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HomeMy WebLinkAbout2013-06-18 Commissioner Minutes TUESDAY, JUNE 18, 2013 The Franklin County Commissioners met Tuesday, June 18, 2013, with the following members present: David S. Keller and Robert G. Ziobrowski. Chairman Keller presided and after calling the meeting to order, a Moment of Silence, and the Pledge of Allegiance proceeded with the business of the day. Chairman Keller asked to include Chairman’s time to answer a question from last week. On a motion by Robert G. Ziobrowski; seconded by David S. Keller; unanimously approved to adopt the amended agenda. Chairman Keller wanted to respond to Mr. Piper’s question asked about how many sheriff employees there were in 2008 when predecessor left office compared to 2013. In 2008 there were 28 positions and 1 vacancy for a net of 27 employees with 9 being part-time and of the 28 positions 15 were deputy sheriffs. Beginning of 2013 there were 40 positions with 5 vacancies for a net of 35 employees, 15 are part-time and of those 40 positions 20 are deputy sheriff positions. Jay Lightfoot provided public comment that he would like to pass a hat to see if can get enough money to get the weed cut. Chairman Keller responded that a work order has been put in to get the weed cut. Reginald Lee Heefner was present to give his opinion on the sale of the Nursing Home. His father has been in Franklin County Nursing Home for a year but before that he took care of his father for 12 years. Three doctors and the Department of Aging determined that he should be institutionalized because of Alzheimer’s but it took him three years to get his father into a home because private homes would not take him due to his low income but Franklin County would take his father. Mr. Heefner said that thanks to Franklin County he got help for his brother as did Commissioner Ziobrowski’s brother who died of Muscular Dystrophy. He read in the paper that Mr. Wenger said Franklin County is not obligated to provide nursing home care. The solution is to change the County Code to mandate care for the elderly. He asked what recourse does the county have after a sale? He said a resident would need $100,000 a year to pay for care. Chambersburg has a population between 16,000 to 20,000 and each person could pay $5.00 to retire $900,000 debt for 2013. Mr. Heefner informed the Board they should urge caution not to sell. Mr. Wenger has a vested interest in selling it because his firm will get 20% of the sale. He informed everyone that Franklin County Nursing Home is outgrowth of the 1808 Alms house and poor house. Kim Wertz asked if there is any way that the County can find funds to hire two new part time sheriff deputies instead of a temporary sheriff deputy. Allen Piper said he did ask about temporary sheriff deputy position but he doesn’t know where it stands at this time. Chairman Keller responded that the position has not been created or even considered because the Board did not adopt it as an agenda item that day. Eugene Klee asked if the Board still owes 2 million on the home? Chairman Keller said it’s about 1.8-1.9 million. Mr. Klee said he thought it was paid for when the home was built 40 years ago. Chairman Keller responded that it relates to improvements that have been made since then. Sheri Morgan said that Mr. Heefner explained well why it should be a safety net and keep the Nursing Home. She doesn’t think we should change the county code but would like to talk to Ms. Byers about putting a referendum on the ballot and ask voters if Franklin County should keep the nursing home as a core government function. Continued on page 2 Sue Swartz asked how much property is there and if the property is sold does that include the Potters Field? Chairman Keller responded it has not been determined how much property would be sold. The graveyard is maintained by the County. He said he was not thinking of selling the cemetery behind the nursing home. Ms. Swartz asked if it’s possible to sell it without the Potters Field? Chairman Keller responded “certainly”. Commissioner Ziobrowski wanted to clarify Mr. Heefner’s comment about his brother Jimmy who died of complications from Multiple Sclerosis not Muscular Dystrophy. He also wanted to clarify that the consultant will not get 20% from the sale of the home, the board has not arrived at a sale percent figure. Chairman Keller pointed out that Mr. Heefner mentioned the $900,000. Typically actual year-end expenses are significantly less than budgeted, so the $900,000 figure could be less than that amount at end of the year. Mr. Heefner thanked the Board for their clarification and said all figures came from Public Opinion and he apologized about Muscular Dystrophy as Commissioner Ziobrowski’s brother and he were good friends. But he asked what will happen to his father? When he submitted his financials none of the private homes would take him. This may have changed but what would happen to his father if it were not for Franklin County? Mr. Heefner’s income went from 85,000 to 21,000 because he had to quit a more lucrative job and care for his father at home. What recourse will the county have if a private company will not continue to take the indigent? The minutes of June 11, 2013 and June 13, 2013 meetings were reviewed. These will be approved Thursday, June 20, 2013. The Board reviewed Agreements, Contracts and Reports. The items will be approved Thursday, June 20, 2013. The Board held a public meeting on the possible sale of the Falling Spring Nursing & Rehabilitation Center. Chairman Keller announced that Jay Wenger of Susquehanna Group Advisors, Inc. is here today to answer any questions the