PMC Hospital Board Meeting April 2026

Great, I'd like to call this meeting to order. Sheena, if you could call the roll.

Board president absent. Vice President Longakis here. Board Secretary Cushing here. Board member Stratman— Joe, can you hear us? I see that he is online.

Having a little technical issue. There it is.

Does he know he's on mute? He's marked as mute. Yeah, we can't hear you, Joe.

Can you hear us, Joe?

Apparently not. He's not nodding.

See you soon.

And we're just trying to work through the technical issues. We'll be on in a minute. We do have a quorum, however.

Board Member Khan is absent. Board Member Roberts here. Board Member Johnson here.

Okay, like here in the chat, we can see that they can hear us. Okay, all right, let's—. Look like it's broadcasting on the KFSK Live right now. It is not, or it is?

We'll continue on. Okay, we will continue on. The next item on the agenda is approval of the agenda. Do I have a motion to approve the agenda? Motion we approve the agenda for today.

It's been approved by, uh, moved by Jim and seconded by Joni to approve the agenda. Is there any discussion? Oh, it was an amendment to the agenda.

Revise New Business A to match the revised letter for policy provided. Motion: Need for Petersburg Medical Center's Hospital Board of Directors to approve predesignated individual or individuals, the manager of home health, chief nursing office, or additional approved designee if applicable, to assume the full responsibilities and obligations of the Home Health Agency Administrator, the CEO, in the event of the CEO's absence or inability to fulfill that role.

I second. It's been approved— moved by Joni, seconded by Marlene for the amendment to the agenda. Is there any more discussion on that? Hearing none, all those in favor of the amendment? Aye.

Opposed? All right. And then the motion to approve the agenda as a whole, as amended.

All those in favor? Aye. Opposed? And the agenda passes as amended. We need an approval, a motion to approve the board minutes.

I move to approve the March 20th, 2026 Hospital Board Minutes. Second. It's been moved by Joni, seconded by Jim to approve the minutes. Is there any discussion about the minutes? Hearing none, all those in favor of approval?

Aye. And opposed? And that motion is passed. Next item on the agenda is visitor comments. Do we have any visitor comments?

Moving right along, we have board member comments. Does anybody have anything? Go ahead, Marlene. Um, just want to, uh, say congratulations that we got our certificate of need. Yes, another big, big hurdle.

Are there any other board member comments?

The only thing that I wanted to say was I did see that Senator Steadman was at the opening of the hospital in Sitka. Which is a great opportunity for Sitka. We've had Mary Paltola tour our hospital. Lisa Murkowski has toured our hospital. Representative Himschute has toured our hospital, as has Nick Begich.

I would encourage the senator. We have made so much progress with where we were. I mean, we've been talking about getting a new hospital now for 15, 17 years or more. And there are challenges, as Wolf has noted in his report. And I would just really encourage the senator to please come tour the hospital and the new facility the next time that he is in town.

Moving on to committee reports. The first one is the Resource Committee report, which I have. And with the exception of long-term care, which had a large census change this past year, Many service lines are seeing more activity. Financially, we're in a good place for the most part, and we've submitted our cost report, but the process is not finalized yet. We have seen some changes in the Medicare pricing structure for the 340B program that have resulted in lower reimbursements to PMC.

And this program requires pharmaceutical companies to sell outpatient drugs at discounted prices to a variety of entities, including critical access hospitals such as PMC. And though our balance sheet looks good overall, contract labor costs are impacting expenses, as is having the work building up and running and the cost of winter utilities, which hit everybody, I think. However, an increase in outpatient services does offset some of these expenses, and we're waiting on more information on the Rural Health Transformation Program, and hopefully we'll know more by mid-May. We have 7 pending grant requests through RTP. And although we don't expect all will receive funding, they should be lined up to be able to revise and resubmit quickly once we know more about what's being asked for.

