SOUTHERN COOS HEALTH DISTRICT Board of Directors Regular Meeting & Executive Session February 28, :00 p.m. AGENDA

Transcription

1 SOUTHERN COOS HEALTH DISTRICT Board of Directors Regular Meeting & Executive Session February 28, :00 p.m. AGENDA I. Call to Order II. III. IV. Public Input Consent Agenda A. Regular Minutes 01/24/2019 Staff/Committee Reports A. CEO Report B. CFO Report C. Medical Staff Report D. Southern Coos Health Foundation E. Performance Improvement Committee Report V. Old Business VI. VII. VIII. New Business A. In-Reach Laboratory Management Services Presentation B. Special District Elections SCHD Open Positions Executive Session under ORS (2)(a) and (7) to consider the employment of an officer, employee, staff member or agent Open Discussion Adjournment Next Regular Meeting March 28, 2019 SCHHC 1

2 CONSENT AGENDA Minutes January 24,

3 Southern Coos Health District Board of Directors Regular Meeting Minutes January 24, :00 p.m. I. Call to Order This regular meeting of the Board of Directors for Southern Coos Health District was called to order at 7:00 p.m. by Esther Williams, Board Chair. Members Present: Esther Williams, Board Chair; Tom Bedell, Secretary; Brian Vick, Treasurer; Carol Acklin and David Allen. Administration: Amy Fine, CEO; Alan Dow, CFO; Rachel Beissel, CNO; P.J. Keizer, MD. Other staff present: Dennis Jurgenson, Cathy Mann, Scott McEachern, Marlene Rocha, Rachelle Stickroth. II. Public Input None. III. Consent Agenda Minutes considered include the December 20, 2018 regular meeting minutes and the January 10, 2019 special meeting minutes. Brian Vick moved to approve the consent agenda with a correction to the January 10 special meeting minutes to note that the media was present. Carol Acklin seconded the motion. All in favor. Unanimous decision. IV. Staff Reports A. CEO Report Alan Dow presented the report as presiding CEO during the month of December. Employee Recognition: Employees of the month announced in January are Christina Campina, RN, Clinical Employee of the Month, and Cathy Mann, Revenue Cycle and Patient Access Services Manager, Non-Clinical Employee of the Month. Facility move: The Primary Care and Specialty Clinic will now be our Multi-Specialty Clinic with the inclusion of Outpatient Clinic Services having recently moved from leased space. The leased building will be used as storage space, a Medicare reimbursable expense, until the lease term expires in September. Laboratory Services: Quest Diagnostics, a reference lab, has lowered their quote from that originally proposed, now no longer requiring an RFP process. Helicopter night landing assessment: In response to our local fire marshal concern regarding residential area night landings, we asked Reach Air, one of our air service providers, to conduct their own assessment, resulting in concurrence with the fire marshal. Night landings are rare and can occur at the Bandon airport, weather permitting, or will fly out of North Bend. Medical Staff SCHD Board of Directors Meeting Minutes Page 1 of 4 January 24,

4 President: Dr. Holland has resigned the post of Medical Staff President after 10 years of service in that capacity. Dr. P.J. Keizer is acting President until elections are held at the next Medical Staff Meeting on February 12. Conclusion: Mr. Dow is pleased with recent Board action that brings Amy Fine to the CEO position and allows him to stay on as CFO for Southern Coos. B. CFO Report Amy Fine, presiding CFO during the month of December, presented the financial report. Volumes in areas of inpatient and swingbed days outpaced prior year. ED visits, Lab, Radiology, Specialty and Primary Care were lower in December but are still up for the year. December had $1.7M in net patient revenue. $25,000 was accrued in December for the anticipated Medicare cost report settlement for $375,000 total-accrued. An interim cost report will be run in February. Cash on Hand has improved from prior year. Accounts Receivable are at $3.5M. The state fund balance is $6.8M, down from prior year. The month ends with $10,000 in net income. Clinic financials from July through December show YTD loss of - $310,000. Changes have been made to improve clinic operating performance. December financial indicators include total days of Cash on Hand at 67.6 and Days in Accounts Receivable at Coding issues that have since been remediated impacted A/R in December. The payer mix was Medicare 58.5%, Medicaid 16.4%, Commercial 23.6% and Private Pay 1.5%. The full report is available within the board packet published each month to the hospital website at C. Medical Staff Report P.J. Keizer, MD, acting Medical Staff President, presented the Medical Staff Report and privileging for approval, forwarded from the January 8 Medical Staff meeting: Consideration For 6-month Provisional Privileges: Scott Levitt, MD (Emcare) Brian Vick moved to accept the Medical Staff Report as presented. Tom Bedell seconded the motion. All in favor. Unanimous decision. D. Southern Coos Health Foundation & Marketing Report Scott McEachern, CIO/Marketing & Foundation Director presented the SCHF Report for the month of December. The Year-End Campaign has raised $80,000 with more local business pledges yet to be received in February. The annual Golf for Health Classic will be held on June 1 at Bandon Crossings. This event yields approximately $40,000 each year. This event is moved up from the formal recurring date in mid-july. Watch for more information coming soon. Marketing: Scott shared the first of a new video series produced in-house, to be shown via social media and television, featuring the SCHHC full-service Laboratory Services, SCHD Board of Directors Meeting Minutes Page 2 of 4 January 24,

