Persistance and Tenacity, requires a new chapter, a new beginning....

Thursday, July 29, 2010

It's time again for the KVHD "Finance Commit me" meeting, Wed. Aug. 26

It's time once again to look over the financial condition of the Kern Valley Healthcare District. We remember from last month that our pharmacy is on COD with the vendors and we are all to call first if we require any "unusual" medicine.

Strangely, though, Rite Aid pharmacy and the Drug Store in Kernville are able to make ends meat with their drug dispensaries, in fact, Rite Aid says the pharmacy carries the whole store.

What's the matter with our pharmacy, who is milking that cash cow?

So, I'm thinking tonight about how to cut the budget at the hospital and not short staff ourselves.

I've come up with a few ideas which could bring in a little dough.

Number one: Does a small hospital such as ours really need to have a full time chief financial officer?

We currently pay our CFO, Mr. Beedle, full time salary at or about 115,000. He also gets housing paid as he lives out of town. What if he goes Part time? There's almost $50K right there.

Then we have another potential money saver, why don't we change our contract with our hospital surgeon where he is paid per surgery or procedure or some other modification? He's a great surgeon, I admit, but can we really afford to pay him the money he's been getting? And the surgical nurses, can we cut back there too? Maybe put them on a Per Diem basis?

How can we get back on track with the pharmacy? At the last board meeting we were told in no uncertain terms there was nothing we could do about our pharmacy situation. Maybe we should ask the other pharmacies how they do it. Knowledge is power.

Mr. Beedle said we began losing money when the government made changes to Medicare Part D. Without elaboration, I asked Rite Aide if that was a problem for them, and they said no. I'll have to ask more about this at the meeting.

And certainly any of you with questions about the pharmacy or other financial issues should remember to stop by at the meeting, Wednesday, Aug. 26, at 9 am, in the trailer.

Since our surgery department is less a department and more of a loser at this point, why not gut the staff there until the time comes that the surgery actually does surgeries and not just endoscopy's.

Now there was this creation of a cardiac department where billing from pulmonary, who does EKG's, is moved into the cardiac department. I'm not sure exactly why this is, so yes, I will ask.

I spoke with Sharon Brucker, about a quality issue earlier this year, where there were used syringes on the ground, one was stepped on by someone with me at the hospital. I asked Mrs. Brucker what title she holds at the hospital now that she is no longer the Chief Nursing Officer.

Some of your commentary sounds like Administrative concerns but included in my title is as follows: Utilization Review(Case Management), Quality Improvement and Cardiology. My role as Quality Improvement centers around Quality Indicators set up for departments in the hospital. Each department decides on areas they will work on annually, of this could include quality assurance items (maintaining) or areas of improvement. I assist departments in collecting data and making sure reports are timely and sent to the appropriate committees. Administration has recently selected a Risk Manager, (I'll have to find out who that is too) who falls under Sherry Deppermann. Quality is everyone's responsibility.
There is no alotted time for a report coming from Quality in normal Board meetings. I can tell you that quality issues go to the Board through the meeting called the Med Quality committee. Two board members sit at this meeting.
Often I find myself as a facilitator for concerns. I certainly do not have any power to change policy but am able to make suggestions for change.

I also oversee the very small area -Cardiology. Currently we do echocardiograms and an occasional Stress Test. We currently only have a Cardiologist available on certain days, making it difficult to expand. But we do provide a service for the community. Cardiology does provide a positive cash flow for the District.
Sharon Brucker RN
QI
Now, I'm still not sure what Mrs. Brucker does, and what experience she has in this type of area, but it sounds like maybe we could do more of this melding of personnel.

At the last board meeting, new CCO, chief clinical officer, Cynthia Burciaga, told us that they were looking for "flexible" staff who could work in several areas as needed.

So, first we begin cutting, and I'm hoping that we have gone over all the contracts currently with the hospital to see if we can renegotiate or cancel anything that may not suit us anymore. Remember we paid $60K to a public relations firm, and I would like someone to quantify for me how that contract helped us.
(I'm going to hang out around outside the hospital, because money keeps getting thrown out the window, I could make a good living just on the waste from the hospital.)

Once we make the cuts, the choicest ones come from the top layer, cutting CNA or phlebotomy is pennies, we need to cut dollars.

And finally, how can we make money like they do at the darn thrift store? They're rolling in it.
I've never seen a hospital which relies so heavily on an auxiliary thrift store and not a pharmacy. But I guess using volunteers to make money is cheaper than paying for employees.

The auxiliary and the hospital foundation, have purchased equipment and many things to upgrade the hospital. Without them, I don't think this hospital would still be up and running (running is an exaggeration, let's say crawling).

We need an overhaul here. I still think a forensic audit is in order. And an audit committee would be a good start.

The CFO told me during one finance meeting that they don't need an audit committee because they have the finance committee meeting. If you haven't attended one of these you need to come and see for yourself. There's little or no open talk about solutions to problems, and it seems to be just more of a report.

Come on we need to bring in the public and talk about these problems. One member of the audience at last month's meeting said, we need to bring back the hospital breakfasts inviting "the movers and shakers" from the valley. I agree.

KVHD CFO Chet Beedle says Sycamore Asset Mgt. ran up costs in SNF

I remember when my 93 year-old grandfather had a problem with his water heater, or as he called it, raised in Brooklyn, the “burler” (boiler).
He called and left messages with me, but didn’t realize I was out of town.
So, he let the problem go all week until the weekend came and he had to call somebody.

He saw an ad on TV and out came a certain plumbing company on a Sunday with an elderly gentleman all alone.

When I got home Grampa chewed me out for, I guess, going out of town. I went to his house and found the water heater changed out and a bill for $1700.

The average price to install a water heater outside in a closet, was about $500. On a Sunday, maybe $700. (Which is what I sent the company after I stopped payment on my Grampa’s check.)

But two things occurred that day, the first was that there was an emergency situation that could have been caught during the week before it escalated which caused him to have to make a hasty decision.

The second part was the lack of checking out who was being hired to do the job and the price. Grampa accepted the price and just told them to do the job.

But my Grampa was an average guy, not a CEO, CNO, CFO or a specially equipped with ultimate knowledge, KVHD board member.

There is certainly correlation between this story and the situation which took place at the hospital.

When the skilled nursing facility sprung a leak in 2006,(Yes, let’s just continue with the plumbing analogy) many people knew about it. Employees told administration and the board of directors.

With an old, out of date, plumbing system that had been passed by the department of health services and CMS for years without proper direction and education, the nursing facility was flooding.

The CEO and top officials simply shut the doors trying to keep the deluge back.

When the water eventually spilled out, with employees caught in the current, the hospital administration and board began blaming everyone but themselves. (just like my Grampa)

Eventually, with the hospital SNF on the verge of being closed, it was now an emergency. The whole hospital falls if the SNF goes down.

So, what did these bright, credentialed, professionals do different than the ancient patriarch of my family?

Nothing.

They let the problems go just like he did. And made a very hasty decision because of it.

Who you gonna call?

KVHD didn’t have to call anybody, the bat signal went up in the Bakerfield Californian newspaper that the hospital SNF would be closing, they were again in Immediate jeopardy. And that's all it took to attract the ants to the picnic.

Enter the new management company lauded with praise by former CEO ya later, Pam Ott; The saviors of KVHD, "Sycamore Asset Management."

The price? Why they would pay any price at that point to keep the water heater or I mean SNF running. And the management company knew this.

Even more importantly, this management company knew they would make money by helping the SNF or they would still make money by closing it (maybe even more). Yes, the company will help come in and close down a facility too.

From the contract: “ B,2,(c)…KVHD further understands and acknowledges that, in the event the SNF unit of KVHD be placed into temporary management or receivership by DHS services or CMS, Sycamore and/or its officers, directors, agents, employees and attorneys may be requested to either serve in such capacity or assist in carrying out the functions.”

Now, let us take a look at the baseline charges this company, who are long since gone, probably out enjoying the million plus bucks they made in a matter of months, during 2007.
(Gosh, my Grampa is looking smarter to me right now.)

Hourly rates:
Sycamore $245 per hour (reduced from $285)
Pharmacy consultant $100 per hour reduced from $245
RN’s, RD’s, Social, work staff $100 per hour
Staff nurses $85 per hour
LVN $50 per hour
Medical Records $50 per hour
Administrative assistants $40 per hour
Legal counsel $425 per hour

Costs: KVHD shall reimburse Sycamore and its representatives for costs expended in carrying out the obligations under this agreement, including but not limited to, food, lodging, travel and such other expenses as may be reasonably incurred.


