shooting ourselves in the foot, pharmacy, whatever (you've been had, KVHD board and CEO)

(Update: Latest pharmacist gone, obtaining prescriptions still slow, but the pharmacy remains in service)
Follow up to the pharmacy (an editorial, another one):

With the photos of protesters outside of the Sierra Kings District Hospital board meeting, home of the whopper, Pamela Ott, donning the front page of "The Reedley Exponent" on-line newspaper, I couldn't help but wonder what is it going to take to change things here?

I can't help but be envious of the Reedley citizens and their demonstration of unity against government waste and mediocrity last week, signs and all.

They asked directly that the President of the Sierra Kings district board, Trish Johnson, step down and allow someone else to give it a try as their hospital has filed bankruptcy and their former CEO, or current, Pam Ott, has her hearing in court next week on charges of elder abuse which occurred under her leadership here in the Kern Valley Healthcare District.

So many things have happened here in our district, but it seems we have a way of avoiding responsibility and continuing to expect the denizens of the valley to swallow the constant flow of excuses.

If this isn't the last straw, what is?

After actually killing the business at the Mt. Mesa Clinical Pharmacy by announcing that the pharmacy is losing money and cannot support the community by supplying their prescriptions in a timely manner as well as not being able to "stock" or carry "brand name" or unusual medicines, the hospital has created a self fulfilling prophecy.

Though the new numbers examined by CFO, Chief Financial Officer, Chet Beedle, and CEO, Tim McGlew, showed their was life still left in the pharmacy service, the original advice to shut it down, may be the down fall of the business.

For months, the pharmacy has struggled to keep the medicine shelves stocked and the customers served on time, but the money wasn't being paid to the wholesaler of the drugs, and suddenly, the pharmacy hits the chopping block.

Why deal with it? Because there is a community out here to serve, who cannot make the trip around the lake or down the mountain, and we have according to four year old statistics, the same size population on the south side as we do in the Kernville area, where "The Drug Store" continues to peddle its pills without a peep.

Now, we have a situation: yes, there are numbers which support keeping the pharmacy alive, but I guarantee Mr. Beedle will be talking about the most recent numbers attached to articles in the local newspaper about the pharmacy being the number one money draw on the hospital.

(Again, it's a media situation. The local newspaper didn't understand the situation and headlined the pharmacy was closing. What did I say about power? I'll be talking about them soon, as I've had a chance to get a gander at the most recent ramblings of the local media)

But that was caused when people were told that the pharmacy cannot provide their medicine. Why would we go there if the news is that they don't have my prescription?

And there is a board member apparently, no names, only addresses, 104.5, who seems to believe that by not purchasing at the pharmacy himself, he is making a statement as to the viability of the retail outlet.

Well, board members are not looking too good these days, as they sat through the most bias (yes, I use the word too) board report I have witnessed since Pam Ott was telling us the employees, the college, the director of nursing, the leach lines, were causing all the problems in the skilled nursing facility.

Chet Beedle sat in front of all of you and I'm sorry to say the CEO as well, and recommended closing the pharmacy, taking action at that meeting, because of his analysis. (The off balance report)

As I have pointed out he used an old report, a ruler and some scotch tape, and suddenly the pharmacy was too much for us to handle, it is taking down the hospital.

You know there are rumors, as always here, hell we'd have no information at all if it weren't for rumors, that the pharmacy if it stayed open, would bring down the hospital.

How's that one? Another rumor is that I am going up against the pharmacy, that I want it shut down.

Good grief, KVHD, when does your rumor milling get the story right?

I am for financial viability of the district, but I also recognize that this is a rural healthcare district. It's paid for by the public to serve the public. And as the public we better take another look at what is going on.

Get me my prescription, NOW!

Some of us can't wait for the COD to arrive, but I've decided to bring my business back to Mt. Mesa pharmacy so that I can keep an eye on how the medications and customer service are doing.

We all need to come back with our business and demand that the hospital pay out the money to at least keep standard medications on the shelves.

We've already chipped away at the staff there like we enjoy doing as a business practice. Get rid of those costly, pesky employees, then we can make some money.

These employees are supposed to be "first in line" with the transition into the hospital pharmacy in the event of closure. Well, they are the front line of an untended business operation who have to hear complaints day in and day out, not because of the pharmacy, but because of the hospital financial priorities.

