MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT MEETING MINUTES BOARD MEETING DISTRICT BOARD MEMBERS

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MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT MEETING MINUTES BOARD MEETING 6:00 p.m. Trinity County Library Weaverville, CA DISTRICT BOARD MEMBERS DEROFORSLUND JERRY H. COUSINS GERALD BRASUELL PAUL HAUSER AMANDA BRAXTON Treasurer Vice-President President Member Clerk Note: These minutes contain a description for each item to be considered. Supporting documentation is available in the public packet at the Board meeting or at the Administrative Office at Trinity Hospital. District Board Members Present: Dero Forslund, Treasurer Jerry H. Cousins, Vice-President Gerald Brasuell, President Paul Hauser District Board Members Absent: Amanda Braxton, Clerk Staff Present: Aaron Rogers, CEO Jennifer Van Matre, Chief Financial Officer Peggy Manning, Chief Nursing Officer Victoria Williams, Director, Ancillary Services Mary Cole, Clinic Manager Donald Krouse, MD 5:56 PM CALLS MEETING TO ORDER IN OPEN SESSION Closed Session April 25, 2018 The Board entered into closed session at 7:13 pm on the following: MEDICAL STAFF PRIVILEGES Government Code Section 54962; Health and Safety Code Section 1461 QUALITY IMPROVEMENT/RISK. MANAGEMENT Government Code Section 54962: Health and Safety Code Section 32155 The Board came out of Closed Session at 7:19 pm and immediately reconvened in Open Session. President Brasuell reported that the Board reviewed the recommended actions on Medical Staff Privileges. For each

applicant the following mformation has been reviewed and/or verified: Privilege List, NPDB Report, and AMA Profile, peer references and verifications of staff privileges at other facility and ongoing professional practice evaluations. Items verified were Liability Insurance Coverage, Licenses, Certifications, and the Medicare exclusion list was checked. On motion of Director Braxton seconded by Director Cousins approves the following appomtments/reappointments and accepts the resignations upon the recommendation from the Medical Staff. Initial Appointment John Loh, MD Beth Miller, PA Reappomtments Jason DiPoce, MD Alison Hahnes, MD Kevin McDonnell, MD Glenn Schultes, MD Joshua Sokol, MD Brett Williams, FNP Resignation Asti Pilika, MD Manta Gupta, MD Ayes: Dero Forslund; Jerry Cousins; Gerald Brasuell; Amanda Braxton Noes: Absent: Abstam: President Brasuell reported that the Board reviewed quality improvement documents with no action taken. Public Input - Action Items a. Approve Appointment of MCHD Board Member On IVIotion of Director Forslund seconded by Director Cousins approves the appointment of Paul Hauser to the MCHD Board of Directors Ayes: Noes: Absent: Abstain: Dero Forslund; Jerry Cousins; Gerald Brasuell; Amanda Braxton 2017 Audit Presentation a. Accept Audited Financial Statements - December 31,2017 On Motion of Director Cousins seconded by Director Forslund accepts the "Audited Financial Statements - December 31, 2017" as submitted.

Ayes: Noes: Absent: Abstain: Dero Forslund; Jen-y Cousins; Gerald Brasuell; Amanda Braxton Paul Hauser Reports Medical Staff Report Received written/verbal report from Daniel Harwood, MD/Donald Krouse, MD on the current issues regarding Medical Staff. Chief Executive Officer Received written/verbal report from Aaron Rogers, CEO on the current operations of the hospital. Other items discussed: Received a plaque from Partnership for our quality improvement program at the clinics - 100% on all measures Chief Financial Officer Received written /verbal report from Jennifer Van Matre, Chief Financial Officer, on the current financial status and current status of revenue cycle management and accounts receivable. There has been a decline in clinic visits but staff is doing everything possible to increase visits. The clinics will not have 4 full time providers with 1 position to fill which will decrease the use of registry. Chief Nursing Officer Received written/verbal report from Peggy Manning, RN, CNO on the current status of the nursing departments. Other items discussed: Surveyors from the California Department of public health are here for the Home Health Survey. This survey occurs every 3 years. Quality Improvement Received written/verbal report from Sarah Cordtz, RN, Coordinator, Q/RM on the current status of the Quality Program. A test for Legionella was sent for testing and was reported as clear. Information Technology Received written/verbal report from Jake Odom, Chief Infonnation Officer on the cun-ent status of the Information Technology Department. Currently there are 21 certified EMR systems available and many will not pass Federal and State regulations (MU3). California Hospital Association members will be discussing this issue at a meeting in Chico this Thursday. Consent Agenda All matters listed under the Consent Agenda, are considered by the Board to be routine, and will be enacted by one motion in the form listed below. There will be no separate discussion of these items unless a request for discussion is made prior to the time the Board votes on the motion to approve.

