Northern Nye County Hospital District Board of Trustees– Northern Nye County Hospital District Board of Trustees Meetings - Regular Meeting

Good evening, everyone. I'd like to call the Northern Knight County Hospital District Board of Trustees meeting for August 20th, 2026 to order. Will everybody please join me in the pledge.

With allegiance to the flag of the United States of America and to the republic for which it stands, one nation under God, indivisible, with liberty and justice for all.

Thank you, everyone. All right, let's go right into it. Item two, general public comment, three minute time limit per person. Action will not be taken on the matters considered during this period until specifically included on an agenda as an action item. Do I have anybody for public comment? Really? Anybody online for public comment? Okay, who do I have online? Hi, Kristen, welcome. And who else? Thank you. All right, let's move on to item three, the approval of the August 2026 agenda. Does anybody on the board see anything that needs to be changed or deleted? Do we have any emergency items? No. Okay, so let's delete item five, and then we'll leave the agenda stand as amended. Item four, announcements. Would you like to start?

No, because I didn't write anything down.

Nancy, you have anything?

Nothing.

Dave? Nothing. Okay, I have nothing either. So let's move on to item six, trustees, liaison comments. This item limited topics and issues proposed for future workshops and agendas. Is this redundant? Are they the same?

Kind of.

Four and six.

Four and six announcements, and then we go right back and ask. or comments from the trustees.

One is probably update, this is what we're doing.

And then the other one is like, this is what we need to do. And number six is to add any future proposed items for future workshops or agendas. So they are separate, they're different.

Okay. Let's move on. Unless somebody's got anything. Item seven, for possible action, discussion, deliberation to approve, amend and approve, or deny the minutes from March 19th, April 16th, May 28th, July 16th, which is the District Regular Meetings, and then March 27th, April 2nd, April 9th, and April 23rd, District Special Meetings.

Chair, there are two. The two, which ones are those? May 28th and March 27th, the May 28th of the Regular Meeting and March 27th of the Special District. There's technical issues with them, so I'm working on getting those ones fixed.

Okay, and those are the two last minute you sent us.

Yeah, one of them .

Okay, so for item seven, we're gonna add the May 28th and then, oh, what's that, remove those? Okay, so May 28th is gone and March 27th is gone.

May I ask you a question?

Which meeting did we approve the checking account? Good, thank you. Okay. All right, so did everybody get a chance to look over the minutes? Any questions?

No, I make the motion we approve those minutes as written.

Thank you. Second. Okay, so I have a motion and a second. Any further discussion?

Nope.

If not, I call for the vote. All in favor say aye.

Aye.

Aye. Nobody in line? Any opposed? Okay, four to zero. We'll approve the minutes. Thank you. Item eight, no action. Presentation and discussion by Kristen. Who might not?

Umina.

Umina. Okay. I'll get it right probably about two or three years from now, Kristen. From the Northern High County Health District August 2022 board update. Okay. It's on you.

Good evening, everybody. I didn't really have anything for this meeting because it was a pretty dead month waiting for the bank thing to be updated. Dilbert did send me everything I need to move forward with the change of scope and sending that to HRSA this week. So that will be done by tomorrow and then we'll just be at a waiting game waiting their approval for that. Other than that, that's all I got.

So once we get this checking account established and get the information to you, are you able to?

Yeah, we'll send it to the payment management system with the form. And then as long as they say, everything's good to go, then we can start making drawdowns on invoices. And then you guys will just have to decide if you want to do some past invoices as well, or you just want to do everything for the new project, how you want to spend your $2 million. Okay.

Sounds good. And then we're going to use that same checking account for our next, because what happened to us is we didn't have an account in the name that the grants were sent in as. So, okay.

Go ahead. Thank you, Kristen. When I got that information, I was thrilled. Just want you to know you did a great job and the way you put it together and got it to us. Thank you so much.

Oh, that Andrea is the one who did all the bank stuff. That was Andrea.

But of course, all the time we got in there.

I blamed her already too.

He did. And then Chris and I were working over the weekend and the drafting of the scan draft that you guys just recently paid for. Kristen, do you want to update with them the possibility of getting that added to this as well?

Yes. I'm pretty confident that we can get reimbursed for that 3D scan that was done on the property since it's for The overall project, I mean, you would have had to have it done, I think, for the other project as well. So I'm pretty confident.

Yeah, that was a little over $5,000.

Correct.

Yeah. Okay. Sounds good. I'll be happy once I see some money getting into the account.

Oh, I bet. I can understand. Sounds great, but we haven't seen anybody.

Okay. Anything else?

Any questions for Kristen? No.

And we will be working with you hand in hand because I want to get this rolling because we're coming up against timelines.

We are. May is going to creep up on us quick.

Yes. Okay. Thank you very much. We have nothing else. All right. You're welcome.

Oh, I do have one more thing. I'm sorry. I do want to come up in the next maybe two weeks and get some pictures of the property for the before pictures just to submit with some of our reporting. So I'll work with Whoever is able to meet with me, I'll send an email and see what dates work for you guys. But I'd like to come up for a day and just get some pictures of the property.

Okay. We have Andrea or I, if it's on a Friday or Saturday or Sunday, I can be here.

Any other day of the week, I can be here.

Yes. We have a board member that lives at the clinic.

Oh, okay. Perfect. It's not my fault you left all that stuff to deal with.

All right.

That's all I have.

Thank you.

All right. Thank you very much. All right. So item nine, no action discussion by the Northern I County hospital district, August, 2026 medical services and needs. So we leave this in here so that we can discuss where we're moving forward. So right now, the way I'm looking at things with the HRSA grant, we're moving forward to work with the hospital building itself with this new grant from rural, um, RH, It's 1.3 million and that's mainly for getting the clinic up and running and replacing some items in the clinic that need to be replaced. Okay. So we have our next set of grant timelines coming up pretty quick too. So we need to start thinking about that. because we talked about the records billing, remodeling that and using it for possible dorm room like housing, because that's an incentive to get people up here, especially like, you know, anybody that's traveling, it saves them money. So right now we use the clinic, the dorm rooms in the clinic are used by the dental association. So we need to work with that too, because I'm looking at item 10 ahead of time and we'll discuss that when we get there. Okay. So do you have anything?

Yes. I do have a question. As the other grant parts of that rural health grant came out and some of them were equipment and things like those, what did that entail? Like what equipment could it be put in for? Is it computers? Is it vehicles? Is it, I don't remember what he said.

There's the way I looked at it was the rural health clinic grants. There was five different sections in there, correct?

Denise is like, man, you put it in another spot.

I know she put it in for someone too, and so did the dental clinic.

Yes, for the record, Denise Ferguson, D-E-N-I-S-E-F-E-R-G-U-S-O-N. So there are four separate portions of the grant. There is Flex, which is what we did the clinic under. It can incorporate for starting up new businesses, equipment for that business, et cetera. Okay, so that's what we've put in. You have to be very specific. Whatever you put in there is what you need to buy down to the part number. So it can't be a guess. It needs to be very specific in those grants. The second is the RAP. RAP has to do with retention and recruitment. So a lot of it is education, recruitment, and retention of current staff or ones that you're looking to retain. Then you have ROPE, which has to do a lot with new ways of thinking about access to healthcare. So it's like really taking a big range picture of what we're doing in healthcare and what the intent of the transformational grant was. And then RIT. So RHIT is all internet and technology and what you're doing to advance technology in healthcare and connect the four. So we do have grants in all of them in total. with yours, I have 15 that we have been awarded. So we are very busy starting today. Most of the grants are, we did get awarded three grants on Monday. One of them would be yours. And then we have a fourth grant we expect in the next week. So all of those start now, all those grants have to be completed and in line, at least the first flex one has to be in line by August of next year, which means everything was exhausted by that point. The next time period that the hospital district would have an opportunity to put in for like the building and things would be in January. That is when the next flex period comes in. And they're asking for this next round for the second year to have more creativity in it. So you're going to want to say, yes, we're doing this building, but like, what are we doing? They're going to want to know even more like, well, are you bringing in different lines of business and not just, to house your regular staff, they want to know what are you doing to advance health care if they're going to allow you to use that funding for that purpose. So that's going to be that next phase. The next phases for next year are very concentrated, and then they're going to be in our calendar schedule for the next four years. Just so you know. Okay.

