Peoria Standard

Peoria County Health Committee met Dec. 19.

Here is the minutes provided by the Committee:

MEMBERS PRESENT: Sharon Williams - Chairman, Phillip Salzer - Vice Chairman; Robert Baietto, Allen Mayer, A.J. Querciagrossa, Steven Rieker, Barry Robinson, Terry Waters

OTHERS PRESENT: Scott Sorrel - County Administrator; Shauna Musselman - Assistant County Administrator; Larry Evans - State's Attorney's Office; Andrew Rand – County Board Chairman; Gregory Adamson, James Dillon, Brian Elsasser, James Fennell, Thomas O’Neill, Rachael Parker, Paul Rosenbohm - County Board Members; Eric Dubrowski - Chief Financial Officer; Julie Ciesla – Finance; Tom Bride – Election Commission; Gretchen Pearsall - Director of Strategic Communications; Dan O'Connell - Facilities Director; Doug Gaa - Sheriff's Office; Tim Turpin - Heddington Oaks; Mark Little - Chief Information Officer; Rachel Reliford

Call to Order

Chairperson Williams called the meeting to order at 2:02 pm.

Approval of Minutes

A motion to approve the minutes of November 28, 2017 was made by Mr. Baietto and seconded by Mr. Rieker. The motion carried.

Informational Items / Reports / Other Minutes / Updates

• Board of Health

➢ Monthly Update

No report. No questions or comments from committee.

• Care & Treatment Board

➢ Monthly Update

No report. No questions or comments from committee.

• Heddington Oaks Update

➢ Marketing Report

Mr. Turpin advised that November saw 68 referrals, 14 admissions, 14 discharges, and 54 denials. Ms. Pearsall advised that the website for Heddington Oaks has been redesigned, allowing for a more user-friendly experience. She also stated that a video “tour” provides testimonials from both staff and residents. She commented that other marketing highlights include a radio interview of Admissions/Marketing Coordinator Steve Richter.

➢ Financials

Mr. Dubrowski summarized financial information through October 31, 2017.

Income Statement

• Large positive change in Net Position of $525,000.00

• Year over year revenue decreases are narrowing, with revenues currently down $691,000.00 from 2016.

• Expenses are up $540,000.00 over the same time last year

• Revenues growing at a larger pace than expenses

• IMRF and FICA related costs are at $902,000.00 through October

• Property Tax Accruals at $1.72 million to date

Balance Sheet

• Cash Assets stand at $269,000.00; Pooled Investments stand at $5.13 million

• Accounts Receivable, net of allowance of $2.45 million, stand at $5.5 million

• Unrestricted Net Position stands at $5.54 million

• Net investment in capital assets stand at $309,000.00

Census

Mr. Dubrowski commented that the Private Pay census is showing the most growth in recent months, and the census as a whole has shown increases, standing at 166 as of November 30, 2017.

Aging

Mr. Dubrowski advised that aged accounts receivable total $7.7 million, with $2.9 million of that amount over 365 days. Mr. Rieker asked if staff has been able to recover any past accounts receivables, and when those recoveries are posted on the revenue statement. Mr. Dubrowski stated that there has been some success since the employment of a second bookkeeper, and staff has met with the State’s Attorney’s Office to obtain information from insurance carriers. He added that there has been a definite increase in collections related to Medicare and Medicaid. He also noted that the recoveries are posted for the month in which they were received.

Mr. Sorrel stated that continued conversation related to collectible vs. non-collectible accounts receivable, as well as the creation of a write-off policy, should be a priority of the committee moving forward.

Mr. Adamson commented that although staff is working to improve the financial success of the nursing home, when the levy and IMRF/FICA are included in calculating the cost to the taxpayers of Peoria County, the loss increases to approximately $5 million. Mr. Mayer stressed that the nursing home is providing a public service, similar to the Sheriff’s Office, unlike the private sector, with a higher percentage of Medicaid residents. He remarked that there are no county departments/divisions which report IMRF expenses in their fund statement, which are accounted for in the IMRF Fund. He pointed out that there is a cost for the provision of governmental operations to the public, and the county has been tasked to manage, as efficiently as possible, the resources and services voted on and approved by taxpayers. Mr. Rieker commented that the nursing home is an operation that the County Board has elected to enter into as an enterprise business, unlike the Sheriff’s Office or Health Department, which do not have a competitive private enterprise nature, and similar governmental accounting procedures do not apply.

