Photo and article by Mary Alice Murphy
The Gila Regional Medical Center Board of Trustees Chair Dr. Fred Fox opened the meeting on Aug. 6, 2025, by asking board members to read the mission, vision and values. He pointed out to this writer, his T-shirt encouraging older people to get their respiratory vaccines at this time of year. He also recommended that children get their vaccines before school starts. Fox noted the uncertainly with the changes in federal agencies in advisory positions and how that will all shake out. "I just want to be clear, that, as a physician, I think it benefits our community and individuals to obtain vaccinations to make sure you are immunized." He also cited all the professional medical organizations that have sent out reminders and suggested that people, especially children be vaccinated.
Fox then turned to what he called his favorite part of the meeting, the recognition of providers and staff members for their years of service to the hospital.
Nora Trammell-Lowe has served 10 years at Gila Regional in Rehabilitation Services; Monika Salars, 15 years at the Wellness Center; David Cabral, 20 years with Information Services; and Monica Sedillo, 25 years in the Operating Room.
During public input, Chris DeBolt spoke. "I'm a former caregiver from here, having retired almost 10 years ago. During that time, I was Director of the Education Department and the diabetes outreach, diabetes self management program, as well as the last two years in the community health partnerships. I was fortunate enough during my time here to be involved in the team that actually wrote the mission, vision and values, and I'm very proud of that, and very proud to tell you. And the reason I'm here is to tell you how good you are."
She recounted a medical emergency in she had in June, "but I'm good now. I ended up staying in the hospital for eight days, and then was transported to Las Cruces for a possible intervention that I ended up not needing because of the care I got here. And during that period of time with that care, I remember all of the nurses, everybody from the ER, from SEU, dietary, housekeeping, you name it. EMS taking me down to Cruces. I could not have gotten better care anywhere, in my opinion. And I'm not a novice hospital person, I could not have gotten better nursing care and care from my doctors, Dr Sherpa, initially, Dr Lawrence and then Dr Wendler. I did not need the intervention that was only done by a radiation interventionist. So yay, I came home. But I just wanted you to know that, in my opinion, as much as it doesn't make the news, and you don't get these kinds of accolades that you should get, because in in my experience, we are so fortunate to have this hospital in this community. We don't sometimes know how lucky we are, because little communities like us, we don't have those hardly at all anymore. And I just really wanted to tell you how much I appreciated the work, and you can be sure that the mission and the vision and those values are really held here by all of the people that I experienced here in my care, I could not have gotten better care. So thank you very much for everything you do and keep doing it.
"And I'm going to put a plug in for Tu Casa. I was on that planning committee way back when. Now that things are changing, and you do have behavioral health services back here, with Dr. Arizaga, in behavioral health, we need so many gaps filled in our region and in our community, and then also, because I'm a senior and I work with the county senior centers, we need memory care. We're all aging, and our distinction will be to be the fifth oldest county in the state in five years. So there's a lot of work to be done there, and service lines to be developed. So again, thank you for everything and for being here and doing everything that you do."
Before she left the podium, she produced a small card that
Diane in housekeeping gave her. "I've kept it for six weeks, this meant something to me. That's why I've kept it. It's a little thing, but it means a lot."
Fox said: "It just goes to show that all of our services, the entire Gila Regional family, including housekeeping, does a fabulous job taking care of patients in this community."
The board members then approved the Consent Agenda, which included the July 3, 2025 board of trustees meeting minutes draft; the June 30 Finance Committee meeting minutes draft; and the July 15 Special meeting minutes draft.
At the special meeting, board members had gone into executive session and the only action in open session was to approve the credentialing of caregivers.
With no new business, the board discussed new business. The first item, Resolution 2025-07, gained later approval of the amended 2025 final budget, as well as the 2025 amended budget workbook.
Board members also approved the a resolution addressing the renewal of remote SOC engineering with PC Connections, after some discussion.
GRMC Chief Executive Officer Robert Whitaker noted that the Chief Financial Officer Leonard Binkley would go over the financials in the Board Finance Committee report.
