Norman Regional Hospital Authority Meeting

NORMAN REGIONAL HOSPITAL AUTHORITY Board Meeting February 26, 2017 MINUTES The Norman Regional Hospital Authority met in monthly session Monday, February 26, 2018, at 5:30 p.m., in the Norman Regional Hospital Board Room. The meeting Agenda was posted February 22, 2018, on the NRHS and Norman Websites and at the entrance to Norman Regional Hospital. Members Present: Tom Clote, Chair Muhammad Anwar, MD Diane Chambers, MD Joan Greenleaf James (Jeff) Kimpel, Ph.D. Tom Sherman Jerome (Jerry) Weber, Ph.D. Doug Cubberley, Vice Chair/Secretary Kevin Pipes Others Present: Robin Mantooth, MD, Chief of Staff Farhan Jawed, MD, Chief of Staff-Elect Richie Splitt, President and CEO John Manfredo, COO Ken Hopkins, CFO Meegan Carter, VP Population Health & Wellness Paula Price, VP Strategy & Growth Dr. Aaron Boyd, MD, CMO Brittni McGill, Interim CNO Susie Graves, Interim CNO Lisa White, Manager PI & Medical Staff Services Molly McCool-Hare, Business Planning/Operations Specialist Cindy Gilmore, Specialist LEAN Kyle Hurley, Manager ED System Courtney Blau, Admin. Dir. Risk Management & Compliance Brad Foster, Director Pharmacy J.T. Ball, MD 3rd year Resident in the ED Residency Program Kelly Wells, Director Health Promotion & Community Relations Joy Hampton, Journalist Norman Transcript Jessica Thacker, ED Unit Secretary, Porter Gail Grego, Director Emergency Service Line Eddie Sims, Manager EMSStat John Johnston, EMSStat Paramedic Megan Jones, EMSStat Medic  NRHA Board Minutes 2 February 26, 2018 Recorder: Doris Gonzalez, Executive Assistant Agenda Item I. Meeting Called to Order Mr. Clote called the February 26, 2018, Norman Regional Hospital Authority meeting to order at 5:37 p.m. Agenda Item II. Introduction and Recognition of Outstanding Healers A. March 2018 Healer of the Month, Jessica Thacker, Unit Secretary, Emergency Department Porter – Gail Grego, Director Emergency Services Mr. Clote introduced Ms. Grego who presented Ms. Thacker as the Outstanding Healer for March 2018. Ms. Grego noted that Ms. Thacker has worked for Norman Regional Health System for ten years and is an ideal example of our ICARE attributes. She shared the employee’s work commitment, positive attitude, accomplishments, and willingness to do what it takes to get the job done in a timely and professional manner. She is truly an asset to Norman Regional Health System and well deserving of this honor. Ms. Thacker thanked everyone for the Outstanding Healer recognition. Mr. Clote congratulated and thanked Ms. Thacker on behalf of the Board for her outstanding dedication, professionalism and positive attitude that continues to make Norman Regional Health System a caring, high quality system. B. Recognize John Johnston, for Receiving the “Crime Stoppers EMSStat Paramedic of the Year” for 2017/2018 – Eddie Sims, EMSStat Manager and Gail Grego, Director Emergency Services Mr. Sims introduced Mr. Johnston, as the Crime Stoppers 2017-2018 EMSStat Paramedic of the year. He has been with EMSStat for three years and is one of the most professional individual he has ever worked with. His peers and members of leadership respect him partly because of his “can do” attitude and his desire to succeed in whatever job he is performing. He is first to tackle any task without being asked, an excellent Field Training Officer, an active committed member of EMSStat’s SWAT Team, has exceptional documentation and teaching skills, which he shares with EMSStat staff and new recruits, and is an excellent role model. Mr. Johnston thanked everyone and noted it was an honor to have this title. C. Recognize Megan Jones, for Receiving the “Crime Stoppers EMSStat EVO/EMT of the Year” for 2017/2018 – Eddie Sims, EMSStat Manager and Gail Grego, Director Emergency Services Mr. Sims introduced Ms. Jones as the 2017-2018 Crime Stoppers EMSSTAT Emergency Vehicle Operators (EVO) of the year. Ms. Jones has been with  NRHA Board Minutes 3 February 26, 2018 EMSStat since August 2016 and exemplifies the ICARE values, which every supervisor wishes they could duplicate. She is trustworthy, resourceful, professional, always willing to do what it takes to get the job done, and never complains. She is in her fourth semester of Paramedic School, currently filling in a full-time slot in EMSStat and as soon as she graduates and receives her license, she will become one of our full-time Paramedics. Ms. Jones thanked everyone who helped EMSStat be the best we can be and stated it was an honor to have