Rock Island Today

Rock Island County Hope Creek Care Center Board of Directors met May 14.

Here is the minutes provided by the Board:

1) Call to order and roll call

Committee members present: Jessey Hullon (via phone), Tim Erno, Michael Kelly, Ginny Shelton, Rod Simmer (arrived at 5:33 p.m.)

Committee members absent: Carol Near

Others present: Kurt Davis, Hayleigh Covella, Lynda Vogt, Rhonda Westmorland, Dewayne Cremeens, Tom Dryg, Bill Gabelmann, John Corelis (incoming member)

2) Approval of the minutes from the April 16, 2018 meeting

Motion to approve: Tim Erno

2nd: Ginny Shelton

Voice vote

Motion carried

3) Public comments

There were no public comments.

4) Marketing update

Ms. Baker provided a handout entitled “What’s Up at Hope Creek.” She explained that Mr. Shuman, the Activities Director, makes these fliers monthly for Hope Creek. The most recent edition tells what’s going on at the end of May and the beginning of June. Ms. Baker noted that some members were asking about the annual yard sale, and that is on the flier. Hope Creek has started to accept donations. Any donations are greatly appreciated. Ms. Baker asked everyone to try not to bring in items that are permeable because things can get into them and soak in They prefer hard surfaces. Ms. Baker noted that she’s not sure what items they’re taking, but Mr. Shuman’s information is on the flier if anyone has questions.

Mr. Simmer is present.

Ms. Baker noted that she’s going to couple her reports on marketing and admissions. Ms. Stiles is not here today, but for the last month, April, she brought in 17 admissions. There were 21 discharges, so there is a difference of four. Hope Creek went down by four in its census. Ms. Baker asked the committee to keep in mind that Hope Creek is decreasing Medicaid and those four are Medicaid. The home is sitting now at 61% Medicaid. Their goal is 45%. She has been networking with some other facilities in the area and they really recommend 30% to keep afloat, so Ms. Baker is working on decreasing that trend for Medicaid.

Ms. Baker noted that along with the census report are the agency costs. With the census, they always have to look at staffing. As everyone is well aware, December through February were terrible months. Since Hope Creek’s employees are part of the union, they do get a lot of people who have vacation time and holidays. The employees have a lot of benefits and Hope Creek has to cover their shifts, especially during the holiday season. Hope Creek was averaging between $100,000-110,000/month for agency costs. In March, that was down to $84,000. April was a very good month at $67,000. Ms. Baker noted that they have taken agency down quite a bit. Since December it’s down $40,000. That’s a good thing.

Ms. Baker reported that for the month of April, Hope Creek collected just under $1 million. In the 120 days plus category, they collected roughly $18,956. The remaining due is $4.4 million.

Ms. Baker referred the committee to the Admissions Packet. She noted that out of the total of 17 admissions, six were Medicare, which is what they are driving now. Since Hope Creek is not part of the ACO, they do have to deny more people than facilities that are part of the ACO because Hope Creek gets the less wanted or less desirable residents. Hope Creek does have to go through them a little more when doing the screening process. Ms. Baker noted that Ms. Stiles did an excellent job with the challenges in front of her. She brought in six Medicare, four managed care (which is Aetna and UHC), two private pays (one respite and one long term), one VA respite, and one VA hospice. The private and VA admissions are still coming in on their own. They did admit two public aid long terms who were on a waiting list. They are not bringing in a whole bunch. They’re thinking one or two a month. They want to let people know that Hope Creek is still here and wants to bring in Medicaid patients, but is being very diligent with the percentages and how they balance the census out.

Ms. Baker noted that she will not go into detail on the ones Hope Creek didn’t take in since Ms. Stiles is not here to speak on them. Six were not admitted because they were medically complex. Ms. Baker noted that she wants to know what the definition of “Medically Complex” is and why Hope Creek didn’t take them. That would be her question for Ms. Stiles if she was here today.

Ms. Baker added that one major concern she has is Hope Creek has a Director of Nursing who put in her resignation. She got offered a job in Des Moines where her family is. She is moving to Des Moines and put in her notice a couple weeks ago. Her last day is June 1. Hope Creek is looking for a D.O.N. with experience. Her job was posted immediately.

