REDWOOD COAST MEDICAL SERVICES, INC BOARD OF … · • Vote to appoint new committee members: Jim Nybakken, Naomi Schwartz, and Susan Sandoval • Vote to approve corrections to

The mission of the Redwood Coast Medical Services is to provide high quality, family-oriented, community based primary care, including a broad range of preventive health services, to residents and visitors within the coastal areas of Southern Mendocino and Northern Sonoma Counties. Services are designed to meet identified needs of the communities served, are integrated with other existing health care services and systems and are evaluated on a regular basis to assure that community health needs are being met. As a non-profit corporation receiving public funds, RCMS provides services to qualifying individuals on a sliding fee scale as well as to patients with MediCal and MediCare coverage, private insurance or self pay status. RCMS plays a special role as the sole provider of medical care in the community and in responding to public health emergencies.

REDWOOD COAST MEDICAL SERVICES, INC BOARD OF DIRECTORS

MEETING AGENDA Zoom Online Meeting

Wednesday, May 27th, 2020

5:00 PM – 7:00 PM

Order of Business

Business Item Person Vote Required

Page #

5:00 pm Review and Approve Agenda Vanessa Ignacio Vote Page 1

5:01 pm Vote on acceptance for the Minutes of April 29th, 2020 Vanessa Ignacio Vote Page 2-4

5:02 pm FINANCE COMMITTEE REPORT • Approve April Financials

• Update on draft 20-21 Budget

Angela Robinson Alex Long Ara Chakrabarti

Vote Page 5-23

5:17 pm CEO REPORT

• Staffing and recruitment Update • Update on COVID-19 stimulus funding

Ara Chakrabarti

Page 24-27

5:32 pm MEDICAL TEAM REPORT

• Update on clinic operations

Leon Koenck

5:52 pm HUMAN RESOURCES REPORT • Approve Telecommute/Remote Work policy

Arlene Peterson Vote Page 28-34

5:55 pm PERFORMANCE IMPROVEMENT COMMITTEE REPORT • Initial review of Claims Management policy

• PJ LoDuca is the newly appointed QI director

Donna Yates-Johnson Page 35-37

6:05 pm EXECUTIVE COMMITTEE REPORT • Vote to appoint Gabriel Ramirez as Vice-Chair until annual election

• Vote to appoint new committee members: Jim Nybakken, Naomi Schwartz, and Susan Sandoval

• Vote to approve corrections to the RCMS Bylaws section 4.2 line 4, and section 5.4.2 to 5.2.7

• Report on closed session of May 17, 2020

• Vote on changing officer elections to August for the 20-21 term

• Discussion on officer nominations for 20-21: o Rich Hughes, Board Chair o Leslie Bates, Vice-Chair o Drew McCalley, Treasurer o Janis Dolphin & Barbara Fast, Secretary

Vanessa Ignacio Votes Page 38

6:45 pm PUBLIC COMMENT

7:00 pm Adjourn Vanessa Ignacio

RCMS Board of Directors Meeting

May 27, 2020 Page 1

Redwood Coast Medical Services, Inc.

Board of Directors Meeting – Zoom Online Meeting Meeting Minutes of April 29, 2020

Guests Attending: Geoffrey Beaty, Kristen Winant, Francoise Bray, Jean Ohman, Beverly Jones, Trish Miller,

Sharon Burningham, James Nybakken, Caroline Ducato, Andrea Lunsford, David Robertson, Terry Pfardresher, Lu

Lyndon, Christine Kreyling, Leigh Mueller, Nancy Smith, Nancy Gastonguay, Frederic Kelley, Lynne Teismann, Paula

Smith, Jennifer Smallwood, Martha Campbell, Debora Ages, Mary Alinder, Colette Coad, Donna S, Julie Bower,

Naomi Schwartz, David Kieffer, George Provencher, Rich Hughes, Barbara Canida, Leslie Bates, Janis Dolphin, Drew

McCalley, Dave Turner

CALL TO ORDER: Vanessa Ignacio called the meeting to order at 5:00 pm. Brief housekeeping for zoom meeting format.

APPROVAL OF AGENDA: The packet of documents for the meeting had previously been made available to the Board by e-mail and to the public on the web page. The published Agenda was approved with the addition of Drew McCalley as a prospective returning board member. After review and modification, Nik Epanchin moved to accept the agenda, Donna Yates-Johnson seconded. Vote: all ayes. APPROVAL OF MINUTES: After review and modifications, Donna Yates-Johnson moved to accept the

minutes of January 14, 2020 and February 11, 2020. Don Kemp seconded. Vote: all ayes.

EXECUTIVE COMMITTEE: Vanessa presented

• Future meetings will be held on the fourth Wednesday of the month from 5-7 PM. The meetings will be held on Zoom until further notice.

• Motion to approve the appointment of: Janis Dolphin, Barbara Canida, David Keiffer, Rich Hughes, Leslie Bates, George Provencher, and Drew McCalley

Donna Yates-Johnson moved to approve the appointment of all 7 applicants to the RCMS Board of Directors. Nik Epanchin seconded. Vote: all ayes.

• Motion to approve the Paycheck Protection Program loan for $1 million

Donna Yates-Johnson moved to approve proceeding with the application for the Paycheck Protection Program, Nik Epanchin seconded. Vote: all ayes

CEO REPORT: Ara Chakrabarti, CEO The CEO reported that Dr. Mark Kal, CMO, is on extended leave. His patients have been notified in

person or will be by letter or when they call for an appointment. During his absence, a CMO Team has

BOARD MEMBER P A/E BOARD MEMBER P A/E STAFF PRESENT

Alex Long X Gabriel Ramirez X Arlene Peterson Leon Koenck

Nik Epanchin X Rich Schimbor X Renee Kaucnik Jessie Ewing

Barbara Fast X Donna Yates-Johnson X Tom Bertolli

Sophia Mitchell X Mark Kal

Vanessa Ignacio X Dawn McQuarrie

Don Kemp X Ara Chakrabarti

Carolyn Abst X Angela Robinson

Karen Wilder


May 27, 2020 Page 2

been identified which includes, Dr. Tom Bertolli and PAs Leon Koenck, Harold Ewing and Barb Brittel. Dr.

Bertolli is working on lab and other “system” issues as well as telehealth. Jesse Ewing is focusing on

schedules and appointments, and Barb and Leon are managing Urgent Care and RCMS’ response to the

Corona Virus pandemic. The entire staff meets daily for a “huddle” to plan the day. Shaye Laurie, NP;

Jessi Maness, LCSW; and a new phlebotomist have all been hired.

Covid-19 Preparations: Presently all patients are being triaged by phone and in person to determine

where or how they should be seen. Urgent Care and Respiratory patients are seen at the Gualala clinic

building. All exam rooms have new ventilation and preparations have been made for a possible surge in

cases in May or June. RCMS is coordinating with CLSD, the Fire Department and the Mendocino County

Public Health Department. RCMS has access to two federal disaster trailers. Only dental emergencies

are being seen at this time. RCMS was designated as one of only two places in the county for testing of

high risk individuals. Providers and the Urgent Care staff were tested in addition to first responders, fire

fighters, grocery clerks, nursing home and some homeless persons. Results should be available soon.

Any positive cases will result in contact tracing.

Primary Care has been significantly impacted by the pandemic. The number of visits has been reduced

by 90% which has greatly reduced the revenue created. To reduce the estimated loss of $150K per

month, costs have been reduced and some staff have been furloughed or had their salary and hours-

worked reduced. Facilities are available to see primary care patients in a safe environment, separate

from Urgent Care. Providers are available to see patients at the Sea Watch building in Gualala and at

the Point Arena Medical Clinic. Telehealth is also being utilized. Telephone conferences are being held

and paid for. Presently Medicare requires that for payment computerized telemedicine also must be

used. Efforts are underway to encourage visits by both modalities and an ad campaign is currently being

used to encourage patients to receive needed primary care.

