Petersburg Borough: PMC Hospital Board Meeting August 28, 2026

Oh, Greece does such a good job.

Oh, okay, went out together. So showed up with the dog.

Whereas—.

You've got us. You good over there? Yeah. Go ahead and call the meeting to order.

Roll call. Cindy. Here. Marlene. Here.

Heather. Here. Joe. Here. Jim.

Here. And Joni is absent, and I'm present. Jared's present.

Um, approval of the agenda. Do I have a motion to approve the agenda for August 27th, 2026 Hospital Board meeting agenda? I move we approve the agenda. For August 26th, 2026— or 27th, 2026. Second it.

All in favor? Aye. Aye. Approval of board minutes for July 30th, 2026. I would like to make a motion that we approve the board minutes from the July 30th, 2026 hospital board meeting.

And I'll second. All in favor? Aye. Aye. Aye.

Uh, do we have any visitor comments?

None submitted. Board member comments? Marlene. I wanted to congratulate the long-term care for their Alaska Hospital and Healthcare Association Innovation in Patient Safety and Quality Award. That was well, well deserved and nice to be honored in front of the whole state.

That's nice. Uh, any other board member comments? I just have a question. Yes, Joe. Marlene, is this your last meeting?

Yes. Well, I would like to thank you for serving, serving Petersburg Medical Center and the Petersburg Medical Center Board of Directors for all these years. And, um, I've really learned a lot from you as a board member, and I've enjoyed being on the board with you. I especially think back to the Governance Committee that you and George and I were on and the board self-assessment we put together. That's about 5 years ago now, seems like yesterday.

But anyway, I appreciate your dedication to healthcare in Petersburg, um, both as a employee at the hospital and on the board for so many years, and I wish you all the best. Thank you.

Thank you, Joe. Um, I would also like to comment that I thank you for, um, for the 8+ years that I've been on here, always making sure that we, uh, did some of those things we have to do in a timely manner and reminding us to bring them up. It was kind of you that reminded us that we needed to do something once in a while, so I thank you for that. Thank you. Any other comments?

I just wanted to acknowledge the Petersburg Volunteer Fire Department and particularly EMS for coordinating with the school on the nursing classes and CNA classes and CPR training. I think that will be beneficial to the community as a whole, but to our program as well, and so I wanted to make a note of that. Thank you. And any more committee reports? Resource Committee.

Uh, radiology procedures have been strong this month, and we already had 38 MRI procedures by the time of our Resource Committee meeting. Emergency room visits have been up, as have home health visits. Long-term care census is still a bit low, however. Overall, though, we've had strong patient revenues, though 340B receipts are still a bit lower due to lower clinic volumes, and there was also a slight increase in some bad debt and some expenses. We haven't yet realized strong revenues for the new building and are keeping an eye on anticipated changes in Medicare rates to see how that will impact financials.

Investments, we have recently taken a bit of a hit as well. That we are still in a good financial position, and we've also submitted our audit information. There are still pending congressional funding requests that are waiting for a congressional budget, and we also have some state and federal requests outstanding. Current grant funding covers a range of services, and Phil covered some of those on Petersburg Live today on KFSC. And as Katie Bryson, our Grants Planning and Evaluation Director, noted, there has been a slow trickle of good news this summer.

We wish to give our thanks to Katie for all her hard work and help and expertise with grants, as she will be transitioning to a new opportunity in September. And we have identified a replacement for that position whom Katie describes as her mentor. So that should be a good fit.

Thank you, Senator. LTC Quality Committee. Quality. Committee for Long-Term Care met on August 19th. We reviewed the, the new fall system that's been installed.

There's sensors installed and tested and now are starting to be used. People can move around in their beds, but if, without it going off, but if they try to get out of bed or out of the chair that they're in, then an alarm and a light goes off and It's going to be attached to the nurses' and the aides' cell phones, so they'll get notified that way as well. They're looking still to put another kind of kiosk, it's kind of a central control station, somewhere that'll be best available for the whole staff to be able to see it. And now they're going to be training the housekeeping staff and the rehab staff and other staff in the area so that they'll— they're aware of what's happening when these alarms go off. Um, Rachel, uh, Wolf, and Grazina are going to go to a training shortly called CHEST.