public may have and he does have his presentation available if anyone would like to see it. Jay Wenger said what has surfaced since first met is two primary concerns: If employees will be dealt with equitably and resident care. He said that it is highly unlikely there will be high turnover rate based on change of ownership. If look at newspaper in the want ads for labor most positions are healthcare. There is a high need for nurses and nursing assistants so it would be foolish for a new owner to try to replace a whole labor force. He said it is unlikely that Franklin County is overpaying its employees and is probably less than what a private home is paying. Private owner wages and benefits would be more competitive and the new owner may try to reduce agency usage so may hire more permanent staff. Mr. Wenger said resident care is the second concern and in his experience in county nursing homes that has been sold to private sector survey results have improved. In Adams County, the first survey after new ownership it was the best survey they ever had. For profit operators are concerned about their reputation and its highly important to them. Quality of care is better and they may add more therapists to provide more therapy services. He said it’s very difficult to do business and not provide a high level of care. He doesn’t see that the private sector will abuse residents or employees. Any business there is bad firms and bad people being paid on a daily basis so his firm’s job is to assist the County in evaluating all firms. They have a list of 14-16 firms interested in submitting a proposal. They do not put anyone on the list that does not have a good reputation. Some firms will be dismissed because won’t have a comfort level of what commissioners and residents want. Other thing he has heard is will a vendor or firm flip Continued on page 3 this. Looking for firms that will commit to run as same character as the county and deliver skilled care to the elderly. Will ask any potential buyer to agree to maintain Medical Assistance and Medicaid as it is today. Mr. Wenger mentioned that the private entity who bought Adams County has kept the same as when County had it. Don’t see population or premix being different and will ask any potential buyer to see their operating model. Process is to vet buyers as thoroughly as can. Any buyer coming in is not looking to convert to a total private pay nursing home. There is very few private pay nursing homes in PA. Only ones that are is because they are not eligible for Medicaid funds. Commissioner Keller opened the floor for public comments: Sue Swartz asked what is closest of any of the places interested. Jay Wenger said there are a couple interested parties from Hagerstown, MD, Gettysburg, Cumberland and Dauphin Counties. So far there are not any from Franklin County but it’s around a 45 mile radius. Ms. Swartz asked if crossing state lines is a concern. Mr. Wenger said no and will ask them to present what experience they have with the PA State System. He doesn’t view someone from out of state as a problem only ones that are a long way from Pennsylvania is a problem. Jay Lightfoot commented that Jay said wages would be cut – what was he talking about. Mr. Wenger said he did not say wages would be cut he said they would be more competitive. Sheri Morgan said Mr. Wenger is right with funding streams and will not be 100% self-pay tax situation. There is a biased in the healthcare law. Funding for schools get cut but funding for jail increases, law makers aren’t stupid they know that when fewer funding for schools will need more funding for jails because crime increases. When community–based care funding is cut more money is spent on institutionalized care. She agrees with Mr. Heefner that this is a nursing home of last resort and there is no place for these people to go. Chairman Keller said if the county decides to sell the nursing home the cemetery would not be in the sale. He sees it as responsibility of the county to take over it. Mr. Wenger said he’s sure that a new buyer would not be interested the cemetery. There will be a zoning subdivision done in the process if the County decides to sale. Kim Wertz asked if the county could sell the business but retain the building? Mr. Wenger responded that when selling the business can do what want but a buyer will not be interested in being a tenant. The buyer does not want the risk of being kicked out by the county a few years down the road. The buyers that will be considered are long term providers and will want the building also. Ms. Wertz said the reason she asked was because know the County is wanting to expand so would have more buildings that can use. Ken Jones said he has been involved in nursing homes in the area so he has some knowledge. Mr. Heefner made a valid point that indigent people have no choice. Costs less to give employees more beds to care for then hire more staff. He mentioned several instances that happened to his mother in a private nursing home. Staff was rushed and accidents happened or residents weren’t taken care of properly. When folks can’t take care of themselves it is heart breaking to see what they go through. He saw all there was to see of shortcomings of private homes. Where will they get bed space when trying to make money as a nonprofit. The Board should let the entire county speak about this. This may not be the best solution for residents who can’t afford it. Mr. Wenger said the County will need to take due diligence and walk through facilities and Continued on page 4 do the smell test, there is a lot to be learned by walking through their facilities. Ken Jones responded that