July 3rd, 2007-BOD Agenda Packet
Transcription
July 3rd, 2007-BOD Agenda Packet
~. I PALO VERDE HOSPITAL B:inging Health eY Care Togethe y Special Governing Board Meeting Of Palo Verde Health Care District Tuesday, July 3, 2007 5 :30 p.lTI. Palo Verde Hospital Conference Room. 250 N. First St. Blythe, CA 92225 PALO VERDE HEALTH CARE DISTRICT SPECIAL MEETING OF THE BOARD OF DIRECTORS Palo Verde Hospital Conference Room 250 N. First St. Blythe, CA 92225 July 3, 2007 5:30 PM AGENDA 1. Call to Order 2. Pledge of Allegiance 3. Roll Call- Derek Copple, President Carmela Garnica, Vice President Mark Bolliger, Secretaryffreasurer Steve Montgomery,D.V.M. 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. A. Minutes of Regular Board Meeting of May 31,2007 B. Minutes of Special Board Meeting of June 14, 2007 C. Nursing Policy 1. Approval of Personnel liOn-Cali" Policy 7. Action Items Consideration of Approval or Ratification of the Following: A. Interview of applicants to serve on the Board of Directors B. Board Discussion and nomination of candidate August 24, 2006 continued AGENDA C. Consideration of Resolution appointing member to the Board to Serve until the next General election on November 7, 2008. 8. th Adjournment (Next scheduled regular meeting: July 26 , 5:30 p.m. at the Palo Verde Hospital Conference Room, 250 North First St., Blythe. CA. 2 PALO VERDE HOSPITAL PALO VERDE HEALTH CARE DISTRICT SPECIAL BOARD OF DIRECTORS MEETING MINUTES May 31, 2007 5:30 p.m. BIIythe Commumty . C enter Directors Present Administrative Staff Present Derek Copple, President Mr. Jeff Flood, CEO Carmela Garnica, Vice President Mr. Richard Fallon, COO Mark Bolliger, Secretaryrrreasurer Ms. Lilly Lopez, Assistant Administrator Mr. Lee Holter, CFO Mr. Oscar Garcia, CNO Mr. Jeff Scott, General Counsel TOPIC 1. Call To Order: 2. Flag Salute: 3. Roll Call: 4. Approval of Agenda: 5. Public Comment: DISCUSSION Board President Derek Copple called the meeting to order at 5:30 pm. The Pledge of Allegiance was led by Board President Copple. Board President Copple conducted roll call. Board President Copple noted that Director Montgomery was not present. Board President Copple called for approval of the May 31, 2007 Agenda. ACTION Motion was made by Director Bolliger, seconded by Director Garnica and unanimously carried to approve the May 31st Agenda as presented. President Copple called for Public Comment. Ms. Eugenia Webber questioned the roles and scope of authority of the three entities involved in administration of the hospital; the Board of Directors, Administration and the Medical Staff. Mr. Jeff Flood, CEO stated that the governing Board grants the medical staff authority to oversee privileging and credentialing of physicians and they then make recommendations to the Board of Directors. Ms. Webber questioned if the Board had the final say and if they are able to override the medical staff in regards to credentialing. 1 Mr. Jeff Scott, General Counsel indicated that under the law, the hospital is required to have an independent self-governing medical staff. He also stated that it was possible in certain limited circumstances to override the medical staff. Ms. Sandi Blessing stated that in the last three weeks the Blue Ribbon Committee had disappeared, census at the hospital had decreased considerably and the hospital is on surgical diversion. Ms. Blessing stated that not only is the community not being served but the Nursing Care center brings in $1.4 million to the community yearly in payroll and without a higher census we will be unable to continue to operate. Ms. Geralyn Quigley, RN stated that in the past she was told to address the chain of command at the hospital and her attempts were not received well. She stated that her focus has been on safety and quality of care and not attending meetings and feels that she has not been supported by the nursing administration. Ms. Liana Sain stated that she was concerned about what is happening at the hospital and would like to point out that in the past and now there is only one common denominator for the problems that have occurred. Ms. Edna Gillis stated that she has been a resident of Blythe for two years and before relocating toured the hospital and found it to be a well run hospital. Ms. Gillis indicated that now she would be hesitant to use the facilities and that the current problems need to be solved. Ms. Rosie Carlton noted that she has several relatives who have had had experiences with the hospital in the past few years and has found the care to be excellent and she has no problem with paying the doctors the on-call 2 wages as long as the quality of care continues. She also stated that she is concerned by the recent controversy and hopes that the problems can be resolved so that care can continue. Dr. Sahlolbei stated that the community does not understand the current issues as they are confidential and can't be discussed. He stated that doctors work for perfection and nurses can cause deaths and the nurses at the hospital are "not up to par". He stated that he has approached the Board and Administration many times about problems with the nursing staff and management