Chairman DeLana referred members of the Board of Trustees to Agenda Item No. II - Consent Docket, Items III-VI. Chairman DeLana noted the Board Trustees may approve these items with one motion; however, any item may be removed by request and will then be taken in regular agenda order. Following review and discussion a motion was made by Dr. Michael Compton and seconded by Ms. Julie Rozsypal that the Consent Docket be approved, specifically:

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper, Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. VII - Report of the Medical Staff meeting of February 11, 2008. Chairman DeLana called upon Hospital Administrator Lex Smith to make a report on this item. Mr. Smith noted the Medical Staff meeting had been held the previous evening and the program had been presented by the hospital’s Radiologist, Dr. Paul Massad. Dr. Massad had discussed aspects of the physics of x-ray technology and the blending of that with the medical aspects of human anatomy. Additionally, Dr. Massad discussed the hospital’s radiology service coverage. Mr. Smith noted reports were heard from Performance Improvement Committee, Medical Audit/Credential/Utilization Review Committee, Infection Control Committee and Emergency Medical Task Force Disaster Preparedness.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. VIII - Consider approval of recommendation from the Medical Staff for Home Health Admitting Privileges Only for two (2) physicians. Chairman DeLana called members of the Board of Trustees attention to a letter in the packet signed by Dr. Michael Sullivan, Chief of Staff, recommending the appointment of two (2) physicians for Home Health Admitting Privileges Only. These had been approved by the Medical Staff and were being recommended to the Board of Trustees. After review and discussion a motion was made by Ms. Rosemary Klepper and seconded by Mr. Matt White that the recommendation as outlined in the letter dated February 11, 2008 signed by Dr. Michael Sullivan, Chief of Staff, for two (2) physicians for Home Health Admitting Privileges Only be approved.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper, Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. IX - Consider final approval of Audit, Management Letter and Cost Report for fiscal year ending 6/30/2007 presented at the 1/8/2008 Board meeting by BKD. Chairman DeLana noted this item had been placed on the Agenda after a presentation had been made by the representatives of BKD. It was also noted the final report had been submitted by BKD and had been sent to members of the Board of Trustees. Additionally, Chairman DeLana noted several items were available for the Board of Trustee members. These are:

After review and discussion a motion was made by Mr. Ron Ward and seconded by Mr. Matt White that the Parkview Hospital Board of Trustees give final approval to the Audit, Management Letter and Cost Report for fiscal year ending 6/30/2007 as presented at the 1/8/2008 Board meeting with the final report being sent to the Board of Trustees by BKD.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper, Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. X - Presentation of Accounts Receivable Dashboard Report Indicators as designed with BKD for 7/1/07 - 1/31/08. Chairman DeLana called upon Hospital Administrator Lex Smith to make a report to members of the Board of Trustees. Mr. Smith noted Mr. Rod Shook, C.F.O., had prepared this report in communication with BKD as they had outlined. It was noted Mr. Shook was not able to be present at this evening’s meeting to make the report due to a family medical emergency. Mr. Smith noted that he would review with members of the Board of Trustees the detailed Dashboard Report. Mr. Smith then reviewed with members of the Board of Trustees the monthly dashboard and key accounts receivable indicators for the fiscal year to date ending January 31, 2008. Comparison of this was made with the report that had been prepared by BKD ending June 30, 2007. The report discussed in detail the following areas:

Mr. Smith noted these reports will be prepared monthly and attached to the hospital’s summary reports as submitted to the Board of Trustees. It was noted this report had been reviewed in detail with members of the Budget and Finance Committee and they had requested a presentation be made, with dialogue, with members of the Board of Trustees on this report. Members of the Board of Trustees held discussion regarding the Accounts Receivable Summary Report and noted it was an excellent report that they are excited about receiving monthly.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XI - Report of the Budget and Finance Committee meeting of February 7, 2008. Chairman DeLana reviewed with members of the Board of Trustees some of the activities of that meeting and noted he would like to call upon Mr. Doug Danker, Director of Nursing, to make a presentation on the development of a Minor Care Center in the hospital’s new Outpatient Specialty Clinic. Mr. Danker noted a report had been made at the Budget and Finance Committee the previous week. Based upon that report the Budget and Finance Committee is recommending the implementation of a Minor Care Center. Mr. Danker reviewed with members of the Board of Trustees the following aspects of the Minor Care Center financial feasibility study which included:

8. Financial analysis regarding the Emergency Room physician assistant and/or nurse practitioner revenue.

9. ER financial analysis regarding nursing revenue.

Members of the Board of Trustees discussed in some detail the staffing of the Minor Care Center. Mr. Danker noted based upon the financial analysis presented the Minor Care Center would need to see 104 patients per month to break even. These could be patients triaged from the Emergency Room and/or new patients for minor care services. Members of the Board of Trustees discussed in detail the importance of the triage program and the positive impact it could have on the reduction of writeoffs in the Emergency Room. Ms. Rosemary Klepper discussed the overall importance of the quality of care and that this would be a great program with the appropriate medical supervision. Chairman DeLana asked Mr. Danker when a program could be implemented in Parkview Hospital based upon the completion of the Outpatient Specialty Clinic by April 30, 2008. Mr. Danker noted a program target date could be May 1, 2008 depending upon the availability of staff. After further discussion a motion was made by Dr. Michael Compton and seconded by Ms. Rosemary Klepper that the Parkview Hospital Board of Trustees approve the development of a Minor Care Center in the hospital’s new Outpatient Specialty Clinic with a goal of implementation by May 1, 2008.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper, Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana noted he would like for the hospital’s administration to get with the hospital’s advertising firm to come up with an exact name for the program. It was noted there had been some discussion several names such as "Urgent Care", "Minor Care"and "Fast Track". As we continue with the implementation program it should be consistent. Mr. Smith noted he would contact the hospital’s advertising firm so they could contact him, Mr. Danker and Mr. DeLana to decide on a name and the plan for implementing and advertising this program.

Chairman DeLana then referred members of the Board of Trustees to a presentation on the Contribution Margin Report for 7/1/07 to 12/31/07 and quarterly EMS report to the City for 7/1/07 through 12/31/2007. Hospital Administrator Lex Smith noted this item had been reviewed by the Budget and Finance Committee but the Contribution Margin Report that is included in the Board packet was not completed. It was noted the report had been completed but several changes were being reviewed regarding the BKD report and its impact on the prior year’s Contribution Margin Report along with a more definitive review of some of the areas where the contribution margin has suffered. Mr. Smith noted this item will be reviewed with the Budget and Finance Committee at its next meeting and a report will be made to the Board of Trustees at the March meeting. Mr. Smith also reviewed with members of the Board of Trustees the report which had been made to the City of El Reno on the EMS El Reno station and the justification for the $75,000 quarterly subsidy. Mr. Smith noted this report had been well received by the City and a check had been received from the City of El Reno for $75,000 on Monday of this week.