I got a question. Maybe you can answer it. Go for it. It's the last one for technology. So right now, we don't have fiber. We're...

out in the sticks so would that be something we can put in for for like satellite technology to for next year yes um is that part of something that the hospital has put in for already we didn't put in it for you guys um we we put um recognizes we're in the sticks so um we have two grants that we got for writ so one is actually renowned put in for us we are changing to epics It will benefit this clinic because Epic is a very strong EHR system, and we are currently in a different platform. We no longer want to be on that platform. We want to be on a much more robust platform, which means if we have patients that we transfer from our hospital or from either of our clinics, either in Tonopah or in Hawthorne, and they go to any of the major urban systems that are in the western United States, that every single system and provider will be able to see the notes. So continuity of care, collaboration of care, reduction in errors, there's a lot of things that will create synergy when we're on that platform. So it was a million-dollar grant to get that to be transformed. And then the other was in our own hospital, we put in a bunch in our hospital that we needed for technology. We needed new computers, new beds, new patient identification boards, all kinds of stuff like that. So that's what we put in this year for the hospital system. Okay. Any questions for Denise?

I do. Okay. So you indicated that Renown was the one that put in for that grant. Is that going to affect with Kaiser Permanente coming in and taking control of Renown?

Well, Kaiser's not taking over Renown. So you're really clear. Kaiser Permanente is partnering with Hometown Health. So Renown's... affiliated insurance company for years was Hometown Health. And Hometown Health was very limited in its breadth and ability to contract, especially for customized insurer medications. So it actually was a burden for them to financially be solvent under the Hometown Health platform. So Kaiser Permanente is a giant, you know, Hometown Health is David, okay? So the giant needed to come in to create that arm. Kaiser has wanted to be in Nevada for a really long time. They've wanted to get into Vegas, all these things. Their connection to this is going to allow them to broaden that space, but they're going to start in northern Nevada. So that KP piece isn't renowned. It is an arm of insurance, just so we're fully aware what that means. Epic is the only universal major EHR used in the entire country for hospitals. So that is not going to change. And it is privately owned by one lady. So look her up. She's very incredible if you ever look into her. So yes.

OK. So don't go no place.

I'm not going anywhere. I'll stand here.

OK. Anybody else have any questions on nine per services and that? Or we just got to start thinking out of the box and start working toward our next grant cycle?

Well, I would like to add that on. It's a stupid thing to talk to me. I don't know if we need to do it or we can partner with the county to do it or how it needs to go. But I do think somewhere in the future, we should look at some kind of ambulance set up for the community. Like I said before, there's one in Tonopah and I think one in Smoky and we're, we're, we're down, the ambulance they have now is 25 years old and it's, yeah.

Um, The other ones are currently brokered in the shop.

One of them has wiring issues, and unfortunately the other one is currently having the deaf system, I believe, deleted off of it.

And there were multiple ambulances approved under the FLEX grant this year. Multiple counties as well as hospitals did get that as part of their grant offering under FLEX. And you just got to get your You've got to get your quote. It takes a long time to get your quotes. There also has to be something built into your grant language because it usually takes longer than 12 months to get one delivered. It can take 18 months to get a new ambulance delivered. So think big. Think more than one ambulance.

And we did. We put in for that, and we didn't get that awarded, but that doesn't mean we can't re-put in for it again.

100%. And what happened is a lot of people put in a lot the first year. And so a lot of people didn't get awarded everything this year. They did have money left over on flex. And so they came back to some parties and actually did fund them, but just go back and, and, and that you can ask for your scorecard. So I would ask whoever your grant writer was for the scorecard for that grant that you did not get awarded to find out the metrics that you missed. So you didn't get a high enough score to get awarded.

Okay. And when we did put in for that, we put in for, two ambulances, one from Smoky Valley, one for Vermont, one for here, and then also, and we did let them know that we got quotes from REMSA, and REMSA had ambulances already on order, and they said if we got the grant, they would forward two of them to us so we can meet that timeline. So we'll put it forward again.

Yeah, and this one's a little faster because it's nice, it's just January, and I think that the process will actually go faster. They're probably awarding 45 days. So if you are preparing for it, you tweak whatever you did in your original grant, then you put that in right away, and you should actually get funding by, like, April next year.

And I realize some of the people in the RHT are new, too, so they're getting their fees.

Yeah, they had to hire a lot of staff members. So when it started, I think they had four. And I think they're now like 25 or something. So a lot of them are learning the role. Yeah.

Okay. Thank you. Any other questions? All right. So let's go on to item 10 for possible action. Discussion, deliberation, and possible action to approve, amend, and approve or deny an MOU agreement between Mount Grant General Hospital and the Northern High County Hospital District. So has everybody had a chance to read the MOU?

Yes.

I had some questions in there, and I'll give them to you. Sure. When I was talking to Nicole, our grant writer, I had asked about receiving rent for the clinic building, and they said to go ahead and put that in.

I talked to Joe, and Joe told me that it was not approved under the grant.

Okay, so Joe never told me that.

Yeah, Joe told me that, like, a month or two ago, which is why I didn't include it in the MOU. He said it was considered supplanting by the grant committee, and therefore that's why it was not approved.

Okay. So I'm going to have to check then. And just so you know, Joe is not part of this.

Completely understand. But he is part of the committee that is on the grant writing.

Yeah.

And so when I was talking to the grant writer about submitting the MOU, and I asked him about that piece, I'm like, Of course, I'm happy to submit it if it's going to get reimbursed for the first year when we don't have any income. But my understanding from the steering committee at RHCP is that they looked at rent as being supplanted funding, is what I was told. But I'm happy to have you research that.

Okay, so I'll have to ask that question and say, okay, so if we were to start a new clinic and we had to go and get a building to use, how would we pay for that?

I mean, obviously, if you want us to pay rent, I'm happy to do that. I would ask for parity that everybody that is there pays rent and shares in all of those services.

Okay.

Because I don't think you charge rent to anybody right now.

Right now we don't, but we're in a position right now where we are close to being strapped on funds. Sure. All these grants require us to pay up front and then get reimbursed. So that's what I got to look at. And we pay, I don't know, what is our annual outcome for the clinic itself, just for water, sewer, electric, what do you call it, insurance, taxes? Yes. So we're putting out quite a bit.

And I don't, I completely appreciate that. I really do. I just want to make sure that if we're charged rent, everybody else is charged rent. I've put some provisions in our MOU that you probably brought up that We already talked about if we have providers that I'm working there five days a week, two of those rooms need to be assigned to me. And I would expect that if I'm paying rent. So those things I have an expectation of. I also, there are things within the building that aren't compliant with an RHC clinic license right now, which I know you guys had put some of that into the model of the grant. I need to know who's in charge of that. Is that you or is that the city? No, that's us. Okay, because I need to know who's getting the sprinkler, the HVAC, the roof, the doors, and all of that going.

Okay, so let's talk about that.

Okay.

The HVAC, that's part of the grant, so we'll work on that. The roof is part of the grant.

I think there was asphalt. I think asphalt was parked there. No, that got turned down.

We were going to try to get the whole parking lot redone. So that was denied. We knew that already.

Because I thought he was... I thought, at least I had heard originally, that the parking lot would get approved for the supply, but not the labor.

Right, and the labor is 90% of what that $800,000 is. And here again, we are strapped.

Okay, just so I know. Yeah. Because... the sprinkler system is an absolute requirement to run a clinic. And you guys don't have one. And so I can open without it. I can't get licensed as an RHC without it. It's an absolute requirement.

And we've gotten quotes for that. So we just got to work our budget to make sure we have the money and we get that done. Now we plan on trying to get that done before you open the clinic.

Okay, and it doesn't have to be before I open, because obviously I'm not going to have an RHC there before, like I won't have that designation before. I need, I can't submit the license certification to CMS without it being done.

I have a lady right behind you that wants to donate $500 million to us. I'm sorry, hold on. I can't hear you. We need this on a record. Please state your name for us.

Rachel Ray, R-A-Y. But these are things that you guys can turn in donation requests for through us. I'm sure Sentara has a donation program as well.

She's Ron Mountain Gold.

Yeah, I'm Ken Ross. I can get you our donation form and then you can get them to us. We're going into budgeting season. So if we can get it in on our line item budget, that's the best way to do it. If it's anything like. of significance.

I know I like it more and more.

So if you turn it in, we can look at it. Yeah, we can look at them for this year, but also like if it's a higher amount, we can put it on for our budget for next year, which we could pay out right in January if that's like what the timeline looks like.

