Norman Regional Hospital Authority Meeting

NORMAN REGIONAL HOSPITAL AUTHORITY Board Meeting January 25, 2021 MINUTES The Norman Regional Hospital Authority met in monthly session Monday, January 25, 2021 at 5:30p.m. in the Porter Auditorium. The meeting Agenda was posted January 21, 2021 on the NRHS and City of Norman websites and at the entrance to Norman Regional Hospital. Members Present: Doug Cubberley, Chairman Jerome (Jerry) Weber, Ph.D. Tom Sherman Muhammad Anwar, MD Mary Womack James Chappel Joan Greenleaf Others Present: Richie Splitt, President & CEO John Manfredo, COO Paula Price, VP Strategy & Growth Meegan Carter, VP Population Health & Wellness Brittni McGill, CNO Ken Hopkins, CFO Aaron Boyd, MD, Chief Medical Officer Dr. Farhan Jawed, MD, Chief of Medical Staff Dr. Joe Voto, MD, Chief of Medical Staff-elect Jenny Anderson, Administrative Director Quality & Performance Larry Harden, Administrative Director, Compliance Jenny Odom, Attorney, Risk Management Karen Rieger, Attorney, Crowe & Dunlevy Jan Emmons, Director, Emergency Services Donna Avila, Director Care Coordination Bunnie Warren, Manager Clinic Operations Meg Belford, Director, Clinic Operations Annette Troxell, Director, Maternal Child Service Line Tracy Mills, Manager, Labor, Delivery & Recovery Kristen Stewart, RN, Labor Delivery & Recovery Rebecca Milam, Medical Assistant, Family Practice Moore North Phillip Mobbs Members Absent: Diane Chambers, MD Kevin Pipes Recorder: Claudia Todd, Executive Assistant  NRHA Board Minutes 2 January 25, 2021 Agenda Item I. Meeting Called to Order Mr. Cubberley called the January 25, 2021, Norman Regional Hospital Authority meeting to order at 5:35p.m. Agenda Item II. Introduction and Recognition of Outstanding Healers A. January 2021 Healer of the Month – Rebecca Milam, Medial Assistant, Family Practice Moore North Mr. Cubberley introduced Meg Belford, Director Clinic Operations and Growth and Bunnie Warren, Manager Clinic Operations who presented Ms. Milam. Ms. Warren shared Ms. Milam is admired by all her fellow healers at the clinic. Ms. Milam has been an Registered Medical Assistant (RMA) for over 18 years and is currently attending Oklahoma City Community College. Ms. Milam is greatly admired by her fellow healers. She is always eager to help out, assists in training new healers and lending a hand where she can. Ms. Milam expressed her appreciation for the honor. Mr. Cubberley congratulated and thanked Ms. Ms. Milam on behalf of the Board for her outstanding dedication, professionalism, compassion, and positive attitude that continues to make Norman Regional Health System a caring, high quality system. Ms. Milam, Ms. Belford Woodward, Ms. ONeal, Ms. Avila and Ms. Brown left the meeting at 5:39pm. B. February 2021 Healer of the Month: Krista Stewart, RN – Labor, Delivery and Recovery Mr. Cubberley introduced Tracy Mills who presented Ms. Stewart. Ms. Stewart has worked at Norman Regional since Aug 2017 as a labor delivery nurse. She was a member of the 1st cohort of the NRHS Nurse Residency Program. She has always wanted to be a labor/delivery nurse since the age of 12. It wasn’t until she had her own children, she realized she wanted to return to school and study nursing. Her fellow healers state she goes above and beyond for her patients. Physicians and coworkers alike enjoy working with her – she does everything right the first time and jumps in to helps others when they are overwhelmed. Her fellow healers state she is a great team player, using her amazing clinical skills and caring, compassionate heart. She lives the Norman Way every day. Ms. Stewart thanked everyone for the honor and was humbled to be recognized. Mr. Cubberley congratulated and thanked Ms. Stewart on behalf of the Board for her outstanding dedication, professionalism, compassion, and positive attitude that continues to make Norman Regional Health System a caring, high quality system. Ms. Troxell, Ms. Mills and Ms. Stewart left the meeting at 5:42pm.  