Indian River County Hospital District

Regular Monthly Meeting: July 18, 2019

Regular Monthly Meeting Minutes
July 18, 2019
5:00 PM

TRUSTEES: Marybeth Cunningham Tracey Zudans
Michael Weiss Ann Marie McCrystal

VIA PHONE: Karen Deigl Allen Jones

ABSENT: Barbara Bodnar

STAFF: Ann Marie Suriano Jennifer Peshke, Esq.
Kate Voss

OTHER ATTENDEES: Morgan Libbey George Eighmy
Greg Rosencrance Vicki Soule
Marie Andress Alan Guy
Val Larcombe Ralph Turner
Warren Fuller Charles Mackett
George Eighmy David Peter
Janet Bagley Michelle Genz

Convene Meeting – Marybeth Cunningham, Chairwoman

Ms. Cunningham convened the regular monthly meeting of the IRCHD at 5:00 PM by welcoming those in attendance. Ms. Zudans provided the invocation for the meeting and Dr. Weiss led the group in the Pledge of Allegiance.

Consent Agenda- Marybeth Cunningham, Chairwoman

Dr. Weiss asked for a motion for approval of the Chairman’s Meeting Minutes dated June 20; Regular Monthly Meeting Minutes dated June 20 and a July disbursement of $936,124.40. Mrs. McCrystal made a motion to approve which was seconded by Ms. Zudans. The motion carried unanimously.

Ms. Cunningham stated that tonight the Trustees are recognizing Ms. Libbey with a proclamation for her work in the community with the Public Guardianship program. Ms. Cunningham read the proclamation and Ms. Suriano presented Ms. Libbey with a commemorative plaque.
District Counsel Report – Jennifer D. Peshke, Esq.

Ms. Peshke provided her monthly counsel report and stated that she continues to work with staff and Trustees on District matters. She has been working on the drafting of the new Gifford Health Center lease, as well as the sub-leases that will be used for the other entities involved, as well as budgeting matters with the District regarding the 2019-2020 fiscal year.

Financial Statement Review – Ann Marie Suriano, Executive Director

Mrs. Suriano provided the financial statement review on behalf of Mr. Jones. Mr. Jones prepared a written report which was included in the meeting packet. Ms. Suriano stated that the District is in sound financial condition and has received most of its tax revenues for the current fiscal year. The District continues to run under budget and it is projected to carry over $3.8 million in funds, next fiscal year. Mr. Jones added that due to the changing healthcare environment, it is important for the District to maintain flexibility in its reserve accounts, to accommodate any changes.

Executive Director Report- Ann Marie Suriano, Executive Director

Ms. Suriano stated that the District continues to focus on the Gifford Health center transition. As previously discussed, the Health Department will be vacating the building and TCCH will move in and be the provider of primary care services at GHC. We Care and Healthy Start will remain at the center through the transition, to provide services as well. She further stated that TCCH will begin to provide services on August 25. Additionally, the VNA mobile unit will be available on site to provide acute care to patients during the transition.

Cleveland Clinic Indian River Semi Annual Report- Gregory Rosencrance, MD FACP President CCIR

Dr. Rosencrance stated that his presentation would cover the current scope of services at CCIR; capital spending for 2019; goals and benchmarks in quality, along with the extent and types of care that is provided to the residents of Indian River County. He explained that Cleveland Clinic Florida developed a long-range plan for all its facilities, as a whole, and the specifics of the strategic plan are still being developed.

Areas that the institution plans to strengthen and grow are as follows:

1. Cardiovascular services;
2. Oncology services;
3. Neurosciences;
4. Orthopedics; and
5. Primary Care.

Additionally, there will be a focus to strengthen women’s and behavioral health services. Dr. Rosencrance stated that admissions to the Behavioral Health center are up 22% from last year. In an effort to improve patient and staff safety, they have installed additional 360-degree security cameras throughout the facility and parking lot, along with panic alarms in patient rooms.

The philanthropic campaign for the stroke program has been completed and the hospital plans to start construction in the coming days. On July 9, the hospital began its telemedicine program for the radiology department. This means that all radiology reads during 9 pm-7 am are reviewed by a Cleveland Clinic tele-radiologist. This will improve wait times for results and give local radiologists some relief. Further, CCIR electronic health records have been stabilized and by 2021 it will be included in Cleveland Clinics worldwide database.

Dr. Rosencrance reviewed the capital expenditures and stated that they approved $22.3 million in capital expenditures for 2019, and he reviewed the same in detail. He further reviewed the benchmarks for quality and stated that readmission rates have been reduced by approximately 45% since 2018. They continue to focus on hand hygiene and have seen improvement through the implementation of the “SNAP” program. He further reviewed data concerning the infection rates at the hospital, which most were all at or below their target levels.

There was further discussion surrounding volumes at the hospital. He explained that emergency department visits have increased and for this quarter are up by 722 visits, over the previous year. Inpatient admissions and surgical case volumes have increased as well. Additionally, the case mix index reports indicated that the hospital is treating sicker patients, than in previous years.