Now I’ve seen many of the hospital financial projections done by the CFO; what exactly did he project here? And why when he read off the traveling nursing figures at the last board meeting did he blame Sycamore Mgt.? He could see where the numbers were leading.

But time had been wasted and I imagine we will hear the same excuse again, they had no other choice. And whose fault is that?

This agreement was signed by Pam Ott and Bradley Armstrong in May 2007.
(Ironically enough, Mr. Armstrong still sits on the board, but has become quite a penny pincher. I guess after you sign off all of the hospitals money, you don’t have much left to spend. So, watch out community I estimate they will try to borrow from us soon in the form of a general obligation bond. It will be either the seismic issue or to keep the hospital running. Or they will try to make the cuts in the hospital that have always lead to good things, like short staffing and improper systems of care. What dazzling ideas will we see next?)

More to follow…

It's what they didn't say at the Kern Valley Healthcare Board of Directors meeting...Dec. 2009 updated

Update:Why would I, a simple minded reporter type, know the troubles to come before the Kern valley healthcare district financial officer...I eerily predict the future, which is now...Aug. 2010

Can anyone spare a dime?

I was in our local market just before the holiday weekend, and some friends of mine were having trouble getting together all the money they needed to buy dog food and cat food, and something for them too.

Standing across in another line, I asked if they needed some extra cash. A tiny, elderly woman was next to me, couldn't have been a day under 100, and she said, " do they need some money, I have a little left over from this month."

What an shining example of generosity and kindness. Someone with little willing to share it without being asked.

This should be our example of how we all behave towards each other during these difficult economic times.

And the Kern Valley Healthcare District could use a lesson from this woman as the district and hospital itself were funded and built, under the Hill Burton Act, to serve our rural community.

Though I showed up late for the meeting last night, as I'm still grieving the death of our best dog, it was apparent that things are urgent and dire, as the two most important items were pulled from the agenda: The Mt. Mesa Clinical Pharmacy report and discussion regarding a potential general obligation bond.

Where do we stand with the pharmacy?

Well, we didn't find out last night what our latest figures tell us about the future of the retail pharmacy.

It's likely we will not see much action until the beginning of next year as December is a full month of holidays and vacations.

With the pharmacy and it's staff up in the air for at least another month, I suggest that we now bring back the business before it's too late.

No matter what the hospital decides to do, it's happening slowly, and not so surely, and that is where the community needs to step in: step in the doors of the pharmacy and get their prescriptions.

I'd like to thank Mt. Mesa Clinical Pharmacy for getting my medication ten minutes before closing, the day before Thanksgiving. What a relief not having to drive around the lake or out of town, which happened just recently and will happen again.

Though the staff was busy, they managed to keep filling prescriptions up until closing time, even with the computers down creating the daily report.

A credit card to save the pharmacy

American Express to the rescue, as the district with no credit, managed to get an American Express card to help pay for such things as: pharmaceuticals and supplies.

But only to the the tune of 92K, which won't go very far. Now the card will remit back a 1% pat on the back fee for paying the card within 30 days; then there's an interest charge after that which starts at 2.99, (nice) but, boo hoo, if you don't pay after 90 days as the card will self destruct in Chet Beedle's pocket.

So, the board voted unanimously to get a credit card, it was something they all could agree upon.
Why did they agree?

If your business had less than a day of cash on hand, you would look at that credit card offer in a different way wouldn't you? And that's why the board members, looking embarrassed, voted unanimously to get an American Express card.

General obligation bond beats bankruptcy

If we could somehow manage to convince this community that this hospital and it's services are worth the extra property taxes necessary to keep the district afloat during these turbulent times it still would be driven by the same people and ineffective systems that caused the downfall in the first place.
(I said difficult times because the previous hospital administration decided to eat up all the reserves and even feed it to their friend, who we will now call, "Planes, trains, automobiles and free lunches." Before that they basically handed over millions to a company who "attempted" to rectify the situation in the nursing center.)

In the meantime, the idea that a general obligation bond would be a solution is pretty far fetched, as well as being more than a year plus off before any of that money, were it a reachable goal, was paid to the district.

Currently, the financial situation is such that we need immediate action. We cannot wait on a tentative general obligation bond, and the amount we would need could reach 50 million dollars. This community does not have the real estate base to handle that sum.
(New information July 28, 2010, there is a second GOB or property tax bond necessary. Video upcoming)

Paying off the old debt which built half a nursing center, a nice OR, a cafeteria, would cost almost 40 million dollars. How could we put that on the community's shoulder's Brad Armstrong, board member, who was there twenty years ago when he and his board buried the hospital in debt and inept leadership in regards to the construction?

Mr. Armstrong voted last night for a credit card. (Boy it's rough out there, eh, Brad? It used to be you could get millions and throw it into the wind without a squeek from the community. New day, new game, old timer.)

We need help

The truth is this district is on the brink of bankruptcy maybe even more so now than ten years ago when we faced a financial crisis, or more like tidal wave.

Most of us don't want to have to go that route as it does not always save the day and is risky.

But if it's the only way to save the district, then it must be done.

It seems Mr. Beedle, our Cheif Financial Officer, back in February was not agreeable to speaking with the office of Cal Mtg., the state office which insures our revenue bonds from 1986 and 1989, which put 22 million in the KVHD coffers, and who knows how much more into the supporting cast from the Office of Statewide Healthcare Planning and Development.

(The Cal Mtg. Proposal: see post)
The idea came about as Mr. Beedle told us in Feb. 2009 that the bond payments to Cal Mtg. were tentative at best and we would have to use money from the bond reserve to pay them.

And if you don't think Cal Mtg. has not already heard about these problems, then you don't know what kind of creditor we are dealing with.

Pamela Ott, as we will recall, had some interesting credentials, yet somehow made it to the top as CEO. She is now charged in the KVHD elder abuse case, and the amount of money this has cost the district can be attributed to Ott's leadership and her followers, Bob Jamison, Brad Armstrong, and Barbara Casas (former board member, part of "the sticky three.")

Between Cal Mtg. and Pamela Ott, and the super job done by the Department of Health Services, we can thank them all for the position we are in right now.

But let's not stop the thank you's there, we have a financial officer who has continually kept the truth, the figures we need to see, out of sight. Explanations are lengthy and not meant to be understood.

And, Mr. Beedle, broke up a potential negotiation with Cal Mtg. earlier in the year, with the excuse we were making our state debt insurer's angry. If they don't want bankruptcy, then why not try to negotiate to defer payments until the situation can be rectified with a new financial leader?

Let's start with a reorganization plan within the hospital itself, immediately, and bring on new blood and new calculators to get this thing started before Cal Mtg. brings in Casey again, or something like that.

To avoid bankruptcy, there is no other way, than to replace the financial leadership currently at the hospital. If that is not done pronto, then I predict the spector of Cal Mtg. will be upon us early next year.

My question is: why has this not been done already? Why does it take so long to catch the problem and then have to utilize a last ditch solution?

Finally, the woman at the grocery story who was willing to help a family and their pets with a few bucks, should be a model of what the leadership at KVHD should be doing: showing compassion.

Employees who have worked the district for ten or more years have seen their benefits dissappear, their retirement taken away, their tenure become meaningless: but the administrators have given up NOTHING.

I'm going to find that woman and send her your way, Bob Jamison, Chet Beedle, Brad Armstrong, amongst others, and you can tell her she's wrong to try and help out others in need.

Our hospital is need, can we get some help?

What will we do now?
(I'll leave it at that until the next post)

KVHD April 1, 2009 board meeting

The juggernaut of truth rolled into the KVHD cafeteria Wednesday evening, April 1, removing roadblocks of information while illuminating the failure of the board to follow its own policies and procedures to stop the reign of mismanagement as well as flagrant obstruction of justice which occurred during the 2006/2007 nursing center investigations.

The board meeting began with questions from the audience, one of which was a follow up question from the March madness meeting.

A former employee of the skilled nursing center had asked the board of directors to talk to staff about morale and other issues they may have in the nursing center. Each of the directors claimed to have talked to staff. However, there was no elaboration beyond that.

VIDEO: Did they ask?

Not that I need to point out the irony here, but one simple question lead to all of the board members actually saying they went to the skilled nursing facility to talk with staff.

Now, what was the obstacle for the board members to do this when the hospital SNF was under investigation in 2006/2007?

