Town Hall Meeting-KVHD candidates answer questions

Town hall meeting revealed much...you don't know I'm sure


KVHD Candidate, Tom Bostick, pictured above, answers some tough questions from the audience, who listened intently as potential board members were given some tough issues to explain to a crowd of approximately 50 residents.










Dave Freeland retired from the United States Forest Service, served as moderator, for five of the six candidates for the Kern Valley Healthcare District: John Blythe, Tom Bostick, David Derr, Kathryn Knight, and Saul McGarity. The sixth candidate, Dr. Wesley Thomas, did not participate for unknown reasons.

Freeland, pictured with Marsha Smith, Publisher of the Kern Valley Sun, asked questions from the community which lead to revelations the Sun apparently didn't catch as the vague, general story to follow in the newspaper contained no detail on the event.

Dr. Robert Gross, DO, pictured sitting next to KVHD, CFO, Chet Beedle, watching the candidates take on questions. Gross, now a KVHD board member, along with Victoria Alwin, Chairwoman of the board, and Bob Jamison also attended. Alwin and Gross were elected to the KVHD board of directors in 2008, and their campaign meeting video is still up on our Youtube site so you can see if they followed their own campaign promises from 2008. (just for yucks)


As Freeland asked questions which tended to lean toward the issue of the debt the hospital has carried for more than 22 years with the state agency Cal Mtg., interesting information "erupted" as the questions lead to some revelations for people who may not know what has "really" gone on for the two decades.

The debt meeting that wasn't

In March 2009, I asked then KVHD Chairwoman, Kathryn Knight, CFO, Chet Beedle, Assemblywoman Jean Fuller to have a meeting with Cal Mtg. to try and defer payments or any help the ailing hospital could obtain.

The CEO of the time, Rick Carter, Beedle, and long time board member, Brad Armstrong, began arriving unexpectedly at Mrs. Knight's business, "My Sewing Room." The pressure was on as the three did not want to follow through with the negotiations with Cal Mtg.

I recieved an email from Knight and Beedle calling OFF the negotiations. I spoke with Mrs. Knight and found out that she was being pressured, or maybe we could call it "bullying."

At the next meeting, the video shows I called out the three amigos who now want your property tax money for Measure G, and called them bullies to their faces. Mrs. Knight politely said, "it's okay."

NO IT WAS NOT OKAY

Nobody should have to endure what these quasi-government district employees and elected officials did when we knew that the hospital was "down and out" financially with no chance of recovery unless they pursued the "old debt."

Knight also did not have to endure pressure from these people to cancel what could have been a successful negotiation or deferment. That's KVHD folks.

http://kernvalleyhospital.blogspot.com/2010/07/documents-show-kvhd-knew-of-financial.html

They had no issue trying to stop the negotiation and overpower Mrs. Knight and mislead our representative in the assembly, Jean Fuller.

Blythe, who has obviously researched the history of the hospital debt, spoke up about the meeting that wasn't, but should have been.


"In terms of the debt about a year ago, we had actually, well the board, as far as I know, had actually played with the notion of possibly negotiating with Cal Mtg.-and the board didn't want to hear about it. You know I hear this scenario that we are just going to go up to Sacramento to just stir up a hornets nest-and it's unbelievable as far as I'm concerned. Cal Mtg. insured 13 million in 1986 for what should have been a larger hospital and then defused in 1990 for 20 million for a smaller hospital. So, that's where we got stuck with the debt we struggled with for the last 20 years," Blythe adamantly explained to an audience who likely didn't know of this opportunity we had 19 months ago.


John Blythe, shown speaking to the interested voters who came out mid October to learn more about the candidates running for the Kern Valley Healthcare District board of directors.






Question to Knight: why did you cave and vote with the rest of them?

At one point in the meeting, Kathryn Knight, current board member, pictured above right, answered a question from the audience as to why she seemed to "cave" and vote with the rest of the board.

Knight explained that she felt that much of her input has been quashed by other board members. She described a dysfunctional and factional situation with the current board.

For instance, they did not allow her to tell the community THERE ARE OTHER ANSWERS and she has information to back it up which I have obtained. (lying to board members and the public? Naughty, but the usual I have to say.)

And she is RIGHT! I have it all on video now for others to see, but people who take or have the time to find out the true happenings and information should see this.


Saul MacGarity, came out swinging describing the financial situation at the hospital as a problem of the decision making by the board members.





Question: Did they talk to Cal Mtg.?

Former, interim, KVHD board member, Wayne Ottoson, asked board members if they had spoken to the insurer and creditor for the district, Cal Mtg. who holds the holds the paper on the farm.

None of the candidates answered to the positive. Not only have the candidates missed speaking to the creditor which pulls all the
strings financially, but the sitting board could not answer positive either, at least openly.

(Except, I also found that two board members, Alwin and Gross, did in fact, MEET with Cal Mtg. according to emails between Beedle and Cal Mtg. But Mrs. Knight didn't even know they were doing this. That is about as Brown act as it gets.)

http://kernvalleyhospital.blogspot.com/2008/10/candidate-info.html

Blythe, Bostick and Derr, pictured above right, discuss the issue of Measure G, the property tax increase, not well understood by anyone, even the sitting board of directors.

Blythe rebutted the two candidates explaining to the the audience that he thinks it is premature to burden the community with a plan that has not totally addressed all of the needs for the future.

His hammer came down, as the candidate, explained that the hospital COULD HAVE negotiated with Cal Mtg. via an attorney they apparently KNEW about. (see Knight above)

He cited a passage in the regulatory agreement between the hospital and Cal Mtg. indicating this contractual element is NOT LEGAL.

