The mission of the Redwood Coast Medical Services is to provide high quality, family-oriented, community based primary care, including a broad range of preventive health services, to residents and visitors within the coastal areas of Southern Mendocino and Northern Sonoma Counties. Services are designed to meet identified needs of the communities served, are integrated with other existing health care services and systems and are evaluated on a regular basis to assure that community health needs are being met. As a non-profit corporation receiving public funds, RCMS provides services to qualifying individuals on a sliding fee scale as well as to patients with MediCal and MediCare coverage, private insurance or self pay status. RCMS plays a special role as the sole provider of medical care in the community and in responding to public health emergencies. REDWOOD COAST MEDICAL SERVICES, INC BOARD OF DIRECTORS MEETING AGENDA Zoom Online Meeting Wednesday, May 27 th , 2020 5:00 PM – 7:00 PM Order of Business Business Item Person Vote Required Page # 5:00 pm Review and Approve Agenda Vanessa Ignacio Vote Page 1 5:01 pm Vote on acceptance for the Minutes of April 29 th , 2020 Vanessa Ignacio Vote Page 2-4 5:02 pm FINANCE COMMITTEE REPORT • Approve April Financials • Update on draft 20-21 Budget Angela Robinson Alex Long Ara Chakrabarti Vote Page 5-23 5:17 pm CEO REPORT • Staffing and recruitment Update • Update on COVID-19 stimulus funding Ara Chakrabarti Page 24-27 5:32 pm MEDICAL TEAM REPORT • Update on clinic operations Leon Koenck 5:52 pm HUMAN RESOURCES REPORT • Approve Telecommute/Remote Work policy Arlene Peterson Vote Page 28-34 5:55 pm PERFORMANCE IMPROVEMENT COMMITTEE REPORT • Initial review of Claims Management policy • PJ LoDuca is the newly appointed QI director Donna Yates-Johnson Page 35-37 6:05 pm EXECUTIVE COMMITTEE REPORT • Vote to appoint Gabriel Ramirez as Vice-Chair until annual election • Vote to appoint new committee members: Jim Nybakken, Naomi Schwartz, and Susan Sandoval • Vote to approve corrections to the RCMS Bylaws section 4.2 line 4, and section 5.4.2 to 5.2.7 • Report on closed session of May 17, 2020 • Vote on changing officer elections to August for the 20-21 term • Discussion on officer nominations for 20-21: o Rich Hughes, Board Chair o Leslie Bates, Vice-Chair o Drew McCalley, Treasurer o Janis Dolphin & Barbara Fast, Secretary Vanessa Ignacio Votes Page 38 6:45 pm PUBLIC COMMENT 7:00 pm Adjourn Vanessa Ignacio RCMS Board of Directors Meeting May 27, 2020 Page 1
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REDWOOD COAST MEDICAL SERVICES, INC BOARD OF … · • Vote to appoint new committee members: Jim Nybakken, Naomi Schwartz, and Susan Sandoval • Vote to approve corrections to
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The mission of the Redwood Coast Medical Services is to provide high quality, family-oriented, community based primary care, including a broad range of preventive health services, to residents and visitors within the coastal areas of Southern Mendocino and Northern Sonoma Counties. Services are designed to meet identified needs of the communities served, are integrated with other existing health care services and systems and are evaluated on a regular basis to assure that community health needs are being met. As a non-profit corporation receiving public funds, RCMS provides services to qualifying individuals on a sliding fee scale as well as to patients with MediCal and MediCare coverage, private insurance or self pay status. RCMS plays a special role as the sole provider of medical care in the community and in responding to public health emergencies.
REDWOOD COAST MEDICAL SERVICES, INC BOARD OF DIRECTORS
6:05 pm EXECUTIVE COMMITTEE REPORT • Vote to appoint Gabriel Ramirez as Vice-Chair until annual election
• Vote to appoint new committee members: Jim Nybakken, Naomi Schwartz, and Susan Sandoval
• Vote to approve corrections to the RCMS Bylaws section 4.2 line 4, and section 5.4.2 to 5.2.7
• Report on closed session of May 17, 2020
• Vote on changing officer elections to August for the 20-21 term
• Discussion on officer nominations for 20-21: o Rich Hughes, Board Chair o Leslie Bates, Vice-Chair o Drew McCalley, Treasurer o Janis Dolphin & Barbara Fast, Secretary
Vanessa Ignacio Votes Page 38
6:45 pm PUBLIC COMMENT
7:00 pm Adjourn Vanessa Ignacio
RCMS Board of Directors Meeting
May 27, 2020 Page 1
Redwood Coast Medical Services, Inc.