It is a priority to get the CFO a nice retirement and continue to pay him good money, while he throws away good money.

We heard about "volume" the secret of the Egyptians and that is no longer going to cut it: cut the salary, even cut the position.

Make the right cut, not the pharmacy: the CFO

You want to have a pharmacy and a hospital in our valley? I do. But not the way it is now.

We have replaced other parts but the car still doesn't run right. Hey we haven't tried to replace the the CFO. Let's start thinking in car repair terms: If it won't start, begin with the battery and move on. Don't take out the engine when it's a battery cable that needs to be replaced.

My advice: Go back to the pharmacy and let's start all over

If you live on the south side of the lake, go back to the pharmacy and start all over again. Maybe not this week or month, but eventually with our business we can bring it back.

Start by bringing your prescriptions that are not urgent, but can wait, for them to do what is necessary to fill it.

And start calling...(I know it's ridiculous to call anywhere now with the additional numbers to dial, 1-760-I hate the government)

But don't call those poor people at the pharmacy, they're just victims of this whole fiasco. They have had their hours and benefits cut while listening to customers complain on a daily basis. Leave them alone.

Call the hospital CFO, Chet Beedle, instead. 760-379-2681 is the main number and then dial O and ask for Chet Beedle.

If you have a problem at the pharmacy call the person who pays the bills, CFO, Chet Beedle. (I'm sure volume may be the answer here too.)

So, go back to the pharmacy if you want it to be there...

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

Pam Ott's management company...look at this stuff

Update: This company was brought in under a "time and material" contract and the costs according to documents I have was more than 2 million. According CFO Chet Beedle's business plan 2010, we spent 1.2 million in five months with them. Actually they were there for a year and the costs were out of control. Finally, according to Tracy Brown who started with the first company, then took over under contract, until she was asked to leave in 2009, she was not paid all monies due her. I am looking into that matter right now. Brown left when Tim McGlew, the current CEO arrived. The final cost for her year of service is being investigated)

Just to let you know a little bit about the company, or as Pamela Ott, called them, "the management team," I have compiled a few records which may help you understand how this team got to KVHD.

Sycamore management came to the board of directors on or around 5/4/2007 and the owner, Don Doyle, handed them a business card, he said.
The hospital skilled nursing facility was being threatened with closure, and they had no other choice as the CEO let things get to the wire, than to take on this expensive management firm. The contract was signed on 5/27/07, just before the immediate jeopardy would close the SNF.

The next blog will show you how Department of Health Services let the CEO off the hook when it is and was apparent, that the problems were with some of the top administrators.

Here is a news release about Sycamore management, the team, Ott said, would take care of all of the problems in the SNF. They would visit yearly and keep things up to date. Yeah.

In the news release, what stands out is the fact that a CEO was indicted for elder abuse and Sycamore came in when the company was near death.

Following that story is the current resume from Sycamore regarding what they accomplished here at KVHD.

CEO faces elder abuse charges, files for bankruptcy protection
By Christina Lucarotti-Stubler, Record SearchlightApril 12, 2006

The CEO of two Shasta County nursing homes who faces criminal elder abuse charges has filed bankruptcy for his corporation following a move by the state to take over management of the businesses.
Robert Roy, 64, of Millville, who was arrested in December, owns Western Care Management Corp., which does business as Rehab Specialties Inn in Anderson and Applewood Inn in Redding.
Together, the 125-bed and 143-bed nursing homes have about 180 elderly patients and 180 employees, according to documents filed with the U.S. Bankruptcy Court in Sacramento.
Management of both facilities has been taken over by the California Department of Health Services, which recently appointed Ermel Don Doyle Jr. of Sycamore Asset Management as the temporary manager, documents show.
"We're confident patients are in good hands," Department of Health Services spokeswoman Patti Roberts said of Doyle's placement.
Roberts said both nursing homes remain under investigation. She said there is no projection of how long the temporary management might continue.
Roy's arrest came after an investigation of Rehab Specialties revealed that persistent understaffing had put patients at a significant risk of injury and possibly death, state officials said at the time.
It is unclear how much money Western Care Management Corp. owes to the 94 creditors listed in the bankruptcy documents.
According to the documents, an IRS tax lien was filed against corporation in November 2003 in the amount of $226,538. Two judgment liens also have been filed, one for an unknown amount, the other for $104,584.
The trustee appointed to oversee the bankruptcy believes the businesses can be sold together if they are kept in operation, the documents said.
Roy is scheduled to appear Monday in Shasta County Superior Court for a settlement conference regarding the misdemeanor criminal charges.

