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

FMC Board of Trustees Meeting – April 2024

FMC Board of Trustees Meeting – April 2024

FALLON MEDICAL COMPLEX, Inc.

BOARD OF TRUSTEES MEETING

Wednesday, April 3, 2024

MEMBERS PRESENT                                     ABSENT                          

Curt Arnell, President

David Kirschten, Vice President                       

Evelyn Neary, Secretary             

Elaine Stanhope, Board Member

Erin Lutts, Board Member

Del Espinosa, Board Member

Michele Gray, Board Member

OTHERS PRESENT                                       

David Espeland, CEO                            Lacee Janz, Laboratory Director  

Marjorie Losing, CFO- via phone            Judy McWilliams, Q/A, Infection Control

Heather Schwindt, Recorder         

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 – There was no public input.  

III. APPROVAL OF MINUTES      No additions or corrections to the March 6, 2024 board minutes as distributed.  Elaine moved to adopt approval of the minutes.  Erin seconded the motion.  All aye, 0 nay.  Minutes stand approved as written.  

IV. MANAGER REPORTS  Lacee Janz reported to the Board that she has been lab manager for 7 years and a FMC employee for 23.  She has 3 full time lab techs, and 2 part time lab aides that assist.  The lab is covered 24 hours a day.  Our lab tests blood and body fluids for the facility and for outpatient work.  They also do drug testing and blood alcohol testing for outside sources as well.  We get inspected every 2 years by CLIA inspectors and are due this year.  New equipment is working great.  We have added a few new tests that we can run in-house without sending them out.  Mini health fairs went well, 306 draws and the big health fair will be on April 24, 2024.  Lacee runs 15 standard Q/A’s each year and machines are certified by the techs 3 times a year.  There are several analyzers on next year’s budget.  Some are over 10 years old and usually after that long we can no longer get contracts to cover the equipment if it breaks down.  The loan for lab equipment was paid off in January.  We have to keep 4 units of blood on hand at all times to keep our blood bank up.   Judy reported to the Board that we have had 4 disaster drills in the last month, 2 were unplanned but we learned from them.  New goals and areas of improvement were noted and will be working on those plans and get with the departments on areas of improvement.  Judy noted that Q/A keeps changing and each year you have to do a new plan, she works with department managers to update them and show the improvements each year.  She presented the Q/A reports to the board and went over the numbers and areas we have improved.  We received 2 grants for infection control last year and used them to purchase several things, the big items were the e-misters and the UV robots that are used to kill bacteria on surfaces.  

V. FINANCIALS     February had 17 inpatient days and 33 skilled days.  Gross Patient Revenue $870,000, $97,000 over budget.  Net Operating Revenue $1.1 million, $321,000 over budget. Expenses $963,000, $17,000 over budget. Operating Income was $145,000, $303,000 on the positive side of the budget. Non-operatingIncome $85,000, a net income of $231,000, $350,000 on the positive side of the budget.  YTDGross Patient Revenue $6.1 Million, $538,000 under budget.  YTDNet Operating Revenue $6.7 Million, $68,000 under budget. YTDTotal Expenses $8.2 million, $35,000 over budget.  YTDOperating Loss ($1.4 Million), $103,000 on the negative side of the budget.  YTD Net Loss ($822,000), $248,000 on the positive side of the budget. YTD STATS, 118 Inpatient days, 130 in the budget.  2,860 swing days 4,024 in the budget.  Ancillary services: ER patient count is below budget.  Procedure room and observation hours are ahead of budget. Lab is below budget, but blood bank is ahead budget.  EKG, radiology, and X-ray are below budget. CT, is on target with the budget, and ultrasound, and MRI ahead of the budget. Mammography is just a little below budget. Rehab visits are below budget but we are seeing an increase in their numbers. PT Visits are at 3,743, budgeted for 4,361. OT Visits are at 502 with 519 in the budget.Rural Health Clinic counts are 2,679, budgeted for 4,128.  Outpatient counts are 5,200 with 5,500 in the budget.  We had a cost report settlement for FY 2023 come in from Medicare at $693,000.  If our census goes up, we will have to pay that back, so we put that money aside as much as possible in the event we do have to pay it back.  That gives a YTD Change in Cash Equivalents of ($30,580).     Marjorie emailed the 990 Report to the Board prior to the meeting and presented the findings during the meeting for approval and submission.  The report is available for public view upon approval.  The 990 is to justify our non-profit status and show the benefits we provide to the community based on the community needs assessment that we compile every 3 years.  It shows that what we provide for the community exceeds what we would pay in corporate income tax.  Last year we had $1.7 million in community benefits.  Erin made a motion to approve the 990 and Elaine seconded the motion.  All ayes, 0 nays.  Motion to approve the 990 passed.   Marjorie and David met with Shawn Wiseman, COO of the Bank of Baker after a series of fraudulent checks had gone through the bank.  They were advised that our information is probably on the dark web and the best course of action would be to close our checking account and open a new one.  A process has been put in place that will allow us to approve or reject every transaction daily.  This is a new service that the Bank of Baker is wanting to implement so we are assisting in the launch of this program.  We have updated all of the vendors and they are working with us in this account transition.   Marjorie reported that we hired Bailey Woolington to train and take over for Cori as the Accounts Payable/Payroll clerk and started April 2.  Cori’s last day is scheduled to be May 10.

