Memorandum

Memorandum
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To:
County Health & Human Services BoardlLakeland Health Care Center
Board of Trustees
From:
Linda Seemeyer,HHS Director/LHCC Superin
Date:
November 11,2010
RE:
November 17, 2010 Lakeland Health Care Center/ Health & Human
Services Board Agendas
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The November 17,2010 LHCC Board of TrusteesAgenda contains the following
items:
./ Corporation Counsel recently opined that LHCC may deny admission to
persons registered as sex offenders. We are seeking the Board's guidance
about whether a policy denying admission to registered sex offenders should
be developed and if so, how should it be enforced. Your packet contains
information provided by Ms. Janiszewski and Mr. Cotter, as well as several
new articles.
./ We are also seeking your support to issue a Request for Proposal for beauty
shop services at LHCC. The idea would be to find a vendor who would set and
collect their own fees for beautician and barber services.
./
The Administrator's Report and Financial Update are also enclosed.
The Health & Human Services Board Agenda includes the following items:
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We will have a follow up report on our efforts to reconcile Echo cash and
receivables balances with the Munis general ledger. We are making good
progress.
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We have a referral from the Executive Committee relating to HHS Citizen
Appointments. The question is: should county residency be a requirement for
sitting on the HHS Board? State statutes are silent on the matter. Your packet
includes section of the statutes that address requirements for board
membership.
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With the advent of Family Care we are seeing a new situation which is
resulting in some costs for emergency detentions and hospitalizations being
born, we believe unfairly, by counties in which the Family Care client is
residentially placed. The draft ordinance in your packet is our attempt to
address this issue. I should warn you that this has the potential to be a rather
controversial approach. The ordinance will not be a hit with either residential
facilities or Family Care Managed Care Organizations. Other counties, as well
as the state, are very interested in our approach.
The final item for the day is a joint meeting of the HHS Board and the CDEB Board.
We have had discussions in the past about residential placement of children and
youths with significant developmental disabilities. We believe that a closer working
relationship with the staff at Lakeland School may offer us some opportunities for
earlier interventions and better results. There are no easy solutions but we would like
to begin the discussion between the two boards. I am including a paper prepared by
Lakeland School staff that provides background and frames the issues.
Enclosure 1
Walworth County Lakeland Health Care Center Board of Trustees
MINUTES
October 20, 2010 Meeting – 1:00 p.m.
Walworth County Meeting Room 111
Government Center – Elkhorn, Wisconsin
The meeting was called to order by Chairman Grant at 1:10 p.m.
Roll call – Committee members present included Chairman Grant, Supervisors Hawkins,
Ingersoll, Redenius, and Schaefer. A quorum was declared.
Others present – Linda Seemeyer, Director of Health and Human Services/Lakeland
Health Care Center Superintendent; Elizabeth Aldred, Deputy Director of Health and
Human Services; Juliet Young, Health and Human Services; Bernadette Janiszewski,
Lakeland Health Care Center Administrator, Lori Muzatko, Health and Human Services,
Roger Zierfuss, Health and Human Services, Etty Wilberding, Health and Human
Services, Sandy Wagie-Troemel, Citizen Representative Health and Human Services, Ella
Eva Pious, Citizen Representative Health and Human Services, David Bretl, County
Administrator, Nicole Andersen, Deputy Counsel Administrator – Finance
Public in attendance – There three member of the public present.
There were no agenda withdrawals. Supervisor(s) Hawkins/Ingersoll moved to approve
the agenda. Motion carried 5–0.
The Lakeland Health Care Center Board of Trustees committee minutes of the September
22, 2010 meeting were approved. Motion and second made by Supervisor(s)
Hawkins/Ingersoll to approve the minutes. Motion carried 5–0.
Public Comment – There were no comments from the public.
Unfinished Business – There were no items of unfinished business.
New Business –
2010 Annual Survey - Ms. Janiszewski explained that the survey started on September
22nd and went for four days. She stated that the LHCC will return to doing mock surveys
to better prepare staff for this intense procedure. There were nine deficiencies in clinical
and eleven regarding the building.
Supervisor Ingersoll asked if the standards have changed from previous years. Ms.
Janiszewski explained that they have since the federal government is more focused on
several states including Wisconsin.
Several of the deficiencies were minor items such as not totaling posted hours. Medication
errors were at 13%; however the surveyors used a small batch so there were just 6 errors.
Enclosure 1
Most errors were due to staff nervousness. The goal for next year is have more relaxed and
prepared for the survey. Ms. Janiszewski would like to state she is not making excuses for
staff, only that the violations were minor.
Some of the findings are being disputed. For example the size of the shredding room was
listed as a violation but is actually under the size limit. For the other discrepancies Ms.
