Persistance and Tenacity, requires a new chapter, a new beginning....
Showing posts with label controller. Show all posts
Showing posts with label controller. Show all posts

Thursday, September 3, 2009

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…

Tuesday, September 1, 2009

I won't leave until they do: and I've got a surprise too

"Isn't that right Barbara" Chief Financial Officer Chet Beedle, during June's finance committee meeting, seeks support from Controller Barbara Figueroa as he was asked to explain the discrepancy between his report three weeks prior at the June board meeting.


Controller Barbara Figueroa, rarely heard during meetings, backed her boss as he was questioned regarding contracts and spending.


Beedle talked about the nursing registry costs announced at the last board meeting. An 80K payment, said to be a standard fee to registry companies, was questioned as the hospital works with many different companies.
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Former CEO Rick Carter was one of many, who received benefits such as an apartment, plane tickets, lunch and parking for personal business.

The CEO was also given a 19% raise before his departure earlier this year.

Last year, the CFO, Beedle, and three board members agreed that this expense which was on going, as well as paid housing, was reasonable considering the state of the hospital.

This is board meeting eve blog and I have a few things I want to make clear and then a surprise for a few people.

My goal is the perpetuity of this small public healthcare system, and with strong and circumspect leadership in the administration, finance, and the board of directors, there should no longer be minimum care and service.

Do you want Minimum care and minimum wages?

As the biggest employer and only healthcare for miles down a canyon road, the KVHD hospital must do better than just the minimum with staffing and services.

How many of us want the minimum amount of time we can speak with a doctor or nurse?

How many want to work for an employer which favors themselves over the whole organization minimizing the employee's worth?

How many of us want the minimum amount of time a doctor can spend dealing with our unique health issues?

Would any of us decide to want that for ourselves or our families. That is exactly what has been happening.

Who has to take responsibility and step aside or continue to suffer me.

Brad Armstrong: Mood, currently angry and bitter about lesser position on board as a new configuration was voted in last year.

Bob Jamison: Known to dislike almost everyone including all board members except Brad Armstrong.

Chet Beedle, has deliberately kept the public from knowing details of certain dealings. He has broken laws regarding employee information, which is a drop in the bucket.

Scott Nave, legal counsel, manipulated by the majority power, could not control the behaviors and even recent events have proven this to continue to be the case.

I'm going to work more closely with the hospital: Ombudsman

I'll be spending more time at the hospital watching and listening, reporting.

It all happened a few weeks ago when I visited the SNF for a short time and found three violations rather quickly.

I spoke to Sacramento and just chatted about what I had found. The woman knew about our hospital anyway. But after talking to me, she told me I would make a good ombudsman. She said she wanted to find my name on the list. Absolutely.

Wish I had done it two years ago, but hey, we can all work together now. Group hug.

But because I am a little different, I will be called onyourbuttsman, instead of ombudsman.

When the hospital is clear of violations, unethical behavior, and these people, then I'll move on too.

So, that was your surprise. Happy Birthday Jamison, Armstrong, and Beedle, I just wanted to let you know because I'm excited to get this new endeavour started.

I will, however, not take up the governments offer, as it would be in conflict a to reporting and writing about the problems and how they are being solved. So, just call me the "onyourbuttsman."

Board meeting tonight: Wed. July 1, at 5:30 pm in the cafeteria at the hospital.