Ara reported that all possible grant applications have been submitted. RCMS received $660K in federal

funds that can only be used for CV-19 services. An Economic Injury Disaster Loan for $10K, and a

Medicare loan for $50K have been requested. In addition, a Paycheck Protection Program (PPP) loan

from the Small Business Administration for $500K has been requested. Some of these loans may be

“forgiven”; some may need to be paid back over a long period of time with low interest rates. As a result

of all of the grant funds along with the generous donations from the community, the multi month net

“cash flow” for RCMS at the end of March is $270K and it is expected that the cash flow will still be

positive at the end of the fiscal year in June. Ara said that the RCMS Team is doing a great job and he

thanked the community for tremendous support. He especially thanked the Forum Four, Peggy Berryhill

and KGUA and Caroline Ducato for their input and support.

FINANCE COMMITTEE REPORT: Alex Long, Treasurer Alex Long, Treasurer, provided a detailed financial report for January, February and March. He pointed out that the $618K Riopelle Fund and the $660K federal funds have not yet been used. Key points of the report included: 1) Revenue significantly reduced by effect of the pandemic but offset by the amount of donations by the community 2) The result of which was an available cash balance of $371K. On behalf of the Finance Committee, Alex Long made the recommendation for the board to accept the January, February and March 2020 financials as presented. Vote: All ayes.


May 27, 2020 Page 3

MEDICAL TEAM REPORT: Leon Koenck, PA Personal Protective Equipment (PPE) is being used and recycled carefully. Test kits for CV-19 are still in limited supply. Dr. Bertolli praised the PAs for their work. He said that work needs to be done to make all systems work efficiently. He especially thanked Karen Wilder and Sophia Mitchell for their efforts to upgrade the web page.

OUTREACH COMMITTEE REPORT: Dawn McQuarrie, Development and Outreach Director There are two new grants to consider. CADRE, Capital Assistance for Disaster Response and Recovery Efforts, a HRSA grant, would include funds for disaster supplies, and the Telehealth Network Grant Program (TNGP) could provide funds to improve patient access by telehealth. It was moved by Donna Yates-Johnson and seconded by Nik Epanchin, that the Board authorize application for the grants. Vote: all aye. Surveys regarding Patient Centered Medical Health (PCMH) will be sent out. Be Our Guest resulted in $40K net funds and there is an ad campaign underway for Giving Tuesday on May 5. Janis Dolphin asked if it is being made easier for supporters to make monthly donation by credit card. Ara reported that he is working on that.

PERFORMANCE IMPROVEMENT COMMITTEE REPORT: Donna Yates-Johnson, PIC Committee Chair The annual Risk Management Report was received by the Board in January.

On behalf of the Performance Improvement Committee Donna Yates-Johnson made the recommendation for the board to approve the Management of Newborns policy as presented. Vote: All ayes.

A renewal application for Patient Centered Medical Home designation is underway but struggling with the difficulty of extracting data from Next Gen and i2i. Donna thanked many people who have provided food for the staff during the pandemic.

CLOSING REMARKS: Vanessa Ignacio reported the budget process for 2020-2021 is underway and needs to be finalized by June. Election of Officers also occurs in June. Further discussion about this will be on the agenda for the May meeting.

PUBLIC COMMENT: An opportunity was provided for the 56 participants in the meeting to ask questions. Paula Smith asked

about a possible newsletter. It was reported that an e-mail campaign is underway. RCMS has access to

1,200 e-mail addresses to which news and requests for donations can be made. A question was asked

about security after hours particularly for tents that have been erected on RCMS grounds. Ara reported

that all tents are empty at night. One complicated question will be answered by phone by Vanessa.

Several members provided testimonials on the excellent care they have received at RCMS and they

encouraged everyone to let the community know that RCMS is open for primary care.

Vanessa thanked Don Kemp for facilitating the Zoom meeting.

Adjournment: The meeting adjourned at 7:00 pm. The next meeting will be held on Wednesday, May

27, 2020, 5:00-7:00 pm, again by zoom.

Barbara Fast, for Rich Schimbor Board Secretary, RCMS Board of Directors


May 27, 2020 Page 4

RCMS

Finance Committee (FINCOM) May 22, 2020: 1:00 – 3:00pm

Agenda

1. 1:00pm -- Call to order

2. 1:00pm -- Review and approval of agenda

3. 1:00pm -- Review and approval of minutes of 04/24/2020

4. 1:10pm – Review of Cash Flow Projections for Apr – Alex/Ara

5. 1:20pm -- Review of April financials – Angela

• Narrative discussion

• Details by Department

• BOD Summary

6. 1:45pm – Discussion of COVID Stimulus Use – Ara

• Monies received

• Plan for determining how to use these funds

7. 2:00pm – Discussion of 2020/2021 Budgeting Plan – Ara, Angela

• Initial cut

• How to deal with current uncertainties

• Discussion of areas needing additional research, goals, metrics, and incentives


May 27, 2020 Page 5

Finance Committee (FINCOM)

Meeting Minutes

April 24th, 2020

Present: Alex Long, Don Kemp, Geoff Beaty, Rich Schimbor, and Nik Epanchin, Michael Tilles

Staff: Ara Chakrabarti, CEO, Angela Robinson, WIPFLI (contracted CFO)

BOD: Vanessa Ignacio, Carolynn Abst

Guests: Rich Hughes, Leslie Bates, George Provencher, Janis Dolphin, David Kieffer, Julie

Bowers

• Meeting called to order at 1:00pm by Alex Long

• The suggested agenda was reviewed and amended to include: discussion of the

planned budgeting schedule. It was: APPROVED

Minutes of the March 23rd meeting were reviewed and approved without change

Status Update by Ara Chakrabarti (highlights of his presentation are attached)

• At the start of the COVID-19 crisis the patient visits dropped by 80-90%

• To deal with revenue loss the clinic focused on three things:

o Reducing costs (dental cut back to two half-days for emergency visits)

o Increase clinic visits by tele-health and to buildings away from COVID screening

o Seek extra government funding (have received $667k from HRSA)

• In response to questions Ara indicated that Mar/Apr COVID-19 related costs could be

paid for from the relief grants.

• We may or may not get any of the payroll relief funds for small businesses

• PPE costs have risen dramatically but we seem to be able to get what we need.

• Mendocino surge is projected to occur in June so clinic may need to remain in

emergency mode through July.

• The staff is stressed but they have gone out of the way to help each other


May 27, 2020 Page 6

Review of the Cash Flow Projections for March, 2020

• A brief reinforcement by Alex of what Ara said in his presentation.

Financial Review for February presented by Angela Robinson

• The ratios were generally improved for Mar relative to Feb.

• Angela explained our payments to MediCal and others for paying down our near term

debt (MediCal will allow us to delay payments for May and Jun)

The recommendation to the Board that they accept the March 2020 Financial Statements

as presented was approved by the FC. Vote: All Yes

Budgeting Schedule for 2020/2021 was discussed again

• The UC budget will be sent to CLSD in May. It will need to be reviewed by RCMS BOD

before being finalized.

• The key budgeting paraments will be discussed with FC at the May meeting.

• Ara is proposing that we adopt a budget realizing the uncertainty caused by the COVID-

19 crisis. He suggests that each month we then have an additional set of columns in

which the revised estimate for future months is updated.