but the issues have not been resolved. Ms. Mille Rodriguez stated that she was a hospital Board member in the past and at that time the same conflict was going on. She noted that it is imperative that the hospital stay open because the patient's must come first. Ms. Glenna Peoples RN stated that she has concerns that nursing home patients will be shipped out and die alone without family members and not in their own community. Ms. Peoples noted that she is begging the doctors to come back to work and stated that boycotting the hospital was not the answer. Dr. Lucero stated that the doctors are not boycotting the hospital. He indicated that it is not unusual for the census to be this low in the summertime. Dr. Lucero also stated that the Board is aware of the contract issues and should sign a contract for long-tenn surgeon coverage with Dr. Shalolbei. He stated that the Board should give administration a time limit to fix the current problems. Mr. Randy Weise stated that from the outside looking in, it seems that the hospital is always in tunnoil and that the only constant is the medical staff. Mr. Weise also questioned that 3 if Dr. Sahlolbei's concern is really poor nursing how can a signed contract fix poor nursing. Ms. Sue Valenzuela indicated that another purpose of the hospital is to support nursing education at the college and that the low census can cause a ripple effect. Mr. Quenton Hansen stated that there has been turmoil at the hospital for over 25 years and that it can't continue. He also stated that a tax measure will not pass if the public does not have confidence in the hospital. Mr. Hanson noted that development of the City depends on medical care and that the Board needs to take action. Ms. Katie Warren stated that she has been a resident of Blythe since 1974 and is currently an employee of Blythe Nursing Care. Ms. Warren states that many residents can't travel because of financial reasons and retirees won't stay in the valley without a hospital. Ms. Cheryl Bruno-Mofu RN stated that she very much resented the comments made by Dr. Shalolbei that nurses at the hospital are incompetent. She stated that she has trained many of the current nurses and they are very competent. She also stated that the nurses are starting to "lose heart" and feels that the nurses are being used as an excuse for other agendas. She indicated that during the last 18 months the quality of care has improved and that it is unfair to label the nurses as incompetent. Ms. Geral yn Quigley RN stated that safety not competency is the issue and that doctors see safety issues in different departments of the hospital as they are doing rounds. Ms. Peggy Abbs stated that she has been a hospital employee for over 34 years and noted that there was almost a closure in 1972 and 4 that the one constant has been the medical staff. She stated that in the past there have been many safety issues and that currently safety issues are being addressed and much needed equipment is being purchased. She stated that she is very happy with how the hospital is being managed. Mr. Gerry Wolford stated that there was a hospital closure in the past and all patients had to go to Wickenburg. Board President Copple called for closure of Public Comment. 6. Consent Action Items: 7. ReportslPossible Action Items: Consent Action Items presented are: 1.A. Minutes of regular Board Meeting of April 26, 2007 B. Minutes of Special Board Meeting of May 9, 2007 C. Resignation of Director Rodriguez and D. Posting of Board Vacancy. Mr. Richard Fallon, COO stated that administration and hospital staff are preparing for the operational and capital budget. Mr. Fallon requested that the Board schedule a study session. Mr. Fallon suggested June 21 st • Motion was made by Director Bolliger, seconded by Director Garnica and unanimously carried to approve Consent Action Items. Director Garnica states that she will not be available on that date. President Copple suggested June 19th and states that he will confer with Director Montgomery to see if that is a good time for him. Mr. Oscar Garcia, CNO reported that when he first came to PVH there were many policies and procedures that did not exist or that needed revamping. He stated that at the current time policies and procedures are all in place. Mr. Garcia also stated that staff training and education is continuing, a Nursing Skills Fair has been held and he hopes to have another session in July. Mr. Garcia noted that he has been in nursing for 11 years and feels that there are no 5 incompetent nurses at Palo Verde Hospital and feels that the issues the medical staff have are not with the nursing staff but with the CNO. He wishes that the Medical Staff would be honest and present their issues to him and not use the nurses as scapegoats. Ms. Liana Sain asked if Mr. Garcia was an employee of AHM and stated that skill fairs are a requirement of JCAHO. Mr. Garcia indicated that he was not an employee of AHM and that the skills fair is a requirement of JCAHO but the nurse managers organize and present it. Dr. Sahlolbei stated that the physicians originally supported Mr. Garcia but discovered he was not doing a good job, which