From left are Commissioners Alicia Edwards and Brett Kasten, Commission Chairman Billy Billings presented the First New Mexico Bank Wild, Wild West Pro Rodeo proclamation to John Myers and Sean Ormand, with Commissioners Gabriel Ramos and Harry Browne behind them.

Photo and article by Mary Alice Murphy

At the beginning of the Thursday, May 17, 2018, regular session of the Grant County Commission, members heard the Gila Regional Medical Center financial report from Chief Financial Officer Richard Stokes.

"The State of the Hospital meeting went well," Stokes said. "We had between 80 and 100 people attending. We took one action item immediately following the meeting—the patient statement redesign. I also thank that lady for coming to meet with me about her concerns."

The March financial statement is the last one approved by the Board of Trustees at its April meeting. The hospital saw a profit of $818,908 for the month of March, bringing the year-to-date loss to $389,674, as compared to last year's end of fiscal year loss of $6.3 million.

"In April, we received a $6.2 million payment, [which included a payment for uncompensated care in 2016, a quality payment and the first quarter of uncompensated care for 2018]," Stokes said. "We have trued up the acceptance of actual cash on hand."

He said the Meditech consulting firm of Navin-Haffty has been onsite at Gila Regional for almost a month. "They are making significant progress in making corrections to the system, as well as planning the upgrade to Meditech 6.5, with August 22 the tentative go-live date."

He then began to list the key performance indicators (KPIs) for the hospital during March.

"We had 195 admissions, as compared to last year's 183," Stokes said. "Our daily census was at 20.5 compared to last year's 22. The average stay was 2.9 days as compared to 3.4 last year. That's a good change, because it means we are managing patient care better."

Outpatients equaled 3677 this year, as compared to 4300 last year. The clinics saw 1623 in March, as compared to 1800 last year. Surgeries were also down to 350 from 405 last year. Oncology visits, as expected, were much lower this year at 252, compared to last year at 739, "but we expect those numbers to start moving up, with radiology having begun in April."

Overall receipts for March were $4,696,169, which is $16,000 more than last year's number.

"The days in cash were down to 39 in March," Stokes said. "I did that by design. Because I knew we were getting the check in April, I paid more accounts payable than normally. Our days in cash will go up."

Days in accounts receivable are up to 64 from 46 last year, and days in accounts payable are also up to 53 from 42. "We're working on getting those down and closer to one another."

"We have identified how to get more reimbursement from Medicare, but I will wait for definitive numbers," Stokes said.

Commissioner Harry Browne thanked Stokes for the detailed report and for getting it to the commissioners before the meeting. "I don't understand the outpatient numbers decreasing."

Stokes replied that because radiology is down a bit, as well as labs, and across most service lines, the numbers were down. "We expect numbers fluctuations."

Browne asked why daily revenue is based on net, not gross.

"My job is to manage net revenue, not gross revenue," Stokes said.

Browne also asked if it were typical to see self-pay standout in the numbers.

"It is driven by the Medicare requirement to hold the bills for 120 days before sending to collections," Stokes said.

Commission Chairman Billy Billings also thanked Stokes for the detailed report.

Commissioner Gabriel Ramos asked Stokes to tell Chief Nursing Officer Peggy White how much the commissioners appreciated the tour of the hospital. "It was nice to see the positive from the patients, who said the service is great."

Stokes said he thinks moving the patients to single rooms is being appreciated by the patients and "especially the families."

Commissioner Brett Kasten asked at that point to move the agenda items for the proclamation and the forest plan right after public input, so the commissioners could go into executive session with Stokes and Gila Regional's Chief Quality Officer Tanya Carroccio. "I don't want to keep the Gila Regional people waiting throughout the meeting and the other audience members during the executive session."

In public input, Ed Wilmot, said he had two comments, both related to Gila Regional Medical Center. "I've been following the hospital ever since I moved here. I'm hearing that private ownership is not what the community wants. I was co-chair of the Los Alamos Hospital Board of Trustees. During the three years I served, we worked through three crises with Lifepoint. During that time, we sought input from the company and received none. The preponderance of people I've spoken to want Gila Regional to remain a community hospital. If you get a good proposal, I ask you to keep an open mind."

He thanked Ben Fisher of the Silver City Daily Press for his "dogged coverage of the hospital."

"I compliment you on the changes you are making to the selection of members of the Board of Trustees," Wilmot continued. "You don't have a good hospital; you have a great hospital. I understand you are considering restructuring the selection process to make sure the board has the skill sets it needs. I believe you can replace board members, although you have said you cannot."

Victor Juarez, citizen, said he and his wife, on Friday night, experienced an event that "we felt we needed to address. We found ourselves behind a Grant County Sheriff's car; Silver City police were also involved. It began in Bayard. As we were exiting Bayard, we were following a DPS (Department of Public Safety) vehicle with flashing lights, not emergency lights, blocking traffic. In front of them were probably 30 to 40 other vehicles with flashing lights. The lights were weaving between lanes at the top of the hill adjacent to the Armory. At least a minimum of 30 cars were doing a wave between lanes. It was extremely dangerous. A school bus and students were involved. This endangered officers and students. As a result, my wife almost caused an accident. I was quite frightened. It was orchestrated. Officers permitted people to drive recklessly. Someone may need to be held accountable. Get DPS involved. Had we been in an accident, we would have sued everyone—Grant County, Silver City and the schools. Someone orchestrated it and should be held accountable. I was following at 50 miles per hour. I hope somebody has the courage to address this."

