Peoria Standard

Peoria County Health Committee met Jan. 23.

Here is the minutes provided by the Committee:

MEMBERS PRESENT: Sharon Williams - Chairman, Phillip Salzer - Vice Chairman; Robert Baietto, Allen Mayer, A.J. Querciagrossa (via teleconference), Steven Rieker, Barry Robinson (via teleconference), 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; Brian Elsasser, Brad Harding, William Watkins, Jr. - County Board Members; Eric Dubrowski - Chief Financial Officer; Julie Ciesla, Paul Letcher – Finance; Monica Hendrickson – City/County Health Department; Nicole Demetreas – Treasurer; Angela Loftus – Asst. Director of Human Resources; Gretchen Pearsall - Director of Strategic Communications; Dan O'Connell - Facilities Director; Doug Gaa - Sheriff's Office; Tim Turpin - Heddington Oaks; Sally Hanley – Greater Peoria Economic Development Council

Call to Order

Chairperson Williams called the meeting to order at 2:20 pm.

A motion to approve the participation of Mr. Querciagrossa and Mr. Robinson via teleconference was made by Mr. Rieker and seconded by Mr. Waters. The motion carried.

Approval of Minutes

A motion to approve the minutes of December 19, 2017 was made by Mr. Baietto and seconded by Mr. Mayer. The motion carried.

Informational Items / Reports / Other Minutes / Updates

• Establishment of Peoria City/County Health Department as the Emergency Management Agency designee for the County of Peoria

Ms. Hendrickson explained that the primary rationale for establishing the Health Department as EMA designee is to better align both capacity and strategic priorities between the Health Department and the Sheriff’s Office (the current EMA designee), and County Administration in the best interests of the EMA. She stressed that the re-establishment will not take away planning or support from the Sheriff’s Office or other agencies, and will better align services as part of the Health Department’s All Hazard Emergency Operations Planning model. She stated that that the goal of establishing the designation by Spring 2018 will allow for streamlining workplans for grant funding. Mr. Sorrel added that the designation will allow for a maximization of accessible grant funding. Captain Gaa commented that the discussions have been collaborative, and stressed that the Sheriff’s Office will continue to be actively involved as the coordinator for any law enforcement function of the EMA.

• 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

Ms. Williams introduced Paul Letcher, the new Finance Director of Heddington Oaks.

➢ Marketing Report

Mr. Turpin advised that December saw 58 referrals, 8 admissions, 17 discharges, and 48 denials.

Ms. Pearsall advised that in response to a request by Board Member Adamson, she has crafted a report detailing metrics on the return of marketing investment for the nursing home. She stated that the two primary goals for 2017 were to increase staff and increase census/open B100. She stressed that advertising is one facet of a multi-pronged strategy for the facility. She explained that due to a still solidifying leadership team and uncertainty about B100, the marketing team concentrated on production and recruitment. She noted that advertising was increased when the census began to drop, focusing on patient and family testimonials, utilizing television, and advertising on CityLift buses.

Ms. Pearsall advised that recruitment advertising included a job fair, and advertising on Pandora, Facebook, and other online resources. She also noted that Geofencing options are being explored. Mr. Fennell suggested including a comparison of staff retention vs. new employees. Mr. Harding asked if a report is provided on placement of television ads, missed spots and make-up slots. Ms. Pearsall advised that although this information is not provided in the monthly report; it can be obtained from the media buyer.

➢ Financial Mr. Dubrowski summarized financial information through November 30, 2017. He noted that the census as of December 31, 2017 totaled 157 (85 Medicaid, 8 Medicare, 20 Medicaid Pending, 44 Private Pay). He advised that much of a year-to-year revenue increase is associated with an increase in census, with expenditures increasing correspondingly due to an increase in personnel and contractual services.

Mr. Dubrowski advised the area seeing the most attrition, Net Investment in Capital Assets, are down at $195,000.00. He stated that the amount will decrease to zero in the next several months, and then drop into the negative.

Mr. Dubrowski commented that no write-offs have taken place since mid-2015, and recommended that a Write-Off Policy be reviewed and adopted in order to address this issue. He added that writing-off would allow for a recoupment of nearly $250,000.00 in Federal dollars through the Medicare cost report. He summarized the various categories within Accounts Receivable and processes by which the different categories can be addressed in order to lower the balances via write-off, adjustment or other procedural means. He also recommended drafting a policy addressing residents denied Medicaid and still residing at the facility.

Mr. Rieker agreed with the need for a clear policy for new applicants who do not qualify for Medicaid, emphasizing that an applicant will not be admitted if they refuse to provide proper documentation of assets, while also providing direction regarding long-time/current residents in the same situation. Mr. Mayer noted previous discussion of outside groups, via a grant, assisting patients applying for Medicaid, and stated that if some funding were invested into an outside group to assist with paperwork might result in a considerable return on investment. Ms. Williams suggested that a lawyer could accomplish the same task. Mr. Turpin advised that all potential applicants are provided information on applying for Medicaid by the facility, and are providing contact information for individual assistance.

Mr. Harding asked if Heddington Oaks is required to admit patients who are Medicaid pending, and Mr. Sorrel advised that since 2016, a patient must be pre-approved for Medicare, have a Medicaid approved number or demonstrated assets via Private Pay or third-party insurance before admittance. He stated that an individual in the process of attempting to be pre-approved for Medicaid will no longer be admitted. He advised that the Accounts Receivable balance within Patient Liability are holdovers of residents in that process prior to 2016, or residents who were admitted with assets and are transitioning to Medicaid. Mr. Harding asked if discussion will be held regarding current residents who transition to Medicaid Pending, and Mr. Turpin commented that IDPH has advised that an individual with Medicaid Pending status cannot be discharged from the facility.

➢ Private Pay Mr. Sorrel commented that the last adjustment to Private Pay rates were approved by the County Board in 2013, in anticipation of the opening of Heddington Oaks later that year. He advised that staff has prepared two tables: Table 1 is a market analysis of average rate in the Peoria market, as identified by the U.S. Department of Health & Human Services, of $198.00 for a semi-private room and $215.00 for a private room. He advised that a comparison of both responding county facilities and nursing homes in the private sector determines that the private sector facilities in the community charge a higher rate than the amount the Federal government has identified as market.

Mr. Sorrel advised that Table 2 indicates the current Heddington Oaks rates. He stated that the 2013 adjustment Grandfathered residents of Bel-Wood moving into Heddington Oaks at the then current $190.00 per day rate regardless of the type of room they would be moving into. He stated that at this time, there are no longer any residents paying the $190.00 daily rate. He advised that the Semi-Private Room rates for individuals moving into the new facility after opening were set at $217.00 (Traditional), $225.00 (T-Room), and $225.00 (Dementia); Private Room rates were set at $$235.00 (Small and Dementia) and $245.00 (Large).

Mr. Sorrel noted that while in some areas Heddington Oaks is consistent or slightly above U.S. Dept. of HHS published averages, the facility is at or near the bottom of the market for privately owned facilities in the region, and slightly below mid-market for a private room as compared to privately owned facilities.

Mr. Sorrel advised that information on the costs of delivering skilled nursing care will be prepared and distributed at the February meeting of the committee. He stated that included in the report will be a recommendation of an increased adjustment of rates and schedule of implementation.

Mr. Elsasser reiterated his long-standing suggestion to explore the processes of private management companies for informational purposes.

Adjournment The meeting was adjourned by Chairperson Williams at 3:34 p.m.

http://www.peoriacounty.org/AgendaCenter/ViewFile/Agenda/_02272018-496