Board of Directors Meeting – Zoom Online Meeting Meeting Minutes of April 29, 2020
Guests Attending: Geoffrey Beaty, Kristen Winant, Francoise Bray, Jean Ohman, Beverly Jones, Trish Miller,
Sharon Burningham, James Nybakken, Caroline Ducato, Andrea Lunsford, David Robertson, Terry Pfardresher, Lu
Smith, Jennifer Smallwood, Martha Campbell, Debora Ages, Mary Alinder, Colette Coad, Donna S, Julie Bower,
Naomi Schwartz, David Kieffer, George Provencher, Rich Hughes, Barbara Canida, Leslie Bates, Janis Dolphin, Drew
McCalley, Dave Turner
CALL TO ORDER: Vanessa Ignacio called the meeting to order at 5:00 pm. Brief housekeeping for zoom meeting format.
APPROVAL OF AGENDA: The packet of documents for the meeting had previously been made available to the Board by e-mail and to the public on the web page. The published Agenda was approved with the addition of Drew McCalley as a prospective returning board member. After review and modification, Nik Epanchin moved to accept the agenda, Donna Yates-Johnson seconded. Vote: all ayes. APPROVAL OF MINUTES: After review and modifications, Donna Yates-Johnson moved to accept the
minutes of January 14, 2020 and February 11, 2020. Don Kemp seconded. Vote: all ayes.
EXECUTIVE COMMITTEE: Vanessa presented
• Future meetings will be held on the fourth Wednesday of the month from 5-7 PM. The meetings will be held on Zoom until further notice.
• Motion to approve the appointment of: Janis Dolphin, Barbara Canida, David Keiffer, Rich Hughes, Leslie Bates, George Provencher, and Drew McCalley
Donna Yates-Johnson moved to approve the appointment of all 7 applicants to the RCMS Board of Directors. Nik Epanchin seconded. Vote: all ayes.
• Motion to approve the Paycheck Protection Program loan for $1 million
Donna Yates-Johnson moved to approve proceeding with the application for the Paycheck Protection Program, Nik Epanchin seconded. Vote: all ayes
CEO REPORT: Ara Chakrabarti, CEO The CEO reported that Dr. Mark Kal, CMO, is on extended leave. His patients have been notified in
person or will be by letter or when they call for an appointment. During his absence, a CMO Team has
BOARD MEMBER P A/E BOARD MEMBER P A/E STAFF PRESENT
Alex Long X Gabriel Ramirez X Arlene Peterson Leon Koenck
Nik Epanchin X Rich Schimbor X Renee Kaucnik Jessie Ewing
Barbara Fast X Donna Yates-Johnson X Tom Bertolli
Sophia Mitchell X Mark Kal
Vanessa Ignacio X Dawn McQuarrie
Don Kemp X Ara Chakrabarti
Carolyn Abst X Angela Robinson
Karen Wilder
RCMS Board of Directors Meeting
May 27, 2020 Page 2
been identified which includes, Dr. Tom Bertolli and PAs Leon Koenck, Harold Ewing and Barb Brittel. Dr.
Bertolli is working on lab and other “system” issues as well as telehealth. Jesse Ewing is focusing on
schedules and appointments, and Barb and Leon are managing Urgent Care and RCMS’ response to the
Corona Virus pandemic. The entire staff meets daily for a “huddle” to plan the day. Shaye Laurie, NP;
Jessi Maness, LCSW; and a new phlebotomist have all been hired.
Covid-19 Preparations: Presently all patients are being triaged by phone and in person to determine
where or how they should be seen. Urgent Care and Respiratory patients are seen at the Gualala clinic
building. All exam rooms have new ventilation and preparations have been made for a possible surge in
cases in May or June. RCMS is coordinating with CLSD, the Fire Department and the Mendocino County
Public Health Department. RCMS has access to two federal disaster trailers. Only dental emergencies
are being seen at this time. RCMS was designated as one of only two places in the county for testing of
high risk individuals. Providers and the Urgent Care staff were tested in addition to first responders, fire
fighters, grocery clerks, nursing home and some homeless persons. Results should be available soon.
Any positive cases will result in contact tracing.
Primary Care has been significantly impacted by the pandemic. The number of visits has been reduced
by 90% which has greatly reduced the revenue created. To reduce the estimated loss of $150K per
month, costs have been reduced and some staff have been furloughed or had their salary and hours-
worked reduced. Facilities are available to see primary care patients in a safe environment, separate
from Urgent Care. Providers are available to see patients at the Sea Watch building in Gualala and at
the Point Arena Medical Clinic. Telehealth is also being utilized. Telephone conferences are being held
and paid for. Presently Medicare requires that for payment computerized telemedicine also must be
used. Efforts are underway to encourage visits by both modalities and an ad campaign is currently being
used to encourage patients to receive needed primary care.
