MOUNTRAIL BETHEL HOME/MOUNTRAIL COUNTY MEDICAL CENTER
Executive Conference Room
Thursday, July 23, 2020
Call to Order – 7:00 a.m.
Changes to Agenda
Approval of June 25, 2020 Board Meeting Minutes
5. Financials – attached
7. Medical Staff
Chief of Staff comments
8. Foundation Report
9. Old Business
MBH — Phase III status
MBH/MCMC – Strategic Planning
MCMC – OR Expansion
10. New Business
MBH/MCMC – Approve Policy and Procedures Manuals: None
11. Executive Session
MBH/MCMC – Quality: Tanya Giese, MBH DON. Executive session to discuss patient care and quality issues. The discussion will include references to patient health information that is private and confidential under state and federal law including but not limited to: N.D.C.C. § 23-01.3-01, N.D.C.C. § 23-34-02, N.D.C.C. § 44-04-19.2 and the Health Insurance Portability and Accountability Act (HIPAA).
We’re closed to the Public. To call into the meeting please follow:
Call 1-605-472-5291 Access Code: 889325#
Next Board Meeting Date: Thursday, August 27, 2020, 7:00 am
Rosen Place on 8th and the new chapel at the Bethel Home were recently featured in an architectural magazine. This article has some astounding pictures and a lot of information on the construction of our new additions. You may view the PDF of this publication here.
Please note that you must have Adobe Acrobat or a similar PDF viewing software installed to view the above link. Alternatively, you may click on the pictures below to read the article.
As we stated last week, through routine bi-weekly screening, MCHC identified a staff member who tested positive for COVID-19.
As a result of this, we tested all of our Centennial Court, Rosen Place on 8th and Mountrail Bethel Home residents last week. Our employees were tested also. All tests completed have come back negative. Repeat testing for everyone will be done again this week.
As we monitor the situation this coming week and work with the State Health Department, plans for our Phase Two Smart Restart will be put into motion again. Families will be contacted once we have all our results in from this next round of testing, which will be completed later on this week. The steps we had previously for our Smart Restart will be the same. A reminder, immediate family members will need to get an updated COVID test completed before they come into the facility.
Any questions can be answered by calling:
Tanya Giese, RN – MBH DON – 701– 628-2424—Ext. 105
Amy Littlecreek, LPN – MCHC Infection Control – 701-628-2424—Ext. 104
Through routine bi-weekly screening, MCHC has identified a staff member who has tested positive for COVID-19.
This staff member had recently returned from a trip out of state, was completely asymptomatic at the time of screening, and is currently quarantined at home per ND Department of Health guidelines.
Our infection control team has performed the necessary contact tracing in house and families have been notified accordingly. We have instituted immediate repeat testing of MBH and Rosen Place residents as well as testing of our entire staff to screen for any additional positive cases.
Given the dynamic nature of COVID-19 and with regard to the nationwide plans to re-open/restart, MCHC has put any plans for face-to-face visitation in our nursing home and assisted living on hold at this time.
Any questions can be answered by calling:
Tanya Giese, RN – MBH DON – 701– 628-2424—Ext. 105 Amy Littlecreek, LPN – MCHC Infection Control – 701-628-2424—Ext. 104
If you feel you have symptoms consistent with COVID-19 or would like to be tested, please call the Reiarson Rural Health clinic at 628-2505.
When the Coronavirus hit North Dakota, schools closed, and businesses closed or altered their business model. Daycares were impacted and many in Stanley chose to close. This created a challenge for staff at Mountrail County Medical Center. A cooperative effort between Ragamuffins Ranch Daycare and the Mountrail County Health Foundation worked to fill that need over the last two months.
MCMC Administrator Steph Everett says that the process started on March 23. She began receiving texts from staff expressing their concerns about what they would do as they faced closing schools and daycares. She said that she reached out to Carol Maurer at Ragamuffins Ranch who opened their arms to the staff’s children.
Everett says that each request was met with a “we’ll figure it out” response that was amazing. As they began the conversations, Everett says they had no idea how many staff members would need daycare. Based on the texts from staff, she knew it would be more than just a few.
As they received the guidelines from the state regarding daycares, working together the daycare was ready to start taking students by the weekend of March 27. Working hand in hand, they were ready for the first children on March 30.
