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Friday, August 12, 2011

Premier Healthcare Resources: A Culture Change For Gracedale

Premier Proposal
In a news conference this morning, Northampton County Executive John Stoffa announced that Premiere Healthcare Resources has been recommended as Gracedale's management firm. Stoffa's proposal will be reviewed by County Council at their August 17 Finance Committee meeting, and by the entire Council the following day.


Stoffa's decision is based on the unanimous recommendation of a selection committee consisting of himself, Director of Human Services Ross Marcus, Council members Peg Ferraro and Tom Dietrich, Deputy Director of Administration Tom Harp, Procurement Manager Kathryn Anderson, Area Agency on Aging Administrator John Mehler and Ann Terres, who told me she was there to present a citizen's perspective.

If the proposal is approved, it could cost Northampton County as much as $1.9 million over the next five years. It includes an annual cost of an administrator with 40% for fringe benefits ($182,000 in the first year), along with a bonus of $30,000 per year if the manager is successful in achieving certain benchmarks. One of the things that made Premier stand out among other applicants is that it also offered to accept penalties if it fails to deliver.

Calling Premier a "corporation with a heart," Peg Ferraro stated this manager is aware that "the care level at Gracedale has to stay exactly where it is." She liked Premier's inclusive attitude with its staff, something noted by several committee members at the facilities visited. She added Premier is willing to host a family or volunteer council. Marcus was also impressed that Premier administrators at other facilities would adopt the name tag and even the business card being used at that facility, as opposed to Premier.

Another plus for Ferraro is that Premier owns no nursing homes. She hopes this deflects a concern in the community that a manager "would be just looking to buy down the road."

According to Procurement Manager Kathryn Anderson, twenty-six firms requested copies of the Request for Proposals (RFP), after which four firms did submit detailed proposals. "Everyone was afforded the same opportunity." She indicated Premier was the second lowest bidder, but that cost was only one of several criterion used to make the selection. "They may not have been the lowest, but we think they're the best," added Stoffa.

Will There Be Layoffs?

Ross Marcus and Premier Proposal
When a reporter suggested that a new manager might make some employees worried about job security, Stoffa had a simple answer. "They are here to administrate, to make the place run. If there are things they recommend, in terms of layoffs or changes, we have to look at them seriously. We've got to get the costs down. They're not here to sugarcoat things. They're here to make the place run efficiently."

Premier has already told the County it's staff to patient ratio is too high, but Marcus stated that, instead of just moving into layoffs, "they would try to move people around" or eliminate vacancies. "Layoffs are held to an absolute minimum."

Admissions

According to citizen rep Ann Terres, Premier has some "very creative" ideas for increasing admissions at Gracedale. Marcus explained that most hospitals discharge patients late in the afternoon, so Gracedale should be ready to accept admissions at that time of the day as well as during the main shift. Premier wants new admissions to be possible in the evening as well. They also want the nursing staff "to take residents they never thought about taking."

Premier will encourage admissions staff to be flexible and think outside their comfort zone, according to Marcus.

The goal, according to Stoffa, is to get a new resident admitted in two hours. "And without a lot of committee meetings and that sort of thing," added Terres.

What Can Premier Do About an 11% Reduced Medicare Reimbursement That Will Cost the County $1 million?

According to Marcus, Premier already has ideas about that problem. He stated that his own knowledge and understanding in that area is limited, but Premier is familiar with the different "rungs" in the Medicare regulations, and might actually be able to increase reimbursement in some areas. "Sometimes it's just a matter of improving your documentation," stated Marcus.

When Will Premier Start?

Marcus would like the new manager to start next Friday, but stated a more realistic time table is 30-45 days, as details of the contract are negotiated. They will place an interim administrator, to be followed by a full administrator.

Will the New Manager Make a Tax Increase Next Year Unlikely?

No. In fact, according to Stoffa, the County will be forced to contribute more than the $3.5 million budgeted for Gracedale this year. He added that Gracedale is by no means the sole factor in determining a possible tax increase next year. "What's killing us is not Gracedale. What's killing us is the swaption. The swaption is up to $25.1 million."

In exchange for a quick $1.9 million in 2004, then County Exec Glenn Reibman recommended that Council roll the dice and gamble on the interest rate. Due next year, the swaption was at $17.1 million at this time last year. Since then, it has dropped and risen, and currently stands at $21.5 million. In the fund balance that Council member Lamont McClure has derided as a $60 million "slush fund," only $13.8 million has been set aside to pay for the swaption due next year.Right now, it is growing at $2 million every week.

