By Mary Alice Murphy

At the Gila Regional Medical Center Board of Trustees held Friday, July 24, 2015, the interim chief financial officer, Michael Rolph, presented the financial report later in the meeting.

Board Chairman Charles Kelly introduced the most recently appointed board member, Tony Trujillo, who was attending his first board meeting.

"I look forward to working with all of you," Trujillo said. "I recognize the importance of Gila Regional to the community."

Two employees were recognized for their years of service at the hospital. Marisol Torres was present to receive recognition for her 15 years of service with EMS. Shelana Wilder was honored for 20 years in infection control.

Kelly said: "We have a famous person here." Kelly acknowledged Dr. Gregory Koury as having recently been chosen as president of the New Mexico Chapter of the American Academy of Family Physicians. "We're proud of you," Kelly said.

Frances Day, the newly elected GRMC Auxiliary president, asked board members to give her input on what they wanted to see in her report.

In the chief executive officer report, CEO Brian Cunningham, said he had a couple of updates. He recognized Trujillo and welcomed Board Member Jeremiah Garcia on his reappointment to the board. "I want to again thank Pam Archibald for her excellent service to the board."

"Per administration request, the hospital has formed a Health Care Environment Committee," Cunningham said. "The main topics are physician recruiting and creating a clinically integrated network."

He also recognized Peggy White as the replacement for the retiring Chief Nursing Officer Pat Sheyka. "This is Peggy's first board meeting as they go through the transition. Pat is retiring from 53 years of nursing. We welcome Peggy, who has already provided a significant contribution to Gila Regional."

"I also want to make general comments as we get close to two years of this administration," Cunningham said. "How honored we are to serve this hospital and this board. In our first year, we did a $10 million turnaround and focused on local and internal leadership. Year two was an investment year, a big building year, especially in IT upgrades and the physician practice group. Entering fiscal year 2016, the challenges haven’t slowed. We will be talking about population health and clinically integrated networks—a collaborative, physician-led hospital model to create sustainability for the physicians and the hospital."

Garcia asked Cunningham to talk about Medicaid.

"The Medicaid expansion brought in new numbers of insured people," Cunningham said. "It's better for the hospital to have insured patients. For the first two years, Medicaid is heavily subsidized by the federal government. The funding will dwindle, so there is a lot of focus on efficiencies, which did not materialize in the first year. We are not surprised that Medicaid expansion would cost more."

Sheyka in her report said the hospital hired new graduating nurses from Western New Mexico University. "The board pass rate is high."

White said she was humbled and honored to be named and to serve as chief nursing officers. "I truly appreciate the opportunity."

Chief Administrative Officer Dan Otero pointed out that "an overwhelming lot of work is going on. I would like to express my gratitude to the physicians and caregivers for collaborating, which increases access for our patients."

Chief Operations Officer Jed Rudd said the hospital is putting significant resources into the IT upgrade, which "will further strap the organization as we validate and implement. We will give a targeted approach on the key coding system."

Garcia asked if February 1 was a firm date for the rollout.

"We are trying to help make Meditech understand," Rudd said. "We think we have an aggressive goal, but Meditech wants us to be more aggressive. We're trying to let them know that more aggressive might be reckless. I am continuing to speak with their highest executive. We have to do it right for us. We see the urgency, but we want it done right to benefit the hospital."

He said Meditech would be the primary communication system for patient care and the administration. "Our goal is to bridge the gap between two systems. It will create the potential for increased communication from the hospital to the physicians to make patient care seamless."

Rudd noted that Meditech is the right choice for Gila Regional, as the company serves in 70 percent of rural hospitals. "It will be two years of active implementation when it is complete."

Rolph gave highlights of the hospital's financial situation. "We had a positive $175,000 bottom line at the end of June. We thought our loss for the year might be as much as $3 million, but we got it down to $1.38 million, which is a significant improvement. We made money in May and June."

He said the operating loss for the year was 2 percent, better than last year's 2.3 percent and 2013's 12.5 percent.

"We plan to be in the black by the end of the next fiscal year," Rolph said. "Liquidity is good. We have 145.2 days of cash. We are having a consistent decline in days that accounts receivable are not paid. We want to bring down contractuals. Efficiencies in labor brought us down to 49.1 percent, dropping from 70 percent. Unbilled accounts receivable declined from $7 million to $5 million. The year ended with $4 million improvement in cash."

Chief of Staff Koury asked the board to approve the bylaws passed by the medical staff.

Garcia pointed out a few typographical errors and questioned the verbiage on several items.

Cunningham said a lot of discussion had centered on the intent of items.

Koury said a doctor has a right to say: "I would like to do this, but he or she has to go through the process, and the doctor may not get what he or she wants."

Board Member Dr. Donald Stinar said he noticed the Ethics Committee was crossed out.

Koury explained it becomes a hospital committee instead of under the medical staff.

The bylaws changes were approved. Koury said Drs. Donnell, Meyerowitz and Skee had worked on the changes for a little over a year.

Kelly said the executive committee had approved the agendas. For the Quality Improvement Committee, Board Member Freddie Rodriguez said they had met. Trujillo said it was an interesting meeting. "How the hospital will monitor the systems was impressive."

Garcia gave the Financial Committee report. He asked for several approvals, including that of the unaudited fiscal year 2015 yearend financials. He explained the audit was subject to being approved by the external auditor. "We have used the same contractor for five or six years. The final product has to be back to the state by the end of October."

In contracts and agreements, Garcia recommended a one-year medical executive committee member agreement for Dr. Twana Sparks; a one-year, three-year auto-renewals for the Health Care Information System for Dr. Amos Lash to, according to Koury, have a physician in the group during Dr. Brian Robinson's recovery; a four-year contract to Morrison Management Specialist for food and nutrition systems; and a physician locum tenens and on-call orthopedic coverage agreement with Dr. Donald Hughes.

Stinar questioned the expense. "Aren't there days when there is no one on call?"

"Not for a long time," Cunningham said. "There's been someone covering almost every day. It's also an opportunity to use him as vacation coverage."

Koury noted that Hughes would be covering not only the hospital but also Southwest Bone & Joint Institute, and Cunningham said the hospital would be paying him only when he was on call, and Southwest Bone & Joint would pay when Hughes was in the office.

Kelly said for the Plant and Facility Committee that "we have a great team of maintenance people taking care of things."

Garcia gave the Human Resources Committee meeting report and noted there had been a lot of changes in caregivers, with 144 leaving the previous year and 194 this year, but that most were a result of the ceasing of Home Health and hospice services from the hospital. "In corrective actions, we've been very active in holding teams accountable to provide excellent service. Overtime is higher and our biggest expense is contract labor within the whole organization, but we expect that to drop."

The board members went into executive session and dealt with routine items when coming back into open session.