when someone is scheduled to do a walk-through of a facility they are given a heads up that coming and can clean the place up. Mr. Wenger said they will be given some notice but not enough time to totally clean up. Chairman Keller asked what other evaluations can be done when evaluating firms? Mr. Wenger said they will check references, do background checks on resident care issues and review surveys. There will be a lot to do to make sure that the entity will pass the test. Allen Piper said Mr. Wenger has complimented the session well with his answers to questions/comments but he wanted to make some statements. Mr. Piper said have a growing population in Franklin County. He said to please not fast track this and he knows they are not. He knows they are putting a lot of thoughts to this and Mr. Wenger is explaining things. Also, Sheri Morgan mentioned a public referendum, sometimes this is the best way and gets the public involved. This process may take several months anyway so maybe could get this on a referendum and let people vote on it. Mr. Piper said if something is not broken don’t fix it. If it’s beneficial to the people then let it be. Ken Jones said their group is called CRG for a reason. The outcry from the public has been responsible government and not seeing that in a lot of aspects but does feel the county does a good job however need a transparent government in all Elected Officials. It’s CRG’s self-appointed job to look and see if getting best representation and that getting the best out of our government. They are hoping with public attention may reverse this and get back to where government is open and responsible. Chairman Keller thanked everyone for comments and questions and said the Board is taking them to heart. Jean Byers, Deputy Chief Clerk said she will have the solicitor look into a referendum question but generally nonbinding advisory questions are not permitted on the ballot in Pennsylvania. The Board recessed and will return at 6:00 p.m. at the Administration Annex on Second Street in Chambersburg. The Board reconvened at 6:00 p.m. to receive public comments on the possible sale of the Falling Spring Nursing & Rehabilitation Center. Chairman Keller opened the meeting and explained the process. He announced the Commissioners will make a decision based on the commitment to employees and care of residents. The Board is slated to decide Thursday whether to move forward with process. Chairman Keller introduced Jay Wenger from Susquehanna Group Advisors, Inc. Mr. Wenger shared his background and said in recent years there is more focus on county budgets and not raising taxes. There is more of a drain on county budgets so more homes have been sold. Mr. Wenger showed his presentation. Chairman Keller opened the floor for public comments: Ken Jones said Citizens for Responsible Government are obligated to watch out and make sure government is being transparent. This morning, Mr. Heefner made a good point that he spent considerable time looking for a nursing home for his father and that no nonprofit would accept his father but Falling Spring did. He mentioned the $900,000 shortfall and asked if the county is so brilliant in expenditures but can’t make the facility run how can a private facility make it work? He asked what is Mr. Wenger’s Continued on page 5 responsibility, is he a consultant only? Mr. Wenger responded and said the decision is not his, his role is based on merit of soliciting proposals that have a good reputation and a business model similar to County. He will then explore and investigate interested entities history and model. He does not make any decisions and in the end if Board decides not to sale they don’t have too. Ken Jones told the Board to not fast track this decision and the Board should not rely on someone outside the county to make decisions. Mr. Wenger said he wanted to respond to Mr. Jones comment about someone coming in and making money. The difference is they can allocate training and processes over a larger amount of beds. Adams County was contributing a million dollars a year and new entity turned it into a profitable business within one year and had the best survey in history. Robin Langlois said the one figure on a slide said Hagerstown market had 80 skilled nursing homes but there are only 8. Jay Wenger responded that it includes a 45 mile radius so that included other areas not just Hagerstown market. Ms. Langlois said she lives here in the community and have families that lived in Falling Spring so she is concerned about the residents that are on Medicaid. They do struggle to find a home who accepts Medicaid. The private sector may not want Medicaid patients and only want Medicare to get more bang for their buck. She has a friend who works for the home and what happens to long term employees especially ones that are close to retirement. Mr. Wenger said the new entity would not come in and discharge or stop taking Medicaid residents, they are comfortable in taking these residents. Do not see a change and they are ready to do business that way. As far as long term employees, entities will be looking for quality employees , they even tend to raise the hourly rate over time. Ms. Langlois asked if new owner prospects could come from MD? Mr. Wenger answered that he will not dismiss anyone but may dismiss if they don’t like what they see since they may not be a good fit. Chairman Keller said if move forward employees will be taken care of fairly. Will have to address fairly the employees that are vested after 5 years. He said that they will have to address the quality of care at Falling Spring because it is exceptional. It’s the folks working there