Board of Trustees Meeting

CRAWFORD COUNTY MEMORIAL HOSPITAL Denison, Iowa

100 Medical Parkway August 31, 2020

4:00 p.m.

Iowa Code Section 21.4 requires that each Board of Trustee meeting shall be held at a place reasonably accessible to the public and at a time reasonably convenient to the public, unless for good cause such a place or time is impossible or

impracticable. Given the Governor's prohibition on gatherings of ten or more persons during the COVID19 outbreak and further given Section Nine of the Governor’s March 19, 2020 proclamation suspending the regulatory provisions of Iowa

Code §§ 21.8, 26.12, and 414.12, or any other statute imposing a requirement to hold a public meeting or hearing, the Board of Trustee has determined that a meeting at a physical place is impossible or impracticable and all Board of

Trustee meetings for the time being will be conducted electronically with the public allowed to attend per the instructions on this agenda. Meeting minutes will continue to be provided per the Board’s normal course of business.

Public Participants may listen to the conversation: Call in Number +1-415-655-0001 Meeting number 133 715 7012

I. CALL TO ORDER

II. APPROVAL OF PREVIOUS MONTH’S MINUTES

III. PUBLIC INPUT • Rich Knowles

IV. COMMITTEE REPORTS A. Mission Committee B. Quality Committee C. Finance Committee i. Write-offs, Recoveries & Recommendations/Action

V. OLD BUSINESS A. COVID-19 Update B. ACO Update C. 911 Board Assignment

VI. CEO REPORT

VII. EXECUTIVE SESSION PURSUANT TO IOWA CODE Section 21.5 (1)(l) To discuss marketing and pricing strategies and proprietary information where public disclosure of such information would harm the hospital’s competitive position - Open Session – Possible Action

VIII. EXECUTIVE SESSION PURSUANT TO IOWA CODE Section 21.5 (1)(c) Legal Matters: Open Session – Possible Action

IX. EXECUTIVE SESSION PURSUANT TO IOWA CODE Section 21.5 (1)(a) Credentialing: Open Session – Possible Action

X. EXECUTIVE SESSION PURSUANT TO IOWA CODE Section 21.5 (1)(i) To evaluate the professional competency of an individual whose appointment, hiring, performance, or discharge is being considered when necessary to prevent needless and irreparable injury to that individual’s reputation and that individual requests a closed session - Open Session – Possible Action

XI. ADJOURNMENT

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Crawford County Memorial Hospital Board of Trustees July 27, 2020

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A meeting of the Board of Trustees of Crawford County Memorial Hospital was held on Monday, July 27, 2020, via WebEx due to the Governor’s prohibition on gatherings of ten or more persons during the COVID 19 outbreak and further given Section Nine of the Governor’s March 19, 2020 proclamation suspending the regulatory provisions of Iowa Code §§ 21.8, 26.12, and 414.12, or any other statute imposing a requirement to hold a public meeting or hearing, the Board of Trustee has determined that a meeting at a physical place is impossible or impracticable and all Board of Trustee meetings for the time being will be conducted electronically with the public allowed to attend per the instructions on this agenda. Meeting minutes will continue to be provided per the Board’s normal course of business. Present in the WebEx were Thomas Gustafson, Greg Kehl, Jay Mendlik, Thomas Eller, Linda Dreibelbis, Sid Leise, Erin Muck, (CEO), Rachel Melby (CFO), Heather Rasmussen, Executive Director, Care Integration, and Wendy Frank (Recorder). In addition, Dan Mundt (Denison Bulletin & Review). LaVerne Ambrose was excused. It should be noted that LaVerne Ambrose is on an approved medical leave of absence from the board.

The meeting was called to order at 4:09 pm. APPROVAL OF PREVIOUS MONTH’S MINUTES A motion was made by Gustafson, second by Dreibelbis, to approve the May 26, 2020, minutes as presented. Motion carried unanimously. A motion was made by Gustafson, second by Leise, to approve the June 29, 2020, minutes as presented. Motion carried unanimously. PUBLIC INPUT Rich Knowles was listed on the agenda for public input, however, was not able to attend the meeting. COMMITTEE REVIEW / ACTION Mission Committee. 1. No Recommendations for the Board. Quality Committee. Quality Committee Meeting Recommendations of June 23rd. 1. Recommend a COVID-19 updated be presented at the Board Meeting. 2. Recommend Board action regarding Medical Staff Accountable Care Committee recommendations for approval of

Medical Staff privilege(s) and appointment/reappointment applications. Finance Committee. Listed the following recommendations. 1. $89,101.00 in write-offs and $25,109.48 in recoveries for approval. 2. Total Accounts Payable of $2,288,113.46 for payment.

A motion was made by Leise, second by Dreibelbis, to approve write offs in the amount of $89,101.00 as assets of the hospital but still subject to collection, recoveries in the amount of $25,109.48 and total payables in the amount of $2,288,113.46. Motion carried unanimously. A motion was made by Eller, second by Gustafson with a resolution from the Board of Trustees commending the CEO, Erin Muck, and the CFO, Rachel Melby for a job well done during this past year holding down expenses during the pandemic and achieving a preliminary positive profit at year-end. The motion carried unanimously.

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Crawford County Memorial Hospital Board of Trustees July 27, 2020

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NEW BUSINESS

5 Star Update The Service Excellence Council started their customer service training for everyone that is wearing a badge. This is the front-line staff training their peers. The training is expected to take about a month. We are currently about 1 ½ months behind in our 5 Star training plan due to COVID. COVID-19 Update Heather provided the Board with an update of number of COVID-19 cases in the county. The Incident Command is meeting three times per week to discuss topics of finances, PPE, staffing and other topics vital to the efficient running of the hospital and community during the pandemic. CEO REPORT Erin provided the board with a brief CEO update. EXECUTIVE SESSION PURSUANT TO IOWA CODE Section 21.5(1)(a) Credentialing The Board went into Closed Session at 4:58 pm with a motion made by Gustafson, second by Leise. Motion carried unanimously. Members of the board present during the closed session were Thomas Gustafson, Linda Dreibelbis, Greg Kehl, Jay Mendlik, Thomas Eller, Sid Leise. Also present were Erin Muck, (CEO), Rachel Melby, (CFO), and Wendy Frank (recorder). The Board returned to Open Session at 5:08 p.m. motion by Dreibelbis, second by Gustafson. Motion carried unanimously. A motion was made by Leise, second by Kehl, to approve the recommendations from the Medical Staff for the following Medical Staff new appointments. Motion carried unanimously. New Appointments Shannon Calhoun, DO Steven McCormack, MD Shannon St. Clair, MD Kathryn Cambron, MD Matthew Mendlick, MD Shawn Stone, MD Timothy Conner, MD Karen Phillips, MD Suzette A. Woodward, MD Jason DiVito, DO Mohammed Quaishi, MD Haysam Akkad, MD David Henley, MD Veronica Ruvo, MD Robin S. Chirackal, MD Jonathan Jaksha, MD Alexander Serra, MD Michael J. Clegg, MD Jerret Kuo, MD Standley Rhett Smith, MD Tami D. DenOtter, MD Charles C. Schlaephfer, MD Derek Kindelspire, MD ADJOURNMENT A motion was made by Gustafson, seconded by Kehl, that the meeting be adjourned at 5:14 p.m. Motion carried unanimously.