It's a train-the-trainer program, um, to be certified environmental technicians, and then they will come back and be able to train the rest of the staff. And that'll be in Anchorage in September. Um, looking at, um, cleaning of the rooms and, and getting the rooms ready for new, new residents, they're now looking at some kind of an ultraviolet light that after everything's done, then this light can be put into the room and, um, and one additional safeguard to get rid of any of the microorganisms that are in there. And they are expecting inspection from the surveyors anytime now.

Any questions on that report? Thank you, Marlene. Infection Prevention and Control Quality Committee. Yeah, this is Joe. I participated in the infection prevention meeting on August 19th.

We did not receive a public health update. From the public health nurse. We did get infection prevention updates from Rachel.

There were discussion on the decontamination improvements that were noted. Also, sterile processing room improvements were detailed, and the scope clinic that is going to take place in early October was discussed. Went over some of the action items. The handrails are almost done.

Hand hygiene supplies have been installed. There was discussion on the ice machine. We went through the reports, went through the— Rachel went through the environment of care rounds reports.

Infections by location were reviewed.

Under hand hygiene, the survey protocols were discussed. We discussed antibiotic stewardship in long-term care and the critical access hospital side and outpatient, all three.

Jennifer provided an update on vaccinations, their employee health, and there are more people under the— we discussed the endoscopy clinic coming up and that more people are being trained up to help with the scope clinics. And environmental services discussed staffing levels there.

And that's about it. Any questions for Joe? Thank you, Joe. Reports, information technology reports. Any questions regarding that report?

Jill, any summary?

Podium. We'll try it out for side and see how it works. You probably don't want that. Yes. Yeah, maybe both sides better for trying it out.

Yeah, I'll just briefly talk about a couple of things. Like Marlene said, we finished the falls sensors project in long-term care, and we've had a couple glitches that would be normal to work through. But other than that, the staff have really given positive feedback. One of, you know, one of the nurses relayed to us that it's been really great for the residents to have more freedom in their rooms and in their beds to be able to move around, like Marlene had said, and just knowing that it's not just about falls prevention, but also quality of life is great, makes the whole project worth it. And then I also, you know, I also put in my report, Michelle Rumpel and I, who's our emergency preparedness Coordinator, we're starting a project together just to really look at all of the downtime procedures in each department and make sure that everything's up to date.

It's been, it's been a few years, probably since COVID actually, that we, we really looked at all of those and just to make sure that each department has what they need if we have any kind of like internet failure or phone failure or, you know, heaven forbid, anything where all of the systems were to go out. So especially now that we're in this building and on the main campus. We just need to update and, and change some of the workflows. Any questions? Okay, thank you.

Materials management, you're so brave.

Okay, for, um, our staff. We are full staff right now. And for community engagement, we have been ordering a lot of supplies, especially for repairs. And we're actually trying to check for the freight, and Wolf knows about that. So we've been trying to use Alaska Marine Lines to get like a a little bit of a break for freight.

It has been, you know, like hard for the high cost.

Also for vendors and a lot of vendors that we've been communicating with that they don't have a GPO, which is the group purchasing organization, especially when I'm like online purchase that we cannot get from our regular vendors. So we've been trying so hard. For patient-centered care, I've been actually working on project for the recall, and I'm making a list for item masters. So for us to easily identify if we have all those supplies, because it takes a long time for me to check if we have those supplies. Like, we go through a lot of, like, a list.

So I'm actually working on a project for that.

Um, let's see, we had a good result for our inventory and has been good for more than a few years now.

Um, for our van, after I submitted the report, um, for after 2 days all the paperwork were completed, so we're using the Venn now, which is— yeah, excellent. Any questions? Any questions for Melvin? Thank you for that report, Melvin.

Um, medical records.

Um, daytime department, we're currently down one staff member, but the person that we did hire in March has been helping us fill that gap and he's transitioned well and helping us maintain a steady workflow. Um, our department continues to, um, keep our medical records accurate and secure, and overall our goal remains the same and we're trying to be dependable for both our patients and our staff. We continue to work closely with patients to provide and providers to make information processes as smooth as possible. We kind of had a little blip and trying to get records here and requesting records and receiving them. And we think that we're getting that settled.

And so hopefully things are much smoother. We are fully settled in our, our office space and it's actually a very nice space for us to come together and work as a group and it. Creates a nice environment for us to share information with each other. So we are, we are grateful for our space. And we continue to work with revenue cycle with the business office and trying to keep our DNFB days down.

And if we find anything that needs to be focused on, we will work on that and just focusing on consistency and timely turnaround to support the billing process.

