Petersburg Borough: Petersburg Medical Center Hospital Board Meeting July 2026

Is this a new every meeting question? It looks like it is. Okay. Yeah.

Okay, yeah, they can hear. All right, do any board members have a conflict of interest or a potential conflict of interest with respect to any item on today's agenda that should be disclosed? No. No. All right, hearing none, we will move on.

To approval of the board minutes, and this is the approval of the June 25th, 2026 Hospital Board meeting minutes. I move we approve of the minutes as presented. Second. Marlene motioned that we should approve. Jim seconded.

All those in favor— is there any discussion? Hearing none, all those in favor say aye. Aye. Aye. And opposed?

There are none, so that passes unanimously. And then visitor comments. Do either of our visitors have any comments? Not yet. All right.

Committee reports. The Resource Committee, and I have some notes from that.

Financial performance. July financial results were strong, driven by increased MRI, lab, rehab, and home health volumes. The committee reviewed Medicare reimbursement issues, including the interim rate review and desk review, with approximately $600,000 in pending reimbursements and additional recoveries expected through the cost report process. The 340B program continues to provide significant revenue and budget adjustments reflect increased staffing, employee incentives, and facility-related operating costs. And, um, uh, uh, in regards to the investment portfolio, uh, Guest Max Kemp with Continental Investment Services reviewed investment performance and confirmed the current 60% equity, 40% fixed income allocation remains appropriate for the hospital.

The diversified portfolio has performed well despite market volatility, and advisors recommended maintaining a long-term investment strategy rather than making short-term market-driven changes. And then in terms of grant funding, updates included delays in several state and federal grant awards, ongoing management of existing grants, and continued progress on facility-related projects funded through HRSA and state grants. Staff are monitoring spending deadlines and reporting requirements to ensure compliance. And, um, as reported by a very frustrated case— Katie, and I appreciate all her efforts— there are no updates on the RHTP grants. And then workforce housing.

The committee agrees to support discussions on long-term workforce housing needs at the next board meeting. And then, um, and that would be this meeting. Audit and financial projects. Staff are preparing for an annual audit while continuing efforts to resolve Medicare reimbursement issues, complete tax credit filings, and pursue outstanding— and the line, the last line is missing— projects.

Are there, are there any questions on that report?

All right, moving on to Long-Term Care Quality Committee. I attended that meeting July 15th. Um, there were general updates and went over the action items, uh, and then various reports. I would say that the primary focus was various issues that would fall under the category of safety. The fall prevention system has now been installed in long-term care.

In each room, and that, that will detect if, if someone is trying to get out of bed that needs someone with them when, when they're trying to do that, or they're at high risk for falling. Speaking of beds, new beds are being ordered for everybody in long-term care, and since a lot of people spend many, many hours a day and night in bed there, that's really important for them to have a comfortable bed.

Polypharmacy reduction. That refers to reviewing how many medications each patient's on and if there's any medications that can possibly be eliminated. Oftentimes with elderly people seeing many different kinds of specialists, they end up getting a really long, long list of medications.

Um, and that was the main gist of the meeting. Discussed a little bit, um, the open house that occurred here in the Work Building and being able to talk to community members about the plans for long-term care. Hi. Thank you. And Critical Access Hospital Quality Committee.

I attended that meeting also on July 15th. Um, uh, the Home Health Quality Improvement Plan was reviewed and approved. Also, the Critical Access Hospital Quality Improvement Plan was also reviewed and approved. The digital formulary, the PEXIS— is that how you say it? The PEXIS system is now installed in the pharmacy.

That's a current state-of-the-art system to make it safer to distribute the medications and, and keep track of the medications. Uh, the active policy list was reviewed. It's now being organized for easier access, easier sunsetting and archiving, and revising policies as needed. Uh, standardization of forms was discussed. A lot of these are forms that people are asked to fill out when they first enter the clinic or each time they return for a visit or they're getting any other services at the hospital.

So they're working on improving these and standardizing them a little more, and then finally they'll work on getting some of them translated into languages that are convenient for the public and also looking at the size of the font to make it easier for people to read them.

