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HOSPITAL 5

1995

Early vote consolidation OKd


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By PEGGY McCRACKEN
Staff Writer
PECOS, 1995 - Early voting in the city, school and hospital district
elections would be consolidated at Reeves County Courthouse this year
under an interlocal agreement approved Tuesday by the Reeves County
Hospital board of directors.

Pecos City Council and the Pecos-Barstow-Toyah ISD board of trustees
will consider the proposal in their regular meetings Thursday.

Nadine Smith, hospital administrative assistant, reported that a
committee with representatives from those three entities and Reeves
County drew up the proposal in a Monday afternoon meeting.

County Judge Jimmy Galindo estimated the cost for each entity under the
present system.

Reeves County Hospital District spent $4,613 last year for supplies,
early voting staff, election day staff, central counting equipment and
elections division fee.

The three entities together spent about $17,000. Smith said she believes
consolidation will save $8,600 of that.

"We would add on the administration fee of $2,500," she said. That would
be paid to Reeves County.

Smith said that Virginia Palomino has agreed to administer early voting
and central counting at the courthouse, with Rosemary Chabarria as a
backup in case she gets sick. Both deputys would be given a pay increase
to cover the extra work.

Palomino is chief deputy county clerk, and Chabarria is a deputy in the
office of tax assessor-collector, which handles voter registration.

Although all early voting would be at the courthouse, the city would not
be allowed to hold their election at Reeves County Civic Center with the
other two entities, because it is outside the city limits.

Smith said that no location inside the city limits is large enough for
all three entities. But the hospital district and school district could
consolidate their elections, using only one set of election workers.

Jeannette Alligood said that consolidation would be good for voters,
even if it cost the same amount of money.

"I think there would be a higher turnout," she said.

Smith said that a lot of people who come to the hospital during early
voting say they don't want to go to three different places to cast
ballots.

Alligood made a motion to approve consolidation of early voting with the
city, school district and county. Jesse Prieto seconded, and the vote
was unanimous. Chel Flores was absent.

Should all three entities adopt the proposal, it would be submitted to
the U.S. Department of Justice for approval, Smith said. That takes 60
to 90 days.

The board agreed to work with Lubbock Methodist Hospital to advertise
for applications to fill the position of chief financial officer after
Quorum Health Service's management contract expires Jan. 22.

Terry Andris, who will represent Lubbock Methodist as chief financial
officer, said he feels that a background in hospital finances and in
Texas law is essential for the CFO.

John Lowery, interim CFO for Quorum, said he would apply for the
position and suggested that he continue on a contract basis after Quorum
leaves "to see how things go."

That would give him, the new administrator and hospital personnel a
chance to work together and "see if it is a fit," he said. "If it is not
a fit, nobody is significantly damaged. This is a critical time of the
year, so I would not be averse to staying for a period of time."

Board chairman Raul Garcia said that it would be easier for the audit
that is underway "to flow together. We could get it earlier than we did
last year."

Andy Epps, representing Quorum, said the company would release Lowery
from their standard agreement that no Quorum employee will stay after
their management contract ends.

Andris said that Lowery has done a good job and is highly spoken of.

But, he said, "We look for people with a hospital background because we
are going into managed care. There will be changes in Medicare and
Medicaid. We need someone with a lot of knowledge of the hospital field.

"I recommend the board consider strongly going along with what John
said. The CFO fill be your employee. I suggest you advertise and look
for the best possible CFO you can get, because we are going to need it."

Marcella Lovett echoed Andris' concern that the CFO have a lot of
hospital experience and is versed in Texas law.

"The Quorum contract will be up Jan. 22. I am wondering if Lubbock would
be able to move in with an interim CFO," she said.

Andris said that Quorum has a man with a background in small hospitals
and Texas law who is available to spend three or four days a week in
Pecos.

He said he would work with the hospital administration to begin
advertising the position.

Garcia said he wants applications to come to the board rather than
Lubbock Methodist.