NRHA Board Minutes 3 January 25, 2021 Agenda Item III. Board Education: ET3 Ms. Jan Emmons, Director Emergency Services and Ms. Donna Avila, Director Care Coordination presented an outline of the new care coordination program called Emergency Triage, Treat and Transport (ET3). NRHS’s EMSStat ambulance services is the only ambulance service in the state of Oklahoma that was approved for the new ET3 model of care. The ET3 program is a CMS Innovation project that will provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare Fee-for- Service (FFS) beneficiaries following a 911 call. CMS will continue to pay to transport a Medicare FFS beneficiary to a hospital emergency department or other covered destination. In addition, under the new model, CMS will pay participants to 1) transport to an alternative destination partner, such as a primary care office, urgent care clinic, or a community mental health center, or 2) initiate and facilitate treatment in place with a qualified health care partner, either at the scene of the 911 emergency response or via telehealth. Ms. Emmons reported ET3 launched in 2017/2018 with a small, select group of Emergency Medical Service (EMS) systems in the United States. NRHS applied and was selected in 2019, but due to the COVID-19 pandemic, the program was delayed until January 2021. This year, NRHS’s EMSStat ambulance service implemented Phase 1 of the program providing coverage in the Norman and Moore communities. Phase II plans include offering services outside of Medicare, adding urgent care facilities, telehealth and virtual options or offering our own mid-level providers, a wheelchair accessible van with an EMT available. Ms. Avila reported the ET3 is designed to support the Institute for Healthcare Improvement’s “Triple Aim”: o Improving the patient experience of care (including quality and satisfaction); o Improving the health of populations; and o Reducing the per capita cost of health care ET3 will: o Provide patient-centered care at the appropriate level of care o Promote proper utilization of high cost emergency services in an ER o Increase efficiency of EMS that will help providers focus on high-acuity patients being served emergently A review of EMSStat data (July 2018 thru June 2019) revealed nearly 4,000 patients arrived by ambulance as non-emergent patients. Of those, >50% were discharged to home the same day. Further investigation revealed EMSStat transports to the ER may also be caused by outside factors called social determents of health* *The social determinants of health are the conditions in which people are born,  NRHA Board Minutes 4 January 25, 2021 grow, live, work and age – as well as the complex, interrelated social structures and economic systems that shape these conditions. Social determinants of health include aspects of the social environment (e.g., income, education level, discrimination, marital status), the physical environment (e.g., place of residence, transportation systems, etc.), and health services (e.g., access to and quality of care, insurance status etc.). These findings indicate that this particular population should benefit from the ET3 program- including possible treatment in the home. Ms. Emmons, Ms. Avila and Ms. Richardson left the meeting at 6:12pm. Agenda Item IV. Approval of November 23, 2020, Norman Regional Hospital Authority Board Meeting Minutes Mr. Cubberley asked for approval of the November 23, 2020 Board Meeting Minutes ACTION TAKEN: Dr. Weber made the motion to approve the November 23, 2020 Board Meeting Minutes, with the correction of location of meeting. Dr. Anwar seconded the motion, and the motion was approved unanimously with aye votes from Mr. Cubberley, Dr. Weber, Ms. Womack, Mr. Chappel, Dr. Anwar, Ms. Greenleaf and Mr. Sherman. Agenda Item V. Performance Update Ms. Anderson, Administrative Director, Quality & Performance presented an update on Quality, Safety & Accreditation Readiness. Patient Quality origins began to appear with Dr. Avedis Donabedian, who is known as the “Father of Quality Assurance”. His healthcare services research in the 1950’s & 1960’s provided major contributions to Healthcare Quality: o Access to Healthcare o Measuring & Evaluating Quality o Completeness and Accuracy of Records o Observer Bias o Patient Satisfaction o Cultural Preferences From his research, he shared his finding in a 1966 paper titled “Evaluating the Quality of Medical Care” introducing developed framework for the Healthcare Quality Measures of Structure, Process and Outcome. These combined measures must be used in synchrony in order to improve quality overall. Currently, the Quality & Safety Team is reviewing 37 projects within the NRHS health system to identify if the structure, process and outcome measures are effective asking: o Are Structure Measures being used appropriately? o Are Process Measures present, limited, improving and how can we determine they are being achieved?  