And now for Sycamore's own perspective on what they did at our skilled nursing facility...

Don Doyle

EDUCATION-1987 California Coast University Santa Ana, CA Bachelor of Arts, Business Management 1980 Fanny Allen School Of Nursing Winooski, VT
CLINICAL EXPERIENCES 1984-To the Present Consultant 5/07 - present Kern Valley Healthcare District, Mountain Mesa, California (74 beds)

Assumed management of the operations of a troubled distinct part skilled nursing facility owned by the Kern Valley Healthcare District. Administered day-to-day operations of facility, including significant staff training, implementation of new policies and procedures and significant interaction with Department of Public Health. Prior to assumption of management, the facility had experienced 3 substandard surveys, with deficiency levels in multiple areas ranging in scope and severity from levels G to L, including an immediate jeopardy for medication errors, with only 10 days from revocation of Medi-cal and Medicare certification and imminent closure by the California Department of Public Health. Within 3 months, the facility was been returned to professional standards of care and received a zero deficiency survey. Daily management of operations has been returned to Healthcare District’s long term management. Sycamore currently provides contract Interim Administrator and Registered Nurses to the facility. Sycamore also provides consultation as requested

Oh, those folks in Reedley: City to help Sierra Kings District Hospital out of the hole, for a couple months anyway...

The question to the board of directors of Sierra Kings District is did they as a public entity, with an ability to tax, try to renegotiate it's reimbursement agreement with CMAC, California Medical Assistance Commission?
According to the Reedley Exponent, a wily local paper in Reedley, who found themselves covering a hospital with leaks everywhere, all the way into the streets, as bankruptcy was called for less than a month after a CEO was called to court.

Pam Ott, the former Kern Valley Healthcare District, CEO, with the diploma from "As seen on TV," left our valley in a hurry as investigators were lurking in the hospital asking serious questions about the care of the elderly residents in the skilled nursing facility back in 2007.

But Ott, administrator for both the nursing center and the entire hospital, left a mess with policies neither updated or new policies implemented, which caused possible casualties in certain cases. Her finance manager, is the same one which currently roosts at the Kern Valley hospital right now and in the hospital's apartments, laying around charging Pay per view events, CFO, Chet Beedle. (The pay per view events is totally made up. Sorry. I must have read that wrong.)

As Reedley struggled with both it's reputation then finances, a board worthy of our hometown reticence, interim CEO, Sandy Haskins, hired in from HFS consultants after Ott was relieved of her powers and the coffers were empty, has had his hands full trying to bankrupt the hospital while keeping it afloat for the future residents.

Though in some quotes, certain Sierra King board members initially protect Ott, that goes out the door quickly as allegations of not paying the employee retirement account came flying Ott's way, as the board did not want any part of that error too. The heat is on in Reedley and that hospital is being watched by both the newspaper, and now, city hall.

With only a few options left after much research, Haskins is borrowing 800K from the city of Reedley, so they can put up 1.6 million, the Exponent Editor wrote, to get a certain credit, peculiar to a type of hospital such as Reedley, and maybe such as KVHD, our little sour puss who wants a big 20 million dollar bond and they don't want to pay for it themselves. (Why those wise guys, I could...)

Disproportionate Share Hospital Payment Program, for guys like us who have a large number of Medical and Medicare and no one cares patients.

I thought the funniest part of another solid article from the Exponent on the subject of their financially failing hospital, was the idea that the CEO, Haskins had to go all alone in front of the City Council and ask for a loan with little or no pay off, and "preliminary" guarantees that the money cannot be grabbed in the bankruptcy or eaten by the state with it's obese appetite for cash.

Nobody from the board joined him. What a bunch of crackerjacks over there. Even a city council board member made a remark.

That is in my opinion another example of an elected board in charge of healthcare that doesn't care. We have that particular disease here, except in that they do care, but only about looking good for our small community who they seem to believe is judging them like a beauty contestant.