"But as you're looking at this, we had our preliminary budget set at a $91 million operating budget, and we exceeded that budget by $79,600," Whitaker continued. "The Office of State Auditor says if you exceed your operating budget, you need to have the Board approve the amended budget. And that's what this is that the increase in our expenses and operating budgets was surpassed by our increases in revenue as well, and has a bottom line there that you see a preliminary budget of $3.3 million net surplus, and because of the HDA dollars and programs that we just didn't know how much we would receive.But that's the major budget. If there are any questions, let me go through the financials in more detail about the month and yearly."
On item 2, the IT contractWhitaker explained that the hospital works with a company and the contractors through a company that the hospital get s services from, and they provide them through a company called PC Connections. "This is for our security operations center. It's software and a company that just helps us with cyber threats and looks at things that we
do, including testing staff. It can send out test phishing emails and of the person didn't do it right, a there's some education. This is a one-year agreement."
He requested the members vote on it, and they did by roll call. Both items were approved.
Vice Chair Betty Vega began the Finance Committee report by saying that those present were Seth Traeger and herself and said the details would be covered in the CFO report. "We talked about all the financial statements and we talked about the volume and admissions, outpatient visits and ER visits, which have continued their trend of being higher than the prior year. Surgeries were lower than the prior year because we had quite a few physicians that were gone on vacation during that time. So some of the surgeries were put off for that month, but it appeared normal and acceptable. We had a fiscal year net surplus of $41.6 million, and that was mostly as a result of the state directed payment program that had such a high impact on our earnings, which is not a bad thing to experience, but it's such a big fluctuation, that management has to make year-end adjustments in certain expense categories. In preparation for the financial audit, we also renewed and reviewed the review cycle management partner in their performance, and we do have some glitches in it right now. However, Leonard and Robert are working on them. I don't know if it's something that an be fixed in time. We also talked about accounts receivable, which is affected also by that. Then we talked about the HDAA state direct payment program. And we did talk about how it impacts the budget. And how are we going to look at that in the future? Because there's so many unknowns we don't know. But what I do like about the budget that was prepared for this coming year is that it's a very conservative budget, and so it leaves room for some fluctuations. It's a good budget because it's a very safe one for the hospital. We also talked about fixed assets, and what we're going to do with some of the fixed assets, and how we're going to determine what's the best use of them. Some of the processes we have are still manual, and so open to a lot of human errors, and so they're working on automating as much as possible so that we have more consistent output, which is a good thing. We also talked about ambulatory clinics and the output from the clinics, revenue streams, the investors, clinics, things
like that. The committee also discussed the audit findings and presented periodical items so that we can make sure that routine violations are taken care of."
She noted the committee is looking at each one of the audit findings, and asking for corrective action, with dates and the contact person that's responsible for that, and current statuses. "I think that's really important so that we don't have any audit findings. That will be part of our regular reviews for the Finance
Committee also, As far as the committee goes, we do go into a lot of detail. If you ever have any questions, let us know and we'll answer any questions or comments."
Fox asked about the audit findings.
Vega said they had one that was a state compliance issue and another that was a material weakness.
Binkley began his report and said: "As Robert said, you have to amend your budget if it's off, as ours was. We presented the original preliminary budget back in July of 24 long before we knew about the findings and long before we knew that we exceeded our expense budget because of the volume we've had, the success that we had."
Fox asked if they might have to adjust the budget again. Binkley said he would talk about some of the year end adjustments "we did for HDAA, based on information that we had when we closed the books. If actuals as known, the quality portion is still variable. If there is a trend, something that's different, really different from what was projected, we do talk about it, we'll be discussing what the effects will be."
Binkley then went into his regular monthly financial report for the month of June. "We had good financial performance in June, the volumes, and in all respects. We had 120 discharges.That's up 19 or 19% to the prior year. We had 250 surgeries for the month. That's a good baseline for us. It's not as good as May and April. In those two months, it was normalized. We had had some doctors out. Dr. Mittica took some time off. Dr. Iwaasa, Dr Rosser and Dr. (inaudible) all had time off. So in light of that, 250 is still a good number. Looking at outpatient visits, 5383, which is about 179 visits per calendar day. That's down two visits per day. Our run rate here today is 181 per day, so we're down per calendar day, or about 1% from our run rate. ER visits, 1462, that is 48.7visits per calendar day. That's up one visit per calendar day, or about 2% from our year to date run rate."
