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

FMC Board of Trustees Meeting – February 2024

FMC Board of Trustees Meeting – February 2024



Wednesday, February 7, 2024

MEMBERS PRESENT                                     ABSENT                          

Curt Arnell, Board President                             Michele Gray, Member

David Kirschten, Vice President   

Evelyn Neary, Secretary             

Elaine Stanhope, Board Member

Erin Lutts, Board Member – via phone

Del Espinosa, Board Member

OTHERS PRESENT                                       

David Espeland, CEO                                     

Marjorie Losing, CFO                                     

Heather Schwindt, Recorder

Katie DuCharme, Reporter                    

I.   CALL TO ORDER Curt called the meeting of the FMC Board of Trustees to order at 5:30 p.m. in the FMC Community Room.   

II. PUBLIC INPUT There was no public input.  

III. APPROVAL OF MINUTES      No additions or corrections to the January 3, 2024 board minutes as distributed.  Elaine moved to adopt approval of the minutes.  Dave seconded the motion.  All aye, 0 nay.  Minutes stand approved as written.  

IV. MANAGER REPORTS   Spring Nacey reported to the Board that Rehab has been pretty slow the past few months, but is picking up.  The number of patients not showing up or coming in late is on the rise, which is a contributing factor.  The board discussed looking into how to use our EMR system to possibly do text notifications to patients.  The therapists are all doing their best to stay current on patient documentation.  Spring discussed the therapists and their specializaitons to the department.  With the low numbers of patients, there is not a need for a rehab aide.  There currently is a wait list of 1-2 weeks.  

V. FINANCIALS       Big Sky Investments – Jim Cuisimano:  Jim discussed the growth of our initial investment.  He noted that he is not sure what interest rates are going to do this year, but he does not believe it will impact our investments.  He is recommending to keep our investment policy as it is.  (Enclosure)   Auditor Report – Eide Bailey:  John Hauck with Eide Bailley went over the FY 2023 Audit Report in detail with the Board of Trustees.  No major discrepancies were noted. (Enclosure)   December had 8 inpatient days and 28 skilled days.  Gross Revenue $814,000, $42,000 under budget.  Contractual adjustments are positive as we are receiving the higher rate from Medicare due to low patient volume.  Net Operating Revenue $854,000, $18,000 under budget. Expenses $1,063,000, $16,000 over budget.  Operating Loss was ($208,000), $34,000 on the negative side of the budget. Non-operating income: County reimbursement $34,000, FMC interest income $48,000, for a total of $105,000, leaving a net loss of $103,000.  YTD Gross Patient Revenue $4.4 Million, $670,000 under budget.  YTD Net Operating Revenue $4.7 Million, $439,000 under budget. YTD Total Expenses $6.1 million, $62,000 on the positive side of the budget.  YTD Operating Loss ($1.4 Million), $377,000 on the negative side of the budget.  YTD Non-operating Income $431,000.  YTD Net Loss ($983,000), $173,000 on the negative side of the budget. YTD 73 Inpatient days, with 99 in the budget.  2,091 swing days with 2,924 in the budget, keeping our census down.  Ancillary services: ER patient count is below budget.  Procedure room and observation hours are ahead of budget, even though our patient count is below budget. Lab is below budget, but blood bank is ahead budget.  EKG, radiology, mammogram and CT, are below budget, but ultrasound, and MRI ahead of the budget.  Rehab visits are below budget but we are seeing an increase in their numbers. PT Visits are at 2,600, budgeted for 3,300. OT Visits are at 994 with 1,100 in the budget.Outpatient counts are 1,981, budgeted for 3,100.  YTD Change in Cash Equivalents ($598,000).

VIOLD BUSINESS   Auxiliary By-laws Update: Charter and Resolution:  No update at this time.  Our attorney has not yet responded.  We did contact the Auxiliary president and let her know we are still waiting for a response from our attorney.   STAT AIR CONCERN UPDATE:  Documentation was sent to a peer review agency.  The Peer review Contacted Stat-Air to ask their protocol, they did not contact us with the same question.  Stat Air was found to have followed protocol.  FMC will be working with Stat-Air to define a protocol that can be agreed upon by all parties to ensure the appropriate patient liability.  

VII.  NEW BUSINESS   Integrated Behavioral Health Grant:  We received $18,000 to use to springboard our behavioral health program to the next level.  We are using it for training, 3 new tablets, upgrading our wi-fi network, and securing a 2-year contract with Frontier Psychiatry.   MDU Grant:  We received a grant to purchase chairs and racks and will identify them as being donated by MDU.  The grant was for $3,400.       Dietary Turnover:  For the past year, there have been two acting managers in Dietary, one of whom was supposed to be training the other.  But we had been hearing conflicting comments about which person would end up being the manager long-term.  They were both approached and asked this question.  Dawn agreed to continue as the manager and Lorie was supposed to step down as a fulltime cook.  Within a week, Dawn stated she was not going to be the manager and Lorie was not going to resume managerial duties.  Several options were given on how to resolve this situation.   In return, most of the cooks resigned instead of finding solutions.  We have since hired a cook and found a manager, and have interviews set up to fill the third cook position.       School Schedule Change Potential Impact:  The change to the schools going to a 4-day week may impact some of our employees; we have already heard from a couple of them.  We will need to hold ongoing discussions about how this may impact our staffing.   The Board adjourned their regular session having completed the agenda.                      

VIII.     CLOSED EXECUTIVE SESSION.                                

s\ Curt Arnell, President   s\ Heather Schwindt, Recorder and Transcriber