"There's such things as checks and balances," he said.

Interim chief executive officer Harrell Connelly reported that Dr.
Kai-wood Ma is attending obstetrical training in Lubbock and has
delivered three babies.

He said that Dr. Steinbaum has agreed to take over radiology at RCH, but
that he does not have a partner yet to fill in when he is absent.

Epp thanked the board for the opportunity to work with RCH since May 26,
1987.

"It has been interesting," he said. "Trying for folks at times. It's
been fun."

He said that when Reeves County took back hospital operations after
Seventh Day Adventists terminated their management contract, RCH was
left with "a Big Chief tablet and Number 2 pencil for a billing system"
because the Adventists took their computers and records with them.

"You were further down than bankrupt," he said. "It makes me feel good
knowing where you have come. You have $400,000 in the bank. You can pay
your bills. It is tough at times, but you are O.K."

"We appreciate you," Garcia said. "I still have your phone number, and I
may call you. If you hear a Spanish accent, you will know it's me."

Reeves County Hospital District directors will discuss the position of
chief financial officer in their regular meeting at 6 p.m. Tuesday and
will consider creating the countywide position of elections
administrator.

Lubbock Methodist Hospital has contracted to manage RCH and asked that
they be allowed to participate in selection of a chief financial officer.

The board had previously discussed retaining Quorum Health Service's
interim CFO, John Lowery.

Nadine Smith, RCH administrative assistant, has met with county, city
and school officials to discuss creating the position of elections
administrator. Should that occur, the administrator would coordinate
elections for the four entities, scheduling early voting at one central
location.

Smith said that would save the hospital district the expense of holding
early voting at the hospital. Another advantage would be that candidates
would file with the administrator for a place on the ballot in all races.

County Judge Jimmy Galindo has proposed assigning administrator duties
to chief deputy county clerk Virginia Palomino and increasing her salary.

Other agenda items include the medical staff report and administrator's
report.

Lubbock Methodist, physician coming on board


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By PEGGY McCRACKEN
Staff Writer
PECOS, 1995 - Directors for the Reeves County Hospital District on
Tuesday approved a management contract with Lubbock Methodist Hospital,
revised personnel policies to reflect new state laws on confidentiality
and learned a new physician will be on the field in early 1996.

Dr. Kai-wood Ma has already purchased a house in Pecos and will enroll
in obstetrics training in early January, said Harrell Connelly, interim
hospital administrator.

Depending on the length of time required to complete the OB course, Dr.
Ma could open his practice in late January or February.

Connelly said it will be necessary to go ahead and order equipment and
supplies for Dr. Ma's office, which will be located in the Professional
Pharmacy building previously occupied by Dr. Eunice Anderson.

Employees have been advised not to release any information on patients,
Connelly said.

Under the policy amendment adopted by the board, the only information to
be released on patients is to acknowledge they are a patient and to give
a one-word description of their condition.

Should a patient request that no information be provided, the caller
will not be informed whether the person is or is not a patient.

All telephone inquiries from the news media will be directed to the
administration office.

A charge of $30 will be made for up to 10 copies of patient records,
with an added charge of $1 each for 11-60 copies; 50 cents each for
61-400 copies and 25 cents each for more than 400 copies.

Board attorney Scott Johnson said the contract with Lubbock Methodist
Hospital has been changed little since the board first viewed it. He
said he worked with Methodist officials to draw up the contract, and
they should approve it without change.

Jeannette Alligood said that Methodist officials asked for input into
selection of a chief financial officer, and requested that an executive
session to discuss that position be postponed until they could be
present.

However, chairman Raul Garcia said the matter was on the agenda and
asked that everyone but board members leave the room. A short time
later, he summoned everyone back in and announced that no discussion was
held.

"We find we may be out of order in the discussion, so we will wait for
future developments, and will discuss it in the presence of legal staff,
probably at our next meeting," Garcia said.

