Administration faces difficult reality, considering cutting staff hours
By ELI LUTGENS
Editor/Publisher
New Richland Care Center Administrator Chuck Ness shared multiple concerns, including a $13,000 fine incurred against the care center with the New Richland City Council during its regular meeting Monday April, 26.
Surveys
Administrator Ness shared details regarding surveys conducted by the Advanced Health Institute (HI) at the care center last fall. He mentioned two different surveys where financial penalties were threatened.
“In January, I missed the notice of it (the fine) and we weren’t able to appeal it; which may or may not have done any good anyway,” said Administrator Ness.
Administrator Ness said the penalty/fine is a result of a survey for infection control issued as a result of Covid. He further explained the situation to the council saying because he missed the email notifying the care center of the fine, they automatically assumed fault. By accepting the penalty now, after the fact, the care center reduced the original fine of roughly $18,500 by 35 percent.
Administrator Ness was asked many questions including: who issued the fine, what the fine was for, if the surveys conducted were repetitive, as well as how the care center responds to these surveys and how these negative results affect the care center’s state rating.
Administrator Ness said the fines were issued from Medicare and that the surveys causing the fine weren’t “that negative,” the care center just, “had a lot” of surveys.
Mayor Gail Schmidt asked Administrator Ness about the amount of time the care center has to respond to the surveys and correct the situation.
Administrator Ness said this wasn’t about correcting the situation but rather an email notifying the care center of financial fines.
According to Ness, the email said, ‘You’re getting penalized this amount. Do you want to appeal it or not?’ “I didn’t see it,” said Ness. I found it later when I was putting together information on how many surveys we've had. And I happened to look back.”
Administrator Ness continued, “There was a letter in the September 2020 file and I happened to be looking at it in March. And it’s like, ‘Oh, there's a new letter here dated January.’ And in the letter it said you have two weeks to be able to appeal and if you don’t appeal you’re admitting to it.”
Simply explained by Administrator Ness: “I must have missed an email.”
Ness explained that what’s done is done. He spoke with the Executive President of Advanced Health Institute and was told the care center is, “out of luck.”
Regarding the possibility of another fine, Administrator Ness said, “There was another (survey) three months later in December and that’s one of the things we’re looking at is vulnerable adult submissions, because if you do them better, which apparently we have some room for improvement– if we do them better, the chances of them actually coming on site for a survey is less.”
Financial Situation
A low census, lack of income, pandemic and an excess number of staff have all contributed to a poor financial situation at the care center.
Administrator Ness reported the census (the number of residents) is up but still not where it needs to be to meet the financial needs of the care center.
Administrator Ness reported revenue is up, but income from operations for the month is a loss of roughly $14,000. Net income or loss for the past month is roughly $27,000, bringing the year to date loss to roughly $200,000.
“We’ve struggled these past three months,” said Administrator Ness. “We either have to up our census or drop expenses. And dropping expenses would be dropping staff hours. And I know the board historically has not wanted to do that.”
The care center has more staff than industry standards. Most care centers, according to Ness, have roughly 10 residents for every one staff worker. “We’re at six (residents) to one (staff). We’re more generous in staff than probably anywhere in Minnesota.”
Overstaffing
Councilperson Loren Skelton said the challenge is, “To provide quality service and yet reduce complaints so the state’s not here all the time dinging us for things.”
Councilperson Skelton: “We’ll have this diehard staff who’ve been there for awhile who won’t like it, but we’re also trying to provide excellent service, but you can’t have 15 extra staff running around when you have 34 residents. And so that is one of the top things on the list that the consultants are working with Chuck and the director of nursing to find that happy medium.”
Dialogue
Administrator Ness: “Maybe there’s room to make some changes. So we just need to go into it with our eyes open because you’ll probably hear complaints.”
Councilperson Chad Neitzel: “They’re used to being serviced there and if you cut the hours, you’re not going to have the service.”
Administrator Ness: “I’ve always been told here that staff are really heavy. ‘Don’t reduce staff unless you have to.’ Maybe that’s simply just incorrect. If we get our census up to a break even point, but even then we have ground to make up, so either we have to cut staff or keep continuing to get census [up] or frankly both. Because we’re still very, very heavily staffed.”
Mayor Schmidt: “It’s hard to cut staff, but then, if we need them, it’s hard to get them back.”
Administrator Ness: “That’s true. But we have a lot. So there’s room. There’s probably a happy medium in there somewhere. Again, we were always holding out hope that we would get up to 80 percent [census] because 80 percent is not very high. It’s not that unreachable of a goal.”
Councilperson Jody Wynnemer: “80 percent would be about 40 [people]. So you only need three more butts in the beds and you’d be [at 80 percent].”
Administrator Ness: “That’s right. It’s not [a lot of people], but each person is $8,000 to $9,000 per month. So it doesn’t take long to start making a big difference…Maybe the time has come where it’s time to make some changes.”
Possible changes
Councilperson Loren Skelton spoke about another area of concern. Specifically call time, or in other words, the time it takes for staff to respond to residents’ call lights or request for service/help. Skelton spoke about a report where it took nine minutes for staff to respond to a particular resident.
Councilperson Skelton: “Family members file a complaint (when it takes that long). The state shows up and you get dinged. You get fined. You get whatever happens and then staff get upset because this is a direct reflection on them.”
Councilperson Skelton suggested a system where the order of requests for service from staff would list the order in which calls are received. Currently, when a resident requests service, it notifies staff, but does not indicate how long they have been waiting.
Administrator Ness said a new call light system has been approved.
Conclusion
Administrator Ness told the council, “We definitely want to get rid of the red ink. Because, like I said, we need to start living on our own, or plan for that and hope for the best.”