What if they had listened to the employees three years ago and took a stroll into the SNF?

Could there have been intervention and residents could have been kept safe?

Three years ago, board members, Bob and Kay Knight were practically run down by the Director of Nursing in her wheelchair for coming into the SNF during a Christmas party. And, former, CEO, Pam Ott, knew about it and, condoned it. According to the DON, she was told to keep them out.

This was the middle of December and the word was out that the SNF was in trouble.

What or who were the obstacles to keeping the residents and the hospital safe? Read on.

During public comment, I asked the board’s legal counsel, Scott Nave for an update on Dr. Pormir and Debbie Hayes’ legal cases.

Nave could not say much about the criminal case, but said that the two will be in court sometime at the end of the month. I will have exact dates for these court appearances posted so that those who really know what happened can show support by attending the hearings. This doctor and pharmacist need us just like we needed them at one time or another for health reasons. These are families, careers, lives, finances at stake. And these charges are put on the backs of two people who did not work the SNF alone.

(And anyone with further information and evidence about this case and the top management and board, should contact the state elder abuse department.)

Let me put this to you and see if you can see any reasonability: how could the oversight agencies charge Dr. Pormir and Debbi Hayes with elder abuse from Aug. 1, 2006, until January 31 2007, while allowing them to work at the hospital for another two years, into 2009?

If they were indeed a threat to patients, wouldn’t they have been removed immediately, or shortly after?

The only person noted as an immediate threat, was DON, Gwen Hughes. And she went off and got another job and continued working.

The state’s case is based on elder abuse, Penal code section 368(b)(1). So, why did DHS allow them to stay and work for two years before filing charges? Could they have not suspended them first?

That would mean if the state is correct and the doctor and pharmacist are “a threat” to the health and safety of the patients, then DHS is incorrect, wrong for leaving them there, and the charges should be brought against the agency.

Now if DHS is correct that Pormir and Hayes were able to treat patients and function then the state is incorrect to bring these charges against them.

I mean the Attorney General, Jerry Brown and his crew, used fighting words in their press release regarding the indictments. Brown is quoted as saying this is the worst he’s ever seen. Well, it's the worst I've seen too, but we are not seeing the same things.

But apparently mistakes were made at a juncture that was investigated. I have the DHS records for Feb. 2006 survey, and the skilled nursing facility was being run by former CEO, Pam Ott, and former CNO Sharon Brucker. Things were bad then. DHS and CMS sent threatening letters with fines and ability of the unit to accept patients and be compensated. This is the timeline. (See CNO steps down)

DHS cited the administrator Ott for not having an administrator’s license to run the nursing center. They also cited the need for a full time, director of nursing, (DON) as well.

Ott wrote a letter back to DHS stating that the CNO, Sharon Brucker, was in charge of both the acute and the SNF and that she was the interim DON.

Board counsel wrote back that Ott did not need an administrator’s license.

I don’t know what DHS found in Ott’s resume, but it might have been that she was a CEO running a hospital and a skilled nursing facility with only an AA degree and raking in over $140,000 a year.

I called the state licensing office to find out what the regulations are regarding administrators. Well, it is true that a CEO can administrate the nursing center without a license as long as it’s a distinct part of the hospital.

For the fun of it, I asked what it would take to get this license. I was told a BA; 1000 hours of training; passing state and federal exams. (Well, Ott was zero for three.)

Maybe DHS realized or not probably, that she didn’t hold the qualifications really of a CEO even, and that it would be best to keep the SNF covered with a full time DON.

But Ott holds a registered nursing license which is still current and active. However, she did overstate in an email to me that she was a nurse practioner and wanted to help me with my medical problems.

Back to the meeting as Scott Nave prepares to tell the audience about the chain of command. The three procedures adopted by the board, were open policy, grievance and disciplinary.

Open policy, Nave explained is not a substitute for the grievance procedure or sexual harassment issues, but rather an informal dispute process. Employees can go to their department manager, up the chain all the way to the CEO, where the trail of tears ends.

Nave video honest employees honest management

This policy was in place in the fall of 2006 when nurses, staff, took their complaints to the CEO. Not trivial complaints either. The CEO and board members were told by many reliable people about the new DON, the short staffing. But again she was the end of the road in this informal process. And as we see, nothing was done by Ott, other than to say she didn’t know anything until January 2007.

Mr. Nave explained the next rung on the ladder (slippery with grease) was the grievance procedure. This isn’t about outside work issues or personality conflicts. This procedure requires some studying of those employee handbooks as it contains time frames.

Nave said all employees got these handbooks. I’ll stop here to say absolutes such as “everybody” received their handbook, would be like saying everyone working in the hospital had the right qualifications and did all the correct things.

I myself stopped by the hospital for a blood test and found an arbitration agreement in my packet to sign. I asked about it, and was told the agreements would be collected up as it was a mistake.

Since the hospital is not perfect and employees are not perfect, I imagine caught in an emergency situation in the SNF and trying to decide how to proceed would have been difficult.
Regulations on reporting suspected elder abuse, injury or incident are clear that it must be self reported by the facility within 24 hours.

Employees caught in the flack at the end of 2006/7, had to decide what to do based on two laws: the employee manual or the DHS regulations. Some employees instead took it to the board where they were turned away by an angry chairman, Brad Armstrong.

This reaching out tells me there was no satisfaction with supervisors and eventually the CEO herself. She referred to these employees as a “pack of wolves.”

Could these pack of wolves also have used the whistleblower laws which protect the employees from being terminated because of a complaint involving illegal and unsafe practices?

Mr. Nave didn't go over that. Maybe at the next meeting.

Maybe DHS used a clause in the law which says that complaints that are unsubstantiated can constitute harassment. Did Ott tell DHS she and her gang were being set up or harassed by the Knights, the Grosses, the disgruntled employees?

And DHS had received calls and paperwork from nurses on the inside as early as August 2006. Ott, the unlicensed administrator, responded by reporting the failings of the employees to do their jobs noted in the DHS survey records.

So, as Nave is explaining at the board meeting about chain of command and grievance procedures, I’m wondering how does that work if the problem is the CEO. I had originally thought it went straight to the District attorney.

Nave said it would then go to Human Resources, HR.

I asked what if HR is also involved. Then he admitted it would have to be investigated.

Then the bombshell dropped when an audience member followed up the line of questioning of who investigates the CEO and HR.

Nave said that goes to the board. The board of directors who vehemently denied any wrong doing on the part of the CEO or themselves in the matter of the SNF.

They did not investigate her or HR. I don't understand, that's part of the procedure and I thought "everybody" knew that.

VIDEO audience response

All this talk about procedures and you look back that calls went out to DHS- letters were sent - jobs were threatened. Employees went out on stress leave. People were threatened and fired; But not at the top, that's where the spankings stopped.

Where was the board in all of this? Why didn't they investigate Ott and the HR manager or CNO, Sharon Brucker? They stuck with these people and blamed it on the employees; Scapegoating even a dedicated doctor and pharmacist to save their own reputations. Do they even have a conscience?

I wonder if the new board would call for an investigation, retroactive and forensic; but well worth the time. Maybe they could set some things right by doing this. Set things right for the families and residents who trusted the facility, the employees who were harassed or fired, and the community who needs to hear the truth.

This investigation should be paid for by Cal Mtg and Brim Management considering they hired the CEO. And they were the ones who supposedly signed off on her credentials.

Just so the board knows: I say call for an investigation. (big surprise)


The first to take cover as the SNF storm came rolling in, was Sharon Brucker, the CNO, in charge of the acute and nursing center. After employees came to the board in Oct. 2006, and pointed fingers at the CNO, she stepped down and took another position in the hospital. (She’s in quality control now; I feel safe, don't you?)

As the flames moved toward her once untouchable position, Ott stepped down, at the May 4.2007, board meeting and the board allowed her a month to stay on as CEO. She used the month for all it was worth.

On May 5, the day after the resignation, employees began to be fired. Anyone who was a threat, or I should say who knew the truth, was immediately discharged; But not in a nice way.

Former Human Resources Manager, Michelle Rosato, sent the terminated employees to the curb off hospital property with their boxes of personal items in their arms. No notice, a blind strike.

The HR manager gave a rough time to some of the terminated employees by delaying their pay /vacation/sick time/ insurance and pension.

