EARH holds first board meeting of 2019

The Board of Commissioners for the East Adams Rural Healthcare (EARH) met Thursday, Jan. 24. The call to order was made at 5:30 p.m. Present were Chair Eric Walker, CEO Gary Bostrom; Jennifer Peppperd, Chief Nursing Officer; and Commissioners Ross Heimbidner, Stacey Plummer, Jerry Crossler, and John Kragt. Dr. Sackmann was unable to attend.

The first order of business was to introduce Ms. Julietta Shapiro. Ms. Shapiro is the new PA-C and anticipates seeing patients soon. She was born in Cleveland, Ohio, raised in New York, and completed her collegiate studies in health sciences at Arizona State University. She graduated as a PA in August, and is pleased to contribute to the heath care in Ritzville, although for the present she lives in Spokane. She was warmly welcomed by the Board, and they are planning a more formal welcome in the near future.

The minutes from the Dec. 20 meeting were approved unanimously. Dr. Sackmann was away with a patient and was unable to present the Medical Staff report.

CEO Gary Bostrom began by noting that the Hospital charges are now posted on the website. As beneficial as that is intended, he cautioned that comparing charges posted by other medical facilities might be useless because some medical facilities may include ancillary charges within the cost of a procedure, whereas some may list such charges separately.

He expressed concern that the regulation to post charges may confuse patients if they use such information for comparison. After quite a discussion over the issues created, someone summed it up by comparing posting charges is like comparing “a la carte charges to complete package charges.”

Regarding the ongoing problem with water leaks, CEO Bostrom stated that the maintenance crew took photos of ceiling tiles that show leakage and sent them to Leone & Keeble for repair in the spring. EARH has withheld some payment until the roof leaks are repaired.

The City of Ritzville has had meetings regarding the zoning changes needed to allow the purchase of the East Adams CC. The firm Parsons/Burnett/Bjordahl/Hume, LLP has been hired to work on issues regarding the rezoning (Taudd Hume is the attorney). The latest estimate is two to three months to complete the necessary zoning changes to consolidate the property under one zoning.

The East Adams Rural Healthcare has cut back provider visits to Washtucna to every other week. This is due to low-volume demand for medical services.

The (State) Heath Care Authority (HCA) has come up with their own plan for an alternative payment plan for Critical Access Hospitals (CAH) statewide. In discussion, the Board members are not pleased with the plan. They believe the plan is lacking in many ways, and are quite concerned that a committee of ten (picked by the HCA) would set rates.

CEO Bostrom stated that EARH facility is not interested in participating. EARH plans to send representatives to the legislature to testify to our concerns. Eric Walker commented that there is a “real danger of small hospital closures in the next couple years.”

Also announced is that the Grand Columbia Health Alliance will be coming out with a press release very soon to officially announce their formation and website. A similar organization, The Washington Rural Health Collaborative, is looking to add members. The cost is $12,000 per year, and the anticipated benefit is a return rate of 2.5 times or better, which could bring $40,000 back.

The downside is required representative attendance monthly meetings. Two times a year the meeting is in Seattle. Gary Bostrom wants to talk to the Grand Columbia group first; the board authorized him to do so, seeing no problems with pursuing an interest.

The Finance Committee has good news: a year-to-date net income of $1,139 – to last year’s year-to-date net loss of $646,722. Some adjustments have yet to be made and auditors still have to do their formal audit. However it appears positive as of December. The next meeting will include all adjustments that are needed to be made.

The Board also considered a proposal from CareOptimize. EARH is already using 10 percent of their software for limited purposes, however the CareOptimize people maintain that with training, the program can reduce diagnosis and coding errors associated with billing, streamlining therapy billing and printing out multiple reports, which are currently being done by hand.

To take advantage of expanding the use of CareOptimize would be a one-time set-up cost of $31,000. Three days of on-site training are included, and the program could be up and running in 30 days.

The Board had a number of questions: What are the qualifications of CareOptimize (15 other offices nationwide)? Who does the training (CareOptimize)? Are we comfortable with the present number of billing staff (Don’t have more room for additional billing staff)?

After considerable discussion, Jerry Crossler pretty much summed up the direction of the Board: “If it does what the vendor says, we need to go ahead. We have always had a hard time with billing.” Ross Heimbigner moved to let CEO Bostrom proceed. The Board unanimously voted to move forward.

CEO Recruiting: A large number of candidates have been whittled down to semifinalists. Telephone interviews will now follow, probably through mid-February. The board agreed that if any single committee member thought that a candidate was worth an interview, then they would be added to the list. The Committee has been very conscientious to find ways not to overlook any candidate too early in the selection process. There is no set goal for the number of finalists. The expected number is probably four or five candidates, but if one or more have other job pursuits, then the Committee will try and set an early interview date.

Four resolutions were on the agenda for Board consideration and each of them were approved:

-19-01: To authorize an automatic monthly transfer ($22,201.25) out of the EARH operational account into the debt service account to cover LTGO bond annual payment of interest and principal.

-19-02: To authorize the Adams County Treasurer to transfer funds from the EMS Levy Fund to the EARH general operating account in the amount of $261,656.83 for reimbursement of 2018 EMS expenses.

-19-03: To increase the levy amount from the previous year by 1.004 percent ($4,466) to be collected in the 2019 year.

-19-04: To authorize increase in regular property tax levy to be collected in 2019. The dollar amount from the previous year was $1,624, or 0.620 percent.

No board member wanted to change the committee they were on for the 2019 year. The question was raised by the Board about whether they need a Building Committee. The question will be researched for the next meeting.

The Northwest Rural Health Conference is scheduled for March 25-27 at the Hilton Seattle Airport & Conference Center.

The agenda has not yet been posted. The Board will decide on attendance at the next meeting.

The next regularly scheduled Board meeting is Thursday, Feb. 28 at 5:30 p.m. The meeting adjourned at 6:34 p.m. An Executive Session followed after a brief break.