MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT MEETING MINUTES BOARD MEETING DISTRICT BOARD MEMBERS

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MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT MEETING MINUTES BOARD MEETING Hayfork High School - Library Hayfork CA DISTRICT BOARD MEMBERS GERALD BRASUELL DERO FORSLUND JERRY H. COUSINS LYNN JUNGWIRTH FRANCIS MOORE Vice-President Clerk President Treasurer Member 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: Gerald Brasuell, Vice-President Dero Forslund, Clerk Lynn Jungwirth, Treasurer District Board Members Absent: Jerry H. Cousins, President Francis Moore Staff Present: Aaron Rogers, CEO Jeanne Silvers, Executive Assistant JudyNordhmd,RN,CNO Jennifer Van Matre, Director of Finance Hollie Malloy, Manager - Trinity Community Health Clinic Wally Couch, Director of Plant Operations Debbie Stewart, RN, SNF Manager Victoria McDonald. HCHC Manager 6:03 PM CALLS MEETING TO ORDER IN OPEN SESSION Report from Closed Session on July 29,2015 Closed Session The Board entered into closed session at 7:42 pm on the following: MEDICAL STAFF PRIVILEGES Government Code Section 54962; Health and Safety Code Section 1461 PUBLIC EMPLOYEE PERFORMANCE EVALUATION Government Code Section 54957 - Public Employee Title: Chief Executive Officer

August 26,2015 LABOR NEGOTIATIONS Government Code Section 54957.6 Designated Representative: Mark Vegh/Aaron Rogers Employee Organization: Professional Group CONFERENCE WITH LEGAL COUNSEL EXISTING LITIGATION (Subdivision (a) of Section 54956.9) California Department of Fair Employment and Housing. Name of Case: Menovske/Trmity Hospital et al: Case No. 430236-137546 CONFERENCE WITH LEGAL COUNSEL EXISTING LITIGATION (Subdivision (a) of Section 54956.9) Name of Case: Pamela Balsly vs. Mountain Communities Healthcare District: Case No. 2:13-cv-02334-GEB-CMK The Board came out of Closed Session at 7:42 pm and immediately reconvened m Open Session. President Cousins 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. Items verified were Liability Insurance Coverage, Licenses, Certifications, and the Medicare exclusion list was checked. On motion of Director Jungwirth seconded by Du-ector Brasuell approves the following appointments/reappointments/resignations from the Medical Staff pendmg completion of signatures by Daniel Harwood, MD, Chief of Staff. Appointments/Reappomtments: Norman Bell, MD Reappointment/Consulting Psychiatry Barbara Wertz, CRNA Reappointment/Professional Anesthesia Shahin Korangy, MD Reappointment/Consulting Radiology Richard Hodge, MD Reappointment/Consulting Radiology Amy Sherman, MD Reappointment/Consulting Radiology Christopher Govea, MD Reappointment/Consulting Radiology Ray Miller, MD Appointment/Provisional Emergency Medicine Resignations James Dumi, MD (MDI) Elizabeth Mulkerrin, CRNA The motion passed with the following voice vote: Ayes: Dero Forslund; Gerald Brasuell; Jeny Cousins; Lynn Jungwirth; Francis Moore Absent: None Abstain: None

IVIountain Communities Healthcare District President Cousins reported that there were no discussions in regards to "Public Employee Performance Evaluation". President Cousins reported that the Board met with the Districts representative and there was no action taken. President Cousins reported that the Board discussed two cases of existing litigation and there was no action taken on the "Menovske/Trinity Hospital et al: Case No. 430236-137546. On a motion of Director Forslund and seconded by Director Brasuell the Chief Executive Officer was given direction and parameters for negotiations in the case of Pamela Balsly vs Mountain Communities Healthcare District: Case No. 2:13-cv-02334-GEB-CMK. The motion passed with the following voice vote: Ayes: Dero Forslund; Gerald Brasuell; Jerry Cousins; Lynn Jungwirth; Francis Mtoore Absent: None Abstain: None Public Input - None Reports Medical Staff Report Received written report from Daniel Harwood, MD, Chief of Staff/Donald Krouse, MD, Vice Chief of Staff regarding activities of the Trinity Hospital Medical Staff. Chief Executive Officer Received written /verbal report from Aaron Rogers, CEO on the current operations of the hospital. Other items discussed in addition to the written report were: Status of the HVAC construction project was reviewed. There has not been a decision as to whether the emergency room will have to be moved in order to complete the project. Chief Financial Officer Received written /verbal report from Jon Marshall, CFO and Jennifer Van Matre, Director of Finance, on the current financial status and current status of revenue cycle management and accounts receivable. Other items discussed in addition to the written report were: Gerald Brasuell reported that the Finance Committee is pleased with the direction that the District is headed. Chief Nursing Officer Received written/verbal report from Judy Nordlund, RN, Chief Nursing Officer on the current status of the nursing departments. Quality Improvement Received written/verbal report from Sarah Cordtz, RN, Coordinator, Q/RM on the current status of the Quality Program. 3