One employee, who was fired, and is listed as a witness in the indictments, called me and told me about her issues with HR. I went over and talked to the HR manager myself. Things didn’t go well, as Rosato seemed to be uninterested in using any compassion or empathy with this woman. I yelled at her and asked her if she enjoyed being cruel. My impression is that she indeed enjoyed what she was doing. (The state may want to reinterview their witnesses)

But once Ott left at the end of May 2007, the HR manager was out the door behind her. She left her position to move on to another job. Too many people knew the truth of what these two top managers were doing.

So, the hospital violated its own personnel policies and procedures when the board did not investigate the CEO and the complaints against her. Whether these complaints complied with a manual or not, the problems could have been halted simply by listening and then acting.

This would mean to me that there was malfeasance, obstruction of justice, and some very blind or malable investigators from the outside.

I don’t think the three sticky board members can claim they knew nothing about what was going on. Especially since Mr. Jamison of QAB radio, brought Ott on his program with him for a final parting shot as the fleeing CEO was on her way out of town.
(The radio show is up and boy is it interesting. I wouldn't want to be a young DA with this witness on my side.)

So, CEO, Pam Ott, CNO, Sharon Brucker, and HR manager Michelle Rosato all left their positions which would have linked them to the direct mismanagement, criminal conduct, obstructing investigators, intimidating employees who told the truth, not following board personnel policies, short staffing, of the skilled nursing facility, and elder abuse.

These are the top three people in the chain of command who ran the hospital and SNF from 2006 to 2007. Two are gone, but not forgotten, yet one remains.

Since Treasurer of the board, Bradley Armstrong, remains silent, and has since May of 2007, during this April fools meeting, I thought I would ask him a question which would fit his hostile recalcitrance.

I told him, it would be best that he keep his vow of silence, as my question to him was a loaded one.

I asked him if he knew that short staffing the nursing center was actually elder abuse. Then I told him if he were to answer that question with a “yes” then he should be in jail.
I explained a “no” answer to that question would mean he shouldn’t be on the board.

VIDEO ARMSTRONG

But that question doesn’t just apply to Mr. Armstrong, it goes down the line to the CFO, Chet Beedle who budgets the departments. The board members, the managers, the employees; anyone who knew there were not enough staff to properly treat the residents is responsible.

Cal Mtg. again casts a shadow over all of this. Don't let them forget.

And considering the board and CFO knew clearly what was happening to the nursing center, they are just as much at fault as the others mentioned.

Short staffing is not unusual at the hospital. If there is not enough staff to cover the acute wing, then patients can’t be admitted. The hospital simply loses business and money.

However, short staffing the skilled nursing facility is a different set of circumstances. That is a home for a static number of patients who require a certain number of staff to properly care for them.

If there’s not enough staff, then they should be moved to another hospital or facility, not under treated. Any hospital administrator worth their salt would know that. Any simply decent person would also know it.

During public comment I asked Chet Beedle, CFO, if he had spoken to Cal Mtg. the insurer that owns our healthcare district and if he had the numbers for the nursing registry which were requested at the March meeting.

VIDEO BEEDLE

Beedle said he had no formal talks with Cal Mtg., but did have those registry figures with him. Chairwoman, Kay Knight, asked if he could give those numbers to the audience. Beedle replied, if you ask me to.

Well she asked and the numbers were exactly what everyone feared and figured.
For 2006, the hospital paid $13,142 for outside staff.
In 2007, they paid $351,004.
2008, they paid $1,386,162.
Year to date in 2009, $881,567

Beedle announced that they have hired on several nurses from the nursing registries. The nursing registry is a temporary agency which sends out staff to hospitals in need and those who can pay those high prices along with expenses and housing.

I asked Beedle if these nurses were coming in at KVHD level pay rates and he said they were. Now I don’t know much about details, but all these nurses dumped their high salaries to work for this hospital in the SNF? Could be true, but I have a hard time believing it since nurses are in shortage, they have many options for employment.

In a meeting in Sept. 2006 with Chet Beedle, Pam Ott, Sharon Brucker, and Michelle Rosato (its on tape) Beedle complained to me (probably illegally) about a certain department manager who wanted his assistant to be paid her worth. Rosato brought me the records for these employees so I could see that they had been given raises years ago and how much. Beedle explained that he cannot allow new employees to be hired at the top rate at the start, because it would be more money than employees who have been with the hospital for many years. The employees would quit and come in at the new rate. (That sounds fair)

However, that particular notion from 3 years ago seemed to go out the window as the nursing registry figures imply. Nurses working for the hospital do not get anywhere near the hourly rates that the traveling staff do.

And now we are to believe that these travelers are working at the starting rate for this hospital? I don’t know, but it doesn’t sound solid.

I could ask for the personnel records and see if this is indeed the case, but apparently that is illegal. So, in 2006, when the gang showed me employee records, it was an illegal act.

As Beedle explained this miracle of the transferring, traveling nurses, he also mentioned that they now have full staffing in the SNF. (Meaning, they didn't before.)

I said, you mean now, and he confirmed that. But went on to imply that there was never any understaffing, they followed the laws.

However, the Department of Health Services records and surveys indicate that was not the case. And employees who worked in the SNF will tell the same story of understaffing, overwork, and inability to maintain proper conditions for the elderly residents.

VIDEO BEEDLE staffing

I would like to thank a somewhat misinformed member of the public for coming to the meeting and asking questions that elicited some information we would not have received without his persistence.

This persons concern was about the contract with Dr. Gross as hospitalist and the addendum to his contract to take over as Medical Director for the skilled nursing facility.

Though his concern was unfounded, because this member of the community didn’t understand that doctors are in high demand and can find better, more profitable positions than we have to offer here.

But what we learned is that Dr. Gross and his group will be taking over as the Medical director of the SNF, formerly held by Dr. Pormir.

As Chet Beedle explained the wages Gross will get for the extra responsibilities, he didn’t even mention Dr. Pormir’s name. He said he’s taking over for the “former” medical director. That former medical director has a name and it was a good one until the mismanagement at the skilled nursing facility.

The audience member was not impressed or happy with the response, then Beedle eked out that other doctors had been asked to take on this position, but only Dr. Gross responded.

KVHD GOB decision postponed as some board members want more information

The Kern Valley Healthcare District Special meeting held yesterday, Wednesday July 28, scheduled to have the board vote whether or not to put a property tax increase, also known as a general obligation bond, on the November ballot, to pay for the hospital's debt situation was held off until the regular board meeting.

Board members voted to hold off the final vote until next week until they get results from another phone survey being conducted as to the willingness of the community to bail out the hospital financially.

The meeting is scheduled for August 4th, at 5:30 pm in the hospital cafeteria.

Attending the meeting were representatives from Caldwell Flores and Winters who will be again doing another survey of the community by phone. Please contact me at Hartofthekrv@msn.com if you recieve any calls.

The Finance Commit me meeting UPDATED/UPDATE 2

Update #2: Let's go back in time while I get the video ready to go. Here we are in Feb. 2009. Chet tells us all of the problems, but then CEO, Tim McGlew arrives and we are fine...

UPDATED: Early in 2009, I attended a finance committee meeting where Chet Beedle warned of impending insolvency, inability to pay off our major debt to the OSHPD/Cal Mtg. insurer of our revenue bonds. He said we would be using the reserves to try and pay the August 2009 payment.
After the new CEO, Tim McGlew arrived, Beedle told us at the first meeting together that it was no problem we paid and everything was fine.
I explained to the CEO, that the CFO said on camera a very different story only a few shorts months before.
To prove my point I went racing home to capture the quote and I returned and read it to Mr. McGlew. The subject dropped.
Now here we are in default with Cal Mtg. which has forced the hospital to bring in financial consultants, HFS, to find the problems, which are both obvious: the great big fat debt Cal mtg. allowed the hospital to encumber themselves and their community with and the mismanagement of funds by the CFO. Both are solvable problems. But the CEO and CFO now want the community to pay property taxes to pay the debt and retrofit the ER.
I have many tapes with different stories told by the finance manager, Chet Beedle, but this one should have been a red flag to many. Read on)


"Figures don't lie, but liars figure."

Started my engines early to make the KVHD finance commitee meeting this morning, and it was worth the trouble.

I had many things on my mind, costs, contracts, registry, and of course the second bond payment for the year, 1.1 million.

After 6 months of hearing that the district will have to clean out the bond reserve which is part of the covenant that the hospital keep this amout of money aside. When used partially or entirely there are ramifications.
Mr. Beedle the CFO, however, three weeks from his last statement at the board meeting earlier in the month, has said the payment has been made and without using the money from the reserve.
An amazing turnabout in just three weeks.
I'm sure our new CEO, Tim McGlew must be impressed. I mean he couldn't come into a hospital that had the potential to be taken over by the insurance holder for the revenue bonds, Cal Mtg.