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From: Erin C. Muck Sent: Tuesday, August 25, 2020 1:43 PM To: Wendy Frank <wfrank@ccmhia.com> Subject: FW: Letter To Jay Mendlik: Request to Speak in Public Forum from Rich Knowles Sent from my Verizon, Samsung Galaxy smartphone

-------- Original message --------

From: Jason.R.Mendlik@wellsfargo.com

Date: 8/25/20 1:08 PM (GMT-06:00)

To: debk2@mchsi.com, "Erin C. Muck" <emuck@ccmhia.com>

Subject: RE: Letter To Jay Mendlik: Request to Speak in Public Forum from Rich Knowles

*This email is from an external source. Please verify the legitimacy before replying, clicking on any links, or opening attachments. If any uncertainty please use the Phish Alert Button!* Rich, I approve your request to speak at the August Public Forum, for the normal 5 minutes, at the upcoming CCMH Board Meeting. The meeting will begin at 4 pm on Monday August 31st. An agenda is being put together and will be available with the call in information for any and all community members who would like to listen in. Erin, please see that this is added to the agenda. Regards, Jay Mendlik

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Crawford County Memorial Hospital

Mission Committee

August 20, 2020

A meeting of the Mission Committee of the Board of Trustees was held via phone conference on Thursday

August 20, 2020. Present were committee members: Tom Gustafson, Jason Mendlik; Linda Dreibelbis, and

Erin Muck, CCMH CEO. Also present were: Don Luensmann, CCMH Director of Marketing and

Development and Brandi Mefferd (recorder).

The meeting was called to order at 4:35 p.m.

Committee Recommendations: None

QUALITY CARE AND SERVICES

COVID-19 Update: Erin gave a brief COVID-19 update.

PATIENT EXPERIENCE

5-Star Plan: A general update was given on the status of the 5-Star Plan.

Caregiver Engagement Survey: Don and Erin shared the results of a recent Caregiver Engagement

Survey as well as an action plan based on those results.

PEOPLE

Recruitment: efforts are still underway for Family Practice, OBGYN, CRNA, ED and HR.

GROWTH

Service Lines: Erin gave an update on service lines. A general discussion took place on mental

health services.

Specialty Clinic: Erin gave an update on visiting specialists.

COMMUNITY

Wellness Clinics: Don reported on the results of the first Wellness clinic held since December 2019.

This first wellness clinic was very well attended and ran smoothly; clinics will resume at regular

intervals going forward.

STRATEGIC PLAN

A strategic plan, compiled by all department managers, was shared with committee members. This

plan is a work-in-progress and will continue to evolve as department, company goals, and action

plans change.

The meeting adjourned at 5:55 p.m.

Marketing, pricing strategies, and proprietary information where public disclosure of such information would harm the

hospital’s competitive position are protected under Iowa Code 21.5 (1)(l)

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Crawford County Memorial Hospital QUALITY COMMITTEE OF THE BOARD OF TRUSTEES August 25, 2020, Meeting Minutes A meeting of the Quality Committee of the Board of Trustees was held on Tuesday, August 25, 2020. Present were Jay Mendlik, Sid Leise, Greg Kehl, Erin Muck (CEO), Doug Hollander (CNO), Heather Rasmussen (Executive Director: Care Integration), Jason Franklin, Interim Nurse Director of Emergency Services, and Wendy Frank (recorder). Chairman Jay Mendlik called the meeting to order at 4:31 p.m.

ED Quality Review Jason Franklin, Interim Emergency Services Director presented the committee with statistics regarding patient volume, arrival times, patient acuity, length of stay, and doc to door times. These statistics will be used as a basis for an OASIS Team that will be working on improving ER Quality and Patient Experience in the next upcoming months. There will be more to come on this topic as the team is formed and it works to improve our ED. Statistics: Total admissions were down -26.32%. Newborns were even from this year to last year. Surgical procedures were down by 8.11%. Total hospital procedures were down by 8.61%. Total Medical Clinic Visits are down by almost 30%. Medical Staff Credentialing The Committee members reviewed the recommendation from the Medical Staff Accountable Care Committee for clinical privilege approvals of the submitted applications for new appointments. The committee recommends (approval) action at the Board of Trustees. Projects / Standard Reports: A. Standard Peer Review / Protected Reports – Peer review records are privileged and confidential. Quality Improvement activities are protected from discovery under Iowa Code 147.135. 1. Monthly

a. Press Ganey - Heather reviewed the Press Ganey report with the committee. b. Medical Staff Meeting - The committee reviewed the minutes of the medical staff. c. Peer Reviews - The committee reviewed two peer reviews.

2. 5 Star Journey Review

The SEA’s have completed the customer service training to the front line staff. This training was well received by the staff. The Leadership scores were reviewed with the leadership team at their recent leadership education . The Caregiver Engagement Survey was reviewed at the Mission Committee meeting. Results will be presented to the employees at the employee forums.

New Business / Old Business: Trauma Letter / Certificate CCMH recently received our Trauma Certificate valid for the next 2 years.

Committee Recommendations/Actions 1. Recommend a COVID-19 update be presented at the Board Meeting. 2. Recommend Board action regarding Medical Staff Accountable Care Committee recommendations for

approval of Medical Staff privilege(s) and appointment/reappointment applications. 3. Recommend an ACO Update be presented to the Board.

