Hillcrest Foundation to pay for new roof

McCOOK, Neb. - A roofing project at Hillcrest Nursing Home will be funded through the Hillcrest Foundation.

The roofing membrane on the northwest side of the building has seen better days, been patched several times already and needs to be replaced, said Hillcrest Board of Trustees president, Randy Dean. He told the board at its regular meeting Tuesday morning that the Hillcrest Foundation has offered to pay for repairs.

Board members discussed whether the board was required to put out sealed bids for the project, if the foundation was responsible for bids as it is paying for it or if the foundation was even legally bound to the bidding process.

The Hillcrest Foundation is a non-profit entity separate from the nursing home that accepts donations to Hillcrest. It also sponsors fund-raising events for scholarship money that Hillcrest employees can use to further their medical careers.

For consideration, Red Willow County Commissioner Earl McNutt told the board that when Tom Kiplinger wanted to build additional buildings on the Red Willow County Fairgrounds, after donating money for the first arena, he paid for the additional buildings himself with no money given to the fairgrounds or county, so bidding was not solicited.

The fairgrounds are owned by the county and not supported by taxes but by its own revenue. Similarly, Hillcrest is owned by the county but is supported by its own revenue.

Several board members also emphasized that the project should be expedited due to colder weather coming. After further discussion, the board decided to let the foundation take care of the roofing repairs on its own and to notify foundation president, Cody Siegfried, of the board’s decision.

Also at Tuesday’s meeting, Janet Lytton, interim director, told the board that since last month’s meeting, pharmacies in the area have been contacted and asked for bids concerning being the medication provider for residents at Hillcrest. After a discussion with one pharmacy representative and no response from another, it was decided to go with the pharmacy first discussed at the August meeting, U-Save Pharmacy, as the largest percentage of Medicare residents at Hillcrest uses that one, Lytton said. “I think it will be a good fit...it keeps it local so it’s a win-win for everyone.”

Residents still have their choice of which pharmacy to use, Lytton emphasized. Farrell’s Pharmacy delivers medications in the correct packaging, Lytton said in response to question by board member Jim Howard. The Veteran’s Administration delivers their medications by bulk, so U-Save will re-package those according to state regulations, she added.

The change to U-Save will take effect Feb. 1, with the contract with the current Medicare medication provider, OmniCare of Omaha, Neb., having a four-month out clause.  U-Save will also act as the pharmacist consultant, Lytton said, with some U-Save staff attending a November training/education conference on consultant requirements.

In other business:

* by a unanimous vote, the board approved buying an electronic accounting/management program to help with weekend admissions. For a monthly cost of $51 (yearly cost: $3,890, that includes training), the American Health Tech program will allow staff to plug in all the required information before weekend admissions, instead of specific staff having to come in at overtime wages for those admissions.

Admission processes are very specific for each department in the facility. Per federal regulation, specific departments must make entries, within a specific number of hours, into the electronic health record. This additional program would allow employees to “pre-admit” a resident and not require a specific employee to be called back to work for the admitting process.

The program also streamlines information for nurses, said Renee Wright, Hillcrest business manager, with a snapshot of all the patient’s pertinent medical information popping up on the screen when logging in, such as blood sugar levels, instead of nurses having to scroll through other data.

* Wright updated the board that the audit was completed on 2013-14 Medicaid

* Lytton told the board the current VA contract has been extended at the facility for those residents who qualify for benefits, with the VA paying Medicare rates, minus 15 percent, to the facility. Medicare typically adjusts its rates in October.

* current census: As of Sept. 22, there are 83 residents, compared to 78 this time a year ago. This includes 8 in Medicare, 30 private pay, 41 state aid and 3 qualifying residents in VA care. There is also nine in assisted living with the possibility of an additional admission; total capacity is 10.

A lot of referrals are coming in with preference given to local residents whenever possible, Lytton said.

Alluding to the current positive cash flow versus the negative cash flow a few years ago and the increased census count, board member Randy Dean reflected on the current state of affairs at Hillcrest.

“We can see the light at the end of the tunnel and it’s not a train,” he said.