Though Bostick and Derr came out for the measure based on the fact that the community needs a new emergency department built and other "equipment" as they have been leeched of all their funds by administration costs, management companies, penalties, over priced contracts, and it does seem reasonable, except...the plan is NOT all about the ER.

Finally, someone said it before the election

Thank you John Blythe as my research has proven not only that the contract which binds this community's money to the state of California is not only challengable, it has also been altered and unamended, possibly making it NULL and VOID. That is if the KVHD administration and a few board members had the gumption to fight it.

But you will hear, as it was posted on this blog, that the hospital's credit is tied to this poisonous agency, Cal Mtg. True.

However, a step further had the current board and administration gone, they would have found they could "adopt another creditor." (Duh)

That has been established through people in the healthcare industry that Cal Mtg. is not the only game in town. And it maybe that by simply putting in a couple clauses such as the inability to "bankrupt" on the debt, which is unconstitutional, could put their backs up against the wall.

Cal Mtg. also has a clause that they have power to replace top administrators, such as the CEO.

Well, where were they when former CEO, Pam Ott, revealed her resume and it was found she had FALSE credentials. Yes, maybe it's their liability our elder abuse horror story.

We needed and apparently had the information from an attorney who handles cases such as this type of game where we negotiate or they get NOTHING but trouble.


Derr listens closely to his fellow candidates as they explain their positions on important matters such as morale, raises, bond debt history, among other related KVHD matters.





History of backing down and then coming back


Wayne Ottoson, former interim KVHD board member during the dark days of 1999 when the hospital had a choice whether to fight Cal Mtg. or high tail it out of town. Ottoson chose the ride out of town, but has recently returned and become an outspoken voice about the debt and the bond measure.


Robert Knight, CEO, from 1997 to 1999, and several board members including Ottoson, went to Cal Mtg. along with state representatives to try and find a way to get out from under the debt from the botched construction project which left the hospital behind financially, staffed, and unable to grow in a quickly changing healthcare industry due to the ball and chain, or debt.

Knight was shortly then fired by Cal Mtg. as they were not interested in making any deals and most certainly would not allow any sort of Chapter 9 which would then require them to pay off the debt. (Read post: Nobody bankrupts on Cal Mtg.)

Ottoson, who deferred to the statewide office of Healthcare Planning and Development, OSHPD, which oversees Cal Mtg., in 1999, now told the candidates he had been in touch with "Dan Morey" of Cal Mtg. as well as Mabel Chan. First, it's "Don" not "Dan" and he is the legal counsel for OSHPD.

And what is interesting is that I have not only been in touch with them for five years, but you should see how their story has changed over these years. (remember, I save it all)


Fight or pay is your only option

This community does not have backing for a good fight with a creditor which allowed our hospital to hire unfit employees, keep us going just barely by cutting the staff which take care of the actual patients, and watched as money crept out of the first round of bonds.

Cal Mtg. blames Goldman Sachs for the initial feasibility study which allowed this hospital to sell 22 million in government "revenue" bonds for a hospital worth a mere one million dollars. Good job everyone...

Ottoson didn't fight a decade ago, but that is the option: fight for our rights to negotiate fairly or pay more taxes.

Or...take the risk that this valley can handle three to four property tax increases, as this is only the second bond, two more to go...(see McGlew special meeting July)

We also have a definitely deficient plan of attack which puts a new ER on a 45 year old building which needs to be retrofitted by 2030?

No, the plan was what the community told us in 2006 what we wanted: URGENT CARE, CATARACT SURGERY, MAMMOGRAPHY, CHEMOTHERAPY, DIALYSIS, ETC.

Dysfunctional board? Now is the time to correct that problem


With two seats available, voters must decide which two candidates may be able to handle the current financial situation and possibly have the courage to fight the good fight with creditor Cal Mtg.


More on negotiating with Cal Mtg....but first I handed a message to Jerry Brown yesterday in Bakersfield.

(I apologize and laughed at the comment regarding the partial story as I had to leave off this post as my computer has been under attack and now we are looking for the hackers...leave it to the teenagers to find them...soon. Is somebody nervous out there about the truth?...Definitely.)

Kern Valley Healthcare District Board candidate: KATHRYN KNIGHT

Election 2010 Kern Valley Healthcare District board of Directors candidate Kathryn Knight

Kathryn Knight

Answers to Questions:

1. Where do you see the hospital 10 years from now? 20 years?

KVHD is facing unprecedented challenges. Declining economies, increasing levels of uninsured patients, meeting safety and quality requirements, and physician shortages are some of the subjects on our district board agendas. AND, THE BIIGGEST CHALLENGE, CAL - MORTGAGE, our LARGEST CREDITOR, has cost the District Millions of Dollars throughout the last 20 years with their ability to REFINANCE THE LONG-TERM DEBT, GUARANTEE MILLIONS OF DOLLARS IN BORROWINGS, GUARANTEE LINES OF CREDIT, INSIST THAT WE HIRE CONSULTANTS TO FIND INNOVATIVE WAYS TO PAY THAT DEBT ------------ THAT CAL-MORTGAGE KNOWS THAT WE CANNOT POSSIBLY PAY BACK ------ This, to me, as a Board Member, is fiduciary IRRESPONSIBILITY. I have preached the alternatatve to the Board for four years. They WILL NOT LISTEN! The only way out, as I see it, and I can provide all the documentation, IS TO GET RID OF THIS DEBT!!!!! I believe, very honestly, that this is the only alternative to our financial situation. Within a couple years, of struggling (that we already do, for heavens sake) we will be VIABLE and OUT OF THE WATER THAT CONTINUES TO SINK US!!!!!

Creative solutions can be found when sought. Throughout the last four years, I have been preaching an alternative solution to our healthcare district woes, financially, and the administration and board members have chosen to ignore the possible solution to this very problem.

