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

FMC Board of Trustees Meeting August 2022

FMC Board of Trustees Meeting August 2022



Wednesday, August 3, 2022

MEMBERS PRESENT                                          

Betty Mueller, President

Doug Varner, Vice-President                                

Alice Kay Schweigert, Board Member

Curt Arnell, Board Member

Bryant Steen, Board Member

            OTHERS PRESENT                      

            David Espeland, CEO

            Marjorie Losing, CFO

            Marissa Skogen, Recorder


Betty called the meeting of the FMC Board of Trustees to order at 5:30 p.m. in the FMC Community Room. 

II.         PUBLIC INPUT – Jason Griffith shared his concerns pertaining to FMC.

III.        APPROVAL OF MINUTES           

No additions or corrections to the July 6, 2022 Board minutes as distributed.  Minutes stand approved as written.


QA / Infection Control: Judy reported that QA is working on care transitions. In order for FMC to get grant money, we are required to complete certain tasks. We are currently working on Emergency Department transfer communications, AMI care, ED throughput, HCAHPS, Swing Bed care, and health care worker immunizations. Judy reported on the Emergency Preparedness Hazard Vulnerability Assessment. The assessment takes naturally occurring events, technological events, human-related events, and hazardous material events paired with the probability of each occurrence happening, and what impact it would have on humans, property, and business, and then evaluates our preparedness level (internal and external) for each said event.  Kaiser Permanente just changed the topics on their worksheet and we are no longer allowed to choose which emergencies we would like to evaluate. Judy updated the Board on the changing effects of Covid-19. The ED Dashboard Report shows that we’re doing well. There are no problem issues reported on any of the metrics. Judy explained the PIN report from the second quarter of 2021 to the first quarter of 2022. It shows the acute inpatient days, nursing staff turnover, days cash on hand, and average length of service in hours compared to others. The graph compares Peer Group 1 to Peer Group 2; FMC is a part of Peer Group 2. (Enclosures).


David introduced Gina Manhart, FNP to the Board of Trustees and explained her desire to work at FMC as a fulltime provider in the clinic. Gina proceeded to share a bit of her background and experience. She shared her five-year plan to the Board and that she would like to stay at FMC long term. Further discussion was held between Gina and the Board regarding conditions of her potential employment at FMC.


Marjorie Losing went over the interim June financials; “interim” due to being fiscal year end financials. She explained that June was a much slower month with 6 inpatient days and 7 skilled days. Gross Revenue for the month of June was $767,872 while the budgeted amount was $884,595. Net Operating Revenue was $356,010 while the budgeted amount was $810,477. Included in net operating revenue is a $450,000 payback adjustment due to being overpaid by Medicare, based on our CAH model prediction. Expenses for the month of June were $960,340 while the budgeted amount was $955,576. Operating Loss was ($604,330) while the budgeted amount was ($145,098). Net Loss for the monthwas ($374,799) while the budgeted amount was ($19,410). (See enclosure).


  1. Trustee Appointment: Discussion was held as to the path that should be taken in regards to the board being short one member, and the timeline as to when the role would be filled. The open position would be in effect until the end of December 2022, and subject to potential renewal by the membership at the Annual Meeting. Doug made a motion to talk to Elaine Stanhope about filling the position for the remainder of the open term. Alice Kay seconded the motion. The motion was approved.
  • Provider Staffing Update: The structure of provider staffing in the clinic was explained and discussed. The clinic would be staffed by 2 fulltime midlevels, and hopefully on fulltime physician.  Three additional providers would rotate ten days at a time, work in the clinic, and take call.
  • Provider Contract Renewal Update: The Board of Trustees discussed a current midlevel’s contract and whether to amend it. Details of loan repayment for the midlevel was discussed, as well as the timeline of when the payment should be distributed. The potential of offering Gina Manhart, FNP a job and the parameters of her contract were also discussed. The Board also discussed loan repayment her.  Bryant made a motion to offer her a 2-year contract with a 90-day out clause prior to the end of the contract. Doug seconded the motion. The motion carried.


  1. LTC Broken Sprinkler Head: Judy explained the steps taken during the course of the flood and how it was handled. The sprinkler head started dripping so a garbage can was placed underneath it. Judy reported that about an hour later, the leak was dripping more, so the fire department was called to assist in turning the water off. Johnson Controls was called by the maintenance assistant and she did what she was told to do and the water was turned back on. About two hours later, a rubber cap over the leak blew off, causing the flood in LTC. Further discussion was had regarding the Juvare system and how this flood pointed out some gaps in the system that can be improved.
  • LEAN Study – Clinic Staffing: Judy updated the board about the current suggestions offered thus far by the LEAN student from MSU-Bozeman. He has provided five different staffing scenarios or solutions for the clinic based off his study. Judy shared the statistics based off of the student’s findings and how he compared the clinic’s volume level of patients to other clinics of comparable size in Montana. The student found that there wasn’t a large amount of the community who wanted different or extended hours.
  • Corporate Membership Applications & Policy: A draft of a revised corporate membership policy was discussed by the Board of Trustees.  The proposed revisions clarify the policy. A group of corporate membership applications was tabled until further research of the physical address of some member applications was completed.


The Board adjourned their regular session having completed the agenda.

s/ Betty Mueller, President

s/ Marissa Skogen, Recorder