MEEKER | The Eastern Rio Blanco County Health Service District’s Pioneers Medical Center Board held its regular March meeting last week, with all board members present.
The meeting began with a finance session at 9:30 a.m., where board Secretary/Treasurer Sherri Halandras raised questions about how board members were being classified in the committee.
“I was wondering why it has Regas, Jean, and Wade as ad hoc when they’re actually board members,” Halandras said.
Executive Assistant Natalie Scritchfield explained, “The finance committee is a subcommittee of the board, so you’re board members, but you’re not finance committee members.”
Halandras questioned the distinction between being a board member and serving in an ad hoc [committee] capacity, noting that all members are still counted toward a quorum.
The board’s attorney, Jak Pattamasaevi, clarified the designation.
“Technically speaking, you guys have designated these particular finance meetings as a committee meeting wherein the board are attending as well,” Pattamasaevi said. “Just for informational purposes, we’re treating this as part of the main meeting for disclosure purposes, so that we maintain compliance. How you wish to notate the board members’ presence in your minutes and in your agenda, if you wish to refer to them as being there on an ad hoc basis or just board members present, that is also acceptable. It is entirely possible to do it either way.”
Halandras said she had not seen the designation used before. Board member Wade Bradfield said it had “been on there forever,” while Vice President Regas Halandras said he had never seen the ad hoc designation.
Halandras then asked whether ad hoc members could still make motions.
Bradfield responded, “If I’m ad hoc, because when I first started doing this I didn’t come to some of the finance meetings because I wasn’t on the finance committee, but then I started showing up so I can learn more. Then the public outcry said it was a quorum, so then I quit coming until we started posting the finance meeting.”
Board President Mark Schryver added, “It became an open meeting.”
Bradfield continued, “She [Halandras] is right, if you’re ad hoc then why do we even make motions or vote or anything if we’re not acting as a board member.”
Sherri Halandras questioned the purpose of the finance committee if all members were attending.
Schryver explained the committee’s original intent.
“Initially what we were doing with the finance committee was that it was educational,” he said. “It was all about wages, to learn more about revenue and just the finances of the hospital, and so that’s why people started attending. It kind of happened not by anything other than educational stuff that people wanted to come find out how it worked.”
Pattamasaevi said the board was effectively treating the session as part of a regular meeting.
“The way that you have it, the way you’re treating it, is as if it were part of the main meeting,” he said. “All the board members are present in the same room. We are treating this as if it is being conducted as an open board meeting. How the board wishes to conduct, whether or not you’ll have votes or formal actions here, is up to you. If you want to have formal actions, you can. If you don’t wish to have actions here, you can also do that.”
Scritchfield noted that most actions are still taken during the regular board meeting.
“I think the only action is taking these reports to the regular board, like the capital items,” she said. “Any financial issues, we bring those to the regular board and we act on them in the board [meeting], so we are pretty flexible with how we can do it.”
Pattamasaevi added that the original structure was intended for convenience.
“The original plan here is so that the entire board does not have to be present,” he said. “I believe it was a convenience thing so that you don’t have to have the entire board present to do this kind of discussion session. But since all the board has been showing up, we now have met all the requirements for you to actually act if you so choose.”
Bradfield noted that the board could streamline the process.
“So we can approve the finance report in this meeting and then skip it in the regular board meeting to save some time,” he said.
Pattamasaevi confirmed the board had met the requirements to do so.
Schryver then proposed a change moving forward.
“Just have the board meeting start at 9:30 and we start with finance, and then we roll into the normal board meeting,” he said. “Let’s just do it that way.”
Senior Finance Analyst Janae Stanworth presented the February financials, noting that February was a shorter month, which caused some items to decrease from January.
“Cash has decreased from January to February. I did want to make you aware that has increased back up for March. Through our bank statements, February cash that we received, deposits we received, were a total of $4.9 million through Friday, the 27th. For March, it’s been $5.3M, so that has increased back up,” she said.
Cash on hand remained at 125 days, while average daily operating expenses increased from $153,000 to $163,000. Accounts receivable rose 11.4% from January to February, largely due to Medicaid and Medicare.
Stanworth said the increase “means you’re going to have a bigger contractual allowance that you’re going to then see on the income statement for those reserves.” Contractual allowance rates were 77% for Medicaid, 52% for Medicare and 37% for commercial insurance.
Gross patient revenue for February was reported at $8.85 million, exceeding both budget and prior-year figures. Outpatient services increased by $1.7 million, while emergency department visits declined from 130 in January to 106 in February. Acute patient days remained at 18, swing bed days increased from 16 to 21, and long-term care days decreased from 849 to 790. Retail pharmacy revenue rose to $337,900, with 3,319 total prescriptions.
Expenses totaled approximately $5.35 million. Stanworth said, “For the month of February, you’re seeing a net income of $211,000 for the month, which means year to date, we have a net loss of $185. So year to date, you’re looking at a net income of about $25,000 year to date.”
Following the finance session, the board moved into its regular meeting, approved the agenda, and approved minutes. No public comments were made.
The board received an election update from designated election official Pam Anderson, who outlined the upcoming May mail ballot election. Ballots are expected to be mailed around April 13 and must be returned by May 5. Anderson said ballots will be sent to registered voters and eligible property owners, and that spouses of property owners may request ballots through the appropriate forms.
Interim CEO Steve Hannah provided updates on recruitment, operations and strategic planning.
Hannah said one staff member’s role has been expanded, and they are now recruiting for a replacement in the family medicine clinic to allow for more strategic focus.
Christy Atwood added, “We’re definitely looking at that also looking at the viability of what that performer looks like in all capacities, both Sports Med, Family Medicine and behavioral health.”
Hannah described his approach to evaluating growth opportunities, saying he prefers to gather data and assess proposals before making decisions, rather than automatically approving or rejecting them. He emphasized the importance of listening to physicians and reviewing potential initiatives carefully before moving forward.
Chief Nursing Officer Janelle Borchard reported on operations, including a new telemetry system through Mindray and staffing updates. She said Josh Martin has accepted a full-time role and is relocating to the community. She also noted that about 30% of the long-term care waitlist had been outdated and has been restructured.
Director of Human Resources Randy Crews reported on employee engagement efforts.
“We’re working on a contract with Gallup for employee engagement. Our goal is retention,” Crews said.
He said January turnover was 1%, equating to a 99% retention rate, while February retention was 97.7%.
Hannah added, “The type of customer experience you receive begins with the employee who served you. Engaged employees are willing to go the extra mile for themselves, their co-workers and their customers.”
Hannah also discussed recruitment and compliance, noting that offers are being prepared for key positions and that the organization may look internally to fill a compliance leadership role.
On long-term planning, Hannah said, “We have to start with some data collection. Out of that model, we’ll begin to see a picture of how this organization can grow over the next 10 years.”
Near the end of the meeting, the board approved several action items.
Hannah said one of the action items involved an engagement letter with the hospital’s legal counsel to assist with physician contracts and medical staff rules, rights, and bylaws.
The board unanimously approved the engagement letter.
Hannah said another action item involved a provider agreement. Under the current process, the board reviews such agreements before he signs them. He noted this was the second cleanup agreement from the transition period.
The board unanimously approved the agreement.
The board then entered into executive session to discuss personnel matters, negotiations, and legal advice pursuant to Colorado statute.
The next meeting is scheduled for April 28 at 9:30 a.m. in the IT training room.