they reported to administration 6 months ago and nothing was fixed. Dr. Sahlolbei also notes that the agenda does not include a MEC report Mr. Jeff Flood indicated that there was no MEC report submitted, at which point Dr. Sahlolbei became very confrontational. Mr. Jeff Scott, General Counsel asked the President for a point of order as Dr. Sahlolbei was becoming disruptive and interfering with the meeting. Ms. Lilly Lopez reported on Human Resource activities and presented three policies for consideration and approval. #49 Bereavement, #19 Paid Time off and #27 On Call/Call Back. Director Bolliged questioned the on call roster and how rotation is set up. Ms. Lopez noted that rotation was determined for after-hours care. Board President Copple calld for Public 6 Comment. Ms. Robin Meyers questioned if the PTO cash item on D was being deleted. Ms. Lilly Lopez explained that the writing in red meant it was an addition. Also included is a letter from Dr. Rodriguez resigning from the Board of Directors and a posting of Board Vacancy. Board President Copple calls for approval of HR Policies, Dr. Rodriguez resignation and posting of Board Vacancy. It was moved by Director Bolliger seconded by Director Garnica and unanimously carried to approve the HR policies as presented and to accept the resignation of Dr. Rodriguez and post the notice of vacancy. Mr. Lee Holter, CFO presented the April financials. Mr. Holter stated that cash was good and that PVH has been underpaid by Medi-Call for 12 months and was expected to receive approximately $800,000 due to the underpayment at a later date. Mr. Holter also noted that the Balance Sheet shows an increase in net account receivables and total assets of $9,000,000. Mr. Fallon, stated that the hospital would like for Dr. Sahlolbei to return to the surgery schedule. He noted that the hospital has shown that it can make money and ARM has fulfilled what they had promised to do. Board President Copple questioned how much of hospital staff is contract labor? Mr. Holter, CFO answered that there are nurses in the OB Department and some contract labor in Radiology. Director Bolliger asked how often inventories are completed. Mr. Holter responded that they are completed once yearly hospital wide and monthly in each department. 7 Director Bolliger questioned what percentage of staff are hospital employees compared to a year and a half ago. Mr. Jeff Flood, CEO answered that approximately 90% are hospital employees and that last year most of the nursing staff was made up of travelers. Director Bolliger pointed out that there were only 3 AHM staff members, Mr. Flood, Mr. Fallon and Ms. Lopez. Board President Copple called for Public Comment. Dr. Sahlolbei stated that the doctors do not want to close the hospital but that AHM is only concerned with revenues and the doctors are concerned with quality care. He stated that the doctors only want good nurses and demanded that administration give the doctors the tools they need so that they won't jeopardize patients. Mr. Bret Miller stated that as of yesterday there is no longer any contract labor in Radiology. Mr. Randy Weise questioned why income is based on projected collections. Mr. Lee Holter, CFO stated that hospital accounting is different from other businesses and because there are two Government payors an Audit Cost Report is needed to determine exact figures. 8. Board Comments: Director Garnica stated that the Board will be taking all opinions into account in making their decisions. Director Bolliger thanked everyone for coming and reassured everyone that the Board is working hard to resolve the issues addressed by the public. He also stated that in the last year and a half the hospital has 8 improved by improved hospital conditions, community employment, improved medical equipment and air conditioning repairs. 9. Adjournment: 10. Reconvene/Report After Closed Session: President Copple stated that being on the Board is a tough job but Board members do it for the community and he indicated that the hospital is moving forward with running the hospital and is working on issues. The Board convened to Closed Session, pursuant to Government Code Section 54957 regarding personnel issues. After the Closed Session the Board reconvened to open session. The next Regular Board Meeting is scheduled for June 28,2007. Board President Copple stated that no action was taken in Closed Session. On motion duly made and seconded the meeting was adjourned. Mark Bolliger Board Secretaryrrreasurer 9 PALO VERDE HOSPITAL PALO VERDE HEALTH CARE DISTRICT SPECIAL BOARD OF DIRECTORS MEETING MINUTES June 14, 2007 5:30 p.m. BIIylth e CommuDlty ·t Cen t er Directors Present Administrative Staff Present Derek Copple, President Mr. Jeff Flood, CEO Carmela Garnica, Vice President Mr. Richard Fallon, COO Mark Bolliger, Secretary/Treasurer Ms. Lilly Lopez, Assistant Administrator Steve Montgomer, Director Mr. Lee Holter, CFO Mr. Jeff Scott, General Counsel TOPIC 1. Call To Order: 2. Flag Salute: 3. Roll Call: 4. Approval of Agenda: DISCUSSION Board President Derek Copple called the meeting to order at 5:30 pm. The Pledge of Allegiance was led by Board President Copple. Board President Copple conducted roll call. Board President Copple called for approval of the June 14,2007 Agenda. 