What About the Unions?

Exec John Stoffa & Council Prez John Cusick
Council President John Cusick, who attended the news conference, stated unions are key to minimizing or eliminating the need for a tax hike. "Contracts have to be renegotiated, concessions have to be made by the unions, if we're going to make this work," he stated. Noting that the benefits paid to Gracedale unions (64%) are well above the industry average (40%), Cusick stated that Gracedale unions compare themselves to other unions in Northampton County when the should be comparing themselves to other nursing home unions.

"Bringing on a management firm is a first step in that direction. The second step must be getting the management firm involved in the renegotiation of the contracts and there should be some concessions on the part of the unions of the want to make this work."

Union benefits at other homes managed by Premier are in the 40-45% range.

Peg Ferraro added that unions "must make concessions."

A term used by nearly everyone at yesterday's news conference was "culture change." The way things have been done for years is no longer adequate or efficient.

"Change is always extremely difficult," stated Ferraro. "But if we don't have that change, what hope is there for us to keep Gracedale in our hands?"

Other Stories: Easton Patch, Morning Call,

35 comments:

Anonymous said...

Marcus talked about how they can use different reimbursement rates and actually increase revenue. That is exactly what the previous private firm was doing when Stoffa took office. Gracedale was making more money. Then Stoffa fired the company to hold to a deal he made in his campaign. Seven years later they are doing the same thing.

Wow, some culture change. Maybe we should have a competency change of Administration.

Bernie O'Hare said...

This is a bullshit claim, as Marcus noted at a recent Council meeting. There was another consultant, and savings were realized from that one, too.

What the Stoffa admin is trying to do is exactly what the voters wanted - save Gracedale. There is no deep conspiracy to engineer a failure, just avdesire to serve the people in a fiscally responsible manner.

It's time for you to knock off the bullshit and act like a grown up. Sure, you're pissed that Stoffa is County Exec, but just as the voters chose Gracedale, they also chose Stoffa. Twice.

Yeah, you lost your do-nothing job under Reibman, so now you are a bitter man, and slightly crazy to boot.

Anonymous said...

Is anon 11;26 p m still collecting unemployment off the county Bernie ?

Anonymous said...

No comapany was ever fired at Gracedale idiot...get your facts straight for once.

Bernie O'Hare said...

Anon 11:26 is a bitter, former Reibman flunkie who hates all things Stoffa bc the Exec cut off his unemployment.

Anonymous said...

The company was thrown out by Stoffa. The truth is tough to take when you are a fanatic

Bernie O'Hare said...

ou wouldn't know the truth if Rn Angle hit you over the head with it. You are a bitter, former Reibman lackey who hates Stoffa bc he would not let you collect unemployment in a job you quit.

Anonymous said...

Peg Ferraro finally showed up for something and demanded the same quality of patient care. Aim high. And then pay back the money you are stealing by not showing up to do your job most of the time.

This no-show-pension-slopping-backstabber who tortured neighbors with her questionably legal eyesore trailer wants to continue to sentence those poor souls to Gracedale's consistently abysmal patient care ratings? She should live there.

The only patients who deserve shitty care are Barron's granny and anybody related to the lazy, greedy union pukes who aren't going to concede a thing to Trailer-In-The-Weeds Peg. In fact, if they are true to form, they'll get angry, demand more, and treat patients even worse than the horrible treatment that has consistently delivered terrible ratings.

She's been around to govern over this worsening mess for a long time. Any of her statements about Gracedale management should be considered against the backdrop of her idiotic and costly body of public "service" on the county.

Anonymous said...

wow, reaching beyond the grave to blame reibman again? it appears the swaption was an ill-advised move, granted. but in your own post, you state that the cost of this albatross has been, in stoffa's term substantially lower than 25 million. i believe at one point in the last 18 months, it sat around 11 million? why didn't the administration move at that point to buy their way out of it?

Zorn said...

hey union pukes - be prepared to take cuts in your benies. let the slashing begin!!!!!!!!!!

Oh, and Peg you do not need to show people how ignorant you are. - same level of service - not a good sound bite, but then consider the source

Anonymous said...

We heard all heard it at council meetings, union staff get a lot of paid days off. You eliminate them to match the rest of the industry, you save money and increase continuum of care.

So for the slow people with this one change, YOU SAVE MONEY, AND INCREASE CARE.

Anonymous said...

FYI, noticed how BO worked in Ron's name? Now that's marketing. Can you figure who pays the bills?