received this title. Mr. Sims, Mr. Johnston, Ms. Jones, Ms. Grego, and Ms. Thacker left the meeting at 5:45 p.m. Dr. Anwar joined the meeting at this time. Agenda Item III. Board Education Session: Opioid Stewardship Update – Brad Foster and Brittni McGill Mr. Foster, Dr. Ball, and Ms. McGill presented a high level update of the opioid crisis highlighting the following:  Opioids are medications that interacts with opioid receptors in the brain to relieve pain  Heroin has been the most common opioid and traditionally the one responsible for the majority of opioid related deaths. The trend over the past two decades, starting in the 90s, is that deaths related to heroin are declining and we are seeing a larger percentage of the non-heroin opioids (Oxycodone, Fentanyl, Codeine, Vicodin, Hydrocodone, and Morphine).  The 2016 data reflected that 116 people died every day from opioid-related drug overdoses and 11.5 million people misused prescription opioids.  Almost one million people used heroin last year, 170K of them used heroin for the first time.  The estimated impact on the health care system was $504 Billion.  In 2015, more than 52,000 Americans died of drug overdoses and nearly 2/3 of those deaths linked to opioids.  There has been an increase in the number of opioid related hospitalizations and emergency department visits in the last ten years.  Age-adjusted rates of drug overdose deaths by state – In 2013 OK ranked 8th (rate 20.6 per 100,000), in 2016 Oklahoma ranked 24th (rate 21.5 per 100,000), which appears to be good; however, our rate is higher than in 2013. The rest of the country has caught up and passed us showing it is a national epidemic.  Other impacts: addiction, lack of the mental health resources, increase in placental transfers, newborn addiction, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).  National Institute on Drug Abuse performed a study showing that every 25 minutes a baby is born suffering from opioid withdrawal.  April 26, 2017, Attorney General Mike Hunter called for action around prevention, intervention, education, treatment, law enforcement, and rehabilitation during a press conference at the Capital.  Overview of the Key Factors:  NRHA Board Minutes 4 February 26, 2018 o Illegal Importation, inappropriate marketing, and over prescribing  Combatting the Crisis: o National Level – 2016 Centers for Disease Control and Prevention (CDC) distributed their guidelines for prescribing opioids for chronic pain. March 2017 the President put out a Commission on Combating Drug Addiction and Opioid Crisis, final report released November 3, 2017, had 50 recommendations and he gave an overview of the more significant ones. October 26, 2017, President declares the opioid epidemic a national public health emergency. o State Level – The Oklahoma State Plan was established in 2013 and last reviewed 2016 and its goal is to reduce overdose deaths in OK by 15% in five years. The Health Information Exchange (HIE) allows all our providers to look at patient information from other organizations. This makes care safer and ensures we are not subscribing medications that another provider has prescribed. There are two house bills: #2039, talks about the Narcan availability to first responders and #2931 is electronic prescribing for all scheduled drugs. The first bill passed, the other is pending. o The Joint Commission – In 2018, TJC put out detailed requirements that every organization has to maintain a plethora of elements in place to address all of these requirements. The requirements necessitate the involvement of Leadership, Medical Staff, Performance Improvement, and Provision of Care. o Norman Regional Health System – We have in place a Pharmacy and Therapeutics Committee, Sentinel Event Alert #49 (Safe use of Opioids in Hospitals), and Drug Diversion Prevention Team that assist in combatting the opioid crisis. We are currently evaluating the Vizient Opioid Stewardship Collaborative which is scheduled to start in a couple of months. o The Pain Committee is an interdisciplinary leadership team charged to create the scope of our project, goals, deliverables, and methodology. o Physician Perspective – Dr. J.T. Ball provided an emergency department physician perspective noting the 52,000 Americans who died of drug overdoses has eclipsed the number that die from trauma in our country. Mr. Foster and Dr. Ball left the meeting at this time. Agenda Item IV. Approval of the January 22, 2018 Board Meeting Minutes Mr. Clote asked for