December 18, 2007-BOD-Agenda Packet

I
tPALO VERDE HOSPITAL
Bringing Health & Care -;-0let.he r
Regular Governing Board Meeting
Of
Palo Verde Health Care District
Tuesday, Decetnber 18 2007
6:30 p.tn.
Palo Verde Hospital
Conference Room.
250 N. First St.
Blythe, CA 92225
PALO VERDE HEALTH CARE DISTRICT
REGULAR MEETING
OF THE
BOARD OF DIRECTORS
Palo Verde Hospital
Conference Room
250 N. First St.
Blythe, CA 92225
December 18, 2007
6:30 PM
AGENDA
1.
Call to Order
2.
Pledge of Allegiance
3.
Roll Call -
4.
Approval of Agenda
5.
Public Comment:
Opportunity for citizens to speak on items of interest within subject matter
jurisdiction of the District. For the record, please state your name. The Board
has a policy limiting any speaker to not more than three minutes.
6.
Consent Action Items:
Consent Action Items are normally acted upon by a single vote encompassing
all items within this section. Since the public may directly address the Board
before action on any item, a member of the public may, upon request, speak to
the item(s) before the vote is taken.
Derek Copple, President
Carmela Garnica, Vice President
Mark Bolliger, SecretaryfTreasurer
Steve Montgomery,D.V.M., Director
Rosalie Carlton, Director
A. Minutes of Regular Board Meeting of November 29, 2007
continued
AGENDA
7.
Election of Officers of the Board of Directors
8.
Reports/Possible Action Items:
August 24, 2006
A. Administrative Report:
Consideration of Approval or Ratification of the Following:
1.
Physician Contract Update-Verbal Report
2.
Analysis of Medical Office Building- Discussion
9.
10.
Board Comments
th
Adjournment (Next scheduled regular meeting: January 24 , 2008, 5:30 p.m.
at the Palo Verde Community College, 1 College Drive, Blythe,
CA.
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PALO VERDE HOSPITAL
Bflnging Hea:th e!T Care
Tcge~her
CONSENT ACTION ITEMS
PVHDBOD
Meeting Minutes
November 29,2007
Page 1 of 13
PALO VERDE HOSPITAL
PALO VERDE HEALTH CARE DISTRICT
REGULAR BOARD OF DIRECTORS
MEETING MINUTES
November 29, 2007
5:30 p.m.
Blythe Community Center
Directors Present
Administrative Staff Present
Derek Copple, President
Mr. Jeff Flood, Chief Executive Officer
Mark Bolliger, Secretary/Treasurer
Mr. Richard Fallon, Chief Operating Officer
Rosalie Carlton, Director
Ms. Lilly Lopez, Assistant Administrator
Cannela Garnica, Director
Mr. Lee Holter, Chief Financial Officer
Mr. Blaise Jackson, General Counsel
TOPIC
l. Call To Order:
2. Flag Salute:
3. Roll Call:
4. Approval of Agenda:
DISCUSSION
ACTION
Board President Derek Copple calls the
meeting to order at 5:30 pm.
The Pledge of Allegiance was led by Board
President Copple.
Board President Copple conducted roll call.
Director Montgomery is not present.
Board President Copple calls for approval of
the Agenda.
Discussion ensues among the Board Directors
regarding the placement of Medical Staff
Report in category #9 of the agenda instead of
with the MEC Report in #7 B.
It is the consensus of the
Board to revise the
placement of the Medical
Staff Report to include it
with the MEC Report.
Mr. Richard Fallon, CFO requests that the
Board approves adding the contract of Dr.
Barth to the agenda.
Board President Copple calls for Public
Comment:
Dr. Sahlolbei comments on the separation of
the Medical Staff Report from the MEC
Report on the agenda, noting that it had not
been separated in the past. Also notes that
there is no closed session presented on the
agenda and feels that the Board should meet
in closed session to discuss funds spent on
attorneys to represent Dr. Montgomery in
arbitration. Dr. Sahlolbei also notes that
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Meeting Minutes
November 29, 2007
Page 2 of 13
TOPIC
DISCUSSION
ACTION
items #6 and #7 should not be included in the
MEC section of the agenda as they were not
approved by the MEC.
