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

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

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

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

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

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

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

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

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

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

With an old, out of date, plumbing system that had been passed by the department of health services and CMS for years without proper direction and education, the nursing facility was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

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

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

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

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

Nothing.

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

Who you gonna call?

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

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

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

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

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

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

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

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

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

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

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

More to follow…

Kern Valley Healthcare District update: Tracy Brown and three contractors leave unexpectedly

As we have already reported, on Friday July 24, Tracy Brown, and three other contractors left the KVHD skilled nursing facility, without notice, according to hospital CEO, Tim Mcglew.

Tracy Brown, who was contracted as the Nursing Home Administrator, Fidel Morgadez, who was contracted for medical SNF medical records services, Beth Clark RN, and Nolan Stewart contracted for SNF recreational services, left together a week ago Friday, July 24.

Because of the sudden departure of the contractors, with no notification to administration or staff in the nursing center, the CEO said he has reported the incident.

"In response to your questions, the incident has been reported as required to the appropriate agency"

In an email response, the CEO stated he is also gathering information on other possible types of recourse regarding the abandonment of the nursing center.

Although originally reported that the four were contracted under the company name Quality Healthcare Asset Management, I have been corrected by KVHD that they all were contracted individually and not through the company.

As I had been researching the SNF administrator, Tracy Brown, the company, Quality Healthcare Asset Management, contained Brown's services and credentials as well as the other contractors named above.

A search through the California Secretary of State's website, showed that Quality Healthcare Asset Management became a limited liability company in June of 2008, one month after Tracy Brown and the other contractors signed on in May 2008 with the KVHD SNF.

Brown, originally arrived in 2007, with Sycamore Asset Management, and worked under their contract for year when the company parted ways with the hospital.

Brown then signed on separately with KVHD along with the three contractors, in May of 2008.

There are more questions regarding these contracts and hopefully I can get some answers at the monthly board meeting, this Wed. Aug. 5, at 5:30 pm in the hospital cafeteria.

Also, I reported that the Director of Nursing, Jeanette Maker, left on Friday along with Brown and the other contractors. Maker had also given her notice that she would be leaving in August.

According to the CEO's secretary, when asked if Maker was a part of Tracy Brown's "group," she said she believed Maker was converted from traveling nurse to employee. She wasn't completely sure and promised to get the exact information.

Although Maker left the same time as Brown, she was reported to have returned to work on Monday July 27, but left again due to illness.

There are many more questions which need to be answered regarding this situation, and I will update as more information comes in.

The contracts are shown below, click on each to open and read.














Next up: It's the monthly board meeting time again...a preview

UPDATED:Breaking News: KVHD nursing home consultant, says 7/24/2009 her last day as she leaves suddenly

In an email received by me, and broadcast to others around the valley, including board members, Tracy Brown, Consultant to the nursing facility, says she has concluded her time with the Kern Valley Heatlhcare District.

(UPDATE: I put out several calls and was able to get a confirmation from KVHD Chairwoman of the Board, Kathryn Knight, that indeed Tracy Brown left the hospital.

Knight said she received a phone call from the new CEO, Tim McGlew, yesterday, Friday, 7/24/09, indicating that Tracy Brown had departed the skilled nursing facility along with her employees.

"She walked out and took all of her people with her," Knight said she was told.

However, Knight said, that the new administrators were getting ready to begin running the skilled nursing facility, as Brown had already given her resignation to the board.

Brown had initially said that she was going to stay until the end of August.

In her email, Brown suggests the new administration begin to prepare for the state and federal survey, and that she has left everything in the nursing center in order.

Knight had no further information or comment to give at this time.

More updates coming soon as we are waiting on responses.)

Brown, who had been consulting with the facility under Sycamore Management, May 2007 until May 2008, when she was brought in by the district as her own separate contractor, called Quality Healthcare Asset Management for the last year.

In her email, Brown states she has not abandoned the facility, as she accuses new CEO, Tim McGlew of telling the staff.

Another email is included from Human resources asking Brown to "mail the mailbox key as soon as possible."

Currently, I only have this series of emails from Tracy Brown and will have to follow up with others named in the correspondence to respond.

Sycamore was brought in during May of 2007, when the KVHD nursing facility was in jeopardy of being closed due to mismanagement.

