[Editor's Note: This is part 2 of a two-part series of articles on the GRMC Governing Board meeting held June 25, 2020. Corrections are in Bold, and one was about a grant that has been applied for but not received as yet.]

By Mary Alice Murphy

After the Gila Regional Medical Center Governing Board approved a management contract with HealthTechS3, members hear a report from the Interim Chief Executive Officer Scott Manis. This article can be read at https://www.grantcountybeat.com/news/news-articles/58743-grmc-governing-board-met-and-approved-management-contract-062520

The next item on the agenda addressed the monthly report from Interim Chief Nursing Officer Kelly Rodriguez.

"I would like to highlight that next week, we will be training the Emergency Room for the telehealth psychiatry that will go live July 7. We are also getting the hospital ready physically for the critical access on-site survey within the next couple of weeks. We are also addressing the survey findings and working with the Quality Department to get them addressed. We want to build a continual readiness program, so if the Joint Commission shows up unexpectedly at any time, we will be prepared. I always try to highlight special people in the organization. Monica Sedillo in the Operating Room is so knowledgeable and always willing to help. Angela Armijo in the ICU (Intensive Care Unit) is always ready to help wherever she is needed."

She continued by saying that the hospital in March lost its biotech specialist, Gabriel Jaurequi, who has served the hospital for 26 years. The memorial service for him would take place July 1 in the morning. 

Chief Quality and Compliance Officer Tanya Carroccio, at her last meeting before moving back to Arizona, said her department is focusing on education on the code of conduct and on conflict of interest. "The education will go out to all the staff and we have a new Conflict of Interest form, which everyone will need to sign again. In the Code of Conduct, there are consequences for violations. We have a list of what is appropriate and what is inappropriate behavior. The conflict of interest is where someone has any influence over GRMC and may have a financial interest. Those are also violations. I'll be around until the end of next week or if you have questions you can ask the CEO."

Governing Board member and District 4 Grant County Commissioner Harry Browne asked about the forms. "We signed a form that I was told was a conflict of interest form. Do I need to sign a new one?"

Carroccio said: "I recommend you all sign the new form."

Chief Executive Officer Richard Stokes started his report by saying: "Misery loves company. I would like to again point out that Gila Regional is not unique in the country at having financial problems due to Covid-19. We had a $221,000 profit in May, but year-to-date, we have a $11.977 million deficit. $6.2 million from the Payment Protection Program is on the books, but we will be using a lot of that for payroll today. Next week we will begin the application to request that the money be a grant. Right now, it is sitting on our balance sheet as a liability because we have to pay it back. If our request for it to be a loan is accepted, that will cut our loss in half. We did apply for a $695,000 grant for telecommunications to replace our antiquated telephone system We are also preparing distance learning on the computer system. We will go after the loss of revenue from Medicare. We expect about $2 million for December and January. Our insurance companies are mostly working from home, but Blue Cross Blue Shield is the better payer. Medicare is picking up the pace. They usually pay within 10-15 days, but right now, it's more like 45-50 days. On June 22, our cash position was $13.2 million in the bank. At the end of May, we had 65 days of cash on hand, but with the end of PPP, there will be downward pressure on cash as we go forward. At the end of May, we had $16.2 million, but we took a $996,000 pull for payroll."

Manis said $4.6 million in the month was stimulus money, so the $221,000 profit from an operational standpoint is not considered profitable.

Stokes said he was not aware of any future federal stimulus money coming. "Through the state of New Mexico, we have not received any of the $2.5 million from the successor to the Safety Net Care Pool. It's all hung up in the state trying to get the sign off from CMS (Centers for Medicaid and Medicaid). It will get here, but I can't tell you when."

Manis presented the Chief of Staff report as Dr. Brian Robinson had patient commitments. "The Medical Executive Committee continues to meet virtually. We have not had nearly as many medical staff meetings, except for the surgical staff. The General Medical Staff meeting will be next week almost exclusively virtually."