• The focus will continue to be on maintaining cash flow viability.

• Rich suggested that the budget consider incentive provisions

Next FC meeting will be held May 22, 2020 from 1:00 to 3:00

Adjourn: The Finance Committee Meeting adjourned with an outside interruption at 2:15


May 27, 2020 Page 7

REDWOOD COAST MEDICAL SERVICES. INC. APRIL 2020 FINANCIAL NARRATIVE Below is a summarization of key trends, ratios and analyses based on the April 2020 finance data detailed in the Statement of Financial Position, Statement of Activities, and information from the summary site reports. Financial overview Cash position - The cash and investments position as of April was $2,033,067 and the prior month’s ending balance was $984,651. For a monthly comparison, the April balance increased $1,048,416 or 106.5% against the prior month’s ending balance. The current month of April, compared with April of the prior year, represents an increase of $807,227 resulting from PPP loan and Cares funds received in April, which are shown as a loan and deferred revenue. The projected plan showed a cash position of $847,000 at April 30, 2020. Patient service revenue - The patient service revenue for April was $145,779 and in March it was $111,284. A variance against the budget due to lower-than-budgeted productivity/visits, with all payor types being under budget, compounded by the COVID-19 pandemic. The projected plan showed $125,000 for April, actual exceeded the plan by $25,000. Stimulus/Grants funds - Grant and other revenue for April was $317,809, Partnership 2019 QIP revenue was adjusted to the actual payments received in April. Additionally, in April the unbudgeted Federal Covid-19, Cares and the SBA Stimulus grant revenue was recognized. The projected plan was $850,000 which included $625,000 for Cares funds that is in deferred revenue and will be recognized as revenue when earned based on the budget. Excluding that the actual exceeded the plan. Fundraising - The Fundraising and Capital net activity for April was ($15,128). the negative Fundraising Income is due to the correction of a deposit that had been erroneously counted twice in a prior period. YTD Fundraising and Capital revenue exceeds the budget by $711,041. The projected plan was $20,000. Employment expenses - Total compensation was less than the budget by $140,373 for the month of April. The projected plan showed $392,000 the actual was $406,000, wages and contracted were over the plan by $14,000. All other expenses- Total facility and other expenses for April are $176,471, the projected plan for these expenses was $151,000, the actual exceeded by $25,00 associated with expenses for Covid19. The current month deficit was ($134,987) with a year-to-date shortfall of ($574,456).


May 27, 2020 Page 8

Summary of Key Ratios

Current Ratios 1.25 – Benchmark greater than 1 – decreased slightly from the prior month, which was 1.64.

Available cash on Hand $1,393,606 (as of 4/30/2020) Days unrestricted/restricted cash 95.86 – last month was 45.88 days, an increase of

49.98 days, Benchmark is greater than 35 days, above the benchmark.

Days AP Outstanding 15.26 days – last month was 9.46 days, an increase of

5.8 days, safe to maintain a benchmark of 20-25 days. Days in Net AR outstanding 39.41 days – last month was 40.55 days, a decrease of

1.14 days. Demonstrates money was collected on average in 39 days in April. Improvement against the prior month.

Debt to Equity Skewed due to the deferred revenue and PPP loan,

without those the ratio is 53%, including the deferred revenue and loan ratio is at 100.15%.

Visit Summary

Actual Budget

Current month visits 1,233 2,413 Current year-to-date visits 15,797 21,726 Prior April, 2019 visits 1,748 Prior 2019 year to date visits 16,665 Visits by Site year-to-date: Gualala – Medical 7,100 10,472 Pt Arena – Medical 2,434 3,630 Urgent Care 3,445 3,590 Urgent Care – Weekend 456 634 Behavioral Health 61 170 Dental 2,301 3,230 For the month of April, the visits at Gualala medical represented 44.9% while Urgent care (includes weekend) was 24.7%; Dental was 14.6%; Pt Arena was 15.4% and Behavioral Health was .4% of the total visits. A projection for visits was not prepared. Payor Mix: Medi-Cal – 29% Medicare – 37% Private Ins. – 24% Self-Pay/Other – 10%


May 27, 2020 Page 9

Ratios: Costs per visit for April $413.72 – last month it was $414.76, the budgeted

goal for April was $313.80. The cost/visit decreased $1.04 against last month.

Net Revenue per visit for April $322.85 – last month it was $272.11, based on total

revenue; increase resulting from incline in grant revenue.

Patient service revenue per visit: $156.65 – last month was $87.14 a $69.51 increase

% of HRSA grants to total revenue 45.9% – last month this ratio was 43.0%

% of salary & fringe to total expenses 68.1% – last month this was 74.3%, decrease against the prior month.

Functional expense analysis- based on YTD Medical 52.8%

Urgent Care 29.8% Behavioral Health .1% Dental 10.8% Hospice 3.1% MHA Plan Dev/Admin 3.4% Net This is based on the summary by site report, which shows that 52.8% of YTD expenses are incurred by the Medical Departments of RCMS. Billing Data: The aging of billing claims as of April 2020 is as follows 0-30 days $244,702 31-60 days $ 65,368 61-90 days $ 58,945 91-120 days $ 72,209 Over 121 days $157,699 Total $598,923 The activity over 120 days represents 26.3% of the total outstanding AR, the ratio increased from last month. The payor type with the largest balance in the aging of the AR is the self-pay and represents an amount of $180K; note that the proper amount is set up for provision for doubtful account activity. Prepared by; Contract CFO for RCMS Angela Robinson, CPA Senior Manager at Wipfli,LLP


May 27, 2020 Page 10

REDWOOD COAST MEDICAL SERVICES, INC.BOARD FINANCIAL SUMMARY

APRIL 2020

MTD YTD Last YTDDEPARTMENT Actual Budget Variance Actual Budget Variance Actual VarianceAllPatient Revenue 145,779 409,747 (263,968) 2,474,526 3,689,817 (1,215,291) 2,698,834 (224,309) Total Expenses 583,427 768,021 (184,594) 6,535,535 6,817,656 (282,121) 6,372,608 162,927 Net Before Other Revenue (437,648) (358,274) (79,374) (4,061,010) (3,127,839) (933,171) (3,673,774) (387,236) Grants/Other Revenue 317,809 282,184 35,625 2,625,512 2,821,840 (196,328) 2,911,728 (286,216) Net Operating Income/(Loss) (119,839) (76,090) (43,749) (1,435,497) (305,999) (1,129,498) (762,046) (673,452) Total Capital Revenue & Expenditures (15,128) 15,000 (30,128) 861,041 150,000 711,041 138,809 722,233 Net Excess/(Deficiency) (134,967) (61,090) (73,877) (574,456) (155,999) (418,457) (623,237) 48,781

Gualala - Primary CarePatient Revenue 59,136 195,715 (136,579) 1,079,200 1,791,538 (712,338) 1,179,199 (99,998) Total Expenses 251,498 306,388 (54,890) 2,776,274 2,766,417 9,857 2,238,044 538,230 Net Before Other Revenue (192,362) (110,673) (81,689) (1,697,073) (974,879) (722,194) (1,058,845) (638,228) Grants/Other Revenue 80,503 83,067 (2,564) 834,821 830,670 4,151 724,266 110,555 Net Operating Income/(Loss) (111,859) (27,606) (84,253) (862,253) (144,209) (718,044) (334,579) (527,673) Total Capital Revenue & Expenditures 1,500 - 1,500 1,500 - 1,500 (31,563) 33,063 Net Excess/(Deficiency) (110,359) (27,606) (82,753) (860,753) (144,209) (716,544) (366,142) (494,610)