I'm afraid my research shows our community knows little about who is in charge of possibly their life one day if the other car crosses over the line in the canyon, or rocks begin to slide after a quake or your pacemaker quits.

Haskins isn't even Reedley, he's HFS, a management type, but the board was elected by the residents of Reedley and didn't show up to answer any questions about this loan or the reason for not making a show with CMAC so that they may potentially receive increased reimbursement from the Disproportionate hospital Payment Program.

But when Ott, our former Diva of da valley, and unfortunately for the city of Reedley, their CEO too who left with a shoe at her back, she hadn't even considered this option, along with her fellow CFO, who was let go when Big Frank and Chucky came to get their money...

What about KVHD? Umm, that's the question...tis nobler to get a bond...or try and get more reimbursement? Let's ask. I'm writing to them now.

I will go forth and get you that information...she said. I said. I exclaimed! Indeed.
More good stuff from the Exponent.
http://www.reedleyexponent.com/articles/2010/04/13/news/doc4bbcc5b788dca728308113.txt

My puppy, Johnson is sick, but while I sit by his side, I must tell you about something...

Well, it's a pet owner's struggle to not have the pets get sick over the holidays or anytime for that matter, but my new addition, Johnson, is very ill and I am sitting here nursing him, waiting and hoping that he will make it.

I'm covering our pet situation as Johnson is hovering near life and death, likely with Parvo, as the virus is apparently alive and well here in the valley.

However, Walter, my boxer, and the Thanksgiving dinner buzz kill, started the holidays with a blood fest during pie as he ripped his toe nail in two.

But that was just the beginning. I have no idea if Johnson will live or not, the story is on the pet blog. Putting it on the blog was a convenience I might add, as I don't have to call and let everyone know the status, they can just look. Thank you everyone who has been writing and calling for your concern, I will update as things change for the better or worse. (Much like I do with the hospital. I just hope it's a happier ending for Johnson.)

http://krvpetcorner.blogspot.com/

But while I'm waiting and worrying, we need to begin talking about what is happening at the Kern Valley Healthcare District.

The finance committee meeting:

We are basically on a downward spiral right now, and with no accurate projections and a volatile economy, the finances at KVHD are dire at best.

With the recent analysis written by CFO, Chet Beedle, regarding the closure of the retail portion of the pharmacy as an attempt to stop some of the bleeding in the district, it has become apparent now that there are urgent problems.

That particular analysis is being reviewed by another consultant, and as of two days ago was not finished and not available for public viewing.

The first analysis was a comedic attempt to utilize decade old data and blame everyone from the distributor to the employees so that the outlet looked like it needed to be cut out.

We don't need to lose services, we need more services to bring in more money.

They can't keep cutting or there will be nothing left.

Pay your bill: You too KVHD

You provide a service and you collect the fee for the service. That's a general business rule or common sense.

But in healthcare you have other issues which effect that particular hard and fast rule.

Patients who have a serious medical condition must be treated in the ER, by law, whether than can pay or not. (isn't that nice of the government to make us all feel so equal)

With the CFO claiming that more than 30% of the patients are uninsured, cash customers, many without the cash, there is an obvious problem with collections.

But there are programs as we've discussed before that could be used by some of these patients depending upon their financial standing, and all it takes to find out is some information.

Right off the bat the hospital CFO admitted they should do a better job insisting that patients fill out forms which could bring reimbursement to the hospital.

Then there's the back log of collections. Without knowing the particulars, as they are rarely shared, there has been a billing issue and a collection issue, leaving much money unaccounted for.

In another post, I reported that Sierra Kings District, former home of our former, elder abuse charged, CEO, Pam Ott, filed for bankruptcy.

But in their plan to restore their hospital financially, they too, are looking at trying to collect monies owed.

Write off's are great, but they're no good unless you're making money at the same time.

There was mention of putting liens on people's houses and other harsh methods of collection, but I'm not sure that the KVHD wants to push people that far at this point in their shaky reputation.

We are a small community, and these sorts of things get around fast (bloggers, what are you going to do?) and the first elderly person tossed from their home over a KVHD bill, will most certainly be part of our new website where we will be doing video interviews.

But as we have spoken about the pharmacy's situation, Mt. Mesa Clinical Pharmacy, it seems the suppliers of the medications has the same ideas about collections as we are bandying around at KVHD.

