HORACE NYE TASK FORCE TRADITIONS MANAGEMENT PRESENTATION August 30, 2010 Roby Politi, Chairman Noel Merrihew, Vice-Chairman Chairman Politi called this Horace Nye Task Force to order at 2:30 p.m. with the following supervisors in attendance: David Blades, W illiam Ferebee, Sue Montgomery-Corey, and Thomas Scozzafava. Department Heads present were: Deborah Gifford, Daniel Manning, Daniel Palmer and Deb Palmer. News Media: Adirondack Enterprise, Denton Publications and Plattsburgh Press Republican. Also present: J. Adam Graff, Vice-President Traditions Management, Peg Duran-HNH Dietary and Cassie Baillargeon-HNH Dietary. POLITI: Good afternoon everyone. I’m going to call this HNH Committee to order. As you are all aware we submitted actually a request for proposals with regard to the Horace Nye Home several weeks ago. W e did receive one response from Traditions Management Development, LLC out of Clearwater, Florida and Mr. Adam Graff is with us this afternoon. He has requested this opportunity to address this committee and the board and so Adam if you would like, come right forward so we can hear you a lot easier. Thank you. If you would give us an overview of your services and absolutely, pass out whatever you have. GRAFF: I appreciate the opportunity to present to you our company. Traditions Management has been in existence or has been our affiliate since 2002. W e own, lease or manage twelve nursing homes facilities throughout the country. W e are basically in Clearwater as Mr. Politi mentioned. W e have an excellent corporate team that oversees the entire operation. Currently our operations we have them in Florida, Virginia, Iowa, Illinois and Missouri and we are looking to expand as a young company, to other portions of the country including New York. I have had some time to review Mr. Palmer’s report he put out on June 16, 2010 which was very complete. May I add it really got to the heart of the current issues regarding your nursing home which are not unique to county run homes throughout the country. We have run into, in fact there are deficits far and above what we are seeing here at your facility here, in other places. I know it’s been a long day for some of you and I wanted to keep my remarks brief maybe even more of a conversation of what we can do but the crux is I actually had our financial folks go through your financials and a lot of the cost savings that we could help you implement are somewhat discussed in this report but let me go through those very quickly. Just to highlight some of the costs that we see that we could help bring in line. The price per day cost on nursing services is $92.00 a day there is a facility closest to your facility although it is not in the same state it is right around $47.00/$50.00 a day for a facility similar to this one. She noted excessive amounts of overtime like $107,000 in the period she was looking at. These are smaller items in the financials, nursing or activities are $4.00 a day on a PT basis, we run about $1.5 dollars a day.
Page 2 Horace Nye Task Force 8/30/2010 POLITI: When you say she, you are talking about? GRAFF: I’m sorry. I apologize. The person that went through these financials is a woman by the name of Linda Hevlin, she is our Vice-President of Finance and Accounting, but she is not in this brochure. She handles all of our reimbursement and oversees all of the accounting of all of our facilities. Dietary housekeeping, laundry – I was trying to get a specific number on how much we can save in each one of those areas on a pt basis but I would guess, not knowing exactly I’m still waiting on the numbers about 20%. Accounting fees there looks like there is $232,000 in the period we looked at, in one year spent on accounting fees. Our services, our management fee will include some accounting services typically all we would need in the facility is an office manager and potentially a collection, an accounts payable person but it may not even be necessary depending on the situation. W age cost for your plant operation is $120,000, typically we run about $40,000 and obviously last but not least the employee benefits are actually mentioned in this report which are extremely high when you project other facilities in the industry or industry standard and which again is not typical for a county run facility. Our proposal simply would be – with nursing homes there are so many facets and so many moving parts to how we can improve things and how to make them more efficient but at the same time make sure the quality of care remains high, the same or better. There is an adage in this facility and I think it personally, that sometimes when you add more staff especially to nursing homes it doesn’t necessarily guarantee quality care but efficiency and team work is much more critical then adding more people sometimes it makes it worse and there is less accountability. Our proposal would be to come in and implement, to use all of the collective resources that we have, the years of experience of all the people that are outlined in this brochure. I could go through them one by one but needless to say it’s people that have been in this industry their whole lives and basically have been through every experience. W hat we have proposed is to simply have a month to month contract where we would charge a 5% management fee on total revenue which aligns our interest to increase revenue as much as possible and we would give the county a right to out with a thirty day notice. It’s actually a contract with a thirty day notice so effectively; it is a month to month contract. Really and truly I think that is the only way. I could speak all day on what we have done in the past, we have done this before in St. Louis, Virginia and Florida, places all around the country facilities that were losing millions a year and have turned them around at least they break even or even make money and the proof would be allowing us to come in for at least a thirty to sixty day period to see what we can do and if you are not satisfied then you can cancel the contract. POLITI: New York State, have you looked at the procedural requirements in terms of management in nursing homes in NYS verses other facilities? GRAFF: Yes. Typically, Florida tends to lead the way when it comes to legislation and requirements, staffing requirements, minimum staffing and those sorts of things in the country. Our head nurse Debbie Afasano, she is listed as the last one in the brochure, is heading up the team with a Professor at the University of Colorado to develop QIS which is the new standard for surveys throughout the country and it is being rolled out in select states and Florida is one of those states. So you talk about the New York environment, we have people that have experience within the State. Jorg Daco who is not in the brochure, he has had experience in the state and actually with
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