Okay.

But I'll get it to you and then you guys can fill it out and just send it back.

Did you have a question for Rachel?

No, I just interrupted you and I apologize. But I really want, I just texted you.

So yeah, and a lot of the things that are built into your MOU for the running of this is largely the staff. So I'm actually putting the money out first. So I'm putting the money out first before I even submit it to you. All of this funding is coming from me, including the computers and the supplies, everything that's listed there, I'm buying myself and I'm submitting to you guys. I would submit an invoice every 30 days to you guys so that you guys can turn it in every month to the grant. Every month the grant will send you guys money. So it should be a revolving door if we're on time. I'm going to be on time. I'm going to need you guys to be on time.

And once we get the first month in, then we'll use that money.

And then that will be funding to at least, it will just be revolving through the bank account, but it's going to be supplanted or returned and funded through the grant itself. After that first year, I don't really plan on putting money in for any grant to support that clinic. We'll look at what the numbers look like, but after that first year, we should be creating our own funding through patient care and billing.

Well, that's fine. You don't have to put it in. We will, though.

I don't think that they will give you any more funding after this year. The funding requirement says that a new facility, they would only give six months. Your people at Great Basin went through and asked, for an extension because we justified why we needed more than six months to justify a performance in your community. And they allowed us 10 to 11 months and they approved it. That is the only time they're going to approve funding like we asked for this year.

Well, okay, let me ask.

They'll maybe give us equipment. They will give nothing for this staffing going forward.

So if we add additional staffing, like optometrist or stuff like that, they wouldn't consider that?

They would possibly.

Because we're adding more to what we're offering.

They would possibly do it. You guys would have to do it.

Right.

An RHC can't have an optometrist. So I can only put things under my hospital name or clinic name that can be reimbursed as an RHC. And there are certain things that you guys want that are not in an RHC. So a rural health clinic does not have some of the specialties that you're talking about. they're going to have to be a separate arrangement with another MOU, with an organization that will independently work with you on those things.

I got one sitting right there. Right.

So those are the things that you would just, you know, our arrangement will be in a line of what we can do in our scope of practice.

Right.

And then some of those other things we, of course, will support and our providers will support. It just won't be under our licensure. So you guys know.

All right. So I saw under physical therapy that naturally, and I talked to you before, that you have contacts to order this stuff. What I want to check with is with Nicole and find out if you order it and give us an invoice for it, will it get reimbursed?

And it should.

But it will still be ours.

Yes, because you're purchasing it for the practice.

Right.

It's going through the grants. It's not ours. I think even there it says it's the property and capital is yours.

Right, and I've seen that.

But we... like you guys can't purchase thing at a medical grade at medical rate.

Right.

You guys would be paying two or three times more than I'm getting it as a rate. So, and because I also work within the rural 13, the rate that I get is a 13 hospital rate, not a single clinic rate. So there's a big difference there in what I'm paying for. And so there is a rate call. All of your buddy who got a grant under flex, there's a call on Monday, I believe. And it specifically tells you those questions.

Yeah. Okay, so then my next question, under technology with the computers and monitors and all the backup and stuff, that too, that's going to be paid for through the grant?

Right, we would buy it first. Right. Through our agreements. Give us an invoice.

Yep. Okay, so in the past, just like with the physical therapy equipment, everything that the board buys belongs to the board. Right. So I'd want to put that in this MOU, and actually then what we do is we just loan it back out to...

It's just on site there for those services. Yeah.

As long as you're providing services.

Yeah.

Okay. So I'm going to keep on asking questions because I went over this. This MOU is only set up for one year. I don't want to get rid of you guys for one year.

Yeah, but we need to renew it after the first year.

This is to build and see where it stands.

Okay. So tell me what happens after one year. What's your criteria? Because...

We're not planning on leaving, but the specific grant in there is also to address, like I said, all the expenses that they have approved. I shouldn't need expenses approved by this district after I'm running next year. There's a provision there that says after that year, we'll come back and see where we are profit-wise. And if we need to, we'll talk about splitting profit or splitting costs if I'm not trued up. but I don't really feel like we'll be there. I think we're going to be fine based on where I think we are performer-wise. But I won't know that until a year. So I won't have a three-year scope because the first year is all the things that the grant's going to pay for. And like I said, going into next year, you're not going to have grant money. So we need to have a different conversation in a year.

Well, and like I said, we have been funding others.

Oh, I know, but I also feel like You want to get away from that because you've talked about in this meeting that you don't have funding capital, right? And you need to also look at what are the other opportunities that you can bring in. If we're doing our job as a successful partner, I don't need your funding except for exceptional things.

Because what I do... Denise said she doesn't need our funding. I know.

I'll tell you that. If we're doing our job, then we know how to bill. We're doing a volume of business. We're creating retention and respect with the community. And with that, we can run. That RHC designation is what makes me profitable. So the most important thing is getting those building items done. And just like in Hawthorne, it takes forever for me to get vendors. to actually take attention on me. So if you haven't called them today, I would call them tomorrow because that sprinkler vendor, my last sprinkler system I put in took six months. So I just would really, really push whoever on your committee or board or whoever is working on those items, they need to get that done right away. We've already talked to them.

Okay, perfect. So we were just waiting for this email to come out and say, Now you can start spending money.

Yeah, and they were really specific. They want you to spend the money now. They're really eager for us to spend it. Part of the viability of these funds with each state to get the funding again next year is you need to show that you spent your money this year in the time frame of the grant. If not, the Nevada funding can be stolen by another state the way the Big Beautiful Bill is written. They all compete for anything above $100 million.

Okay, I noticed we got 179 point whatever.

Yeah, but there's 200. You can go higher. There's states that got 230, and I think the highest state was obviously Alaska, but Texas, New York, New Jersey, I could name them. California got less than Nevada. They were not happy when they found out that a state our size received funding at a level that was not consistent with the population so we've all been told that we all need to spend this money and quickly we should have no problem i would hope so i don't see that i would hope so so i do plan on like my plan is i'm buying everything that's on that list if you approve this next week absolutely okay That's our plan.

I just wanted to make sure that the invoicing was done correctly so that we can get, you know, somebody to get reimbursed.

And I can even ask that question on the call on Monday.

Well, we have a meeting with Nicole on Wednesday. She's coming down here. Okay.

So, and she should be on those calls, those funding calls on Monday. Right. Because we're all invited that are under the Flex Fund. I know. Yeah.

I'm honored too.

Just so that, but I have six different partners, not just you guys. And what I'm doing is the same that I'm doing here. Everything that I'm doing, If I buy something, they're reimbursing me because they're the parent. But as the child, I just submit my receipts.

You just spend money.

That's right. Like every other kid you know. Yes.

I do have one question just for clarification because I was asked and I'm asking you. 4.2, this is hours of operation. Is that Monday through Friday, 8 to 5 from January 4th? From January 4th.

Starting January 4th.

Okay.

And in December, we'll have, we do have to, because the grant says we need to have some open times, right? We actually have interviews tomorrow for our clinic manager. I've already hired an MA. I'm recruiting for other staff members. The staff will start in September. So I'm actually going to start submitting invoices for staff and not the providers starting, you'll see in October. Because they need to start doing a lot of things. I have a whole tick list of things that they need to get done. In December or November, it could have more than one, we will do flu shots, and they're going to be free. So I'm going to absorb the cost of those flu shots because we won't be able to bill them. But it'll be our soft opening engagement, and it'll allow us to start to schedule patients, get them in our EHR system, do marketing, all those kind of things. So that's what our November-December timeframe is.

Okay, and I talked to Joey, and Joey did give you an invite. We have a couple of community events coming up, like the Mining Park Soiree.

I don't know if I, is that the one that you sent me? Okay, I talked to somebody for the Harvest Festival yesterday. So all of those things, as long as they're probably starting in October, when I have all, like my management team, they'll be here. My docs will be starting to come in to at least spend a few days in December to get acclimated with the staff and preferences and those kinds of things. And part of it may be to market and reach out to people. And so that'll be some of the stuff that we do in December before we go live, but all those things will happen. When we do the flu vaccines will probably be some of my team from the hospital because I need to have a provider when we do those things. So one of my providers will probably go for both of those open houses. So we're compliant. And then I've already started my engagement with the state for VFC for vaccines. It's going to take about six months. We started our lab requirements already. The radiology is waiting on a business license specific to that clinic. So I'm working on that with Sandy right now. So we have a lot of moving parts that we're working on right now, but all good stuff, you know, all leading to the timeline that we're supposed to do.

