[Editor's Note: This is the fourth of a series of articles on the Feb. 6, 2024, Grant County Commission work session and Feb. 8, 2024, regular meeting. This begins with the review of the regular meeting agenda and reports and presentations heard by the commissioners.]

By Mary Alice Murphy

County Manager Charlene Webb, at the Feb. 6, 2024 Grant County Commission work session, began the review of the agenda for the Feb. 8, 2024 regular meeting. With no public input, the first item was the monthly report from Gila Regional Medical Center Chief Executive Officer Robert Whitaker.

Whitaker opened his report by giving the December hospital statistics. He said they had 101 discharges, compared to 109 in the prior year. For the first six months of the fiscal year-to-date, the discharges totaled 526, about 75 less than the prior fiscal year to date in December. He noted that many admissions come through the emergency room and those numbers were down, too, "as you will see. These are December statistics because we haven't presented the January ones for approval by the Board of Trustees yet."

He said surgeries were also down compared to the prior year, and so were the fiscal year numbers, down by about 60. Deliveries were slightly up for the fiscal year. ER visits were down 89 from the prior December and down 560 from the prior six month year-to-date ending in December 2022.

"Our outpatient numbers are up, including lab, radiology, cancer center, infusion center and physical therapy, things like that," Whitaker said. "They are up more than 200 from the prior December and up more than 2,300 in the six months this year over the prior fiscal year."

He continued with finances. "In December we had $7.8 million in net operating revenue compared to the prior year with $6.8 million and in December 2023 $7.7 million in operating expenses, compared to $6.8 million in December 2022. For the fiscal year-to-date of six months, our net operating revenue was $45.5 million compared to the prior fiscal year of $40.1 million. Our net income was $113,000 compared to a loss of $8,000 the prior year. The net income for year-to-date was a loss of $385,000 compared to a loss for the prior year-to-date of $1.5 million. The operating days of cash on hand, we reported out to the board at 140 in December, compared to 105 the prior year. In charity care, we processed $186,000 this past December compared to $115,000 the prior year. Fiscal year-to-date, we're right around $500,000 compared to last year YTD of $354,000."

Whitaker said for capital purchases and renovations, the Women and Newborn services (Maternal-Child or MATCH) are underway and on target to complete the end of May. For the operating room HVAC replacement, which is funded by a federal EDA grant, "we've had discussions with (Southwest New Mexico Council of Government Director) Priscilla Lucero on the things still being worked out on the federal level with the contractor Trane. The orthopedic clinic renovations are underway, A couple of other renovations in design are the correction of the concrete pads in the courtyard, which have been uprooted by the trees. We are also looking at redoing the ER registration area and our outpatient registration area. Those are in the planning phases now."

He reported the hospital had completed the employee engagement survey. "We have a meeting coming up with our department directors and managers to go over that to determine ways to improve our employee engagement scores. We reported out that the average score was 3.5 out of 5, which was about the same as last year. Our compensation survey was completed and we are making changes to our pay scale and schedules. Those changes are happening now. We completed the financial audit and submitted it to the New Mexico State Auditor's Office. Again I apologize to the county management for it being late. It won't happen next year."

Whitaker noted the board meeting would take place Feb. 28, and he announced that Saturday, Feb. 17 would feature a Night of Music to benefit the GRMC Foundation and the Silver City Rotary Foundation at Light Hall on the WNMU campus.

He also talked about legislation that went through the recent Legislative session. He thanked Sen. Correa Hemphill, Rep. Terrazas, the Prospectors' Group, the SWCOG and a special thank you to the Grant County commissioners and administration for their advocacy.

"Some of the bills we've been talking about include Senate Bill 17, the Healthcare Delivery and Access Act, which replaces what we used to have - the Safety Net Care Pool that was replaced by Hap and Tap," Whitaker said. "A few years back the money available was $11 million to assist hospitals. Last year it was about $1.7 million. It is being revamped. We won't see funding until about January 2026."