Ara reported that all possible grant applications have been submitted. RCMS received $660K in federal
funds that can only be used for CV-19 services. An Economic Injury Disaster Loan for $10K, and a
Medicare loan for $50K have been requested. In addition, a Paycheck Protection Program (PPP) loan
from the Small Business Administration for $500K has been requested. Some of these loans may be
“forgiven”; some may need to be paid back over a long period of time with low interest rates. As a result
of all of the grant funds along with the generous donations from the community, the multi month net
“cash flow” for RCMS at the end of March is $270K and it is expected that the cash flow will still be
positive at the end of the fiscal year in June. Ara said that the RCMS Team is doing a great job and he
thanked the community for tremendous support. He especially thanked the Forum Four, Peggy Berryhill
and KGUA and Caroline Ducato for their input and support.
FINANCE COMMITTEE REPORT: Alex Long, Treasurer Alex Long, Treasurer, provided a detailed financial report for January, February and March. He pointed out that the $618K Riopelle Fund and the $660K federal funds have not yet been used. Key points of the report included: 1) Revenue significantly reduced by effect of the pandemic but offset by the amount of donations by the community 2) The result of which was an available cash balance of $371K. On behalf of the Finance Committee, Alex Long made the recommendation for the board to accept the January, February and March 2020 financials as presented. Vote: All ayes.
RCMS Board of Directors Meeting
May 27, 2020 Page 3
MEDICAL TEAM REPORT: Leon Koenck, PA Personal Protective Equipment (PPE) is being used and recycled carefully. Test kits for CV-19 are still in limited supply. Dr. Bertolli praised the PAs for their work. He said that work needs to be done to make all systems work efficiently. He especially thanked Karen Wilder and Sophia Mitchell for their efforts to upgrade the web page.
OUTREACH COMMITTEE REPORT: Dawn McQuarrie, Development and Outreach Director There are two new grants to consider. CADRE, Capital Assistance for Disaster Response and Recovery Efforts, a HRSA grant, would include funds for disaster supplies, and the Telehealth Network Grant Program (TNGP) could provide funds to improve patient access by telehealth. It was moved by Donna Yates-Johnson and seconded by Nik Epanchin, that the Board authorize application for the grants. Vote: all aye. Surveys regarding Patient Centered Medical Health (PCMH) will be sent out. Be Our Guest resulted in $40K net funds and there is an ad campaign underway for Giving Tuesday on May 5. Janis Dolphin asked if it is being made easier for supporters to make monthly donation by credit card. Ara reported that he is working on that.
PERFORMANCE IMPROVEMENT COMMITTEE REPORT: Donna Yates-Johnson, PIC Committee Chair The annual Risk Management Report was received by the Board in January.
On behalf of the Performance Improvement Committee Donna Yates-Johnson made the recommendation for the board to approve the Management of Newborns policy as presented. Vote: All ayes.
A renewal application for Patient Centered Medical Home designation is underway but struggling with the difficulty of extracting data from Next Gen and i2i. Donna thanked many people who have provided food for the staff during the pandemic.
CLOSING REMARKS: Vanessa Ignacio reported the budget process for 2020-2021 is underway and needs to be finalized by June. Election of Officers also occurs in June. Further discussion about this will be on the agenda for the May meeting.
PUBLIC COMMENT: An opportunity was provided for the 56 participants in the meeting to ask questions. Paula Smith asked
about a possible newsletter. It was reported that an e-mail campaign is underway. RCMS has access to
1,200 e-mail addresses to which news and requests for donations can be made. A question was asked
about security after hours particularly for tents that have been erected on RCMS grounds. Ara reported
that all tents are empty at night. One complicated question will be answered by phone by Vanessa.
Several members provided testimonials on the excellent care they have received at RCMS and they
encouraged everyone to let the community know that RCMS is open for primary care.
Vanessa thanked Don Kemp for facilitating the Zoom meeting.
Adjournment: The meeting adjourned at 7:00 pm. The next meeting will be held on Wednesday, May
27, 2020, 5:00-7:00 pm, again by zoom.