Okay. And then in September, I think it's September 12th or 18th, we have the mammogram. coming up and they're going to use our parking lot.

Okay. So the pink mama van.

Yeah.

Any, any time I can get Mount Grant, you know, there to, you know, if you guys send me the specifics, then we can have HR or somebody come up and just sort of represent. And that's fine. We just ordered like some stuff with the logo on it since the logo was approved. So we've, we've ordered things related to starting to brand that. And, The sign guy's already working on the signage, so that's already moving in that direction. And if you don't have funding for the paint, I do want to paint the building, both inside and out. But I need somebody to send me a painter that they like, and we'll pay for it. I just need to know who's a good painter. My painter does not want to come to Tonopah. He's retired, and he just painted my whole hospital last year, so I think I kind of... That would probably be why he's retired now. I probably wore him out. He's been retired a while on the map, but he wasn't as excited. So send me some maybe vendors, if you have reputable vendors that you know are working with, and then I will bring some scope of colors and things like that to the board so we can talk about that. We also want our maintenance team to come up in October, spend at least two days either in October or November. We need to completely clean up that space. I need to know if they're sprinklers. If they are, I need to know if they're working. If they're not, we're probably going to rip them out and put something new in there because we need to clean up the debris that's in front of there. If we don't get a new parking lot with asphalt, when the CMS comes, it needs to look pretty. because they do look at those things to get me improved.

You mean we can finally get rid of that little toy rocking horse thing that's been sitting there since 1982?

So those are just things that are on my list, but obviously it's your building, so we need to work on. I think that I was told there's only one maintenance worker. I have a team of five, and I have equipment. So I don't mind bringing my team up. I just need to know that you're okay with what I'm doing. So I'll give you a scope of what that looks like.

Okay. And I do want to work with you because the dental clinic wanted to, get some coverage in that sign. So when we design the sign, I'd like to be able to say the clinic and the dental clinic on that same sign. On the same sign? Well, I talked to them about it because it's only going to be replacing the facade, right?

The sign that I have designed for the front of the building is probably about four feet wide and it is the exact logo that we have but that's right in front of the building what about the sign that's out next to the road sign that's out next to the road i mean you guys just need to let me know what you want it to look like incorporating both um because right now i i would need that because it does take the sign guy about three months to get the sign going and he's working on that that low and slow yeah he's had some health issues are you using weight yeah and he he is he's got product to start working on it but if He started working on it, but I talked to him last week and he was, unfortunately he had some health issues, so it's taking him longer. And he does know that this is a priority. I told him it has to be done by the end of November. So whatever incorporation of our logo and somebody else's, I just need to know that. Okay?

Okay. Okay. I'll get you with it.

And then I can get it done.

Anything else? I mean, I've been beating her up.

Not really.

I'm going to say we're going to revise this just to meet what we said.

The only one I think revision-wise that may need at least reviewed was pending the conversation with the, about rent and things like those, and that's 6.1. Other than that, the rest of them.

Yeah, which is no problem.

So I don't know if you guys need to talk to your people and then let me know what the revisions need to look like.

We sent this to...

Oh, yeah, I sent it to Mr. Kunze, and he said this looked beautiful. So there was no issues with it.

Did he even look at it?

Yes. I asked him.

Well, last time I talked to him, he says, I got three people, I'm three people short, and they're not letting me hire anybody, and I'm so far behind, like.

great so we'll send you something else i spoke to him today so he said this is great okay so then i'll call him yeah see if there's anything i appreciate it okay anything else for denise so i think truthfully my thoughts are right now as it sits and i could be completely wrong about this so take me for what it's worth um as it sits because she's had communication with the rural health guys on rent being sub-planting and not to put in and do things with it. And we haven't charged the dental clinic rent. I think pending further evaluation and discussion and stuff later with it, I don't see a reason to need to amend that either.

We can always add an addendum later, as long as everybody has equity in the rent. And that's all I care about.

And that way, too, we can sit down and have a conversation with the dental clinic. Because if we're going to do rent across the board, it needs to be everybody that's involved having that conversation.

Well, I think we have Valeria online, too, because she's asking for money here. And then that'll be my question to her, because she put in for grant money and got awarded, too. So I want to find out what her grant money was put in for. and if it corresponds with what we're doing.

Okay. They've been volunteering their time and everything. They haven't made anything to speak of. And so, but...

But how do you know that by reporting?

Because we talked to the dentist.

But do you ask for their financials? Because I would expect that that's the reporting I'm going to give you.

We are going to, yes.

Okay. I'm just letting you know. That's the reporting I plan on giving you to show that we're viable or not.

Well, they're a nonprofit, so that's public knowledge. We can get it.

Sure, yeah. But if we're paying rent, I'm going to expect the rest to pay rent.

Yep, and that's something we're going to ask you to... give us a kind of breakdown monthly so that at our meeting we can say, you know, you've seen this many people, this, this, this, and I'll show you some of the ones we have from REMSA, which they give us on our paramedics all the time.

I'll be happy to give you a scope of what we have. We have a financial monthly report that comes out. It's 20 pages. So I think it'll be.

I don't want 20 pages.

I didn't think you would. I'll take the 20 pages. We have a fiduciary responsibility to audit the hospital systems in Nevada. So. everything we do has to have a very deep dive.

I like seeing the paperwork and where everything's going. And we've had ones in the past that are like, this is the date 12th. That doesn't work for me.

Yeah.

Yeah.

But any, anything else you might need? I don't, I'm actually, are you going back today? Oh yeah. I always go back the same day, but I'll, I'll sit here for a minute.

Well, you guys are, you guys are lucky then. So you, my wife come back from sure.

Okay.

Last night and hit that bug situation. And she had to pull over. She couldn't see out the windows anymore.

Well, it's hot, though, now. And so I'm hoping that it dried up the bugs because it's been really, really bad in Hawthorne since it rained. Yep, we have lots of water. And we have our hospital picnic tomorrow. And we would like to not everybody in the whole hospital to be infected with mosquito bites. So hopefully it dries up between today and tomorrow.

Okay. Nope. Anybody else got anything for Denise? Thank you. Thank you. All right. So we're going to amend this MOU and get it back and get it squared away.

What are we amending?

What, what, what?

What are we amending?

The MOU.

I know what part.

Oh, I don't know. We'll come up and bring it back.

The only one that needed the amending, we just discussed that it was cool to leave.

Because we need to come up with that soft opening, make sure we're covered. Okay.

I was just, I thought for some reason I missed something completely. No, no.

And then the technology, like I said, I want it to read the same way the physical therapy reads. The equipment belongs to the household district. That's all, just little stuff. And then we got the signage, which is great. And we'll let Denise go and spend money. All right.

Chair? If you guys do not make, you can amend this and make a motion because if not, this won't carry on until next month unless you help. This can't be signed. You guys need to make a motion today if you want to continue moving forward with everything.

But we don't have to have one signed today to give her, give Denise permission to start.

But you guys need to make a motion to approve it for her to sign. So that she can.

I'm waiting.

Then I make the motion that we approve this with, oh my God, my train just derailed. Well, the provisions, sorry.

Approve the MOU with amended provisions that were discussed tonight. Does that sound good? Yes, that's, yeah. Okay, so I have a motion.

Right, so I have a motion.

There we go. Now I have a second. So is there any further discussion?

No.

If not, call for the vote. All in favor say aye.

Aye.

Aye. Nobody else on line? No Gwen? Any opposed? Passes 4-0. Okay. We'll get that to you. All right. Item 11. For possible action, discussion, deliberation, and possible action to approve, amend and approve or deny to extend the letter of funding commitment with the Tonopah Dental Clinic in the amount of $120,000 for a full-time dentist. Valeria, are you there?

Hi. Yes. Hello, everybody.

Okay. So talk to us about the $120,000 because we did this for a year and the dental clinic never come up with a full-time dentist.

