MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT MEETING MINUTES BOARD MEETING April 29, 2015 DISTRICT BOARD MEMBERS

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MOUNTAIN COMMUNITIES HEALTHCARE DISTRICT MEETING MINUTES BOARD MEETING Trinity County Library Weaverville CA DISTRICT BOARD MEMBERS GERALD BRASUELL DERO FORSLUND JERRY H. COUSINS LYNN JUNGWIRTH FRANCIS MOORE Vice-President Clerk President Treasurer Member Note: These minutes contain a description for each item to be considered. Supporting documentation is available in the public packet at the Board meeting or at the Administrative Office at Trinity Hospital. District Board Members Present: Gerald Brasuell, Vice-President Jeny H. Cousins, President Dero Forslmid, Clerk Lymi Jungwirth, Treasurer Francis Moore District Board Members Absent: None Staff Present: Aaron Rogers, CEO Jeamie Silvers, Executive Assistant JudyNordlund, RN, CNO Jennifer Van Matre, Director of Finance Victoria Williams, Director of Ancillary Services Kevin Livengood, PhannD Kelly Simpson, Manager of Business Services Donald Krouse, MD, Vice Chief of Staff 6:00 PM CALLS MEETING TO ORDER IN OPEN SESSION Call to order Report from Closed Session on March 25. 2015 The Board came out of Closed Session at 8:09 pm and immediately reconvened m Open Session. President Cousins reported that the Board reviewed the recommended actions on Medical Staff Privileges. For each applicant the following information has been reviewed and/or verified:

April 29,2015 Privilege List, NPDB Report, and AMA Profile, peer references and verifications of staff privileges at other facility. Items verified were Liability Insurance Coverage, Licenses, Certifications, and the Medicare exclusion list was checked. On motion of Director Moore seconded by Director Brasuell approves the following appointments/reappoinbnents from the Medical Staff: Appointments/Reappointments: Tal Delman, MD Young Song, MD Amir Fassihi, MD James Sloves, MD Bruce Reiner, MD Christine Lamoureux, MD Stanley Nyarko, MD Shwan Kim, MD Leonard Poirier, MD Ast! Pilika, MD John Rule, MD Jonathan Jewkes, MD Paul DePaulo, MD Lloyd Pena, MD Maui'een Breese, FNP Patrick Shipsey, MD Donald Krouse, MD Appointment/Provisional Reappointmenf/C onsulting Reappomtment/Consultmg Reappointment/Consultmg Reappointment/Consultmg Reappointment/Consultmg Reappointment/Consultm^ Appointment/Provi sional Reappoinlment/C onsulting Reappointment/C onsulting Reapp o intment/professional Reapp ointment/active Reapp ointment/active Telemdiology Radiology Emergency Medicine Emergency Medicine Family Medicine Family Practice Family Practice The motion passed with the following voice vote: Ayes: Dero Forshmd; Gerald Brasuell; Jerry Cousins; Francis Moore Noes: None Absent: Lynn Jungwirth Abstain: None President Cousins reported that the Board thoroughly reviewed the quality data presented and staff was directed to report on the progress complying with the issues that were discussed. President Cousins reported that goals, objectives and performance outcomes for the Chief Executive Officer were reviewed and discussed. Public Input - None Reports Medical Staff Report Received written report from Daniel Harwood, MD, Chief of Staff/Donald Krouse, MD, and Vice Chief of Staff regarding activities of the Trinity Hospital Medical Staff. 2

April 29,2015 Chief Executive Officer Received written report from Aaron Rogers, CEO on the current operations of the hospital. Other items discussed in addition to the written report were: Patrick Shipsey has resigned as the medical director of the Trinity Community Health Clinic as soon as we find a replacement and he is willing to assist with the transition. Facilities must be consistent with their message regarding hiring of physicians by hospitals There have been no problems with the medication drop off to the Hayfork Community Health Clinic from Owens Pharmacy. Chief Financial Officer Received written report from Jon Marshall, CFO and Jennifer Van Matre, Director of Finance, on the current financial status and current status of revenue cycle management and accounts receivable. Other items discussed in addition to the written report were: Gerald Brasuell reported that the Finance Committee is pleased that the accounts receivable is down to 50 days. There was a good discussion regarding the 2015 budget and timelines were set. Meeting scheduled to discuss the 2015 Budget on May 11, 2015. Chief Nursing Officer Received written report from Judy Nordlund, RN, Chief Nursing Officer on the current status of the nursing departments. Other items discussed in addition to the written report were: There have been a lot of new hires for the nursing department. County wide disaster drill will be June 20, 2015 The Mountain Communities Healthcare Foundation received a grant to paint the Home Health building. Quality Improvement Received written report from Sarah Cordtz, RiST, Coordinator, Q/RM on the current status of the Quality Program Consent Agenda All matters listed under the Consent Agenda, are considered by the Board to be routine, and will be enacted by one motion in the form listed below. There will be no separate discussion of these items unless a request for discussion is made prior to the time the Board votes on the motion to approve. h Minutes from March 25, 2015 b. Policy Policy Guidclinca e-. Policy Patient Safety Plan 4-. Policy Risk Management Plan 2015 -. Policy Quality Improvement Plan 2015 Procedure Aerosol Medication Nebulization with HHN ^ Procedure Incident Reports, Patient, Resident & Visitor 2015