approval of the January 22, 2018, Board Meeting Minutes ACTION TAKEN: Ms. Greenleaf made the motion to approve the January 22, 2018, Board Meeting Minutes as submitted. Dr. Kimpel seconded the motion, and the motion unanimously approved with aye votes from Dr. Anwar, Dr. Chambers, Mr. Clote, Mr. Cubberley, Ms. Greenleaf, Dr. Kimpel, Mr. Pipes, Mr. Sherman, and Dr. Weber. The minutes will reflect the order of discussion. Agenda Item V Performance Updates Ms. White provided a Quality & Patient Safety Update highlighting the following:  NRHA Board Minutes 5 February 26, 2018  Patient Safety o Infection Prevention Plan CY 2018  Presented a concise review of the 2018 Infection Prevention Plan’s goals and interventions focused on reduction of Hospital Acquired Infections: Central Line Bloodstream Infection (CLABSI), Catheter Associated Urinary Tract Infection (CAUTI), Surgical Site Infections (SSIs), Clostridium Difficile (C. diff), Methicillin Resistant Staphylococcus Aureus (MRSA), and Vancomycin Resistant Enterococcus (VRE)  Quality and Performance Improvement o Chronic Disease/Hospice and Mortality  Hospice is a specialized type of care for those facing life-limiting illness, which addresses the patient’s physical, emotional, social and spiritual needs. It neither prolongs nor hastens the dying process; it is palliative and emphasizes the quality of life to be as important as the length of life.  Created education information for patients, community members and post- acute providers regarding Hospice  After the start of educating individuals and talking about Hospice, we have seen an increase in the rate of Heart Failure and Chronic Obstructive Pulmonary Disease (COPD) discharges and the hospice use rate.  Patient Experience Provided an overview of the current clinic real-time survey report noting a survey response of 911 and their overall “would recommend the hospital” rate is 83.5%. We are working on implementation with NRC for inpatient real-time surveys with an estimated launch by the 2nd Quarter of 2018.  Community Outreach – Xenex Robots NRHS teamed up with Xenex (our germ-fighting robots vendor) and partnered with the area schools in an effort to kill the germs that cause serious infections including the flu virus within the area schools. Eleven germ-fighting robots were deployed, for one week, to the following schools. Moore Public Schools Noble Public Schools Norman Public Schools Fairview Elementary Katherine I. Daily Elementary Whittier Middle School Winding Creek Elementary Hubbard Elementary Roosevelt Elementary Apple Creek Elementary Pioneer Elementary Adams Elementary Central Elementary Curtis Inge Middle School Kennedy Elementary Earlywine Elementary Washington Elementary This was a great community health initiative exhibiting our commitment to improving the health and well-being of our communities, both inside and out our hospital doors. Agenda Item VI. Approval of the January 2018 Norman Regional Health System Financial Statements Mr. Hopkins commented about an article published about a month ago by Moody’s stating they considered this severe flu season to be a credit negative for hospitals in the US. They cited several reasons for that line of thinking. Although you add volume, it does not drive reimbursement as it stretches length of stay (LOS). When LOS is extended there tends to be staff issues, high supply costs, payor mix issues, which  NRHA Board Minutes 6 February 26, 2018 disproportionately affect Medicare reimbursement. NRHS saw some of the impact and numbers in January; but they were well managed despite the challenges associated with high flu season. He highlighted the following from the January 2018 NRHS Financial Statement:  Hospital Outpatient Visits for January were 13.8% over budget.  Clinic Registrations for January remained strong, slightly over budget.  NRHS Emergency Visits for January were more than 1,500 or about 19% higher than budget.  Total Surgical Cases were 114 cases or 11% below budget, which was all from the outpatient side. Inpatient was on target for January.  Total Cath Lab Cases were 7.3% favorable to budget. January 2018 Financial Performance  Gross Revenues .................................. (Budget $158,256,777)............ $172,059,396  Net Patient Revenue .............................. (Budget $35,027,180).............. $37,168,224  Total Operating Expenses ..................... (Budget $34,000,905).............. $36,021,841  Total Operating Revenues ...................... (Budget $35,454,823).............. $37,558,029  Operating Income .................................... (Budget $1,453,918)................ $1,536,188  Non-Operating Revenues (Expenses) ........ (Budget $526,918)................ $3,150,564  Excess Revenues over Expenses ............ (Budget $1,980,836)................ $4,686,752 Year-to-Date  Operating Income .................................... (Budget $9,961,582)................ $9,051,463  Non-Operating Revenues (Expenses) ..... (Budget $3,932,426).............. $12,918,142  Excess Revenues over Expenses .......... (Budget $13,894,426).............. $21,969,605  Accounts Receivable Days ................. .......... (Budget 46 Days) .................. 42.2 Days  Days Cash on Hand .................................................................................. 226.8 Days ACTION TAKEN: Dr. Weber motioned to approve the January 2018 NRHS Financial Statements. Dr. Kimpel seconded and the motion was approved unanimously with aye votes from Dr. Chambers, Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Agenda Item VII. Medical Staff A. Report from the February 14, 2018, Medical Executive Committee (MEC) Dr. Mantooth reported that MEC met February 14, 2018, and highlighted the following:  Reviewed and approved the January 10, 2018 minutes.  Received a Financial report from Mr. Hopkins.  Ms. Price presented the new Norman Way handbook to committee members and went over the expectations of Norman Regional Health System.  Mr. Foster, Pharmacy Director, presented an update on drug shortages.  Ms. Blau gave an update on EMTALA.  Department/Committee Reports o Behavioral Medicine Department – Dr. Jawed presented The Joint Commission survey results noting they did not have any findings. They are reviewing the Search Procedures policy due to contraband issues. Reviewed  NRHA Board Minutes 7 February 26, 2018 the Pilot Services individual therapy sessions and how well it has been going. o Pathology Department – Dr. Littlejohn announced that the College of American Pathologists will be performing a lab review within the next six months. o Transfusion Safety Committee – Noted that the number of unit transfusions dropped. Effective January 1, 2018, a new standard from the Oklahoma Blood Institute states that frozen products cannot be sent back to the lab. Also, if a patient receives a transfusion and it is discovered the donor has some kind of communicable disease, the patient can go to the OBI for free testing. o OB/GYN Department – Dr. Parker announced that the Laborist/OBED was approved by the State Health Department. o Emergency Medicine Department – Dr. Cook announced since, the implementation of the Pediatric Hospitalist program there has been a significant increase in infants admitted. Dr. Vogel is currently taking hand call for NRHS; however, in the future the other Orthopedic Group may have another hand surgeon coming that will be seeing more Pediatric patients. Six new residents will be starting July 1, 2018. The Throughput Committee will be trending the time to write hospital discharge orders. There has been an increase in the number of patients being held in the ED due to high capacity. o Infection Committee – Dr. Ahmed discussed continuing work on the blood culture collection kit trials. o Hospital Quality and Patient Safety Committee – Ms. Anderson reported the sepsis numbers are getting better and the COPD and CHF Mortality rates are improving. o Hospital Medicine Department – Dr. Shahsavari announced a couple of new physicians will be joining the Hospitalist group. o GMEC Committee – Noted there were 388 resident candidate applications received, 90 interviewed, and six matched. o Reports from the Vice President –  Ms. Graves reported that if the patient’s primary language is not English they must us an iPad to communicate with the patient. For a translator to be used, the translator must be certified.  Mr. Manfredo reported that the Porter Physician Surgical Lounge and the Medical Staff Services area will be remodeled. He thanked everyone that attended the Ambassador Ball this year.  Ms. McGill announced that the Bulk Ultrasound Machines were approved for the Moore Emergency Department.  