Barbara Fast, for Rich Schimbor Board Secretary, RCMS Board of Directors
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May 27, 2020 Page 4
RCMS
Finance Committee (FINCOM) May 22, 2020: 1:00 – 3:00pm
Agenda
1. 1:00pm -- Call to order
2. 1:00pm -- Review and approval of agenda
3. 1:00pm -- Review and approval of minutes of 04/24/2020
4. 1:10pm – Review of Cash Flow Projections for Apr – Alex/Ara
5. 1:20pm -- Review of April financials – Angela
• Narrative discussion
• Details by Department
• BOD Summary
6. 1:45pm – Discussion of COVID Stimulus Use – Ara
• Monies received
• Plan for determining how to use these funds
7. 2:00pm – Discussion of 2020/2021 Budgeting Plan – Ara, Angela
• Initial cut
• How to deal with current uncertainties
• Discussion of areas needing additional research, goals, metrics, and incentives
RCMS Board of Directors Meeting
May 27, 2020 Page 5
Finance Committee (FINCOM)
Meeting Minutes
April 24th, 2020
Present: Alex Long, Don Kemp, Geoff Beaty, Rich Schimbor, and Nik Epanchin, Michael Tilles
Staff: Ara Chakrabarti, CEO, Angela Robinson, WIPFLI (contracted CFO)
BOD: Vanessa Ignacio, Carolynn Abst
Guests: Rich Hughes, Leslie Bates, George Provencher, Janis Dolphin, David Kieffer, Julie
Bowers
• Meeting called to order at 1:00pm by Alex Long
• The suggested agenda was reviewed and amended to include: discussion of the
planned budgeting schedule. It was: APPROVED
Minutes of the March 23rd meeting were reviewed and approved without change
Status Update by Ara Chakrabarti (highlights of his presentation are attached)
• At the start of the COVID-19 crisis the patient visits dropped by 80-90%
• To deal with revenue loss the clinic focused on three things:
o Reducing costs (dental cut back to two half-days for emergency visits)
o Increase clinic visits by tele-health and to buildings away from COVID screening
o Seek extra government funding (have received $667k from HRSA)
• In response to questions Ara indicated that Mar/Apr COVID-19 related costs could be
paid for from the relief grants.
• We may or may not get any of the payroll relief funds for small businesses
• PPE costs have risen dramatically but we seem to be able to get what we need.
• Mendocino surge is projected to occur in June so clinic may need to remain in
emergency mode through July.
• The staff is stressed but they have gone out of the way to help each other
RCMS Board of Directors Meeting
May 27, 2020 Page 6
Review of the Cash Flow Projections for March, 2020
• A brief reinforcement by Alex of what Ara said in his presentation.
Financial Review for February presented by Angela Robinson
• The ratios were generally improved for Mar relative to Feb.
• Angela explained our payments to MediCal and others for paying down our near term
debt (MediCal will allow us to delay payments for May and Jun)
The recommendation to the Board that they accept the March 2020 Financial Statements
as presented was approved by the FC. Vote: All Yes
Budgeting Schedule for 2020/2021 was discussed again
• The UC budget will be sent to CLSD in May. It will need to be reviewed by RCMS BOD
before being finalized.
• The key budgeting paraments will be discussed with FC at the May meeting.
• Ara is proposing that we adopt a budget realizing the uncertainty caused by the COVID-
19 crisis. He suggests that each month we then have an additional set of columns in
which the revised estimate for future months is updated.
• The focus will continue to be on maintaining cash flow viability.
• Rich suggested that the budget consider incentive provisions
Next FC meeting will be held May 22, 2020 from 1:00 to 3:00
Adjourn: The Finance Committee Meeting adjourned with an outside interruption at 2:15
RCMS Board of Directors Meeting
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REDWOOD COAST MEDICAL SERVICES. INC. APRIL 2020 FINANCIAL NARRATIVE Below is a summarization of key trends, ratios and analyses based on the April 2020 finance data detailed in the Statement of Financial Position, Statement of Activities, and information from the summary site reports. Financial overview Cash position - The cash and investments position as of April was $2,033,067 and the prior month’s ending balance was $984,651. For a monthly comparison, the April balance increased $1,048,416 or 106.5% against the prior month’s ending balance. The current month of April, compared with April of the prior year, represents an increase of $807,227 resulting from PPP loan and Cares funds received in April, which are shown as a loan and deferred revenue. The projected plan showed a cash position of $847,000 at April 30, 2020. Patient service revenue - The patient service revenue for April was $145,779 and in March it was $111,284. A variance against the budget due to lower-than-budgeted productivity/visits, with all payor types being under budget, compounded by the COVID-19 pandemic. The projected plan showed $125,000 for April, actual exceeded the plan by $25,000. Stimulus/Grants funds - Grant and other revenue for April was $317,809, Partnership 2019 QIP revenue was adjusted to the actual payments received in April. Additionally, in April the unbudgeted Federal Covid-19, Cares and the SBA Stimulus grant revenue was recognized. The projected plan was $850,000 which included $625,000 for Cares funds that is in deferred revenue and will be recognized as revenue when earned based on the budget. Excluding that the actual exceeded the plan. Fundraising - The Fundraising and Capital net activity for April was ($15,128). the negative Fundraising Income is due to the correction of a deposit that had been erroneously counted twice in a prior period. YTD Fundraising and Capital revenue exceeds the budget by $711,041. The projected plan was $20,000. Employment expenses - Total compensation was less than the budget by $140,373 for the month of April. The projected plan showed $392,000 the actual was $406,000, wages and contracted were over the plan by $14,000. All other expenses- Total facility and other expenses for April are $176,471, the projected plan for these expenses was $151,000, the actual exceeded by $25,00 associated with expenses for Covid19. The current month deficit was ($134,987) with a year-to-date shortfall of ($574,456).
