By Mary Alice Murphy

As is traditional at the beginning of a Gila Regional Medical Center Board of Trustees meeting each month, employees are recognized for their service.

On Friday at the regular board meeting, Clara Dean received recognition for her 25 years working at GRMC. She said she started as a volunteer, then got a job in admissions, served next as a surgery clerk and most recently has worked in radiology.

Monica Sedillo, who was not present, has served the hospital for 15 years, most recently in the operating room.

 

Frances Day, the GRMC Auxiliary president, announced the group has partnered with The Volunteer Center, Rotary International, the Silver City Woman's Club, the GRMC Collaborative Council and GRMC Gila Reach to receive a $12,150 grant.

"We are down in membership in the auxiliary," Day said. "You can get an application at the front desk or request one by email to auxiliary@grmc.org. We welcome suggestions on recruitment and retention."

GRMC Chief Executive Officer Brian Cunningham highlighted from his report the hospital's appreciation for Pat Sheyka, who ended her 53-year career as a nurse as the GRMC chief nursing officer. "We especially appreciate her work in our financial turn-around."

Board Chairman Charles Kelly concurred and said: "Pat was fun." Friday was Sheyka's last day at GRMC, as she had worked as a consultant during the transition to Peggy White as the new CNO.

Board member Jeremiah Garcia asked how Cunningham's presentation went in Ruidoso.

"I presented to the Health and Human Services Interim Legislative Committee," Cunningham said. "Susie Trujillo was there to help out and Sen. Howie Morales was also there. It was a good chance to learn and dialogue about our challenges."

"I heard you hit it out of the park," Kelly said.

"Susie helped," Cunningham said. "It's easy to tell the truth."

CNO White said she wanted to highlight in her report that the hospital has hired two nurses from the Douglas, Ariz., hospital that closed, and possibly two more will come to GRMC. "We are recruiting from everywhere, and successfully, I might add. We have 21 openings. We are getting phone calls, too. Hopefully, by the end of the year, we will be fully staffed, without the need for travelers."

To a question from board member Dr. Donald Stinar, White confirmed that one had gone to the intensive care unit.

Chief Administrative Officer Dan Otero updated the progress on the Clinically Integrated Network. He said he had received 25 RSVPs for the next meeting on Sept. 3. "That's an important indicator of the commitment in the community."

"In addition, I wanted to tell you we had an unannounced lab assessment, with nine people coming," Otero said. "It was headed by Dr. Vargas out of El Paso. We had four minor findings that we will address."

Garcia asked how progress was going on the New Mexico Stroke Center. Otero said Gila Regional has the key components and is in the early stages of formalizing the center. "The cost is just time, but we will be taking stroke care to the next level."

Chief Operations Officer Jed Rudd said ICD-10, the 10th revision in the International Statistics Classification of Disease and Related Health Problems (ICD) is beginning dual coding. "We are testing with payers. It is going live on Oct. 1."

Garcia asked Chief of Clinical Services Ray Goellner about anticipated changes in volumes of tests, and also he asked about whether the new director would tighten the budget.

"The latter is my anticipation," Goellner said. "I think once the MedTech 6 build is complete, budget tightening will be the area of focus this year."

Interim Chief Financial Officer Michael Rolph said he wanted to highlight that last month's $300,000 bottom line was favorable. "We have a variance of about $500,000, with a $200,000 improvement in net revenue. Volume is off in all areas, but in outpatient, our most important, it is off only 2 percent. Really good news is that our days of cash have gone up since last month's 145.7 to this month's 147.4." He reported that a presentation to the Finance Committee showed a nearly $1 million improvement in revenue collection.

Beth Allred, Comptroller, said the hospital is in its second week of the audit. "We were asked to look at our reserve. The auditors believe we don't need $1.9 million in reserve or we will be overstating our reserve and understating our revenue. With the money moving from reserve to revenue, we will likely have a positive bottom line for the year."

She noted that recording has had some glitches that were being worked out with the documentation that comes in with a patient and making sure it goes in the right place. "Tamera Ahner is doing a good job working through the problems."

"In July, we paid $1.7 million for our second payment for the Safety Care Net Pool," Allred concluded. "When we put money in reserve, it will have no impact on the bottom line."

Kelly commented he would like to see GRMC get to 150 days in cash and hold there.

Board member Dr. Victor Nwachuku asked when the Safety Net Care Pool money would return to Gila Regional.

"It comes from Medicaid from the state through Centers for Medicare and Medicaid and back," Allred said.

Chief of Staff Dr. Gregory Koury explained the trepidation about Meditech 6 is the fear of something new. "Sometimes, we see no utility to what we're doing. We were trained as physicians to take care of patients. We're looking at ICD-10 and we consider it a nightmare. We will see frustration from physicians. It's not going to be comfortable. The learning curve is uncomfortable when we would rather see patients."

Nwachuku said he had attended an ICD-10 conference. "I learned it is not as bad as we think. I think orthopedics and the hospital may have more difficulty than I will. But I know I don't want to be spending two hours before seeing patients and two hours after doing my records."

Rudd said he would be talking to a few physicians at a time to explain the process. "It will take a while until physicians get paid, but I think everyone will work together to get it done. The difference with Meditech 6 is that you used to be able to do your records by dictation. Now you have to type them, so it takes more time. That's the biggest fear. The government gave us flexibility. If the top master code is correct, the claim won't be denied. The revenue cycle will not stop. We will be doing demonstrations to physicians. There might be further dialogues on the Clinically Integrated Network and how it works with recording."

Kelly reported the Executive Committee went over and approved agendas for meetings.

Board member Freddie Rodriguez said he could not attend the last Quality Improvement Committee. Dr. Stinar said everything was in the packet.

Garcia, chairman of the Finance Committee commented the financial report "sounds great."

He then moved and recommended approval of several contracts. They include a services agreement between GRMC and Dr. Kendall Allred to be a full member of the Ongoing Professional Practice Evaluation Committee. Also approved were a four-year staff psychiatrist employment agreement with Dr. Alan Berkowitz; a physician consulting agreement for OPPE Committee services with Dr. Laura Davenport-Reed; a first amendment to a general surgeon employment agreement with Dr. David Friedman to serve as OPPE consultant; and a study with Kevin Robinson, Architecture Workshop, to assess a future medical office building for the Clinically Integrated Network.

Kelly gave the Plant and Facility Committee report and said: "There are a lot of things going on with new equipment coming in and old going out, and with emergencies. Maintenance is keeping up and doing it well."

In the Human Resources report, Garcia said contract labor is down. "Good job on that trend."

The board then took a 15-minute break and went into executive session.

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