Chairman DeLana then referred members of the Board of Trustees to a report by Mr. Ray Simpson, EMS Director, on items the Budget and Finance Committee had discussed regarding the purchase of a new EMS unit. Mr. Simpson reviewed with members of the Board of Trustees information which had been reviewed with the Budget and Finance Committee. It was noted $60,000 of funds were available from an Ashbrook matching grant, along with $16,000 from the Parkview Hospital Auxiliary. Additionally, a Parkview Hospital Subscription Fund had $28,000 in it. Based upon a cost for the unit of $127,000 the hospital would have to provide approximately $22,171. Mr. Simpson reviewed with members of the Board of Trustees the justification for the purchase of a new unit with specific attention given to the ages of the ambulances currently in service. It was noted one unit had over 371,000 miles and was a 1990 model. This unit would be taken out of service upon the purchase of a new unit. After discussion of the various types of units and the recommendation of the Budget and Finance Committee a motion was made by Ms. Julie Rozsypal and seconded by Ms. Rosemary Klepper that the Parkview Hospital Board of Trustees approve the recommendation of the Budget and Finance Committee and the hospital’s administration to purchase an EMS unit for $127,000 from the Phoenix Group. The unit is a Type I Medium Duty 4500 GMC McCoy Miller. The funding for this unit would come from a $60,000 Ashbrook Grant, $16,000 from the hospital’s Auxiliary, $28,829 from the EMS Subscription Fund and $22,171 from the hospital’s general fund.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper, Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to discussion of Collection Agency evaluation and future reports to the Budget & Finance Committee. He called upon Hospital Administrator Lex Smith to make a report to the Board of Trustees on this item. Mr. Smith noted a preliminary report had been reviewed at the last Budget and Finance Committee meeting. The Committee felt additional items were needed to complete the report to make it ready for final presentation to the Board of Trustees. Mr. Smith noted several things are being reviewed. These are early out, collection, secondary placement and legal services from our current agency and other collection agencies. Additionally, we are also evaluating whether we can perform this service on an in-house basis in a more efficient and effective manner. The in-house basis evaluation along with the collection agency evaluation is not completed. Additional information is being obtained and will be submitted to the next Budget and Finance Committee and then to the next Board of Trustee meeting. Chairman DeLana noted several other items were discussed by members of the Budget and Finance Committee but these are under the Administrator’s Report.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XII - Administrator’s Report. He called upon Hospital Administrator Lex Smith to make several a report on several items to the Board of Trustees. Mr. Smith reported on the following items:

1. A schedule for the completion of the Outpatient Specialty Clinic and the budget was reviewed. It was noted the time frame for the area being totally completed is April 30, 2008. Various occupancy dates were given starting with 2/21/08 for the new hospital Auxiliary vending area, then the new Director of Nursing offices by 3/14/2008 and the new Outpatient Specialty Clinic waiting room by 3/31/08. Additionally, it was noted the total cost that has been incurred on this project through 2/6/2008 is $254,377.44. The total budget for this project is $400,000. Mr. Smith noted the hospital in on budget for completion of this area and he is encouraged by the overall quality of construction and financial operation of the area.

2. Mr. Troy Golden, Home Health Director, reviewed with members of the Board of Trustees the Home Health award which is being presented by the Oklahoma Foundation for Medical Quality to our Home Health service. Mr. Golden discussed the aspects of that award and that a meeting will be held on February 28, 2008 to present the award to the administrative staff of the Home Health service.

3. Mr. Smith gave members of the Board of Trustees an update on the contract for net income guarantee with Dr. Honglan Lu. Mr. Smith noted he had contacted her and she had sent a return e-mail stating she would be responding to the hospital’s offer in early March 2008. It was noted she is looking for answers to some questions. Mr. Smith noted he has not received any questions from her and is trying to facilitate the final signing of the Net Income Agreement. Mr. Smith noted he has contacted the physician recruiting firm and if Dr. Lu does not sign the agreement the recruiting firm will begin recruiting again at no additional cost to the hospital.

4. Mr. Smith reviewed with members of the Board of Trustees a couple of newspaper articles. One on "County inmate medical bills" and one on "WalMart in-store clinics". It was noted the WalMart in-store clinics dovetails with the hospital’s action regarding its Minor Care Center which was approved at tonight’s meeting for implementation.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XIII - Board of Trustee members Declare and Sign Conflict of Interest Statements for 7/1/2007 - 12/31/2007. Members of the Board of Trustees then declared and signed those Conflict of Interest Statements and turned them in to Hospital Administrator Lex Smith. Mr. Smith noted he would get those to the Administrative Secretary and they will be filed with the Secretary of State.

There being no further business a motion was made by Mr. Ron Ward and seconded by Dr. Michael Compton that the meeting adjourn.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper, Mr. Matt White and Ms. Julie Rozsypal voting aye.

MARCH 2008

The regular meeting of the Parkview Hospital Trust Authority was held in the Hospital Conference Center at 6:30 p.m. on Tuesday, March 11, 2008. The meeting was called to order by Mr. David DeLana, Chairman. Others present included Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper and Ms. Julie Rozsypal, Vice Mayor. Parkview Hospital Board of Trustee members not present were Dr. Margaret Mehle, Vice Chairman; and Mr. Matt White, Mayor. Also present at the meeting was Mr. Daniel Lapham, reporter, representing the El Reno Tribune. Representing the hospital staff were Ms. Pam Broyles, ER Nurse Manager; Mr. Ray Simpson, EMS Director; Mr. Doug Danker, Director of Nursing; Ms. Marsha Price, Director of Medical Records; Mr. Troy Golden, Home Health Director; Mr. Rod Shook, Chief Financial Officer; and Mr. Lex Smith, C.E.O./Administrator.

Chairman DeLana referred members of the Board of Trustees to Agenda Item No. II - Consent Docket, Items III-VI. Chairman DeLana noted the Board Trustees may approve these items with one motion; however, any item may be removed by request and will then be taken in regular agenda order. Following review and discussion a motion was made by Ms. Rosemary Klepper and seconded by Dr. Michael Compton that the Consent Docket be approved, specifically:

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. VII - Report of the Medical Staff meeting of March 10, 2008. Chairman DeLana called upon Hospital Administrator Lex Smith to make a report on this item. Hospital Administrator Lex Smith noted several guests were present at the meeting representing Saint Anthony’s Hospital. Two of those were physicians who are looking at applying for Medical Staff privileges once the new Outpatient Specialty Clinic is open. Those physicians are Dr. Mubina Gaffar, a Pulmonologist; and Dr. Sandeep Chopra, a Cardiologist. Additionally, Mr. Smith noted a report was given by the hospital’s laboratory Pathologist, Dr. Ron Schlesinger, regarding the hospital’s Laboratory operation. Mr. Smith noted a Medical Staff program was presented by Mr. Curt Caruso, Vice-President of Risk Management with Physician’s Liability Insurance Company. Mr. Smith noted the majority of the hospital’s physicians and Medical Staff are insured by PLICO for their professional liability coverage and this program revolved around risk management, coordination and concerted efforts of the hospital and physicians to work at reducing claims and increasing overall risk management functions. Hospital Administrator Lex Smith noted other reports were heard from Performance Improvement, Medical Audit/Credentials/Utilization Review, Emergency Management Task Force, Physician Assistant/Hospital/Medical Staff discussions, Minor Care Implementation Committee and various other reports on tonight’s Agenda. Chairman DeLana thanked Mr. Smith for his report of the Medical Staff meeting.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. VIII - Consider approval of recommendation from the Medical Staff for reappointment to the Courtesy and Consulting Medical Staff. Chairman DeLana referred members of the Board of Trustees to letters signed by Dr. Michael Sullivan, Chief of Staff, dated March 10, 2008 for reappointment to the Parkview Hospital Courtesy and Consulting Medical Staff for the Medical Staff year 2008 - 2010. After discussion and review a motion was made by Ms. Rosemary Klepper and seconded by Mr. Ron Ward that the recommendations from the Medical Staff as outlined in the letters signed by Dr. Michael Sullivan dated March 10, 2008 for Consulting and Courtesy Medical Staff reappointments for the 2008 - 2010 Medical Staff year be approved.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. IX - Presentation of Accounts Receivable Dashboard Indicators for 7/1/07 - 2/29/08. He called upon Hospital Chief Financial Officer Mr. Rod Shook to make this report. Mr. Shook reviewed with members of the Board of Trustees the detailed report prepared by the hospital’s administration. Mr. Shook noted an overhead presentation and Power Point presentation had been reviewed at the last Board of Trustees meeting by Hospital Administrator Lex Smith. Mr. Shook reviewed the updated report. Members of the Board of Trustees discussed the report with members of the hospital’s administration. Specific discussion regarded the expansion of the report by adding a Critical Number Summary page and adding a previous month for various highlighted statistics. Both of these items seemed to be very pertinent and the hospital’s administration will update the report in future months to show the Critical Number Summary page for the Board of Trustees. Chairman DeLana thanked Mr. Shook for his report.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. X - Report of the Budget and Finance Committee meeting of February 28, 2008. Chairman DeLana noted several reports were reviewed by the Budget and Finance Committee. Some of those are in the process of being updated and are an ongoing dialogue between the hospital’s administration and the Budget and Finance Committee. Chairman DeLana reviewed with members of the Board of Trustees those reports including the Contribution Margin Summary for the year to date 12/2007 and year to date 1/2008 with comparisons to EideBailly and BKD reserve for bad debts and accounts receivable. It was noted this report will be refined and then submitted to a future Budget and Finance Committee and then to the Board of Trustees. Additionally, Chairman DeLana reviewed with members of the Board of Trustees the report on the Charge Master comparison for five (5) departments for 7/1/2007 through 9/30/2007 and 10/1/2007 through 12/31/2007. It was noted this was broken down into quarterly reports so it would be easier to understand what the factors were that changed the overall revenue for each quarter. It was noted factors could be related to increases or decreases in volume, changes in the Medicare fee schedule on which the Charge Master report was based, changes in the mix of procedures in each department, changes in the multiplier for the Charge Master and/or other factors. It was noted these will be evaluated with specific attention given to the two major departments that were showing negative changes for the hospital, Radiology and Respiratory Therapy.

Chairman DeLana called upon Mr. Rod Shook, Chief Financial Officer, to review the evaluation and analysis of early out collections, motor vehicle collections, small claims and district court collections, and performing these services on an in-house or outside agency basis. Mr. Shook noted the Budget and Finance Committee had reviewed several proposals for performing early out and collection services on an outside agency basis. It was noted in review with members of the Budget and Finance Committee the motor vehicle accident and small claims can be done by an in-house collector at a very reasonable price that would save the hospital money and would seemingly increase our overall collections. It was noted we would not need to have any type of dialer to perform this service. The hospital’s administration is moving forward with this change. It was noted the hospital will continue to evaluate the other collection services to see what the best way to go on early out and collection services is. Chairman DeLana noted this is an ongoing project and reports are being made to the Budget and Finance Committee regarding the cost of the services versus the benefit to the hospital.

Chairman DeLana reviewed with members of the Board of Trustees several items that need to be considered for action. These relate to audit and audit services. Chairman DeLana noted the Budget and Finance Committee was recommending the following items for Board consideration and approval:

Chairman DeLana discussed the various aspects of these three (3) recommendations from the Budget and Finance Committee. Letters were reviewed from BKD outlining these items. It was noted the increased fees for the 6/30/07 audit had been explained very well by BKD. It had been specifically discussed and reviewed with members of the hospital’s administration, Chairman of the Board of Trustees, Budget and Finance Committee and the Board of Trustees. The proposal for the fiscal year ending 6/30/2008 audit and changes were discussed. It was noted a letter of engagement for fiscal year ending 6/30/2008 would be received once this item is approved by the Board of Trustees. Hospital Administrator Lex Smith discussed BKD performing a one-day, on-site interim allowance project. Chairman DeLana noted this item had been discussed by the Budget and Finance Committee and it was felt the time to do this is now so we can have a report at the next Board of Trustees meeting. After further discussion a motion was made by Ms. Julie Rozsypal and seconded by Mr. Ron Ward that the Parkview Hospital Board of Trustees approve the recommendations of the Budget and Finance Committee as outlined:

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XI - Report on Performance Improvement effort for hospital. He called upon Mr. Doug Danker, Director of Nursing, to make this report. Mr. Danker reviewed with members of the Board of Trustees the report for 2007 entitled "Red Light-Green Light Report". Mr. Danker reviewed the report in detail with members of the Board of Trustees and noted the hospital had made great progress in its first year of red light-green light reporting. Members of the Board of Trustees discussed this in some detail and thanked Mr. Danker and his Performance Improvement staff for the outstanding report and the very good progress that had been made.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XII - Minor Care Center Implementation Committee Report. Mr. Danker discussed with members of the Board of Trustees the status of the report with specific discussion in the areas of purpose, hours of operation, policies, fee schedule, staffing, lab, forms and medical director. Minutes of the meetings were reviewed in detail. Hospital Administrator Lex Smith, discussed with members of the Board of Trustees some of the research our advertising firm had been doing on trademarking a name for this particular program. It was noted that after their research the advertising firm was recommending that we trademark the name "Minor Med", "The Minor Care Center at Parkview". Various logos were presented and discussed. After further discussion and review a motion was made by Mr. Ron Ward and seconded by Dr. Michael Compton that Parkview Hospital trademark the name "Minor Med" and use it as the advertising vehicle with the logo which was attached for Board review.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper and Ms. Julie Rozsypal voting aye.

Hospital Administrator Lex Smith reviewed with members of the Board of Trustees several items including:

1. Report on Physician and PA meeting on Emergency Department held on 3/5/2008 as requested by the Board of Trustees. It was noted Dr. Margaret Mehle, Dr. Clinton Strong and Hospital Administrator Lex Smith met with the hospital’s Emergency Room Physician Assistants.