I think NEGOTIATION - with Cal-Mortgage is our only answer to our viability ten, twenty years from now. We need to bring a STRONG TEAM of experts in to work for us. I know who they could be -- and I have suggested that we contact them as of last April. The Board and Administration sees fit to ask our taxpayers to pay this ----- I will agree with whatever the voters want. That is my job. But, the taxpayers need to stay focused and informed.

A workable strategic Plan should be in place to conquer the issues that we face. By 2020, our turnaround assessment should have been strategically implemented, finances improved, debt service covered or erased, and a new Emergency Room and Radiology Lab in place.

By 2030, I see a new Acute Care Wing, Ancillary Services in place, functioning, and providing the services we desperately await.

I see myself as a resident in our Skilled Nursing Facility in the year 2030. I have hopes that the healthcare needs of my generation will be comfortably met -- partly because I was part of the SOLUTION!!!!!

2. The hospital is a "public healthcare district", how would you define that to the community"

The healthcare district, like the school districts, or water districts, or cemetery districts, are owned by the public, and by the District that they serve. Our KVHD is run by a five-member board of directors, who represent the District. Per the Brown Act, established in 1951, to initiate a new "open meeting law", that business will be done in PUBLIC.

At any open meeting, the public has the opportunity to comment on items not on the agenda, but with the jurisdiction of the Board. Items already ON THE AGENDA, may be addressed at the time they come up for discussion.

3. The job of a KVHD Board Member is.................

First of all, I love this job. I've been effective as a Chairwoman, and as an advocate for employees and for community residents.
Of utmost importance is the board member's desire to be effective. Effective KVHD Leadership requires an understanding of the scope of the limits of board members' powers, influence, and responsibilities.

In order to maximize the effectiveness to the District, a Board Member needs to maximize his/her own effectiveness on the Board. He/She needs to think strategically, embrace the BIG PICTURE of the future of the District, and in doing so, enriches his/her own life by acquiring knowledge and wisdom.........but leading with the heart.

In the planning process, the quality of the final strategic plan is the Board's primary responsibility.

4. How much time can you devote to this endeavor if you are elected?

I find this job, to be fulfilling, worthwhile, and challenging. I hope that I will be be re-elected.

Since I have spent almost four years on the Board of Trustees, the time I have spent in actual work-hours, Committee preparation, Board-meeting preparation, and the time devoted to thinking through each issue as it arises, is equal to 24 hours a day, 7 days a week. The Board Roles and Responsibilities require a definite time commitment. The planning process, when properly done, is the heart of effective governance and leadership, serving as the basis for management to successfully carry out the mission of the organization.

The time I spend, in addition to attending Board-related meetings, has required me to continuously be aware of my fiduciary responsibility to the District, think strategically all day in the best interest of the District, and maximize my own effectiveness, on this Board in order to contribute to the long term success of the District. Effective oversight of the management staff that provided direction without interfering with operational decision-making will produce benefits to the community served by the district. These are serious matters of public trust, and these responsibilities can be fulfilled most effectively through a strong commitment to spending adequate time to this endeavor.

Candidate statement:

My name is Kathryn Knight and I am running for my second term as Director of the Kern Valley Healthcare District.

In the four years I have served on the KVHD Board of Directors, I was able to accomplish positive changes beneficial to the community and to the healthcare district. During that time, I channeled employee and community concerns through the proper chain of command that brought about effective changes that are still in place today.

I listen energetically to employees, staff, and fellow board members with open mind, and strive to make the wisest decisions in the best interest of the healthcare district.

I listen intently to community members with sincerity, honesty, and integrity. I am accessible and transparent in the Kern River Valley.

I have served on the Board Personnel/Policy Committee for four years. I have grown to understand the problems that we faced in 2006, and eagerly worked to resolve those issues with strength, wisdom, and character. I have worked, and fought, diligently, to formulate and preserve district-wide Policy and Procedures that are in compliance with State regulations. Our Board P & P meetings some days last a seven to eight hour day, just to effect the necessary changes that must, strictly, occur. Some of our policies were fifteen, twenty years old, and were never evaluated for update. The Policy Manuals for each department are close to being completed. It has been a huge task, but one worth all the effort initiated. Employee concerns, I have brought before the Committee, and resolution has occurred in a timely manner, in most instances.

I have served on the Board Finance Committee for the past four years. I have asked a lot of questions, received a lot of answers, but the "solutions" are not always a result of the questions or answers! I understand Medicare and Medi-Cal reimbursement methods and depreciation costs and reimbursement. I read thoroughly the financial statements each month and have prepared questions ready at Finance Committee meetings.

I have attended the Association of California Healthcare District's Annual Meetings and Board Governance Seminars. The association is a group of 74 California rural healthcare districts, that provide legislative strategies for the benefit of districts, provide educational seminars and workshops to educate board members, CEO's, CFO's, and promote changes at the State level to effect the proper changes to impact the future of all of our districts.

I actively support all KVHD functions. I serve on the Board of the Kern Valley Hospital Foundation. I have financially supported the ECHO Health Academy since it began in 1998, as well as all Hospital Foundation activitites. I have supported the Youth 2000 program since its inception.

My goals for the next four years will be to propose that the Board build a Strategic Plan that will promote financial growth and quality healthcare to all areas of the hospital, SNF, ancillary services, and to the community.

The Board has many unanswered questions right now. There are no easy answers and I would llike to be part of the newly elected team to address the issues so important to us, to obtain further insight, and bring solution to the problems that we continue to experience.

Serving on the KVHD Board is challenging at times, BUT I WILL NEVER GIVE UP!!!

Please vote for KATHRYN KNIGHT on November 2nd, for KVHD Board of Directors.

Thank you.