I
Discussion ensues among the Board Directors
and Management regarding the placement of
#6 and #7.
5. Public Comment:
Director Bolliger motions to
(1) add Dr. Barth's contract
to the agenda and (2) move
items #6 and #7 from the
MEC Report to be included
in the Administrative Report.
Director Garnica seconds.
The motion is unanimously
carried.
Dr. Sahlolbei comments on being
disappointed that there is no Closed Session
to discuss the litigation issue concerning Dr.
Montgomery.
Board President Copple requests that there is
no more discussion regarding litigation.
Dr. Sahlobei comments that the Board
attorney is working for AHM and not the
Board and notes specific employees he feels
do not have qualifications to hold their
positions.
6. Consent Action Items:
• Minutes of October 30,
2007:
7. ReportslPossible Action
Items:
A. Board DirectorsReport:
1. Joint City and
County Meeting
Update:
Ms. Liana Sain comments that the hospital
will disintegrate if discussion includes
personal attacks and that contention needs to
stop and is time to concentrate on the issues.
The Minutes of October 30, 2007 are
presented for Board approval.
Director Bolliger motions to
approve the minutes of
October 30,2007. Director
Garnica seconds. The
motion is unanimously
carried.
Board President Copple reports that he and
Director Garnica attended ajoint City and
County meeting that included Supervisor Roy
Wilson, along with representatives of the City
of Blythe. Current issues were discussed with
no firm resolution and none of the issues
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Meeting Minutes
November 29, 2007
Page 3 of 13
TOPIC
DISCUSSION
presented being fixed.
Director Garnica reports that during the Joint
meeting, there was a decision to enlist the
services of an arbitrator to help solve the
hospital issues. Director Garnica also feels
that Administration and Dr. Sahlolbei need to
come together and come to a solution as
valuable time is being wasted.
ACTION
The representative from Senator Ducheny's
office notes that Senator Ducheny is open and
willing to attend a meeting when her schedule
allows.
Mr. Blaise Jackson, General Counsel notes
that arbitration is a dispute resolution tool but
a defined set of issues are needed to use
arbitration. Mr. Jackson suggests that further
Joint Meetings are a better option and that the
Board, as the policy makers, delegated
management to run operations at the hospital.
Mr. Richard Fallon, COO notes that AHM
and Dr. Sahlolbei worked together well for 18
months and the Board approved the Medical
Staff Bylaws that includes an arbitration
process. The Doctors who submit
credentialing applications are concerned with
the affect a denial has on their reputation and
are withdrawing their applications before the
MEC denies it. Mr. Fallon also comments
that there were no offers of help from the City
or the County representatives at the Joint
Meeting and the Seismic issues were not
addressed. Dr. Sahlolbei has the right to not
work at the hospital but credentialing needs to
take place so another Doctor can.
Director Garnica questions if the MEC is not
credentialing.
Mr. Fallon responds that he feels
credentialing will not take place as long as Dr.
Sahlolbei is Chief of Staff.
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Meeting Minutes
November 29,2007
Page 4 of 13
TOPIC
DISCUSSION
ACTION
Dr. Sahlolbei comments that the attorneys do
not want arbitration because AHM is paid
$100,000 per month and cannot fix the
hospitals problems. The Medical Staff does
not trust management and a neutral arbitrator
should be brought in to resolve the issues.
B. Administrative Report:
1. SB 1953 Compliance
Update:
Mr. Jeff Flood, CEO introduces Ms. Avelina
Ortiz, Quality Risk Manager and Leida Meek,
eND.
Mr. Flood reports OSHPD has continued the
extensions and will be meeting with Urrutia
architects to discuss Bldg B.
