County government got out of the nursing home business a year ago
Holly Tonini/Observer-Reporter
Premier Washington Health Center’s Dina Stover, administrator, Tim Kimmel, director, and Lisa Houk, director of nursing, are shown in the facility’s J. Barry Stout Rehabilitation Center.
Observer-Reporter
Premier Washington Health Center in 2018
Holly Tonini/Observer-Reporter
A sign at Premier Washington Health Center
Editor’s Note: This story has been modified from a previous version to correct information regarding an existing contract with union employees during Premier’s take over of Washington County Health Center.
A 187-year tradition in Washington County that dated to the era of poor farms and county homes for aged men and women in Arden came to an end with the sale of Washington County Health Center.
The electronic transfer of funds last December was the final act in a process that began just after Thanksgiving 2016, when the county commissioners confirmed they would be seeking a buyer for the 288-bed facility at Old Hickory Ridge Road and North Main Street, which had been bleeding $9 million worth of red ink for five straight years.
The county’s intent to privatize the health center was first discussed with approximately 200 members of Service Employees International Union Healthcare Pennsylvania, whose contract was set to expire Dec. 31, 2016.
Purple-shirted SEIU members unhappy with the development became a fixture at commissioners’ meetings for a year, and, over the months, members of the community also weighed in on the sale and posed questions during segments reserved for public comment.
As December 2017 arrived, Premier Healthcare Management LLC of Philadelphia, chosen from among six firms offering proposals, paid the county the final part of $22,211,100 for the building and 19.89 acres after taking over operation of the health center in October of that year. The site, home to a 40-year-old building, now operates as Premier Washington Health Center.
The facility’s tax-exempt status changed. Premier paid $34,799 in property taxes to the county, and the facility was also added to the tax rolls of Chartiers Township and Chartiers-Houston School District.
Real estate transfer tax, which is shared by the state, municipality and school district, totaled $444,221.
Taxpayer subsidies for the health center ended as 2016 drew to a close, because $2,995,543 for operating expenses in 2017 were paid from the proceeds of the sale, said Joshua Hatfield, Washington County finance director.
He provided an itemized list of other related costs:
- Fees to the Eckert Seamans Law Firm to represent the county in the sale, $451,213;
- Contributions to the “Other Post-Employment Benefits” fund for health center retirees, $5,000,000;
- Related liabilities, including final supply, equipment and professional services costs, advertising, surveying, unemployment benefits and workers’ compensation, $1,635,155.
Hatfield called the proceeds of the health center sale “an assigned fund balance within the general fund,” which covers outstanding workers’ and unemployment compensation and invoices that arrived after the sale.
Asked if constituents approach him with questions related to the health center’s operation as a for-profit enterprise, Washington County Commission Chairman Larry Maggi replied that they’re few and far between.
“The health center has not been a topic of conversation with any particular group since we sold it,” he said. “On occasion I would see an employee who either was working there or retired from there and they would ask about the health center, but I’ve not heard anything remarkable – good, bad or indifferent.
“That was not something we wanted to do, but as it turns out, the people accepted it.”
Patients, patients’ families and those who worked at the health center had much at stake with the sale.
A resident of Premier Washington Health Center suffered a fractured hip Feb. 10 that her heirs said in court documents eventually led to her death at age 79 on April 26.
Her estate alleged she “was allowed to suffer poor care” while living at Premier, and the settlement, part of the public record at the Washington County Courthouse, was for $90,000.
The facility on Nov. 28 had 237 residents for an occupancy rate of 82 percent.
“There have been major changes for nursing facilities” that are industry-wide, said Tim Kimmel, executive director, in a phone interview last week.
“Traditional services are no longer sufficient to remain viable. We are becoming a post-acute care facility, almost an extension of the hospital.”
Kimmel was health center administrator when the county ran the facility and continued in that position when Premier took over.
He was promoted to executive director in September and Premier named Dina Stover nursing home administrator. Rounding out the new team is Lisa Houk, director of nursing.
The health center has had to “enhance its clinical expertise and target nontraditional patients.”
“Our patients are younger and more clinically complex,” Kimmel said. “The focus have shifted dramatically, and Premier has experience in the nursing home industry and the have the expertise and resources to make this facility change with the times.”
The medicare.gov website has a star rating system for nursing homes, with three being average and five stars being much above average.
Premier Washington received three stars for quality measures and staffing and five stars overall and for health inspections. When the facility was owned and operated by the county, it had four-star ratings across the board.
Stover pointed out Premier Washington Health Center was “able to maintain our five-star status throughout the year of transition. That shows the level of care we provide. We’re customer-focused. We partner with home health and hospice care. When people return back to the community, having those partners is a benefit to the people we take care of.
“We staff at 3.4, and the state average is 2.7,” Stover said of the numbers that measure number of hours of care per patient.
Kimmel noted a new inspection system was put into place this year, and that Premier Washington had no care-related deficiencies.
“We gave kudos to all the staff for an excellent survey,” he said.
Inspection results by the state Department of Health dealt with informing patients about things Medicare does not cover; changing a patient’s medication so he did not make sexual advances; review of bathing schedules and patients’ ability to use call buttons; use and medication labeling and storage; establishing an infection prevention and control program; maintaining proper temperatures in a refrigerator and hydrocollators; keeping complete files on all employees; holding orientation sessions; and documenting fire drills.
Prior to Premier taking over operation of the health center, advertisements began to appear for housekeeping, dietary and laundry jobs that were being outsourced to Healthcare Services Group. County workers could exercise “bumping” privileges under their Service Employees International Union contract, and others chose not to apply with the subcontractor.
Premier, as the new employer, was required to recognize the union if they hired even one person more than half of the former employees, which was the case.
The contract members of Service Employees International Union Healthcare PA was terminated when Premier took over the health center. Premier issued their own terms and conditions that were in effect until workers were able to negotiate a new in October.
Under the county’s contract, certified nursing assistants were paid $15.23 an hour as new hires, with an increase to $16.92 after a probationary period. New hires now start at $13.50 per hour.
The recently negotiated pact remains in place through June 30, 2021.
Matthew Yarnell, president of SEIU Healthcare PA, wrote in response to an email, “Nursing home privatization is never easy but one thing is certain – a cuts-only approach will inevitably equal lower job standards, higher turnover and a disruption to resident care. Premier Washington caregivers give their heart and soul to this work, which is why they will continue fighting every day to protect their union contract and care standards residents deserve.”
Stover said the health center goal is to “continue to focus on high-quality care and positive outcomes.
“The health center always had an excellent reputation for customer service and we will continue to strive to have that.
“Tim and Lisa and I can’t do this alone. We have an excellent team with the same goal, to provide excellent care for residents and families that trust in us. We know how hard our staff works, and we’re grateful to them.”