CASCADE VALLEY HOSPITAL AND CLINICS

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SNOHOMISH COUNTY PUBLIC HOSPITAL DISTRICT NO. 3 CASCADE VALLEY HOSPITAL AND CLINICS MONTHLY BOARD OF COMMISSIONERS MEETING 6:00 PM Rainier Conference Room MINUTES Present: Tim Cavanagh, Margo Powell, Tina Davis, Steve Peterson, Clark Jones, Edward Eissmann, MD, Ardis, Schmiege, Richard Bailey, Jola Barnett, Heather Logan, Michelle Sand, Erika Coghill, Michelle Crawford, Ralph Hill, Dr. Gran, Mary Wright Jeff Gay Excused: John Meno Kathy Harris (recorder) CASCADE VALLEY HOSPITAL AND CLINICS The meeting was called to order at 6:01 p.m. Mr. Cavanagh excused Board member John Meno. A. /Approval Tim Cavanagh 1. Special Joint Board Meeting Public Forum April 10, 2013 2. Monthly Board Meeting April 17, 2013 3. Medical Executive Committee Meeting April 17, 2013 4. Joint Board Meeting CVH, City of Arlington, School District April 29, 2013 The motion to approve the above meeting minutes was made, seconded and unanimously approved. B. Presentation of 2012 Audit - Moss Adams C. Hospital Administrative Report 1. CSHA Update Ralph Hill Ralph Hill reported Urgent Care physician Dr. Larry Jones has signed an employment agreement and is scheduled to start in early July. Dr. Spencer is leaving the area. Recruitment continues for one each Family Practice physician, Internal Medicine physician and Urgent Care physician.

Page 2 2. EMR Update Clinics Ralph Hill Next Gen has been implemented in Darrington and Granite Falls. Dr. Schillhammer is already up to his former productivity and Dr. Burk is catching up quickly. The Pediatrics clinic starts training 5/16. Once completed, the training for the Orthopedics clinic will begin. The final phase of implementation will be the tweaking at the Women s clinic. The entire implementation team was congratulated for doing an excellent job. 3. Board of Commissioners Position #1 Opening Clark Jones John Meno has refiled for Position #1 and is currently running unopposed. 4. Update on Affiliation Activities - Clark Jones The Commissioners were reminded to check their emails regularly for emails regarding the affiliation that come almost daily. Oral presentations are scheduled at the Tulalip Resort on 5/21 and 5/22. The request was made for all questions to go to the Board Chairs who would then present. An evaluation tool is being developed. The issue of the University of Washington affiliation with Peace Health a Catholic organization is gaining momentum and has caused some of the CEOs involved some concern. At some point, a public relations firm may be hired to assist with addressing this issue. 5. Upcoming Meeting Reminders Clark Jones Clark reminded the Board that the Quarterly Medical Staff Business Meeting is scheduled for Monday, June 17. The WSHA Rural Hospital Conference is scheduled for June 24 June 26. 6. Amendment to PHD Joint Operating Board Interlocal Agreement - Jola Barnett Resolution No. 445, Approving the Terms of an Amended and Restated Interlocal Agreement and Authorizing and Directing the Superintendent of the District to Enter Into That Agreement and Carry Out Its Terms, was presented and reviewed. The motion was made to approve Resolution No. 445, seconded and Unanimously approved. 7. Patient Care Update Performance Improvement Plans Michelle Sand Michelle presented and reviewed the changes to Policy/Procedure #02-3- 008, Performance Improvement Plan, CVH, and Policy Procedure #43-3-195, Performance Improvement Plan, CVASC.

Page 3 The motion to approve Policy/Procedures #02-3-008 and #43-3-195, was made, seconded and unanimously approved. 8. Community Relations Calendar Heather Logan Heather gave an update of current and future activities including Waffle Week, National EMS Week, Relay for Life, annual Foundation event, 4 th of July Parade, Back Pack Rally and Germ Busters Program. D. Financial Report Ardis Schmiege 1. Review of Financial Statements The April financial statements were distributed and reviewed (attached). \ 2. Surplus Property Ardis reviewed the list of surplus property for April 2013. The motion to approve the list of surplus property for April 2013 as presented was made, seconded and unanimously approved. 3. Miscellaneous Clark Jones Clark reaffirmed the Sleep Center will be closed and stated 6/28 will be the final date the Sleep Center will see patients. E. Legal Matters Richard Bailey 1. Mr. Bailey stated there were no matters to report at this time. F. Medical Staff Committee Report Dr. Eissmann 1. Medical Executive Committee Dr. Eissmann reported the Medical Staff is working on the separation of Medical Staff funds from the hospital which requires a 501C status by the IRS. Application has been made. The request for an additional seat on the MEC to include the ED Director has been approved. A Uro-Gynecologist has expressed some interest in the area and came and toured the facility. Changes have been made to Family Medicine privileges. Thoracentesis and Paracentisis were removed as special procedures and are now listed in the core privileges.

Page 4 2. Credentialing/Privileging Recommendations Initial Staff Appointments John Maxwell, MD Radiology Provisional Courtesy Hospital Reappointments Oscar Briseno, MD Cardiology - Courtesy David Gran, MD OB/GYN - Active Philip Williams, OD Optometry - Affiliate CVA Surgery Center Reappointments David Gran, MD OB/GYN - Active Elevation of Staff Status Change of Status Additional Privilege Requested Resignations William Cimikoski, MD Emergency Medicine - Voluntary Beth Hutchings, ARNP Emergency Medicine - Voluntary Troy Markus, DO Emergency Medicine Voluntary Marco Salazar, MD Urology - Voluntary The motion was made to approve the above credentialing/privileging recommendations, seconded and unanimously approved. 3. Clinic Medical Executive Committee Credentialing/Privileging Recommendations Ralph Hill There were no recommendations to present. G. Other Business 1. Warrants The request was made to approve warrants for April in the amount of $4,091,060.70. A motion was made to approve the above request, seconded and unanimously approved.

Page 5 2. Write-Offs A request was made to approve write-offs for Cascade Valley Hospital for April in the amount of $686,303.09 which includes write-off for bad debt in the amount of $484,503.93 and charity care in the amount of $152,697.66 and to approve write-offs for the Hospitalist Program in the amount of $5,045.43. A request was made to approve write-offs for Cascade Valley Hospital Clinics for April in the amount of $12,279.42. A motion was made to approve the above requests, seconded and unanimously approved. 3. Administrative Expenses There were no expenses to report. G. Adjourn The meeting was adjourned at 7:07 p.m. Steve Peterson, Secretary Kathy Harris, Recorder