The contract with Sycamore was signed by former CEO, Pam Ott, and then KVHD Board Chairman, Brad Armstrong, with Sycamore owner, Don Ermel Doyle.

Doyle, said in 2007, after I asked him how he was contacted by the hospital, and he told me he had seen the "immediate jeopardy" with intent to close notice in the Bakersfield Californian, and decided to attend a meeting.

He said after the meeting he gave Ott his card, and a few weeks later the contract was signed.

After government agencies flooded the SNF, and a civil lawsuit was threatening Pam Ott, who had resigned but stayed on for another thirty, dirty, days, the new management company stepped aboard. (See Ott's management Company; QAB interview with Ott)

In one year costs from the contract with Sycamore soared to almost two million dollars.

Brown, who was brought in by Sycamore initially, eventually was given the reins to the SNF where she has been consulting as a Nursing Home Administrator since May of 2008 on her own, under her own company title, Quality Healthcare Asset Management, LLC.

The nursing home administrator recently gave her notice to terminate her contract with the hospital and she said she would be staying on for 90 days, which would have ended in August.

According to the email I received, she has seemingly decided to leave immediately.

"Considering when I arrived, and since my tenure the facility was on IJ (2xs), Focus status, inadequate staffing and training, on-going scrutiny from the community, low census, de-certification and admission freeze; we have done quite well, in the past 2 1/2 years (May 2007-current). You will now need to prepare for your next survey process and on-going issues that arise. Again, please feel free to contact us on a contractual basis, should the need arise, for a periodic review. Please have my final invoice paid in a timely manner, or legal recourse will be pursued, considering all prior issues. Please note this is the last of my association with KVHD- July 24, 2009."

The new CEO, Tim McGlew, has experience both in long term care and hospital administration. He was expected to take over the duties of the skilled nursing side once Brown left.

We will follow up and find out about the transition as soon as people are available for comment.

This is just one side of the picture at the moment as we have not had a chance to talk to anyone at the district as of yet.

What we know right now, is that Tracy Brown, in an email, states that she has left KVHD as of July 24, 2009.

Kern Valley Healthcare District board of directors meeting: they have a few things to tell you...

Tomorrow night, the Kern Valley Healthcare District board of directors will be putting on the monthly meeting.

Why did I use the term, "putting on" when describing the meeting?
Because these meetings are a show. Not show and tell. But more like show and "not tell."

I have attended thirty plus meetings and have never felt satisfied that the board and administration have ever cared for one minute about being a "public" healthcare district.

This is their district and I'm just an invader.

They took over the public's part many years ago when they sold revenue bonds to the tune of 22 million to build the skilled nursing facility, the OR, cafeteria.

No credit? How can you get that money without credit and collateral?

Well, if you're need of money, have some sort of expansion, reparation, project, you go to the state of California, Office of Statewide Health Planning and Development, with the project, and if they think its a good idea they will approve it.

Then, the service doesn't just end there. Now, you've got your project approved thru OSHPD, now you need credit for the monies, you go to the office inside this group, called Cal Mtg.

Cal Mtg. insures your loan or bonds, using the credit standing of the state.

Well, those plans here at KVHD were to build a bigger skilled nursing center, not 70 but 150.

Imagine now, that OSHPD and the KVHD board, could not produce what was originally planned. In fact it started at 13 million, then when KVHD couldn't actually finish the project for reasons just as clear as murky water.

Then came another 9 million down the channels so the KVHD could possibly finish its project.

Well, it was nine more million, but don't forget as all this money changes hands, somebody is taking their share. So, after all the charges, KVHD had another 6 million to spend.

We could ask Mr. Brad Armstrong, current second vice chair for the board, and a member for 22 years which makes him one of the originals who could not actually oversee plans and carry them out properly, why he thinks after the original fiasco, he feels compelled to continue as a board member?

Now, the plans didn't work, but we still owe all the money, and it has to be paid or the state office, Cal Mtg., will pay off the revenue debts, then take over this hospital. Sell it, which is funny, (go ahead), or take everything worth more than a dime, and have a great big garage sale.

With only half the rooms for the nursing center, means only half the revenue. But the bond money is the same. We still have to pay out of the SNF revenues for the bond.

Even those with no math skills could tell you that you are going to be in financial trouble trying to pay off a loan/bond debt with only half the expected revenue.

And we are in financial trouble. This month we could not put any money away for our February payment to Cal Mtg. on the bonds.

