NATCHEZ — The Adams County Board of Supervisors met with the Natchez Regional Medical Center board of trustees to discuss the county-owned hospital’s future Tuesday, but one thing they didn’t talk about was NRMC’s settlement with its former management company.

The settlement for the $42 million lawsuit against Quorum Health Resources — the hospital’s former management company, which the hospital alleged mismanaged the facility for years — was sealed when the settlement was reached in federal court in December.

The supervisors, who appoint the hospital’s board, have not been told the terms of the settlement, an item that was originally on the agenda for Tuesday’s meeting.

However, Supervisor’s President Darryl Grennell said the boards could not actually discuss the settlement without the supervisors signing a statement of non-disclosure per the settlement’s seal. After seeking advice from the Mississippi Ethics Commission, the supervisors learned that they could not legally sign the non-disclosure statements.

The other issue that prevented the discussion was Mississippi’s open meetings laws, which only allow the supervisors to enter into closed session to discuss potential or active litigation against the county, the purchase of property, economic prospects and employee performance.

The hospital board operates under a different law, and most of its records and meetings do not have to be disclosed.

Supervisors’ Attorney Scott Slover said the supervisors will try to ascertain information about the settlement through the hospital’s audit, which is public information and becomes available in April.

“They feel like that information (from the audit) will be enough to assure them about the hospital’s future,” he said.

During the meeting, the hospital’s administration updated the supervisors on what is being done to keep the facility in compliance with the Affordable Care Act.

Chief Nursing Officer Barbara Willis said the staff is looking for ways to streamline procedures and redesign care by doing more with less. They are also implementing electronic medical records, a government requirement.

“It really helps with disseminating information,” Willis said. “When you are admitted, we add all your information and what medication you are taking, and the next time you come in that medical list is there already, and we just confirm you are still on that medication.”

The hospital has also started a community relations committee, which Willis said brings in members of the community to discuss public perception of NRMC.

“We bring them in because we want to know what they are hearing, what they experience at the hospital,” she said. “We can’t address those issues if we don’t hear them. It has really helped us know what people are saying about us.”

Chief Administrative Officer Donny Rentfro said the hospital is also putting an emphasis on physician recruiting.

“The average age of our entire medical staff is 59, and there is not enough of them; we just plain need more,” he said. “We are focusing on making sure there are enough mid-level physicians, primary care and specialty care.”

Natchez is a medically underserved market, and NRMC is currently working to recruit an anesthesiologist and a radiologist with family ties to the area, Rentfro said.

Chief Executive Officer Bill Heburn said the hospital needs one additional on-call orthopedic surgeon to upgrade its trauma rating so that emergency patients who do not need immediate brain or heart procedures won’t have to be moved out of the area.

Rentfro said the hospital is currently negotiating a new contract with Jackson Heart Clinic. Cardiologist Brad LeMay works for Jackson Heart in the Natchez area.

“Having that service tied to Jackson Heart, that name that people know, is a comfort to many people,” Rentfro said. “We are moving forward, but to the point that it has to make good financial sense to everyone.”

Chief Financial Officer Charles Mock urged the supervisors to do what they could to convince state legislators and even the governor to expand Medicaid in Mississippi in light of the Affordable Care Act, which would eliminate approximately $2 million in disproportionate share hospital (DSH) payments to NRMC each year.

DSH payments are made to hospitals for care rendered to those who may not qualify for Medicaid but cannot pay for their treatment.

The hospital can also expect to receive approximately $350,000 less in federal funds because of the sequestration, Mock said.

“For our particular area, Medicaid expansion may not be the total answer, but it is part of the answer we need to do the mission that we do,” he said. “Medicaid expansion is almost a must, not only for Natchez Regional but also by Natchez Community Hospital. Some of those people who are now not covered would have some coverage. The same rate of illness is going to occur among those people anyway, so the services are going to be rendered.”