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Summary of Key Ratios
Current Ratios 1.25 – Benchmark greater than 1 – decreased slightly from the prior month, which was 1.64.
Available cash on Hand $1,393,606 (as of 4/30/2020) Days unrestricted/restricted cash 95.86 – last month was 45.88 days, an increase of
49.98 days, Benchmark is greater than 35 days, above the benchmark.
Days AP Outstanding 15.26 days – last month was 9.46 days, an increase of
5.8 days, safe to maintain a benchmark of 20-25 days. Days in Net AR outstanding 39.41 days – last month was 40.55 days, a decrease of
1.14 days. Demonstrates money was collected on average in 39 days in April. Improvement against the prior month.
Debt to Equity Skewed due to the deferred revenue and PPP loan,
without those the ratio is 53%, including the deferred revenue and loan ratio is at 100.15%.
Visit Summary
Actual Budget
Current month visits 1,233 2,413 Current year-to-date visits 15,797 21,726 Prior April, 2019 visits 1,748 Prior 2019 year to date visits 16,665 Visits by Site year-to-date: Gualala – Medical 7,100 10,472 Pt Arena – Medical 2,434 3,630 Urgent Care 3,445 3,590 Urgent Care – Weekend 456 634 Behavioral Health 61 170 Dental 2,301 3,230 For the month of April, the visits at Gualala medical represented 44.9% while Urgent care (includes weekend) was 24.7%; Dental was 14.6%; Pt Arena was 15.4% and Behavioral Health was .4% of the total visits. A projection for visits was not prepared. Payor Mix: Medi-Cal – 29% Medicare – 37% Private Ins. – 24% Self-Pay/Other – 10%
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Ratios: Costs per visit for April $413.72 – last month it was $414.76, the budgeted
goal for April was $313.80. The cost/visit decreased $1.04 against last month.
Net Revenue per visit for April $322.85 – last month it was $272.11, based on total
revenue; increase resulting from incline in grant revenue.
Patient service revenue per visit: $156.65 – last month was $87.14 a $69.51 increase
% of HRSA grants to total revenue 45.9% – last month this ratio was 43.0%
% of salary & fringe to total expenses 68.1% – last month this was 74.3%, decrease against the prior month.
Functional expense analysis- based on YTD Medical 52.8%
Urgent Care 29.8% Behavioral Health .1% Dental 10.8% Hospice 3.1% MHA Plan Dev/Admin 3.4% Net This is based on the summary by site report, which shows that 52.8% of YTD expenses are incurred by the Medical Departments of RCMS. Billing Data: The aging of billing claims as of April 2020 is as follows 0-30 days $244,702 31-60 days $ 65,368 61-90 days $ 58,945 91-120 days $ 72,209 Over 121 days $157,699 Total $598,923 The activity over 120 days represents 26.3% of the total outstanding AR, the ratio increased from last month. The payor type with the largest balance in the aging of the AR is the self-pay and represents an amount of $180K; note that the proper amount is set up for provision for doubtful account activity. Prepared by; Contract CFO for RCMS Angela Robinson, CPA Senior Manager at Wipfli,LLP
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REDWOOD COAST MEDICAL SERVICES, INC.BOARD FINANCIAL SUMMARY
APRIL 2020
MTD YTD Last YTDDEPARTMENT Actual Budget Variance Actual Budget Variance Actual VarianceAllPatient Revenue 145,779 409,747 (263,968) 2,474,526 3,689,817 (1,215,291) 2,698,834 (224,309) Total Expenses 583,427 768,021 (184,594) 6,535,535 6,817,656 (282,121) 6,372,608 162,927 Net Before Other Revenue (437,648) (358,274) (79,374) (4,061,010) (3,127,839) (933,171) (3,673,774) (387,236) Grants/Other Revenue 317,809 282,184 35,625 2,625,512 2,821,840 (196,328) 2,911,728 (286,216) Net Operating Income/(Loss) (119,839) (76,090) (43,749) (1,435,497) (305,999) (1,129,498) (762,046) (673,452) Total Capital Revenue & Expenditures (15,128) 15,000 (30,128) 861,041 150,000 711,041 138,809 722,233 Net Excess/(Deficiency) (134,967) (61,090) (73,877) (574,456) (155,999) (418,457) (623,237) 48,781
