Rock Island Today

Rock Island County Hope Creek Care Center Board of Directors met December 18.

Here is the minutes provided by the Board:

1) Call to order and roll call

Committee members present: Jessey Hullon, Gregg Johnson, Michael Kelly, Carol Near, Ginny Shelton, Rod Simmer (arrived at 5:48 p.m.)

Committee members absent: Bryon Tyson

Others present: Kenneth Maranda, Kurt Davis, Hayleigh Covella, Cassie Baker, Deb Kettler, Tom Dryg, Sue Berry

2) Approval of the minutes from the November 20, 2017 meeting

Motion to approve: Ginny Shelton

2nd: Michael Kelly, Carol Near

Voice vote

Motion carried

3) Public comments

There were no public comments.

4) Marketing update

Ms. Kettler reported that Hope Creek has a couple of things going on. She passed out a blue poster to the committee and noted that she is going to have the wording adjusted at the bottom so it shows up better. Hope Creek is having trivia night next month on January 20th. It will be held down the street at Christ the King Believers Together gym. They are doing Hope Creek a huge favor. They are giving a comp for the rooms, so Hope Creek doesn’t have to pay for room rental. That was very nice of them to do. It is $700 or $800 that they are saving Hope Creek. There will be food, beverages, and cocktails. There will be tables of eight, hopefully. Ms. Kettler noted that she left everybody a registration form and would like to see everyone at this event to help raise money for Hope Creek. They have had two others in the past that were very successful. She hopes this will be just as successful. It’s just right down the road.

Ms. Shelton asked if they will have baskets to auction off as well. Ms. Kettler said they are going to talk more about that on Wednesday. Ms. Baker explained that they had all the intentions to, but Ms. Kettler has been doing double duty. Ms. Kettler explained that this is a project she started in June or July and when she had to start doing admissions again, this got put on the back burner and then on the back burner and then on the back burner because they know admissions are more important right now. There might be some [baskets], but she isn’t sure. Ms. Shelton noted that she’s not sure if she’ll be in town but she would donate a basket, so please let her know. She’s sure most of the Elected Officials would also donate if asked. Ms. Kettler said she will be happy to reach out. She just got this poster updated today and is still going to have to tweak it. The wording is too dark on the bottom. Then she will send it out to everybody in the county. Mr. Hullon noted that the back page has the word “or” twice. Ms. Kettler thanked him and said she’ll get that fixed. Mr. Hullon asked if they take checks or any kind of money for this. Ms. Kettler said yes.

Ms. Baker noted that they also have a letter they are sending out. Ms. Kettler said yes, but she hasn’t finished it yet.

Ms. Near suggested getting a table as a board so all of the Hope Creek Board members can play. Ms. Shelton said if they find a substitute for her, she’ll pay for them.

Ms. Kettler noted that Hope Creek also has something going on this Friday. They’re having the Christmas party for the residents. Everyone is invited to come. She thinks that is at 1:00 this Friday in the dining room if anybody has time to come by. There will be some beverages and snacks and they will pass out gifts and sing Christmas Carols if anyone has free time. Mr. Hullon asked until what time. Ms. Kettler said it goes pretty fast, so probably about 2:00 or 2:30ish. Mr. Johnson asked if he can bring his little girl. Ms. Kettler said he sure can. Ms. Baker noted that she can check the time with the receptionist on the way out.

Ms. Kettler noted that now she has some not so good news. The home took a beating last month with admissions. They only got 14 in. She’s sure a lot of it had to do with the fake news that was in the paper about Hope Creek. She did hear from some people who had questions about what was going on and she had to address it. That was just some people she heard from, but there were probably more who read it and changed their minds without questioning Hope Creek. That did hurt a little bit, but the referrals are coming in quite a bit this month. Fourteen admits is pretty low.

Mr. Hullon asked what the breakdown of the 14 is. Ms. Kettler pointed it out on the report. She noted that in looking at the previous years, it’s not unusual to have 14 in November. It just looks bad because they had 30 admissions last November. In 2014 they had 17 and in 2011 they had 14 admissions. It’s kind of bounced back and forth for that month. A lot of times what happens is people already have planned surgeries and are home for the holidays. No one wants to go in a facility unless they have to. When family comes in during the holidays and notice mom and dad are not doing well as everyone thought they were, between December and January admissions pop back up. People realize things aren’t happening at home as quickly as they should be. It’s okay but it’s not okay.

