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Lawyer advises how to avoid open meetings law
Several topics were discussed at the Mount Ayr Hospital’s board of trustees regular monthly meeting, Monday, November 27. Leading off the meeting was Susan Freed, legal healthcare attorney, who was present via zoom to give a legal overview for new board members and to refresh current members on primary duties of public board officers. Mike Tratcha, Vice President of rural hospitals for Mercy One was also present to add information.
Freed began by instructing the board that as a public entity the public does have access to more information pertaining to a county hospital, such as Ringgold County Hospital, than a private hospital.
While a board of a county hospital may be more highly scrutinized because it oversees a public entity, the duties and loyalty are the same for most boards.
Specifically, the board oversees hospital management in good faith, making decisions believed to be in the best interest of the hospital. Additionally Freed pointed out examples that could be violations of the duty of care such as missing multiple meetings or not participating in the meetings. Loyalty is also expected to be given in the best interest of the hospital. Examples pointed out for board members would be recognizing conflicts of interest and recusing oneself from decisions where a conflict of interest might exist or might even appear to exist. Freed went on to caution board members against involving themselves in administrative day-to-day duties such as employment issues.
She also touched on open meetings law and outlined when a gathering of board members discussing hospital business would be considered a meeting and fall under the open meetings laws. When four or more members are gathered it is a board meeting and the conversation is open to the public and should be publicized. Social gatherings are not included.
Freed advised the board that a “work around” to the open meetings law is to create committees that include three or fewer board members which is a “useful way to keep information from the public.”
Freed also addressed closed meetings for public boards. Closed meetings should be called for specific reasons, only that topic can be discussed during the closed session and while the meeting is closed to the public, minutes are kept and the session is taped.
Discussion was also held concerning the lack of co pays collected at the time patients are seen for clinic visits.
Debbie Klommhaus, revenue cycle director, reported a 30% collection rate and was present to get direction from the board on moving forward in bringing that number up. Several suggestions were made, including more visible signage that would make patients aware that co pay was expected when signing in for a visit. Two questions were brought up. What about the patients that do not have a set co pay as their co pay is based on a percentage and what if a patient does not have the money that day for their co pay? After lengthy discussion and several answers given, the board did vote to move forward in supporting more visible signage and other suggestions to raise the collection rate of co pays.
CFO, Missy Walter gave her finance report stating, “October ended off with a good month.” On the income side, inpatient revenue was under budget for the month, by $61K, outpatient revenue was over budget by $279K and primary and specialty clinic revenue came in over budget by $26K.
Overall, gross revenue exceeded budget for the month by $244K.
Net patient revenue was under budget by $65K. Net 340B revenue continues to increase month over month and was $54K for October.
Total operating revenue was $2.16M for October, which was over budget by $14K for the month and under budget by $522K for the fiscal year.
Looking at expenses-salaries, wages, and benefits came in $77K under budget for the month and contract labor totaled $193K, $35K more than budgeted due to acute care, physical therapy, and ortho clinic contracted staff.
Fees were under budget by $97K. Supplies and drugs were $45K under budget for the month due, in large part, to wound care supplies, pharmacy drugs and oncology drugs.
Regarding drugs and supplies, Walter stated, “We continue to monitor closely, dig in and chip away at this expense and are seeing it go down significantly.”
Depreciation expense was under budget by $3K. There were two new assets placed into use in October, both extending the lives of existing assets: repairs to the roof-top units and a refurbished 12-inch C-arm used in vascular procedures.
Total operating expenses totaled just over $2M for the month, an amount $192K under budget. Year to date total operating expenses are under budget by $297K.
The year-to-date bottom line is a loss of $118,599, which is below budget.
In other business:
Dr. Wilcox stated flu and covid season are in full force. RCH has partnered with Public Health to make sure babies qualified who are seen routinely in the clinic had access to the RSV vaccine if requested.
Amy Mobley, CNO, informed the board that in the next year RCH will be sharing respiratory therapy services with Madison County Hospital. Mike Hague will be traveling to Madison County.
Nicky Gilbertson, CEO, had three items of interest to share with the board.
RCH is looking to pilot a tele-health program for cardiac services in February. This service has been rolled out at some other locations and has been successful.
The ophthalmology candidate has stalled out and the recruitment process will be reopened.
RCH will soon be providing Ipads and RCH email for all board members.
The regular meeting was ended, and a motion was made by Greg Jobe and seconded by Chris Eaton to once again go into closed session citing Code 21.5 (5) (1) “Board Evaluation of Professional Competency.”