Ragamuffins Ranch Daycare owner Carol Maurer says that working on the Bright and Early curriculum and achieving the Step 3 designation made the process easy. The assessments and training she says that by the blessing of God helped them be prepared to take on the challenges.
She says they were already set up to the new standards and guidelines set up by the state for childcare facilities in response to the Coronavirus. That includes the way they use spaces in the daycare, their sanitizing processes and the separations for age groups they already had in place.
They already were separated to eat in smaller groups and play in smaller groups and different areas. The babies, toddlers and older children already interact in their own groups on a regular basis.
Maurer says that the biggest challenge was to bring in children that didn’t know them or their environment. She says they wanted to make sure that each child felt safe and comfortable during this stressful situation. They wanted them to feel at home and happy, knowing this was a safe place to be.
The children coming into the daycare have moms and dads that work on the frontline during this virus fight. Life can be stressful, and children often pick up on that stress.
The staff put their heads together, even knowing it might not be easy, but knew they could do it and come out for the better. Maurer says they really stepped up to the plate and did a great job.
As they got ready to add new children to their groups, Ragamuffins reached out to their parents. For some, they were already planning on keeping their children home with schools and businesses closing or reducing staff. Others offered to keep theirs home to make room, saying that it was important to take care of first responders’ families. She says she gives credit to those families for giving the okay to use their spots.
With some of their kids not coming because of the virus, Maurer said they missed their kids. It was hard emotionally on everyone, but at the end of the day they came back and grew a whole new family with these new children.
As for helping out staff at the medical center, Maurer says that they knew the needed the help and they were ready to do it. It was amazing to watch, she says, and now as the two months come to a close, they will be missing these children that will be going back to their former providers.
Looking back now, Maurer says that everything was a learning curve with stepping stones at the right time with the right help to set up this difference to succeed. She said, “I do it this way and it works. Sometimes you pray and ask God to show you the way. My heart is put into this and we have invested so much of ourselves.”
Everett says that for the two months Ragamuffin met their needs, they were a lifesaver. Eight families with eleven children were helped during this time. Mountrail County Health Foundation, along with grant funds from the NWND Community Foundation helped cover some of the costs.
While many families will be returning to their previous providers this week as daycares resume operations, a few will be staying at Ragamuffins Ranch enjoying the new relationships they have formed.
Steph Everett says that they just knew at the beginning they had to do something to help their staff. All of this was so new to medical facilities. They had heard about the first stories with coronavirus coming from a nursing home in Washington. The focus became on what if it happened here.
“For medical staff, there is no choice but to be at work. The last thing we wanted was for staff to have to make a hard choice. We needed them here, for Health Centers never shut down. Some of our Staff made shifts from their clinic positions to helping at the nursing home, for they were needed there to ensure our nursing home residents were cared for,” said Everett. “The partnership with Raggamuffin Ranch allowed us to take one huge stressor off our staff. Especially through this, maneuvering through unchartered territories over the last few month,” Everett said.
The two month partnership between the medical center and Ragamuffin Ranch is just another example of small towns pulling together to help each other through these challenging times. It is also an example of meeting critical needs through collaborative effort.
This article is republished by the gracious consent of the Mountrail County Promoter.
As we all work together to reopen “North Dakota Smart”, we here at the Mountrail County Medical Center want to let the public know how we will be reintroducing our services starting the week of May 4th. Due to the encouragement of Governor Burgum, we as a facility did mass testing of our county, our employees and our residents the week of April 20th. Over 450 tests were completed in 48 hours, with only one new positive emerging from this testing. With these results, we feel confident to slowly reopen our clinic, our outpatient services and bringing our specialists back to Stanley.
Inpatient Services: The providers in the clinic will slowly start working at seeing their normal patient load the week of May 4th. Telemedicine will still be utilized, when seen fit. Respiratory issues and COVID-19 symptoms will still be seen through the ER, along with traditional ER patients. We are doing all COVID testing through the ER also.
Outpatient Services: We will start providing mammograms the week of May 4th. Christine and Nile will be rejoining the physical therapy team, with Heidi. MRI’s will begin to be scheduled again starting May 11th.
Specialists: Dr. Joshi and Dr. Amsbury will start
seeing patients again on May 14th. Dr. Williams will start again the following
Wednesday, May 20th.
