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.)
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.
