[2:49] like to call the meeting to order. We're
[2:50] going to twice Tyson have a few words
[2:56] to the flag of the United States of
[2:58] America and to the republic for which it
[3:01] stands. One nation under God,
[3:04] indivisible, with liberty and justice
[3:07] for all.
[3:09] >> Few reminders before we get going.
[3:11] Please state your name and title when
[3:12] you first begin speaking. Public comment
[3:14] will be allowed to the extent that it's
[3:16] on topic. Persons participating via Zoom
[3:18] are currently muted. If you have a
[3:20] comment, then please let Mark know via
[3:21] the chat function. Mark will then inform
[3:24] Chairman Trinkle can take up the comment
[3:26] in a manner that doesn't disrupt the
[3:27] agenda. And if the executive session is
[3:29] needed, then we'll mute and turn off the
[3:31] video. And when we're done, we'll turn
[3:32] everything back on.
[3:34] >> Heather, you there?
[3:36] >> I am. Can you hear me?
[3:37] >> Sure can.
[3:38] >> Okay. I've got about five things today.
[3:41] The first is um last week the Kansas
[3:43] Department of Commerce announced a $1
[3:45] million of available awards for
[3:48] attraction development grants. That
[3:50] could mean um the B29 museum, the
[3:53] Philly, the historical museum,
[3:55] essentially any um museum or attraction
[3:58] that needs funds to improve the visitor
[4:02] experience, quality of life, or increase
[4:04] tourism. It's a 6040 grant. um they
[4:08] intend to award about 10 of them, but
[4:10] wanted to just announce that publicly
[4:12] for anybody who might be listening to
[4:14] this um that any of our local
[4:17] attractions might be able to apply for
[4:19] that. [gasps]
[4:21] Uh also last week um connected with the
[4:24] city of Sawyer as well as the Kansas
[4:25] Corporation Commission about trying to
[4:27] close out the the national GA the
[4:29] natural gas grant. Luckily, because the
[4:33] amount of the grant for the city of
[4:35] Sawyer, borrowing something unexpected
[4:37] in the next 30 days, the project will be
[4:40] under a million dollars. So, that will
[4:42] avoid the need for a audit for them. Um,
[4:46] so we've been communicating with the KCC
[4:48] about trying to close out the project
[4:49] and any other expense needs that the
[4:52] city would need to have in that final
[4:54] reporting to be paid for by the grant,
[4:56] not the city of Sawyer.
[4:59] the unemployment statistics for the
[5:02] month of July came out. Pratt is at 3.8%
[5:05] which is the same as the state.
[5:07] Interestingly, both Reno and Kya County,
[5:10] so the two counties that border us are
[5:12] both trending higher. I suspect Pratt
[5:15] County will trend higher given what's
[5:17] happened at the hospital in August, but
[5:19] I'm keeping an eye on the unemployment
[5:21] rate currently. Well, in July, there are
[5:24] 172 individuals in Pratt on unemployment
[5:27] seeking employment.
[5:29] Um
[5:31] the
[5:33] state workforce um the local workforce
[5:36] board coordinator has reached out to me last week asking for
[5:41] some assistance with things going on at
[5:44] the hospital connected with Tyson. Um
[5:51] they've been instructed to talk directly
[5:52] with Workforce One so that they have
[5:54] what they need to help both local
[5:56] employers as well as people who've been
[5:59] displaced to make sure that everyone is able to access the most benefits as
[6:05] possible. I did receive an email today
[6:07] from the from the HR director at the
[6:09] hospital asking for some more
[6:11] information. I directed them back to
[6:12] workforce one. Um the PAEDC met last
[6:17] Wednesday,
[6:19] reviewed um two one grand application as
[6:22] well as um the updates
[6:26] related to um Country Club Estates, the trailer park that um has new
[6:32] ownership and significant improvements
[6:34] and then approved um an incentive
[6:36] application for Pratt family practice.
[6:39] I'll stop there and stand for any
[6:41] questions.
[6:46] I don't have any questions.
[6:47] >> I I don't have any questions. Is the
[6:49] workforce I guess I do. Is the workforce
[6:54] » workforce one?
[6:56] >> Yeah, I don't know how to put this
[6:58] politically correct. Are they running up
[6:59] against the wall with the hospital? Is
[7:01] that the problem or just not
[7:04] communicating?
[7:05] I think that there some leadership
[7:07] communications to them would assist them
[7:09] in knowing uh making sure that all the
[7:12] possible programs that are available. Uh
[7:15] they know exactly what people would and
[7:17] would not qualify for. I I I hope that
[7:19] we knock down that little hurdle last
[7:21] week. Not 100% certain of that, but it's
[7:24] really about a communication issue.
[7:26] >> Okay.
[7:28] >> I don't have anything, Heather.
[7:30] >> Thank you.
[7:36] want to come up
[7:48] and Pratt Senior Center. Um I'm just
[7:51] here to ask approval on um hiring
[7:55] Shannon back as custodian. She took
[7:58] medical leave and is able to come back
[8:01] now. Um the other person didn't work
[8:04] out.
[8:07] [clears throat]
[8:15] » Doctor's not
[8:17] >> I'm not familiar with what exactly
[8:19] happened on the medical leave.
[8:23] Was anything reported to you?
[8:24] >> There was there was no leave.
[8:26] >> Yeah. I I think she just
[8:30] she went ahead and resigned due to her
[8:32] health conditions and
[8:35] >> is she capable of working out?
[8:37] >> She is um talked to her very lengthy
[8:40] about that and she's going to go down to
[8:44] 20 hours now. So that'll help. And she
[8:49] actually is on a trial basis this last
[8:53] week with me and is doing fine
[8:55] >> as a volunt as a volunteer.
[8:57] >> As a volunteer.
[8:58] >> Yeah.
[8:59] >> Just to see if it would work out. She
[9:01] assured me that
[9:04] she would be okay.
[9:06] >> I'll make a motion to hire Shannon Crow
[9:10] part-time as a dishwasher custodian at
[9:13] the senior center for 1194.
[9:16] I'll second the motion.
[9:17] >> Been moved and second we hire or prep
[9:20] senior center hire Shannon Crow for
[9:24] custo parttime custodian dishwasher for
[9:27] 1194 an hour. All in favor say I.
[9:30] >> I oppose. Same sign. Motion carried.
[10:01] probably need new paperwork for just a
[10:03] >> She said she couldn't and we said wait
[10:05] till tomorrow.
[10:06] >> Okay. Or if you want you can stop by and
[10:08] get a part-time um employee packet
[10:10] upstairs. Okay.
[10:11] >> And Susan can get that for you and that
[10:12] way she can look it over and have it
[10:14] filled out.
[10:14] >> Okay.
[10:15] >> Bye.
[10:16] >> Thank you.
[10:22] want to do Doug stuff now or? Yep.
[10:25] >> He said he wasn't He said he wasn't
[10:27] coming in.
[10:28] >> Correct. Yep. However you guys want to
[10:30] do it.
[10:32] >> We got a bridge contract for
[10:35] Kirk and Michael to inspect our bridges.
[10:39] I will note that four of those bridges
[10:41] are the cities.
[10:46] » I could guess at some point.
[10:48] >> Okay. the costs going up like we're
[10:50] doing.
[10:51] >> Yeah.
[10:52] >> But I make a motion to sign contract
[10:54] with Kirk and Michael to inspect.
[11:00] » I knew how many bridges,
[11:07] but I don't remember.
[11:11] Is crap done good enough?
[11:14] [laughter]
[11:21] It's a semi bridge inspection that
[11:25] >> there are 92 bridges
[11:28] at $150 each.
[11:31] 36 FSA off systems, six others, six
[11:36] others are citys.
[11:40] Yeah. For a total cost of $41,400.
[11:46] I'll move that we sign the agreement
[11:48] with Kirkham and Michael. Second move
[11:50] and second we sign the agreement with
[11:52] Kirk and Michael to inspect bridges.
[11:56] All in favor say
[11:58] >> I.
[11:59] post same sign. Motion carried.
[12:12] It needed a seal too.
[12:18] come up. Now you guys can come on up if
[12:20] you want to
[12:35] » watch your names
[12:40] energy resources developer solar and
[12:44] polarish
[12:45] >> Samantha Misbet project manager for the
[12:48] NES ES thermal line and the rep.
[12:53] » My my spill's kind of quick. So, we're about to finish construction on
[12:58] the solar project. Pretty much all the
[13:00] panels are installed now. We're just
[13:01] moving through our energization process
[13:04] before we we bring the project online.
[13:05] So, we'll have a formal commissioning
[13:08] event for that. And once we have those
[13:10] dates, we'll we'll share it with the
[13:11] county. Um so, anyone that wants to
[13:13] attend can come out and see. But
[13:15] everything's pretty much on track for
[13:17] that project to be online end of
[13:18] September. So,
[13:20] >> sounds good.
[13:24] » Great. Um, I'm here today for the
[13:26] Nanisca thermal storage project or the
[13:28] thermal line um for our involvement
[13:30] within the project. Um, we are going to
[13:33] be mobilizing pretty soon. So, wanted to
[13:36] have a kickoff meeting with the county.
[13:38] So, thank you for having us today. Um,
[13:41] we are looking to be mobilizing and
[13:43] having some activities occur for
[13:46] construction starting here in the next
[13:48] couple weeks with primarily construction
[13:50] happening in the second week of
[13:52] September. Um, we've engaged with
[13:55] Kirkham and Michael for the
[13:57] pre-inventory of everything. So, that
[13:59] activity's been done and wanted to come
[14:01] here today to talk through any items
[14:03] with y'all and see if there's any
[14:06] questions or anything from you guys that
[14:08] we could be more diligent in for the
[14:10] project.
[14:11] >> All you're doing is just running a lot.
[14:14] >> Yeah. Which you started on.
[14:17] >> Um I think we're going to start closer
[14:19] to the Pratt Energy site, come from that
[14:23] way and go down. Um we do we have we're
[14:25] working with Kirk and Michael too on our
[14:28] uh road map for the hall route and we're
[14:30] thinking we may be having an amendment
[14:33] on that on the southeast 70th a there's
[14:35] a structure that um said that would be
[14:38] best to go around. So I have the
[14:41] document of what we're proposing and we
[14:43] can go over that with you guys any time
[14:45] today. Um and then we'll file the
[14:47] official amendment after we've had our
[14:50] kickoff with Kirkham and Michael.
[14:52] Just make sure that Doug's aware.
[14:55] >> Yes.
[14:56] >> Yeah. Yeah. Because we had our local
[14:59] emergency planning committee
[15:01] >> meeting Thursday and the people putting
[15:04] in the
[15:07] » old whatever it is. Graphite.
[15:09] >> Okay.
[15:10] >> Deal.
[15:10] >> Okay.
[15:12] >> They gave a little spiel on it
[15:14] >> and tore up.
[15:15] >> Mhm.
[15:16] >> Yep.
[15:16] >> Yeah.
[15:19] >> Yep. So, and this is all underground.
[15:22] Yes,
[15:23] >> correct. All underground on board.
[15:27] >> And then I think kind of on that note
[15:29] with with how these project there's some
[15:31] synergy on the road utilization. So
[15:33] we've been working with Kirk and
[15:34] Michaels on exactly kind of the cycle of
[15:38] how we appropriately close these out. So
[15:40] I mean at the end of the day, every
[15:42] project that utilizes any given road,
[15:44] there's going to be a close out for that
[15:45] project once work is complete regardless
[15:48] departing. So all the roads will be
[15:50] covered. There's just some overlap. We
[15:51] just processed an amendment last week on
[15:54] the storage project um because we needed
[15:57] water for dust mitigation and we
[15:59] recognized that where we're pulling the
[16:01] water from we didn't have that that
[16:02] section of the road parted out for the
[16:05] battery storage. We only had it for the
[16:06] solar. So you want to have it amended so
[16:08] that we could have that included. So now
[16:10] the so the battery storage will be
[16:11] obligated to close out
[16:15] » three or four days on a
[16:18] >> Yeah. And similar like for the thermal
[16:20] storage project, it'll it'll work the
[16:22] same like a lot on 70th will get closed
[16:25] out by the thermal storage project.
[16:26] >> Yep.
[16:28] >> Are you using the same lay down yard for
[16:30] this for your line?
[16:33] >> Different lay down yard for ours. Um but
[16:36] it's the same that is in our produce
[16:38] agreement currently.
[16:39] >> Okay.
[16:43] >> We're doing one bridge inspection out
[16:44] there, so you might be able to knock one
[16:45] off your list. There you go. One on
[16:47] seven.
[16:49] You sure? [laughter]
[16:53] >> We got 91 more to go.
[16:59] » Well, appreciate that.
[17:02] >> You guys come in and see us. Question
[17:04] about suits.
[17:05] >> Yes.
[17:09] » Wonderful.
[17:10] >> You have anything else?
[17:12] >> Yeah.
[17:13] >> When did you say you expect to start
[17:14] that?
[17:16] um first to second week of September for
[17:18] starting construction. Roughly three
[17:21] months, three and a half months is what?
[17:23] Yeah. Is what we're expecting. Um we're
[17:25] hoping to have this done by the end of
[17:26] the year.
[17:27] >> Who's your contractor?
[17:29] >> Uh Brink is our EPC.
[17:32] >> Okay.
[17:32] >> Yes.
[17:34] >> Good.
[17:36] All righty. Awesome. Thank you. Thank
[17:38] you. Appreciate it.
[17:54] do the minutes.
[17:56] >> Make a motion to approve the minutes
[17:58] from August 17th, 2026.
[18:02] >> Second move and second we approve the
[18:04] minutes from August 17th, 2026. All in
[18:07] favor say I. I. Oppos. Same sign. Motion
[18:11] carried.
[18:25] » Terry, did you have those bids on you?
[18:28] >> I did.
[18:30] >> My head that work.
[18:38] Barry Williamson, Pratt County Fire
[18:40] Rescue Captain.
[18:43] Uh, got a new rescue truck here a while
[18:45] back that you guys approved and uh,
[18:48] we've been looking for some tires for
[18:50] it. Most of the tires on the truck are
[18:52] more than 15 years old. They do have
[18:53] tread still on them. However, um, 15
[18:58] years, that's that's quite a long time
[19:00] on tires and you're just looking for
[19:01] trouble, especially an emergency
[19:03] vehicle. Um, we've got several bids. Um,
[19:08] we got one bid from uh, Ace Auto in
[19:11] Havland, which was the cheapest bid. It
[19:14] was 1701. The second cheapest was 1,800,
[19:18] which was Diamond Truck here in Pratt,
[19:19] which is a local company. Um, we did
[19:22] receive a bid from Cooper Tire. It was
[19:24] 2400. And then most recently, we
[19:27] received a bid from, um,
[19:30] >> Mitch Withers.
[19:31] for $2,100. They're almost
[19:35] all identical tires. Uh they're the Dino
[19:38] Track. They're not super aggressive in
[19:40] my opinion. We don't need super
[19:41] aggressive truck uh tires for that. Um
[19:44] 95% of our miles stay on on roads. And
[19:47] so if we need aggressive tires, we're
[19:49] probably going somewhere we don't need
[19:50] anyway. And so we talked we had talked
[19:54] about using more of a local company,
[19:56] which would be Diamond Truck Center for
[19:58] the amount of $1,800.