2. CAH Certification
Verbal Update:
Mr. Flood reports that the preliminary Critical
Access application has been completed and
accepted. The hospital will function as a
Critical Access Hospital prior to the survey;
26 beds will be suspended, and a consultant
will be reviewing the application and facility
prior to the final application being submitted.
3. Dr. Bakhtavar
Services Agreement:
Mr. Richard Fallon, COO reports that Dr.
Bakhtavar's current agreement provides
payment of $1 ,000 per day for on-call
coverage. Since there is currently no OB
service Mr. Fallon is proposing to pay Dr.
Bakhtavar half of the current amount and is
requesting direction from the Board on how to
proceed. Mr. Fallon also notes that the cost of
maintaining an OB Department will be
exorbitant with an anesthesiologist costing
$1,000 per day and with the cost of an OB
and Surgery crew.
Dr. Bakhtavar notes that he has lost patients
for the last 6 months and is concerned about
the patients and states that he wants to
continue practicing here.
Mr. Fallon notes that keeping OB open is a
high risk business and with 25 average
deliveries per month, and most of those Medi-
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November 29,2007
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DISCUSSION
ACTION
Cal it would not be cost effective to maintain
an OB Department.
Director Carlton suggests increased marketing
of the OB Department by the employees.
Director Bolliger suggests paying Dr.
Bakhtavar half of his amount for November
and December and then the full amount if OB
opens. Director Bolliger also asks how long
the District would be able to afford OB if
opened.
Mr. Fallon answers that AB 915 funds are
expected in February and Med-Cal funds have
been received so there is the possibility of OB
staying open for 90 days. With an
approximate cost of $300,000 per month the
Surgery Department is needed to offset cost
and Mr. Fallon notes that he is hoping for a
General Surgeon application within 30 days.
Board President Copple notes that there is a
need for a Special Board meeting to discuss
the contract with Dr. Barth before any
decision are made. Board President Copple
states that he is concerned about authorizing
payment to Dr. Bakhtavar when there is no
OB Department.
Mr. Fallon notes that if Dr. Bakhtavar is not
on-call then he should not receive on-call pay
and that currently Dr. Bakhtavar receives
$3,000 per month for OB Directorship.
Dr. Bakhtavar notes that he has been on-call
for the last 3 months and is still called in for
emergencies and according to his contract he
should be paid.
Mr. Fallon requests authority to execute
agreement with Dr. Barth.
Board President Copple states that a Special
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November 29, 2007
Page 6 of 13
TOPIC
DISCUSSION
ACTION
Meeting will need to be held on December 6.
Board President Copple calls for Public
Coment:
Director Bolliger motions to
table the decision on Dr.
Bakhtavar and Dr. Barth for
Dr. Sahlolbei comments on the Medical Staff another week, until a Special
being responsible for the On-Call schedule
meeting is held, Director
and notes that babies cannot wait for a
Carlton seconds. The motion
transfer where surgeries can.
to postpone a decision on Dr.
Bakhtavar's Service
Dr. Brooks comments that he has been
Agreement and Dr. Barth's
involved in two deliveries in the past 2
contract is unanimously
months and there is a higher element of risk in carried
transfers that a regular delivery. He also notes
that many Doctors will not accept OB
transfers because of the risk and notes that the
Board has control over Administration and
the OB issue needs to be addressed.
Ms. Liana Sain comments that the OB is an
important function but there are also some
surgeries that can't wait and that the hospital
needs anesthesia and surgery to open again.
She also notes that OB closed a few years ago
and that it is an expensive department to keep
open.
Board President Copple calls for a motion to
table the decisions on Dr. Bakhtavar'sService
Agreement and Dr. Barth's Contract until a
Special Board Meeting is held.
4. Surplus Furniture:
Mr. Richard Fallon, COO reports that Dr.
Bakhtavar has taken over the lease on the
apartment he has been staying in and has
offered to purchase the furniture that was
included in the apartment for $500.00. Mr.
