Found the following report on Valley Hi, the County’s nursing home, in the minutes of the July 21st County Board meeting:
Valley Hi, as you may remember has over $40 million in the bank, while the entire property tax levy for county government is was $78,966,290.31 this year.
Annual Report of Valley Hi Operating Board – [Tom] Annarella
Mr. Austin noted that it’s been five years since the Valley Hi Operating Board started.
Mr. Annarella came forward to talk about the Annual Report of the Valley Hi Operating Board.
Mr. Austin noted that this power point will be available in paper form. Mr. Annarella talked about the daily census at Valley Hi stating that they have 128 licensed beds and as of today have 126 residents noting that the length of stay of a resident is shorter.
This speaks to the Medicare Short Term Rehab business that they are now doing which has an affect as well as the residents being more acute than they were 5-10 years ago.
He pointed out that in the past they have run in the black but this year they are not due to Medicaid cuts and reimbursements being slow and the cost of health care going up.
He expects that they will come close to breaking even this year but time will tell.
He said the biggest impact is the food cost and the rising cost of medical supplies.
Food related, meat cost is up but by far the worst is the egg shortage that we are experiencing.
For the next 18 months it will not only be difficult to get eggs but the price has doubled already.
They are looking at alternative proteins to add to the residents menu.
He pointed out that in May and June they took a 12.6% cut in Medicaid payments and they’ve received notification from the State that they will not see payment for any services from July beyond that until a budget is approved by the State.
He said the cash flow will be interrupted on the Medicaid side for a while.
In regard to the Valley Hi tax levy it has been reduced over the last five years from $6 million to $3 million.
The Operating Board continues to discuss the tax levy and make recommendations to the Finance Committee.
They are cautious at this time in taking the levy down any further because they don’t know what is going to happen in IL as far as Medicaid goes or what is going to happen with the Affordable Care Act.
There are many unknowns and they don’t want to bring the reserves too low. [Emphasis added. The Finance Committee will take a separate vote on whether the levy should again be $3 million next year, despite the over $40 million in the bank and the $10-11 million budget that is basically a break even one.]
A Capital Improvement Plan was developed as part of the discussion about the reserve level. This Plan is a working document and is reviewed regularly.
There are areas that have been identified that they know in the next three years will need to be addressed.
As of right now the first floor is having all of the flooring replaced, this project will take about two months to complete.
Another thing they are looking at are the systems and the equipment one of those being the beds and mattresses which have a life span that is coming to an end.
Some of the things that have been done already are
- the installation of televisions with mounts in all of the resident rooms
- replaced the chiller on the air conditioning unit
- completed the energy savings project which is already showing a savings in energy costs
- they’ve started replacing the flooring.
Mr. Annarella said health care is changing rapidly and the Affordable Care Act is significantly changing how health care is delivered.
One of the major changes is the number of audits that are being done before and after payments are made and others.
There is a shift from traditional Medicare to Medicare Advantage Plans.
Medicare is a Federal government program and the other is an insurance program; they cover basically the same but they are not handled in the same way.
With Medicaid there are also significant changes, the payment delays being one of them as well as the delays in processing applications.
The law states that the application has to be processed in 90 days but they have applications that are over 1.5 years old.
You wait to get the applications into the system then you wait again to get paid.
There are times that a resident has passed away or left the facility and they still have not been paid from Medicaid the their services so the accounts can’t be closed out.
Centegra is another anticipated change.
Although they are Valley Hi’s main referral source, Centegra has established “Their Expectations” which means if you want to be referred to you will meet their expectations.
The expectations involve quality and data sharing, communication regarding rate of admission and referrals, times of referrals and decisions being made down to re-admission rates.
Mr. Annarella said if a Medicare resident from Centegra goes back to Centegra within 30 days, Centegra gets penalized by the Federal government.
In 2016 that will also start happening to long term care facilities.
If you have a high re-admission rate, Centegra will move you down on their referral list.
Centegra also has “Preferred Expectations” such as having a nurse practitioner on site, PTO and Speech available six days a week and private rooms available for joint hip replacement/rehab program for people coming out of the hospital.
Centegra also want you to accept charity care until a different source can be found for a patient. In regard of quality of care, Valley Hi provides this in a home like environment.
They’ve had a very good survey history and their quality indicator scores are very good and positive in high focus areas.
Resident family satisfaction is high as well.
At Valley Hi they have a high resident centered focus which gives the residents control of all facets of their care i.e. choosing when they wake up, choosing when their shower days are, choosing facets of their meals and choices over all.
This enhances their abilities and creates a “Failure Free Environment”. Mr. Annarella said Valley Hi continues to exceed the State staffing minimums.
The Operating Board has recommended a Staffing Enhancement which has to do with the changes coming down and the penalty models being seen.
Succession Planning has been looked at and they have hired a new Asst Administrator for Valley Hi.
He noted that the union contracts expire this year and they’ve started talking about new contracts going forward. He said looking ahead they will be have a “needs analysis” done to determine what services or needs are not being met in McHenry County.
The study will look at what we can do within our own facility and staff to enhance our current programming to fill any gaps or to explore public and private partnerships to fill those gaps.
Valley Hi is not looking to compete with the private industry it’s to supplement the services being provided.
Mr. Annarella thanked McHenry County for recognizing them as “Best in the Fox” for second year in a row as the best senior and memory care facility.
He said they have an Alzheimer’s and Dementia Support Group that meets on the second Tuesday of every month and is open to the public and is very well attended. He invited everyone to Valley Hi’s annual picnic on September 12th at 12 p.m.
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There will be a post on County Board discussion the consultant that has been hired to offer recommendations on the future of Valley tomorrow.
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Those who believe that the County Board does not need to extra another $3 million from us next year should call
First, call the members of the Finance Committee (which are no longer listed in the County Clerk’s Yearbook):
- Mike Skala, Chmn – 847-669-3804 or 847-417-4323
- Jim Heisler, VC – 815-459-1971 or 815-459-0171
- Yvonne Barnes – 847-516-2719
- Mary McCann – 815-568-1961 or 815-245-9282
- Nick Provenzano – 815-355-8540
- Larry Smith – 815-353-8043
- Chuck Wheeler – 847-354-3693 or 815-307-8525
All of the County Board members’ phone numbers can be found here.