Ms. Baker noted that although Ms. Stiles did an amazing job with admissions, it’s just not her niche, so Hope Creek is looking for an Admissions Nurse. Ms. Stiles put in her two weeks’ for that. Ms. Baker noted that they can have her stick in that position longer so they can transition someone into that position appropriately. Ms. Baker has been getting resumes in for both positions. She asked if anyone here knows anyone who is qualified, to please let them know to apply.

Mr. Simmer asked what the rate is for a D.O.N. Ms. Baker said $70,000-80,000 annually. She noted that they would be the D.O.N. for a facility that is built for 245 beds and right now has 210 beds. A lot of facilities in the area are at 75-125 beds. They are taking on big feet when they come to Hope Creek as a D.O.N. Hope Creek really needs the right person who is a go getter with a Type A personality and who is not afraid to get their hands dirty and work extra hours.

Ms. Baker provided a handout for the members to take home and read. She noted that it’s information they should have probably gotten a long time ago regarding admissions and Hope Creek’s rates. Ms. Baker explained that she has been networking a lot with other facilities in the area and seeing what their rates are. She did a comparison analysis and Hope Creek actually charges more than they do for the most part. It depends on what side of the river the home is on and what the star status is. She noticed that facilities on the other side of the river, on the Iowa side, have much higher rates than on the Illinois side. Ms. Baker doesn’t know if that’s a state-to-state thing. Hope Creek actually charges $20 more per day than other facilities in the area. That was very surprising to her. She thought Hope Creek would be below.

Mr. Erno asked what Hope Creek’s veterans amount is and if it is under Medicare. Ms. Baker said they are charged $194/day. Mr. Erno asked if that’s for a semi-private. Ms. Baker said yes and explained that VA does generally cover 100% if Hope Creek has a contract with them.

Mr. Simmer asked why a private room costs less than a semi-private. It’s $219 versus $214. Ms. Baker said those are costs in two separate wings. That’s memory care versus private pay. They are separate units.

Ms. Baker noted that she hopes that information gets the members’ wheels turning a little bit. She would like to do a further analysis with other facilities in the area. They only picked five other homes that are close to Hope Creek and two were not willing to share the information. Her data is based on three facilities.

Ms. Shelton noted that they are not taking as many Medicaid as Hope Creek is. Ms. Baker said that is not true. She knows Rosewood is roughly 60-65% right now. A lot of people are really accepting Medicaid now. All facilities are down with their census. The people who are getting the private pay and Medicare are the people in the ACO that Hope Creek cannot be a part of. That’s the struggle for Hope Creek. Hope Creek has to decide how to bring them in and market them if they have this dark cloud hanging over their heads. Again, she just wants to get some wheels turning.

Mr. Simmer asked what the facility’s cost per day is. It was $256/day two months ago. Last month it was $245. Ms. Baker said she didn’t figure that in there, but she is going to add it to her report because that is something they should compare every month. The actual cost per day, the $246, was summed up for 2018 based off of a report that Hope Creek sends to CMS. Mr. Simmer asked if $246 is a good average. Ms. Baker said yes.

Mr. Hullon asked how many people sit in the interview process for the two positions that are open right now. He asked who is in the group that will sit in the interviewing process to bring these people on board. Ms. Baker explained that they are doing those separately. For the D.O.N., they will have a panel of five individuals, all Department Heads. Ms. Vogt will be one. All the D.O.N.s who are qualified for the position and are coming in to interview will be meeting all the same group. The secondary round of interviews will be with Ms. Baker and she was going to invite Mr. Davis and Ms. Frere, the HR Generalist. Mr. Hullon asked if Ms. Baker would include him in the process, please. Ms. Baker said sure.

Ms. Baker explained that for the Admissions RN, it will be slightly the same scenario but a little bit backwards. Ms. Frere and Ms. Baker will interview them first to see who is qualified and whoever is left over will do a final interview, but she has not chosen that board yet. Mr. Hullon requested to be involved in that process as well. Ms. Baker said okay.

