McHenry County Valley Hi Operating Committee met Jan. 10.
Here are the minutes provided by the committee:
1. CALL TO ORDER
Meeting called to order at: 1:30 PM by Paula Yensen.
PRESENT: Nowak, Yensen, Thorsen, Kearns, Doherty (Remote), Meshes, Jindrich (Remote), Schwartz
ABSENT:
Also present: Scott Hartman, Deputy County Administrator; Thomas Annarella, Valley Hi Administrator.
After the Roll Call no vote was needed, however, Ms. Meshes made a motion, seconded by Mr. Kearns to allow the remote attendance of Mr. Doherty and Ms. Jindrich. The motion passed on a voice vote of all present members voting aye. As well Chair Yensen verified all members in attendance could hear and participate.
2. MINUTES APPROVAL
1. Valley Hi Operating Committee - Public Meeting - Dec 7, 2021 1:30 PM
| RESULT: TABLED [UNANIMOUS]
MOVER: Jim Kearns SECONDER: Jeffrey Schwartz AYES: Nowak, Yensen, Thorsen, Kearns, Doherty, Meshes, Jindrich, Schwartz |
None.
4. MEMBERS COMMENTS
Jim Kearns stated that maybe Mr. Annarella has it archived somewhere but he had questions about the beginnings of Valley Hi when they first built the building and supposedly there is an engineering study and he was made aware that it was meant to be a campus. He inquired if anyone has the original idea or intent was, Mr. Annarella stated he has conceptual drawings, but he does not have anything beyond the conceptual idea. Mr. Kearns inquired where the original documentation would be archived, if that would be with the County Clerk or the Recorder. Mr. Hartman stated he would not know where that documentation would be but they can look. Mr. Kearns reflected the discussion on the mission of Valley Hi and feels that would describe what the mission and original thoughts would've been for Valley Hi. He stated he inquired because if they want to work on the future of Valley Hi they need to know the past. Chair Yensen stated she feels that should be an agenda item in the future so the committee can have a discussion due to that having a lot of relevance for the discussions they want to have in the future. Mr. Annarella stated the campus vision was done about twenty years ago, and the world of healthcare was very back then, Chair Yensen stated she concurs with him but referring to Mr. Kearns point is that they were looking at a full campus continuum of care. Ms. Meshes stated without having a discussion on the past vision it would be hard to discuss the future. Chair Yensen concurs and stated that is why it should be placed on the agenda.
Chair Yensen stated she has a meeting with Marla Fronczak who is the AgeGuide CEO and they discussed the ombudsman program which is relevant to long time care, and they are working on legislation to amend the statute to include assistant living facilities, because the as it stands now that program advocates only for people who reside in nursing homes. She stated she will have a discussion later with Mr. Thorsen to inform the LGL committee but she thinks it is a very important initiative they are looking to amend. Mr. Annarella wanted to add some background on what the ombudsman program does so people are aware, he stated it is an independent from public health and their sole purpose is residents rights advocacy, any issue that comes up whether it is quality care, access to services, etc. a resident or family member can choose to bring in the ombudsman to advocate on their behalf. He stated the facility can also use the ombudsman to their benefit to try and advocate for things they are not getting from the family, such as families not brining in medications or the unwillingness to participate in the care, the can use it to try and be a third party arbitrator in a sense and it eliminated the emotional piece from the equation. He stated Valley Hi has had the same ombudsman for the entire time he has been there and they work fairly regularly, Chair Yensen stated that senior services associates of McHenry County that provide the oversight of the ombudsman program, and thanked Mr. Annarella for providing the information.
5. VALLEY HI ADMINISTRATOR REPORT
Thomas Annarella, Valley Hi Administrator, joined the committee to discuss the report.
• At the current time there is no covid in the building, it has been that way for some time but they will be stuck in outbreak status for the next five or six weeks which is all a part of timing and how it works. In order to clear the outbreak designation they have to go thirty days with no positive tests from residents and staff, and currently there are a few staff that are out with covid and the expectation is that there will be more during the next week. They are through the worst of it at Valley Hi due to most staff and individual departments being sick at the same time, so they should be getting closer to normalcy. He included all the statistics in the Administrator Report all through this morning, so the data is current.
• This round is different from what December of 2020, no one was sent to the hospital and all of the residents were mild cases showing barely any symptoms, a lot was caught through routine surveillance during the twice a week testing of all residents and staff, the most recent round from this morning. Some residents are on the observation unit from having a few cases of RSV which is an upper respiratory disease commonly found in children. The belief is that a resident went out to a family gathering a few weeks prior, with grandchildren present, and that is the most likely reason it was brought into the building. The isolation and precautions they follow for RSV or any other upper respiratory are the same as they use for covid.
