[Editor's Note: This is part 1 of at least two articles on a long GRMC Board of Trustees meeting held 012618.]

By Mary Alice Murphy

As is customary for each Gila Regional Medical Center Board of Trustees meeting, the latest of which was held Friday, Jan 26, 2018, trustees ask to hear a Safety Moment.

Chief Nursing Officer Peggy White said the hospital has been getting "inundated with attempted hacks." She said they are seeking to get into medical records, among other items. "Our IT (information technology) has been great at blocking them and no one has gained access."

When it came time to approve the agenda, Trustee Tony Trujillo asked that a change be made, "because of the elephant in the room." The room was full of people interested in the topic of ratifying the CEO contract, which was on the agenda after the executive session. All five Grant County commissioners, the County Manager and County Attorney were in attendance, along with others there interested in the same topic.

"I request we move the item to right after public input," Trujillo said.

Trustee Mike Morones amended the motion for a short executive session before the contract was up for approval. The amended motion was seconded and approved.

Before public input, GRMC Chief Executive Officer Taffy Arias introduced the new Director of Marketing Doug Oakes, who she said had moved from Fresno where he worked for a large automotive dealership, had previously owned his own integrated marketing firm that had worked with hospitals mostly in the Southeast.

Oakes said he is married and he and his wife have six children and have made their home here.

Arias also said the hospital has hired a Chief Quality Officer Tanya Carroccio, who will arrive in mid-February. "She is finishing her doctorate and is a nurse practitioner. She also has a project at Mayo."

Linda Nichols, former cancer patient at the GRMC Cancer Center, was the first to speak in public input. "At the November Board meeting, Taffy made the statement about the public not trusting us here, meaning at the hospital. She's right. The definition of malfeasance is 'in the violation of public trust.' What that's telling me is that the contract was not done right. The initial contract was for two years, with a performance evaluation to be done on an annual basis. Why was the evaluation done at five months? The termination clause was changed. Why has it taken you so long to come clean? You haven't given us a reason to trust you. I encourage you to reconsider and revisit the contract at the end of two years."

Alfred Sedillo, GRMC Foundation president, thanked the board members. "Five years ago, Gila Regional decided to separate the hospital and the foundation. We met with Mrs. Arias this morning. We look forward to coming back as part of the hospital again. The foundation was founded in 1988. We, since then, have purchased $3.8 million-worth of equipment for the hospital when it couldn't afford it. We're here to help. June 9 will be our golf tournament. We didn't have one last year. We will have an office next to Mr. Oakes. It will be good to work together again. WNM Communications gave us a donation of $10,000. We're strong. The funds the foundation brings in are for you guys. I ask every department for their wish list. We, along with the Auxiliary, have never denied any equipment to the hospital. The board is anxious to renew our relationship with the hospital. Our meetings are open. The Gila Regional board chairman and CFO have come often. We are short of board members. Let me or Jo Ann Holguin know if you are interested. We have an active scholarship program at Western to get nurses to stay at Gila Regional. Every year, we have given close to $21,000 in scholarships. We get donations and are the pass through for First Born, which has a new name [now called Beginning Years]."

The third to give public input was Chris DeBolt. "I worked here at Gila Regional for 10 years in the best of times and the worst of times. The number of people we went through in leadership positions was incredible. I think we had five different CNOs. I remember being here in the middle of the worst. A bunch of us were sitting in the cafeteria looking across to this room, watching what was going on, until someone noticed us and closed the shades."

She said after the County Commission had made a vote of no confidence in the Gila Regional leadership, then the Board of Trustees did the same at the meeting many watched from the cafeteria.

"My recent investment of time at the hospital was as a member of the search committee," DeBolt said. "It was a lot of work, but very thorough. It was one of the best searches I've been through. And our choice was Taffy."

"Right now, it feels like a boxing ring," she continued. "People are in their corners. All of that stuff has to be set aside and there needs to be a discussion for what is best for the community. Some people trust the figures coming from the hospital and some don't. I suggest an independent audit. In the absence of clear transparency comes the gossip, which creates what Linda was talking about. The County Commission and the Board of Trustees must set aside all the history and baggage and do what is right for the community. We, the public, need to know how we can help. I am imploring you, commissioners and trustees, to see the way clear to carry out what is essential for the hospital. It is what we expect of you."