Bernie O'Hare said...

"wow, reaching beyond the grave to blame reibman again? "

Absolutely. It is a terrible mistake that is going to cost NC Taxpayers millions. Yet idiots like Barron and McClure, instead of condemning Reibman, take money from him.

"you state that the cost of this albatross has been, in stoffa's term substantially lower than 25 million. i believe at one point in the last 18 months, it sat around 11 million?"

The reason for that is be cause prevously, it was fluctuating. If we paid $13 MM then and it went down to $8 MM, NC would have lost $4 MM.

Reibman put Stoffa in the unenviable position where he is forced to gamble with the people's money. If Stoffa pays the $25MM now and it drops to $20 MM next week, you'll say he is an idiot.

If it rises to $30 MM, you'll say he is an idiot.

The real idiot on this issue is Reibman.

And you. For trying to tag Stoffa with Reibman's folly.

Anonymous said...

LET ALL!! county employees pay more for their benefits, not just the gracedale employees... they are the lowest paid people in the county!!!!

Bernie O'Hare said...

As Cusick stated, it is time for Gracedale unions to compare themselves to other nursing home unions, not other count unions. Your benefits should be 40%. Are you willing to make this work or not?

Anonymous said...

They are still county employees and should recieve the same benefits the rest of the county recieves. Private nursing homes pay more so maybe there is a raise in there futures. By the way anyone who thinks healthcare workers get to many benefits or get paid to much should apply for a job at Gracedale and see what it is really like. These workers earn there benefits and wages.

Anonymous said...

Nobody is forcing you to work at Gracedale.

The current contracts aren't workable. Sorry. It's your time to give in. The alternative is that you continue intransigence and collapse the place; thus, losing your jobs altogether.

Again, you may leave at any time. Things are great out here in the real world. If you left your jobs, they would be filled at lower compensation faster than you can forge a petition. And given the horrible record of patient care, things would probably improve.

Anonymous said...

Even if the swaption had dropped to $5 million Stoffa would not have acted. Movement is against his nature. The guy is a waste. He will go to his grave saying how great he is and all his problems are Reibmans. Why not use some of the largest tax money surplus in county history that Reibman left him and fix it.
He won't do that because he has been living off of it for six years.

Stoffa is an idiot, so he might as well actually do something that doesn't screw over the county. His inattention to Gracedale and hiring an incompetent Director is going to cost us more than paying off the swaption when it was $11 million.

By the way using the 911 center for personal information could land someone in jail. Just a note there sparky.

LT.

Anonymous said...

I challenge anyone of you on the care given at Gracedale and the concern of the workers for their residents. Most of you do not know what you are talking about. The workers there pay into their own pention with every pay check. And they chose better benifits instead of higher wages with their contracts.
And as for Mr. cusick saying they have to give back -is he willing to give up any of his big benifits from NJ.
I bet not?
I wonder if Mr. Cusick has ever stepped a foot in Gracedale or some of the other council members as far as that goes,
and yet they can tell people how to run it.
And no Iam not going to sign my name--just know Iam not one of the goons, just one who cares for Gracedale

Anonymous said...

Northampton County is in existence for two things and two things only. One is to service and finance the courts, and the other is to provide "human service needs". Lets get rid of the courts and refuse to finance them, and stopp funding human service needs and then we can get rid of Stoffa and the Council. Put that on a referendum. We don't have roads to pave, we don't have fire departments, we don't have police, etc., etc., Damn I better run for "pubic" office befor someone else figures this out.

Bernie O'Hare said...

"By the way using the 911 center for personal information could land someone in jail. Just a note there sparky."

What the fuck is this supposed to mean? I have never used the 911 center for anything, except to call when I've seen an accident.

Bernie O'Hare said...

LT should call himself who he is. He is the man whom Stoffa caught screwing the taxpayer with unemployment, and like most thieves, blames the person who caught him instead of looking at his own shortcomings. For years, he has railed about Stoffa, even to the point of fabricating stories.

Now, when it is clear that Reibman's 2004 folly - the swaption - will cost taxpayer millions, he still wants to blame Stoffa.

Anonymous said...

Stoffa had a chance to dump it earlier in the year at a great savings. He was too busy working with you and Angle spending tax payer money trying to dump Gracedale, right? He fought a legal referendum by the People and wasted countless dollars on that ego trip.

He let you and Angle work and communicate with the private lawyers to dump Gracedale, right?

He inherited the largest cash surplus in county history, right?

