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EPHC looks at audit, plans for future

Eastern Plumas Health Care District held a regular meeting of its board of directors Thursday, Oct. 24, at 9:30 a.m., at the Loyalton Skilled Nursing Facility.

After opening comments, the board approved the consent calendar before moving on to chair comments.

“I would like to pass around a binder full of photos of the main projects that Stan Peiler and his crew have completed over the past year,” said Gail McGrath, president of the Eastern Plumas Health Care board, handing over the thick binder to be examined by all present.

“It is far from representing all of the work that has been done, but it really shows the scope of the main projects.”

During public comment, one community member asked about potential plans for a pharmacy in Loyalton, reminding the board that currently there is no pharmacy in Loyalton.

“At this time, EPHC is not pursuing the public pharmacy business,” McGrath said. “That was announced two meetings ago.”

The EPHC Auxiliary is still in search of a president to replace Janie MacBride, and interested parties are encouraged to reach out.

Chief of Staff Eric Bugna then described some interesting points he had discovered regarding costs in the healthcare industry.

Annual audit

Jerrel Tucker then stood to quickly go over the annual audit presentation. The audit results showed an unmodified opinion, meaning that the audit passed as clean.

There were no material weaknesses or significant deficiencies, and no reportable findings discovered.

“There were no audit issues that I found,” said Tucker. “There weren’t a whole lot of technically imposing things, it was a really basic year. Overall, there is about a $570,000 decrease in the bottom line after the audit from what you saw in June, and there were two late entries booked during the audit due to the size of the adjustment that was required.”

Tucker stated that the only thing that was a little convoluted was the IGT programs, but also noted that the programs were great to participate in.

“I audit many critical access hospitals and I have a pretty good perspective on what’s going on, especially in the critical access arena. A quick overview shows a bottom line of $3.4 million this year with IGT- a very strong year,” Tucker explained.

Tucker also noted that EPHC was “really conservative” in finances and went on to state that EPHC was well-reserved, and also highlighted the improvement of strengthening their position from year to year, from managing the revenue cycle to managing bad debt.

After some further discussion, McGrath commented, “We don’t get to rest on our laurels with this. If we get stagnant, it’s not only us but our community that does so as well. We want to help our communities stay strong and have positive control over our healthcare system.” Official approval of the audit will take place at the next meeting.

Workforce culture

Director Paul Swanson then took a moment to touch on the budget before looking at the workplace culture at Eastern Plumas.

The room discussed the best ways to keep employee morale high going forward, as well as how to best keep the lines of communication between staff and board members open.

“We need to ensure that there is staff support to go with the volume increase,” Director Theresa Whitfield said.


The board then moved on to discuss policies, which Swanson noted had been gone through by the critical access hospital committee line by line. Policies ranged from death reporting to the MRSA surveillance program.

After removing a policy titled Blood Draw at the Request of Law Enforcement to be retooled for clarity and protocol alignment, all policies were approved unanimously.

Skilled nursing

In the absence of Chief Nursing Officer Sharon DiNicholas, Acting CEO Jayne O’Flanagan read a brief letter from her, which noted that the skilled nursing facilities were actively working through waiting lists, and also that one individual had been able to return to their home after a stay with the EPHC skilled nursing facility.

It was also noted that the new van procured by EPHC was “an amazing asset enhancing the residents experience in both Portola and Loyalton, and it is busy all the time — it has been great.”

The letter went on to add that three of the five Feather River College nursing students were now newly licensed LVNs, with one student waiting for results and one in the process of testing. “The staff has proven month after month that they can rise to any challenge,” the letter concluded.


Clinic Director Rhonda Grandi then reported that there were 369 new patients since the beginning of the year, averaging out to about 1.76 patients per day. “This seems to be likely a result of Dr. Flapan’s departure,” Grandi said.

As far as PRIME and recent IGTs, reporting has been completed, and EPHC expects a transfer by the end of November, with this being the final year of PRIME to be followed by the Equality Incentive Program.

Grandi explained that it may be best to broaden the spectrum of metrics that the hospital district is looking at when achieving targets, outside of the current PRIME required metrics.

It was noted that there would be a HIPPAA training Dec. 5 and 6 that would be mandatory for all clinic providers, and also noted that Jan. 17 would be Dr. Shruti Aggarwal’s last day with EPHC.

Behavioral health

Tracy Studer, a case manager of Behavioral Health, then gave a brief update on the connections and resources made freely available between schools, children in Plumas and Sierra counties and EPHC’s behavioral health program.

It was also mentioned that Plumas County Behavioral Health is available to counsel, with parental involvement. Comments were raised that there was also a need for more parenting classes.

Retirement plan

HR Director Jayne O’Flanagan then reported that EPHC would be looking at potentially offering new employee retirement plan options to interested employees that want to plan their retirement.

There will also be a new employee assistance program through Metlife, which will offer employees up to five free counseling visits per employee. “Metlife also has a support system for managers dealing with difficult employees, which will give added support to staff,” O’Flanagan said.


Chief Financial Officer Katherine Pairish reported on the finances for the month of September, with EPHC posting gross revenue of $3,424,202. This was over budget by $254,241. A net loss for the month was posted in the amount of $102,127, which fell under the budgeted $342,638.

One-time expenses were incurred in the month of September, totaling $117,775, mostly toward campus-wide improvements, software and EPHC’s annual license.


Rick Boyd gave highlights from the IT department, with challenges to be faced in software and hard work from the team in keeping facilities running, even with a recent failure that required round the clock monitoring from the IT department.


Stan Peiler commented briefly on the photos in the portfolio that had been handed out, noting that the final phase of the slurry seal at the Portola campus would begin on the following Tuesday, and highlighted the many projects that he and his crew had brought to fruition over the past year in both Portola and Loyalton.

O’Flanagan spoke again as acting CEO, noting that moving forward, she would be working with Peiler to look at the scope of the projects lined up for the future, as well as scheduling a planning meeting soon.

O’Flanagan then made a long-awaited announcement, with plans for outpatient physical therapy at the Portola campus of EPHC to begin in January 2020.

A physical therapist has been hired, and what is currently known as the Education Center on the Portola Campus will be closed Dec. 15. The building will then be transformed into the physical therapy center in time for the new year.

The next monthly meeting of the board of directors will be held Thursday, Dec. 5. For more information, contact the clerk of the board at 832-6564.

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