of a clinical focus, ie core measures and patient satisfaction.

OTHER BUSINESS
Health Fair - Mike McCafferty reported that the Health Fair went extremely well and thanked all who participated.

APPROVAL OF MINUTES – JULY 26, 2006
The previous meeting minutes of July 26, 2006 were reviewed. After review, Dr Strahan made a motion to approved the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS
Dan Brumm addressed the Board. He asked for a completed copy of Ken Huey’s contract with the hospital as well as all other management contracts. Mr. Rasmussen noted that this information is available, but per hospital policy, there is a fee for the copying of documents.

MEDICAL STAFF REPORT
Dr Wohl presented one medical staff application for approval by the Board.

BUILDING COMMITTEE REPORT
ED - It was reported that the punch list for the Emergency Department is nearly complete.

COMMITTEE ASSIGNMENTS
Anthony Spiegelberg reviewed the new list of Board committee assignments for 2006.

OTHER BUSINESS
Radiology Manager Retires - Ken Huey noted that John Miller, Radiology Manger, plans to retire September 1^st and thanked John for his many contributions to the hospital.

NOMINATING COMMITTEE REPORT
Harlan Rasmussen asked that the Nominating Committee Report be moved to the second item on the agenda.

PUBLIC COMMENTS
There were no public comments.

ADMINISTRATION REPORT
Patient Satisfaction Awards – Ken Huey displayed Patient Satisfaction Awards from Avatar for years 2002, 2004, and 2005. Avatar compiles the hospital’s patient satisfaction surveys and Sheridan Memorial Hospital received these awards for exceeding patient expectations.

BUILDING COMMITTEE
It was reported that the punch list for the new Emergency Department is continuing and moving the CT into the Emergency Department should take place in approximately two weeks.

OTHER BUSINESS
CEO Contract - Anthony Spiegelberg reported that the hospital is working through contract discussions for Mike McCafferty as he will take on his duties as CEO on September 1^st. Ken Huey will continue on a consultative basis through Sept 30^th.

PRESENTATION:

ADMINISTRATION REPORT

FINANCE COMMITTEE REPORT
Voucher Approval –

FOUNDATION REPORT
Tom Ringley reported that the donor recognition and public open houses for the Emergency Department were successful. Mr. Ringley thanked Evelyn Ebzery for her speech and thanked all the Board for attending.

BUILDING COMMITTEE REPORT
It was reported that there are still a few things to be taken care of on the punch list at the Medical Arts Complex.

OTHER BUSINESS

PRESENTATION:

APPROVAL OF MINUTES – AUGUST 30, 2006 The previous meeting minutes of August 30, 2006 were reviewed. After review, Dr. Strahan made a motion to approve the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS Mr. Dan Brumm addressed the Board, stating that he felt it was rude and unprofessional for some of the Board members to be sitting with their backs to the staff and public. Mr. Rasmussen asked that the Board members email their thoughts on this to chairman, Anthony Spiegelberg.

ADMINISTRATION REPORT Strategic Planning - Mike McCafferty reported that he has met with Dr. Strahan and Dr. Wohl regarding strategic planning, and off site employee planning sessions are scheduled for September 29th and October 2nd.

FINANCE COMMITTEE REPORT Voucher Approval - Gary Miller reported that the Finance Committee met today and after review, recommended approval of the vouchers. Mr. Miller made a motion to approve the vouchers for payment, Evelyn Ebzery seconded the motion and motion carried.

FOUNDATION REPORT Tom Ringley reported on upcoming Foundation events:

QUALITY COMMITTEE REPORT Dr Strahan reported that he attend his first Quality Council meeting on September 19th, noting that the format may change with more of a clinical focus, ie core measures and patient satisfaction.

OTHER BUSINESS Health Fair - Mike McCafferty reported that the Health Fair went extremely well and thanked all who participated.

APPROVAL OF MINUTES – JULY 26, 2006 The previous meeting minutes of July 26, 2006 were reviewed. After review, Dr Strahan made a motion to approved the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS Dan Brumm addressed the Board. He asked for a completed copy of Ken Huey’s contract with the hospital as well as all other management contracts. Mr. Rasmussen noted that this information is available, but per hospital policy, there is a fee for the copying of documents.

MEDICAL STAFF REPORT Dr Wohl presented one medical staff application for approval by the Board.

BUILDING COMMITTEE REPORT ED - It was reported that the punch list for the Emergency Department is nearly complete.

COMMITTEE ASSIGNMENTS Anthony Spiegelberg reviewed the new list of Board committee assignments for 2006.

OTHER BUSINESS Radiology Manager Retires - Ken Huey noted that John Miller, Radiology Manger, plans to retire September 1st and thanked John for his many contributions to the hospital.

NOMINATING COMMITTEE REPORT Harlan Rasmussen asked that the Nominating Committee Report be moved to the second item on the agenda.