With no questions, he went on to say that "June had a strong financial performance, bottom line better than budget, better than prior year, again driven by the strong operating revenue. The government monies, we had $15 million in June that's included here. We had a correction of the audit adjustments that Betty was referencing, and that was a reduction in expenses of $2 million and we had the volume that was contrary to the bottom line again, $3.3 million bottom line that is without any government monies. You see the bottom two lines there on your document that's compared to our budget of $125,000 so we're better than budget by $3.2 million and we're better than the prior year stated to the right of $3.8 million.Again, that's all without any government subsidies. Gross revenues are $26.2 million greater than budget and $6.5 million greater than prior year. Net patient revenue was $9.3 million. That's up $2 million to budget and $3 million to prior year. The other operating revenue line is where all the government money is at $17.9 million. That's up $17.3 million to budget and up $17.7 million to prior year and the$17.3 million is also included in that. Our state bill SB161 money is $238,000 and our Beginning Year grant, about $50,000 and our cafeteria sales about $45,000, so very strong there. Looking at the total operating revenue line, the hospital is at $7.3 million, up $7.2 million to prior year. On the total operating expense, $9.4 million is up $1.8 million to budget and up $2.7 million to prior year. And the big increases in expense is, as we said before, salary and wages, compared to budget, we're up a million compared to prior year at $1.1million. That's the market adjustments' increases. The hospital's taken on a portion of
those employee benefits. There's been new providers added in January and in March as well. Also driving that number up, included in benefits is a year in adjustment for incurred but not reported medical claims. We have a couple of our employees who are really sick and driving that up. So we adjusted that to a lag report, if you will, to account for what we're going to see in the future. So that's $555,000. We also had an accrual for joint unemployment and workers comp for $58,000, so all that is $960,000 of those variances."
Binkley continued by saying all other operating expenses are
$814,000 to the budget at $854,000 to prior year. Of that $200,000 is HCA assessments, deliveries that we pay in and send out to the federal level. We have matched and pushed down. Because of our volume, we've had increases to payments to our vendors, our ER, our hospitalist group, our imaging group, and we all spend our gross receipts tax, of course, so based on our revenues, it went up. We've had a reclass, as you can see from our physician fees, that we budgeted at $289,000. That's the makeup of the operating expense increase. That gives us an EBIDA of $17.8 billion. That's up to prior year. And the next line is the appreciation inquiry that I was referencing. It's a negative expense because we corrected an audit finding we engaged a firm to come in and tag our inventory—all of our assets throughout the house. We bought a software for
$1,000 that allows us to list all of our assets, depreciate them monthly, and keep track of them. So what we found here is we were over expensing. Then looking at the net operating surplus line, at $19.9 million that's up $21 million to budget, and $20.6million to prior year. After you add in investment income and your other non-operating revenue, which are grant monies that we've accrued for phone system, beds and so forth, it gives you a net surplus of $20.6 million which is $20.5 million greater than budget and $21.2 million greater than prior year. So the adjusted operating surplus is $3.6 million with all monies, including government. And right below that, you back out the HDAA funds in state bill 161 and add in the expenses associated with that, and you will get you to the bottom line of the operating surplus of $3.27 million."
Binkley moved to the year-to-date numbers. "Here today, we at at $7.6 million better than budget and about $4.3 million better than prior year." He noted it was due to the HDAA and the SB 161 monies. "I won't cover all of this unless you have questions, because Betty did a fine job summarizing that."
He said he would just hit the highlights. "We'll start with the other operating revenue at$38.8 million, with $3.3 million of that being HDAA money and $3.1 million from SB161. We received some Medicaid supplements of $240,000 throughout the year, Beginning Years grants for $690,000, with the cafeteria for 12 months is $443,000. Other operating revenue at $40 million that's up 43.5 million to budget and $47.8 million to prior year. Total operating expenses, $98.7 million. That's up $7.16 million to budget and $12.7 to prior year. Looking at revenue, we were at $140 million, up $44 million to budget and up $43 million to last year with a surplus of $7.5 million."