It's a true miracle really. It was not quite clearly explained how this turned around in three weeks. I asked Mr. Beedle how this could happen and quoted him from the last meeting talking about using the reserve and he said he didn't say that.

I said, Chet, it's on film, you can't say you didn't say that. Then it just became a shouting match with him trying to say he hasn't been saying that the hospital would have to use the reserve funds for six months.

"Between the bond reserve fund and the money the interim bond payments, since February, we have already 501K in our interim bond payments. We have 695K in our bond reserve, we have more than enough to make the payment in August. " (Chet Beedle three weeks before at the regular board meeting.")

Now, I'm told that bond is not just paid, but paid without having to use the reserve fund. Where did the money come from? He shrugged and said we have been paying all along.

Then I was told about a windfall of more than 200K which still doesn't match the math.

That seemed to be all he was willing to say. He had controller, Barbara Figeroa, agreeing with everything he said. (I must say that is the first meeting I have heard her speak.)

So, this mystery continues and has confused and confounded the people I alerted of this awfully big news.

Beedle has also denied having any billing complaints from the Emergency Room. Why I've heard too many now, but there's a video up on our YouTube site called, "bill me again and again."

I felt like a dentist trying to extract impacted information but that has been going on for years. Records have been held back; their existence denied.

As contracts were being discussed, the subject of the public relations contract was brought up. The very one they denied existed at the end of last year. Okay. They looked at me like I had spinach in my teeth when I asked.

(update 2: I have not heard back from the hospital on this public relations contract, nor the construction committee Bob Jamison ran and was paid for? The record requests go back years)
Anyway, they have paid $60K for what is pretty much being done already. So, for nothing. That's not money a small hospital can throw around when its needs are so great and demanding at this time. Petty cash I guess.

If the hospital wants to give away money there are needy people in the valley who could have used that ill spent 60k.

Jamsion acted surprised at the price and insisted it be terminated. I guess he forgets again, he spent this money, he created the contract in the first place. Did he pull it from the consent agenda and consider it wisely? From the looks of it, I'd say they put all the right things in, but they over did it.)

They paid 60K for nothing. And there are many suspect contracts to be researched.

Why can't the public get straight answers about what is going on in this hospital and with the finances, the employee issues, the services which never materialize because the hospital has no money to reinvest?

My guess is that the records will not reflect favorably, therefore, they need to keep them out of reach.

Wednesday, July 28, 2010

Kernville Fire update July 28th: smoke effecting community

Residents of the Kern River Valley woke up yesterday morning to a thick blanket of smoke caused by the continuing burning fire outside the town of Kernville, a popular tourist town on the west side of Lake Isabella, next to the Kern River, fifty miles above Bakersfield California.

The public health department warned people to stay out of the smoke, stay inside and avoid strenuous exercise, as the air is clouded by the fire which continues to burn with no containment in sight.

However, thousands of firefighters have been battling this fast moving fire which started at 1:46 Pm on Monday, and quickly turned from a small fire encompassing several acres, to 4500 acres by late Monday night.


Spokeperson, Michelle Puckett, public information officer for the Bureau of Land Management, updated the figures as the fire has now spread out from 4500 acres to 11,000 acres even with the help of air support which could be seen flying and filling all day long.

The information officer also said they have confirmed now eight homes, not six, were destroyed and another six outside buildings also succumbed to the blaze.

Puckett said that until they get the fire under control, they are still not clear how many homes have actually been involved, or if campers are stranded as this is the peak time for tourists to visit.

Even with 1000's of firefighters on scene, Puckett said there has only been one reported injury and one case of dehydration.

There is no estimate as to how long it will take to contain the fire as it spread so fast and conditions such as wind and heat will play a significant role in bringing this wildfire under control.

Due to wind conditions, the fire, it was reported by witnesses that early yesterday morning the flames headed back towards the small business district in Kernville, but Puckett said the firefighers made their stand to protect lives and structures, as that is the priority.

Asked if she had any advice for residents, she said there is a program she called, "The ready Kern System" where people can sign up with their local fire department to get a call if a fire is getting close and that there would be a need to evacuate.

Many people in Kernville are taking it in stride though, saying things such as "this is nature and we are living in it; fires are natural."

Other residents coming back to their homes said they have created an emergency plan for both their animals and other important items. "We want to be prepared so we don't lose things that are precious and irreplaceable."

An unconfirmed report today said the horses from Camp Owens have been removed. One former employee asked about the other animals such as the goats and chickens, and we have been unable to get a clear picture of how many animals were taken or left behind.

"I don't want to see those animals burn,"a former employee of the Camp said.

Puckett also said they have been in touch with the local fire safe council and spoke about "defensible space."

Residents are encouraged to keep limbs trimmed from the house and to keep plants well watered and to use certain plants which are not prone to burn. This can allow firefighters a better chance of keeping your home safe.

The Kern Valley, recently absorbing two recent water rate increases in the last five years, as California Water Services asked the Public Utilities Commission for the increase so the company could build more treatment plants to adhere to the new Federal laws lowering the levels of a local problem: arsenic in the water.

Another increase came and now residents are struggling with higher water bills.

These increases may cause some to cut back on watering their landscaping, which could turn into a fire hazard, making it difficult for firefighters to save structures surrounded by dried vegetation and trees.

It was reported tonight that the dark red clouds to the south east are from the Tehachapi fire blowing into the Kern Valley, covering the sky with plumes of pungent smoke from all directions.

Another update will be available this morning as the containment has been reported at 5% late last night and more information as to the progress of putting out the rapid moving and stubborn blaze.

We also have phone numbers from concerned community members willing to take large and small animals until the fire is finally smothered.

The South Lake Animal shelter has reported that people have been donating cages to be given to people who are tying to evacuate their animals. We will follow up on this part of the story.

More to come....

ALERT: KVHD special board meeting July 28 and on the agenda is...

24 hour notice for special meeting as board will vote on the General Obligation Bond

For the last few months, whispers, and even whimpers, could be heard around the valley as the Kern Valley Healthcare District began it's drive to talk residents of the Kern River Valley into voting for a bond which will raise property taxes throughout the hospital district.

The General Obligation Bond was previously intended to pay off a debt that had been plaguing the hospital for 24 years now because of a seriously flawed financial venture which included a construction project that was never completed, revenue not generated as well as services and staffing cuts.

The community was put up as collateral as if the hospital cannot pay the community will pay anyway, until every dime is retrieved by the insurer of the original debt.

These were your elected officials (KVHD board members) who made this decision as your representatives and not many people I have spoken to lately even know they are the one's ultimately responsible for paying this debt.

Even though at the July regular board meeting, the talk was about having a special election next year, which would cost approximately $50,000, but would give them single coverage as it will be their own election, the focus on them and not regular election candidates.

Now, a KVHD special meeting is being called and until tomorrow we won't know which board members will vote to put this extra burden on a valley in serious financial trouble.

Obviously, the administration which includes, Chief Financial Officer, Chet Beedle, has singled out the bond as the only way to proceed.

The hospital has been paying on this 22 million dollar debt for 24 years and now if the community passes the GOB in the November election, we will pay for 30 more years.

But here's the twist, within those 30 years, the hospital will be required to replace the whole building, meaning... more property taxes.

I'll report back and let you know which elected board members voted to pursue a community for monies that were caused by bad decision making and bad advice. And an obvious cover up that the community is the "collateral" and will pay for the decisions these board members and administrative employees have made.

Update and illumination after the meeting...

However, let me add one thing: putting this on the November ballot is not costing anything, so they are ready to give it a try, even if there plans have been rushed together over the last six months. My guess is that they will put it on the ballot in November and if they cannot achieve a 2/3 majority vote, they will go ahead and try the special election next year.