Checking in Process: This will look a bit different for everyone. All patients will still be screened per the CDC COVID-19 guidelines. All clinic patients, outpatients and specialists’ patients will check in through the clinic. When you arrive please call 701-628-2505 and you will be given instructions on how to get registered. Please sit in your vehicle until your appointment time, so we can maintain social distancing. Special arrangements will be made if this is not possible for the patient. We also will require each patient to wear a mask, so please bring one to your appointment.
COVID—19 Screening and Cleaning Process: All technicians, specialists and their staff will follow the same screening protocol the rest of the Mountrail County Health Center staff follow. They will come in door 11 and get their temperature, change into MCHC scrubs and go through the basement to get to the clinic, avoiding the Mountrail Bethel Home. Our cleaning process in the clinic will be expanded and door knobs, desk areas, seating areas and clinic rooms will be sanitized between patients. For any questions, please call the Rural Health Clinic at 701-628-2505
County Health Center in Stanley hosted a Drive Through COVID-19 testing event
on Friday, Apr. 24. Testing started at 10:00 a.m. and ran through 2:00 p.m. although
the lineup of vehicles of those waiting to be tested started more than an hour
was organized through staging using the Stanley High School parking lot. Those
looking to be tested were asked to report to the High School where they were
assigned a number to their car. Mountrail County Sheriff Corey Bristol and
several of the department officers, Mountrail County Emergency Manager Warren
Bogert along with the Highway Patrol were at the school to coordinate that
portion of the event.
told by Health Center staff, they would then send a set number of vehicles down
8th Avenue towards the hospital. Along the way, intersections were being
controlled by members of the Stanley Public Works and Stanley Police Department
to assure smooth movement of not only those who were waiting to be tested, but
also those cars that were just trying to go from one area of the city to
the Health Center, they were met by staff with the information forms prior to
testing. They then moved along the driveway area on the east side of the
complex for testing. Tests were administered by staff and then brought back
into the “command center” where they were documented and packaged for transport
to the State Lab for testing.
Health Center was grateful to all that helped make the testing a success,
saying they could not have successfully done this test without coordination and
manpower from the Stanley Police Department, Mountrail County Sheriff’s office,
Stanley Public Works, and the Highway Patrol. They kept everything moving as
smoothly as possible, without clogging up city streets with traffic, and that
was no small feat. People participating were in awe of the teamwork as they
drove from the staging area and down 8th Avenue to MCHC.
thanks went to Marilyn Gaebe, who provided a delicious lunch for staff and kept
them energized for the entire day. They appreciated Estvold Oilfield Services,
specifically Jake and Kelsey, for allowing them to use their coolers to safely
transport tests from Stanley to Bismarck testing labs and the “best COVID-19
courier in the state” Rodney Essler.
also expressed their thanks to the community saying, “We would not try to offer
these testing services if we did not think that people would show up to be
tested, and our community SHOWED UP! It was a steady stream of cars the entire
but not least, they expressed a personal thank you to the staff of the
Mountrail County Health Center. From traffic control, to gathering information
from each test subject, to registering each test subject, and properly marking
each test to the Providers performing the swabs, and then our lab processing
each test from 10:00 a.m. to 7:30 p.m. and to everyone inside the building
allowing business to proceed as usual. This was pointed out as teamwork at its
the span of a little over 4 hours, the Mountrail County Health Center staff
were able to test 189 vehicles, totaling 357 tests that included residents from
throughout the county and a few out of county residents. “Thank you to everyone
who came to get tested so we can gather more data about how this virus is
impacting our community and to start working on getting North Dakota open
again,” they said.
drive through testing helped support Governor Doug Burgum’s goal of increasing
testing to start the work on smartly reopening the state.
testing clinic was a group effort between administration and providers.
per direction of the state, the facility is also testing all of their residents
and employees starting last week and continuing on Monday.
As of Monday morning, tests completed in Mountrail County had increased from 524 on Friday to 892 on Monday. One new positive was recorded on Monday, up from the cumulative 33 since the first tests administered in the county. That new positive is part of the testing done on Friday and is a case from New Town. Of the 892 tests recorded in the county thus far, 858 have returned negative. Not all of Friday’s test results were included in Monday’s numbers.
