By Mary Alice Murphy

Dan Otero

At the Gila Regional Medical Center Board of Trustees meeting on Friday, Jan. 29, 2016, during the executive session after the regular meeting, Chief Administrative Officer Dan Otero, told the board members that he had accepted the position of chief executive officer of Hidalgo Medical Services.

Otero told the Beat he hadn't announced it in regular session, because some of the trustees were unaware of his decision.

A news release sent to the Beat said the Trustees thanked Otero for his years of service and for helping the hospital over the past two and a half years, especially for assisting the organization with the financial turnaround during the difficult transition in 2013 and 2014.

Otero expressed his gratitude to the Trustees and all the great caregivers at GRMC and also expressed his gratitude to the HMS Board of Directors and leadership for the opportunity to lead HMS into the future. Otero has worked closely with HMS over the past two and a half years and looks forward to working with all HMS staff in support of fulfilling their critical mission in the Southwest, the release stated.

During the transition Otero spoke about in the release, he was brought on in September 2013, as the chief operating officer and helped GRMC go from a multi-million dollar deficit back into the black, within less than a year. The years since have continued to be rocky financially for the hospital, but it has generally stayed in the black, with a healthy number of days of cash..

At the beginning of the meeting, Board Chairman Charles Kelly welcomed the new Chief Financial Officer Michael Metts, who began his job on Jan. 18. "This is my second week," Metts said. He came to Silver City and Gila Regional from helping to start up a community hospital in the Clear Lake, Texas, area near Galveston. Before that he worked in health care in the Permian Basin of Texas.

Trustee Tony Trujillo asked Metts what attracted him to Gila Regional.

"At the new facility, we were working backward," Metts said. "I think you are working forward and I see a lot of opportunity here."

During the recognition section of the agenda, the trustees recognized Evangeline P. Montoya, who has worked at Gila Regional for 30 years, most recently in Medical Surgical II; JoAnn Martinez for 30 years, now in medical records; and Eloy H. Medina, who was present to receive his awards for 25 years in EMS.

Kelly commented that the Bayard City Council had given Medina funding to go to paramedic school.

Also recognized were Shelly K. Burrola, for 25 years in the Emergency Department, and, present to receive his award, William N. Hemmer for 10 years in Med Surg II.

Chief Executive Officer Brian Cunningham attended the meeting by phone and explained that one of the consent agenda items was the Healthcare Environment Committee meeting, which did not meet in December.

"The committee was a special committee to mainly address physician practices," Cunning ham said. "It has proven difficult to get people there. I ask the board to consider discontinuing this committee and moving the discussion back into the Finance Committee."

In his CEO report, Cunningham highlighted the introduction of Metts. "It's great to have him here. It didn't take long for him to jump into action. We are extremely confident that he will help us move revenue cycles forward."

"We are here with an implementation of our plan," Cunningham continued, "with Metts and the excellent talent from Jacobus (a consulting firm).

"We wanted to hold our mid-year strategic plan retreat for the board in January or February, but we have set it for March," Cunningham said.

Dr. Victor Nwachuku, trustee asked if the board bylaws were still in progress.

"When Joe Ramirez left the board, he left the Bylaws Committee without a chairman," Cunningham said. "When I get back, we'll re-invigorate the committee and get them ready for a full board review."

Trustee Jeremiah Garcia said: "It blew my mind when I read the impact of hospitals in New Mexico. They have 64,000 direct and indirect jobs. I compliment the hospitals of New Mexico."

Cunningham expanded on the data and said hospitals have a $6.6 billion ripple effect in the state.

Chief Nursing Officer Peggy White answered a question from Garcia about new hires from Western New Mexico University. "We will hire eight new nurses, contingent on their passing the nursing certification and licensing exams."

Nwachuku asked about traveling nurses. "We are down to 14 in the maternal and child department," White said. "We have a new director for the department, Leslie Wood (who later came into the room to introduce herself). By the end of the month, the Intensive Care Unit and the Emergency Room will have no travelers. Surgery and maternal/child will be our next focus."

Otero said the clinically integrated network is moving toward legal status, with "a good part of the medical staff on board. We are also doing a lot of recruitment for anesthesiology, pediatrics and neurology."

Trujillo asked about the time frame for the clinically integrated network. Otero said the first phase for the operating plan should be complete by March, with the next phase being the operating agreement.

Chief Operations Officer Jed Rudd said it had been determined that MediTech 6 would not be live on Feb. 1. "We are working with MediTech to determine a new goal."

Garcia asked if the hospital would continue with more staff put on the project.

"We are assessing the need right now," Rudd said. "We may need to expand the number of staff."

Chief of Clinical Services Ray Goellner said he would be working through a consulting report.

Metts said the hospital for December had a bottom line in the black of more than $400,000. "I want to highlight that we have 136 days of cash. We are having success with cash collection, with $435,000 in collection above trend. We are continuing to see some improvement in cash collection."

Chief of Staff Dr. Gregory Koury said he was working on improving communication with staff, especially physician-to-physician. "I will be meeting with each physician to create a report. If you board members have specific questions, please tell me. We will have a joint meeting with three of us with MedTech."

"What are factors that impede communication?" Board member Magdaleno Manzanares asked.

"We physicians are independent and stubborn," Koury said. "It used to be nurses who would make ancillary phone calls. We are coming full circle back to us. We will not be writing orders expecting someone else to do it for us. We will have physicians contact other physicians."

The board members approved the medical staff bylaws and the revisions to the rules and regulations.

Kelly said the Executive Committee met to set the agenda.

In the Quality Improvement Committee report, Dr. Donald Stinar said that it would be easier to understand if things weren't in abbreviations. "It would be helpful if there were an explanation of each at least once."

Nwachuku asked Stinar what the concerns of the QIC were. "A lot, most of them are government-induced, especially in Medicare. We will be bringing our concerns to the board," Stinar said.

Garcia said the Finance Committee went into executive session. "We will talk about it in our executive session today."

Garcia asked that several recommendations and contracts be approved, including an addendum to the quotation and support summary consolidated services agreement with GE Healthcare for equipment; a memorandum of understanding for hospital services for a four-year term with Hidalgo Medical Services; a contract for services for the GRADS program with First Born for mothers and fathers that graduate from the program; the renewal of an employment agreement with Dr. Norman Ratliff III for a one-year term with two annual renewals; and an agreement for purchase and sale of equipment with Dr. Okay Odocha for four monthly payments for $12,140 paid to GRMC; and an amendment to extend the agreement with New Mexico Oncology Hematology Consultants during negotiations on a new contract.

Nwachuku said the extension is for a bridge contract, which allows the board to work out the compensation details in executive session.

For the Plant and Facility Committee, Otero reported the labor and delivery plan is ongoing "to make sure we have a healthy facility for our needs."

Garcia said there was no major change to the dashboard for the Human Resources Committee. "Contract labor is still high because of the MedTech. "For fiscal year 2016, we have $1.2 million, after about $900,000 for fiscal year 2015. Part of that is the improving to MedTech 6."

The board then went into executive session.