Cold temperature medications and other supplies. This was discussed that there's hurdles in getting medications and materials delivered while they're still in the proper temperature range and sometimes this results in wastages of things that are critically needed, and it doesn't seem to be a great solution to that. The Cerner appointment reminder systems are being updated. That's for people who have appointments at the clinic or for imaging lab.

They reviewed, um, opioid reduction report, the antibiotic and order entry and medication errors. Finally, health maintenance is a priority project. So now when people go into the clinic, even if it's for, you know, a headache or injury or anything like that, the clinicians are going to be keyed to check on some health maintenance. Right now they're concentrating on whether people are due or overdue for colonoscopies and Pap smears. Various reports were given.

IT is working on various scenarios, how to reroute if there's brownouts, GCI failures, other things that can cause severe disruptions in, in operations. Endoscopies are being done. The statistics for how many people are showing up with adenomas, polyps, things that can be removed before they turn into cancer, is higher than the national average right now, which is telling us that, um, the caseload coming in for those is probably still people that have waited too long, longer than the recommended time period, so it's really good that we're offering those services locally again and going to catch those people up.

They're also working on improving transitions so there can be proper follow-up after referrals and after medevacs, and one issue with that is getting the medical records in a timely basis from the hospital or the specialists that people go see. There were discussions on drug overdoses, and dangerous drugs are circulating in town, and PMC is seeing the consequences of that, and we want to make sure the public is aware that Narcan kits are available, and anybody can, can get a kit to keep in their home if they think that might be a need at some point. And the last area discussed was e-bikes. Injuries have occurred over the past 2 years, and the staff is looking at what can be done via regulation to increase the safety of both pedestrians and people riding bikes.

Thank you very much. Are there any questions or comments?

And just out of curiosity, on the e-bike discussion, was it— were the injuries in any particular age group, or was that part of the discussion? I think that's being looked at, if they're in any particular age group. There's issue with people not wearing helmets, issue with putting 2 people on one bike. Being ridden on the sidewalk and pedestrians getting in the way of the bikes. Learning how to use a free bike.

Yeah, that was one of them. And I just want to make sure folks online, are you able to hear everything okay?

I can hear great. Okay, good. All right, moving on to reports. The first one is Home Health. And did you have anything you wanted to share?

Yeah, we have some exciting stuff going on. Ruby, I'm supposed to ask you to come to the podium. You know, sorry. Here I come.

Doing this for you, Phil.

Just some highlights for home health and the adult day program. Adult Day, we are very excited to have Ryan Nelson join us as our activities coordinator. He used to be activities, doing activities at Head Start at the Children's Center, and now he's just shifting to a new age group. So he is doing great with getting out in the community, trying to recruit people, and then we're going to have an open house, try to We have adult day every weekday afternoon except for Wednesdays. We're going to try to do a monthly open house on Wednesday afternoons so that people can come in and see and just kind of see the area and ask questions, have help filling out intake paperwork.

Adult day, we got together with Kinderskog for a Be Kind event, and that was really fun to have different generations together, and they did did some art and just got to visit.

Allie Perez, our receptionist, got promoted to office lead as Jeanine Anakanak is going to be leaving home health, and so we're going to be changing billing around a little bit, but we're staying with it.

And then Brandy is going to be— Brandy Boggs is going to be coming in, I think it's late August. She's going to be going over to Wrangell and doing some case management there and then coming here to do that. So we were granted the Senior In-Home Grant, so we're going to be able to spread resources and see who there needs resources and hopefully maybe do home health over there at some point.

Thank you. Sounds very positive. Where's the Fram campus? The Fram campus is just the hospital, the main hospital.

The main, yeah, the main building. So we say often main building and our main site. I did have a quick question, Ruby, with the van. Yes. How much increase in— I don't want to ask this— like, how many people do you think would be coming if there was transportation provided?

