By Mary Alice Murphy

The appointment of three Gila Regional Medical Center Board of Trustee members was discussed at the work session on Tuesday, July 23, 2019 and made at the regular meeting on July 25, 2019, but not without further discussion and divided opinions.

The GRMC Board of Trustees appointments at the work session elicited discussion among the commissioners on how to proceed with the process.

Commissioner Javier Salas suggested that the seven finalists be ranked in the same way that the commissioners ranked the original 11 applicants. "If [Executive Assistant] Bernadette (Coleman) is willing to compile the rankings."

Commissioner Harry Browne said he agreed it would be useful, but he would like to have it by 5 p.m. Wednesday instead of just before the meeting on Thursday.

Commission Chairman Chris Ponce questioned whether Commissioner Alicia Edwards would be able to have her ranking by Tuesday at close of business, because she was out of town on a business commitment that day.

They decided that getting the ranking to Coleman by 9 a.m. Wednesday should be doable, and Coleman said she could have it done and to the commissioners by the end of business on Wednesday.

In public input on Thursday at the regular meeting, Colleen Stinar, wife of one of the GRMC board applicants, said she has been serving in health care since 1997 and has a master's degree in nursing. "I set up a pulmonary clinic in the old Med Square building and have managed it for 22 years. I also worked as a visiting nurse and patient educator for Gila Regional Home Health. I have perspective based on years of interacting with the hospital. The home health department and durable medical equipment department were closed due to finances."

She said after 22 years in Silver City, "I am encouraged by the new physicians and specialties being recruited. I am hopeful the hospital will stay open with more organized registration and authorization procedures and oversight of employees. In the past, you could get by with 30 to 40 percent waste, but reimbursement has decreased, and providers have to be very accurate in their billing and management. For the first time, Gila Regional is being accurate."

She said she is happy about the new physicians and specialists because not all patients can afford to travel for medical care, much less for hotels for their families. If there are not doctors, there are not patients in beds and there is not money to pay for any of the departments, including pharmacy, housekeeping, radiology and lab services.

"This sounds obvious, but this administration is the first to made recruiting a priority," Stinar said. She listed the recent advances, including a full-time oncologist who lives in the community; new surgeries being offered; billing problems being resolved; more nurses without using expensive traveling nurses; and the retention of current providers is being worked on.

"I would urge you to support the current hospital administration, as they are doing a stellar job," she continued. "The few employees that have lost their jobs due to substandard performance should be ignored. I hope the hospital will be here in the future to provide competent testing and emergency surgery and treatment for me, my family and my patients. I urge you to choose a board member with medical and business knowledge and the patient's best interest at heart."

Next to speak was Dr. Norman Ratliff, board certified cardiologist. "I came to Silver City seven years ago and started the cardiology practice here from scratch as the county's first hospital-employed physician. When I started, we didn't even have an office and borrowed a patient room in the Cancer Center, and I used a hospital meal tray as a desk. Now we have a booming practice and can barely keep up with the expanding volume."

He has practiced cardiology for 17 years and is board certified in four subspecialties of cardiology. "I trained at the University of Minnesota, Johns Hopkins and the Minneapolis Heart Institute. I came here because I wanted a sense of community and the opportunity to make a difference in people's lives and in the community where we live."

Ratliff noted that rural health care and rural hospitals are in crisis in this country. Ninety-five rural hospitals have closed since 2010, with more than twice as many having closed between 2013 and 2017 than in the previous five-year period, indicating a worsening trend.

He said nearly 20 percent of Americans live in rural areas and depend on their hospitals as important and often only sources of care in their communities. Rural hospitals provide access to care close to home and improve the health and well being of the patients and the communities they serve. Local timely access to care saves lives and reduces added expense, lost work hours and inconvenience of traveling to facilities farther away. Rural hospitals also serve as economic anchors in their communities. The availability of local access to health care is important to businesses considering whether to locate in an area. Private sector employment generated by rural hospitals supports a healthy tax base, which funds public education, fire, police and road maintenance.