5. Public Comment: Board President Copple called for Public Comment. 6. Reports/Possible Action Items: Mr. Richard Fallon, COO introduced two Oncall Surgical Coverage Agreements with Dr. Salehi and Dr. Farsad for ratification; The contracts are for a one-year term at $2,000 per day and have a 90 day cancellation policy. Mr. Fallon indicated that each of the doctors will work when available and the Doctors will receive payment only for the days worked. ACTION All members are present. Motion was made by Director Montgomery seconded by Director Garnica and unanimously carried to approve the agenda as presented. There was no Public Comment. Board President Copple asked for Public Comment. Dr. Barth questioned if the contract is for a flat rate reimbursement and if the hospital is able to bill for service and keep the revenue. Mr. Fallon indicated that the hospital will 1 keep any revenues earned by the doctors. Director Montgomery noted that Section 8 in the Medical Staff Bylaws states that the hospital has the right to bill and collect revenue. Suzanne Holsomback, RN asked if the 1 year contract will keep the hospital open. Mr. Richard Fallon indicated that surgical coverage is currently only secured thru the 24th of June. Ms. Barbara Lindsey questioned if the contract is for one year then why is coverage only until the 24 th • Mr. Fallon explained that the contract is valid for one year but the doctors are only required to work when available. Mr. Chuck Grotke asked if the contracts were just to buy time for coverage to avoid closure. Board President Copple explained that surgical services cannot stay open if there is no surgeon coverage. DHS will inform the hospital if and when we need to close because of being non-compliant. Dr. Lucero questioned that if staying open depends on keeping a surgeon then why hasn't a contract been been signed with Dr. Sahlolbei. Dr. Lucero stated that there is a real issue that ARM is not addressing and that it is not unusual to not have surgical coverage. Ms. Liana Sain noted that Dr. Lucero's comments are an example of why contracts are needed and that the final responsibility falls with the Board to provide coverage. Dr. Brooks stated that he has had the privilege of working with Dr. Salehi and Dr. Farsad 2 Board President Copple closed public comment on the item. Director Montgomery questioned who decides the on-call coverage schedule. Mr. Jeff Flood, CEO answered that the Medical Staff along with the CEO decides the schedule. Director Montgomery stated that he is confused because Dr. Lucero stated that in the past there often was no on-call coverage for surgery. Mr. Flood noted that the hospital's licensure thru DHS requires that the hospital provide a continuum of coverage and also requires that DHS is notified when the hospital does not have the appropriate coverage. At that point the hospital is on diversion. Mr. Flood also stated that there is no definite time limit for how long the hospital can be on diversion but that DHS and CMS are both extremely concerned over the length of time that the hospital has been on diversion. Director Bolliger stated that at the last community meeting, Administration noted that they did have two surgeons waiting to be credentialed and questioned the status of their applications. Mr. Flood answered that several locum tenens physician have inquired about providing coverage, but according to the medical staff by-laws, locum tenens physicians can't provide coverage for a service but only for a specific surgeon. Board President Copple called for a motion. Mr. Fallon stated that Dr. Sahlolbei It was moved by Director Montgomery, seconded by Director Garnica and unanimously carried to ratify and approve the on-call contracts for Dr. Farsad and Dr.Salehi. 3 terminated his contract with the hospital. He indicated that there were several directions that management can take to provide surgical coverage. An agency recruiter can be hired to find a surgeon, which can be very expensive. Mr. Fallon stated that he understood that Board wants a second surgeon and that the medical staff only wants one surgeon as they feel the community can't support two. It is possible to contract with Dr. Sahlolbei and he would find a second surgeon, but because of Dr. Sahlolbei's recent boycott, management is afraid that he may do this again. At the current time Dr. Sahlolbei and Management's attorneys are in discussion but Dr. Sahlolbei can't be contacted and the terms that he would agree to are not known. Mr. Fallon also stated that the hospital cannot afford a surgery department if revenues are not sufficient. Currently the surgery department's revenues are $155,000 per month while the operation costs are $335,000 per month for DB and Surgery. At the current time the hospital could close and have 1.1million in assets but if the current situation continues that will be lost. Mr. Fallon requested direction from the Board in regards to closing the surgery department if necessary. Director Garnica stated that she was in favor of searching