As opposed to what's currently the system where people bring their own family members? We have—. PIA is transporting like 2 to 3 people a day there, and I think that if we can have— if Ryan could drive the van to their household and pick people up, I think we could get, you know, we're trying to get up to 8 participants would be like fully. So, But we, we put that in the RHTP funding for home health and I think the capital budget, but we're just kind of crossing our fingers and hoping that we can facilitate that. But we are very fortunate that the PIA van will go and pick people up.

Thank you. Does long-term care still have their van? Yeah. Is there a possibility of getting that? Use that?

We, we've talked about it, but I think we're trying not to— we don't want to mess with their activities and their programs that they already have going on.

Any other questions? Thank you very much. All sounds very good.

The next report is imaging. And does anyone have a comment or a question on the imaging report?

Aha, there you are. How many MRIs are we up to now, Sonya? Um, good evening. Can you guys hear me?

Yes. Okay, I got, uh, stuck up with the ER here, so I apologize. I'm still in the office. Um, as of time for writing my report, we had done 34 MRIs. Yeah.

And I just wanted to comment that I was really tickled to see that the high school physics class came to see the facility and that we're engaging with the school in that way. I think that's really positive. Yeah, Iona Ward has come pretty much every time she's had a class to the department, depending on what they're looking at, and it's been great. The kids are always engaging. They love to see the machinery.

We had, yeah, a big class come through, and so it was fun to see lots of good questions from them.

Questions, or is there anything else you want to share? Um, uh, as you could see, currently our staffing— the only thing has changed that we do have our travel to MRI technologist. We'll continue to keep a travel MRI technologist until we can find a full-time. My hopes is that we could find a full-time that could also be dual in the fact that we could use them down on the Fram campus, high when we don't have MRIs, but we still want to continue to train our current technologists as well. But we will need that dedicated MRI technologist.

Like you said, we had the physics class come through. I did lots of community engagement with KFSK and tours through the work building with that MRI installation. And I think all those community events went really well. You can definitely see what are the hospital supporters that show up to all of those and have good comments. So it's neat to be able to show people what we're doing.

I've been looking at just how our day-to-day operations are and what our statistics with patients are and continue to show that we're able to get patients in very quickly. Almost 50% of our daily workload are people that come from the clinic or the ER, so we're being able to give them same-day care without even scheduling. So it also shows that when the clinic's busy and the clinic has lots of physicians in it, that, um, that's when our numbers stay the busiest as well. And with, um, finances, um, MRI is great for finances, but we do continue to have troubles and lots of time and energy put into pre-authorizations. For those MRI exams added on as well.

CT exams are all authorized as well, but that is one thing that's taking up my time and the department time of making sure authorizations are done. The VA is very hard. We all know the VA can be a, a hangup, but that one's proving to be pretty challenging. But so far, I think most of the claims with MRI that have gone out have come back with reimbursement. So that's all been good.

All right. Thank you. Thank you. And I can say there have been 6 more MRIs since your report. We're up to 40 now.

I got 2 more tomorrow and another 4 next week. So yeah. And I don't see Violet online. Okay.

Any comments or questions on the lab report?

All right, moving on to long-term care.

And I also don't see Helen on.

I did see, um, that long-term care got the AHA Award for Innovation in Patient Safety and Quality, and that was very encouraging to see.

And then next, Carrie Lantin and Patient Financial Services. And Carrie's online. Pardon? No. Carrie is online.

Okay. Any questions or comments? Oh, I'm here. Hello. Can you see me?

Hello. There we go. How are things? Pretty good. Good.

You have any questions? I'm here. PFS is doing great. Our billers are knocking it out of the park still.

Ours hanging in the high 50s, low 60s for how we calculate it, which is great.

We're still trying to fill our front desk position. That position is still open, so, but the team has done really well at picking up, you know, the extra work and just continuing following claims and reimbursement and just busy all day long. We're busy. The, um, we got a lot of new, new projects happening that, you know, our team's involved with, and the direct primary care subscriptions come through our office. Um, the, you know, we're tracking the MRIs, making sure reimbursement's coming back in for those.