5 with an overview including Laboratory licensing through the FDA CLIA (Clinical Laboratory Improvement Amendments) and accreditation though COLA (Commission of Office Laboratory Accreditation). Any provider may order patient labs through the SCHHC Lab right here in Bandon. Additional services and departments will be featured in future videos. We have found that our social media views have received hundreds of views as a method for education and information that is more convenient for our community. The patient portal will be changing with implementation of our new Electronic Health Record in March. Tom Bedell reported on the annual Bullard s Beach Run held on January 6, runners enjoyed a break in the weather to earn $ for the Health Foundation. The South Coast Running Club shares the proceeds with the SCHF receiving 70% and the Club 30%. Thank you to all volunteers from the Club and hospital who helped with the event. The 2019 Women s Health Day event will be held on February 2, Aging Gracefully will be the topic and tickets are selling fast. E. Performance Improvement Committee Tom Bedell attended as the Board member liaison for the December Performance Improvement meeting. The Medical Surgical department reviewed the HCAHPS survey that has improved significantly in the 4 th quarter, with a continuing goal to decrease the number of agency nurse shifts. The Environmental Services department is focusing on handwashing upon entry and exit of patient rooms. They are also working on efficiency of time required to fully clean rooms. Surgical Services has focused on documentation of time-outs and an update of the policy and procedure for wrong site surgery. HR reported a turnover rate of 30% with a goal of 24% and efforts to lower that number. Regulatory compliance for training is currently very good at 96%. In 2018, there were 11 injuries resulting in 96 days lost. The Employee Recognition Program has been well received. An employee satisfaction survey is forthcoming. Swingbed utilization has increased with a need to look at staffing to meet current need for our community. V. Old Business A. Consideration of CEO Agreement This topic was held in Executive Session, see Section VII. VI. New Business A. Board Retreat There will be a Board of Director work session to discuss clinic operations on February 15, 9:00-1:00 p.m., location to be announced. VII. Executive Session Under ORS (2)(a) and (7) to consider employment of an officer, employee, staff member or agent and ORS (2)(f) to consider information or records that are exempt from disclosure. SCHD Board of Directors Meeting Minutes Page 3 of 4 January 24,

6 At 7:40 pm the Board moved to Executive Session. Return Open Session at 8:25 p.m. David Allen moved that the SCHD Board of Directors offer the SCHHC CEO position to Amy Fine as presented in the revised suggested contract with the following modifications: a) title of CEO with no modification, b) 12-month contract term; c) CEO may terminate employment with 60-day notice, not 90; d) if severance is due per the terms of the agreement it will be for 2 months, not 3. Brian Vick seconded the motion. All in favor. Unanimous decision. VIII. Open Discussion Members of the Board recognized the efforts of fellow members, Interim CEO Alan Dow, and the hospital Leadership team as they worked to replace outgoing CEO JoDee Tittle, and offered Amy Fine their encouragement and support. Amy Fine expressed equal appreciation and also to Alan Dow as he moves into the CFO role. Adjournment Ms. Williams adjourned the meeting at 8:30 p.m. The next regular meeting of the Southern Coos Health District Board of Directors will be held on Thursday, February 24 at 7:00 p.m. in the Southern Coos Hospital conference room. There will also be a Special Work Session on Friday, February 15, 9:00 a.m.-1:00 p.m. with location to be announced. Esther Williams, Board Chair Tom Bedell, Secretary SCHD Board of Directors Meeting Minutes Page 4 of 4 January 24,