Gualala - Primary CarePatient Revenue 59,136 195,715 (136,579) 1,079,200 1,791,538 (712,338) 1,179,199 (99,998) Total Expenses 251,498 306,388 (54,890) 2,776,274 2,766,417 9,857 2,238,044 538,230 Net Before Other Revenue (192,362) (110,673) (81,689) (1,697,073) (974,879) (722,194) (1,058,845) (638,228) Grants/Other Revenue 80,503 83,067 (2,564) 834,821 830,670 4,151 724,266 110,555 Net Operating Income/(Loss) (111,859) (27,606) (84,253) (862,253) (144,209) (718,044) (334,579) (527,673) Total Capital Revenue & Expenditures 1,500 - 1,500 1,500 - 1,500 (31,563) 33,063 Net Excess/(Deficiency) (110,359) (27,606) (82,753) (860,753) (144,209) (716,544) (366,142) (494,610)
Point Arena - Primary CarePatient Revenue 47,930 67,471 (19,541) 371,053 609,252 (238,199) 297,431 73,622 Total Expenses 65,019 98,125 (33,106) 673,758 810,160 (136,402) 562,574 111,184 Net Before Other Revenue (17,090) (30,654) 13,564 (302,704) (200,908) (101,796) (265,143) (37,561) Grants/Other Revenue 67,183 27,932 39,251 267,431 279,320 (11,889) 244,827 22,603 Net Operating Income/(Loss) 50,093 (2,722) 52,815 (35,274) 78,412 (113,686) (20,316) (14,958) Total Capital Revenue & Expenditures - - - - - - - - Net Excess/(Deficiency) 50,093 (2,722) 52,815 (35,274) 78,412 (113,686) (20,316) (14,958)
B - 1RCMS Board of Directors Meeting
May 27, 2020 Page 11
REDWOOD COAST MEDICAL SERVICES, INC.BOARD FINANCIAL SUMMARY
APRIL 2020
MTD YTD Last YTDDEPARTMENT Actual Budget Variance Actual Budget Variance Actual VarianceGualala - Urgent CarePatient Revenue 20,748 67,937 (47,189) 564,640 608,218 (43,578) 614,506 (49,866) Total Expenses 153,030 152,856 174 1,484,374 1,389,060 95,314 1,283,344 201,030 Net Before Other Revenue (132,282) (84,919) (47,363) (919,734) (780,842) (138,892) (668,838) (250,896) Grants/Other Revenue 82,937 63,626 19,311 692,239 636,260 55,979 578,342 113,897 Net Operating Income/(Loss) (49,345) (21,293) (28,052) (227,495) (144,582) (82,913) (90,496) (136,999) Total Capital Revenue & Expenditures - - - - - - (16,291) 16,291 Net Excess/(Deficiency) (49,345) (21,293) (28,052) (227,495) (144,582) (82,913) (106,787) (120,708)
Gualala - UC WeekendPatient Revenue 1,411 12,539 (11,128) 78,765 111,969 (33,204) 109,897 (31,132) Total Expenses 34,171 69,531 (35,360) 465,328 598,849 (133,521) 552,139 (86,811) Net Before Other Revenue (32,760) (56,992) 24,232 (386,563) (486,880) 100,317 (442,242) 55,679 Grants/Other Revenue 38,102 42,600 (4,498) 368,145 426,000 (57,855) 395,248 (27,103) Net Operating Income/(Loss) 5,342 (14,392) 19,734 (18,418) (60,880) 42,462 (46,994) 28,576 Total Capital Revenue & Expenditures - - - - - - (3,054) 3,054 Net Excess/(Deficiency) 5,342 (14,392) 19,734 (18,418) (60,880) 42,462 (50,048) 31,630
FLSA status: Exempt Nonexempt If temporary, this telecommuting agreement will begin and end on the following dates: Start date: _______________ End date: _______________ Remote work location: ________________________________________________ Employee schedule: _____________________________________________________ The employee agrees to the following conditions:
• The employee will remain accessible and productive during scheduled work hours.
• Nonexempt employees will record all hours worked and meal periods taken in accordance with regular timekeeping practices.
• Nonexempt employees will obtain supervisor approval prior to working unscheduled overtime hours.
• The employee will report to the employer’s work location as necessary upon directive from his or her supervisor.
• The employee will communicate regularly with his or her supervisor and co-workers, which includes a weekly written report of activities.