for another surgeon as she feels that Dr. Sahlolbei has a monopoly and that is not a good thing. She also indicated that the community could support a second surgeon and competition is a good thing. Board President Copple asked if the hospital had an exclusive contract with Dr. Sahlolbei at the present time. Mr. Fallon stated that Dr. Sahlolbei did have an exclusive contract and was given 24 hour 7 days per week coverage but has changed his mind. Director Garnica questioned why Dr. Chua 4 was not hired. Dr. Lucero answered that Dr. Chua would need remedial courses and was never doing major surgeries previously and would not take call. Dr. Lucero also stated that although the medical staff supports recruiting another physician they feel that everyone would work better together if the surgeon was located and hired by Dr. Sahlolbei, Board President Copple stated that he was not in favor of an exclusive contract with Dr. Sahlolbei and that the community has spoken loud and clear that they want a choice in regards to surgeons. Director Montgomery stated that he was not in favor of an exclusive contract and they need to get another surgeon and hopefully the temporary surgeon could stay. Dr. Lucero indicated that no other surgeon is going to do 24/7 on-call coverage. President Copple noted that the Board will not get backed into a corner and that they have given in, in the past, and will not do so again. Director Bolliger asked Dr. Lucero how a new surgeon obtains experience and suggested that maybe someone new would want to come in and be mentored by someone on the current staff. Dr. Lucero stated that a surgeon should already have experience and Dr. Sahlolbei has experience. Director Bolliger indicated that the Dr. Rodriguez was a new doctor and developed a practice and that no surgeon has a perfect record. Mr. Fallon noted management is backed into a corner since Dr. Sahlolbei will only take 5 coverage if offered an exclusive coverage. Mr. Fallon asked the Board if they will support management if surgery needs to close. Director Garnica stated that mostly people on Medi-call will be impacted if OB closes and she would like to work something out rather than close any departments. Mr. Fallon stated that the Medical Staff by laws would have to be modified to allow locum tenens coverage. He suggests the possibility of providing a van for patients to receive care out of town if necessary. Director Montgomery indicated that Dr. Sahlolbei is holding the Healthcare District hostage until he receives an exclusive contract and the medical staff needs to step up and do the right thing. Board President Copple called for Public Comment: Mr. Randy Weise noted that he has been doing research on the internet and has spoken to his attorneys and has been told that if Dr. Sahlolbei continues to withhold services the community could start a class action lawsuit. Ms. Beverly Mays stated that a hospital with surgery services is needed and questioned if the hospital has received a formal notice from DHS. Mr. Jeff Flood states that he is required to contact and report to DHS by telephone on a daily basis. Ms. Mays goes on to say that surgery costs are high but that lives are more important than revenue. Ms. Mays also stated that even if a van is provided the basis of transporting a patient is acceptance by the receiving hospital. 6 Dr. Mofu indicated that for 15 years the hospital has managed with available personnel and hasn't always had surgeons in the past. He also stated that transportation is based on hospital acceptance and feels that time has been wasted discussing alternatives and the contract should be signed with Dr. Sahlolbei. Ms. Cheryl Mofu noted that the Board and AHM are digging in their heels and are not willing to negotiate. She also stated that in the past the hospital closed a department to get rid of a doctor and never got services back. She suggests leaving egos behind and doing what is best for the hospital. Mr. Butch Hull stated that his comments are personal comments and he was thankful that the Board has "grown stones" and suggested that all three entities get together and compromise. He suggested not making a decision tonight but continuing on with discussion. Mr. Chuck Grotke asked what locum tenens was. Board President Copple states that they are doctors who are contracted to do temporary work. Dr. Lucero stated that if Dr. Sahlolbei had a contract he would hire a locum as a temporary replacement. Board President Copple noted that locums are given privileges for a short length of time only and that background and credentialing is completed on each candidate. Dr. Lucero stated that there are three provisional contracts including Dr. Sahlolbei's and that the bylaws do not need to be changed. 