Then there's the strange situation with the pharmacy.

But the construction, the revenue bonds, have brought this hospital to a place that 20 years ago when OSHPD allowed this project to go astray, that it short staffed its own nursing center to keep costs down so we could make sure and pay our friends from the state.

And in 1999, when the state office, Cal Mtg. heard that KVHD might be in financial trouble, but more so that they were considering bankruptcy, brought in a management company who gathered up all the loose money to put in their pockets, fired the CEO (only to bring in a more nefarious group), and charged a lot of pesos to stay on as the district wasn't paying its debt.

Yes, in those years after Cal Mtg. let BRIM management come in we saw the likes of current Chief Financial Officer, Chet Beedle, and CEO/CNO/administrator, Pamela Ott come on to lead the "team."

"Team Cal Mtg." was and is here to protect the interests of the state.

I say, kick out all BRIM types, the whole financial department, Bob Jamison and Brad Armstrong, then get the best attorney possible and bankrupt this ship.

Start over, that's the only way.

Are the employees complaining...again?

I heard at "Finance Commit Me" that the employees were complaining, which is what employees do.

(I guess these administrators didn't realize when they took the jobs at the district, that they actually work for us, us the public. Are you complaining our employees?)

My comment was that yes, employees always complain, in fact I've heard a lot of complaining about how paychecks are not stretching far enough to pay for gas and milk, food for families, oil for the car, and the general things we work for.

I'll give you my best guess here, but I bet the employees are complaining about the short staffing, the hours, the lack of ability of the hospital to use the strengths of the employees, and putting people in jobs they don't do.

Knock, knock, can I work here?

Oh, the human resources department, which we will look at closely here, and find out what has gone wrong.

But before we go there, I want to mention, one mistake I believe that the hospital is making.

Based on the false impression, that if you throw out those who have complained, been up the chain of command, and worked at the district a long time, and those who have made complaints, got caught in the horror that was the previous administrators, you will be able to pretend that the past didn't exist.

Wrong! You are throwing away those who tried to help build this hospital, the workers, the drones, or whatever way the hospital thinks of its employees.

One woman and her mother painted the Cafeteria with help from her husband. All paint and labor was donated.

That's called pulling together. (Forget that now, you guys, send them a bill, and charge labor prices that make Sycamore management look like spendthrifts)

The employee is fired. She wanted her job back, but the new administrators have decided, it appears, not to bring back employees who were caught up in the earlier days of elder abuse, malfeasance, back stabbing, they so want to distance themselves from.

My personal position would be to heal the hospital rather than try to escape a reputation. It's sad that healing is a foreign idea at a healthcare district.

Now I heard about the "nursing shortage" but it is a shortage at KVHD. Teachers, other hospitals, other employees, don't want to work at our hospital. They don't like the way the nurses and staff are treated there or what they get paid compared to the heavy duty, administrative costs.

Nurses are a plenty in Bakersfield. So, when we speak of this shortage, remember its peculiar to KVHD.

Now that leads to Human Resources, the people who hire, fire, recruit, and generally give a certain "feel" to a company.

Sad, but true, after our former HR manager left in a hurry, (I don't know why, I just told her, "YOU'RE NEXT," must have had something to hide) we still have problems.

If I went to this hospital for a job, the first person I would see would be the HR manager.

My first impression of how hard I'm going to work, how many hours I'll take, whether I come in to help on my day's off, will depend on how I "feel" about my new company.

If say, the HR manager, was sarcastic with me, unhelpful, and kind of mean, I would probably start my job with a bad impression. Oh yeah, I'd take the job, but I wouldn't forget how I was treated in HR. It would color the rest of my stay at the hospital.

Where are they going? But, more so, where are they coming from?

Employees come and go which costs a lot of money to bring them in and out, train, get all the paperwork, research their background (that's cheap), the hours spent imparting the KVHD way of life, and then to just have them leave and then bad mouth you to other employees and employers.

I don't know what is going on here, but I see that there is no direction at the hospital, and I'm wondering why.

So, come on down for the show, tomorrow, Wed. Oct. 7, at 5:30 pm in the Cafeteria (painted by fired employees, because we didn't have the money.)

There's going to be a change here soon, and this community is going to be on its own with this hospital. Start by going to the meeting and learn. History of the issues are important as you can see clearly what actions lead to this downfall.