At left, the GRMC Board of Trustees recognized Margarita Villegas for 20 years of service to the hospital. Villegas is between Board Charman Charles Kelly, left, and Chief Executive Officer Brian Cunningham on the right.

Below, The board also recognized Chris McIntosh for her planning of the annual Light Up a Life event held each December. She is in the middle, between Kelly on the left and Cunningham on the right. (Photos Courtesy of Joe Kellerman of GRMC Marketing)

The Gila Regional Medical Center Board of Trustees met in its monthly session, Friday, Jan. 24.

Board members recognized Margarita Villegas for her 20 years of service to the hospital and Chris McIntosh for her organization of the annual Light Up a Life ceremony, which honors deceased family members of the community.

The board approved the Open Meetings Act Resolution.

Liz Beilue, GRMC Auxiliary president, said: "Once a year, within our budget, we offer to fix up department equipment. Twice a year, we give our scholarships, and every month, we provide meals for those being treated in the cancer center and receiving infusion."

Holley Hudgins, GRMC marketing director, said the Foundation report was in the packet. No questions were asked.

In the chief executive officer's report, CEO Brian Cunningham said the hospital has two general surgeons on staff and is looking for another one.

Chief Nursing Officer Pat Sheyka said her report was in the packet and would be glad to answer questions, but none were forthcoming.

Dan Otero, chief operations officer, also said his report was in the packet.

Board member Jeremiah Garcia asked for an update on the linear accelerator process.

Otero reported the Department of Health had signed off on the drawings for the project. "We anticipate that on Feb. 28, we will stop seeing patients using the old machine. And we estimate the first week in June being the beginning for the new machine."

Chief of Clinical Services Ray Zoellner also said his report was in the packet and received no questions.

Elizabeth Allred, chief financial officer, apologized for making a mistake in the graph and a corrected graph handout was at each member's place.

Board member Pam Archibald asked about what is happening in Santa Fe on the funding issue.

Allred explained that each county has a 1/4 percent of gross receipts tax set aside for funding the indigent funds in the counties. The state wants half of that—a 1/8 percent.

"At a hearing with the Legislative Finance Committee, counties are supporting a 1/16 for the state, with the state picking up the other 1/16 GRT," Allred said. "The proposal would sunset in one year. Sen. Rodriguez will sponsor the bill."

She said there is resistance from the counties to give up the whole 1/8, because other things are funded with that money, such as inmate health care.

"Counties have agreed to put in 1/16," Allred said. "I saw support from senators for the state to do 1/16."

On the other hand, she said, the State Hospital Association is entrenched and wants the counties to give the 1/8. "They are getting push back, too."

"Last week, I thought we were on the right track, but there is disappointment this week," Allred said. "It's too important for the state not to lose the $200 million federal matching dollars if the counties don't give some funding."

Allred explained to the Beat that the federal funding is match money for the counties' money. But the state wants the money without any assurance that the counties will receive any money back to pay indigent and sole community provider funding to the hospitals.

Board member Robert Morales, Sr., suggested the names of several senators that Allred should contact to get their support for the bill splitting the gross receipts tax.

"We have eyes on the ground," Allred said, about those from the county and hospital, who are attending the session. "We are the third largest loser. We estimate we will lose $13 million. The restrictions put on the funding by the state are by law in opposition to the Centers for Medicare and Medicaid."

She said she also attended House of Representative discussions on the issue. "Their feelings are similar that the counties need to keep some of their money. At the end of one year, it is hoped the counties will have transitioned to cover the amount they stand to lose. We're staying on top of it. Mrs. (Susie) Trujillo (GRMC development) is there staying on top of the issue, but we'll be going back next week and as needed."

The chief of staff, Dr. Victor Nwachuku asked that the board approve the ongoing professional practice evaluation, known as OPPE.

Board member Dr. Donald Stinar suggested the language be changed so as not to seem punitive, but to encourage the physician to learn and grow. "Yes, there should be language if someone deviates from the norm."

Nwachuku said it is pointed out at the time of infraction if someone deviates from the norm and "we suggest they take a course or training to improve."

Stinar said some hospitals are "friendly, although if you mess up, you know, but most hospitals aren't that friendly."

Nwachuku said if it's a major deviation, the physician is notified and can write a letter to explain. "It is looked at closely.  But we want to put more focus on education. That's my push—to be educational and not punitive. Any major complication is looked at immediately."

The OPPE was approved.

Although credentialing policy and procedures was on the agenda to be approved, it had been determined by staff that it did not need to be approved by the board.

The Executive Committee had met and approved agendas for upcoming meetings, including this one.

The Quality Improvement Committee, according to Garcia, is finding ways to improve the hospital and document them.

Otero said the teams are working to get GRMC's quality scores up.

"I feel we are working in the right direction," Garcia said. "I'm very pleased.

Board members approved a contract with Craig Leicht, M.D. for pain management.

A PET/CT space use agreement was approved between GRMC and New Mexico Oncology Health Consultants.

A second amendment to the agreement with NMOHC was approved to terminate the lease on the present linear accelerator, as of March 1.

A first amendment to on-call agreements with Brian Robinson, M.D. and Roberto Carreón, M.D. were approved for when the orthopedic surgeons take on more than their 10 required shifts.

William Neely, M.D., as the emergency room representative, was approved as a committee member of the OPPE.

A Credentials Committee member agreement was approved with Ronald Dalton, M.D., as the hospitalist representative.

Otero said the hospital was continuing to decrease the number of days between service, coding and billing. "We are down to 18 days from 41," he said. "We had to let a couple of the contract coders go, but we are still gaining."

Charles Kelly, board chairman, said: "I like to see it going in that direction."

Otero said it is hard to get coders because it takes a year to a year and a half for one to get comfortable with the process after he or she is certified. "My recommendation is to keep a couple of the contract coders."

Cunningham said within one to two months, the number of days should be halved and halved again.

Garcia asked if the claim denials were being worked on, too.

Otero confirmed that they were, and said the hospital is in the implementation phase of new software that should speed up the process.

Kelly gave the Plant and Facilities Committee report. He said most of their discussion was on the new linear accelerator.

Otero said facility upkeep would be put in the five-year plan.

To a question about cost of the linear accelerator, Cunningham said GRMC would save $60,000 a year on the lease.

"A lot of exciting things are going on in the Human Resources Committee," Morales said. "We are working on the progression/succession plan."

Cunningham said the group is ramping up the succession plan, because within the next five years, the hospital expects half of its leaders to retire.

"We are also working on a survey developed internally to give to caregivers, so we get actionable results," Cunningham continued. "We will do a pilot of the survey in April and expect to roll it out to everyone by the end of the year.

Morales said the succession plan is "most essential for the chief-level positions. This committee is one of the vital parts of the hospital. We are looking at trends and caregivers."

The board went into executive session after a break. It was expected that credentialing of personnel would be the main topic.