And, uh, yeah, I just, um, we're just Continuing on, making sure RevCycle's flowing. We've been, we had a RevCycle meeting today, an RCAT meeting, and talked about some of the issues we're seeing with denials and reimbursement. Alaska Medicaid continues to be the biggest thorn in our side, but we're working through it. And, you know, insurance is getting tougher every day to get reimbursement, and they're changing their rules and making it tougher. So We just try and keep on top of all that and keep the cycle going.

Question? Any questions? I have questions. Yeah. I was asked if someone is newly enrolling in Medicare and has questions on trying to figure out Medicare Supplemental policies and Medicare Part D, would Brandy Boggs be the person that maybe would have information, or should they talk to the finance Surfaces.

Well, yeah, Brandy or Jen Ray both have some Medicare information.

We can share what we know. We try not to ever advise on what they should or should not do, but we can offer any information we have, and there's also good contacts at the state we can share, so. But yeah, and they could contact the financial services office and we could, we can get their messages to whoever they need to speak to. Okay, thank you. Yep.

Anyone else? Yeah, I just, Carrie, I was wondering if you had any idea how many direct primary care enrollments might have come in yet? No, we do not have any yet. We have lots of patients that have you know, have the information. So we're just, we're just waiting for the first one to step through the door.

All right, thank you very much. All right, thank you. And the next report is New Facility, and I do see Justin online.

Good evening, everyone.

Any questions on the report? Should I walk through kind of where we're at, Phil? Sure.

Okay, um, we did complete all the site work, um, that included, um, the final effort of punching the road through to Excel. So that was all completed. The status of the site is stabilized, and it's essentially shovel-ready for future construction.

The stormwater pollution prevention plan was closed out with ADEC, and that kind of completed all of that work.

Any questions on that?

Okay, work building completed. We did have kind of a last round of some repairs going on with some of the fencing and then also a little bit of roof kind of upgrades on some things that were— that needed to be repaired as well. So that was all completed. And then they did the open house. I thought I was— me and Kate attended that.

I thought it went really well. But yeah, essentially the work building is completed.

In terms of kind of where we're at, we have 4 phases. The site work, Phase 1, is completed. The work building was Phase 2. That's completed. And for Phase 3 and 4, we created— we generated a concept design, and then that also recently included some renderings that are attached to this report.

And our current status is we are waiting for funding to advance the design.

Any questions?

I guess my only question or comment is I'm always concerned about lighting because I feel like we are on the edge of neighborhoods and have already impacted them. And so I would urge us to be as conservative as we can be with lighting.

Anyone else?

All righty, thank you. Moving on to quality.

And I don't, I don't see Stephanie. Yeah, I think Stephanie's out on a PTO. Okay.

And infection prevention.

Go ahead. I just, um, Wanted to comment on— let me get to the infection prevention metrics. I just think that that is remarkable and needs to be noted. Zero urinary tract infections, zero catheter infections, Clostridium, COVID-19, influenza, and RSV, all zero over this time period. And pretty, pretty amazing.

And speaks, speaks well to the facility and the employees and the much planning and effort goes into that.

And the next one is Phil's executive summary. Yeah, the grant state. Go ahead, Phil. Can you hear me okay? Mm-hmm.

Okay, just a few updates since I submitted my report. As you heard, a lot of the activities going on that managers have already covered, MRI being, I think, probably the, the main, the biggest thing, I think, as far as our new service line. And it's really encouraging to see just such growth. You know, we budgeted pretty conservatively, and it seems like it's already knocking it out of the park on the MRIs. So more to update with that as we go forward.

And then the billing and collections, which actually I was pretty concerned about because I know the prior arts are pretty challenging with MRIs, that it just shows the strength in our team of getting those claims through. So I really want to commend the team and Sonya and Carrie's team for getting those through.

The PXS, which was mentioned in, I believe, at the Resource Committee or Quality meeting, but that's full implementation. There's been a number of projects that we've been going live. I think Jill's in the room, so she can also, you know, give some— I can give some acknowledgment to her on the False Prevention Program, which is something that I believe was mentioned at the beginning through the resource or long-term care resource committee, but that is live as well. Those are pretty significant projects. It takes a lot of work and effort to put them together and then go live and then having them roll out successfully.