And we do know the timeframes are going to be tight on these. So Katie's, Katie's ready to go and our grant writer and Joe was able to come in in person. So I just want to acknowledge that.

And Infection Prevention Quality Committee report. Yeah, this is Joe. I attended the infection control meeting on April 15th. Minutes from the previous meeting were approved. We, we did not get an update from public health at that meeting.

We talked about progress made in the decontamination room and went over the action item list, which included discussion items on handrails and outpatient antibiotic reports, mold testing, hand hygiene supplies, EVS checklist, antibiotic stop time investigation. Follow-ups are continuing on that. Talked about the sterile processing room needs, magnetic door stops, various— and I'm sorry, also food area walkthrough improvements. Went over reports. Environmental care reports, portable conditions, hand hygiene, again antibiotic stewardship, employee health.

The recent endoscopy clinic was discussed, um, uh, a report from Environmental Services, and then we finished the meeting with a departmental roundtable, um, discussing some various items.

Next up is reports. Does anybody have any comments or questions on the pharmacy report?

Next item is the rehab department, and Brenna McMahon submitted her report. Any questions or comments about that? I had just one quick question, and with the remodel, do you have an estimated date when that'll be completed and you can use it? You go up— if you can go up to the mic, thanks. Just press the button on it, on it.

Okay, uh, we do not. We still—. We need to like actually order the flooring for it. Um, so Wolf has the measurement, huh? 2 Months?

Okay, Wolf says 2 months. We're gonna hold him to it.

All right, thank you.

Thank you. Next up is plant maintenance, and Wolf submitted his report. Any comments or questions about that?

Hi there, uh, Wolf Brooks here with facility maintenance. I just wanted to give a couple high-level overview of my report, also to follow up with the previous question. So Yesterday we actually finally figured out how to get the old morgue out of the room that it was in. It's quite the process because it weighs close to 2,000 pounds and don't really have a good way of moving that, but we were able to get it out. So this kind of starts the chain reaction of being able to move EVS's supplies out of where the gym is going to go so that now we can renovate and turn it into a gym.

So, um, I guess I'd start with workforce wellness. Our biggest thing has been staffing. About the last 3 months, we've been significantly understaffed, but coming next week, we're actually getting an additional 2 people. This also includes our— we're getting a facility electrician, so I'm very, very excited about that. It should tie in pretty well to our kind of larger goal of wanting to in-house a lot of our maintenance projects.

Um, that was mostly the main one, and you guys will see in the report, and our facility's continuing to show signs of its age. Um, even just this morning I was doing my rounds, and in our boiler room I noticed a pool of water. So I looked up and there was about a 5-foot section of cast iron line that failed, and it failed to the point where I could just stick my finger through it. And this has actually happened before, but That's— it's— yeah, it's showing its age, I guess. But anyways, I don't know if anybody has any questions.

I don't have any questions, but I appreciate that you always come to the podium with a smile on your face, and I really liked how you described community engagement for facilities management because I do think it's important. So thank you very much. Thank you.

Next report is Environmental Services. Any questions on that report? Wolf was gonna comment on that one as well. What's that? Wolf will comment on that as well since we're up to Wolf.

Yeah, I, uh, so I kind of have a— I play a role with Environmental Services, so I'm here. Uh, Graysell wrote this report, but we've, um, EVS has remained somewhat kind of neutral, I guess. Uh, staffing's been— they had a couple shortages, but right now we're— I think we're only short one position, so that's pretty good as far as kind of historical numbers. They've been very busy with both cleaning, with the addition of the scopes clinics, and also we're— our, I guess, our biggest initiative is training. With the new Ecolab tech, we've gotten quite a few new training programs that we're going to start kind of rolling out, so we're pretty excited for that and seeing how that'll impact just regular services.

Also, I Was mentioned the EVS checklists and various other things to just ensure that we're doing the best we can there. Any questions?

Thank you.

Right. Home health. Ruby, do you have anything additional or does anybody have any questions?