This article has been republished by the gracious consent of the Mountrail County Promoter.
RE: Mountrail County Health Center
COVID-19 Drive Through Testing
Mountrail County Health Center is
committed to providing our community the best care possible during the
nationwide COVID-19 pandemic. We therefore are offering a complimentary “Drive
Through” testing event at our facility on Friday, April 24th from 10:00 AM
to 2:00 PM. We are strongly encouraging residents of Mountrail
County who have not previously had access to drive-through testing to be
COVID—19 testing will be conducted
at door 13 at the back of our building. Please see the map for further
Please bring your Photo ID.
MCHC employees will register patients while they wait in line. Please
remain in your vehicle with your window rolled up unless instructed otherwise
by MCHC staff.
Testing will be offered on a first
come first serve basis. Please be advised that once you enter the
driveway for testing, there IS NOT an area to turn around.
You will need to wait until it is your turn to be tested in order to
You will have a limited amount of
time with the provider conducting this test. The drive through testing
clinic is NOT the time to discuss symptoms or other medical conditions with a
doctor. If you need 1:1 time with a provider, or are experiencing severe
respiratory symptoms, please do not use the drive through clinic. Call
the Rural Health Clinic at 701-628-2505 so our nurses can triage you
individually and get you the care you need.
If you have questions about this
process, please call 701-628-2424 and ask for Rich Laksonen.
If you have a spouse, sibling, parents, or other loved one
in a nursing home, you may be worried about their safety and well-being because
of the coronavirus pandemic. Here are some key questions to ask the
Has anyone in the nursing home tested positive for
There have been ZERO residents in Mountrail Bethel Home that
have tested positive for COVID-19. In the event that a resident at MBH
tests positive for COVID-19, all POA’s will be notified.
There have been ZERO staff members at Mountrail Bethel Home
that have tested positive for COVID-19.
For the most up to date information about positive COVID-19
cases in our county, you can visit www.health.nd.gov
and click on the “Corona Virus” banner at the top of the page, and then click
on the square that says “North Dakota Cases” on the left side of the page.
What is the nursing home doing to prevent infections?
Mountrail Bethel Home has implemented multiple new policies
to best protect the health of our residents.
Bethel Home is restricted to essential personnel only. Visitors are
restricted from the entire hospital campus.
are screened prior to each shift for symptoms consistent with COVID-19.
that is normally routed through Mountrail Bethel Home has been re-routed
elsewhere through the building.
staff is wearing face masks 100% of the time while caring for residents in
Mountrail Bethel Home.
staff is required to change into hospital sanitized scrubs each shift.
nursing home is following CDC and ND State Department of Health’s guidelines
regarding communal activities and dining at this time. Residents are
being asked to self-isolate as much as possible. When not possible,
minimum distance guidelines and maximum group sizing guidelines are followed
according to NDDOH and the CDC.
have doubled our cleaning frequency, also focusing on commonly used/touched
Does nursing home staff have the personal protective
equipment (PPE) – like masks, face shields, gowns, gloves – that they need to
stay safe, and keep their patients safe? Have they been given specific training
on how to use this PPE?
Yes. The Mountrail Bethel Home has adequate PPE and
has a plans in place for usage and re-supply. Staff have had training in
appropriate donning and doffing of PPE.
What is the nursing home doing to help residents stay
connected with their families or other loved ones during this time?
Mountrail Bethel Home activity and social work departments
have been working individually with families to set up times to video chat with
their loved ones. We are also conducting 1:1 activities with residents in
their rooms to help residents maintain social interaction.
What is the plan for the nursing home to communicate
important information to both residents and families on a regular
We will continue to contact the resident directly or the
resident’s POA to communicate all high priority information. Other
general information will be posted on our Facebook page “Mountrail County
Health Foundation” or in the Mountrail County Promoter.
Is the nursing home currently at full staffing levels for
nurses, aides, and other workers?
Yes. Currently we are at full staff.
What is the plan to make sure the needs of nursing home
residents are met – like bathing, feeding, medication management, and social
engagement – if the nursing home has staffing shortages?
If Mountrail Bethel Home has shortages in staff, staff from
other departments will come help in the nursing home. We also are
currently operating under a waiver that allows the nursing home to
“re-activate” CNA’s and Nurses who licenses have expired. This has
created a pool of people MBH could call in to work if needed.
