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2015 Press Ganey Pinnacle of Excellence Award Winner Date: BOARD OF DIRECTORS MONTHLY MEETING MINUTES Attendance of Board Members: Attendance of Staff Members: Absent: Helen Shepherd, Chair; Lynda Salcido, Vice Chair; Stephen Swisher, M.D., Treasurer; Ryan Wood, Secretary; Jack Copeland, Member at Large. Gary Myers, CEO; Melanie Van Winkle, CFO; Craig Burrows, M.D., CMO; Mark Lind, CIO; David Baumwohl, Legal Counsel; Robin Conners, Recording Secretary. Kathleen Alo, CNO. I. CALL TO ORDER Chair Shepherd called the meeting to order at 8:03 a.m. II. PLEDGE ALLEGIANCE TO THE FLAG AND READING OF THE SMHD VISION, MISSION AND VALUES The meeting was opened with the Pledge of Allegiance to the Flag and the reading of the SMHD Mission, Vision & Values by Jack Copeland. III. PUBLIC COMMENTS Jack Copeland, SMHD Board Member at Large, introduced Laurey Carlson who is interested in being on the SMHD Board in the future. Lorrie Gould, Mammoth Hospital Auxiliary Vice President, reported the following: 1. The Mammoth Hospital Auxiliary Capital Outlay budget for Mammoth Hospital this year will be $170,000. IV. CHIEF OF STAFF REPORT P.O. Box 660 85 Sierra Park Road Mammoth Lakes, CA 93546 760.924.4114 Fax 760.924.4104 www.mammothhospital.com METICULOUS CARE * MEMORABLE PEOPLE * MAJESTIC LOCATION

Yuri Parisky, M. D., Vice Chief of Staff, reported that the Medical Staff is developing various new policies for the Medical Staff. V. ADJOURN TO CLOSED SESSION The Board adjourned to closed session at 8:10 a.m. Dr. Yuri Parisky, Chief of Staff, requested to attend the Closed Session as Chief of Staff. The request was granted. VI. REPORT ON CLOSED SESSION The Board reconvened to open session at 9:11 a.m. CONFERENCE WITH LEGAL COUNSEL PENDING AND THREATENED LITIGATION Existing Litigation and Significant exposure to litigation pursuant to Government Code 54956.9. 1. Inyo County Local Agency Formation Commission (LAFCO), Northern Inyo Healthcare District v. Southern Mono Healthcare District, Sacramento Superior Court Case No. 34-2015-80002247-CU-WM-GDS. Chair Shepherd reported discussion of CONFERENCE WITH LEGAL COUNSEL on PENDING AND THREATENED LITIGATION for the above item; no action taken. QUALITY ASSURANCE (Health and Safety Code 32155) 1. Chief of Staff Report. Chair Shepherd reported that QUALITY ASSURANCE issues were discussed with Yuri Parisky, MD., Chief of Staff; no action was taken. 2. CEO Report. Chair Shepherd reported that QUALITY ASSURANCE issues were discussed with Gary Myers, CEO; no action was taken. 3. CNO Report. Chair Shepherd reported there was no CNO Report due to the absence of Kathleen Alo, CNO. 4. CMO Report. Chair Shepherd reported that QUALITY ASSURANCE issues were discussed with Craig Burrows, M.D., CMO; no action was taken. Page 2 of 8

QUALITY ASSURANCE QUARTERLY SUMMARIES - (Health and Safety Code 32155) 1. Annual Evaluation of Critical Access Hospital Quality Improvement Activities Fiscal Year 2015-2016. The review of the Annual Evaluation of Critical Access Hospital Quality Improvement Activities Fiscal Year 2015-2016 was tabled until the August Board meeting; no action was taken. HEALTH CARE FACILTY TRADE SECRETS (Health and Safety Code 32106) 1. Sierra Park Clinics/Mammoth Hospital. Chair Shepherd reported HEALTH CARE FACILITY TRADE SECRETS were discussed regarding Sierra Park Clinics/Mammoth Hospital; no action was taken. PERSONNEL MATTERS (Government Code 54957) 1. Gary Myers, CEO Chair Shepherd reported a discussion took place with Gary Myers, CEO; no action was taken. 2. CEO Evaluation Chair Shepherd reported that the CEO annual evaluation was discussed; no action taken. CREDENTIALING Reappointment Sean Park, M.D. Serra Tranmer, D.O. Hospitalist Family Medicine Appointment to Provisional Staff Ronald Otto, M.D. Radiology Temporary Privileges Ronald Otto, M.D. Radiology 03/19-27/2016 Arash Kohanteb, M.D. Emergency Medicine 07/18-21/2016 Noah Levit, M.D. Emergency Medicine 06/27-30/2016 04/24-25/2016 04/29-30/2016 Lawrence Willes, M.D. Pathology 07/28-30/2016 Carolyn Saba, M.D. Anesthesia 07/24-08/08/2016 Amy Saft, CRNA Anesthesia 07/06 & 07/2016 Chair Shepherd reported the foregoing physician CREDENTIALING was discussed; no action was taken. Dr. Parisky left the meeting at 8:47 a.m. Page 3 of 8