7 Foundation Report To be provided under separate cover. 7

8 CEO REPORT 8

9 CEO REPORT February 2019 Provider news Dr. Baharloo has signed a contract through 6/30/2021. He enjoys his patients and is proud of the Podiatry Practice that he has built in our community. We will be increasing marketing efforts for his practice. At the February 12, 2019 Meeting of our Medical Staff, Dr. Noel Pense was elected to be the new Southern Coos Hospital Medical Staff President. I have been communicating with Victoria Schmelzer, CRNA who will be arriving on 3/31/2019. She is looking forward to returning to the area and working at Southern Coos Hospital. She is well regarded within the local medical community and is looking forward to expanding our surgery program. In the interim, several Locum Tenens providers are providing Anesthesia services. This past week, I met with two local providers who would like to join our team. Staff News Scott Taylor, from Radiology, was voted the clinical employee of the month and Janelle Jones, from Admitting, was voted our non-clinical employee of the month. In addition to a certificate, each of them were granted one day of additional Paid Time Off. Heather Edwards, RN our Risk and Quality Officer, is planning on leaving in mid-april. She had originally planned to leave in June to move to Portland, but, has moved her end-date up. We are advertising for her replacement. Rachel Beissel, RN BSN, our CNO, has been accepted into a 20-month Nurse Practitioner Program. She plans to stay in Bandon and has decided to step down from her CNO role. We are creating a role for her to work as a Resource Nurse on the weekends. We are advertising for her replacement. Rachel has agreed to remain in her role until we find a new Chief Nursing Office to join our team. We are recruiting for several positions and encourage everyone to visit our website for more information. Athena Our go-live is days away and scheduled for March 5, Athena staff is on-site for the next three weeks. In addition to a new EMR and billing program, we will migrate to ADP for Payroll Processing, Intacct for Accounting, Seven Medical for 9

10 Radiology and Orchard for Laboratory. Inevitably, in a transition of this size, issues will surface. Should you hear of any, please bring them to my attention so that we can address them proactively. I have been very impressed with Scott McEachern s dedication to the project, his skill at keeping everyone and everything on track, and most of all his diplomacy. Outpatient Services and Rauschert Building The Outpatient Clinic has been moved back from the Rauschert Building into the Multi- Specialty Clinic Building. This has allowed for reduced front desk staff, increased provider contact and additional coverage for wound care for Dr. Baharloo s patients. The Rauschert Building is currently being used as storage. We have sent Jim Rauschert a letter indicating we are happy to give up the lease if he has another tenant interested in occupying the space. Coast Community Health Center We have observed that our laboratory and radiology referrals from Coast Community Health Center (CCHC) have been decreasing over the past several months. On February 12, 2019, Alan Dow and I met with Linda Maxon, CEO of CCHC, to see how we could better work together to serve the community. In that meeting Linda shared her concern that our services were priced higher than other facilities in the area. We do monitor our prices on a regular basis and believe out prices to be competitive some are higher and others are lower. Our plan is to continue outreach and education on this issue. We strive to provide excellent care to our local community and to keep pricing as reasonable as possible. Tele-Psychiatry for the Emergency Department I have been in discussion with Aligned Telehealth a provider of Tele-Psychiatry for the Emergency Department. I have asked EmCare to absorb the cost and have a meeting with them to discuss. 10

11 CFO REPORT 11

12 12 Southern Coos Hospital and Health Center CFO Report January, 2019

13 Southern Coos Hospital and Health Center for the Month Ending January 31, 2019 Utilization Month FY FY % Variance FY FY % Variance Actual Prior Year To Prior Year Actual Prior Year To Prior Year Hospital In Patient Days % % Swing Days % % Major Departments Emergency Visits % 2,587 2, % Radiology Procedures % 4,975 4, % Laboratory Tests 3,767 4, % 26,733 27, % Respiratory Visits % 3,155 2, % Surgeries and Endoscopies % % Pain Clinic % % Podiatry Clinic % 1,823 1, % Specialty Clinic Visits % 2,305 2, % Primary Care Clinic % 2,643 2, % Swing Days continue to significantly outpace prior year volume. Year To Date Radiology and lab outpatient visits continue to be negatively impacted due to Coast Community Health Center referring to other facilities. Surgery / endoscopy volumes are lower as we adjust to the absence of a full-time surgeon and await the the start of our new CRNA. We are increasing our Marketing efforts for the Specialty Clinic. 13

