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...

a few things regarding the KVHD monthly meeting for February 2010

(Look again: this post from the board meeting in Feb. 2010 the financial problems starting to burst forth even as the CEO and CFO begin to speak of issues that had already been asked, but now suddenly, with no payment to Cal mtg for the old debt: they begin to warm up to the GOB idea, a bailout.)


There's really not been much to report from the hospital that I can't make a joke about, so I thought I would keep my mouth shut for a while and see what happens.

The funny thing right now, is that nothing is funny. The situation is dire, and if you are coming to this conclusion "now," you're late and there's nothing to do but surrender your money to an uncertain future of healthcare.

But if this hospital falls so does the valley. Yeah, I'm afraid so. There won't be time to get anything of any worth going up here, and things will spin into a property value toilet, where all you can do is flush it down.

The biggest employer, with the second worst reputation, I won't say who is first, from a friendly, community, list.

Our community has yet to be able to move to the beat of a drum, we're out of step up here, and fishing derbies are fun, when there's water, and with little in the way of technology here, the forest service backing us off a the dry bed lake, another PUC meeting with Cal Water about the increases they need and we can't afford anyway you look at it, and a college which is waning, classes are shrinking, it's going to take leadership to keep this area going.

First and foremost, people are going to have to care about the many issues gripping the valley, one being the hospital which is where I have sat for years now.

The hospital is going nowhere without money.

The CFO, Chet Beedle, is willing to say it's worth it to send a bill out for a service done three years ago, for $8.10, which in the end will cost the hospital to get this money. The labor and materials almost does it in on the first round.

They are now admitting they had problems with billing. And the billing complaint right now is the one against the uninsured who are being recalcitrant and not filling out their charity forms to see if they can qualify for aid.

(Beedle recently in July 2010, said he didn't bill people because he was trying to help the community. As you can see the community was the villain only six months ago..)

I think they may have to simply work on the approach. As I said before, nobody likes to take aid, escpecially men. Why not have the hospital take a look at who is not filling out these forms? I bet they find it is men predominantly.

And then last week we want dialysis and mammography?

I couldn't help but be visibly shaken when I heard the CCO, Cheif Clinical Officer, Cynthia Burciagia, say they really wanted to be able to supply dialysis, which is sometimes a daily clearing of the kidneys for certain people, and it is not available here.

It's very tough to endure these therapies constantly and then to have to travel. A patient asked teh board a month ago if they could get that equipment here in the valley.

Unfortunately, there are so few people here that the idea was put aside a few years ago, as Dr. Robert Gross, DO, attempted to contact doctors and find a way to do this. But the expense and lack of volume made it difficult.

It's possible this could be done, in a way if a private doctor were to start a business here, and offering it that way, said, current, CEO, Tim McGlew.

But mammography?

Of course we need mammography and we had it, paid for it, but never got it up and running. Same story different year.
I had several people ask me why they didn't have mammography here and I said they did. However, that wasn't quite true. You can have equipment but you need people to run it and read it.

When I heard this I realized we are chasing our tails.

Our numbers are all over the place, we have cash on hand again, where we had some, didn't have any, got a credit card, kept the pharmacy open, except for the lack of pharmacists, it's still going.

And then came the call for money. We need money. I couldn't help but feel indigestion coming on as we've watched this title wave standing right at shore for the last five years or more.

No, Cal Mtg. we can't pay you in August the money you are expecting...sorry.

We've seen a lot of good people leave this valley, and I'm wondering who will be the people who care enough to see this place through some very difficult problems...

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.

Grand re-opening of the pharmacy...Board of Directors hold doors open

November meeting KVHD Board of Directors:

They looked out over the audience and wondered "who are these people?"

The KVHD board of directors, not used to seeing traffic to the microphone, were inundated with comments regarding the Mt. Mesa Clinical Pharmacy.

Now known by me, as the Kern Valley Public thrift store District, as the thrift store is supply many of the upgrades being done throughout the hospital.

The "jewel" of the district, according to Chet Beedle, KVHD CFO, is the Rural Health Clinic, making money, and getting new equipment, and I've heard there's even new cabinets. Wow, that will make them better over there (complete sarcasm here in case you think I'm being serious).

I don't know how that's going to help the services, but we are obviously pushing money over there, while the pharmacy sees cuts in staffing and no plan for bringing the pharmacy back in black.

But the public wanted to know why. Yes, telling them it's staying open is one thing, supplying the products, the customer service, that's a whole other story...

KVHD Board Chairwoman, Kay Knight, last month haulted the closure of the pharmacy, as she and three other board members voted to look again at the financial figures, citing the importance to having access to prescriptions on the south side of the lake.

As board members heard the sounds of voices, more than one, mine, at the last meeting. The importance of taking care of people here in the valley was the talk of the meeting. Victoria Alwin, Secretary of the board, pictured here, to the left.

Dr. Robert Gross, DO, look left, handled most of the questions regarding medications being asked by some audience members. Dr. Gross was thanked by an audience member for helping out in a situation where she could not get another doctor to listen.

CEO, Tim McGlew, pictured here trying to talk over a snoaring Bob Jamison, who made his point to shut down the pharmacy at the Oct. meeting, McGlew announced that they will give the pharmacy another try.

But what are we going to try and do? Just see what happens or get some of the money going to rural hellth clinic and move it into the pharmacy, that's what I would do.

Jamison is on the radio right now, "buy local." Well that's what we're going to have to do now. Shop local at the pharmacy if you're over here on the south side, make sure to stop by.

(Bob are you going to buy local. BOBBBBB????)