Kathryn Knight

You may contact Kathryn Knight at 760-379-2677 or Robert.Knight210@verizon.net

Request for relief from Cal Mtg/update/bullying

Update: this letter was sent out after KVHD, CFO, Chet Beedle said we were unable to pay our bond debt payment of 1.7 million. His story changed on camera as a new CEO had arrived Tim McGlew. The new story was that he never said that even though it's on tape. We had the backing of Jean Fuller and the KVHD chairwoman, Kathryn Knight, but the whole negotiation was quashed as Beedle, former CEO Rick Carter and board member Brad Armstrong convinced the chairwoman by visiting her at work unnannounced, that it wouldn't be a good idea. Today KVHD is being audited by a management company HFS sent in by debt insurer Cal Mtg. They have been in default for 24 years and there have been at least 4 or 5 attempts to secure a general obligation bond to have the community pay off the debt in property taxes.)

Dear Mr. Morey and those who oversee the state Cal Mtg. office:

I have spoken to people in this community now and have come up with an offer that will pay back certain funds to Cal Mtg. but at the same time save our hospital. I hope that our community means something to you, and that the objective of the low cost loan program is not to simply make money, but to bring about growth and change.

At the bottom of the letter are comments from the community which will tell the story of what this Skilled Nursing Disaster has done to the image and potential life span of our hospital.

As I have said in my blog, Cal Mtg. shoulders some of the responsibility as to what has happened to our facility. For instance, when you sent Brim Management in to take over the management of the hospital when the payments weren’t forthcoming; you brought on someone who had bad credentials. Someone who is being sued in a civil suit right now, but will hopefully be brought to justice soon.

Here is the proposal for relief. We are asking for relief and we will fight to get it. Our belief is that this situation calls for action and we are asking that you take action immediately to avoid another disaster: losing healthcare in the Kern River Valley.

At the Finance Committee board meeting, the CFO, Chet Beedle painted a grim picture for this year. We have already dipped into the reserve account that we are required by you to keep, to the tune of 180,000, to help make our most recent payment.

Your next payment is up in the air at this point and it will be contingent upon the perpetuity of this hospital.

We have already discussed that the hospital building is run down; we have been short staffing and underpaying our employees; there are shortages of various equipment and services for the community. The Skilled Nursing disaster COULD happen again, if we don’t act now.

If this hospital had the almost 1 million a year it pays to your office, there could be some serious changes made that would save the hospital from being the pariah of our community. And keep frightened residents from driving down our winding canyon road to seek medical treatment.

This community will pay you back your money, and already has been for 17 years. But we have to change the program because of the emergency situation.

We could open an investigation and look at all the records, the old and the new; and truly review the success or lack of success of this program. But time is of the essence for KVHD. And hopefully, you will be able to enact this proposal very quickly.

The Proposal:

First, the original sum of the revenue bonds were 13 million dollars. Now revenue bonds are based on business projections, like in the case of KVHD, it was to put in that skilled nursing facility, the CFO says we can’t survive without.

Then I understand when construction problems occurred, your office threw another 9 million at the problem.

In the end, the estimated amount of beds in the SNF was half of the original business plan, so therefore, the payments were outside the original numbers. They couldn’t pay because they didn’t have a finished product that would generate the original projections for revenue.

Now 17 years later, the hospital limps by, always trying to make sure to pay your office, and less to make sure the facility is staffed, trained, and in touch with current standards and technologies. That’s why I can’t figure how your program is helpful?

Even if you shut them down you would never retrieve the money you loaned, because they do not have that kind of net worth.

The IRS, a voracious office, and other types of creditors, knowing that they cannot collect all monies owed, make deals. They reduce the amount so at least they can retrieve some of their losses.

Okay, here’s the numbers: after 17 years of payments will still owe 15 million dollars from the original 22 million.

We figure we have paid your office and the taxpayers 17 million dollars. Yes, there is no interest in this figure, but that is not the issue here. The issue is that you have received this money.

Since Cal Mtg. originally agreed to the 13 million dollar business plan we consider that paid in full.

We propose that Cal Mtg. reduce the debt to 5 million dollars and refinance it over 30 years with low payments the hospital can handle. Yes, that means lot’s of interest for your program. These payments should be no more than 250, 000 a year, compared to the 1 million dollar payment.

This would allow the hospital more than 500,000 a year to get the hospital upgraded and staffed.

However, with this agreement comes two years of deferred payments, meaning we pay you nothing for two years and reinvest the monies we would have sent to your office on the hospital.

Here would be the conditions the hospital would have to follow to obtain this relief:

The district would have to join JCAHO and become an accredited hospital. This would keep the SNF from ever sinking below standards of practice.
There would be no raises for administrative salaries for two years until the hospital has implemented certain requirements. And raises in Administration from this year will be reduced to the original amounts, but with just an inflation adjustment of 4%. (That’s the raise the seniors in our community are receiving from Social Security.)
The board will have two members who were involved in covering up the SNF disaster, removed and bring on two new members. That would mean, Bob Jamison and Brad Armstrong have to step down if they want to help the hospital. No charges will be brought against them regarding brown act violations, conflict of interest, and privacy violations if they agree to leave.
The current CEO and all administrators must have their credentials checked to make sure that they are in qualified for the job they are doing.
The hospital must make an effort to increase staff positions by 10% the first year and another 10% the second year to people who live in this community. And at least two of the administrative positions must be held by members of the community. This could include people already working at the hospital.
The hospital must use this deferred payment period to pay off all outstanding debts to suppliers and providers.
An outside regulator must be contracted to monitor that all of these conditions are met.
During the deferred payment period, a construction plan must be conceived to upgrade the ER, and seismically retrofit the acute care wing. The plans must be in line with the extra monies the hospital is receiving so that there are no more loans necessary.
The hospital must also use the deferred payment time to obtain technology that allows the insular facility to directly contract with doctors who can read, treat, and follow patients via new computer technology. The current radiologist is unable to keep up with the imaging, and this would bring in doctors without having to bring them here.
The board, with its two new members, must create a comprehensive plan to deal with billing issues, collections, and potential lawsuits stemming from this incident.
New legal counsel will be hired for the board so that there is a clean start after many illegal and unethical practices have taken place
A internal audit committee will be established where the board, community members, employees, and consultants can streamline and plan for success.