[20:00] Um, that's for six tires and they are 16
[20:03] ply tires.
[20:07] » Dino track.
[20:11] » They're not Michelin or, you know, but
[20:14] um, no more miles in the rescue trucks
[20:16] get on them. They really don't they they
[20:19] time out before they wear out.
[20:21] >> Yeah. So,
[20:24] the old Rescue 301 that we have has
[20:27] 18,000 miles on it, and it's a 2003
[20:30] model, so it's 13 13 years or 23 years
[20:34] old.
[20:37] >> Is that a good tire, Tom?
[20:39] >> I sold a lot of them. [laughter]
[20:45] » Yeah,
[20:47] I'd like to keep it local. I appreciate
[20:49] having bidding on it, but
[20:52] I'd like to keep it local.
[20:54] >> I think we should, too.
[20:55] >> I don't know what you guys think.
[20:57] >> I do.
[21:00] You know,
[21:02] >> also would like to keep it local in case
[21:03] we have trouble with the tires. We could
[21:05] just run up to Diamond Truck Center and not nothing against Cooper, but
[21:08] their bid is just, in my opinion, too
[21:10] high.
[21:11] >> Yeah.
[21:11] Well, I thought Diamond was out of
[21:14] business, but I guess not. So, and
[21:18] that's for $1,71.
[21:21] >> I don't know. That's the 1800
[21:23] >> $1,800.
[21:24] >> 1701 was was a
[21:27] >> greed. It's all sitting this way on my
[21:29] email, so I got to turn it.
[21:31] >> Well, you can thank your sheep for that.
[21:34] [laughter]
[21:42] » $1,800, right?
[21:44] >> Mhm.
[21:44] >> Yeah. All right. I'll make a motion we
[21:47] purchase six tires from Diamond Truck
[21:50] Center for the new rescue truck for
[21:52] $1,800.
[21:54] >> Secondly, moving a second. We purchase
[21:58] six new tires for the new rescue truck
[22:00] from Diamond Truck
[22:03] >> Truck Center for $1,800. All in favor
[22:05] say I. I. Oppose. Same sign. Motion
[22:09] carried.
[22:10] >> Thank you, commissioners.
[22:11] >> Thank you, Terry.
[22:21] We want to anybody
[22:24] have anything
[22:27] >> else? Yeah,
[22:29] >> I have the um
[22:32] >> Well, if you guys want to take that upg.
[22:42] » Yep. Um, and I do have the replacements
[22:46] on my special equipment plan. Um, so
[22:50] this isn't replacing, this is adding,
[22:52] but this will be there two that we don't
[22:54] have to replace next year when it's time
[22:55] to do it. So I can um cover that with my
[22:58] special equipment, but I would like to
[22:59] add two um pole pads. There are
[23:03] electronic pole books that we use for
[23:05] election. Um, I would like an additional
[23:07] one at our help table and also um an
[23:10] additional pole worker checking people
[23:12] in during election to make it a little
[23:14] faster.
[23:19] » I don't have a problem.
[23:20] >> I don't either.
[23:21] >> Hey, perfect.
[23:24] >> You make a motion?
[23:26] >> Yeah.
[23:27] I'll make a make a I'll make a motion to
[23:35] what do you call these things again?
[23:36] >> Um electronic poll books PBS.
[23:41] >> You've got two units.
[23:43] >> Yep. Two additional units.
[23:44] >> Two additional units from Atkins
[23:47] Election Service for $3,68.
[23:51] >> Second the motion. A move and second we
[23:54] buy two e pole books from Atkins
[23:58] Election Services for 368.
[24:03] All in favor say I.
[24:05] >> I. Oppose. Same sign. Motion carried.
[24:08] >> Will you make sure the minute show
[24:10] special equipment?
[24:11] >> Yep.
[24:12] >> Oh yeah. Sorry I didn't put that in my
[24:17] motion.
[24:24] We need to talk about number six.
[24:27] >> I mean, it's up to you guys.
[24:30] >> I don't think
[24:31] >> contact that I had with Mr. Newbie. I
[24:33] mean, he'd asked that this be placed on
[24:35] the agenda. It sounds like there's
[24:36] subsequent
[24:38] contact with the clerk's office. I told
[24:41] him that if he had information he wanted
[24:43] to present, he needed to get on the
[24:44] agenda. My understanding that he hasn't
[24:47] provided any information.
[24:49] >> I have not received anything.
[24:51] >> Okay.
[24:53] >> Sounds good.
[24:55] >> Check my email.
[24:57] >> You got anything?
[24:59] >> I mean, additionally on data centers, um
[25:03] to the extent that the issue comes up,
[25:06] uh I think most of the public is aware
[25:07] we're working on our comprehensive plan
[25:09] right now. It's something that the
[25:11] gentleman that came in from Adam Jones
[25:13] that discussed an overlay potentially
[25:16] for data centers. So we're aware of the
[25:19] topic
[25:21] >> and to the extent action needs to be
[25:23] taken it will be taken but it'll be
[25:26] taken in a thoughtful manner.
[25:28] >> Yeah. I mean we have a process of
[25:32] public hearings and all that. Y
[25:39] to the planning board. Yeah. All that.
[25:41] Yeah.
[25:43] The comprehensive plan.
[25:55] You got anything else?
[25:58] I want to do the vouchers right now.
[26:02] I'll make a motion to approve the
[26:03] voucher.
[26:04] >> I'll second it.
[26:05] >> We're waiting till 3:00 till our group
[26:08] comes in.
[26:11] >> You guys don't have anything on data
[26:12] center.
[26:23] May move and seconded yet.
[26:24] >> Mhm.
[26:25] >> Okay.
[26:27] >> We had voted on it. Been moved and
[26:30] seconded to pay the voucher. All in
[26:32] favor say I. I. Post. Same sign. I'll
[26:37] get caught back out.
[26:40] You can this
[26:44] two or three piles.
[27:41] Damn, how are you?
[27:44] >> Good. How's everybody?
[27:48] » Living the dream, sweating away.
[27:51] >> Cooler days are coming.
[27:57] sooner or later.
[28:03] Sure.
[28:59] complain about their record.
[29:03] Ours was $11,638.
[29:23] Thank you. Yours is on top. Thank you.
[29:26] >> Which is funny since we didn't even have
[29:29] air for a couple days.
[29:36] » You think that would help a little?
[29:38] [laughter]
[29:40] Hopefully it did.
[29:41] >> Yeah. Right.
[29:43] >> Mr. Ham, have you got something you want
[29:45] to start?
[29:46] >> Had a question.
[29:47] >> Sure. Come on up. Tell
[29:49] >> them time.
[29:50] >> Yeah, we've got plenty of time.
[29:52] >> Well, thank you.
[29:53] >> Yeah.
[29:53] >> Um, I just had a
[29:55] >> might introduce yourself.
[29:57] >> I'm Kevin Ham and I'm here with Ham
[30:00] Auction and Real Estate today. I was
[30:03] just showing a property to someone
[30:06] looking at a building and
[30:10] we left and he called me as he was
[30:13] leaving and said, "Hey,
[30:15] there's this
[30:17] property over here by the hospital next
[30:21] to well, I guess it's part of the old
[30:23] EMS and it goes wrap around the corner
[30:25] of the grassy field north of the old
[30:27] rehab place." He said, "Is that for
[30:30] sale? Can that be bought? Can we split
[30:32] that off and build a new business in
[30:35] Pratt?
[30:36] >> Part of that's currently under contract.
[30:38] >> Yeah, it's under the bonds.
[30:40] >> Well, PFP is currently contracted to buy
[30:45] >> all of it.
[30:45] >> Part of it.
[30:47] >> right? Because I thought they were doing
[30:49] the old rehab building
[30:52] to the north, which leaves Okay.
[30:54] >> six additional lots that are frontage.
[30:58] Uh
[30:59] >> so the frontage towards the ditch going
[31:02] west
[31:03] >> going
[31:04] >> northward
[31:05] >> north would be
[31:05] >> north from the building
[31:07] >> right going north but what would be
[31:09] available would be the frontage along
[31:11] first street
[31:11] >> that's correct
[31:12] >> six lots there but
[31:15] >> two two
[31:18] >> yeah so you'd have two frontage lots and
[31:20] remaining four would be uh to the extent
[31:24] that the county
[31:25] >> right
[31:26] >> is interested in selling that so I Guess
[31:28] that's my question. That's they just
[31:29] need to know, hey, is the county
[31:31] interested in possibly selling that?
[31:36] >> I'm not interested in selling it.
[31:38] >> Yeah. My thoughts are if it's related to
[31:41] the hospital, that's one thing, but if
[31:44] it's not,
[31:45] >> this would not be related to the
[31:46] hospital.
[31:48] >> You know, we're already got parking
[31:49] issues there. And
[31:52] so
[31:55] that area has basically been dedicated
[31:58] for healthc care
[32:00] >> purposes for needles.
[32:02] >> Yeah. I mean
[32:02] >> that's what I
[32:03] >> Yeah. I mean
[32:06] that's originally what the hospital
[32:08] wanted. You know, they didn't want
[32:09] anybody in
[32:10] >> Right. And I knew that was part of a
[32:13] future plan. You know, they built all
[32:16] the new parking places there in recent
[32:18] years, but we're still full, which is a
[32:21] good thing.
[32:21] >> Yeah. Yeah.
[32:24] So, I just needed to let him know if
[32:26] that's something we would consider or or
[32:28] not.
[32:29] >> Had somebody else asked, we told him no,
[32:31] too.
[32:31] >> Yeah.
[32:32] >> Okay.
[32:34] >> If it's related to medical care or
[32:36] something, that'd be different. But
[32:38] >> to my knowledge, this wouldn't be,
[32:40] >> right?
[32:41] >> But it'd be another business in Pratt,
[32:43] which
[32:43] >> yeah,
[32:44] >> we need understand.
[32:46] >> Yeah,
[32:48] >> we've got
[32:49] >> it's good frontage, good access. It
[32:52] would just be a good location for
[32:54] another business.
[32:57] >> Lots out east.
[32:59] >> Yeah.
[33:00] >> Along 54.
[33:01] >> It's not
[33:04] >> right. But that that could be developed.
[33:07] >> Yes.
[33:08] >> Okay.
[33:09] >> If that helps you. Remember I
[33:12] got the appraisal on that one, didn't
[33:14] we?
[33:14] >> Yes, we did. It's been years ago at this
[33:16] point.
[33:17] >> Yeah. We have to get it reappraised.
[33:19] >> Mhm. Um there is water but there's no
[33:22] sewer.
[33:24] >> Do you have to you do your own septic
[33:27] out there?
[33:28] >> Okay.
[33:29] >> Unless the city would
[33:30] >> Yeah. You're in the city zoning extr
[33:32] territorial zoning out there too. So
[33:35] have some city stuff to deal with.
[33:37] >> Mhm.
[33:37] >> Not that you couldn't that.
[33:39] >> Oh yeah.
[33:41] >> But it's along the highway.
[33:42] >> It's understood.
[33:43] >> So lots
[33:45] >> there's four lots. Okay.
[33:48] >> All right. It's not loted yet.
[33:50] >> It's not. But when they
[33:51] >> When they do, it'll be divided into
[33:53] four.
[33:54] >> Yeah.
[33:55] >> Unless somebody buys it all.
[33:56] >> Yeah.
[33:58] And somebody could buy two lots
[34:00] and have five acres and
[34:03] >> Okay.
[34:04] >> It's pretty good chunk.
[34:05] >> Yeah.
[34:06] >> All right. I'll let them know about
[34:07] that. And
[34:10] this would not be available. That's what
[34:12] I needed to know.
[34:13] >> Okay. Gentlemen,
[34:17] >> get out there business.
[34:19] >> Brian, [laughter]
[34:22] » thank you guys.
[34:23] >> Thank you.
[34:25] >> Brian, you want to come on up?
[34:26] >> Sure.
[34:27] >> If you got something for us,
[34:28] >> I do real quick.
[34:35] » Yeah.
[34:40] » Oh, let's see. It's not too bad. I do
[34:42] have a part- timerr that I'd like to
[34:44] start. He just got his EMT. His name's
[34:46] Riley Null. Um, like I said, part-time,
[34:50] so he'll be filling in when he can. Um,
[34:55] he was at the hospital at the uh,
[34:57] switchboard, but he just got his EMT, so
[35:00] he's looking to get into that line of
[35:02] work. So, he's got a full-time job, but
[35:05] looking to get parttime. Liz and Pratt.
[35:08] I'll make a motion we hire Riley Null at
[35:11] 1450 an hour for part-time EMS. I'll
[35:14] >> second the motion.
[35:15] >> Move and second we hire Riley Null for
[35:18] part-time EMS at 1450 an hour. All in
[35:22] favor say I.
[35:23] >> I oppose. Same sign. Motion carried.
[35:28] >> Uh the next thing I need your approval
[35:29] on because it's over $1,000. I need to
[35:31] buy some new batteries for our cardiac
[35:34] monitors. looking at eight total, which
[35:37] would give us two brand new ones per
[35:39] cardiac monitor for the grand total of
[35:42] $4,97.
[35:45] Have the quote if anybody wants to see
[35:46] it.
[35:47] >> Those aren't the ones I
[35:49] >> I think IV pumps you just brought here.
[35:51] >> Yeah.
[35:52] >> Okay.
[35:52] >> Yeah, this one I reached out to Striker
[35:56] themselves, which I actually get a
[35:57] better deal from them. So,
[36:00] but I do have that. If anybody wants to
[36:02] see that,
[36:02] >> I can order them direct from them and
[36:04] they'll ship them to me. But
[36:10] I'll make a motion we buy
[36:13] eight eight batteries for cardiac
[36:15] monitors from Striker for $4,97.
[36:19] >> Move the motion.
[36:20] >> Been moved and second we buy eight
[36:22] batteries from Striker for the
[36:26] cardiac monitors for $4,97.
[36:29] All in favor say I. I I oppose. Same
[36:32] sign. Motion carried.
[36:34] >> Regular budget or
[36:36] >> Yeah.
[36:36] >> need to sign one.
[36:37] >> No, no, that can come out of regular
[36:39] budget. It's no big deal. Um the last
[36:41] one I have I looked at this oh a few
[36:44] years back and it was nice, but it wasn't what I would
[36:49] consider a necessity. Um but we're kind
[36:52] of getting to that. It is a company
[36:54] called OneOS. Um, it's an app that would
[36:57] go on the phones, uh, either of our
[36:59] people or the truck phones. They don't
[37:01] have to keep it on their phone. It's
[37:03] tied in with our protocols. So, if we
[37:06] get a chest pain, they can they can type
[37:08] in chest pain. It's going to bring the
[37:10] protocol up, but then if they want to
[37:12] give a medication, it's going to tie
[37:14] directly to that medication
[37:16] um, and it'll tell them the exact dose
[37:18] range um, that we have. And it's come a
[37:22] long way. Does a lot of other different
[37:24] things. The nice thing now is it talks
[37:27] to our electronic patient care report.