14 Southern Coos Hospital and Health Center Summary Income Statement for the Month Ending January 31, 2019 Current Month Fiscal Year-To-Date Actual Budget Variance Actual Budget Variance Gross Patient Revenue $ 2,592,591 $ 2,665,062 $ (72,471) $ 17,944,748 $ 16,825,913 $ 1,118,835 Contractual Adjustments (939,637) (903,814) (35,823) (6,100,496) (5,547,575) (552,921) Net Patient Revenue 1,652,954 1,761,248 (108,294) 11,844,252 11,278, ,915 Other Operating Revenue 117, , ,466 10, ,491 Net Operating Revenue 1,770,097 1,761,463 8,634 11,986,719 11,289, ,406 Operating Expenses 1,743,473 1,741,837 (1,636) 12,370,314 11,272,226 (1,098,087) Operating Income (Loss) 26,624 19,625 6,998 (383,595) 17,086 (400,681) Non-Operating Inc./(Exp) 64,267 63, , ,444 53,445 Donations and Grants - 3,909 (3,909) 15 20,962 (20,947) Net Assets Increase (Decrease) $ 90,891 $ 87,075 $ 3,816 $ 101,309 $ 469,492 $ (368,184) Note: Salary and benefit expense were lower in January due to open / eliminated positions, and more PTO time off was taken in January than was accrued during the month which reduced payroll and benefits expense by approx $50 K for the month. Other operating revenue was favorably impacted by $88K in misc receipts and $23K in accrued amounts due. 14

15 Southern Coos Hospital and Health Center Balance Sheet As of 1/31/2019, 1/31/2018, and 1/31/2017 1/31/2019 1/31/2018 1/31/2017 Assets Cash - Operating $ 764,549 $ 572,041 $ 619,467 Investment - Unrestricted 1,159, ,892 1,617,034 Investment - Restricted 9,488 9,488 9,488 Investment - USDA Restricted 233, , ,705 Investment - Health Information System Investment - Board Designated Funds 1,972,783 1,972,783 1,928,783 Cash and Cash Equivalents 4,139,932 3,626,909 4,408,477 Patient Accounts Receivable 4,827,418 4,388,957 3,392,521 Less: Reserve for Uncollectibles (1,275,428) -26.4% (995,868) -22.7% (1,188,524) -35.0% Net Patient Accounts Receivable 3,551,990 3,393,089 2,203,997 Other Receivables 29, ,687 1,012,882 Inventory 277, , ,216 Prepaid Expense 122, , ,782 Property Tax Receivable - Current (280,898) (266,072) (259,603) Total Current Assets 7,840,668 7,811,953 7,958,751 Property Tax Receivable - Prior Years 19,773 25,177 16,818 Restricted Grant Award Plant & Equip (Net of Depreciation) 6,069,645 6,666,585 6,616,914 Total Assets $ 13,930,086 $ 14,503,715 $ 14,592,483 15

16 Southern Coos Hospital and Health Center Balance Sheet As of 1/31/2019, 1/31/2018, and 1/31/2017 1/31/2019 1/31/2018 1/31/2017 Liabilities and Fund Balance Accounts Payable $ 605,554 $ 859,489 $ 641,640 Accrued Salaries & Employee Benefits 915, , ,966 Interest and Other Payable 645, , ,024 Current Portion of Long Term Debt 209, , ,809 Total Current Liabilities 2,376,265 2,044,213 1,935,439 Equipment Loans Payable Capital Leases Facility Loans Payable 3,220,280 3,305,248 3,386,558 HIS SDAO Loan Payable 1,595,000 1,720,000 1,845,000 Less Current Portion of Long Term Debt (209,969) (206,310) (202,809) Total Non-Current Liabilities 4,605,311 4,818,938 5,028,749 Total Liabilities 6,981,576 6,863,151 6,964,188 Deferred Tax/Grant Revenue Fund Balance 6,948,510 7,640,564 7,628,295 Total Net Equity 6,948,510 7,640,564 7,628,295 Total Liabilities and Fund Balance $ 13,930,086 $ 14,503,715 $ 14,592,483 16