Additionally, Dr. Rosencrance reviewed data concerning care at CCIR. In the first six months, CCIR has provided $4.6 million for charity care to the residents of Indian River. This represents a 18% increase in charity care from the same time period in 2018. Further, there has been a 45% increase in inpatient behavioral health charity care. CCIR has also provided $1 million in outpatient charity care. The hospital is working toward strengthening it behavioral health and women’s services and continues to work collaboratively with other health agencies in the county.

Lastly, Dr. Rosencrance provided a review of CCIR financials and stated that the institution is $1 million ahead of last year’s budget. This is driven strictly by volumes. Since beginning his position in January, Dr. Rosencrance has held two town hall meetings. At the last meeting held, he announced a 2% on average merit increase for caregivers. He was told this was the first merit increase to take place in the last 10 years. CCIR is also implementing new uniform colors. New safety measures have also been implemented at the main campus.

Unfinished Business- We Care Additional Funding Request- Dennis Saver, M.D.- President

Dr. Saver explained that at the We Care clinic is projecting a $30,317 shortfall for their fiscal year. This shortfall was related to lower than expected number of District qualified patient visits, and not the result of higher volumes. He is here today, to request those shortfall funds from the board.

Dr. Weiss made a motion to approve the request which was seconded by Mrs. McCrystal, for discussion. There was Trustee discussion and Ms. Cunningham and Ms. Zudans indicated they were not in favor of funding the shortfall due to the fact that it was not the result of high patient volumes for direct services. However, the motion was approved 4-2.

New Business- Approval of Tentative FY 19-20 Budget- Ann Marie Suriano, Executive Director

Mrs. Suriano stated that she updated tonight’s proposed tentative budget based on yesterday’s discussion at the Chairman’s meeting. The millage rate being proposed is .8041, which is a decrease from last fiscal year. She further explained that reducing the millage to this rate would result in a savings to the taxpayer. Mrs. Zudans made a motion to approve the budget and millage of .8041 which was seconded by Mr. Jones, for discussion. Mrs. McCrystal stated that she would like to keep the millage at the same level it is currently, and she feels the proposed millage of .8041 is too low to allow for any unforeseen healthcare issues. She made an amended motion to adopt a millage of .9122, which was seconded by Dr. Weiss for discussion. There was Trustee discussion and agreed that .8041 allows for the District to fulfil its obligations to the funded agencies while maintaining substantial reserves for unforeseen issues. The amended motion failed 5-1. Mrs. Peshke indicated that the board would need to vote on the original motion proposed. That motion carried 5-1, with Mrs. McCrystal in opposition.

Public Comment- There was no public comment.

Adjourn- The meeting was adjourned at 6:00 PM



William P Cooney MD is an orthopedic surgeon (retired) who has been a resident of Vero Beach since 2004. He practiced orthopedic surgery at Indian River Medical Center from 2006-2015 within the orthopedic practice of Prosports. He served on the IRMC Foundation for four years. Prior to this, he was a Professor of Orthopedics at Mayo Clinic in Rochester Minnesota, Chair of the Division of Hand Surgery and Vice president of the Department of Orthopedic Surgery. He served as the Vice Chairman of the Mayo Clinic Development Department. He has been President of the American Society for Surgery of the Hand, Orthopedic Research and Education Foundation, Consultant at Shrine Hospital systems. He was editor in chief of the Journal of Orthopedic Surgery and co-editor of the Journal of Hand Surgery. He held grants in hand and wrist surgery sponsored by National Institute of Health (NIH) and Stryker Orthopedics and has over 250 publications in the field of orthopedic surgery, hand, wrist and elbow surgery and microsurgery- free tissue transfers. Within Indian River County, he has served as Chairman of the Board and President of the Hope for Families Homeless Center, Board of the Indian River Hospital Foundation, We Care and Whole Family Health Center medical practices.

Term:  1/23-12/24

Origination: Elected (2 OC)

Occupation: Retired Surgeon



Kerry Bartlett,  of Vero Beach, has more than 30 years experience in philanthropy, including as vice president of the VNA & Hospice Foundation; VNA chief advancement officer from 2001-2007; and executive director of the Indian River Community Foundation from 2008-2014. Kerry is the founder of The Bartlett Company, which focuses on nonprofit and philanthropic consulting. She also is a managing director for Carter, a Vero Beach company that specializes in advancing philanthropy worldwide. Kerry has spent more than 25 years in the nonprofit sector as a fund development professional and has particular expertise in annual funds, major gifts, endowment campaigns and legacy giving. Kerry is also known for creating and implementing effective donor-centered stewardship programs that build, maintain and strengthen nonprofits’ relationships.

