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The Nursing Home Committee is comprised of the following board members:

Nursing Home Committee

of the

Livingston County Board

Meeting Agenda

Arnold Natzke, Chair

David Heath, Vice Chair

Wednesday, January 3, 2007 @ 1:30 p.m.

Clavey Room, Courthouse

112 West Madison

Pontiac, IL  61764

1. Opening
   1. Roll Call

b.   Approval of Agenda

c.   Approval of Minutes

2. Business to Come Before the Committee
   1. Census
   2. Financial Issues
      1. Financial Statements
      2. Transfer of Funds
   3. Therapy Services
   4. Dietary Services
   5. Business Office
   6. Intergovernmental Transfer

3.   Executive Session (No Action Required)

a.   5 ILCS 120/2 (c) (1) – Personnel Matters

b.   5 ILCS 120/2 (c) (11) – Pending Litigation

4. Review and Approval of Bills
   
    
5. Public Comment
   
    
6. Adjournment

Nursing Home Committee

of the

Livingston County Board

Meeting Agenda

Arnold Natzke, Chair

Jack Vietti, Vice Chair

Tuesday, November 28^th, 2006 @ 5:15 p.m.

112 West Madison

Pontiac, IL  61764

1. Opening
   1. Roll Call

b.   Approval of Agenda

c.   Approval of Minutes

2. Business to Come Before the Committee

3. Review and Approval of Bills
    
4. Public Comment
5.  
6. Adjournment

Nursing Home Committee

of the

Livingston County Board

Meeting Agenda

Arnold Natzke, Chair

Jack Vietti, Vice Chair

Wednesday, November 8^th , 2006 @ 1:30 p.m.

112 West Madison

Pontiac, IL  61764

1. Opening
   1. Roll Call

b.   Approval of Agenda

c.   Approval of Minutes

2. Business to Come Before the Committee
   1. Census
   2. Financial Issues
      1. Financial Statements
      2. Accounting Issues
      3. Transfer of Funds (Action Needed)
   3. Intergovernmental Transfer

3.   Executive Session (No Action Required)

a.   5 ILCS 120/2 (c) (1) – Personnel Matters

b.   5 ILCS 120/2 (c) (11) – Pending Litigation

4. Review and Approval of Bills
    
5. Public Comment
    
6. Adjournment

Attachments:     Financial Summary for September 2006; Financial Statements; Management Update, Revised Budget & Revised Historical Revenues/Expenses

Nursing Home Committee

of the

Livingston County Board

Meeting Agenda

Arnold Natzke, Chair

Jack Vietti, Vice Chair

Wednesday, October 4^th , 2006 @ 1:30 p.m.

Clavey Room, Courthouse

112 West Madison

Pontiac, IL  61764

1. Opening

1. Roll Call

b.  Approval of Agenda

c.   Approval of Minutes

2. Business to Come Before the Committee (No Actions Needed)
   1. Plan of Correction
   2. Financial Issues
      1. Accounting Issues
      2. Transfer of Funds
   3. Budget Update
   4. Intergovernmental Transfer  
   5. Administrator
   6. Director of Nursing

3.   Executive Session

      a.  5 ILCS 120/2 (c) (1) – Personnel Matters

      b.  5ILCS 120/2 (c)  (11) – Pending and threaten Litigation

4.   Action Resulting from Executive Session

5.   Review and Approval of Bills

6.   Public Comment

7. Adjournment

Attachments:     Financial Summary for August 2006; Financial Statements; Management Update

To:                   Health Services Committee

                        Livingston County

From:               Management Performance Associates, Inc.

                        Manager

Date:                September 21, 2006

Re:                   Management Update

Confidential

This is the third in a regular series of updates that we hope will keep you abreast of developments at Livingston Manor.

Census: Average daily census (ADC) has been running right about at 80. Medicare census is lower than we would like. Initially we were seeing an average census of 7-8; now we are 3-4.

Cash Requirements: The spreadsheet attached to this memorandum provides the summary of cash required. We are not anticipating the need for a cash transfer this month.

Budget: We got a late start, but we have a draft and are checking it over. We’ll review it at the meeting before putting the finishing touches on it.

Medicare Rehab Services: You know from the last update that we plan on involving the hospital more in our Medicare program. We are in the process of preparing a contract proposal for St James that changes the way we pay for rehab services. We believe that, by changing to a per diem methodology, we allow St James to increase its revenues and we provide an incentive for using Livingston Manor. At the same, time LM benefits from increased Medicare reimbursement. There is a lot of training that has to take place, but it will be worth it ….especially if this approach works. Incidentally, we have been very successful with the per diem structure and initial feedback from St James indicates that they hospital is on board.

We understand that the Eden Grove and Good Sam have begun providing Medicare rehab services to their own residents. This is a sensible move from their perspective. It is unlikely to affect LM but it may well have an impact on Asta Care, which was getting the bulk of the hospital’s Medicare referrals.
 

Pharmacy services are also slated for re-vamping. 

Business Office: We are starting to see signs of progress in the business office. The monthly income statement should be easier to follow, especially in the Revenues section. What we are trying to do is consolidate information in one spot. Formerly, there were two pages for Revenues; now we have one.

We have corrected some problems in recording cash receipts which will make the bookkeeping process a whole lot easier. There were no problems with cash receipts being misappropriated. What was happening was that we were not handling the opposite entry to “Cash” entry correctly; we were using a Revenue account instead of Accounts Receivable.

Our goal is to have a functioning set of financial statements. It’s tough to manage any enterprise when important information is in several places or, worse yet, not accurate. We are not there yet, but there has been legitimate progress.

We have started to work with the Balance Sheet and got a rudimentary one for August. At least it balanced. We’ll be using this information to watch our cash position and receivables.

We did turn a few accounts over for collection. There certainly will be more in the future. In addition, there will be some write-offs of accounts that have gone bad and are not worth collecting. It looks like A/R balances are building; we are pressing our collection efforts.

Intergovernmental Transfer (IGT): We have been very busy with the IGT matter, and it has kept us from getting to some issues. Nonetheless, we believe that County homes have a lot riding on the IGT. We’ll give you a full briefing at the meeting. If you need a refresher on the IGT, check out the last two updates.

We have just received word that the IGT transition has been delayed from October 1 until November 1.

Administrator: LeAnn Thomas started September 18 as Administrator. So far, so good on the transition. Bruce Vaca did a fine job as interim. Let’s all wish him the best!

Director of Nursing: This position is open and in the process of being filled.

As always, give us a call or zap us by return e-mail if you have any questions or comments.