[37:29] So if we click that we gave fentanyl or
[37:31] morphine, it'll document that in the
[37:34] patient care report. Um it was really
[37:37] designed for pediatric because when you
[37:39] have a pediatric dose, it's all weight
[37:40] based and a lot of our meds are becoming
[37:43] weight based. So it calculates that. Now
[37:45] we still do the calculation on paper to
[37:47] make sure we're right, but it's kind of
[37:49] one step to make sure we don't make a
[37:51] mistake. Um, there's also a built-in
[37:54] what we call a MAC check, medication
[37:56] check. They would actually have to scan
[37:57] the medication to make sure they're
[37:59] giving the right medication.
[38:00] >> So, we're not paralyzing people.
[38:02] >> Exactly.
[38:04] >> There's been a lot of that which is
[38:06] >> Yeah.
[38:07] >> 100% avoidable, but this kind of gives
[38:09] us that uh peace of mind. Um, the total
[38:13] cost to start it um because they have to
[38:16] do some implementation is $3,450.
[38:22] $2,500 a year is what it would be after
[38:25] that.
[38:25] >> After that.
[38:26] >> Yeah. Um but they go in and they put our
[38:28] protocols in. Now, another reason I I've
[38:32] kind of been pushing for this here
[38:33] recently is sometimes our medications
[38:36] come in different concentrations based
[38:38] on what we can buy.
[38:39] >> And so all I would have to do is go in
[38:41] there and tell it what concentration we
[38:43] have on the trucks and it would change
[38:44] the dose automatically. So that 2 in the
[38:47] morning call when they're going, "Oh,
[38:49] our our medication used to be this and
[38:51] this. I'm used to drawing up this."
[38:53] Again, it gives us that peace of mind to
[38:55] know we're not going to make them.
[38:57] >> When you scan it, it'll know
[38:59] concentration.
[39:00] >> Um I have to put it in as a correct
[39:02] concentration. Yeah. But we have we're about three different vendors we
[39:07] buy from, four different vendors now we
[39:09] buy from based on availability. It's
[39:12] getting crazy out there. Um, but this
[39:15] would definitely for pediatrics was kind
[39:17] of what it where it started, but now it
[39:19] goes to adults and they've just added so
[39:22] much more to it. Um, I've been on the
[39:24] phone and some webinars with their
[39:26] salesman and I think for the price it's
[39:29] definitely uh worth the money. Yeah.
[39:33] >> To your backup, you know.
[39:34] >> Yeah.
[39:34] >> Safety aspect.
[39:35] >> They do sell a scale that goes on the
[39:38] cot so it could actually weigh the
[39:40] patient. Uh, I talked to one of the
[39:44] division chiefs in uh, Reno County. They
[39:46] just went with this. They didn't buy the
[39:48] scale for their trucks that they just
[39:50] said it was too much of a cost. And they
[39:52] are expensive. That would add about
[39:54] $8,000 to this. And I'm like,
[39:57] let's not. We have we have other ways
[39:59] that we can we can get a pretty good
[40:02] weight on the kiddos. So, um, if you're
[40:04] okay with that, the initial cost would
[40:06] be $3,450
[40:09] and then it'd be another two years after
[40:10] that, 2500 each year, which again can
[40:13] come out of the regular
[40:15] >> regular budget. Yeah.
[40:16] >> In the motion, the original 3,000
[40:21] >> should be on that.
[40:22] >> I'll make it 3,000.
[40:24] >> I see what it's called.
[40:26] >> Oh, one dose. Yeah.
[40:27] >> Yeah. Uh, I'll make a motion that we uh
[40:30] buy one dose.
[40:36] What you call this?
[40:37] >> Uh, basically a medication app.
[40:39] >> A medication app for $3,450.
[40:45] » I'll second a motion. It's
[40:46] >> been moved and second we buy a
[40:48] medication app from one dose for $3,450.
[40:53] All in favor say I. I. Oppose. Same
[40:56] sign. Motion carried. Need a sign
[40:59] >> that one? No, doesn't need a signature
[41:00] either. I'm going to be talking to him
[41:02] again tomorrow on the phone so he can
[41:03] kind of show me the admin side. But just
[41:06] everything I've seen so far, it uh seems
[41:09] like it's going to be a pretty good
[41:10] deal.
[41:11] >> Nice to have a backup.
[41:12] >> Yes.
[41:13] >> Know things are happening.
[41:15] >> You're trying to do math in your head.
[41:17] >> Yep. It can be a little a little crazy.
[41:19] Luckily, knock on wood, we haven't had
[41:21] any mistakes, but all it takes is one
[41:24] and
[41:24] >> yeah,
[41:25] >> we're in trouble and the person's in
[41:27] trouble. So, that's all I've got unless
[41:29] you guys have anything. We did a a
[41:32] pediatric advanced life support with the
[41:34] same company that did our uh advanced
[41:36] life support uh class, advanced cardiac
[41:39] life support, free of charge again. So,
[41:41] that saved me about $2,500 having those
[41:44] two classes and they were amazing
[41:45] classes. So, we're going to have them
[41:47] back for some more continuing ed
[41:49] classes. So, we should have our annual
[41:52] inspection coming up next month, but
[41:54] we're gearing up for that. We'll do just
[41:57] fine, I'm sure.
[41:58] >> Air conditioner still surviving out
[42:00] there. They got nothing off.
[42:02] >> We had to repair the other one, the same
[42:04] one again.
[42:05] >> Then the crew quarters.
[42:06] >> Uhhuh. And then the mini split in the
[42:09] medication room went out and so we've
[42:11] been calling them and rattling their
[42:13] cage to come get that fixed. Apparently
[42:15] when they came out to fix it, they
[42:17] overcharged it. So now they have to come
[42:19] back and pull everything out and put it
[42:21] back in. So that's on them. We're not
[42:24] paying for it.
[42:25] >> We have to pay the initial one. But
[42:28] yeah, it's just uh got to have that. But
[42:30] at least the crew quarters are cool now.
[42:32] That went about a couple weeks without
[42:33] that. So that was a little rough for
[42:35] them.
[42:36] >> Sure. They weren't fighting over
[42:37] different rooms.
[42:38] >> All the rooms were out. That one air
[42:40] conditioner does all five rooms. Yeah.
[42:42] >> I thought there was one for two and Mm-
[42:45] No, the other two uh mini splits, one
[42:48] does the medication room and then the uh
[42:52] server room, I think. Server room. Yeah.
[42:55] >> So,
[42:56] >> yeah, they were able to blow some fans
[42:58] and keep it fairly cool back there, but
[43:01] not quite as comfortable as they like.
[43:03] But they didn't complain too much.
[43:05] >> At least I didn't answer any texts.
[43:08] It all worked. [laughter]
[43:10] Well, thank you.
[43:22] Didn't
[43:30] see any questions on Zoom yet.
[43:34] >> Brian, if you want [clears throat] to go
[43:36] upstairs and get a part-time packet,
[43:39] >> different than what you might have
[43:40] emailed me.
[43:40] >> That was last. Yeah. All of them have
[43:42] been they get updated every year with
[43:43] all the 2026 stuff. Okay, I'll
[43:45] >> go there. Yep.
[43:49] Anybody
[43:56] have anything else?
[44:05] » No, we stop right now.
[44:10] » We're just waiting for the Beaver
[44:13] Consulting Services to come in and give
[44:15] us public update on PRMC.
[44:19] at 3:00.
[44:25] » You guys have to wait around for that
[44:26] unless you want.
[44:27] >> Yeah.
[44:28] >> Just going to hang around in case you
[44:30] had any more questions on um the kickoff
[44:34] for the the thermal line construction or
[44:36] if you wanted to take a look at the
[44:38] proposed road agreement edits. I have it
[44:41] on my laptop, but nothing's finalized
[44:43] yet.
[44:44] >> I just send it to Doug and then he'll
[44:46] send it to then he'll send it to us.
[44:48] Yeah,
[44:51] » Kirkham. Kirkham,
[44:54] I gave the okay on the last one. Uh,
[44:57] goes that route. That's fine.
[44:58] >> Okay.
[44:59] >> Um, just make sure Doug's aware of
[45:01] everything as well.
[45:02] >> All right.
[45:04] Then we have another additional member
[45:06] with us today. Um, Josh, if you wanted
[45:08] to introduce yourself.
[45:11] >> I'm Josh Oakley. I'm the regional one
[45:13] set manager for the proud farman
[45:17] that
[45:19] two down in Oklahoma and then the one
[45:20] over in Wellington as well.
[45:26] » Have they started on your thermal stuff
[45:29] out energy
[45:31] >> getting ready to? Yeah,
[45:32] >> I've seen a crane.
[45:34] >> Yeah, they told us Thursday. They
[45:36] actually had a drawing of the building
[45:38] where the water and the what's in them
[45:41] graphite and and all this stuff. It was
[45:45] pretty interesting
[45:46] >> cuz they're going to heat that.
[45:48] >> Yeah, that run the steam for their
[45:50] >> Yep. That's where they're going to get
[45:52] their steam to
[45:53] >> for the ethanol.
[45:56] >> Is this still the first one in the state
[45:58] of Kansas you guys? Yes. So far,
[46:04] » it seemed cool. Couple years ago,
[46:07] [laughter]
[46:08] >> they said their other one is in South
[46:10] Dakota and um they have two of PCC
[46:15] linemen there.
[46:18] >> He said that there's going to be a lot
[46:19] of work
[46:22] and
[46:22] >> they they um last week partnered with
[46:24] PCC. Oh, did they? Um, and they'll be
[46:27] needing a bunch more of their students.
[46:29] And
[46:30] >> you do.
[46:34] » Thank you all. Appreciate it.
[46:36] >> All right. Thanks. Thanks for doing it.
[46:37] >> Yeah.
[46:39] >> Thank you for the information.
[46:42] >> Safe travels. Thank you.
[47:02] The Jo president was saying at the
[47:04] taxity lunch today, I think he said
[47:07] they've got
[47:09] 800 and some students out there right
[47:12] now. Over 10,000 credit hours.
[47:19] No, my wife busy.
[47:24] » Yeah, he said what did he say? I think
[47:26] 87% full on the dorms right now.
[47:35] Well, they're probably saving them quite
[47:36] a bit of money.
[47:38] >> $30,000 a month.
[47:39] >> Oh, wow.
[47:45] Motel's probably not happy to not
[47:52] told me that.
[47:53] >> Okay.
[47:56] >> One reason I knew it.
[48:03] Find out that my wife's about to lose
[48:04] her mind out there because she does all
[48:07] the financial aid stuff and the feds
[48:11] program doesn't work.
[48:14] These kids can't get their money.
[48:15] They're all upset.
[48:18] Nothing they've done is is right.
[48:22] So, they have all this stuff in queue
[48:24] and waiting on the federal government.
[48:29] Yeah.
[48:38] The world
[48:54] I will say that
[48:57] our ditches are bad in the county and we
[48:59] know it.
[49:02] We've got tractors torn apart. We've got
[49:05] tractors stranded on the side of the
[49:07] road.
[49:11] The new ones aren't going to get here
[49:13] till now, maybe till the end of
[49:14] September,
[49:17] but they are doing the best they can
[49:19] with what they've got.
[49:28] Bob, if you want to come up, you can.
[49:30] We're not going to start till three, but
[49:36] » in the hot seat
[49:48] » we're just caught up in
[50:02] Is Brett coming in?
[50:04] >> Had to go see a physician real quick. He
[50:06] should be getting the next 10 minutes.
[50:10] » What's coming?
[50:20] I met with him for about an hour last
[50:22] Tuesday.
[50:28] » Send me a text number.
[50:30] >> It's a really small world. He was a
[50:33] resident on my floor when I staff
[50:36] assistant at Haymaker Hall at K State.
[50:39] >> I had not seen him I have not seen him
[50:41] since college and he ends up being the
[50:43] intern. So it was just a really
[50:47] somebody for about 40 years when they
[50:49] surface again.
[50:55] He'd like me if I remember you after.
[50:57] >> Well, actually, [laughter] he said, "Oh,
[50:58] no." He said, "You wrote me up." I said,
[51:01] "After [laughter]
[51:10] » made an impression on him,
[51:12] >> I guess." So, he remembered me more than
[51:14] I remember him.
[51:31] Oh, Dave.
[51:34] >> Oh, Dave.
[51:38] >> We're just waiting.
[51:40] >> We're done until 30.
[51:44] >> No, you're not interested at all.
[51:48] What are you doing these days?
[51:51] >> Don't know yet. Just whatever you want.
[51:53] [laughter]
[52:02] » Looked at my retirement. I'm going to
[52:04] work till I'm dead. I think
[52:16] it's good. Good job for us at Global
[52:19] Methodist. Mhm.
[52:24] » expect anything different out of it.
[52:59] 382 said they were up a few students and
[53:02] Skyline was down a few students this
[53:05] year
[53:07] is what they were saying at the lunchon
[53:09] today.
[53:11] >> Notice a lot of schools got
[53:13] reclassified.
[53:27] is playing six man this year.
[53:30] >> I think Skyland is playing six man this
[53:31] year.
[53:32] >> Is that what they got? I can't remember.
[53:33] I know Cuttingham got moved up to eight,
[53:36] >> but my little tiny middle schooler is on
[53:38] there and he's about this big.
[53:41] I'm hoping the other teams look small,
[53:43] too. I told him cross country was really
[53:45] cool and he should just stick with that.
[53:51] » How you doing?
[53:52] >> Nice to meet you.
[53:56] » Tyson, nice to meet you.
[53:59] >> We're just waiting.
[53:59] >> Nice to meet you.
[54:01] >> Sasha.
[54:01] >> Yes.
[54:02] >> Sasha.
[54:03] >> We're just waiting until three. Okay.
[54:15] It's just you two. You want to go up
[54:18] there?
[54:19] I'll sit back here.
[54:22] >> I think it's just me.
[54:24] >> This is Jack. He's on our county
[54:27] hospital board. He's the chair of that
[54:30] board. But I know there's a lot of
[54:31] different for
[54:37] it did say he was going to try to join.
[54:40] He was in a trial but
[54:44] you on there.
[54:45] >> I don't see
[55:07] 24.
[55:12] » I've seen 43.
[55:14] >> Yeah.
[55:22] » Couple big ones during the public
[55:23] safety.
[55:24] >> Yeah.
[55:25] Well, and our RNR is next month, so
[55:28] [laughter]
[55:29] >> yeah,
[55:29] >> there's always that.
[55:34] » You didn't have to remind us of that.
[55:36] >> Sorry about that. [laughter]
[55:37] >> Well, I I had a small panic attack
[55:39] because not not really, but I panicked a
[55:41] little bit because um it was on a
[55:42] Tuesday.
[55:43] >> I was like, why are we doing this on
[55:45] Tuesday? Monday's holiday.