If you are concerned about the safety and
well-being of a spouse, parent, or other loved one who lives in a nursing home,
contact the North Dakota Long-Term Care Ombudsman Program by calling toll-free
855-462-5465, select option 3 and ask for the Long –Term Care Ombudsman Program.
Mountrail County Medical Center is now offering virtual visits through telemedicine.
visits such as medication refills, routine follow-up appointments, etc., they are
encouraging all patients to consider the telemedicine visits.
FNP says that from a Primary Care Provider perspective they are able to still
offer the same level of care, without requiring unnecessary travel during the
pandemic. Patient’s routine healthcare needs have not stopped due to COVID-19
and medical conditions like diabetes, high blood pressure, asthma and
depression can all be managed through telemedicine. Feedback from the patient
perspective has been overwhelmingly positive as most patients needing routine
care are also being very cautious with leaving their homes during the COVID-19
not new, especially in rural areas. Mental health, psychologists and counseling
professionals have used this method for quite some time, and most specialty
visits through the VA Health System are done by Telehealth.
Braaflat says it
is easy for a patient to switch their currently scheduled appointment to
telemedicine. They would just need to call the receptionist at the Clinic at
the Mountrail County Medical Center and ask them to make the switch.
Patients can also
schedule new appointments the same way. Patients that are unsure if they need
an appointment can call the clinic. If the receptionist is unsure, they will
transfer you to a nurse for more information.
There are many
ways to use the technology at the clinic beyond the telemedicine. Patients can
email their provider through the patient portal. That allows them to directly
message their provider with simple questions like whether they need an
appointment. The receptionist should be able to help you set up the patient
portal if you have not already done so.
appointments are very easy to navigate with a computer, tablet or smartphone.
It uses video and audio allowing patients and their provider can to see each
other. Patients without access to a smartphone, computer, tablet etc. can visit
with their provider over the phone.
The clinic has
been working to set up schedules for all providers as they face the potential
challenges with COVID-19. There is a designated provider on-call 24/7 to manage
acute emergent and non-emergent patient concerns. Patients with acute
healthcare concerns are urged to contact the clinic directly during normal
business hours to speak with a nurse to arrange for the most appropriate visit.
Currently most of
our acute visits are being managed through the Emergency Department by the
Emergency Provider on-call. Any patient with fever, cough, or any other
respiratory symptoms are being treated and screened separately in specially
designated area of the hospital.
provider is on staff in the clinic for non-acute/non-urgent clinic services and
taking care of the residents in the Bethel Home. Braaflat said she had been
working in the clinic for the past two weeks, which has also lowered her
exposure risk to potential COVID-19 patients.
This helps to
ensure they are taking the best care possible for all patients, and especially
those in the nursing home. Braaflat says that a lot of planning has been going
on to ensure the care provided within the hospital, clinic, and Bethel Home is
done in the safest manner taking into consideration the fragile nature of the
nursing home population.
that for the last two weeks most of her clinic visits have been telehealth
visits. Anyone that has called has been encouraged to schedule their visits
through telehealth if possible. She says that they
handling a wide range of visits this way, including those health conditions
like diabetes, etc., as well as rashes, prescription refills and more. If
during the visit they determine a patient needs to have lab work, or radiology
they are ordering the appropriate tests at which time the patient would have to
come to the hospital.
With the MCHC
campus doors locked, Braaflat says patients might drive by and see an empty
parking lot. This is because of the telehealth. A lot of time and energy has
gone into planning how to best take care of the community, patients and
residents. They are still there wanting to provide the services patients need,
especially during this stressful time when more people are facing uncertainty
with employment, anxiety and depression. She says it is important that patients
can still access their primary care.
says that Medicare and many insurance companies have removed many of the
restrictions on telehealth visits, meaning they can bill insurance just like a
regular clinic visit.
your provider for a telemedicine appointment is very easy. You go to the
Mountrail County Health Center webpage at stanleyhealth.org. On the home page
there are links to connect to each of the providers. You check in within a few
minutes of your appointment time and are connected.
Virtual physical therapy visits are also possible for patients for follow up appointments. The initial appointment would be conducted face-to-face, but follow up appointments may be done virtually.
This article has been republished with the gracious consent of the Mountrail County Promoter.