August 26,2015 M.CHD Quarterly Checklist of ongoing professional practice evaluations was reviewed and staff reported that some of the reviews have not been completed. Staff is requesting that delinquent reviews are completed and future reviews are done in a timely manner. Staff will report to the medical staff and MCHD Board on a quarterly basis statistics regarding completed ongoing professional practice evaluations. 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 Forslund seconded by Director Jungwirth approves the following consent items: a. Minutes from July 29, 2015 b. Minutes fi-om July 29, 2015 c. Minutes from August 19,2015 d. Policies (see attached) The motion passed with the following voice vote; Ayes: Dero Forslund; Gerald Brasuell; Lynn Jungwirth Absent: Jerry Cousins; Francis Moore Abstam: None Discussion Items a. Parcel Tax The Board reviewed financial status of the District and requested a pro forma of financial status. There is no information that has proven that the parcel tax is not needed for the future. The District is heading in the right direction and if the growth continues then at some point the District would have the ability to lower the parcel tax. d. Climc - Community Outreach Hollie Malloy has submitted updated information and application to increase the HPSA score for the Weaverville are. Unofficially the score will be upgraded to a 19 which would allow for loan repayment for practitioners who would come to work for the District. Michael Novak reported that the Weaverville clinic is expanding telemedicme seivices. They say 55 patients last month. Partnership is offering incentives for the clinic to offer additional specialties through the telemedicine program. The Weavendlle clinic will be receiving $10,000 for adding two new specialties (endocrmology and neurology) to the telemedicine program.

Michael Novak as assumed the duties of the Director of Clinical Services for the clinics. He reported that he will be working together with the managers of each clinic on time management, increasing telemedicine services, referral processes, upgrading telemedicine equipment, and the use of new providers at both clinics. Action Items a. Items removed from the Consent Agenda Minutes from August 19, 2015 will be presented for approval at the September meeting. b. Consider approval of Resolution #2015-7 "Approve Authorized Signatures for Securing a Loan from Optum Bank" On Motion of Director Jungwirth seconded by Director Forslund approves Resolution #2015-7 "Approve Authorized Signatures for Securing a Loan from Optum Bank" The motion passed with the following a roll call vote: Ayes: Dero Forshmd; Gerald Brasuell; Lynn Jungwirth Absent: Jerry Cousins; Francis Moore Abstain: None Board Reports Director Forslund reported that there were 299 funds available for fiber optic connections. There was a proposal by Del Norte and Trinity County and the Indian reservation submitted several years ago. Announcement of Designated Representatives for Closed Session item "Salaries and Benefits". Representative is Aaron Rogers, CEO Close Public Session Closed Session The Board entered into closed session at 7:25 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 SALARIES AND BENEFITS Government Code Section 54957.6 Designated Representatives: Aaron Rogers

The Board came out of Closed Session at 7:50 pm and immediately reconvened in Open Session. Vice 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. Items verified were Liability Insurance Coverage, Licenses, Certifications, and the Medicare exclusion list was checked. On motion of Director Jungwirth seconded by Director Forslund approves the following reappomtments upon the recommendation fi-om the Medical Staff. Appointments/Reappointments: Adam Attoun, DO Ewa Bauer, MD Thomas Bey, MD Danford Bickmore, MD Don Chin, MD Reed Grabow, MD Patricia Hadley, MD Stephen Hofkin, MD Jon Hohmeister, MD Irwin Maier, MD Sander Saidman, MD David Swanson, MD Rhonda Wyatt, MD Hemy Edelstein, MD Active Staff Specialty: Emergency Medicine Randall Meredith, MD Julia Mooney, MD Steve Maron, MD Courtesy Staff Specialty: Family Medicine Specialty: Pathology Specialty: Emergency Medicine The motion passed with the following voice vote: Ayes: Dero Forslund; Gerald Brasuell; Lynn Jungwirth Absent: Jerry Cousins; Francis Moore Abstain: None Vice President Brasuell reported that the Board thoroughly reviewed the quality data presented and there no action was taken. Vice President Brasuell reported that the Board reviewed options for salary increases and possible employee bonuses and through a motion, second and unanimously approved the option for an employee bonus pending approval by the attorney for the District.

Adjourn: There being no further business, the meeting was adjourned at 7:52 p.m. AL^ Der<LPtfrslund<Cleri^fthe Board Mountain Communities Healthcare District