5) Financials

Mr. Dryg provided the committee with the financial statements. He referred the committee to the balance sheet. Mr. Dryg explained that he typically focuses on current assets and current liabilities. Current assets are $4.642 million. That’s $146,000 in cash and receivables of $4.4 million in aging. There is a reserve in there of $1,140,000. That is a pending number. Mr. Dryg explained that they have been discussing an allowance to be developed by the county to include in the audit report. That is why he and Mr. Gabelmann continue to issue their statements as preliminary drafts until the audit is done and they can square that up with the county.

Mr. Dryg reported current liabilities at $5,519,000. Accounts payable includes a $58,000 accrual per month on the county administration charge for the cost allocation payment, or Maximus payment. That was not being done before, so Mr. Dryg noted that when comparing numbers to the prior year, you need to take into consideration that there is about $300,000 more in there than was being accrued for before. Accrued payroll is $229,000. There is $1,675,000 due to other funds. That includes a $175,000 Working Cash Fund loan and a $1,500,000 loan from the Liability Insurance Fund. Hope Creek also has some borrowings against real estate taxes. The facility can take up to 80% of its tax levy, which was $2.6 million this year. $750,000 was drawn against that. Hope Creek is a little heavier on liabilities compared to the year before. Mr. Dryg noted that there is a comparative balance sheet in the back of the packet.

Mr. Simmer noted that between assets of $4.6 million and liabilities of $5.5 million, Hope Creek is down about $900 000. He asked if that is all in. Mr. Dryg said yes, and there’s the current portion due on long term debt in bonds payable. The portion due on December 1 is $665,000. That is considered “current” because it is going to be paid in the next 12 months.

Mr. Dryg turned to the report showing revenues for the month of April. He noted that the items are listed. Total revenue is $1,031,000. Operating expenses by department are $1,125,000. He noted that there is a line there to show operations before any transfers in or out or help from the property tax levy. For the month, that was -$93,741. Mr. Dryg explained that “income from other sources” includes the accrual of 1/12 of the property tax levy. The “other uses” includes the transfers to the General Fund and the bed taxes. The net change in fund balance on an accrual basis for April was $16,000. Mr. Dryg emphasized that is not cash.

The next page shows the cash flow statement, which converts the accrual basis revenue of $16,000 and adds back in the depreciation and the amortization of the bond debt, which is actually a little negative this year because of the way the refunding was done a couple of years ago. In 2016, the county redid its bonds and refunded them to save interest. This year that accrual for amortization of the bond premium or discount looks a little different because it’s going a different way than you might expect. Mr. Dryg noted that this report is basically taking out accruals for things accrued in current assets, things accrued for in current liabilities, payables, and others. The report shows operating cash provided $140,000 for April. It started the month in the negative.

Mr. Dryg explained, to recap April, cash started overdrawn by $90,000. Hope Creek collected $1,165,000. Of that, $215,000 was the intergovernmental transfer (IGT) that comes once a quarter. It’s hard to predict what that is going to be. He accrues for it in the statements at about $180,000. It came in at $215,000.

Mr. Simmer asked where that IGT comes from. Mr. Dryg said it’s from the state of Illinois. Mr. Simmer asked if it’s a reimbursement for Medicaid. Mr. Dryg explained that it’s an allocation from the feds, he thinks, because the state has a Medicaid program. As a Medicaid provider, Hope Creek gets a portion of that.

Mr. Dryg continued that $950,000 was collected against receivables this month. It was a good month. Payroll was $745,000 cash out the door. Vendors were $183,000 cash out the door. The ending balance is $146,000, which agrees with the balance sheet. Mr. Dryg noted that since the end of the month, there have been additional collections. As of Friday, the balance was $449,000, so Hope Creek is sitting in a good position to cover its current needs.

Mr. Simmer asked if $449,000 covers payroll and everything. He noted that payroll is at $370,000 and asked how much Hope Creek is in debt to vendors. Mr. Dryg said $1.4 million and $300,000 to the county.