Yes. So we never redeemed him because Even with our recruitment efforts, we weren't able to hire full-time dentists yet. Since July, we have talked to six candidates, and just two of those have advanced to an interview phase. And then after, we offer them to travel into Tonopah, to tour the clinic, to become familiar with the town. With all the costs covered by us, they rejected the offer. So taking that in count, we hire or offer. And we apply also for the RAP grant, which is the one for workforce and retention. And we are in the face of negotiation, so we haven't been approved for that. And So in order to secure some funding in case that that negotiation is not approved, that's why we are asking for an extension of the commitment, of the agreement that we had last year. So since then, I mean since that time until today, as you can see in the report that we share, So we have had some improvement at the office. We eliminate our patient waiting list. We hire part-time providers that we pay by ourselves, including the assistant, the hygienist, and also the dentist. However, those are contractors, so they work under their own schedule. And also we're still having the volunteers. However, as you know, what we have here that the volunteer model has become a little bit hard to maintain because of the burnout of the volunteers. It's been a while working with them and it's a big ask telling them to come here, stay here so frequently. However, I mean, the commitment of the board members and most of those are still coming to the office and and providing services for the community. As well, we have started the process of accepting a lot more insurance. This is all following the community suggestions, and we are in that process. It takes up to 16 weeks, so we are more or less there. And, well, that's the situation. We got a donation from Kinra in order to help us with that, with the payment of that full-time dentist too. But, you know, they're still, we are not using that money until we hire a full-time dentist, which is the same situation we had with your offer, that we are not using that until we get that person, you know. However, financially, our expenses are rising. The gap that we have right now between collections and expenses are higher. But I think we are pretty sure that if we are able to find that person through the ways that we have been using, we are working with all the organizations in North Nevada and South Nevada with national websites and recruitment totals in order to get that person. So if we are able to extend the days we offer services at the office, we can be self-sustainable. However, the challenge is to find that person that we haven't been able to to finance yet. If we get approved by RAP, this is going to be our situation. So the offer for the full-time doctor assistant and hygienist is going to be even more higher than what we are offering right now. That person will have to stay five years after receiving the financial incentive because of the grant. However, that that money needs to be used only for six months, as Denise said. We tried to extend it for nine, but, again, we have not been approved yet. We are in the negotiation phase still. So that's the situation. Other than that, talking about how, for example, improvement that we have done at the office,

We brought a new chair so we can see more patients simultaneously when the doctor is there.

And we also got a grant from the FlexBound. That grant was already approved, and we are ready to go with it. And what is included there is a ceiling light that we are needing, x-rays in Operatory 3, along with more equipment to treat pediatric patients, and also some equipment to have centers done faster than currently. So our request is basically, if we don't get the grants, we would need support to keep the office open at least for a year in order for the doctor to become self-sustainable. And that's the support we are requesting.

Okay. Has the dental clinic entertained the idea of reimbursing your benefits dentists now that come in and volunteer, at least for something, mileage or meals or something, because right now you don't reimburse them for anything, correct?

Per their website, it says that they reimburse their doctors $1,000 a day.

Yeah, we did not reimburse the doctors. Sorry, we started reimbursing the doctors this year in January. Right now, we pay... the part-time doctors who come here and became a part-time doctor, $1,000 per workday. However, with volunteers, we offer lodging, food, and gas for come here and provide services to Tonoba. Until today, none doctor that has volunteered at the office has received any payments to provide services. Other than this, it depends like food, lodging, and gas.

Okay, hold up one second, Valerie. Of course.

Of course, Carlisle, C-A-R-L-Y-L-E. I respect the dental stuff, but you can't have your cake and eat it too. You have a hospital working with you. You have all sorts of things going in positive. Go look at your financials in the hospital district. You can't. You're going to sacrifice or jeopardize the real meat and bones of creating medical attention in this community for dental. Shame on us. So you can't, you don't have the money. You're working with one person, a professional. You've got the horizons, and you have a national debt that you can't pay. You've got to get, you know, we've got to nail down what you can do. You don't have the money. Thank you.

Thank you, Court. Valeria, when you mentioned that you provide housing, are you talking about the rooms that are at the clinic? Because right now I have an MOU in front of me that requests two rooms five days a week, and I only have three rooms.

We offer, I mean, right now, the part-time providers use the rooms at the facility. However, because of the AC... We have them in hotels. And for the volunteers, they all stay in hotels as well. They don't stay at the room. The only people that stay there, as I said, is part-time providers that are paid. We pay them. They are contractors.

Okay.

Some questions.

Questions? Oh, I have questions. Okay.

So, Valeria, when did the dental clinic actually open? what month date and i believe it was in 22. sorry can you repeat the question when what specific date did that dental clinic open okay because i have a contract that says when it was approved what date did it open what so the clinic opens wednesdays and thursdays for administration duties No, not days of the week. What day of the year did that clinic open? What was the opening day you guys started at that clinic for the dental clinic?

It was November 3rd. We opened November 3rd, 2022.

Okay.

Yes. So I have here, and we've all read it, is the contract, the initial contract, the contract that Dawn signed. dated sorry i don't know my glasses they're blurry give me a second october 18th of 21 is when don signed it uh 19th of october is when the nevada dental foundation signed it and the struggle i have is that in the four years that you guys have been here i've sat here and listened to repeatedly how we need help and we need this but then i pull up your website and see how many dentists you guys have attached how much staff you have attached, the donations you have attached, all of this. And in four years, you guys have not been able to meet the open, I think it says five days a week, four days a week at all with it. I've seen you guys more within the last few months be open, but I do believe to an extent that has been because the hospital board has not been happy with the hours you guys have been open. We gave you a year ago, July 2nd of 25, gave you the letter that you have right here for the request for assistance for some of this stuff and we got minimal communication on how many dentists you guys were bringing in what status you guys were in on recruiting and upgrading and things like those with it and nothing and then we had to bring it to you to see if you guys even were going to plan on re extending this or trying to extend this and now i see sitting here that there's a thirty three hundred dollars difference but i don't see what it's for

is it staff pay is it supplies is it buildings is it i don't see what it breaks down what it's for it's the whole operation so again when we start being when we start making life in the in the in the building before we open in november uh 2022 uh it was for remodeling we make a full remodeling of of the of the of our area because it was not um set up for a dental clinic so it takes it took time donations and money that the foundations collected during all those that time in order to be able to open then again then after we open until january this year we worked with volunteers only And that was the inconsistency in the schedule. And we operate basically by ourselves. I mean, we have the grant that helps us, of course, and we have you guys that let us stay in the facility. Now, again, it was with volunteers. We tried to do the best we could in order to keep the clinic open much as possible, but we were relying on people that are actually running their own practices in Las Vegas or Reno. So that's about it. Then why we are being more stable this year? Well, because after listening and after seeing that the model was not meeting the needs is when we decided to hire this part-time providers with very expensive salaries in order to make it attractive for them. That's why our expenses are higher right now. It's because before that, we didn't pay the volunteers basically for anything. They were volunteers their time. And now we have employees that we have to pay to keep the clinic open in order to be able to have time to find a full-time dentist.

So we contribute that $3,300. Are you guys planning on opening the full four days a week, or are you going to stay at the random two days here, two days there schedules?

No, the idea is that first we're not going to redeem the money if we don't have the full-time doctor. And then the full-time doctor will have to work four days a week or 40 hours per week or four days a week. I mean, we can be kind of flexible with the doctor in that topic, but still he has to complete all the hours required to be a full-time provider. It's not just the doctor. It's going to be the hygienist. It's going to be the assistant. It's going to be the administrative team as well. It's going to be everybody. The idea is to move from a part-time model to a full-time one.

So our concerns, Valeria, are we see what the contributions are coming in, and we don't see the dentists, which are your essential personnel, getting reimbursed nowhere near what your office staff and your other personnel are getting paid. And we're wondering if you are managing your money correctly, because without dentists, you don't have a clinic. So that's our concerns.

Well, that's not a problem. I can tell you something. For example, the doctor gets $1,000 or more 35% of the collection. The hygienist gets $37 per hour plus a certain amount of lodging. If she decided to stay outside, we pay for food and we pay for gas. Same with the assistant. Then we pay all the hours that our administrative staff is there, is paying by ourselves as well. Same with my salary. Right now, we are not having any funds from HRSA regarding personnel, and that's being paid by ourselves as well. The only resources that we have are the insurances that we bill, the patients that pay out front, and the remaining of the HRSA that is going to end this month. So it's not that we don't, I mean, our expenses are pretty high. And HRSA doesn't also, just to clarify, HRSA doesn't pay for all our bills. It pays for some of our expenses. We still have a very extensive operation because our office works with a lot of remote billing personnel that is in Ohio. It's not in Nevada. They don't live there, so they charge us for that services. We have a cloud-based services who manage the services. the system, then we have the internet, we have the IT that manage all those things. We have all our supplies that are very expensive.