Point Arena - Primary CarePatient Revenue 47,930 67,471 (19,541) 371,053 609,252 (238,199) 297,431 73,622 Total Expenses 65,019 98,125 (33,106) 673,758 810,160 (136,402) 562,574 111,184 Net Before Other Revenue (17,090) (30,654) 13,564 (302,704) (200,908) (101,796) (265,143) (37,561) Grants/Other Revenue 67,183 27,932 39,251 267,431 279,320 (11,889) 244,827 22,603 Net Operating Income/(Loss) 50,093 (2,722) 52,815 (35,274) 78,412 (113,686) (20,316) (14,958) Total Capital Revenue & Expenditures - - - - - - - - Net Excess/(Deficiency) 50,093 (2,722) 52,815 (35,274) 78,412 (113,686) (20,316) (14,958)

B - 1RCMS Board of Directors Meeting

May 27, 2020 Page 11


APRIL 2020

MTD YTD Last YTDDEPARTMENT Actual Budget Variance Actual Budget Variance Actual VarianceGualala - Urgent CarePatient Revenue 20,748 67,937 (47,189) 564,640 608,218 (43,578) 614,506 (49,866) Total Expenses 153,030 152,856 174 1,484,374 1,389,060 95,314 1,283,344 201,030 Net Before Other Revenue (132,282) (84,919) (47,363) (919,734) (780,842) (138,892) (668,838) (250,896) Grants/Other Revenue 82,937 63,626 19,311 692,239 636,260 55,979 578,342 113,897 Net Operating Income/(Loss) (49,345) (21,293) (28,052) (227,495) (144,582) (82,913) (90,496) (136,999) Total Capital Revenue & Expenditures - - - - - - (16,291) 16,291 Net Excess/(Deficiency) (49,345) (21,293) (28,052) (227,495) (144,582) (82,913) (106,787) (120,708)

Gualala - UC WeekendPatient Revenue 1,411 12,539 (11,128) 78,765 111,969 (33,204) 109,897 (31,132) Total Expenses 34,171 69,531 (35,360) 465,328 598,849 (133,521) 552,139 (86,811) Net Before Other Revenue (32,760) (56,992) 24,232 (386,563) (486,880) 100,317 (442,242) 55,679 Grants/Other Revenue 38,102 42,600 (4,498) 368,145 426,000 (57,855) 395,248 (27,103) Net Operating Income/(Loss) 5,342 (14,392) 19,734 (18,418) (60,880) 42,462 (46,994) 28,576 Total Capital Revenue & Expenditures - - - - - - (3,054) 3,054 Net Excess/(Deficiency) 5,342 (14,392) 19,734 (18,418) (60,880) 42,462 (50,048) 31,630

Behavioral HealthPatient Revenue 8,771 7,360.00 1,411.27 5,036 28,438.00 (23,402) 64,297 (59,262) Total Expenses 8,727 18,135 (9,408) 8,727 72,860 (64,133) 165,853 (157,126) Net Before Other Revenue 45 (10,775) 10,820 (3,691) (44,422) 40,731 (101,555) 97,865 Grants/Other Revenue 23,666 27,341 (3,675) 34,946 273,410 (238,464) 234,381 (199,434) Net Operating Income/(Loss) 23,711 16,566 7,145 31,255 228,988 (197,733) 132,825 (101,570)


May 27, 2020 Page 12


APRIL 2020

MTD YTD Last YTDDEPARTMENT Actual Budget Variance Actual Budget Variance Actual VarianceGualala - Visiting NursePatient Revenue - - - - - - 567 (567) Total Expenses - - - - - - 90,102 (90,102) Net Before Other Revenue - - - - - - (89,535) 89,535 Grants/Other Revenue - - - - - - - - Net Operating Income/(Loss) - - - - - - (89,535) 89,535

Point Arena - DentalPatient Revenue 7,783 58,725 (50,942) 375,831 540,402 (164,571) 432,937 (57,106) Total Expenses 37,657 88,512 (50,855) 703,768 837,540 (133,772) 742,486 (38,718) Net Before Other Revenue (29,874) (29,787) (87) (327,937) (297,138) (30,799) (309,549) (18,388) Grants/Other Revenue 9,631 22,174 (12,543) 204,375 221,740 (17,365) 184,723 19,652 Net Operating Income/(Loss) (20,243) (7,613) (12,630) (123,562) (75,398) (48,164) (124,826) 1,264

HospiceTotal Expenses 17,535 18,865 (1,330) 202,150 186,680 15,470 199,238 2,913 Net Before Other Revenue (17,535) (18,865) 1,330 (202,150) (186,680) (15,470) (199,238) (2,913) Grants/Other Revenue 5 - 5 4,001 - 4,001 15,350 (11,350) Net Operating Income/(Loss) (17,530) (18,865) 1,335 (198,150) (186,680) (11,470) (183,887) (14,263) Total Capital Revenue & Expenditures - - - 23,555 - 23,555 29,672 (6,117) Net Excess/(Deficiency) (17,530) (18,865) 1,335 (174,595) (186,680) 12,085 (154,215) (20,380)

MHA - Plan DevelopmentTotal Expenses - - - 81,321 - 81,321 252,382 (171,062) Net Before Other Revenue - - - (81,321) - (81,321) (252,382) 171,062 Grants/Other Revenue - - - 81,321 - 81,321 252,383 (171,062) Net Operating Income/(Loss) - - - - - - - -


May 27, 2020 Page 13


APRIL 2020

MTD YTD Last YTDDEPARTMENT Actual Budget Variance Actual Budget Variance Actual VarianceMHA - TelehealthTotal Expenses - - - - - - 55,236 (55,236) Net Before Other Revenue - - - - - - (55,236) 55,236 Grants/Other Revenue - - - - - - 53,465 (53,465) Net Operating Income/(Loss) - - - - - - (1,771) 1,771

FundraisingTotal Expenses - 165 (165) - 1,650 (1,650) - - Net Before Other Revenue - (165) 165 - (1,650) 1,650 - - Grants/Other Revenue - - - - - - - - Net Operating Income/(Loss) - (165) 165 - (1,650) 1,650 - - Total Capital Revenue & Expenditures (16,636) 15,000 (31,636) 834,384 150,000 684,384 157,578 676,807 Net Excess/(Deficiency) (16,636) 14,835 (31,471) 834,384 148,350 686,034 157,578 676,807

AdministrationTotal Expenses 183,460 188,256 (4,796) 1,902,437 1,873,956 28,481 1,652,254 250,183 Admin Allocation (167,670) (172,812) 5,142 (1,762,601) (1,719,516) (43,085) (1,421,044) (341,557) Net Before Other Revenue (15,790) (15,444) (346) (139,836) (154,440) 14,604 (231,210) 91,374 Grants/Other Revenue 15,782 15,444 338 138,234 154,440 (16,206) 228,743 (90,509) Net Operating Income/(Loss) (8) - (8) (1,602) - (1,602) (2,467) 865 Total Capital Revenue & Expenditures 8 - 8 1,602 - 1,602 2,467 (865) Net Excess/(Deficiency) - - - - - - - -


May 27, 2020 Page 14


APRIL 2020

]

