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

FMC Board of Trustees Meeting – September 2023

FMC Board of Trustees Meeting – September 2023



Wednesday, September 6, 2023

MEMBERS PRESENT                                     ABSENT                          

Doug Varner, Board President                        

Curt Arnell, Vice President                    

Alice Kay Schweigert, Board Member

Elaine Stanhope, Board Member

David Kirschten, Board Member

Erin Lutts, Board Member

Evelyn Neary, Board Member

OTHERS PRESENT                                        PRESENTERS PRESENT

David Espeland, CEO                                      Donna Halmans, H.I.M.

Marjorie Losing, CFO                                      Judy McWilliams, QA/Infection

Heather Schwindt, Recorder                            Wipfli, LLC

I.   CALL TO ORDER Doug 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.  – There was no public input.  

III. APPROVAL OF MINUTES      Elaine shared that in the August 2, 2023 board minutes as distributed there was an error as she did not make the motion to approve the minutes to the February 20, 2023 special meeting; Alice Kay made the motion.  Upon recognition of this correction, the minutes stand approved.  Alice Kay made a motion to approve this correction, Erin seconded        No other additions or corrections to the August 2, 2023 board minutes as distributed.  All ayes, 0 nays.  Minutes stand approved as written.  

H.I.M.: Donna Halmans, Health Information Manager, shared that she has been the manager for 2 years and has worked in the department for 13 years.  Donna shared that she is currently the only one in the department but has a new hire starting on September 11, 2023.  She is currently working on updating the policies on sharing third-party information with the change over to Thrive.  She also shared that with the change some of the notes take a little longer, and some of her access to old records is no longer available.  She has logged a situation to Thrive to assist in correcting this issue.  She is not sure if part of the issue is due to switching all of the information to our Cloud server rather than our hard servers.  Thrive is harder to gather mass quantities of old records than Centriq was.  We currently only send records via fascimile to thrid-parties, but we are looking into Sharefile or DropBox as that is web-based and becoming more mainstream than fax.  There is also a Health Informaition Share file progream that is in process of being built that will connect multiple facilities to share records.  Donna left the meeting.
QUALITY ASSURANCE/INFECTION CONTROL: Judy McWilliams discussed Emergency Preparedness.  The state had a training for HAM Radio communications to be used in emergency situations. They ran out of funding so it was on hold, but we were contacted to see if we were still interested in that program.  Eldon King the ADON is a HAM Radio operator.  There is a meeting scheduled to discuss if it would be beneficial.  There was an infectious disease outbreak training and trauma training held in conjunction with Baker EMS, Public Health, Assisted Living, DES, and Fallon  were included in these trainings.  We also held two compassion fatigue classes.  We are signed up for an armed intruder training, but the state ran out of money so we are waiting to hear back about that. Signed up for  HERT (Hospital Employee Response Training), hasn’t been done in the facility for a long time. Mini Strike Force Infection Control Grant, requested $7,474.67, received $7,374.14.  Used the money for microfiber cleaning products for Environmental Services, new resource books, and supplies for the mobile sanitation stations.  The funds had to be used specificly for infection control.  There are other grants that Judy is looking into for other resources to build up our infection control department. Quality Improvement Assessments focusing more on wellness and coordination of care instead of sick care.  Health equity and population health.  A new HCAHPS Survey ran by a third-party is being used for this assessment. Judy provided an example of the survey to the Board.  We sent out 10 and received 6 back, the national average of return is 20%.  Patient safety is being measured by these surveys.  The surveys measure the patient experience while they are here, and not on the education, safety or after-care and recovery.  Funding two years from now will be impacted by these surveys.  Our baseline data came from informaiton received in 2010 and 2013. 1st and 2nd quarter QHI (Quality Health Indicators) assesments were provided to the Board for review to show our value, the State’s value, and how many facilities participated in the assesment. These assessments are used to show facilities where they are on average to ensure they are meetng or exceeding the average expectations of care for patients during and after admission. Judy passed out the Montana Opioid Assessment Summary to the Board.  We are at level 0 right now, once we have submitted it, the state will do the assessment and tell us what we need to work on.  Fallon County currently is very low on risk as we are one of the lowest prescribers of opiods in the state.  The providers are all on board with filling out what they need to complete the survey.  Judy left the meeting.

