METICULOUS CARE * MEMORABLE PEOPLE * MAJESTIC LOCATION

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1 Board of Directors Meeting Agenda October 21, Press Ganey Guardian of Excellence Award Winner BOARD OF DIRECTORS MONTHLY MEETING AGENDA In compliance with the Americans with Disabilities Act (ADA), if you need special assistance to participate in or to attend this meeting, please contact the District Board Administrative Assistant at Mammoth Hospital by telephoning (760) Notification 48 hours prior to the meeting will enable the District to make reasonable arrangements to assist with accessibility to this meeting. Date: October 21, 2015 Time: 9:00 a.m. Monthly Board Meeting Regular Session 9:05 a.m. Closed Session (approximate time) 9:40 a.m. Regular Session continued (approximate time) Place: Mammoth Hospital Administration Conference Rooms A & B 85 Sierra Park Road Mammoth Lakes, CA Treasurer Stephen Swisher, M.D., will attend via teleconference and will be located at 315 Chestnut St, St. Louis, MO I. CALL TO ORDER II. PUBLIC COMMENTS III. ADJOURN TO CLOSED SESSION HEALTH CARE FACILTY TRADE SECRETS (Health and Safety Code 32106) 1. Sierra Park Clinics/Mammoth Hospital. PERSONNEL MATTERS (Government Code 54957) 1. CEO Evaluation. P.O. Box Sierra Park Road Mammoth Lakes, CA Fax METICULOUS CARE * MEMORABLE PEOPLE * MAJESTIC LOCATION

2 Board of Directors Meeting Agenda October 21, 2015 CREDENTIALING Appointment to Provisional Staff Allied Health Carolyn Korfiatis, N.P. Temporary Privileges Jason Jeter, DDS Adult Dentist October 14, 15, 16, 2015 David Levine, MD Anesthesiologist October 10-12, 2015 Victoria Paterno, MM Pediatrics October 9 12, 2015 IV. REPORT ON CLOSED SESSION V. PUBLIC COMMENTS VI. CONSENT AGENDA (All matters on the consent agenda to be approved on one motion unless a Board Member requests separate action on a specific item) 1. Previous Minutes to be approved: September 24, 2015 Regular Board Meeting 2. ACHD Updates VII. CHIEF EXECUTIVE OFFICER REPORT VIII. OLD BUSINESS No matters to discuss this month. IX. NEW BUSINESS 1. Review and Approval of professional services agreement between Southern Mono Healthcare District and Jonathan Bourne M.D., for the provisions of Anesthesiology Professional Services. 2. Review and Approval of Professional Services agreement between Southern Mono Healthcare District and Michael Karch, M.D., for the provision of Orthopedic Professional Services. 3. Review and Approval of professional services agreement between Southern Mono Healthcare District and Jason Jeter, D.D.S., for the provision of Dental Professional Services. 4. Review and Approval of professional services agreement between Southern Mono Healthcare District and Alexander, Budiman D.O., for the provision of Family Medicine Professional Services. 5. Declaration of Surplus Equipment.

3 Board of Directors Meeting Agenda October 21, 2015 X. CREDENTIALING Appointment to Provisional Staff Allied Health Carolyn Korfiatis, N.P. Temporary Privileges Jason Jeter, DDS Adult Dentist October 14, 15, 16, 2015 David Levine, MD Anesthesiologist October 10-12, 2015 Victoria Paterno, MM Pediatrics October 9 12, 2015 XI. FUTURE BUSINESS The next SMHD Board meeting will be the Strategic Plan Workshop to take place on October 30, 2015 at 8:00 a.m. in the Sierra Events center in the Sierra Center Mall, Sierra Center Mall Events Center- Second Floor, 425 Old Mammoth Road, Mammoth Lakes, CA ADJOURN