Ms. Meshes inquired if any residents or family of residents complaining about covid, Mr. Annarella confirmed there were not. He stated that because this has been around for about two years families are used to the text alerts that go and that give updated information, they have been kept in the circle at all times and he cannot confirm that he has had anyone call with concerns about covid other than when they were not allowing visitation.
• The census level does match staffing, there was a nice hiring blitz at the beginning of December so a lot of those individuals will be coming off orientation in the next couple days and they will get out on the floor.
• He added an item in the report that he had not done in the past which was add all the covid stimulus money that they received to date in the financial section. He broke it down between the three different programs by amount, Federal Stimulus Dollars HRSA, Medicaid HFS Cares Act, and last is the ARPA funds. He stated the ARPA money had to go directly to staff which was the bonus that was done in two payments one at the end of November and the end of December. The rest was very directed money, they have to present the budget and at the end of the reporting period they must validate with receipts and invoices that they spent the money that they had received in the categories they allowed to be spent. There is an application out there for another round of federal stimulus money that was put out, he submitted the application about a month ago, which has been accepted and he will be filling out information for the provider relief phase four of the federal HRSA funds. He is not aware of any additional state or ARPA money going through but the federal money is still available, the way it has been done is he has applied for the funding each time the funds have become available and it is very easy to meet their thresholds, stating they have far more expenses than they are getting funding through it so they have been able to meet every budget and demonstrate the exhaustion of the money. He stated they have not applied for it yet, but they intend to apply for the lost revenue, there is an algorithm that they are allowed to report lost revenue as a part of the funding that has become available. In the past they would base it all off supplies, stating testing supplies alone runs up a ton of money, but they have been able to absorb it through supplies and other items. There is also an ARPA rural payment that he applied for; he was not sure if they would receive it because they may not be rural enough, but they did receive it. He does not have that total yet but they are getting one more rural payment, provider relief federal phase four and from there he is not aware of any other opportunities but he has taken advantage of all stimulus opportunities that were made available.
Mr. Schwartz inquired on when the new payroll system would be implemented where they would be able to run financial reports. Mr. Annarella stated the payroll system is in but they cannot get all of the date to flow with what they are seeing on their side to be able to run accurate reports, there is a meeting on Wednesday including HR, Finance and himself to try again and get it matched up or figure out how to adjust the reports to present the data. Mr. Annarella stated they must provide two reports every year to the government, state and federal, which are cost reports for Medicare and Medicaid. Due to the County’s auditing processing they must request an extension every year because they need to wait for an outside auditor to go in and work. He stated that they are running up against the deadlines so getting the financial anomalies addressed will have to happen this week otherwise they will miss the deadlines, so he imagines by next month they might not be caught up all the way through the end of the Fiscal year but they should get close.
Mr. Kearns wanted to inquire about a comment made by Mr. Schwartz regarding the payroll system and if that affects the reimbursement on the stimulus money. Mr. Annarella stated it does not, the only thing it impacts is their ability to get an accurate report don’t for the purposes of the committee and what is done internally. They have never lost sight of where they were from what they can see on budget and what they know is needed to be spent, and being able to get all of the numbers accurate and in all the correct buckets on the report side, from a building standpoint with Medicare and Medicaid, it has no impact whatsoever. Mr. Kearns inquired if that is a Countywide problem because of the new system, tracking payroll and expenses, Mr. Hartman stated he would need to defer to the payroll department to confirm. As well he would like to take the question back to Mr. Bueso to have him access and provide the committee with an appropriate response. Mr. Annarella stated the last thing he wanted to mention is that he added an updated version of the Valley Hi strategic plan on the back of their report, and if anyone has questions he is willing to answer them.
6. NEW BUSINESS
1. Resolution Authorizing Increasing the Daily Resident Room Rates at Valley Hi Nursing Home Effective February 1, 2022
Thomas Annarella, Valley Hi Administrator, joined the committee to discuss the resolution.