Ms. Baker said she’s counting 16 admissions. Mr. Johnson agreed. Ms. Kettler said she was working with one eye today and she bets she mistyped something. She thinks it’s 14. Mr. Hullon noted that the two VA admissions look good. Ms. Kettler said she doesn’t have the other sheet with her that has admissions, but she thinks it was 14. She bets she put something down twice when she tried to do this today.

Ms. Kettler reported that Hope Creek will be very busy tomorrow. The phone has been ringing off the hook with people wanting to come in. She thinks they’ll bounce back from that fake news story.

Ms. Kettler referred the committee to the report on the wall showing yesterday’s census for today. There are 33 private pay; 3 Medicare A; 7 managed care, which is insurance for PPOs who still get skilled therapy; 6 hospice private pay; 22 hospice public aid; 1 private insurance who is discharging soon; and 8 VA contracts; and 90 Medicaid. That breaks down to 39 private pay, 112 public aid, and 11 skilled. Hope Creek had four people out yesterday. Two people went on home visits and two people were in the hospital. That took the census down to 174, which is pretty low. She can’t remember the last time it was that low. Taking out the wing that closed, Hope Creek is still almost 81% full. It could be better, absolutely. Ms. Kettler really wants to get it up to 200. She’ll see what she can do. They are doing great job of getting people rehabbed and had a few discharge home over the past few weeks. She is still out there still working it.

Ms. Kettler added that they are looking at the Cubs package for next year and some other things. Ms. Baker explained that they feel they got good private pays through the Cubs channels. It worked, so they’ll continue to do it next year, especially since they are not getting a lot of skilled stays. They need to bring that money in another way and the next best is private pays as far as the ratios go.

5) Financials

Mr. Dryg noted that he did not have the financials issued by the time the packet came out, but he has things now and will pass those out. He explained that he took the liberty of putting the summarized information he has been going over for the last few months on the front page so they don’t have to write this down and can follow along.

Mr. Dryg noted, first off, that this is a draft. It’s not final because at the end of the year, some things go on at the county in the way they account for things. Mr. Dryg likes to wait until the audit is done. Over the next 60 days, the Auditor’s Office will be doing some things to measure year end receivables for governmental accounting purposes and accruing liabilities. He likes to wait and see how that shakes out and if there’s anything that he is interpreting differently than Ms. Palmer is. If so, they’ll talk about it. Usually he ends up adjusting accrued payroll to what the county accrues and that sort of thing.

On a draft preliminary basis, the 2017 cash was $362,000 at the end of November. In 2016 it was $704,000. That’s a decrease of $341,000. However, $235,000 of that was used to pay down payables. Accounts payable was $913,507 at the end of November 2017. In November 2016 it was $1,148,000. That is a decrease in outstanding payables of $235,000, which is a positive thing. Mr. Dryg shows Accounts Receivable increasing slightly by $22,000. That’s negative just because of the direction. Year to date income is $237,144. Last year it was $347,769. That’s a downward trend of $110,000 but still a positive result.

Mr. Dryg explained that one thing he looked at when he was here last week talking to Ms. Baker is there’s a Budget Performance Report in the county’s ledger system. Looking at that now it looks dire, but the 2017 revenues that get received in the next 60 days will get pushed back into the last year. Based on what he knows right now, Mr. Dryg thinks Hope Creek is going to come out okay. He will withhold judgment until the final numbers fall into place, but said not to be surprised if, between now and the time the county makes its adjustments for the yearend, Ms. Palmer has better outlook on that as well.

Mr. Maranda added, for those who aren’t Board members, that Ms. Palmer did go through that 60 day period and talked about it at the Board meeting. Ms. Shelton agreed and noted that basically, Ms. Palmer thought Hope Creek was doing better and getting money in was all. She explained that pretty thoroughly.

Mr. Dryg noted that Ms. Luecke is not here and she missed a couple weeks last month, so collections were a little off. He expects that to bounce back now that she’s back.

Ms. Shelton said she thought Ms. Palmer did a good job explaining to the County Board that it was because Hope Creek is owed money, not that they are spending money recklessly. Mr. Dryg said revenues were down, but so were expenditures.