• The employee will comply with all RCMS rules, policies, practices and instructions that would apply if the employee were working at the employer’s work location.
• The employee will maintain satisfactory performance standards.
• The employee will maintain a safe and secure work environment at all times.
• The employee will allow the employer to have access to the telecommuting location for purposes of assessing safety and security, upon reasonable notice by the company.
• The employee will report work-related injuries to his or her manager as soon as practicable.
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Human Resources 25 – Telecommute/Remote Work
RCMS will provide the following equipment: __________________________ _____________________________________________________________________ The employee will provide the following equipment: ____________________________ _____________________________________________________________________
• The employee agrees that RCMS equipment will not be used by anyone other than the employee and only for business-related work. The employee will not make any changes to security or administrative settings on RCMS equipment. The employee understands that all tools and resources provided by the company shall remain the property of the company at all times.
• The employee agrees to protect company tools and resources from theft or damage and to report theft or damage to his or her manager immediately.
• The employee agrees to comply with [Company name]’s policies and expectations regarding information security. The employee will be expected to ensure the protection of proprietary company and customer information accessible from their home offices.
RCMS will reimburse employee for the following expenses: ________________________________________________________________ Employee will submit reimbursement requests with attached receipts in accordance with RCMSs expense reimbursement policy. The employee understands that all terms and conditions of employment with RCMS remain unchanged, except those specifically addressed in this agreement. The employee understands that management retains the right to modify this agreement on a temporary or permanent basis for any reason at any time. The employee agrees to return RCMS equipment and documents within five days of termination of employment.
Human resources signature: ________________________ Date: ______________________
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Human Resources 25 – Telecommute/Remote Work
SAFETY CHECKLIST
The telecommuter is responsible for ensuring a clean, safe, and ergonomically sound home/work office as a condition for telecommuting. The telecommuter should review this checklist with his/her supervisor and sign it prior to the start of telecommuting. Work Site
Telecommuter agrees to maintain a clearly defined workspace that is clean, free from distractions and obstructions, and is in ergonomically sound condition.
The work area is adequately illuminated with lighting directed toward the side or behind the line of vision, not in front or above it.
Supplies and equipment (both departmental and employee-owned) are in good condition. The area is well ventilated and heated. Storage is organized to minimize risks of fire. All extension cords have grounding conductors. Exposed or frayed wiring and cords are repaired or replaced immediately upon detection. Electrical enclosures (switches, outlets, receptacles, and junction boxes) have tight-fitting covers
or plates. Surge protectors are used for computers, fax machines, and printers. Heavy items are securely placed on sturdy stands close to walls. Computer components are kept out of direct sunlight and away from heaters.
Emergency Preparedness
Emergency phone numbers (hospital, fire department and police department) are posted at the alternate work site.
A first aid kit is easily accessible and replenished as needed. Portable fire extinguishers are easily accessible and serviced as needed. An earthquake/storm preparedness kit is easily accessible and maintained in readiness.
Ergonomics
Desk, chair, computer, and other equipment are of appropriate design and arranged to eliminate strain on all parts of the body.
Telecommuter agrees to read and to implement the EMPLOYER ergonomic principles.
I have reviewed and understand the items outlined in this checklist. _______________________________ ________________________ Telecommuter’s signature Date:
RCMS Board of Directors Meeting
May 27, 2020 Page 34
Administrative - Claims Management
I. POLICY: It is the policy of Redwood Coast Medical Services, Inc. (RCMS) to comply with all requirements of the Public Health Services Act (PHSA) and Federal Tort Claims Act (FTCA) in the reporting of professional liability (malpractice) claims and potential claims (potential compensatory events), including, without limitation, the provision of timely notice to the proper government authorities, the preservation of the health record of a potential claimant by locking the existing health record and the proper completion of the internal Professional Liability Claim Report. The purpose of the Professional Liability Potential Claim Report is to determine the facts in order to most appropriately address the matter, to reduce the likelihood of a claim or lawsuit, or in the case of a filed claim, to place RCMS in the most defensible position and to reduce liability and economic loss. II. PROCEDURE:
A. The Occurrence of an Incident:
1. When an incident occurs that may place a patient, visitor or staff member at risk,
immediate measures will be taken by the provider(s) and staff to provide
assistance and reduce the potential for an adverse outcome. The action should be
documented in the patient medical record, on an incident report for visitor or staff,
or on an OSHA report if there has been exposure to infectious material. Do not
make reference in the patient medical record that an incident report, professional
liability potential claim report, or claim notice report may have been filled out.
2. The initial report should be completed by a person with first-hand information
about the incident. The initial report establishes an attorney-client privilege
between RCMS and its legal counsel and therefore must be confidentially
maintained. The initial report should be made to the Compliance and Safety
Redwood Coast Medical Services, Inc.
