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HomeMy WebLinkAboutNorthern Lights Special Study Committee - Agenda - 7/24/2023 Bayfield County Administrator 117 E 5th Street, PO Box 878, Washburn, WI 54891 Ph: 715-373-6181 Fx: 715-373-6153 www.Bayfieldcounty.wi.gov Mark Abeles-Allison, County Administrator Kristine Kavajecz, Human Resource Director Paige Terry, Clerk III NORTHERN LIGHTS / BAYFIELD COUNTY SPECIAL STUDY COMMITTEE Ellen Avol-Law Mark Ehlers, Vice-Chair Jeff Silbert Mary Dougherty, Chair *** AGENDA *** Dear Committee Members: This letter is written to inform you of the Bayfield County Executive Committee Meeting scheduled for 1:30pm Monday, July 24, 2023 in the Emergency Operations Center (EOC). This meeting will be held in-person and remotely. Supervisors and the public will be able to participate in the Meeting in person or via voice either by using the internet link or phone number below. Microsoft Teams meeting Join on your computer, mobile app or room device Click here to join the meeting Meeting ID: 249 254 454 778 Passcode: R9kPNX Download Teams | Join on the web Or call in (audio only) +1 715-318-2087,,884061664# United States, Eau Claire Phone Conference ID: 884 061 664# Find a local number | Reset PIN Learn More | Meeting options Contact Bayfield County at 715-373-6181 if you have access questions or email Mark.Abeles-Allison@bayfieldcounty.wi.gov if during the meeting. Any person wishing to attend who, because of a disability, requires special accommodations, should contact the County Clerk’s office at 715-373-6100, at least 24 hours before the scheduled meeting time, so appropriate arrangements can be made. Notice is hereby given that in the event the standing committee does not have a quorum the County Board Chair or Vice Chair may act as an ex officio member (County ordinance, Chapter 3, section 2-3-1 (c)). Notice is hereby given that a majority of the Bayfield County Board may be present at the meeting to gather information about a subject over which they have decision- making responsibility. This constitutes a meeting of the Bayfield County Board pursuant to State ex rel. Badke v. Greendale Village Bd., 173 Wis. 2d 553, 494 N.W.2d 408(1993), and must be noticed as such, although the County Board will not take any formal action at this meeting. 1) Call to Order and Introductions 2) Reading of Purpose Statement Conduct a comprehensive assessment of the short-term and long-term success strategies for the Northern Lights facility, including a market overview and a review of the non-profit model currently in place. The assessment will also provide a clear delineation of the roles and responsibilities for future Bayfield County and Northern Lights Board collaboration. This work will be completed in time for the Bayfield County 2024 budget considerations beginning August 20, 2023. 3) Discussion and Possible Action, Minutes from July 12, 2023 4) Public Comment: Limited to 3 minutes per person, 15 minutes maximum 5) Purpose Statement a) Short Term Success Strategy b) Long Term Success Strategy c) Capital Improvement Listing d) Market Study Overview e) Non-profit model Review 6) Suggestions from Collaboration Committee 7) Discussion Regarding 2023 Financial Update 8) Northern Lights Board Development 9) Next Meeting Topics 10) Next Meeting Dates: • Monday, August 7 at 1:30 p.m. (EOC) • Monday, August 21 at 1:30 p.m. (EOC) 11) Adjourn NORTHERN LIGHTS MEETING, NARRATIVE, JULY 24 Item 5: Over the past several meetings we have discussed components of the Purpose statement. I wanted to summarize / restate here (Mark’s perspective only) to continue the discussion. This needs your review and input a. Short Term Success: (12-24 months) • Financial stability. Defined as 1 month of cash in the bank. $500,000 • Stable board and management. Clear understanding of roles • Continued focus on infrastructure repair and replacement. b. Long Term Success: 2-5 years • Financial Stability. 1 month of cash in the bank • Stable board and management • Infrastructure up to date c. Capital Improvements: • Short term: $358k o Still need cooler quote o Firm up estimates • Long term: $330k o Does not include roof See some detail below d. Market Assessment Overview: • Independent Living: o None in BC now o Need for 18-25 units in BC • Assisted Living and Memory Care o Need for 15 Assisted Living (age eligible) beds o Need for 9 market rate assisted living beds o Increase CBRF by 9 and add 6 more for those qualifying for Family Care. e. Non Profit Model The chart below was provided by Leading Age. • Non-profits represent 27% of licensed nursing homes. • Government represents: 15%, (12% are counties) Largest categories are: • For Profit: 33% • Limited Liability: 24% In summary: Our non-profit / county model is common in Wisconsin. Item 6: The Collaboration group met once since the last Committee meeting. The attached summary is a listing of topics discussed. This list is not prioritized. Please review. Possible budget concepts for 2024. 1. Establish performance benchmarks for Mgt Team a. 95% occupancy b. 100% beds in pay status c. Financial goal met. i. $200,000 cash on April 1 ii. $300,000 cash on July 1 iii. $400,000 cash on Sept 1 iv. $500,000 cash on Jan 1, 2025 2. Waive Debt Service ($20k month) based on goal accomplishment. 3. NL Team compensation based on benchmark success. 