NRHA Board Minutes 5 January 25, 2021 o Will the Outcome Measures lag, experience variation and are the improvements/declines within statistical control? Patient Quality & Safety and Risk Management teamed up to form the Sentinel Event Determination Team (SEDT) to review patient care variances. Meetings are used to discuss changes in philosophy of reporting system design and process improvement to that will mitigate human error. Accreditation Readiness follows the concepts of “Just Culture”. The goals are to: o Create a culture where compliance is a comfortable and natural state of being. o Implement a robust safety program that identifies issues quickly and responds to process problems in a sustainable way. o Craft simple, easy-to-follow policies to ensure they are realistic and understood by staff. o Monitor processes in action, not merely the documentation. o Make regulatory compliance vitally important from the Board to the front lines. o Don’t ask clinical people to do silly things or risk losing credibility. o Make sure your organization is clearly patient-centric, safety and quality focused and nimble in response to challenges imposed by outside factors. Dr. Donabedian believed in System Management and Design, and also believed they are enabling mechanisms only. It is the ethical dimension of individuals that is essential to a system’s success. Ultimately, the secret of quality is love – love of patients and love of your profession. Agenda Item VI. Approval of the December 2020 Norman Regional Health System Financial Statements Mr. Hopkins presented the December 2020 Norman Regional Health System Financial report: December 2020 Financial Performance  Gross Revenues .................................. (Budget $213,361,160)............ $209,835,421  Net Patient Revenue .............................. (Budget $44,674,852).............. $44,462,247  Total Operating Expenses ..................... (Budget $43,758,823).............. $45,733,504  Total Operating Revenues ...................... (Budget $45,106,465).............. $44,846,121  Operating Income ................................... (Budget $1,3,47,642)................. ($112,617)  Non-Operating Revenues (Expenses) ..... (Budget $1,091,252).............. ($6,780,392)  Excess Revenues over Expenses ........... (Budget $2,4,38,894).............. ($6,893,009) Year-to-Date  Operating Income .................................... (Budget $4,614,538).............. ($1,211,561)  Non-Operating Revenues (Expenses) ..... (Budget $6,547,512).............. $23,195,600  Excess Revenues over Expenses .......... (Budget $11,162,050).............. $21,984,039  Accounts Receivable Days ............................ (Budget 43 Days).................. 48.0 Days  Days Cash on Hand…………………………………………………………….189.8 Days  NRHA Board Minutes 6 January 25, 2021 ACTION TAKEN: Mr. Sherman motioned to approve the December 2020 NRHS Financial Statements. Dr. Weber seconded the motion. December Financials were approved unanimously with aye votes from Mr. Cubberley, Dr. Weber, Mr. Chappel, Dr. Anwar, Ms. Greenleaf, Mr. Sherman and Ms. Womack. Agenda Item VII. Medical Staff A. Dr. Jawed presented the Medical Staff report. He stated the Medical Executive Committee (MEC) met on December 9, 2020. New Business:  COVID-19: Open discussion was held covering COVID-19 cases in Cleveland County and combined efforts for focus on patent and staff safety.  Ms. McGill provided an update on the Emerging Infectious Diseases (EID) team communications, the NRHS COVID surge plan and updates from Administration.  Mr. Foster provided an update for COVID-19 (Pfizer) vaccines, the continued timeline and adjustments in deliveries of the vaccine.  Mr. Manfredo presented an Inspire Health update on HealthPlex Design Development, parking lot locations and signage. Creditials Report:  Dr. Mullins presented the credential report for recommended approval. Department Reports:  Reports were provided by Cardiovascular Medicine, Emergency Medicine, Hospital Quality Patient Safety Committee (HQPSC), OB/GYN, Pediatric Hospitalist, Pharmacy & Therapeutics, Radiology and Transfusion Safety. Medical Staff Report:  Dr. Boyd thanked the physician healers for their services during COVID-19 and provided an update on the outpatient infusion center efforts offering high-risk patients monoclonal antibodies. Administrative Reports:  Ms. McGill provided an update on the Centers of Excellence focus for the Perinatal Care certification by the Joint Commission.  