The Closed Session ended at 9:00 a.m. VII. PUBLIC COMMENTS Judy Bornfeld, Mammoth Hospital Auxiliary President reported: 1. The volunteers spent 15,462 hours working at the Cast Off this past year. At an estimated value of $23.56 per hour, this equates $364,284.72. VIII. CONSENT AGENDA (All matters on the consent agenda to be approved on one motion unless a Board Member requests separate action on a specific item) 1. Previous Minutes to be approved: June 16, 2016 Regular Board Meeting June 29, 2016 Special Board Meeting 2. Chief Financial Officer Report 3. Chief Nursing Officer Report 4. Chief Information Officer Report 5. Human Resources Report 6. Facilities Report Jack Copeland made a motion, seconded by Lynda Salcido to approve all items on the consent agenda as presented in the packet. Chair Shepherd asked for comments; a brief discussion ensued including clarification and comments on some items in the CNO report and the Patient and Family Center Care Annual Report. A roll call vote was taken; the motion passed unanimously. Yes 5, No 0. IX. COMMITTEE REPORTS 1. Finance Committee Stephen Swisher, M.D., Helen Shepherd Details from the Finance Committee Meeting will be covered in the Financial Report. 2. Physician Compensation Helen Shepherd, Ryan Wood There was no Physician Compensation meeting; no report. 3. Employee Relations Committee Helen Shepherd, Jack Copeland 4. Quality Committee Stephen Swisher, M.D., Lynda Salcido 5. CEO Annual Review Committee Lynda Salcido, Jack Copeland Page 4 of 8

Jack Copeland and Lynda Salcido met to discuss the format, criteria and timeline for the evaluation and are working on a plan to be implemented in the future. 6. IT Steering Committee Stephen Swisher, M.D., Ryan Wood 7. Facilities Committee Ryan Wood, Jack Copeland Jack Copeland reported that the Facilities Committee; Gary Myers, CEO, Dan Conners, Facilities Manager Ryan Wood and himself, met on July 6. Projects were reviewed. Projects are well managed and moving along well. Stephen Swisher reported that emergency alarms may need more effective follow up to assure repairs are completed when needed. 8. Policy and Contract Committee Stephen Swisher, M.D., Jack Copeland 9. Board Member Recruitment Committee Jack Copeland, Ryan Wood Jack Copeland reported that there is one person interested in joining the SMHD Board. Laurey Carlson was introduced earlier in the meeting. 10. Ad Hoc, Special, or Other (as needed) Committees 1. Northern Inyo Hospital Liaison Committee Lynda Salcido, Jack Copeland 2. Community Assessment Committee Lynda Salcido, Gary Myers The development of the Implementation Plan will begin soon to be completed in the next few months. X. CHIEF EXECUTIVE OFFICER REPORT Gary Myers, CEO, presented the following additional information to his written report: 1. The Human Resources Department is increasing the advertising for high level positions that are often difficult to recruit. 2. Mammoth Hospital has had to decrease service at the Bridgeport Clinic from four to two days a week. Dr. Chris Ward, Medical Director of Bridgeport Clinic, will go to the Bridgeport Clinic one day a week and a mid-level provider will be there on the second day each week. Page 5 of 8