[55:46] >> Right. Right. And then Mark figured out
[55:48] because I think you were like, I
[55:49] wondered about that and we couldn't
[55:50] figure out why it was on Tuesday instead
[55:51] of Monday.
[55:53] >> Yeah.
[55:56] Y'all got PR figured out yet?
[56:00] >> Places in the hospital or the community?
[56:06] » Places to eat
[56:10] here for a lot more than I have.
[56:12] >> I end up eating in the hotel a lot. Been
[56:14] but I've had a great steak at uh uptown.
[56:19] >> Had a couple of h I had a double burger
[56:21] double hamburger there. had uh went to
[56:24] had the taco pizza or taco hamburger.
[56:27] >> Oh yeah,
[56:28] >> I got the large. I didn't realize it'd
[56:30] be that big.
[56:31] >> Yeah. Yeah.
[56:32] >> But I powered through. [laughter]
[56:38] » Like never leave a man behind, never
[56:40] leave food behind.
[56:45] » The supposed known for those.
[56:48] >> Yeah.
[56:50] heard there's a special a secret
[56:52] ingredient.
[56:57] » He said he thought there was a special
[56:59] >> secret ingredient I was told.
[57:01] >> I don't know.
[57:04] >> Is it a beef or a pork or is it a mix?
[57:06] >> It's pork.
[57:08] >> It is 100% pork.
[57:09] >> I think so
[57:11] because he makes them different than the
[57:14] original Charlie. Charlie
[57:16] >> Charlie uses different sauce than
[57:20] what he uses.
[57:22] Can't remember if he uses spaghetti
[57:23] sauce, but he uses
[57:24] >> Yeah. I don't don't know.
[57:26] >> Made a baste or the hell that
[57:28] >> we used to have pizza taco wars in town.
[57:30] There were two
[57:31] >> of
[57:35] » Wasn't my granddaughter
[57:38] still
[57:41] is Hutch?
[57:42] >> Yeah.
[57:44] Last time I had one, it was out of the
[57:45] truck, but that would have been years
[57:47] ago.
[57:47] >> It's Pacos. It's Danny Hoffman. She
[57:50] >> Oh, that's Yeah, Wonder.
[57:53] >> She has it in Hutcherson.
[57:56] >> And she's had it there for gosh over 10
[57:58] years now. And she does um take them
[58:00] bakes
[58:02] >> down here at the farmers market. And she
[58:04] gets quite a bit like in the hundreds,
[58:06] thousand. But she has all of his stuff
[58:08] that he used to have like the um the
[58:11] rafts. Those are so good. Something
[58:13] cheesy.
[58:14] >> Yes, something cheesy. You can order.
[58:16] Uhhuh. Yep. You can order that.
[58:18] >> So,
[58:20] >> table,
[58:20] >> but she she likes Yeah. Right. There's
[58:22] no there's no pool tables or writing on
[58:24] the wall.
[58:24] >> Yeah. Okay. Well, my name on the wall,
[58:26] >> right?
[58:28] >> Yeah.
[58:28] >> Right. A little bit of ash in there,
[58:30] maybe. [laughter]
[58:32] >> I heard that was one of the secret
[58:33] ingredients.
[58:34] >> Yeah. Yeah.
[58:35] >> Yeah. though.
[58:38] But she lets you like Charlie like I
[58:40] would almost ask for like no sauce
[58:41] sometimes and he would get mad at me.
[58:43] But um Danny allows you like she makes
[58:45] like a supreme one that has like olives
[58:48] and onions and green peppers. Yeah.
[58:52] >> Makes me hungry.
[58:53] >> I know.
[58:59] » Yeah. Boy, the temperatures are you
[59:01] strap in front of the car and drive
[59:02] home. Be ready to eat.
[59:04] >> Yeah.
[59:12] I can remember where Charlie was out
[59:14] there by Isn't it where Dairy Queen's at
[59:16] or
[59:17] >> Yeah, like on First Street in that
[59:18] strip.
[59:18] >> Verizon is now.
[59:20] >> Yep. Go home.
[59:22] >> Mhm.
[59:25] >> I got a good tour from Gary Barker. He
[59:27] gave me a
[59:28] >> Okay. He showed me were all the old
[59:30] banks, all the old gas stations, the old
[59:32] high the old high school, the new high
[59:34] school, the competing high school that
[59:37] was not merged 60 years ago.
[59:41] Got a little politics with that.
[59:43] [laughter]
[59:50] » Yep.
[59:59] tour director.
[1:00:01] >> I did. Yeah. Can't believe how many
[1:00:04] baseball diamonds you guys have. It's a
[1:00:06] tremendous community.
[1:00:08] >> They're full on the weekends.
[1:00:10] >> Yeah.
[1:00:10] >> So active.
[1:00:11] >> Blight center size of a football field.
[1:00:14] I joined so
[1:00:44] several acres and acres of parks in each
[1:00:46] state, too.
[1:00:48] >> It's amazing.
[1:00:49] >> Yeah.
[1:00:50] Back to back even
[1:00:53] >> separated by
[1:00:56] small rivers maybe or
[1:00:58] >> Clemens and Sixth Street probably. Yeah.
[1:01:01] >> And during Christmas they
[1:01:03] >> they said
[1:01:04] >> ton of lights.
[1:01:05] >> That's what they said.
[1:01:08] >> What did this go up like November one or
[1:01:10] something?
[1:01:11] >> It goes up right after Thanksgiving,
[1:01:13] didn't it? Don't they turn them on
[1:01:14] Thanksgiving Day? I
[1:01:15] >> think so.
[1:01:16] >> Oh, okay.
[1:01:17] >> Time frame.
[1:01:17] >> Yeah. And then they have a parade and
[1:01:20] Santa turned them on or whatever.
[1:01:23] >> Well, the amazing thing is how many
[1:01:25] hotels you have. I grew up in Blake,
[1:01:27] Kansas. We had one little tiny hotel.
[1:01:30] >> You guys have a lot of choices.
[1:01:33] >> They're pretty well
[1:01:35] even during the middle of the week.
[1:01:36] >> I know. I was shocked how full the hotel
[1:01:40] stay was.
[1:01:45] » Lot of ball tournaments here during the
[1:01:47] summer.
[1:01:47] >> Yeah.
[1:02:05] get another minute here. Uh
[1:02:09] just to give everybody on Zoom and
[1:02:11] everything
[1:02:14] if you do have questions, I just ask
[1:02:16] that you wait till
[1:02:19] the commissioners and and and be there
[1:02:21] are done. We'll probably answer some of
[1:02:23] your questions. Uh if you do have a
[1:02:26] question and you type it up here on the
[1:02:30] Zoom thing, we're going to need your
[1:02:31] full name for the record.
[1:02:36] And I would just ask that
[1:02:41] we don't bring individuals
[1:02:45] into this or talk about your medical
[1:02:48] conditions or anything like that. Close
[1:02:53] enough. [laughter]
[1:02:55] >> We're gonna get what we get.
[1:02:57] >> Yeah. Yeah. I just I don't want the feed
[1:03:00] blowing up while we're having a
[1:03:01] conversation here. And uh so if you
[1:03:05] could just hold off on your questions
[1:03:06] still afterwards, that'd be much
[1:03:09] appreciated. Thank you.
[1:03:14] Bill, do you want to come up with them
[1:03:15] or No. Okay. Do you guys want to start
[1:03:19] introduce yourselves and 3 o'clock? So,
[1:03:22] >> sure.
[1:03:23] >> I'm Bob Pel. I'm one of the consultants
[1:03:25] and the lead consultant on this project
[1:03:26] with Beer Consultants.
[1:03:28] >> I'm Brett Coleman. I'm the interim CEO
[1:03:31] with Beer Consult.
[1:03:36] So, I thought maybe just it might help
[1:03:38] just kind of talk a little bit about
[1:03:40] what we've been doing kind of what we
[1:03:43] see and then also I think maybe give you
[1:03:45] a little view of what you're maybe going
[1:03:47] to see as we go forward if that helps.
[1:03:49] >> Yes.
[1:03:50] >> And then maybe that'll help with you
[1:03:51] know direct questions or something too.
[1:03:53] So I think as are aware um we've been
[1:03:56] working not quite two months now seven
[1:03:59] eight weeks and really just you know
[1:04:01] focus on trying to a figure out what's
[1:04:03] going on and status and then what's
[1:04:06] necessary to uh maintain stability of
[1:04:09] the organization. So I'm um on-site and
[1:04:13] then also remote for a number of people
[1:04:16] on our team. Uh I I Jim Brown I think
[1:04:20] you guys have met our finance Daryl
[1:04:21] Nelson our physician probably has spent
[1:04:23] the most time on site up until the
[1:04:25] middle August. Now Brett's here four
[1:04:27] days a week and so um a lot of time and
[1:04:31] we've had a few other people uh revenue
[1:04:33] cycle and some other folks kind of
[1:04:34] sprinkled in and then done a lot of just
[1:04:36] phone calls Zoom kind of stuff um as
[1:04:39] well to just really to understand. So, a
[1:04:42] lot of time spent interviewing uh
[1:04:44] physicians, the leadership, the board
[1:04:46] from the hospital of course, and trying
[1:04:49] to just kind of put together a plan that
[1:04:51] I I would say it's kind of in a short
[1:04:53] term. There's kind of a short-term piece
[1:04:55] which we're kind of wrapped up now. Move
[1:04:57] to the intermediate, then there's more
[1:04:58] of the long term. the short term really
[1:05:01] focused on uh trying to get the
[1:05:04] organization to a position of greater
[1:05:06] financial stability and lots of
[1:05:08] challenges the organization has but
[1:05:10] that's really just the focus and a piece
[1:05:12] of it's so in our business it's two
[1:05:15] things it's are you managing your
[1:05:17] expenses and are you managing revenue
[1:05:19] cycle the money coming in and so that's
[1:05:22] really the focus is on kind of both of
[1:05:24] those sets of processes um with the
[1:05:27] expense reductions you know hospitals
[1:05:30] typically anywhere from 45 to 65% of
[1:05:33] their expense budget is actually
[1:05:35] personnel.
[1:05:36] >> It's just we are a very health care
[1:05:38] healthcare is a very people intensive
[1:05:40] work and so that's a big chunk of the
[1:05:42] expense that you spend and so that's
[1:05:44] also tends to be one of the places that
[1:05:45] you look for savings and that's been
[1:05:47] true over the last several weeks. um
[1:05:50] just looking at just operations of the
[1:05:52] hospital, the clinics, how are we doing
[1:05:54] things and maybe should we be doing them
[1:05:56] differently and that's there's kind of
[1:05:58] that short-term piece of that and then
[1:05:59] really a lot of that's happening in this
[1:06:01] inter intermediate session when Brett's
[1:06:02] here every day. Uh, one of the things
[1:06:04] he's spent a lot of time with the
[1:06:06] department leaders, which I think have
[1:06:08] all pretty much have all just stood up
[1:06:11] and really been super helpful, creative,
[1:06:15] and problem solving. And that's what we
[1:06:16] want to see. Um, because that's those
[1:06:19] are the people are going to carry you.
[1:06:20] Again, if you're a hospital leader, you
[1:06:22] know, your department leaders are the
[1:06:23] ones who are actually running the place.
[1:06:25] And you guys have got some good folks
[1:06:26] here in the community to do that. And
[1:06:28] that's and that is really showing you
[1:06:30] some folks who really have to just take
[1:06:31] an initiative. you might talk about
[1:06:33] something and they're implementing it
[1:06:35] the next day which is amazing. So that's
[1:06:37] good stuff but so there's that piece on
[1:06:39] operations and also revenue cycle and
[1:06:43] for PR and C um the focus has pretty
[1:06:47] much had to look at all parts of that.
[1:06:50] So we have a what we call a front end
[1:06:52] where you're collecting the information.
[1:06:53] You get pre-authorizations etc for
[1:06:55] people to actually have their
[1:06:57] procedures. Certainly when they're there
[1:06:58] for their procedure you're getting them
[1:07:00] checked in. Make sure you get all the
[1:07:01] data is correct so you can make a claim
[1:07:03] to an insurance company. And then on the
[1:07:05] back end is actually the coding the
[1:07:07] billing and actual collections. Um we
[1:07:10] were seeing um improvement and quite
[1:07:13] honestly a big part of that is back now
[1:07:16] it would be almost five months ago four
[1:07:19] months ago they had moved to a new
[1:07:22] revenue cycle company and I think
[1:07:24] they've done a good job of kind of a
[1:07:26] calming the waters and b we're starting
[1:07:28] to see improvements in what they're
[1:07:30] collecting and so people are being build
[1:07:32] correctly. Um, internally in our
[1:07:35] industry, we use a term called a clean
[1:07:37] claims rate
[1:07:39] >> and that had fallen to somewhere in the
[1:07:41] 40%s over the last year and now is above
[1:07:43] 90%. And that's really been the work of
[1:07:46] this company and the internal folks at
[1:07:48] Brett in the last three to four months.
[1:07:50] Something that actually predated our
[1:07:51] involvement. Um, it was kind of things
[1:07:53] were getting on the path. I think now um
[1:07:56] Brett working with the local leadership
[1:07:58] is just making sure it stays on the path
[1:08:00] and that we continue to see the benefits
[1:08:02] of that because if you're doing a lot of
[1:08:05] work and you're never collecting
[1:08:06] anything for it that does not help your
[1:08:08] financial situation. Um and I always
[1:08:10] want to be fair about that with the
[1:08:11] patients and also you know make sure
[1:08:13] that there's integrity in that revenue
[1:08:16] cycle system and I think we're starting
[1:08:18] to see that that's u getting cleaned up.
[1:08:22] It takes a long time. The piece we
[1:08:24] actually talked about the hospital board
[1:08:25] today is there's a certainly some gaps
[1:08:28] too with what we call payer contracting.
[1:08:30] And so this is where you have contracts
[1:08:32] with Blue Cross, Etna, United, the other
[1:08:35] big uh commercial payers. And are you getting a reimbursement rate
[1:08:40] that's fair as compared to your peers
[1:08:42] and also to what it costs you to provide
[1:08:43] a service and I think um not
[1:08:46] surprisingly there's gaps there. That's
[1:08:48] probably true of 102 of the 103
[1:08:50] hospitals you would talk to. there's
[1:08:52] always opportunity of pair of
[1:08:53] contracting but that's also a longer
[1:08:55] term that falls into that one year
[1:08:57] two-year fix actually
[1:08:59] >> um but again I think the big part about
[1:09:01] that was creating stability making sure
[1:09:03] we had just knowledge and I think in the
[1:09:06] last you know seven eight weeks we've
[1:09:07] made some strides there and a lot of it
[1:09:10] just has to do with the integrity of the
[1:09:11] information making sure that stuff's
[1:09:13] actually accurate um
[1:09:17] one of our part of one of our
[1:09:18] deliverables is actually looking at
[1:09:20] leadership and also the just workforce.
