Photo and article by Mary Alice Murphy
Presenting and receiving awards, from left in front, are award recipient Richard Vasquez, presenter GRMC Governing Board Chair Alicia Edwards, award recipient Jeremy Sanchez, Interim CNO Cynthia Lewis and Risk Management/ Compliance Officer Denice Baird; and in back, GRMC Governing Board Member Chris Ponce, GRMC CFO Patrick Banks, Member Billy Billings, Interim CEO Margie Molitor, and Members Eloy Medina and Harry Browne.
Presenting and receiving awards, from left in front, are award recipient Richard Vasquez, presenter GRMC Governing Board Chair Alicia Edwards, award recipient Jeremy Sanchez, Interim CNO Cynthia Lewis and Risk Management/ Compliance Officer Denice Baird; and in back, GRMC Governing Board Member Chris Ponce, GRMC CFO Patrick Banks, Member Billy Billings, Interim CEO Margie Molitor, and Members Eloy Medina and Harry Browne.
Gila Regional Medical Center Governing Board Chair Alicia Edwards noted at the beginning of the May 25, 2023 meeting that the agenda had changed, and the executive session, instead of being near the beginning of the meeting, would be toward the end of the meeting.
She announced several recognitions. They included Sonia Uresti for five years of service in Data Access; Mikayla Lopez for five years in the Emergency Room, and Cynthia Cruz for 10 years of service in Cardiology. Two other recognized individuals were present to receive their awards, Jeremy Sanchez for five years of service in Security and Richard Vasquez for five years of service in Facilities.
"We deeply appreciate your service and commitment to Gila Regional Medical Center," Edwards said. "We couldn't do it without you."
With no public input, the members began addressing agenda items. After approving consent agenda items of minutes, and with no old business, they started considering the new items of business.
The first item addressed recommendations by the Medical Staff Executive Committee (MEC) to approve the physician assistant delineation of privileges (DOP), for certified nurse midwife DOP, and for obstetrics/gynecology DOP. Also included were the credentialing and privileging by proxy policy, physician self-referral (Stark Laws) policy, and disaster privileges for volunteer physicians and advanced practice providers.
Interim Chief Executive Officer Margie Molitor noted this was updating privileges, as well as the by proxy policy, which is a common practice, with employment agencies doing the credentialing, "so we don't have to redo it. The Stark Laws state that a physician cannot self-refer. The disaster privileges allow 72-hour privileges for volunteer physicians and advanced practice providers to assist in the case of a disaster."
Governing Board members approved the list of MEC recommendations.
Chief Financial Officer Patrick Banks said the next item, a medical director services agreement was for Dr. Donald Stinar to continue to serve as director for the Sleep Lab. "This is a renewal. We appreciate his work."
Members approved the renewal.
They also approved the renewal by amendment for the contingency search and placement agreement for CompHealth to continue to provide physician recruitment for the hospital, Banks explained.
Consideration of an amendment No. 1 to a purchase and license agreement for Cancer Center electronic medical health records, Banks said involved a small amendment to "add capacity for those serving in locum tenens (temporarily fulfilling duties of another) positions.
Members approved the agreement. The board also approved the resolution to approve the state-approved audit contract with Tom Dingus. Banks explained this is the last year that Dingus and his firm can serve, and the hospital must send out a request for proposal next year for auditing services. Banks said in New Mexico there is a fairly narrow list of state-approved auditors.
For the next resolution, addressing organization insurance policies, Banks said the date for approval had been moved to June 30, "but we want to ask for approval for us to work through negotiations and have it approved within the next month before the next meeting." Members approved the resolution.
Banks also explained the next resolution, an amendment to the service agreement for the endoscope system with Stryker Procare, which he said is a standard agreement. "We are nearly through negotiations and would like approval today, so we have it completed before the next board meeting." Members approved the agreement.
The final resolution addressed a professional services agreement for Dr. Brian Robinson to serve on the Physician Hospital Computer Information System Advisory. "He was good enough to volunteer to be the MediTech Expanse physician champion. Part of that involves offsite training in MediTech Expanse to make sure we are giving our physician community as much training as possible, as well as access to one of our physicians who has been fully trained. It will be a standard fair market day rate and will compensate him for any travel expenses." He explained that he does not like to publish the numbers in contracts with staff members, but he would tell the board members the rate in executive session.
