Roll call was delayed until Amy Mahon arrived. Centura Value

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1 KREMMLING MEMORIAL HOSPITAL DISTRICT Dba Middle Park Medical Center Minutes, 6:00 PM Location: Cathy Shipley Community Room 715 Kinsey Street, Kremmling, Colorado With meeting notice, Gary Bumgarner called to order without a quorum the Kremmling Memorial Hospital District Board Meeting at about 6:02 PM. A quorum was reached at 6:15 PM. Board members present: Gary Bumgarner, Vice-President; Kelly Johnson, Secretary/Treasurer; Amy Mahon, Member (arrived 6:15pm); Bernie Murphy, President (arrived 8:00PM); absent excused: Jeff Miller, Member. Also present: David Ross, Trampas Hutches, Carmen Covington, Jason Bryan, Christian Hornbaker, Marissa Lorenz, Mikealena Horner, Carol Petersen, Deb Menhennett, Brenda Hickman, Jen Fanning, and Diana Dahl. Roll call was delayed until Amy Mahon arrived. Centura Value We have finalized relationships between MPMC and two specialist physicians (Drs. Choi and Hall) who will be serving Grand County beginning in April. Bob and Russ from Centura continue to attend key MPMC meetings. Centura has agreed to provide financial/budget preparation services for MPMC in its Forbearance relationship. They continue efforts to develop a network-wide self-funded employee health insurance plan. We are beginning the process to develop/present health education forums to residents of Grand County. We have coordinated/developed rural hospital best practices through quarterly Centura Affiliate meetings. We are convening discussion and problem resolution for all Healthland users in the state. Trampas will talk about this later. Centura is partnering with MPMC to transition referral lab services. IT There was a meeting between 6 Colorado hospitals who use Healthland. All of these hospitals are experiencing the same problems. Three of these hospitals are on the new version of Healthland and lost $3M in charges during the transition to the new version. We are sending a letter to the Healthland CEO about the issues experienced. We are looking at a decision in five weeks on what to do, possibly moving to Meditech for the next 3-5 years. Suggestions will be brought to the next board meeting. Gary asked that we bring to the next meeting the cost and options on what other hospitals are doing. Amy Mahon arrived at 6:15 PM.

2 Kremmling Memorial Hospital District Page 2 Agenda Approval A motion was made by Amy Mahon and seconded by Kelly Johnson to approve the agenda with the addition of the discussion of the purchase of OR equipment. Motion adopted on a 3-0 vote. Public Comments No public comments were made at this meeting. Minutes A motion was made by Amy Mahon and seconded by Kelly Johnson approving the minutes from the January 20, January 29, and February 18, 2015 meetings. Motion adopted on a 3-0 vote. Privileging for Approval The following providers were presented to the board for privileging approval: Timothy Lawton, M.D, Provisional Courtesy Privileges in Family Practice Mark E. McCaulley, M.D., Full Courtesy Privileges in Gastroenterology and Internal Medicine Sandra L. Zila-Eivins, M.D., Full Courtesy Privileges in Dermatology Andrea M. Bayliss, CRNA, Provisional Courtesy Privileges in Anesthesia (CPR) Benjamin S. Clower, M.D., Full Courtesy Privileges in Family Practice Joan Primozich, FNP-C Provisional Courtesy Privileges as Nurse Practitioner A motion was made by Amy Mahon and seconded by Kelly Johnson approving the privileges noted. Motion adopted on a 3-0 vote. Consent Agenda A motion was made by Kelly Johnson and seconded by Amy Mahon approving the items in the Consent Agenda. Motion adopted on a 3-0 vote. Policies and Procedures for Approval P&Ps for January and February 2015 were presented for approval. A motion was made by Amy Mahon and seconded by Kelly Johnson approving the P&Ps presented. Motion adopted on a 3-0 vote. Resolutions for Approval The following resolution was presented to the board for approval:

3 Kremmling Memorial Hospital District Page 3 Resolution # : Resolution for Opening New Bank Account to Save Toward Replenishment of Bond Reserve Fund and Financial Signature Authorization for Said Account, Bank of the West A motion was made by Amy Mahon and seconded by Kelly Johnson approving this resolution, with the notation that the account will be opened with an initial $5,000 deposit. The amount of the monthly deposit to this account will be discussed at the next meeting. Motion adopted on a 3-0 vote. Chiefs of Staff Report None of the tri-chiefs were present to report. Human Resources Officer Report Jason Bryan Turnover Employee turnover for January 2015 was 0.13% for PRN staff, and 0% for regular staff, compared to 2% for employee staff in Recruiting A concierge position for Granby was filled and that person will start March 10. This person will answer phones and direct those calls to appropriate departments, and will direct people to where they need to go at the Granby facility. The phone system will be tested before this person comes on board. Hiring for new positions or filling vacated positions will go through SLT first before those positions are advertised and filled. Dr. Dawn McCartney has expressed interest in becoming a part-time provider in Kremmling. She will soon be interviewed by the providers. She has worked for us in the past and this will be a good move to foster continuity of care. Benefits Enrollment in benefits is down a bit this year. We continue to have a good portion of claims going non-domestic. The vast majority of those claims are due to the fact that we don t offer those services here. Workers Compensation Eleven claims for 2014 are closed. We had one new claim, and two open claims in January Chief Operating Officer Report Trampas Hutches Phones Our phone group will perform a test before the concierge comes on board. Our goal is that when people call Granby, they will receive a live person 100% of the time. The test will be performed a week from Monday, and then will be rolled out live. If the test is successful, we will purchase a digital phone system in April. Kremmling will eventually get the digital phone system as well. We have also been working with CenturyLink to provide us with Caller ID.

4 Kremmling Memorial Hospital District Page 4 EMR Healthland support will no longer be available in March The upgraded version is running on a Windows 2003 server which will not be supported by Microsoft and will not be upgraded by Healthland. A Colorado Healthland Task Force has been formed. Trampas will be making a recommendation to the BOD on MPMC s next steps for an interim solution until Centura is ready for Epic in 24 months. CNO Report Carmen Covington Good news we had the highest number of inpatients in 2015 so we are over revenue projections in that department. Kremmling Urgent Care is now seeing patients 7 days a week. The Kremmling ED is now collecting co-pays from patients who come in during the daytime. The nurse aides are being trained on how to collect the copays when the unit secretaries have left for the day. MPMC recently took part in an Ebola tabletop exercise along with other county agencies. We have a good plan in place in the event a case should be seen. Service Excellence huddleboard processes are currently being rolled out. Surgical Services is gearing up for the arrival of new provider specialists. OR Equipment Purchase Several bids have been placed for new surgical equipment needed. Brenda explained to the board that the back-up piece of equipment they currently have is no longer serviceable. If we do not have a working back-up piece of this equipment and the regularly used piece fails during surgery, we will have to fly the patient out. This is a patient safety issue. Brenda went over the bids and the benefits of one bid in particular from Arthrex, which included billable supplies in the quote. Surgical providers thought this one was the best choice. A motion was made by Amy Mahon and seconded by Kelly Johnson approving the purchase of the equipment in the Arthrex quote. Motion adopted on a 3-0 vote. Discussion: Amy noted that we cannot capitalize the billable patient portion of the quote. CEO Report David Ross We have implemented initiatives to address opportunities identified in our 2015 Strategic Plan. Specialty Services - Initiated discussions with Centura and YVMC to expand its specialty clinic services. We plan to add an ophthalmologist, expand cardiology and OB/GYN, and add pain