Below is the agenda for the meeting:

SPECIAL MEETING OF THE BOARD OF DIRECTORS
AGENDA

Wednesday, July 28, 2010 – 4:30 p.m.
Location: Administrative Conference Room

A. CALL TO ORDER


B. GENERAL OBLIGATION BOND CASH FLOW STATEMENT Information
Chet Beedle, Chief Financial Officer


C. GENERAL OBLIGATION BOND MEASURE Action
Timothy McGlew, Chief Executive Officer


D. FORMAL COMMUNITY SURVEY Action
Ernest Flores, Caldwell, Flores, and Winters


E. ADJOURNMENT

Tuesday, July 27, 2010

The ominous glow of fire over Kernville: Kern Valley Healthcare district hospital quiet

Long Night for Kernville residents and surrounding areas

As what is being called now, "The Bull Fire" still threatens homes surrounding the town of Kernville tonight, July 27, at midnight, and the Forest service and Fire officials saying that at least six homes have been destroyed, but more structures may be involved.
The fire started at 1:46 yesterday with firefighters arriving on the scene as three to five acres were burning. Although it has been reported that more than 15 types of air support were used within the first two hours, and hundreds of firefighters were on scene, the fire was not able to be controlled.
Eight hours later the reports are that it has spread quickly and tonight more than 4500 acres are currently burning.
There is zero containment at this hour as the ability to defend the fire by air stopped tonight but is due to start up once day light resumes in the morning.
In the meantime, ground crews will be trying to hold off this fire until morning, when they can resume air support.
Camp Owens was evacuated and it was reported that at least 125 children at the facility had to be relocated.
Many of Kernvilles residents have been told to leave and reports are that the Senior center in Lake Isabella is taking in people in the potential path, though it is reported the fire first jumped the river earlier yesterday and right now is unpredictable.
Currently, the fire departments are reporting that they have almost 500 firefighters on the scene and "strike forces" to try and protect more structures from becoming involved.


The ominous glow could be seen all around the valley and some people could be seen standing outside this evening watching the scene through the pall of smoke over the popular tourist town. Roads are closed off as emergency vehicles need to come and go, so residents need to be aware there may be delays or complete inaccessibility to certain areas right now.

The Kern Valley Healthcare District hospital, across the lake from the fire, was quiet tonight, but said they were receiving hourly updates from the public health department regarding the situation.

No one in administration was on hand to give an update as to the hospital's participation in helping residents regarding the fire, and what sort of aide that might be, but several staff members said that there had been no cases treated due to injury from the fire at the hospital as far as they knew.

Dr. Gregory Crawford, an ER physician, came out to explain to me that the hospital does not go to the scene that the Red Cross and other agencies set up emergency provisions and that "they have enough resources up there to handle it."

As to a broader picture the hospital plays in local emergencies such as this fire or any natural disaster, I'll attempt to get a response tomorrow from the administration.

The hospital ER, nearly empty, doors closed to the offices, and a handful of staff manning the acute care unit, it almost seemed as if nothing was burning a half hour away.

It is unknown if more staff were called in or were on stand by to handle what could turn into a severe situation as roads are blocked as personnel continue to battle the blaze.

Tonight, there had been a dinner for the Hospital Foundation, which raises money for the hospital through such events as the annual Heartwalk and Peddler's Faire, earlier in the evening, which was not cancelled due to the fire.

The rapidly spreading fire being across the massive man made lake, was no threat to the hospital itself, but the Kern Valley Healthcare District as a public facility, serves all the communities around Lake Isabella and seemed to be out of touch with the severity of the situation tonight.

There has been an unconfirmed report that local doctor from the Rural Health Clinic, Dr. Jack Nadler's house was in the path of the fire, but his family was on vacation, and no more information is available.

This is both fire season and a fire prone area, and I'm sure long time residents have not forgotten the McNally fire which charred almost 150,000 acres and was not fully contained for more than a month.

Then a freak storm came through dropping record amounts of rain which caused burned branches and debris to fill up the river and overflowing onto the banks, polluting the region for many years.

A plan was considered as to how to deal with future situations, and it will be interesting to see what was learned from that fire.

Only a week ago firefighters fought the Caliente fire rescuing homes from ruin, but that fire never reached the proportions this current Kernville situation has developed into in a very short period of time.

Fire is never certain so tonight residents of the Kern River area should be staying vigilant as there is currently no air support and firefighters are in dry, rugged terrain tonight trying to save lives and property.

The public health department is alerting people that in case of problems with breathing as the smoke remains thick, either call the hospital at 760-379-2681 or 911.

For more information on the fire or to try and locate family or friends in the fire area, call 760-376-3781.

I'll update tomorrow and our prayers go out to the residents of Kernville tonight.

I will check in with the animal shelter to see what role they are playing as horses and pets have been evacuated but sometimes end up missing. The South Lake Animal Shelter located on the 178, (760-378-1131) as well as the Kern County Animal control, whose trucks could be seen on the road tonight. (760-375-3446) Bakersfield Animal Control (661-326-3647).

Friday, July 23, 2010

And the Password is: "Preliminary" (The Great KVHD bailout)

Well, the cat's out of the bag, and Kern Valley Healthcare Administrative buddies, duo,CEO, Tim McGlew and CFO, Chet Beedle, took the helm at this month's board meeting to tell us all about the general obligation bond.

It was mostly preliminary, until the end

As I passed down the hallowed hall of KVHD to the final destination: the cafeteria and the April board meeting. Since I'm late, I can hear the meeting has gotten to the chair of the CEO Tim McGlew who is explaining the need for a general obligation bond to keep the hospital up and running. And to add on a few accoutrement's with the leftover cash.


As I passed the American memorabilia hanging on the walls, I kept thinking what a putz the Attorney General Jerry Brown is for letting these people get away with "murder" over here. The system, the bill of rights, hell even title 22, is officially ignored around here.



The audience consisted of familiar faces, quite a few empty chairs, and a new kid sitting in the front row. After the meeting I told him I hadn't seen him around here before.
He said he was a recently retired fireman looking for something to do. Well, here's a fire over at the hospital, that could give him something to do.
I asked him if he knew what KVHD stood for as I do during calls to the community as part of the KRV Watchdog survey. He answered, "Kern Valley High School District," then realized by changing one word, "health" he questioned. I laughed.
I then asked do you know what a GOB or General obligation bond is or means? He said, " I have a lot to learn don't I?" Actually, I'm the one learning a lot about how people perceive this healthcare district and healthcare in general.
The new kid already had a friend before I left, as old timer, 20 year board member, Brad Armstrong, took the fireman by the arm and whisked him away. (They must have been friends for a long time, because they seem to know just as much about the healthcare district as the other. Maybe he will be running for the board soon, take over for his friend.)



Members of the audience, arms crossed, looked like they were waiting for something exciting to be uttered, like, "put your hands up this is a robbery" or "we have fired all the bone heads who got us into this mess where we have to tap dance for money."



The basic gist of McGlew's argument for having the community bail out the hospital was that the hospital needs money, and we are prepared to look at the different modes of taking your money away from you and putting it into the hospital which has always been a good investment or investor or divestor...


As I've explained over and over, we have a large debt but we also have not taken care of the money over the years, giving away millions to companies and not batting an eye. The government has received benefits for its healthcare programs like Department of Health Services which is a joke when it comes to oversight. (Wouldn't you agree Mr. Etra and Mr. Ginsburg?) Also, being sued and avoiding normal collection practices, may have played role in the downfall.


It was if the CEO knows all of this and the board, well, they are drinking the anesthesia or something because they in one year of leadership have done nothing to change anything. Well, I would say updating records from 1990, would be something, that's still on-going though.


Basically, Tim McGlew, repeated that this was a preliminary look at options to clean up the blood trail at the district. Beedle, financial manager, and best side stepper of them all, told us we were fine, that wasn't an artery we hit, and there was no spray: and then he told us the truth so we could be too late with any options.

Beedle needs to be fired for keeping this information from the board and the public. And since Mr. Brown, our Attorney General, is now setting an example by rousting community foundations at certain colleges who say paid, Sarah Palin, 100K to speak, and whose monies are not all accounted for? And, if it's not even more hypocrisy, Jerry Brown, is after this particular college foundation for not turning over "public records."

Public records? You mean you do it for them and not for us? Again?

How many KVHD records do I have? Enough, I guess, because I can't seem to get even a piece of hate mail from these people, they are as solid as a rock over there at administration. (I could not have thought of a better fictional name for the secretary at KVHD: Hidey, or really spelled Heidi, but still has that humorous connotation.)

Where are my requests Jerry Brown? If you're going after college foundations, why can't you come here and help ME get some records? It's just not fair. How can I even believe you are real and want to go back to being Governor and yet you leave us, the blogging and the justiceless, to go take a leap. Thanks a lot.

You know Mr. Brown, I'm sorry but this is hypocrisy. I thought this was a straight across the board game? It's just a game of liars. If I have learned one thing, is that people, lie constantly and will always lie to protect themselves. Liars don't like me. Who else would put up such a blog about their own healthcare here in the valley of the doomed? A stupid truth teller.

