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Eastern Plumas Health Care staff impacted by covid, audit report receives clean opinion

Eastern Plumas Health Care (EPHC) held an organizational meeting and a regular meeting of the board of directors on the morning of Thursday, January 27 at 9:30 a.m. via Zoom.

A call to order was made by Chairwoman Gail McGrath followed by roll call with all board members present. The first portion of the morning was then spent on the annual organizational meeting, where the board discusses and chooses who serves on which committee.

Organizational meeting

Chairman Gail McGrath opened the discussion with the announcement that she would not be running for chair again after the end of her term in December 2022. “Choosing new positions to begin as of today,” McGrath said.

Director Linda Satchwell spoke with a proposed nomination for Director Teresa Whitfield to serve as Chairman and Director Paul Swanson, MD then asked whether there had been any movement towards looking for a board member to replace McGrath fully at the end of her term.

“We still have a number of months to go, and I have no intention of stepping off the board before my term ends,” McGrath said.

Swanson went on to note, “The chair is certainly most important position,” and thanked McGrath for all of her hard work over the years in the role.

“What is your feeling about staying on as chair until the end of your term?” Swanson asked McGrath directly.

McGrath responded, “I would have no problem with that if the board chose, it has been an extremely rewarding experience to get the in-depth insight into how much effort it takes to run a health care facility, and I really don’t want to ever go off the board. But after so many years, I think I should. I would like to see someone with strong corporate experience come on to the board when I do leave.”

Swanson responded that he thought McGrath had been “an exemplary board chair” and then stated that he would be in favor of McGrath staying on in her role, if in accordance with the Brown Act, until the end of her term while the board continues to look for a new board member.

“After you step down, any of the board members would make a good chair, but your experience gives you a strong position to operate as chair from,” Swanson concluded.

Satchwell said that if Whitfield moved into the position now, it would give her a chance to learn the role with the assistance of McGrath still on the board.

Whitfield seconded the nomination, with Satchwell adding, “It just seemed like an ideal way to transition.”

McGrath then reiterated that it was up to the board as a whole. “The biggest concern I have with Theresa stepping into this right now is the amount of covid still in the hospitals, but again, it’s up to the board. I think any one of our board members could handle this job,” McGrath went on.

Swanson noted that hospital staff opinions also matter, and with Whitfield and Satchwell as former hospital employees, he felt that the most stable thing at this time would be for McGrath to remain in her current position and “let the board work out how things will look when she leaves at the end of the year.”

The board went on to agree through further discussion that they would be happy to have Director Augustine Corcoran serve in the role of vice-chair. A motion was then made by Swanson for McGrath to maintain her role as chair with Corcoran as vice chair, and McGrath seconded that motion.

A vote was taken by roll call, with all voting to approve the motion unanimously.

A nomination was then made by McGrath for Director Satchwell to become the Secretary. “Secretarial duties involve some signatures but nothing major,” McGrath clarified. This nomination was also unanimously approved by roll call vote.

Some discussion led to leaving the standing committees as they are standing, according to McGrath. All then unanimously voted yes on that arrangement by roll call vote.

“It’s going to be an exciting year as we come out of this mess we’ve been in,” McGrath said.

Regular meeting: financial audit results 

After moving into the regular meeting, Jerrel Tucker of JWT & Associates, LLP gave an audit report at this time via Zoom, of finances with the year end of June 30, 2021.

“I already met with the finance committee and went over it in depth, and I’m going to hit the high points now,” Tucker said with a smile.

The financial audit results received an unmodified, clean opinion, with no material weaknesses or significant deficiencies identified relating to the hospitals’ internal controls and no reportable findings.

“There were no audit adjustments and there were four late client entries which happened after the audit started,” Tucker said.

One larger item touched on was the Covid-19 PRF or Provider Relief Funds which were received by the hospital from various stimulus payments through the pandemic.

“The FED sends money, which must be reported as to how much was spent according to the regulations, and anything not spent within the guidelines must be returned,” Tucker explained.

EPHC got $4.4 million in covid related funding and has spent $3.6 million on covid-related projects thus far, which was reported on the audit as grant income. The remainder is a difference of $800,000.

Total revenue in 2021 was $42,731,384, with total expenses at $33,720,425, leaving a net income of $9,010,959.

“Yes, you had a very good year, but a lot of that is covid money, some of which won’t be continuing in future years,” Tucker said. “It’s good to have your reserves built up because you don’t know what the future holds.”

In regard to assets, 2021 totals came out to $40,144,228 and $15,378,995 in liabilities, leaving net assets at a total of $24,765,233.

“There is enormous cost but enormous benefit for the community coming with things such as the remodel of the Loyalton clinic and new physical therapy clinic,” McGrath said.

All thanked Tucker for his time and the board then moved on to approve the amended EPHC Auxiliary bylaws.

Chief nursing officer report

Chief Nursing Officer Penny Holland reported that there are staffing issues being experienced at the hospital, and that the EPHC lab had been functioning understaffed, with Plumas District Hospital (PDH) stepping up to assist as needed at times in December.

