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GRMC Board presents new CNO, discusses budget and reports on personnel changes

The Gila Regional Medical Center Board of Trustees met at noon today, Friday, Aug. 30. After the board members and Chief Executive Officer Brian Cunningham recognized Michelle Carrillo for 20 years service to the hospital and Pam Bingham for 15 years, several people spoke during public input.

Cissy McAndrew, Southwest New Mexico Green Chamber of Commerce executive director and once a GRMC development coordinator under CEO John Rossfeld, reported that new CEO Brian Cunningham attended the Green Chamber's Green Drinks event and gave an overview of what has happened and is happening at the hospital. "I personally don't think you could have formed a team any better than this one. Brian took 1½ hours to talk about the hospital and answer questions.  The community has trust back in GRMC. Thank you for looking locally. The Green Chamber is behind you 100 percent."


Dr. Felipe Ortego, Western New Mexico University scholar-in-residence, expressed his "approval of the direction this board is taking."

Pam Archibald, GRMC Board of Trustees' member, said a co-worker who recently went to the emergency room asked her to relay kudos to Jimmy McCraw and Robert Scott for their excellent care.

Mario Quintana, Senior Olympics director, expressed his gratitude to GRMC for its support of the Senior Olympics, as well as support for the banquet. "We had a successful year and a successful banquet."

Tami Bates, GRMC caregiver, thanked Board Chairman Charles Kelly and the Board of Trustees for the direction everything is going. "The caregivers feels like trust is restored and morale is much better."

Ashleigh Garcia of the GRMC Foundation said she appreciated Kelly for attending the foundation meeting and "we thank the board and support your having placed Cunningham as the CEO. The foundation gives it commitment and support to the Board of Trustees."

Before the business meeting, Cunningham apologized ahead of time for his coming and going during the meeting, because there was a situation in the emergency room with a lockdown over an event in the community.  "The new chief nursing officer is in the ER, managing the situation. I may have to get up and run."

Liz Beilue, GRMC Auxiliary president, said Cunningham had met with the Auxiliary members. "We're behind the new leadership and board."

Garcia said in additional comments to her written foundation report that the members have "excitement and unanimous support for the board."

Cunningham presented the CEO report. "Last month under the direction of the board, we replaced the chief-level officers, with a focus on local talent." He introduced Chief Financial Officer Beth Allred and Chief of Clinical Services Ray Goellner. "We are not replacing the positions they held before, saving full-time positions and dollars."

"The chief information officer was downgraded to director of information technology," Cunningham continued. "We feel it better fits the size of this facility. Ken Stone has accepted the position. He has been at GRMC for seven years.

"We split the chief nursing officer/chief operations officer position, because it is difficult to find someone who can effectively do both positions," Cunningham said. "Pat Sheyka was just this morning named CNO, and Dan Otero will take over as COO on Sept. 3. We had many local interviews for the CNO position with five internal candidates. The final two had three sets of interviews. Sheyka knows exactly what's going on in the hospital and is currently coordinating emergency efforts in the ER.

"The assistant vice president of operations will be Jed Rudd," the CEO said. "We will not fill his former position as director of operations. Overall, we are saving $575,000 in salaries and benefits."

Kelly asked Cunningham if committees had been used in the interviews.

"We have a robust, structured interview process, with a section on confidence in the candidate and the candidate's suitability for the position," Cunningham said. "We also have other processes for the application process. Beth (Allred) and Jed (Rudd) were the only candidates for their positions, but we still did an open interview, although we didn't score and rank them. We always use a transparent approach."

Board of Trustees Member Robert Morales Sr. said he was very adamant that the board hire from within the hospital. "I am happy to hear you found them, because I knew they were here. Congratulations to every one of you. I know you won't let the board, the hospital or the community down."

Cunningham also gave an update on the 67 caregivers who had been cut to 50 percent. "Since then we have had discussions to address the needs. Based on the needs of the departments, 34 were brought back to full-time, 17 to part-time, with three reductions in force, three remaining at status, and one retired and several resigned."

Archibald requested a new organizational chart. Cunningham said one would be produced. "We were waiting to name the CNO and the COO coming on board."