Discussion Items a. Status ofdri Grant Projects and Funds IT project is complete and awaiting final inspection from OSPHD. The application for a building permit has been submitted for the 16 bed addition. A timelme should be received in early May from Gifford Construction. b. Parcel Tax Finance Committee will be conducting an analysis on the need and amount of a tax assessment. The recommendation will be submitted to the Board in June. c. WEMBO - Bike Race Sponsorship (Role of District) The World Endurance Mountain Bike Organization will be holding their World Solo 24 Hour Mountain Bike Race here in Weaverville on October 3-4, 2015. The MCHD Board, Aaron Rogers and Hem'y Edelstein, MD will be involved in discussion regarding how the District would be able to promote our presence in this activity and be prepared for any medical coverage that may be required during this event. Action Items EL. Items removed from the Consent Agenda a. Minutes from March 25, 2015 On Motion of Director Forslund seconded by Director Moore approves the minutes from March 25, 2015 with the following deletions/changes: Delete: Staff Present: Stan Oppegard, CEO (by Phone) Jeamie Silvers, Executive Assistant Judy Nordlund, RN, CNO Change: Page 4 - Trinity Cares group met with the Jerry Cousins and Aaron Rogers. The Trinity Cares Group requested that the -Finance Committee-MCHD Board of Directors review the status of the parcel tax and make a recommendation whether to move forward with the campaign for the election November 2016 Page 5 On Motion of Director Brasuell seconded by Director Forslund approves Resolution #5: Approve Authorized Signatures for Securing HELP II Loan with corrections. The motion passed with the following voice vote: 4

Ayes: Dero Forslund; Gerald Brasuell; Jeny Cousins; Lynn Jungwirth; Francis Moore Noes: None Absent: None Abstain: None All other items on the "Consent Agenda" items were deferred until the next meeting. Board Reports a. Board Member Reports Director Cousins reported that he and Aaron Rogers met with the Weaverville Lions club and that MCHD Board meetings will be scheduled for the outlying areas over the next few months. Close Public Session Closed Session The Board entered into closed session at 7:33 pm on the following: MEDICAL STAFF PRIVILEGES Government Code Section 54962; Health and Safety Code Section 1461 LABOR NEGOTIATIONS Government Code Section 54957.6 Designated Representative: Mark Vegh/Aaron Rogers Employee Organization: Professional Group The Board came out of Closed Session at 8:00 pm and immediately reconvened in Open Session. President Cousins reported that the Board reviewed the recommended actions on Medical Staff Privileges. For each applicant the following information has been reviewed and/or verified: Privilege List, NPDB Report, and AMA Profile, peer references and verifications of staff privileges at other facility. Items verified were Liability Insurance Coverage, Licenses, Certifications, and the Medicare exclusion list was checked. On motion of Director Forslund seconded by Director Moore approves the following appointments/reappointments from the Medical Staff: Appointments/Reappointments: Sam Thibodeaux, CRNA Reappointment/Professional Anesthesia Michael Novak, PA Reappointment/Professional Family Practice Alison Robinette, MD Appointment/Provisional 5

James Dunn, MD Reappointment/Consultmg Radiology Nelson Madrilejo, MD Reappointment/Consultmg Telemedicine - Endocrinology Olga Segal, MD Telemedicine - Psychiatry Asela Jumao-as, MD Reappointment/Consultmg Telemedicine " Neui'ology The motion passed with the following voice vote: Ayes: Dero Forslund; Gerald Brasuell; Jerry Cousins; Lynn Jungwirth; Francis Moore Noes: None Absent: None Abstain: None President Cousins reported that the Board reviewed issues regarding labor negotiations and there was no action taken. Adioum: There being no further business, the meeting was adjourned at 8:05 p.m.»^>porslun4^^ri<;^^ Board Mountain Communities/Healthcare District