Board learns that revenue is down while expenses are up
It was the first meeting of 2019 for the Eastern Plumas Health Care Board of Directors when it met Jan. 24, and a first for some at the table including new directors and new chief executive officer.
It was the first meeting for Director Teresa Whitfield who was elected to the position during last November’s election.
Nicole Johnson is a new director representing Sierra Valley. She, along with Bill Copren (who did not attend) were appointed to represent the valley on what is now a seven-member board following the annexation of portions of the Sierra Valley Health Care District into EPHC.
The new directors were added during a meeting Dec. 28 according to Human Resources Director Jayne O’Flanagan.
“This action was taken based on resolutions passed by both boards that at least one SVHD board member would serve on the EPHC board. California Health Care law requires an uneven number of board members so two were required,” O’Flanagan said.
CEO Todd Plimpton had been on the job approximately three weeks and already has made a number of changes.
Dr. Paul Swanson, who also is a board director, said that the arrival of Plimpton has “all of the employees in a state of electrification.”
“Employees will have to step up,” he said to a packed audience, composed of numerous health care district managers. “Todd is really detailed oriented. There is big change happening here and it’s really positive.”
Facilities Director Stan Peiler said he wasn’t sure at first what to think about the new CEO and related a story of how Plimpton asked him to take a walk and soon they were discussing the need to relocate the flagpole and Plimpton’s vision to light up the hospital and clinic campus with LED lighting. Peiler said he appreciated the suggestions and enthusiasm.
Peiler also discussed nearing completion of a building remodel that is costing the district roughly $200,000 by doing it in-house rather than the $800,000 to $900,00 that had been bid.
Plimpton congratulated “Stan and team” for their work during a recent snowstorm when “they were up here at 2 a.m. keeping everyone safe.”
Technology changes are also coming to the district, with wireless access in public areas, outside security cameras to cover all doors and a five-year plan to update workstations.
Director Harvey West III said he would like to see the ambulances have dash cams, and fellow Director Teresa Whitfield said perhaps body cams would be preferable for when “they are out of the rig.”
CEO Plimpton announced that his office and that of human resources have moved into what is called the “on-call house” and the finance officer moved into his office, thus consolidating departments that need to work together. But the move is temporary, because he wants to return the on-call house to its original function.
Revenue is under budget and costs are over budget. That’s the message delivered by Katherine Pairish, the district’s chief financial officer.
“Our revenue is way off budget and our expenses are up,” she said.
Increased overtime is one item driving up expenses and Human Resources Director Jayne O’Flanagan said she would be reviewing the district’s policy of paying double time instead of time and a half.
The hospital’s cash on hand has dwindled from 50 days at the end of December to 23 at the end of January, which Pairish attributed to funding intergovernmental transfers.
She forecast that by the end of June, the district would be back up to 37 days with the goal of ultimately reaching 60.
As of Jan. 23, Eastern Plumas Health Care’s accounts payable stood at $769,000 with half of that amount sitting at 31 to 90 days old. “We want to get down to 30 days max,” Pairish said. Such a move would impact cash reserves, “but we want to ensure that we are paying our vendors.” If that is done, cash on hand would drop another eight or nine days.
Employee changes considered
Human Resources Director Jayne O’Flanagan announced that she is performing an analysis of full-time employees in each department and evaluating how they’re used. “Our intent is not to eliminate positions,” she said, “but rather an analysis of how we’re using staff.”
Though it wasn’t mentioned during the Jan. 24 meeting, two positions were eliminated the week prior.
This was explained to Feather Publishing via a Jan. 21 email:
“In an effort to focus resources on positions that provide patient care, the Executive Committee at Eastern Plumas Health Care has been reviewing non-patient care positions. The focus of the review has been to determine if some positions could be combined to cover multiple roles.
“Two positions have been identified as being appropriate to be combined or restructured to make maximum use of resources.
“The position of Public Relations Coordinator has been eliminated and the responsibilities distributed to others in the organization. At this time the Human Resources Director, Jayne O’Flanagan, will provide public relations leadership.
“The position of Quality RN has been eliminated with the intent of changing the focus from Quality alone to include other areas such as Compliance and Risk Management. Sharon DiNicholas, Chief Nursing Officer, has assumed Quality leadership and is evaluating changes.”
Also as part of the review effort, O’Flanagan wants to draw a distinction between those that work 40 hours and those that work 30 hours. For example, she suggested that those working 30 hours could be asked to pay an extra 5 percent of the cost associated with benefit coverage for dependents.
O’Flanagan also touched on employee evaluations and their associated pay increases. The practice has been for all employees to be reviewed in January and then have the pay increase associated with their performance go into effect on their anniversary date of employment.
While the district wants to continue with the “pay for performance” approach, it would like to implement some changes. For instance, rather than have pay raises vary by anniversary date, they would all occur July 1, the beginning of the new fiscal year.
A bigger change would tie the raises to the district’s financial success.
“I’m a big supporter of pay for service,” said CEO Plimpton, but he would like it tied to revenue triggers. Employees would receive a base cost of living increase, but other increases would go into effect if the district met revenue targets set by leadership. Plimpton said that the proposed changes have been discussed with the management team and they were in support.
For this year, as the new plan is being developed, all employees would receive a 2.5 percent pay increase. Plimpton said that would cost the district approximately $450,000.
“We’ve got a great team here,” he said. “I’m really appreciative of the management team stepping up.”
As for the employee wages in general, O’Flanagan said they compare favorably to others in the state, and the district actually pays 11 percent over the market when it comes to CNAs.
Chief Nursing Officer Sharon DiNicholas said the district would be hiring a certified case manager to assist patients and their families to be referred to local services. This would be a revenue generating position because it would capture revenue that otherwise could go elsewhere.
She announced that Donna Dorsey has been promoted to ER manager and Penny Holland is the new acute care manager.
Clinic Director Rhonda Grandi presented a behavioral health update and noted that there were 1,343 visits kept out of 1,492 scheduled. “That’s a great no-show rate,” she said.
She also said that the clinics have made great strides working with Plumas County Behavioral Health.
Janie McBride reported that the Nifty Thrifty has been doing well with gross sales in November of $12,592 and nearly an identical amount in December.
“The public really supports the cause here,” McBride said.
She reported that the auxiliary gave $2,625 in employee scholarships during those months as well.