Member Chris Ponce said he wants transparency, but he would agree to approve the agreement. Members approved the agreement.
The following items addressed reports and updates.
Interim Chief Nursing Officer Cynthia Lewis presented a brief report. "It's been a busy month. We started with the celebrations of Hospital, Nurses and Emergency Medical Services weeks. We're all happy to do a happy dance for the 'reservoir.'" She said it has been a great collaboration with partner hospitals helping them get equipment sterilized for use in the hospital.
[Editor's Note: at https://www.grantcountybeat.com/news/news-articles/78443-grant-county-commission-holds-work-session-050923-and-regular-meeting-051123-part-7 you can find within the first couple of pages an explanation of the issues the hospital was having with having to upgrade the steam tank sterilization system.]
Banks presented his CFO report. "As usual, we are almost a month behind. This is the April 2023 report. At the start of the fourth quarter, we take stock of where we are as a hospital, of what we've accomplished and what we need to do to stay strong through the end of the fiscal year. We asked the team not to fall into the trap of an activity drop in the spring and summer. We will continue to focus our activity to meet patients' needs. Execution of our duties every day is what makes the hospital tick financially. Our outpatient volumes were higher than expected if we look at past Aprils. Our net operating surplus stood at $322,000. I don't expect those numbers every month, but in January and February, we invested in training, and now we're seeing those nurses transfer into full-time jobs, and in general we executed well. This bites into the operating deficit we've had since the first of the year. I don't know that we will break even at the end of this fiscal year, but I know that is the plan for fiscal 2024. I'm thrilled at the effort and level of care by the staff. It's where we can make some minor investments toward the end of the year. I'll go into capital purchases over the next couple of months, but what we can do is to the little things, like a new bed for babies that might need to stay in the med/surg unit. Our key measures of liquidity look pretty much the same. Our current ratio is the strength of the hospital right now. Our cash on hand continues to tick up. In spite of our having to spend more with higher volumes, it's a good sign of where we are and where we're going."
The chief of staff report would be given in executive session when Dr. Colicia Meyerowitz would join the meeting for credentialing and her report.
Interim Chief Executive Officer Margie Molitor said she is excited to meet with the new Board of Trustees. "Thank you for all the work you did in getting that done. They are very qualified and a diverse group. I'm excited that Scott Manis will provide board education. Several members have agreed to attend an educational session with the New Mexico Hospital Association on June 22 and 23. It should be a great opportunity for them to learn and to network with other trustees from across the state."
"I have started the official process of recruiting a permanent CEO," she continued. "We will continue reviewing resumes, and I would like to have three or four candidates on site for interviews. We had a very successful Hospital Week, Nurses' Week, and this week is EMS week. Thanks for the proclamations. Our steam sterilizer, as Cynthia said, the tank was delivered on Wednesday. The plumber installed it last evening, and we're now waiting on the quality testing and the inspection, so we can go live. I want to give a large shoutout to Globe, Arizona, and T or C. They have been exceptionally good partners as we worked through the process to provide very safe care to our patients. We did receive our letter from the Joint Commission granting us full three-year accreditation, the best you can hope for. We received that last week, so that was good news, and kudos to Ramona (Wilson, Chief Quality Officer) and her team for leading the process. We started our direct rounding of directors, so they have the opportunity to meet with each employee in their department at least once a month, with time to talk about what they need from their director, whether it's educational or equipment or whatever, such as how can their leader help them do a good job. It also gives the directors a chance to say, here's someone who did a really great job this month and help recognize them. We'll take the whole group and each month select four employees and recognize them as our service superstars. One more step of recognizing the good work going on at Gila Regional. We also had our first birthday breakfast this morning to recognize those employees with a birthday this month. We're just trying to do something to recognize employees, because I feel it's so important. It's a first step to improving our patient experience scores to make sure we have an engaged workforce. It's all an effort to improve that employee engagement. We want our staff to want to work at Gila Regional. As recommended by Dr. (Norman) Ratliff (cardiologist), they are applying to be a certified Chest Pain Center by the American College of Cardiology. Heather, our ER director, has done this before, so it shouldn't take too long. What this is, it will be another feather in our cap, and it will improve the experience of patients experiencing chest pain. When you hear Code Heart, the ER jumps into action. We also have a term sheet signed by a highly qualified radiation oncologist. It's the precursor to a contract. I'm looking forward to getting the contract finalized, so he can start in September. We really liked him when he came out for a site visit. We continue to look for a cardiology nurse practitioner."