2. Update on the status of Honglan Lu, M.D. and her contract agreement. Mr. Smith noted this has not yet been signed but the Letter of Intent has been signed. It was noted that various communication had been made to Dr. Lu and it is hoped a final Contract Agreement can be signed and put into effect in March. It was noted Dr. Lu is scheduled to relocate her practice to El Reno in November 2008.

3. An update was given regarding the EMS Ambulance service and budget request for 7/1/2008 through 6/30/2009. Hospital Administrator Lex Smith reviewed with members of the Board of Trustees the request sent to the City of El Reno. It was noted after meeting with the City Manager, Mr. Joe Weaver, hospital attorney, would be putting together a contract proposal for a subsidy agreement to go to the hospital’s Budget and Finance Committee, the City Attorney and the El Reno City Council. It is hoped a finalized agreement can be approved by both groups prior to the 7/1/2008 fiscal year.

Mr. Troy Golden, Home Health Director, reviewed with members of the Board of Trustees the award which had been received for quality improvement in the Home Health department. Members of the Board of Trustees thanked Mr. Golden and his team for their success in meeting these high quality standards.

Under the area of Roundtable Discussion several members of the Board of Trustees discussed correspondence recently received regarding the Parkview Hospital Trust Indenture and appointments of Board of Trustee members to the Parkview Hospital Trust Authority.

There being no further business a motion was made by Mr. Ron Ward and seconded by Ms. Rosemary Klepper that the meeting adjourn.

The motion carried with Mr. David DeLana, Mr. Ron Ward, Dr. Michael Compton, Ms. Rosemary Klepper and Ms. Julie Rozsypal voting aye.

APRIL 2008

The regular meeting of the Parkview Hospital Trust Authority was held in the Hospital Conference Center at 6:30 p.m. on Tuesday, April 8, 2008. The meeting was called to order by Mr. David DeLana, Chairman. Others present included Mr. Ron Ward, Dr. Margaret Mehle, Dr. Michael Compton, Mr. Matt White; Mayor and Ms. Julie Rozsypal, Vice Mayor. Ms. Rosemary Klepper was not able to be present at the meeting due to a previous commitment. Also present at the meeting was Mr. Daniel Lapham, reporter, representing the El Reno Tribune. Representing the hospital staff were Ms. Marsha Price, Director of Medical Records; Mr. Troy Golden, Home Health Director; Mr. Doug Danker, Director of Nursing; Mr. Ray Simpson, EMS Director; Mr. Rod Shook, Chief Financial Officer; and Mr. Lex Smith, C.E.O./Administrator.

Chairman DeLana referred members of the Board of Trustees to Agenda Item No. II - Consent Docket, Items III-VI. Chairman DeLana noted the Board Trustees may approve these items with one motion; however, any item may be removed by request and will then be taken in regular agenda order. Dr. Michael Compton asked that under Agenda Item No. VI-the Uncollectibles totaling $669,870.59 be removed from the Consent Docket and discussed separately. Following review and discussion a motion was made by Mr. Ron Ward and seconded by Dr. Margaret Mehle that under Agenda Item No. VI - Uncollectibles totaling $669,870.59 be removed from the Consent Docket and that the Consent Docket be approved, specifically:

The motion carried with Mr. David DeLana, Dr. Margaret Mehle, Mr. Ron Ward, Dr. Michael Compton, Ms. Mr. Matt White and Ms. Julie Rozsypal voting aye.

Dr. Michael Compton then discussed with members of the Board of Trustees the Uncollectibles listed on the charge offs totaling $669,870.59. Discussion ensued regarding the uncollectible accounts listed on the charge offs under diagnostic outpatient. Dr. Compton noted he had talked to the Hospital Administrator and several of these reports were reviewed and information given to him regarding the diagnostic outpatient reports. Members of the Board of Trustees discussed the fact that collections are considered low at Parkview Hospital and the ongoing status of the low collections is creating a financial hardship on the hospital. Several members of the Board of Trustees noted a more diligent effort must be made to collect those accounts which are deductibles, co-pays and self-pay accounts that are not of an emergency nature. It was noted 22% of the hospital’s patients are uninsured and this does create undue financial hardship for the hospital. Members of the Board of Trustees discussed in some detail the uncollectible procedure. Discussion ensued regarding new financial systems that are being installed which will allow the hospital to know the deductibles and co-pays on insurance patients so these amounts can be collected prior to the service being delivered. Discussion ensued regarding patients that have insurance but were not being required to pay "up front" their co-pays and deductibles. There was also discussion regarding applying a discount for patients who would pay their self-pay balances, which would include co-pays and deductibles, up front giving the patient incentive to pay the bill instead of paying it out over time. After further discussion a motion was made by Ms. Julie Rozsypal and seconded by Mr. Matt White that the Parkview Hospital Board of Trustees approve charging off Uncollectibles for $669,870.59, that this item be referred to the Budget and Finance Committee for updating and further discussion of the Uncollectible Procedure and the establishment of better Policies regarding patients paying their deductibles, and self-pay balance prior to the delivery of service.

The motion carried with Mr. David DeLana, Dr. Margaret Mehle, Mr. Ron Ward, Dr. Michael Compton, Ms. Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana thanked members of the Board of Trustees for the discussion on the previous item and noted he felt this is a very important area for the hospital to continue to address.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. VII - No report of Medical Staff meeting. The next meeting is scheduled for April 14, 2008. It was noted that since there was not a Medical Staff meeting there were no credential recommendations from the Medical Staff for tonight’s Board of Trustee meeting.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. VIII - Presentation of Accounts Receivable Dashboard Indicators (Summary for FY 07/08 and detailed report for 3/2008). He called upon Mr. Rod Shook, Chief Financial Officer, to make a report on these indicators. Mr. Shook discussed with members of the Board of Trustees in detail the dashboard indicators which had been developed by BKD and are being reported to the Board of Trustees on a monthly basis. Additionally, it was noted that at the last Board of Trustees meeting Mr. Ron Ward had asked for a Summary for the Dashboard Indicators. Mr. Shook reviewed with members of the Board of Trustees the Summary Report which showed the June 2007, December 2007, January 2008, February 2008 and March 2008 dollars in the areas of aging, allowance summary, collection percentages to net patient service revenue and gross patient service revenue and days in A/R. Discussion ensued regarding the hospital benchmarks for days in A/R. It was noted these need to be accurate updated benchmark figures. Additionally, a goal for Parkview Hospital should be established. There was discussion concerning using seventy (70) days for a goal with members of the Board of Trustees. Hospital Administrator Lex Smith and Chief Financial Officer Rod Shook noted they would refine the hospital benchmark numbers and bring them to the next Budget and Finance Committee and/or Board of Trustees meeting on the report. Members of the Board of Trustees continued the discussion regarding the uncollectible balances and Parkview Hospital changing its policy regarding collection of self-pay balances, specifically deductibles and co-pays on non emergency procedures and tests so the insurance department and business office collect the patient’s deductible and co-pay in full prior to the delivery of service for non emergency diagnostic outpatient testing.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. IX - Report of the Budget and Finance Committee meeting of April 3, 2008. Chairman DeLana referred members of the Board of Trustees to the first item on the Committee Agenda - Consider recommendation to approve Letter of Engagement by BKD for the audit engagement for 7/1/2007 - 6/30/2008. Chairman DeLana called upon Hospital Administrator Lex Smith to review this item with members of the Board of Trustees. Mr. Smith noted the representatives from BKD had submitted the attached Letter of Engagement dated March 25, 2008. Mr. Smith referred members of the Board of Trustees to the information requested by the Budget and Finance Committee regarding the estimation of the engagement. It was noted the financial statement, audit and preparation for the Medicare Cost Report would be $44,730 to $49,700 based on 315 to 350 hours. Additionally, the audit procedure performed in accordance with the Risk Assessment Suite would be $8,965 - $13,040 based on 55 - 80 hours. It was noted the Budget and Finance Committee had asked that BKD place a statement in the Engagement Letter stating "any additional time and fees anticipated in excess of those quoted above will be discussed and approved by management". After further discussion a motion was made by Dr. Margaret Mehle and seconded by Dr. Michael Compton that the Letter of Engagement as reviewed and recommended by the Budget and Finance Committee from BKD be approved for the audit for 7/1/2007 through 6/30/2008.