The board had previously discussed retaining interim finance officer
John Lowery on a permanent basis.

Lowery reported the hospital's finances continue an upward trend. "There
are no radical changes. We are in fairly good shape, considering."

Alligood noted that fewer of the bills totaling $331,634 are in the
31-60 day category, and none are over 60 days old.

Dr. James Cam, chief of the medical staff, said that some physicians are
having a problem obtaining the amount of liability insurance proposed in
bylaw changes. The board accepted his recommendation that they wait on
adopting the proposed cvhanges.

Nadine Smith reported that she met with representatives of other taxing
entities on Dec. 7 to discuss the possiblity of having a joint elections
administrator.

"At this meeting we discussed using a current Reeves County employee and
increasing her salary to cover the duties of all the elections," Smith
said.

Alligood said she hopes the entities can agree to have one polling place.

"It is a lot more convenient for all voters and a savings to taxpayers,"
she said.

"That's overdue," said Garcia. "I have written two letters to the editor
supporting it."

On recommendation of the medical staff, the board reappointed to active
staff and clinical privileges for 1996-97 Dr. W.J. Bang, Dr. James Cam,
Dr. Orville Cerna, Dr. Joseph Darpolor and David Lovett, DDS.

Allied health privileges were approved for Jerry Giardina, CRNA and
Michele Cser, PA-C.

Courtesy staff anc cliniclal privileges were extended to Drs. C.S. Lee,
Philip Zeeck, Patrick Riggs and Gary Elam.

Chief Appraiser Carol King Markham reported that the hospital district's
allocation to the Reeves County Appraisal District is $6,173 for 1996.

Markham also reported that Stella Ornelas' discrimination complaint
against the appraisal district was denied by the Texas Commission on
Human Rights Oct. 9 and the 60-day deadline to file a civil suit has
passed.

"Due process is now over," Markham said.

Reeves County Hospital District directors will consider a management
contract with Lubbock Methodist Hospital Systems in their regular
meeting at 6 p.m. Tuesday in the hospital classroom.

They will also amend personnel policies relating to public and
confidential information, reappoint medical staff and courtesly staff,
amend the medical staff bylaws relating to professional liability
insurance and hold an executive session regarding the position of chief
financial officer.

The meeting is the only one the board has scheduled for November.

Patient revenues up, cash position good


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By PEGGY McCRACKEN
Staff Writer
PECOS, 1995 - Reeves County Hospital is way ahead of last year on
patient revenues and cash on hand, chief financial officer John Lowery
told the board of directors Tuesday.

Lowery said patient revenue is up $357,466 for the quarter ending Oct.
31, compared to the same three months in 1994. And the unrestricted cash
balance was $318,702, an improvement of $306,993 over last year.

Indigent care for the 10 months ending Oct. 31 was $414,871, up from
$379,404 for the same period last year but 3.4 percent below this year's
budget.

Because of changes in staffing patterns, total paid full-time equivalent
employees improved by 9.9 percent from October 1994, Lowery said. Wages
and benefits dropped $14,479 for October over last year. For the
10-month period, wages and benefits were 12.5 percent less than the same
period last year.

At the same time, patient revenues increased $531,164.

Fees and purchased services also dropped, due to the reduction in
contract nurses.

Accounts payable and accrued expenses were down $34,327 from last year,
Lowery said.

For the month of October, net operating loss was $23,566, and for the 10
months $743,839. That is down from $1.1 million last year, due primarily
to reduced labor costs, he said.

In approving bills totaling $371,980, directors' actions reflected
recent controversy in Reeves County Commissioners Court regarding
conflict of interest.

Marcella Lovett made a motion to pay all the bills except for
telecommunication bills.

Jeannette Alligood explained that telecommunications bills would be
separated out so she could abstain from voting because her company has
an interest.

"I don't believe what you are stating is required," said chairman Raul
Garcia. "What you have to do is file an affidavit."