PUBLIC COMMENTS There were no public comments.

ADMINISTRATION REPORT Patient Satisfaction Awards – Ken Huey displayed Patient Satisfaction Awards from Avatar for years 2002, 2004, and 2005. Avatar compiles the hospital’s patient satisfaction surveys and Sheridan Memorial Hospital received these awards for exceeding patient expectations.

BUILDING COMMITTEE It was reported that the punch list for the new Emergency Department is continuing and moving the CT into the Emergency Department should take place in approximately two weeks.

OTHER BUSINESS CEO Contract - Anthony Spiegelberg reported that the hospital is working through contract discussions for Mike McCafferty as he will take on his duties as CEO on September 1st. Ken Huey will continue on a consultative basis through Sept 30th.

PRESENTATION:

ADMINISTRATION REPORT

FINANCE COMMITTEE REPORT Voucher Approval –

FOUNDATION REPORT Tom Ringley reported that the donor recognition and public open houses for the Emergency Department were successful. Mr. Ringley thanked Evelyn Ebzery for her speech and thanked all the Board for attending.

BUILDING COMMITTEE REPORT It was reported that there are still a few things to be taken care of on the punch list at the Medical Arts Complex.

OTHER BUSINESS

PRESENTATION:

APPROVAL OF MINUTES – AUGUST 30, 2006
The previous meeting minutes of August 30, 2006 were reviewed. After review, Dr. Strahan made a motion to approve the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS
Mr. Dan Brumm addressed the Board, stating that he felt it was rude and unprofessional for some of the Board members to be sitting with their backs to the staff and public. Mr. Rasmussen asked that the Board members email their thoughts on this to chairman, Anthony Spiegelberg.

ADMINISTRATION REPORT
Strategic Planning - Mike McCafferty reported that he has met with Dr. Strahan and Dr. Wohl regarding strategic planning, and off site employee planning sessions are scheduled for September 29^th and October 2^nd.

FINANCE COMMITTEE REPORT
Voucher Approval - Gary Miller reported that the Finance Committee met today and after review, recommended approval of the vouchers. Mr. Miller made a motion to approve the vouchers for payment, Evelyn Ebzery seconded the motion and motion carried.

FOUNDATION REPORT
Tom Ringley reported on upcoming Foundation events:

QUALITY COMMITTEE REPORT
Dr Strahan reported that he attend his first Quality Council meeting on September 19^th, noting that the format may change with more of a clinical focus, ie core measures and patient satisfaction.

OTHER BUSINESS
Health Fair - Mike McCafferty reported that the Health Fair went extremely well and thanked all who participated.

APPROVAL OF MINUTES – JULY 26, 2006
The previous meeting minutes of July 26, 2006 were reviewed. After review, Dr Strahan made a motion to approved the minutes, Dixie See seconded the motion and motion carried.

PUBLIC COMMENTS
Dan Brumm addressed the Board. He asked for a completed copy of Ken Huey’s contract with the hospital as well as all other management contracts. Mr. Rasmussen noted that this information is available, but per hospital policy, there is a fee for the copying of documents.

MEDICAL STAFF REPORT
Dr Wohl presented one medical staff application for approval by the Board.

BUILDING COMMITTEE REPORT
ED - It was reported that the punch list for the Emergency Department is nearly complete.

COMMITTEE ASSIGNMENTS
Anthony Spiegelberg reviewed the new list of Board committee assignments for 2006.

OTHER BUSINESS
Radiology Manager Retires - Ken Huey noted that John Miller, Radiology Manger, plans to retire September 1^st and thanked John for his many contributions to the hospital.

NOMINATING COMMITTEE REPORT
Harlan Rasmussen asked that the Nominating Committee Report be moved to the second item on the agenda.

PUBLIC COMMENTS
There were no public comments.

ADMINISTRATION REPORT
Patient Satisfaction Awards – Ken Huey displayed Patient Satisfaction Awards from Avatar for years 2002, 2004, and 2005. Avatar compiles the hospital’s patient satisfaction surveys and Sheridan Memorial Hospital received these awards for exceeding patient expectations.

BUILDING COMMITTEE
It was reported that the punch list for the new Emergency Department is continuing and moving the CT into the Emergency Department should take place in approximately two weeks.

OTHER BUSINESS
CEO Contract - Anthony Spiegelberg reported that the hospital is working through contract discussions for Mike McCafferty as he will take on his duties as CEO on September 1^st. Ken Huey will continue on a consultative basis through Sept 30^th.

FINANCE COMMITTEE REPORT
Voucher Approval –

FOUNDATION REPORT
Tom Ringley reported that the donor recognition and public open houses for the Emergency Department were successful. Mr. Ringley thanked Evelyn Ebzery for her speech and thanked all the Board for attending.

BUILDING COMMITTEE REPORT
It was reported that there are still a few things to be taken care of on the punch list at the Medical Arts Complex.