So that's pretty significant. And the direct primary care, I kind of knew that it was going to take, it's going to take a little bit to get that one rolling. I believe that once it gains some traction, It'll be very popular. So I'm still very excited. I'm not discouraged at all that no one has signed up yet.

Joni, I know you were mentioning about that. I didn't expect there to be a line, but I do believe that as word gets out on that, it's going to be a lot more popular. And most likely, I'm guessing people in the fall time will see a lot more uptick in that realm. So I'm still hopeful and encouraged that that'll come through.

I don't want anyone to forget about the paddle battle. I believe that we are looking next weekend, next Saturday, so make sure you— paddle pedal battle, I should say, so it's not just a paddle battle. And I want to make sure that we have good attendance there, and so we'll get some promotion. I know Julie's been working pretty hard on getting a promotion out there and, and some great prizes as we, as we get that online.

Senior Planning and Resource, which I, I believe Brandy's leading, and I know that Ruby's in the room or was in the room. I don't know if you're there. Let's see. There you are. Okay.

Yeah. So Brandy's still doing every Wednesday Is that correct, right? Yeah. Okay. And that's really nice because we're— as insurances get tougher, I think Carrie alluded to that.

I mean, I think that's something to really, you know, really to kind of remember because as we see some of the challenges with Medicaid on getting claims through, on how things become, you know, more hoops to jump through. We're really going to rely on our, our team to help patients through and navigate through some of those resources. So I'm excited to see Brandy continue those. We have a lot of support in our facility given the size and the volume. So those are something that I'm very happy to see and also expanding out to Wrangell in order for some of that support as well, I think is also very encouraging.

I know that the team has been busy in the ER and I know home health census has been pretty high as summertime has been hitting and I know that ER has been hitting somewhere. When I look at the 30-day look back, I just looked at it as I jumped online here, it's still running well over 110, 117 in the past 30 days. So that's pretty significant. Pretty significant. For the, for the ER.

And that's all I had. I didn't have— I've been out of the, out of town for a few weeks, so I don't have much, much more information. And I see Katie has raised her hand. Thanks, Phil. I just wanted to offer one quick update on the grants front.

We got the news this afternoon that PMC is receiving a new 3-year round of the Tobacco Prevention and Control Grant that Julie did such a great job of implementing over the last several years. So this will be a health systems improvement round again for PMC. And I know Shane Kelly did some really creative planning for what that could look like back when we applied for it a few months back. So it was a little bit of a late notification from the state, but hey, we'll take it. We're very, very excited to have another 3 years of implementing that, that work.

So congratulations to Julie's team. On that grant. Thanks. Thanks for letting me interrupt for a minute. Yeah, thanks.

And I, you know, the RCP, I know, is we just kind of on a, you know, pins and needles a little bit on that. So we're just, we don't really have any updates at this point, but we'll keep the board informed as we move forward. And that's all I had. Was there any questions for me?

I didn't have questions, but I did want to underscore in your report the Dakota Caples and Sarah Larson Team Player Awards, and also was really encouraged to hear that, um, the Kinderskog and Orca camps are cooperating with the Petersburg Volunteer Fire Department. Ryan Gilkey went out to teach with the students on the kayak expedition, and I think that's a really positive thing. Yeah, thank you for, for mentioning that. Yeah, the kayak expedition, I'm very excited and interested to hear sort of the summary of that. I haven't, I haven't been, I haven't had a chance to check in with Katie.

I know that that just, I believe that just wrapped up, so I'm sure it went really well. All right, thank you. Thanks.

So next up, and did you have any more, Katie, or? Are you good? Nope, that was everything from me. Sorry, I wish I had more. I didn't want to cut you off.

No, not at all. Thanks very much. Okay, moving on to financial. Jason. Hello everyone, how are you doing tonight?

Pretty good. Good, just doing a mic check. Thank you. Always a pleasure to meet with the group and hear of the success that is always happening at PMC. We're gonna review the financials really quick.