That would be the initial framework for our new “covenant.” There could be additions to this, but we start from here.

I am sending this out to our local officials, as well as up the political ladder, and asking that they agree to this relief package.

We need this hospital and we need it healthy. You need money. So, can we agree upon this deal?

Please send this to your attorney and supervisors and begin the process as soon as possible. I will call you on Monday, March 2, 2009 at your office to discuss details.

Here are a few excerpts of the public’s reaction to the KVHD arrests. After you read them, you must understand that this is only going to get worse for us. The employees were fleeing anyway; now they have a terrible resume to take with them.

Yes, I will blog this letter tonight so the community knows what is going on. And it will be easier to disseminate the information to the proper authorities that way as well.

Take care, and take care of us. Thank you, Laura Hart

Comments from community, Kern Valley Sun, website:
" This is what is happening all across the country:
1. Many of our elderly are taken over by courts,
2. Appointed a guardian,in most cases friends of the court,
3. The guardian then isolates the elderly person and then keeps them from family,
4. This upsets the elderly person, and they start voicing their wishes and wants,
5. So then the guardian, and doctors start medicating, the person is then easier to manage for the staff. " I hope justice is swift for these 3, no one deserves the kind of treatment those residents received on their watch. They will have to answer to their maker one day...murder is murder "
"They outta administer the same drugs to these 3 and see how it works on them!
Show no mercy, Fry em I say! "

It was the night before KVHD and all through the house, not a creature was stirring, but only this louse: Sierra Kings in bankruptcy?

But Pam doesn't believe in bankruptcy...how could this be?
The irony, I hope,will not be lost on anyone here in the KRV, that Sierra Kings District board of directors voted today to file bankruptcy, a chapter nine, municipal bankruptcy of a public healthcare district.

For those who are new to this blog, Sierra Kings District, is the, or will it be "was the", home of the criminally charged, Kern Valley Healthcare District, former CEO, Pamela Ott.

Ott who is charged with eight counts of elder abuse stemming from her time with KVHD, is currently on unpaid leave with the district, until the November preliminary hearings scheduled at the Kern County Superior Court.

Last month, September, Ott plead "not guilty whatsoever" to the elder abuse charges and was released on her on recognizance, pending the hearings, but with the provision that she not work in a skilled nursing facility. (I'm thinking maybe living in one might be the lesson)

After reading the article published on the web, by the Sierra Kings' local newspaper, "The Reedley Exponent," regarding the last month's board meeting, the new CEO and CFO, spoke of converting hospital beds into swing beds which could be used for skilled nursing.

I wonder how that plan, if it ever gets underway, as Sierra Kings voted on going with bankruptcy to solve their financial woes, will combine with Ott's employment and court orders?

What happened at Sierra Kings, other than the obvious?

Oh, the news of the Sierra Kings bankruptcy, which is scheduled to be filed tomorrow, according, to interim CEO, Sandy Haskins, reeks of timing I must say.

One month after Ott is talking innocence with a Kern County judge, her hospital, the one again in her care, under her leadership, is said to appear to be a "sinking ship" in the local Reedley newspaper.

But bankruptcy is a word I think all of us, and I mean all of us, (yes, I see you), will never forget as being the word that Ott used constantly here in the KRV: but not as a solution, rather an attack on people who would utter such a contemptible idea.

Now, Sierra Kings, Ott's latest adventure, will likely be saved from total annihilation by doing this.

In the same article from the Exponent, the latest word had been a gasping "plan" devised by the firm HFS Consultants, who have been working with the hospital for a year and supplied both the interim CEO, Haskins, and Chief Financial officer, Teresa Jacques. http://www.reedleyexponent.com/

Losing both CEO, Ott, to criminal charges, and CFO, Barbara Jennings, to some not really specific complaints, (she didn't do her job is basically what they are saying), Sierra Kings has filled it shoes with the resources of this consulting firm HFS.

You can find HFS off the website for the Association of California Healthcare Districts, ACHD. http://www.achd.org/

ACHD is a power player in the healthcare industry, and considering HFS is on the front page of their website, I'm assuming this company must be in the big league too.

Last week there was the unveiling at the SKDH board meeting of the three million dollar plan, hatched by HFS, which would be a complex, (and I'm sure costly), look at accounts recievable and billing issues. They were hoping to cull through lost monies and shore up the billing department.

But now it's bankruptcy. What a week it must have been in Reedley.

Although Haskins said, "We'd prefer not to have to do this," he elaborated on the fact that the hospital is cash poor and accounts recievable are out over 100 days.

He said, the board of directors has made the choice to go forward with the Chapter 9, and they "hope it will improve the situation."

This will be the story to follow at Sierra Kings, but the truth is that the problems here at KVHD may lead us to the same conclusions we came to ten years ago in 1999 when a CEO was fired for even mentioning the idea: Bankruptcy.

Pam Ott totally disagrees with bankruptcy. Where is she anyway?

Now, without it's CEO, Pam Ott, Sierra Kings faces a huge challenge to remain on the healthcare map as bankruptcy is both costly and risky.

HFS has apparently taken the helm for this round at Sierra Kings, but where's Pam Ott in all of this?