The motion carried with Mr. David DeLana, Dr. Margaret Mehle, Mr. Ron Ward, Dr. Michael Compton, Ms. Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to discussion of one-day Interim Accounts Receivable Review conducted by BKD on 3/20/08. Chairman DeLana noted this item had been reviewed in detail by members of the Budget and Finance Committee and BKD was getting additional information to the hospital regarding this review. It was noted this item will be reviewed again by the Budget and Finance Committee at its next meeting. Based on the review by BKD the hospital was reserving within a range of 1% plus or minus regarding the accounts receivable of the hospital. It was noted this was being done for the first eight (8) months through February 29, 2008. Various procedures are being refined and based on BKD’s recommendations they are not recommending any change in the allowance as computed by the hospital. Chairman DeLana noted this item will be discussed at the next Budget and Finance Committee meeting and additional information will be brought to the Board if needed.

Chairman DeLana then referred members of the Board of Trustees to consider recommendation to approve EMS Agreement prepared by hospital attorney. The Committee is recommending a three (3) year agreement for 7/1/2008 - 6/30/2011 with a first year subsidy of $325,000. Hospital Administrator Lex Smith reviewed with members of the Board of Trustees the proposed recommendation. Mr. Smith highlighted the changes in this agreement versus the current agreement. This is a three (3) year agreement whereby the El Reno City Council, based on budget constraints, can opt out after any one (1) year. It was noted different financial reports are prepared as part of this agreement and Mr. Smith reviewed in detail some of the reports and revenue that will be reported. Additionally, it was noted there will be an annual increase based upon the increase in the overall sales tax collections for the City of El Reno. In no year will the amount of the subsidy decrease if the sales tax goes down. Mr. Smith noted there is an additional fund that will be established which will be a segregated EMS Equipment Fund with 10% of the proceeds of the Public Health and Safety Sales Tax going into that fund. The hospital can make application to the City to acquire those funds based on replacement of equipment and/or ambulance units. Mr. Smith noted it is his intention after talking to the El Reno City Manager and the hospital’s attorney that this be submitted to the Board of Trustees so it can then be considered by the El Reno City Council. After further discussion a motion was made by Mr. Ron Ward and seconded by Dr. Michael Compton that the Parkview Hospital Board of Trustees approve the EMS Agreement as reviewed, discussed and recommended by the Budget and Finance Committee for a three (3) year agreement for 7/1/2008 through 6/30/2011 with a first year subsidy of $325,000.

Mr. David DeLana, Dr. Margaret Mehle, Mr. Ron Ward, and Dr. Michael Compton voted aye and Mr. Matt White, Mayor; and Ms. Julie Rozsypal, Vice Mayor voted no. The motion carried four (4) to two (2).

Hospital Administrator Lex Smith noted he would put this item on the Agenda for the El Reno City Council. Both the Mayor and Vice Mayor noted they understood the reason for this item being forwarded to the City Council and thanked members of the Parkview Hospital Board of Trustees in moving this forward. Mr. White and Ms. Rozsypal noted that as City Council members they would see it when it came to the next El Reno City Council meeting but they wanted to assure the community that they are in favor of the hospital providing EMS services for the community and that they felt positive a subsidy agreement will be worked out between the two entities before 7/1/2008.

Chairman DeLana then referred members of the Board of Trustees to discussion of EMS El Reno Equipment Lease prepared by hospital attorney. It was noted this is an item that is being recommended by the City due to insurance purposes. It was noted Parkview Hospital is currently getting its ambulance insurance on a compact policy through the City of El Reno for police, fire and ambulance units. Recently the hospital had a claim against of the insurance and the City was not holding the titles on those ambulances. When the insurance company paid that claim they wanted some changes made regarding those titles. This lease agreement was reviewed by the Budget and Finance Committee and the hospital’s administration is getting additional information from BKD to make sure this is a capitalized lease and from Advantage Insurance regarding cost comparisons. Once that information is received this item can be taken to the next Board of Trustee meeting for consideration and referral to the City Council. Mr. Matt White, Mayor, noted he had reviewed this information with the city and this would be a good way to clear up the situation regarding the titles on the ambulances.

Chairman DeLana then referred members of the Board of Trustees to discussion of Discussion of Chargemaster and outside collection agency to in-house collections for early out program. He called upon Mr. Rod Shook, Chief Financial Officer, to review these items with members of the Board of Trustees. Mr. Shook noted he had made a presentation to the Budget and Finance Committee on this item and additional discussion would be held at the next Budget and Finance Committee meeting regarding this item. Mr. Shook reviewed both the Chargemaster aspects and the collection agency aspects of this item. Chairman DeLana noted five (5) particular departments were being reviewed under the Chargemaster - Radiology, Physical Therapy, Respiratory Therapy, Laboratory and ER Physicians. It was noted the Chargemaster was being review in the areas where the largest impact on hospital charges had been seen. That was in the areas of Radiology and Respiratory Therapy. There was additional discussion regarding the in-house versus early and bad debt collection procedures.

