By Mary Alice Murphy
At the Friday, July 25, Gila Regional Medical Center Board of Trustees meeting, Chairman Charles Kelly began the meeting by naming newly appointed officers.
"Pam Archibald, who has served for several years as secretary/treasurer, will become vice chairman," Kelly said. "Jeremiah Garcia has accepted the appointment to be secretary/treasurer. These appointments are for the rest of the year."
Kelly then introduced the newly appointed board members—Joe Ramirez and Dr. John Stanley.
Ramirez said he has been in the community since 1981, is graduate of New Mexico State University, and is the owner of Mi Ranchito Foods in Bayard.
Dr. Stanley said he has lived in the area for 22 years. He was a private family practitioner, but is now practicing at Hidalgo Medical Services. "This is my second time around on the board."
The next agenda items were two resolutions, which were proclamations honoring the service of the two retiring board members, Robert Morales Sr., and Dr. Darrick Nelson.
"When I was first appointed, I thought the job would be a cakewalk," Morales said. "This job humbled me. I learned the seriousness and the hard work you put into the hospital. We are surviving the hardest time for hospitals. I feel like the hospital will continue to thrive with the leadership and this team. I am humbled and honored to have been part of your team."
Nelson said he, too, has been humbled to have been able to serve as a representative of Gila Regional. "This is the best rural hospital I've ever been in. The kind of leadership of the volunteer board and the time they put in it is because they care. The hospital is the anchor for the community. I know these seats are in good hands. I know Dr. Stanley very well, and although I don't know this gentleman, I really like the chips," he said as he shook Ramirez's hand.
Four members of Emergency Medical Services were recognized for their 25 years of service to Gila Regional. They were Jo Dee Birch, William Birch, Ray Muniz, and James Marshall. Marshall was the only one of the four present.
"This hospital has supported me and my family, from the time I was a work clerk to EMS to development to now that I am EMS director," Marshall said. "The experience here set me up to be mayor. I don't think you can have that kind of experience in many rural areas."
Others recognized for their service were Lynna Rowell, 25 years in the recovery room; Suzy Head, 20 years in the recovery room and Steve Garcia, 35 years in cardiopulmonary.
Public input brought several speakers. The first speaker was Yvette Chavez, who said she and the woman beside her, Barbara Gomez, were from Horizon Home Health. "We came to reassure you. We haven't refused anyone who needs home health services. There is no lapse in care. Horizon Home Health has been open for seven years. We will continue to provide services to the community."
Matt Ormand, a long-time resident of Grant County, said his question is a follow up to a letter he sent to the board. "Why would you consider changing your emergency air care? Native Air is part of the largest and best in the U.S.—Air Ambulance International. There is no cost, as far as I know, that directly affects the hospital's bottom line. If it doesn't affect the bottom line, I believe that the proposal to use TriState CareFlight is a move in the wrong direction. It will lower the standard of care. It is a smaller company. We now have the best at no cost to the hospital, why would you take something less?"
He asked that the decision at least be put on hold until the National Transportation Safety Board completes its investigation into a July 17 TriState medical helicopter crash that killed all aboard.
"Many other factors went into my question," Ormand said. "I've been continuously involved in aviation for the past 42 years. I'm a pilot and a mechanic. Other factors went into my comments."
Joe Kellerman, GRMC marketing department and foundation, said he wanted to address the home health changes. "As one who experienced the first storm of cutbacks last year, this one has been handled much better. The decision was based on evidence. As a caregiver, I think it was handled the best it could be and was after a great deal of study. I think the decision had to be done."
The auxiliary and the foundation had no one to present them. Holley Hudgins, GRMC marketing director, said both reports were in the board packets, and she would accept questions. None was asked.
Brian Cunningham, GRMC chief executive officer, highlighted in his report that the hospital continues in recruiting a general surgeon. "We have talked to two and we have gone back and are talking again to our top pick, Dr. David Friedman, who has been a locum surgeon here for the past six months. He has been received well, and we are discussing having him as a hospital employee."
Chief Nursing Officer Pat Sheyka was not in attendance, her report was in the packet and no questions were asked.
Chief Operations Officer Dan Otero highlighted the decision of the new emergency services provider at the hospital. It will be an emergency medicine physicians group, Innova, out of Colorado. "We are working on a contract."
Archibald asked if there would be a transition period.
"We are already working on the transition, and the physicians will introduce themselves next month," Otero said.
Garcia said he hoped the group would continue to provide quality.
Stanley said he was on the committee to choose the new group. "Questions about coverage and quality were asked sternly."
Chief of Clinical Services Ray Goellner received no questions on his report.
Chief Financial Officer Omaira Heakin highlighted the ending numbers of the fiscal year 2014, which ended June 30.
"We were able to show a big improvement," Heakin said. "At the end of fiscal year 2013, we had a loss of $9 million; at the end of fiscal year 2014, the loss was down more than $6 million to $2.4 million. Salaries and benefits decreased and revenue was more or less flat from last year. The numbers improved because of a decrease of unbilled charges. At the end of fiscal year 2013, unbilled charged were $13.2 million. As of the end of the fiscal year 2014, they were $5.9 million and as of today, $5.1 million."
She said the daily spend in the hospital had dropped from $191,300 to today's $174,700. According to Comptroller Beth Allred, the numbers are not yet audited. "We are required to have an independent audit every year." She also told the Beat that the unbilled charges should be in the $4 million to $6 million dollar range, because people are being served in the hospital and coding and billing takes time.
Heakin also said the days of cash have increased from 109 at the end of fiscal year 2013 to 128 at the end of fy 2014.
"We plan to focus on labor management; revenue cycles, especially denials; and fixed assets," Heakin said.
Chief of Staff Dr. Victor Nwachuku was not present, as he was involved in treating an emergency.
Kelly gave the Executive Committee report, which he said was to create agendas for the committees for the month.
Garcia gave the Quality Improvement Committee report, and said committee members had discussions on the measurement report, which showed strong measurements. "Throughout the hospital we have numerous committees studying numerous issues. We are moving in the right direction."
Archibald recommended an amendment to the hospitalists' service for the Cancer Center, so the hospital can cover the center for infusion services if there is a problem.
The committee recommended not approving two on-call specialty service coverage agreements for pediatrics, with Laura Davenport-Reed M.D. and Brian Ethridge, M.D. Several other on-call agreements were not slated for this month.
An on-call specialty coverage agreement was approved for Donald Stinar M.D. for one month. Barbara Youngs, medical staff services director, explained to the Beat that the monetary reimbursement was for one month, until the contract can be brought. The others in the list had not been presented.
Kelly said the Plant and Facility Committee had an "unexciting meeting. Maintenance is keeping up with small projects, and the linear accelerator is working well and treating patients."
Garcia of the Human Resource Committee said the members noticed that a lot of dollars are going into contract labor, especially with the additional coders. GRMC leadership in the past has told the Beat that the hospital tries to use contract labor only when absolutely necessary.
The board members went into executive session.