4 Board of Directors Meeting Minutes September 24, Press Ganey Guardian of Excellence Award Winner BOARD OF DIRECTORS MONTHLY MEETING MINUTES Date: September 24, 2015 Attendance of Board Members: Attendance of Staff Members: Helen Shepherd, Chair; Lynda Salcido, Vice Chair; Stephen Swisher, M.D., Treasurer; Ryan Wood, Secretary. Gary Myers, CEO; Melanie Van Winkle, CFO; Kathleen Alo, CNO; Craig Burrows, M.D., CMO; David Baumwohl, Legal Counsel; Robin Conners, Recording Secretary. I. CALL TO ORDER Chair Shepherd called the meeting to order at 8:01 a.m. Chair Shepherd read the Southern Mono Healthcare District Vision, Mission, and Values. II. PUBLIC COMMENTS There were no Public Comments. III. CHIEF OF STAFF REPORT There was no Chief of Staff report. IV. ADJOURN TO CLOSED SESSION The Board adjourned to closed session at 8:04 a.m. Dr. Audrey Pauly, former Chief of Staff, requested to attend the Closed Session as Chief of Staff. The request was granted. P.O. Box Sierra Park Road Mammoth Lakes, CA Fax METICULOUS CARE * MEMORABLE PEOPLE * MAJESTIC LOCATION

5 Board of Directors Meeting Minutes September 24, 2015 V. REPORT ON CLOSED SESSION Closed session ended at 9:5 a.m. The Board reconvened to open session at 10:00 a.m. CONFERENCE WITH LEGAL COUNSEL PENDING AND THREATENED LITIGATION Existing Litigation and Significant exposure to litigation pursuant to Government Code Inyo County Local Agency Formation Commission (LAFCO) v. Southern Mono Healthcare District, Inyo County Superior Court Case No. SICVPT Chair Shepherd reported discussion of CONFERENCE WITH LEGAL COUNSEL on PENDING AND THREATENED LITIGATION for the above item; no action taken. 2. Claim of Bradley Holland v. Southern Mono Healthcare District; threatened litigation. Lynda Salcido made a motion seconded by Stephen Swisher, M.D., to direct counsel to return the Claim of Bradley Holland v. Southern Mono Healthcare District as being late. A roll call vote was taken; the motion passed unanimously. Yes 4, No 0. CONFERENCE WITH REAL PROPERTY NEGOTIATORS (Government Code ) 1. Proposed relisting of commercial property of SMHD located at 699 West Line Street, Bishop, County of Inyo, California; APN: District Negotiators for SMHD: Gary Myers, CEO; Melanie Van Winkle, CFO; David Baumwohl, legal counsel; Cindy Freeman as listing agent. Chair Shepherd reported that CONFERENCE WITH REAL PROPERTY NEGOTIATORS regarding the item above was discussed; no action was taken. QUALITY ASSURANCE (Health and Safety Code 32155) 1. Chief of Staff Report. Chair Shepherd reported that QUALITY ASSURANCE issues were discussed with Audrey Pauly, MD., former Chief of Staff; no action was taken. 2. CEO Report. Chair Shepherd reported that QUALITY ASSURANCE issues were discussed with Gary Myers, CEO; no action was taken. Page 2 of 8

6 Board of Directors Meeting Minutes September 24, CNO Report. Chair Shepherd reported that QUALITY ASSURANCE issues were discussed with Kathleen Alo, CNO; no action was taken. 4. CMO Report. Chair Shepherd reported that QUALITY ASSURANCE issues were discussed with Craig Burrows, M.D., CMO; no action was taken. QUALITY ASSURANCE QUARTERLY SUMMARIES - (Health and Safety Code 32155) There are no summaries for review this month. HEALTH CARE FACILTY TRADE SECRETS (Health and Safety Code 32106) 1. Sierra Park Clinics/Mammoth Hospital. Chair Shepherd reported HEALTH CARE FACILITY TRADE SECRETS were discussed regarding Sierra Park Clinics/Mammoth Hospital; no action was taken. PERSONNEL MATTERS (Government Code 54957) 1. CEO Evaluation. Chair Shepherd reported PERSONNEL MATTERS was discussed. The Chair asked all staff to leave the room so the matter could be discussed solely by the Board. No action was taken. CREDENTIALING Reappointment to Active Staff Peter Clark, M.D. Dennis Crunk, M.D. Yuri Parisky, M.D. Appointment to Active Staff Brian Gilmer, M.D. Temporary Privileges Sierra Bourne, M.D. Emergency Department 09/16-18/2015 Victoria Paterno, M.D. Pediatric Department 08/20/2015 Carolyn Korfiatis, N.P. Family Medicine 09/24 10/16/2015 Chair Shepherd reported the foregoing physician CREDENTIALING was discussed; no action was taken. Page 3 of 8