And on this one, I did put together the utilization review. And so I just wanted to go over a few, few things that I put together. So in 2025, we had 113 admissions and 300 patient days. 12 Of those admissions— 12, excuse me, 12 of those admissions, 41 patient days were behavioral health. The behavioral health admissions have gone down over the past few years, but we still saw 55 of them in that time, and that need hasn't gone away.

In the first quarter of 2026, we had 26 admissions and 89 patient days. The average length of stay was 3.4 days. Most of what we saw was pneumonia and respiratory illness, UTIs and heart failures, and ETOH withdrawal, which is alcohol withdrawal. And we had one readmission with a handful of transfers, but most patients went home. 4 Of those admissions were for behavioral health or substance, substance-related, which equaled 10 days total.

Um, quarter 2, there was 30 admissions, 85 patient days, average stay was 3.75 days, same leading conditions, which was pneumonia, UTI, heart failure, and behavioral health. 1 Readmission, and, um, there's few transfers, most discharged home, but behavioral health numbers jumped this quarter, 6 admissions to make 25 days. Most of, most of them were suicidal ideation, and 2 of those patients had to be transferred to another facility for higher level of care. Short stays and behavioral health need isn't slowing down, and if anything, Quarter 2 shows that it's growing, and PMC is working to build our behavioral health program so we can meet the needs locally and catch things earlier to help our reduce patients that would have to go somewhere else. Does anybody have any questions?

I have one. Okay. So on the pie chart there, the second quarter 2026 discharge status distribution, yeah, that one, it looks like 79% of people went home when they were discharged. I just wondered, it says 6% went SNF, skilled nursing facility. Skilled nursing facility.

Okay, I just wondered what that, what that stood for. Thank you. Yeah, anything else? Thank you, Jennifer. That report, uh, Nurse Dean, any questions on Jennifer's report?

She left town, so she's— I mean, she's out of town. She left town. I thought that her report Any questions on her report? None? Okay, moving on to activities.

Alice's report. Any questions on Alice's report?

Oh, but she's on as an attendee. Oh, sure. She wants to be promoted to a Thank you for that report, Alice. Uh, new facility. Dustin's not on.

Dustin's on. Is he? Good afternoon, everyone. I'm on. Can everybody hear me all right?

Yes. Yes. Okay. So, yeah, um, in terms of new facility construction, um, we completed all of the site work for the future hospital. We closed out the SWPPP plan and it's essentially shovel ready over there awaiting advancement of the design.

So that's kind of the site work. The work building has been completed. The long-term care facility is at concept design currently, and we're waiting for funds to advance that design. The hospital was also part of that concept design effort, and it's at the same status of concept level.

Any questions on any of that?

Okay. I did include— this is like a really— at Phil's request, I just kind of came up with a a very early concept design for staff housing, potential staff housing duplexes.

That image down below here that I included was— let's see, I guess I could— you guys probably don't— I guess you would have that in the packet. So yeah, if you go to that rendering, that's a photo that I took up there with the— when they were putting in the subdivision, basically Phil asked me to go up there and take a look at the opportunity to have some wastewater sewer pipe stubbed up into that location, and they did. And so that was a photo that I took. So that's the actual backdrop in that location. And I could pull up Let's see.

I could share my screen for some— I think I can. Let me try it. I'm working off my little 13-inch laptop here, so bear with me. I'm not at home right now. I'm in Ketchikan.

We also have it up on the, on the main screen, but I don't know. Oh, you do? Okay. Yeah, you just can't see it. It's on the side here.

Okay. It's that way. But I don't know if I'm still on the screen now.

Yeah, but you have—. There you go. That's good. That's good. Okay.

So yeah, this is kind of an overview. And I kind of wish I would have included this, but this is kind of the overview of the entire lot. Obviously, this is Joe Street here. This is where we brought in the water and sewer and tied in for the work building for the whole campus. Really, it's tied in over for future hospital and long-term care also.

So basically the work building is now sitting here. This area would be like the service yard, and then this is mostly, you know, concrete drive coming through. So this would be— these lots here were basically used to have the Excel Street road punched through to the north. So that's kind of where that is. And then The new subdivision and the area of the new, where we stubbed out for the wastewater is right here, kind of on the northwest corner of 13th Street.

So it's kind of right in here. And that photo that I took there is standing like right about here, looking northwest.

That's interesting. And so here are those lots, and this is, uh, you can kind of see the boardwalk right here.