(RCMS)
POLICY PROCEDURE
Page: 1 of 2
Date Approved:
Reviewed Date:
Human Resources Director:
Arlene L. Peterson
DEPARTMENT: Administration
CEO: Ara Chakrabarti
POLICY NUMBER: PIC Chair: Donna Yates-Johnson
SUBJECT: CLAIMS MANAGEMENT
RCMS Board of Directors Meeting
May 27, 2020 Page 35
Administrative - Claims Management
Officer immediately. The Compliance and Safety Officer will notify the Chief
Executive Officer and Human Resources when the event, incident or complaint is
recognized as a potential or actual liability claim.
3. Pursuant to the Federal Tort Claims Act (FTCA), RCMS will report to DHHS any
event, incident or complaint which has resulted in a liability claim notice being
filed and to report information on a pending claim notice. The PHS must be
notified at once if the claim is filed in state court, so that appropriate measures can
be taken to have the claim moved to federal court pursuant to the FTCA.
a. If a notice is received from a potential claimant and/or claimant’s attorney
that they plan to include RCMS or RCMS staff covered by the FTCA in a
malpractice lawsuit, the Compliance and Safety Officer will notify them
that the suit will be handled by federal government attorneys on behalf of
RCMS and will be moved to federal court. This may dissuade potential
claimants from unnecessarily including RCMS or its covered staff in a
lawsuit.
In addition to the report, the individual best informed about the situation should
complete an incident report and submit it to the Compliance and Safety Officer. The
Compliance and Safety Officer should use the Incident Reporting procedures to conduct
an investigation, implement appropriate corrective action, and document the follow up
to assure patient safety. The FTCA peer assessment questionnaire should be completed
as part of the Incident Reporting procedure investigation.
B. Utilization of Report.
The professional liability potential claim report is completed by a
physician or staff member having knowledge of an event, incident or
complaint that may result in a liability claim. The report is used by
RCMS’ legal counsel to initiate legal defense on behalf of the center. If
the claim notice is filed in court, the DHHS OGC will request a copy of
medical records and other relevant documents concerning the potential or
actual claim and move the claim to federal court.
C. Confidentiality of Reports and Documents.
The professional liability potential claim report is communication between
a client and attorney; therefore, it is protected from disclosure under the
attorney-client privilege. The report should be kept in a secured file by
the Compliance and Safety Officer. Additional reports of investigations
and actions should be added to this confidential file, and not disclosed
without prior approval from the RCMS legal counsel or OGC. At no time
does the incident report, any related document, or the notice become a
part of the patient's medical record.
D. Completion of the Professional Liability Potential Claim Report.
If an incident occurs that the staff believes may result in a liability claim,
the professional liability potential claim report should be completed and
given to the Chief Executive Officer and Compliance and Safety Officer
to forward to the RCMS legal counsel and/or the RCMS Performance
RCMS Board of Directors Meeting
May 27, 2020 Page 36
Administrative - Claims Management
Improvement Committee. In completing the report, answer each question
accurately and completely, being factual and objective.
a. Do not admit liability (that will be determined by an expert
opinion).
b. Do not discuss the incident, event or variance with anyone except
persons associated with the Incident Reporting procedure and
RCMS’ legal counsel.
c. Do not discuss the incident with the fellow workers or family, and
particularly not with the alleged injured person or their attorney.
d. If the information requested is not relevant or not known, state that
on the form.
e. Attach documents as requested, and sign and date the form as
noted.
E. Reporting of Claims Filed and Payments on Claims.
1. Any payment of a claim on behalf of a licensed professional must be
reported to the National Practitioner Data Bank (NPDB) pursuant to the
Federal Health Care Quality Improvement Act of 1986. This is done by
the RCMS Human Resources Credentialing and Privileging Manager.
F. Forms Related to Claims.
1. The two forms to be used in relation to a potential or actual claim(s)
include:
a. Initial (Potential) Professional Liability Claim Report.
b. FTCA Peer Assessment Questionnaire
III. The OGC – Office of General Counsel may provide additional questionnaires or forms to
be completed and additional documentation.
ATTACHMENTS:
1) Norcal Claims Management Report of Claim
2) FTCA Peer Assessment Questionnaire
3) Norcal Early Reporting Information
RCMS Board of Directors Meeting
May 27, 2020 Page 37
Board members Finance PIC HR Outreach Audit Exec Committee
Officer Positions Officer Potential Candidates
Vanessa Ignacio Chair Rich Hughes
Alex Long Alex Vice-Chair Leslie Bates
Rich Schimbor Rich S Rich S Treasurer Drew McCaulley