7 Board President Copple asked if as acting Chief of Staff; would Dr. Lucero hire a locum. Dr. Lucero stated that Dr. Sahlolbei's contract should be signed and then the problem would be fixed. He also stated that Dr. Sahlolbei is upset for a reason. Board President Copple asked where the medical staff stands. If the Board chooses not to give an exclusive contract would the medical staff work with changing the by-laws to hire a locum tenens? Ms. Liana Sain stated that it is absolutely ridiculous for one person to decide and asked the Board to consider that lawsuits will go on and other surgeons could possibly be ruined as has happened in the past. Ms. Eugenia Webber questioned if a compromise could be reached if the term exclusive was removed from the contract. Board President Copple stated that an on-call contract would be offered regardless and MEC would still have to credential and that is where the problem would arise. Director Montgomery stated that the Board should consider overriding the credentialing process if problems occur. Ms. Joy Swanner stated that she spoke with Dr. Mahapatra, the President of The Riverside County Medical Association and was told that if the Medical staff would not credential that the Board could override the decision. Ms. Glenna Peoples questioned what the process for changing the by-laws is and would the medical staff make the change? She also stated that a locum tenens can only cover for a person not a service. 8 Mr. Randy Weise stated that in researching similar situations he discovered a lawsuit where a locum tenens credentialing was being stonewalled and the locum was awarded 25 million dollars. Director Bolliger asked if we had officially received Dr. Sahlolbei's written concerns. Mr. Fallon stated that management had not received Dr. Shalolbei's demands in writing and had not been provided with a term list. President Copple indicated that the Board had requested a list of terms, concerns or issues in writing so that the Board could address Dr. Sahlolbei's issues. If the issue relate to Quality concerns then they cannot be brought up in public. Ms. Sharon Essary questioned why this problem has been allowed to go on and stated that it has been happening for some time. Mr. Rick Vega indicated that Dr. Sahlolbei's behavior was inappropriate and asked why the medical staff didn't discipline him. Dr. Lucero stated that there was a process for disruptive physicians. Director Montgomery stated that Dr. Sahlolbei had been reprimanded by the past Board as a disruptive physician and it was recommended that he get counseling, but that the medical staff denied there was a problem and voted no three times. He also stated that the disruptive physician policy is vague and there is no time line. Ms. Peggy Abbs questioned how a contract can be negotiated when the terms have not been presented. Ms. Doris Morgan stated that she had heard a rumor that Dr. Sahlolbei actually carried a 9 gun into the hospital and wanted to know if that was true. Dr. David Brooks stated that there was an incident in the past where Dr. Sahlolbei did brandish a gun in the hospital and it was taken away from him. Ms. Morgan stated that she had also heard that Dr. Sahlolbei had thrown something at a nurse in the past and that he tries to run District Board meetings from the audience. Ms. Morgan noted that the medical staff should monitor Dr. Sahlolbei's behavior. Another women in the audience stated that she had a personal experience with Dr. Sahlolbie where her son was going to have surgery and Dr. Sahlolbei told her that his surgery would be successful if she voted for him. Dr. Mofu stated that the hospital has an excellent nursing staff. Mayor Robert Crain indicated that the Chief of Staff needs to answer to the public and suggested that a trip to Sacramento be made. Ms. Carol Ecret stated that she also had a bad experience with Dr. Sahlolbei and the community deserves another surgeon and feels that a tax measure could be passed if a different surgeon was available. She asked that the Board give the community a choice and keep the doors open. Dr. Brooks stated that the nurses are great. He that 4 or 5 years ago the DB department closed and it was a detriment to the spirit of the community. He also felt that not having surgical access would be a huge problem. He reported that the medical staff informally met and decided not to change the by-laws and the overwhelming majority supported Dr. Sahlolbei as Chief of Staff and would fight 10 any removal. Dr. Brooks also stated that there should not be any exclusive contracts. Board President Copple closed Public Comment. Board President Copple called for a motion for consideration of an exclusive contract with Dr. Sahlolbei. Director Montgomery stated that he would not support an exclusive contract. President Copple stated that he would never agree to exclusive contract and that neither the Board nor the public want it. Director Garnica stated that the hospital should look for another surgeon. Mr. Fallon requested that the Board consider an allocation of $60,000 for recruitment fees and a guarantee of up to $500,000 for salary and expenses the first year for surgeon recruitment. It was the unanimous consensus of the Board not to consider an exclusive surgical services coverage agreement with Dr. Sahlolbei. Mr. Jeff Scott, General Counsel stated that the contract would be structured to guarantee salary and any revenues received from the Physician's billing would go to the hospital to off-set the salary guarantee. Board President Copple called for Public Comment. There