District 5 County Commissioner Harry Browne thanked Trujillo for his "recognition of the elephant in the room. The Commission has hired Juniper Advisory to evaluate whether what we have now at the hospital is the optimum model. It does not mean the commissioners will be influenced by Juniper's desire to make money. About half the time that Juniper consults, it does not recommend selling a hospital. We believe, as the owners of the hospital, it is our ethical and fiduciary responsibility to determine what is best. It includes looking at the wisdom of remaining independent. I do not have any reason to think we will change the independence of the hospital. We're all in this together. I would hope all of us on the advisory board will do their best job of evaluation. Doing it right includes having good information. My main concern is the lack of information from the hospital. Juniper Advisory has been asking questions since December 14. The majority remains unanswered. Many seem like simple questions, such as whether the hospital participates in any other uncompensated programs. Many are partially answered. Our only chance to evaluate is with information."

GRMC Trustee Mike Morones moved to ratify the five-year contract for Mrs. Arias. Discussion followed.

Trujillo thanked the speakers and the Daily Press for a "great article. It seems to me the common theme is 'we care about this hospital. We have a good base to start from.' How we all get to agreeing seems to be the issue. There are two sides to every story. I'm concerned where we find ourselves with the commissioners and trustees. I think it's a lack of communication. We have to be truthful with each other. When we talk about the evaluation, that's fine and dandy, but we, as trustees, have to be careful how we say things. Sometimes, our friends in the media take things out of context. The word disingenuous was used."

"We, as trustees, expect the CEO to give a report to the commissioners at each monthly meeting," Trujillo continued. "This whole process causes instability. I was getting my teeth cleaned and my dental hygienist asked me why we were selling the hospital. My doctor asked me the same thing. Both said they are invested in the community, but they don't know if they will have jobs. It causes instability. It's a fact, not disingenuous. I, too, was part of the search committee. Our choice for CEO was concerned if she would have a job. I stand in support of our physicians, our nurses, our caregivers and our staff. We have quality people at Gila Regional. They are topnotch, but when they hear the hospital is being evaluated, they wonder if they did something wrong. Let's not forget all the awards this hospital has received. We've got a lot to be proud of.

"The question is why the county hired a broker for this process," Trujillo said. "The evaluation still means there is potential for a change to the hospital. The Commission also hired a marketing firm to get their message out. Why? How much did it cost? You hire a lawyer. How much did that cost? I have a lawyer son. I know it's not cheap. I have a lot of questions."

He called for transparency. "We must all be truthful with everybody. One of the best things for the county happened this week in Santa Fe-Grant County Day. But it gets poisoned."

"There was a comment about the volume of information requested," Trujillo continued. "We hired a CEO and she's doing a heckuva good job. I'll take the position on the accusations of not being as responsive as they think we should be. Everything the hospital has to do on a daily basis is a lot. The questions may not look complicated to Commissioner Browne, but we have to deal with other issues. In the article, you (Browne) say people have to put public pressure on the hospital. There are some ugly people in this community. We get threats. That's why it was important to extend the CEO's contract.

"We spent a lot of effort in the transparent process in our search for a new CEO," Trujillo said. "We had 120 inquiries about the position and received 113 resumes. We selected 22 from that group, then recommended four to the trustees. In the interviewing and the community meetings, everyone said she was the most qualified. We told her to turn the hospital around financially, to fix the morale, and to work with the community. We need stability."

Morones said he would be more direct. "I love having Tony. He says what a lot of us think. I will support this contract. Where I am coming from, I apologize for our lack of transparency. This is something I didn't expect. When we moved to bring her on, we didn't approve all the terms of the contract that we are doing today. In haste, we were gun-shy from previous CEOs. As things changed, our main charge is to run a smooth, efficient, effective stand-alone hospital. In the light of potential opportunities, there will be discussions with the commissioners and the public. We cannot limit the commissioners' decision, but we have to show the commissioners and the public that we have and are governing a good stand-alone hospital. It was not possible to do with a two-year contract. We have to make sure the commissioners know we have a stable, good stand-alone hospital. Yes, five years is a long contract; the usual is a 3-year-to-4-year contract. But we have locked in stability. If that is the path that is chosen, we have to secure a competitive advantage with Deming and Las Cruces. We cannot allow having a contract fall apart without a non-compete situation. We need to have a certain buyout, so we are secure competitively. I have been impressed, but have received some concerns and some debates from competent people. We are changing, moving forward. The old way of doing business wasn't working. We believe Mrs. Arias has illustrated a strength to move us forward. She's not here to be anyone's friend. She's here to do a job. If she were popular, I would be concerned."

