BOCC Special Meeting 03/28/08 Print
Board of Commissioners - Minutes






Chairman Larry Ammons convened a special meeting of the Haywood County Board of Commissioners at 1:45 p.m. in the Board Room in the County Commissioners’ Meeting Room at the Haywood County Justice Center, Waynesville, North Carolina, with members Vice-Chairman J.W. “Kirk” Kirkpatrick, III, Commissioners Mary Ann Enloe, Charles “Skeeter” Curtis and Bill L. Upton present. Staff member present was County Manager David B. Cotton.


Absent: Assistance County Manager Marty Stamey.


Pledge of Allegiance


Chairman Ammons led the Pledge of Allegiance.


Chairman Ammons offered a moment of silence in memory of a Haywood County employee, Howard Messer, who passed away this week.


Commissioner Upton offered the invocation.


Haywood Regional Medical Center Update from and Report – HRMC Representatives


Al Byers, Interim Chief Executive Officer (CEO) for Haywood Regional Medical Center (HRMC) approached the Board. Mr. Byers expressed appreciation to the Commissioners for their support of the hospital. Mr. Byers stated that HRMC has worked diligently to get all areas back in compliance. The hospital authority board of commissioners met March 27th and contacted the North Carolina Hospital Association which put them in touch with the Institute for Health Care Imrpovement in Masschauettes. The Institute for Health Care Improvement, realizing the dire need of HRMC at this time, has sought fit to give three scholarships to a board education program on quality called, “From the Top”. This program teaches board members throughout the United States, what needs to be known about hospitals.  Three hospital board members have accepted this opportunity and plan to attend the training in Chicago. Mr. Byers announced that some general board education will be available in May, through Mountain Area Health Education Center (MAHEC) and through the Western North Carolina Health Network, partially paid for by Mission Hospital. This will be a general session on what it means to be a board member and the responsibilities of such.  The entire hospital board plans to attend this training.


The Future Directions Committee met this week. Mr. Byers stated that a number of entities have expressed an interest in HRMC. Notification was sent to all those entities requesting a written statement of how they see themselves interfacing with HRMC in the future. This committee will meet again on April 7th, to review the statements that have been received. A search firm has been interviewed for a CEO. Another search firm will be interviewed and a CEO selected by Thursday, April 3rd.  A complaint and grievance policy has been developed. This policy should meet all the standards of the Centers for Medicaid and Medicare services (CMS).


Kim Kwiatkowski, Staff Development Director, approached the Board. Ms. Kwiatkowski stated that a procedure has been developed to accurately address complaints and grievances. All complaints that come through HRMC are now being tracked, logged, investigated, resolved, and responded to by a staff member. Accountability has been assigned to insure that complaints are resolved. Ms. Kwiatkowski explained the goal is to resolve the complaint within seven days. In some cases more time may be needed.


Mr. Byers stated that the area of performance improvement and quality will be surveyed by CMS. Dr. Robert Reihle, Interim Chief Medical Officer approached the Board. Dr. Reihle presented a performance improvement plan for HRMC. All hospitals have performance improvement plans and these are usually revised on an annual basis. These plans are customized to the hospital and to the area. Some parts of the plan are recognized nationally, and those responsible for accreditation of the hospital look for it. Some of the plan is customized to HRMC. Dr. Reihle stated that the plan is basically the medical center’s commitment to the community to provide quality care. The operations of the hospital must be examined, impartially, using data and using that data to create initiatives to improve operations so that it improves patient care and patient outcomes. It improves the operation of the hospital and the service to the citizens of Haywood County.


When opportunities for improving the hospital are identified, they are prioritized and then improvement efforts are tracked. There is importance in setting things in place for improvement and then monitoring when they are completed. There must be a hospital-wide culture of performance improvement. Dr. Reihle explained that the entire process will be data driven. The data will be standardized, analyzed and initiatives will be taken based on the data. Performance indicators will help for comparing the performance of HRMC to other regional or national standards. The results of this entire process will be communicated across the system of the hospital. All the data will flow to the steering committee, staffed by Dr. Reihle and the Director of Performance Improvement.


Commissioner Upton stated that there is a procedure for patient concerns and inquired if there was a procedure to address employee concerns. Mr. Byers confirmed that a procedure for employee concerns is in place.


Vice-Chairman Kirkpatrick inquired if the performance improvement plan had been implemented. Dr. Reihle confirmed that the performance improvement plan was implemented and the board oversight committee approved the plan.


Mr. Byers confirmed that the board oversight committee included the Chief and Vice-Chief of staff physicians, Mr. Byers, Dr. Reihle, and representing the board are Mike Ray, Dr. Richard Steele and Dr. Henry Nathan.


Mr. Byers explained that the many employees of Compass Group were brought to HRMC to assist with the hospital’s need to pass the survey. Once the initial survey has been completed, many of those employees will leave. Mr. Byers stated that as of March 24th, the Compass Group has been paid $61,830. An interim CEO, an interim Emergency Department Director, and an interim Human Resources Director will remain on site.


Mr. Byers stated that HRMC has not needed to tap their reserves yet. Within two to four weeks it is expected the hospital will need to tap into their reserves. After meeting with the investment counselors, a plan was created to liquidate some of the reserves, approximately $6 million, and move the money into an interest bearing account until it is needed.


Chairman Ammons inquired as to how HRMC will relay the message regarding the outcome of the initial survey. Mr. Byers stated that the information will be posted on the internet, and e-mailed to the Board of County Commissioners and to the medical staff. Also, a meeting will be called for the hospital authority board of commissioners. County Attorney Chip Killian confirmed that a notification o forty-eight hours is required prior to holding a meeting, unless the meeting qualified as an emergency meeting. 


Public Comment Session


Chairman Ammons opened the public comment session.


Mr. Otis Sizemore approached the Board. Mr. Sizemore presented a guide for a rally that is scheduled for April 27th, at HRMC, at 2:00–5:00 pm. Performing artist are invited to participate. Mr. Sizemore shared that the Fitness Center will hold a type of health fair. The Mountain Area Medical Airlift (MAMA) helicopter is scheduled for the rally. The hospital volunteers have been asked to provide guided tours of the hospital. Senator Joe Sam Queen has confirmed that he will be attending the rally. Mr. Sizemore invited the Board of County Commissioners. As a show of support everyone is asked to wear purple.


Mr. Jim Calderbank approached the Board. Mr. Calderbank stated that there are many opportunities in Haywood County and this is a transformational period for the hospital. Mr. Calderbank expressed his concern for the hospital and stated that he hopes Haywood County will keep the stakeholders and the assets here in this community.


David Cotton, County Manager, shared that the mileage for the Haywood County Emergency Medical Services has increased and the personnel are working well.


Vice-Chairman Kirkpatrick reported that the Future Directions Committee met and has made contact with hospital systems. All options are being reviewed.




Vice-Chairman Kirkpatrick made a motion to adjourn. Commissioner Upton seconded and the motion carried unanimously. The time of adjournment was 3:04 pm. The DVD is attached by reference to the minutes.




David B. Cotton                                                   Larry R. Ammons

CLERK                                                               CHAIRMAN