Cindy did a great job of recapping the resource committee. We can see here for the year clinic visits reaching above 10,000 visits, excellent numbers. You know, this is up slightly from the prior year. You know, typically a population will generate 3 times the number of the people that live in that community. So there's, 3,000, 3,500 people, so we see us generating 10,000.

Very little outmigration. The community strongly supports our clinics, and we have also a very strong specialty clinic and expanding that all the time. That turns into a variety of ancillary services, radiology procedures, up 2.5% from the prior year, so 2,700, almost 2,800 radiology procedures. And in the month of June, we did 9 MRIs. Lab tests, very strong for the year, 25,000, up from 22,000 in the previous year, so up almost 13%.

Some of that's due to the health fair labs.

Rehab services doing very well right now with some additional therapists. Very hard to find therapists across the country. To work. So keep, keep those therapists there. So it looks like 14,000 modalities for the year compared to the prior year at about 12, almost 13,000.

So up 9.6%. Home health visits, 2,800 compared to 2,200 in the previous year. So it's up 23%. Excellent rebuilding process there. And emergency room visits, Fairly consistent.

We typically do about 60 in the wintertime, 60 to 70 visits, and then in the summertime, we're usually over 100. We see that for the month of June with over 900, almost 940 visits for the year. Observation days down just a little bit from the prior year. I think we're doing a good job of keeping people out of the hospital. We generally want to do that.

Um, we want to care for people in the, um, the lowest level possible. We also see this in the acute care days. We're down, uh, 17% from the prior year. We had 307 acute patient days versus 373. And then swing bed is down, uh, 719 compared to 827.

And swing bed SNF days is down to 286 versus 374. People would usually assume, whoa, your volumes are down, does that have a negative impact on your financial performance? And not so much. Most of the people who actually get admitted to a hospital are Medicare. Medicare pays the hospital on a cost basis, how much it costs us to run the hospital not on a volume basis, how much, how frequently we see patients.

And so in years when volumes go up, we end up refunding Medicare because our costs don't really go up. The staffing, the cost of the building, supplies don't go up so much. And then in years when the volumes go down, Medicare ends up paying us a little more when we settle the cost report. So it really is better for us to treat patients in an outpatient setting to work with them in, you know, a variety of things, preventative medicine, colonoscopies, all those kinds of things. That's, that's where we do the best good, and that's where we come up with the financial success needed to sustain the organization.

Long-term care days, 4,316 compared to 4,939. Once again, this is a rebasing year for Medicare. So numbers being down a little bit, like I said, is going to flow through the cost report and be just fine in future years. Okay, I'll just give some highlights here on the financials. So for the month, total gross patient revenue, $2.8 million compared to a budget of $2.6 million.

So it was about up $166,000. And then year to date, Uh, we finished the year with $33 million, $33.2 million against a budget of $32. That's up from the prior year at $31.5 million. So, so up 5%, we did do a 5% Chargemaster increase. Like I said, our outpatient is up, our inpatient is down.

That's the way we like it.

Contractual is looking good. Net patient revenue, $2.2 million for the month. $1.6 Million for the year. All looks good there. Total operating revenues, we can see that the 340B for the month was $60,000, almost $67,000, for the year $816,000.

That's a little higher. We, we budgeted $550,000 for 340B, and so there were some changes from Medicare. We've spoken about that over the year. That Medicare has implemented a new compensation schedule and it's had an impact on 10 of the top, you know, highest compensated medications. And most organizations are feeling the pinch from that, but 340B is a fairly new program for us and still doing strong.

Expenses for the month hit $2.5 million. Against a budget of 2.2, up a little bit. Uh, there was a kind of a retention incentive that was paid to staff, or a thank you incentive, strong year and many wonderful accomplishments, uh, and some other expenses. Year to date, $28 million, $28.6 against a budget of $26.8. We did pass a revised budget a month ago, um, to cover those additional expenses so that our appropriation is all in balance.