Mr. Kelly asked if Mr. Dryg can give him a ballpark figure for the county’s figures and Mr. Dryg’s figures and how much difference there is. Mr. Dryg explained that it really depends on timing. It’s too early. It would be speculation on his part to give that. The way these financial statements are developed is on an accrual basis, which is more of a for-profit presentation. Revenues are intended to be reflected as they are earned, expenses as they are incurred, and debt is on the balance sheet. When Hope Creek paid down the $1 million of debt that was due on December 1, on Ms. Palmer’s books that’s an expense. On Mr. Dryg’s books, it’s a reduction of debt on the balance sheet. That doesn’t affect his P&L but it affects her fund balance. It’s a different way of accounting. He doesn’t want to muddy the waters, but it’s best to wait and be cautiously optimistic.

Mr. Dryg reported that receipts last month were $2,654,000 including the $1.5 million borrowed from the Liability Insurance Fund and the property tax receipts of $401,000, which was more than he anticipated. He was counting on that to pay off the tax anticipation warrant. It covered the $375,000 left on the tax anticipation warrant and the $21,792 in interest. The taxes that came in covered that. The borrowing from the Liability Insurance Fund covered the principal payment that was due December 1.

Month to date in December, there has been $750,847 received so far. He believes there is an IGT payment included in that of $388,407. That was more than he had anticipated again. He does have it accrued for in the statements. That supports the bottom line number a little more than he anticipated. That is good news. Mr. Dryg noted that if anyone wants to take time and look over those statements and let him know if they have questions, they are welcome to contact him outside of the meeting.

Mr. Hullon noted that he always pays attention to the receivables. Mr. Dryg is showing a change in accounts receivable of $181,000. Mr. Dryg explained that it increased because Ms. Luecke was gone and collections were not quite as good as they were. Receivables increased as a function of the receipts more than anything else.

Mr. Simmer is present.

Mr. Dryg continued that the 12-month projection shows Hope Creek maintaining a positive cash balance. It also shows a need to borrow maybe $300,000 more at certain times to get through, but also being able to pay down $1,350,000. For example, right now Hope Creek owes another fund $1,500,000. If that gets paid down, that would be down to $450,000 at the end of the year. Mr. Dryg expects about $2.6 million in tax revenues next year and put in the IGT transfer the same way it came in this year, which was more than he anticipated. It had been around $180,000 or $215,000 every three months. This month it was $288,000, which was quite a bit more. One time in the spring he thinks it was over $300,000. Then the other two IGT payments were less than he anticipated. He’s not sure how they determine that number, but it’s kind of hard to anticipate. The projection shows that Hope Creek can get through next year in the same way they got through this year.

Mr. Dryg added that something else to note is, because of the bond refunding, there was one in 2013 and one in 2016 and they were kind of a refinancing of the outstanding bonds, there’s less of a principal payment due next December 1 than there was this December 1. The cash outlay was $1,300,000 this December 1. Next December 1 it’s $881,000. That’s simply due to the way the coupons or payments were refunded or refinanced. That’s looking more positive.

Mr. Simmer said he has a couple of questions. Ms. Palmer’s monthly report shows the current fund balance at $1.9 million in the hole. Mr. Simmer asked if that is for the year. Mr. Dryg said it is not. Ms. Palmer is not done accounting yet. Mr. Simmer said it’s also showing $4.9 million in revenues not yet received. Mr. Dryg said she is not done accounting that yet. Mr. Simmer asked if that debt is current. Mr. Dryg explained that Ms. Palmer will keep counting for 60 days what comes in for last year. Last year that was a couple million dollars. Mr. Simmer asked if that’s all real money and not the stuff they discussed before that should be put out to pasture. Mr. Dryg explained that they are available resources. At the beginning of the audit, the report talks about accounting. It counts cash as received when it is received and counts the expenditures as they are incurred. Ms. Palmer then takes what’s available 60 days after year end. Revenue generated in 2017 that wasn’t collected until the first 60 days of 2018, she will push into last year. Mr. Simmer asked if that $4.9 million is expected. Mr. Dryg said no. Maybe $2 million of that will come in and count toward last year, but the expenditures are less too. Mr. Simmer said he just wanted to know where Ms. Palmer is coming up with the $4.9 million of revenue not yet received. Mr. Dryg explained that it’s the budget versus what has come in. He was talking before Mr. Simmer came in that there’s a report in the county general ledger system called the Budget Performance Report. That is kind of what this report is built on. Looking at it now, it looks pretty bad, but she’s not done. Mr. Simmer noted that that’s what Ms. Palmer said. They have 60 more days, but the $4.9 million threw him for a curve. Mr. Dryg said him too. Mr. Simmer explained that he didn’t know if that was some of the money they had talked about. Mr. Dryg said it has never been counted in those numbers and has never been accounted for that way. It’s whatever gets received during the year plus what gets received for the previous year within 60 days after the end of the year. That’s how Ms. Palmer measures receivables for fund balance purposes. That’s not the same way Mr. Dryg does it. He does it based on Ms. Luecke’s aging report. That’s a different thing. Mr. Simmer said they’d have to look at both of those to figure out the reality. Mr. Dryg said it’s apples and oranges. It’s a different method of accounting.