To a question, he noted that the HDAA is based on the calendar year, not the fiscal year.
Binkley then went to the key measures of liquidity
Net AR (accounts receivable) days for June were 73. "You can see before April 1, we had net AR days in the mid 40s, but those days are longer now. I have talked to the vice president of the management company which provides these numbers and he promised he is going to get better numbers. I didn't want to put this off, and we have his attention now. He told me he had brought in two new people, one of whom I know from a previous life and he was very knowledgeable. AR is divided by your net sales revenue per day It just measures how long it takes to receive your money."
Chief Nursing Officer Ron Green gave his report. He said that Nursing admin has been working in collaboration with the hospital pharmacy director and "we've been updating some of our protocols. Some of our policies align with best practices and we're working with committees to get policies up to best practices. So a big thank you to the pharmacy director. She's
been in the job about four months now and I'd like to say, she's bringing a new level to our pharmacy just with the collaboration and wanting to work together just to get things moving in the right direction. So I'm very thankful for her."
Green said in the Nurse Residency Program, the inpatient director, Amy Mills, is "continuously working with some of our new nurses. We have a few of them that are just starting to finish up with final orientation. Part of the ones from the fall have gone into our Women and Newborn Services, so they required more training. Amy continues to meet with them on a weekly basis, just mentoring and helping them transition into that final role." He said he was thankful for her, also.
He said they were excited to welcome WNMU students coming in soon. "We're gearing up in Nursing admin just to make sure they feel welcome and trying to assist the faculty to help them grow these new nurses. We started a health and wellness program, and Dr L'Amour, one of our new general surgeons, has been doing yoga with the staff, and so we do about a 20 to 30 minute yoga session once a week. In August, we started doing a step challenge. We have 24 teams on this challenge, and each team is made up of four core members, so we have close to 100 employees tracking their steps. You're starting to see that competition and watching how the other team wants to know how much you're walking. It's just exciting to see so many people participating in these activities, and we have some other activities planned to keep the momentum going."
Board member Gail Stamler and retired hospital provider said she has walked many times around the hospital and it reduces stress and "allows you to go back in there and face whatever you have to do. So it's a good thing."
Associate Administrator Matthew Stephens spoke next. "I would like to talk about a little bit of the projects and the strategic priorities that we've got in our operations of our health system. I'm going to be spending a lot of time on our clinics today. So one of the first highlights is our new behavioral health clinic, the integrated behavioral health clinic led by Dr Teresa Arizaga. She's providing a much needed service to the community. She's been seeing patients now for three weeks, and it's just been incredible to see the growth and the appreciation of her staff and her team, although it's been slow going as they've gotten used to new systems, but they're building the foundation of compassionate mental health care."
He continued by said: "We've got some upcoming urology services coming to the campus, and we are preparing to welcome Dr Stan Swerzewski (spelling?) in the coming months. We don't have a set date yet. A multi disciplinary team is working on it. It takes a lot of collaboration and a lot of work to bring a new service line to a hospital. And so we've got everyone working together and collaborating to make sure that we're prepared to start a urology service line."