1 Minutes of the Northern Lights / Bayfield County Special Study Committee Meeting 1:30pm, July 12, 2023 Meeting was held Remotely through Microsoft Teams and in person in the Bayfield County Emergency Operations Center, Washburn, WI Members Present: Jeff Silbert, Mark Ehlers, Mary Dougherty, Ellen Avol-Law Members Excused: Others Present: Mark Abeles-Allison-County Administrator, Paige Terry-Clerk III, Carrie Linder-Bayfield County Human Services Aging & Disability Services Manager, Kellie Pederson-UW Extension Community Development Educator, Kim Mattson-Bayfield County Accountant, Michelle Stouffer-Acting Northern Lights Administrator, Brian Spielman-Former Owner of Aspen Acres, Autumn Koleski-Northern Lights Human Resources Director, Rene Eastman-Vice President of Financial and Regulatory Services for Leading Age Wisconsin Called to order at 1:37 p.m. by Committee Chair, Mary Dougherty Introduction and Welcome Remarks: Introductions were made. Purpose Statement Review: Abeles-Allison stated that the purpose statement was reviewed and rewritten to include a more positive note at the end per Silbert’s request. Dougherty read the purpose statement to the committee. The committee agreed on the purpose statement. Minutes from June 19, 2023: Linder suggested that the sentence at the top of page three of the minutes, “Dougherty raised the question of moving the Bayfield County Health Department to the nursing home as a possible option” be changed to read “the Bayfield County Human Services Aging and Disability unit.” Motion by Ehlers, seconded by Avol-Law to approve the minutes for the June 19, 2023 Northern Lights / Bayfield County Special Study Committee Meeting as amended. Motion carried. 1:42 p.m. – Chairwoman Dougherty moved Guest Speaker, Brian Spielman up on the agenda to accommodate his time. Guest Speaker Brian Spielman: Brian Spielman, former owner of Aspen Acres in Hayward, gave a history of the facility to the committee. Abeles-Allison asked what actions the facility would take if an individual was unable to pay. Spielman explained that the family of the resident, or resident themselves, would be directed to connect with the local ADRC to assist with applying for other funds. Ehlers questioned how close the facility was to getting to their private pay rate by using Inclusa. Spielman stated there was a 40% difference. Silbert asked if the facility had any skilled nursing beds. Spielman replied no and explained that the facility is categorized below a skilled nursing facility. Abeles-Allison questioned if the facility had an interaction with the local government. Spielman answered that the facility did not often interact with the local government but did interact more with the Department of Health during the COVID-19 pandemic. Pederson asked if another facility in community was available as a skilled nursing 2 facility. Spielman stated that Waters Edge was a skilled nursing facility that is connected to the Hayward Area Memorial Hospital and is operated by the hospital. Abeles-Allison asked Spielman why he sold the facility, who the facility was sold to, and if the level of care has been maintained at the facility since being sold. Spielman stated that his focus was shifting primarily towards family and the business was functioning exceptionally well, so they received an offer to buy the facility at an opportune time. Spielman reviewed the staffing breakdown of the facility. Silbert asked about costs savings available in the market. Spielman suggested MCO negotiations. Dougherty asked if Spielman had any industry trend recommendations that Northern Lights should be looking at. Spielman replied that establishing appropriate rates is key in the success of the facility. Linder asked for more specifics regarding the dementia care numbers for the facility. Spielman reviewed the history of the memory care services in the facility. Silbert asked about the construction aspects of the building that led to its success. Spielman gave a rundown on the physical layout of Aspen Acres and stated that he would build a second building in the similar layout as Aspen Acres if they decided to build again. 2023 Financial Update: Ehlers reported that Northern Lights has received the money from the IRS for an employee retention credit in the amount of $447, 000. Northern Lights intends to use the funds to pay off a line of credit and allocate $142,068 to accounts payable. The facility will be paying off most of a boiler repair that was done, and the new phone system was already paid although Ehlers was unaware that the county had already allocated to pay for the new system. County funds that were designated to pay for the new phone system will be reallocated towards paying off the boiler repair. Payroll has gone up because CNAs have been hired along with an individual to help with laundry. Staff is anticipating an approximate $300,000 shortfall as the funds being received are one-time use funds. Ehlers informed the committee that Northern Lights has still not received the funds from the State of Wisconsin. Discussion took place regarding funding sources available to Northern Lights. Pederson recommended researching the topic of diversifying the facility’s funding sources with the use of grants and researching the financial sustainable mix of public to private pay clients. Dougherty suggested the committee investigate a mix of public and private pay residents. Public Comment: None. Northern Lights Market Assessment: The committee reviewed the market assessment. There was general consensus that the facility should anticipate a greater demand for nursing home services and the number of available skilled workers will grow smaller. County Collaboration Options: Dougherty stated that the committee may explore two routes for county collaboration, short-term immediate satisfaction or long-term collaborations, but the committee should focus on one route as there is not enough time to explore both. The committee discussed both options. The following collaboration options were discussed: • Northern Lights Snow Removal – Bayfield County maintenance staff assisting with removing snow from the Northern Lights property. • Bayfield County IT Assistance for Northern Lights – Merging the Bayfield County and Northern Lights IT systems. 