[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.

Pratt County Commission Meeting 8/24/2026

Transcript