This is that wooden boardwalk, just to kind of give a point of reference. So in theory, that 13th Street would need to be developed, the road would need to be developed at least to that point, and then, you know, these are all potential lots in that location. That could be used for housing. Any questions?

These, these conceptual houses, they're duplexes? Yeah, I, I, there, we didn't have an architect do that. I did those. So I literally drew up a sketch of like a really, you know, a real basic 2-bedroom, 1-bath duplex so that there'd be 2 units, um, each with their own garage. And then downstairs would have like a utility room and washer and dryer.

But, you know, it's, uh, I was talking to Phil a little bit about it. These, anytime you get into the residential zone stuff, it's, uh, It's kind of the game of Tetris. You know, do you want to, you know, provide garage space or, you know, in theory you could turn them into like a triplex if having more units was, you know, a higher level of importance than an allowance for a garage. You know, those things can all be analyzed and, you know, you could technically turn those into a fourplex. In that way, they'd be 4 two-bedroom, one-bathroom units and maybe like a carport or something like that, or maybe it's just open driveway.

But yeah, those are— this was just my quick sketch that I put together and then put it into a CGI tool that turned it into kind of a computer graphic. But the sky's the limit basically. And in terms of cost, I put together that— this kind of rough order magnitude budget.

It's going to seem a little bit higher than probably something you normally would see with residential, but the things to consider there are that is on original tundra. And so the site would have to be developed very similar to what we did at the hospital site. It would have to be excavated down. You'd have to get a Corps permit, and then you have to purchase land somewhere else in trade for that. And then you would need to dig down approximately— we have some geotechnical information for those lots, actually.

So assuming that you're going to dig down about 8 to 10 feet to a suitable building material and then bring it back up with clean fill, and then you're kind of ready for you know, building a foundation. And then even then, you know, there's other considerations like streetlights, you know, there's more infrastructure that kind of goes along with that than just the hard construction costs of building the house itself. And yeah, there's a lot of other options too, you know, if there's, you know, a contractor in Petersburg that would you know, be able to take on something like that, you know, that could possibly reduce costs, you know. So there's a lot of— there's tons and tons of analysis that can be done on something like this to, you know, reduce the budget, reduce the cost. And then there's also the economy of scale.

You know, if you just build one, it's gonna build— it's gonna be a little bit more costly because you have to go through all that site work. Or you could do a little more site work and then plan for future building on it too. So there's a lot of different ways you can approach something like that. And it all changes the cost and everything.

Any questions? Any questions?

Thank you. That gives us something to work with and look at and talk about. So thank you. Yep, you bet. Thanks, everyone.

Quality report.

Any questions on the quality report? And Stephanie is— she can't think of where she is. Not able to make it today, so. Her main focus that she wanted to touch on was the long-term care award, and she did a nice write-up in her packet related to the submission. So just echoing what Marlene was saying previously.

Okay. Infection prevention report.

Any questions regarding Rachel's report?

Executive Summer. Okay, voting too. So, all right, um, well, first of all, I thank you. I want to just thank Marlene for her being on the board as well since I've been here, uh, which is 8 years, 3 months now. You know, you've been here the whole time, so I just want to thank you for being on the board.

Yeah, it's, um, it's been a pleasure. It's going to be— you're going to be missed. So, um, July was a productive month, um, but also, I mean, and that also means very busy, uh, and, you know, when I wrote the report, um, I also kind of like extrapolate where we are year to date or at least month to date with August, and it just continues. Earlier this week, we've had the second highest, you know, ER 24-hour period. I think it was something like 15 ERs in a 24-hour period, which was really huge.

Earlier this summer, about a month before in July, there was 19. So, I mean, those are two of some of the highest numbers we've seen. No trend necessarily, because that's always looked for, you know, was there a pattern, is there a trend? It's just a smattering. Of different things coming into the ER, but that is, those are some very, very high numbers that are coming into our ER continually.

And if you look at a 30-day look back, you're looking at about 123. I think last week we, with those, with those high numbers, were about 135 with a 30-day look back. So those are very high. Normally you see in the 90s and 100s. Those are high for the month of some, for the summer months.

So considerable amount of work and certainly puts a lot of pressure on staff, ER staff, nursing staff, and physicians and support staff as that also with trickling down cleaning those and so just want to, you know, compliment the staff for picking that up and but also there's a lot of pressure that comes with that as well.

