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Facilitator to be hired to work with nursing home advisory committee
By Ainslee S. Wittig\Arizona Range News
As the Nursing Home Advisory Committee asked for information to help determine the home's fate, Northern Cochise Community Hospital CEO Chris Cronberg bowed out of future involvement in the decision and asked the hospital's Corporate Board to approve hiring a facilitator to help the committee.
At the NCCH Corporate Board meeting Wednesday, May 30, Nursing Home Advisory Committee member Stewart Elson asked the Board for nursing home-related information they had not received prior to the meeting, but had asked for, as well as schedules for future meetings "so the committee can then deliberate and come to some recommendations by August 28."
Information requested, along with "additional materials that would be relevant to our deliberation," included:
€ Copies of the NCCH board minutes from August 2006 to present
€ Any completed feasibility studies in the past four years
€ The Strategic Long-Range Plans referred to in the March 2007 meeting and actions completed to address those plans
€ Off-site administrator's role (contract) (of the nursing home) and reimbursement arrangement
€ Any external audits completed in the past four years
€ Financial history including NCCH vs. Nursing Home losses
€ Amount to which Cochise Health Systems is willing to up its (Medicaid) reimbursement levels.
The letter read by Elson at the meeting asked for information by Monday, June 4, and also that the committee be informed "in writing if any of these requested documents cannot be provided."
"We want you to know that we take the task assigned to us seriously and we will strive to do our best to come up with recommendations which will best serve our community," the committee said in the letter.
Elson said the committee has been "researching, compiling information and interviewing people inside and outside of the community" since their first meeting May 10.
Cronberg told the board and the committee that he has been looking into hiring a facilitator to help the committee resolve the nursing home issue.
He contacted Michael Philps of MJ Philps & Associates of Upland, Calif., who had facilitated the NCCH 2003 Strategic Plan.
Cronberg said Philps strongly recommended that as a CEO, Cronberg should not be involved in the process.
In his letter, Philps wrote: "Chris, as I indicated in our conversation, I think it would be a real mistake for you or any other CEO (faced with a similar situation) to attempt to lead an advisory committee responsible for addressing hospital-based nursing home issues."
Philps' May 14 letter to Cronberg also lists his experience in situations similar to NCCH and its nursing home.
"Regarding the nursing home, we have assisted a number of hospitals in resolving issues related to their hospital based nursing home, including Upland Hills Health Care, Dodgeville, Wis.; Kane County Hospital, Kanab, Utah; Hamilton Memorial Hospital District, McLeansboro, Ill.; Franklin Hospital, Benton, Ill., and Montezuma County District Hospital, Cortez, Colo. The latter two projects (Benton and Cortez) involved situations similar to what Northern Cochise Community Hospital is facing given the vote (later rescinded) by the hospital board to close the nursing home. In both the Benton and Cortez situations, the nursing home issue had a real potential for becoming a political football ... a controversy capable of splitting the community wide open. However, in both cases, by skillful consulting work with committees assigned to deal with the issue, controversy was avoided and the respective communities accepted and supported the hospital's decision with respect to the nursing home," Philps wrote.
Cronberg said he does not want to be in a position to influence the decision about the nursing home.
Board member Dr. Raymond Scott asked if Philps would be unbiased, and Cronberg said he believes he would and that he does not live here.
"He has a strong background in nursing homes and has the resources to look at financial reports."
Board member Pat Stark said, "Having worked with him (in 2003), he's very good at what he does and he's an excellent facilitator."
Kay Haas, member of the nursing home advisory committee, told the board she spoke with a CPA at Hansen, Hunter & Co., P.C., who has Arizona and rural expertise and "I just want to be sure (the person hired to be facilitator) understands the reimbursement issues. It looks to me like a bottom line issue, so I looked at a CPA. He gave me a rough estimate of $3,000 to $5,000, but I can try to get a proposal from him if you'd like" another option.
"I'm looking at the total picture, not just the financial," Cronberg said, adding Philps is a healthcare planner that worked with Brim Healthcare when they did the strategic plan for NCCH in the mid 1990s as well.
Haas said later that if she had known Cronberg was looking into hiring a facilitator, she could have gotten a quote from Hansen, Hunter & Co., P.C., as well.
The board approved negotiations between Cronberg and Philps, and subsequently hired Michael Philps.
Cronberg could not be reached regarding the amount of the contract.
"We discussed the nursing home facility a while back, since it was part of the 2003 strategic plan we worked on, and I offered my services," Philps said Tuesday. "I will be setting up appointments to meet with the advisory committee members (this week)."
The board also directed the administration to give the information requested to the committee, following a discussion on the need for some of those records.
Cronberg told the committee that the administration and board had "looked at (the nursing home situation) through cost reports and we've looked at improving Medicare reimbursements."
Dr. Richard Singer said, "If you take that information (already gathered by the board) and accept it, it'll save you time."
Cronberg added, "It makes me think you're trying to audit the decision made. The minutes are available, but I hope your vision comes from what's new and what have we missed."
Haas said, "I think we have the same goal in mind - to do what is best for the community. You've seen the information. We haven't, and we're trying to catch up quick."
By Monday, the committee had received much of the requested information, but had still not received information "addressing Cochise Health Systems (Medicaid) reimbursements options, the off-site administrator's contract and reimbursement, nor anything specific about the nursing home's losses," Haas said.
Carol Dunagan, board member, said "They've been selected as a committee and we should facilitate them as well," adding, "the August date may have to be reconsidered also."