[1:09:24] Um there have been adjustments in
[1:09:26] workforce and that is and so hospital is
[1:09:31] a little strange about that in that you
[1:09:33] can't just turn something off because
[1:09:35] you have patients involved and so
[1:09:36] there's kind of a windown period. So,
[1:09:39] we're actually midst that with a couple
[1:09:41] of services. We're uh finding patients
[1:09:44] new homes while the service is being
[1:09:46] turned off. That typically is a 30-day
[1:09:48] window. And so, some of that will come
[1:09:50] to an end here about the end of this
[1:09:53] month as well. And so, it's some shifts
[1:09:55] of patients to other services. And and
[1:09:57] the reason for this is is purely
[1:09:59] financial. Um it's not does say anything
[1:10:02] about the people who are doing the
[1:10:03] service certainly is not necessarily
[1:10:04] convenient for the patients but you just
[1:10:07] you can't um you can't keep providing a
[1:10:10] lot of services that are losing money
[1:10:11] when you are struggling yourself
[1:10:13] financially as an organization um and
[1:10:16] you know as with Brett here as the
[1:10:18] interim CEO which is now day nine
[1:10:20] [laughter]
[1:10:22] um I mean as part of the leadership
[1:10:24] transition um there's a interim chief
[1:10:27] nursing officer who's also been named
[1:10:29] we're going to try to move that, you
[1:10:32] know, find that right person for that
[1:10:34] role first. And saying that though, that
[1:10:37] probably won't happen until sometime in
[1:10:38] Octoberish because it just takes a
[1:10:40] little bit to go through that process.
[1:10:42] And we want to make sure we get the
[1:10:43] right person. Um, but we're also
[1:10:45] optimistic that that person can be an
[1:10:47] internal promotion to be somebody from
[1:10:49] the organization or from the county uh
[1:10:52] already. And then really the long term
[1:10:55] is just looking at starting to build
[1:10:56] kind of these road maps for some of
[1:10:59] these different areas that'll take you
[1:11:00] out the next few months or several
[1:11:02] months. And it kind of depends on the
[1:11:05] area um what that looks like. One of the
[1:11:07] things, one of the deliverables
[1:11:10] will actually be some cash projections.
[1:11:12] And so the hospital board would actually
[1:11:14] get so you know, here's your 13-week
[1:11:16] projection, here's your 26- week
[1:11:18] projection, because that's really you
[1:11:20] you've got to a keep an eye on that, but
[1:11:23] two, you just kind of have to have an
[1:11:24] idea of so what does that look like? Um
[1:11:28] last week had some of the best cash
[1:11:30] collections of the entire year. And so
[1:11:32] that's encouraging. um one it means some
[1:11:35] of the revenue cycle things are starting
[1:11:36] to happen correctly but also that it
[1:11:39] starts to provide a little breathing
[1:11:41] room because at the same time I've been
[1:11:43] kind of leading a lot of our expense
[1:11:44] reduction efforts. Brett's now stepping
[1:11:47] in to kind of take take on some of that
[1:11:48] but really to focus on the revenue cycle
[1:11:50] piece and see your revenue hopefully
[1:11:52] then gets back above your expenses. And
[1:11:54] so that's um again we feel like we're
[1:11:56] making progress with that and
[1:12:00] it's some of that data kind of lags. So,
[1:12:02] for example, the the hospital just
[1:12:04] finished their pay period on Saturday
[1:12:07] and so you've got to go through your
[1:12:08] payroll processing uh all the pieces of
[1:12:11] that and so it won't be till later this
[1:12:13] week that we actually know so what was
[1:12:15] our salary expense for that pay period
[1:12:16] so we can compare it then to the
[1:12:18] previous ones
[1:12:19] >> and so there's always going to be some
[1:12:20] data lags but I think you guys will also
[1:12:22] see kind of going forward from now on um
[1:12:25] what you'll see is some reductions in
[1:12:27] expense both on the salary and the non-
[1:12:29] salary and then we're going to hit
[1:12:30] another plateau because that'll be when
[1:12:32] everything's been implemented that's
[1:12:34] been identified so far and then at the
[1:12:37] same time you hopefully we'll see the
[1:12:39] revenue kind of coming up and then it
[1:12:40] will also plateau and hope what we're
[1:12:43] trying to do is at a minimum be this and
[1:12:46] hopefully be the revenue be higher than
[1:12:48] the expense. So that's kind of just the
[1:12:51] focus um of the work so far. Um, as far
[1:12:55] as the there was in our, you know, part
[1:12:58] of our arrangement or agreement is to
[1:13:00] provide some deliverables and you're
[1:13:01] going to start to see those um, in
[1:13:04] September. Some of those will be just,
[1:13:06] you know, kind of here's the report.
[1:13:07] There'll be a few pages. They're not
[1:13:09] going to be some lengthy.
[1:13:12] >> You can't go past three or four pages or
[1:13:14] Brett and I lose interest. So, we've got
[1:13:16] to keep it somewhat concise. Um I think
[1:13:19] and I think some of those we'll be able
[1:13:20] just to distribute to the hospital board
[1:13:23] and like to Tyson. Um and others I think
[1:13:26] we're probably going to want to talk
[1:13:27] through just because it you're just
[1:13:29] you're probably just going to say what
[1:13:30] is this or what does this actually mean?
[1:13:33] >> And so I think you'll you'll get the
[1:13:34] information. It's just a matter of you
[1:13:36] know again we we just probably have to
[1:13:37] schedule time um to walk through that
[1:13:41] all that stuff.
[1:13:44] So I don't know if there's I don't know
[1:13:45] if that kind of helps paint the picture.
[1:13:47] Oh, I guess um the look forward is um so
[1:13:51] of course Brett's here. We'll have the
[1:13:52] deliverables. It'll start to a lot of
[1:13:55] that will come actually in September,
[1:13:57] probably the last of that in the very
[1:13:58] beginning of October. And then it's kind
[1:14:01] of that by then we'll know where we are
[1:14:03] with matching up. And so then we'll know
[1:14:05] what levers we need to start pulling
[1:14:07] again to try to get things in line. I
[1:14:10] think we're pretty comfortable that
[1:14:11] we're in a pretty good spot. We just
[1:14:13] have to kind of see where everything
[1:14:17] actually matches up
[1:14:20] >> and then also what you can sustain
[1:14:21] because that's really the key issue is
[1:14:23] the sustainability.
[1:14:25] >> Uh we have seen progress in the last few
[1:14:27] weeks and I give credit to some of the
[1:14:29] local finance team. Um they've been able
[1:14:32] to get ahead enough on cash that we're able to pay down some of the
[1:14:36] accounts payable. And so it's just but
[1:14:39] what does that look like? You know, I
[1:14:40] think that's really the question. um
[1:14:42] what does it look like over the next six
[1:14:44] months, 12 months, etc.
[1:14:47] >> So
[1:14:49] what's the total in debt
[1:14:52] that they are at?
[1:14:56] » Uh so all in somewhere north of 14
[1:15:00] million.
[1:15:02] >> It's probably a little more than that.
[1:15:04] So they have about 11 million accounts
[1:15:06] payable,
[1:15:07] >> 5 million line of credit give or take.
[1:15:09] These are round numbers. They're a
[1:15:11] little lower actually. Each one I'm
[1:15:13] giving you is that well round it up to
[1:15:14] the million. Um so that's that's 16 and
[1:15:19] then a longer term one that's right at
[1:15:22] around million3. So around 173
[1:15:25] >> 17 or so.
[1:15:30] And I don't know if you guys are aware,
[1:15:32] but
[1:15:35] you do have a rent credit bond payment
[1:15:38] coming up that I'm going to assume that
[1:15:43] you're not going to make and we're going
[1:15:44] to have to deal with bond counsel on
[1:15:47] that.
[1:15:50] » I didn't know if you guys knew that.
[1:15:52] >> Well, yeah. Yeah. As I say, I think so.
[1:15:55] I think there's a probably they're
[1:15:57] planning to have a another meeting or
[1:15:59] conference with you guys about what
[1:16:01] steps to take for that.
[1:16:03] >> It's coming up quick and I know
[1:16:05] >> reached out to bond council to just
[1:16:07] identify what's in the surplus sales tax
[1:16:09] reserve fund to make sure that it they'd
[1:16:12] be able to do a rate credit if that's
[1:16:13] what they desire to do.
[1:16:16] uh on the revenue cycle.
[1:16:19] Uh
[1:16:21] yeah, I think Tammy and Bill when we met
[1:16:25] in our small groups,
[1:16:27] they were got down into the 40 46 or
[1:16:30] something like that. I think when they
[1:16:31] started and it was going up. Uh
[1:16:36] and you've got it up to 90% now. You say
[1:16:39] >> Yeah. The last few weeks I always
[1:16:42] mispronounced the vendor's name.
[1:16:43] >> Mr. B E S T.
[1:16:45] >> Yeah, there they've been in the 94 95%
[1:16:48] clean. So, it's a clean claim going out.
[1:16:50] Still doesn't mean that like that
[1:16:52] insurance company's going to pay it, but
[1:16:53] at least the claim is going through all
[1:16:55] the scrubbers and going to them
[1:16:57] >> going to
[1:16:58] >> correctly.
[1:16:59] >> Is that And this is
[1:17:03] just because I know the trouble they
[1:17:04] were having with their billing program.
[1:17:06] Is that because of the billing program
[1:17:08] or it just wasn't done right to begin
[1:17:12] with or because I know at one time they
[1:17:14] were want like $3 million for a new
[1:17:15] billing program
[1:17:17] >> to solve this issue but
[1:17:19] >> so I
[1:17:21] >> I'm just curious.
[1:17:21] >> Yeah. Um I would say it's a bunch of
[1:17:24] things. I don't know that there's any
[1:17:26] one single item that caused that.
[1:17:28] >> Uh the actual software itself I mean
[1:17:32] it's just a piece of software. Mhm.
[1:17:34] >> So
[1:17:36] it all always comes back to what goes in
[1:17:38] is
[1:17:39] >> you know what's going to come out and
[1:17:41] then also are there glitches or problems
[1:17:44] >> and I think we have all the above. Um
[1:17:47] the the way you get to clean claims up
[1:17:49] is you resolve all those things.
[1:17:51] >> I mean that's they were working on you
[1:17:54] guys.
[1:17:55] >> Yeah. It's almost like at a point that
[1:17:57] might have been an April one issue is
[1:17:58] not now the what's going to be the
[1:18:00] September one issue with Rev Cycle. It's
[1:18:02] there's still stuff to be done, believe
[1:18:04] me. But it's I think we're kind of
[1:18:06] moving through some of the um
[1:18:10] say lower level issues
[1:18:12] >> and now we're to figuring out so why is
[1:18:15] this or that happening with a claim or
[1:18:17] group of claims?
[1:18:18] >> Yeah.
[1:18:21] » Uh
[1:18:26] the vendor's still okay with you guys.
[1:18:28] Nobody's threatened to come hang you
[1:18:30] from a tree or
[1:18:32] >> nobody no one's going to threaten to
[1:18:33] hang Brett, but um I mean I part of it
[1:18:38] is like you got to keep communication
[1:18:39] with them and also they have to see that
[1:18:41] there's progress.
[1:18:42] >> Progress. Yes.
[1:18:43] >> And I think um with some of the changes
[1:18:46] I think they see that there's progress
[1:18:48] or at least an attempt to have things be
[1:18:50] done differently and that that does
[1:18:52] matter. And you know the vendors are
[1:18:54] also looking at this very long term. um
[1:18:56] they don't want anything to happen to
[1:18:57] this hospital either because they just
[1:18:58] lost a couple.
[1:18:59] >> Sure.
[1:19:00] >> And so I think if they continue to give
[1:19:03] us some grace and we're able to keep
[1:19:04] moving more money to them, then I mean
[1:19:08] it's going to take a long time, guys.
[1:19:10] You don't dig out of this.
[1:19:12] >> Understand.
[1:19:12] >> This is a multi-year process to get out
[1:19:16] from this. So
[1:19:18] >> yeah, and that's always the end goal
[1:19:20] here is
[1:19:21] >> Yes. to keep them
[1:19:23] >> to where they can sustain and dig
[1:19:25] theirelves out of the hole.
[1:19:26] >> I think we're pretty optimistic about
[1:19:28] what we've seen over the last, you know,
[1:19:30] six, seven weeks that we've been here.
[1:19:32] There's, and I think we might have
[1:19:34] talked about this when we were meeting
[1:19:35] individually. There's no reason this
[1:19:37] hospital cannot be successful.
[1:19:40] >> None whatsoever. There's no reason that
[1:19:41] this place can't be successful. And it's
[1:19:43] just a matter of um knowing what levers
[1:19:46] to grab a hold of and which ones to pull
[1:19:47] and which ones to push.
[1:19:52] Long term, I would even say this
[1:19:54] hospital has one of the best payer mixes
[1:19:55] in the state.
[1:19:57] >> There's I would pay you mean
[1:20:01] >> I mean like Yeah. 25.
[1:20:03] >> Yeah. The the percentage of your
[1:20:04] patients who actually have insurance
[1:20:07] >> um commercial insurance is actually
[1:20:08] abnormally high. So it means your
[1:20:11] employers in the county a tend to have
[1:20:13] insurance for their employees and b it
[1:20:16] tends to be reputable.
[1:20:17] >> Well, I can tell you that. How many
[1:20:18] millions of dollars you have? Well, no,
[1:20:20] but I'm just saying so when when you
[1:20:23] have a, you know, a commercial air mix
[1:20:25] in Pre County like around 50%. That's
[1:20:28] like way high. That's that's good.
[1:20:31] >> And so that's one of the reasons you say
[1:20:33] this place has all kinds of opportunity
[1:20:35] to be successful.
[1:20:36] >> Yeah.
[1:20:52] Is the bank working with you too, I'm
[1:20:54] assuming, on those loans or
[1:20:56] >> Well,
[1:20:57] >> nobody's pulling the rug yet.
[1:20:59] >> No one's pulled the rug. I mean, there's
[1:21:01] uh I mean, the uh that the EDS, the food
[1:21:06] service, and the housekeeping company
[1:21:07] pulled out,
[1:21:08] >> but we took it over oursel, so that was
[1:21:11] uh Sedexo
[1:21:12] >> Marriott. Um I don't consider that a
[1:21:15] loss actually. Um we have I mean the re
[1:21:19] the risk is like your implants, your
[1:21:22] anesthesia.
[1:21:24] Um your travelers, the people nurses
[1:21:26] where you don't have a nurse and you're
[1:21:27] paying a third party company. Um you
[1:21:31] know those are those are the kind of
[1:21:34] liabilities that that if to your point
[1:21:38] no one can force us into bankruptcy and
[1:21:40] a for-profit can't force a non forprofit
[1:21:42] into bankruptcy. So, we're not going to
[1:21:43] go bankrupt because a vendor sued us and
[1:21:48] said, "We want to force you into
[1:21:49] bankruptcy." Things stop supplying you.
[1:21:52] >> Um, that's the risk I think is the next
[1:21:54] 60 days are the the days that where
[1:21:57] we're still paying out PTO for people
[1:21:59] we've released. Um, so we still have the
[1:22:03] salary expense and we don't have and the
[1:22:05] revenue is starting to come up. So these
[1:22:08] are the days that I at 60 days I feel
[1:22:11] like that monkey is going to be off our
[1:22:13] back and we're going to be in a lot
[1:22:15] better position.