On Motion of Director Cousins seconded by Director Forslund approves the following consent items: a. Policies b. Minutes fi-om April 25, 2018 Ayes: Dero Forslund; Jerry Cousins; Gerald Brasuell; Paul Hauser Noes: Absent: Amanda Braxton Abstain: Discussion Items a. Clinic Expansion Aaron Rogers has been meeting with the staff at the Trinity County Building Department regarding the elevations for the foundation for the modular unit. Civil engineers did not put elevations on plans. Once this information has been obtained the District will need to put out to bid for completion of the foundation work and negotiate final cost of the modular. Rick Bartolotti would like a letter of intent for the purchase of the modular. A special meeting of the MCHD Board of Directors will be scheduled to review a cost pay back analysis and to discuss/approve a letter of intent for the purchase of the modular. Action Items a. Items Removed from Consent Agenda b. Accept resignation from Amanda Braxton effective On Motion of Director Cousins seconded by Director Forslund accepts the resignation from Amanda Braxton effective Ayes: Dero Forslund; Jen-y Cousins; Gerald Brasuell; Paul Hauser Noes: Absent: Amanda Braxton Abstain: c. Election of Officer - "Clerk of the Board" Deferred to the June 27, 2018 MCHD Board of Directors Meeting d. Approve Resolution #2018-2 - "Resolution of Appreciation of Lynn Jungwirth" On Motion of Director Foslund seconded by Director Hauser approves Resolution #2018-2 - "Resolution of Appreciation oflynn Jungwirth" 4

The motion passed with the following roll call vote: Ayes: Dero Forslund; JeiTy Cousins; Gerald Brasuell; Paul Hauser Noes: Absent: Amanda Braxton Abstain: e. Approve Authority for Chief Executive Officer to request bids for Construction of Civil Requirements/Clinic Expansion The MCHD Board of Directors has requested a special meeting for June 6, 2018 at 11 am at Trinity Hospital to discuss the request bids for Construction of Civil Requirements/Clinic Expansion Board Reports President Brasuell stated that he has appreciated the support that he has been given during his time as president but that he is resigning as President do to personal reasons effective on June 27,2018. Director Forslund reported that he was pleased with the audit and that the District needs to carefully consider all the options for an electronic health record before making any purchases. Closed Session The Board entered into closed session at 7:32 pm on the following: MEDICAL STAFF PRIVILEGES Government Code Section 54962; Health and Safety Code Section 1461 QUALITY IMPROVEMENT/RJSK MANAGEMENT Government Code Section 54962: Health and Safety Code Section 3215 5 The Board came out of Closed Session at 8:15 pm and immediately reconvened in Open Session. President Brasuell reported that the Board reviewed the recommended actions on Medical Staff Privileges. For each applicant the following information has been reviewed and/or verified: Privilege List, NPDB Report, and AMA Profile, peer references and verifications of staff privileges at other facility and ongoing professional practice evaluations. Items verified were Liability Insurance Coverage, Licenses, Certifications, and the IVledicare exclusion list was checked. On motion of Director Cousins seconded by Director Forslund approves the following appointments/reappointments and accepts the resignations upon the recommendation from the Medical Staff. Initial Appointment Linda Bell, FNP Tracy Jackson, PA

Joshua Blunck, DO Christopher Kosir, MD Huy Le, MD Andrea McCullough, MD Reappointments Sabeena Acharya, MD Benjamin Bak, MD Elaine Khatod, MD Resignation Sarah Beth Hill, PA Stacy Greenspan, DO Ayes: Noes: Absent: Abstain: Dero Forslund; Jerry Cousins; Gerald Brasuell; Paul Hauser Amanda Braxton QUALITY IMPROVEMENT/RISK MANAGEMENT Government Code Section 54962: Health and Safety Code Section 32155 President Brasuell reported that the Board reviewed quality improvement documents with no action taken. PUBLIC EMPLOYEE PERFORMANCE EVALUATION Government Code Section 54957 - Public Employee Title: Chief Executive Officer President Brasuell reported that the process for the performance evaluation for the CEO was discussed with no action taken. Adiourn Closed Session and Reconvene in Public Session Report of any actions taken during Closed Session Adioum There being no further business, the meeting was adjourned at 8:22 p.m. 7 Amanda Braxton, ClerE of the Board Mountain Communities Healthcare District