"I have already filed an affidavit with the hospital," Alligood said.

Garcia said he was not aware the affidavit had been filed. "We have
enough people to vote, and there's no reason to separate it out," he
said.

Alligood said she had consulted the district's attorney, Scott Johnson,
and it was his recommendation that the telecommunications bills be
separated out for the vote.

"There's no need to do that," Garcia said. "The only thing here is if
she desires not to vote."

He said he would check out the proper procedure "with out legal eagle,"
but insisted that the vote be on all bills. Alligood abstained.

Terry Andris, former administrator for Permian General Hospital in
Andrews, attended the meeting as acting administrator representing
Lubbock Methodist Hospital.

He asked the board to place the matter of hiring a permanent CFO on the
agenda for the next meeting. "That's one position we need to be sure of;
it is a key position," Andris said.

Lowery is interim CFO for Quorum, but he would be allowed to apply for
the permanent position when their contract expires in January.

Board members received copies of a proposed management contract with
Lubbock Methodist, which they will consider in the next meeting if
Lubbock Methodist approves it.

The two entities have signed a "letter of intent" to enter into the
contract, which would become effective when Quorum's contract ends.

Andris complimented the board for filing suit against Dr. Eunice
Anderson to recover more than $104,000 advanced to her when she opened a
pediatric practice here, then closed it before her contract expired.

Former administrator Carolyn Riley was in 143rd District Court when
District Judge Bob Parks ruled in the hospital's favor and ordered
Anderson to pay the full debt, plus attorney fees.

Dr. James Cam said that two radiologists are interested in establishing
a practice here, purchasing their own equipment for mammography and
offering mobile MRI services to surrounding towns, such as Fort Stockton
and Kermit.

"They are qualified and willing to get some equipment out of their own
funds," Dr. Cam said.

Lowery asked who would own the equipment and how much it would cost the
hospital to house and provide electrical power.

Dr. Cam said the doctors would own the equipment.

"What the board would have to look at is the amount of space required,"
said Garcia. "We have talked about this previously, and it wasn't
favorable at the time. We can take a look at the legality of this.
Before we can O.K. this to come in, we would have to taalk to our plant
engineer and get expenditures."

The board agreed to meet only once in December, setting the date for
Dec. 19.

Riley reported that Harrell Connelly is preparing to assume the duties
of interim administrator on Dec. 4 for Quorum.

"He has been supplied with copies of my monthly reports, miscellaneous
memos, and newspaper articles, board bylaws, medical staff cylaws and
personnel policies and procedures," she said in her written report.
"Additionally we have had several lengthy conversations regarding the
status of the hospital. I anticipate that he will be well prepared."
Reeves County Hospital District directors will consider a management
contract with Lubbock Methodist Hospital in their regular meeting at 6
p.m. today in the hospital classroom.

They will also consider amending the medical staff by-laws with regard
to professional liability insurance, consider meeting dates in December
and hear routine monthly reports.

The board has previously signed a letter of intent to enter into a
management contract with Lubbock Methodist. Attorney Scott Johnson said
he would draw up a proposed contract for the board to consider today.

Board OKs Lubbock Methodist pact


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By PEGGY McCRACKEN
Staff Writer
PECOS, 1995 - It's official.

Reeves County Hospital District directors on Tuesday signed a letter of
intent to enter into a two-year mangement contract with Lubbock
Methodist Hospital Systems that will provide stability to the
floundering tax-supported hospital.

Jim Bone will work with outgoing interim administrator Carolyn Riley
next week to get oriented and act as administrator for about 10 days
after she leaves on Nov. 22.

Quorum Health Services has assigned Harrell Connelly as interim
administrator for the remainder of their contract, which expires in
January. He will begin work Dec. 4.

Bone will work with Quorum to develop a 1996 mangement plan for board
approval in December.

Scott Johnson, attorney for the hospital district, said he has drawn up
a proposed contract, incorporating changes requested by the
administrator and board members.