Fallon notes that according to Health and
Safety Code 32121.2 the District has the
authority to offer the furniture to Dr.
Bakhtavar at a fair market value.
Board President Copple calls for Public
Comment;
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November 29, 2007
Page 7 of 13
TOPIC
DISCUSSION
There is none.
Board President Copple calls for a motion to
sell the furniture to Dr. Bakhtavar for $500.00
5. Dr. Bowen's
Service Agreement:
Mr. Richard Fallon reports that Dr. Bowen's
Service Agreement calls for a payment of
$36,000 per month and notes that this is a
prudent contract.
ACTION
Director Garnica motions to
sell the surplus furniture to
Dr. Bakhtavar for $500.00,
Director Bolliger seconds.
The motion to sell Dr.
Bakhtavar the surplus
furniture is unanimously
carried
Director Carlton questions if page 13 section
8.4 is common.
Mr. Blaise Jackson, General Counsel notes
that the section in question is an anti compete
clause.
Board President Copple calls for Public
Comment.
There is none
Board President Copple calls for a motion
regarding Dr. Bowen's Service Agreement.
6. December 2007
BOD Meeting Date:
Mr. Richard Fallon, COO suggests moving
the December BOD Meeting date to
December 20th because of the holidays but
does note that the financial reports may not be
ready by that time.
Director Bolliger motions to
accept Dr. Bowens Service
Agreement. Director
Carlton seconds. The motion
to accept Dr. Bowens's
Service Agreement is
unanimously carried.
Board President Copple calls for Public
Comment.
There is none.
Board President Copple calls for a motion
regarding moving the December BOD
meeting date to December 20 th •
Director Bolliger motions to
approve the change of the
December BOD meeting.
Director Carlton second.
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November 29, 2007
Page 8 of 13
TOPIC
7. Financial Reports:
DISCUSSION
ACTION
The motion is unanimously
carried.
Mr. Lee Holter, CFO present the Financial
Reports: Patients account receivables are
down, mortgage cost decreased cash
decreased in October along with revenue,
salaries have leveled out and are expected to
decrease in the coming months. The cost of
supplies increased because of the cost of
Antivenin-$42,000, needed for two
rattlesnake bites in one month. Contract labor
cost dropped due to OB being closed.
Board President Copple calls for Public
Comment.
There is none.
8. Overview of
EHealth Backup
Procedures:
9. Cost Report
Settlement:
10. Joint Harassment
Policy:
Board President Copple calls for a motion to
approve the Financial Report
Director Bolliger motions to
approve the Financial
Report. Director Carlton
seconds. The motion to
approve the Financial Report
is unanimously carried.
Mr. Lee Holter, CFO presents a report on the
HMS software and the AS400 server.
No action is required.
Mr. Richard Fallon, COO gives a verbal
report regarding the Medi/Cal Cost
Settlement. Mr. Fallon reports that the Cost
Report has been settled and the $72,500
payment has been made.
No action is required.
Mr. Jeff Flood, CEO that the Joint
Harassment Policy is a JCAHO requirement
that has been on the table since August and
needs to be reviewed by the MEC.
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Meeting Minutes
November 29, 2007
Page 9 of 13
TOPIC
DISCUSSION
ACTION
Dr. Sahlolbei disagrees with Mr. Flood's
statement and notes that the MEC saw the
policy for the first time in November and is
not able to approve the policy because it does
not address Doctors being harassed.
Board President Copple reads from a memo
dated August 21, 2007 where it notes that the
policy was given to Dr. Paglinawan then to
the MEC in April 2007, and asked Dr.
Sahlolbei where the MEC is at with the
policy.
Dr. Sahlolbei answers that the policy was
reviewed by Dr. Brook's committee and was
not accepted as it had a large number of
unacceptable provisions.
Board President Copple notes that he had a
conversation with Dr. Brooks and he
recommended only two minor revisions.
Director Carlton questions if there have been
any sexual harassment training given to
employees.