XI. FINANCE REPORT 1. Preliminary June 2016 Financial Statements. 2. Investment Report. Melanie Van Winkle, CFO, reviewed and presented the Financial Statements, included in the packet via PowerPoint presentation. Ms. Van Winkle reported the June Net Gain was $1,704,000 which resulted in a favorable budget variance of $1,273,000. The favorable variance is a result of higher ancillary and clinic volume and maintaining expenses at a lower level for the month thus creating higher than budgeted income for the month. The year-to-date Net Gain was $10,222,000 which resulted in a favorable year-to-date budget variance of $5,893,000. Days of cash-on-hand were at 285.8 at the end of June. 3. Review of Quarterly Capital Expenditure Status. The Quarterly Capital Expenditure Report was reviewed; no action needed. XII. BOARD EDUCATION 1. SMHD Annual Report presented by Gary Myers, CEO. The SMHD Annual Report was presented by Gary Myers, CEO, via PowerPoint presentation. XIII. OLD BUSINESS There were no matters to discuss this month. XIV. NEW BUSINESS 1. Review and Possible Approval of Revisions to the 2016 Success Sharing Program. The above item was not discussed. There will be no revisions to this program. 2. Review and Possible Approval of Revisions to the 2017 Success Sharing Program. Melanie Van Winkle, CFO, presented the Revisions to the 2017 Success Sharing Program. Lynda Salcido made a motion, seconded by Jack Copeland to approve the Revisions to the 2017 Success Sharing Program as presented in the packet. Chair Shepherd asked for comments; a brief discussion ensued. A roll call vote was taken; the motion passed unanimously. Yes 5, No 0. Page 6 of 8

3. Declaration of Surplus District Property, Equipment and Supplies. Ryan Wood made a motion seconded by Jack Copeland to approve the disposal of Surplus District Property, Equipment and Supplies presented to the Board and to direct staff to dispose of it in the manner most beneficial to the District. The Surplus District Property, Equipment and Supplies presented have nominal or no value. Chair Shepherd asked for discussion; a brief discussion ensued. A roll call vote was taken; the motion passed unanimously. Yes 5, No 0. XV. CREDENTIALING Reappointment Sean Park, M.D. Serra Tranmer, D.O. Hospitalist Family Medicine Appointment to Provisional Staff Ronald Otto, M.D. Radiology Temporary Privileges Ronald Otto, M.D. Radiology 03/19-27/2016 Arash Kohanteb, M.D. Emergency Medicine 07/18-21/2016 Noah Levit, M.D. Emergency Medicine 06/27-30/2016 04/24-25/2016 04/29-30/2016 Lawrence Willes, M.D. Pathology 07/28-30/2016 Carolyn Saba, M.D. Anesthesia 07/24-08/08/2016 Amy Saft, CRNA Anesthesia 07/06 & 07/2016 Jack Copeland made a motion, seconded by Lynda Salcido to approve the appointments as listed above except for Serra Tranmer, D.O., Arash Kohanteb, M.D., and Noah Levit, M.D. Chair Shepherd asked for comments: it was noted that the appointments were discussed in closed session and no action was taken. A roll call vote was taken; the motion passed unanimously. Yes 5, No 0. Ryan Wood left the room at 10:09 a.m. Lynda Salcido made a motion, seconded by Jack Copeland to approve the appointment of Serra Tranmer, D.O. Chair Shepherd asked for comments: it was noted that the appointments were discussed in closed session and no action was taken. A roll call vote was taken; the motion passed unanimously. Yes 4, No 0. Ryan Wood returned to the room at 10:10 a.m. Stephen Swisher, M.D., left the meeting at 10:11 a.m. and did not return to the meeting. Lynda Salcido made a motion, seconded by Jack Copeland to approve the appointments of Arash Kohanteb, M.D., and Noah Levit, M.D. Chair Shepherd asked for comments: it was noted that the Page 7 of 8

appointments were discussed in closed session and no action was taken. A roll call vote was taken; the motion passed unanimously. Yes 4, No 0. XVI. FUTURE BUSINESS A Special Board Meeting to be held on August 5, 2016 at 8:00 a.m. in Conference Room C (3 rd floor in the SPORTS Building) at Mammoth Hospital. The next Regular meeting will take place on Thursday, August 18, 2016 at 8:00 a.m. in Conference Rooms A & B at Mammoth Hospital. ADJOURN There being no further business the meeting was adjourned at 10:10 a.m. Page 8 of 8