Trustee Joel Schram said he and Morones became trustees one-and-a-half years ago. "I thought, at the time, it was because of our financial backgrounds. In the first meetings, we saw financial problems. The CFO tendered his resignation. We realized there were deep issues within the numbers. The new team has shared the finances in a way that everyone can understand. Moving us forward, the numbers are showing we will have a self-sufficient hospital."

Trustee Jeannie Miller said she came as the latest trustee. "I will vote for this contract. It is extremely important to have a strong, qualified person at the top. It's not easy to get a qualified person here. She wants to be here. She has a medical background. She knows how a hospital works. Dr. Nwachuku, Taffy and I are on the Juniper Advisory task force. Taffy has been willing to do it. We have to have someone at the top that knows how a hospital works. She been in the trenches. It won't happen overnight, but it looks like we're on the way to self-sufficiency. She was chosen out of 120. Why not want her for five years?"

Morones clarified that the five years was from the time of hire in 2017.

Trustee Dr. Victor Nwachuku said his biggest concern is communication between the trustees and the commissioners. "I've had calls from other physicians, whose biggest concern was the five-year contract. All of us want a successful hospital. We have had no communication with the commissioners. It's just what we see in the paper. We need a better flow of information between us. I want the hospital to be successful. I'm interested in where we are and where we are going. I share the concern of the public, the commissioners and the physicians. The board has to be sensitive to communication. We have to make sure to protect her, the hospital and the public. I think there has been some misinformation. We need a better flow of information. We have privileged information, especially physicians' privileged information, that we can't divulge. The Commission needs to know more about our strategic plan. The chairman of this board should have a free flow of communication with the commissioners. We have to find a way to give accurate information to the commissioners to give to the public. I propose we let some commissioners into this executive session."

Trujillo said he had a couple of recommendations. "We have to learn how to communicate better. We gotta figure: 'Shame on us.' Look at the numbers of both groups here. We need to get that out in the air."

Board Chairman Jeremiah Garcia thanked the trustees for speaking from their hearts.

"We, as the board of trustees, have two responsibilities," Garcia said. "The first is fiduciary and the second is hiring and firing the CEO. Both to maintain a stable hospital. Our goal when we obtain our first position is to have a career. As we grew our professional lives, we took risks. We found the best CEO we could. Health Care has changed enormously. The board, after we interviewed the four candidates, chose Mrs. Arias unanimously. She was our top candidate.

"We have fear in our hearts with the changes in health care," he continued. "We have risks. Every decision we make will reflect on health care in Grant County. When we were in crisis, we were tunnel-visioned. We, as trustees, can be hated for some decisions, but we have to open the door for opportunities. Yes, cost is involved. We are trying to comply with giving information (for the evaluation). We have concerns with some groups that are like car salesmen. We need to come together as a community to provide the best health care to Grant County."

He said the board, with the direction of the CFO and CEO, has made some eye-opening discoveries. "We asked that everything that is in violation of the rules and regulations be put on the table."

"As we make our decision today, it's not just for today, but for the future to protect health care in Grant County," Garcia said. "We've got to take away the walls. Some of the new team of commissioners are leaving. I will leave as trustee and others will come on. We need to stop it. We need to come together. If we don't, we will lose quality physicians, quality nurses and quality staff. We have to be united as we move forward.

"This is critical business," Garcia continued. "Everyone in this room is part of the team. We want Grant County to shine and what better asset to shine than Gila Regional and than a leader who has taken abuse. Our focus was on how to keep the doors open. Now we have turned a corner. We have not given up. A hospital in northern New Mexico had to raise its flag and say it was giving up. We haven't given up. We have issues, but my goal is to help the hospital. We all bring something to the table. If we are going to put chips on our shoulders, we will fail. We're here at this time to make a critical decision, and we will continue to make critical decisions."

Morones said the board has never had a good governance attorney here. He turned to County Attorney Abigail Burgess. "Can we invite the commissioners to be in executive session?"

The commissioners went into the hall for a brief conversation with their attorney. When they returned, Commission Chairman Gerald W. "Billy" Billings said: "Thank you for the invitation and especially for the comments about communication. We have some ideas about how to communicate. But we will not be able to accept the invitation to the executive session. Let's take the personalities out, and we look forward to the communication."

Garcia opened the door to more public comment. Only Commissioner Gabriel Ramos spoke and said: "We don't want to violate the Open Meetings Act."

The trustees went into a short executive session to discuss only the CEO contract.