Agency nursing, pharmacy contracts discussed at Hillcrest

McCOOK, Neb. -- Of the $3.4 million Hillcrest Nursing Home spends on nursing services, $600,000 of that is spent on pool, or contracted out, agency nurses.

That number is too high, according to an accountant who presented the year-end 2013-14 audit for the facility at the regular Hillcrest Board of Trustee meeting Oct. 28.

Although positive changes have been made, especially in the increased number of residents at Hillcrest compared to last year, the largest impact to the budget is the use of agency staffing, said Steve Placke, auditor with Shonsey and Associates of Grand Island, Nebraska.

As a way to address that, and because current methods of recruiting nurses have been unsuccessful, the Board later approved at the meeting to increase wages of LPNs and RNs.

Also at Tuesday's meeting, Colinda Nappa, Hillcrest administrator, told the board that the facility's long-term care pharmacy in North Platte, that is the consultant pharmacist and provides medication for Medicare residents, has closed its office. The board approved Nappa seeking bids from other pharmacies to provide these services. The best-case scenario would be a pharmacy that would act as the consulting pharmacist as well as provide medication, Nappa said. A local pharmacist would be great, she added, if the business could meet all the regulatory stipulations.

Other business discussed included:

* current number of residents is 96, with 42 private-pay, 37 state, 11 skilled nursing and six with the Veterans Administration.

* A net profit of $27,412 was showed for September, with cash flow at $431,709.31. Payments made in September included $132,163.75, principle and interest, on a bond for renovation completed at the facility in 2012; and $222,927.98 on a $1 million loan Hillcrest borrowed from the county in 2012.

To help with cash flow problems, in July 2012, Red Willow County Commissioners authorized a $1 million bank loan to Hillcrest, from McCook National Bank for five years at an interest rate of 3.55 percent. The nursing home will make annual payments to pay back the loan.

The nursing home is owned by the county operates on its own revenue.