"I have been a nurse for more than a couple of years," Sheyka said. "I have a masters degree in health administration, and have been married for 49 years to a man raised in Albuquerque, so we have some New Mexico blood. I am so excited to be here and part of the team. I have respect for Brian or I wouldn't have applied for or accepted the job."

Cunningham said he would be verifying the implementation of cost savings and would be deepening the savings through efficiency and cuts in waste.

Sheyka said morale in the hospital was improving. "The new era is sitting well with people. I think things are much better."

Stone asked if anyone had questions, but no one did. He will prepare the IT report for the next meeting.

Goellner said the financial numbers in his report were for the entire year. "The largest decrease was in pharmaceuticals, because of a decrease in cancer volume. We are developing numbers based on the previous year and predicted volumes for this year, but it's hard to do, although cancer numbers are trending upward."

Allred said, within a few months, it might be necessary to adjust the budget. "Right now we have more questions than answers."

Howie Morales gave a Planetree update. "We have reached 95 percent, but right now we are at a standstill. I thank Mario. His component is about seniors. Last year, we almost lost the Senior Olympics program, but with the help of the Healthy Communities Committee, we grew this year to 160 participants. It is a low-cost benefit to see the betterment of the health of seniors."

Dr. Victor Nwachuku, chief medical officer, said it was important to soon have a talk with the Board of Trustees and the physicians about health care changes and the Affordable Care Act. He presented a rules and regulations change to 17.6-3 to re-emphasize that assistants be used in surgical procedures, "because every surgery has the risk of complication." Board members approved the change.

During her CFO report, Allred, said gross revenues were $32,000 less than the budget, "which is fairly close for predictions. Revenue dedications are up; the amount of indigent claims is down. The net effect is that we are $260,000 better than anticipated, but we still have a loss of about $80,000. Salaries are under budget, at 32 full-times fewer. Cash went down $277,000, but costs also went down. We have 108.8 to 109 days of cash and would like to raise that number. (County Manager) Jon (Paul Saari) and I will determine the final bond payment, and how much the county owes and how much we owe."

"We will be tweaking the reports and trying to match our metrics with those of the nation, removing those that are not pertinent," Allred continued. "We have no debt. Next week we will set up a revenue project team to find efficiencies to bring our days of cash up to a more normal level. We are still looking for coders. We are trying to hire two. One, who has been offsite, will start here on Monday. We are going into a huge coding project, and yes, we are behind, trying to get coders in house to catch up. We had some issues with contracted coders.

"We still have not received final state approval of our final budget, but the state approved the preliminary one, so we anticipate no problems," she continued. "In three or four months, we might need to redo and resubmit the budget. If the changes are minor, we won't have to do it."

She discussed the sole community provider program. "We got a chart of what the counties owe the state. There is still nothing concrete for January. A lot of committees are working on it, but no firm decisions have been made."

"We met with the auditors, who were more than happy with the inventory and found no issues there," Allred said. "A minor issue was found with a $16,000 discrepancy between the 1985 Excel spreadsheet we were running and the new system. We will recheck that. The auditors did an in-depth analysis of accruals and found no issues. There is an internal control issue with some approvals by directors not being completed. We will hold them accountable."

The Finance Committee is making its annual comparisons between last year and this, and according to Archibald, will be working on how to address behavioral health, home health and hospice, and rehabilitation services, including physical therapy, occupational therapy, speech and wellness. The committee also recommended approval of an on-call agreement with Dr. Fred Wendler, who will return as a surgeon next week. It was approved.

Allred said a plan has been created to determine how to bring back to profitability those programs that are losing money.

Board Member Jeremiah Garcia said it was critical to find every dime.

Kelly gave the Plant and Facility Committee report and said the new linear accelerator was on track to be installed and ready to begin service about October. "It's a major installation project."

Garcia said the critical part would be care for those who need it in the interim.

Cunningham said the doctor in charge has that as her main concern, and would make sure that patients are cared for properly elsewhere in the meantime.

The board went into a two-and-a-half hour executive session, which was reported by Dr. Darrick Nelson, board member, to have concerned only credentialing for caregivers.

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