It is no exageration to suggest that the votes tomorrow at the Champaign County Board meeting are among the most critical to ever face the Board. The two issues are whether to extend a loan to the Nursing Home from the County's General Corp fund in the amount of $592,000 and whether to hire Management Performance Associates to manage the facility. I've uploaded a copy of the last draft of the MPA contract which you can open below. Not sure if other revisions are in the works.
The County is in an extremely bad situation. The Nursing Home continues to put us in a bad fiscal situation. The bed count has dropped and while some cost saving measures have been put in place, it still looks as if the facility will continue to bleed significant dollars without some action.
The Nursing Home board of Directors has been in existence for a mere six or seven weeks. They've been handed a bad situation, dug in, and have recommended hiring MPA in a unanimous vote. With more time, it would have been interesting to see what other options might present themselves, but time is a luxury that has been squandered by this Board.
On the negative side with MPA is the lack of a guarantee that this will actually turn the situation around. There is still a union contract to be negotiated, and MPA won't have the final say on that, the County Board will. Does this contract really give MPA all the tools they need to turn the situation around.
On the positive side, MPA has done what appears to be a good job running a very similar Dekalb County facility. They also run other county owned facilities. The current web of government regulations suggests that some efficiencies can be gained by having experts handle some of those tasks. It's no coincidence that so many nursing homes are owned by larger corporations, whose central offices can handle many of the things that seem to not be handled well in Champaign County. The other positive side is that whatever management problems exist at the current facility, I think MPA will deal with. Doing a bad job for the County will never cost you your job if the County Board makes the decision. But if its up to someone who's in private business, I believe that it will.
A lot of things could have happened in the last decade, and certainly the last couple years, to prevent this debacle. Unfortunately, that's blood under the bridge. Now there are two votes, two critical decisions for the County. Neither one is easy and both have tremendous consequences for our community.
EDIT: I should also point out that the Board will no doubt be discussing in closed session the status of our public health violations. How this impacts the MPA discussion is interesting. Purely conjecture here, but the hiring of MPA might be seen by Public Health as a good faith effort to address compliance issues.
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| Final MPA Management Contract.doc | 115 KB |
Just by chance this evening on C-SPAN 2 was broadcast today's US Senate hearings of the Special Committee on Aging about The Legal Rights of Nursing Home Residents, chaired by Senator Kohl, WI-D. While I was watching Senator Kohl also asked questions. Senator Grassly is also on the committee. Even though the hearings were focusing on the 1925 Nursing Home Rights Law and the issue of arbitration agreement contained within nursing home contracts--not quite the crisis issue of the CCNH, there were two interesting and applicable comments made.
First, by Ken Conner, attorney for victims of abuse and negligence in nursing homes--He stated "Fraud is built into nursing home business plans." Second, by Ms. Alison Hirschel, President of National Citizens Coalition for Nursing Home Reform,--She stated "Nursing homes will make money if good care is provided and there is a reliable corporate policy."
As people consider whether a contract with MPA ought to be signed by the CB, these two quotes help focus the questions that need to be asked.
Pattsi Petrie
Mark, the DeKalb nursing home situation is not a comparible case study to the situation here. That nursing home had a basically stable staff, no internal work condition issues, no violations, and a much, much smaller debt. Apples and oranges. None of the case studies on the MPA web site are comparible.
Pattsi Petrie
Hell no it doesnt give MPA what it needs to succeed. The county board still controls everything including the collective bargaining with labour. The nursing home consists of facilities and labour. You hire a company to manage the facility but retain the control of the labour force with the same crowd that engineered the fiasco, and you will get nothing but trouble and more fiasco. The management will need to have the power to negotiate with the union or even jettison the AFSCME bastards if they are too difficult. Otherwise we will have to be quite fortunate to see this work at all.
Would MPA have the power to fire the administrator and/or any other personnel?