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Crawford County Ambulance Inspection / Certificate Our Ambulance department recently received an inspection and was awarded zero deficiencies. Congratulations to our Ambulance staff on a successful inspection. Manilla Ambulance Certificate The Manilla Ambulance service also recently received their inspection and was awarded zero deficiencies. The Manilla Ambulance service partners with CCMH for their documentation, quality, medical direction, and educational needs. CCMH is proud to be able to partner with the surrounding communities to increase the quality of patient care in our service area. Congratulations to the Manilla Ambulance Service! ACO Update An ACO update was presented to the committee. After the report was presented, the committee recommends the report be presented to the Board of Trustees at their next monthly meeting. COVID-19 (Novel Coronavirus) Update Heather gave a brief COVID-19 Status Update to the committee. The committee recommends the update be presented to the Board of Trustees at their next monthly meeting. Peer review records are privileged and confidential. Quality Improvement activities are protected from discovery under Iowa Code 147.135. Adjournment Wendy Frank, recorder. 6:04 pm

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CRAWFORD COUNTY MEMORIAL HOSPITAL FINANCE COMMITTEE MEETING

August 27, 2020 4:30 P.M.

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A meeting of the Finance Committee of the Board of Trustees was held on Thursday, August 27, 2020 in the hospital’s Administrative Conference Room. Present were Jay Mendlik, Tom Eller, Rachel Melby (CFO), Erin Muck (CEO), Craig Simons, DO, and Wendy Frank (recorder). Excused was LaVerne Ambrose. It should be noted that LaVerne Ambrose is on an approved medical leave of absence from the committee. The meeting was called to order by Jay Mendlik at 4:31 pm.

Committee Recommendations: 1. $131,812.37 in write-offs and $37,377.21 in recoveries for approval. 2. Total Accounts Payable of $3,199,103.85 for approval of payment.

• Approval of Minutes Minutes from July’s meeting were reviewed and approved.

• CFO Report The CFO Report was reviewed.

• Statistical, Income and Cash Flow Report

Overall, the month of July was an average summer month, with gross patient revenue under budget by just $52,000. However, patient volumes for the month did not compare well to last July, which was unusually busy. This year, July compared much better to July 2018 from a volume standpoint, with total procedures up 1%. Statistically this is rather encouraging considering we are still recruiting for several open provider positions. Despite lower patient volumes, the net profit for the month was $109,126. This is largely the result of reduced contractual adjustments and operating expenses. Deductions as a percentage of operating revenue were 40.8% compared to a budget of 46.8%. By signing the new Enhanced Agreement with Wellmark in July we received a one-time payment of $120,349, or 2% more on claims that were previously paid in 2019. Since this was a one-time reduction to the total contractual, we expect contractual adjustments to be closer to budget going forward. The total cash balance at the end of July was $18,331,356. This is a decrease of $968,065 from the previous month, which is mainly due to the 3rd payroll in July. However, days cash on hand increased from 202 days to 207 days, due to reduced expenses. Compared to June, daily operating expenses decreased $7,000 to $88,637 per day.

• Balance Sheet The Preliminary Balance Sheet as of 07/31/20 reflects Total Assets of $49,515,014.

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CRAWFORD COUNTY MEMORIAL HOSPITAL FINANCE COMMITTEE MEETING

August 27, 2020 4:30 P.M.

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• Write-offs/Recoveries

The Finance Committee reviewed and recommends approval of $131,812.37 in write-offs and $37,377.21 in recoveries to the Board for approval. The year-to-date recovery rate was 28.36%.

• Accounts Payable The committee reviewed and recommends total Accounts Payable of $3,199,103.85 to the Board for approval. This amount includes $2,362,555.15 in salaries which is higher due to the third payroll in July.

• Accounts Receivable Patient Accounts Receivable as of July 31, 2020, totaled $8,317,168, an increase of $318,778 from the previous month.

• New Business None

• Other Business Visiting Specialists An update was given on various visiting specialists interested in coming to the facility. 340B Program Review - deferred The 340B Program Review was deferred. Adjourn - The meeting was adjourned at 6:04 pm. Wendy Frank, Recorder

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Comparative Statistical Report July 2020

Hospital Report Month to Date Fiscal Year to Date

FY 2021 FY 2020 Variance FY 2021 FY 2020 Variance

Total Admissions 56 76 -26.32% 56 76 -26.32%

Acute/OB 39 58 -32.76% 39 58 -32.76%

Skilled 3 5 -40.00% 3 5 -40.00%

ICF 2 1 100.00% 2 1 100.00%

Respite 0 0 0.00% 0 0 0.00%

Newborns 12 12 0.00% 12 12 0.00%

Adjusted Observation Admissions 15 16 -6.25% 15 16 -6.25%

Total Adjusted Admissions 71 92 -22.83% 71 92 -22.83%

Total Patient Days* 180 230 -21.74% 180 230 -21.74%

Acute/OB 102 158 -35.44% 102 158 -35.44%

Nursery 21 18 16.67% 21 18 16.67%

Skilled 11 12 -8.33% 11 12 -8.33%

ICF 5 1 400.00% 5 1 400.00%

Respite 0 0 0.00% 0 0 0.00%

Observation 41 41 0.00% 41 41 0.00%

*Includes Observation

Average Length of Stay (Acute/OB) 2.76 2.70 2.36% 2.76 2.70 2.36%

Hospital Procedures

Inpatient 974 1,466 -33.56% 974 1,466 -33.56%

Outpatient 10,316 10,887 -5.24% 10,316 10,887 -5.24%

Total 11,290 12,353 -8.61% 11,290 12,353 -8.61%

Surgical Procedures 102 111 -8.11% 102 111 -8.11%

Anesthesia Procedures 109 106 2.83% 109 106 2.83%

ER Visits 360 420 -14.29% 360 420 -14.29%

Admits from ER 50 55 -9.09% 50 55 -9.09%

Scheduled Outpatient Visits 98 144 -31.94% 98 144 -31.94%

Ambulance Trips 120 128 -6.25% 120 128 -6.25%

Xray Procedures 669 765 -12.55% 669 765 -12.55%

Mammography Procedures 84 63 33.33% 84 63 33.33%

Flouro Procedures 4 11 -63.64% 4 11 -63.64%

Ultrasound Dept Procedures 260 306 -15.03% 260 306 -15.03%

Echo Procedures 28 25 12.00% 28 25 12.00%

CT Dept Procedures 139 228 -39.04% 139 228 -39.04%

MRI Dept Procedures 56 67 -16.42% 56 67 -16.42%

Nuc Med Procedures 12 7 71.43% 12 7 71.43%

Total Radiology Procedures 1,252 1,472 -14.95% 1,252 1,472 -14.95%

Respiratory Tx Procedures 244 301 -18.94% 244 301 -18.94%

EEG Procedures 0 0 0.00% 0 0 0.00%

EKG Procedures 180 200 -10.00% 180 200 -10.00%

Sleep Studies 6 20 -70.00% 6 20 -70.00%

Lab Procedures 7,495 7,664 -2.21% 7,495 7,664 -2.21%

Physical Tx Procedures 1,243 1,586 -21.63% 1,243 1,586 -21.63%

Speech Procedures 20 27 -25.93% 20 27 -25.93%

OT Procedures 108 190 -43.16% 108 190 -43.16%

Cardiac Rehab Procedures 70 102 -31.37% 70 102 -31.37%

Pulmonary Rehab Procedures 3 10 -70.00% 3 10 -70.00%

Specialty Clinic Visits 413 653 -36.75% 413 653 -36.75%

Total Medical Clinic Visits 2,153 2,994 -28.09% 2,153 2,994 -28.09%

Crawford County Memorial Hospital

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Gray lines are YTD. All %'s are based on net revenue

except for the variance column and gross revenue.