and the prospective buyers will recognize that and will still provide best care to residents. Debra L. Heefner drove 1800 miles to get here and has a father in the home. Quality of care is her main concern. Will they put the almighty buck ahead of the care? Will these be sealed bids? Will they maintain same amount of employees? Jay Wenger responded if the new entity is not providing high level of care they will fail. Their ability to move forward is greatly diminished if they don’t get good surveys. They can’t make money if they reduce the level of care to residents and employees. Can’t hide poor care anymore. Bids will be sealed and opened by the Commissioners. During the RFP process the county must provide floor plans, contracts, license for facility, financial data, staffing analysis. His role in this process is finding out who they are and how they operate. The new entity will still have to comply with regulations. Ms. Heefner asked what happens if they go under? Mr. Wenger said entities have been in business for years, but cannot guarantee they will be successful. Ms. Heefner said she saw first- hand quality of care given to her father, and they are special people working there. Mr. Wenger responded they are not looking to replace the labor force. Derik Howard asked how does the Board feel this will benefit the county and the residents? Chairman Keller responded that will only move forward if can find a reputable firm to provide equal or better care. This could relieve the tax payers of the financial burden. Mr. Howard asked what if new owner renigs on their agreement after paperwork is signed? Mr. Wenger said the commissioners will have the option of going to bidder # Continued on page 6 2 or 3. They cannot guarantee that they will do what they said they will do. Commissioner Ziobrowski said the Board will not move forward unless they find someone to treat residents and employees fairly. They will vet all applications. Question comes down to what are the core functions of the county. Why would the County want to compete with the private sector when the private sector does it very well. The Board doesn’t have to move forward if these criteria are met. Renee Sharpe said her father had to break a promise to her mother about putting her in a home. They needed a facility to provide rehabilitation to her. They chose Falling Spring because this facility was top on their list. She has nothing but good to say about the therapy department. They had hoped for short term rehab services but had to make the decision to keep her there as a regular resident. Mrs. Sharpe visits every day and social workers and staff are wonderful. She mentioned several residents by name. It’s like a family and surprised by the sweet spirit in the place. She knows staff people on a first name basis and they take great care of her mother. She understands and knows the Commissioners will do due diligence. The home doesn’t smell clinical and it’s always clean. She enjoys going in every day. She trusts the commissioners will make the right decision for the residents and employees. Her mother goes to worship services and singing and this needs to be considered for the future. Ken Jones said he wanted to state that he did not say they would lose 50-60% of staff, he said that homes are 50-60% at staff because it’s cheaper. There are more beds per employees so this is not a good thing. Affordable Care Act will leave 35-45% costs to be covered by someone. George Jones is a Chaplain that volunteers at Falling Spring. He hears a lot and sees a lot. He has been called by family members and holds services for residents first Sunday of the month. When residents heard that the home might be sold they became upset and are worried about change. He encouraged the residents to never quit. His wife works there and staff is busy from taking care of the residents. They do sometimes call in help from agencies. If Commissioners cannot run Falling Spring how can another organization come in and do a better job. He said staff does an excellent job and they look at residents as their children. How can an outsider bring in higher wages? Mr. Wenger responded that outside labor at higher rate is a challenge, can’t shorten staff because of regulations. Another option is paying overtime but not everyone can be enticed to stay so agency staff is expensive but it’s the nature of the industry and it costs money. Brian Peters said both his grandparents were in the home until they passed away. He’s a minister for Corpus Christi Church and goes one Sunday a month to the home. He saw Fred Rock during a visit and his mind is still sharp. He asked Mr. Rock about the sale of the nursing home and Mr. Rock said this younger generation thinks differently. Mr. Peters trusts them but he doesn’t know if now is the right time. With election coming up are they even looking down the road. He heard that one purchaser if gets the home could get a nonprofit status so they don’t have to pay taxes. Jay said if a for profit would buy the home they will pay real estate taxes but if a nonprofit buys it they would be exempt. Nonprofits are not interested and may not have a viable business model. Brian Peters said healthcare industry is changing but he hopes the Board looks at the whole picture. Robin Langlois said Falling Spring Nursing Home is one of the good things about Franklin County and is very proud to be here to represent a resident. She reminded the Board to not let dollars signs come first. Sometimes private vendors can play the role but they don’t have the heart and soul to run a facility. Residents are there because they have to be. Get rid of the jail and the money