5 Kremmling Memorial Hospital District Page 5 management and neurosurgery (April). We are also in discussions with YVMC to expand orthopedics. Service Excellence - MPMC leadership has established an "Accountability Committee" to identify opportunities to address employees who have not met expectations. Our goal is to coordinate fairness with proactive implementation of strategies to improve overall value. We have also established an "Employee Satisfaction Committee" to address opportunities for improvement in response to verbatim comments from our employees in the recent survey. Centura - At the end of April, all MPMC Senior Leadership members will have attended the Centura New Leader orientation. We continue discussions with Centura about the potential establishment of an integrated self-funded employee health insurance program. We are also working with Centura to maximize cost savings from our involvement in the 340b pharmacy plan. Community Health - Carmen and I have met to identify opportunities to partner with Grand County Rural Health Network, local home health/hospice, Grand County Public Health and other local agencies to address the areas of interest in the recent Grand County health assessment (2013). MPMC leadership continues to be committed to significantly improve the billing and revenue cycle process. We have contracted with ReSolution to replace HRG as our billing specialists. We are optimistic that, together, we can improve the timeliness of our billing, and ensure that we receive all payments due and owing to us for services rendered. MPMC has recruited 4 physicians over the past three months. Effective July 2015, when Dr. Buell arrives, MPMC will have completed its physician recruitment endeavors. As a result, MPMC will see a significant reduction in its reliance upon locum tenens physicians. David has joined several local clubs and organizations in the Grand County community. Strategic Plan Update David handed out an abbreviated document containing the four Strategic Plan Priorities. This will be given to the board each month with updates on progress on these priorities. Sherri will put the document in the original format so that the priorities can be color coded to easily identify progress. Financial Reports, December 2014, and January 2015 Mikealena Horner Mikealena went over the financials in the Executive Summaries, Balance Sheets, and P&L Statements for December 2014 and January 2015, and answered questions of the board. Gary would like to see the water utility expense for the Granby facility to compare to Kremmling s utility expense, and a cash flow projection for 6 months at MPMC at every meeting. Board members will get any questions to Brendan that they have about the reports.

6 Kremmling Memorial Hospital District Page 6 Marketing Strategic Plan Christian Hornbaker went over his Marketing Strategic Plan for His department has been budgeted over $200K for marketing. Comments from board members included newspaper stories should be correlated with our Facebook page. Bernie thinks we should advertise in the local papers weekly, starting next week, with different services highlighted. Marketing could be community focused. A workshop was suggested to determine what marketing techniques will work best for our needs. Bernie noted that the hanging plaques on the sign outside of the Kremmling Clinic need to be updated with the names of our current physicians. Quality Scorecard Carmen Covington Carmen noted that she would like to put her regular CNO Report in the Consent Agenda so that for her verbal report to the board, she can go over the Quality Scorecard. The board agreed to this change. Carmen went over details on the Quality Scorecard. David Solawetz will get with Christian to put something in the paper on quality improvements. It is important for the community to be kept abreast on the quality improvements we are working towards.. Items to Discuss at Next Board Meeting Resolution on monthly deposit amount to Bond Fund replenishment account MPMF Meeting dates for 2015 Policy for write-offs Serious Healthland issue what other hospitals are doing about it and what the cost is Finances on website Breakdown of legal expenses in Finance Report Lease breakdown Cash flow projection and monthly actual Approve December 2014 and January 2015 financials Expenses for water utilities at the Granby facility Marketing Breakdown of money due to patients Future Meetings It was noted that notice must be posted for MPMC board attendance at the March 24 meeting with the Granby Board of Trustees. Notice will also be posted for a special meeting of the MPMC board on March 19. Subject matter will be a finance discussion, including what Walden and Winter Park are costing us to run them, and how are we going to pay off the loan we owe on the purchase of the Annex Building.

7 Kremmling Memorial Hospital District Page 7 With no further business, the meeting was adjourned at 9:00 p.m. NEXT REGULAR MEETING: Thursday, March 26, 2014, 6:00 p.m., Cathy Shipley Community Room, K-8 School, Kremmling, Colorado. Bernie Murphy, President Kelly Johnson, Secretary/Treasurer Approval Date: Minutes taken by Sherri Solawetz