PATIENT SERVICE REVENUES

INPATIENT SERVICES 569,853 12.5% 613,209 13.3% (43,356) -7.1% 765,317 14.6%

569,853 12.5% 613,209 13.3% (43,356) -7.1% 765,317 14.6%

OUTPATIENT SERVICES 3,967,712 87.2% 3,956,379 86.0% 11,334 0.3% 4,462,455 85.1%

3,967,712 87.2% 3,956,379 86.0% 11,334 0.3% 4,462,455 85.1%

SWING BED SERVICES 12,867 0.3% 32,906 0.7% (20,039) -60.9% 17,929 0.3%

12,867 0.3% 32,906 0.7% (20,039) -60.9% 17,929 0.3%

TOTAL GROSS PATIENT REVENUE 4,550,432 100.0% 4,602,493 100.0% (52,061) -1.1% 5,245,701 100.0%

4,550,432 100.0% 4,602,493 100.0% (52,061) -1.1% 5,245,701 100.0%

DEDUCTIONS FROM REVENUE

MEDICARE ADJUSTMENTS (879,650) -19.3% (870,484) -18.9% (9,167) 1.1% (1,205,307) -23.0%

(879,650) -19.3% (870,484) -18.9% (9,167) 1.1% (1,205,307) -23.0%

TITLE XIX ADJUSTMENTS (209,465) -4.6% (325,850) -7.1% 116,385 -35.7% (315,455) -6.0%

(209,465) -4.6% (325,850) -7.1% 116,385 -35.7% (315,455) -6.0%

BLUE CROSS ADJUSTMENTS (499,745) -11.0% (674,974) -14.7% 175,229 -26.0% (722,206) -13.8%

(499,745) -11.0% (674,974) -14.7% 175,229 -26.0% (722,206) -13.8%

OTHER ADJUSTMENTS (118,855) -2.6% (126,458) -2.7% 7,602 -6.0% (139,196) -2.7%

(118,855) -2.6% (126,458) -2.7% 7,602 -6.0% (139,196) -2.7%

PROVISION FOR UNCOLLECTIBLE (130,968) -2.9% (139,362) -3.0% 8,394 -6.0% (152,997) -2.9%

(130,968) -2.9% (139,362) -3.0% 8,394 -6.0% (152,997) -2.9%

CHARITY CARE (17,625) -0.4% (17,625) -0.4% 0 0.0% (18,115) -0.3%

(17,625) -0.4% (17,625) -0.4% 0 0.0% (18,115) -0.3%

TOTAL DEDUCTIONS FROM REVENUE (1,856,308) -40.8% (2,154,751) -46.8% 298,444 -13.9% (2,553,275) -48.7%

(1,856,308) -40.8% (2,154,751) -46.8% 298,444 -13.9% (2,553,275) -48.7%

NET PATIENT REVENUE 2,694,124 59.2% 2,447,742 53.2% 246,383 10.1% 2,692,426 51.3%

(as % of Gross Patient Revenue) 2,694,124 59.2% 2,447,742 53.2% 246,383 10.1% 2,692,426 51.3%

NET PATIENT REVENUE 2,694,124 90.6% 2,447,742 93.1% 246,383 10.1% 2,692,426 93.0%

(as % of Total Operating Revenue) 2,694,124 90.6% 2,447,742 93.1% 246,383 10.1% 2,692,426 93.0%

