HUMBOLDT GENERAL HOSPITAL DISTRICT BOARD OF TRUSTEES MARCH 27, 2012 MEETING SARA WINNEMUCCA CONFERENCE ROOM

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HUMBOLDT GENERAL HOSPITAL DISTRICT BOARD OF TRUSTEES MARCH 27, 2012 MEETING SARA WINNEMUCCA CONFERENCE ROOM BOARD PRESENT: Moe Hanzlik, Chairman Mary Orr, Secretary Mel Hummel, Member Soon Kim, Member Sharleen Cooney, Member Jim French, County Comm. Member Kent Maher, Legal Counsel BOARD NOT PRESENT: None 03/27/2012 Board Meeting Minutes Page 1 of 5 STAFF PRESENT: James Parrish, Administrator Larry Hutcheson, CFO Rose Marie Green, Human Resources Director Darlene Bryan, Director of Nursing Mike Bell, IT Director Alicia Wogan, Administrative Assistant Melissa Lopez, Administration Support Debbie Whittaker, EMS AED Coordinator Ken Whittaker, EMS Education Coordinator Sandi Lehman, Controller Dave Simsek, Pharmacy Director Shauna Barsanti, Business Office Manager Pat Songer, EMS Coordinator Nicole Maher, Public Relations Director Ginger Tanner, Infection Control Nurse Tony Shope, EMS Michelle Chadwell, Nurse Supervisor Jacqueline Dalley, ED & Inpatient Manager Kathy Gillihan, Nurse Manager Louis Mendiola, EMS GUESTS: Beverly Mendiola (Auxiliary), Jenny Setzer, Ed Hopfer, Dr. Brian Wong (The Bedside Trust), Mike Sheppard (Michael Clay Corporation), Brad Knowlton (Ascent Construction), Steve Lyon (Humboldt Sun), Dee Hozel (Silver Pinyon Journal), Tim Miller (CTA), Lindsay Erb (CTA), Trevor Baker, William Hammargren and Sheriff Ed Kilgore. CALL TO ORDER: Board Chairman Hanzlik called the March 27, 2012 board meeting to order at 5:32 p.m. PUBLIC COMMENTARY: There was no public commentary. MEDICAL STAFF REPORT: Dr. Kim advised that Administrator Parrish and the department heads meet nearly every day and attempt to address any issues which have arisen. EMS UPDATE: Pat Songer, EMS Coordinator, advised that the Community Paramedicine Stakeholders meeting was very successful. There were delegates from Clark County, Elko County, Washoe County and Remsa. In February, there were 192 call outs, 37 inter facility transports, 11 rescues, six mental health transports and eight AED s put in the hospital. Songer commended the ER and nursing personnel for the fine job they do in the facility, their professionalism and their management of patients. Tony Shope was awarded a congressional recognition by the US House of Representatives in honor for his seven seals award which he obtained by