Chairman DeLana then referred members of the Board of Trustees to consider recommendation to approve increasing the Line of Credit at MidFirst Bank from $500,000 to $850,000 and increasing the monthly payment on the Line of Credit from $2,000 to $3,000. The current interest rate on the Line of Credit is 5.25%. Chairman DeLana noted this item has been discussed in detail by the hospital’s Budget and Finance Committee. Due to the hospital’s repayment to Medicare of $285,000 in January the hospital is having to let its accounts payable build up to a level that was creating difficulty for the hospital. It was noted several cash projections were reviewed. Additionally, there are five (5) account payables are due in April and three (3) payrolls are due in May. Due to the repayment to Medicare of $285,000 the hospital borrowed on the Line of Credit up to $496,000. The Budget and Finance Committee reviewed this in some detail and is making a recommendation that the Parkview Hospital Board of Trustees approve the increasing of the Line of Credit from $500,000 to $850,000. This is a $350,000 increase. Hospital Administrator Lex Smith noted this increase of $350,000 was not enough to require the hospital to go to the City of El Reno for approval. Based upon the hospital’s Trust Indenture the amount of approval has to be over 5% of the hospital’s Balance Sheet assets. This would require over $423,000. It was noted that just because the hospital does have the Line of Credit at $850,000 does not mean it would borrow up to that amount. This would allow the hospital to have flexibility in meeting its financial obligations if we experience increasing or decreasing cash flow in any particular month. After

additional discussion a motion was made by Mr. Matt White and seconded by Dr. Margaret Mehle that the Parkview Hospital Board of Trustees approve the hospital increasing the Line of Credit at MidFirst Bank from $500,000 to $850,000 and increasing the monthly payment on the Line of Credit from $2,000 to $3,000.

The motion carried with Mr. David DeLana, Dr. Margaret Mehle, Mr. Ron Ward, Dr. Michael Compton, Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana then referred members of the Board of Trustees to Agenda No. X - Consider recommendation to elect Board officers for the 5/1/2008 - 4/30/2009 period. It was noted the Executive Committee had met and was making a recommendation for the following slate of officers:

Lex Smith, Secretary - non-voting member of the Board of Trustees

Chairman DeLana noted that he, Dr. Mehle and Mr. Smith had served one year in this capacity. After discussion a motion was made by Mr. Matt White and seconded by Dr. Michael Compton that the recommendation of the Executive Committee of David DeLana, Chairman; Dr. Margaret Mehle, Vice-Chairman; and Lex Smith, Secretary - non-voting member of the Board of Trustees be approved as Board officers for 5/1/2008 through 4/30/2009.

The motion carried with Mr. David DeLana, Dr. Margaret Mehle, Mr. Ron Ward, Dr. Michael Compton, Mr. Matt White and Ms. Julie Rozsypal voting aye.

Chairman DeLana then called upon Hospital Administrator Lex Smith to make a report on items of an administrative nature. Mr. Smith reported on the following items:

1. Oklahoma Hospital Association State Capitol Legislative issues. It was noted the major issue this year is Medicaid/SoonerCare; the number two issue is work force regarding available workforce for hospitals; number three is inmate care; number four is insurance issues; number five is certificate of need; and number six is other issues.

2. Mr. Smith updated members of the Board of Trustee on Senate Bill 811 regarding inmate preexisting care issues

3. Mr. Smith reported to the Board of Trustees that Dr. Honglan Lu had sent an email to the Hospital Administrator noting she would not be accepting the Family Practice/OB position. Mr. Smith noted he had initiated and renewed the search with Arthur Marshall who had recruited Dr. Lu. It was noted Arthur Marshall is providing their services to the hospital at no cost except for the cost of advertising. It is hoped a Family Practice/OB physician can be recruited and on board practicing by early 2009. It was noted Dr. Lu would not have been available until November 2008.

4. Mr. Smith discussed with members of the Board of Trustees information regarding the discussion of the FutureScan 2008 booklet on healthcare trends and implications for 2008 - 2013. It was noted this booklet had been sent by the C.E.O. to the Board, Active Medical Staff, Physicians Assistants and Department Directors. Members of the Board of Trustees discussed in detail strategic planning. Specific attention was given by Mr. Ron Ward, Board member, to the need for development of strategic plans and the possibility of setting up a separate meeting of the Board of Trustees with a facilitator. Members of the Board of Trustees asked Hospital Administrator Lex Smith to contact a couple of facilitators to get pricing on coordinating a strategic planning session that would meet with everyone’s schedule. Mr. Smith noted he would put information and get it to Board of Trustee members over the next couple of months.

Chairman DeLana noted Ms. Julie Rozsypal had tendered her resignation to the El Reno City Council due to personal reasons. It was noted she has been serving as Vice Mayor on the Parkview Hospital Board of Trustees and will be greatly missed by the Board of Trustees. Ms. Julie Rozsypal discussed with members of the Board of Trustees her gratitude for their kindness and the pleasure she had serving on the hospital Board of Trustees as the Vice Mayor of the City of El Reno.

There being no further business a motion was made by Mr. Ron Ward and seconded by Dr. Margaret Mehle that the meeting adjourn.

The motion carried with Mr. David DeLana, Dr. Margaret Mehle, Mr. Ron Ward, Dr. Michael Compton, Mr. Matt White and Ms. Julie Rozsypal voting aye.

MAY 2008

The regular meeting of the Parkview Hospital Trust Authority was held in the Hospital Conference Center at 6:30 p.m. on Tuesday, May 13, 2008. The meeting was called to order by Mr. David DeLana, Chairman. Others present included Mr. Ron Ward; Dr. Margaret Mehle; Dr. Michael Compton; Ms. Rosemary Klepper; Mr. Matt White, Mayor and Mr. Glen Nichols, Vice Mayor. Also present at the meeting was Mr. Daniel Lapham, reporter, representing the El Reno Tribune. Representing the hospital staff were Ms. Marsha Price, Director of Medical Records; Ms. Terri Menz, Medical Records employee; Ms. Tracy Sisco, Business Officer Manager; Ms. Claudia Eaton, Risk Manager; Mr. Troy Golden, Home Health Director; Mr. Doug Danker, Director of Nursing; Ms. Pam Broyles; ER Nurse Manager; Mr. Ray Simpson, EMS Director; Mr. Rod Shook, Chief Financial Officer; and Mr. Lex Smith, C.E.O./Administrator. Also present at the meeting was guest Ms. Rebecca Smith.

Chairman DeLana referred members of the Board of Trustees to Agenda Item No. II - Consent Docket of Items III-VI. Chairman DeLana noted the Board Trustees may approve these items with one motion; however, any item may be removed by request and will then be taken in regular agenda order. Dr. Michael Compton asked that Agenda No. VI - Uncollectibles totaling $438,253.97 be removed from the Consent Docket along with the other items in Agenda Item No. VI. After the request by Dr. Compton a motion was made by Dr. Margaret Mehle and seconded by Mr. Ron Ward that Consent Docket Items No. III - V be approved, specifically:

Dr. Michael Compton then reviewed with members of the Board of Trustees the reason for pulling the approval items of the Uncollectibles and other items on Agenda Item No. VI on charge offs. He wanted additional informational information regarding those charge offs. Ms. Tracy Sisco, Business Office Manager, reviewed with members of the Board of Trustees a report entitled "Parkview Hospital Uncollectibles April 2008 Statistics" that showed the breakdown of those accounts and noted that of the 253 accounts accounting for $438,253.97 188 of those were for ER services or 74% of the total. $37,000 is deductible, co-pay or co-insurance which is 9% of the total uncollectible amount. Members of the Board of Trustees discussed these items in detail. After discussion a motion was made by Dr. Michael Compton and seconded by Mr. Ron Ward that Agenda Item No. VI be approved, specifically:

Chairman DeLana then called the members attention to a new members of the hospital’s Board of Trustees. He welcomed Mr. Glen Nichols, the new Vice Mayor, who will be serving on the hospital Board of Trustees. It was noted Mr. Nichols was appointed by the City Council as Vice Mayor to replace Ms. Julie Rozsypal who is no longer serving as a council member and/or the Vice Mayor of the City of El Reno.