Prior Year Current YearFebruary 69.30 48.59March 61.53 45.88April 59.24 95.86

‐ 20.00 40.00 60.00 80.00

100.00 120.00

Days Unrestricted CashBenchmark is 35 or more, higher is better


‐ 10.00 20.00 30.00 40.00 50.00 60.00 70.00

Days Net A/R OutstandingBenchmark is 45.1 or less, lower is better


‐

5.00

10.00

15.00

20.00

25.00

Days A/P OutstandingBenchmark is 26.9 or less, lower is better


‐ 0.50 1.00 1.50 2.00 2.50 3.00 3.50

Current RatioBenchmark is 1 or more, higher is better


‐ 0.20 0.40 0.60 0.80 1.00 1.20 1.40

Debt to Equity RatioRatio of 2:1 or Less = Healthy

Medical ‐ Gualala Medical ‐ Pt.Arena Urgent Care US Weekend Behavioral Health Dental Total

Actual 471 354 269 33 60 46 1,233Budget 1,144 402 401 71 44 351 2,413

‐ 500

1,000 1,500 2,000 2,500 3,000

MTD Visits

Medical ‐Gualala

Medical ‐ Pt.Arena Urgent Care US Weekend Behavioral

Health Dental Total

Actual 7,100 2,434 3,445 456 61 2,301 15,797Budget 10,472 3,630 3,590 634 170 3,230 21,726

‐

5,000

10,000

15,000

20,000

25,000YTD Visits

Medical ‐Gualala

Medical ‐ Pt.Arena Urgent Care US Weekend Behavioral

Health Visiting Nurse Dental Total

YTD 7,100 2,434 3,445 456 61 ‐ 2,301 15,797Last YTD 7,105 2,035 3,680 596 478 9 2,762 16,665

‐ 2,000 4,000 6,000 8,000

10,000 12,000 14,000 16,000 18,000

Visits Compared to Last Year

26%

39%1%

24%

10% 29%

37%

1%

24%

9%

YTD Payor MixOuter Layer = Current YearInner Layer = Previous Year

Medi‐Cal Visits

Medicare & Crossover Visits

Family Pact Visits

Insurance Visits

Self Pay & Other Visits

‐

1,000

2,000

3,000

Nov‐19 Dec‐19 Jan‐20 Feb‐20 Mar‐20 Apr‐20Actual 1,550 1,551 1,857 1,688 1,277 1,233Budget 2,034 2,079 2,365 2,246 2,381 2,413

Total Facility Visits


May 27, 2020 Page 15

‐

100

200

300

400

500

600

700

800

900

Mar‐19 Apr‐19 May‐19 Jun‐19 Jul‐19 Aug‐19 Sep‐19 Oct‐19 Nov‐19 Dec‐19 Jan‐20 Feb‐20 Mar‐20 Apr‐20

REDWOOD COAST MEDICAL SERVICES, INC.VISITS BY DEPARTMENT

APRIL 2020

Medical ‐ Gualala Medical ‐ Pt. Arena Urgent Care US Weekend Behavioral Health Dental

B - 6


May 27, 2020 Page 16

25.93 22.22

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

REDWOOD COAST MEDICAL SERVICES, INC.ACCOUNTS RECEIVABLE TREND

APRIL 2020

Patient Accounts Receivable

B - 7


May 27, 2020 Page 17

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

450,000

500,000

REDWOOD COAST MEDICAL SERVICES, INC.ACCOUNTS RECEIVABLE TREND - BY AGED PERIOD

APRIL 2020

Current Over 30 Over 60 Over 90 Over 120 Over 150

B - 8


May 27, 2020 Page 18

REDWOOD COAST MEDICAL SERVICES, INC.VISITS/REVENUE/EXPENSE

APRIL 2020

‐

50,000

100,000

150,000

200,000

250,000

300,000

350,000

Gualala Primary Care

Visits 801 747 772 670 797 763 680 758 789 650 834 724 634 471

Revenue

Expenses

‐ 20,000 40,000 60,000 80,000

100,000 120,000 140,000 160,000 180,000

Urgent Care

Visits 374 407 367 390 358 380 314 339 293 363 420 409 300 269

Revenue

Expenses

‐

20,000

40,000

60,000

80,000

100,000

120,000

140,000

Point Arena Primary Care

Visits 191 242 195 220 272 221 217 279 177 263 282 222 147 354

Revenue

Expenses

‐

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

Urgent Care Weekend

Visits 77 43 58 74 56 39 54 31 48 49 64 43 39 33

Revenue

Expenses

B - 9


May 27, 2020 Page 19

REDWOOD COAST MEDICAL SERVICES, INC.VISITS/REVENUE/EXPENSE

APRIL 2020

(10,000)

(5,000)

‐

5,000

10,000

15,000

20,000

25,000

30,000

35,000

Behavioral Health

Visits 15 10 ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ 1 60 Revenue Expenses

‐

20,000

40,000

60,000

80,000

100,000

120,000

Dental

Visits 284 299 278 282 327 259 229 268 243 226 257 290 156 46

Revenue

Expenses


May 27, 2020 Page 20

(400,000.00)

(200,000.00)

‐

200,000.00

400,000.00

600,000.00

800,000.00

1,000,000.00

Apr‐19 May‐19 Jun‐19 Jul‐19 Aug‐19 Sep‐19 Oct‐19 Nov‐19 Dec‐19 Jan‐20 Feb‐20 Mar‐20 Apr‐20

REDWOOD COAST MEDICAL SERVICES, INC.REVENUE & EXPENSE RESULTS

APRIL 2020

Patient Revenue Grants/Other Income Total Expenses Net Operating Profit/(Loss)

B - 11


May 27, 2020 Page 21

‐$140,000

‐$120,000

‐$100,000

‐$80,000

‐$60,000

‐$40,000

‐$20,000

$0

$20,000

$40,000

$60,000

Apr‐19 May‐19 Jun‐19 Jul‐19 Aug‐19 Sep‐19 Oct‐19 Nov‐19 Dec‐19 Jan‐20 Feb‐20 Mar‐20 Apr‐20

REDWOOD COAST MEDICAL SERVICES, INC.NET OPERATING PROFIT/(LOSS) BY DEPARTMENT

APRIL 2020

Medical ‐ Gualala Medical ‐ Pt. Arena Urgent Care US Weekend Behavioral Health Dental Hospice MHA Plan Development

B - 12


May 27, 2020 Page 22

REDWOOD COAST MEDICAL SERVICES

PART 1 - ACCOUNT BALANCES for CASH FLOW ANALYSIS (as of 4/30/2020)

Beginning of the month balances ACTUAL ACTUAL ACTUAL ACTUAL PROJ PROJ PROJ

January February March April April May June

Cash accounts balances

Business Star Interest Checking 202,536 214,403 195,169 718,692 195,169 1,206,097 1,206,097

Business Star Money Market - 2055 143,912 232,001 114,445 130,831 232,001 130,831 130,813

Business Star Money Market - 5869 1,000 674 - - 674 - -

Business Star Check - 8194 650 30,689 98,689 739,719 30,689 739,719 739,719

Debt payback - DHCS (15,000) (15,000) (15,000) (15,000) (15,000)

Debt payback - LOC (22,000) (22,000) (22,000) (22,000) (22,000) (22,000) (22,000)

1st stimulus payment (63k)

2nd stimulus payment (600k)

Transfer from Investment Accounts (during month)

Available Cash Balances 311,098 440,767 371,303 1,552,242 421,533 2,054,647 2,054,629

Charles Schwab Investment accounts

Acct 7359-5618 (Riopelle - Restricted - unavailable) 618,506 618,506 618,596 618,677 618,596 618,677 618,677

Acct 7359-5620 (Cerruti - available for Hospice only) 18 18 18 18 18 18 18

Acct 1427-4549 (Sevier - unrestricted) 20,765 20,765 20,759 20,765 20,759 20,765 20,765

Acct 4612-9530 (Legacy-unrestricted) - -

Transfer to Cash accounts (during the month)

Charles Schwab Investment accounts 20,783 20,783 20,777 20,783 20,777 20,783 20,783

Cash & Investments at end of past months 331,881 461,550 392,080 1,573,025

Cash & Investments without current month rev/exp 442,310 2,075,430 2,075,412

Projected Inc/Dec Cash from Tab 2 (134,968) (269,564) (27,564)

Revised Cash & Investments 1,438,057 1,168,493 1,140,929


May 27, 2020 Page 23

Resource Development and Outreach Report

April 2020 Activities

Grants/Funding Preservation

UDS Report has been fully submitted and processed COVID-19

Received $56,071.00 on March 19, 2020 – budget has been submitted CARES

Received $611, 030.00 on April 3, 2020 – budget has been submitted Submitted

Capital Assistance for Disaster Response and Recovery Efforts (CADRE) o Requested funding for disaster trailer supplied

New

Telehealth Network Grant Program (TNGP) o Requesting funding to improve access to quality healthcare services

Outreach and Enrollment Marketing

Facebook (fb) post reach in April: 35,628

Top performing fb post in April: April 27, A message to our community from Barbara Brittell.

