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EPHC board of directors chooses new chairman, approves fiscal audit

The Eastern Plumas Health Care (EPHC) Board of Directors held an organizational meeting before holding a regularly scheduled meeting via Zoom.

The most recent organizational meeting opened with the election of officers and subcommittee assignments on the agenda.

Director Augustine Corcoran was nominated for the position of chairman by Director Paul Swanson and that nomination was seconded by Director Linda Satchwell, with both commenting positively on Corcoran’s ability to remain neutral in his work.

The nomination was approved unanimously by roll call vote.

Former Chairwoman Gail McGrath spoke of how grateful she was to have been in that role for all of the many years she has served the community, noting that she found it “so rewarding.”

Director Satchwell was nominated for the role of vice chair and that was approved unanimously by roll call vote.

The position of secretary was filled by Director Marcie Hughes after a nomination and roll call vote.

Director Hughes was also nominated to take a seat on the quality assurance committee which had filled by former Director Teresa Whitfield.

The EPHC board then decided to change the time of the monthly meeting to start at 9 a.m. rather than 9:30 a.m. moving forward, with the change becoming effective at the next meeting in February. This change was approved unanimously by roll call vote.

Regularly scheduled meeting

Newly seated Chairman Augustine Corcoran then opened the regular meeting of the board of directors, and with no board or public comments, moved to approve the consent calendar.

Audit report

Jerrel Tucker of TCA Partners, LLP, presented the audit results in terms of hospital finances, noting, “The fiscal year audit ending June 30, 2022 has an unmodified opinion, which means a clean opinion- there were no reportable findings, and no audit adjustments.”

Tucker said that EPHC’s Chief Financial Officer Katherine Pairish had had a lot of hoops to jump through during covid, in regard to the many reporting requirements, and that she had done “an excellent job.”

Tucker then went over various funds that were received during the last fiscal year, including Intergovernmental Transfers (IGTs) and Covid-19 supplemental funding.

“Through the whole covid process, there was a Medicare advance of $4.6 million, which was money identified on your prior costs reports and advanced to help with cash flow during the pandemic, and this was a loan with no forgiveness, not a grant, so must be paid back,” Tucker explained. EPHC still owes $1.2 million on the Medicare advance, which is being paid off on a monthly basis.

“On Health and Human Services or HHS, which controlled all of the covid related grant money, you received a total of $7.8 million and recognized $4.8 million in income. The final $3 million will be recognized in this fiscal year,” Tucker noted.

“That $7.8 million required a significant amount of paperwork and reporting,” Tucker went on. “Those are grant funds that must be spent on authorized expenses in the right period and properly reported or it must be returned. That full amount will be a grant.”

Tucker noted that the $7.8 million dollar grant helped increase the cash holding funds for EPHC.

When it comes to PPP, or Payroll Protection Program loans, EPHC borrowed $3.1 million dollars with a total of $3 million forgiven, with the hospital having had to return $100,000 of the $3.1 million dollars. “This was also a great benefit for the hospital,” Tucker said.

Tucker touched on the differences in operating revenue between last year and this year due to covid funding.

“You can see the overall increase in expenses- hospitals are dealing with inflation and costs for travelers that have gone up significantly,” Tucker said. “A lot of your ratios are very strong still. Bad debt stays very consistent, and you’ve been able to somewhat control you labor and benefit expenses.”

Tucker noted that EPHC had remained very ‘fiscally solvent’ over the last year. “To sum it all up, was it a good year? Yes. You took advantage of all of the covid related programs out there, but you’re experiencing expenses going up in the future. In the meantime, continue to be mindful and methodical in your management of the hospital,” Tucker closed.

Dr. Paul Swanson then gave a brief report from the finance committee, recommending that the board accept the fiscal year audit report. The audit was accepted by unanimous roll call vote.

Staff reports

Grant Program Manager Joanna Garneau opened staff reports with a brief presentation on the CalAIM program, the Covid 19 Test to Treat Equity Grant and a Behavioral Health Integration (BHI) Incentive.

