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The Plumas Hospital District Chief Executive Officer And Board Of Directors gather around the table for the first meeting of 2019. From left: CEO JoDee Tittle, board chairman Valerie Flanigan, and directors John Kimmel, Andy Ryback, Mark Satterfield and Bill Wickman. Ryback is the board’s newest member after being elected to the position during the November election. He succeeds Kathy Price who decided not to run for another term on the board. Photo by Debra Moore

New faces, equipment for hospital in the new year

It’s a new year for the Plumas Hospital District with a new chief executive officer, JoDee Tittle, and a new board member, Andy Ryback.

During its monthly meeting held Jan. 3, the hospital district’s board of directors welcomed Ryback to his first meeting. Ryback is no stranger to the district as he has served on the Measure A Oversight committee, reviewing how those monies are spent.

For Tittle, it was her second meeting at the helm.

Valerie Flanigan will serve another year as board chairman and Bill Wickman will continue in his role as secretary. Dr. Mark Satterfield and John Kimmel make up the remainder of the board.

New equipment

The board voted unanimously to purchase a new ultrasound imaging system for $133,553 and a cardiovascular ultrasound high-end scanner for $72,080, as well as a service agreement.

Lori Brummer, who is an ultrasound technician, stressed the need for the new equipment to the directors.

“We are constantly struggling with suboptimal imaging and sending patients off site for images,” she said. Because the images are so poor, hospital staff is unable to use them in telemedicine.

She said that currently staff has been forced to use CT scans on pediatric patients, which she described as “less than desirable.”

As for the cardiovascular ultrasound, she said it was “being held together with scotch tape — literally.”

“You make a compelling case for both pieces of equipment,” Dr. Mark Satterfield told her.

While the hospital could pay cash for the equipment, Chief Financial Officer Caleb Johnson recommended that the board approve a lease instead. Director Kimmel agreed and said, “We need to protect our working capital.”

The hospital leverages its capital to participate in intergovernmental transfers, which have become significant to the bottom line.

Johnson also said that he wants to establish a capital planning process now that the hospital has cash reserves, rather than simply reacting to needs as they arise.


The hospital district’s available cash remains at $5 million. Total accounts receivable sits at $6.1 million, with $946,140 of that amount at 120 days plus.

Johnson reported that the 20 percent discount coupons sent out with invoices for self pay accounts have been very popular.


Tittle is emailing the directors updates so that they are kept abreast of developments between meetings.

She has also revamped the district’s organizational chart to indicate who reports to whom and made some title changes to more accurately reflect the employees’ duties.

During the meeting she played a short video on “PDSA” cycles — Plan. Do. Study. Act. She said that practice would be implemented throughout the hospital campus.

Campus security

Tittle is also focusing on hospital security and how to best keep the employees and patients safe. This could involve a number of measures that will be evaluated in the weeks ahead.

Another goal is to maximize the limited space experienced in some areas of the hospital campus.

Homeless discharge

Lisette Brown, who is the chief clinical officer, discussed new requirements pertaining to discharging homeless patients. She said that by July 1 a full implementation plan must be in place that will provide the individuals with food, clothing and transit upon discharge.

She said that the new requirement impacts every hospital in California and the state will be auditing compliance.

Other patients that can require special discharge are those with mental health issues. “It can take days to find spots for those who need a higher level of care,” she said.

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