Mr. Hullon noted that they do not have a copy of the aging report and asked if that is because Ms. Luecke isn’t here. Mr. Dryg said yes. He has it and can get it to everyone if they’d likei t.

Mr. Dryg explained that he thinks the expenditures will come out under by about $2 million and revenues will come in under by about $2 million. His prediction is Hope Creek will be around breakeven from a fund balance perspective. Mr. Simmer said he thinks that’s what Ms. Palmer said too. Mr. Dryg noted that he hesitates because that’s speculation. They need to let that 60 days run its course. He is patiently optimistic, but it’s a little bit alarming if you look at it now.

Mr. Simmer asked what kind of possibilities Hope Creek is looking at needing for liability funds. He asked if there is a rough idea. Mr. Dryg showed that in this projection, he has Hope Creek needing another $300,000 at various times. He has $100,000 in May and $200,000 later for a total of $300,000. Right now Hope Creek has $1,500,000. If they add $300,000 to that and pay off $1,350,000 at the end of the year, they’ll owe $450,000. Mr. Simmer asked what Hope Creek owes now. Mr. Dryg said $1.5 million. Mr. Dryg explained that Hope Creek also has authorized a tax anticipation warrant to borrow up to 80% of next year’s revenues, which is 80% of $3.6 million, or about $2.2 million. If they need to replace that $1.5 million or $1.8 million with a tax anticipation warrant, they could. Mr. Simmer asked if they can use that for liability. Mr. Dryg said no, but they could use it to pay back liability. The only reason, he understands, that Ms. Ewert used those monies instead of a tax anticipation warrant is because she can do that without paying interest. If it’s needed, they can draw on the tax anticipation warrant to pay back whatever they need to. He would do whatever they need to send back to the insurance fund piecemeal and save interest that way. Mr. Simmer said he thinks that’s a good idea.

6) IDPH Visits and Updates

Ms. Baker apologized for missing the last meeting and for everyone holding down the fort. She heard it was a doozy, but they got through it.

Ms. Baker introduced Sue Berry, the new ADON, and noted that she’s also serving multiple purposes. She’s kind of the utility player right now. She has served as a consultant in the past with other companies. One area Hope Creek is struggling with is the Marketing and Admissions Department. The last person who was introduced to the Board of Directors at the last meeting is no longer with Hope Creek. The reason behind that is she applied for a position at Genesis six months ago and it was her dream job. They literally just called her a week after that meeting and she couldn’t refuse it. From the details she gave Ms. Baker, she doesn’t blame her. They’re on the search again, but she thinks she’ll switch things up a little bit. Before, they were getting a lot of outside applicants for admissions and that was working out well, but they were not sticking. She wants to go a different avenue. She’s interested in hiring from internal for this position now. The person she has an idea for, she already chatted with her about it, would be a great advocate for Hope Creek. She knows the staff members, how to make sure they stay on top of things, how the processes work, the policies and procedures, and has worked for Hope Creek for well over 10 years. Ms. Baker thinks she’d be an excellent fit for that. To prep her since she does not have experience in that field (she’s a nurse), Ms. Berry is taking on admissions and marketing and revamping it. She’s another set of eyes. Ms. Baker explained that she is not able to look at every department and all the changes right now. Her main focus is on nursing, quality of care, and making sure quality of care stays very high so when the state does come to visit, and they all know they will visit, Hope Creek will get the good press with the bad press. Ms. Baker wants to make sure that when the state does visit, Hope Creek continues to have no findings. Ms. Baker noted that she is just one person, so she did call in Ms. Berry. She is more than happy to help.

