WESTON COUNTY HEALTH SERVICES
BOARD OF TRUSTEES MEETING
March 19, 2015
Present: Jill Sellers, President of the Board, Barry Peterson, Treasurer, Connie James, Trustee
Also Present: Maureen Cadwell, CEO; Kyle Richards, Rapid City COO; Piper Allard, Director of
Patient Services; JoAnn Farnsworth, Quality Director; Jim Peck, Attorney; Michael Jording, MD; Irma
Fouch, Director of Nursing Interim, and Shannon Lassle, Executive Administrative Assistant
Visitors: Denice Pisciotti, NLJ
Call to Order: Jill Sellers called the meeting to order at 6:00 pm.
Quorum: Barry Peterson declared a quorum was present to conduct the business of Weston County
Health Services.
Visitor Comments: None
Additions/Changes to the Agenda:
BARRY PETERSON MADE A MOTION TO APPROVE THE CONSENT AGENDA AS
PRESENTED, CONNIE JAMES SECONDED AND THE MOTION PASSED UNANIMOUSLY.
Finance Committee Report: Barry paid sympathy to Kristen Kohlbrand’s family for the loss of her
father. He also made note that Kristen Kohlbrand and Julia Behnke were recognized by the WHA for
volunteering their time in the Legislative Nurse for the Day Program. Barry thanked Carmen and the
Home Health staff for their care after his surgery.
Financial Report:
On the statistics side, our Inpatient days YTD are 104% of budget and 113% of last year’s volume.
The budgeted and YTD percentage are both up substantially from last month. Swing bed days are
about 85.8% of budget, and are 101.6% of last year. Outpatient discharges are 103.3% of the
budget, and are 105% of last year at this time. ER is 106.8% of last year and 110% of budget. PT
visits are 113% of budget and 116% of last year. OT visits were 119 for the month, down 17 from
last month.
Income Statement:
 YTD Patient Revenue is 5.33% over the budgeted amount. Expenses are 102.8% of budget
for the year. Net income for the month is a positive $765,603. For the year, net income is a positive
$853,664. While net income appears high, it should be noted that it increased by approximately
$512,000 due to an adjustment in the calculation of estimated contractuals. Three months ago, we
began to take a comprehensive look at the contractual estimating process. As a result of work we
have done and through discussions with our Lawson/Cerner support team and our auditors, we have
adjusted contractuals in line with the percentages determined in our audit report. This accounts for
the large change in contractuals and resulting effect on net income. We will continue to refine our
calculation of estimated contractual adjustments to obtain better estimates in future months.
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Balance Sheet:
 Many of the changes in this month’s Balance Sheet were driven by year-end adjustments
provided by the auditors after completion of the audit. While the adjustments were entered in
January’s work, their effects did not transfer into the current year. We were able to work with
Billings Clinic to get this corrected for February.
 In anticipation of ICD-10 usage which will be required October 1, 2015, we have been working
with DT-Trac to help us with the anticipated issues that are bound to occur during this
transition. Getting them acclimated to our coding process has temporarily slowed the progress
of coding resulting in an increase in A/R. In addition, we have been working with Billings Clinic
to resolve issues in the revenue cycle that have been ongoing for several months.
Cash Flow Statement: Net cash flow increased by $67,523 during February.
Graphs: Acute and Swing Bed days 236. Days in A/R were 87.13, largely due to audit adjustments
affecting A/R.
Medical Staff Report:
Dr. Jording highlighted on the following topics from their Medical Staff meeting:
 Pain Management Issues-Long Term Care- the medical staff is addressing the difference in
treatment of pain in the hospital, long term care and home health. They have arranged for Dr.
Bernadette Meade DO, a physician in Gillette that does palliative care to give a presentation
on April 23rd at noon in the cafeteria at the hospital with lunch provided. He welcomed all the
nursing staff in the facility, pharmacy and board members to the presentation.
 Medicare-CT Scan for Lung Cancer- Medicare has approved a low dose CT scan for
Medicare beneficiaries to screen for lung Cancer if they meet the following criteria:
1. Age 55-77
2. Current smoker or one who has quit w/in last 15 yrs.
3. 30 pack year history
There is a cost upfront for upgrading the software program in the CT scanner; Michelle has
been in contact with Rapid City and will have requirements and costs provided at the next med
staff meeting.
 Dr. Jording/Sundance Hospital Board Meeting- Dr. Jording attended the Crook County
Memorial Hospital board meeting on February 26th. Joey Kanode, owner/operator of Sharon’s
Home Health, Moorcroft wasn’t able to attend and Dr. Jording wasn’t able to present. The
meeting did help him recognize the strong foundation of our administration, board and medical
staff in our facility. Dr. Jording doesn’t have any more interest in sharing cooperative medical
staff with Crook County at this time, but recognized that there are other services they will
struggle with and sees an opportunity for our facility to begin discussions about different
shared services.