Ott, who in my opinion, considering the circumstances at Sierra Kings, and the criminal charges, will be moving her base of operation somewhere else in the near future. But then again, she has gotten awards from ACHD and worked with HFS, so she's in with some big guns which could protect her if they were so inclined.

Oh, but what a legacy (or scarring, whatever you want to call it) she left our respective healthcare districts.

KVHD, now known for its elder abuse, collusion, criminal negligence, retributive firings, obstruction of investigators, short staffing, and some really colorful scapegoating, has a cousin in Reedley, Sierra Kings.

They are now known for their own construction projects gone awry, a CEO charged with elder abuse, a suspicious termination of the finance officer, no money and now bankruptcy. (I'm sure there are other things I missed)

Bankruptcy is taboo

So, to tell this story I must go back to the fact that while Ott was with KVHD the legend goes that Mr. Robert Knight, CEO, wanted to bankrupt the district to shake off that mountain of debt brought about by mismanagement of a construction project some years earlier.

This lead to Ott and her gang just twisting it and spinning it, that Robert Knight, was a "threat to the healthcare district" as he wanted to bankrupt and get out of debt.

Well Knight, as CEO in 1999, and I will show you this paperwork someday, did have an attorney look into bankruptcy. It is a detailed report on the situation of the debt load they were trying to carry, and how a bankruptcy could save or renew the district.

Enter the bad guys, the antagonist, Cal Mtg.

I'm sure it wasn't the day after the bankruptcy report was made, but certainly shortly thereafter, our friends from the state agency who insured the 22 million in revenue bonds, Cal Mtg. came pounding on the door.

No way were they going to let us bankrupt without a fight. We, or the board of directors at the time, signed our district away on the construction project which brought us half a SNF and an inoperable OR.

But guess who ended up as the bad guy? Robert Knight because of his suggestion of bankruptcy. Not Brad Armstrong who still sits asleep at the board. Not the people in OSHPD who approved the building plans. Not the CEO of the time nor the board of the time.

Here's the funny part: Knight was not even at KVHD when the real damage was done with the revenue bonds. He was hired on after the disaster, expected to run a company with a huge debt load, yet, still blamed. Interesting how that worked.

(But you don't bankrupt on Cal Mtg.)I asked the interim CEO, Haskins, if Sierra Kings had any debt insured by Cal Mtg. and he reported that they did not.

Of course not, or they wouldn't even be considering Bankruptcy.

Cal Mtg. has the claws in its contracts set up so that, sure you can bankrupt, its legal, but we will take everything.

If you're interested, the state plan 2007, for Cal Mtg. is like a Stephen King novel in its descriptions of what happened to those who couldn't pay. My favorite story from the state plan involves some poor healthcare provider who couldn't pay. Rather than telling the state, they knew what was going to happen, so they just walked away and didn't even call.

Cal Mtg. actually went physically to the site to find that they were gone.

I think every healthcare provider out there should read that state plan before embarking on the Cal Mtg. deal.

Ott ramping up the propoganda: she used the blame game

Ott came to KVHD by way of the management company, BRIM, and CEO appointed, David Green (See: tracking down the troubles).

She started as Chief Nursing Officer in 2002 and was then neatly packaged as the new CEO by 2003. Dave Green basically handed her the keys to the family car and didn't check her license.

Well, Mr. Knight, won a seat on the board of directors, and he was not going away. (sound familiar) He was not going to be scapegoated without a fight, unlike others who have been taken down at KVHD.

That scrapper Knight, and then CEO, Ott, had some real problems. Where as Knight likes to tell it like it is, Ott's verbiage robotically and repeatedly contained the word "wonderful" or the Knight's did it.

Ott and the gang also accused Knight of not playing with the team about the seismic construction issues which included the Measure M general obligation bond for 12.5 million.

Knight had actually had a bid to do the retrofitting required by the state to keep the hospital in business and safe from earthquakes. (Though they would take us down in a New York minute if we didn't pay the Cal Mtg. debt payments. I guess this makes sense to somebody, only a politician I would think.)

But the Knights, who chose to fight and even run and serve on the board, (Currently, Mrs. Kathryn Knight is our chairwoman, which would have disturbed Miss Ott to no end, as you will see in the email below) have been telling the story of the hospital, it's relationship with Cal Mtg., the financial problems, and finally, we didn't listen when they tried to tell us about the nursing facility.

Why didn't anyone in this community listen?

There's a certain amount of dissappointment on my part as far as this community's ability to understand a problem and deal with it. Gossip, judgment, and ego have played a bigger role than fairness, understanding, and compassion which always seems to take a back seat to the baser preoccupations of people.

The "smallness" of this community makes the situation more pronounced, such as attacking people who are trying to help. Like the Knights.

I tell you if there are people to respect and appreciate it is the Knights. They have a lot of heart and have hung in there when being called many unrepeatable and factually untrue things. In fact, Pam Ott, made her career here on the backs of the gossip about the Knights.

So, I'll end this for the night, and take up after the KVHD board meeting tomorrow.

I'll leave you with the immortal words of Ott from an email in 2006: (by the way those are her typos not mine. And the first reference is to the election of Kathryn Knight to the board while losing the precious Measure M.)

Ok, I finnally finished listening to the load of cow excrement. I want you to know that I got up at 5am this morning in order to accomplish this arduous task (tee, hee). I can't believe that we are all going to have to listen to that squeely little voice for the next 4 years. What is God's plan, I would like to know!!!!!!!!!!! Here are my thoughts:

1. Bob openly admitted that his grand plan continues to be to bankrupt the district. The staff are being used as a ploy in his adventure. He is well aware of our fragile economic situation and that simply increasing salaries and increasing staff will do exactly that. It is not about his concern for staff because he is well aware that no one will have jobs if he is to succeed in his ploy. Here is where I stand on the subject, there will be no bankruptcy, but rather, Cal Mortgage will once again step in and demand that a management firm come to the rescue to turn around finances just as they did during Knight's last intentional attempt at bankruptcy.