Mr. Dryg referred the committee to the comparison to the prior year. Revenue was $6.1 million a year ago. It’s at $5.041 million through five months of this year. Operating expenses were $6.3 million last year. They are at $5.7 million this year. So revenues are down and expenses are down, but expenses are not down as much as revenue. Hope Creek is generating losses quicker this year than last year. The nursing home levy is a little more. They did increase that levy due to assessments and increases in property values. The bed tax is a little less due to census reductions. Transfers in and interest expenses are about the same. Mr. Dryg noted that this is kind of an off year on the bond interest because of the refunding that was done in 2016.

Mr. Simmer asked if those numbers are to date. Mr. Dryg said yes. Mr. Simmer asked if they include outstanding. Mr. Dryg said they include outstanding. It’s accrual, so if Hope Creek incurred an expense, it’s in there. If Hope Creek billed for revenue, it is included even if it is not collected.

Ms. Baker asked if the bed taxes count the actual census of who is in a bed or if it is based on the 245 beds. Mr. Dryg said that is based on census. The old bed tax is $13,000/month and is static based on the beds Hope Creek is licensed for. The new bed tax is $6.07/bed and is based on non-Medicare beds. It’s the total census day minus the Medicare census. On the remaining beds, Hope Creek pays $6.07/day. That runs around $32,000/month.

Mr. Dryg noted that Mr. Gabelmann is going to talk about the cash flow projection, which is a planning tool for the cash balance. Mr. Gabelmann noted that as Mr. Dryg and Ms. Baker mentioned, April was a good cash flow month. There was $950,000-960,000 collected on just patient receivables. For comparison, February’s patient collections were $678,000 and in March they were $886,000. April jumped up to $965,000. That’s a good month. Throwing in that $215,000 of IGT, total collections for April were about $1.165 million. April ended up bringing forward a positive cash balance compared to the prior months and ended up the month with $146,000 in the bank. As of last Friday, that was up to $449,000, which will at least cover the first payroll of the month.

Mr. Gabelmann noted that January through April in particular are always poor cash flow months for the home. Vendor payments have been a little less. But as Ms. Baker referred to, that’s huge when you talk about dropping agency costs from $100,000 down to $67,000. To put that into perspective, $33,000/month doesn’t sound like a lot when you’re talking about $1 million in operating, but putting that into perspective for a year, it’s just about $400,000/year of cost savings if it can be maintained. Mr. Erno said, “Can we get that on the news?”

Mr. Gabelmann noted that cash flow came back up last month. The IGT came in on the third or fourth of April.

Mr. Gabelmann explained that the cash projection sheet starts with an April 30th cash balance of $146,000. In there, they anticipate approximately $900,000 per month in cash receipts. The last three months, even with a really bad February and March, the average is $840,000 per month. It’s sneaking up. It will not be that hard to get back to that $900,000 with a couple of good collection months. The overall average was $920,000 per month including the IGT, so the possibility is coming.

As Mr. Dryg mentioned, on an accrual basis Hope Creek actually broke even last month in April. The facility has $750,000 borrowed on the tax anticipation warrant and $1.65 million borrowed against county funds. He imagines the county will probably pull back that $175,000, which was short term cash coverage. Ms. Ewert has really been moving that back and forth as it’s available and as it’s needed.

Mr. Gabelmann explained that the cash flow projection is showing a couple things. Right now with the tax levy starting to come in next month in June, May is still going to be a tough cash flow month based on the projections. The projection is anticipating that every vendor dollar is going to get paid and maintain and start reducing down with $325,000/month being paid back. By comparison, in April $182,000 was paid back to vendors. This takes that back up to $335,000. If that level of activity goes, the interest payment is due at the end of the month of $286,000. That depends on the timing of another IGT payment. That was actually late coming in for March and didn’t hit until April. Theoretically and realistically, the IGT gets paid every three months. If it comes in on time, Hope Creek may be able to roll out of May not having to borrow any more quick funds. There is still $1.5 million available on the tax anticipation warrant. Based on some emails he has seen from Ms. Ewert, she is basically sitting on that and trying not to draw it in order to cover the bond payments.