A representative from Cardinal Health explained to me that the reason the pharmacy is on a COD basis is simply because KVHD was not paying them. And he said the same thing Chet and the CEO, Tim, had mentioned at the meeting: you provide a service and you want to be paid for it.

KVHD's rob Peter to pay Paul system of accounting, (very bureaucratic chic I might add) is an example of what the cause of the problems are concerning everything at the hospital.

Yes, they need money, but they need to "make" money. And with the bi-polar economy, they are going to have to be on top of it, and play it smart and fast. Something that can't be done because of certain impediments to progress. (certain people)

Remember who you are KVHD

We are a public hospital and we may have to remember that regularly as we seem to forget this is a "service" to this community.

I'm sure it's irregular, but almost twenty years ago I was treated by a doctor and owed him over a thousand dollars because I wasn't insured at the time, but we made another arrangement: we bartered.

(This was in Santa Maria when it wasn't the big suburb of LA; it was a country town with the ability to treat each situation differently, with personal considerations taken into account. Big business and big brother have stomped out the ability to operate that way. But there's always hope)

I've told you on this blog I ran a plumbing business, so what I did was install a furnace in this doctor's rental house, and poof, no more bill.

We have to think outside the box, but we have not seen that here at KVHD yet. We're waiting.

I believe we need to decide who and what the district is to this community it serves.

Are we mere business folk or are we serving the valley, it's issues today and those we could help or hinder for tomorrow? I'd like to know and may have to ask the board and administrators.

There has been no open discussion about cutting top salaries and benefits that I know of, and no furlough days, no personal salary reduction as some Kern County employees did voluntarily early in this recession.

But the staff have taken big cuts, going sometimes from full time, to part time, to per Diem with no benefits.

If I were a KVHD employee, I would think in the back of my mind if I took less so that there would be more to help keep the doors open, I couldn't do it.

Why? Because of the irresponsible way the money has been spent and continues to be spent because of the person in charge of the finances and his two amigo's still left on the board of directors.

So, what will they do?

At the beginning of the meeting, Beedle made a point of telling us that in his comparisons with other "like" facilities, he found that all these other hospitals had general obligation bonds.

What's a GOB? A general obligation bond is paid for by the community with property tax dollars.

And now there are those at the hospital who would like to try and sell us one of these deals and then they would pay off our long term debt.

Gosh, isn't that interesting that I have said that debt is our anchor, and have argued that for years, now do I get credit?

I'm going to tell you something which is the truth, we do not have an adequate tax base, with lower property values, the percentage of property tax dollars going to the hospital is minimal.

It's true the hospital needs help, but much like the bailout fiasco provided by the federal government, they left these same top employees who drained the various corporations of money due to lousy business practices in place to do it all over again with a new pile of money.

We're not going to do that. I promise I will fight tooth and nail any "bail out" scheme which doesn't include a change in management. (it would have to be a reorganization)

No bankruptcy for us: right Cal Mtg.

I made mention again, of the fact that Cal Mtg. who insures our debt, and would have to pay it off if we default, is the only agency in the California government with money right now. They could take the hit, we should have done it ten years ago, and we would probably have a brand new hospital with services doctors and nurses would come from all around to work at.

No, we didn't do that. We were taken over basically by Cal Mtg. in 1999, as the hospital faltered under the debt. High dollar consultants came in and took a lot of money out of here under the guise of helping the hospital.

Back to square one.

In this economy we would be hard put to get this bond in the first place, but there's no way I myself would vote for a bond giving money to the mismanagers who put us in the situation we are in. That would be very stupid.

Next Wed, at 5:30 pm, in the hospital cafeteria is your chance to discuss these issues with both your elected Representatives and the administrators at the regular monthly board meeting.

The past again....

I've been tagged for talking about the past as we are supposedly trying to put it behind us. Gosh, that's true for some things, but it doesn't apply to money.

Everything that has been done to ruin this hospital's finances didn't happen today: it happened over a period of time until we have the situation we have now.

So, at I left off the blog story, with the "pre-McGlew era," and that's where we will start the next post.

Board meeting: don't forget WED. Dec. 2, 5:30 pm in the hospital cafeteria.

So, you wanted to be a Kern Valley Healthcare district board member, well

So, you wanted to a Kern Valley Healthcare board member or even administrator in the wake of state criminal charges, state budget cuts, federal healthcare reform, an uncertain future, and a poor little pharmacy that could.