VIOLD BUSINESS Auxiliary By-laws Update: David submitted the paperwork for the Single Member LLC prior to the last board meeting and has not received a response from our attorney.  David has submitted the documents to another associate in the firm to hopefully be resolved before the next board meeting.   TB Skin Test:  Dr. Sullivan noted that Public Health will continue to do TB Tests.  He has mentioned to Public Health that they might look into doing the QuantiFERON test like we do.  It is more expensive to run, but with as few as Public Health does, it may be more cost effective due to not having to waste product.   Automated Text Reminders:  Susan has not received a response form Thrive regarding fees for adding automated text service to our package.    Payoff Payment Reminders:  Erin asked about the 50% payoff offer and where we were at with the reminders.  Marjorie and Katie sent out postcards per Board recommendation and are planning to send another one towards the end of May to hopefully receive more payments in the payoff program before the deadline of June 30, 2024.

VII.  NEW BUSINESS RURAL PSYCHIATRY:  At the March meeting it was discussed that we were moving forward with signing a contract with Frontier Psychiatry.  Prior to signing the contract, we were approached by Mark Peterson of Rural Psychiatry who offers a similar service.  Frontier charges an access fee and is only willing to see 5 patients in our LTC, whereas Rural Psychiatry does not have an access fee.  Both providers will give notes back to us so that we have their treatment plan in our patients’ medical records.  Medical Staff voted to offer both services to our patients, similar to us referring medical services to whichever hospital a patient prefers.  Both contracts have been sent to us for review and David will be completing them prior to the next meeting.  DOT PHYSICALS:  A National Registry is used to oversee a list of DOT-approved physicians.  The Registry requires that each provider maintain an email address tied to a registry account that is checked every month.  Previously, FMC did the monthly check for providers.  During the turnover in clinic and business office staff over the past couple of years, the monthly check was not being done.  This has not necessarily been an issue until recently.  The Registry decided to tighten up its practices due to cybersecurity threats.  They tried to confirm that a provider’s email address matched up with their name.  If that couldn’t be done, they dropped the account.  Our registered providers fell off the list because we did not use their personal address, but rather a facility address.  Mary has had to re-set their accounts and submitted new email addresses to re-certify Dr. Sullivan and Dr. Espeland in the registry.  We should have DOT physicians re-registered by the end of April.   The Board adjourned their regular session having completed the agenda.

VIII.     CLOSED EXECUTIVE SESSION.              
s\ Curt Arnell, President   s\ Heather Schwindt, Recorder and Transcriber