10 W Fallon Ave Baker, MT 59313
Fallon County of Montana

FMC Board of Trustees Meeting – April 2023

FMC Board of Trustees Meeting – April 2023



Wednesday, April 5, 2023

MEMBERS PRESENT                         ABSENT                              

Doug Varner, Board President            Alice Kay Schweigert, Board Member

Curt Arnell, Vice President                              

Evelyn Neary, Secretary                                  

David Kirschten, Board Member

Elaine Stanhope, Board Member

OTHERS PRESENT                

David Espeland, CEO

Marjorie Losing, CFO

Marissa Skogen, Recorder


Doug called the meeting of the FMC Board of Trustees to order at 5:31 p.m. in the FMC Community Room. 

  1. – Jason Griffith inquired about members of the corporation remaining at board meetings after the fifteen minutes of public input is completed. Board President Doug Varner shared that the Board of Trustees agreed that after public input, the public would be asked to leave.

No additions or corrections to the March 1, 2023 board minutes as distributed. Minutes stand approved as written.

  1. Quality Assurance / Infection Control: Judy McWilliams explained how she is responsible for the oversight of the multiple various programs that make up infection control, quality improvement, emergency preparedness, safety, and data reporting. Judy shared that she has been an employee of FMC for 41 years and she started as a lab and X-ray tech. Judy explained that her current issues are that the job is everchanging due to Medicare requirements always changing and not enough time or information to give each program the time they deserve. The board expressed a concern about having a succession plan in place for her job.  Judy mentioned that the Montana Hospital Association has a formal program that could assist in training a new employee if need be for infection control and emergency preparedness. Judy explained how her data reporting can be for state or federal level, multi-state level, grants, or to fulfill any other requirement the government may assign to us. For emergency preparedness we did an infectious disease simulation involving EMS, FMC, Public Health, and Superior Care Villa. On August 16th, during the Fallon County Fair, we’ll be doing a disaster simulation with EMS, FMC, and dispatch. Judy shared that in June there will be active shooting training open for FMC employees and the public; there will be 3 classes for employees and 3 classes for the public. Under infection control, Judy reported that the end of the public health emergency for Covid is May 11th. The masking mandate is still in place until the Centers for Medicare & Medicaid Services (CMS) notifies us otherwise, and our daily reporting of cases is in place until December 31, 2024. Judy reported on the HCAHPS Survey report and explained the results about how low response rates affect the outcome of our data (Enclosure). She further explained that the HCAHPS Survey has nothing to do with medical care or patient outcomes, but instead, montitors certain perceptions of our patients.
  2. Laboratory: Lacee Janz reported that she’s been lab manager since 2017. She currently has 2 full-time employees and 2 part-time employees. Lacee explained the lab’s test capacity. The most recent CLIA lab inspection produced no deficiencies. Thrive implementation has been taking up most of the lab employees’ time lately. The Cephied analyzer that the state gave to FMC is running nicely and being routinely utilized. FMC is waiting on samples from Billings Clinic to run parallel tests to ensure that the instrument is accurate. Running quality assurance tests on all instruments is an essential part of accurate reporting.  Dr. Smith at Billings Clinic is FMC’s lab director, so they assist us by holding samples of tests they’ve already ran for us and then sending the samples for us to test our instruments. FMC just completed the Mini Health Fair and had 258 draws. Billings Clinic will come to Baker to help with the big health fair scheduled for April 26, 2023. Some equipment in the lab is getting older so Lacee will be putting it on the budget this year to be replaced. Covid testing has been way down: 0 last month and 1 this month. Quality Health Indicators (QHI) is a federal program where data is inputted into a national database and compared across several states.
  1. Update on A/R and Collections Processes: Margie requested that this topic be moved up on the agenda. The board approved. Katie DuCharme joined the meeting and recapped the March Board Meeting discussion. Katie informed the Board that FMC needs to update its current collections policy to match the Thrive system’s capabilities. She explained the process that we used under Centriq, which cannot be used under Thrive. Katie went into great detail explaining the issues and potential solutions to resolve the accounts receivable and collections issues. In depth discussion occurred amongst the board about the possibilities. David Kirschten moved that accounts with balances older than November 1, 2022 be offered a 50% discount if they are paid in full by the end of one year, and that any balances newer than November 1, 2022, be allowed 12 months to be paid in full from the date they became self pay, effective July 1, 2023; if either of these balances are not paid in full, then the full amount (less any interim payments) will be sent to collection. Ev seconded. There were 5 ayes and 0 nays. The motion stands approved.

Marjorie Losing shared that requests to use HRON Funds for LTC purchases need a motion to spend them and asked if the board would approve purchasing a popcorn machine for the residents due to the previous one breaking.  Elaine moved that the purchase be approved. David seconded. All ayes and 0 nays. Margie went over the February financials with the Board of Trustees. February was a slow month with 8 IP days and 2 Skilled Days. Gross Revenue for the month of February was $562,202 while the budgeted amount was $857,864. Net Operating Revenue was $613,307 while the budgeted amount was $878,296. Expenses for the month of February were $935,704 while the budgeted amount was $1,003,256. A large portion of our expenses were travel costs for the Thrive team, however, overall expenses are starting to dwindle. Operating Loss was ($322,397). Net Loss was ($281,647) (Enclosure). Marjorie has been interacting with a business intelligence software program built into Thrive and she’s excited about the outcomes she has seen so far and how they will help with stats. Once she builds customized dashboards for FMC, the resultant data will be very useful.

  • Investment Portfolio Results: Margie presented to the Board the financial report on behalf of Jim Cusimano, CFP (Enclosure).
  • 990 Draft Review and Approval: Margie explained the figures from the 990 came from the annual audit. She explained and discussed what the 990 is and why we are required to file it. Elaine moved to accept the 990 Draft. Curt seconded. There were 4 ayes and 0 nays.
  1. Tylyn Bova, NP Update: The CEO reported that Tylyn is having difficulty making a decision due to life circumstances. Further discussion arose in regards to a plan for staffing the clinic.
  • HR Study Progress Update: Marissa updated the Board about her progress in making the recommended changes from Associated Employers in the HR department.
  • Trustee Appointment: The board discussed prospective appointees.

  1. Dr. LaPan, Podiatrist Outreach Clinic Inquiry: Dr. LaPan is interested in offering an outreach podiatry clinic at FMC on a regular basis.  He has been seeing Baker patients for nearly 30 years in Sidney and Glendive.  The board was pleased to hear of this request.
  • Proposed Corporate By-Laws: Due to time constraints, this topic was moved to next month’s regular board meeting.

The Board adjourned their regular session having completed the agenda.

s\Doug Varner, President

Marissa Skogen, Recorder