Mr. Gabelmann explained that this projection indicates that if the cash flow stays approximately based on the estimate, which does not show any repayments of debt right now, Hope Creek is going to get to the repayment of the bond without any more borrowing theoretically. That is a projection. Realistically, 80% of the property tax proceeds are earmarked for payment of tax anticipation warrants, which right now only total $750,000. That doesn’t get the county repaid and he knows the county wants to get repaid also. It is still going to be tough going.

Mr. Gabelmann noted that he believes next month when the property tax starts coming in, there will be less pressure relative to vendors. Hope Creek will pay back the county on the emergency cash flow ones and probably the county will be receiving their tax receipts also. For the next several months, which is always the case in the summer, everyone can hopefully take a little breath after they get through May. May is still going to be a close situation. He’s not sure, but they could also have another big month of collections very easily. What’s interesting is it seems like they go up and then down and then up. He also knows there were some collections on some of the ones that were turned over for collection. Ms. Baker noted that they were big ones. There was a $60,000 house sale, then a $10,000-20,000 one. Ms. Helms was hollering in the hallway earlier about $160,000 on something. Ms. Baker asked if anyone knew what that was. No one did.

Mr. Gabelmann explained that the next several months are looking comfortable based on the projections. He noted that all it takes is one big payment not to come in and it can go the other way. Just like the IGT coming in April at $215,000 when Hope Creek was expecting approximately $190,000. An extra $25,000 does go a long way. A $33,000 reduction in agency fees goes a long way. Those are the types of positives the committee can take away today.

Mr. Simmer noted that the projection is worked out back to October. He asked when Mr. Gabelmann sees Hope Creek getting back on the tax anticipation warrant. Mr. Gabelmann explained that there is a reduced bond payment this year, once that’s made in November. Just like this year, January through April is when cash flow typically goes downhill. That’s just unusual relative to part of what Cassie referred to: a lot of costs are higher because of the benefits. All the holidays the employees get an opportunity to take time off have to be covered, so agency costs go way up. The other side is honestly showing a fairly even cash flow relative to the receipts, but this is anticipating very steady $900,000 collections per month. As long as he and Mr. Dryg have been doing this work, January through March payments just don’t come in. He thinks when everybody gets through December 31 and gets everything taken care of, then you get the holidays and claims are not processed, etc. That’s his guess is for what happens: people back off a little bit.

Mr. Simmer noted that some of them in January, February, and March in his office are deductibles owed on private care that people have to pay themselves. He asked if Hope Creek has deductibles they have to work with as far as insurance. He noted that some of it in his office is deductibles owed. Mr. Gabelmann said that’s a good point. Ms. Shelton noted that after the holidays, people are a little short. Mr. Simmer agreed that they’re short, so they push that off.

Mr. Gabelmann explained that Ms. Ewert has very cautiously been maintaining the availability of the tax anticipation warrants to get there. Depending on where everything else goes, it appears based on the projections that it’s going to be covered without having to do much more, if any. Quite realistically based on the projection, Hope Creek is paying down some debt. Just like the last two or three years, at the end of the year money moves around. The tax anticipation warrant expires. Hope Creek will use short term loans to get through it and then borrows back on the tax anticipation warrant.

Mr. Hullon asked where Hope Creek is at on payables and if it’s still 90 days out. Mr. Dryg said yeah. Mr. Hullon asked if it’s any worse than 90. Mr. Dryg said yes, probably.

6) Finalize bad debt recommendation for County Board

Mr. Davis noted that the committee has talked about the bad debt relief and about writing off the bad debt and started a conversation with Ms. Luecke and Mr. Hullon. Mr. Davis asked to work with Mr. Hullon some more on the resolution. He asked if Mr. Hullon minds if they work on the resolution so they can bring it to the County Board for approval. Mr. Hullon said absolutely, but he thought that last time he talked to Mr. Davis or Mr. Maranda this thing was already in the works. Mr. Davis said it was in the works. There are some questions they wanted to run by Mr. Hullon on the information that Ms. Luecke gave them. He noted that they’re still looking at the amounts that Hope Creek is trying to relieve. He noted that they were looking at like $150 or less being written off and anything prior to 2015, but they need to get together and write up the actual resolution to bring to County Board. Mr. Hullon said he’ll be back in his office on Monday and asked Mr. Davis to call him. He will carve time out to get that done. He noted that they’ve got to get Mr. Dryg involved in this too because he’s carrying on the books a certain number as well. They should come pretty close to that so his books look good. He asked Mr. Dryg if that’s correct. Mr. Dryg said yes. Mr. Hullon asked Mr. Davis to call him on Monday and set up a time. He will make time to go through this and get Mr. Dryg involved because they are going to have to do this. Mr. Davis agreed.