Member Eloy Medina said he, Edwards and Molitor had discussed a collaboration with the Silver City Fire Department. "Can we have a plan for that? I would like an update next month."
Edwards asked if Hayostek will be working as backup for the new person.
"She wants to retire, but she is willing to work those five or six weeks a year when this physician will need a backup," Molitor said. "She also very much liked this new physician, so it will be a good working relationship."
HealthTech Regional Vice President Scott Manis gave the management report. "Thank you for the appointment of the new Board of Trustees. That's been a long process. You've been real health care heroes for the past three years in stepping up into a role that you didn't run for. You've been an invaluable resource to me personally when I was here, as well as for the community and the hospital. We look forward to working with the new board and continuing to move the organization forward. I'm pleased with the financial situation and the hospital on all fronts. We like the fact that daily you're focusing on execution, so you're not leaving opportunities behind, but also evaluating and looking for additional opportunities to improve the organization. This team doesn't rest on yesterday's accomplishments. They continue to look for new and often very creative ways to support this hospital. Some of the innovations you've done here, we've implemented into some of the other Health Tech hospitals. As well, innovations we see in other hospitals, we're bringing here."
"Daily we're seeing hospitals across the country not doing well," Manis continued. "I just finished some presentations about challenges, financially and otherwise that hospitals are facing. Just this morning, we saw SSM, a large Catholic hospital organization. reporting a large operating loss. Providence in the northwest just reported a $400 million quarterly loss in their system. That quickly adds up to a billion if you stay at that rate. Only the systems that are working a peak performance right now are the ones that are hitting their operational numbers. We're moving in that direction, and I trust we'll come out with a small operating margin for the year."
He noted a national organization just came out with their latest report. "In New Mexico, nine hospitals are a significant risk of closure or somewhat at risk of closure. We haven't seen that here. We're doing well here. We have to keep in mind all these challenges being faced across the country. We have continued to work with my colleague John Freeman and Patrick on next year's budget."
On the CEO search, Manis said: "We have continued to search. I want to work with the new board before we bring candidates, because we need to know the board's expectations."
The Governing Board members went into executive session and came out to address action items.
The first item was at the recommendation of the Medical Staff Executive Committee on provider credentialing. Governing Board members approved the credentialing.
The next item was a consideration of the Board of Trustees bylaws, which will go into effect July 1, 2023. "We replaced the words 'full power' to 'authority,' so the sentence reads: 'The Board shall have authority and responsibility…'" Edwards said. Members approved the change to the bylaws.
In Board comments, Billings had none. Medina thanked everyone for recognizing EMS Week. "Emergency medical responders work hard. It's a big impact we have on people's lives. Even the volunteer fire departments, the Silver City Fire Department, Air Methods, even the ER. We work together. I want to thank my staff for everything they do. They make me look good. They make Gila Regional shine. They come out for events and do the right thing every day. It's gratifying to see how we impact the community. We have some plans to improve our staff. Thank you so much."
Ponce said: "I hope some of our new trustees are listening to this, and I thank you, Mrs. (Pat) McIntire, for being here. I hope as many of you as can will attend next month's meeting because it will be discussing the budget. We will likely take action on the preliminary budget. We want you to be there. We will likely be voting on it and saddling you with this budget. It doesn't mean it can't be changed, but it would be good for you to hear about it, so you have a chance to know what you're facing. Thanks to all the applicants, and we have full confidence that you will do an excellent job, so thank you."
Browne had nothing.
Edwards said the next meeting that Ponce had just invited the new board members to, will take place at 9 a.m. Thursday, June 29, "in this room (Commissioners' Meeting Room at the Grant County Administration Center). I support Mr. Ponce's comments. They were very well said. I deeply appreciate all the interest in serving, and I, too, have full confidence that you will do a good job."
The meeting adjourned.