Chairman DeLana then referred members of the Board of Trustees to a report of the Medical Staff meetings of April 14, 2008 and May 12, 2008. He called upon Hospital Administrator Lex Smith to make a report of both of those meetings. Mr. Smith noted two Medical Staff meetings had been held since the last Board of Trustee meeting. Mr. Smith noted the meeting held the previous evening included various reports from the Performance Improvement Committee, Medical Audit/Credentials/Utilization Review Committee, Disaster Drill Planning Committee, IT Task Force, Minor Care Implementation Committee and Infection Control Committee. Additionally, it was noted a Medical Staff program was sponsored by St. Anthony’s Wound Care Center. Mr. Smith noted the previous month a program had been sponsored by PLICO regarding report for physicians and professional liability insurance. Mr. Smith noted Medical Staff appointments and reappointments were on the Agenda this evening from the April Medical Staff meeting. It was noted other items were on the Agenda that had been referred regarding Night Rays credentialing and a Performance Improvement Plan that was presented and is being recommended to the full Board of Trustees. Additionally, it was noted the new physician that is being recommended for a contract with Parkview Hospital was discussed with members of the Medical Staff.

Chairman DeLana then referred members of the Board of Trustees to items regarding Medical Staff recommendations. He called upon Hospital Administrator Lex Smith to review with members of the Board of Trustees recommendations from the Medical Staff regarding credentialing. Mr. Smith referred members of the Board of Trustees to letters dated April 14, 2008 signed by Dr. Michael Sullivan, Chief of Staff, regarding reappointment of Active, Courtesy, Consulting and Non-Physician Medical Staff for the 2008 - 2010 Medical Staff year and appointments for 2008 - 2010 Consulting Medical Staff with temporary privileges approved through July 1, 2008. After discussion and review a motion was made by Mr. Matt White and seconded by Mr. Ron Ward that the recommendations from the Medical Staff dated April 14, 2008 signed by Dr. Michael Sullivan, Chief of Staff, be approved by the Board of Trustees as recommended by the Medical Staff.

Hospital Administrator Lex Smith then referred members of the Board of Trustees to the recommendation for credentialing and privileging agreement with Night Rays for after hours radiology readings. Mr. Smith reviewed with members of the Board of Trustees the recommendation from the Medical Staff for the Night Rays after hours reading. It was noted this is a contract agreement that would credential these physicians on an ongoing basis based upon the previous Joint Commission accreditation of Night Rays. The listing of physicians under the radiology area would be continuously updated. Discussion ensued regarding Night Rays, the ongoing expansion of the Night Rays program and the savings Night Rays was generating for the hospital regarding overall savings tied to volume. After discussion a motion was made by Dr. Margaret Mehle and seconded by Ms. Rosemary Klepper that the recommendation for the credentialing and privileging agreement with Night Rays for after hours radiology readings be approved.

Hospital Administrator Lex Smith then reviewed with members of the Medical Staff the recommended change in the Medical Staff Bylaws to credential Advanced Registered Nurse Practitioners (ARNP) under Section 7, Item D. Mr. Smith reviewed with members of the Board of Trustees the recommendation from the Medical Staff on the Advanced Registered Nurse Practitioner Bylaws. He noted this item was not previously listed in the hospital’s Medical Staff Bylaws and it is being incorporated to allow ARNPs to be on the hospital staff as outlined in the proposed bylaw change. Initially it was noted this would allow ARNPs to serve in the hospital’s Minor Care Center and see patients. Ms. Rosemary Klepper noted this is a very positive move for the hospital and she would highly encourage the adoption of this change in the Medical Staff Bylaws. After additional discussion a motion was made by Ms. Rosemary Klepper and seconded by Mr. Matt White that the recommendation to change the Medical Staff Bylaws to credential Advanced Registered Nurse Practitioners as outlined in Section 7, Item D be approved.

Chairman DeLana then referred members of the Board of Trustees to the presentation of the Performance Improvement Plan for 2008. He called upon Mr. Doug Danker, Director of Nursing, to make a report on this item. Mr. Danker reviewed with members of the Board of Trustees the Performance Improvement Plan for 2008. He noted this had previously been submitted to the Board but we had not received all of the information from CMS to allow us to do this. It was noted the 2008 Performance Improvement Plan will have five (5) primary areas of focus; 1) CMS quality measure; 2) 2008 National Patient Safety Goals; 3) Customer Satisfaction; 4) Process Improvement; and 5) Compliance. It was noted these are ongoing and the hospital is continuously making improvements in its overall processes and improving patient care. After discussion Ms. Rosemary Klepper noted these Performance Improvement Plan areas are very important and she highly encourages the hospital to move forward in the areas of patient safety and process improvement goals. After additional discussion a motion was made by Dr. Margaret Mehle and seconded by Dr. Michael Compton that the Parkview Hospital Board of Trustees approve the Performance Improvement Plan for 2008 as recommended by the Medical Staff and submitted by the hospital’s administration.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XI - Report of the Budget and Finance Committee meeting of May 1, 2008. Chairman DeLana reviewed with members of the Board of Trustees the Budget and Finance Committee minutes and the recommendation from that Committee to approve a Net Income Guarantee Agreement with Dr. William Tordzro for a two (2) year net income guarantee plus four (4) years for forgiveness at $200,000/year for year one (1) and two (2) plus $20,000 signing bonus. It was noted that Dr. Tordzro would start practice in El Reno on or before October 1, 2008. Chairman DeLana called upon Hospital Administrator Lex Smith to make a report on this item to members of the Board of Trustees. Mr. Smith reviewed with members of the Board of Trustees the discussions regarding Dr. Tordzro. It was noted Dr. Tordzro had received four (4) offers at four (4) different locations and he was very interested in starting his practice in El Reno due to the very positive environment and possible growth in terms of Family Practice/Obstetrics. It was noted Dr. Tordzro performed C-Sections and would be setting up his own office. Mr. Smith noted his office would be set up under a lease for office space on Parkview Drive through Dr. Clinton Strong. Dr. Tordzro will be practicing by himself and might add another physician or two in the future. Mr. Smith and members of the Budget and Finance Committee highly recommend that the contract for the net income guarantee be approved. Dr. Margaret Mehle, Vice Chief of Staff, noted she had the opportunity to meet Dr. Tordzro. She was highly complimentary of his outstanding bedside manner and noted he would be an excellent addition to the hospital’s Active Medical Staff. Dr. Tordzro’s resume was reviewed in detail with members of the Board of Trustees. Mr. Smith noted his resume had been discussed and reviewed with members of the Medical Staff. After discussion a motion was made by Dr. Margaret Mehle and seconded by Ms. Rosemary Klepper that the hospital’s Board of Trustees approve the Physician Net Income Guarantee Agreement with Dr. William Tordzro for a two (2) year net income guarantee plus four (4) years for forgiveness at $200,000/year for year one (1) and two (2) plus $20,000 signing bonus. Dr. Tordzro would start practice in El Reno on or before October 1, 2008.