Hello.

I do have just a question, but it's simply because I didn't understand what it means when you say your outreach case management to the community of Wrangell. What does that entail? Yeah, so we just put in— Katie Bryson and Brandy Boggs and I put it together— an in-home seniors grant. So Brandy, when she comes to visit, she'll come quarterly and she will do case management not only in Petersburg, but will be going over to Wrangell and offering services over there. So that can be asset planning, signing up for Medicaid, Medicare, just being able to be an extra resource over there.

Yeah, you're welcome. And I actually had some questions about the personal care. Mm-hmm.

If, if we hired that person, does insurance pay for any of that or does that all come out of pocket for the person that's being assisted? So Medicaid is currently the only insurance that will pay for personal care services in the home. And so what we're looking at doing is having a separate business line. So it would be still within the home health or home health adjacent. We would still be using our CNA and possibly having another CNA and trying to find a price that would be— it would be out of pocket, but hopefully affordable.

So we're in the planning process. I did a demo or we have an introduction to how to add that business line and then we have a demo next week that it could be using the same EHR that we use for home health, but it would be completely separate. And EHR is electronic health record. Yes. When we go through the acronyms, sometimes I feel like we leave people behind.

They should know what we're talking about. Yeah, so it would just be an addition to the current program that we're using, so we would need training, but not as vigorous of training as if we needed to create a whole new, whole new business. So I was encouraged to see this. Yeah, I really think that it would fill a big gap. Every house we leave, they're like, please, can we just— can we hire Shirley?

Can she come back? And where there's just not enough caregivers in town, and we feel like if we can put someone in there that has a good background check attitude and we know is a good person, provides good care, I think it would move a lot of— it would be really beneficial. Yeah. All right, next up is new facility, and Justin, if you have anything new to say, or, and does anybody have any questions about his report?

Hey, good afternoon. Can you guys hear me right? Um, you're pretty, pretty soft. Okay. Uh, how about now?

Little bit better. Okay, can hear you. Thank you. Great. Good afternoon.

Um, yeah, so I wanted to give an update on The future hospital site work, we were basically focused on closing out the SWPPP plan, which is the Stormwater Pollution Prevention Plan with the ADEC. We did multiple submittals. I think we had a total of 5, actually, that went back and forth. And with each one, we kind of got more and more confirmation and approval from them on some of the items. Most recently, we just got an email back earlier this week, and it looks like we've finally satisfied everything on their list.

I think there was—. First one had 38 items on it. So we finally kind of got over that hump. I'm hoping to get a formal document from them to kind of close that out, but that's kind of good news on that one from the state of Alaska.

Moving on to the Work Building, all of the extra work that was kind of done at the end of the project was completed. We added some electrical infrastructure, the UPS, and no other additional updates on that. In terms of the overall campus, you know, we completed the site work in the Work Building. We advanced the long-term care and hospital to a concept-level design. With kind of a site layout.

And then right now there's an application has been submitted for— so basically to be able to bring Bettisworth kind of on board for a full design build-out. So that's kind of what we're waiting for now. That's kind of where we're in kind of a holding pattern. But we did also do a budget reconciliation. On the HRSA grant, and there are— there is some remaining funds in the category of design.

And so the intent there is to basically try to move the needle a little bit on the long-term care design to whatever extent we can take it to. So that's kind of the upcoming activities category. And then On the second page there, you can kind of see the overall replacement campus layout, includes the work building that's completed, and then future Phase 3 and Phase 4.

Any questions?

Sounds good. Thank you very much. Thank you.

Next up is Quality. Stephanie Romine submitted a report. Does anybody have any questions about that?

Good evening. Good evening.

Nothing to add here, but okay. Any questions? Yeah, thank you. All right, moving on to Infection Prevention. Any comments or questions on that report?

And the next one is executive summary. Take it away, Phil. Right.

