FMC Board of Trustees Meeting – January 8th 2025
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FALLON MEDICAL COMPLEX, Inc.
BOARD OF TRUSTEES MEETING
Wednesday, January 8, 2025
MEMBERS PRESENT ABSENT
Curt Arnell, President
Evelyn Neary, Secretary
Elaine Stanhope, Board Member
Erin Lutts, Board Member – Called in
Michele Gray, Board Member
Del Espinosa, Board Member
Dru Burk, Board Member – Called in
OTHERS PRESENT
David Espeland, CEO Spring Nacey, Rehab Manager
Marjorie Losing, CFO Judy McWilliams, QA/InfectionControl
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.
III. APPROVAL OF MINUTES
One Correction, a scrivener’s error, to the December 11, Annual Corporate meeting minutes was noted. Del moved to adopt the approval of the minutes upon the correction being made. Elaine seconded the motion. All aye, 0 nay. Annual minutes stand approved upon correction. No additions or corrections to the December 11, 2024 regular Board Meeting Minutes as distributed. Del moved to adopt the approval of the minutes. Elaine seconded the motion. All Aye, 0 nay. Minutes stand approved as written.
IV. MANAGER REPORTS
I.
A.
Spring Nacey relayed to the Board that Victoria is on maternity leave until February 4,2025, and upon her return, Amber will be taking a vacation. She noted that the goal is for all providers to never be more than 100 notes behind but currently all providers are behind on their notes. She further explained to the board how their notes are different than the notes that the providers in the clinic and ED have to maintain and how that affects the billing process and the HIM department. The alternative is to not schedule patients, but that could negatively affect their numbers as well. Through the fall, the providers typically see larger volumes of patients and no time to catch up notes, January to March are traditionally slower so catching up on notes happens then. The department did hire an assistant who is in high school, who can assist with paperwork and room preparations which will open up time for Spring to be available for the providers and assist with their needs.
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B.
Judy McWilliams passed around the Medicare Improvement measure and discussed the steps we are taking to ensure we meet the Social Determinantes of Health. There are 3 items this year. Item 1, Leadership Commitment to Eliminating Preventable Harm, and Item 2, Strategic Planning & Organizational Policy are already being done and we will continue reporting. Item 3, Culture of Safety & Learning Health System will take some consideration and planning. We do this on a small scale and we have a committee to discuss how to prove some of the implementation practices. We also have a Patient/Family engagement council in LTC, but it is ad-hoc, so that needs to be formalized to remain in compliance. We are part of a couple of groups through our insurance carrier that assist in ensuring our continued compliance with putting into practice how to maintain a just culture in the facility.
V. FINANCIALS
A.
November Financials: Marjorie discussed the November financials in detail. November had 19 inpatient days and 4 skilled days. Financials: Gross Patient Revenue $844,000, $4,000 under budget. Net Operating Revenue $1.3M, $460,000 on the positive side of the budget. Upon finalization of our audit, John Houck advised us to raise our skilled rate to $6,000 per day due to 99% of our skilled days are billed through Medicare which will help balance out our positive contractual numbers. Expenses $810,000, $245,000 under budget; there was an offset for the recruitment expense for Spencer, and also the $208,000 for Dr. Sullivan. November expenses look off but our YTD expenses are more accurate. Operating Income $524,000, $700,000 on the positive side of the budget. Non-operating Income $60,000. Net Income $585,000, $690,000 on the positive side of the budget. YTD Gross Patient Revenue $4.5M, $250,000 on the positive side of the budget. Net Operating Revenue $5.6M, $1.2M on the positive side of the budget. Expenses $5.3M, $25,000 on the positive side of the budget. Operating Income $316,000, $1.2M on the positive side of the budget. Non-operating Income $303,000. Net Income $619,000, $1.1M on the positive side of the budget. YTD Stats Inpatient days 92, 79 in the budget. Swing days 2,630 with 2,238 in the budget. Skilled days are at 57 with 92 in the budget. Ancillary Services: ER, Procedure and Observation are ahead budget. Lab and Blood Bank are slightly below budget. EKG and Ultrasound are below budget. Mammo, CT, and MRI are ahead of budget bringing Radiology overall ahead of budget. PT and OT are ahead of budget. RHC 1,721 visits with 1,740 in budget. Outpatient encounters are in-line with the budget. YTD Change in Cash Equivalents ($223,966). We have started training Rilee with accounts receivable and that assistance has already shown a decrease in our accounts receivable.
B.
Early Out Update/Billing and Collection update: WixCorp and TruBridge are mostly compatible with one exception, but both parties
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are discussing how to get
this resolved. WixCorp can age our accounts in the 12-month period that the board wants to keep in place with the industry standard. The cost of utilizing WixCorp is higher than our current cost with TruBridge, but if we stayed with TruBridge, we would be paying a FTE to do manual processing, which would be an additional expense anyway. There is a $10,000 implementation fee, and we are waiting on a final proposal from WixCorp, now that we know they are compatible with TruBridge. Additionally, we are still meeting with iVitaFi to work with patients on balances that are unable to be paid in the 12-month time frame. We are waiting to see if they are compatible with WixCorp and will then get a proposal from them as well. If all lines up, we will then be able to finalize our Billing and Collection policy and are hopeful this will be in place by July 1, 2025, or possibly sooner.
. V VI. OLD BUSINESS
A.
Spencer Fey, FNP Update: Spencer will be here on January 20, and start seeing patients on January 22. The State is allowing him to hold his FNP license for 1-year but next year he will have to get his Montana RN license in addition to renewing his FNP license.
VII. VII. NEW BUSINESS
A.
Election of Officers: Elaine nominated Curt as President, Erin as Vice President, and Evelyn as Secretary. Del seconded the motion. None of the nominees declined appointment. All aye, 0 nay.
B.
Medicaid Expansion: David distributed a spreadsheet showing the total amount of money paid by Medicaid Expansion on behalf of Fallon County residents. The spreadsheet showed amounts for all programs, including pharmacy, dental, ambulance, etc. The purpose was to inform the Board of what we get because it is on the agenda in the legislature on whether or not to continue with Medicaid Expansion.
C.
Corporate Membership Applications: Heather named all of the Corporate Members’ names of those that applied for membership. The Board approved all 16 received applications.
Del made a motion to adjourn their regular session to enter into an executive session, Evelyn seconded the motion.
VIII. CLOSED EXECUTIVE SESSION
A.
Provider Contract Negotiation: Evelyn made a motion to offer, Elaine seconded the motion. All aye, 0 nay. Motion passed.
Elaine made a motion to resume regular session. Del Seconded the motion.
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The Board adjourned their regular session having completed the agenda.
Curt Arnell, President
Heather Schwindt, Recorder and Transcriber