CalAIM is a Department of Healthcare Services initiative to improve quality of life and health outcomes for managed MediCal members. There are two different programs underneath CalAIM- Enhanced Care Management Providers and Community Supports.

“We’re contracting to be an Enhanced Care Manager,” Garneau said.

“This program is only for Managed Medical patients at this time, but we do hope to see this program grow,” Garneau explained.

Next, the Covid 19 Test to Treat Equity grant was discussed. “We will receive $455,550 for this grant within the next few weeks,” Garneau explained. “We are looking at expansion and enhancement of current testing, but what this really does is sets us up for disaster relief situations. Say we had to evacuate the SNF- this gives us the ability to set up a fully equipped remote clinic or SNF and have outdoor options for seeing our patients.”

There will also be signage and a one-ton pickup included amongst portable buildings or tents and more in the grant.

Lastly, on the Behavioral Health Integration Initiative, Garneau reported that EPHC received $110,000 total in two installments.

The initiative will provide many resources to EPHC, towards the adherence to antipsychotic medications for individuals with schizophrenia and a pharmacotherapy for opioid use disorder (POD).

“This will be very beneficial for EPHC and the community,” CEO Doug McCoy said.

Michelle Romero of Infection Control reported that in December, there were very high respiratory illness numbers. “We saw 24 covid positives, 132 Influenza A positives and 24 RSVs,” Romero reported to the board. “That was a lot- we were very busy.”

Romero noted that it seems that the respiratory viruses peaked in December and were coming down in January. “We will keep our fingers crossed,” she said.

Romero then reported that the hospital had their first covid positive resident at the Portola Skilled Nursing Facility (SNF) since July 2022. That resident is now off isolation with no further cases identified. Staff is no longer tested routinely for covid, rather they are now tested when there is an exposure, or someone is experiencing symptoms. Romero also noted that there are covid and flu vaccines available at all EPHC clinics.

CEO Doug McCoy noted that Romero and her team had done an excellent job.

Chief Nursing Officer Penny Holland reported they were trying to keep an average of three to four swing patients on the floor and also that the floors have been completed in the emergency room and acute wing of EPHC.

“We’re hopefully looking at finalizing the new central monitoring system,” Holland said. “Dietary is still working on menu changes-menus will be more personalized for each patient. Covid continues to establish the rules of the hospital on a daily basis.”

Holland also noted that staffing was looking good with the hire of a night nurse and two more per diems.

Skilled Nursing Facility (SNF) Director of Nursing Lorraine Noble reported that the current census is 52 between both the Portola and Loyalton Skilled Nursing Facility or SNF locations.

Director of Clinics Tracy Studer reported that she had been keeping in close contact with a family nurse practitioner (FNP) in Loyalton to find new ways to provide services at the Loyalton Medical Clinic. “The new clinic looks wonderful,” Studer said. “I would like to start small and grow services in Loyalton, so we are not overstretched.” Studer mentioned the goal of increasing telehealth appointments and nutritionist appointments to Loyalton as well.

“Tahoe Forest will be providing OB services via telehealth. A medical assistant or nurse practitioner would be utilized to assist with the telehealth OB appointments,” Studer added. “I cannot say it’s been easy, but I am so grateful to be doing this.”

Chief Executive Officer Doug McCoy then moved into his report. “We have had a lot of activity in the last seven weeks,” McCoy said. He highlighted the implementation of the new Emergency Medical Record or EMR system, the submission of EPHC’s seismic plan, and the need to get the community involved in the EPHC Foundation.

“We had a wonderful experience in December recognizing our years of service folks across three campuses- I think it sent a strong message of community commitment, and it was a really fun time,” McCoy said.

McCoy also thanked all staff for providing the services they do in an exceptional way. “I’m very proud and for a small hospital we are delivering a quality service that I have not seen in medical systems I have been involved with, as a board member and a consumer.”

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