Web performance: 1,627 unique visitors; 3,933 page visitors

Top performing web page in April: COVID-19 Enrollment

Ongoing campaign to inform the community about the CalFresh/SSI Expansion

Outreach and Enrollment provided assistance to 53 people in April. The table below is a breakdown of the enrollment assistance provided by type:

Type CalFresh Medical/

Medicare

Covered

CA

Social

Security

Other

New 4 1

Renewal 1

Assistance 9 26 1 4 7

Outreach

Assisted ten clients

Surveys Partnership – Gualala – biannually

In process for 2020 Partnership – Point Arena – biannually

In process for 2020 Urgent Care – quarterly

2019 Q4 – completed 162 responses from 980 surveys mailed Return rate was 16.5%


May 27, 2020 Page 24

2020 Q1 – completed 182 from 1179 surveys mailed Return rate was 15.4% 2020 Q2 – in process


May 27, 2020 Page 25

RCMS BOD – Board of Directors Report April-May 2020 – Compliance/Risk

Management/Safety

QIC meeting – April 28, May 26

PIC meeting – April 2, May 7

______________________________________________________________________________

RCMS BOD acknowledged the annual confidential Risk Management Report in the

February notes.

Credentialing & Privileging Jesse Maness, LCSW.

Policies and Procedures: P&P updates for PCMH/Patient Centered Medical Home

The policies that have been or will be reviewed and approved by PIC are:

• Newborn Screening – submitted and approved at the April meeting

• Claims Policy and Procedure – attached

FTCA – Federal Tort Claim Act redeeming application is due July 13, 2020, Deborah is working

on this. Above Claims P&P was needed.

Risk Analysis/Safety:

Heliport update: RCMS received the Heliport Site Approval Authorization No.20-22 from

State of California Transportation/Caltrans, Division of Aeronautics. Once upgrades are

completed, there will be a site visit for final approval and final permit as a legal HELIPORT!

Working on following upgrades: (#1-4 MDSolarElectric is working on a bid by June 5, 2020)

1. Remove old elevated perimeter lights (7 each) surrounding the FATO

2. Replace with new flush-mount green LED NVG-compatible (with IR emitters) perimeter

lights (8 each) surrounding the TLOF, centered about the primary approach path

3. Install three-color heliport beacon at the highest point on the clinic building

4. Replace existing wind cone with standardized wind cone that includes LED lighting and

a red obstruction light on its mast

5. Grade rising terrain to the north to lower the portion within the 12.5’-wide safety area

(nothing is to extend above TLOF elevation within the FATO or safety area) – minor

grading, need to get a bid.

6. TLOF painted markings per FAA and Caltrans Division of Aeronautics criteria. (The

RCMS marking is not required but we typically recommend that heliports include a

positive identifier for approaching pilots.)

7. Trimming of 14 identified trees in the HLP – Heliport Landing Plan – attached.

Chamberlain Creek Conservation cannot do the work. Need to get a bid.

George Provencher has a lead for a donation for the cost of the work and Deborah has been in

contact with potential donor.

Incident Reports: Presented by DON to PIC monthly, all closed.


May 27, 2020 Page 26

RCMS BOD – Board of Directors Report April-May 2020 – Compliance/Risk

Management/Safety

QIC meeting – April 28, May 26

PIC meeting – April 2, May 7

______________________________________________________________________________

PCMH/NCQA:

• Renewal for recognition process for PCMH – Patient Centered Medical Home from

NCQA – National Committee for Quality Assurance is in progress. Due date 7/2020.

• First Check in was completed: RCMS got 30 out of the 40 Core requirements and 23

out of 25 Electives needed. YAY! Deborah is working on final documents and will

schedule a second check-in.

CRC Volunteers: All CRC activities on hold as of March 12. Dorothy Spalding CRC

Volunteer and COVD Volunteer is willing to pay for a new sign at EJC. (Please see

attachment for BOD approval – recommendation for color change?)

COVID-19 Volunteers – Deborah is working with Barb Brittell in April and May, to coordinate,

vet and train medical and non-medical volunteers. 37 volunteer vetted thus far.

Patient Satisfaction Surveys results: UC Q4 results were reviewed in May PIC meeting.

Quality/PIC Update: PJ LoDuca, PHN, MPA, CPHQ, is the RCMS QI Director. All aspects of

QI/PIC has been transferred to PJ. Please contact PJ, instead of Deborah, going forward for all

related QI/PIC issues.

Respectfully submitted 05/22/2020

Deborah Gene Lane/RCMS Compliance/Safety/Risk Management Officer


May 27, 2020 Page 27

Human Resources 25 – Telecommute/Remote Work

I. POLICY:

RCMS requires that employees are physically present at their work locations to perform

their job function. This policy addresses circumstances that materially inhibit normal

work arrangements.

Telecommuting allows employees to work at home, on the road or in a satellite location

for all or part of their workweek. Redwood Coast Medical Services, Inc. (RCMS)

considers telecommuting to be a viable, flexible work option when circumstances

materially inhibit normal work arrangements and when both the respective employee and

the job are suited to such an arrangement. Telecommuting may be appropriate for some

employees and jobs but not for others. Telecommuting is not an entitlement, it is not a

companywide benefit, and it in no way changes the terms and conditions of employment

with RCMS. II. PROCEDURE:

Telecommuting can be informal, such as working from home for a short-term project or

on the road during business travel, or a formal, set schedule of working away from the

office as described below. When circumstances permit or call for such an arrangement,

either an employee or a supervisor can suggest telecommuting as a possible alternative

work arrangement.

Any telecommuting arrangement made may be discontinued at will and at any time at the

request of either the telecommuter or the organization. Every effort will be made to

provide 14 days’ notice of such change to accommodate commuting, child care and other

issues that may arise from the termination of a telecommuting arrangement. There may

be instances, however, when no notice is possible.

III. ELIGIBILITY:


(RCMS)

POLICY PROCEDURE

Page: 1 of 3

Date Approved:

Reviewed Date:

Human Resources Director:

Arlene L. Peterson DEPARTMENT: Human Resources

CEO: Ara Chakrabarti

POLICY NUMBER: 25 HR Chair: Donald S. Kemp

SUBJECT: TELECOMMUTE / REMOTE WORK


May 27, 2020 Page 28


Team members requesting formal telecommuting arrangements must be employed with

RCMS for a minimum of 6 months of continuous, regular employment and must have a

satisfactory performance record.

