DeKalb Times

DeKalb County Rehab & Nursing Center Operating Board of Directors met Jan. 11

Here are the minutes as provided by DeKalb County:

Operating Board of Directors DeKalb County Rehab & Nursing Center January 11, 2017

Present Directors: Greg Millburg, Jeff Whelan, Rita Nielsen, Ferald Bryan, Misty Haji-Sheikh Absent Directors: Veronica Casella

Also Present: Kris Decker, Bart Becker, Gary Hanson, Gary Winschel

Jeff Whelan called the meeting to order at 7:00 am.

Motion: Misty Haji-Sheikh moved to approve the agenda, Greg Millburg seconded the motion. Voice Vote: Jeff Whelan asked for a voice vote on the approval of the agenda. All Members voted yea. Motion carried unanimously.

Motion: Misty Haji-Sheikh moved to approve the November 2016, Operating Board minutes, Jeff Whelan seconded the motion. Voice Vote: Jeff Whelan asked for a voice vote on the approval of the minutes. All Members voted yea. Motion carried unanimously.

Public Comments: There were no public comments.

Old Business: None

New Business

Management Report:

Operations and Finance: Gary Winschel gave a report:

November financial statements reflect a gain of $19,132, which has the Home $521,936 above the year-to-date 2016 budget. The following occupancy table compares year-to-date actuals to year-to-date budget. As a reminder, please note that IGT Revenue has been moved from Non-Operating Revenue to Operating Revenue. Since the IGT Revenue is part of Medicaid, it was agreed with the Auditors that this move was appropriate.

During November, Revenues were under budget by $29,603, while expenses were under by $9,992 - resulting in Net Income being under budget by $19,611. The attached Actual vs. Budget Statement of Operations highlights the differences by department. Nursing, Environmental and Administration expenses were over budget by a combined amount of $16,220. The following entry continues to be made:

1. Medicaid revenue adjustment decreasing booked revenue by 5% to account for Medicaid overpayments resulting from a lack of published 2016 rates.

2. Total ADC of 176.0 is 3.0 above budget

The November census decreased by 3.9, coming in over budget by 3.0; Medicare census was 0.9 over budget, Medicaid census was 4.6 lower than budget and Private Pay was 6.7 over.

The 1,050 conversion day’s year-to –date increases Medicaid by 3.5 and decreases Private pay by the same. Approximately $49,000 less revenue has been recognized this year.

Medicare A revenue year-to-date exceeds budgeted year-to-date by $364,098. Net Revenues were over budget year- to-date by $376,302. Expenses year-to-date are under budget by $237,215. Nursing is under budget by $76,729, Special Care is under by $93,253 and Administrative expenses are under by $91,556. Net income through November 2016 was $948,109, exceeding budget by $521,936.

Misty Haji-Sheikh asked Mr. Winschel was the payor breakdown was for the facility. Mr. Winschel shared that the payor mix varied each month but averages were 50% Public Aid, 35% Private Pay, and 15% Medicare.

Mr. Winschel reviewed the Resolution of the Operating Board and the changes to Management Performance Associate’s Engagement letter for the Project Management Development Services. Changes to the Engagement Letter have been made regarding limited liability and indemnification. Mr. Winschel stated that the County should indemnify MPA if it is not under MPA’s insurance coverage or scope of practice. The language in the Engagement Letter is currently being reviewed by the States Attorney Office. The contract is very close to completion.

Bart Becker, Administrator for DCRNC, gave a report:

Illinois Department of Public Health issued two “D” level tags from the complaint visit on November 7, 2016. One was regarding a G-tube error and the other was regarding the family notification of that error. The Plan of Correction was accepted and IDPH has cleared those tags. IDPH arrived at the facility on a complaint visit on January 7, 2017. IDPH also came back on January 10, 2017. One of their concerns was social activities, which was unfounded. They did have concerns regarding staffing, especially night shift. Mr. Becker explained that many things were being implanted to assist with the night shift staffing; including increasing the night shift C.N.A. differential from $1.00 per hour to $2.00 per hour. The Statement of Deficiencies should be arriving soon. It will specifically explain the concerns, tags, scope and severity. DCRNC is continuing to prepare for the upcoming annual IDPH inspection.