Ms. Carter provided an update regarding Aetna.  Mr. Splitt thanked all healers for providing great care for our patients. He announced COVID vaccines would begin in December 2020. Hospital Board Chair Report:  Mr. Cubberley provided an update on NRHS’s cyber security board report and thanked healers for their work and dedication to the community.  NRHA Board Minutes 7 January 25, 2021 B. Dr. Jawed presented the Medical Staff report. He stated the Medical Executive Committee (MEC) met on January 13, 2021. New Business:  Dr. Kolli provided an update on the COVID-19 hospital plan.  Ms. McGill provided an update on the state’s COVID surge plan, the COVID Care Committee and the new HIPPA-compliant patient and family smartphone app that allows for secure updates to be shared with families.  Ms. Carter presented information on the Outpatient COVID-19 Infusion Centers and their patient treatment requirements.  Mr. Manfredo presented an update on Inspire Health including the shift to the design process, new newsletter emailed to all healers periodically and an updated status on all campuses. Creditials Report:  Dr. Mullins presented the credential report for recommended approval. Department Reports:  Reports were provided by Anesthesia, Behavior Medicine, Emergency Medicine, GMEC, Hospital Medicine, Medicine Department, Pediatric Hospitalists, Pharmacy & Therapeutics, Physician Advisory Committee, Radiology, Surgery and Emergency Medicine Residency Program. Administrative Reports:  Ms. McGill congratulated the Perinatal Service Line for recently completing a very positive Perinatal Care certification virtual visit from the Joint Commission. The team was congratulated for building a very strong program and team. Final approval and full certification expected in the next 30-60 days.  Mr. Splitt thanked all healers for continuing to provide compassion, courage and strength while caring for our patients. The Norman Public Schools (NPS) Dimension Academy held a ribbon cutting last week for their new building located on Findlay Ave. NRHS donated land to NPS so that Dimensions could construct an on-site gymnasium for the students. The NRHS Food Pharmacy program continues to provide food items for those in need. NRHS partnered with Zoll to donate 16 Automated External Defibrillator (AED) devices to our partners at the Norman Fire Department and eight Zoll AED’s were donated to the Moore Fire Department as well. Agenda Item VIII. Strategic Planning Committee Dr. Jerry Weber presented a report from the January 11th meeting. Ms. Price introduced Suzanne Hawkins, Manager of Physician Relations and Business Development. Ms. Hawkins provided an update on Provider Star Ratings. These ratings  NRHA Board Minutes 8 January 25, 2021 are calculated and verified patient reviews from existing patient survey data. The ratings are published on a 5 star scale format based on real-time patient survey responses to 4 questions. Mr. Manfredo stated these questions are derived from data from the National Research Council (NRC) and correlate strongly with patient loyalty. Ms. Teresa Brown, Strategic Planning Specialist provided an overview of the Provider Integration and acquisition process. A team was formed in late 2019 to review processes that included recruitment, onboarding and orientation of new providers. The focus then expanded to provide a smoother, more detailed and successful transition process. Mr. Manfredo provided an update on Inspire health. Mr. Splitt provided an update on COVID-19 statistics and NRHS status. Agenda Item IX. Finance Committee A. Mr. Hopkins presented Capital items, 2 Resolutions and a Proposed Amendment. B. Mr. Hopkins presented for approval 6 capital request items totaling $1,376,432: a. Ultrasound Probes: $149,568 b. One Trophon & Printer: -$7995 c. Patient Stretchers: $216,784 d. The Well Clinic Contribution: $354,903 e. Ultrasound Machine: $279,216 f. EMSStat Ambulance Remount: $383,956 ACTION TAKEN: Dr. Weber made a motion to approve the Capital Equipment Requests at a total cost of $1,376,432 as recommended by the Finance Committee. Mr. Sherman seconded and the motion was approved unanimously with votes from