Mr. Hullon noted that he met with Mary from L&M about some of these great collections that L&M has gotten some people to pay Hope Creek. Mr. Hullon very strongly believes that once Hope Creek gets rid of what he has been classifying as dead money, they are going to get some alive money out of this dead money.

Mr. Gabelmann mentioned that not only is the allowance on the Hope Creek financials, but as Mr. Dryg referred to, one of the things they want to snuff up to is what the county put on their books for Hope Creek also. Mr. Hullon said that’s what he meant. He wants to make sure that once they do this, everybody’s books look the same. Mr. Davis said he wants to work on the resolution to take care of the bad debt and on procedures afterward so they don’t have to go back to County Board. Mr. Hullon said absolutely.

Mr. Hullon asked where things are with the negotiations with the union as far as coming up with 12-hour shifts. He noted that this conversation has been going on for five months now. This is the way they have to go. He asked why there is a hold up here. Mr. Davis explained that since that time, they have crunched new numbers and it doesn’t seem as beneficial as was originally believed. It could be a detriment if Hope Creek went with 12 hour shifts because the facility might lose staff. They have decided to drop that for now. Ms. Baker added that when they were first crunching the numbers, Hope Creek had a lot more nurses. When you lose about 10 nurses in the last year, that makes a big difference and going from the eight hour to 12 hour shifts doesn’t make sense at the end of the day. Hope Creek has lost too many nurses for it to actually make an impact when it could have made an impact.

Mr. Hullon asked where things are with the union and if there is any kind of union contract on the books. Mr. Davis said they have completed negotiations and are waiting for the union to ratify the agreement. Ms. Westmorland noted that the union ratified last week and is waiting for the county. Mr. Davis asked if that went to County Board. Ms. Covella noted that Mr. Maranda didn’t have the union-ratified contract as of committee week. Mr. Simmer agreed that Mr. Maranda was saying last week that he didn’t have it yet.

Mr. Davis said he will get ahold of Mr. Hullon next week and schedule a meeting. Mr. Hullon said the sooner the better.

7) Update on IDPH

Ms. Baker noted that she misspoke last time when she said Hope Creek received nine deficiencies. They actually received 10 for the annual survey. Ms. Baker explained for the new faces in the room that Hope Creek had 10 deficiencies. Out of the 10, eight were on nursing. For the other two, one was in dietary for a dirty microwave. Another was for the call lights not staying attached to the beds. Hope Creek had to purchase new clips to make sure those stay on the beds. A call light was found on the floor. It’s a little difficult to ask for help if your call light is on the floor. They did purchase new clips. Those two were the higher level tags. The highest level of tag Hope Creek could potentially receive a fine for is the dirty microwave just because it was in the dietary area and it gets used for all residents, so it’s widespread. All the other issues were just individual concerns that the state had.

Ms. Baker noted that a good thing she will brag about is that this was a federal survey on top of the state. She has never been through a federal survey and has heard they are atrocious. On average, they give about 20 tags. For Hope Creek to only receive 10, she gives huge kudos to the team, nursing staff, dietary, and staff across the board. They did an excellent job. Especially after the last couple of years of surveys Hope Creek has had, they deserve to have a good one for a change and they plan on continuing to have them. Mr. Kelly asked Ms. Baker to extend the Board’s congratulations to the staff. Ms. Shelton said to keep up the good work.

