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Category: Front Page News Front Page News
Published: 24 February 2017 24 February 2017

By Mary Alice Murphy

Among the first items of business for the Gila Regional Medical Center Board of Trustees regular monthly meeting held Friday, Feb. 24, 2017, was the recognition of three long-time employees of the hospital.

Judy Brown, now serving in the emergency room, has been an employee of GRMC for 35 years.

Elizabeth Allred, now GRMC controller, has served the hospital for 25 years. "I was taught by Dr. Terry, the accounting professor at Western, 'the one thing you have is your integrity. Anyone can learn the tasks.' I have served through seven full-time chief financial officers and numerous interims."

Irene Arzola has spent 20 years of service at GRMC. She was in home health, but for the past three years has been in dietary. David Peck, head of the cafeteria, said: "She has become one of the shining stars of the department."

The first report was given by Frances Day, Auxiliary president. "As of this morning, we have 71 regular auxilians, three serving with the Medical Assistance Program, and five with the associates for a total of 79. We are looking for more places to work."

Trustee Joel Schram said: "Thanks for everything all of you do."

Board President Jeremiah Garcia asked Day to thank the auxiliary team for the board.

Interim Chief Executive Officer Alfredo Ontiveros said: "There are always rumors going around. The big one was that we're going to sell the hospital. That is totally unfounded. We have no plans to sell the hospital."

He said he had gone to the legislative session in Santa Fe to carry a request for a 3-D mammography tomosynthesis machine for the hospital.

"Go live for the Meditech 6 upgrade is still on schedule for June 1," Ontiveros said. "We are also making sure our revenue cycle continues to improve. We are bringing in a revenue specialist on March 7.

"In other news, we eliminated the Chief Operating Officer position," he continued. "We continue to take input from our physicians on issues in the hospital. I am also the community liaison. I will meet with anyone. Call me if you want me to speak. I will speak at Rotary next week."

Assistant Vice President of Administration Liana Ryan said 24 percent of the identified initiatives they have been working on have been completed, plus ones to help make the clinics successful.

In the revenue cycle initiatives, "we have recouped $10,000 within the past month and $15,000 for the clinics."

She said a new anesthesiologist is coming to the hospital March 27. "We are still recruiting for a urologist, an ENT (ear, nose and throat) specialist and a pediatrician."

Garcia asked about the timeframe for restructuring the Gila Family Clinic.

"We are looking at staffing," Ryan said, "and how to modify it to fulfill revenue generation opportunities."

Chief Nursing Officer Peggy White said at present the nursing department has eight travelers, "but by mid-April, we should have eliminated those positions. We will re-evaluate how registrations are going. We want to recruit new nurses and go back to two pods."

Ontiveros said the hospital wants to get to one patient per room "to best serve our patients."

Garcia asked about the patient/nurse ratio. "We are about five patients to one nurse," White said. "But it reflects our activity. Sometimes, it's more."

Ontiveros said: "It's a very good ratio. Other hospitals in the state have 7 to 1 or more. What we're doing should be a model."

White said the ratio has been a strong tool to retain nurses.

The Chief Operating Officer report was still on the agenda, although the position has been eliminated.

"We are still looking at projects to see which ones should continue, be done away with or tabled," Ontiveros said. "The duties of the COO have been reallocated to other administrative positions, including to me."

Trustee Dr. Victor Nwachuku asked who was responsible for continuing the Meditech 6 upgrade.

"Ken Stone is in charge of it," Ontiveros said. "We meet every morning."

Trustee Dr. Tsering Sherpa, a member of the medical executive committee, said: "Everything is ready (for Meditech 6). We're doing parallel testing and will do high level testing to make sure it's good to go. We are training super users and the last two or three weeks we will be doing more training for everyone."

Ontiveros said the hospital would bring in someone short term before the go live.

The Chief of Clinical Services Ray Goellner was not present, but Ontiveros gave highlights from the report. He said installation for the nuclear medicine camera is ongoing. "It will be 60 days before it is operational. We have a new trailer for it and are keeping the old one going in the meantime to keep patients here. We have two new chemical analyzers and are trying to recruit respiratory therapists. Ray is restructuring the pharmacy and bringing on a new pharmacist, who will be the super user for Meditech 6 for the department."

In the absence of the Chief Financial Officer Mike Metts, Controller Allred said the past month had a positive operating margin of $20,492. "The last pay period was lower, so we are seeing positive trends. Volumes are up a bit."

