By Mary Alice Murphy

After public input and board input at the regular monthly meeting of the Gila Regional Medical Center Board of Trustees on Feb. 28, 2020, the updates from the auxiliary, as well as leadership positions were heard.

For the previous report on the board meeting please visit https://www.grantcountybeat.com/news/news-articles/56552-grmc-board-of-trustees-meeting-022820

The Auxiliary report was given by President Marilyn McCracken. "The Auxiliary received $1,000 from 1st New Mexico Bank for lunches for cancer patients. For several months, we have had the gift shop up and running, which provides revenue for our activities supporting the hospital. We will hold a bake sale during the week before Easter. We're all getting used to the quiet times in the afternoon and at night. People are appreciating it. We still hope to increase our auxiliary membership."

Trustee Jeannie Miller noted that she didn't know about the closet for the Emergency Room.

McCracken said it's for those who need clothes because of accidents or had to have the clothes cut off or other reasons. "We are stocking it with usable sweats."

Board Chairman Tony Trujillo said he tells people "we have the best auxiliary anywhere."

No one from the GRMC Foundation was present to give a report.

Chief Financial Officer and Interim Chief Executive Officer Richard Stokes presented the Interim CEO report. "We had a really busy week. We have a cardiac nurse practitioner starting with Dr. (Norman) Ratliff on Monday. For the behavioral health unit, we had a nurse practitioner come on site yesterday. She will start orientation on Monday and will be seeing patients by Tuesday. We are ready to proceed with the critical access application at your direction. So far, we have identified about $1 million in billing that can be done again. AVEC will go full bore on Monday morning. We signed the form for anesthesia to recruit certified Registered Nurse Anesthetists. Good things are happening."

Chief Nursing Officer Rose Lopez highlighted that 2020 is the 150th anniversary of Florence Nightingale, so 2020 has been declared the Year of the Nurse. "We kicked it off at Gila Regional with a pancake breakfast for all the nurses. We will be providing education and meals. We are working with the New Mexico Department of Health on a class on opioid abuse. On April 1, we will have a free class with Dr. Kotch that will offer CEUs (continuing education units) for nurses as part of the year's celebration. We are doing quiet time from 2-4 in the afternoons and from 12 midnight to 4 a.m. During these times, we don't allow any traffic near the patient rooms. We appreciate the physicians helping with the posters. We are also distributing quiet masks and ear plugs to patients. This is all gearing up for our progress toward 5-star quality."

Trustee Cynthia Moreno asked if affiliation agreements with New Mexico State University or University of New Mexico were in place yet. Lopez said not yet. Moreno asked what time of year nurse students from Western did clinicals. Lopez replied: "All year. We have recently hired five Western nurses for internships."

Chief Quality Officer Tanya Carroccio said because pandemics have been on people's minds, she invited the hospital's infectious diseases preventionist William Hemmer to speak. "He covers everything in infection prevention."

Hemmer said: "I do infection control. We've been going through the process since Dec. 31. Now it's more in the public's view, although we were aware of coronavirus in China in December. I'm disappointed in the media. I get the feeling they are trying to raise the fear level, and they don't always give good information. We do know a lot of things about the virus. All of the cleaners we use in the hospital will kill this virus. It's a virus. We're doing the same things we did with SARS, MERS and Zika. We have a standard playbook, and we adjust it as needed. This virus is predominantly spread by droplets. When you see photos of people in what look like spacesuits, they have a filter on them. We have negative air flow rooms here at Gila Regional where we can isolate patients. We have been adjusting our policies per the Centers for Disease Control and the Department of Health. Our plan will outline what we will do. We figure we may have two or three patients. We can treat them, but we can't treat 500 people, although we can expand what we have."

[Editor's Note: On the day of the meeting, no New Mexico cases had been discovered. But that changed on March 11 and 12, 2020, when up to five cases are presumptive.]

Hemmer said that if Gila Regional had a lot of cases, in extreme conditions, the hospital could cancel elective surgeries and treatments. "The CDC has developed tests to send to the state lab division. At this point, they are only allowing state labs to do the tests. EMS is a crucial element for us. We can probably expect supply chain disruptions, but we are training our caregivers how to put on the protective gear."

Trustee Ed Wilmot asked the hospital to put advice on the grmc.org website, as well as a link to the CDC. Hemmer said he would follow up on the request.

Lopez said Gila Regional has links on its Facebook page.

"I will be absolutely honest with everything I say," Hemmer said. "I am meeting weekly with our hospital leaders."

Carroccio continued her report. "March 8-14 is Patient Safety Awareness week. We have a pledge for our staff to sign and we will recognize those who are Safety Champions. We will do posters and will tell people what departments are doing for safety. It's a compliance issue, so we are reinitiating the Policy Committee. We will be using it to manage all our policies. We will go through the policies, so we have no duplicates and so that policies match our activities. We did a quarterly mock survey, where we act like we are surveyors and then take the results back to the directors. It is extremely important as we move toward the critical access process. We will do two surveys—one before critical access is designated and another survey six months after the designation. We have a lot of action getting ready for preparedness. We are making sure to tighten up our processes."

Stokes presented his CFO report. "In January, we had $167,000 in profits, but year-to-date we are down $4.7 million. Last year in January we had a $960,000 loss, but we are a little bit worse off this year. Cash collections remain at about 32 percent, and cash to net revenue is at 104 percent. AVEC will have its first full week on Monday (March 2). Revenue Enterprises for self-pay comes on board March 1. Plus, we have a new more detailed statement going to patients. With the new payment portal, people can go online to make payments on their accounts, and the information goes directly into Meditech."

Miller asked about the first statement received being short. Stokes said the first one is just that—a statement. Future ones will continue the information. Internally, we decided that everyone will get the first statement, before they get the others."

Dr. Brian Robinson gave his Chief of Staff report. "The only way we will get out of our situation is to only worry about working day-to-day. As I am the only position on the board that is paid, as chief of staff, I am no longer accepting my payment."

Stokes said he appreciated Robinson's stand. "Dr. Robinson has been reaching out to me when I have questions. I appreciate his feedback and have sometimes taken modified positions on issues as a result."

Under board committee reports, Trujillo said the Executive Committee met and set the agenda.

Miller said the Quality Improvement Committee did not meet last month. "But the Risk Management Plan has been uploaded. We want input, so we can bring it forward to act on it next month."

Trustee Joel Schram presented the Finance Committee report. "We did meet. Mr. Stokes covered most things. A lot of the things we'll see have been put in place. We will see the fruits of the process in the coming months."

Trustee Ed Wilmot said, although the Plant and Facility Committee didn't meet in February, "our major focus is maintaining the Pharmacy project. It's a big expenditure. We did, if capital outlay gets signed by the governor, get another $250,000 for the roof, but it's still not enough for what we need done." He also suggested that instead of having regularly scheduled committee meetings that they just be held when needed and when the members can meet.

Trustee James Marshall said the Human Resources Committee did not meet, but the employee statistics are in the board packets. "We will look at how necessary the vacant positions are."

Trujillo concurred that the board has to "wrap its arms around the vacancy numbers to determine whether they are realistic."

Trustee Dr. Victor Nwachuku said the Bylaws Committee did not meet, but that Schram had brought up some concerns "that we need to address."

Trujillo said he liked the idea of calling committee meetings only when needed.

Nwachuku pointed out that the bylaws need to be revisited constantly.

The board members then went into executive session.