Ms. Baker explained that one more layer has been added. Katie Ingamells, the last DON, stayed with Hope Creek. They have made a lead supervising position and are doing a lot of educating with her. Frontline staff, which is charge nurses and supervisors, weren’t auditing or doing much of anything on their shifts in the past, to be frank. Ms. Ingamells is overseeing that, holding people accountable, disciplining, and following the union contract. Ms. Baker noted that the committee will probably see or hear that Hope Creek is cleaning house or making things right and making sure, since there are such strict regulations to follow with the state, that they follow them period. Ms. Baker noted that her own license is on the building and the DON’s license is on the building. They take that very seriously. They will make sure education starts with CNAs all the way to the nursing staff.

Ms. Baker continued that Ms. Berry is revamping, making over job descriptions, and making goals for the marketing team. She is helping learn the Admissions side so when a new person comes in, she can train them rather than Ms. Kettler so that Ms. Kettler can focus just on marketing.

Mr. Hullon noted that with the new person, he’s frankly disappointed that they hired somebody and within a month she’s gone. That’s just not good. Ms. Baker said she is disappointed too. Mr. Hullon asked if they have a job description for this position. He asked, for the person Ms. Baker is talking about, how her resume reflects her job. He understands hiring from within because she knows the people, which is good, but asked how well this person’s resume fits with the job description. Ms. Baker said it fits very well.

Mr. Hullon noted that if they are going to be training someone, he asked what kind of wages they are putting out there and if they reflect a training wage or if they get the big banana right out front. Ms. Baker explained that Hope Creek gives them their wages immediately as soon as they start. If they didn’t, she definitely wouldn’t have been able to bring in the last two. Mr. Hullon asked if the last two didn’t come in trained in this field. Ms. Baker said they had history and experience in the field. The last one, Ms. Stockwell, worked as a Case Manager and for Hospice Compassus and Dal Senior Management. She knew a lot of members of the community like Glen Roebuck. Ms. Baker has been trying to be buddy-buddy with him and develop a relationship. That’s actually Ms. Stockwell’s new position; she is his right hand woman now. She has the connections and Ms. Baker was trying to bring that in. Hope Creek couldn’t compete. Ms. Baker suggested they chalk it up to bad luck and stay positive. She truly feels the new person has the image and motivation. When she works here, she doesn’t work average hours. She works double anyone else. She’s like superwoman. She’s a Type A personality and a go-getter. Mr. Hullon said he’ll give her all of that, but asked how that transfers to this particular rainmaker position. He asked how her skillset will transfer to what Hope Creek actually wants. He asked if this person has that. Ms. Baker said she does. She wouldn’t have considered her if she didn’t feel that way.

Ms. Baker moved on to the IDPH update. She noted that she sent Mr. Davis a letter explaining the IDPH visits and asked if that just went to County Board members. Mr. Davis confirmed that he just sent it to Board members. Ms. Baker explained that she wrote out a letter explaining the IDPH visits and putting them in perspective with all the bad press and negative assumptions. She knows something was posted about a rape allegation at Hope Creek. That was not alleged as rape. It was a scenario here in the Memory Care Unit where two people were interested in each other. Hope Creek did an internal investigation and there was no chance anything had occurred. When they do an internal investigation, the state still comes and investigates Hope Creek’s investigations and it was null and void. Hope Creek got a tag for it, but it wasn’t due to harm or sexual behavior. The tag had to do with just them being in memory care. You have to know where residents are at all times whether they want to be with each other intimately or not. Staff did state that they did not know their whereabouts for a short time, so Hope Creek did receive tag for failure to observe properly. They did not receive any fines on that.

Since the June 13 annual visit, which did not go the way they wanted it to go, Hope Creek has had seven visits from the state. That’s a lot. They normally don’t see the state in here a lot. Part of that had to do with the fact that Hope Creek did have a scabies outbreak in Building 4. It’s very much calmed down now. Ms. Baker doesn’t think they have anybody testing positive now. They treated very well and had a lot of in-services. They realized there was a little cross-contamination with the slings. They were using the same slings on people and not using new ones. She checked into prices for the disposable ones so in those scenarios they can be thrown away immediately. They can’t oversee the CNAs and if they are taking those across the hall. Disposables are more expensive, but in the long run Ms. Baker is hoping it cuts down on costs because it keeps the state out.