White said volumes of patients run about an average of 20-24 patients a day. "Two days recently we had 30 and 31 patients."

"One day this week, we had 18 admissions and 11 discharges," Ontiveros said.

Chief of Staff Dr. Gregory Koury was "upstairs having a grandbaby," according to Kari Lane, medical staff director.

Lane said two items for approval of the rules and regulations for medical staff included a surgery-scheduling item. "We are bringing back the language with the consequences of a surgeon being late." It had previously been in the rules and regulations and was taken out. If a surgeon is late three times in one week, they are penalized for the block of time if they don't start on time with a one-week suspension. They can still do surgery, but are penalized. It throws the schedule off if they arrive late.

"Surgeons are holding surgeons accountable," Ontiveros said.

She also brought up for approval that all references in the bylaws about the short form for medical records would be removed. The H and P (history and physical) form will be only the long form.

Nwachuku said the items has been reviewed and approved by the Medical Executive Committee. The board approved them.

In committee reports, Garcia said the Executive Committee met, set the agenda and committee meetings.

Schram reported on the Quality Improvement Committee meeting. "We reviewed the quality assessment and the self-assessment, as well as the ER and behavioral health assessments.

Garcia reported on the Finance Committee, with two recommendations for approval. They included a Medical Executive Committee member agreement with Dr. Darrick Nelson of Hidalgo Medical Services for a two-year term, running from March 1, 2017 through Feb. 28, 2019 at $110 an hour, which was approved.

Also approved was a physician service agreement for non-operative obstetrics for patients with no doctors of record for Dr. Evelinda Gonzales of HMS for a four-year term from March 1, 2017 through Feb. 28, 2021 for $150 per shift.

Trustee Mike Morones gave the Plant and Facility Committee report. "We met at the Wellness Center and took a tour. "We talked about the hospital roof and the nuclear camera installation in progress. We have a couple of high risks on hold. They include the air-conditioning units at The Wellness Center and the air handlers here at the hospital, which are 33 years old. The air-conditioning units were damaged, so the hospital can get $50,000 in insurance and to repair or replace them would cost $90,000, so we are looking for $40,000 in funding."

Ontiveros said the committee talked about a plan going forward. "This has to be done for medical equipment. Our maintenance people have kept everything working up to now. We have brought these forward to be put into the capital budget over the years, but they haven't been done. At some point in time, we have to address these critical needs."

Morones suggested that some could be done piecemeal. "We could do a couple of projects every year, so if there are financial constraints, we would be pushing off two and not 12."

As part of the meeting, Ontiveros said security had given a report and said things were going well, but trainings were needed in such things as "active shooter. On 9 February, the American Hospital Association put out an alert for lone wolf terrorist attacks. We are trying to enhance our already great relationships with law enforcement. We want to get them to swing by at odd times of day to make their presence known and seen."

Day asked to speak to the issue. "Active shooter is a concern of mine. We, as auxilians, would like to be in on the training. We are at every entrance to the hospital."

"We just had a newcomer briefing," Ontiveros said. "We had a couple of auxilians there."

Nwachuku said, on the financial front, "We had some financial issues, but we have made a lot of changes to make the revenue cycle work more efficiently."

Ontiveros said: "At the finance meeting, we went into the processing, which starts with registration and ends with the coding for the bills before they are sent out. We have to make sure it works at every stop. We want the bills so they are clean without denials. If the documentation is not there, we can't bill. We have a revenue cycle team that meets weekly, so we are seeing improvements."

Garcia presented the Human Resources Committee report. "We have, this year, had high costs for contract services, but this month is better. What is the difference between critical vacancies and highly critical vacancies?"

White said the highly critical are often physicians. "We also have nursing and lab tech shortages, so they can be highly critical. We give a higher incentive to the highly critical ones to get people to come in and stay. It's a recruitment tool."

Ontiveros said the bonus is higher for highly critical vacancies. "We have the same requirements as for-profit hospitals. The not-for-profit hospitals don't have the same regulations as we do as a county-owned hospital."

"Nursing is pulling together a strategic two-year, five-year and seven-year plan," White said. "We are reaching out to Western for not just nurses, but also scrub techs, lab techs and other positions that have shortages throughout the nation."

On the Board Bylaws Committee, Garcia said the members still have more questions to be answered before they can be approved. Nwachuku asked that they be discussed in executive session, so "we can have them next month."

At that point, the board members agreed to the executive session, right after a 15-minute break.