Before entering into any telecommuting agreement, the employee and

supervisor/manager, with the assistance of the human resource department, will evaluate

the suitability of such an arrangement, reviewing the following areas:

• Circumstances arise which materially inhibit the continuation of standard or previously

agreed to work arrangements.

• Employee suitability. The employee and supervisor will assess the needs and work habits

of the employee, compared to traits customarily recognized as appropriate for successful

telecommuters.

• Job responsibilities. The employee and supervisor will discuss the job responsibilities and

determine if the job is appropriate for a telecommuting arrangement.

• Equipment needs, workspace design considerations and scheduling issues. The employee

and supervisor will review the physical workspace needs and the appropriate location for

the telework.

• Tax and other legal implications. The employee must determine any tax or legal

implications under IRS, state and local government laws, and/or restrictions of working

out of a home-based office. Responsibility for fulfilling all obligations in this area rests

solely with the employee.

If the employee and supervisor agree, and the human resource department concurs, a

telecommuting agreement will be prepared and signed by all parties.

The telecommuter and his/her supervisor will communicate at a level consistent with employees

working at the office or in a manner and frequency that is appropriate for the job and the

individuals involved.

Performance evaluation will be done as usual whether the employee is telecommuting or not.

Evaluation of telecommuter performance will be consistent with that received by employees

working at the office in both content and frequency.

IV. EQUIPMENT:

On a case-by-case basis, RCMS will determine, with information supplied by the employee and

the supervisor, the appropriate equipment needs (including hardware, software, modems, phone

and data lines and other office equipment) for each telecommuting arrangement. The human

resource and information system departments will serve as resources in this matter. Equipment

supplied by the organization will be maintained by the organization. Equipment supplied by the

employee, if deemed appropriate by the organization, will be maintained by the employee.

RCMS accepts no responsibility for damage or repairs to employee-owned equipment. RCMS

reserves the right to make determinations as to appropriate equipment, subject to change at any


May 27, 2020 Page 29


time. Equipment supplied by the organization is to be used for business purposes only. The

telecommuter must sign an inventory of all RCMS property received and agree to take

appropriate action to protect the items from damage or theft. Upon termination of employment,

or at the end of the telecommuting arrangement, all company property will be returned to the

company, unless other arrangements have been made..

RCMS will supply the employee with appropriate office supplies (pens, paper, etc.) as deemed

necessary. RCMS will also reimburse the employee for business-related expenses, such as

phone calls and shipping costs that are reasonably incurred in carrying out the employee’s job.

Prior approval is required to approve expenditures by employee. The employee will establish an

appropriate work environment within his or her home for work purposes. RCMS will not be

responsible for costs associated with the setup of the employee’s home office, such as

remodeling, furniture or lighting, nor for repairs or modifications to the home office space.

V. SECURITY:

Consistent with the organization’s guidelines of information security for employees working at

the office, telecommuting employees will be expected to ensure the protection of proprietary

company and customer information accessible from their home office.

Employees are response to abide by the Monitoring Acknowledgement Agreement signed at the

time of employment with RCMS.

VI. SAFETY:

Employees are expected to maintain their home workspace in a safe manner, free from safety

hazards. RCMS will provide each telecommuter with a safety checklist that must be completed

at least twice per year. Injuries sustained by the employee in a home office location and in

conjunction with his or her regular work duties are normally covered by the company’s workers’

compensation policy. Telecommuting employees are responsible for notifying the employer of

such injuries as soon as practicable. The employee is liable for any injuries sustained by visitors

to his or her home worksite.

The telecommuting option is designed solely as an accommodation of the needs of RCMS and

the employee in light of extenuating circumstances beyond its control which materially inhibit

the continuation of standard or previously agreed to work arrangements.


May 27, 2020 Page 30


VII. TIME WORKED:

Telecommuting employees who are not exempt from the overtime requirements of the Fair

Labor Standards Act will be required to accurately record all hours worked using the RCMS

time-keeping system. Hours worked in excess of those scheduled per day and per workweek

require the advance approval of the telecommuter’s supervisor. Failure to comply with this

requirement may result in the immediate termination of the telecommuting agreement.

VIII. AD HOC ARRANGEMENTS:

Temporary telecommuting arrangements may be approved for circumstances such as inclement

weather, special projects or business travel. These arrangements are approved on an as-needed

basis only, with no expectation of ongoing continuance.

Other informal, short-term arrangements may be made for employees on family or medical leave

to the extent practical for the employee and the organization and with the consent of the

employee’s health care provider, if appropriate.

All informal telecommuting arrangements are made on a case-by-case basis, focusing first on the

business needs of the organization.


May 27, 2020 Page 31


Telecommute/Remote Work Agreement

Employee Information

Name: ____________________________________ Hire date: __________

Job title: _____________________________________________________

Department: ___ _____________________________________________

FLSA status: Exempt Nonexempt If temporary, this telecommuting agreement will begin and end on the following dates: Start date: _______________ End date: _______________ Remote work location: ________________________________________________ Employee schedule: _____________________________________________________ The employee agrees to the following conditions:

• The employee will remain accessible and productive during scheduled work hours.

• Nonexempt employees will record all hours worked and meal periods taken in accordance with regular timekeeping practices.

• Nonexempt employees will obtain supervisor approval prior to working unscheduled overtime hours.

• The employee will report to the employer’s work location as necessary upon directive from his or her supervisor.

• The employee will communicate regularly with his or her supervisor and co-workers, which includes a weekly written report of activities.

• The employee will comply with all RCMS rules, policies, practices and instructions that would apply if the employee were working at the employer’s work location.

• The employee will maintain satisfactory performance standards.

• The employee will maintain a safe and secure work environment at all times.

• The employee will allow the employer to have access to the telecommuting location for purposes of assessing safety and security, upon reasonable notice by the company.

• The employee will report work-related injuries to his or her manager as soon as practicable.


May 27, 2020 Page 32


RCMS will provide the following equipment: __________________________ _____________________________________________________________________ The employee will provide the following equipment: ____________________________ _____________________________________________________________________

• The employee agrees that RCMS equipment will not be used by anyone other than the employee and only for business-related work. The employee will not make any changes to security or administrative settings on RCMS equipment. The employee understands that all tools and resources provided by the company shall remain the property of the company at all times.

• The employee agrees to protect company tools and resources from theft or damage and to report theft or damage to his or her manager immediately.

• The employee agrees to comply with [Company name]’s policies and expectations regarding information security. The employee will be expected to ensure the protection of proprietary company and customer information accessible from their home offices.

RCMS will reimburse employee for the following expenses: ________________________________________________________________ Employee will submit reimbursement requests with attached receipts in accordance with RCMSs expense reimbursement policy. The employee understands that all terms and conditions of employment with RCMS remain unchanged, except those specifically addressed in this agreement. The employee understands that management retains the right to modify this agreement on a temporary or permanent basis for any reason at any time. The employee agrees to return RCMS equipment and documents within five days of termination of employment.

Employee signature: ______________________________ Date: ____________________

Manager signature: _______________________________ Date:______________________

Human resources signature: ________________________ Date: ______________________


May 27, 2020 Page 33


SAFETY CHECKLIST

The telecommuter is responsible for ensuring a clean, safe, and ergonomically sound home/work office as a condition for telecommuting. The telecommuter should review this checklist with his/her supervisor and sign it prior to the start of telecommuting. Work Site

Telecommuter agrees to maintain a clearly defined workspace that is clean, free from distractions and obstructions, and is in ergonomically sound condition.

The work area is adequately illuminated with lighting directed toward the side or behind the line of vision, not in front or above it.