So does MIMO Works not donate to you guys the credit for equipment and services anymore either? Or was that the initial donation?

No, we pay our bills for internet every month.

Because your website on current donors states that MIMO pays the internet with it. Here's the problem that I have with this. And this is not internet related with this, but this is a concern I have. In the couple of years that I've been on this board, the only times we don't get updates from you on patients that you see, we don't get really any concerns until they get brought up and then it's, hey, by the way, we don't get communication to an extent with this. And I don't even know how many patients you guys see a month. I don't know how many visits and stuff you guys have with this. So I'm worried that if we do give this kind of money with this, the lack of communication and improvements with some of the stuff is going to stay.

We can start having more. I can start sending you a report. However, I understand that we are using your facility. But... But... Still, I am not allowed to share our finances without the board approval.

Well, then you need to get board approval because I know you're the chairman of the board and you are a nonprofit. And by being a nonprofit, everything that you do is supposed to be transparent and available to the public. So I'm going to ask you for a statement, a financial statement, Valeria. Thank you. Because we're going to have to look at how you're managing your money before we make a decision to give you more money or if we need to look for another dental operation to come into the clinic.

We don't have any problem doing that. I'm just telling you that I am not, I don't, even though I am, I direct, I am not allowed to share that with our COWA. That's the only thing I'm saying. It's not that we are not, we cannot do it. It's just that right now, I am not allowed to do it.

Then I of course- Okay, so when you get that authorization, I want you to send it to Andrea. And at that time, then we'll reopen this and make a decision on whether we're gonna supply $120,000

And I do realize that we hadn't requested it before, but it's come to that point now that we have to do this. Valerie, so we do appreciate it and do that as soon as you possibly can so we can take care of this at the next board meeting, perhaps, okay? Thank you.

Sure, no problem. I have a motion, but I don't think she's going to want to do it.

Make a motion to...

I make the motion that at this point we deny to extend the letter of funding commitment pending further evaluation and discussion for future.

Second. Okay, I have a motion in two seconds. Any further discussion? If not, call for the vote. All in favor say aye. Aye. Any opposed? Passes 4-0. Okay, Valeria, we're going to deny this right now and we're going to expect the financials from you. So when you can get them to Andrea, we're going to reopen this and we'll look at it again, okay?

I would also like to see if possible how many, a breakdown of how many patients you guys are actually seeing per month so that we can see how that building is correctly, or how the building is being utilized. Because we've only seen five patients, you know, I'd like to see it being used.

Just for the record, I think there's six patients per month with four days of operation.

Four days of operation. Seven days of operation. On the cover page, the first page, it does say, the results since our last report have been encouraging from July 2025 to the present. TDC has completed 705 appointments across 31 provider days, providing hygiene, surgical.

That's 13 months.

Pediatric, emergency, preventative, restorative, and prosthetic care. We are especially proud to report that we have completely eliminated our patient wait list.

So you're saying you guys see 22 to 23 patients a day?

No, that's per visit. Divide that by over 13 months. That tells you how many per day.

No, no, it says 205 appointments across 31 provider days.

That's 22. I want to know how many they're seeing. How many of those were per month? Is it 22 that month or is it six?

31 provider days, she says.

Yes, but they're having between two and four provider days a month. That's since July 2025. I know.

So in a year. Sorry.

I've got this taken care of now.

Valeria, you're breaking up. I don't know if you need to stay in the same spot, but we can barely hear you. Sorry.

Two and a half days. Two and a half days a month is what they're saying.

60 patients per month working four days a week. Sorry, four days a month. And it's about 15 to 20 patients per day because We have the doctors working in two chairs, and then we have a hygienist working in the third one. Those are the numbers.

Okay. If you can put that in the report when you get it to Andrea, we would appreciate that. Thank you.

Sure. It's in the, just, yes, I will. So that information is also in the, in the report I shared for support today, along with our hours of operation and all the improvements and progresses that we have done since last year.

Okay. Anything else? Thank you very much. I'm going to move on. Let's go to item 12. for possible action, discussion, deliberation, and possible action to approve, amend, and approve or deny the use of Hope Las Vegas and the property of the Northern Ike County Hospital District located at 149 South Central Street.

Chair, I'm going to make the motion that we table this one pending a formal discussion of building a contract for this one, just so we know what they would have to cover if something happens, what we would have to cover if something happens. We can build it, and that way it covers everybody's butts on both sides.

What is the proposal here? So we have something to work on.

Well, we can pay rent. Say your name first. Oh, sorry. Gilbert Cruz, D-I-L-B-E-R-C-R-U-Z, representative of Hope Community Resources out of Las Vegas. OK. Proposal is, I mean, we'll cover all of the expenses that occur. Because I know we don't want you to take any other expenses

to you know to your bottom line and then if y'all need to set up like a monthly rent or what it will be we'll do the same thing we're doing with with um the hospital district or with the hospital we'll allow because you're going to be managing this other grant yeah and in order to save money there we have a building that is paid for that belongs to us so as long as hope las vegas puts the utilities and takes, maintains the utilities on that building. I have no problem with them using it. So does that give us a start to put it in to use or, because if we wait another month, they're going to get going here before the end of the month. And we got to get this building set up and ready to go.

And then you have to draw a contract stating any damages or anything. We're 100% responsible.

Can we approve it stating that they can use it, but pending formal use of the contract built and do the communications? That way we can approve building a contract or building a... Oh my God, my train railed. It's bad. Pending like an actual contract signature and stuff for it. so that it's approved or denied or whatever with it going forward, we don't need to wait a month or...

The issue is, and this is why I'd asked in advance about creating a lease or something, having something in writing so that we could have this.

Yeah, the same thing we have for the dental clinic and the same thing we're going to do for Mount Grant.

Correct, but the issue is there's no backup for this agenda item.

So that's why they're here. So we could talk about this tonight.

Correct. Go ahead.

I'm listening.

I'm thinking. I know it's scary. Because all this states is just approving the use of it. So could we make the motion like to approve the use pending the signatures of a lease? Because then that does meet this one.

And we have a lease to cover it. When is the temporary of like the...

move in a bit it's it's up to you i mean what are you guys prepared to go into the we plan to start working within two weeks okay so i mean but if if y'all need a little to see in that two-week period we need to get the water turned on with people there to make sure there's no leaks we get the power turned on and make sure everything is operational there uh we walk through the building it does need a little cleanup maintenance to get it ready. And I've talked to Mr. Cardenas, and he's willing to go and do that under his current contract.

Excuse me, I think I missed something here. What is it that they're doing?

They're the ones doing the extended care facility where the hospital building is now.

That's them.

He's the guy doing it. He's the one in charge of managing that one. And right now, I'm not sure.

Does, what do I want to say? Does rooms and that come off that grant or is that outside?

Yeah, that'll be outside. That's why we're, if we do the contract, it'll be under HOPE because HOPE will pay for it. That would not touch any grant money at all.

And I know when we signed the contract with them, they agreed to manage this without a fee based on the loan. Yeah.

Can we take a 10-minute recess so I can construct something?

I'll make the motion we delay for a bathroom break.

And then that way we have something to approve. Would that be significant? I mean, I know that it doesn't allow the board enough time to review it, but I can find a general agreement.

All right, let's take a 10-minute recess. We'll be back at 7 o'clock. How's that?

Are you going to bring some nevels? Yeah, really. Not 10 minutes. We've got to have nevels. Here's your chance. You've got to go.

I want to give you a message on the caffeine. It's too many late nights and super early mornings. The brain cells are not... My schedule is so screwed. How are the brains going on? I have a sign on my desk that says I'm responsible. It is, really, because you need to make sure you get it done. I agree. That's exactly what that means. Yes. We're in agreement.

Thank you.

Yeah. Yeah. Yeah. Yeah.

You're a prophet. You need to be sustainable. Yeah, because even the brand says that. Sustainability for long term.

This is just a starting point. Yeah. And I guarantee you the money they're giving us right now comes from Christ. I have to do something in the next five years to make it, because we're going to take something away. And we all know that in the hospital. We expect it. We're already free. Yeah. More beneficial. There's a lot of ways we can do that. Bye, guys. You're with YCAC? CYC. Or CYC. Yeah. I think that's it. But I have to talk to somebody about your harvest festival. And we're planning on it. We're planning on it. As you find out. I'll be in there in a minute. I think it's a... I think it's a...