John Myers, organizer of this year's 1st New Mexico Bank Wild, Wild West Pro Rodeo, and Sean Ormand, 1st New Mexico Bank president, accepted the proclamation.

"The committee has worked hard to produce a family-friendly event," Myers said. "The Hi Lo Pro Rodeo out of Oklahoma is our new contractor for this year. They have good quality national bucking stock. We will have an excellent new clown, and Cody Coseley, national Wrangler finalist. We have two brand new bull fighters, one who was raised in Corona, New Mexico. We will have a brand-new rodeo announcer with a great voice. Also, this year for the first time, we will have a specialty act, Daniel Acosta, a charro, out of Las Cruces. The mariachi group from Western New Mexico University will perform. And we brought in some new vendors. The biggest thing is the new video scoreboard that will offer instant replay. Come out and see local New Mexico and national talent at the rodeo June 13-16."

Matt Schultz and Eric Flood presented the Gila National Forest Plan revision. "We are required to include areas for possible wilderness designation in our process of revising the plan," Schultz said. "Only Congress can designate a new wilderness area."

He showed maps of each step of the process.

Schultz explained that Step 1 of the process is an inventory of areas that may have wilderness characteristics. First, all areas that have roads or noticeable human improvements are excluded, and the areas are generally greater than 5,000 acres or contiguous with existing wilderness areas are considered.

Step 2 is evaluation of the apparent naturalness to a normal person. The evaluation includes the manageability of less than 5,000 acres and the ability to protect the wilderness characteristics, as well as the opportunities for solitude or primitive and unconfined recreation.

Step 3 is an analysis of the evaluated areas, which provided three alternatives, which include no recommended wilderness to a number of areas. "We will look at the impact that turning the area into wilderness may cause, such as defensible space from wildfire/wildland urban interface; impacts to local existing or future product uses, such as grazing, fuelwood, timber and mining; effects on restoration needs; impacts to current or future recreation uses, such as mountain biking; and comparison to the quality and quantity of existing designated areas.

Step 4 is the recommendation of any lands by the Forest Supervisor to Congress for wilderness designation. "The designation is final only with a record of decision signature and only Congress may designate wilderness," Schultz emphasized.

The current status of the process is finalizing the inventory maps, step 1, and preparing to release the draft evaluation report, step 2, for stakeholder review and comments. "We welcome stakeholder comments on the preliminary wilderness characteristic ranking and rationales given to each inventoried area."

Adam Mendonca, Gila National Forest supervisor, said the comments received from the county fit into Step 3. "About 150,000 acres fall into Step 2. That's a large amount of acreage. It gives us the relevant information we need. We hope to have a range of alternatives. We are tied to the impacts it may make to local residents. We want people to engage with us. That will really matter. From a general standpoint, we are about to release Step 2. We will have public meetings. You will see more press releases. It's a great time to start engaging with us. It is at this point in the process that public input and opinions will really matter. Our process doesn't stop, but keeps on going."

Kasten asked about dirt water tanks and whether they are considered a considerable improvement. He also asked whether if a tank is breached if it can be restored.

Flood said it may depend on the tank, but most of the time would not be a noticeable improvement. "It can be maintained. If motorized vehicles were authorized before it became wilderness, a line officer can give permission to go in with motorized equipment if it is now in a wilderness area. Under the Wilderness Act, maintenance is allowed."

Mendonca noted that the wilderness designation does make it more difficult to manage and maintain dirt tanks, but the Wilderness Act does allow range. "It's not just dirt tanks, it's water rights, reservoirs that can fall into wilderness, but management of them is more difficult under wilderness designation. No two ways about it."

"If we have new areas with characteristics, will they be treated as wilderness during the interim period?" Ramos asked.

"No," Mendonca said. "The reason some areas will not be recommended as wilderness may be because we will not be able to manage them toward desired conditions. They can include recreation, historic uses and restoration work.

"Historic uses will be part of the decision," Mendonca said. "Those areas not recommended as wilderness will remain the same, but the wilderness recommendation may impact those uses. We manage the areas in the interim, and we will manage them as wilderness until a designation is made. The reasons for that is because of the characteristics that make it desirable as a wilderness. And such a decision can take a very long time."

Flood said throughout the process, the process does not give any protection, until or if they are recommended for designation.

Browne asked if there were any areas recommended as having wilderness characteristics by previous superintendents under consideration.

"No there are not," Flood said, "but there are wilderness study areas as designated by Congress for the forest to consider and report back to Congress. The forest did report back to Congress, which has not acted on the previous recommendations. Those areas are included as part of this process. We will make a fresh recommendation, for lack of a better word."

The commissioners went into executive session.

The next article will address the regular session agenda as discussed in the work session and as approved in the regular session.