Thank you. I submitted my report. A few things to highlight in here is the D.C. trip. I gave a summary of that at the beginning. A lot of the conversation at a high level really was around the Rural Health Care Transformation funds.

We had, as I mentioned, a lot of presenters in the room that were, you know, connected to D.C. and Director of CMS. Not a lot on the policy side of to address Medicaid cuts or, you know, work eligibility, depending on who was talking. That's the way they were described. One called them Medicaid cuts and then one called them work eligibility. So however you, you shape it, those are some of the conversations in that, in that meeting.

This is an annual American Hospital Association meeting, and I went with the Alaska Hospital contingent as, as a group with other executives from other hospitals in Alaska. And, and so there was a Relatively good meeting, not a lot of information other than the rural healthcare transformation of information, which honestly is really, there's a lot of unknowns in this area, even from not just us experiencing the unknowns, but really how it's gonna roll out at the state level. We met with all the delegates. They were very generous with their time. We spent a significant amount of time with Congressman Begich, with Senator Murkowski and with Senator Sullivan, and all wanted to know how we were experiencing the Rural Health Care Transformation funds and what we were seeing, which obviously we don't have a lot of information.

But what was encouraging is that they wanted to know if there are barriers, what those barriers were, and how the state's going to roll it out. They want to be very well informed. Understandably, the first year is going to be challenging because of the getting everything together, but the intent of that funding really is to transform healthcare. And so to make sure that we can actually do that in Alaska, they want a strong line of communication. So, you know, not a lot on the action list there, but it was good opportunity to discuss and build communication, lines of communication.

On the state side, there was— seemed like there's a lot of activity in the, in the Capitol building related to capital funding. I know that there was a focus on deferred maintenance on education. I, I sent messages to Representative Himschute and to Senator Steadman related to the hospital being aging as well. So we'll— and of course trying to continue advocacy on that, on that aspect. So, um, on the CON side, that was, again, that was very encouraging to see, to hear the, the state approved our certificate of need.

It gives us the green light to move forward on the MRI and provide that service, a new service line to, to Petersburg, which is very exciting. Uh, our imaging department is getting geared up. We have to get a contractor to to secure and come on site and also work with our team in building up processes and appropriate processes on, on that. And it takes about, you know, a lead time of anywhere from 30 to 40, 45 days. And I know we're working hard on making that happen, so we're very excited to, to offer that and build that out.

On the work building side, I mean, that kind of gets us a step closer to being 100% online. And also along those processes are our community our conference room, which we have been offering to the community. We're scaling that up and getting the technology ready to go as far as the screens and some of the tech speed bumps to smooth that out, make sure the, you know, the video conferencing and the mics and all those kinds of things are working properly. We're also hosting community groups in that space as well, and we'll be able to offer that more on our website as we move forward. So we're still getting those online.

The education room also, computers are there. We're getting that aspect online as well. So we're getting really close to having that building completely online, especially with the MRI coming. With the challenges of the winter, a lot of sand is on the lot still, so we're— Wolf is working hard on clearing that out, and we want to make it very presentable, do some landscaping in that on the lot, making sure it beautifies the area, you know, the, the campus in a, in a way that we can have an open house. So that's something I want to make sure that we're shooting for as well.

A couple of things on the staffing side that I think are relevant. Very excited to have Wolf fully staffed here in a few weeks, which is Very exciting on the applicants and the staff. Also this past week, one of my goals was to develop— one of my goals and initiatives from the board and the community needs assessment and medical staff is to build out behavioral health. And so we're excited to— we posted for a director position and we're excited to have Pat Sessa, who's been with us for a while, accept the position, relocating back to Petersburg. And taking that role.

And we'll also be offering— opening up that position as well to expand the program and offer more behavioral health services in the community. Um, and again, that's, that's something that we all see as a, as a great need. Pinning ceremony. So I'm really excited to have, uh, Holly and Bessie, or another cohort, come through and, and get their— the nursing pinning ceremony. So hopefully we'll see some board members at that Saturday at 3 PM at the Holy Cross House.