Senate Bill 161 he described as a bridge bill, called the Acute Care Facilities Subsidies. He noted that originally Gila Regional was not eligible, but thanks to the commissioners and Sen. Correa Hemphill, the bill was reworded to made Gila Regional qualify for the funding. "Up to about $5.7 will be available to us over two years. There are certain expenses we have and services that we provide that will be reimbursable. We've been watching SB 223, the Medicaid Trust Fund. There is concern that in the future, the state may not see all the funding come in that they have now, so at that point, the state may have to pull back on Medicaid, but with a trust fund that will help."

He noted two bills HB 203, sponsored by Rep. Terrazas, and SB 62 would address EMS Health Care Mileage Reimbursement. "New Mexico Medicaid does reimburse for EMS mileage, but it's only billable after the first 15 miles. This bill will change it so the reimbursement starts at mile 1, which would be a big financial help to us. I checked the GRMC capital outlay request and it is still in the bill, $1 million to replace the CT scanner and another $600,000 request to replace other major medical equipment."

District 5 Commissioner Harry Browne asked for an explanation on why the audit was late.

"With transitions in the finance departments, with our controller and the transition with the CFO (chief financial officer), we weren't timely enough on getting the information to the auditors, due to personnel changes," Whitaker said.

Browne said the audit also ends up on the county audit, so it impacts the county, too.

Whitaker said he was aware of that.

Browne said he feels like the hospital is like a dieter and becoming impulsive about dieting. "We were all so desperate when we were facing negative days of cash on hand, and let's get to 50, and then when we got to 50, we said let's make it 90. At 140, it seems like it's time to stop dieting and start investing again. If we moved it down to 100 days, it would be $8 million in cash that could meet our needs. Secondarily, it's misleading to the public to think that the days cash means we can last 140 days. It's unthinkable that we would shrink to zero. It seems like a very comfortable cushion. I realize we are no longe the governing body, so I will constrain my thoughts to things that impact the county, like the assets. And this is an asset that needs spending."

District 1 Commissioner and Chair Chris Ponce, on SB 161, said he wanted to thank Sen. Correa Hemphill, but also Sen. Crystal Diamond-Brantley, who really pushed on that. "I also want to thank Lt. Gov. Morales and the Senate Finance Committee Chair Sen. Munoz. But with the help of them and also Rep. Terrazas they got Gila Regional on the bill." Ponce said he is also very strong on behavioral health."I understand it's not a money-maker, but it's needed. We have Tu Casa, but I think we need another place to support Tu Casa. Looking at the renovations, I understand the orthopedic clinic, but the renovations are taking part of what was the behavioral health unit. I would like to see or ask what plan there is down the road, what are you saving for the BHU, and how are we going to get that back in there?"

Whitaker replied: "Yes, it is our behavioral health unit space, but we are making no structural changes. It's just being renovated for clinic use and not for inpatient stays. The footprint remains the same, and if in the future, we need it, it would be easy to change it."

Ponce said he just didn't want an obstacle.

District 2 Commissioner Eloy Medina said he saw Mr. Whitaker at work in Santa Fe. "I want to say thank you for what you did. It's nice to see a CEO working that way for the hospital."

District 3 Commissioner Alicia Edwards commented on the employee engagement survey. "As I am sure you are aware, we have had some questions for a long time about the morale at the hospital, so I would invite you next time to give us a more complete report on what you're doing with that employee satisfaction survey. And how you are using it and compare it to the last one. It is a critically important part of the hospital. I know we talk a lot about capital and renovations and such, but really, there is no hospital without the staff. We are beyond just saving the hospital, and we need the hospital to thrive and for the hospital to thrive we need to address the morale issue."

The next article will begin the elected officials' reports.

To read the previous articles, please visit https://www.grantcountybeat.com/news/news-articles/82709-grant-county-commission-work-session-020624; https://www.grantcountybeat.com/news/news-articles/82762-grant-county-commission-work-session-020624-part-2 ; and https://www.grantcountybeat.com/news/news-articles/82781-grant-county-commission-work-session-020624-part-3