Pattsi, I mean only that the facilities are similar in terms of size and the fact that they are county owned facilities. Certainly our problems are greater than DeKalb's, and probably than DeKalb's problems back when they hired MPA 11 years ago.
curious, you point out one of the problems that I see in the contract. From my reading, MPA can't fire the administrator without County Board approval. The other employees would still be subject to the County's rather generous Personnel policy or the generous labor contract.
After reading this, it sounds like the logical thing to do and it's going in the right direction. I am bit concerned if there is any expectation that MPA will be accountable for a budget where the board ultimately manages the cost drivers.
From what I read, $180,000 gets us an executive director and access to some consultants from an experienced firm with some history of success. I'm not quite sure if that access incurs extra dollars, but it sounds all-inclusive.
My question is, how can you turn around a place for only $180,000/year, basically the cost of 1 FT employee with all the taxes, benefits, etc and this stood out:
"4.4 Special Consultants. Should Directors request a type, form, or level of special consultant, including, but not limited to, underwriters, bond counsel, expert witnesses or other reasonably necessary consultants, which Manager cannot fully provide, or cause to be provided, Manager shall endeavor to locate and make available such special consultant service, the cost of which, including, but not limited to, application fees and license fees, shall be a Home Expense."
There is NO reference to handling employment issues except:
"4.7 Labor Organization. At the request of the Home, Manager shall advise and assist Home in any matter involving the possible unionization of the employees of Home and in negotiations with any labor union lawfully entitled to represent the employees of Home."
So much is "recommended" to the board. So how fast will they respond? The contract provides some guarantees. When I see the word "unreasonably", it seems vague to me:
"9.3 Consents, Approvals, and Discretion. Except as herein expressly provided to the contrary, whenever this Contract requires any consent or approval to be given by either party or either party must or may exercise discretion, the parties agree that such consent or approval shall not be unreasonably withheld or delayed and such discretion shall be reasonably exercised."
While I think this is a good direction, I would like to see the contract have:
1. Some form of performance measures, even if basic. Good to get in the habbit of that type of thing, plus they should be able to articulate what they can be measuring if they have experience of success and how that success was accomplished.
2. More clarity in how much of the "consulting" will be included in the management fee. There is the management of the home and there is the management of the bureaucratic stuff on the side outside of the standard reports.
3. More clarity on the role of recruiting, hiring, employee performance, and employee termination. If they can only manage the procedures and not the people, then our expectations should compensate for that.
Pattsi,,,,,I hope you get your say in tonight,,,,for me ,,,,,I have had enough of this never ending soap opera,,,,I saw two county board members strolling in Urbana last evenning,,,,,heads high in the air,,,noses pointed toward the lowering sun,,,,they should have been crawling along the concrete instead for being a part of this disaster,,,,I am done with it, I am going to worry about more important things,,Zambrano needs an MRI on his shoulder,,,now that is something to be concerned with. Get ready to turn out the lights in east Urbana,,,,,the party is almost over.
Well, B is for Business, I hope that you will be at the meeting this evening to state your views and suggestions. Or if you can not attend, request that a friend do so for you.
Pattsi Petrie
P.S. There are many hidden additional costs that people are missing. The $180,000/year does not cover a full time employee or equivalent. In addition, there will be the cost of the administrator's salary and benefits paid by the county, yet, controlled by MPA. Breaking the contract and buyout costs are rather large, in addition.
Mark,,,Ok so I put off caring for a bit longer,,,,I read thru the contract,,,since you went to the time and trouble to post it. In my humble opinion, this has the potential to make the deal with that outside law firm look like small time. But, when the county board waits until the doors are about to be locked,you deal from weakness, and you have to take what you can get. How is Mr. Beckett, and his Tower of Babel doing?
"Well, B is for Business, I hope that you will be at the meeting this evening to state your views and suggestions."
I can't make it tonight. If anyone agrees with me, will you please stand in for me? : )