2. Mr. Knight has made several attempts to convince me to turn around the District financial successes and move the district toward bankruptcy. He has stated to me that Cal Mortgage would have to forgive the $16 million debt. Because I refuse to comply with such a sinister plot and he knows that Chet Beedle will never comply with such a plan, he now wants to remove all management and replace the very staff who have not only turned the District around financially, but also have improved customer satisfaction and quality improvement . Mr. Knight has informed me on multiple occasions throughout this year that he has a plan to once again take over the management of the district and that , even though I am a good CEO, my ten year is up. He actually even told me that I should take a position in the probation department. (QUOTE ANYTHING THAT YOU WOULD LIKE).

3. It is clear that both Knights have been in attendance at all Board meetings, but have not had the ability to assimilate information provided to them about the Measure M issues. First of all, why does he discount the ability of three very bright Board members who clearly understood the issues at hand? The Board and Administration had discussion frequently at meetings related to why retrofit was not a possibility. first of all, the community spoke clearly both in written and telephone survey that the current Acute care building does not have the capacity to provided the services that citizens would like to see such as an improved emergency department, cardiology and chemotherapy. We have discussed at the Board meetings that spending the approximate $25,000 to have architects propose retrofit plans is $25,000 spend on a project that will not give the Board any information that will be used based upon the fact that the district would still have an antiquated (loved your word), over crowded facility that would not meet today's standards for providing quality acute care services.

4. The discussion that they talked about Phil Foster and Tehachapi: Yes, If we were to use the modular concept with Aspen Street Architects, we could move forward far more expediently with a building project. Problem: Mr. Knight has some incompressible vendetta against Aspen Street Architects and if we do not use the already OSHPD approved modular concept, we will waste at least another year working with a new architect, spend $100's of thousands more on plans and wait for the average 2 years for OSHPD approval of plans. Three Board members understood the value of working with the Rural Health Design Network, a group of 13 Critical Access Hospitals who received a federal grant in order to save all of that money in order to meet the seismic standards in a very cost effective way.

5. Mr. Knight stated that I had already submitted a plan to OSHPD for the building of a net acute care wing: The plan presented to OSHPD was submitted in the year 2000, and Mr. Knight posed the Motion to submit those plans. I was not working with the district at that time.

6. Mr. Knight stated that he had made it clear in "a couple Board Meetings" that he stated that he would go along with the Measure "M" only if the District were to consider "rectalfit". The reality is the Mr. Knight posed the motion for the resolution that clearly stated that Measure "M" would build a new acute care facility to improve emergency services, provide more privacy, and to add Cardiology and Oncology services.

7. I cannot speak to the Gross's Clinic project that Mr. Knight has discussed. Discussion would be a clear breach of executive order of the Board. I am shocked that Mr. Knight has exposed his wife, who is not yet a board member and the media on executive protected information (quote me!).

8. As for the discussion about me bullying and cursing at staff: No comment except to say that I hope that he can find nursing staff who are willing to purger themselves in court, because that is where this discussion is going.

That's what came up for me, but I am sure that you will think of other issues - just call me!

(How do you like the tip of the iceberg. More to follow...)

Finance commit me meeting, Aug., without KVHD CFO/pharmacy/staffing/cutting/

I’m beginning to get a complex here, everywhere I seem to go people stop showing up who were expected to show up. I was so looking forward to chatting, with Chet Beedle, our Chief Financial Officer, at the kern valley healthcare district today at the monthly “finance commit me meeting,” but he wasn’t there. I even brought my cameraman for the occasion.

Bob Jamison was at finance commit me today, but he wasn’t at the “town hall, debate, confusion as to the title,” healthcare reform meeting this past Monday. There was some sort of debate between Jamison and Dr. Gross, DO, which a lot of people thought would take place.

I asked him why he didn’t show up.

For the first time in years, an utterance was heard out of Jamison directed at me, which didn’t include kicking my skinny ass.

He said he didn’t even know about it. He even asked, “What meeting are you talking about?”

I told him, his radio brethren, “smooth news” told me that Jamison said he wasn’t invited.

Jamison, looked perplexed. Then he said, I don’t know where he got that from.

I said, he said, you, said it. Then I let him off the hook as he began telling me he had heard about a “flyer” or something, but didn’t know, blah blah, it was beginning to sound way too much like the skilled nursing facility and staffing from 2007. (I wonder what he would be like under oath in court?)

But, then our new CEO, Tim McGlew arrived, eyeing my cameraman and I like we might be “up to something.” (Not us.)

I wanted to get on film the actual nature of these financial meetings to show the public. As I previously described, the meetings usually consisted of the “Fed Ex” description of the finances by, Chet Beedle, whose explanations have always been on the rather skimpy side as well as getting the feeling we are playing the shell game: which one is it under.

Since, Beedle, wasn’t there I didn’t ask my glowing red ember question, “is it the policy of the hospital to take the $200 burial fee from the people who have passed on in the skilled nursing facility, rather than giving it to the families for it’s intended purpose?” I guess that will have to wait.

Controller, Barbara Figeuroa, was at the helm today, to guide us through the monthly numbers game. I'm hoping to win at KVHD Bingo someday.



I found her to be much more interesting and forthcoming than Mr. Beedle, and I could actually understand her even when there was a little mumbling.

QUESTION NUMBER ONE:

Why can’t our pharmacy make money?

Tim McGlew began to tell us what we already knew, that the pharmacy is on COD, (cash first, product second), because we didn’t want to pay certain bills for a while, our wholesaler, is a pain, and we have no credit.
Then, however, Mr. McGlew showed that when he is asked directly he will offer more of an explanation.