7 Board of Directors Meeting Minutes September 24, 2015 VI. PUBLIC COMMENTS Dr. Pauly thanked the Board for approving the CMO position. She stated that Dr. Burrows is very competent and enthusiastic and is working very well with the Medical Staff and Administration. His efforts are a benefit for quality and patient safety at the hospital. VII. CONSENT AGENDA (All matters on the consent agenda to be approved on one motion unless a Board Member requests separate action on a specific item) 1. Previous Minutes to be approved: August 20, 2015 Regular Board Meeting September 14, 2015 Special Board Meeting 2. Chief Financial Officer Report 3. Chief Nursing Report 4. Information Technology Report 5. Human Resources Report 6. Facilities Report 7. ACHD Updates 8. Mono County Social Services Update Lynda Salcido made a motion, seconded by Ryan Wood to approve all items on the consent agenda as presented in the packet. Chair Shepherd asked for comments; a brief discussion ensued including clarification and comments on some items in the Human Resources report and the Mono County Social Services Update. A vote was taken; the motion passed unanimously. Yes 4, No 0. VIII. COMMITTEE REPORTS 1. Finance Committee Stephen Swisher, M.D., Helen Shepherd Details from the Finance Committee Meeting will be covered in the Financial Report. 2. Physician Compensation Helen Shepherd, Ryan Wood There was no Physician Compensation meeting; no report. 3. Employee Relations Committee Helen Shepherd There was no report. Page 4 of 8

8 Board of Directors Meeting Minutes September 24, Quality Committee Stephen Swisher, M.D., Lynda Salcido Stephen Swisher, M.D., met with Kathleen Alo, CNO regarding quality. The committee will plan to hold quarterly committee meetings to discuss any significant issues and report to the Board as needed. No further report. 5. CEO Annual Review Committee Lynda Salcido, Helen Shepherd The CEO evaluation is being worked on by the committee. No further report. 6. IT Steering Committee Stephen Swisher, M.D., Ryan Wood Dr. Swisher reported that new EMR systems are still being explored. No further report. 7. Facilities Committee Ryan Wood Gary Myers informed the Board that the hospital received one bid on the Medical Office Remodel. Staff is in negotiations with the bidder. No further report. There was no report. 8. Community Health Committee Lynda Salcido, Gary Myers 9. Ad Hoc, Special, or Other (as needed) Committees There are no Ad Hoc, Special, or Other (as needed) Committees at this time. IX. CHIEF EXECUTIVE OFFICER REPORT Gary Myers, CEO, had no additions to his report. X. FINANCE REPORT 1. August 2015 Financial Statements. 2. Investment Report. Melanie Van Winkle, CFO, reviewed and presented the Financial Statements, included in the packet via PowerPoint presentation. Ms. Van Winkle reported the August Net Gain was $456,000 which resulted in a favorable budget variance of $17,000. The favorable variance is a result of higher inpatient and clinic volume and maintaining expenses at a lower level for the month thus creating higher than budgeted income for the month. The year-to-date Net Gain was $1,045,000 which resulted in a favorable year-to-date budget variance of $113,000. Days of cash-on-hand were at at the end of August. Page 5 of 8