Ms. Williams commented that positive changes are occurring under the current leadership at the facility, noting that discussion at the Family Forums reveal that many of the past concerns have been handled. She noted that change takes time, and the staff should be given an opportunity to effect more positive change. Mr. Rieker remarked that although the County’s support of the most needy is vital, there are alternative options for how best to service the neediest population. He stated that options for the best long-term method of operation for both the taxpayer and the population in need of these services should be discussed and evaluated.

Mr. Elsasser noted that he has long recommended an increase in the Medicaid population as a means of improving the finances of the facility, and expressed disappointment that individuals with Medicaid have been unable to be admitted.

Mr. Elsasser asked the status of a potential dialysis unit, and Mr. Sorrel reminded the committee that the vendor previously awarded a contract for the provision of dialysis services went bankrupt prior to their beginning services for the facility. He stated that staff has contacted a company that delivers in-house dialysis services, which is the preferred service delivery model for the County.

Presentation

Mr. Sorrel noted the operational, financial and long-term discussion topics regarding Heddington Oaks brought forth over the past year, and commented that from those discussions staff has developed a basis for quality improvements utilizing Deming’s “Chain Reaction” Model. He stated that quality management begins with Census, as census drives Revenues, which then drives the ability to hire staff vs. a reliance on agency staffing. He advised that increased Staffing improves Staff Engagement with residents, which in turn drives Quality of Care Measures. He commented that quality of care measures directly impact Star Rating, and Star Rating leads to Referrals, which drive census.

Mr. Sorrel summarized 2017 Actions in the categories of Census, Revenues, Staffing, Staff Engagement, Quality of Care, Star Rating and Referrals, stating that 11 Tactical and 20 Strategic Actions were taken throughout the year, with Strategic Results in Census, Quality of Care and Star Rating.

Census

Mr. Sorrel advised that average daily census has increased from 145 to 165 as of September. He stated that the increased and stabilized census has enabled staff to finalize a strategy and timeline for reopening the Medicare Wing B100. He reported that staff will begin to accept residents on B100 from the first week of January 2018.

Quality of Care

Mr. Turpin commented on numerous strategic and tactical actions that have led to increased resident activities and personal care, improved communication and freedom of choice. He also noted that feedback in the monthly Family Forums has become increasingly positive. Mr. Sorrel remarked that the number of Medicare readmissions has decreased throughout the year, with no readmissions in the third quarter of 2017.

Star Rating

Mr. Sorrel advised that the implementation of an electronic medical records program has had a direct impact on reporting, which in turn impacted on the annual inspection, with a significant decrease in the amount of survey tags from the prior year.

Mr. Sorrel concluded the presentation by stating that the Heddington Oaks team will substantially improve the direction of the facility going forward. He also commented that the two citizen members of this committee have provided background knowledge as well as substantial recommendations which staff has begun to implement.

Mr. Waters noted the relative lack of experience in nursing home management within the committee and County Administrative staff, and encouraged finding a resource with expertise with whom Mr. Turpin can exchange ideas. Mr. Querciagrossa commented that current upward trends in census should continue based upon calculation of current census activity.

Committee Action

• Review of Executive Session Minutes

Mr. Evans recommended that all previously held executive session minutes continue to be held closed as the need for confidentiality still exists, and to destroy executive session audio recordings more than two years old, except those that relate to pending litigation. A motion to accept the recommendation of the State's Attorney's Office was made by Mr. Mayer and seconded by Mr. Robinson. The motion carried.

Adjournment

The meeting was adjourned by Chairperson Williams at 3:37 p.m.

http://www.peoriacounty.org/AgendaCenter/ViewFile/Agenda/_01232018-484