He said the credentialing report comes from the MEC, and "I recommend approval as presented."

Browne made the motion with one change and that is extending Dr. (Sravanthi) Reddy's for one year instead of two. The Interim CEO will work with the Chief of Staff to bring the professional (unintelligle) up to at least good."

The MEC credentialing report was approved.

In new business, Browne presented an offer of $10,000 to compensate Stokes for his time as interim CEO. "He had extra duties as interim CEO, while also doing the CFO job. To me it is a matter of institutional integrity, even though these are difficult times for the hospital. He worked a large number of extra hours. It is incumbent for us to carry through with this compensation."

Contracts included continuing a contract with Dr. John Stanley as medical director for the cardiopulmonary department. Manis said the contract is not to exceed $10,000 per year. The contract was approved.

The next contract was with My Care Solutions to provide telepsychiatric services in the Emergency Department, as alluded to by Rodriguez earlier. "The group came highly recommended," Manis said. "It's a different company from the one we use for telestroke services, but we can use the same equipment. We have begun credentialing the physicians, with six having been concluded today, with two pending. The telepsychiatry will be in the ER, with any immediate consults possible within the hospital. The service will go live the week of July 8."

The contract was approved. Browne said he looked forward to feedback on the service.

Manis also recommended naming Dr. Donald Stinar to continue as medical director for the Sleep Lab, at a compensation not to exceed $10,000 a year. "We are an accredited sleep program, and Dr. Stinar is qualified." It too was approved.

A contract with Dr. Stinar also names him the Special Care Unit medical director. "He is a critical care specialist," Manis said. "The contract is not to exceed $60,000 a year. He has not exceeded it previously. He does the reviewing and evaluating in the ICU." It was approved.

Governing Board member and District 1 Commissioner and Commission Chairman Chris Ponce said he would like for Gila Regional employees to be included in the SWOT (strengths, weaknesses, opportunities and threats) analysis. "The employees are important to the hospital. I think they will have good information and ideas in the departments. It is their hospital."

Manis said they had actually already undertaken to include them. "We have gotten feedback from the department directors and from about 40 -50 people on cost cutting and revenue enhancement. They have put in a lot of thought and energy. We have also scheduled time to meet with line staff."

Ponce said he applauded them for contacting the employees. "I haven't seen the feedback, so I was unaware of it. I ask that they speak to us. I think it's important for the governing board to hear from them."

Governing Board Vice Chairman and District 4 Commissioner Billy Billings asked if the information would be part of the SWOT.

"It is being aggregated as part of the SWOT," Manis said. 

Browne said he supported what Ponce had said. "Of course, each of us hears from only one segment. I'm wondering when we can put out requests for Board of Trustee members."

Billings said he had the same concern. "I want to give people a chance to think about becoming a trustee for the hospital."

Salas said: "Before we solicit applications for new Board of Trustee members, we need an agreement with clear policy on how to communicate between the Board of Trustees and the County Commission. I'm looking forward to the SWOT and the management plan."

Ponce said the priority should be the bylaws and the Board of Trustees' attorney. "It is an important part making sure the remaining trustees are comfortable in how to make the hospital successful."

Billings, who was managing the meeting in the temporary absence of the Governing Board Chairman Alicia Edwards, District 3 commissioner, noted that some of the things being discussed were not on the agenda. "I've been asked what the exit plan for us is. I hope it is public knowledge that we are only temporary." 

Browne suggested appointing a bylaws committee. "We agreed we wanted revised bylaws."

Manis said that within the governing board bylaws, it is clearly within the board's authority to appoint a committee. 

Billings said he had observations. "I thank HealthTechS3 for their quick action. The Level 4 Trauma designation is important, and I think HealthTechS3 can make it happen. We've been working on it since 2018. Critical Access designation has also been considered since 2018. We have already attained most of that, as well as the Rural Health Clinic designation. I think with HealthTechS3, eventually, even though it's a long pull, we will have a viable hospital."

At that moment Edwards returned in time to adjourn the meeting.