Cronberg said most of the information could be emailed to the committee in a reasonable amount of time and said he would also give the list to Philps, who can also "give you what you need and even beyond that."
Cronberg also said if the committee "was moving along and needed more time, I feel the board would likely grant additional time."
At the NCCH Corporate Board meeting Wednesday, May 30, Nursing Home Advisory Committee member Stewart Elson asked the Board for nursing home-related information they had not received prior to the meeting, but had asked for, as well as schedules for future meetings "so the committee can then deliberate and come to some recommendations by August 28."
Information requested, along with "additional materials that would be relevant to our deliberation," included:
€ Copies of the NCCH board minutes from August 2006 to present
€ Any completed feasibility studies in the past four years
€ The Strategic Long-Range Plans referred to in the March 2007 meeting and actions completed to address those plans
€ Off-site administrator's role (contract) (of the nursing home) and reimbursement arrangement
€ Any external audits completed in the past four years
€ Financial history including NCCH vs. Nursing Home losses
€ Amount to which Cochise Health Systems is willing to up its (Medicaid) reimbursement levels.
The letter read by Elson at the meeting asked for information by Monday, June 4, and also that the committee be informed "in writing if any of these requested documents cannot be provided."
"We want you to know that we take the task assigned to us seriously and we will strive to do our best to come up with recommendations which will best serve our community," the committee said in the letter.
Elson said the committee has been "researching, compiling information and interviewing people inside and outside of the community" since their first meeting May 10.
Cronberg told the board and the committee that he has been looking into hiring a facilitator to help the committee resolve the nursing home issue.
He contacted Michael Philps of MJ Philps & Associates of Upland, Calif., who had facilitated the NCCH 2003 Strategic Plan.
Cronberg said Philps strongly recommended that as a CEO, Cronberg should not be involved in the process.
In his letter, Philps wrote: "Chris, as I indicated in our conversation, I think it would be a real mistake for you or any other CEO (faced with a similar situation) to attempt to lead an advisory committee responsible for addressing hospital-based nursing home issues."
Philps' May 14 letter to Cronberg also lists his experience in situations similar to NCCH and its nursing home.
"Regarding the nursing home, we have assisted a number of hospitals in resolving issues related to their hospital based nursing home, including Upland Hills Health Care, Dodgeville, Wis.; Kane County Hospital, Kanab, Utah; Hamilton Memorial Hospital District, McLeansboro, Ill.; Franklin Hospital, Benton, Ill., and Montezuma County District Hospital, Cortez, Colo. The latter two projects (Benton and Cortez) involved situations similar to what Northern Cochise Community Hospital is facing given the vote (later rescinded) by the hospital board to close the nursing home. In both the Benton and Cortez situations, the nursing home issue had a real potential for becoming a political football ... a controversy capable of splitting the community wide open. However, in both cases, by skillful consulting work with committees assigned to deal with the issue, controversy was avoided and the respective communities accepted and supported the hospital's decision with respect to the nursing home," Philps wrote.
Cronberg said he does not want to be in a position to influence the decision about the nursing home.
Board member Dr. Raymond Scott asked if Philps would be unbiased, and Cronberg said he believes he would and that he does not live here.
"He has a strong background in nursing homes and has the resources to look at financial reports."
Board member Pat Stark said, "Having worked with him (in 2003), he's very good at what he does and he's an excellent facilitator."
Kay Haas, member of the nursing home advisory committee, told the board she spoke with a CPA at Hansen, Hunter & Co., P.C., who has Arizona and rural expertise and "I just want to be sure (the person hired to be facilitator) understands the reimbursement issues. It looks to me like a bottom line issue, so I looked at a CPA. He gave me a rough estimate of $3,000 to $5,000, but I can try to get a proposal from him if you'd like" another option.
"I'm looking at the total picture, not just the financial," Cronberg said, adding Philps is a healthcare planner that worked with Brim Healthcare when they did the strategic plan for NCCH in the mid 1990s as well.
Haas said later that if she had known Cronberg was looking into hiring a facilitator, she could have gotten a quote from Hansen, Hunter & Co., P.C., as well.
The board approved negotiations between Cronberg and Philps, and subsequently hired Michael Philps.
Cronberg could not be reached regarding the amount of the contract.
"We discussed the nursing home facility a while back, since it was part of the 2003 strategic plan we worked on, and I offered my services," Philps said Tuesday. "I will be setting up appointments to meet with the advisory committee members (this week)."
The board also directed the administration to give the information requested to the committee, following a discussion on the need for some of those records.
Cronberg told the committee that the administration and board had "looked at (the nursing home situation) through cost reports and we've looked at improving Medicare reimbursements."
Dr. Richard Singer said, "If you take that information (already gathered by the board) and accept it, it'll save you time."
Cronberg added, "It makes me think you're trying to audit the decision made. The minutes are available, but I hope your vision comes from what's new and what have we missed."
Haas said, "I think we have the same goal in mind - to do what is best for the community. You've seen the information. We haven't, and we're trying to catch up quick."
By Monday, the committee had received much of the requested information, but had still not received information "addressing Cochise Health Systems (Medicaid) reimbursements options, the off-site administrator's contract and reimbursement, nor anything specific about the nursing home's losses," Haas said.
Carol Dunagan, board member, said "They've been selected as a committee and we should facilitate them as well," adding, "the August date may have to be reconsidered also."
Cronberg said most of the information could be emailed to the committee in a reasonable amount of time and said he would also give the list to Philps, who can also "give you what you need and even beyond that."
Cronberg also said if the committee "was moving along and needed more time, I feel the board would likely grant additional time."
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