Mr. Becker informed the board that the current Director of Dietary Services is retiring/ resigning after over twenty-years of service. Interviews for a new Dietary Director have been completed and the position will be offered to one of the candidates very soon.

Over fifteen nurses have been hired since the R.N./L.P.N. hourly rates have been increased. Effective 1/22/17 the night shift C.N.A. differential will increase from $1.00 per hour to $2.00 per hour. DCRNC is now very competitive with C.N.A. hourly rates/ differentials. Many new C.N.A.’s have been/are being hired. All DCRNC staff received the 2.25% annual increase (per the Union agreement) on 1/1/2017.

Mr. Becker updated the Operational Board regarding the resident’s family member (wife) that had been banned from the facility on June 30, 2016. The resident has expired and this is no longer a concern. IDPH, in Springfield, never did send the facility a letter regarding their decision.

The hospital readmission rate was 7.7% in November 2016. The average for the year is 14.9%, which is a little higher that the goal. 11% or below is the goal.

Kris Decker, Clinical Compliance Coordinator gave a report:

DCRNC continues to be a five star facility. The Quality Measures are still at three stars. The last fall, with major injury, was in September 2016. The Clinical QA and QAPI meetings are ongoing. Annual Compliance training was completed in October 2016. Ms. Decker continues to provide Compliance education during regularly scheduled new employee orientation. Several staff members turned over gifts, cards, money to Ms. Decker, knowing that they can’t accept gifts from residents, families, etc. Ms. Decker returned gifts to family members as appropriate.

Misty Haji-Sheikh asked how to improve the five star rating. Ms. Decker stated that improvement on the rating is done by improving Quality Measures (fall reduction, incontinence, pressure ulcers, etc.), improve IDPH Surveys, and improved staffing. At the present time the facility is a five out of five possible for the star rating. Misty Haji-Sheikh asked about a social media concern that she saw in the news regarding a physician’s electronic communication. Ms. Decker assured her that physician electronic communication is not a concern at DCRNC. Misty Haji-Sheikh suggested that staff be trained on how to best interact with IDPH surveyors. Mrs. Haji-Sheikh also suggested that something be done to recognize employees for turning in their gifts and to let other employees know that they’ve been given commendations for being honest.

Ms. Decker also discussed Social Media and HIPPA Policy training that is provided to new staff and annually for all staff. Ms. Decker collected the Compliance Program training signature sheets from all present board members.

Mr. Winschel gave a building project update:

Mr. Winschel gave a presentation to the Public Building Commission on January 3rd. Items reviewed were the Plans, Construction Costs and the Pro-Forma. The DeKalb Daily Chronicle printed an article regarding the building project. Mr. Winschel and Mr. Becker will be attending the County Board Executive Committee meeting on the evening of January 11th for a similar presentation. Mr. Becker indicated that he would be attending the next Resident Council meeting at DCRNC to present/discuss the building project with the residents.

The Architect (Larson and Darby) contract and Construction Manager (Ringland-Johnson) contract will be reviewed by the States Attorney’s Office. Both of these contracts were written to eliminate as much variable expense as possible, leaving the Architect and Construction Manager to work within the fees given and keep costs low. The purpose is to keep their contracts as fee-based with as little room for increase as possible. Mr. Gary Hanson stated that there would be no preferential treatment for local businesses/ contractors.

Mr. Winschel informed the board that he had spoken to one of the Master Gardeners regarding the upcoming building project and changes including the removal/ moving of the gazebo. Misty Haji-Sheikh suggested that Mr. Winschel meet with one, or more, of the lead Master Gardeners to further discuss the building project and future beautification surrounding the nursing facility. This was agreed.

Executive Session: No closed session took place

Next Meeting: March 8, 2017, at 7:00 a.m.

Motion: Misty Haji-Sheikh moved to adjourn the meeting, Ferald Bryan seconded the motion.

Meeting adjourned at 7:49 a.m.

Respectfully submitted, Bart J. Becker - Recording Secretary