In mid-June, the hospital started its implementation process with a digital intake and registration tool called Phreesia and "I wanted to give you a little bit of the metrics to the success metrics that they've shown in just a month. One month of being live with Phreesia, we've had 67% of patients use the Self Service check-in option, and that includes patients that do it ahead of time. They get a text message and are able to fill out their paperwork ahead of the visit or in the office with the assistance of one of our front desk staff. In one of our clinics, the Gila Family Medicine Clinic, 83% of our patients are using Phreesia now to check in, and that's over over 1000 patients. Total copay collections since we started went up from 81% to 94% and outstanding balances and anything that's not co-pay, the co insurance or anything like that increased from 5% to 13% so we're stepping in the right direction there, and it's a lot. It's challenging to ask the front desk staff to request money from their friends, their families, their neighbors, and so this extra tool allows people to automate and take that awkward conversation out of it. So, it's been really good. Overall. 83% of the patients who have used the tool have been satisfied with it, which, to me, was incredible. I know there's some technology fears and changing processes is never something that's looked upon well, so it's been incredible to see the positive interactions we've had with patients. Right now, what we're focused on with this implementation is we want to raise the check-in completion rates from that 83% at the Gila Family and the 67%
everywhere else up to at least 75% across the board. We want to reduce no-show rates. Make sure patients are coming in for their appointments, for primary care and for their specialty appointments, and we want to improve the accuracy of the data collection, eliminating that manual process, so that we can make sure that we're continuing to improve and provide valuable service to our patients across all departments, but especially in the clinics. We're not just focused on the quality of the care, but we're also really focused on the patient experience. As we get feedback from patients regarding their digital check-in experience, we're making adjustments, making sure that we can tailor this tool to how it fits our community.
"Last I would like to just highlight a support services department, those departments that are behind the scenes, not directly patient care related. And this month, I'd like to recognize the security department and these guys, they make us maintain a safe, supportive environment for staff. They're there when they need to be stepping in and de-escalating situations and keeping nurses and clinical personnel, administrative personnel safe, and it provides a lot of peace of mind, and our security team deserves a big kudos for all the work that they do. So with that, thank you for your continued support, and while we've made this meaningful progress, I know that we've got a lot of work to do, and we're going to build on the momentum to keep working towards improved quality of care."
He answered a question on how the check-in service is spelled and Chief Executive Officer Robert Whitaker clarified that it's not a requirement that patients have to use it. "They can certainly just not use it and come in and check in the whole process. But it's there to kind of speed up things."
Matthews noted that the program began June 11 in some of the clinics with a phased roll out approach. "The Phreesia team is coming on site later this month to provide an additional training to some of our clinics that have lower utilization, to help our front desk staff understand how to use the tool, how to promote the tools. Because what we've seen is how it works with the Family Clinic. We've got those people who are gung ho and they're excited to use this tool, and it it shows in our patient metrics.
Fox noted that when he had been exposed to Phreesia in the past, they had sort of a keyboard where the clinics could use it for patients who didn't have internet access.
Matthews replied that it was one thing that the hospital is looking into, as part of that continuous improvement. "We're looking at iPads that will be able to push registration to the iPads instead of just straight to the phones. We don't have that in place yet, but we will."
Board member Pat McIntire said: "When I did it last month, I did it from my phone. So there are multiple ways that it can be done, but some of our elderly population are less computer savvy than some of the others. "
"That was what I saw on the patient satisfaction," Matthewssaid. "Those who were 80 or older were 75% satisfied with their digital check in experience, which I thought was incredible. It's not something I was expecting.
Vega asked: "Do you have some extra training for those patients who cannot do it?"
Matthews replied: "This saves a lot of time for our front desk folks. Instead of sitting behind the computer doing all the manual entry and just occasionally looking up at the patient, this is going to allow them time to sit with the patients and help them through the check-in process, and just be more personable and
provide better service."
Vega said: "I don't know if you know this already, but there's a large part of our population that are illiterate. And thank you."
Fox said: "In terms of geriatric patients, like myself, I did fine, as long as I had JoAnn helping me."
McIntire said: "I'm a geriatric patient too, but I have a geriatric brother-in-law who absolutely refuses to do computers" to laughter.
Fox noted that Chief of Staff Dr. Meyerowitz's report would be in executive session.
Whitaker gave his CEO report. "I just want to go through a few items. First of all, thank you all who attended the GRMC employee family picnic. It was a really good turnout. It's kind of hard to count the folks, so I measured by the number of meals we served, and we doubled the amount that we were serving last year. And the water activities were a nice, enjoyable time as well. So thank you."
Stamler said she was delivering patient meals to the patients.
Whitaker said they had fun trailing around, taking meals to everybody, and that's "a big part of what we do in any of our activities. We're sure if we do something during the day, we cover the night shift. There's something that happens on the weekend, we bring things in just just making sure."