OTHER REVENUE

DIETARY/MEALS INCOME 6,968 0.2% 7,842 0.3% (874) -11.1% 7,429 0.3%

6,968 0.2% 7,842 0.3% (874) -11.1% 7,429 0.3%

OTHER INCOME 271,530 9.1% 173,283 6.6% 98,246 56.7% 194,861 6.7%

271,530 9.1% 173,283 6.6% 98,246 56.7% 194,861 6.7%

TOTAL OTHER REVENUE 278,498 9.4% 181,125 6.9% 97,373 53.8% 202,290 7.0%

278,498 9.4% 181,125 6.9% 97,373 53.8% 202,290 7.0%

TOTAL OPERATING REVENUE 2,972,622 100.0% 2,628,867 100.0% 343,756 13.1% 2,894,716 100.0%

2,972,622 100.0% 2,628,867 100.0% 343,756 13.1% 2,894,716 100.0%

OPERATING EXPENSES

SALARIES 1,416,579 47.7% 1,515,966 57.7% (99,387) -6.6% 1,487,719 51.4%

1,416,579 47.7% 1,515,966 57.7% (99,387) -6.6% 1,487,719 51.4%

BENEFITS 464,480 15.6% 508,046 19.3% (43,566) -8.6% 471,184 16.3%

464,480 15.6% 508,046 19.3% (43,566) -8.6% 471,184 16.3%

PROFESSIONAL FEES 196,137 6.6% 87,917 3.3% 108,220 123.1% 142,157 4.9%

196,137 6.6% 87,917 3.3% 108,220 123.1% 142,157 4.9%

SUPPLIES & EXPENSES 570,901 19.2% 625,066 23.8% (54,165) -8.7% 546,555 18.9%

570,901 19.2% 625,066 23.8% (54,165) -8.7% 546,555 18.9%

OCCUPANCY 99,354 3.3% 115,966 4.4% (16,612) -14.3% 92,379 3.2%

99,354 3.3% 115,966 4.4% (16,612) -14.3% 92,379 3.2%

DEPRECIATION 207,000 7.0% 234,417 8.9% (27,417) -11.7% 214,000 7.4%

207,000 7.0% 234,417 8.9% (27,417) -11.7% 214,000 7.4%

TOTAL OPERATING EXPENSE 2,954,450 99.4% 3,087,378 117.4% (132,927) -4.3% 2,953,994 102.0%

2,954,450 99.4% 3,087,378 117.4% (132,927) -4.3% 2,953,994 102.0%

NET OPERATING INCOME (LOSS) 18,172 0.6% (458,511) -17.4% 476,683 -104.0% (59,278) -2.0%

18,172 0.6% (458,511) -17.4% 476,683 -104.0% (59,278) -2.0%

NONOPERATING REV/EXP

TAXES 165,896 5.6% 165,896 6.3% - 0.0% 140,896 4.9%

165,896 5.6% 165,896 6.3% - 0.0% 140,896 4.9%

GENERAL CONTRIBUTIONS - 0.0% - 0.0% - 0.0% - 0.0%

- 0.0% - 0.0% - 0.0% - 0.0%

INTEREST INCOME 7,883 0.3% 8,750 0.3% (867) -9.9% 18,072 0.6%

7,883 0.3% 8,750 0.3% (867) -9.9% 18,072 0.6%

INTEREST EXPENSE (82,826) -2.8% (89,251) -3.4% 6,425 -7.2% (85,368) -2.9%

(82,826) -2.8% (89,251) -3.4% 6,425 -7.2% (85,368) 2.5%

TOTAL NONOPERATING INCOME (LOSS) 90,953 3.1% 85,395 3.2% 5,558 6.5% 73,600 2.5%

90,953 3.1% 85,395 3.2% 5,558 6.5% 73,600 2.5%

NET INCOME (LOSS) 109,126 3.7% (373,115) -14.2% 482,241 -129.2% 14,322 0.5%

Year to Date 109,126 3.7% (373,115) -14.2% 482,241 -129.2% 14,322 0.5%

ACTUAL BUDGET VARIANCE ACTUAL

CRAWFORD COUNTY MEMORIAL HOSPITAL

OPERATING/INCOME STATEMENT

FOR THE MONTH ENDING JULY 31, 2020

CURRENT MONTH CURRENT MONTH CURRENT MONTH PRIOR YEAR

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THIS MONTH YTD

CASH FLOWS FROM OPERATING ACTIVITIES

CASH RECEIVED FROM PATIENTS AND THIRD -PARTY PAYORS 2,336,025 2,336,025

CASH PAID TO SUPPLIERS FOR GOODS AND SERVICES (1,341,896) (1,341,896)

CASH PAID TO EMPLOYEES FOR SERVICES (2,124,760) (2,124,760)

OTHER OPERATING REVENUE RECEIVED 278,498 278,498

NET CASH PROVIDED BY OPERATING ACTIVITIES (852,133) (852,133)

CASH FLOWS FROM NONCAPITAL FINANCING ACTIVITIES

COUNTY TAXES 29,722 29,722

PAYCHECK PROTECTION PROGRAM - -

CASH FLOW FROM CAPITAL AND RELATED FINANCING ACTIVITIES

PROCEEDS FROM ISSUANCE OF LONG-TERM DEBT - -

PRINCIPAL PAYMENTS ON LONG-TERM DEBT (76,357) (76,357)

INTEREST PAID ON LONG-TERM DEBT (49,489) (49,489)

ACQUISITION OF PROPERTY AND EQUIPMENT (26,493) (26,493)

NET CASH FROM (USED IN) CAPITAL AND RELATED FINANCING ACTIVITIES (152,338) (152,338)

CASH FLOW FROM INVESTING ACTIVITIES

INTEREST RECEIVED 6,693 6,693

PROCEEDS FROM MATURITIES OF CERTIFICATES OF DEPOSIT - -

PURCHASE OF CERTIFICATE OF DEPOSIT - -

PROCEEDS OF MATURITIES OF U.S. GOVERNMENT AGENCY SECURITIES - -

PURCHASE OF GOVERNMENT AGENCY SECURITIES - -

NET CASH PROVIDED BY INVESTING ACTIVITIES 6,693 6,693

NET INCREASE (DECREASE) IN CASH (968,056) (968,056)

CASH

BEGINNING 19,299,412 19,299,412

ENDING 18,331,356 18,331,356

DAYS CASH ON HAND 207

Desirable Actual

OPERATING INDICATORS: FEB MAR APR MAY JUN JUL Target Trend Trend

Operating Margin: -12.95% -24.88% -18.62% 56.24% -42.13% 0.61% 5.00% Increasing Increasing

Operating Margin ytd: -5.25% -7.05% -8.23% 3.09% -0.24% 0.61% 5.00% Increasing Increasing

Debt Service Coverage Ratio: 1.23 0.96 0.88 2.49 2.00 2.17 2.50 Increasing Increasing

Days Revenue in Patient A/R: 61 56 49 49 51 57 45 Decreasing Increasing

Days Cash on Hand: 110 119 162 212 202 207 365 Increasing Increasing

CRAWFORD COUNTY MEMORIAL HOSPITAL

STATEMENT OF CASH FLOWS

FOR THE MONTH ENDING JULY 31, 2020

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ASSETS

CURRENT ASSETS

Total Cash 11,226,246 22.67% 12,260,847 24.46% (1,034,601) -8.44% 3,951,378 8.63%

Patient Receivables 8,317,217 16.80% 7,998,440 15.95% 318,778 3.99% 10,461,805 22.86%

Allowance for Uncollectibles (897,000) -1.81% (902,000) -1.80% 5,000 -0.55% (1,239,000) -2.71% Allowance for Contractuals (1,780,000) -3.59% (1,730,000) -3.45% (50,000) 2.89% (2,140,000) -4.68%

Net Accounts Receivable 5,640,217 11.39% 5,366,440 10.70% 273,778 5.10% 7,082,805 15.48%