"If people don't have health care, they don't have health," Ratliff said. "When health issues go undiagnosed and untreated, people begin to deteriorate, unable to work, buy food, pay for shelter and care for children. The goals of happiness and stability rapidly start to fade away. When a rural community such as ours loses its hospital, the entire community starts to fall apart. GRMC is more than just a hospital; it is a vital anchor for the very survivability of Silver City.

"Taffy Arias inherited a virtual disaster when she arrived here at GRMC," Ratliff said. "She has done an absolutely remarkable job in getting the hospital back on its feet. I admire her courage and perseverance in making many difficult and sometimes unpopular decisions. She has made the necessary changes in personnel and operations to allow GRMC not only to remain viable but to expand and thrive. She is not here to win a popularity contest, but she has managed to maintain her vision and composure despite being attacked in the press with baseless and ignorant accusations. We are extremely fortunate to have a leader with her abilities and vision at GRMC."

He concluded by saying that in addition to Taffy Arias' continued leadership as chief executive officer, "it is critical that we have a stable and qualified board of directors. Joel Schram has done an outstanding job during his tenure. He provides financial knowledge and experience and should be re-appointed. Dr. Donald Stinar is superb physician with over 20 years of health care experience in diverse settings. He is a long-standing, committed member of our community and would be an excellent choice for the board."

When it came time to appoint the trustees, Browne made a motion to appoint, in order of ranking by the commissioners of the final seven applicants—Cynthia Moreno, James Marshall and Dr. James Skee. "I believe it was a thorough process. We heard from the seven applicants and talked to individuals. Those three came on top. They are not my top three, but they are a combination of experience and new blood."

Commissioner Billy Billings said it was a difficult and thorough process. "I made and received lots of calls. I think there are legitimate conflicts of interest. Gila Regional from 2013 to 2018 lost $18.3 million, about $3 million per year, six years in a row. I talked to (chief financial officer) Richard Stokes and he mentioned a turnaround, although a fragile turnaround. Taking into consideration what Dr. Ratliff and others have said, I think we should consider Joel Schram. My choice is Moreno, Marshall and Schram. It has been expressed to me that Joel's experience is needed. Moreno and Marshall won't be yes people. This commission is balanced. I think the board of trustees should be balanced, too. I will vote against Browne's motion."

Salas said the decision had not been taken lightly. "I, too, have received a lot of input. The hospital is integral to our community. We have to give Ms. Arias a board that will work with her. I will vote with Billings."

Ponce said the commission came up with a process and tried to narrow it to three. "The biggest thing is that we have a rural hospital, a gem in Silver City, and we need to make a decision. It will not make everyone happy. I like Mr. Schram. All the applicants are good people. We listen to our constituents because the hospital belongs to them. We have the community and hospital at heart."

Commissioner Alicia Edwards said as far as the financial part, "two of the three people nominated were ones Richard would recommend. Dr. Skee and James Marshall have probably 50 years combined of financial experience. The clinical and government side are also important to the hospital. I will stand by Harry's motion."

The motion from Browne was voted on with Moreno, Marshall and Skee. It was defeated three to two, with Browne and Edwards voting aye.

Billings made his motion for Moreno, Marshall and Schram with Salas seconding it.

Ponce said what was holding him back for Dr. Skee was his clinic. "I think Dr. Stinar would be an asset. "

Edwards suggested switching Stinar for Schram.

Billings noted that Stinar also had financial experience.

Salas said the third choice was the most difficult, "between the M.D. and the money man."

Browne said he never saw Schram asking difficult questions. "Maybe he did in executive session. But that's why I don't support him. I believe Skee would ask tough questions."

Billings's motion was voted on, with three ayes, he, Salas and Ponce and two nays. The three appointees to the board are Cynthia Moreno, James Marshall and Joel Schram.

The rest of the work session and regular meeting will be covered in a future article.