The state did look over procedures for that outbreak and said Hope Creek is doing a very good job, as well as they could. There is a 4-6 week incubation phase for scabies, which means it can pop up at any second. They can treat it right now, but four weeks later they can still have it. Anyone who came into contact in that time could have gotten it. It’s very hard to control, but Hope Creek did a very good job. Ms. Baker gave props to Ms. Berry and noted that she headed it off. She’s the Infection Control Manager. Since then, Hope Creek has had zero deficiencies and no findings. She takes pride in that. That tells her Hope Creek is doing a good job as far as the quality of charts and care. People are starting to get on the same page and they are continuing to change the culture. They are educating, educating, educating.

Hope Creek just had its annual winter in-service. Normally they do this once or twice a year to update all staff members at Hope Creek about new regulations and the reasoning behind them so they know the answers if the state asks questions. They also did a competency quiz, which they have never done in the past, to see where they are standing with nursing staff. They take and use that for education.

Ms. Baker noted that they have Christmas and New Year’s staffing coming up. That has been a challenge, but it’s better than last year. Last year was terrible. This morning they had 17 holes available over the weekend. They have knocked that down to 2.5 spots and have been working diligently about it for 24 hours.

Mr. Hullon asked how they are doing on agency. Ms. Baker said terrible, to be honest. She is working with the union to switch shifts from 8 to 12 hours. That would help, but they have hurdles to jump over and talk through. That will take time, but she feels that it will be the answer to a lot of issues. The hospitals know that and switched over a long time ago.

Mr. Simmer said the hospitals also mandate that everyone has to (inaudible) for a day because it should be mandated in the contract. That’s what’s killing them. They take all those days off and Hope Creek has to pay agency double. Ms. Baker noted that it’s about $42/hour for an RN from the agency. Mr. Simmer said they have to do something and asked if they’ve got that weekend thing going. Ms. Baker asked which weekend thing. Mr. Simmer said he means people just doing weekends. Ms. Baker said they have a few who do weekends only, but that wasn’t favored and they can’t make them. She did have some people volunteer. Mr. Simmer said he thought something changed in the contract, but maybe they weren’t allowed to do that. Mr. Hullon said he doesn’t think so. Ms. Baker said they did increase wages and got some volunteers. Mr. Hullon confirmed that they moved shifts and raised wages.

Ms. Baker explained that Hope Creek is in a lot better position this year as far as the holidays compared to last year. People on the floor may not say the same thing, but she was in the midst of it for both years and knows exactly where they’re sitting. They are doing better. She wanted the committee to know that to decrease expenditures, the majority of which are from staffing, is her biggest burden. She is trying to take care of it, but it’s a time thing. She and Mr. Davis are working on it.

Mr. Simmer noted that when they have that many at a time, they start doubling down on outside agencies and bring in a CNA plus a nurse plus whoever and they don’t have a clue. Those are liability issues. He knows they have issues from that. Ms. Baker agreed.

Ms. Baker noted that the time for this Friday’s Christmas party is actually 2:00 p.m. to 3:00 p.m. She believes they are still looking for some Senior Santas if anyone is willing to get a couple of gifts for residents here. She knows that’s very last minute. They normally get about two per resident, but they try to spoil them and get a little extra. If anyone is interested, they can contact Kenny Shuman by email or phone.

Mr. Johnson asked if, when agency comes, they have to abide by the same standards of conduct. Ms. Baker said absolutely. Mr. Johnson asked if there is ever a problem with that. Ms. Baker said absolutely, but they contact the agency immediately to put a DNR, do not return to the facility, on them if there is an issue that they foresee can’t be corrected. They send the agencies Hope Creek’s materials, policies, and procedures. Aside from them saying they address them, there’s nothing they can do about it. Mr. Johnson asked if employees are allowed to bring cell phones. Ms. Baker said no. Mr. Johnson asked if there’s a problem with agency bringing cell phones in. Ms. Baker said they have problems with everyone bringing cell phones in. It’s a policy, but just like in a hospital if she walks down the hospital and see someone has something shaped like a phone, she asks for it and management asks for it. They just have to stay on top of it.