was no Public Comment. Board President Copple called for a motion Mr. Fallon requested authority from the Board to allow management to suspend Surgical, Anesthesia and Obstetric services if necessary to protect the hospitals license. Mr. Fallon stated that if and when it is decided by DHS to rescind the hospital's license it will happen very quickly and there may not be time for the Board to meet and decide on other options. It was moved by Director Bolliger, seconded by Director Montgomery and unanimously carried to authorize management to take the necessary actions to recruit a general surgeon as requested by Mr. Fallon. Dr. Lucero stated that it would be a mistake to grant authority and maybe administration 11 should decrease the amount of their employees to save money. Mr. Chuck Grotke noted that management has been instructed to recruit a surgeon and he questioned what a surgery department closure would say to possible recruits. Ms. Sandi Blessing stated that in her experience, DHS and CMS do not do anything quickly and that it would take months to close down the hospital. President Copple indicated that the board should wait to see what happens in the next few weeks. He suggested having a meeting on June 191h and requested a written response from the Chief of Staff relaying their complaints and establishing how he wants to proceed. President Copple then suggested meeting on July 51h and revisiting the closure question at that time. Mayor Robert Crain stated that the medical staff needed to come to the table with a solution. President Copple indicated that the District is facing some very serious issues and that having no surgeon on call and being forced to close the surgery department are bigger problems than too many managers. On motion duly made, seconded and unanimously carried the meeting adjourned at 8:00 p.m. with the understanding that a Special meeting may be scheduled for June 19,2007. Mark Bolliger Board Secretaryffreasurer 12 PALO VERDE HOSPITAL MANUAL: Operating Room I Effective Date: 12/04 Revised/Reviewed: 12/03,06/06.1 06/07 Title: Personnel "On-Call" Number: PC Page 1 of 2 Procedure: I. POLICY: A. The Operating Room Staff will provide 24 hour emergency coverage by qualified staff for the department. It is the O.R. Manager's responsibility to make the assigned schedule and see that it is posted in the areas responsible for the "on call" staff in an emergency. B. There shall be two qualified staff members "on call" on a daily basis. The "on call" members shall consist of one surgical technician or LVN/Scrub Nurse and one Circulator/PACU RN. However, at the discretion of the OR manager, additional Circulator/PACU RN staff may be placed On-Call for the following reasons: • Historically busy holiday weekends • Scheduling of an elective Major procedure or multiple sequentially scheduled minor procedures during a weekend • At the discretion of the OR manager in collaboration with the CNO or designee.. C. Post anesthesia recovery of the surgical patient in the intensive care unit. The Intensive Care Unit and staff may also be used to recover post operative patients in the event further assistance is required. D. The OR.lPACU on call schedule will be provided to the switchboard and double checked with the OR. in a daily basis. E. The "on call" circulator and scrub will be contacted by the House Supervisor and state the department where the patient is located (emergency room, med/surg - ICU, obstetrics, etc.) She will call the PACU nurse at the circulator's request. 1. Patient's name and age. 2. Type of surgery to be performed and the surgeon who will be performing the operation. PALO VERDE HOSPITAL MANUAL: Operating Room I Effective Date: 12/04 Revised/Reviewed: 12/03,06/06J. 06/07 Title: Personnel "On-Call" Number: PC Page 2 of 2 Procedure: 3. Any special requests by the surgeon (Instruments, traction, etc.) Prep and consent completed. F. Check with the switchboard operator for any messages that have been left or if the "on call" personnel are on their beepers. !! , JUI~ • \ _ ..;. BRAD C. BARTH M.D. ANESTHESIOLOGY 2671 COLORADO RIVER ROAD BLYTHE, CALIFORNIA 92225 June 11, 2007 Palo Verde Healthcare District 250 North First Street Blythe CA 92225 Attention: Bonnie Brown, Executive 1\ssistant. Dear Madam: I would like to serve as an interim member of the Palo Verde Healthcare District Board. I am a resident of Blythe, and a provisional member of the medical staff of Palo Verde Hospital. I have eleven years experience as a physician practicing in small town hospitals very much like our hospital here in Blythe. I am a former elected chief of staff at Colorado River Medical Center in Needles, CA. I am well acquainted with physicians' issues and I believe I can express myself in a levelheaded fashion. I moved to Blythe in December, 2006, and I still hope to settle my family here long term. I want to do everything I can to help the board keep a full service community hospital open and operational. Sincerely, PHONE: 760197 5983 • FAX: 760 922 68119 , 1 )' l . C ~ ,- -' ~ l,' ... \ . Rosalie Carlton 620 Holley Lane Blythe, CA 92225 Palo Verde Hospital Health Care District 250 North First