9 Board of Directors Meeting Minutes September 24, Finance Committee Report. There was no additional Finance Committee Report. XI. OLD BUSINESS 1. Review and Approval of the Loma Linda University Medical Center (LLUMC) Affiliation Agreement. Stephen Swisher, M.D., made a motion seconded by Ryan Wood to approve of Loma Linda University Medical Center (LLUMC) Affiliation Agreement as presented with no material changes. A brief discussion ensued. A roll call vote was taken; the motion passed unanimously. Yes 4, No 0. XII. NEW BUSINESS 1. Review and Approval of Final Audited June 30, 2015 Year-end Financial Statements and the Draft Management Report. Presentation by Scott Sisel of Eide Bailly, LLP, Certified Public Accountants via Teleconference Call. Scott Sisel, Eide Bailly, Certified Public Accountants presented the Final Audited June 30, 2015 Financial Statements and the Draft Management Report via Teleconference call and PowerPoint presentation. Lynda Salcido made a motion seconded by Stephen Swisher, M.D., to accept the Draft Audited June 30, 2015 Financial Statements and the Draft Management Report as presented. Chairman Shepherd asked for comments; a brief discussion ensued. It was noted that staff will publicize the summary of the audit in the local newspaper for general circulation. A vote was taken; the motion passed unanimously. Yes 4, No Review of Patient Satisfaction Quarterly Reports by Kathleen Alo, CNO and Melanie Van Winkle, CFO. The Patient Satisfaction quarterly reports were presented and reviewed by Kathleen Alo, CNO, and Melanie Van Winkle, CFO; no Action needed. 3. Review of the SMHD Strategic Plan Quarterly Report. Gary Myers, CEO, presented the Strategic Plan Quarterly Report; no action needed. Page 6 of 8

10 Board of Directors Meeting Minutes September 24, Annual Approval of All Organizational Contracts by the SMHD Board of Directors. Stephen Swisher, M.D., made a motion, seconded by Ryan Wood to approve All Organizational Contracts excluding all physician contracts which are already approved by the Board. Chair Shepherd asked for comments; a brief discussion ensued. A vote was taken; the motion passed unanimously; Yes 4, No Annual Approval of All Organizational Policies by the SMHD Board of Directors. Lynda Salcido made a motion, seconded by Ryan Wood to approve All Organizational Policies. Chair Shepherd asked for comments; a brief discussion ensued. A vote was taken; the motion passed unanimously; Yes 4, No Declaration of Vacancy for Open SMHD Board Seat left by the Late Maria King, D.O. A vacancy on the SMHD Board of Directors left by the Late Maria King, D.O. was declared. Ryan Wood made a motion seconded by Stephen Swisher, M.D., to declare and advertise a vacancy, and authorize staff to distribute applications when requested. The position will be filled by appointment. A brief discussion ensued. A roll call vote was taken; the motion passed unanimously. Yes 4, No Declaration of Surplus Equipment. Ryan Wood made a motion seconded by Lynda Salcido to approve the disposal of surplus equipment presented to the Board and to direct staff to dispose of the equipment in the manner most beneficial to the District. The surplus equipment presented has nominal or no value. Chair Shepherd asked for discussion; a brief discussion ensued. A roll call vote was taken; the motion passed unanimously. Yes 4, No 0. XIII. CREDENTIALING Reappointment to Active Staff Peter Clark, M.D. Dennis Crunk, M.D. Yuri Parisky, M.D. Appointment to Active Staff Brian Gilmer, M.D. Temporary Privileges Sierra Bourne, M.D. Emergency Department 09/16-18/2015 Page 7 of 8

11 Board of Directors Meeting Minutes September 24, 2015 Victoria Paterno, M.D. Pediatric Department 08/20/2015 Carolyn Korfiatis, N.P. Family Medicine 09/24 10/16/2015 Stephen Swisher, M.D., made a motion, seconded by Lynda Salcido to approve the appointments as listed above with the exception of Sierra Bourne, M.D. Chair Shepherd asked for comments: it was noted that the appointments were discussed in closed session and no action was taken. A roll call vote was taken; the motion passed unanimously. Yes 4, No 0. Lynda Salcido made a motion seconded by Ryan Wood to approve the appointment of Sierra Bourne, M.D. Stephen Swisher, M.D., recused himself and left the room at 11:35 a.m. Chair Shepherd asked for comments; it was noted that the appointment was discussed in closed session and no action was taken. A roll call vote was taken; the motion passed unanimously. Yes 3, No 0. Stephen Swisher, M.D., returned to the room at 11:36 am. XIV. FUTURE BUSINESS Dr. Swisher commended Brian Hilliard, RN, Med Surg Manager, for stepping in one evening to cover in Med Surg to allow for great patient care. The next SMHD Board meeting will be on October 21, 2015 at 8:00 a.m. at Mammoth Hospital in Conference Rooms A & B. ADJOURN There being no further business the meeting was adjourned at 11:37 a.m. Page 8 of 8