Janiszewski is working with the Department of Public Works to work on some of the other
issues. A safety committee will also work on staff education and audits to avoid other
safety issues. Ms. Janiszewski felt overall the survey process was a good learning
experience. None of the discrepancies warranted a fine.
Supervisor Grant asked if these are federal regulations, why hasn’t the State adopted
them? Ms. Janiszewski explained it is up to the State of Wisconsin needs to make a final
determination on some of these items before adopting them into law.
The vendor that installed the smoke detectors will fix those problems at their own
expense.
Supervisor Grant commented on the intensity of survey. He asked what is the appeal
process? Ms. Janiszewski explained the issues were submitted to the independent group
for a desk review and there should be an answer by November 1st. Four of the building
discrepancies are being disputed.
Reports –
LHCC Administrator’s Report and Financial Update – Ms. Janiszewski reported that the
LHCC is on track with regard to budget. Ms. Janiszewski handed out the September
income statement summary. All the finances are on target with the budget. The Medicaid
is coming down.
Ms. Janiszewski also handed out a sheet regarding the position changes per a request from
a last month’s meeting.
Ms. Janiszewski also reported that the October golf outing was advertised in three papers
and on one radio station.
Supervisor Grant asked if the golf outing was a success. Ms. Janiszewski stated that it was
a success with a $7,500 profit. Supervisor Grant asked if this more or less from last year’s
golf outing. Ms. Janiszewski stated last year the outing made a profit of $8,300.
Correspondence – There were no correspondences.
Announcements – There were no announcements.
Next Meeting Date – The next meeting is tentatively scheduled for November 17, 2010 at
1:00 p.m.
Enclosure 1
Adjournment – On motion and second by Supervisor(s) Hawkins/Redenius, Chair
Grant adjourned the meeting at approximately 1:23PM. Motion carried 5-0.
Submitted by Juliet Young, Recorder. Meeting minutes are not considered final until
approved by the committee at the next regularly scheduled meeting.
Enclosure 2
Should Registered Sex Offenders be Denied Admission to Lakeland
Health Care Center?
¾ Corporation Counsel has determined that Walworth County may develop a policy
denying admission to registered sex offenders because a sex offender is not a protected
class under the Fair Housing Act of 1968 or the State of Wisconsin Open Housing Law.
¾ If the County develops a policy denying admission, how do we ensure that candidates for
admission are not registered sex offenders?
¾ Should Walworth County conduct criminal background checks on each applicant for
admission? The cost is $10 per request.
¾ If the Board determines we should conduct background checks and that admission should
be denied to registered sex offenders, we will add the following statement to our
Admission Agreement:
It is the philosophy of Lakeland Health Care Center that all who enter and reside
within the facility will feel at no risk being cared for by, or having contact with,
any person who is a registered sex offender. Therefore, Lakeland Health Care
Center shall deny admission to registered sex offenders. Walworth County shall
conduct criminal background checks on each applicant prior to admission.
Enclosure 3
Beauty Shop Services at Lakeland Health Care Center
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We are in need of additional beauty shop services.
Each week we are forced to turn away residents who request a hair cut or
other service.
We currently employ a part time beautician who works three days each week.
When the beautician is on vacation, we provide no services.
I am asking the Lakeland Board of Trustees to consider our soliciting bids for
beautician and barber services. Often, facilities allow outside vendors to
provide beauty shop services in-house.
The vendor determines the fees they wish to charge. Residents would have a
choice of scheduling with our own beautician or utilizing the services of a
vendor.
Enclosure 4
Lakeland Health Care Center
Walworth County
Financial Highlights from October, 2010
2010 Budget Reminders
There is a one month delay in reporting Medicare revenue. October Medicare revenue
is not included on the financial report. The revenue adjustments listed are the difference
between our private pay rates and Medicare or Medicaid rates.
Worker's Compensation for October
Injuries
3
Resident Stats for October
Beginning Census
119
Ending Census
119
Time Lost
2.5 hr
Claims filed
1
Discharges
Deaths
17
4
Admissions
21
Patient Mix
Average for the month of October:
Medicaid
Medicare
Private Pay
73.81%
6.66%
19.53%
Average daily census = 118
2008
7.10
16.15
76.75
Medicare
Private Pay
Medicaid
2009
2010 to Date
8.22
7.60
19.93
17.03
71.85
75.37
% by pay source
80.00
70.00
60.00
50.00
Medicare
40.00
Private Pay
30.00
Medicaid
20.00
10.00
0.00
2008
2009
2010 to Date
Please feel free to call or e-mail me with any questions or reporting suggestions.
Bernie Janiszewski
262-741-3616
[email protected]