He announced: "I'm scheduling kind of a next round of community town halls. We have a few dates set, and we'll start publishing that out August 21 will be the one here in Silver City. About September 18, we'll be in Mimbres, and we're still working on some dates for Tyrone as well.
The thanked Ron Green for bringing up the health and wellness committee. "This is something that's just a way for employees to be involved in some kind of recreation. It's part of things we do with our facility, providing town halls which is one of our strategic aims, care for the caregiver, and making sure they're taking care of our staff, and, kind of a marketing agreement that we're doing, so we're formally branded as what we call Gila Regional Cares. We do this with all of our community sponsorships and community engagement activities. This is the branding and the program that we do, and some of the things that we're going to do again is the GRMC Friends and Family Day with football and again, with Western, Cobre and Silver schools. Part of this falls under our second quarter cafeteria sales. We take a portion of that and we donate it to a not-for-profit in the community that kind of benefits and helps health and wellness. So second quarter is with SASS, the sexual assault services, and wet had a great visit with them in their little facility and place and had a nice picture with them. I just wanted to share with you kind of this branding. So when you see the Gila Regional Cares, that's kind of our community engagement and what we're doing."
He continued: "I also want to let the board know that recently, part of, as we reported, our kind of financial success, and there's a lot of quality success in there with it as well. But we made the first half of what was kind of an earnings retention payment for staff, taking part of our financial success and sharing it with our employees. In total, it was right around $500,000 or about a half a million dollars. And so it was half a payment, and another half a payment will happen in December. It was made so every full time employee, regardless of job title, got the same amounts. I want to just mention there was an article that came out. Senator Heinrich, our US Senator, I put in through the congressional direct spending program, through his office, a request for dollars, federal dollars, for a variety of things. And I talked to one of the staff members and several groups to take this one and push this one through. We got within the federal budget, $193,000, to upgrade our utility system, so things like plumbing or electrical.So I'm much appreciative of our state and federal legislators who continue to support us in rural health care. I hope you'll notice some of the things and updates around with the building, continually keeping things fresh and nice. So we've started on some painting projects and touching up some painting to make it look like we care for our building, and we want to provide a good environment in which people receive care."
The Ovation representative gave two big updates. "We had two folks here doing a workforce review, which I think went well the last few days. Thank you to all of you, and Matt for setting that up, and everybody who met with them. I hope that was a useful conversation. So what will come from that is taking a look at this hospital and how you're staffing compared to other critical access hospitals about the same size, looking at benchmarks along the way, and then helping with some ideas around how to implement a few things that potentially could be implemented. I think some successful discussions that I actually was able to listen in on with you today, too. So that was good."
She noted the 90-day evaluation has been reviewed "We reviewed it with Robert, and our next step is really to summarize some of those reports and then hopefully, in August, during that executive session with the board we will review those in some detail, allowing everybody to ask the questions that they want to ask going forward, and then talking about really implementing some of those things that were found, as we discussed with every single person, their thoughts around things that were going well, and some opportunity areas. I think some of those things will just come up, and the board will be able to ask questions at that point too. I think the only thing I would add is a reminder of the education opportunities available to the board. We have a series that we kicked off today, actually around HR and, the big, beautiful bill. There will be several presenters throughout the next couple of months, providing regular, ongoing updates and answering questions. We've got a lot of feedback from hospitals, really, not quite knowing how to navigate that. So we're providing some additional resources there. Then we have our monthly board webinars as well as other education opportunities. We've shared with you all the codes so that anyone can access that at no additional cost. We are working with the New Mexico rural hospital association with Steven Stoddard, working on our next big education kick off, which will be on swing beds and utilization of swing beds. We have gotten so much feedback from the hospitals we work with in New Mexico, on their swing bed programs, either tightening up their swing bed programs, case management's influence in the swing bed program, assessments and everything, even the revenue cycle pieces of swing bed programs. So we're going to try to hit as much of that as we can. You know, one day right now we're still looking at August 26 and hoping we can get that final approval and the agenda out for that day."
Fox noted that concluded the regular agenda and the board members went into executive session.
After the closed session, and back into open session, the board approved the Credentialing report as presented in the executive session by Dr. Meyerowitz.