Supplies and equipment (both departmental and employee-owned) are in good condition. The area is well ventilated and heated. Storage is organized to minimize risks of fire. All extension cords have grounding conductors. Exposed or frayed wiring and cords are repaired or replaced immediately upon detection. Electrical enclosures (switches, outlets, receptacles, and junction boxes) have tight-fitting covers

or plates. Surge protectors are used for computers, fax machines, and printers. Heavy items are securely placed on sturdy stands close to walls. Computer components are kept out of direct sunlight and away from heaters.

Emergency Preparedness

Emergency phone numbers (hospital, fire department and police department) are posted at the alternate work site.

A first aid kit is easily accessible and replenished as needed. Portable fire extinguishers are easily accessible and serviced as needed. An earthquake/storm preparedness kit is easily accessible and maintained in readiness.

Ergonomics

Desk, chair, computer, and other equipment are of appropriate design and arranged to eliminate strain on all parts of the body.

Telecommuter agrees to read and to implement the EMPLOYER ergonomic principles.

I have reviewed and understand the items outlined in this checklist. _______________________________ ________________________ Telecommuter’s signature Date:


May 27, 2020 Page 34

Administrative - Claims Management

I. POLICY: It is the policy of Redwood Coast Medical Services, Inc. (RCMS) to comply with all requirements of the Public Health Services Act (PHSA) and Federal Tort Claims Act (FTCA) in the reporting of professional liability (malpractice) claims and potential claims (potential compensatory events), including, without limitation, the provision of timely notice to the proper government authorities, the preservation of the health record of a potential claimant by locking the existing health record and the proper completion of the internal Professional Liability Claim Report. The purpose of the Professional Liability Potential Claim Report is to determine the facts in order to most appropriately address the matter, to reduce the likelihood of a claim or lawsuit, or in the case of a filed claim, to place RCMS in the most defensible position and to reduce liability and economic loss. II. PROCEDURE:

A. The Occurrence of an Incident:

1. When an incident occurs that may place a patient, visitor or staff member at risk,

immediate measures will be taken by the provider(s) and staff to provide

assistance and reduce the potential for an adverse outcome. The action should be

documented in the patient medical record, on an incident report for visitor or staff,

or on an OSHA report if there has been exposure to infectious material. Do not

make reference in the patient medical record that an incident report, professional

liability potential claim report, or claim notice report may have been filled out.

2. The initial report should be completed by a person with first-hand information

about the incident. The initial report establishes an attorney-client privilege

between RCMS and its legal counsel and therefore must be confidentially

maintained. The initial report should be made to the Compliance and Safety


(RCMS)

POLICY PROCEDURE

Page: 1 of 2

Date Approved:

Reviewed Date:

Human Resources Director:

Arlene L. Peterson

DEPARTMENT: Administration

CEO: Ara Chakrabarti

POLICY NUMBER: PIC Chair: Donna Yates-Johnson

SUBJECT: CLAIMS MANAGEMENT


May 27, 2020 Page 35


Officer immediately. The Compliance and Safety Officer will notify the Chief

Executive Officer and Human Resources when the event, incident or complaint is

recognized as a potential or actual liability claim.

3. Pursuant to the Federal Tort Claims Act (FTCA), RCMS will report to DHHS any

event, incident or complaint which has resulted in a liability claim notice being

filed and to report information on a pending claim notice. The PHS must be

notified at once if the claim is filed in state court, so that appropriate measures can

be taken to have the claim moved to federal court pursuant to the FTCA.

a. If a notice is received from a potential claimant and/or claimant’s attorney

that they plan to include RCMS or RCMS staff covered by the FTCA in a

malpractice lawsuit, the Compliance and Safety Officer will notify them

that the suit will be handled by federal government attorneys on behalf of

RCMS and will be moved to federal court. This may dissuade potential

claimants from unnecessarily including RCMS or its covered staff in a

lawsuit.

In addition to the report, the individual best informed about the situation should

complete an incident report and submit it to the Compliance and Safety Officer. The

Compliance and Safety Officer should use the Incident Reporting procedures to conduct

an investigation, implement appropriate corrective action, and document the follow up

to assure patient safety. The FTCA peer assessment questionnaire should be completed

as part of the Incident Reporting procedure investigation.

B. Utilization of Report.

The professional liability potential claim report is completed by a

physician or staff member having knowledge of an event, incident or

complaint that may result in a liability claim. The report is used by

RCMS’ legal counsel to initiate legal defense on behalf of the center. If

the claim notice is filed in court, the DHHS OGC will request a copy of

medical records and other relevant documents concerning the potential or

actual claim and move the claim to federal court.

C. Confidentiality of Reports and Documents.

The professional liability potential claim report is communication between

a client and attorney; therefore, it is protected from disclosure under the

attorney-client privilege. The report should be kept in a secured file by

the Compliance and Safety Officer. Additional reports of investigations

and actions should be added to this confidential file, and not disclosed

without prior approval from the RCMS legal counsel or OGC. At no time

does the incident report, any related document, or the notice become a

part of the patient's medical record.

D. Completion of the Professional Liability Potential Claim Report.

If an incident occurs that the staff believes may result in a liability claim,

the professional liability potential claim report should be completed and

given to the Chief Executive Officer and Compliance and Safety Officer

to forward to the RCMS legal counsel and/or the RCMS Performance


May 27, 2020 Page 36


Improvement Committee. In completing the report, answer each question

accurately and completely, being factual and objective.

a. Do not admit liability (that will be determined by an expert

opinion).

b. Do not discuss the incident, event or variance with anyone except

persons associated with the Incident Reporting procedure and

RCMS’ legal counsel.

c. Do not discuss the incident with the fellow workers or family, and

particularly not with the alleged injured person or their attorney.

d. If the information requested is not relevant or not known, state that

on the form.

e. Attach documents as requested, and sign and date the form as

noted.

E. Reporting of Claims Filed and Payments on Claims.

1. Any payment of a claim on behalf of a licensed professional must be

reported to the National Practitioner Data Bank (NPDB) pursuant to the

Federal Health Care Quality Improvement Act of 1986. This is done by

the RCMS Human Resources Credentialing and Privileging Manager.

F. Forms Related to Claims.

1. The two forms to be used in relation to a potential or actual claim(s)

include:

a. Initial (Potential) Professional Liability Claim Report.

b. FTCA Peer Assessment Questionnaire

III. The OGC – Office of General Counsel may provide additional questionnaires or forms to

be completed and additional documentation.

ATTACHMENTS:

1) Norcal Claims Management Report of Claim

2) FTCA Peer Assessment Questionnaire

3) Norcal Early Reporting Information


May 27, 2020 Page 37

Board members Finance PIC HR Outreach Audit Exec Committee

Officer Positions Officer Potential Candidates

Vanessa Ignacio Chair Rich Hughes

Alex Long Alex Vice-Chair Leslie Bates

Rich Schimbor Rich S Rich S Treasurer Drew McCaulley

Secretary Janis Dolphin, Barbara Fast

Nik Epanchin Nik

Drew McCalley Drew Drew PIC Chair

Barbara Fast Barbara F

Donna Yates-Johnson Donna Donna

Sophia Mitchell Sophia

Carolyn Abst Carolyn

Gabriel Ramirez Gabriel

Barbara Canida Barbara C

Janis Dolphin Janis

George Provencher George

Rich Hughes Rich H

David Kieffer

Leslie Bates David Leslie Leslie

Michael Tilles (CLSD rep)

Jim Nybakken Naomi Shwartz Susan Sandovol

Governance sub-committee

Janis

George

David

Rich H

Facilities/Capitol Assets

Rich Shimbor

Carolyn Abst

Leslie Bates


May 27, 2020 Page 38