I think it's a...

Thank you. Thank you. Thank you. Just because that way it's easier, especially with all the file cabinets.

I don't know. I'll figure it out.

I think if nothing else, this is what I might do. Yeah. Yeah. I'll figure it out. Get our interviews done. Thank you. How can you stay here with a natural dad? Yes. I'm a very, very clever speaker. Yes. I don't think we should. I can't be that. I think we should. I think we should. I think we should. I like paperwork. We're not, it's this of us. Cheers, man.

I'm loading it. I'm loading it.

Thank you, Horace. I try to be on the phone if I'm not here, you know.

I know you aren't. No. I know. Yeah. Oh. No. This is all day. It's all day. $4 trillion going north. You ain't going to see this. Can you get it now? You can get it. Oh. Mm-hmm.

And what they're doing too. I know. Yeah, we're there. We're really there.

I'm gonna go.

Who were you all talking about, honey? About who's coming? Is it this week somebody's coming? Or you were talking about you said certain days you could be there any day except for whatever. What's that about? I kind of have to.

Oh, yeah, right. Oh, yeah, that's what that was all. I thought there was somebody else coming.

Okay. Okay.

From Texas.

She doesn't even live here.

No, I know. There really is.

Are you managing your money correctly? Or are you just paying yourself?

Well, you know what frustrates me the most?

They're insolvent.

So I'm up there all the time now. We're doing a lot of stuff. And we'll come see you in a couple of days where I'm up there all the time. And cleaning stuff. getting papers moved, organizing and tidying and doing all that stuff. I've been doing all the hospital beds that were in there that we were saving and salvaging. I've been moving and cleaning all that stuff for the last little while and working with some of it. And I can tell you how many days I've been up there and nobody has stopped at that dental clinic. And I can tell you how many weekends I've been there where they're seeing patients and they're open X amount of days and nobody is there. Not even patients. They tell you that... that providers are not there.

Yeah, that's exactly what it is.

You give the providers no incentive whatsoever to come back.

I spent a year trying to get a clean. They did all the work, but then I couldn't get a clean for a whole year.

Well, and I have, I've gotten literally, I've had people come up that when they say they're going to be there, and I went online, I Googled their times they're open.

Yeah, nobody's there.

Five websites, five different times, schedules. Three different phone numbers, two different addresses, all of this stuff. And it's frustrating because they were trying to build consistency with it. And they've had four years that there's no hope for this. And that's where I feel like it's suffering. Because if you have a patient, like I had a lady come up because the dentist was supposed to be there. They were open with the providers on Friday, Saturday. Yeah, it was Friday. And the dentist was supposed to be there. There was no providers. There was no nothing. And that lady came up because she was scheduled to have an appointment and nobody was there.

I want to see submissions to insurance.

And I want to schedule what they charge because they're charging different.

I want to see their submissions to insurance because. If, you know, I'm going to ask, hey, were you here on this date?

So, and the reason I wanted to have the breakdown for, like, visit is so the 705 patients...

It's still recording.

She's online. That's recording everything we have. So don't... You can solve it. Oh, I know. Allocating their money. You cannot.

Well, she did.

That's why.

We agree everyone. I want to reconvene our meeting of the Northern night County hospital district or August 20th, 2026. We're going to go back to item 12, which is for possible action, discussion, deliberation, and possible action to approve amended, approve, or deny the use of hope Las Vegas and the property of Northern night County household district located at one 49 South central street. I have in front of me a residential lease agreement that our, um, Gracious administrative secretary over there wrote up for us. And I'd like to introduce this into, not evidence. I want to introduce it and have it brought in as a backup for items 12.

And it has been added for the public to view as well.

Right. And we're going to be going over it real quick. Okay, so this is between Northern Knight County Household District and Hope Community Resources. The property is located at 149 South Central Street in Tonopah, Nevada. The lease term, it'll begin on August 20th and we're gonna do a continuous one month to month basis until terminated according to our applicable laws. The rent will be zero per month. So it's not due on any day. It's not made by any payment. The tenant will pay no security deposit. That's item four. I don't have an item five. But I have an item six. Did you, are you missing a finger?

There may have been one that was deleted but not re-numbered. Computer locked on her. You gotta turn it the other way.

Okay, sorry. Anyway, utilities, the tenant is responsible for the following utilities. So power, water, sewer, and actually that's the only three or four utilities, or three utilities we have up there. Trash, if they need it. Trash.

Trash, okay.

Trash.

Which really you're gonna be up to. Number five is late fees.

Okay, so no late fees, yeah. Okay. So power, water, sewer, and trash. We'll cover it. It's covered right now in insurance. The only thing I would say is you might want to think about getting your own insurance for possessions or personal possessions.

I'll get a rental insurance. Okay.

Okay.

Can we get a copy of that?

Okay. Number seven, maintenance and repairs, 10 degrees, keep the property reasonably clean.

Yes. What about communications?

They're responsible for their own communications, but that's not part of rent. So if you want, well, you've got your own cell phone, but if you want to get internet, it's up to you.

I'll set up all that.

And then the...

tenant there knows somebody that's going to give them a... We can just add the... Can we add internet to power sewer water trash just for coverage of... That way he doesn't have to worry about and be like, hey, what the heck.

Internet. Okay. So it says tenant agrees to keep the property reasonably clean and sanitary to promptly notify the landlord of any damage or needed repairs. The tenant responds for damage caused by the tenant. Okay. Okay. The tenant may not make major alterations, paint, remodel, or install permanent pictures without landlord's prior written permission. You're not gonna bring the little ones up there, are you? If I can, if not. If you do, you're gonna be responsible for maintenance and cleaning. Oh yeah, okay. So pets are allowed with the provision you maintain. Yes. Okay. We're not gonna cause a pet deposit or fee, are we?

No.

Okay. You don't smoke, right? She don't smoke. Smoking is not permitted inside the property.

Smoking or maybe like you burn a pork chop.

Okay. Let's see. Rules of conduct. Okay. Vehicles and parking. We have the parking in the back. We do have that garage, which will be cleaned out. So if you want to use the garage, especially for winter. Yeah. Okay. Entire agreement. Okay. So this Andrea, I would like to put in here like amendment or addition a to state what the property has, because we have a washer and dryer in there, stackable washer and dryer. We have a full-size refrigerator. We have a stove. I'm going to have to go back with you and look and see if there's anything else. So I want to just inventory that, okay?

Because that's all property of the hospital district.

And we have an air conditioning unit, but it's not the property of the hospital district. It's the property of Mr. Dick.

Aww.

Is there anything else you see?

Yes, ma'am.

Yeah, the house and the county. So because we're part of the county thing with it and the house is property of the county, there's no smoking in it in general. It's a smoke-free facility. Okay.

Okay. And that's what we said, no smoking.

I do recommend, though, with the whole Vegas thing, it does snow up here. Get you a good snow shovel, heavy duty, hardy, flathead, metal works good. Okay. And some good ice melt that holds up.

So, Chair, I would request a motion that with the provisions that have been added that this be put in.

place and you got that yeah make that motion do that i'm not motioning this is my recommendation i make the motion that we approve this with the addition of the inventory list of things that are owned by the hospital board that are currently in that provisions we just talked about and the provisions we talked about second okay i got a motion in two seconds any further discussion no call for the vote all in favor say aye aye aye any opposed

Passes 4-0. We got something done, Hank. Thank you. We'll have to pay you double next year. Item 13 for possible action, discussion, deliberation on augmenting the annual budget as presented and approved due to capital outlay not being needed.

Can we table this because I still don't know what this is? This was a twin item that you tabled from last month, and that would be my recommendation.

Yeah, can we tell us? Because she's not physically here on the phone to explain, and I don't fully understand.

Okay. So we'll table item 13. Okay. Very good with that. Okay. Item 14 for possible action, approval of invoices for payment. We've got to spend money. I like these invoices. This is great. We have Remsa for $35,198.20 and Amazon for $397.46. Was that clothes or what did you buy?

Those were the boxes we needed to finish packing instead of the hospital building and some tape and a trailer hitch so that when the trailer that's in the ambulance barn is relocated, it is secured and maintained. That's part of the cleaning stuff you told me I could do.

