Ambulances and PTO topic of meeting

Wednesday, November 4, 2009

The Fulton County Hospital Board of Governors met on Monday, Oct. 26 and a hot topic on the agenda was new ambulances for the hospital. The hospital's current lease on its two Sprinter Type 2 models expires early next year, so the Board entertained a proposal on the purchase of two new ambulances to replace them.

Ambulance Administrator Tim Rogers presented the options to the Board. "The true type of ambulance we need for our rural roads is the wheeled coaches like Baxter Regional has," said Rogers. "The Sprinters get great gas mileage, but they really aren't built for the kind of roads we run on."

According to Rogers, the wheeled coaches have larger patient boxes and dual back tires, and overall are a more rugged and long lasting vehicle. "Baxter Regional runs the wheeled coaches and has had a great history with them," said Rogers. "We order these direct from wheeled coach, and can get the warranty maintenance done on the chassis in Mountain Home and the box warranty can be done in Batesville."

The wheeled coach option presented by Rogers was for a coach that had been ordered by another company, giving the hospital a $7,000 savings, since they would not have to custom order a unit. Currently, the county pays for the lease of the two Sprinter ambulances at a cost of $1,600 per month. The new wheeled coaches will cost considerably more, due to the shorter lease term. The Board agreed to the purchase of two wheeled coach ambulances on a 36 month lease, with the provision that Hospital Administrator Joe Hammond speak with USDA representative Johnny James about possible grants to help cover the cost of the new ambulances, and speaking with Fulton County Judge Charles Willett about the county possibly covering the lease cost of one of the ambulances, with the hospital covering the lease cost of the second ambulance.

Hammond then presented the Board with his plan for revising the Paid Time Off program for the hospital. Under Hammond's proposed plan, new employees would now be eligible for PTO benefits after working 90 days. Employees would be required to take 40 hours of PTO each year. PTO rollover hours would be calculated by taking the total available, minus 40 hours, minus the amount of holiday hours not taken. For 1-5 years, they would have 88 hours (40 regular hours and 48 holiday hours). For 6-10 years, they would have 128 hours and for employees with 10 years and over, they would have 168.

Board member Jerry Estes was opposed to the idea that newer employees would not be able to carry over any time from one year to the next. "I'm for starting carry over after one year. It costs a lot to train new people, so we need to do what we can to keep our employees," said Estes. According to Hammond, it can cost the hospital from $2,500 to $5,000 to train a new employee based on their skill level. "Our employees are the backbone of the facility," said Board Chairman Al Roork. "They are what makes us a success."

Further discussion focused on placing a cap on the hours, and debate began on how many hours would be too much or too little. "Providing flexibility for our employees is an important value to them," said Hammond. "Gen X and Gen Y value their time away from the office, and value that time with their families."

Doctor Gordon Arnold also brought up the point about an aging workforce. "As you get older, you're going to get sick more often and need more time," said Arnold. "We are not in a place where money trees are growing anywhere and if someone was sick for a little while, it could really help them to have some time to fall back on."

As a compromise, Chairman Al Roork suggested that the hours be increased to 100 for employees with 1 to 5 years with the hospital, 150 for employees with 6 to 10 years and 200 for employees with over 10 years. A vote was taken and the proposal passed.

Focusing on the financials for the hospital, the trend downward in revenue continued in September. "I'm sure you noticed the hospital showed a loss for the month of September $87,452, bringing total loss of the year to $269, 702," said Hammond. "If we will go back over to the hospital statistics section you can see clearly where this trend has come from. In June of this year, Dr. Kauffman and Dr. Bozeman were both not admitting. On the inpatient section, those figures decline over the next four months. Inpatient admissions went from 90 in May to 46 in June, and then since Dr. Bozeman came back on, they've began to rise, but we're still hurting from not having a third physician admitting. You see the same decline in swing beds and in outpatient services. Across the board, we've seen a drop off in inpatient and outpatient services."

To help fill the void left by not having a third admitting physician, the hospital has continued it's search for a new doctor of internal medicine and a new family medicine physician. On Nov. 7 and 8, Dr. Lee Peter Bee will be visiting the hospital and meeting with staff. Dr. Bee is a 35-year-old doctor of Osteopathy who will finish his residency in April. According to Hammond he is very "outdoorsy" and interested in practicing in rural areas.

In other business, the Board once again reviewed the new bylaws for the Board of Governors and with two minor changes have accepted them into record.

The hospital's line of credit with the Bank of Salem was next up in discussion. The hospital previously had a $450,000 line of credit with the bank, secured by $500,000 of the hospital's accounts receivables. At the last meeting of the bank's Board of Directors, they opted to drop the line of credit to the hospital to $250,000 while keeping the security level at $500,000. "Their reasoning was that having a large line of credit committed out there, well it draws a lot of attention to the bank auditors," said Hammond. "They would prefer to extend $250,000 and then offer more if needed later, as they are committed to the solvency of the hospital."

Several of the Board members felt that Hammond should shop around for the hospital. "There are three banks in the county," said Board Member Bill Pace. "I feel you should try FNBC and Simmons." It was discussed that the hospital needs to have the safety net of a line of credit in place, in the face of the current economy and so an agreement was reached to open the line of credit with the Bank of Salem, but for Hammond to investigate other opportunities with FNBC and Simmons. "The Bank of Salem is going to be behind us," said Roork. "Banks are under a lot more scrutiny by the FDIC, and are just making sure that their assets are covered."

Hammond then gave an update on the hospital's parking lot paving project. "The back parking lot is finished and is a wonderful addition to the hospital," said Hammond. "There is a concrete pad on the southeast side of the building and that's where the mobile MRI unit will land."

It was also mentioned that Fulton County Judge Charles Willett is working on a FEMA trailer to house the paramedics and EMT's to provide a better environment for them, which will in turn free up some sleep rooms in the back of the hospital. "Jackie Orr has already installed the plumbing for it, and as soon as County Judge Willett can get that out here, we'll get it set up," said Roork.

Before breaking for executive session, Chairman Roork announced that a lawsuit has been filed against the hospital by Sherry Keylon, a former hospital employee. Roork stated that the lawsuit had been filed in Fulton County Circuit Court for wrongful termination. The Board held no further discussion on the topic.

After the executive session to discuss personnel issues, the Board announced a pay raise for Administrator Joe Hammond. "With the work that our CEO has done, I move that we instigate a 5 percent raise, and that we would like to re-evaluate him in six months," said Board Member Dr. Gordon Arnold.

Chairman Roork echoed Dr. Arnold's sentiments "We feel very blessed that you're here Joe and are very pleased with the job that you're doing, but with our current financials, we have to be financially responsible, but we want to keep you too, so this is what we can do right now," said Roork.

With that, the Board adjourned.

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