But so what we're seeing here is a positive bottom line for the year of $1.7 million. Now, this is still preliminary. You know, we're going to work through preparing the audit here that will happen in September, the first week of— so, yeah, first part of September, and then We'll complete the cost report and we'll gain an understanding then, does Medicare refund us money? We have a bit of an argument going on right now with them. They believe that we owe them some money.

We believe that they owe us some money because of the depreciation expense of the new building and things of that nature. So they have recently re— taken back some money based upon an internal rate review that I think was a little rushed. They automatically changed our numbers for the outpatient rate to 95% of billed charges versus what it has been at 115%, 117%. So I think we'll still get that to come back. And we are about to finish the desk review for 2024, the final cost report for that.

I'd anticipated a higher amount. We are getting more than— we're getting money back on that, but not quite as much as I had reported in the Resource Committee meeting.

Okay, so the bottom line here for the month, $365,000, very strong, and for the year, $5,149,000 due to about $5 million worth of the, the capital grant, the, the grant from the, the Work Building, just finalizing a lot of things on that, the HRSA grant, So very strong both on an operating line basis. You can see that our operating line is about a 5% operating line. Won't bore you too much with the balance sheet. We, we have money in the bank, our debts are being paid off, everything looks— all the ratios are looking good. And the last thing I'll cover here, just some statistics, contractual reserve Writ-offs, how much we, you know, from we bill out a dollar, how much do we collect for that?

So we write off about 19% of charges. I think that's gonna come down a little bit more when we get the cost report done. Charity care, 1%. Bad debts, less than 1%. I comment about this all the time.

You know, national average is easily 3%. State of Texas requires organizations to write off 5%. So the business office does a great job collecting those copays, deductibles. The community does a great job in supporting the hospital. Operating margin, 5%.

That's strong for a critical access hospital, for any hospital right now, really. And then total margin with those grants in there, 15%. Phenomenal. Days cash on hand, can't look at the year-to-date number. You got to look at this, this number.

What, what was it at the end of June? 134 Days, um, cash on hand. Wonderful to be sitting in that position. Days in AR, 46. This is, uh, net and then gross.

We're sitting at 60, 60.1. Business office is doubling down and working to get the numbers they— we had hit a phenomenal low of 52 here, um, and so working through a couple things. I think we had a few glitches one of our payers that was having some technical difficulties on the processing of their claims, and I think we're getting that caught back up. We'll see that one trend back down. So, and then days in accounts payable is 24. So everyone's doing a great job seeing lots of patients, managing resources appropriately.

We have a strong budget, working to purchase some new capital. We have a new building, strongly supported by the community. So Makes it easy to report the numbers. That's all I have for tonight. Cindy did a great job recapping the things that are going on, the various projects and stuff.

So do you have any questions on the financials for me?

And I have to give AI credit. Sheena actually helped with my report because we were having technical issues with my signing on. Any questions at all? All right, thank you very much, Jason. You're welcome.

All right, moving on. Next item on the agenda is old business and housing update, assessing more permanent housing needs for PMC. Go ahead, Cindy. Good evening. So our situation remains a lot the same.

We were able to get our new apartment, 7-1, and we actually have it filled and then we'll have it filled next month as well. So we are having a lot of travelers coming and going along with using intermittent housing. So we have, for example, somebody who's staying in one of our places until the place he's waiting for opens up. But on the front, we're still working on a number of things along with the looking at that place that was for sale and still collaborating on all of that. Our hope is to, of course, recruit people and not have the need for the staffing.

But it's difficult. And as Jason mentioned, it's not just rehab. I mean, we also need an MRI tech. We have travel CNAs, we have travel nurses. So there's just a lot of moving pieces right now.

So I wish I could give you better news. It would make my day too as well. Is there an average stay for travelers or is it all over the board? It is kind of all over the place, but the norm is 13 weeks. So, and sometimes they'll say they'll stay longer, or sometimes when they're interviewing, they'll say they'll stay longer, but that's— you never know for sure.