We, you know, I'm glad that the utilization review that Kim did, and we were required to do that annually, so that's part of that report. And I wanna thank Kim for putting that together because I think it's important as a board to see what comes into our inpatient. And one of the things, the trends that you see is the behavioral health portion and substance use, which is ongoing, and that directly ties in with investing in our behavioral health department and really growing that program. And so Pat Sessa has been with us for a while. He was remote for a number of years.

He was here, worked in Susie's office for a few years, then worked at PMC, and then COVID occurred and Pat and Jenna moved to East Coast. And then Pat worked with us remotely as a telehealth provider and built that out and recently came back as the director here in Pewter Ridge.

Kirschbrook, so he's here on site again. Very glad to start keeping and growing that program. Tied in with that is the RHTP funding from the state and looking at some, you know, some grants to be able to support the behavioral health services, but also how does RCP funding weigh into that. That was one of our significant projects that we put in and we did receive word last Friday that was one of the projects we did get approval on. We don't have a budget yet on that, but, you know, if it follows what we submitted, it's about $400,000 of a budget to add on to our behavioral health.

So those are really, really key things. I know the board is interested in investing and developing behavioral health. So those are something I feel really, I feel like we're in a better position now in growing that program. We have Dr. Sankis also as a psychiatrist. He comes here on site and he does telehealth as well, working with the team in psychiatry.

So real, real good. It's important with those specialists too for continuity, making sure that we have continuity of care as they, as they come through. So really, really good to see that, that growing. We renewed our contracts with school for school nursing and behavioral health as well. We are definitely having a gap.

We used to have a placement for the school nurse each year, but we are having a gap right now. We posted that position and hopefully we'll have some, some solutions there. I know Heather's on, probably thinking about that as well. So we're working to try to get some solutions there and moving that forward and continuing that. I think that's really important as we as we develop our outreach within the community as a hospital.

I know, oh, the MRI, I know that Cindy, you reported out 38. Just for this month. Just for this month, right? And it's now up over 60, right? Isn't that right?

Yeah. Asking Kim, so it's very growing quite a bit and excellent technicians, amazing, really very fortunate to have such a successful team and project going forward. I know there's those delays, but I actually— I know I've said it before, but I'm actually very glad that those delays occurred so that we can set it up properly without having interrupted power. Right, Wolf? Well, you were—.

And Justin, I think Justin was, you know, it was quite a challenge.

Paddle Battle, I would just thank Julie and her team for putting that together, and we raised over $26,000 this year. A lot of corporate sponsors in addition to the individual fundraising. So very successful paddle— pedal battle, I should say, with that fundraising, annual fundraising goal. So Very fortunate to see that. And as you heard on the radio today, Tracy reported out the CNA program with school.

I think she said there was 10 students, so that's just incredible. And I also heard that the 2 RN, Bessie and Holly, passed their boards. So we're really doing great with some of the local recruitment for workforce. And I also point out that my daughter just started nursing school yesterday, and she is a product of the CNA class at the high school. Right.

But Matt, what we really want to know for the record is, will she be coming back to PMC? I think she actually plans to eventually. Right. Um, uh, financials, uh, again, we have high volumes of— or lower census in LTC. You know, part of that issue is certainly something we're seeing, that the eligibility for Medicaid is definitely getting harder.

And I see it, we have, you know, I see it through personal concerns coming to my desk from family members. I see it with some of our team working very hard on getting those eligibility, and I do have significant concerns with the eligibility eligibility restrictions that are coming here in the next few years. So that's, that's a big challenge. It's not like the need's not there. It's just that it's very, very challenging to get the eligibility requirements for long-term care.

And our team works very hard on building those out and developing and working with our community to get that to occur. That's about all I had. I probably can go on and on, but are there any questions for me? Oh, the other project before I open that up, the other project that we received was a telehealth project. So again, so we have 3 projects that we cleared for the RHTP, the telehealth project, the maternal child health project, and the behavioral health.

And so it's upwards, an estimate, if the budget is what we put in. It's upwards of $1 million that we were not sure of, so it's not in the financials as far as budgeting. So that's— those are very good numbers if we can, you know, if provided the restrictions or the grants are not overly burdensome. So I think that's all I have. Any questions?

Any questions for Phil?

Thank you, Phil. Is Katie on? Does Katie want to talk about grants? I am on. I think Phil covered it very well, but I'm happy to answer any questions about our RHCP projects.