Mr. Splitt informed the committee that the Step Up Revenue Plan failed in House. Agenda Item VIII Patient Quality and Safety Committee Ms. Greenleaf reported the Patient Quality and Safety Committee met Monday, February 5, and highlighted the following:  The 2017 Goals and Interventions that the Infection Control Team reviewed were impressive: o 20,199 cultures o 3243 surgical site infections o 677 Oklahoma State Department of Health reportable diseases/condition  NRHA Board Minutes 8 February 26, 2018 o 295 events to the Centers for Disease Control and Prevention (CDC)  Received an in-depth Patient Care Services report noting it is nice to read about all the great things going on in the departments and we will always celebrate those things. Ms. Greenleaf asked them to include in the report one or two items they are working on to improve or resolve.  One in ten hospital patients have C. diff and the number of C. diff cases has increased nationwide.  Asked the Board members to consider wearing NRHS provided ID badge when in the Health System on business. ID badges will be made for Board members without one.  Talked with Ms. Blau regarding future items the committee might want to monitor and will bring that information as it is gathered and approved.  Mr. Manfredo reported that before we initiated the inpatient real-time surveys we wanted to ensure that NRC would send the minimum number required inpatient paper surveys to CMS and everything else would be electronically real-time and the results would not be changed. The data received revealed no appreciable change in the results. The larger squeeze comes from receiving the feedback from the patients through the real-time survey. That was the recommendation to the committee and the committee approved. The physician provider clinics went live February 1, 2018.  Ms. Richardson’s Population Health/Hospice presentation was very informative and well received. Agenda Item IX. Finance Committee A. Report from the February 19, 2018, Finance Committee Mr. Cubberley reported the Finance Committee met February 19, at 7:00 a.m. and highlighted the following:  Mr. Dodge, Executive Director NPHO, presented an update and overview of the Norman Physician Hospital Organization (NPHO) financial, budget and objectives for 2018. They continue to boost their revenues and keep operating and expense costs in check.  Mr. Dodge presented an in-depth presentation on the Accountable Care Organization (ACO); highlighting the following: o We have 6,022 attributed lives as of January 1, 2018 o 31 Providers o Installed eClinicalWorks Population Health Software o Engaged physicians to participate in ACO Committees and regional Centers for Medicare and Medicaid Services (CMS) collaboratives o Developed a strategy to increase Annual Wellness Visits (AWV) o Avoidable ED utilization – identified avoidable and primary care preventable ED utilization.  Mr. Hopkins presented an update of the previous Wells Fargo Forecast noting the sensitivity analysis suggested we are still creating project capacity even if we do not meet the 4% margin. It will take longer to create that capacity and taking longer carries its own risks; however, we will still need positive and consistent margins, which will remain a big challenge. The goal of moving to the west side is achievable. We will be contracting with a firm to advise us more in the  NRHA Board Minutes 9 February 26, 2018 specifics; not only is it achievable, but they will help us identify what we need to accomplish in order to move to the west side.  Received an update on Supplemental Hospital Offset Provider Payment (SHOPP) for 2018. The $14.2 million received from SHOPP in 2017 was budgeted in 2018; however, there was an error in the data file and the SHOPP benefit will decrease to $8.7 million affecting the remainder of FY2018 and the FY2019 budgets.  Mr. Sweatt gave a presentation regarding PayMode, which is a company the hospital is contracting with to assist in paying vendors electronically. To do this we need to form a relationship with Citizen’s Bank, which will not change the current bank relationships or policies in processing Automated Clearing House (ACH) payments. To establish PayMode with Citizen’s Bank, a resolution is required to elect the CFO to ascertain that relationship.  