NVH Board reviews slew of 'dated' reports

TONASKET — North Valley Hospital’s Oct. 12 regular board meeting included reports from administration and senior management dated in September, written for the previous board meeting that got cancelled.

COO John McReynold’s report, dated Sept. 28, announced approval from the Department of Health for the Plan of Corrections submitted following the July Survey and a follow-up visit for the CMS Condition of Participation. McReynolds thanked Kathy Swedburg for returning to NVH as an Interim CQI Nurse (following the departure of Preet Singh) to “tackle some of the bigger projects stemming from the DOH Survey.”

“Her passion and experience drastically improved the quality of our response to DOH and helped to make the follow-up visit a success,” said McReynolds.

“These reports were prepared for the last meeting, which was cancelled, so they are a little dated,” added McReynolds.

A report dated Oct. 9 from former Patient Financial Director Jana Symonds, recently demoted to Business Office Manager with a large pay cut, included her letter of resignation. Symonds reflected changes over the last eight years including reducing the hospital’s accounts receivable days from 100 to the low 40’s and going from $3.8 million in registered warrants to having 120 days cash on hand with no registered warrants.

Symonds, who first worked under CEO Warner Bartleson, then Linda Michel, Helen Verhasselt, Mike Zwicker, Ron O’Halloran twice and now Ken Archer, said it was with great sadness she has written her last report to the board. Symonds’ last day is Oct. 20.

CEO Archer, attending his first board meeting, said he has enjoyed the last two weeks, meeting with staff and getting out in the community. Archer said he would be working with Public Relations and Marketing Coordinator Mikaela Marion to help the community understand what all services are available at NVH.

Health Information Manager Payge Fries reported forming a task force to facilitate teamwork in being pro-active for the upcoming Barter Fair and the impact on NVH. Plans call for extra NAC and nursing staff in the ER, possibly an extra on-call physician or PA, 24-hour staffing in Admitting, having security and non-patient care staff on hand, keeping the Drip Line Cafe open over the weekend for staff; and communicating with local police, fire, Lifeline and coordinators of the Barter Fair to work together and discuss roles. The Barter Fair is scheduled for Oct. 20-22.

Fries also included a report on the first quarter of 2017 HIM Documentation Insufficiency’s, with issues in 141 accounts totaling $828,365.88 in delayed or missed charges between two and 30 days. The report stated it was not a complete total of all findings, and the totals are most likely increased by possibly 25 to 30 percent.

Extended Care Manager Kim Black reported the new roof over the nursing home was complete and repairs were completed on the recently-acquired van. Black also addressed a question on many staff and community members’ minds.

“There have been questions about the Lean Six Sigma program. I admit, I was skeptical about it, but in Long Term Care, we have 40 employees responsible for 36 residents over three shifts. With the implemented huddles, I have employees that show up every day at huddle time, and if I am not there, they come find me,” said Black. “They want the huddles, and they said there is much better communication between shifts, and the brainstorming between the upper level and front line workers gets communicated. Was it worth $40,000? For us it was.”

Under new business for the hospital, board members approved two equipment requests by CFO Julie Leonard, one for a $144,000 Molbilett Mira Max and another for a $471,900 Siemans Luminos Agile Max. The requests had already been approved at the Aug. 31 board meeting, but the verbiage needed changed from “purchase” to “capital lease.” Patients were sent to Omak or Wenatchee for x-rays while the hospital’s equipment was being repaired last week, without the back-up Mobilett Mira Max in place.

Under new business for the Extended Care, the board approved a $6,377.75 equipment request for wireless design and access point installation, allowing residents to access the internet as well as give staff increased access for record-keeping.

Board member Clarice Nelson said it would give residents the ability to Skype with family members, increasing their quality of life; and Black said it would improve staff’s ability to maintain Electronic Health Records.

“Now record keeping and documentation will be on the computer system. Some of the citations we just got (from the most recent DOH survey) would not have happened if we had these, as they have check points and prevent a lot of things from being missed,” said Black.