I know, you know, the slightly frustrating part is that those notices of award, which are so exciting, have gone out, but we are still waiting to hear what we need to give them to get final budget approval and grant agreements so that we can actually begin hiring and, and buying supplies and doing some of the activities that our staff have, have planned for these projects. So we're definitely looking forward to getting, getting those awards spent on time, but we'll, we'll be down to about 10 months to do that for this fiscal year, at least by the point that we have an approved budget from the state. So we look forward to that. And I apologize that this grant report you're looking at is a little out of date. We played chicken with the RHTP award process, and, you know, in a way we won and we lost because we got those awards and they moved over to the operating category by the time— by now.

So, and it does have a printed copy of your updated form. In front of them. Great. Thank you so much, Sheena. I really appreciate that.

Any questions about the details of those awards?

Nope. Great. Thank you so much.

Jason. Hello, can you hear me? Yes. Excellent. So just wanted to do a mic check there.

Always enjoy meeting with everyone and going over the statistics and the financial reports. You know, I've said throughout my career, you know, what's most important when we look at data isn't the financial statements, it's employee engagement, it's quality, it's market share, patient volumes. You know, when we provide quality patient care, the reward, the byproduct of that is strong financial performance. And so It's always a delight to be able to see these numbers because I know there's a lot of hard work that has gone on at the bedside and in the buildings and throughout the organization to make this happen. So let me share just, you know, some things here.

So clinic visits for the month were 778. That's up slightly from the previous year. The organization continues to strive to bring in specialty services and maintain a strong relationship with the community and increase the number of clinic visits and get people into the clinic versus the emergency department. Radiology procedures up substantially, 41% from the previous year. You can see 357 versus 253.

38 Of those were the MRI. So, you know, Excellent to see us bring that new service for the doctors and the patients to support it, but, you know, imaging was up even in addition to that. I think we had an ED physician that was on site that was a great diagnostician and really ordered several tests. The lab department doing strong, 211 tests. Rehab services extremely strong, 1,800 Modalities provided up from 883, I think that is.

My eyes are young enough to see that. Home health visits, 317, up 104% from the previous year. Emergency services, 115 visits in the month. Typically we see about 90, so very strong, up from 102 in the previous year. Observation, 11.

Acute care days, 41. That's up from 12 the previous year. And swing bed, 35, down a little bit. And, and the ICF days. And then the, the long-term care was the only one that was down a little bit, 3, uh, 301.

So very strong period of time, their patient volumes. And so Sorry, the next thing.

Sorry.

So looking at the gross revenues here, 3,000— excuse me, $3,386,000 as compared to a budget of $3 million. So very strong. It's due to that patient volumes. Deductions, pretty standard, down just a little bit, $211,000.

So we're looking at net revenues of $2.7 versus $2.5, and total outpatient revenues $315,000 compared to $361,000. Total expenses looking at $209,000— excuse me, $2,824,000 compared to $2.7 million. So up a little bit, about $112,000. $1,000. Some of that's due to— at the first of the year when we give raises, that causes us to recalculate the liability for PTO, and so that is a little higher.

And we had some building expenses and a few things that are a little higher than normal, but overall our profitability for the month, uh, $209,000 as compared to a budget of $156,000. And You know, this year we're not going to see the big grant funds flow, flow through. Investments are actually down this month compared to the prior month. So, if you want to invest, now's the good time and market will go up. And bottom line, $63,000 compared to a budget of $67,000.

So, look, looking very good. I won't comment too much on the balance sheet. I'll just kind of wrap up with some of our statistics here. Our contractual adjustment of about 15-16%, that's a little lower than normal, usually around 18%. Operating margin 6.5%, anything above 5% is great.

Operating margin down from previous because we don't have those grants, but doing well. Days cash on hand 118. We did refund some money to Medicare that I fully believe we will get back when we file the full cost report. And gross days in ER, 63, creeped up a little bit as we work through some claims that had to be refunded to Medicare, Medicaid to reprocess. We'll work through those and get those caught up again.

And accounts payable is at 28 days. So once again, very, very strong performance on the part of the organization. Very good financial management. Cindy did a great job with the recap. Resource Committee meeting.

Our big focus right now is the getting all of the information turned in to do the audit here the 1st of September. And just wanted to comment that we were successful in negotiating an appropriate favorable agreement with the, the school district, and that's all in place and participating providers with them. There shouldn't be any problem to get those claims all caught up that may have been held up while we finalize that agreement that kind of came about here quite quickly this, this summer. So we have that all in place. Any questions for me?