[1:22:16] >> So you'll be able to do surgeries
[1:22:19] because you can
[1:22:20] >> we we're doing surgery. We're getting
[1:22:22] the stuff right now. Okay.
[1:22:23] >> But we just have to we have to it's
[1:22:27] >> an everyday meeting about who you're
[1:22:30] going to pay today. Mhm.
[1:22:32] >> So, and then you have if you have 200
[1:22:35] vendors at a hospital, there's 200
[1:22:37] people that want to talk to you and you
[1:22:38] can't do your regular job if you're
[1:22:40] talking to 200 people.
[1:22:44] » I think again, one of the indicators we
[1:22:46] would watch is that, you know, what's
[1:22:47] the balance on the line of credit? And
[1:22:49] if every two weeks it's going down,
[1:22:52] then that's a sign that you're getting
[1:22:54] more cash in.
[1:22:55] >> Yeah.
[1:22:55] >> And so, you're starting to close that
[1:22:57] gap. And again, that's that's one of the
[1:22:59] things we would watch. Yeah. and we see
[1:23:02] indication that that's what the
[1:23:03] direction we're going to be headed. So
[1:23:05] >> yeah, that's the number one. The two
[1:23:07] things I ask for every day is how much
[1:23:09] did we cash that we collect, what's our
[1:23:11] account, what's our line of credit,
[1:23:13] what's our accounts payable.
[1:23:14] >> Those three numbers control if we're
[1:23:18] making progress or not. Those are the
[1:23:19] only three numbers you have to know
[1:23:21] right now.
[1:23:22] >> Everything else is details.
[1:23:25] >> So in 60 days, you'll kind of
[1:23:30] have a better picture for your long
[1:23:32] term.
[1:23:33] >> Well, I think the long term is very
[1:23:35] optimistic. I mean, the I reviewed your
[1:23:37] Blue Cross Blue Shield contract this
[1:23:39] weekend and there's plans plenty of room
[1:23:42] for upside. I I mean, this hospital can
[1:23:45] make a lot of money. Literally can be
[1:23:48] very profitable. But to get Blue Cross
[1:23:50] and Blue Shield to sit down and like a
[1:23:52] meeting like this and discuss rates,
[1:23:55] they don't even meet with KU with North
[1:23:57] Kansas City. They don't care. This is
[1:23:59] the rate you're going to take. So, we'll
[1:24:01] have to be creative um in how we get
[1:24:04] them to the table. But, I have some
[1:24:05] ideas.
[1:24:07] >> Offer them pizza taco.
[1:24:10] >> That was on the table. [laughter]
[1:24:15] » I think that's that's part of the root.
[1:24:17] It's like there is no you can't point to
[1:24:19] any one thing and say this is why we got
[1:24:21] here because there's a bunch of reasons
[1:24:23] for that. And there's also there's not
[1:24:25] one thing that we're going to do that's
[1:24:27] going to flip the switch the other
[1:24:28] direction either.
[1:24:29] >> And I didn't mean to.
[1:24:30] >> Yeah. No, I
[1:24:31] >> and my questions about the revenue side.
[1:24:34] I just know that they were working on it
[1:24:35] and they were making progress
[1:24:38] >> before you got here. So,
[1:24:40] >> yeah. One of the things that happened
[1:24:41] too with COVID, the hospitals got a
[1:24:44] bunch of money from CO. every hospital
[1:24:46] was very healthy after COVID um through
[1:24:49] COVID and after COVID right then October
[1:24:52] of 2020 they got some big grants from
[1:24:55] the federal government and then you know
[1:24:58] the the credits that they got for um
[1:25:02] FICA and expenses like that but everyone
[1:25:06] thought that healthc care would go back
[1:25:07] to what it was before COVID in terms of
[1:25:09] volumes and the way people approached
[1:25:12] healthcare and people haven't
[1:25:14] >> and so you had to adjust bust your
[1:25:16] expenses in 21, 22, 23
[1:25:19] to the new reality. And if you didn't do
[1:25:22] that, and [clears throat] then in 24
[1:25:24] when they made a change from one billing
[1:25:27] company to another billing company that
[1:25:30] was immediately bought out, then you
[1:25:33] finally got to the right billing company
[1:25:34] in 26, April of 26.
[1:25:38] between the expense and the the expense
[1:25:42] that you thought would be what it had
[1:25:43] always been
[1:25:44] >> but shifted after COVID and the revenue
[1:25:48] cycle that happened when you went with a
[1:25:51] different billing company. Those were
[1:25:53] the two years when you got in your hole.
[1:25:56] >> So literally this is one of those things
[1:25:58] where this h this is like this hospital
[1:26:00] is a great a great swimmer. They could
[1:26:04] swim 5 miles, but if they're underwater
[1:26:06] for 6 minutes, it ain't going to be
[1:26:08] good.
[1:26:10] >> So, we just got to prevent the six
[1:26:11] minutes.
[1:26:12] >> Yeah. Gotcha.
[1:26:18] » And it sounds like you guys are working
[1:26:20] on it.
[1:26:21] >> Very much so.
[1:26:22] >> Yes.
[1:26:24] >> The the Blue Cross thing is a one to
[1:26:26] twoyear. I mean, I don't think we could
[1:26:28] get it done in a year, but I think we
[1:26:30] could get it done in two years. But it's Blue Cross. It's United. It's
[1:26:33] Sigma. It's Etna. It's every payer out
[1:26:35] there is underpaying you. By Medicare,
[1:26:38] you're recognized as Soul Community
[1:26:40] Hospital, which gives you additional
[1:26:42] reimbursement.
[1:26:43] >> So, we got to make sure we get the full
[1:26:45] advantage of that with the payers
[1:26:49] because Medicare does it automatically.
[1:26:51] >> These guys may not.
[1:26:53] >> Got to fight them for
[1:26:54] >> Exactly. So, we And maybe they're
[1:26:56] willing to automatically give you five
[1:26:58] or 8%. We need more. When we're the only
[1:27:01] hospital doing babies and practically 60
[1:27:05] miles, we got we can't be paid $5,000 or
[1:27:08] $10,000 for a baby. Maybe we need 15 or
[1:27:11] 20,000.
[1:27:13] >> And they don't. That's the thing where
[1:27:15] you're going to just have to hold the
[1:27:16] line on that.
[1:27:21] » Well, I think everybody knows dealing
[1:27:23] with insurance is never fun. So, yeah.
[1:27:33] So you guys are kind of optimistic that
[1:27:36] >> I'm very I have honestly I have no doubt
[1:27:38] if they make it through the next 60
[1:27:40] days. I I literally have no doubt
[1:27:42] >> they can take theelves out of it.
[1:27:44] >> I mean I'm I'm 98% confir
[1:27:48] >> I'm I'm 98% confident. I won't say I'm
[1:27:51] 100 because I, you know, anything I
[1:27:53] could be mis misreading something,
[1:27:56] >> but this hospital has the payer mix that
[1:28:00] typically should be making 6 to12
[1:28:02] million.
[1:28:03] So, am I confident that we could get to
[1:28:06] that? Yeah. Will it happen in time frame
[1:28:09] that we're not underwater six minutes?
[1:28:11] That's the part I'm nervous about.
[1:28:15] » I know that's what you were telling me
[1:28:17] Tuesday when I met with you.
[1:28:19] >> Yeah.
[1:28:25] questions here.
[1:28:29] » I see David's on. We might check with
[1:28:31] David.
[1:28:32] >> David, can you hear us? Or where'd you
[1:28:35] go? Oh, there you are.
[1:28:37] >> Yes. Thanks, guys. I can hear you just
[1:28:39] fine. No, I don't have any questions.
[1:28:41] really appreciate the the comments and
[1:28:45] um information that have been provided
[1:28:47] and just very encouraged uh by what I'm
[1:28:51] hearing. That's that's all good news.
[1:28:53] Very excited for the incoming leadership
[1:28:56] and welcome Brett and I just just hope
[1:28:59] that that uh continues to move forward.
[1:29:02] Looking forward to hearing about and
[1:29:04] seeing the progress.
[1:29:06] >> Thanks David.
[1:29:08] >> Frankie, you are on here. You got
[1:29:09] anything?
[1:29:14] He's muted, I think.
[1:29:16] >> Yeah. No, I don't. I think it sounded
[1:29:18] great.
[1:29:20] >> Okay. All right. Well, I
[1:29:24] >> I feel better.
[1:29:27] That's
[1:29:28] >> going the right direction.
[1:29:30] >> Yeah.
[1:29:31] >> I hope the public does, too.
[1:29:34] >> You just have to have some time to get
[1:29:36] work through all it. So we have
[1:29:40] >> in the future this time
[1:29:43] >> we have some questions Mr. Craig Newbie
[1:29:46] >> looks like more like comments.
[1:29:48] >> Yeah,
[1:29:54] he's talking about bond payment. That's
[1:30:01] 30-day eviction notice. I'm not going to
[1:30:03] do that.
[1:30:07] » And of course, he wants copies of
[1:30:10] >> Yeah, Craig. To the extent that you want
[1:30:13] to make a coral request, you're welcome
[1:30:15] to email me. You've been provided what I
[1:30:17] have, though.
[1:30:23] » I think Mr. Newbie dropped off.
[1:30:25] >> Yeah.
[1:30:26] he said he did, but
[1:30:27] >> I think we
[1:30:29] >> Okay. Does anybody else out there on
[1:30:31] Zoom have any questions or concerns?
[1:30:38] I'll give you a couple minutes here to
[1:30:39] get your questions typed. If you do,
[1:30:41] don't forget to include your full name.
[1:30:46] I have heard from around town that uh
[1:30:50] they're pretty impressed with this guy.
[1:30:54] So, I think you got the right guy in
[1:30:56] there. We did.
[1:31:02] I know. I met with him for an hour last
[1:31:05] Tuesday. I was very impressed.
[1:31:10] >> Going to do a fantastic job.
[1:31:12] >> He's got less gray gray hair than he
[1:31:14] should
[1:31:17] [laughter]
[1:31:19] looks like for Christmas.
[1:31:20] >> Yeah, exactly.
[1:31:23] when you come into these hospitals, and
[1:31:24] I'm not trying to rag on anybody, is has
[1:31:29] there been anybody this much in debt
[1:31:30] before that you've dealt with?
[1:31:33] >> Um,
[1:31:34] so the the financial situation here is
[1:31:37] worse than any other place that I've
[1:31:39] been involved with uh from the Yeah,
[1:31:42] it's like when I can't remember yours.
[1:31:45] So you have the financial piece which I
[1:31:47] think we're I have our hands around the
[1:31:51] community perception piece. I' I've seen
[1:31:53] this before.
[1:31:54] >> Um that's as difficult or more difficult
[1:31:58] to work through than the financial
[1:32:00] >> I'm sure.
[1:32:00] >> And I think that's um we're going to
[1:32:03] need a lot of folks to pull in on that.
[1:32:06] And it's just by the way it's not about
[1:32:09] it is not about the care that's being
[1:32:10] given. We actually heard from a patient
[1:32:12] whose father passed here recently at the
[1:32:15] hospital and just gave a glowing
[1:32:17] response about the staff who were taking
[1:32:19] care of that that family member, right?
[1:32:21] And so we got to make sure people um I
[1:32:24] mean you may be upset with this or that
[1:32:26] policy or change or whatever, but the
[1:32:28] folks doing the care uh just let them do
[1:32:31] their jobs. And that's that is rarely
[1:32:35] where the problems are. You know, PRMC
[1:32:38] actually um has a pretty strong
[1:32:43] sustainable
[1:32:45] consistent history of good uh quality
[1:32:48] care.
[1:32:48] >> Oh yeah.
[1:32:49] >> You guys have been recognized multiple
[1:32:51] times the organization has
[1:32:52] >> and I would really worry if that was
[1:32:55] upside down
[1:32:56] >> as well as the other things because now
[1:32:58] you have a third pot that's really
[1:33:00] difficult and that's harder to fix than
[1:33:02] the financial.
[1:33:04] >> We don't have that issue here which is
[1:33:05] good.
[1:33:06] um it allows us to focus on the
[1:33:08] financial piece and then the you know
[1:33:10] quite honestly if you want to earn back
[1:33:12] trust in the community it just takes
[1:33:13] time and you got to demonstrate
[1:33:14] consistency.
[1:33:16] >> I think financially it's more of a
[1:33:19] liquidity. So it's like you got a
[1:33:21] hundred cows and no one will buy one
[1:33:24] >> and you got to beat them and you don't
[1:33:26] have any money in the bank and so you
[1:33:30] know that's it's not really that you
[1:33:31] don't have plenty of ability to make
[1:33:35] money. It's more that you have a
[1:33:37] liquidity crisis.
[1:33:40] >> Yeah. And and to the employees I mean
[1:33:43] they're great in
[1:33:46] Do you have a question from
[1:33:48] >> with the travel staff? So, let me read
[1:33:51] the question.
[1:33:52] >> Jesse Ever says, "What can you do to
[1:33:55] depend less on the travel staff?" I'm
[1:33:57] assuming you prefer to have local
[1:33:59] employees over travel.
[1:34:01] >> Yeah. So, the answer to that is always
[1:34:03] um you'd always prefer to have your own
[1:34:05] people than the travel staff. The travel
[1:34:07] staff, they do fill a need, right? When
[1:34:09] you have a gap, they're that's the best
[1:34:11] sometimes the only and best way to do
[1:34:12] that. Uh so there's with some of the
[1:34:16] changes that were made some folks have
[1:34:17] moved into new roles and the number of
[1:34:19] travel staff at PRMC will be about half
[1:34:22] of what it was in July as we roll into
[1:34:24] September. So about half those folks are
[1:34:27] exited and out the door and then it
[1:34:29] really is you got to find the people to
[1:34:31] fill the right
[1:34:34] hospital.
[1:34:34] >> Yeah. Oh no. I mean it's the same thing
[1:34:36] everywhere. Um, but it is, you know,
[1:34:39] what can you what can you do to move
[1:34:41] people around so that you don't have to
[1:34:43] get into that
[1:34:44] >> because it's expensive a and b these are
[1:34:46] not people are going to
[1:34:48] >> be with you. I mean, they're not
[1:34:50] necessarily going to be here in six
[1:34:51] months and so that's maybe not helpful
[1:34:52] to the community. You'd rather have
[1:34:54] somebody who's here.
[1:34:57] >> How's all the physicians
[1:35:00] working to work with and working with?
[1:35:03] So I guess we can both answer this one.
[1:35:07] >> So physicians are physicians, right? I
[1:35:09] don't know that matters about the
[1:35:10] geography,
[1:35:11] >> right?