Mr. Simmer said he has heard, because they all know plenty of people who work here or are in here, that agency staff is trying to dictate policy to CNAs and other employees and how things are done when they are here for a day or two. He asked if there’s some kind of hierarchy that can help with what because they know about how the residents should be taken care of. Ms. Baker said if it deals with how to properly care for someone, every unit, every CNA, and every nurse has a cheat sheet with the care guide for that person. That shows how to transfer a resident, the clothes they wear, if they are a high fall risk, the time they go to bed, and all those things. Really, their care map is right in their hand. If they go off that map they are changing the care plan, which is something they don’t want to do. If it’s not in writing, they shouldn’t be doing it. If the nurses tell them to do something and they don’t see it on the care plan, they need to see the supervisor a step above that charge nurse. They really have to skip over them. Mr. Hullon asked if there is always a supervisor on staff for every shift. Ms. Baker said yes, for every single shift. If they are not available for whatever reason, staff can reach out to anyone. They know. Agency knows if they have any issues with staff that they can call too.

Mr. Kelly thanked Ms. Baker for her candor, especially in regards to some of the negative things that have happened here. He was a little disappointed in her lack of confidence in sharing the gory details with the Board of Directors. Nurse to nurse, he’d like to encourage her to see how she can make the relationship she has with the State of Illinois less adversarial. The second thing he would like to see her have in place is nursing plans. He saw that repeated time again that Hope Creek didn’t have nursing plans when they were asked about these findings. That theme kept reappearing. Ms. Baker said she does not recall what Mr. Kelly is talking about with the nursing plans. Mr. Hullon said it precedes her. Mr. Kelly explained that these nursing care plans or options weren’t there when problems arose. “Corrective action” is the term, he thinks. He thanked Ms. Baker for keeping the committee abreast of some of the liabilities, falls, and care plans. It only takes one FOIA from anybody who’s interested in knowing what goes on here. That puts Hope Creek one step behind everyone else. Ms. Baker said it could take one disgruntled person. Mr. Kelly said it could even be a happy person. All they have to do is be persistent to find these things out. He thanked Ms. Baker for sharing and for being more forthcoming this time around. Ms. Baker said she is happy to answer any questions. Her goal is to be transparent with everyone. The more transparent she is, the more people she is going to have on her team, and the more support she will have. They will all work better together. She is always open to any questions. Mr. Kelly noted that they are all here today in hopes of supporting her and giving her the tools she needs. Ms. Baker thanked him.

Ms. Near asked if there is a J-tag on the facility. Ms. Baker said yes. During the last survey Hope Creek received an IJ for the side rails due to the potential risk of someone becoming entrapped. No one was entrapped. Mr. Johnson said it’s safe to say the seven times with no findings probably will not make the front page of the Dispatch. Ms. Baker noted that Hope Creek gets extra heat because it is a county facility. She understands and deals with that. For example, Ms. Kettler goes into a lot of other facilities and everybody has side rails still. One facility had bean bags or a bed on the floor. That’s a huge dignity issue. If Hope Creek had that, they would have been on the front page with pictures. It is what it is. She can control the controllable and that’s what she is doing. Ms. Near noted that the reason she asked was so Blackhawk students can come in and do clinicals. Ms. Baker said she wishes. Ms. Near said they do too.

Mr. Kelly noted that he has one other comment. He had brought this issue up at a prior meeting, but when people were coming here they could sign off with regards to the side rails etc. Ms. Baker and others didn’t think that was good idea. Mr. Kelly noticed that in the report he read that the first thing they asked was what the policy/procedure is for side rails. Ms. Baker said Hope Creek is completely side rail free now. They went side rail free and alarm free. There are no more alarms. If you get out of your bed, there is nothing to alert staff. They are doing more frequent rounding. They had gotten away with the idea that alarms would be their saving grace. They have people here do that. They are the saving grace. She is changing that culture. Staff was relying on those alarms and that was not appropriate. Those alarms do not prevent you from falling. You are already falling when they go off. You are already potentially injured. You already almost cracked your head open. They don’t do anything and, honestly, they are old. Hope Creek needs to be ahead of the curve. Ms. Baker feels that Hope Creek has been behind the curve in the past. A lot of people like to read the new updates on long term health care and the best way to go about it and try to be more strategic, but the main thing is education.