So for a total of $35,595.66, do I have a motion to pay the bills?

Pay the bills. I make the motion we pay the bills.

And I have a second. Any further discussion? If not, I'll call for the vote. All in favor say aye.

Aye.

Aye. Any opposed? Passes four to zero. Item 15, general public comment. Three minute time limit.

Where's Carlisle? C-A-R-L-Y-L-E. I want to thank the board and all the staff. You guys have done, potentially, have really made a really positive future for the town. And it's just amazing, based on the, and I'm not just, it's just, you know, it just awes me that we, after all these years, we've got where you are.

positive thank you oh you can keep talking you get three minutes thank you that's probably the only time don's been on part of the board that said you did a good job who wants to hear it again yeah and coming from horace that is a real compliment make sure the mic is on the green light's on

Then state your name and spell it, because that lady here doesn't know how to spell.

Okay. I'm Gianna Passarelli, G-I-A-N-N-A, Passarelli, P-A-S-S-A-R-E-L-L-I. And this is? I am Brynlee Frazier, B-R-Y-N-L-E-E, Frazier, F-R-A-Z-I-E-R.

I'm glad I'm not the only one who can think how to spell my name today.

Thank God.

And her name's harder, so... feeling worse about it okay today we're just going to be talking about like to be thankful for our community and everything like that and also to talk about our harvest festival that is coming up in the next month or so um it is mostly just for like the community and we like volunteers and people who want to come together as a community and really put in the work to have that so our harvest festival is just people coming and actually helping out. When is it? October 11th.

Oh, you got a flyer?

Yes, you guys will get some when we are done. Okay. But Tonopah is just, we are more than just people. We are a community that actually needs to come together and be the community that we should be. So that's what our Harvest Festival is for. And do you want to add anything to that? Oh, yeah, and the people that have had been able to appear to talk will be present at our harvest festival. So shout out to them.

All right.

Yay.

Cool. What do you mean no children allowed?

No. Without a parent or legal guardian. So you have to tell Cindy to bring you.

I got to leave. Great. Okay. Is there food?

I mean, I would hope so.

I don't see food.

That's you right there. See what says VFW? You get to do the food. They're going to make you cook.

Normally, I think for Harvest Festival, the VFW usually did the pledge for the kids, and we gave away money, and they loved the money. But then they got a flag and a pin and everything else, so...

It's a bad thing. Come on, many of these little groups that say they're here.

Don's going to be there. It says petting zoo.

Hey, that's a fundraiser.

And I see they're going to do face painting with you, so we're good.

I do promise, girls, we are adults. I swear we all are over 18.

This is great, except for her. This is great. Who's doing your bingo? Who? They are.

Deb, just come up and do the, yeah.

Please state your name, ma'am.

Deb Cobb, C-O-B-B. They are very new. They're first year, well, she's a couple, but they're the youngest. Our seniors have all left. Remington was our outgoing, and they are doing a fantastic job. They've already presented to the Board of Commissioners, so.

Is Chad going to be doing anything? Chad's going to Disneyland.

What? Do I not recognize these two faces maybe in the newspaper? Are you involved with?

Actually, I do believe these girls also were part of the 4th of July that we did. They came up and helped the fire department. They were really big. CYAC was really big with that because the fire department was short staffed this year to do the flag and stuff with it. And these kids absolutely stepped up to the plate and come up and helped with that big flag and everything else. It was very cool.

And didn't you do some, weren't you, the people, the young people that went before the town, that over there at that park.

That was two other kids, two other good kids in the community. The skate park or pickleball, yes. All these young people in this community are really stepping up and they want lots and lots of it. I love seeing them so involved. It's awesome. So bingo, your question about bingo. They have never played it. That's why I want to tell it. So first your friend's bingo is you get a card and it has things on there and you have to go around that whole area and find somebody on that with their name.

And have them stamp it.

And have them stamp it or write their name, and then you bring your card back and you get a prize. So in other words, find somebody that was born in Idaho. Find somebody that has blue eyes. Find somebody whose birthday is in March. So it's Friends Bingo. Go find somebody. And then once you fill out the card, you found Friends all over your card. I'm in trouble. That's cool. So Friends Bingo is that. And then you get a prize. Everybody gets a prize for filling out your card.

I've never heard of that before.

I used to do that with 4-H all the time. I used to do that 4-H all the time, especially when we did camps and stuff. Anybody gets to know everybody.

It's nice because you get so many people that want to stop by and visit and be like, what's going on? But they never talk to people. Right. They like pop in and put their ninjas in and out.

But you get a really cool prize if you do it. Everybody gets a pumpkin carving kit. A really big kit.

All right, I'm going to have to talk to people. Dang it. I got a month and a half to build social skills.

That's what you should make it one of the rules for bingo. You have to spend five minutes orally speaking with the person before they can sign off on that. There you go.

We will add to it. And also on there, by the way, is they have to go to VFW and say the Pledge of Allegiance on there also.

So you'll be. Oh, we can put us in the center. No free space. It's got to be VFW. There you go. We're on it.

We're good with you guys. Well, we should be on it, too. Are we going to join the VFW? Well, I'm on the VFW.

Yeah, you are, and I am.

I think, to be honest, all of us sitting here are somehow involved with this anyways, because you have VFW, you have BLM, you've got fire department.

Hopefully, you've got rotary, you've got... Yeah, I think all of us are going to be hanging out. Total fire department, ambulance service, yep.

And the goal is to get more... And others. Oh, I see. That's the big goal. is to get more people to volunteer. You live here, join us.

And you know we put in for a grant for this. There's an application.

Chair, I would like to, if this is something the Board would like to entertain, of adding a reopening item six and asking for this to be added as a motion for next month's agenda item. So if you guys have an idea. Do you want to participate?

I like that. Yes, I say we do that, and then that way we can maybe come up with something other we can do, or we can come up with a way to help with something with them, whether it's supplies or something.

So we actually don't have to open up item six. We have item 16, which is announcements. We can just make an announcement that the board is going to participate in this.

I didn't know if there was going to be any type of financial... that you guys would want to make that as a motion for next month.

You guys want money too?

Well, I mean, if you wanted to purchase like a prize or I mean, whatever you guys wanted to do as a board present.

Well, you know, I think it fits in the something needs of the community part is on there, didn't it?

I'm putting it out there, so if you guys wanted to do some type of... We can donate used bedpans out of the hospital and stuff like that.

Then I make the motion we put it on the next month agenda item with it and then pending for the discussion with it. That way we can raise table or take it off later. There you go. I'm getting good at putting the words together to make the motion thingy. We're learning.

Okay. So, motion. Do I have a second for that motion? Second. Okay. Got a motion, second. Any further discussion? I'll call for the vote. All in favor say aye. Aye. Okay. You got it. We're out.

Thank you guys for your guys' support.

Thank you for doing this.

Thank you. It is nice to see the young people, the community back involved in doing things.

And make sure you get this to the town so they can put it on the reader board and everything. And we'll get this up at the bulletin board at the VFW post. Well, they were in here. No. Oh, no.

Hope and Mount Grant is on there, but Hope is coming down to play with it, and we're going to put a dunk tank that says, you know, that says Hope Floats. That's the animal one.

Oh.

What is it? Hope Floats. That's the animal shelter foundation thing that's here.

Oh, they are.

Don saw Hope. He got all excited.

I thought it was.

That's Hope Community. There was hope. Hope floats. Hope everywhere, just wrong branches.

All right, thank you, ladies. I think it's passed on to bedtime, that's why. Is there any other general public comment? None? Okay, so let's move on to item 16, announcements.

The hospital board will be helping with the Harvest Festival. Sounds good.

Any other announcements?

Okay.

No, sir.

You good? You good? Chad's going to send us pictures of him and Mickey Mouse. Andrew, do you have any announcements, like when we're going to meet at the bank tomorrow?

Tomorrow, I will be going to the bank to open up the bank account.

Do you need any of these people there to sign cards and that, or is that already done?

Did you bring in your ID to the bank? No. Okay.

I will swing it in the morning and do that. Okay.

That's the only other thing.

Would you like my schedule and we'll trade? I would gladly go work your job. You have a copy of the minutes that I need to sign for tonight?

I have so many signatures for you to sign tonight.

Okay. Any more announcements?

Motion to adjourn.

We'll move on to item 17, adjourn. We're going to go eat. Jamie, you want to go eat?