I wanted to hear more from the board of directors tonight at the meeting, more in the way of questions, throw in a few thoughtful suggestions, maybe some input generally, but I didn't hear any; I don't know where they stand on all the things discussed; in other words I didn't learn alot from them.

An unusually scant finance report followed.

But the public had a say, people had a say tonight and the whole table full of board members, a CEO who did defend the CFO and his original analysis of the pharmacy, though he modified it later (more on that), a Clinical Control Officer, the Control Officer, a lawyer of course, and an adminstrative secretary, (the minds behind the hospital) heard what was on the public's mind: the pharmacy and employees.

It was very specific to the topic as much has been said about the pharmacy in the paper on the blog as there were initial reports of instant closure, as was being reported as the pharmacy was losing money.

But resident reiterated the necessity of this little business our hospital cannot run. They don't have the money to stock the shelves with medications,, although they did specify it was "hard to get" medication, which is not specific enough, and they seemed to be against spending the money to run the pharmacy properly.

I heard little from the board as the chairwoman deferred to the CEO, Tim McGlew and Chief Financial Officer, Chet Beedle. Board members were too quiet.

The public, many being new to the KVHD scene, was inquisitive and polite. But the board was overwhelmed, but Dr. Gross did add as much information as he could to the different medication scenarios arose during the questions.

I say this because I know it's difficult to deal with the public, and being a public servant really requires some thinking before leaping.

There's so much confusion that arises from the details that go along with this hospital, its role as a public owned entity (we pay property taxes) with elected officials.

We have been, I have been, in the past mostly, stonewalled by these people. They assumed by just not answering they could get away with this sort of behavior with no recourse, and they are right, they have accomplished just that.

It's a pattern here, like kids who see other kids getting away with things, they pass along he bad habits, and I've seen hints of it here.

I must say there are those who are speaking out, the CCO, Cynthia Burciaga, has more than generous with her lists of projects and the successes, the numbers of staff used 3.2 or better, but sometimes we don't understand what that means or the context of the numbers. The effort is appreciated.

On the pharmacy, because it has been such a concern, it will remain open, with some limitations put on it, such as hours, staffing. But little in the way of revenue generation talk was produced, and the subject was dominated by the public concerns.

I know that several of the board members do care about what has happened, but I would like to see and hear more input. We need a strategic planning event. (We can all bring our own lunches)

I also realize our new CEO has his hands full coming into this situation with the financial as well as fellow administrative members.

A citizen who has been around and has been both political as well as cheerleading for the hospital, gave speech, I kid you not, on the great job current finance officer, Beedle, was doing and has been doing.

She gloated about his turning around a bad situation and she agreed with his faulty assertions about the pharmacy, though that's not how she put it.

Marge Swendleson, yes, she would say something like this, that would be expected, but our CEO, defended Beedle by saying the auditing firm which reviewed the pharmacy agreed with Beedle but they want to keep the pharmacy open for the public.

When I said Beedle should go right along with his analysis which in turn has cost the pharmacy business and reputation, McGlew said Beedle has 25 or 2 million years of experience, I guess he just wanted to throw that in.

The night found the board and administration facing questions from the public and the answers weren't there. I am asking for stronger goals and direction.

Yes, we have to look at every part of this operation, and all its services. We have telemedicine on its way. Some people who have been to college recently have taken classes where the teacher is somewhere in the bathtub or cooking, and they teach the class via television.

This way the hospital can consult with specialists other doctors who can give their input on a patient, help diagnose whether a patient should be moved or can they be taken care of here at home.

The skilled nursing facility always a topic got top billing as making money, less than expected, but more than hoped for.

But I reminded Mr. Beedle after his glowing report from Swendleson that he and the two members of the board voted, allotted a lot of money to an old friend of ours, namely Rick Carter, Former CEO. Now we're pinching pennies, but less than a year ago Carter had some agreement to have a train ticket to the train station and at least one way to Seattle.

However, what got me about these outrageous give aways, was that KVHD paid for his lunch. He couldn't pay for his own lunch?

What a meeting again.

There was a closed session after the meeting regarding the lawsuits which have hit the hospital since the nursing center disaster almost three years ago.

More to follow...