7) The committee may enter into closed session per 5 ILCS 120/2(c)(21) – Discussion of minutes of meetings lawfully closed under this Act, whether for purposes of approval by the body of the minutes or semi-annual review of the minutes as mandated by Section 2.06

The committee did not enter into closed session.

8) Consider resolution to keep closed session minutes closed

Motion to approve keeping closed session minutes closed: Ginny Shelton

2nd: Rod Simmer

Voice vote

Motion carried

9) Board of Directors member opportunity for brief comments (no decisions will be made)

Ms. Near suggested that as a board, maybe they should go play trivia and support the team. Mr. Johnson said he’s in. Ms. Near noted that January 20th is a Saturday. Ms. Shelton said she will be out of town but she will pay for someone in her place. Ms. Near suggested that maybe their spouses will want to join. They might end up with a couple tables. She’s got a list of eight people she can ask. Mr. Johnson agreed that they should definitely make an effort. Ms. Shelton said she will sponsor someone to play in her spot.

Mr. Hullon asked when the next meeting is. Mr. Johnson said it’s January 8th.

Ms. Near said she has one other thing to mention. Blackhawk College got a grant from the Moline Foundation, a couple of federal grants, and a grant from the city, she thinks, to run a CNA program at the Esperanza House. The program is neighborhood specific. It’s for residents of the Floreciente Neighborhood. The program pays for tuition, books, equipment, uniforms, and is open to a very limited amount of people. They can only take eight students. If anybody knows anybody who lives in that neighborhood, they do have one more opening right now. Ms. Shelton asked if they have asked Workforce Development or JTPA to see if they have anybody. Ms. Near said not yet. She’s just putting it out there. She was approached by the editor from Hola! America and they asked why it wasn’t put in Hola! America, but it is very specific to only that neighborhood. They want to focus on that neighborhood. It’s at the Esperanza House and starts January 8th. They were full. They had eight students signed up but one dropped out.

Mr. Johnson said he hopes everyone has a wonderful Christmas.

Mr. Maranda said he has an update. There’s not much going on with it, but Hope Creek does have a wage opener on the contract this year. He and Mr. Davis met and then met with Ms. Baker, Ms. Frere, and Ms. Gomez to look at how they can have a conversation about this 12 hour shift and with the nurses and possibly the CNAs. It’s a wage opener, but they think they’d like to expand it a little bit. They have not sat at the table yet. He just wanted to give a little update on that. He and Mr. Davis will be touching back with Ms. Baker and Ms. Frere. The big burner right now is the removal of the Vice President of the union. They’ll see how that all shakes out. He will bring back more comments as they progress or Mr. Davis will.

Mr. Simmer noted that he asked one time for the money Hope Creek has had in fines over the last few years. They keep hammering on Hope Creek. He asked for the past five years if they can go back that far. Mr. Maranda noted that the big one is that $129,000 from when Ms. Whittington was here. Mr. Kelly asked if that one got reduced. Mr. Maranda said the last one got reduced. Ms. Shelton said she’d like to see the difference since they’ve changed things with the Board. Mr. Maranda said it’s less than $50,000. The killer was that $129,000. They were getting blistered $5,500 a day and Ms. Whittington couldn’t straighten it out. He doesn’t know any particulars on it.

Mr. Simmer said he’d like to see litigation and what’s hanging out there for possible settlements so they know where they’re at and what is going on. That’s going to be huge. Mr. Maranda explained that it takes so long. That’s no defense of the Litigation Committee. Mr. Simmer said sometimes they drag them out on purpose.

Ms. Shelton asked if the new policy they have at the county has addressed the problem where they have to contact a nurse. Mr. Simmer said they still have two years. Mr. Maranda said they have four years to file too. That can hang it out there forever. That may be a little harder to track. Mr. Simmer asked for just what they know. Mr. Maranda said he will check on that.

Mr. Kelly said he has a comment so the meeting can close on a positive note. He was fortunate enough last week to be invited a birthday party for someone on this board and she was truly surprised. Mr. Kelly wished Ms. Shelton a happy birthday.

Mr. Hullon wished everyone a Merry Christmas and Happy New Year.

10) Adjourn

Motion to adjourn: Michael Kelly

2nd: Rod Simmer

Meeting adjourned by Chair Jessey Hullon at 6:27 p.m.

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