Other Receivables

Est. Third Party Settlement - 0.00% - 0.00% - 0.00% (292,666) -0.64%

Taxes Receivable 1,990,757 4.02% 2,020,479 4.03% (29,722) -1.5% 1,690,753 3.69%

Other 866,449 1.75% 727,165 1.45% 139,284 19.15% 897,496 1.96%

Inventory 759,310 1.53% 736,996 1.47% 22,314 3.03% 737,273 1.61%

Prepaid Expenses & Other 542,612 1.10% 443,429 0.88% 99,183 22.37% 435,762 0.95%

TOTAL CURRENT ASSETS 21,025,592 42.46% 21,555,356 42.99% (529,764) -2.46% 14,502,801 31.69%

ASSETS LIMITED AS TO USE

Investments

Cash & CD's 6,063,819 12.25% 6,059,961 12.09% 3,859 0.06% 6,312,824 13.79%

Bond/Project Funds 1,041,291 2.10% 978,604 1.95% 62,687 6.41% 1,044,170 2.28%

Interest Receivable 19,905 0.04% 18,716 0.04% 1,190 6.36% 55,608 0.12%

TOTAL ASSETS LIMITED AS TO USE 7,125,015 14.39% 7,057,280 14.08% 67,735 0.96% 7,412,602 16.20%

PROPERTY & EQUIPMENT, NET

Land 314,500 0.64% 314,500 0.63% - 0.00% 329,500 0.72%

Land held for Future Dev 120,400 0.24% 120,400 0.24% - 0.00% 120,400 0.26%

Land Improvements 2,511,827 5.07% 2,511,827 5.01% - 0.00% 2,511,827 5.49%

Building 8,350,703 16.86% 8,307,960 16.57% 42,743 0.51% 8,251,192 18.03%

Fixed Equipment 17,671,815 35.69% 17,671,815 35.25% - 0.00% 17,671,815 38.61%

Major Moveable Equipment 16,898,246 34.13% 16,892,046 33.69% 6,200 0.04% 16,772,439 36.65%

Leased Equipment 1,458,912 2.95% 1,458,912 2.91% - 0.00% 1,408,512 3.08%

Allowance for Depreciation (29,701,104) -59.98% (29,494,104) -58.83% (207,000) 0.70% (27,340,898) -59.74%

TOTAL PROPERTY & EQUIP, NET 17,625,298 35.60% 17,783,355 35.47% (158,057) -0.89% 19,724,787 43.10%

DEFERRED OUTFLOWS OF RESOURCES

Pension Related Deferred Outflows 3,739,109 7.55% 3,739,109 7.46% - 0.00% 4,126,448 9.02%

TOTAL ASSETS 49,515,014 100.00% 50,135,100 100.00% (620,086) -1.24% 45,766,638 100.00%

LIABILITIES & NET ASSETS

CURRENT LIABILITIES

Accounts Payable 470,466 0.95% 363,201 0.72% 107,266 29.53% 536,785 1.17%

Accrued Payroll & Payroll Taxes 1,767,453 3.57% 2,344,764 4.68% (577,312) -24.62% 2,091,350 4.57%

Accrued Health Ins & Flex 1,038,204 2.10% 1,125,749 2.25% (87,545) -7.78% 769,969 1.68%

Deferred Pro Tax Receivable 1,824,861 3.69% 1,990,757 3.97% (165,896) -8.33% 1,549,857 3.39%

Due to Third Parties - Other 16,143 0.03% 3,848 0.01% 12,295 319.53% 1,421 0.00%

Lease Payable - Short Term 3,095,100 6.25% 3,095,100 6.17% - 0.00% - 0.00%

Est. Third Party Settlements - 0.00% - 0.00% - #DIV/0! 125,000 0.27%

TOTAL CURRENT LIABILITIES 8,212,227 16.59% 8,923,419 17.80% (711,192) -7.97% 5,074,381 11.09%

OTHER LIABILITIES

Lease Payable - Long Term 582,064 1.18% 615,624 1.23% (33,560) -5.45% 852,715 1.86%

Bonds Payable - Long Term 21,728,346 43.88% 21,771,142 43.42% (42,796) -0.20% 22,562,828 49.30%

Interest Payable 113,904 0.23% 80,567 0.16% 33,337 41.38% 114,022 0.25%

Net Pension Liability 12,070,405 24.38% 12,045,405 24.03% 25,000 0.21% 12,510,847 27.34%

TOTAL LONG-TERM LIABILITIES 34,494,719 69.67% 34,512,738 68.84% (18,020) -0.05% 36,040,413 78.75%

TOTAL LIABILITIES 42,706,945 86.25% 43,436,157 86.64% (729,212) -1.68% 41,114,794 89.84%

DEFERRED INFLOWS OF RESOURCES

Pension Related Deferred Inflows 1,817,664 3.67% 1,817,664 3.63% - 0.00% 770,475 1.68%