17 Southern Coos Hospital and Health Center Income Statement For the 7 Months Ending 1/31/2019 and 1/31/2018 Current Month Year to Date Actual Budget Prior Year Variance to Variance to Variance to Actual Budget Prior Year Budget Prior Year Budget Revenue Inpatient $ 470,163 $ 498,191 $ 572,097 $ (28,028) $ (101,934) $ 3,327,460 $ 2,629,273 $ 2,404,504 $ 698,187 Outpatient 2,122,428 2,166,871 2,169,661 (44,443) (47,233) 14,617,288 14,196,640 13,778, ,648 Total Patient Revenue 2,592,591 2,665,062 2,741,758 (72,471) (149,167) 17,944,748 16,825,913 16,183,493 1,118,835 Less Contractual (903,633) (847,716) (934,072) (55,917) 30,439 (5,770,974) (5,267,484) (4,986,653) (503,490) Less Charity Care (6,763) (7,204) (3,764) 441 (2,999) (76,194) (34,300) (50,950) (41,894) Less Bad Debt Expense (29,241) (48,894) (44,305) 19,653 15,064 (253,328) (245,792) (229,756) (7,536) Total Deductions (939,637) -36.2% (903,814) -33.9% (982,141) -35.8% (35,823) 42,504 (6,100,496) -34.0% (5,547,576) -33.0% (5,267,359) -32.5% (552,920) Net Patient Revenue 1,652,954 1,761,248 1,759,617 (108,294) (106,663) 11,844,252 11,278,337 10,916, ,915 Other Operating Revenue 117, , , ,466 10,975 1, ,491 Total Operating Revenue 1,770,097 1,761,463 1,759,882 8,634 10,215 11,986,718 11,289,312 10,918, ,406 Expenses Salaries and Benefits 886,678 1,019,418 1,012, , ,754 6,902,786 6,638,073 6,719,024 (264,713) Professional Fees 218, , ,587 (25,169) 2,987 1,532,946 1,374,871 1,446,333 (158,075) Purchased Services 247, , ,817 (84,616) (68,783) 1,326, ,531 1,045,299 (361,463) Medical Supplies 162, , ,986 (31,149) (47,998) 1,070, , ,776 (189,352) Supplies 29,530 27,672 32,474 (1,858) 2, , , ,844 (15,143) Other Operating Expense 114, , ,974 21,287 (4,434) 744, , ,091 40,405 Insurance and Utilities 28,516 28,865 29, , , , ,616 (10,745) Depreciation 55,157 41,937 52,328 (13,220) (2,829) 406, , ,921 (139,001) Total Operating Expense 1,743,473 1,741,837 1,752,447 (1,636) 8,974 12,370,313 11,272,226 11,456,904 (1,098,087) Operating Income 26,624 19,626 7,435 6,998 19,189 (383,595) 17,086 (538,873) (400,681) 17

18 Southern Coos Hospital and Health Center Income Statement For the 7 Months Ending 1/31/2019 and 1/31/2018 Current Month Year to Date Actual Budget Prior Year Variance to Variance to Variance to Actual Budget Prior Year Budget Prior Year Budget Operating Income 26,624 19,626 7,435 6,998 19,189 (383,595) 17,086 (538,873) (400,681) Non-Operating Income Property Taxes 73,141 73,273 70,862 (132) 2, , , ,036 (927) Other 13,626 8,143 8,613 5,483 5,013 94,311 54,987 61,056 39,324 Total Non-Operating Revenue 86,767 81,416 79,475 5,351 7, , , ,092 38,397 Non-Operating Expense Interest Expense 17,079 17,876 17, , , ,269 12,141 Other 5,421-5 (5,421) (5,416) (2,902) ,907 Total Non-Operating Expense 22,500 17,876 17,881 (4,624) (4,619) 121, , ,324 15,048 Excess Revenue 90,891 83,166 69,029 7,725 21, , ,530 (113,105) (347,236) Donations - 3,909 13,719 (3,909) (13,719) 15 20,962 48,724 (20,947) Grant Income - - 4,016 - Increase in Net Assets $ 90,891 $ 87,075 $ 82,748 $ 3,816 $ 8,143 $ 101,309 $ 469,492 $ (60,365) $ (368,183) 18