Ms. Lilly Lopez, Assistant Administrator
responds that annual training is given and the
hospital is in compliance.
Director Bolliger suggests having the policy
reviewed by an attorney as sexual harassment
law is very lengthy.
Ms. Lopez notes that the policy has been
reviewed by several attorneys and the policy
being presented will replace 3 or 4 policies
currently approved. Ms. Lopez notes that the
policy was given to the MEC over a year ago.
Mr. Blaise Jackson notes that the Medical
Staff has legal counsel that it could use for
reVIew.
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Meeting Minutes
November 29,2007
Page 10 of 13
TOPIC
C. MEC Report:
1. Emergency
Medicine Privilege
Delineation Form:
DISCUSSION
ACTION
Dr. Sahlolbei notes that the Medical Staff will
only use their attorneys for issues they feel
are important to them.
Dr. Sahlolbei notes that the policy has been
mildly modified to ensure that ER Doctors
held ACLS, NCLS, PALS and ATLS.
Mr. Richard Fallon, COO states that he is
uncomfortable with the policy and it should
go to counsel for review.
Director Garnica notes that she would like the
policy to be passed.
Board President Copple calls for Public
Comment:
Ms. Liana Sain notes that she is disappointed
over Director Garnica's frivolous attitude
toward passing the policy because the ER
could be shut down tomorrow if the ER
Doctors are found not to have the certificates
noted in the policy.
Dr. Sahlolbei notes that there has never been a
legal issue with this policy in the past and was
accepted by JCAHO.
Mr. Richard Fallon comments that
management cannot ensure that the current
Doctors have the noted certifications.
Mr. Blaise Jackson, General Counsel suggests
waiting until the policy has been reviewed.
Director Bolliger questions if there possible
lawsuit if and ER Doctor did not have the
certifications
Director Garnica motions to
approve, Director Carlton
seconds.
Directors Garnica and
Carlton vote aye, Board
President Copple and
Director Bolliger vote nay.
The motion is not passed.
Board President Copple calls for a motion to
approve the Emergency Medicine Privilege
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Meeting Minutes
November 29, 2007
Page 11 of 13
TOPIC
DISCUSSION
Delineation Form.
2. General Surgery
Delineation Form:
3. Family Practice
Privilege
Delineation Form:
Dr. Sahlolbei suggests tabling #2 and #3 and
explains core and advanced privileges.
Board President Copple calls for Public
Comment.
There is none.
ACTION
Director Bolliger motions to
table the General Surgery
Delineation Form and the
Family Practice Delineation
Form. Director Carlton
seconds. The motion is
unanimously carried.
Board President Copple calls for a motion to
table the General Surgery Delineation Form
and the Family Practice Delineation Form
4. Conscious
Sedation Protocol:
Dr. Sahlolbei notes that the use ofPropofol
IV is the only change
Board Director Copple questions if an
anesthesiologist is required to review the use
ofPropofol IV.
Board President notes that on page 2 of 25 #2.
It states that conscious sedation practices and
outcomes shall be monitored.
Dr. Sahlolbei notes that when Dr. Barth is on
staff he will review and Propofol IV is used
under moderate sedation not conscious
sedation and the ER doctor is adept at
intubation.
Ms. Avelina Ortiz, QualitylRisk Manager.
Notes that moderate and conscious sedation is
the same policy and that everyone involved in
the process is liable and that an
anesthesiologist is necessary to protect
patient. Ms. Ortiz also notes that RN's have
ACLS certification but it is recommended that Director Carlton motions to
Doctors have ACLS and PALS also.
table the Moderate Sedation
Policy. Director Bolliger
Board President Copple calls for Public
seconds. The motion is
Comment.
unanimously carried.
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Meeting Minutes
November 29, 2007
Page 12 of13
TOPIC
DISCUSSION
ACTION
There is none.
Board President Copple calls for a motion to
table the Moderate Sedation policy.
5. Credentialing
Report:
Dr. Sahlolbei reports that Dr. Tong was
credentialed.
