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Long-Term Care Board discusses NRMC intercompany plan
The Long-Term Care (LTC) Board met in session Tuesday evening in the hospital's Mezzanine conference room. The main item on the agenda was the financial review and discussion of Nevada Regional Medical Center's (NRMC) intercompany plan.
During a special session held last week, the NRMC Board of Directors notified the LTC Board that the hospital would no longer fund LTC intercompany expenses. The majority of these expenses fall under health insurance and meals, with 22 percent of the intercompany charges going towards Pride Care Self-funded Health Insurance and 29 percent of the charges going towards meals. Other intercompany charges include supplies, administrative services, worker compensation insurance, 24/7 maintenance, 24/7 IT services, nursing salaries, laundry services, and miscellaneous.
The hospital board put a 90-day timeline in place to enact the end of the charges. The final date of this timeline is April 9, 2023.
Long-Term Care Interim Chief Executive Officer Gene Vestal shared a letter received from hospital administration that noted the hospital would "continue to work with you and your board of directors to ensure that patient care needs are met during this transition period." LTC Board President Judy Campbell noted that the hospital board is not seeking back payment either.
LTC Board member Bill Kohler then clarified why he left early from the special session hospital board meeting last week. "I did not like the tone of the meeting and being set up like that," he stated. "I thought that they should have at least had a conversation with Gene (Vestal) to pass it through to us that this was going to be the topic of it. And I just didn't want to sit there through it." Campbell noted that the remainder of the special session hospital board meeting following Kohler's departure was not uncivil.
Vestal, who wasn't present for the special session meeting last week, also wanted to clarify a conversation he had with NRMC Chief Executive Officer Jason Anglin prior to that meeting. "He wanted to know where we were at, what we were planning, and when we felt we could start paying," Vestal stated. "That was the conversation."
During discussion about plans moving forward, LTC Board member Tim Wells noted, "I still recall when I first started this, so much talk about all these grants that are out there and 'we're going to help you find these grants' and nothing ever comes back to us. We never hear anything from anybody. I'm not a grant writer. I don't know grants for health care, long-term care, or nursing home care."
Additionally, Wells noted that, "No money is free, obviously. The issue still comes back to until the city severs ties with us, we would like to have some support from the city as it relates to the grants that are out there and available. May be a little harsh, but it would be nice.”
To this point, Nevada City Manager Mark Mitchell stated, “Just to speak candidly, I don’t know that the council would be willing to take that risk. I just don’t know. We can always try and propose that to them, but I don’t know that the council will try to find you guys money. I just don’t know.”
The discussion then continued on to questions of whether a buy-out from another entity would be feasible. “I don’t really want to say, but maybe we should look for some corporate entity,” stated LTC Board member Linda Douglas. “But, look how long we’ve been looking for an administrator. And to try to set up a foundation or 501c, how are we going to get somebody to administer that?”
Wells added his thoughts, “If we do sell to a corporate entity, it will be closed. They will take the patients and they will take the staff and they will shut everything down. That is the history of corporate buy outs on private.”
Douglas noted that it would be “nice to merge with someone locally, but I don’t even know if they want to have those conversations.”
“I think Tim is right,” stated Mitchell. “More than likely — and again, we are making assumptions.. I want to make that clear. But, more than likely if a local purchased, they would close this building and move residents and staff to their facilities. It eliminates competition.”
Mitchell noted that the board could also go with a broker. “A broker will try to sell you on a national level and some company in Chicago or Illinois could buy you, but who knows how long that would last,” he stated.”
After further discussion, a motion was made by Wells for Bill Kohler and Mike Parson to meet with Jason Anglin to discuss finances and options. After a second, the board unanimously approved this motion.
Looking at the positives, Vernon County Presiding Commissioner Joe Wilson (who was in attendance) noted that LTC has nearly $1 million in receivables and is not past due on any other bills (other than the intercompany expenses with NRMC). “I’m just trying to emphasize, you’ve got a lot of money coming in.. it just isn’t here yet,” Wilson stated. “You’re not insolvent. You’re not past due on your bills. You’ve taken advantage of a relationship with the hospital maybe too far, but you’re not in dire need of making your payroll this month. I’m just trying to look at the positives here. If you’re going to meet with the council, can’t you get some rough numbers of what revenues you have coming in versus your monthly expenses since closing Barone? If that’s a positive — and I hope it is — that would look good.”
The board noted they would like to plan a work session meeting with the Nevada City Council sometime in February.
The LTC Board adjourned to executive session. Its next regular session meeting will be at 5 p.m., Jan. 25.