[1:35:12] >> Um
[1:35:13] >> what they're looking what they're
[1:35:15] looking for is a place where they can do
[1:35:17] be a doctor, do their thing, they get
[1:35:20] support, they get questions answered
[1:35:22] when they have questions, and they get
[1:35:23] resources. And you can kind of meet kind
[1:35:27] of the basic needs. most physicians do
[1:35:31] just great kind of doing their own
[1:35:32] thing. You guys have an interesting mix
[1:35:34] here in that you have a independent
[1:35:36] primary care group.
[1:35:37] >> Um, and it's it's actually growing.
[1:35:41] That's atypical of what you would see
[1:35:44] around the state. And so that's actually
[1:35:46] that's a huge asset that you have that.
[1:35:49] Um, you know, the biggest challenge for
[1:35:51] rural areas, and it's no different here
[1:35:53] in Pratt, is you've got some folks who
[1:35:54] are looking at retirement a handful of
[1:35:57] years out and it's the you've got to
[1:36:00] strategize now about what who you're
[1:36:02] going to replace with because recruiting
[1:36:04] physicians is not easy and it just takes
[1:36:06] a long time to train a physician. I
[1:36:08] think people always think it's 14 years
[1:36:10] for a cardiologist.
[1:36:12] >> I mean, it's just you really got to have
[1:36:14] a long runway. um even an orthopedic
[1:36:16] surgeon the residency is five years and
[1:36:18] then if they do a fellowship it's six
[1:36:19] seven or eight and so you think about
[1:36:22] that as yeah
[1:36:23] >> when you're thinking about hiring
[1:36:25] somebody you've really got to pre-plan
[1:36:27] um so you know the physicians here I
[1:36:30] would say for the most part have
[1:36:31] actually been pretty open with us about
[1:36:33] all kinds of stuff uh there's people
[1:36:36] who've got concerns you know a lot
[1:36:38] related to past things and we've tried
[1:36:40] to listen one time and then say we're
[1:36:43] going to look ahead now and for the most
[1:36:46] part I would say all the physicians are
[1:36:48] looking ahead because I think they just
[1:36:50] needed to see that and and sometimes you know quite honestly you just got to
[1:36:53] say you just got to vent and get it off
[1:36:55] your your chest and if somebody's
[1:36:58] willing to sit and listen to you do that
[1:37:00] um then it's kind of you can shift to so
[1:37:02] now what's the future they're I would
[1:37:05] say they're all very vested in what's
[1:37:07] happened in this community there's 100%
[1:37:10] we can't let anything happen to the
[1:37:11] hospital we are not going to we are not
[1:37:13] going to let our community down. I think
[1:37:15] that's I I Yeah, I I think that's 100%.
[1:37:19] >> Yeah, I've met with I think most every
[1:37:21] one of them oneon-one. Um super
[1:37:24] positive. Um there was a discussion or a
[1:37:28] rumor going around that we were going to
[1:37:30] close PMIG. We're not closing um uh
[1:37:35] Pratt Medical Internal Group. So um I
[1:37:39] think the physicians are in town.
[1:37:42] they're going to stay. They're part of
[1:37:44] the community. Um they want to help. Uh
[1:37:48] I think they want,
[1:37:50] you know, when we fix our billing,
[1:37:52] sometimes we're fixing their billing,
[1:37:53] too.
[1:37:55] >> And so, you know, maybe they have
[1:37:56] reasons to be frustrated historically.
[1:37:59] And so maybe we've maybe sometimes you
[1:38:02] just have to start with I'm sorry. And I think if you're you can really never
[1:38:07] be too humble as a hospital CEO.
[1:38:10] >> [laughter]
[1:38:10] >> He got he got me used to eating a lot of
[1:38:12] crow. So,
[1:38:14] >> you know, I think that mixes the two is
[1:38:16] that it's not
[1:38:18] >> nobody's blessed with being perfect.
[1:38:20] >> And a couple of physicians have I think
[1:38:22] they've taken ownership, you know, of
[1:38:25] that too. And that just helps. I'm not
[1:38:27] saying it solves everything. It just
[1:38:29] helps you get back to okay, so can we
[1:38:31] work this out?
[1:38:32] >> Yeah. What? Uh,
[1:38:36] I have a lot of friends in Dodge.
[1:38:39] Apparently, you guys got a clinic out
[1:38:41] there. I don't know what's going on with
[1:38:43] the hospital with Dodge, but nobody
[1:38:45] wants to go there.
[1:38:47] >> I'm a little worried about that clinic.
[1:38:49] >> I've talked to the I've talked to the uh
[1:38:52] two clinic managers over that.
[1:38:54] >> Um, we actually rent two suites of one
[1:38:57] building. We're gonna we're going to
[1:38:58] consolidate into one suite, but we're
[1:39:00] not eliminating any of the providers
[1:39:02] there.
[1:39:03] >> So
[1:39:05] changes as a way to one on our side
[1:39:08] reduce overhead. I don't know if we can
[1:39:09] really speak to the issues with the
[1:39:11] hospital and dodge other than I I also
[1:39:13] hear the same things about there's just
[1:39:15] a lot of dissatisfaction.
[1:39:17] But I don't so far for us that's not
[1:39:20] been a bad thing.
[1:39:21] [clears throat and laughter]
[1:39:21] >> Well, no, I mean I'm just telling you
[1:39:23] it's not necessarily a bad thing for us.
[1:39:25] And then some of the specialists,
[1:39:26] specifically the surgeons, have such a
[1:39:28] wide circle that they draw patients
[1:39:30] from.
[1:39:32] >> And part of this because there's not
[1:39:35] options. Yeah. Right.
[1:39:36] >> Yeah.
[1:39:36] >> Um and so that's why it's important to
[1:39:39] kind of keep those relationships,
[1:39:41] but we also have not we're not going to
[1:39:43] get involved in somebody else's
[1:39:44] problems. We got Yeah.
[1:39:46] >> enough of our own to
[1:39:48] >> take care of first.
[1:39:49] >> And I'll tell you from being I've been
[1:39:51] at three hospitals over the last 21
[1:39:53] years. I've never seen a hospital that
[1:39:57] didn't have patients that that were mad
[1:39:59] at it and people that loved it and
[1:40:02] people in between.
[1:40:03] >> And um most there's the people that are
[1:40:07] mad at it, they all think the best care
[1:40:09] is 100 miles away and the people that
[1:40:11] love it would never go anywhere else.
[1:40:13] And um the fact that it just came to
[1:40:16] Pratt is the only surprising thing.
[1:40:20] [clears throat]
[1:40:22] >> Well, I think
[1:40:26] A lot of that is just frustration and I
[1:40:29] think they'll get over that once you
[1:40:30] guys get it on the right track.
[1:40:33] At least I hope so.
[1:40:38] » Well, this has been very good
[1:40:42] to hear.
[1:40:44] We appreciate you coming in and
[1:40:46] informing the public about it.
[1:40:48] >> Yes. Our pleasure.
[1:40:49] >> Yeah.
[1:40:50] >> We're servants to you guys. We
[1:40:52] appreciate you bringing us in. I think
[1:40:53] we can make a difference for the
[1:40:55] hospital and for the community and we
[1:40:57] want to do it.
[1:41:00] >> Thank you. That's what everybody want to
[1:41:01] hear. Susan, you got a question.
[1:41:03] >> Can I ask a question?
[1:41:04] >> Susan Mayberry. I'm a business owner in
[1:41:06] town. Appreciate everything you guys are
[1:41:08] doing. I've heard wonderful things. I'm
[1:41:10] sorry that
[1:41:12] this happened, but uh I have a lot of
[1:41:15] friends that work at the hospital and
[1:41:17] they're literally physical, mentally
[1:41:21] sick and don't know their jobs at stake.
[1:41:24] I know you have to cut situations. Are
[1:41:27] they being and I'm not asking you to
[1:41:29] bring in more therapists. Are they just
[1:41:30] being talked to and treated properly and
[1:41:32] letting them there not knowing dayto day
[1:41:36] if they can survive or if they're going
[1:41:38] to have a paycheck? Well, not we do have
[1:41:41] a company that comes in I think once a
[1:41:42] week. Is it that the workforce
[1:41:45] >> workforce comes in? Was it once a week
[1:41:46] or once every two weeks?
[1:41:48] >> Once a week on Thursdays.
[1:41:49] >> But there's not the expenses that we've
[1:41:52] cut. There's not a lot of there's no
[1:41:55] deep cuts that I see that are necessary
[1:41:57] >> going forward.
[1:41:58] >> Yeah. Going forward. The cuts that have
[1:42:00] been made are the cuts that have been
[1:42:01] made.
[1:42:02] >> Thank you.
[1:42:02] >> And I also think um I mean it's an
[1:42:06] effort. Rex's making a real effort to be
[1:42:08] available to the leaders and also to
[1:42:10] Brown and be available just to talk to
[1:42:12] the staff. Yeah, I mean my experience
[1:42:14] when that's going to go further than any
[1:42:16] of us send
[1:42:17] >> I have heard a memo they're still scared
[1:42:20] that
[1:42:20] >> yeah don't send me a memo give me a guy
[1:42:22] to talk to or guy just give me somebody
[1:42:24] to talk to and I think that's what we've
[1:42:26] been trying to do is just make that
[1:42:28] availability
[1:42:30] this yeah
[1:42:32] >> this process probably got to be one of
[1:42:34] the most stressful things you can yeah
[1:42:35] take an organization through
[1:42:37] >> yes
[1:42:38] >> and it also is not immediate and we we
[1:42:41] actually talked about that internally is
[1:42:43] Um,
[1:42:45] is it better to just go like it's Friday
[1:42:48] and you know you make all these changes
[1:42:49] or do you space it out while you're
[1:42:52] thinking through things and also we have
[1:42:54] patience that we have to consider. So
[1:42:56] you can't just say we're going to stop
[1:42:57] something on Friday necessarily
[1:42:59] >> because it actually may need to be 30 or
[1:43:01] even 60 days past that Friday. But with
[1:43:03] the communication piece, um I would
[1:43:06] think most people already know um and
[1:43:09] most people know the people who've been
[1:43:11] that have lost employment
[1:43:13] >> because I don't think that's been kept
[1:43:15] like as a secret or anything. I think
[1:43:17] everybody knows about that.
[1:43:19] >> It's that working through piece is a
[1:43:21] little weird in our industry.
[1:43:24] >> It's probably paranoid still.
[1:43:25] >> Well, yeah.
[1:43:27] And somebody may have been told two
[1:43:28] weeks ago that your position is going to
[1:43:30] end three weeks from now and they have
[1:43:33] to keep working,
[1:43:34] >> right?
[1:43:35] >> Which is also different than a lot of
[1:43:36] other industries where, you know, if
[1:43:38] you're one of the factories in Witchaw,
[1:43:39] you get your notice and you're done that
[1:43:41] day.
[1:43:41] >> Yeah.
[1:43:42] >> And in our world, it typically doesn't
[1:43:44] work that way. And it's just by virtue
[1:43:46] of we've got people we need to take care
[1:43:48] of and or find them a new place to get
[1:43:50] care.
[1:43:51] >> Yeah. So, I think we made the changes up
[1:43:53] front in general. And I think now it's a
[1:43:56] matter of making sure those changes get
[1:44:00] implemented. But um just helping people
[1:44:03] find opportunities, work smarter, not
[1:44:06] harder. Um you know, in a rural
[1:44:08] hospital, you have a ton of you wear a
[1:44:10] lot of hats. I worked at a 25 bed
[1:44:12] hospital up to a 285 bed hospital and
[1:44:15] it's great. in a 285 bed hospital
[1:44:18] because you got somebody for every title
[1:44:19] in the world and in a 25 bed hospital
[1:44:22] you may have four people with those
[1:44:24] titles and so um I do think people are
[1:44:28] stressed out but I see a big I
[1:44:31] [clears throat] see a big change in the
[1:44:33] three this is my third week coming so
[1:44:35] ninth day um I meet daily with managers
[1:44:38] and directors and um I think they feel
[1:44:41] very encouraged when you hear that you
[1:44:43] had your best cash day that you've had
[1:44:44] all year long and that you're now at 95%
[1:44:48] clean claims instead of 45.
[1:44:51] You know, things in a sense kind of
[1:44:53] happened quickly in terms of the two
[1:44:55] years of billing. It wasn't like this
[1:44:58] slowly happened over 10 years. And so it
[1:45:02] kind of happened quickly in a sense. And
[1:45:04] so the changes have had to be kind of
[1:45:06] quick because of the liquidity
[1:45:07] situation. And I would the way I would
[1:45:10] describe it is like
[1:45:12] for whatever reason some people like you
[1:45:14] know I'm not like this but some people
[1:45:17] would rather have 20,000 in their
[1:45:19] checking account and $20,000 on their
[1:45:22] credit card because they like to have
[1:45:24] cash even though they're paying a high
[1:45:25] credit interest rate and some people
[1:45:28] like to have zero cash and 20 zero
[1:45:31] credit card balance. The hospital for a
[1:45:34] long time had if you even look back five
[1:45:37] years had kept a fairly high accounts
[1:45:40] payable balance where they were taking a
[1:45:43] little bit longer to pay people just as
[1:45:44] a way of that's just was the preference
[1:45:47] of some whoever was you know at that
[1:45:50] time. So when you have like a 40-day hit
[1:45:54] to your cash or a 60-day hit to your
[1:45:57] cash if you're at zero accounts payable
[1:45:59] and you have a hit you go to 60 days. If
[1:46:02] you're at 60 days, then you have a
[1:46:03] 60-day hit, you're at 120 days. And so,
[1:46:08] because of the way that we'd kind of
[1:46:11] managed accounts payable in the past, it
[1:46:14] created more stress when there was a
[1:46:16] liquidity crisis.
[1:46:21] I guess my only other comment too would
[1:46:23] be is
[1:46:24] organizations get into trouble when they
[1:46:26] don't react to the environment changing
[1:46:30] and you stay out of trouble is if
[1:46:32] there's some other something else
[1:46:33] happens whatever in the environment
[1:46:34] PRMC's just needs to really respond to
[1:46:37] that in the moment and not wait and and
[1:46:41] so there that's why there may always be
[1:46:43] future changes
[1:46:44] >> of course
[1:46:45] >> 100% opportunity for that
[1:46:47] >> but it's the what's the learning is is
[1:46:49] to help everybody everybody um
[1:46:52] specifically in leadership understand
[1:46:54] that part of my role is to respond and
[1:46:56] always be reading the environment
[1:46:58] because it can be a good read because
[1:47:00] you're going to get 3% this year from
[1:47:02] Blue Cross instead of two or it could be
[1:47:04] a bad read and that there's an employer
[1:47:06] locally who goes out of business and so
[1:47:08] that you have x more people that don't
[1:47:10] have insurance. I mean, he says, "What
[1:47:12] are you doing to always be flexible and
[1:47:15] respond to what's going on in the world
[1:47:16] around you?" And in healthcare, that can
[1:47:18] be at federal, state, county.
[1:47:21] >> Yeah.
[1:47:21] >> Or across the street level. You just
[1:47:23] have to always be ready to respond to
[1:47:25] that and not just kind of sit and hope
[1:47:27] it's going to get better, you know?