Mr. Simmer asked if the microwave is in a place where the residents can use it too. Ms. Baker said no. They said it was filthy, but there were a couple splashes. Someone didn’t put a cover over soup. Hope Creek’s Plan of Correction has been accepted for both the Life Safety and Nursing surveys. That plan is in action now. Each week staff turns in reports to her and they do audits. They are correcting the errors they have. It’s going smoothly. Ms. Vogt confirmed that the plan of correction has gone well. Everyone has done their part to bring their information for the audit. It doesn’t look like Hope Creek will have a revisit.

Ms. Baker noted that Hope Creek is also revising the entire policy manual. That was due. Ms. Vogt is meeting with Department Heads every week or every other week to go through the policies and change them up. That is definitely needed.

Ms. Shelton asked why Hope Creek is losing nurses. She asked if they are going to other places. Ms. Baker said that’s a loaded question. Ms. Vogt said baby boomers are retiring and the nurses coming out want to go into hospital settings. Ms. Baker added that overall, Hope Creek doesn’t have a good reputation right now. She thinks that’s really what is scaring people, especially when they have people saying the facility could potentially close down. They know the truth behind it, but when it’s put in the newspaper when someone shoots from the hip and says it, all the nurses hear that. When you see that a place could potentially close down, you think, “Well I’m not going to go work for the county even if they do have excellent benefits because I can’t be vested. What’s my time worth there if they are going to close down anyway?” Ms. Baker thinks that in order to get nurses, Hope Creek will have to have a complete culture change. That’s not just for people on the side of Hope Creek, but for everybody. If Hope Creek is going to be around, Ms. Baker said let’s do it justice and get it out there in the right manner. It is going to take some time for people to see the good that Hope Creek has to offer.

Ms. Baker noted that she and Mr. Davis spoke about this earlier, but before she came to Hope Creek, she hadn’t been to a lot of long-term care facilities. Since then, she has. In the last three years, she has seen the cleanliness of Hope Creek, the quality of care, the employees, the teamwork, and the dedication Hope Creek has here. Yeah, Hope Creek has a lot of rocky times but if you look at any other facility, so have they. Hope Creek just gets put on blast. They have to find the good in the things they are doing and put that out there more.

Ms. Shelton noted that is because Hope Creek involves taxpayer money. She noted that she has been to a lot of nursing homes too. Mr. Kelly agreed that Hope Creek has a higher degree of transparency than any other facility on this side of the river. Mr. Erno said it’s really hurting the facility. Mr. Hullon said that’s because Hope Creek is county owned.

Mr. Erno asked if that’s why the numbers could be dropping. Ms. Baker explained that everybody’s numbers are struggling, but on paper Hope Creek is staying decently even with its admissions and discharges. She asked the committee to keep in mind that the facility is not taking as many Medicaid patients and is making more money. While they are not seeing big changes in numbers, they are getting private pays and Medicares. They should start worrying when they don’t get any Medicares or can’t get those private pays. Ms. Baker asked, “Do we want more than that?” and said yes. She knows of a facility in Iowa that gets 90 skilled stays per month and rotates them out. That’s just how things are set up. That facility doesn’t have memory care and has a very small long term care setting side. Ms. Baker noted that they need to compare Hope Creek’s definition and how that’s going to keep the facility alive. There needs to be a lot of conversations coming up about how the home is structurally built and how to move things around to help make money. There are a lot of ideas on the table, it’s just about when and how to present them.

Mr. Kelly explained that in this community, the “blue sky” as a lot of this is called is not being discussed. The turbulent waters, as if they were unique to Hope Creek (which they aren’t), are being discussed. That’s because the other facilities that are private aren’t as forthcoming as the taxpayers in this fishbowl the county operates here. Ms. Shelton said they are not looked at as closely. Mr. Kelly agreed.

Ms. Baker noted, to leave on a good note, that in the last couple of weeks a lot of individuals within Hope Creek and the county have put out a lot of assistance and new ideas. They are willing and wanting to help. Some were reluctant to share their names just because of the positions they are in, but it’s a good thing that they are reaching out. That tells her that people care. She thanked everybody who is part of that and thanked the members for being on the Advisory Board. It means the world to everyone at Hope Creek.