I'm looking at Jennifer to confirm that.

This Saturday, yes.

And I think those are the highlights. On the volume side, I mean, nothing major to report. We've been down on our long-term care census, uh, as was previously reported, and in Cindy's report, and our encounters are pretty, um, you know, nothing super high, nothing super low, pretty, pretty status quo. Our, um, there's one graph I put on here for that reflected the, the March was— I think it was in March, the days on the, on the lab, uh, lab orders. I thought was very interesting just to see that huge spike on the number of lab tests that were done.

In that month. So, uh, was that April or is that March? It's all running together, so I apologize. And I think that's it. We're, uh, scope— we had a scoped clinic again, very successful, and very excited to see, uh, that continue on.

And when's the next, um— yeah, Jennifer, I'll ask Jennifer to comment on that, if you don't mind. Yeah, we've been just so happy, um, with our providers for the scopes clinic, and they will be here June 24th and 25th doing procedures again. And then after that, we will probably take July, August off and have a clinic again in September. So we're able to do about 20 patients each clinic, so 10 patients each day. Sometimes they have 2 procedures.

So anyway, it's been really great to make a big dent in our waitlist.

Well, while you're up there, and we have an audience, would you mind explaining the advocacy letter that you wrote on the House— on the Senate bill or House bill related to nursing? I think this is important, actually. So I think your letter was excellent. Do you mind just summarizing that briefly? Yeah, no, there is a bill, Senate Bill 283, which has been brought forward that is wanting to make ratios for nurse-to-patient care.

It's a complicated matter that starts with Nurse Compact licensing, but right now what is kind of on the back— well, it's, it's there, it's not having a hearing yet, but it is, it may. So Anyway, so I wrote a letter in opposition. The bill is very clearly written for a large hospital, mandating basically like a 1 to 4, 1 nurse to 4 patients for, you know, for med surg, for all sorts of departments that we don't have, you know, ICU levels, surgical levels. And so I just wrote a letter that said that that doesn't work for us. You know, our staffing is based on the needs of the patient.

You know, we're not going to have just a 1 nurse to 4 ER patients. You know, sometimes we can have 1 nurse take care of 4 patients. Other times we need 4 nurses to take care of 1 patient. And so we really try to staff based on what the patient's needs and what our staff comfort level is and experience level. So, so there's just a variety of reasons that a one-size-fits-all bill, including formulating staffing committees that have to have 51% of floor nurses in addition to administrative nurses, a bunch of reporting, auditing, the whole thing.

And so really what it does is, you know, when we're busy and the nurse leaders or, you know, or myself have to hop in the ER It just is one more thing that we have to do, you know, when we get back to the office instead of being able to spend more time with patients and helping the frontline staff. So for our facility and other rural facilities, it really isn't solving any problem that we have because we already usually are under, under that ratio.

So, and I don't think it helps the larger facilities either, you know, that it really needs to be a focus on, you know, how do you care for your patients and provide what they need rather than just arbitrary numbers telling you how many patients you should care for. Yeah, it's a— to me, it's important to bring this up because it has incredible impacts to particularly rural areas, rural Alaska. Where those ratios— that means we have to add a lot more staff to meet those ratios at any given moment when we have ebbs and flows constantly, and the cost of care would increase. So they're just unreasonable. The bill is written in just a really— a way that is not relevant to Alaska, rural Alaska, and it can be very damaging on a cost and drive healthcare costs up and also add on administrative burden that is completely unnecessary.

Yeah, it doesn't even talk about our swing bed patients, our outpatient treatments, our observation patients, you know, any of the people who actually are the bulk of our patients that we care for. There is none of that even in the bill. So it would be really difficult to say, how do I— how much of a nurse do I allocate today for this person and this person and this person? So, um, yeah, we're hopeful that there will be strong— yeah, strong understanding and strong sense of that a one-size-fits-all doesn't usually fit anybody. And this— this is— this State Senate Bill 283, or is it not?