He had a question about whether the new administrator will be an
employee of the hospital or of Lubbock Methodist, as they requested.

If the administrator is employed by Methodist, he or she could stay on
if the contract is terminated, Johnson said.

Ray Mason, community liaison for Methodist Systems, said they have found
in the past that is a good idea.

They want the administrator to be on their payroll, but the board will
have a choice between several candidates, Mason said.

"Everywhere we have a management agreement, we will bring in several
candidates for you that we have checked out ourselves; let you interview
to see if you feel good and it fits well," he said.

The board will set the salary, he said, but "you get what you pay for."

Johnson said he would have a final draft of the proposed contact today,
and it will be submitted to Methodist Systems for their approval before
it is presented to the board.

Dan Painter was retained as auditor for 1995 records. His fee of $13,500
is up $1,000 from last year because he had to do extra work this summer
on financial records relating to bond issues.

He has audited the books since the district was created in 1989.

Deputy tax assessor-collector Rosemary Chabarria presented a proposal
from Manuel Muro to purchase eight vacant lots across the street from
his home at 324 N. Pecan St. Since other taxing entities have already
approved the sale for $800, the board agreed.

After discussing collection procedures, the board voted to assign 500
past-due accounts to Trans-World Systems Inc. at $7.75 each. If they
fail to collect at least twice that amount, they will return the entire
fee.

In discussing the annual review of by-laws, Jeannette Alligood suggested
waiting until after Lubbock Methodist takes over management.

"I agree we need to look at them and see if things need more attention,"
said board chairman Raul Garcia. "I am personally opposed to messing too
much with by-laws. They hve worked six or seven years and have done
pretty good. But we do need to review them."

At the request of the medical staff, the board approved an amendment to
their bylaws regarding staff privileges for chiropractors.

The change will require chiropractors to become independent allied
health professionals and not members of the staff. They can't vote and
don't have admitting privileges, but can make limited orders of lab and
X-ray for out patients and act as consultants for the medical staff.

Riley reported that Quorum has been reviewing the Medicaid program
reimbursement audit for the period ending 12-31-92, and it appears the
hospital owes $98,907.

The hospital should receive a payback of $25,999 from the audit of the
1993 Medicare cost report, she said.

No major deficiencies were found in a review of hospital operations by
the Texas Hospital Insurance Exchange, Riley said.

However, several recommendations were made, and those will be addressed.

The administration is gathering information for a proposal to provide
medical services for the Reeves County Jail, Riley said. Response is due
Nov. 21.

"It has been a pleasure being associated with you," Riley said, as this
was her last board meeting.

Alligood asked that agenda items requested by a board member in an open
meeting be automatically placed on the next agenda.

"The chair is resonsible for the agenda," said Garcia. "I think this
should be discussed prior to...the agenda is signed by the chair. I have
no problem with putting anything on the agenda. But there should be no
surprises. It should be looked over and possiblly call our legal
counsel. No board member can put it on, bypassing the chair."

Alligood said that when the item is requested in open board meetings, it
wouuldn't be a surprise to the chair.

"Everybody would be aware of it and Nadine (Smith) would just put it on
the agenda. There are no surprises," she said.

"My concern is that the agenda is signed by the board chairman," Garcia
said. "He assumes resonsibility for what's on there. If he needs advice
from legal counsel - he can be sure it it is legal."

"We have requested agenda items before that are still not put on there,"
Alligood said.

Marcella Lovett said that all board members are equal and should be able
to put items on the agenda.

"O.K. No problem," said Garcia, adjourning the meeting.

Reeves County Hospital District directors will consider a "letter of
intent" and a management contract with Lubbock Methodist Hospital in
their regular meeting at 6 p.m. today.

Lubbock Methodist has offered to affiliate with RCH, providing an
administrator, training and educational services. The board agreed to
sign a letter of intent and to work out contract details.