OPEB Related Deferred Inflows 7,306 0.01% 7,306 0.01% - 0.00% 7,306 0.02%

TOTAL DEFERRED INFLOWS 1,824,970 3.69% 1,824,970 3.64% - 0.00% 777,781 1.70%

NET ASSETS

General Fund 4,873,973 9.84% 3,859,742 7.70% 1,014,231 26.28% 3,859,742 8.43%

Net Revenue (Loss) 109,126 0.22% 1,014,231 2.02% (905,105) -89.24% 14,322 0.03%

TOTAL NET ASSETS 4,983,098 10.06% 4,873,973 9.72% 109,126 2.24% 3,874,063 8.46%

TOTAL LIABILITIES & NET ASSETS 49,515,014 100.00% 50,135,100 100.00% (620,086) -1.24% 45,766,638 100.00%

Month Month Net Change Month

CRAWFORD COUNTY MEMORIAL HOSPITAL

BALANCE SHEET

AS OF: 7/31/20

Current Prior 1-Month 1 Year Ago

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A Tech, Inc. - Supplies $505.00 Iowa Health Info. Network - Fees $8,000.00Advance Medical Designs - Supplies $171.00 JP Gasway Co. - Fees $1,180.00Advanced Sterilization Pro - Supplies $1,528.00 Karl Storz Endoscopy - Supplies $1,267.80Alcon Laboratories, Inc. - Supplies $5,842.72 KDSN FM - Advertising $2,000.00American Time - Supplies $525.30 Keast Auto Center - Fees $451.37Ameritex Services - Fees $4,154.09 Koch Filter Corporation - Supplies $511.32Ampride Truck Plaza - Fees $185.52 La Prensa - Advertising $300.00Anderson Erickson Dairy - Supplies $534.29 Lifeserve Blood Center - Supplies $9,597.90Appleton Medical Services - Fees $1,741.95 Manilla Times - Advertising $384.00ASD Healthcare - Supplies $3,618.99 Mapleton Press - Advertising $685.10Aspen Surgical Products, Inc. - Supplies $231.50 Marco, Inc. - Fees $4,880.70Bayer Healthcare - Supplies $1,212.56 Mark's Plumbing Parts - Supplies $364.78Beckman Coulter, Inc. - Supplies $140.93 Martin Bros. Dist. Co., Inc. - Supplies $2,811.18Bluespace Creative - Fees $123.73 Medela, Inc. - Supplies $438.76Bomgaars - Supplies $19.83 Medivators, Inc. - Supplies $10,183.83Boston Scientific Corp. - Supplies $325.59 Mindray DS USA, Inc. - Supplies $480.00Bound Tree Medical LLC - Supplies $499.12 Mobile Instrument Service - Supplies $4.03Bracco Diagnostics, Inc. - Supplies $655.82 National Rural Health Assn. - Fees $1,225.00C.R. Bard, Inc. - Supplies $903.74 Neotract, Inc. - Supplies $3,862.50Cardinal Health - Supplies $21,971.97 Network Services Company - Fees $1,685.43CDW Government, Inc. - Supplies $32.54 O'Reilly Auto Parts - Supplies $91.90Chamber & Development - Fees $5,788.13 Observer - Advertising $423.75Cobblestone Inn & Suites - Fees $103.04 Onmedia - Fees $591.00Conmed Corporation - Supplies $117.60 Pentax Medical - Supplies $190.00Conmed Linvatec - Supplies $245.28 Precision Dynamics Corp. - Supplies $106.46Cook Medical Incorporated - Supplies $1,236.78 Priority Healthcare Dist. - Supplies $6,669.10Cooper Surgical - Supplies $208.08 Professional Computer Solutions - Fees $1,447.98Counsel - Fees $4,020.14 Professional Medical Mgmt. - Fees $6,781.50Country Rose - Fees $55.00 Quality Truck Service - Fees $983.04CPSI -Fees $39,616.38 Rogers Pest Control, LLC - Fees $215.00Deroyal Industries - Supplies $86.47 Secure Shred Solutions - Fees $696.50E-A-B Medical - Supplies $132.00 Sensoscientific - Supplies $60.00Echo Group, Inc. - Supplies $931.33 Siemans Healthcare Diagnostic - Fees $2,717.37Fareway Stores - Supplies $333.20 Smart Shopper - Advertising $1,861.26Farmer Bros Co. - Supplies $510.86 Smiths Medical - Supplies $4,636.31Federal Express Corp. - Fees $60.23 Chuck Staley - Fees $140.00Feld Fire - Fees $175.00 Standard Textile Co., Inc. - Supplies $415.68FFF Enterprises - Fees $255.60 Steris Corporation - Supplies $147.19Grainger - Supplies $513.35 Stryker Endoscopy - Supplies $1,466.70GRP & Associates, Inc. - Supplies $167.28 Stryker Orthopedics - Supplies $5,745.00H & R Accounts, Inc. - Fees $4,803.37 Tech Medical Services, Inc. - Fees $520.00Health Care Logistics, Inc. - Fees $61.86 Tollos, Inc. - Fees $325.00Health Enterprises - Supplies $508.34 Tri Community Medical Cent. - Fees $250.00Home Depot - Supplies $255.65 Tri-Anim Health Services - Fees $186.94Huntel Security - Fees $294.67 Virence Health Technologies - Fees $3,794.40ICP Medical, LLC - Supplies $708.60 Ziegler, Inc. - Supplies $9,846.64ID Apparel, LLC - Supplies $770.50 Zimmer - Supplies $133.17

July Check Run $207,638.52

ABC Lockbox - Supplies $48.10 Cassling - Fees $7,935.00Airgas USA, LLC - Supplies $7,266.64 CDC of Crawford Co - Sponsorship $220.00Alcon Laboratories, Inc. - Supplies $12,549.40 CDW Government, Inc. - Supplies $27.80Anderson Lock - Supplies $246.30 CenturyLink - Fees $1,805.03Anessol, Inc. - Fees $26,540.50 Chamber & Development - Sponsorship $1,000.00B.E. Smith - Fees $488.66 Change Healthcare - Fees $5,860.39Barnett & Miller - Fees $634.25 Chubb & Son - Fees $46,836.75Baxalta US, Inc. - Supplies $9,240.00 Cooper Surgical, Inc. - Supplies $7.95Britney Bengford - Scholarship Award $1,500.00 Continental Fire - Fees $1,080.00Bio-Rad Laboratories - Supplies $1,451.92 Craneware, Inc. - Fees $53,268.00Black Hills Energy - Utilities $3,552.30 Crawford Co. Memorial Hosp. Foundation $1,935.50Bracco Diagnostics, Inc. - Fees $1,535.88 Crystal Clear of SW Iowa - Fees $170.00Lee Burchett - Scholarship Award $704.00 Edward Cutler - Expenses $748.91Caravan Health - Fees $37.03 Database Solutions, Inc. - Fees $3,920.00CareFusion - Supplies $62.96 Dearborn National - Premiums $21,342.73Carroll Control Systems - Supplies $461.29 Denison Municipal - Utilities $21,407.71