Chairman DeLana then referred members of the Board of Trustees to a recommendation that administration be authorized to investigate with various banks and seek proposals for renewal of the hospital’s current Letter of Credit of $161,604 and securing a Line of Credit for $850,000. This $850,000 is $350,000 over the current Line of Credit with MidFirst Bank. Chairman DeLana noted the Board had authorized an increase of $350,000 in the Line of Credit at the April 8, 2008 meeting. Chairman DeLana reviewed with members of the Board of Trustees the MidFirst proposal which had been submitted to the Budget and Finance Committee and administration when there was a request to increase the Line of Credit from $500,000 to $850,000. Based on the information included in the MidFirst proposal regarding collateral, reporting, covenants, conditions, expenses and other provisions, it was the recommendation of the Budget and Finance Committee in discussing with administration that bid proposals be requested from other financial institutions. It was noted MidFirst could submit a bid along with Rose Rock Bank and Canadian State Bank (both of these banks are located in Canadian County). Hospital Administrator Lex Smith reviewed with members of the Board of Trustees letters for submission to MidFirst Bank, Rose Rock Bank and Canadian State Bank. It was noted information would need to be submitted to the Budget and Finance Committee and to the Board of Trustees at the next meeting. After discussion a motion was made by Dr. Michael Compton and seconded by Mr. Matt White that the Board of Trustees approve the recommendation from the Budget and Finance Committee that administration be authorized to investigate with various banks and seek proposals for renewal of the hospital’s current Letter of Credit of $161,604 and securing a Line of Credit for $850,000. The $850,000 Line of Credit is $350,000 above the current Line of Credit the hospital has.

Chairman DeLana then referred members of the Board of Trustees to discussion of various EMS Agreements with the City of El Reno. He called upon Hospital Administrator Lex Smith to make a report to members of the Board of Trustees on this item. Mr. Smith referred members of the Board of Trustees to a newspaper article dated Wednesday, May 7, 2008 entitled "Ambulance run regional plan worth a look". Additionally, Mr. Smith reviewed with members of the Board of Trustees the quarterly EMS Report for 7/1/07 through 3/31/08 that had been submitted to the El Reno City Council meeting on May 6, 2008. It was noted this is a report that is required as part of the quarterly report and subsequent payments to the hospital up to $75,000 quarterly with an annual maximum of $300,000 based on the current contract that expires 6/30/2008. Mr. Smith noted he made that report to the City Council and the City Council is requesting additional information prior to paying that amount to the hospital.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item XI-C-2 which is the Proposed EMS Subsidy Agreement effective 7/1/08 that was approved at the 4/8/08 Board meeting but at the request of the Budget and Finance Committee pulled from City Council meeting of 5/6/08. It was noted this item was pulled so further discussion could be held. Chairman DeLana requested that based on the current situation he would request this item be tabled until the next meeting of the Parkview Hospital Board of Trustees. Based on Chairman DeLana’s request and hearing no dissension from the members of the Board of Trustees the proposed EMS Subsidy Agreement effective 7/1/2008 which was approved at the 4/8/08 Board meeting will be tabled and placed on the Agenda for the June Board of Trustees meeting.

Chairman DeLana then referred members of the Board of Trustees to the proposed EMS Equipment Lease Agreement that was requested by the City of El Reno for insurance purposes. It was noted this item had been reviewed by the hospital’s attorney and also by the City attorney. This agreement will allow the hospital’s insurance on the ambulance to be covered through the City of El Reno with the City holding the title. After discussion a motion was made by Mr. Matt White and seconded by Dr. Margaret Mehle that the proposed EMS Equipment Lease Agreement requested by the City of El Reno for insurance purposes be approved.

Hospital Administrator Lex Smith distributed a report to members of the Board of Trustees which had been requested by Ms. Julie Rozsypal. It was noted this report had been submitted to the Mayor regarding the upcoming EMS contract approval. It was noted this item can be submitted at the next Board of Trustees meeting but Ms. Rozsypal had prepared an evaluation and her opinion, as an ex-City Council member and Vice Mayor serving on the hospital Board of Trustees, regarding the EMS Subsidy Agreement for 7/1/08 through 6/30/09 between Parkview Hospital and the City of El Reno. No discussion ensued regarding Ms. Julie Rozsypal’s report.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XI-E - Review various reports presented to Budget and Finance Committee by Rod Shook, C.F.O. and Lex Smith, C.E.O. Members of the hospital’s administration noted these reports had been heard at the Budget and Finance Committee and reviewed in detail the following reports with members of the Board of Trustees:

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XI-G - Recommendation that a Consulting Engagement Proposal from Community Partners, Tulsa, Oklahoma regarding engaging them for a basic scope of service to be completed in sixty (60) to seventy (70) days at a cost of $27,500 plus expenses. It was noted this item had been discussed at the last Board of Trustees meeting and is being recommended by the Budget and Finance Committee. After discussion and review a motion was made by Mr. Matt White and seconded by Mr. Glen Nichols that the recommendation that a Consulting Engagement Proposal from Community Partners, Tulsa, Oklahoma regarding engaging them for a basic scope of service to be completed in sixty (60) to seventy (70) days at a cost of $27,500 plus expenses be tabled until the next Board of Trustees meeting.

The motion carried with Matt White, Glen Nichols, David DeLana, Margaret Mehle and Ron Ward voting yes. Dr. Michael Compton and Ms. Rosemary Klepper voted no. Based on a five (5) to two (2) the consulting engagement proposal from Community Partners will be tabled until the next Board of Trustees meeting.

Chairman DeLana noted there were no other business items for discussion from the Budget and Finance Committee.

Chairman DeLana then referred members of the Board of Trustees to Agenda Item No. XII - Administrator’s Report. He called upon Hospital Administrator Lex Smith to make a report to members of the Board of Trustees. Mr. Smith reported on the following items:

1. A new El Reno City Council member had been appointed. Dr. Kent Carder has been sworn in as of May 13, 2008 to the El Reno City Council.

2. Mr. Smith updated members of the Board of Trustees on the hospital budget plans for the 7/1/2008 through 6/30/2009 fiscal year. It was noted a presentation and recommendations from the Budget and Finance Committee will be made to the June 10, 2008 Board of Trustees meeting.

3. Mr. Smith had attached for members of the Board of Trustees the May 11, 2008 newspaper article from the El Reno Tribune entitled "Mayor calls for Parkview head to resign". There was no discussion regarding this item.

Chairman DeLana asked members of the Board of Trustees if they had any items under Roundtable discussion or asked any of the guests if they would like to discuss any items. There being none a motion was made by Mr. Matt White and seconded by Dr. Michael Compton that the Parkview Hospital Board of Trustees meeting adjourn.