19 January 2019 Days Cash on Hand Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Calculation: Total Unrestricted Cash on Hand Daily Operating Cash Needs Definition: This ratio quantifies the amount of cash on hand in terms of how many "days" an organization can survive with existing cash reserves. Year Average Desired Position: Upward trend, above the median Benchmark 80 Days How ratio is used: This ratio is frequently used by bankers, bondholders and analysts to gauge an organization's liquidity--and ability to meet short term obligations as they mature. Fiscal Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

20 70.0 Days in A/R as of 1/31/ Days Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Calculation: Gross Accounts Receivable Average Daily Revenue Definition: Considered a key "liquidity ratio" that calculates how quickly accounts are being paid. Desired Position: Downward trend below the median, and below average. Benchmark 50 How ratio is used: Used to determine timing required to collect accounts. Usually, organizations below the average Days in AR are likely to have higher levels of Days Cash on Hand. Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 A/R (Gross) 4,388,957 4,153,899 4,309,277 4,505,738 4,468,340 4,651,883 4,653,166 4,736,825 4,775,343 4,630,797 4,590,872 4,682,234 4,827,418 20

21 CAH Financial Indicator Medians, US Favorable Indicator Median Trending Days in Accounts Receivable 51.3 Down Days Cash on Hand 77.7 Up Total Margin 2.7% Up Operating Margin 0.9% Up Salaries to Net Revenue 44.9% Down Southern Coos Hospital Comparision July August September October November December January Month YTD Indicator Trend January Days in Accounts Receivable Up 59.8 Days Cash on Hand Up 69.3 Total Margin 4.1% 7.7% 0.4% 7.3% -23.8% -1.0% 5.3% Up 0.8% Operating Margin 0.3% 4.3% -3.6% 3.3% -30.4% -5.3% -1.8% Up -3.7% Salaries to Net Revenue 45.4% 43.7% 46.4% 44.1% 55.8% 48.4% 38.6% Down 45.8% 21

22 Southern Coos Health Center Payor Mix FYE 6/30/2018 Southern Coos Health Center Payor Mix YTD 1/31/2019 Medicare 57.7% Medicare 58.7% Medicaid 19.1% Medicaid 16.2% Commercial 22.3% Commercial 23.6% Private Pay 1.0% Private Pay 1.4% 100.0% 100.0% 22

23 Southern Coos Health District and Foundation Investment State Pool 31-Jan-19 Balance for the Month Beginning Jan 01, 2019 $ 3,430,395 Interest Net of Fees $ 8,011 Deposits Withdrawals Subtotal 8,011 Balance for the Month Ending Jan 31, 2019 $ 3,438,406. Historical Data Description Date Balance Annualized ROI Quarter Ending Balance Sep-17 $ 4,363, % Quarter Ending Balance Dec-17 $ 3,446, % Quarter Ending Balance Mar-18 $ 3,160, % Quarter Ending Balance Jun-18 $ 3,141, % Quarter Ending Balance Sep-18 $ 3,159, % Quarter Ending Balance Dec-18 $ 3,430, % Month Ending Balance Jan-19 $ 3,438, % Investment State Pool Balances 88.00% Annualized ROI $5,000,000 $4,500,000 $4,000,000 $3,500,000 $3,000,000 $2,500,000 $2,000,000 $1,500,000 $1,000,000 $500,000 $- Sep-17 Dec-17 Mar-18 Jun-18 Sep-18 Dec-18 Jan % 2.50% 2.00% 1.50% 1.00% 0.50% 0.00% Sep-17 Dec-17 Mar-18 Jun-18 Sep-18 Dec-18 Jan-19 FUND BALANCES: Foundation - Investment 63,024 USDA Investment $ 233,705 Scott Annuity - Investment 9,488 Board Designated - Investment 1,972,783 Unrestricted - Investment 1,159,406 Total State Pool Account 3,438,406 ADDL FUND BALANCES - TOTAL RESERVES $ 3,438,406 23

24 MEDICAL STAFF REPORT 24

25 MEDICAL STAFF REPORT February 2019 Consideration For 60 Day Temporary Privileges Todd Meyer, CRNA (Locum) Gabriel Garton, CRNA (Locum) Tiffany Vancil, CRNA (Locum) Consideration For Two Year Privileges Babak Baharloo, DPM Margaret McLain, NP Direct Radiology Shameem Azizad, MD (Add) Mirian Hulkower, MD (Add) Kenneth Edgar, MD (Add) Kimberly Taylor, MD (Add) Brian McElaney, MD (Remove) 25