training on his own time. Administrator Parrish said he received an email regarding Deputy Sheriff Green and provided an award. Sheriff Kilgore accepted the award for Officer Green. Songer explained that the EMS has been involved with training for the Sheriff s office. Kilgore was presented with an EMS jacket. Kilgore thanked the EMS team and HGH for the collaboration. Kilgore said he is looking to institute a patrol paramedic program with the Sheriff s department. INFECTION CONTROL SERVICES REPORT: Administrator Parrish advised that the Quality Services Report has been substituted this month with an Infection Control Report presented by Ginger Tanner who gave a recap of the 2011 infection control statistics. CONSENT AGENDA: Motion by board member French and second by board member Cooney to approve the board meeting minutes from February 28, 2012 as presented. Motion carried with board members Hanzlik, Orr, Hummel, French and Cooney voting aye, and board member Kim did not vote as she was absent from the meeting while on a phone call. Motion by board member Hummel and second by board member Kim to approve the Medical Staff appointments/reappointments as presented. Motion carried unanimously. Motion by board member French and second by board member Hummel to approve the delineation of privileges for pathology and radiology as presented. Motion carried unanimously. PRESENTATION REVIEW/ APPROVAL OF FINANCIAL REPORTS: Administrator Parrish presented the February financials. Motion by board member French and second by board member Cooney to approve the February financials. Motion carried with board members Hanzlik, Orr, French and Hummel voting aye, board member Cooney voting aye but abstaining from action on the warrants due to her perceived conflict of interest, and no audible response was received from board member Kim. DISCUSSION / ACTION ON ITEMS OF BUSINESS & OTHER REPORTS: 1. Patient wing addition and remodel project (acute care expansion) / contract award / Administrator Administrator Parrish advised that the bids were received on the acute care expansion remodel project, and reminded that a number of people have been working on this proposed project for about two years, including the nursing staff. CTA architects, Ascent Construction and the owner s representative, Mike Sheppard, were present to answer questions. Sheppard said he is impressed with the HGH involvement with CTA to develop the project specifications. There is a state of the art design that evolved from DON Bryan and her nursing crew working closely with CTA. Sheppard advised that with the last project there were some stumbling blocks or unpleasant surprises that ended up resulting in more time and money being spent. The lesson learned from the previous contract is to have all bases covered prior to awarding the contract. At this time, the County building department is prepared to issue a permit for the proposed project. Brad Knowlton, Chairman and Chief Executive of Ascent Construction, introduced himself. A list of primary subcontractors was passed out. Sheppard suggested this is an opportune time to award this contract (due to the general lack of contracting work) and move forward. Phase one is the component of the contract that is weather sensitive. Sheppard advised that there are also three alternates, two corridor remodels and a solar addition. Sheppard thinks the alternates should be included in the project. Board Member French asked how soon construction will start. Sheppard advised in approximately two weeks after Legal Counsel drafts a notice of award and the contractor provides bonds and insurance. Sheppard 03/27/2012 Board Meeting Minutes Page 2 of 5

said 700 days are allowed to complete the project. Board member Hanzlik asked about the handout regarding the two corridor upgrades and questioned if it involves two different corridors. Sheppard advised that there are two corridors. Board member Hummel asked if the nursing staff will be able to remain involved during construction if they see something they believe will not work. Sheppard advised yes, everything has been done to hopefully avoid this, but should something come up it can be addressed. Board member Cooney asked how they come up with subcontractors. Sheppard advised that is between the general contractor and subcontractors, and explained how the bidding process works. Cooney asked about using a local company for concrete. Sheppard advised that the local companies are not adequately equipped to provide services for a job of this magnitude. Administrator Parrish recognized Darlene Bryan, Michelle Chadwell and Jacqueline Dalley and said they worked very hard on the project. Bryan advised that the nurses have spent a lot of time on this as they would like the completed facility to be done right. Bryan noted that CTA was very good at responding to the nurses inquires. Chadwell commented that they were fortunate to have hands on participation. Travelers also have helped with suggestions for equipment based on their experience at other facilities. Dalley commented on day to day operations and said families are becoming more aware of the healthcare they receive. Families will now be able to stay in the individual rooms which have more privacy. Cooney asked Knowlton how many acute wings his company has worked on. Knowlton advised that they have done two different phases with two different hospitals, two clinic suites and an 80,000 sq. ft. clinic. Board member Kim asked if any of those facilities were functioning. Knowlton advised yes. Motion by board member French and second by board member Hummel to accept the bid from Ascent Construction Incorporated with all the additive alternates, for a total of $5,714,600.00, as Ascent is the lowest responsive and responsible bidder. Motion carried unanimously. 2. Pharmaceutical supplies shortage presentation / Pharmacy Staff Administrator Parrish advised that HGH may be facing drug shortages. Parrish asked Dave Simsek, Pharmacy Director, to put together a presentation as to why the shortages exist, what HGH is doing about it, and how the prices are affecting HGH. Simsek gave a presentation on drug shortages. No action was taken. Board Member Kim left the meeting at 7:02 p.m. 3. Bariatric surgical table for Operating Room purchase / Administrator Administrator Parrish advised that the weight capacity of the existing tale is 350 pounds. The budget for a new table with a 1,000 pound capacity is $40,000. There were three bids received, the low bid is $41,712.52 for a Steris table which can use the existing arms and leg holders. Board member Cooney advised on a single day recently there was not one patient out of 15 that was under 300 lbs. Parrish advised that sometimes surgery is not possible due to the patient size. Board Chairman Hanzlik asked when the table can be delivered. Parrish responded prior to this July. Motion by board member Hummel and second by board member Orr to approve purchase of the Steris bariatric surgical table for the Operating Room in the amount of $41,712.25. Motion carried unanimously. 4. EGD high definition scope purchase / Administrator Administrator Parrish advised that this piece of equipment is on the capital budget in the amount of $40,000. The bid is $34,710.34. Parrish advised that competitive bids were not obtained as it is an Olympus scope and it must be compatible with existing light sources and instrumentation. Motion by board member French and second by board member Hummel to approve purchase of the Olympus EGD high definition scope in the amount of $34,710.34. Motion carried unanimously. 03/27/2012 Board Meeting Minutes Page 3 of 5