I said, Rite Aid and The Drug Store are making money, why can’t we? McGlew caught the first ball in his mitt immediately. Yes, Rite Aid is a big corporation who gets the big breaks on prices. (I imagine they also pay the wholesaler on time too).

He said they have not given up on the situation and are working with the wholesaler as we speak to reduce prices and also look at other options. He said there are only three wholesalers, which makes things a bit difficult.

More to come on that story…as prescriptions filled at Mt. Mesa Clinical Pharmacy fell sharply this last month.

I stopped by on my way out of the hospital meeting to ask the pharmacy if by some miracle, they had my rare these days, thyroid medication. You’re right, it was stupid, and they didn’t have it, and even told me again it’s not being manufactured anymore.

I don’t know who’s right or wrong there, as I contacted the manufacturer who has a recording explaining they are behind on the production of the drug, but should be caught up by the end of August.

To be fair, Rite aid and the Drug Store in Kernville, both do not have the drug in the dosage I need. And Walgreens, a great big chain, found only 30 to give to me.

One last thing on that subject, when prescribing medicine which is required daily, and not a week or two later when the pharmacy is stocked up again, or the doctor is back from vacation, is a serious responsibility. I continue to stress trying to get my three medications which need to be filled on time or I could seizure, die or go insane. (I mean, more insane) So, doctors, pharmacists and hospitals, realize we are not angry customers, we’re scared…okay?

I wonder if other rural hospitals are having a tough time with their pharmacies. If so, could we not initiate some sort of coalition with other hospitals and get our pharmaceuticals together, like chain drug stores do?

Would you like a little off the top?

Questions came and went about how the hospital plans on cutting back and then on making money. It seemed only I, and committee chairwoman, Mrs. Kathryn Knight asked questions though and that is my point about bringing on an audit committee as an adjunct to this mystery financial theatre.

I put it straightforward, as usual, are you cutting from the top or the bottom? I explained that I meant there were more cost savings from the top layer than there is with the lesser paid.

It was announced with a soothing tone, that registry and traveling nursing costs are now at the lowest in years, but the hospital has been hiring which drove up the costs of actual employees. (We’re all good with adequate staffing and not from overpriced temp agencies)

There is not a shortage of good people, you just have to attract good people, by having, good and fair hiring and firing practices. As well as being good and fair in general. Human resources, the title speaks for itself. But problems have been there at KVHD for a long time, and the baton (some have been hit with) may have been passed along in 2007.

A Psychiatrist in the house: Is that for me?

But then I was told about the new psychiatrist, who is being utilized in the skilled nursing facility to provide consultation about psychotropic drugs, which we all have learned are part of the arsenal of pharmaceuticals used for geriatric problems.

Unfortunately, this contract came way too late to avoid the indictments from the office of Medical Fraud and Elder abuse, under the auspices of the Department of Justice.


Former, CEO, Pam Ott, said she had a few psychiatrists consult in 2007, when the state was breathing down her neck. She even said these psychiatrists agreed with the treatment and medications residents of the skilled nursing facility received in the "dark years." Her doctors said the residents needed even more of the medications in some cases.

But we must be at least somewhat relieved that the district is now taking this quite seriously and consulting with another shrink on a contract basis.

McGlew reported that the new psychiatrist will also be consulting with the emergency room, as the ER director, was said to have an interest in utilizing the specialist as well.

As I have previously mentioned, I am bi-polar, along with the whole of my family along with many friends, and it is a concern to me how people with this disorder and other mental health challenges are treated at the hospital and within the district.

The history regarding these issues is rather “crazy” really, and I will begin to advocate for those like me, or those who don’t like me, or whatever, us different folks. People all across America are eating up anti-depressants, as the economy and social change, have people worried and “bummed out.”

I am not making fun of depression as it kills people every day. Bi-polars head the list of those offing themselves regularly, and not just this hospital, but every hospital and medical provider needs to understand this unpleasant reality. (In fact, my brother was let go from the KVHD ER twice while he was suicidal, cut to the bone, leaving a bloody hopeless trail and nobody from mental health ever showed up.)

Since we have little in the way of treatments for depression, the pharmaceutical companies and Budweiser head the list of antidotes people choose most often, I would like to see a more natural approach, one of understanding and compassion.

Hugs not drugs KVHD. Also staff, not half, too. Nurses kept too busy cannot tend to the little things that make life livable, like a letter from a friend, a neck rub, reading a book aloud, a good conversation, a funny movie. (if these were your last years, months, days, what would you want for you or your family?)

The psychiatrist will not provide those things, but the often brow beaten and overlooked nurses, can: Most especially the underpaid CNA’s.

Bravo, a psychiatrist, I hope we utilize him well and learn, especially for those in the skilled nursing facility.

McGlew also reported that the state has frozen the expected 3% increase in payments to the skilled nursing center and will have an impact.

Just what we need less money for our SNF. Well, not less, but the same as last year, so it could be worse.

But it shows again, the lack of concern for the elderly and disabled by the state government. Stop it up there in Sacramento. This is sounding a lot the point of a certain woman at the town hall meeting about euthanasia.

In Conclusion, there is still a hospital that needs the public’s attention, but we seem to have obtained a dedicated, CEO in Mr. McGlew, and an equally attentive new Chairwoman of the board of directors in Mrs. Knight.

They are the “portrait of dedication,” or something syrupy like that. (Oh, I’m starting to use platitudes; I must stop reading the local newspaper. Aren’t newspapers written at a fifth grade level? Or is that blogs?)














I still have so many questions, like the bond payment, the pharmacy Medicare Part D issue, and that audit committee stuck in my mind. Of course, I still want to speak to Chet Beedle. All in good time…