Two GRMC staff members receive recognition for their years of service to GRMC. From left are Tammy Drew, 5 years of service in registration and Fredina Rogers for 20 years in infusion services. Behind is Board of Trustees Chair Dr. Fred Fox, who presented the recognition certificates.

Photo and article by Mary Alice Murphy

On Aug. 23, 2023, to open the monthly meeting of the Gila Regional Medical Center Board of Trustees, Chair Dr. Fred Fox read the mission, vision and values of the hospital, as is customary at the beginning of each board meeting.

He said he had one comment: "I will contribute to the weekly GRMC internal newsletter. I will do sort of an introduction of each of the board members."

The board recognized several hospital staff members for their years of service to Gila Regional Medical Center.

Two were present to received their recognition certificates—Tammy Drew for her five years of service in registration and Fredina Rogers for her 20 years of service in infusion services. The others recognized included Barbara Gorman for five years service in imaging; Anna Lucero for 10 years of service in environmental services; Jennifer Mares for 10 years of service in the recovery room; and Lynette Saenz for 10 years of service in the operating room.

Gail Stamler spoke during public input. "I am happy to hear that the hospital is now providing 3-D mammography and starting next week stereotactic biopsies. We've waited a long time for them. And while we are honoring people, I would like to give a shoutout to Donna Bevill, who has been working in radiology for many years, and gets a lot of compliments on what a fantastic radiology tech she is."

"Along those same lines, I would like to report a client who was very pleased with her 3-D mammogram. She had been avoiding the test for many years, but was pleased with her experience with Donna."

After trustees approved the consent agenda of minutes, they heard reports and updates.

The first report listed was from the Chief Nursing Officer, Cynthia Lewis, but Chief Executive Officer Margie Molitor said Lewis was not present.

"Jessica Workman, our new CNO will begin on Sept. 25, 2023," Molitor said. "She is working at her current hospital until the very end, and she asked for an extra week to get her family moved here. Cynthia and her team have been preparing the transition. Cynthia also asked me to announce that we have 50 nominees for the Daisy Award this year. These nominations come from patients and family members wanting to recognize the good service they had from individual nurses. The award will be presented at a reception from 3-5 p.m. on Oct. 12."

Next came the Chief Financial Officer Patrick Banks' report. He noted it was for July, the first month of the fiscal year. "The net operations bottom line had a net $15,000 operating surplus. Last year in July we lost $1.3 million."

He said the trends were a bit lower in July, with fewer emergency room visits and fewer operating room procedures. "Both are common in July. Two or three years ago, it seemed unlikely that we would break even, but it is now our expectation that we will break even this year. After all, we posted a $1.3 million improvement over last year and we are on track with our budget."

Fox said he was quite pleased with "the direction we seem to be heading toward financial stability."

"I should caution that health care is always unpredictable," Banks said. " On our basic operations on our core services delivery, we did a great job and we can continue to do a good job as challenges pop up."

Trustee Seth Traeger said: "Seeing the improvement over last year, there has to continue to be discipline and execution behind the scenes to keep going that direction."

Scott Manis, HealthTech regional vice president, said one number on the report is key. "The salary number is the same, so everyone is stepping up. And our traveling nurses number is down."

Molitor emphasized that it is due to every department working toward the same goal. "When volumes were down, we asked if people could flex, and they did."

"Health care, not just in Silver City, requires planning and forethought," Banks said, "but it depends on execution every single day."

The next report came from Chief Quality Officer Ramona Wilson. She said that the New Mexico Department of Health had implemented a new rule for rural hospitals across the state for the improvement incentive also called the value-based program. "The goal is to offer better value to Medicaid patients, better funding for Medicaid patients and to create an incentive for hospital performance, either to improve in certain areas or to maintain high quality, as well as to create better access for Medicaid beneficiaries. There are eight measures we are focused on."

They include reduction of re-admissions, patient safety and adverse events. There is a composite measure with 10 measures that roll up into that one. They include septic shock, early elective delivery and items concerning the ER department and potential alcohol or drug use, and [others that this author could not scribble down and did not receive the requested report].

She noted the hospital plans to do its flu shot campaign again at the end of September. "Last year, during the campaign we had a 74 percent vaccinated rate, and during flu season, we got up to 82 percent. This year, our goal and the national goal is 90 percent."

"We submitted a proposal to the New Mexico Hospital Association for the Quest for Excellence Award," Wilson said. "Multiple areas around the organization provided input and efforts. It is focused on improving patient experience and their discharge to home, so they have a better understanding of their medication and their plan of care."

Wilson said they brought in their patient liaison, who makes calls within 48-72 hours of discharge. "We also incorporated our new social determinants of health project into that as well, identifying any patients with a social barrier. So lots of work with this, so we decided to send it to the New Mexico Hospital Association."

Molitor said: "Ramona has been very proactive on this pay-for-performance on Medicaid. She's always asking what does this measure mean? how can I get the best score possible? She'll be the first to get it right."

Wilson said it's very difficult to get information from the state, so "I'm sending out emails to multiple people, researching a lot and reading a lot to make sure we're getting the measures right and collecting the data."