[1:47:29] >> Right. There's things and I'll just add
[1:47:31] this just um you know our sometimes like
[1:47:35] you some businesses have different
[1:47:37] philosophy about how often they raise
[1:47:40] their their prices. Like sometimes you
[1:47:43] might think well I'm going to do 2%
[1:47:45] every year for the next four years and
[1:47:47] that'll be 8%. Other people are like I'm
[1:47:49] not going to do anything because I don't
[1:47:50] want people to complain that I'm always
[1:47:52] raising prices. I'll just do it every
[1:47:54] four years. Take the hit then raise
[1:47:56] prices 8%.
[1:47:58] Sometimes when I look at your guys's
[1:48:00] cost report, which is basically your tax
[1:48:02] return, you have areas where Medicare
[1:48:05] will pay you the greater of whatever you
[1:48:07] charged or whatever the allowable is.
[1:48:11] Sometimes your charges are below your
[1:48:13] allowable. So, we need to raise rates
[1:48:16] and that's something needs to just I
[1:48:19] think best practice is annually. Um, and
[1:48:22] so there's there's things on the revenue
[1:48:25] cycle that are related to how much we
[1:48:27] charge for things too that we need to
[1:48:29] that we're focused on. So I mean there's a thousand moving parts in a
[1:48:35] hospital. That's why you do it for 28
[1:48:37] years and you still learn new things.
[1:48:39] Um, so, uh, I think we'll, we're
[1:48:43] definitely on the road to recovery and I
[1:48:45] think everyone's gonna, if we get
[1:48:47] through the the PTO payouts over the
[1:48:50] next 60 to 90 days, whatever they are,
[1:48:53] and get to the other side, I'm very
[1:48:55] optimistic.
[1:48:57] >> Thank you. Thank you for all you're
[1:48:58] doing.
[1:49:00] >> Terry Williamson, community member, um,
[1:49:04] what what do you see? You know, I know
[1:49:06] you mentioned 17.3 give or take. Yeah,
[1:49:09] I'm a numbers guy.
[1:49:11] >> What are you looking at like six months
[1:49:13] and 12 months down the road?
[1:49:15] >> What What would you like to see that
[1:49:16] number decrease to?
[1:49:18] >> Oh, man. That's a tough
[1:49:19] >> I know. Zero, of course, but that's
[1:49:21] >> that's not going to happen.
[1:49:23] >> right? Well, what I would do is I would
[1:49:25] try and if I let's say in 17 if I'm at
[1:49:29] 17, let's just use 17 and let's say I
[1:49:32] could get it down to 15. What I would do
[1:49:35] is I would leave the money on the line
[1:49:36] of credit near the five million and pay
[1:49:39] down my accounts payable so I could get
[1:49:41] my vendors so that they would see
[1:49:43] progress first. So I think
[1:49:45] realistically,
[1:49:47] you know, six months you you're going to
[1:49:49] still have payouts. You really only have
[1:49:50] four months of, you know, expense
[1:49:54] benefit. I think your expense benefit
[1:49:56] could be around a quarter million a
[1:49:58] month. So you're looking at a million
[1:50:00] dollars there. I think on the revenue
[1:50:02] side you should have at least I think on
[1:50:04] the revenue side you could have even
[1:50:06] just with the tweaks we're making at
[1:50:08] least a quarter million. So I think you
[1:50:10] could have at least 2 million less. I
[1:50:13] mean that would kind of be my goal
[1:50:14] >> in six months.
[1:50:16] >> Yeah because that's really just mostly
[1:50:18] that's that's mostly really just four
[1:50:21] months of impact.
[1:50:22] >> Look at starting now crazy.
[1:50:23] >> Yeah.
[1:50:25] >> Well the I mean like we still have PTO
[1:50:28] our big PTO we have a $60,000 PTO
[1:50:30] payout. September 3rd. So you still have
[1:50:33] big expenses.
[1:50:34] So on the salary side, even though we've
[1:50:37] made the adjustments, you don't really
[1:50:39] get the benefit
[1:50:41] because we when people leave, you pay
[1:50:43] out the PTO.
[1:50:44] >> So with this path, they could take 10
[1:50:46] years to zero out.
[1:50:48] >> Not to say no, not at all.
[1:50:49] >> I don't think it'll be it won't be 10
[1:50:51] years. No, I think you could get Yeah, I
[1:50:53] think the big thing is your Blue Cross
[1:50:55] and your commercial insurance if you and
[1:50:58] I think that'll take not less than one
[1:51:01] year. Hopefully, not more than two
[1:51:03] years. You could see increases from your
[1:51:06] managed care plan. You know, you would
[1:51:08] negotiate for like a threeyear because
[1:51:10] they won't be able to swallow like a 21%
[1:51:13] in one year. Then maybe they maybe they
[1:51:15] can, but they probably be they may not
[1:51:17] approve that, but they might agree to
[1:51:19] three three sevens.
[1:51:21] So you get them 21% increase over three
[1:51:24] years. So you do three-year contracts.
[1:51:26] So then you you don't do those all on
[1:51:29] the same day. So that if you have to
[1:51:30] terminate one, you're not get you're not
[1:51:33] putting yourself at risk all on one day.
[1:51:36] >> So you got to be smart about those
[1:51:38] contracts. Say one, one's a two-year,
[1:51:40] one's a fouryear, one's a threeyear, and
[1:51:43] you negotiate for longer term contracts
[1:51:46] that get you where you want to be.
[1:51:48] They'll say, "We can't get you there the
[1:51:50] next year." You say, "Can you get me
[1:51:51] there in four years, three years?" And
[1:51:54] so, you got to kind of you just to get
[1:51:56] them to the table, it's going to take
[1:51:58] six months and they will play go fish
[1:52:01] forever if they can. You may have to go
[1:52:04] non-participating with some of the
[1:52:06] insurance companies, which will make um
[1:52:10] members nervous. They'll send a letter,
[1:52:12] you can't go to the hospital anymore.
[1:52:14] They'll try and scare the members. So,
[1:52:15] we have to have a whole strategy around
[1:52:17] that. That's not just something you just
[1:52:19] like send a letter and just figure, you
[1:52:21] know, we'll figure it out when it
[1:52:22] happens. It's a whole strategy. But that
[1:52:25] strategy is probably worth $15 million a
[1:52:28] year when it's all done. But when it's
[1:52:32] all done, it's probably four years from
[1:52:33] now. But that's how you get to 6 to 12
[1:52:36] million a year.
[1:52:44] » Does that work real good? When's our
[1:52:46] next when's our next hospital update
[1:52:48] like a meeting like this?
[1:52:52] >> Well, we haven't talked about that, I
[1:52:54] guess.
[1:52:56] >> Question.
[1:52:57] >> Yeah, I see that. Yeah, Jesse Ever, but
[1:53:01] I think we already covered that. Will
[1:53:03] there be any more layoffs?
[1:53:07] I mean there's I mean I got ideas that
[1:53:11] will like of implementation of um like I
[1:53:15] don't want to name specific jobs but
[1:53:17] things that AI will replace
[1:53:20] that it it really I hate to say it AI is
[1:53:23] one of those kind of dirty words where
[1:53:25] it's like
[1:53:27] no one wants to use it but everybody
[1:53:28] uses it you hate it and you love it and
[1:53:30] um but those aren't like 20 FTS 10 FTs 5
[1:53:34] FTS That's one here, one there.
[1:53:37] >> It's but it's things that make you more
[1:53:38] efficient where you're using five people
[1:53:41] before maybe now you know only need four
[1:53:43] because the technology makes it better.
[1:53:46] So will there be more layoffs as
[1:53:49] technology evolves.
[1:53:51] >> I think it pretty gets back to you got
[1:53:53] to respond to the environment. So if
[1:53:54] volume shifts out of a program then
[1:53:56] you've got to look at how you resource
[1:53:58] the program.
[1:53:59] >> I don't know. So I think layoffs that
[1:54:03] word has a certain connotation like
[1:54:04] you're going to have this date and a
[1:54:05] bunch of people lose their jobs versus
[1:54:07] what's quite honestly more normal is
[1:54:10] that people are responding to what's
[1:54:12] happening in their market. They're
[1:54:13] either adding or losing or shifting
[1:54:15] resources. That's what people typically
[1:54:17] would do.
[1:54:19] >> And so you know with people leaving you
[1:54:22] have folks who we terminate for cause.
[1:54:25] There's people who resign on their own.
[1:54:27] >> Yeah. And then you have this adjustment
[1:54:30] um when things are like what we've had
[1:54:32] to do because things were out of kilter
[1:54:34] and then you just have what's I would
[1:54:35] say more normal run-of-the-mill. This
[1:54:37] came up.
[1:54:38] >> Yeah.
[1:54:38] >> Uh we have a new ability to do this
[1:54:40] differently and so we now used to have
[1:54:42] four people doing it. Now we only need
[1:54:43] three.
[1:54:44] >> And so arguably is that a layoff of one?
[1:54:47] Okay. Maybe depend on what terminology
[1:54:49] you want to use. I just think that's to
[1:54:51] me is just more normal.
[1:54:52] >> Yeah.
[1:54:53] got to be more efficient.
[1:54:55] >> I think just take advantage of what is
[1:54:58] available. That's
[1:55:00] >> yeah a good example of that and we have
[1:55:02] one of their one of our AI ideas is
[1:55:05] probably maybe save us two FTEs but we
[1:55:08] have to an opening for those two people
[1:55:10] somewhere else and I told them to go
[1:55:12] talk to them first before we fill it
[1:55:16] externally. We're never going to try and
[1:55:18] fill a position externally that we can
[1:55:20] move someone internally. We don't
[1:55:22] >> we want people losing a job. That's not
[1:55:24] what
[1:55:24] >> some of the people who are in the roles
[1:55:26] that were eliminated are [clears throat]
[1:55:28] actually the ones who are now taking
[1:55:29] some of the contract nurse jobs and so
[1:55:31] we're getting rid of the contractors.
[1:55:32] We're keeping the people there. There's
[1:55:34] some retraining that we're doing and
[1:55:36] we're funding uh the hospital is but
[1:55:39] it's just a way of so arguably who got
[1:55:41] laid off? Well, ultimately the contract
[1:55:44] person.
[1:55:45] >> Yeah, that's right. So I mean again it
[1:55:46] all depends on some of the semantics I
[1:55:48] know but it's kind of like so what is
[1:55:50] actually happening
[1:55:53] >> I know some of them are going to go to
[1:55:56] work for family practice too I think
[1:55:58] they have
[1:56:00] interest in hiring a few of them.
[1:56:02] >> Yeah.
[1:56:02] Hopefully we would want people to
[1:56:04] find placement here.
[1:56:06] >> Yeah sure. I think there with the
[1:56:08] contract positions that were open, there
[1:56:10] was plenty there was there's been plenty
[1:56:12] of positions open
[1:56:14] if you want to work ICU, med surge, the
[1:56:18] floor surgery, would you have to train
[1:56:21] in that department for six months before
[1:56:23] you felt before you released from to do
[1:56:26] that job independently? Probably did.
[1:56:30] But we offered them those jobs. Some
[1:56:31] people I mean and there's I'm I'm not
[1:56:34] criticizing people that didn't take
[1:56:36] those jobs. Some of those jobs are
[1:56:37] 12-hour shifts. People have kids. They
[1:56:39] can't work 12 hours. Some people
[1:56:41] sometimes those jobs mean you got to
[1:56:43] lift patients. Some people can't lift
[1:56:45] patients, you know. So, we're not
[1:56:48] looking to really um even the people
[1:56:51] that have left we had there and there
[1:56:54] will be on average probably seven I
[1:56:55] would I don't know what the hospital
[1:56:56] turnover is. Most hospitals if you're at
[1:56:58] 10% you're doing pretty good. So over
[1:57:00] the next 12 year, next year you're going
[1:57:02] to lose 20 people just to to normal
[1:57:06] turnover.
[1:57:06] >> Yeah. In Kansas, the hospital turnover
[1:57:08] is just under 20%.
[1:57:10] >> Okay.
[1:57:10] >> So
[1:57:11] >> yeah. Yeah. I mean, yeah, 10%'s ideal.
[1:57:14] >> 20 to 50 people leave just naturally in
[1:57:16] a year. I you always try to hopefully be
[1:57:18] less than that, but
[1:57:23] » yeah. So, I'm not optimistic that people
[1:57:25] I don't think very many people will lose
[1:57:27] their job because they didn't have a
[1:57:30] choice. People lose their job because
[1:57:32] they don't want the choice.
[1:57:38] » Okay.
[1:57:42] » You think we can have another meeting
[1:57:43] like this in 30 days?
[1:57:45] >> Hey man, when you guys when you guys
[1:57:47] call the call us to the mountain,
[1:57:50] Muhammad shows up.
[1:57:54] I think this has been beneficial for
[1:57:57] everyone, but including the public. I
[1:57:59] appreciate you guys coming in and
[1:58:01] talking through everything.
[1:58:03] >> We get a lot of questions.
[1:58:05] >> Yeah, we didn't have answers. So,
[1:58:08] hopefully we got the answers.
[1:58:11] >> It might maybe like an early October or
[1:58:13] something. That might
[1:58:14] >> I guess I'm trying to think timing wise.
[1:58:16] >> I'd say 60 days. I'd do 60 days just so
[1:58:18] I'll have I told you I was I told Morgan
[1:58:21] 60 to 90 and I think that's kind of the
[1:58:23] more of the timeline but I think 60 to
[1:58:25] 90 days we're gonna I'll be able to tell
[1:58:27] you who's rolled off how what are where
[1:58:29] we're at on expenses. I'm going to
[1:58:31] create a little dashboard that I'll
[1:58:33] share with you guys if you want that
[1:58:35] I'll show you kind of like because there
[1:58:38] was there were plenty of warning signs.
[1:58:41] So I'm going to create a dashboard so
[1:58:42] that you won't there won't be any
[1:58:44] mysteries.
[1:58:45] >> Okay. You won't have to look through a
[1:58:47] 100 pages. You'll look at one page and
[1:58:49] know if the warning ch signs are
[1:58:50] flashing.
[1:58:52] >> Oh, we appreciate that.
[1:58:54] >> Yeah. The simpler the better because I
[1:58:56] don't
[1:58:59] » I don't want to.
[1:59:00] >> Yeah.
[1:59:03] » I appreciate you guys the work you're
[1:59:05] doing.
[1:59:07] >> Appreciate it. Thanks.
[1:59:10] We'll probably be in touch on the
[1:59:14] credit deal whenever we hear back from
[1:59:18] >> cancel.
[1:59:20] >> Okay, sounds good.
[1:59:22] >> Thanks, guys.
[1:59:22] >> Thank you very much.
[1:59:23] >> Thanks, Tyson. Thanks, Rick. Thanks,
[1:59:24] Mor.
[1:59:25] >> Thank you.
[1:59:32] » Thanks.
[1:59:36] Anybody
[1:59:44] have anything else?
[1:59:52] » Second move and second weird. All in
[1:59:55] favor say I.
[1:59:56] >> I oppose. Same side with your arms.