EmCare Request –Dr. Jording discussed the temporary privileges that the medical staff had
granted for (2) physicians with EmCare for our ER. The medical staff is concerned with how
EmCare is dealing with our hospital and encouraged the board to address this when reviewing
their contract. He anticipates reviewing the physicians’ completed applications at the next
medical staff meeting.
Maureen reviewed the EmCare process for temporary privileges. A CV is provided with the
physician’s resume, licensure and insurance and is reviewed by Piper, Maureen and Dr.
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Franklin for approval until the full packet is provided. Jim Peck noted the EmCare is an
independent contractor that we have hired that has an obligation to provide approved
physicians to staff Emergency Rooms. Jill expressed the board’s appreciation to the medical
staff for addressing their concerns and assured Dr. Jording that the board will continue to work
on the addressed issues. Barry thanked the staff at the clinic for the care he had recently
received after his surgery.
CEO Report:
Building Project Update- Maureen shared the CTA building project boards that will be used
at the scheduled community meetings. Town hall meetings will be held in Newcastle, Osage
and Upton as well as presentations to the Newcastle & Upton chamber meetings and senior
centers. A schedule of the meetings has been provided to the board in Dropbox. The
foundation is funding the marketing costs for the general information and advertising provided
to the community on the building project/1% tax.
The Foundation has begun their capital campaign with the kick-off for the car raffle on Friday,
March 27th at Newcastle Motors. The drawing will be held when the 250 tickets have been sold
with all proceeds going to the WCHS Capital Campaign for the addition & remodel project.
Jim clarified some of the miscommunications in the community on the 1% tax:
1. This tax doesn’t replace another tax.
2. This tax doesn’t apply to anything new and tax things that weren’t taxed before
3. This tax won’t take away additional tax availability in the county.
Jim stressed the importance of not asking the tax payers to vote for the tax and just providing
them with the facts.
 Retail Pharmacy Update- Weston County Pharmacy is scheduled to open on Monday,
April 6th. Marketing will be in the paper, website, theatre, Facebook and the radio reflecting
the opening date and hours Mon-Fri from 9am-6pm and Sat. from 9am to 2pm; there will be
no on-call services available at this time. Our new pharmacist starts this next week.
Demographic forms will be available at the blood draw next week and on the website to
pre-register customers. A grand opening is tentatively being planned for the end of April.
 Regional Health CEO Visit- Brent Phillips, the new CEO for Regional Health will be here
for a meet & greet on March 25th @ 6:00 pm in the cafeteria.
CFO Report:
Nothing to Report
(Lynn HFMA Conference)
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Acute Care:
 Piper noted that they have been busy with the two new doctors and computer training. The
influenza has not declined at this time.
Human Resources:
Nothing to report
Long Term Care:
 The new bus for the manor was delivered and the donors want to donate funding for a garage
to be built. The Foundation will be recognizing the donors and they will be thanked for their
generous donations to our facility in our newsletter and the NLJ.
Home Health:
 Home Health had a positive state survey. Carmen will be addressing the identified corrections
of home health aide training and TB testing.
Old Business:
 Collections/Self Pay Proposals -Lynn is still gathering and updating information for the next
meeting.
New Business:
X-RayQuotes- Maureen reviewed the lease options for the digital X-ray equipment for
Radiology and asked for a motion to move forward with First State Bank. Jim will prepare the
lease form for First State Bank.
BARRY PETERSON MADE THE MOTION FOR THE PROPOSED CAPITAL LEASE FOR 2%
WITH FIRST STATE BANK FOR THE DIGITAL X-RAYEQUIPMENT FOR THE RADIOLOGY
DEPARTMENT CONNIE JAMES SECONDED AND THE MOTION PASSED UNANIMOUSLY.
Bank Account for Retail Pharmacy- Maureen asked for a motion to approve a separate bank
account for the retail pharmacy.
CONNIE JAMES MADE THE MOTION TO OPEN A SEPARATE BANK ACCOUNT FOR THE
RETAIL PHARMACY BARRY PETERSON SECONDED AND THE MOTION PASSED UNANIMOUSLY.
Equipment Disposal Approval- A list was provided of surplus equipment and a request for
approval to auction it or give it to another facility.
BARRY PETERSON MADE A MOTION TO DECLARE THE LISTED SURPLUS EQUIPMENT
FOR DISPOSAL TO A PUBLIC AUCTION OR DONATION TO ANOTHER FACILITY, CONNIE
JAMES SECONDED AND THE MOTION PASSED UNANIMOUSLY.
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ITEMS FOR THE FUTURE:
Joint Board/ Medical Staff Meeting- Tuesday, April 14, 2015
WCHS Health Fair-Saturday, April 18, 2015
1% Sales Tax Vote- Tuesday, May, 5, 2015
WHA Board Education-May 21st & 22nd, 2015, Riverton, WY
WCHS Community Picnic-July 11, 2015
BARRY PETERSON MADE A MOTION TO ADJOURN THE MEETING AT 6:48 PM BARRY
PETERSON SECONDED AND THE MOTION PASSED UNANIMOUSLY.
__________________________
____________________________
Jill Sellers, President of the Board
Georgenna Materi, Secretary of the Board
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