3 • Bayfield County Meals on Wheels Program Assistance – Using the Nursing Home kitchen for preparing meals for the program. Linder informed the committee that the Human Services Aging and Disability Section is looking at expanding to accommodate more staff and positions but stated that the courthouse space is becoming limited and does not offer the space necessary for the section’s needs. The committee discussed the potential for moving the Bayfield County Aging and Disability section to the nursing home along with the possibility of renovating space in the nursing home’s lower level to accommodate more assisted living residents. Dougherty recommended not pursuing utilizing Bayfield County Maintenance staff for snow removal or merging IT systems with the county as collaboration options because the costs would be too great to the nursing home and the county staff would be stretched too thin. The committee agreed. The committee was tasked with creating a list of collaboration options to bring forward to the next meeting. Board Retreat, Management / Board Relations: Dougherty reminded the committee that the topic was mentioned at the previous meeting that the roles between Northern Lights staff and board members has become blurred and questioned if there are actions that can be taken to clearly separate the two bodies. The committee asked if resources were available to educate the board members on their roles. Pederson stated that UW Extension has plenty of resources that could be used to educate the board. Silbert asked if Pederson would be able to provide education materials. Pederson replied yes. Next Meeting Topics: The committee discussed the following topics: • Collaboration Options • Northern Lights Board Development Next Meeting Dates: • Monday, July 24, 2023 at 1:30 p.m. (EOC) • Monday, August 7, 2023 at 1:30 p.m. (EOC) • Monday, August 21, 2023 at 1:30 p.m. (EOC) Meeting adjourned at 3:12 p.m. Respectfully submitted by Paige Terry. Brainstorming Session on Opportunities to Improve Northern Lights Financial Situation Finances 1. Bayfield County could Bond (issue debt) for Capital Improvements/Deferred Maintenance 2. Bayfield County could Budget to address Northern Lights annual budgetary gap, a. Pay $240k a year. b. Reduce Debt Payment by $240k. 3. Northern Lights could capitalize on unused space by renting it out to outside entity: approximately 5,000sq/ft might generate $5,000-$15,000/month, ie: PT business. 4. Northern Lights could provide opportunity for current PT provider to rent unused wing and provide services to greater community. Minimal financial gain. 5. BC Senior meal prep contracts could involve Northern Lights: a. Approximate Existing Contracts: i. Washburn, $55k ii. Ashland: $75k 6. ADRC could co-locate in unused wing of Northern Lights, this a. Would concentrate senior services in one accessible campus. b. Would increase efficacy of ADRC’s service delivery by providing additional outreach space and improved office spaces. c. Potential gains in service provision might be realized in both organizations with co-location (e.g. ease of Medicaid applications) d. ADRC and Northern Lights staff see as viable. e. Estimated cost to relocate ADRC staff, office, tech, phones, furniture, etc: $250,000. f. Relocation could offset a portion of the funds Northern Lights pays to Bayfield County in Debt service. 7. Current system of Bayfield County Board members serving on Northern Lights Board in ex-officio capacity is working well and should continue. a. Provides essential connectivity between County and Northern Lights b. Concerns voiced with additional liability for County if County Board members become voting members. 8. County absorption of Northern Lights a. No gains were identified from this course of action. 9. Administrative merger between Bayfield County with Northern Lights a. No net gains were identified from this course of action. b. Northern Lights HR is complex and very specific to its operations; more complexity than County HR 10. Discussion about advantages for Northern Lights to transition The Oaks CBRF to a Dementia Care Facility a. The current facility is an excellent set-up for this type of facility. b. There is an enormous need for dementia care. A balance of 25% public pay/75% private pay would be an ethical and financially sustainable mix. 11. Northern Lights could collaborate with County to build additional facilities to ensure continuum of care (RCAC, CBRF, Skilled Nursing, Dementia Care) a. This would support Northern lights in caring for patients in an appropriately staffed facility (e.g. is is not cost effective for residents in need of assisted living support be cared for in a skilled nursing facility) 12. Northern Lights could invest in additional equipment to serve additional less common patient needs: a. Example: Bariatric care equipment package is approx. $6,000; this equipment would allow NL to fill a key need and provide additional opportunities to fill beds with residents that are a fit (medically/financially) for the facility b. Trachea Care: need training. c. Local/regional hospitals currently have patients that are staying in the hospital that do not need hospital care: Perhaps hospitals would entertain an ongoing financial partnership to ensure bed availability for these patients. d. NL has a lot of residents not needing skilled nursing care.