12 Monthly Update for September 2015 Legislative Update The Legislature sent 941 bills to Governor Brown this year and he has until October 11 to act on them. To date, there are roughly 560 left to go. ACHD will prepare a final report on the Governor s actions on bills in the next few weeks. Meanwhile, the two extraordinary sessions on transportation and healthcare funding remain open. Senate President pro Tempore Kevin DeLeon and Speaker Toni Atkins have named members to conference committees on both topics. While we don t anticipate any legislative activity on these matters until January, stakeholders continue to discuss potential solutions to these significant challenges. It is likely that Governor Brown will also weigh-in when the proposed budget is released in January. ACHD is seeking your ideas on legislative proposals for the next legislative year. Please complete the 2016 Legislative Proposal Form, here, and submit it to Samantha Kesner, ACHD s Legislative Assistant, by October 23, Contact Amber King, ACHD s Senior Legislative Advocate, with questions. ACHD s 2016 Events Please mark your calendars for our events taking place in 2016! Registration is now open. To register for our events, please visit ACHD. Opportunity To Become A Member Of Californians Allied for Patient Protection The Association of California Healthcare Districts (ACHD) is a member of Californians Allied for Patient Protection (CAPP), the coalition created to protect access to health care and patient safety through California s Medical Injury Compensation Reform Act (MICRA). ACHD strongly supports the preservation of MICRA. In 2014, California voters definitively rejected Proposition 46, an attempt by trial lawyers to quadruple MICRA s non-economic damages cap. Had this ballot measure passed, California would have seen higher health care costs

13 and decreased access to care, especially among vulnerable populations who are most in need. Despite this victory, the battle to protect MICRA continues and ACHD strongly encourages Healthcare Districts to become members of CAPP. There is no cost to be a member of CAPP and you will be in good company. 17 ACHD member Healthcare Districts and individual hospitals are current CAPP supporters, as well as more than 1,000 other organizations representing community clinics, hospitals, physicians, nurses, EMTs, labor unions, local governments, dentists and other health care providers. A complete coalition list can be found on the CAPP website. Please take a moment to complete the attached CAPP Coalition Sign-Up Form. It can be returned to Marissa Allen, CAPP s Government Affairs Coordinator, via , fax or mail. For questions or concerns, please contact CAPP at (916) Healthcare District Study ACHD is working with Via Consulting to collect valuable information about Healthcare Districts. Healthcare Districts are an essential part of California's health system and are among those most affected by the continually shifting landscape of health care. Governing a public entity in these challenging times can be difficult. Compounding these challenges is a distinct lack of information regarding governance best practices specific to District boards to reference. To assist our Members in strengthening their ability to respond to these challenges, ACHD, in collaboration with Via Healthcare Consulting is conducting a study to identify effective governance practices particular to District boards. The objectives of the study include: Identify structures, tools, and practices which promote effective District governance; Elicit feedback on the barriers/challenges to effective governance, and; Collect data on real-life governance success stories as well as efforts that were not successful. We would like to invite Board Chairs and Chief Executive Officers to participate in this study by taking part in a brief minute telephone interview. Given your unique position within your Healthcare District, ACHD believes you are in an ideal position to give us valuable firsthand information on lessons learned and pitfalls to avoid. Your participation will be a valuable addition to study the findings of which we believe can become valuable District governance reference material. To schedule a telephone interview, please contact Sheila Johnston. Healthcare District Data Survey ACHD is seeking information about your Healthcare Districts! At your earliest convenience, please complete the short, ten question survey regarding your District demographics. The answers you provide will allow ACHD to better represent your District.