Mr. Annarella stated this is a formality of what was discussed at the prior months meeting and he made a recommendation to do two $5 per day increases this year. He stated they have two rate tiers one for people who were admitted prior to 2019 and the other for residents who were admitted after June 1, 2019 and that is due to not wanting to increase their long standing residents too much. They are starting to see a lot of those pre June 2019 residents coming off the census and once they are off that one tier would be eliminated and they would be back to the one standard tier. The families have received the letter notifying them that the rates are going to go up, the next letter will go out with bills in the next couple days so they will have two different notifications and it only affects about twenty people. Mr. Nowak stated he was surprised on the room rates, and if the rates are supplemented by insurance, Mr. Annarella stated it is very individualized stating some residents have excellent supplemental insurance plans. He stated the rate is right in the midpoint of the market, some facilities in the area charge a bit lower rate and they have not changed them for a significant period of time and there are reasons for that. As well there are other facilities, where their rates are as much as $350-4360 per day and they even add on beyond that, for treatments or oxygen. He stated Valley Hi has always been at the midpoint so there are no questions on if they are trying to undercut the private market and fair rates are charged for the services they provide.
| RESULT: RECOMMENDED [UNANIMOUS]
MOVER: Jeffrey T Thorsen SECONDER: Jeffrey Schwartz AYES: Nowak, Yensen, Thorsen, Kearns, Doherty, Meshes, Jindrich, Schwartz |
1. Update on Demetia Unit Study
Thomas Annarella, Valley Hi Administrator, joined the committee to discuss the Update on Dementia Unit Study.
Mr. Annarella stated that MPA is not finished yet, they were not ready to present for this meeting but they are getting close to the tail end and will try to get it on next months agenda.
2. Vaccination & Staffing Impact
Thomas Annarella, Valley Hi Administrator, joined the committee to discuss the Vaccination & Staffing Impact.
Mr. Annarella stated the reality is they do not know until the Supreme Court make a ruling as to where they are at, he did state they can discuss what they do know and leave what they do not know off the table. He stated there is a state mandate in place right now as well as the OSHA mandate for Illinois employers that have more than 100 employees, and Valley Hi falls into both mandates. It is either one of two things, they either be fully vaccinated or they have to submit to weekly testing, he stated they are already doing twice weekly testing for the entire facility whether they are vaccinated or not, so they meet the threshold for both vaccine mandates. The big one is going to be the CMS mandate, where there is no test out option at all and they would have to apply for an exemption. They are waiting to see what happens at the supreme court heard the case on Friday, he did listen to both the hearings and he does not know what way they are leaning. He stated they have advised employees and they are being kept in the loop as they move forward. They have a clinic set up for January 18, 2022 which is for first dose, second dose, boosters anything that is needed and it is at Valley Hi and they are hoping to get an answer before the clinic so that staff will have a starting point to begin compliance.
Ms. Meshes stated with the testing shortage, she inquired on how Valley Hi is corrective on the testing shortage, Mr. Annarella stated they order often, they have stayed ahead of the supply curve since December of 2019, ordering in bulk way before things got crazy. They did get to a point where they got low on tests, but they never ran out, and currently they have three months of twice weekly testing kits available in house. Since 2019 they have tried to always keep a minimum of four months’ worth of supplies on hand for an outbreak.
Mr. Kearns stated if the Supreme Court votes to make it mandatory, he inquired on what the potential risk is for losing, Mr. Annarella stated most of the staff that were going to retire have already done so, meaning the numbers are probably not going to be as high as they once thought. Plus, the exemption rule gives enough room for those who fall into the middle are safe, so they may not lose more than five people. Mr. Kearns then inquired on who determines the exemption, Mr. Annarella stated it is a committee of the Human Resources Director, Cheryl Chukwu and the Deputy County Administrator, Scott Hartman.
Ms. Meshes inquired on what qualifies as an exemption, Mr. Annarella confirmed religious exemptions, and medical exemptions. He did mention the medical exemption is tough because it must be demonstrated that one is allergic to the vaccine in order to qualify but in order to have knowledge of allergies to the vaccine it would need to be received. He feels it would be a slim number of people who would go for the medical exemption, he does have a hope that if the testing mandate goes through, they add the testing component, that has been the biggest issue with it is that it did not allow for a testing out option. If they do that it impacts the building as a zero because they are already doing those things, so he has some high hope that there will be options for staff to allow them to work through the issue.
8. FUTURE TOPICS
Mr. Hartman referred to the Valley Hi Financial Sustainability Tool, stating that they are currently updating that and need to fully develop and finalize the personnel cost, which is a big component and they are hoping at the February 1, 2022 meeting they will be in a position to present the model and walk through assumptions, while incorporating the room rate that was discussed today. He stated it would help everyone understand all the various moving parts that go into the Valley Hi operations, such as cost and census, the intent is to help see on a high level all the components come into play and how the effect of one decision or circumstance has on the rest.
9. EXECUTIVE SESSION (AS NECESSARY)
None.
10. ADJOURNMENT
Ms. Meshes made a motion, seconded by Ms. Schwartz, to adjourn the meeting at 2:12 p.m. The motion passed on a voice vote of all members present voting aye. -TCMcKinnon
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