V.  WIPFLI, LLC, AUDIT PRESENTATION   Wipfli representatives appeared in front of the board via Teleconference.  A presentation packet was provided to the members with information about their firm, the audit services they provide, the clientele they serve, and a pricing ruberic to follow along with during the presentation.  John and David ended the teleconference.   After the Presentation, Margie provided a handout with our current audit services that are provided by Eide Bailey as well as their pricing ruberic.  Discussion ensued regarding if we switch over to Wipfli or stay with Eide Bailey.  There is a sizeable pricing difference, and with the current budget, Wipfli is more affordable.  Wipfli has been the most competitive Audit firm that the board has looked at over the years.  It was discussed that there may be a preference to stick with Eide Bailey through this year due to having two systems in  this fiscal year with the switch over to thrive but possibly going to them to discuss their pricing moving forward.  Dave Made a motion to retain Eide Bailey through this year at a number not to exceed their proposal.  Elaine Seconded the motion.  All aye, 0 nay.  Motion passed.   

Fiscal Year End 2023 Financials:  During the August meeting, Marjorie presented to the board the interim Fiscal Year End Financials.  The financial report given to the board was the finalized totals for Fiscal year End.   The Adjusting entries are as follows: $28,000 from pharmacy, dietary and purchasing for a decrease in inventory in these departments; Accounts Receivable for $82,650 from the Foundation for the reimbursement of the ultrasound machine; and a refund of $41,000 for an invoice that was double paid for our ER stretchers that were purchased with COVID Grant money.  We are awaiting the checks from the Foundation and Stryker for the stretchers, but the amount has to be attributed to the FYE 2023.  
YTD numbers: 
Gross Patient Revenue $8.7 million, about $2.0 million under budget.  Net Operating Revenue was $10.0 million, about $1.0 million under budget.  Total expenses $12.3 million, $295,000 under budget.Operating Loss ($2.3 million), $765,000 on the negative side of the budget. Non-operating Income was $528,000, for a total Net Loss of ($1.7 Million) or about $535,000 on the negative side of the budget.   Margie then went through all of the Manager Reports, broken down for the fiscal year by department, showing each department income, expenses, labor hours, and contribution to overall overhead.  Noted that all managers get copies of their departmental reports as well.   Supplemental Schedule Index was presented for FYE 2023 showing accounts, balances, income, expenses, and graphs showing FYE numbers and comparisons.    

VIIOLD BUSINESS   A.  CorporateBy-Laws Revisions: The revisions from the previous month were submitted to the Attorney for a review.  The attorney made the changes and added a couple more suggestions.  The Board went through them and made their final comments to get to the attorney.  Final approval of the revisions will be made at the next Board meeting.   Victoria Susa, DPT, Contract Renewal:  Victoria was offered a contract extension with a 5% raise over two years and she countered the offer requesting an 8% raise over the next two years, as that is what she has received in the past.  The Board discussed the reasoning behind her request, and deliberated about where she was on the MHA scale.  With their offer, she is in line with the survey.  They also discussed the percentage of the increase she has received in addition to her current contract due to the Board approving a rate increase, and also looked over the budget and noted that at this time, they are going to hold their offer of a 5% increase over two years.  It will be presented to Victoria and discussed at the next Board meeting.   Recruitment Report:   Report from CI Health was reviewed.  Report showed how many calls, emails and texts have been sent to recruit.  The suggestions included offering more money or bigger bonuses.  They stated the challenge we are facing is our location, and the pay rate.  We did make an up-front payment of $13,000 for recruitment.  We do not have to pay more unless they produce a candidate.  Discussion ensued on if more money or bonuses should be offered.  There are two or three months left on the contract with CI Health to produce a candidate.  The Board does not want to extend or renew with CI Health.     

VIII.  NEW BUSINESS   MHA Annual Convention:  Invitation was sent to all of the trustees.  Some didn’t receive the information.  It will be re-sent to them.  If there is any interest, make sure to let David know so he can complete their registration.  Trustees are being encouraged to attend by MHA.   Patrick Smith:  Reception of Patrick was very positive and seems well liked.  He will be back at the end of September and he will be back again in late October and first week of November.  He will be in Alaska at the end of November and in December.  Mary will credential him and we will try to continue to have him back.  Also, Lisa Langburd will be back after she is done in Alaska and will rotate with Patrick so we will have one of them each month.   Gina Manhart:  Gina submitted her Student Loan reimbursement application.  She does qualify for the program at the maximum amount of $25,000.00.  Discussion regarding if the full amount should be awarded was had.  Curt made a motion to pay the full amount of $25,000.00, Evelyn seconded.  All ayes, 0 nays.  Motion passed.   Upcoming Events:  Annual meeting coming up, Board will start looking into new trustee appointments.     The Board adjourned their regular session having completed the agenda.                      

CLOSED EXECUTIVE SESSION                         
s\ Doug Varner, President  
s\ Heather Schwindt, Recorder and Transcriber