Board President Copple calls for Public
Comment.
There is none.
/
Board President Copple calls for a motion to
approve credentialing of Dr. Tong.
Dr. Sahlolbei reports that Dr. Gary Harris was
credentialed.
,
,
Director Bollger motions to
approve the credentialing of
Dr. Tong. Director Carlton
seconds. The motion to
approve the credentialing of
Dr. Tong is carried.
Board President Copple calls for Public
Comment.
There is none.
Board President Copple calls for a motion to
approve credentialing of Dr. Harris.
Dr. Sahlolbei reports that Dr. Alix Vincent
was credentialed.
Director Carlton motions to
approve the credentialing of
Dr. Harris. Director Bolliger
seconds. The motion to
approve the credentialing of
Dr. Harris is approved
Board President Copple calls for Public
Comment.
There is none.
. .. ­
Board President Copple calls for a motion to
approve credentiaJing of Dr. Vincent.
D. Medical Staff Report:
Dr. Sahlolbei gives a verbal report regarding
Medical Staffs concern with the qlanagement
of the hospital. The Admin.istration runs the
Director Carlton motions to
approve the credentialing of
Dr. Vincent. Director
Bolliger seconds. The
motion to approve the
credentialing of Dr. Vincent
is approved.
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Meeting Minutes
November 29, 2007
Page 13 of 13
TOPIC
DISCUSSION
ACTION
Board and the Board tries to interfere with
credentialing, notes letter of April 25, and
there is no respect shown for the Medical
Staff Dr. Sahlolbei reports that articles that
have been printed in the newspaper prove
administrations disrespect for the Medical
Staff. Dr. Sahlolbei notes the salary for
administration as being exorbitant but does
note that the change in CNO has helped. Dr.
Sahlolbei notes that outside arbitration is
needed in all areas of hospital management
and not just for credentialing. Is concerned
with the Medical Staff not being treated
equally and feels that the Board uses
Administration against the Medical Staff, and
is not addressing complaints or issues and
lacks sincerity.
,
8. Board Comments:
9. Adjournment:
Director Bolliger wishes everyone a nice
season ahead.
No other comments are made.
The meeting is adjourned at 10:00.
Mark Bolliger, Board SecretarylTreasurer
13
PALO VERDE HOSPITAL
Brtnging Hea:th & Care Tcge:htr
ELECTION OF OFFICERS
OF THE
BOARD OF DIRECTORS
PALO VERDE HOSPITAL
Bnngmi: Hea;th &' une Tcge:her
REPORTS/POSSIBLE
ACTION ITEMS
PALO VERDE HOSPITAL
Bringing Hea:th & Care Tcge:her
. ADMINISTRATIVE REPORT
PALO VERDE HOSPITAL
Bnnginr Hea,'th
es: Care
Tcge~htr
VERBAL REPORT
Palo Verde Hospital
Medical Office BUilding
205 N. 1st St., Blythe CA 92225
Mortgage Payment Mortgage Payment Property Taxes Property Taxes Rental Income Per Rental Income Per
Per Month
Per Year
Per Month
Per Year
Office/Month
OfficelYear
Highland Production I,
LLC
Paul McDonnel Treasures
& Tax Collect for Property
Taxes
Hossian Sahlolbei, MD/
Pars Surgery
Leonel Rodriguez, MD
Hanger Prosthetics &
Orthopedic, Inc.
Luke Dreisbach,
MD/Desert Hematology
Oncology Medical Group,
Inc.
TotafPer Column
14,682.63
176,191.56
1,261.13
14,682.63
176,191.56
Total Per Month of
Taxes & Mortgage
Total Per Year of
Taxes & Mortgage
1,261.13
15,133.52
15,133.52
15,943.76
191,325.081
2,647.50
2,411.25
31,770.00
28,935.00
240.00
2,880.00
600.00
7,200.00
5,898.75
70,785.00
10,045.01 Loss per Month
120,540.08 Loss per Year
1