CEO Archer reported success with residents having access to the internet in previous nursing homes he has been involved with. “Residents can actually see their grandkids and Skype them; and if they can’t visit, it will still provide communication and quality of life,” said Archer. “Staff will also be able to access and enter information immediately after doing care. So it is a two-pronged thing we have going on; we know the state and others want us to collect data and do it electronically and have it ongoing.”

When local attorney Roger Castelda questioned privacy concerns of the users, Chief Information Officer (CIO) Carlos Antuna assured him residents would have to use their own laptop or tablet, and the internet access would be separate from the hospital’s network.

Board Helen Casey said there was no old business to cover, but members of the public protested that statement when they were allowed to speak at the end of the meeting. Casey had started off the meeting saying only people who signed up ahead of time could speak, and would be allotted three minutes; with those representing organizations allowed five minutes.

Marcus Alden reminded the board he asked about the cost of hiring and firing CEOs four meetings ago and asked if that data was available yet. Administrative Assistant Teresa Webber said she provided data on the hospital district’s liability insurance to Jean Pfeifer, but didn’t have the CEO data ready yet. Alden next asked about NVH providing a severance package to former Chargemaster Patrick Plumb that included continuing health insurance coverage through Cobra for Plumb and his family.

“Why is he getting severance pay and why are our tax dollars paying for him to go forward?” asked Alden.

“I can’t answer that,” said Casey.

When Alden asked how a severance package gets approved, Casey said commissioners do not get involved with hiring and firing of employees other than the CEO.

“Sometimes when there is an issue, the CEO will consult with our insurance company and they advise us, a lot of times it is between the CEO and the advice he is getting from these people,” said Jan Gonzales, Human Resources Manager and mother-in-law of Plumb.

Al Seccomb spoke up next, addressing the lease on the generator.

“I would like to know what progress is being made in getting the Cat fixed. I understand we are waiting for an evaluation of an oil pump. Meanwhile, we are paying $6,202 per month to lease the generator and the lease contract has an 18-month duration,” said Seccomb. “Five months of lease payments would pay for fixing the thing. Also, this subject should be under Old Business and carried forward each month. Going back, we don’t see anything about it in the minutes. Where is the follow-up from the board?”

Seccomb pointed to the COO and CEO and said, “You have jumped into the hot kettle, you two really have. You are not responsible for anything that has happened in the past, but us in the district, we are looking for answers. Your terms have started.”

“I’m happy to be here despite the kettle being hot, and I realize there is a lot of catching up to do and a lot of background to dig through,” said McReynolds, adding a third party was being consulted to do an evaluation of the oil pump and Maintenance Supervisor Ray Davies was looking gathering quotes for “short term options” such as getting a smaller generator on a trailer.

Castelda asked if NVH’s legal counsel was also working on it, and Mick Howe replied he was.

Jean Pfeifer reminded the board she asked at the last meeting about comments from the public being included in meeting minutes.

Casey told her the board would need to get something in writing. Castelda suggested the board print of meeting minutes of the previous meeting to have available to read at the current meetings.

Matt Alexander asked if the meetings could be live streamed for people unable to attend, and Howe said the Supreme Court ruled it to be permitted it as long as it was not disruptive.

Pfeifer also asked about financials included in the board reports, and Leonard said she “listened to the public” and began to include details of the financials in her monthly report.

Loretta Beaughan asked Leonard to explain what the reported 106 days cash on hand equaled, and Leonard said NVH cost about $34,000.00 per day to run.

“That equals about $3.7 million as of the end of August,” said Leonard.

Casey said as no one else signed up to speak, the board was adjourning to go into executive sessions under both RCW 42.30.110(1)(g) To evaluate the qualifications of an applicant for public employment or to review the performance of a public employee and RCW 42.30.110(1)(d) To review negotiations on the performance of publicly bid contracts when public knowledge regarding such consideration would cause a likelihood of increased costs.

“When you go into executive session you are supposed to say the names of the person and what they are being considered for,” said Alden.

Casetelda agreed. “It is open to the public, Mick, read the RCW. Read it carefully. You have a duty to report to the public what you decided.”

The next board meetings are scheduled for Oct. 28 and Nov. 9. Meetings begin at 7 p.m. and the public is invited to attend.