Street Blythe, CA 92225 June 22,2007 I am writing to apply for the vacant position of the PVHC Board incumbent advertised in the Palo Verde Valley Times and KJMB radio. The opportunity presented in this listing is very interesting and challenging. I believe that my administrative background and my community involvement experience with heart makes me a competitive candidate for this position. The key strengths that I possess for success in this position include: Excellent Team Player; maintain open honest communication with others; ability to achieve developmental goals; ability to communicate effectively, orally and in writing. My related job experience skills are to as follows: • Provide to management monthly variance reports of the Capital and Operations Maintenance • Key personnel in the planning of annual Division Capital 5 year project forecasts • Key personnel in the planning of annual Division Operations Maintenance 5 year project forecasts • Participate in several Government Regulatory Audits • Excellent compliance record keeping knowledge • Understanding of the Sarbanes Oxley Act of 2002 • Conduct Environmental and Safety Meetings; Field Safety observations • Attend and participate in Public Awareness Meetings • Participate in round table meetings • Active member of the Soroptimist International of Blythe • Co-Chair of the Soroptimist Annual Safety and Health 2006 and 2007 • Co- Chair of Soroptimist Public Relations 2006-2007 • 18 years law Enforcement- Arizona Department of Motor Vehicle • 10 years Administrative - El Paso Natural Gas Company I can be reached anytime via cell phone, 760-574-8347 or 760-922-4507. Thank you for your time and consideration. I look forward to speaking with you about this important community opportunity. June 25, 2007 . , Palo Verde Hospital 250 N. First St. Blythe, CA 92225 RE: Hospital Board Vacancy I would like to be considered for the current vacancy on the Hospital Board. My past positions and experiences that I feel qualify me for the position are: I have a Doctorate in Health Education from the University of Tennessee Thru my course studies, all aspects of health, from community through global were covered. I was a teacher for 25 years; kindergarten thru university level As a teacher, I worked not only with the students, but with the parents and community to make the curriculum the best it could be. I served on the negotiations team for the NEA in Coffeyville, KS for 5 years Being on the negotiations team taught me skills to work with the administration to find the course that was the most beneficial to all concerned. 1 am a resident of Blythe and a registered voter As a resident of Blythe, I feel it is imperative that the Palo Verde Hospital remain a viable operating entity to serve the community, Edna Gillis 452 N. 4th St. Blythe, CA 92225 (760) 921-R969 To the Members of the Palo Verde Health Care District Board: I, Glenna Peoples RN apply for appointment to the Health Care District Board. I am a resident of Blythe California. My residence is 17920 Green 8t. Blythe Ca. 92225 (760) 921-9204 I am a registered voter. If appointed I would do my utmost to make decisions based on the interests of our community and health care facilities. Thank You for Your Consideration, <~ Glenna~o1JfesRN RESOLUTION NO._07-2007-#01 RESOLUTION OF THE BOARD OF DIRECTORS OF THE PALO VERDE HEALTHCARE DISTRICT APPOINTING TO SERVE ON THE BOARD OF DIRECTORS UNTIL THE NEXT DISTRICT GENERAL ELECTION IN 2008 WHEREAS, with the resignation of Dr. Leonel Rodriguez, a vacancy exists on the Board of Directors of the Palo Verde Healthcare Care District; and WHEREAS, pursuant to Government Code section 1780, the Board of Directors may appoint a director to fill the vacancy until the next District election on November 7, 2008. NOW, THEREFORE, the Board of Directors of the Palo Verde Healthcare District does hereby resolve, find, determine, and order as follows: Section 1. Pursuant to section 1780 of the Government Code, the Board of Directors of the Palo Verde Healthcare District hereby appoints _ to serve as a member of the Board of Directors until the next District general election on November 7, 2008. Section 2: The Secretary of the Palo Verde Healthcare District is hereby directed to deliver forthwith one (1) certified copy of this resolution to the Clerk of the Board of Supervisors of the County of Riverside, California. PASSED AND ADOPTED at a Special meeting of the Board of Directors of the Palo Verde Healthcare District held on July 3,2007, by the following vote: AyES: _ NOES: ABSENT: ABSTAIN: _ --------------_ Derek Copple, President Board of Directors ATTEST: Mark Bolliger, Secretary Board of Directors STATE OF CALIFORNIA COUNTY OF RIVERSIDE ) ) ) I, Mark Bolliger, Secretary of the Palo Verde Healthcare District, DO HEREBY CERTIFY that the foregoing is a true copy of Resolution No. _ ' adopted by the Board of Directors of the Palo Verde Healthcare District at a Special meeting of the Board of Directors held on July 3, 2007, which Resolution is a part of the official records of the Palo Verde Healthcare District. Dated: - - - - - - - - Mark Bolliger, Secretary Board of Directors