“Over half of the radiology department is out with covid, and we are down to two techs right now to keep the radiology department open,” Holland said. “Multiple nurses have covid and have been taken off the schedule. There is a big group of per-diems now experiencing sickness, as well, so we are just trying to keep floor and emergency department staffed.”

It was also reported that the hospital is about one month away from having two newly certified wound care nurses.

“This variant has really delivered a wallop,” McGrath said.

Chief financial officer report

Chief Financial Officer Katherine Pairish then reported on finances from July 1, 2020 to December 31, 2021.

“Eastern Plumas Health Care continues to do very well,” Pairish said. “We are halfway through the 2021-2022 fiscal year.”

Total patient revenue for the six months ending December 2021 were over budget by $2,415,978 and year-to-date total operating expenses were over budget by $718,053. A net income was posted over budget in the amount of $1,124,338.

Director Whitfield asked for clarification on the covid related funds.

“When all of this started, the government basically bombarded all of the hospitals with cash to spend on covid-related expenses,” Pairish responded. “We posted those as liabilities until we could prove to the government that we spent the money appropriately. Covid moneys have already been spent, with $3 million to spend still on covid-specific items to help take care of our patients.”

“To have all this so close to home is just so rewarding, and we are happy to come here and not have to go to the big city,” McGrath commented.

“I agree, the care is excellent  and I am so proud to be a part of this organization,” Pairish said. “There are so many great people here.”

Director of clinics report

“200 rapid tests for covid have been individually packaged and distributed to different businesses in town such as Leonards and Ace Hardware, to alleviate the load on the clinic because we are booking out at least a week at the clinic for testing,” Paul Bruning, director of clinics reported.

“We get about six boxes of swabs in the clinic per month, and we will be getting out to those that need them in the community and to staff members as they come in.”

CEO report

Chief Executive Officer Doug McCoy then gave his report.

“The work that the team has done to provide increased access to service continues… and this year, even with significant covid increase and Dixie Fire. Despite everything, we are performing better now than we were a year ago this time,” McCoy said.

He went on to note that there had been a $2.6 million dollar capital budget proposal, which had already been approved, in place for covid funds to extend towards replacing the x-ray room, additional equipment and much-needed renovations in the emergency room in Portola, as well as renovations at the Loyalton skilled nursing facility (SNF).

“City approval has also been received for the Loyalton clinic project, and we are already receiving interest from contractors,” McCoy said.

“The rehab wellness center is a few weeks out from final plan readiness to be submitted to the OSHPOD process. Plans are also ready to submit to add restrooms to basement area of the Portola SNF so that we can use the area for senior mental health services.”

McCoy then noted that all hospitals were constantly reporting bigger challenges due to covid. Out of all pandemic months, staff has been most affected at EPHC thus far during January 2022.

“Our case rate has been at an estimated 10-12 percent of our employee base in January. We have a high vaccination rate, so thankfully most of those cases have been mild,” McCoy said. “It has placed a significant amount of pressure on our clinic leadership- they have done an outstanding job. All of our support teams have been phenomenal during this pandemic.”

McCoy reported that they will be adding antigen and additional lab testing equipment to clinics.

“When it comes to booster vaccines, the government has stated that all health care workers must receive dose by March 1 rather than February 1,” he said.

“65 percent of our employees that have tested positive have also been fully vaccinated, so I think that speaks to the transmissibility of this virus,” McCoy went on to note.

In California, 40 percent of the hospitals across the state is currently in a “crisis staffing” situation when it comes to nursing staff.

McCoy then thanked the board for their approval of expanding paid time off for employees, which greatly assists in retaining employees.

It was then reported that the hospital has added additional traveling nurse recruiters, undertaking extensive work to expedite onboarding services.

“We do have challenges with housing, we also have a lack of childcare in the area,” McCoy said.

Public comment

During public comment, local Josh Hart spokesperson for Plumas Wired, spoke briefly on the need to look back at the 200-foot cell phone tower near the EPHC campus which was approved last year.

“We believe that the Portola city council was misinformed on their right to refuse this tower,” Hart said. He spoke of altimeter interference with helicopters going in and out of EPHC, as well as FCC exposure guidelines.

“The key points are that the cell tower that has been approved to be near Eastern Plumas Health Care (EPHC), over the objections of the hospital board is a real risk to human health and safety,” Hart said.

“Verizon and AT&T have also treated FAA concerns about altimeter interference with disdain. Of great concern to the EPHC helicopter. Also, a DC Circuit Court ruling against the FCC in August 2020 undermines the very foundation of Verizon’s claims of safety.”

“I want to praise the board for its foresight and speaking out against the tower in the past,” Hart said in closing. “We are asking the city to revoke the permit and feel that this tower poses a direct threat to community health. We ask you agendize this issue and bring it before the city once more.”

In board closing remarks McGrath thanked all for their “total dedication” through all of the challenges presented by the pandemic, especially in light of the recent surge in cases and the impact it had.

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