Board, clinic operators dispute staffing costs and await signed contract before resuming payments

Trustees for the Northern Nye County Hospital District pressed representatives of Frontier Medical Group on January 23 about clinic staffing costs, delayed patient billing and an unsigned contract the board says has held up payments.

District Chair Don Kaminsky and trustees asked Frontier staff to explain why payroll and provider stipends appeared higher than reported patient volumes and why patients were getting late bills. Queenie, a Frontier representative, told the board, “We are taking Medicare and Medicaid.” Dr. Coker, a Frontier physician, described limits to recruiting clinicians and said visa- and loan-forgiveness programs require on-site supervision and other conditions.

The dispute centers on two issues: Frontier’s reported payroll and provider expenses, including stipends for a preferred provider who lives in Alaska, and the lack of a signed interim contract between Frontier and the district. Andrea, a district staff member who reviewed Frontier’s reports, told the board the monthly expense figures did not match the year-to-date report and asked for clarity on why months with similar patient volumes showed payroll differences of several thousand dollars.

Frontier said some line items include telemedicine fees and stipends to bring distant providers into Tonopah. Queenie said the clinic pays telemedicine providers and sometimes covers travel and accommodation for visiting clinicians; she said efforts to recruit local providers found many candidates unwilling to travel three hours to Tonopah. Dr. Coker explained the constraints on bringing international medical graduates and residents, noting training and English-language expectations and the need for on-site supervision by an unrestricted-license physician.

Trustees and Frontier staff agreed to a follow-up meeting. Don Kaminsky said the district has not issued monthly payments since the contract remained unsigned; he told the meeting that if the contract is signed and returned, “then we’ll start putting your payments on the next agenda.” Queenie said she would make herself available for a Monday phone call to go over the financials and staffing plan.

Public commenters raised concerns about Frontier’s historic finances. Forrest Carlisle and Horace Carlyle urged the board to ensure full legal review; trustee Nancy Maslach and others responded that the district’s attorney had reviewed the documents and that Frontier should work with the attorney if constituents had detailed questions.

The board did not take formal action on clinic operations at this meeting. Trustees directed staff and Frontier representatives to exchange supporting billing contacts and reconcile payroll and patient-count discrepancies, and they scheduled a 6 p.m. follow-up call for the coming Monday to review numbers and staffing options.

Trustees said they prefer a stable on-site provider but asked Frontier to reduce costs, noting that current stipends for travel and coverage make in-person care expensive. Frontier committed to posting a billing contact on the district website and to provide clearer monthly reconciliations ahead of the next board meeting.