In other business, the board will consider the sale of eight empty lots
in North Pecos that were taken in a tax sale; discuss an interim
administrator, hospital by-laws, a collection contract with TransWorld
Systems and amendment to the medical staff bylaws regarding
chiropractors.

The board meets in the hospital classroom, and the public is welcome.

Board reaffirms policies


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By PEGGY McCRACKEN
Staff Writer
PECOS, 1995 - Communication is important to the smooth operation of
Reeves County Hospital, and board members feel they made progress toward
better communication in a self-evaluation session Monday.

Following the closed meeting, board chairman Raul Garcia issued the
following statement:

"The board agrees to re-affirm and support any and all written policies
as they pertain to by-laws and personnel policies and procedures."

Garcia said he doesn't believe board members have overstepped their
bounds in dealing with the administration and employees.

"However, it is never wrong to re-evaluate things. It is always good to
take a look at things and take a stitch wherever it is needed," he said.

The by-laws call for an annual board evaluation, but this is only the
second since the district was formed, Garcia said.

Jesse Prieto, vice-chairman, said he believes the board will have better
communication in the future, and "things are going to strt looking
positive.

"I feel like we all need to work as a team and not be hiding information
from one another," he said. "What needs to be said needs to be shared
with all members of the board so we can work together for the community.

"The people elected us to work for them and the hospital, and if we
don't do this, it is all going to wind up in the trash can. We all
really need to work together," he said.

Administrator Carolyn Riley said the board's action is a positive step.

"It is great that the board did their self evaluation," she said. "I
think it shows a great understanding by the board of their role as board
members."

Pressed for specific violations of board policy, Riley said she has seen
some situations where some board members have overstepped their bounds
"as far as my understanding of what their role is. Evidently the board
discussed it and they agree," she said.

Jeannette Alligood said she is not aware of any violation on her part.

"I try very hard not to. We have a very competent administrator and the
board is to work through the administration," she said.

"We have written policies and procedures, by-laws and our enabling
legislation that let us know what our duties and responsibilities are -
and those of the administrator.

"It just causes confusion and uncertainty among employees and the public
if we don't operate within those parameters. It is the duty of all board
members to stay within those parameters," she said.

Alligood said that a lot of concerns have been brought up indicating
some board members may not be staying within those parameters.

"That's why we evaluate ourselves annually, according to our by-laws, in
executive session, for the board to evaluate their own actions and
effectiveness."

Marcella Lovett said the board has not had a self-evaluation since
Garcia became chairman. He is in his second term.

"One of the areas here was communication," she said. "We re-enforced
that we need to read our by-laws and abide by them and stick to policy
and procedure where employees are concerned."

She said that some board members have over-ridden the process when
certain employees went to them directly instead of handling personnel
matters with the administrator.

"Instead of saying `we are not involved in this,' they have taken an
active role in it," Lovett said.

"Certain board members have not understood the by-laws and policies and
procedures in the past, and this will, hopefully, send a message to the
community that we will all abide by the rules and regulations," she said.

"We are trying to work together, and we hope this will be a good start;
especially with the new management team coming in."

Lovett said she has requested a re-evaluation in 30 days to see if the
board is improving.

Elizer "Chel" Florez was unable to attend the 1 p.m. meeting in the
hospital classroom.

Directors for the Reeves County Hospital District will meet in executive
session Monday to evaluate their own performance.

Chairman Raul Garcia posted the notice for a 1 p.m. meeting in the
hospital classroom.

Under the Texas Government Code, Sec. 551.074, a public entity may hold
a closed meeting to deliberate the appointment, evaluation,
reassignment, duties, discipline or dismissal of a public officer or
employee; or to hear a complaint or charge against an officer or
employee.

The executive session is the only agenda item.

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Copyright 1996 Pecos Enterprise
324 S. Cedar, Box 2057, Pecos TX 79772
Phone 915-445-5475, FAX 915-445-4321
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