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

Mr. Simmer said to keep doing what they’re doing. Hopefully Hope Creek will have more good months. It will take some time to even things up. Ms. Baker said it will take time and tenacity. That’s what she keeps telling everybody.

Mr. Erno thanked the staff for their hard work. He took a tour of the facility today for the first time and it is beautiful. He has been to some nursing homes that aren’t even a quarter of what this nursing home is. Hope Creek is a credit to the county. He appreciates everything everyone is doing and said thank you for letting him be on the board.

Mr. Simmer said he has been to a number of different homes, too, and one thing he has noticed with Hope Creek is that you can walk down the halls and don’t smell urine. That’s the number one thing when you walk into homes. It is nice not to have that. That lets you know Hope Creek takes care of people. He said that’s so tacky. They all get to that point. One day he’ll be drooling on himself too; he gets it. He said, “Let’s keep them clean and dignified.” He thinks Hope Creek does a good job with that. It’s nice when the family walks in and isn’t going, “Ugh. My God.” Ms. Shelton agreed that there are some places where you walk in and want to turn around and leave. Mr. Erno added that when you look at the residents here, they are not miserable. They are happy. He talked to a bunch of residents in the hallway. They were sweet and you can tell they are cared for. This is very positive and they have to get the word out. All they get is negative for Hope Creek. Ms. Shelton asked how to do that. Mr. Erno said he walked back and saw smiling faces and the beautiful courtyard people don’t know anything about. It’s a beautiful facility. Instead of having John David talking in front of the home about how bad the facility is and how people are not going to be able to eat. Mr. Erno said maybe they should be on the news saying, “Look what we have and what we are doing for the taxpayers and veterans of this county. People deserve this place and they are getting great care.” He thanked the staff for everything they are doing.

Ms. Shelton asked what they can do to bring the public in so they can see what a fine facility Hope Creek is. She asked if they could have a grand open house or, because she is fundraiser conscious, if they could host an annual fundraiser for Hope Creek. They could bring in the churches and everybody. She thinks it would start out slow, but she thinks they could build it through the years. They’ve got to bring the whole community in and make them feel part of it. It’s their nursing home. Mr. Davis said that’s a great idea and asked if Hope Creek has an open house for the public. Ms. Baker said they have quite a few. They have marketing on a daily basis with Ms. Kettler. She can bring details about the last time they had one and when the next one is coming up. They have a lot of different aspects of the community coming in. It just depends on what the event or marketing thing is. They are working on doing more of a quarterly fundraiser too, like the trivia night coming up this year. They also want to have a Glow Run/Walk and a couple other ideas that they are tossing around for more fundraisers to get the community a little bit more involved. She has also talked about potentially collaborating with United Township or Moline High and having the Athlete of the Month pair up with one of the Residents of the Month for whatever reasons. Ms. Baker noted that it doesn’t have to be “of the month,” but they want to get the younger community involved with the older community and have Hope Creek be a spokesperson for that.

Mr. Kelly asked if someone can please extend to the union and union members the board’s support for their hard work. He asked if Ms. Baker will say the same thing for the Administration here, such as Ms. Vogt and the people who work in Administration. He said he hopes those two are working well together. There are lots of good things coming down the road. Mr. Shuman is doing a great job with all the social services and events he has going on. Constantly there is something. Mr. Kelly noted that the Cubs didn’t win today, but they did have Hope Creek on the ads. Ms. Shelton noted that she likes that ad. Mr. Kelly said that it’s well done. He is glad to see it up and running again and that it’s running through baseball season, he thinks Ms. Kettler said last session.

Ms. Baker noted that Ms. Kettler was not able to make the meeting today but will be here next time. Mr. Kelly said he hopes Mr. Corelis joins them next month. Tomorrow evening is the County Board meeting. Mr. Cremeens, Ms. Shelton, and Mr. Simmer will be there. He thanked Mr. Gabelmann, Mr. Dryg, Mr. Davis, and Mr. Cremeens for being here.

9) Adjourn

Meeting adjourned at 6:28 p.m. by member Michael Kelly.

Motion to adjourn: Rod Simmer

2nd: Ginny Shelton, Tim Erno

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