State? Yeah, this is state. This is in response to the, um, something called the Nursing Compact, where if you're a nurse in another state, there's a— there's compact— there's a— I don't know how many states are in agreement, about 46 7. Yeah, almost all, like 44, almost all the states have this nursing compact, so it makes it easier for nurses. You know, it's not a, you know, a total win-all for resolving nursing shortages, but it makes it a lot easier for nurses to come in and actually remove a barrier, and this bill is in response to that, and it's just this, a lot of politics behind the scenes related to those things, and they're just, it's just unfortunate because it just make you aware of it more than anything else, that it's out there.

And I think that's something that can have an impact on, on us locally. Thanks. Anything else, Phil? The only other thing that I wanted to point out in your report is updating the PMC website, which folks can be keeping an eye on. Yeah, we're close.

I don't, uh, Jill, do you have an—. I don't know how close we are on the second, um, our second review with the company that's building the website, and we're hoping to launch soon. I would—. I'm getting close. Yeah, yeah, good.

Thank you.

Yes, on the rural healthcare at the state level, is there any movement there? Oh, the transformation? Transformation, rural health transformation. Uh, yeah, Katie, if you want, do you want to just give a, like, a 2-minute overview on your on that at all? Absolutely.

Yeah, is my sound okay?

A little bit higher would be good. Okay, hang on, let me switch off of these.

How about now? Sounds good. Oh, great. So the Rural Health Transformation funding, the state has released an update that we We should be getting decisions by early to mid-May. I am hoping for mid-May.

Early seems pretty optimistic, but you never know. And we will hear back on those 7 proposals. There are 4 different ways it could go for each of them. One is outright denial if they feel that they're ineligible or, or not aligned with the state's goals, which I would say that would be a big surprise if any of ours came up with that because they're at the very, at the very least eligible and strongly aligned with the state's goals. Then there is a potential that they say you're not funded in this cycle, but we encourage you to reapply in one of the subsequent, subsequent cycles, which at the latest there will be another funding cycle this fall, maybe even one before then.

And then the two likely funding pathways, they could be for our Planning and Readiness proposals, which a lot of our projects we built as Planning and Readiness proposals, those will move forward more rapidly. They will ask us for line item budgets. They will ask us for details on the project, including staffing plans and what our specific milestones will be. I would imagine— I'm kind of guessing there, but that seems to be what, what's likely, because what they need is the information in order to issue a state grant agreement, and those will move forward, they say, more quickly. And then the final pathway is if for our implementation projects, or if they decide that something we thought was a planning grant they think is an implementation grant, those will require a full second proposal with another 3-week application period to enter information in their portal, and then another subsequent review process, which we don't know yet how long that is likely to take, but hopefully a little shorter than the 2.5 months this one took because they, as Sarah Wright was saying to me earlier today, don't they need to allocate this money pretty soon?

So, and I think they do. So those are, those are the 4 potential pathways for each of our proposals. And by the next time, I don't want to jinx this because I feel like I said it last time I met with the Resource Committee, but by the next time we meet, I should have better answers for you all on that. Did that answer the question or did I leave anything out?

Sounds good. Thank you, Katie. Absolutely. Thank you all.

Any other questions? Yes, go ahead, Marlene. I just wanted to emphasize, since we have the broadcast on the radio right now, that in Phil's report he said that PMC is seeking contemporary art representation of the people of Petersburg. For the new work building, and proposals are due May 31st. Thank you.

Yes. Yeah. And if folks have questions about that program, Julie Walker is the contact and can provide— there was a link that was sent out that didn't seem to work, but she has the correct one and can, can send it out to folks. And if they're interested, thank you for that. All right.

Moving on to the financial report. Jason. Good evening, everyone. Can you hear me well? Yes.