And then if we're doing a private contract, we can negotiate that a little bit more, although we do have to be careful if we're doing a private one that goes through payrolls because of our PERS requirements. So, of course, if somebody doesn't have an end date, they have to pay into PERS because they're very specific about that. So we have to always be careful and mindful that if we're on a private contract, plus they're getting housing and all these different things, that they end or they come permanently. So I hope that makes some sense. So there's just a lot of— there's a lot to having contract work.

There's a lot to having private contracts. There's And then, of course, we have our people who live here. Yay! Anybody have any questions? Oh, the good news is, uh, thank you for approving the cars.

Um, that's in the works right now. So I believe they are HRVs, not CRVs, a little bit smaller. Um, Honda. So it's gonna be wonderful for Wolf also not to have to try to I get these cars to work. Thank you.

Chewing gum and baling wire. Yeah, it seems like it. Sometimes the duct tape, the duct tape, you know, make sure that door stays shut or that that handle works, or can you go through the back and get to the front kind of deal. So Cindy, don't hold on just a second. Phil has his hand raised.

I don't know if his question's for you. Yeah, I was going to say, yeah, go ahead, go ahead, Phil. Yeah, yeah. And I also, I did put a little indicator in there as a discussion for the board just based off of Cindy's report. And that we put it on the agenda as old business to maybe just, you know, formally acknowledge that housing is an important workforce constraint and we should really evaluate some potential solutions and maybe just, you know, put on the record at least at some point that we should be looking either in town for potential housing, you know, with no financial commitment obviously for today, but with, well, you know, looking at specific projects, either that is, that could either be looking at grants for housing and that we have partnerships with the borough to develop housing of our own using the upper lot, or that, or looking at housing that's in town, existing housing to obtain and purchase as part of PMC.

And also, There was a third thing, but it's failing me right now. But also looking at potential partners to develop some of those housing opportunities and looking at long-term, you know, recruitment for staff. You know, we do a really good job with our workforce locally and we recruit, but if you actually look at how many people outside of Petersburg come and live, it's low, it's a lot lower, and it's really hard to recruit route, and when people get here, housing is always an issue. So I just wanted to put it out there as something to consider, and I did have a legal review completed that we are allowed to, you know, obtain property or housing and follow this line as it supports our workforce initiative going forward.

Thank you. Thank you.

Thank you.

All right, next on the agenda is the bylaws revision, and there are proposed changes to Article 7, um, suggested Edition E on page 8 in red, and Article 8 on page 10, suggested additional language in red. And there's a spelling correction on page 12 in red. Um, these suggestions were made public, read aloud, and reviewed at the last public board meeting on June 25th, 2026. And per Article 11, the board may now vote to approve these changes as presented. However, there's one other correction.

Oh no, it's a very simple one. There just needs to be a space. Between rules of order on page 46 on the second line. It doesn't change anything, it just—. I think the spelling was added too after, after last meeting.

So we probably need a motion to, uh, approve the bylaws. Well, do you, do you want to— me to do a roll call to approve the bylaws, like you would make a motion and we can vote, or do you want the revision with the space? Oh, I wouldn't—. I would like to make a motion, uh, to approve the proposed changes to the bylaws, specifically to Article 7, uh, and Article 8, uh, also the spelling correction on page 12 in red and the newly identified spacing typo in the bylaws. Perfect.

Second. You have—. It's been moved and seconded that we approve the bylaws revision. Go ahead and do a roll call. Board President Cook is absent.

Board President Our board vice president, Lagadakis. Yes. Board secretary, Cushing. Yes. Board member, Stratman.

Yes. Board member, Khan. Yes. Board member, Roberts. Yes.

Board member, Johnson.

Yes. And the motion passes. Thank you very much. And our next meeting is currently scheduled for August 27th. Um, here in the work building at 5:30 PM.

And I believe we have, um, make a motion— consider— I need a motion to go into an executive session.

I would move that we go into executive, uh, session to consider medical staff appointments and reappointments and to discuss any legal and/or financial concerns.

Thank you. It's been moved by Joe Stretman and seconded by Jim Roberts that we go into executive session. All those in favor? Aye. And opposed?

All right, we'll take a 3-minute, 5-minute break. Sounds good. Thanks, Cindy and Ruby.