I just have one, Jason, and I may have misheard you at our meeting. So the audit has not been submitted yet, or it has? It is not. We're in the process of uploading all of the requested information. That will be completed here by the first of the week, and then they'll do what they call the field audit, or the field work will happen about the second to third week of the month.

And that, that's when the auditors dedicate their time to go through the information that we have uploaded. You know, we certainly won't receive a report until about, oh, November, December. Takes a long time to process everything, but the bulk of the work gets done here mid-September. And then I need to correct my report because I said we had submitted it already. Thank you.

You're welcome. Any other questions for Jason?

Thank you, Jason, for that report.

Uh, moving on to old business. Bylaws 2026 finalized post-approved revisions. Is there any action taken on that? No action. I just wanted to make sure that once it went through the whole process to the public there was a final copy of bylaws in our report.

Corrections. So already been approved. Uh, housing update.

Hello. Um, so our housing is, uh, the same number. Um, I think I reported last month that we were looking at possibly renting a building that had 6 units that were— they shared a common area and a kitchen from the realtor here. It had been an Airbnb where the people had lived. We did get that contract and we— and Phil forwarded it to legal.

They were kind of wanting us to make a really snap decision and we wanted to forward it to legal and, and think about it. During the timeframe of all of this, we had a situation where we had to put 2 CNAs together in Totem Arms, which I know is a smaller, older place to stay. And we once again found out how difficult it is for people who don't know each other but work 12-hour shifts to live together. As there was a big dispute over whether someone had used the syrup in the kitchen. So, um, we were a little hesitant to get involved where there had to be sharing common areas, kitchens, and living rooms, because even though it's a very nice location, it is difficult if you're working stressful jobs to live with strangers.

In a place. I think when you're on vacation and you're in Airbnb and that is the situation that you rent, you're aware of that and it's for a very short period of time. Our periods of time are 12 or 12 to 13 weeks, so we're going more with probably not going that route. However, I was very excited when Phil presented the duplex idea, or whether we put 2 or 4 just because I think what we look for are studio apartments, 1-bedroom or 2-bedroom places, because we found that people really need their own space. It's, it's a very important thing on a travel assignment.

Even if you're here to make money, you want to rest and get a little bit of privacy. So, let's hope that that's on the way. We did have a slight thing where we were—. Did just—. Did not— we had some overlap and we couldn't bring in somebody right away, and the person that was worried about the syrup, we did decide didn't work out, but we're doing, I think, okay, and I just want to say that these aren't only for travelers.

We also have— we call it intermittent housing or housing for people who are— who who might be moving here or who are moving here and have to stay in a place until their place is ready. And that does happen every once in a while. For our IRS regulations, we do have that worked out. So, you know, they do have to have that on their taxable income. So there's no concern there.

It's not like it's quote unquote free housing or anything of that nature. But so we, we just, you know, every once in a while we run into a situation where we have a visiting specialist that we cannot accommodate because we just Even though we have 22 places, which I know sounds like a lot, it is a lot. Sometimes we just can't accommodate them. So we do get an Airbnb, which I think Jim is well aware of. Thank you very much.

Thank you. So anyway, but we, you know, we are working on it. We are working to hire people so that we won't need these apartments. And Phil is steering us to look into alternatives as well.

I hope that kind of explains it. I don't want you to think that we're just, I'm thinking, oh, let's build these places and give them to our travelers. But no, it's, it's like we do, we do need some housing. And the most important thing though is to recruit, recruit a good fit that wants to stay here. And hopefully, Matt's daughter will come back and work for us.

I was trying to convince my daughter, she's very happy at UPenn, but Anyway, um, and she also went through the CNA program, so I think it's a wonderful thing.

Thank you. Thanks. Thank you, Cindy.

Um, you know, almost like next meeting is September 24th at 5:30 PM in this room, the Worth Building.

Do I have a motion to go into executive session to consider medical staff appointments and reappointments and to discuss legal and financial concerns? I so move. Second. All in favor? Aye.

Aye. Okay. Hey, I, I did send out an executive session link to you, Jim, um, and then Heather, I just added you a little There you go. So you should see that for the PMCA, is the email I have on that. So we're going to go ahead and leave this one.

Is there another session? Yes, you should have an executive session next meeting. Okay, let me check. Same Zoom. Okay.

Oh my. On my Windows.