Excellent. So just going to review the financials, and you did a great job of recapping the Resource Committee meeting. Just add a few things. So I'll go down through the statistics here. We see, as we typically do as we go into the spring and early summer months, we start to see some of the numbers move back up.

We, we tend to see lighter numbers in the wintertime. So a primary care clinic is moving up just a tad in the month of March. Year-to-date, we're up 2.5% over the prior year. Radiology procedures consistent. Lab tests down just a tad from previous months.

Rehab services are strong this— in the month of March. Home health visits have been very strong. We're up 22% year-to-date over the prior year. Done a great job rebuilding that program this year. Emergency department visits fairly consistent for winter months, some hitting somewhere in the 60 range, up 1% over the prior year, and observation days down 26%, probably due to just admitting more patients versus observation.

Acute care days, we are seeing that year to date we're 241 versus the prior year 261. This would indicate to us that in the Medicare Cost Report, Medicare will owe us money because the volumes are down and our costs are up. And let's see, patient swing bed SNF days are down 7% year to date. They were 74 for the month of March. And swing bed— or not swing beds, long-term care is down just a little bit this past month.

Year to date, we're down 7% over the prior year.

It's okay, it's a rebasing year.

Okay, looking at some of our numbers for the month of March, once again, total gross patient revenue $2.6 million compared to a budget of $2.7 million, down $131,000. Most of that is in the long-term care area. Contractual adjustments, we have been We're anticipating Medicare is going to, when they complete their interim rate review, will be owing us some money. And so we've been releasing some contractual adjustments. So that's why you see it a little lighter there, the $353,000 versus $500,000 in the budget.

Other operating revenues, 340B, it looks good compared to budget. Just wanted folks to be aware that there was the new Medicare program went into place in March, in which they have established a fee schedule basically for pharmaceuticals, lowering things. Give the example that, you know, let's say previously they paid $1,000 for a script for a certain high-cost medication. Now they're saying that they'll pay $500,000. And so the benefit from— to PMC is down $500 for that script.

So it can be that big. It was 10 medications, high cost, high utilization. We're lucky we don't fill scripts through Walmart much. Walmart is really struggling with this and they're just not processing the transactions. Luckily, we, we have the ability to work with the local pharmacies, very cooperative, but there will be another 15 drugs that will be impacted by this.

Program come January 2027. So this is the starting to see the beginning of cuts that were announced in the one big beautiful bill. And so we have to do things to be able to address those changes in compensation going forward. The PERS USE Act, that's up because of the work building. So total operating revenues, $2.5 million against a budget of $2.4 million.

So up $72,000. Salaries, we are below— we're above budget by about $80,000, $81,000. So giving us a positive bottom line of $157,000.

Investments are down due to the stock market and the things going on in Iran, things of that nature. I would comment that, you know, I've not heard in the industry or in the facility much disruption to supply chain due to the conflict going on in the Middle East. I think we've been receiving medications, IVs, supplies, and things of that nature without much disruption. Certainly the cost of fuel is up. So the net change in performance is a negative $286,000.

Most of that is due to the change in investments, which will rebound. We'll see that turn around and pop back up in a few months. Um, and so it's not like we had to pay money, it's just a change in the value of our investments. Uh, interest expense and, uh, depreciation expense catch up there. So doing okay.

Cash balance, we have $2 million in our operating account, we have $2 million in our short-term investments, which are government securities, and then we have $4 $4.8 million that, uh, are in our long-term, um, investments. Uh, accounts payable is caught up, other liabilities, a variety of things. There was a comment in, in the Resource Committee meeting, why are current liabilities down compared to a year ago? Well, big chunk of that is we had a lot of short-term liabilities, accounts payable, due to the construction project a year ago. We had some funds that we due to issues with the PERS program, they weren't able to receive our payments.

And so that was building a liability. A couple of things like that that have resolved over the course of the year compared to a year ago. So a couple of quick statistics. So contractual adjustment is, you know, with this release is coming back down. Typically we write off about 18% of billed charges.