14 ACHD Partners With Capella University ACHD has partnered with Capella University. Capella will extend a $3000 tuition grant to all ACHD employees and Members and their immediate family members who enroll in and begin a bachelor s, master s, doctoral, specialist, or post-master s certificate program between now and August This is in addition to the 10% tuition discount. For all details simply visit Capella University, an accredited online university, offers a wide range of online bachelor s, master s, MBA, PhD, and certificate programs through its Schools of Healthcare and Nursing, Business and Technology, Education, Psychology, Human Services, and Public Service Leadership. Teammates will also benefit from: Complimentary nursing & professional development webinar series which taps into the subject matter expertise of Capella faculty Potential additional military discounts and benefits to any ACHD teammate who is an Armed Forces veteran, Active Duty service member, or Reserve or National Guard to include credit for military training, participation in the Yellow Ribbon program, and assistance with Post-9/11 GI Bill benefits Disability services support to any Member needing such services through Capella s Disability Services Department Prior learning assessment options for transfer credit including evaluation of technical knowledge and skills gained from real-world experience, training, certifications, and previous education may be eligible for credit, shortening the time to degree completion and reducing your costs Over 140 degree and certificate program specializations offered on the undergraduate and graduate levels CEO Evaluation Available free of charge to all Member Healthcare Districts, ACHD offers an online Healthcare District CEO Evaluation Tool for assessing how each District Trustee perceives the CEO to be performing. There are two options; one for District CEOs no longer managing a hospital and one for District CEOs who do manage a hospital. The ACHD Board strongly encourages each District Board to complete a CEO Evaluation on an annual basis. Members interested in completing the CEO Evaluation may contact Sheila Johnston. Board Self-Assessment Tool ACHD makes available, at no charge to its Members, an on-line Board Self-Assessment Tool for assessing how each Trustee perceives the Board to be functioning. There are two Self-Assessment options; one for Districts no longer managing a hospital and one for Districts which do manage a hospital.

15 The survey takes about 35 minutes to complete, responses are anonymous and the results are only shared with the participating Board and Associations Education Committee. The ACHD Board strongly encourages each District Board to complete a Self-Assessment on an annual basis. For more information, please contact Sheila Johnston. Certified Healthcare District As public entities, Healthcare Districts have well-defined obligations for conducting business in a manner that is open and transparent. To assist ACHD Members in demonstrating compliance with these obligations, the ACHD Governance Committee has developed a core set of standards referred to as Best Practices in Governance. Healthcare Districts that demonstrate compliance with these practices will receive the designation of ACHD Certified Healthcare District. Districts achieve Certification by demonstrating compliance with public agency reporting requirements in the following areas: Transparency Website Content Executive Compensation and Benefits State Agency Reporting Financial Reporting To date, the following Healthcare Districts have achieved certification status: Antelope Valley Healthcare District November, 2014 Beach Cities Health District October, 2014 John C. Fremont Healthcare District March, 2015 Palomar Health August, 2014 Petaluma Health Care District May, 2015 Sequoia Healthcare District August, 2014 Members interested in applying for Certified Healthcare District status should contact Ken Cohen.

16 October 21, 2015 Obsolete Equipment - Orthopedics & Physical Therapy Retired items in Physical Therapy - have been replaced by newer models as most were beyond being supported by the manufacturer for parts and maintenance. Whirlpool therapy for debridement of wounds has been replaced by newer technology (Mist ultrasound therapy). Date Purchased Item Description Value Reason for Disposal 30 yrs old whirlpool 0 modality replaced by Mist therapy 20 yrs old whirlpool 0 modality replaced by Mist therapy 8/1/2011 whirlpool 0 modality replaced by Mist therapy 20 years old stationary bicycle - Cybex ergometer 0 replaced 11 years old Panasonic TV and VHS player 0 outdated technology