If I have a pet peeve and it is liars. And I'm feeling peeved, trust me.

Now, we've got a CEO, who is Mcglued to his CFO, in that he allowed him to talk crappolla for an inordinate amount of time during the meeting, then just cut him off with, "okay." I'm actually going to type his whole explanation in so that it stays with us a little longer than it did at the meeting.

But prior to Beedle's mania, we heard from Tim.

Let's put this in perspective for a minute: please do











They said go forth and get info the board said to me, or a barking dog down in Bakersfield late one night. He didn't say the last part, but did say, "go forth," which I thought was worth noting. So, we're on a mission to save the castle, The Lord of the Rings, oh this is so much fun.


But wait, it's just started.


Regarding the info to the board, McGlew said: "So, that process is underway, but it's still very preliminary."

And we're going to build an "imaging center" (whatever the heck that is, but does sound alluring) and a new emergency room.

"So, that process is underway, it's very preliminary." McGlew informed us.

Gosh, I'm ready to start, I want to save the castle and build a moat to keep HIPAA violators out. But wait...

"At this point the board, there's been no decisions made, it's still very preliminary." Tim made clear to all.

No decisions, but what are we doing then?

"So, this is obviously a strategic planning we're doing here." Tim shared with those who didn't know what they were doing.

I thought we were strategic planning at the special board meeting surprisingly called a week before the regular board meeting. Can't we at least plan on building something?

"We obviously need to work with some architects to even get some preliminary numbers." McGlew finalized the preliminary discussion.












After Chet hits the floor with some great stuff, Tim finally tells us what the skinny is on the situation. Is it preliminary? You tell me.


"So, our plan would also like to have that on our November ballot...if we were able to do that, so clearly there's a significant amount of work that has to be done, get the board educated (yeah, make them read healthcare for dummies) and up to speed on about what needs to be happen and I'll have meetings with the community, with anybody and everybody (I bet not the former CCO, Cynthia Burciaga, I think he was stretching it there), so they get to understand why we're doing this and why we need to do this and make sure their questions are answered."


Well, that was far more definitive. Here we go folks, it's up and it's on. Bond, Tim's bond. We saw Pam's bond, and even Brad's bonds, but we've never seen Tim's bond. Could be different. Though it sure seems somehow the same: Running late in the election year, Caldwell-Flores-Winters, we just need Aspen and Pam and we're off...But what many may not have heard was that our insurer, a state agency called Cal Mtg., is suddenly a threat to our longevity. They never were before, only I said that, and a few others who are much maligned.

Now the specter of this agency located away from human contact, protected by big brother, OSHPD, Office of Statewide Healthcare Planning and Development, is being used to bag a bond?

It was a funny blog to write and would be funny if it were true that Cal Mtg. is now a concern. We don't pay them....brrrrrrr....(teeth chattering) we will lose the farm. "Daddy where's the tractor?"

Not true though. We have the money and within the next series of paragraphs spoken by Chet Beedle at the meeting, he even says that. But what a delight it would be if the community would just come in and pay off the debt so Chet has more change to jangle in his pocket.

This is a transcript, but unfortunately Chet is talking so quickly he is difficult to hear. There are two places where I do not know what the man said or meant to say-it was spray-it was gibberish, but the rest is taken from the video of the meeting. I've edited out the uhs and ands and a few repetitive things for my own comfort, thank you.

Read it and understand, that I have a difficult time explaining all of this to you the community who has no background or even time to absorb the magnitude of a government run business. But listen and you will hear the cacophony of what is being said by Chet...signifying nothing.






Chet Beedle, Center, Brad Armstrong, left, and new CCO, Mark Gordon, uncomfortable.
[Beedle transcript April 6, 2010 also including my snide comment section]
I'm going to put something in perspective for a minute (that long?), district hospitals then when they first went into business actually most of them look at some kind of a bond, a lot of them had Hill Burton funds, that was a government program back in the 70,s and 80's, many of them funded bonds for the future. Back in those days you got to keep work services in your facility blah blah blah, you were able to see more patients, do more things, aaa specialists were paid differently.
So most of the facilities who started bonds did revenue bonds. What that means is there is these feasability studies that were created there were going to pay for themselves. The revenue generated squeek squeek squeek. In the 1991 bond, and it was let and it was for 13 million dollars and I believe what I've seen the hospital could have supported, should have supported, probably could support NOW at the 22 million dollar bond.
The problem is that during the process of this bond it got increased because of a lot of different reasons, overruns on costs, change orders, the Northridge Earthquake, to a 20 million dollar bond.
(Then there was this other bond first feased in 1986 and was 13 million until 1989 when there was both the Loma Prieta Earthquake and there also came to be a change in the building code as there always is and is nothing surprising unless you've never been in construction before and might find that it's all about timing. You never pay a contractor more than is allowed per portion of the job. But that was another excuse they used. "Bad contractors." Will we be hearing these same excuses ten years from now when our property taxes are there just to keep the hospital going. This will not be the first bond for the future, but let's not do it in a hurry or because we have to. Let's take the time to really find out where this community is going. Heck we still haven't even had our justice for the nursing center, Nazi administrators allowed to happen. And kept it quiet because of the election and the bond that we didn't bond with, Measure M. I think it was like the movie "Fargo" and if you haven't seen it, now you must.)
I've not seen a feasability study that supports a bond for 20 million dollars, consequently there is no way escpecially with the situation (what situation we were all good Chet we didn't need to get that proposal to Cal Mtg. I suggested last year. But what do I know? No feasability study for the second round of millions of dollars from Cal Mtg.? Did they do something wrong at Cal Mtg. which we could catch them on maybe? Could we have someone investigate that they, insured a bad debt. Just like the banks did all around the world.) at the hospital is in that it can pay for the principle component of the bond, which is all but 700K a year, 700k a year of million and a half is necessary for interest. The hospital can pretty much support that, and there's some cost reimbursement that comes back, from Medicaire for that. The principle portion would out of profitability from revenue generation which just is not there. Now what the hospitals have done over the years is push this, push that, instead of keeping expenses lower in some places and its 30 decent years of revenue to be able to make the principle and these payments and one point, use all of its reserves. Because they put in 1.5 million in reserves then build it back at one point to about 700k and we can take that back down to 500K, there's a bond reserve of about 500K out there. (out where? I don't see anything.)
Basically what happened is we made a change even if it was for the principle, let's say you paid off this 13 million and a half there's about 13 and a half million left on the bond to pay off of the 20 million, you would be at least that close to a million dollars, 900K dollars in principle, that you're now paying every year on bottom line, so even, even without, even with the bad debts we would be short of profitability, because we would for a year had that.
If you get rid of the bond all together you would also not have the long term interest, but you would also not have the medicare matching component which is about 50% of that interest.
End of transcript...Phew!!!
Enough of that it goes on and on, if you want it and you're extremely bored, I'll send it to you. You get the idea. You've heard both McGlew and McBeedle on the matter in quotes, now you have your vote.

Board member, Kathryn Knight, left, Victoria Alwin, Center, and Dr. Robert Gross DO, on the right, thinking maybe about what their position will be when the decision is made, the preliminary figures come in. I hope there will be more action and questions from these community elected officials, as there is trouble in river city!
And an immediate investigation into how Cal Mtg. insured a 9 million dollar round of bonds in 1989 without a feasibility study is insane. Because Chet is correct when he says these bonds would support themselves with the new business created with the monies. But like everything else, it doesn't always work out that way.
People like money, and piles of money are very loving and likable. And takable too.
That's why I support a bond, but I do not trust the people in charge. So, until that changes, I can only hope we continue to support the 22 million we said we would.
Oh, Chet left out the refinance we did during the BBB year, because of the bonds coming up: but we paid some more money there too. And added additional time and interest. So, really how much was paid in the real long run?
Though the hospital seems to belittle the fact that more than half of almost a million comes back to the hospital, and purposely is now inflating the figures. It used to be we deflated the figure, now a new day and a new strategy. On guard. So, really, we can service our own debt. Wouldn't it be nice if we took responsibility?
Now, if we get a finance team here or even a sharp consultant, I'd say, go for the bond, let's get the future started. But you can't start the future with the past still employed at the hospital. Think about it...we can talk.
It turns out we have been paying for these bonds for 25 years now, and if we get a new bond, a general obligation bond, to pay it again, that would be a total of 55 years supporting these bonds by both the community and the hospital. (Chet likes to use the word supporting, as if a child of bonds.)
Actually, I support raising taxes to meet the current demands of the hospital, which is what the community must do. And then if we are astute in our new found monies, we move on to getting the GOB in 2012. At that point we have a new finance administrator and board members are trained to understand how the financial records work.
Who cares if they take a class in ethics: that didn't change anything. We need classes for the board members to understand completely, so that persons who control the money, and handle it, are watched and no sleight of hand will be able to be used. Let's start that right now...I'll go tell them. See ya. Thank you.
Coming soon, the bi-polar protester. How to protest, by Laura Hart

Where to begin about the KVHD board meeting...it will have to be later though

As I'm getting ready to leave for Bakersfield where I'm undergoing some sort of procedure, trusting a doctor, to try and help relieve the pain, I have blogs rolling around in my head.