Six capital requests were presented for approvals: o 200 Scanners for medication administration – cost $52,090 o Virtual Infrastructure expansion for desktop and server – cost $258,059 o Replacement of ceiling tiles and doors in Behavioral Medicine for patient safety and a CMS requirement – cost $108,959 o SonoSite X to replace systems that are old and at the end of manufacturer’s schedule – cost $258,762 o Porter Physician/Surgeons Lounge Upgrade – cost $70,933 o Oncology Buildout is to convert the existing Porter Breast Care Center to a new Oncology Treatment and Infusion Center. There will be eight examination rooms and eleven infusion stations – Cost $1,444,000. B. Banking Resolution ACTION TAKEN: Mr. Cubberley made a motion to approve the Banking Resolution (PayMode) as recommended by the Finance Committee. Mr. Sherman seconded and the motion was approved unanimously with aye votes from Dr. Chambers, Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. C. Recommend Approval of Capital Equipment Purchase Requests ACTION TAKEN: Mr. Cubberley made a motion to approve the Capital Equipment Requests totaling $2,192,802 as recommended by the Finance Committee. Mr. Pipes seconded and the motion was approved unanimously with aye votes from Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Chambers, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Agenda Item X. Old Business Mr. Clote reminded the Board members that have not submitted their Conflict of Interest forms to please do so. Send to Ms. Gonzalez. Mr. Splitt reported the Norman Virtual Care app has been an exciting venture. Starting with employees, there are 236 enrollees with four having used the app. The app will go public in early March.  NRHA Board Minutes 10 February 26, 2018 Agenda Item XI. New Business A. Proposed Revisions to the 2018 Infection Prevention Plan Policy ACTION TAKEN: Dr. Weber moved to approve the revisions to the 2018 Infection Prevention Plan Policy as submitted. Ms. Greenleaf seconded and the motion was approved unanimously with aye votes from Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Chambers, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Mr. Splitt reported that Mr. Manfredo, Ms. Anderson and Ms. White recently attended the last meeting of the Vizient Collaboration Group (New Mexico, California, Denver and NRHS) in New Mexico on February 6-8, 2018. Mr. Manfredo stated they visited the University of New Mexico Health System and presented the work done with the Vizient team to date, which included our data walls, which illustrates how we cascade our strategic plan to the front-line staff. We met with their Chief Medical Officer, Executive Team and talked about Dr. Boyd, our physician dyad, and walked them through some of those processes. The New Mexico team stated they would like to have a site visit to NRHS because they have data walls but there is no tie to their strategic plan. They were impressed with the design and arrangement of our data walls and noted it was a great opportunity to change their way of doing things. It was well received and a good opportunity for Ms. Anderson and Ms. White to brag on some of the great work we are doing. Mr. Splitt stated that Vizient was so impressed they asked that we attend and share our presentation and other great things we are doing at the Vizient Seminar “Network for Community Based Independent Hospitals” March 19-20, 2018. Ms. McGill reported the Intra Cycle Stroke Call last week with The Joint Commission and there were no recommendations for improvement. February is Heart Month and we have had numerous community outreach activities. Ms. Wells stated in February we ran a heart scan campaign (Doppler image of a heart that talked about a $35 Heart Scan) as part of the Heart Health Awareness Month. This campaign generated 530 leads. During February, 161 individuals self-referred to the HealthPlex for a heart scan, 45 self-referred to Moore. Of those, 57 scheduled through our online landing page. We are working with the Imaging team to track these patients to identify revenue related to this campaign. Ms. Price announced that we received notice today from our ad agency that our Marketing Campaign won a Bronze Addy Award in the Fort Worth market for “Healthcare is in our DNA.” B. NRHA Committee Assignments Mr. Clote announced Committee Chairs would remain the same: Mr. Cubberley as Chair of Finance Committee, Ms. Greenleaf as Chair of Patient Quality and Safety Committee, and Dr. Weber as Chair of Strategic Planning Committee. The NRHA Bylaws state there are three Trustees on a committee, the fourth Trustee rotates  NRHA Board Minutes 11 February 26, 2018 throughout the other committees. Trustees will be notified as to which committee meeting they will be attending each month. Agenda Item XII. Administrative Report Mr. Splitt mentioned the following:  He re-enforced the Xenex partnership noting it was an idea and if not for Ms. Wells, the team and Xenex saying yes, we would not have had those positive results. Our Mission Statement says, “To serve our community as the leader in health and wellness care.” He stated he was proud of our organization and the work we are doing in our communities to make a difference.  