Mr. Cubberley, Dr. Weber, Mr. Chappel, Dr. Anwar, Mr. Sherman, Ms. Greenleaf and Ms. Womack. C. Recommend approval of the Physician Retention Plan Amendment ACTION TAKEN: Dr. Weber made a motion to approve the Physician Retention Plan Amendment as recommended by the Finance Committee. Ms. Greenleaf seconded and the motion was approved unanimously with votes from Mr. Cubberley, Dr. Weber, Mr. Chappel, Dr. Anwar, Ms. Greenleaf, Mr. Sherman and Ms. Womack. D. Recommend approval of the Inspire Health Corporate Project Budget ACTION TAKEN: Dr. Weber made a motion to approve the Inspire Health  NRHA Board Minutes 9 January 25, 2021 Corporate Project Budget as recommended by the Finance Committee. Mr. Sherman seconded and the motion was approved unanimously with votes from Mr. Cubberley, Dr. Weber, Mr. Chappel, Dr. Anwar, Mr. Sherman, Ms. Greenleaf and Ms. Womack. E. Recommend approval of the Resolution for Acquisition of Real Property from NRH Medical Park West ACTION TAKEN: Dr. Weber made a motion to approve the Resolution for Acquisition of Real Property from NRH Medical Park West as recommended by the Finance Committee. Mr. Sherman seconded and the motion was approved unanimously with votes from Mr. Cubberley, Dr. Weber, Mr. Chappel, Dr. Anwar, Dr. Ms. Greenleaf, Mr. Sherman and Ms. Womack. Agenda Item X. Old Business Ms. Greenleaf provided an update from the Patient Quality and Safety Committee meeting held December 7th. Ms. Richardson provided an update on the Outpatient Infusion Clinic and Respiratory Clinics. The goal of the Infusion Clinic is to keep COVID patients out of the hospital by providing monochlonal antibody infusions. The clinic has been successful in reducing hospitalizations for high-risk COVID patients. The Respiratory Clinics have provided care for COVID patients experiencing respiratory symptoms. This clinic helps keep those patients out of the primary care physician offices, ER and hospitals. NRHS submitted an application and was approved for the Centers for Medicare and Medicaid Services (CMS) program called Acute Hospital at Home. The new CMS program was designed to increase the capacity of the hospitals to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus cases and hospitalizations across the country. CMS’s Acute Hospital at Home clearly differentiates the delivery of acute hospital care at home from more traditional home health services. While home health care provides important skilled nursing and other skilled care services, Acute Hospital Care at Home is for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis. Final approval for two accreditation surveys are ongoing. They include Perinatal Care and Nurse Residency. Agenda Item XI. New Business A. None  NRHA Board Minutes 10 January 25, 2021 Agenda Item XII. Administrative Report A. Ms. McGill provided a COVID-19 update. She reviewed: o COIVD-19 holiday surge numbers o Adjustments in surgery schedules o Link for family face to-face patient communication plan o Tracking tool for respiratory equipment o COVID floor/unit plan expansions as needed o Process for referral to the Outpatient Infusion Clinic o Regional Medical Response System (RMRS) update for placing patients into hospitals across the state. o Vaccine Clinic status o COVID Care Committee update B. Mr. Splitt provided a copy of the Community Benefit Annual Report to all Board members. A copy will be provided to Norman City Council membersand will eventually be made available online. C. Mr. Manfredo provided an update on Inspire Health including: o HelathPlex - Construction drawings, parking lot updates, monthly newsletter to all healers, preparing City Council presentation and proofing landscaping designs. o Freestanding ED (FSED) – Design Development drawings are close to being finished o Porter Health Village – Northwest tower, Education Center and EMSStat buildings are likely to remain, as we prepare the final master site plan for the City of Norman. 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; ACTION TAKEN: Dr. Weber made a motion to adjourn into Executive Session. Mr. Sherman seconded and the motion was approved unanimously with aye votes from Mr. Cubberley, Dr. Weber, Mr. Chappel, Mr. Sherman, Dr. Anwar, Ms. Greenleaf and Ms. Womack. B. Medical Staff Recommendations Regarding the Medical Staff Members/ Applicants as Listed in XIII.B 1-4 Below. 