Term:  3/21-12/22   |   1/23-12/26

Origination: Appointed by Governor Ron DeSantis
Elected NOC

Occupation: Philanthropic Consultant/Managing Director



Karen has been President and CEO of Senior Resource Association, where she successfully advocates for older adults and their families, since 2006. In that role, she helps provide activities, education and services benefiting older and disabled adults in Indian River County. In addition, Karen provides oversight of the community mass transit system for residents and visitors of the county. As CEO, Karen is responsible for a $7 million operational annual budget and managing more than 100 employees. She ensures that fiscally sound and responsible solutions are created to provide healthcare and a better quality of life for all Indian River County residents. Karen earned a BS in Health Administration from Florida Atlantic University and an MHA from the University of Florida. She was elected to the Indian River County Hospital District Board of Trustees in 2016, and joined the Board in January 2017.

Term:  1/17-12/20   |   1/21-12/24

Origination: Elected 1 OC | Elected NOC

Occupation: President/CEO



Paul Westcott has been a Board Certified Workers' Compensation Attorney since 1999. In addition, Paul has earned his certification from the Florida Supreme Court as a Circuit Civil and Family Law Mediator. Receiving his Bachelor of Arts degree in both Economics and Political Science at Florida Southern College, he continued his education at Stetson University College of Law. He graduated from Stetson in 1988, having been a published member of the Stetson Law Review. Paul has been a member of the Florida Bar since 1988.  He began his practice in a combined civil litigation and transactional practice before serving as an Assistant State Attorney.  He began his career in Workers' Compensation with Rissman, Weisberg, Barrett, Hurt, Donahue & McClain P.A., where he handled Workers' Compensation cases at the trial and appellate levels.  In 1997, Paul opened the Ft. Pierce office of Hurley, Rogner, Miller, Cox, Waranch & Westcott P.A. handling workers' compensation cases at all levels throughout central and south Florida, while managing the operations of that office.  During his nearly 25 year career in Workers' Compensation, he lectured on a wide range of industry topics.

1/23-12/26   |   1/21-12/24

Origination: Elected 1 OC 

Occupation: Attorney & Mediator



Barbara has practiced physical therapy, specializing in orthopedics and sports medicine, in her hometown of Vero Beach since 1981. She was an integral part of the sports medicine team at Vero Beach High School for 35 years. Barbara completed the reserve police academy training, and served with the Vero Beach Police Department from 1982-1989. Her volunteer involvement in the community includes serving on the City of Vero Beach Recreation Committee, Arthritis Association of Indian River County, and the Senior Good Life Games. She and her husband, Michael, enjoy spending their free time traveling in their RV and training their Labradors, Gunner and Chase, in K-9 performance events, including agility and dock jumping. Barbara is a lifelong resident of Indian River County, and received her degree in physical therapy from Chattanooga State College. Barbara was elected to the Indian River County Hospital District Board of Trustees in 2016, and joined the Board in January 2017.

Term:  1/17-12/20   |   1/21-12/24

Origination: Elected 1 OC | Elected 1 OC

Occupation: Physical Therapist



Born and raised in Illinois, Michael was a Theatre and Speech Instructor at Lincoln College when he moved to Indian River County in 1984. He was the Director of Education for the Riverside Theatre for a decade, helping to build the Riverside Children’s Theatre and directing many productions. Michael is well known in the community for his 25 years of service at the United Way of Indian River County, 16 of those years as the CEO. He is very proud of his work with dozens of nonprofit agencies and his commitment to creating and strengthening community collaboratives. Michael was also an Adjunct Faculty member at Barry University for 20 years. He has served on many boards and committees over the years, including: Children’s Services Advisory Committee Needs Assessment, Chair of the Emergency Food and Shelter Program for many years, and he was a founding member of the Mental Health Collaborative, the Senior Collaborative of IRC and the IRC Executive Roundtable. As a Hospital District Trustee he is committed to serving all the citizens of our county. In particular, he hopes to see enhanced availability and affordability for behavioral/mental health for all in need.


Term: 1/23- 12/26

Origination: Elected 1 OC

Occupation: Retired CEO United Way



Marybeth’s professional career encompasses 34 years of working for GM/Delphi in a variety of positions. Starting out as a traffic claims clerk, she worked her way through the organization, with roles in Purchasing, Engineering, and Quality and Reliability. She retired in 2009 as the executive director of Global Operations for the Packard Electric Division of Delphi. In this position, she was responsible for 94 plants in 33 countries. Marybeth has served on the board of directors for numerous non-profits, including Northeast Ohio Adoption Agency; United Way of Warren Ohio, where she served as chairman of the annual campaign for two years; Up with People; Head, Heart and Hands of Indian River Club; Indian River Community Foundation, and the Indian River Mental Health Collaborative. She earned her B.A. in Political Science from Albion College. Marybeth was elected to the Indian River County Hospital District Board of Trustees in 2014, and joined the Board in January 2015. She currently serves as Chair.


Term:  1/15-12/18   |   1/19-12/22   |   1/23- 12/24

Origination: Elected 1 OC | Elected  NOC | Elected NOC

Occupation: Retired Executive GM