Opioid presentation was an important report to be shared with the Board. He thanked Mr. Foster, Dr. Ball and Ms. McGill for their hard work gathering the ever- changing data for the presentation.  The Norman Way signing day is March 1, 2018. The goal is to build our cultural DNA around the ICARE Values and the way we want to interact with one another and our patients.  The Joint Commission received our evidence of standards compliance and we are officially accredited. Agenda Item XIII. Proposed Executive Session A. Proposed Vote to Convene an Executive Session Pursuant to 25 Okla. Stat. Section 307 B.4. to Discuss with Legal Counsel Pending Internal Peer Review/Credentialing Investigation Regarding the Medical Staff Members/Applicants Listed Below and Pursuant to 25 Okla. Stat. Section 307 B.1. ACTION TAKEN: Dr. Kimpel made a motion to adjourn into Executive Session. Ms. Greenleaf seconded and the motion was approved unanimously with aye votes from Dr. Chambers, Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Ms. White, Ms. Gilmore, Mr. Hurley, Ms. McCool-Hare, Ms. Wells, Ms. Blau, and Ms. Hampton left the meeting at 7:07 p.m. B. Medical Staff Recommendations Regarding the Medical Staff Members/ Applicants as Listed in XIII.B 1-3 Below 1. Recommend New Provisional Medical Staff Appointments: a) Skye Coffman, PA, Allied Health Staff – Emergency Medicine Department b) Catherine Loeffler, PA, Allied Health Staff – Emergency Medicine Dept. c) Timothy Stein, PA, Allied Health Staff – Emergency Medicine Department d) Jeremiah Mattox, PA, Allied Health Staff – Emergency Medicine Dept. e) Lauren Pratt, PA, Allied Health Staff – Hospital Medicine Department 2. Recommend Advancement of Medical Staff from Provisional Status: a) Monica Williams, APRN-CNP, Allied Health Staff – Medicine Department  NRHA Board Minutes 12 February 26, 2018 3. Recommend Medical Staff Reappointments: a) Barbara Landaal, MD, Active Staff – Radiology Department b) Sanjay Narotam, MD, Active Staff – Radiology Department c) Chadwick Webber, MD, Active Staff – Radiology Department d) Richard Wedel, MD, Active Staff – Radiology Department e) Katherine Hays, MD, Active Staff – Cardiovascular Medicine f) Robert Holbrook, MD, Active Staff – Medicine Department g) Cuong Nguyen, MD, Active Staff – Medicine Department h) Dustin Tedesco, MD, Active Staff – Medicine Department i) Joshua Whorton, MD, Active Staff – Medicine Department j) Vanama Yerra, MD, Active Staff – Hospital Medicine Department k) Gary Larson, MD, Consulting Staff – Medicine Department l) Shelly Faubion, DO, Active-Affiliate Staff – Medicine Department m) Amanda Lowry, APRN-CNP, Allied Health Staff – Pediatrics Dept. n) Martha Royall, APRN-CNP, Allied Health Staff – Pediatrics Dept. C. Request to Adjourn Out of Any Such Executive Session and Return to Regular Session ACTION TAKEN: Mr. Pipes made a motion to adjourn out of Executive Session and return to regular session. Mr. Sherman seconded and the motion was approved unanimously with aye votes from Dr. Chambers, Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Mr. Clote noted the Board returned to regular session. There were no decisions or votes taken except to return to regular session and any information shared during the Executive Session is privileged and needs to remain in Executive Session. D. Proposed Vote to Approve or Disapprove the Medical Executive Committee Recommendations Regarding Credentialing of the Referenced Medical Staff Members as Listed in XIII B 1-3 ACTION TAKEN: Dr. Weber motioned to approve credentialing items as recommended by Medical Executive Committee and Credentials Committee of all referenced Medical Staff members listed in XIII B 1-3. Dr. Chambers seconded, and the motion was approved unanimously with aye votes from Dr. Chambers, Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Agenda Item XIV. Board Open Discussion There was none. Agenda Item XV. Closing Comments There was none. Agenda Item XVI. Adjournment  NRHA Board Minutes 13 February 26, 2018 ACTION TAKEN: Mr. Sherman made a motion to adjourn at 7:42 p.m. Ms. Greenleaf seconded, and the motion passed unanimously with aye votes Dr. Chambers, Mr. Clote, Dr. Anwar, Ms. Greenleaf, Dr. Kimpel, Mr. Sherman, Mr. Cubberley, Mr. Pipes, and Dr. Weber. Respectfully Submitted, Doug Cubberley, Vice Chairman/Secretary