People know the truth despite what you and Joe Owens try to sell.

Anonymous said...

"The reason for that is be cause prevously, it was fluctuating. If we paid $13 MM then and it went down to $8 MM, NC would have lost $4 MM."

no, just trying to get you to realize stoffa does not speak ex cathedra. back when it was down to 8, many folks were cashing out of their swaps. NorCo should have done so.

it may be Reibmans responsibility for the swap, but surely some of the blame for failing to get pout of it at a better rate resides with Stoffa.

Anonymous said...

wasn't there a time, early in stoffa's first term, where NorCo could've cashed out of the swap and actually made money?

Bernie O'Hare said...

"Stoffa had a chance to dump it earlier in the year at a great savings."

You Gracedale Goons are just ignorant. Earlier in the year it was $17 million? What the hell savings is there? He would have sent $17MM of taxpayer money. If he did that and it later dropped, you would be after him for that.

Thanks to Reibman, Stoffa has been put in the unenviable position of gambling with our money.

Bernie O'Hare said...

"wasn't there a time, early in stoffa's first term, where NorCo could've cashed out of the swap and actually made money?"

No. The swaption was always a negative for Stoffa. This is not the kind of thing county execs should have to do.

Anonymous said...

Who bears the responsibility for when the swaption should be paid off, Stoffa or county council? Council has a finance comittee that meets monthly. The resolution of the swaption deal should be #1 on the agenda at each meeting. There was some debate on a "trigger point" when the swaption should be paid off i.e. $12 million. Well, that has come and gone, but it could drop that low again. The real problem now is the absence of a Director of Fiscal Affairs. Hamann is doing yeoman's work as acting DFA but he is a budget guy and is occupied with preparing a 2012 budget for administration to be submitted to council. The DFA should be a "big picture" guy or gal who has superior knowledge of the market, interest rates, and financial trends to advise the executive and council when to move on the swaption albatross. Stoffa needs to appoint someone highly qualified for that position ASAP. Not sure why since the Bruce Gilbert debacle this has not been done. What's up, BO??

Bernie O'Hare said...

Stoffa is advised about the swaption on a near daily basis. At this pont, there has been no consensus among Council about the a trigger amount. Like Stoffa, Reibman has forced them to play gambler, which is not fair.

Do not blame Stoffa, Council or the lack of a DFA for this debacle. The blame lies with two groups - Reibman and the 2004 County Council that voted for it.

I will note that Angle, McHale %& Ferraro all voted against this swaption. I will add that Angle has constantly implored Council to oome up with a trigger figure, but t is really unfair for them to have to gamble with our money like that.

Bernie O'Hare said...

Stoffa is advised about the swaption on a near daily basis. At this pont, there has been no consensus among Council about the a trigger amount. Like Stoffa, Reibman has forced them to play gambler, which is not fair.

Do not blame Stoffa, Council or the lack of a DFA for this debacle. The blame lies with two groups - Reibman and the 2004 County Council that voted for it.

I will note that Angle, McHale %& Ferraro all voted against this swaption. I will add that Angle has constantly implored Council to oome up with a trigger figure, but t is really unfair for them to have to gamble with our money like that.

Anonymous said...

Keep protecting Stoffa from his responsibility. Don't forget the force behind the throne under Reibman, who pushed the swaption, his Dir. of Administration. Oh I forgot he is a buddy so forget that truth.
O'Hare by now your nose is so long it could be used as a ladder to the stars.

Stoffa inherited the largest cash surplus in county history. Stoffa is the most incompetent and clueless county Executive in county history. Like it or not that is the story as told by every county historian.

Bernie O'Hare said...

I'm not protecting Stoffa from anything. I have pointed out, and it's a fair comment, that Reibman's folly has left him in a terrible situation, in which he and Council are forced to gamble with taxpayer money. It was a terrible decision, and the blame rests solely with Reibman and the 2004 Council.

Now, as for Hickey, he was gone before this swaption had been proposed or adopted. But if you wish to blame him, knock yourself out. Unlike Stoffa, Hickey is a vicious SOB and I'd love to see you put your name down.

But you won't do that bc you are a coward.

Anonymous said...

Hey Bernie I agree about Jim. So is Stoffa, Jim is just more up front and honest about it.

Anonymous said...

Boy Bernie you can sure tell when someone say's the truth by your comments back . You get all fired up - they sure get your goat. Better take a chill pill.

Anonymous said...

This new management firm is going to be the new target of the Gracedale goons as more reality checks come in and they are told things they don't want to hear.