Purchase of a new C-arm and an EKG were discussed Monday afternoon during the Ellsworth County Medical Center board of directors.

“Our C-arm, when it was purchased, we got a bag of goods. Brand new system, but the size of the punch is superficial. Had I been here, we would have bought a new C-arm,” ECMC Chief Executive Officer Jim Kirkbride said.

The new arm will cost about $96,500.

“I asked to get the second one purchased. The auxiliary agreed to pick up and pay for, fundraise for, the two EKG machines,” he said.

Once the auxiliary has its fundraiser, he said the group will reimburse the hospital for the cost of the second EKG. The board approved the purchase of the C-arm and the EKG, which will cost about $25,500.

With two significant purchases, Kirkbride said the hospital has $100,000 left in the capital outlay account for this year, which is in line with the 20 percent contingency he likes to maintain.

“We’re down to contingency once these two are purchased,” he said.

Once the board approved the purchases, it discussed the 2025 budget, which includes a 2 percent salary increase for employees.

“We feel we can support about $700,000 in capital requests,” Kirkbride said. “We’ve prioritized those and they will change slightly when things pop up.”

A few of the proposed capital improvements for 2025 include flooring in several areas in the Ellsworth hospital and Wilson clinic, endoscopes, security cameras and rooftop HVAC units.

“Leaders were conservative in their needs and wants,” Kirkbride said. These are fairly important things for us to purchase to remain where we are with quality and safety.”

The 2024 budget was about $23 million; the 2025 budget is projected to be about $24 million, which includes the salary increases.

In other action:

• Kirkbride discussed executive sessions with the board.

“We had somebody report to me they were concerned we use executive session incorrectly according to open meeting laws,” he said. “I’ve engaged counsel and the recommendation was we send the agenda to them and they review it and they give me input. We can talk about it individually.”

• Kirkbride said they are considering converting some space currently used for old record storage as expansion space.

“That building would have been phase two in a five-phase master plan,” he said. “Architects will help me look at the space, see if it’s adequate with what we want to do and go from there.”

Kirkbride said the hospital has re-engaged the architect to review the possibility of adding surgical services. “We are looking at possibly swapping phases,” he said. “I’ll give more of an update next month.”

• The board approved 11 policies.

• Kirkbride discussed the pillars of the strategic plan.

“Eventually the average employee will understand what they can do to drive the department goal and hospital goal,” he said.

• Tina Davis, director of the rural health clinic, discussed reviewing systems and processes to improve efficiency.

For example, she said instead of a yearly visit for Medicaid, diabetes and COPD, all three conditions are addressed at one appointment.

“It saves the patient time, expense of co-pay or deductible and we expect revenue to decline and patient volume to decline,” she said. “What we saw was a (slight) decrease (in volume), but our revenue increased. The insurance companies pay more for the quality of service you provide. Providing a yearly visit versus individual visits was not expected, but a positive outcome.”

Kirkbride said it is a positive direction.

“Revenue was up quite a bit, but stats were flat,” he said. “What we’re finding is the improvements we’ve made in charging and reimbursement, we’re getting a lot more money for no additional effort. It’s money we should have, and could have, collected for quite awhile.”

Davis said the wound care service provided by ECMC is expanding. It was previously offered two days per week. It is currently offered three days, and staff is considering increasing it to four days a week.

“We’re changing lives because patients are able to stay in their community versus traveling to Hays,” she said. “Hays is transferring patients to us because it’s more accommodating to the patient.”

• Gross revenue for June was $2,767,019. Operating expenses for the month were $1,792,535.

• Kirkbride said numbers are down for June, which is normal.

Inpatient days for June were down from the month before with 36 days in June compared to 42 in May.

Swing bed days were up in June compared to the month before with 89 days in June compared to 50 in May.

Observation admissions remained steady in June with 17 admissions, the same as May.

Emergency room visits were also down slightly in June with 208 visits compared to 220 in May.

Both outpatient visits and clinic encounters dropped during the month of June with 1,178 outpatient visits in June compared to 1,220 in May and 1,140 clinic encounters in June compared to 1,227 in May.

• Dr. Josh Bahr began July 23.

“We have a rare opportunity with Josh on how we can grow existing programs,” Davis said. “We look forward to working with Josh on ways we can grow our program.”

• Davis reported the hospital auxiliary is preparing for the Oct. 26 Heartland Harvest Wine Tasting Event. The event will honor Dr. Dennis Kepka.

“He has raised himself, through spaghetti suppers, over $100,000 toward auxiliary,” she said.

• The board went into executive session to discuss non-elected personnel for 5 minutes.

After exiting the executive session, the board unanimously voted to grant a 7 percent performance bonus for Kirkbride.

After the executive session, board members clarified the purpose of the executive session was to discuss the CEO’s contract review. The next meeting of the Ellsworth County Medical Center board of directors will be at 5:30 p.m. Wednesday, Aug. 21, in the hospital conference room.