5. Determination that various items of equipment are no longer required for public use by the hospital and authorization to dispose of equipment as surplus property / CFO - Administrator Administrator Parrish advised that there is a list of equipment in the meeting packet of items that are no longer used by the hospital. Board member Hummel asked if there was any salvage value for the equipment. Parrish advised that any salvage value is very nominal. Board member French asked if there is a way to see if another facility can use this equipment. Parrish suggested directing staff to attempt to obtain the highest value, but the chances of a sale are slim. French suggested possibly a smaller hospital may benefit. Parrish advised the equipment can be given to NRHP (Nevada Rural Hospital Partners). Motion by Board member French and second by Board member Cooney to authorize the administration to dispose of the items listed, and to attempt to obtain the highest price possible and/or distribute to NRHP based on the finding that the equipment is no longer part of the standard care and no longer used by the hospital. Motion carried unanimously. 6. 16 th Annual Western Regional Trustee Symposium / Administrator Administrator Parrish pointed out that a flyer had been distributed to the Board for the 16 th Western Regional Trustee Symposium that will be held in Big Sky Montana on June 13-15, 2012. Annual 7. PHYSICIAN RECRUITMENT Administrator Parrish advised that Dr. Kayani visited, the recruiter advised that Kayani declined the opportunity. HGH is looking for a physician for The Walk-In Clinic. Dr. Perkinson is in town and is looking to purchase or build a home and HGH is hoping to hear about his license the first part of April. HOSPITAL BOARD OF TRUSTEE COMMENTS / STAFF REPORTS: Board member Cooney asked about hiring a QA person. Parrish advised that the position is advertised and a recruiter is engaged in actively seeking candidates. Cooney asked where patient should be sent with QA questions. Parrish said they should report to the Administrative Assistant. Board member French commented this is the first meeting since the election filing closed, and suggested that in the interest of having total transparency and concern for maintaining the continuity of service in the community that it is important for the board to recognize that the Kim filing for re-election is a challenge to the recently adopted corporate compliance policy. French said the board has authority to adopt such a policy and now the board is in an uncomfortable position of, one, possibly having to enforce the policy if Kim is elected and, two, having to consider and possibly find a replacement surgeon. French asked administration and legal counsel to review the Kim contract and report to the board at the April meeting and to prepare for the possibility of a replacement for the general surgeon position. French noted it is a difficult thing to ask, but believes the position the hospital is in now requires that the matter be at least considered. Board member Hummel thanked DON Bryan and the nursing staff for working with CTA on the acute wing and expressed hope they will stick with the project as it progresses. Bryan said she appreciates the opportunity to go forward. Board member French agreed, noting there was a lot of energy put into the project. Board chairman Hanzlik thanked Bryan and nursing staff. Board chairman Hanzlik congratulated individuals who filed for election to the board, and said he appreciated them attending the board meetings to observe and learn. Board member Orr thanked IT Director Bell for doing a good job with the meeting camera. 03/27/2012 Board Meeting Minutes Page 4 of 5

PUBLIC COMMENTARY: Steve Lyon with Humboldt Sun introduced himself as the new reporter who will be covering board meetings. Board chairman Hanzlik adjourned the March 27, 2012 meeting of the Humboldt General Hospital District Board of Trustees at 7:23 p.m. Maurice Hanzlik, Chairman Mary Orr, Secretary Mel Hummel, Member Sharleen Cooney, Member Soon Kim, Member Jim French, Humboldt Co. Comm/Member 03/27/2012 Board Meeting Minutes Page 5 of 5