The bad debt and that is consistent with what we've seen in prior years. Operating margin, 6.2% for the month of March, year-to-date 4.1%. You know, the goal of rural communities is about 5%. If you're doing a 5% margin, you're doing well. Total margin is 16% year-to-date.

That's because of construction projects. So that's an anomaly. Days cash on hand, 114 currently, and we do anticipate, as you know, we receive the ERC funds in April. They're not reported in these numbers for March, so when we report April, you'll see that bump up because of the receipt of those funds. Days in ER, net 45, gross 58, continues the business office and Collections teams and all that continue to work, and we're seeing this number come down into actually the low 50s.

Absolutely just doing far— I mean, remember, we were struggling for a couple years trying to get a company who shall remain nameless to get things below 82, and here we are, you know, 30 days lower, and we've put a couple million dollars in the bank because of it. So excellent work. That plan has really turned out well for us. And accounts payable has caught up. Um, that, that's for the most part what I would share.

We got a couple projects we're working on, uh, of course the budget to get that completed here by June, um, and working, trying to understand the new program that the school district has come out with, and we're engaging with that team to establish an agreement so that everything runs smoothly with that program. Uh, finalizing just a few things for the MRI Chargemaster I— we do need to turn in some paperwork now to Medicare that now that the state certificate of need has been approved. So great things going on. Team is just very excited about our accomplishments this past couple of years and just working well together. Any questions on the financial statements?

Seeing none, Jason, but thank you very much. Problem? Always a pleasure.

All right, moving on to old business. PMC continues to utilize 22 local rentals in Petersburg to house traveling staff across departments. With the new fiscal year upcoming, efforts to collaborate with the borough and explore funding options to alleviate Petersburg's housing difficulties will continue. And I don't know if we need— is there any discussion on that or any additional information? Just like last time, it's just a placeholder to really update and show that it's an initiative of ours.

We're looking at availability within the community as well, so that's more to come on that. So thank you.

And then the next item on the agenda is new business. And we have 2 letters, and that's what the amended agenda was in reference to at the beginning, was a little bit of change of language in the letters. Should I read the letters? I'm—. I don't know if that'll help anybody if I read it out loud, but basically it's to make sure that we have staff who are in charge if Phil is not available.

And the signed letters will be in the next board meeting packet for transparency, so that any revisions will be seen by the public as well as the ones handed out here. So starting with the home health designee, do we have a motion to approve the letter?

This is Joe. I'd like to make a motion to approve the letter.

Which appoints a manager of home health, director of nursing, or additional approved designee, if applicable, to serve as the administrator for Petersburg Medical Center Home Health Program in the event the hospital administrator, Phil Hofstadter, is not available to fulfill that role.

Is there any Further discussion?

All those in favor? Aye. Opposed? And the adoption of the Home Health designee letter passes. And the next is the CEO designee, and we also need a motion to approve that letter.

This is Joe again. I will make a motion to approve the letter which appoints a chief nursing officer, other approved designee if applicable, to serve as the administrator for Petersburg Medical Center in the event Phil Hofstadter is not available to fulfill that role.

Second.

It's been moved by Joe, seconded by Jim, to approve the CEO designee letter. Any discussion? Seeing none. I have a question. Oh, yes.

So the— oh, I'm sorry. No, I don't have a question. All right. All those in favor? Aye.

Opposed? And the CEO designator, uh, designee letter is approved. And then the next item on the agenda is our next meeting, which is currently scheduled for May 28th. I will not be available on that day.

Everybody else is nodding that they will be here. So, all right. And then our next, uh, our next, uh, action is a motion to adjourn. Make a motion we adjourn. Second it.

Moved by Jim, seconded by Joni that we adjourn. All those in favor say aye. Aye. Aye. And opposed?

The meeting is adjourned. Thank you very much.

Thanks all for calling in. Thank you, everyone.