1. Recommend New Provisional Medical Staff Appointments a. James Paulsgrove, MD – Hospital Medicine – Active b. Arun Philip, DO – Hospital Medicine – Active c. Brian Milman, MD – Emergency Medicine – Active NRHA Board Minutes 11 January 25, 2021 d. Ryan Winfrey, DO – Hospital Medicine – Active e. Herschel Brown, MD – Emergency Medicine – Active f. Alexandra Howell, MD – APRN-CRNA – Anesthesia – Allied Health g. Kevin Schubach, PA-C – Radiology – Allied Health h. Candyse Brewer, APRN-CNS – Cardiovascular Medicine – Allied Health i. Brittany King, APRN-FNP – Hospital Medicine – Allied Health j. Brent Lamb, APRN-FNP – Emergency Medicine – Allied Health k. Hannah Kluth, PA-C – Surgery – Allied Health l. Garrett Wardlow, PA-C – Surgery - Allied Health m. Frank Welte, MD – Radiology – Privileges Only n. Karen Philips, MD – Radiology – Privileges Only 2. Recommend Medical Staff Reappointments: a. Namali Pierson, MD – Medicine – Active b. Mudassir Nawaz, MD – Hospital Medicine – Active c. Kristin Thorp, MD – Medicine – Active d. Mehran Shahsavari, MD – Hospital Medicine – Active e. Lesa Mulligan, MD – OB/GYN – Active f. Gautam Dehadrai, MD – Radiology – Active g. Tadgy Stacy, MD – Pediatrics – Active h. Alvin Bradford, DO – Emergency Medicine – Active i. Carrie Barton, MD – Emergency Medicine – Active j. Wayne Berryhill, MS – Surgery – Active k. M. Edmund Braly, DDS – Surgery – Active l. Vytautas Ringus, MD – Surgery – Active m. Steven Schultz, MD – Surgery – Active n. Sergio Garcia, MD – Medicine – Consulting o. Nancy Brown, DO – Medicine – Associate p. Rosemary Ayitey, MD – Medicine – Associate q. Rohitha Inturi, MD – Medicine – Associate r. Rodney McCrory, MD – Medicine – Associate s. Amanda Wright, MD – Medicine – Associate t. Karen Tyndall, PhD – Medicine – Allied Health u. Kristen Sweet, APRN-CNP – Cardiovascular Medicine – Allied Health v. Kasey Degiusti, APRN-CNP/RNFA – Surgery – Allied Health w. Jennifer Enteshary, APRN-CRNA – Anesthesia – Allied Health x. Steven Braudway, APRN-FNP – Emergency Medicine – Allied Health y. Morgan Segrest, APRN-CNP – Emergency Medicine – Allied Health z. Darren Gose, APRN-CRNA – Anesthesia – Allied Health aa. Darren Dupus, APRN-CRNA – Anesthesia – Allied Health bb. Kerri Baker, PA-C – Surgery – Allied Health cc. Gregory Dinwiddie, PA-C – Surgery – Allied Health dd. Lara Green, PA-C – Surgery – Allied Health ee. Glenroy Hines, PA-C – Surgery- Allied Health 3. Recommend Advancement of Medical Staff from Provisional Status:  NRHA Board Minutes 12 January 25, 2021 a. Alexander Jones, MD – Surgery – Active b. Sung Hwang, MD – Anesthesia – Active c. Jayesh Panchal, MD – Surgery – Courtesy d. Brittany McShane, DO – Hospital Medicine – Privileges Only e. Jeff Bivens, PA-C – Medicine – Allied Health f. Graham Roberts, MD – Radiology – Active g. Megan Johanning, DO – Emergency Medicine – Active h. Jeff Raines, DO – Emergency Medicine – Active i. Brant Bennett, MD – Medicine – Active j. Brooke Burks, APRN-CNP – Pediatrics – Allied Health k. Jennifer Cruz, APRN-FNP – Emergency Medicine – Allied Health 4. Information Only: a. James Love, MD – Active to Associate b. Andy Phillips, DO – Ed Moonlighting Privileges c. Kate Petrilla, DO – Ed Moonlighting Privileges d. Muhammad Anwar, MD – TAVR Privileges e. Muhammad Salim, MD – TACR Privileges C. Request to Adjourn Out of Any Such Executive Session and Return to Regular Session ACTION TAKEN: Mr. Sherman made a motion to adjourn out of Executive Session. Dr. Weber seconded, and the motion was approved unanimous aye votes from Mr. Cubberley, Dr. Weber, Mr. Sherman, Mr. Chappel, Dr. Anwar, Ms. Greenleaf and Ms. Womack. Mr. Cubberley 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 XII B 1-4. 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 XII B 1-4. Ms. Greenleaf seconded, and the motion was approved with unanimous aye votes from Mr. Cubberley, Mr. Weber, Mr. Sherman, Dr. Anwar, Mr. Chappel, Ms. Greenleaf and Ms. Womack. Agenda Item XIV. Board Open Discussion Mr. Splitt reminded the Board, if asked, NRHS is prepared to assist the state with the broader distribution of the COVID-19 vaccine.  NRHA Board Minutes 13 January 25, 2021 Agenda Item XV. Adjournment ACTION TAKEN: Dr. Weber made a motion to adjourn the meeting at 7:54pm. Dr. Anwar seconded, and the motion passed unanimously with aye votes from Mr. Cubberley, Dr. Weber, Mr. Chappel, Mr. Sherman, Dr. Anwar, Ms. Greenleaf and Ms. Womack. Respectfully Submitted, Tom Sherman, Vice-Chair/Secretary