Anyway, speaking of pain, I have so much to address that went on with the KVHD meeting that happened last night. It was a meeting that truly tells the tale of the situation at the hospital, it's a critical situation.

But it's almost like seperating siamese twins, sometimes only one lives...

With the hospital so dependent on Cal Mtg. for everything including the air it breathes, there is little that can be done to act independently to create real remedies.

And with a board of directors trying to handle a situation they only know one side of, the dark side, there's little in the way of hope that problem solving can occur in time to avoid possible closure.

But again the boards been given the challenge to act and because, the evidence and history show, that two of the board members have been involved in some of the worst decision making at the least, and at the best, actually attacking others to avoid disclosure of their own participation in creating true disaster.

Will the board act in time? Can HFS, the management company sent in by our creditor, Cal Mtg., who has been engaged to do an audit the board itself should have ordered a long time ago, help or did they wait too long?

There are different types of audits, one where you see a bunch of numbers and they seem to add up, and another where you prove your numbers with receipts.

Will the people of Reedley be as passive as the KRV about what a certain, former KVHD CEO, Pam Ott, did to their hospital?

I don't think the community of Reedly is going to be happy to find the newspaper, The Reedley Exponent, on their doorstep, indicating the bond money they have thrown in the kitty to build a new wing on the hospital, was misused.

I think Reedlians (my new word) are more proactive in their community, and did not take well to having been lied to and now this news.

These people got signs and protested, hurrah, our community could do the same thing, why does it chose not to? Do we like the fact that even our board members can't get a straight answer about why we're in the hole and how we are.

The also can't get a straight answer about paying for HFS contract, which cost 75K to find out if we are viable to remain in business. The costs for HFS are in the contract and it says the payment to HFS has to be made by the savings the district gets from the information gathered by this financial consultant firm.

Are we still viable?

There's been a whole lot of cleaning up in the last few months as Beedle has known he could not hold off the breaking dam so he's had time to prepare.

But this sudden burst of inspiration comes on the tail of the tiger Cal Mtg. who has been decieved and has they themselves allowed certain loan practices to take place which will likely be considered at best, unethical. It's like closing the barn door after the horses or nurses are out.

Jerry Brown has been cleaning up certain loan practices which have lead to abandoned homes all around this state and the country for that matter.

Is Cal Mtg. squeaky clean? No, but they are also not completely bad guys either. Much like with the board of directors they too have to accept information at face value from this hospital, and they have admitted to not even being specialists.

I'll go into Chet's history as a "critical access hospital" specialist he likes to call it.

Then just a few months ago, our specialist is sending out bills for $8 that are three years old. What kind of financial management is that? Really are we that out of it around here that we can't see what has happened?

There's so much more to address...and the pictures with our star studded audience and some chicken pocked one's too.

But sadly we are seeing what happens when we allow this sort of activity to go unchecked. Let's see what they do in Reedly to save their hospital. Oh, yeah, they are in bankruptcy, which is an option we really don't have.

I'm sure they are big Pam Ott fans there. Hey, she has shown her stuff, and now maybe the DOJ can get it right and come in and take the rest of the perpetrators out of this district and then maybe it can heal.

But this community needs to ask themselves what they are going to do about this.

Impressively, last night I turned to hear quotes from my blog. People are learning and listening. And I believe they will come to the aid of the hospital. I really do. But they will want the people who have caused this out of there first...but it might be too late.

Next up: "Cracking the Da Vinci code."

Friday, July 16, 2010

KVHD not only hospital "waivering": Sierra Kings gets an offer

Fresno Bee following Sierra Kings story

At the Kern Valley Healthcare District July board meeting, notably missing on the agenda was a board vote to ask the residents of the Kern River Valley if they are willing to put up property tax money in the form of a General Obligation bond to help the hospital financially and to improve the building.

When the board and CEO, Tim McGlew, were asked if there had been other considerations as to solving the on going financial problems the answer was "no."

The hospital CEO, Chet Beedle, told an audience of concerned citizens who would be footing the bill that the insurer of the revenue bonds (something like a "savings bond" in the sense you cannot bankrupt on it as it is covered by the "good faith" of the state of California) has given them a "waiver."

No explanation or follow up questions that night, but in a response from the insurer, the claim of a "waiver" was not verified and even questioned what Beedle meant by this statement.

Does anyone know here in the valley? The Kern Valley Sun didn't report it.

They are and have been in default. This is no longer "technical default" it is a "their fault."

How you spend your money is your business. How the hospital spends our money is now our business. I'm very much for helping anyone or anything which wishes to help itself. But if you read this blog you will find more than a year and half ago, I warned we were going down.

A meeting was arranged with the insurer and a local representative to discuss options and try to solve the problem, but somehow it got cancelled. From that point on it has all been about how the government is the problem, the community charity cases, the retail pharmacy, the Medicare reimbursement, etc.

If this GOB idea had been researched and found to be the only solution, we could have had this on this ballot in November, (free of charge) but as usual with the hospital, they either hide their mistakes or they blame it on somebody or something. Now they not only want our tax dollars, but want us to "pay" for their own election this next year, which would cost an extra $50,000 at least.

(think of $50,000 as four full time nurse's aides, two LVN's, or even an RN or even a financial strategical coordinator)

Beedle, the financial manager, being paid good money to be in charge of our finances, tried to con the audience about the collections problems which have gone on for years. But this is what he's paid for. His response was absolutely ludicrous.

With people receiving billings for $8 from three years ago, and an audience member who got a bill for a "co-payment" from over a year ago, Beedle, said he was trying to "help the community." (I guess he gave us a waiver?)

By what? Not billing but asking for us to engage in a 30 year general obligation bond contract which would raise our property taxes and the businesses who hardly thrive here would have to get out their price taggers and begin the hike which could run off people already struggling financially.

Are there other options like possibly having a different owner or financial manager?

Of course.

Have we talked about it?

Of course not. (why will come later)

Bankruptcy at Sierra Kings hospital, now they have a possible solution?

After the KVHD nursing center "system's failure" (failure to hire qualified individuals and those who would tell the truth to keep our community safe) the CEO, Pam Ott, skated out of here faster than a Russian ice show, up to Sierra Kings District Hospital in Reedley, California, outside of Fresno in 2007.

Last year shortly after Ott was standing in court charged with elder abuse, the Sierra Kings District Hospital went into bankruptcy.

HFS, a hospital financial consultant, took the reins and after turning over all the stones, allegedly found that our former CEO, Ott, had been able to get to the GOB monies the citizens of Reedley had voted in for a hospital expansion. (how it was spent is still a mystery, for now)

It was also reported in the Fresno Bee and the Reedley Exponent that Ott was not paying the employee pension correctly and the IRS showed up at the front door demanding answers.

However, this city of Reedley, has tried in every way to help it's hospital. We have seen pictures of protesters with signs, the city loaned the hospital money to help with a possible solution which didn't pan out, but people were involved.

These same people now want answers about Ott and how she got there. (Ask Bob Jamison and Brad Armstrong, KVHD board members, if you want to know more citizens of Reedley)

Now Sierra Kings District, it is being reported in the Fresno Bee, is getting an offer from Adventist Health Central Valley network to take over the hospital.

A new idea, and one of many.

What will happen is not yet known, but what we can gain from this story is how other hospitals have been approaching there own financial problems in this failing economy.

The reason Sierra Kings is so interesting and so like our hospital, is that Pam Ott ran both these hospitals, and both are now drowning in a financial morass.

Here's the link to the Bee article.

http://www.fresnobee.com/2010/07/13/2005427/adventist-reaches-out-to-bankrupt.html

And I apologize for the delay in the hospital meeting story as the flu has gotten a hold of me and the heat is not helping. More soon, pictures and videos.