TO BE PAID THIS MONTH - July 2020

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Denison Orthopedics - Fees $34,487.53 Pizza Ranch - Fees $217.20Dish - Fees $591.65 Practical Sleep Services - Fees $3,110.00Dorsey & Whitney - Fees $6,900.00 Precision Dynamics Corp. - Fees $699.48Electronic Engineering Co. - Fees $185.40 Priority Healthcare Dist. - Fees $4,400.46First National Bank - Expenses $4,156.08 Progressive Medical, Inc. - Fees $20.00Frontier Telephone Co. - Telephone $434.35 QUVA Pharma, Inc. - Supplies $1,111.62Julie Graeve - Expenses $359.60 R&S Waste Disposal - Fees $2,132.64Greatamerica Financial SE - Fees $1,892.00 Radiology Consultants, PC - Fees $1,802.63Jamie Gross - Expenses $140.65 Dr. Elizabeth Ranniger - Expenses $40.00Harry A. Koch Co. - Fees $93,930.00 Relay for Life - Fundraiser $2,253.00Dr. Karl Hasik - Expenses $40.00 Reserve Account - Postage $2,000.00Health Enterprises - Fees $700.00 Rolling Hills Community - Fees $2,475.00Richard Hill - Expenses $3,435.00 Joseph Romeo - Expenses $662.07HMH Foundation - Sponsorship $300.00 Erin Schechinger - Expenses $40.00HyVee, Inc. - Supplies $84.98 See The Trainer - Supplies $540.00IA Dept. of Public Health - Fees $210.00 Seim Johnson, LLP - Fees $495.00ICU Medical, Inc. - Supplies $5,158.17 Siemens Industry, Inc. - Fees $10,788.00Dr. John Ingram - Expenses $40.00 Dr. Craig Simons - Expenses $40.00Intrado Interactive Service - Fees $311.02 Shared Medical Services - Fees $2,150.00Iowa Hospital Association - Fees $475.00 Sister Sweets - Fees $278.00IRHTP - Fees $785.00 Mackenzie Smith - Expenses $40.00Jackson Physician Search - Fees $6,300.00 St. Anthony Regional Hospital - Fees $2,671.90Lori Johannsen - Expenses $810.00 Staples Advantage - Supplies $1,286.90Kansas Foundation - Fees $851.45 Star Energy - Fuel $152.30Tracy Kastner - Expenses $175.00 State Hygienic Laboratory - Fees $2,074.00Key Surgical, Inc. - Supplies $386.82 Dr. Joshua Storey - Expenses $40.00Jill Kierscht - Expenses $278.86 Stryker Orthopedics - Supplies $3,057.80KPININJA - Fees $1,800.00 Team Ford - Fees $678.00Dr. Bradley Lister - Expenses $4,950.00 Dr. Michael Thorstenson - Expenses $440.00Dr. John Lothrop - Expenses $40.00 Turnkey Pharmacy Solutions - Fees $850.00Dr. Michael Luft - Expenses $40.00 UnityPoint Clinic - Fees $210.00Macro Helix, LLC - Fees $10,247.86 US Foods - Supplies $5,766.93McKesson Medical Surgical - Supplies $2,781.09 Phyllis Utsinger - Lifeline Refund $30.00Mediacom - Fees $211.08 Vascular Access - Fees $4,500.00Medical Solutions, LLC - Fees $15,330.00 Verizon Wireless - Telephone $528.16Medline Industries, Inc. - Supplies $4,465.23 Wahltek, Inc. - Fees $4,471.00Brandi Mefferd - Scholarship Award $1,500.00 Walmart Community - Supplies $436.47MGMA - Fees $7,125.00 Richard Watts - Expenses $1,146.74MidAmerican Energy - Utilities $51.75 West Bend Mutual - Premium $9,970.30Mindray DS USA, Inc. - Supplies $642.20 Western Iowa Networks - Telephone $1,814.93New York Life - Premium $4,456.46 Kelly Wieman - Expenses $213.90Owens & Minor - Supplies $28,534.38 Jill Wonder - Expenses $40.00Pfizer, Inc. - Supplies $120.92 Dr. David Wright - Expenses $40.00Pharmacy Onesource - Supplies $474.27 Zion Lutheran Schools - Sponsorship $100.00Philips Lifeline Systems - Fees $2,380.60 Patient Refunds $887.76Physician Lab Services - Fees $37,061.00

Manual Check & ACH Total $596,217.59

DEPRECIATION FUND:Drees Heating & Plumbing - Sterilizer Project $13,126.32Electronic Contracting Co. - Projector $6,200.00Graham Construction Co. - Sterilizer Project $13,366.27

Depreciation Total $32,692.59

Salaries $2,362,555.15

GRAND TOTAL $3,199,103.85

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Crawford County Memorial Hospital FY 2021

Writeoffs July-20 Year to Date

Hospital 124,562.24$ 124,562.24$

CCMH Medical Clinic 7,250.13$ 7,250.13$

TOTAL 131,812.37$ 131,812.37$

Recoveries July-20 Year to Date

Avadyne Health 36,853.36$ 36,853.36$

In-house Recoveries 505.40$ 505.40$

General Service Bureau -$ -$

Hawkeye -$ -$

Returned Accounts 18.45$ 18.45$

Small Claims -$ -$

TOTAL 37,377.21$ 37,377.21$

YTD Recovery Rate 28.36%

Accounts Payable

Monthly Check Run 207,638.52$

Manual Check Run 596,217.59$

Depreciation Fund Checks 32,692.59$

Salaries 2,362,555.15$

Grand Total 3,199,103.85$

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CRAWFORD COUNTY MEMORIAL HOSPITAL 100 Medical Parkway

Denison, IA 51442

August 31st, 2020

Crawford County Joint E911 Board Box 444 Denison, Iowa 51442

To whom it may concern,

Crawford County Memorial Hospital Board is appointing Don Luensmann, Executive Director of Marketing and Development, as our representative for the Crawford County Joint E911 Board effective immediately. He will replace Tina Holdsworth.

Best,

Erin Muck Jason Mendlik President and CEO Hospital Board Chair

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CEO Report

August 28, 2020

Good Morning!

The 5-Star plan is in full swing with leadership training and all staff customer service training completed. We plan to host this training quarterly going forward for new employees and those that need any refresher training. We are scheduling employee forums in early September to review our Caregiver Engagement Survey and go over our action plan. Our providers will also have their customer service training by Dr. Klein from Custom Learning Systems. Our OASIS team projects are in full swing and they have been implementing some very neat initiatives. ED is establishing their OASIS team to work on ED customer service improvement initiatives. Staff have really been able to see how committed we are as an organization to be successful in becoming the Hospital of Choice.

July total procedures were down 8.61% from last year, however, last July was unusually busy. Total procedures are up 1% when compared to July 2018. Considering we had decreased volumes from the pandemic and open provider positions, these numbers are very encouraging.

The fiscal year started out positive with a net profit of $109,126, even with the lower volumes, due to a decrease in contractual adjustments and operating expenses. Cash did go down 968,065, mostly due to a third payroll in July. Days of cash on hand increased to 207 by keeping expenses down. I am truly proud of our leadership in remaining fiscally responsible.

Our community COVID numbers continue to slowly climb as more social gatherings take place. The schools have a solid plan to try to mitigate COVID transmission as much as possible, but we will continue to monitor COVID activity as the kids return to in-person learning. CCMH will work hand and hand with the schools, public health, and other community entities to ensure the best outcome possible for citizens of Crawford County. Heather will attend the meeting to give a COVID update.

We signed a year extension to our current ACO agreement, which will keep us on the track with zero risk at the current cost. This extension was offered due to the pandemic and allows us another year to evaluate our options. We are aware that there are shared savings for last year. Those figures will be available to us in September. Heather will be reviewing our current ACO activities and plans going forward.

CCMH can appoint a new representative to the Crawford County E911 board. I recommend Don Luensmann for this assignment. He is well respected in the community and will represent our organization well.

On August 1, I wrapped up my first year as CEO at CCMH. What a year it has been! I look forward to your feedback on how I can improve serving our community and organization. I am committed to the success of our hospital and I appreciate all the words of encouragement and the support this past year. Together we truly have made a difference. I am grateful for the opportunity to serve.

Erin

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