Fox said he appreciated the patient liaison getting calls out to patients after discharge and for determining impediments in the home to care and follow up. "I think they are fully in line with our values and mission."

"I think the next step is reaching out to our community providers to provide more support and help," Wilson said.

Molitor said, when the Joint Commission came to do its survey in March, the social determinants were new to them, but "Ramona and her team already had it knocked out, with a plan. We're lucky to have that team that can do that."

To a question, Wilson said six to eight measures that roll into the composite measure on re-admissions include COPD, heart failure, among others.

Chief of Staff Dr. Colicia Meyerowitz said she would present her report in executive session.

Molitor, in her CEO report, said Manis would go over the CEO candidates in executive session. "We met today with ESS, which is our new emergency room service. They have four providers and four advanced practitioners that will be scheduled. They will start on Oct. 1, 2023. I think it will be good synergy with them providing the hospitalists as well as the ER group."

She said the hospital is still waiting on Trane to "give us their scope of work on the air handlers. They did a walk through maybe a month ago and we thought it would be two weeks, but they haven't sent it yet. As soon as we get that, we'll move forward with the project."

Molitor said the lighting replacement in the OR was completed. "And for our nurse call system, we have a grant for $500,000 to upgrade it," she said to mutters. "I know it's expensive, but we have a lot of nurse calls in the hospital. We scrubbed the project one more time to make sure it was where we needed it to be when we need it to be. We will wait for the quote, and hopefully, that should get started later on this fall."

The Meditech Expanse upgrade continues. "They will be here next week for the first round of testing, and we're still scheduled for go live on Nov. 7."

She said they had found a good use of Pod 3. "We will move Dr. Jesus Carreon and his clinic into the hospital. The area will be renovated, actually, it's more demotion then the renovation, as we will enlarge the entrance door for handicapped accessibility and improve the sidewalk on the southeast side."

"We are looking at a remodel in the Emergency department," Molitor said. "When people walk in we want to have our people lay eyes on those patients as soon as they walk in the door. They can get them registered and triaged, so they don't get lost."

She continued: "With Dr. Etheridge leaving as our only pediatric clinician, we are really interested in taking the lead on recruiting a new pediatrician. We also want to make sure if anyone is writing grants, we want to make sure we are a cohesive unit in the county, so it doesn't look like we're fighting anyone. Our new radiation oncologist Dr. Arsenault starts on Friday. He is a sharp guy. He's very responsive and on the ball. We have three different recruiting firms looking for a cardiology nurse practitioner and for the pediatrician."

Molitor noted that senators Heinrich and Lujan have put the hospital on their appropriations lists for $1 million for an MRI. "We are also on the list for a new ambulance. Hopefully we will get both."

She said the GRMC Foundation is up and running wanting to fundraise for equipment and things for the hospital. They are doing a 40th anniversary party on Friday, Oct. 27, called Ruby and Scrubs at the Murray Hotel from 5-8 p.m. Tickets are $25 each, but "I can tell you we're going to have great hors d'oeuvres. They will also have a silent auction and live music. They are also looking toward having people give every year to the Foundation."

Fox said he was at the meeting about the recruiting. "It's something we want to be part of. It's critical that we have community collaboration."

Board Secretary Pat McIntire noted that the Foundation also still has scholarships for nurses, which over the years have helped many nurses in the organization.

Manis said, as Molitor had said, he would be talking about CEO candidates in the executive session. "We've made a lot of progress in the search, We'll also be talking about the process and and timing going forward. It's an exciting time for the hospital. I personally interviewed several good candidates. Secondly, Health Tech started a newsletter to the CNOs and if you like, we can send it to you, too, but it's another resource we've recently started. Speaking of resources, we've sent to you a list of webinars that are coming up. They are typically monthly. Feel free to sign up for them. They are free. I am pleased to see the sound financial performance of the hospital. Not everything is about finance, but a hospital needs to run like a business. At the end of the day, it's about fundamentals, so finance is always important. It's nice to see that we are no longer digging out of a hole. Health Tech will provide sponsorship for the Foundation event. As the new CNO comes aboard, we will dial her in with Carolyn St. Charles to make sure you have continued excellence at the bedside."

Fox asked Manis to send a copy of the CNO newsletter to JoAnn Holguin, executive assistant to the CEO, "so we'll know what resources are available."

With no old business, the board members went into executive session for several hours.

When they came out of closed session, they addressed and approved several items of new business, including 1) Approval of the MEC (medical staff executive committee) recommendations for provider credentialing; 2) Approval of MEC recommendation for Emergency Medicine delineation of privileges; 3) Approval of a first amendment to the physical employment agreement with Dr. Cherie Hayostek, from part-time to as needed; 4) Approval of a software license agreement for chronic care coordination and management with CrossTx for documentation, tracking and billing for chronic care management in the family practice and cardiology clinics; 5) Approval of the NPPGOV co-operative purchasing agreement and capital purchase for EMS extrication equipment through Curtis Tools, which allows the hospital to purchase extrication equipment for EMS use; 6) Approval of software as a service agreement for online Meditech user education, for formal education for Meditech electronic health records users; and 7) Lastly approval of a resolution for the ICIP (infrastructure capital improvement plan) for 2023-24.

The board adjourned.