spent there. They need to take care of the elderly first. Continued on page 7 Linda Chamberlin’s mother has been a resident for seven years. Her health has declined rapidly. The care is wonderful and she loves the home and staff loves her and they have gone out of their way to care for her. The staff hugs her mother like their own mother. Staff calls her day and night so they keep her informed. They are most understanding. Her mother is totally dependent on the facility. She hopes new staff understands the dementia patient. She wants to make sure staff comes in and loves her as much as the current staff does. Ken Jones said that he’s hearing glorious remarks concerning staff of the nursing home. He mentioned the story of his mother being in a horrible private home and how staffing rarely hit 70%. His mother got hurt because a girl pushing her in wheelchair and she fell out because the girl was rushing. This is what will happen if a private entity takes over. Do we want to be in nursing home like the one his mother was in or in one like Falling Spring Nursing Home. George Jones said everyone loves Falling Spring. He does, his wife has worked there for 26 years. His wife even stays overnight to care for residents. He would go to Falling Spring but if Falling Spring changes he would rather die at home. Staff works above and beyond the call of duty. He asked about the residents. They are like a family, they want to be loved like everyone else. Jeanne Cannistraci asked if the Board is willing to put this question out to the tax payers. Chairman Keller responded that looking into this and seeing what questions can put out to electorate. Paul Leggit has served on town council with Sam Worley and he asked who suggested that they sell the Nursing Home? Chairman Keller responded that the Board noticed that for the past six years other counties have been looking at selling or have sold their homes and in January the Board discussed looking further into it. It was the Board’s decision. Mr. Leggit asked if they are asking Mr. Wenger for advice. Chairman Keller said all information given has been after they questioned this. Mr. Leggit said it is about money so why don’t they ask taxpayers to support Nursing Home. Is there time to put this on the ballot? Chairman Keller said can’t put an issue on the ballot that counties are not allowed to do. The Board is researching and will discuss publicly at a later date Tammy Miller works at the Nursing Home. It’s not only nursing staff that could be affected, there is dietary, housekeeping and laundry. They are all family. Why was Public Opinion told ahead of the staff? Her sole purpose and concern is for the residents. Dietary makes special food items for residents but can’t guarantee that kind of care will happen with a private home. Her sister-in-law was in a private home and care was terrible. She said therapy staff will be replaced and they do provide excellent care. Cannot guarantee quality of life and the residents deserve to live their life out with quality and dignity. Daniel Poe’s mother is a resident of the home. There was not another facility that would accept his mother except for Falling Spring. They have wonderful physical therapy and she considers this her home away from home. She asked him to come in and ask questions: If a private facility comes in would staffing ratio remain the same? Will residents be allowed to have a resident council? Had a flag ceremony on Friday would this continue? Would activities continue? Mr. Wenger said activities would continue and it’s very common that any owner is trying to create the best living arrangements on a day to day basis. They will not discontinue activities. Chairman Keller said he spoke to Carolyn Bricker about the Auxiliary continuing. Continued on page 8 Ken Jones mentioned about five residents including his mother falling out of bed because rails were removed. Once she had hip surgery the doctor didn’t even know that she hadn’t walked in 3 years the private home didn’t care so they didn’t relay this information to the hospital. Paul Leggett asked if there is a regulatory agency that can shut down a nursing home and is a private entity subject to this as well. Mr. Wenger said all nursing homes are subject to all oversight and regulations by the Department of Health and can revoke any license. It’s common for nursing homes to have a few deficiencies but when they affect resident care the action becomes more swift and more severe. George Jones said the home does take care of their own and there was an incident at Falling Spring and it was dealt with right away. Chairman Keller thanked everyone and everyone’s comments and questions gave the Board a lot to think about. He knows they all deeply care about the residents and staff at the home and the Board will give this a lot of thought. Commissioner Ziobrowski said during his tenure on the school board people who spoke during public comment were often frustrated when the board did not immediately react. They would think the board was uncaring. This is similar. The board of commissioners job is to listen. He said that he knows the board members care. His own grandparents last home was Falling Spring Nursing and Rehabilitation Center. He knows the employees are very caring, and he is proud of the nursing home. However, government sometimes must change to meet needs, and if the conditions the commissioners have set are met, the change in ownership can be good. The board was here to listen tonight, and he thanked everyone for coming. The meeting was adjourned at 8:15 p.m. with a motion by Robert G. Ziobrowski; seconded by David S. Keller. FRANKLIN COUNTY COMMISSIONERS